CLPNBC Baseline Competencies_Feb 2009.pdf

COLLEGE OF LICENSED PRACTICAL NURSES OF BRITISH COLUMBIA

Baseline Competencies

for Licensed Practical Nurses Professional Practice

February 09, 2009

CLPNBC Baseline Competencies February 2009

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Table of Contents

Table of Contents .................................................................................................................... 2

Preamble ................................................................................................................................. 3

Introduction to the Competencies ............................................................................................ 5

The Competencies ................................................................................................................... 7

1.0 Professional, Ethical, Legal ............................................................................................ 7

2.0 Foundations of Practice .................................................................................................. 9

3.0 Collaborative Practice ................................................................................................... 10

4.0 Focused Areas of Specific Knowledge/Judgment/Attitudes .......................................... 12

Conclusion ............................................................................................................................. 15

Appendices ............................................................................................................................ 16

Appendix A: A Guide to Decision-Making ...................................................................... 17 Appendix B: Expectations of Quality Practice Environments .......................................... 18 Appendix C: List of Relevant CLPNBC Documents ........................................................ 19 Appendix D: Glossary of Terms ..................................................................................... 20


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Preamble

The College of Licensed Practical Nurses of British Columbia (CLPNBC) licenses and

regulates Licensed Practical Nursing in British Columbia. The Colleges mandate, established

by the Health Professions Act 1996, RSBC, c 183, is to protect the public. The CLPNBC fulfills

its mandate by establishing licensure and professional practice requirements for practical

nurses including standards of practice, continuing competence, academic achievement, and

ethical behaviour. In this way, the College ensures that the public receives safe, competent,

and ethical nursing care.

The CLPNBC Professional Practice Baseline Competency Document (2008) is based upon

the framework of the Canadian Practical Nurse Registration Examination Blueprint (2007-11)

developed by Assessment Strategies Inc. The framework, developed by a national

consortium of educators, regulators, and other stakeholders, sets the licensure examination

standards for practical nurses in Canada. The Blueprint reflects baseline competencies. In

some instances, the CLPNBC has revised the wording to more accurately reflect the

expectations of the new LPN practitioner in B.C. Where appropriate, the CLPNBC Standards

of Practice & Competencies (November 2004) wording has been used.

This document establishes the competencies (knowledge, skill, judgment, and attitude) that

Licensed Practical Nurses (LPNs) in British Columbia are expected to possess as an outcome

of their nursing education. These competencies reflect the minimum standards required to

ensure nurses provide the public with safe, competent, and ethical care. In addition, these

competencies may serve as a guide to employers and other care providers, and inform the

public as to what they may expect from LPNs who are at the point of entry into practice.

Scope of Practice for Licensed Practical Nurses The scope of practice for nursing provided by LPNs is set out in the Nurses (Licensed

Practical) Regulation under the Health Professions Act.

Purpose of the B.C. Baseline Competency Document The purpose of this document is to define the foundations of practice for registration with the

College of Licensed Practical Nurses of British Columbia.

Additionally, the document also:

Assists the public by: o Serving as a guideline that sets the baseline expectation for ensuring that LPNs

provide safe, competent, and ethical care to members of the public in British Columbia.

o

Assists employers by: o Serving as a guideline for the development of competency assessment tools and

methods, performance-management systems, and LPN role descriptions.


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o Providing baseline information and reference for long-term human resource planning for health care.

Assists other health-care providers by: o Providing information about the role of the LPN as a team member. o Clarifying the LPNs contribution in a variety of practice settings.

Assists educators by: o Providing direction to post-secondary institutional programs regarding essential

curriculum components and the review and recognition of those components.

Assists LPNs by: o Serving as a reference to assess individual competence.

Acknowledgements The College of Licensed Practical Nurses of British Columbia would like to acknowledge the many individuals who participated in the development of this Baseline Competencies Document for LPNs. The process of revision involved consultation with individuals, groups, and numerous LPN focus groups. In addition, we would like to thank Assessment Strategies Inc. for allowing us to base this document on its Canadian Practical Nurse Registration Exam Blueprint (2007-11).

