LPN assessment in LTC

chase · Oct 16, 2003

The initial assessment can be done by an LPN, but must be co-signed by the RN present. Need to know what is the policy of the facility,and the Nurse Practice Act within that State. Please protect your license.

chase · Oct 16, 2003

Is this legal !! The Board of Nursing in New Mexico is aware of this practice.

sassynurse78 · Oct 21, 2003

I always have done my own assessments. We usually don't even have an RN in the building on the pm shift. I think the RN has to sign the care plan but the LPN can do it. I don't do care plans we have a careplan nurse who does it during the day.

chase · Oct 21, 2003

I still do belive it all comes down to the policy of the facility, and the Nurse Practice Act for LPN"s within the State. I urge you to protect your license.

Rustyhammer · Oct 21, 2003

From the NM nurse practice act:

I. Standards for licensed practical nursing practice. Licensed practical nurses practice in accordance with the definition of licensed practical nursing in the NPA [61-3-3, G. NMSA 1978].

(1) LPNs may assume specific functions and/or perform specific procedures which are beyond basic preparation for licensed practical nursing [61-3-3,G. NMSA 1978] provided the knowledge and skills required to perform the function and/or procedure emanates from the recognized body of knowledge and/or practice of nursing, and the functions or procedure is not prohibited by any law or statute. LPNs who perform procedures which are beyond basic preparation for practical nursing must only perform these procedures under the supervision/direction of a RN.

(2) LPNs may perform intravenous therapy, including initiation of IV therapy, administration of intravenous fluids and medications, and may administer medications via the intraperitoneal route provided the LPN has the knowledge and skills to perform IV therapy safely and properly.

(3) When assuming specific functions and/or performing specific procedures which are beyond the LPN's basic educational preparation, the LPN is responsible for obtaining the appropriate knowledge, skills and supervision to assure he/she can perform the function/procedure safely and competently.

J. Educational program criteria. Educational programs preparing either RNs or LPNs to perform specific functions and/or procedures that are beyond basic educational preparations should:

(1) prepare the nurse to safely and properly perform the function and/or procedures.

(2) prepare the nurse to recognize and respond to any complication(s) which may result from the procedure, and

(3) verify the nurse's knowledge and the ability to perform the specific functions and/or procedures.

K. Nursing practice advisory committee. Board of nursing may appoint a minimum of a 7-member advisory committee to assist the board in regulating the practice of nursing. The committee shall assist and advise the board in the review of issues related to the practice of nursing.

txsugarlvn · Oct 21, 2003

Rustyhammer, I think it's wonderful that the NM BON recognizes the abilities of the LVN and don't just see us an "assistant" to the RN. I'm not devaluing an RN's knowledge but it's time the States recognize that LVN's can be trained to perform more than perfunctory duties or work as a clerical assistant with the extra fun of administering medications. Hurrah!

Forgive my cynicysm....it comes with years of experience. :)

Thanks for the written proof from the NM LVN scope of practice guidelines.

Oh yes, and for those who still question, please be sure to note in the guidelines that an LVN must be trained and certified to perform the duties and is also under the supervision/direction of an RN. This really frees up the RN to perform many of the duties they otherwise don't have time for which, in my humble opinion, increases the quality of care.

robynrn2b · Oct 26, 2003

I too had that question. I was informed by my board of nursing that basically the DON-RN is "covering" for you. We have a MDS and Medicare coordinator that sign off on assessments and that is supposed to cover you. I have done assessments for ten years as an LPN before becoming an RN

nurseygrrl, LPN · Nov 21, 2003

Does anyone know where I can find in writing the NY state guidelines for LPNs doing admission assessments in LTC. Quick help would be MUCH appreciated as I would like to bring this info into work tomorrow...thanks!

jkaee · Dec 6, 2003

where I work, only RN's are to do admission/initial assessments and initial wound assessments, however that does not mean that LPN's don't do these when an RN is not available. But, legally, it all depends on what your scope of practice in your state tells you what you can do.

purplemania, BSN, RN · Dec 9, 2003

The word assessment can be confusing to some. In Texas, only an RN can do an assessment, but LVN's are allowed to re-evaluate. Nursing homes allow LVN's to "evaluate" but the original assessment was done by an RN (I hope). The difference is that LTC clients are residents, not acute care patients. Bottom line, you are right to find out what is appropriate for your situation.

agnewRN · Dec 12, 2003

In my practice. LPNs can "gather data" which includes completing admission paperwork, assessments. An RN must cosign the admission assesssment then.