LVN/LPN Assessments

[Simpleplan]

I was taught in school LVN/LPN's were not allowed to assess. I keep hearing LVN's at work trying to make the case that they can. What are the limits to the tasks the LVN can be delegated?

[classicdame, MSN, EdD]

it may make a difference in the type of facility where you work. For instance, in Texas there are "acute care" rules and "long term care" rules. However, LVN's in this state cannot do the initial assessment. In an acute facility they cannot do the required 24 hour full assessment. They may do focal evaluations at any time.

[mrsraisinkain]

I am in LPN school and we are learning how to do head-to-toe assessments, however they're called "data collection". We learned that the RN is responsible for the assessment but that she can delegate it to the LPN. We have been taught that in an LTC setting an RN must do the initial assessment on a patient upon their admission, but that we may do the daily "data collection".

[Simpleplan]

I am in LPN school and we are learning how to do head-to-toe assessments, however they're called "data collection". We learned that the RN is responsible for the assessment but that she can delegate it to the LPN. We have been taught that in an LTC setting an RN must do the initial assessment on a patient upon their admission, but that we may do the daily "data collection".

The RN does the initial assessment and then sets goals for the patient. The RN can delegate the data collection and then evaluate this data to see if the goals have been met. This is on a stable patient. If the patients status is changing and the goals must be constantly reevaluated then the RN must do the assessment.

Is this right?

[MelodyRNurse]

In DE LPNs are not allowed to do initial assessments in any facility, according to the BON. In the long term care setting, however, LPNs are expected to do initial assessments. It is part of the job. Its crazy that they expect people to do something they know is out of their scope of practice.

According to the the NCLEX material I studies (Kaplan), RNs can only delegate implementations to CNAs and LPNs, which is so far from reality.

Its a shame their is no specific documentation of the roles of these positions, it would be better for everyone.

[Smokey9283]

I am currently working a LPN scope of practice committee in the hospital that I work in and we have received consultation from the MN BON. The consultant stated that doing a head to toe examination is not considered doing a assessment. The assessment is what happens with that data and how the plan of care is changed.

[APBT mom, LPN, RN]

In Florida LPN's are not allowed to do the initial assessment and the pt has to be assessed by a RN at least once every 24 hrs. We're also not allowed to make the care plans or change the priorities of the care plan but if our assessments bring up another issue we can add it to the care plan.

[Simpleplan]

In DE LPNs are not allowed to do initial assessments in any facility, according to the BON. In the long term care setting, however, LPNs are expected to do initial assessments. It is part of the job. Its crazy that they expect people to do something they know is out of their scope of practice.

According to the the NCLEX material I studies (Kaplan), RNs can only delegate implementations to CNAs and LPNs, which is so far from reality.

Its a shame their is no specific documentation of the roles of these positions, it would be better for everyone.

Thanks, it was actually kaplin that sparked my question. I overheard LVN's at my job talking about assessments. According to an instructor at Kaplin you can not delegate E.A.T. to an LVN. (Evaluation, Assessment, or Teaching). I wonder if it might be the terminology that is getting everyone confused.

[Smokey9283]

I like the acronym E.A.T. good way to think of it. So then LPN's can doe Monitoring, Examination, and Reinforcment (M.E.R.)

[RFWB]

I am currently working a LPN scope of practice committee in the hospital that I work in and we have received consultation from the MN BON. The consultant stated that doing a head to toe examination is not considered doing a assessment. The assessment is what happens with that data and how the plan of care is changed.

This is exactly what we have been taught in my LPN program. Our instructors have made it very clear that the LPN is responsible for "Data Collection" but that the actual PROCESS is the same as the RN's assesment in practice. Our data collection has to be co-signed by the RN (at least in acute settings). I don't know if this is the standard everywhere - my school's program is longer and more in-depth than any other LPN program in our area (a fact which our instructors love to remind us of - and probably rightly so...:) ).

So while the process is more or less the same and utilizes the same skills, the ultimate responsibility for interpreting the data falls with the RN.

[Virgo_RN, BSN, RN]

Echoing what others have said. When an LPN does it, it's "data collection". When an RN does it, it's "assessment".

[purpil29]

i am an lpn. i do head to toe assessment on admit and i do the careplan for the resident the rn comes if i need her to stage a wound. the docter and rn sign off on the careplan q mth with the orders. i think the scope of practice for an lpn varies from state to state. i have a friend that sits on the board of nsg in my state (she is the only lpn on the board) so when in doubt i give her a call. also i think acute care an ltc differs.