CLPNBC Contact information:

College of Licensed Practical Nurses of British Columbia 260-3480 Gilmore Way Burnaby, BC V5G 4Y1 Phone: 778-373-3101 or 1-877-373-2201 (Toll-Free within B.C.) Fax: 778-373-3102 Website: www.clpnbc.org


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Introduction to the Competencies

These competencies represent the baseline knowledge, skills, clinical judgment, and attitude

of a competent beginning practitioner. The expectation is that the beginning LPNs practice

will focus on the care of clients with less complex and more predictable outcomes. However,

through a combination of further education and experience, the LPNs role will accommodate

clinical situations of a more complex nature in a variety of practice areas. LPNs can enhance

their competency by taking advantage of opportunities available, such as practice supports,

and by integrating their learning into practice.

The LPN at the Point of Entry into Practice is defined as: A person who has completed sufficient education and training, is in the early part of their

professional practice career, and has been granted registration with the College of Licensed

Practical Nurses of British Columbia, or another practical nurse regulator in Canada.

CLPNBC Assumptions about Practice and the LPN at the Point of Entry into Practice.

1. The competencies include the knowledge, skill, clinical judgment, attitude, and abilities

LPNs require to provide safe, competent, and ethical nursing care.

2. LPN practice is based upon Legislation, Scope of Practice, Standards of Practice, and the Code of Ethics.

3. LPNs are accountable for their decisions and actions.

4. LPNs practise in collaboration with other members of the interdisciplinary health-care

team to meet the physical, psychosocial, and spiritual needs of their clients.

5. LPNs are committed to lifelong learning and maintaining standards of practice.

6. LPNs are committed to providing, facilitating, and promoting safe, competent, and ethical nursing care.

7. Practice decisions are client-specific and consider client acuity, complexity, variability,

and resources available.

8. LPNs create and maintain a caring environment for clients by connecting, sharing, and exploring with them in a collaborative relationship.

9. LPNs respect the diversity of their clients.

10. LPNs care for clients throughout the lifespan. They follow a systematic approach to

nursing carethrough critical thinking and clinical judgmentin applying their knowledge of assessment, planning, implementation, and evaluation.

11. LPNs share knowledge with other LPNs and members of the health-care team as

appropriate.


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Expectations of the Beginning LPN The new LPN practitioner is accountable for:

1. Knowing and meeting the CLPNBC Standards of Practice and Competencies. 2. Understanding the Scope of Practice as documented in legislation and regulation. 3. Decisions regarding individual competence to provide care, given the context and

client circumstances. 4. Actively identifying and asking questions of self, colleagues, interdisciplinary health-

care team members, and clients. 5. Ensuring that those with whom she or he may consult with or seek advice from are

competent to provide appropriate information/direction. 6. All client care she or he provides, and for decisions about consulting with other health-

care providers.

Arrangement of the Competencies The competencies have been arranged in four separate categories:

o Professional, Ethical, Legal; o Foundations of Practice; o Collaborative Practice; and o Focused Areas of Specific Knowledge, Judgment, and Attitudes.

These categories are further broken down into sub-categories to reflect all of the

competencies required of the Licensed Practical Nurse at entry into practice. These are the

competencies that the new LPN entering into practice must demonstrate knowledge and

understanding of in order to pass the Canadian Practical Nurse Registration Exam. Upon

successful completion of the exam, the Practical Nurse is then eligible to apply for registration

with the College of Licensed Practical Nurses of BC.


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The Competencies

1.0 Professional, Ethical, Legal

1.1 Professional

Competent licensed practical nurses entering practice:

1.1.1 Are accountable for their own decisions and actions.

Practise within their Scope of Practice.

Verify policies, procedures, and orders.

Provide care using clinical judgment for decision-making.

1.1.2 Identify effects of own values, biases, and assumptions on interactions with clients and other members of the health-care team.

Provide client care in a non-judgmental manner.

Respect clients right to self-determination, informed decisions, and directives.

