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Discussion

LPN scope of practice in PA

We are having a debate where I work...can LPN's perform an admission assessment and/or an 8 hr assessment independently? We have LPN's and they do the assessments..they facility just requires that an RN co-signs an assessment once in 24hrs. What happens is that 3 lpn's fill in the daily nursing assessment sheet and then the charge nurse will cosign them all...sometimes they are co-signed days later by an RN who wasn't even working on the day she is co-signing assessments. They don't seem to understand how wrong this is? Am I being anal or what? Personally, I feel that an RN should ACTUALLY perform and document an entire assessment at least once in 24hrs and NO WAY would I sign my name to somebody elses assessment??? If you sign your name then you are agreeing with all 3 assessments? No notations is made they just sign their name on the back of the sheet? I have refused to do this which is what the big debate is about. I don't mind doing the assessment but I am not going to sign my name blindly? Everyday I find examples of false documentation and the DON looks the other way. People signing off meds/treatments/wound care that was never done? How do I know...because the dressing from 2 days ago with another nurses date/time/initials is still on the patient? ***????

So, bottom line..are LPN's allowed to perform assessments, admission or otherwise in the state of PA... the PA code doesn't address it one way or the other as far as I can see..the only thing they address is verbal orders, treatments, IV's...

Thanks for any insight.

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The last place I worked in PA the LPN's were allowed to do the initial assessments (admissions) w/o an RN signature.

In LTC, the LPNs are doing the admission assessments and obtaining orders from the docs. The only thing they need signed by and RN is the MDS.

When I worked LTC in PA LPN's could not take T.O's. But that was in 2002 so I don't know if things changed or not.

Last year or the year before it changed...maybe even longer. Helped me aout alot

Im glad to hear that LPN's can now take T/O's. Does an RN now have to transcribe it or check it before it is ok? Just curious.

In homecare/ private duty, the LPNs can take TOs and transcribe, we start working under those orders right away. A copy is sent to the case's nursing supervisor but that does not affect the validity of orders. Only thing we all think is really wierd is that there is a spot for time the order was recieved that only needs to be filled out by LPNs, RNs do not need to fill out that line. ?? I think time is always part of an order so I include it anyway, and did, before the new forms.

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