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As of July 1, 2023, licensing and other health and occupational licenses will become part of the Iowa Department of Inspections, Appeals and Licensing (DIAL) as a new organizational structure for state government goes into effect. Government departments and agencies that provide related services or have similar business functions are aligning to better serve Iowans.

Iowa Board of Nursing

Fluoroscopy Audit Process for ARNPs

ARNP's - Fluoroscopy Audit Process - Effective January 12, 2015

The administrative rules governing nursing in Iowa require ARNPs who supervise the use of fluoroscopic x-ray equipment to have the appropriate education and continued annual radiological safety updates. Please see the following administrative rule excerpt to review your requirements, and the audit process that will be followed by the Board of Nursing.

7.2(2) Supervision of fluoroscopy. An advanced registered nurse practitioner (ARNP) shall be permitted to provide direct supervision in the use of fluoroscopic X-ray equipment, pursuant to 641—subrule 42.1(2), definition of “supervision.”

a. The ARNP shall provide direct supervision of fluoroscopy pursuant to the following provisions: (1) Completion of an educational course including content in radiation physics, radiobiology, radiological safety and radiation management applicable to the use of fluoroscopy, and maintenance of documentation verifying successful completion.

(2) Collaboration, as needed, as defined in rule 655—7.1(152). (3) Compliance with facility policies and procedures.

b. The ARNP shall complete an annual radiological safety course whose content includes, but is not limited to, time, dose, distance, shielding and the effects of radiation.

c. The ARNP shall maintain documentation of the initial educational course and all annual radiological safety updates.

d. The initial and annual education requirements are subject to audit by the board pursuant to 655—subrule 5.2(5).

Pursuant to 7.2(d), the initial and annual education requirements are subject to audit by the Board. Therefore, the Board of Nursing will be auditing ARNP’s who supervise fluoroscopy.

The initiation of the audit process began January 12, 2015. The process is as follows:

  • The ARNP online renewal application asks if the practitioner provides direct supervision in the use of fluoroscopy. The renewal process is every three years,
  • If the practitioner answers yes, they will be required to provide verification of completion of the initial course and yearly safety courses, along with a copy of course objectives and outcomes,
  • Board staff will contact the practitioner if there are any questions about the submitted course work or if the practitioner has not completed their required education,
  • If board staff identifies the ARNP is not complying with the course requirements and the audit process the information will be submitted to the Enforcement Unit.

Contact Kendra Lindloff, Associate Director of Education/Continuing Education for questions and concerns at

Updated: 1/2/2023