Recognize and implement steps toward a resolution of ethical dilemmas. 1.1.3 Evaluate own practice, identify gaps in own competence.

Evaluate knowledge and skills on an ongoing basis.

Recognize when to seek assistance and guidance.

Establish learning plans to enhance knowledge as required.

1.1.4 Demonstrate professional conduct.

Adhere to standards of practice of the profession.

Respond professionally to unacceptable behaviour (e.g.: client abuse, harassment of staff).

Identify and respond to incidents of unsafe practice and/or professional misconduct.

Document incidents and actions taken.

Advocate and participate in quality-improvement activities.

1.2 Ethical Competent licensed practical nurses entering practice: 1.2.1 Understand the ethical framework of the nurse-client relationship.

Establish and maintain respect, empathy, trust, and honesty in interactions with the client.

Recognize, understand, and respect the values, opinions, needs, and ethnocultural beliefs of client and self.

Establish and maintain a professional, therapeutic nurse-client relationship.

1.2.2 Promote clients rights and responsibilities. Obtain client consent prior to initiating nursing care.

Protect clients rights by including confidentiality, privacy, dignity, and self-determination as part of the plan of care.

Advocate for clients.


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1.2.3 Contribute to a Quality Practice Environment.

Value and advocate for safe practice environments.

Support/advocate for resources (human and material) to ensure safe practice environment.

Support and develop respectful, supportive, collaborative relationships.

1.3 Legal Competent licensed practical nurses entering practice: 1.3.1 Adhere to the legal requirements of nursing practice.

Adhere to the Health Professions Act, Nurses (Licensed Practical) Regulation, College bylaws and policies, and other relevant provincial and federal legislation.

Adhere to all requirements related to reporting communicable diseases and client abuse.

Recognize and respond to questionable orders, actions, or decisions.

Practise within established policies and procedures of employer agencies. 1.3.2 Disclose relevant information to the appropriate individual.

Respect and maintain client confidentiality.

Provide relevant information to the client and/or family. 1.3.3 Adhere to legal requirements regarding documentation.

Document client information in a timely manner.

Document in an accurate, clear, concise, and legible manner.

Complete incident reports as required.

Document within established policies and procedures of employer agencies.


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2.0 Foundations of Practice

Competent licensed practical nurses entering practice will: 2.1 Assess: Demonstrate knowledge in performance of comprehensive health

assessments throughout the lifespan:

Identify and collect relevant information on client status from a variety of sources, such as: physical assessment, observation, communication, and previous health records.

Perform comprehensive holistic and specific nursing assessments for appropriate clients across the lifespan.

Assess and monitor clients actual and potential strengths and limitations. Individualize client assessment to meet clients unique needs, preferences, and

diversity.

Collaborate with clients, families, and other health-care providers in performing assessments.

2.2 Plan: Apply critical thinking and clinical judgment to the planning and delivery

of all aspects of nursing:

Utilize critical-thinking and problem-solving skills to make appropriate clinical judgment about clients, care requirements, and client outcomes.

Use evidence-based knowledge to develop individualized nursing interventions.

Analyze and interpret data from clinical assessment to anticipate health needs and establish care strategies in collaboration with other members of the health-care team.

Exercise judgment in assuming care for clients within own range of competence.

Select nursing interventions that meet expected levels of competence as defined by the Standards of Practice for LPNs.

Select, prioritize, and organize nursing interventions that reflect clients unique needs.

Collaborate and contribute to the development of a mutually agreed-upon plan of care with clients and other health-care providers.

Use effective time-management skills to organize nursing care.

2.3 Implement: Select and implement appropriate nursing interventions according to evidence-based practice:

Use evidence-based knowledge to conduct individualized nursing interventions.

Provide nursing interventions that meet expected levels of competence as defined by the Standards of Practice for LPNs, with clients that have predictable outcomes.

Promote client self-care and wellness to achieve mutually agreed-upon health outcomes.

Perform a range of nursing interventions (actions, treatments, and techniques) to meet client outcomes.

