Scope of Practice

[uptoolateagain]

I have been tasked to help determine the scope of practice of LPNs and Medics within an Army MEDCEN. Right now we are having some controversy over trying to determine what the definition of assessment is, and what an LPN can do as an assessment. The big debate is over the terms full assessment/head-to-toe asssessment/focused assessment. Which one can LPNs do? And what is your definition of each?

[Lunah, MSN, RN]

You might want to see if the state BON's scope of practice provides any guidance. Some states do get specific about what LPNs can and cannot do.

In our MTF, and RN must sign behind an LPN's initial assessment of patients.

[jeckrn, BSN, RN]

Lunah has it right contact your state BON since Army MTF go by the rules for the state they are in. Also, I have worked in 4 states and every state the RN has to complete the first assessment, not just sign off on it. There are parts of the assessment which can be done by LPN's but the physical assessment had to be done by a RN.

[uptoolateagain]

Our NPA states "Assessment: The licensed practical nurse makes basic observations, gathers data and assists in identification of needs and problems relevant to the clients, collects specific data as directed, and, communicates outcomes of the data collection process in a timely fashion to the appropriate supervising person." (WAC 246-800-700)

The problem is we have different people interpreting the wording differently. We have one person who says that this means subjective data, and another who says this means both subjective and objective data. We also have people interpreting the phrase appropriate supervising person differently. The ones who say an LPN is only allowed to collect objective data think that the appropriate supervising person is always the RN, while the the people who think the LPN can collect all data say that the appropriate person can be the RN or the MD depending on the severity of the problem.