CLPNA Jurisprudence – Module 4: Scope of Practice Page 1 of 17

Jurisprudence Study Guide

Module 4: Scope of Practice

Handout

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Module 4 – Scope of Practice

1. Scope of Practice 1.1 Welcome

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1.2 Module Topics

Narration JILL: Hi, and welcome to Module 4 of the Jurisprudence Study Guide. I’m Jill here with Carlos. CARLOS: Hi Jill. So in this module, it looks like we will be discussing the LPN scope of practice, restricted activities, and supervision and delegation. Is that correct? JILL: Yes, you’re right! Those are the topics for this module.

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1.3 Scope of Practice

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1.4 Framework

Narration JILL: The scope of practice defines what nursing activities LPNs are allowed, and not allowed, to do. CARLOS: So where do I find the LPN scope of practice? JILL: Unfortunately, there is no ONE document that defines all the aspects of the LPN scope of practice! To get the complete picture, LPNs have to refer to: the Health Professions Act, LPN Regulation, Standards of Practice, Code of Ethics, and the Competency Profile. We will now take a closer look at how some of these documents and how they define the LPN scope of practice. CARLOS: Great!

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1.5 Role and Responsibilities

Narration JILL: Let’s start with the HPA. Schedule 10 (3) states: “In their practice, licensed practical nurses do one or more of the following: apply nursing knowledge, skills and judgment to assess patients’ needs; provide nursing care for patients and families; teach, manage and conduct research in the science, techniques and practice of nursing; and provide restricted activities authorized by the regulations.” CARLOS: So in summary, the HPA defines the LPN scope of practice as assessing patient needs, providing nursing care, doing research and providing restricted activities. JILL: Yes, that sums it up nicely.

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1.6 Professional Nurse

Narration JILL: According to the Standards of Practice, LPNs are self-regulating and accountable for providing safe, competent, compassionate and ethical care within the legal and ethical framework of nursing regulation. LPNs are required to know and follow the four broad standards. CARLOS: The first standard is Professional Accountability and Responsibility. It states: Licensed Practical Nurses are accountable for their practice and responsible for ensuring that their practice and conduct meet both the standards of the profession and legislative requirements. JILL: The second standard is Knowledge-Based Practice. It states: Licensed Practical Nurses possess knowledge obtained through practical nurse preparation and continuous learning relevant to their professional LPN practice. CARLOS: The third standard is Service to the Public and Self-Regulation. It states: Licensed Practical Nurses practice nursing in collaboration with clients and other members of the health care team to provide and improve health care services in the best interests of the public. JILL: The fourth standard is Ethical Practice. It says: Licensed Practical Nurses uphold, promote and adhere to the values and beliefs as described in the Code of Ethics.

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1.7 Competencies

Narration JILL: The Competency Profile for Licensed Practical Nurses of Alberta provides a detailed and comprehensive description of the competencies found in the total LPN profession in Alberta. No one LPN is expected to be proficient in all of the competencies listed. There are three categories of competencies listed in the Alberta LPN Competency Profile. The first are entry-level competencies that are acquired through formal practical nurse education. Post entry-level competencies may be gained through informal and formal learning, experience, on-the-job training, post-basic education or certification. Advanced authorization competencies are acquired through completion of approved programs and advanced certification.

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1.8 Restricted Activities

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1.9 Legislation

Narration JILL: Restricted activities are those activities that are considered high risk to the public and therefore are restricted to those regulated health professionals authorized to perform such activities. These restricted activities are defined in Schedule 7.1 of the Government Organization Act. CARLOS: The types of individuals that may perform restricted activities are: regulated healthcare professionals authorized under professional regulation; a person or group authorized by the Minister to perform one or more restricted activities subject to any conditions included in the regulations; and, for the purposes of preventing, combating or alleviating a public health emergency, the Minister may by order authorize a person or category of persons to perform one of more restricted activities subject to any terms or conditions the Minister may prescribe.

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1.10 Restricted Activities

Narration JILL: CLPNA has identified three levels of authorization in reference to LPNs performing restricted activities. These are: entry-level restricted activities taught in the basic practical nurse program; post entry-level restricted activities acquired through experience, on-the-job education or post-basic education; and advanced authorization restricted activities requiring advanced education recognized by the College. However, despite any of the authorizations to provide restricted activities, LPNs must only perform the restricted activities they are competent to perform and are appropriate to their area of practice and the procedures being performed.

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1.11 Supervision and Delegation

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1.12 Health Care Aides

Narration JILL: The last section of this module is about supervision and delegation. Known by various job titles as determined by their employers, health care aides work in any setting where care is provided. Some settings are within the health system and others are with the housing sector. Increasingly health care aides are being employed in acute care settings. CARLOS: Health care aides come from a variety of backgrounds including internationally educated nurses who are working towards meeting their licensure requirements, students in nursing programs, or those who have no experience in health care. Experienced health care aides may or may not have taken a variety of educational programs. JILL: Health care aides are NOT a regulated health profession. However, they are increasingly part of the health care staff mix. Effective communication is critical to ensure the sharing of necessary information between the health care aide and the nurse and to integrate the care activities.

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1.13 Restricted Activities

Narration JILL: Let’s talk a bit about what restricted activities health care aides are allowed to do. Health care aide can perform a restricted activity if he or she has the consent and supervision of a regulated nurse. CARLOS: Unregulated providers of care such as health care aides to are permitted to perform “activities of daily living”. These are activities that individuals normally perform on their own behalf to maintain their health and well-being. JILL: The ultimate deciding factor in what health care aides can or cannot do is determined by the employer’s policy.

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1.14 Supervision

Narration JILL: To conclude this section, we will describe some general points about effective supervision of health care aides by LPNs. Supervision is defined as consultation and guidance by the regulated nurse in the practice setting. The health care aide being supervised is responsible for requesting consultation or guidance from the regulated member when they need assistance. Supervision may be direct, indirect or indirect remote. CARLOS: The supervising nurse retains responsibility for assigning client care appropriately to the health care aide, and for ongoing evaluation of nursing care. The health care aide is responsible for the assigned tasks and the care he or she provides.

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1.15 Summary

Narration JILL: This brings us to the end of Module 4 on Scope of Practice. Carlos, would you please summarize? CARLOS: Okay. The first topic was about the LPN scope of practice. We outlined the several documents that define the scope of practice. We took a look at LPN role and responsibilities and the definition of a professional nurse as described by the standards of practice. We concluded this section by looking at the College’s Competency Profile that defines the expected competencies for the LPN profession. Our next topic was restricted activities. We briefly outlined the definitions of restricted activities, and the authorizations to perform restricted activities as laid out by the Government Organization Act. We also described the different categories of LPN restricted activities – basic, advanced and specialty – and the conditions LPNs have to meet to perform restricted activities in each category. Our final topic was supervision and delegation as it applies specifically to health care aides. We discussed the role of health care aides and the importance of integrating them into the nursing teams. We then described what restricted activities health care aides were allowed to perform and under what conditions. We concluded with some general pointers about how LPNs can effectively supervise health care aides. JILL: Thanks for doing that summary. I’m Jill along with Carlos saying goodbye for now. CARLOS: Goodbye.

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1.16 The End

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