Provide nursing interventions in a collaborative manner with the client and other health-care providers.

Provide nursing interventions in an effective, efficient, and safe manner.


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Utilize appropriate technology and equipment based on client needs and available resources.

Explain rationale for nursing intervention.

Facilitate teaching to increase client understanding.

Respond appropriately to changing situations or emergencies that affect clients health and/or safety.

2.4 Evaluate: Monitor and evaluate the effectiveness of nursing interventions:

Compare actual outcomes of nursing care with anticipated outcomes.

Verify evaluation findings with client and other health-care providers.

Evaluate teaching strategies to facilitate client understanding of care interventions and facility protocol.

Review and revise the plan of care in collaboration with other health-care providers.

3.0 Collaborative Practice

Competent licensed practical nurses entering practice:

3.1 Establish and maintain a caring environment to foster partnerships with clients and family:

Establish therapeutic relationships.

Promote client safety and comfort.

Reinforce information given to clients by other health-care professionals.

Provide client and family with emotional support.

Provide opportunities that encourage clients to interact socially, depending upon the context of care.

3.2 Collaborate and consult with clients and other health-care providers to ensure continuity of care:

Establish and maintain a caring environment that fosters a collaborative partnership with clients.

Identify when collaboration is required and seek assistance from other members of the health-care team when appropriate.

Integrate evidence-based findings into practical-nursing practice in collaboration with other members of the interdisciplinary health-care team.

Facilitate and participate in interdisciplinary collaborative problem-solving and decision-making processes.

Respect unique and shared competencies of members of the interdisciplinary health-care team.

Use constructive feedback and mediation strategies as necessary.

Demonstrate leadership as appropriate.

Share knowledge with unregulated care providers, novices, and students.

Support colleagues to practise as effective members of the health-care team.

Communicate client status to appropriate team members.


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3.3 Demonstrate leadership skills within the interdisciplinary health-care team:

Collaborate with other members of the interdisciplinary health-care team.

Demonstrate leadership in initiating the revision of goals, priorities, and nursing interventions in collaboration with other members of the health-care team.

Use leadership skills effectively to teach, implement, guide, and assess care interventions.

Provide direction, assignment, and supervision of unregulated care providers as appropriate.

Facilitate problem-solving and decision-making.

Provide constructive feedback.

Direct and coordinate actions of others, as appropriate, in emergency situations.

3.4 Exercise judgment in accepting and/or assigning client care to other appropriate unregulated care providers, within their range of competencies:

Exercise clinical judgment in accepting assigned client-care functions within own level of competence.

Exercise clinical judgment in assigning client-care functions, within the level of competence of unregulated care providers.

Provide direction, assignment, and supervision of unregulated care providers as appropriate.


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4.0 Focused Areas of Specific Knowledge/Judgment/Attitudes

This section is included to highlight specific areas of knowledge and skill that are required at

the point of entry into practice. While this is not an exhaustive list, it represents key areas of

practice that are expected of the LPN early in professional practice.

The knowledge components directly reflect the competencies as set out by the Assessment

Strategies Inc. Blueprint. The psychomotor section has been developed by the CLPNBC

based upon staff expertise and review with focus groups of LPNs and stakeholders.

Competent licensed practical nurses entering practice: 4.1 Demonstrate principles of safe care:

Maintain safe work environment.

Medical/surgical asepsis.

Standard precautions.

Isolation precautions/techniques.

Implement/maintain strategies to prevent spread of communicable diseases.

Demonstrate principles of risk management.

4.2 Perform Comprehensive Health Assessments throughout the Lifespan:

Assess all body systems using an organized framework.

Assess clients in all stages of growth and development.

Monitor vital signs, including: pulse (carotid, brachial, radial, apical, femoral, and pedal), respiration (rate and quality), blood pressure, and temperature (e.g. oral, rectal, axillary, and tympanic).

Auscultate bowel sounds, breath sounds, and heart sounds.

Assess client appearance and changes in condition: observation, inspection, auscultation, and palpation.

