4.1 Legal Scope of Practice

Question 1

Michigan Public Health Code (1978) defines LPN scope of practice.

LPN Scope

Answer 1

Michigan Public Health Code (1978) defines LPN scope of practice.

LPN Scope:
Limited in assessment privileges
Limited in interpretation of clinical data
Typically DO NOT have authority to alter
nursing care plans.

Question 2

LPN Role Responsibilities

Answer 2

Under Michigan law LPN must:
Be licensed
Be supervised by RN, Physician, or dentist
Be trained to perform the nursing tasks he/she does
Not delegate LPN tasks or functions to unlicensed personnel.

Only RN can “delegate” nursing functions/tasks.
Assistive personnel function only under supervision of the RN

Michigan nursing practice guidelines legally are vague & give little detail
Individual facility policy often defines LPN practice
Cares for persons who are: well, ill, injured, convalescent, or handicapped
Work under own license

Question 3

Duties of the LPN

Answer 3

Assisting with ADLs
Assist in development & modification of patient care plans.
Observe patients, chart and report problems to RN or DR in charge
Taking vital signs, administering meds (usually not IVs or central lines)
Implementing plan of care (cannot initiate the POC)
Evaluating whether identified expected outcomes are met
Documentation and reporting patient condition/problems
Following approved institutional procedures
Catheters, dressings, trach care & suctioning, tube feedings, irrigating wounds
Assist in teaching patient and family
Emotional support
Perform simple diagnostic tests (stool occult, urine dip)
Postmortem care
Observe patient monitoring equipment.

Question 4

Delegation

Answer 4

The process of directing another person to perform a task or activity.
The person delegating task retains accountability for the outcome of the activity.

You can only delegate tasks down the chain of command.

Can’t delegate any nursing intervention RT:
Critical thinking
Professional judgment
Assistive personnel function under RN

Remember you are delegating a task NOT
the responsibility.

Question 5

Delegation

RN

Answer 5

RN
Specialty care
Severe cases
Sterile procedure
Assessment
Teaching
Evaluation
IV meds

Question 6

Delegation

LPN

Answer 6

LPN
Chronic cases
Stable clients
Routine procedure

Question 7

Delegation

UAP

Answer 7

UAP
Routine procedures
Activities of daily living

Question 8

Delegation Principles to Follow

5 rights

Answer 8

5 Rights of Delegation
Right Task- “can I delegate it?”
Right Circumstance- “Should I delegate it?”
Right Person- “Who is best prepared to do it?”
Right Direction/communication- “What does the NAP need to know?”
Right Supervision- “How will I follow up?”

NCSBN Delegation video (27min) https://www.youtube.com/watch?v=9K4rG9qrIBU