Current through Register Vol. 63, No. 3, March 1, 2024
(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.
Stat. Auth.: ORS
678.150
Stats. Implemented: ORS
678.150 &
678.010