Assess various insertion sites (e.g. central line, chest tubes, epidural catheter, drainage tubes, suprapubic catheter, tracheotomy, and ostomy).

Perform mental, spiritual, and psychosocial assessments.

4.3 Demonstrate Knowledge of Oxygenation:

Perform oxygen saturations.

Establish, position, and maintain oxygen and humidity.

Perform oral and nasal suctioning.

Perform peak flows and incentive spirometers.


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4.4 Demonstrate Appropriate Mobilization and Positioning of Clients:

Use the principles of good body mechanics.

Demonstrate appropriate use of lifts, devices, and mobility aids.

Position dependent clients in appropriate body alignment.

Assist clients with prosthetic devices.

Assist clients with crutch walking, walkers, and canes.

Operate mechanical chairs and other transfer devices.

Apply splints and braces.

Assess clients and perform cast care.

Assess clients for risk of falls and take appropriate action.

Assist clients with exercise instruction and/or range of movement instructions.

4.5 Demonstrate knowledge of nutrition/hydration:

Assess and record food/fluid intake (e.g. 24-hour fluid balance, calorie count).

Provide appropriate nutrition and fluid intake.

Maintain dietary restrictions and supplements.

Administer enteral feedings and medications via nasogastric, jejunostomy, and gastrostomy tubes.

Maintain and remove nasogastric tubes.

Assess and monitor clients who are receiving total parenteral nutrition.

4.6 Demonstrate knowledge of elimination:

Implement nursing measures to maintain regular elimination.

Administer enemas and suppositories.

Care for a colostomy, ileostomy, and urostomy.

Care for urinary drainage systems (including continuous bladder irrigation).

Insert, maintain, and remove urinary catheters.

Apply condom drainage.

Implement bladder and bowel training and retraining programs.

4.7 Perform collection of specimens:

Collect and label sputum, urine, and stool specimens.

Collect and label Culture and Sensitivity specimens (C&S swabs).

Collect and test body fluids as required.

Perform capillary blood-glucose monitoring.

4.8 Demonstrate the knowledge of pharmacology and the principles of safe medication administration:

Verify and transcribe medication orders.

Utilize the rights of safe medication administration. Administer medication via routes including oral, rectal, vaginal, intramuscular,

subcutaneous, aural (eardrops), ophthalmic (eye drops), intradermal, topical, nasal, sublingual, inhalation, nasogastric tube, jejunostomy tube, and gastrostomy tube.

Document medication administration and client response.


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4.9 Demonstrate the principles of peripheral infusion therapy (IV):

Verify infusion orders.

Assess insertion site.

Change IV tubing and solutions.

Regulate the rate of IV flow.

Set up and prime the infusion line.

Insert a subcutaneous infusion device.

Flush an intermittent infusion device.

Convert IV to an intermittent infusion device.

Discontinue a peripheral infusion device.

Assess and document client response to infusion therapy.

4.10 Demonstrate the knowledge of infusion therapy to blood and blood products:

Obtain blood/blood-products from Blood Bank/Transfusion Services.

Check patient identification on label of blood/blood-product with appropriate health professional. Co-sign blood administration.

Set up and prime the infusion line (NOT initiating infusion).

Monitor infusion of blood/blood-products.

Assess and document client response.

If reaction is recognized, stop blood/blood-product infusion and start alternate flush solution. Notify appropriate health-care professional.

4.11 Demonstrate Principles of Wound-Care Management:

Change sterile dressings (dry and moist).

Clean and irrigate wounds.

Remove sutures, staples, and drains.

Insert and remove packing.

4.12 Demonstrate knowledge of care of patients with issues of mental health, addictions, and/or substance abuse:

Assess mental status and evaluate changes in the client.

Identify functional/dysfunctional health behaviours, encouraging clients to assume responsibility for their own health.

Describe symptoms, record findings, and consult/collaborate/report to health team.

Respond appropriately to prevent and manage aggression.

Recognize individuals at risk for self-harm and/or harm to others.


