OAR 851-045-0050
Scope of Practice Standards for Licensed Practical Nurses
(1)
The Board recognizes that the LPN has a supervised practice that occurs at the clinical direction and under the clinical supervision of the RN or LIP who have authority to make changes in the plan of care, and encompasses a variety of roles, including, but not limited to:(a)
Provision of client care;(b)
Supervision of others in the provision of care;(c)
Participation in the development and implementation of health care policy;(d)
Participation in nursing research; and(e)
Teaching health care providers and prospective health care providers.(2)
Standards related to the LPN’s responsibility for ethical practice, accountability for services provided, and competency. The LPN shall:(a)
Base LPN practice on current nursing science, other sciences, and the humanities;(b)
Be knowledgeable of the statutes and regulations governing LPN practice and practice within those legal boundaries;(c)
Be knowledgeable of the professional nursing practice standards applicable to LPN practice and adhere to those standards;(d)
Demonstrate honesty, integrity and professionalism in the practice of licensed practical nursing;(e)
Be accountable for individual LPN actions;(f)
Maintain competency in one’s LPN practice role;(g)
Maintain documentation of the method that competency was acquired and maintained;(h)
Accept only LPN assignments that are within one’s individual scope of practice;(i)
Recognize and respect a client’s autonomy, dignity and choice;(j)
Accept responsibility for notifying employer of an ethical objection to the provision of a specific nursing intervention;(k)
Ensure unsafe nursing practice is addressed immediately;(l)
Ensure unsafe practice and unsafe practice conditions are reported to the appropriate regulatory agency; and(m)
Protect confidential client information and only share information in a manner that is consistent with current law.(3)
Standards related to the LPN’s responsibility for nursing practice. Applying practical nursing knowledge, at the clinical direction and under the clinical supervision of the RN or LIP, the LPN shall:(a)
Conduct focused assessments by:(A)
Collecting data through observations, examinations, interviews, and records in an accurate and timely manner as appropriate to the client’s health care needs and context of care;(B)
Validating data by utilizing available resources, including interactions with the client and health care team members;(C)
Distinguishing abnormal from normal data, sorting, selecting, recording, and reporting the data discrepancies to the supervising RN or supervising LIP;(D)
Identifying potentially inaccurate, incomplete or missing data and reporting as needed;(E)
Recognizing signs and symptoms of deviation from current health status; and(F)
Evaluating data to identify problems or risks presented by the client.(b)
Select reasoned conclusions that communicate client problems or risks;(c)
Contribute to the development of a comprehensive plan of care or develop a focused plan of care. This includes:(A)
Identifying priorities in the plan of care;(B)
Setting measurable outcomes in collaboration with the client; and(C)
Selecting appropriate nursing interventions as established by the RN or consistent with the LIP’s plan of care.(d)
Implement the plan of care; and(e)
Evaluate client responses to nursing interventions, progress toward measurable outcomes, and communicate such to appropriate members of the health care team.(4)
Standards related to the LPN’s responsibility to assign and supervise care. At the clinical direction and under the clinical supervision of the RN or LIP, the LPN:(a)
May assign to an LPN, nursing interventions that fall within LPN scope of practice and that the licensee receiving the assignment possesses the competency to perform safely;(b)
May assign to the CNA and CMA the duties identified within Chapter 851 Division 63 that the certificate holder possesses the competency to perform safely;(c)
May assign to the UAP work the UAP is authorized to perform within the practice setting and that the UAP possesses the competency to perform safely;(d)
Shall ensure the assignment matches client service need;(e)
Shall provide clinical supervision of the LPN, CNA, CMA, and UAP to whom an assignment possesses been made:(A)
Provides supervision per the context of care;(B)
Ensures documentation of supervision activities occurs per the context of the assignment;(C)
Evaluates the effectiveness of the assignment; and(D)
Reports effectiveness of assignment to the supervising RN or supervising LIP.(f)
Shall revise the assignment as directed by the supervising RN or supervising LIP; and(g)
Prior to making an assignment, the LPN is responsible to know the duties, activities or procedures the recipient of the assignment is authorized to perform within the setting.(5)
Standards related to the LPN’s responsibility for client advocacy. The LPN shall:(a)
Advocate for the client’s right to receive appropriate care, including client-centered care and end-of-life care, that is respectful of the client’s needs, choices and dignity;(b)
Intervene on behalf of the client to identify changes in health status, to protect, promote and optimize health, and to alleviate suffering;(c)
Advocate for the client’s right to receive appropriate and accurate information;(d)
Communicate client’s choices, concerns and special needs to the supervising RN or supervising LIP and to other members of the health care team; and(e)
Protect the client’s right to participate or decline to participate in research.(6)
Standards related to the LPN’s responsibility for collaboration with the health care team. The LPN shall:(a)
Function as a member of the health care team;(b)
Collaborate in the development, implementation and evaluation of an integrated plan of care appropriate to the context of care;(c)
Demonstrate a knowledge of health care team members’ roles;(d)
Communicate with the supervising RN or supervising LIP and other relevant health care team members regarding the plan of care; and(e)
Make referrals as directed in a timely manner and follow up on referrals made.(7)
Standards related to the LPN’s responsibility for the environment of care. The LPN shall:(a)
Promote and advocate for an environment conducive to safety; and(b)
Identify safety and environmental concerns, take action to address those concerns, and report to the supervising RN or supervising LIP.(8)
Standards related to the LPN’s responsibility for leadership and quality of care. The LPN shall:(a)
Identify factors that affect the quality of nursing service delivery and report to the supervising RN or LIP;(b)
Implement policies, protocols, and guidelines that are pertinent to nursing service delivery;(c)
Contribute to development and implementation of policies, protocols, and guidelines that are pertinent to the practice of nursing and to health services delivery;(d)
Participate in quality improvement initiatives and activities within the practice setting; and(e)
Participate in the development and mentoring of new licensees, nursing colleagues, students, and members of the health care team.(9)
Standards related to the LPN’s responsibility for health promotion and teaching. At the clinical direction and under the clinical supervision of the RN or LIP, the LPN may participate in the development, implementation and evaluation of teaching plans appropriate to the context of care, that address the learner’s learning needs, readiness to learn, and ability to learn.(10)
Standards related to the LPN’s responsibility for cultural responsiveness. The LPN shall:(a)
Apply a basic knowledge of cultural diversity; and(b)
Recognize and respect the cultural values, beliefs, and customs of the client.
Source:
Rule 851-045-0050 — Scope of Practice Standards for Licensed Practical Nurses, https://secure.sos.state.or.us/oard/view.action?ruleNumber=851-045-0050.