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Conclusion

Through review by a variety of stakeholders, the competencies have been confirmed as the knowledge, skills, attitude, and clinical judgment of the beginning LPN practitioner. The competencies form the basis for a better understanding of the LPN role by the public, employers, other health-care providers, educators, and LPNs themselves. However, these are only the baseline competencies. LPNs can provide more support in a variety of areas that require further development. The creation of a document that outlines Advanced Competencies learned through further education and/or experience will assist in addressing the critical shortage of nurses. The CLPNBC will begin working on the Advanced Competencies as the next step in the development of LPN professional practice.


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Appendices

A. A Guide to Decision-Making B. Expectations of a Quality Practice Environment C. List of Relevant CLPNBC Documents D. Glossary


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Appendix A: A Guide to Decision-Making

Critical Thinking and Decision-Making

Decision-making involves asking questions and considering the answers to those questions.

Critical thinking is performed by the LPN at a level consistent with his/her educational

preparation and individual range of competencies. Critical thinking is integral to decision-

making and includes the activities of organizing assessment information, recognizing patterns,

and compiling evidence to support the conclusions drawn.

Practice decision-making is context-specific and changes according to client and practice-

setting circumstances. Accordingly, this guide identifies both the expectations of LPNs

entering into practice, and of quality practice settings. It is intended to assist the novice LPN

with practice decision-making.

A Practice Decision-Making Framework for the LPN Entering Practice The following questions provide a decision-making framework for the LPN entering Practice.

1. Has the predictability of the clients condition been established by a person with the ability to make that determination? If not, have I consulted with a colleague to ensure that this is an appropriate client assignment?

2. Is the assessment complete? Do I have a complete understanding of the data? Must I

consult with a more experienced colleague or an interdisciplinary team member?

3. Based on the assessment data, what are the possible options of care? Do I know what the research indicates about each option, or do I have to inquire about this? What are the indications and contraindications for each option?

4. Am I satisfied that the proposed nursing interventions are appropriate for the client,

given the particular circumstances and the range of alternative options available?

5. Do I have the authority to perform the proposed nursing interventions?

6. Am I competent to perform the proposed nursing interventions?

7. Has the nursing care provided achieved the desired outcome(s)?


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Appendix B: Expectations of Quality Practice Environments

Organizations support the delivery of client care, services, and programs through their

philosophy, policies and procedures, health and safety requirements, and recruitment and

retention strategies.

Possible strategies for LPNs include:

1. Having mission, value, and philosophy statements of the organization that support and recognize the need for inter- and intra-professional collaborative practice;

2. Having a collaborative practice model within the organization that guides professional practice expectations; and

3. Developing evidence-based policies and/or guidelines that outline:

o Role expectations, limitations, and responsibilities of LPNs.

o Accountabilities of all health-care team members associated with collaborative professional practice.

o Circumstances requiring LPNs to consult and collaborate with other

members of the health-care team.

o Situations that: threaten client safety; support collaborative decisions and actions taken to ensure client safety; examine the appropriateness of those decisions given the professional practice model, CLPNBC Standards, and the agency-specific practice expectations.

o Additional resources (human and material) that may be required.

Employers have a responsibility to create practice environments with strong organizational

attributes that support all LPNs to provide a quality outcome for the client.


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Appendix C: List of Relevant Documents

The following documents are available from the Government of British Columbia. Official

copies may be obtained from the Queens Printer: http://www.qplegaleze.ca/default.htm or

from the Ministry of Health legislation and professional regulation website:

http://www.health.gov.bc.ca/leg/

Health Professions Act

Nurses (Licensed Practical) Regulation The following complementary documents are available for download through publications

page of the College of Licensed Practical Nurses of British Columbia (CLPNBC) website:

www.clpnbc.org

College of Licensed Practical Nurses of British Columbia and College of Registered Nurses of British Columbia joint publication: Registered Nurses & Licensed Practical Nurses Working Together for Client Safety, (2008)

Standards of Practice and Competencies (2004)

Standards of Practice and Competencies: Companion Guide (2006)

Code of Ethics for LPNs (2006)

Code of Ethics for LPNs: Companion Guide (2006)

CLPNBC Practice Directives: o Allergy Testing, Administering Desensitizing Medications, and Immunizations

(2007) o Blood Transfusion Therapy (2007) o Consent (2007) o Documentation (2007) o Duty to Provide Care (2007) o Duty to Report (2007) o Medication Administration (2008) o Nurse-Client Assignment (2007) o Nurse-Client Relationship (2007) o Obtaining, Taking and Transcribing Verbal/Telephone/Faxed Medication

Orders (2007) o Peripheral Infusion Therapy (2007) o Pronouncement of an Anticipated Death (2007) o Self-Employment (2007)

Canadian Practical Nurse Registration Examination (CPNRE) Blueprint: 2007 to 2011

Pharmacology and Medication Administration Self-Assessment Tool (2005)

Patient Assessment Self-Assessment Tool (2006)


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Appendix D: Glossary of Terms

Accountability: The LPN must be able to account for, and explain, his/her actions with regard

to nursing interventions.

Assignment: The act of assigning or being assigned a specific task.

Client: The person or persons with whom the nurse engages in a professional therapeutic

relationship. The client can include a group of family members and/or friends. In some clinical

settings, the client may also be referred to as a patient or a resident.

Clinical Judgment: The forming of conclusions based on the assessment and analysis of

client data.

Collaboration: To work together with one or more members of the health-care team, each of

whom makes a unique contribution to achieving a common goal. Each individual contributes

from within the limits of her/his Legislated Scope of Practice.

Competence: The ability of a nurse to integrate the professional attributes required to perform

in a given role, situation, or practice setting. Professional attributes include, but are not limited

to: knowledge, skill, judgment, attitude, values, and beliefs.

Competencies: The knowledge, skills, attitude, and judgment required to perform safely,

competently, and ethically within an individuals nursing practice, or in a designated role or

setting. An individual nurses competencies are influenced by a number of variables, such as

basic nursing education, experience, and ongoing formal and informal learning.

Consultation: Seeking advice/information from a more experienced and knowledgeable

member of the nursing profession (LPN, RPN, or RN), or a member of another profession

when a nursing activity is outside the Entry-Level LPNs individual range of competencies or

the Legislated Scope of Practice for LPNs. The Entry-Level LPN may also seek advice from

other sources, as appropriate.

Critical Thinking: Reasoning in which we analyze the use of language, formulate problems,

clarify and explain assumptions, weigh evidence, evaluate conclusions, discriminate between

good and bad arguments, and seek to justify those facts and values that result in credible

beliefs and actions. Critical thinking is performed by the Entry-Level LPN at a level that is

consistent with her/his educational preparation and individual range of competencies.


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Delegation of Task: The delegation of a restricted activity by a registrant, or the authorization

by a registrant to perform a restricted activity under her or his supervision, must be in

accordance with the bylaws of the College of which the registrant is a member.

Predictable Outcomes: Client health outcomes that can reasonably be expected to follow an

anticipated path. Predictable clients are those whose health status can be anticipated and

whose care needs are within known levels and ranges of negative outcomes.

Unpredictable Outcomes: Client health outcomes that cannot reasonably be expected to

follow an anticipated path. Unpredictable clients are those whose health status cannot be

anticipated and whose care needs are not within known levels and ranges of negative

outcomes.

Unregulated Care Provider (UCP): An individual who assists with or provides personal care,

and may deliver some basic elements of nursing care such as personal hygiene, dressing,

feeding, and assisting with medications. UCPs observe and report their findings to the

appropriate regulated health professional. UCPs are not regulated health professionals under

the Health Professions Act (HPA) and they are not accountable to a regulatory body that sets

standards or monitors the quality of care. They are also known as Personal Support Workers

(PSWs), Resident Care Aides/Attendants (RCAs), Personal Care Aides (PCAs), Long-Term

Care Aides (LTCAs), or Home Support Workers (HSWs).