West Virginia Nurse Edition 18 : Page 6
8G>I:G>6;DG9:I:GB>C>C<H8DE: D;EG68I>8:;DGA>8:CH:9CJGH:H 6C9 <J>9:A>C:H;DG9:I:GB>C>C< 68IHI=6IB6N7:9:A:<6I:9DG 6HH><C:97NA>8:CH:9CJGH:H >CIGD9J8I>DC The intent of this document is to present a process to determine acts appropriate to nursing at various levels and acts appropriate for delegation to the licensed practical nurse, as well as to determine those acts appropriate for assignment to unlicensed assistive personnel. The Board has reviewed and refreshed the Scope of Practice and Delegation Models and they are included in this magazine. They also reviewed and reframed how we issue a license. Individuals must consult the law, applicable rules and Board position statements in making a practice decision. Related position statements are included in the Appendix of this document. Additional law, rules or position statements may be developed after the publication of this document. The nurse must assure that current publications are referenced when using the Models in this publication. Changes in health care delivery are occurring in health care organizations throughout West Virginia and the nation. These changes could lead to role confusion. In view of the mandates of the West Virginia Board of Examiners for Registered Professional Nurses and the West Virginia State Board of Examiners for Licensed Practical Nurses to act in the best interest of public safety and health, the respective boards support professional collaboration to deliver competent care and treatment of the client in a safe, professional and cost effective manner. The guidelines contained in this document provide comprehensive criteria and examples for use in the decision making process required to determine acts that are appropriate to nursing at various levels, and acts appropriate for delegation to the licensed practical nurse as well as to determine those acts appropriate for assignment to unlicensed assistive personnel. The guidelines, however, do not have the force and effect of law except as provided through the Legal Standards of Practice, WV §19 CSR10 and WV§ 10 CSR 3. Many nurses would like a “yes” or “no” answer to questions about the delegation of nursing practice; however, in most cases it is not that simple. In reality, the answer to most questions is “it depends.” It depends upon the complexity of the task to be delegated. It depends upon the care needs of the client, as assessed by the registered professional nurse. It depends upon the educational preparation, skills, and ability of the licensed practical nurse or unlicensed person to whom the task is to be delegated/assigned. And, it depends upon the availability and accessibility of essential resources, including supervision, while the task is being performed. Nursing judgment is the essential element in every delegation or assignment decision. Licensees are expected to read the scope and delegation information and then refer back to the portions that will assist in making a final decision. Therefore, this information is best used when an individual has the time to review all related information so the foundation for decision-making is present when a quick decision is required. Revised by: The West Virginia Board of Examiners for Registered Professional Nurses and The West Virginia State Board of Examiners for Licensed Practical Nurses June 17, 2009 9:;>C>I>DCH Accountability -Being responsible or answerable for actions or inactions of self or others in the context of delegated or assigned duties. Advanced Practice Nurse -A registered professional nurse practicing nursing at a level which requires substantial theoretical knowledge in a specialized area of nursing practice and proficient clinical utilization of the knowledge in implementing the nursing process. The competencies of specialists include but are not limited to the ability to assess, conceptualize, diagnose, analyze, plan, implement and evaluate complex problems related to health. Assignment -Designating nursing activities to be performed by another nurse or nursing assistive personnel that are consistent with his/her scope of practice (licensed person) or role description (unlicensed person). (NCSBN) Competence -Possessing verifiable knowledge and skill to perform an activity or task safely and effectively. Delegation -Transferring to a competent individual the authority to perform a selected nursing task in a selected situation. (NCSBN) Licensed Practical Nurse -“Practical Nursing” means the performance for compensation of selected nursing acts in the care of the ill, injured or infirm under the direction of a registered professional nurse or licensed physician or licensed dentist, and not requiring the substantial specialized skill, judgment and knowledge E6<:+
Criteria For Determining Scope Of Practice For Licensed Nurses And Guidelines For Determining Acts That May Be Delegated Or Assigned By Licensed Nurses
Introduction & Defintions
Revised by: The West Virginia Board of Examiners for Registered Professional Nurses and The West Virginia State Board of Examiners for Licensed Practical Nurses June 17, 2009<br /> <br /> Introduction<br /> <br /> The intent of this document is to present a process to determine acts appropriate to nursing at various levels and acts appropriate for delegation to the licensed practical nurse, as well as to determine those acts appropriate for assignment to unlicensed assistive personnel. The Board has reviewed and refreshed the Scope of Practice and Delegation Models and they are included in this magazine. They also reviewed and reframed how we issue a license. Individuals must consult the law, applicable rules and Board position statements in making a practice decision. Related position statements are included in the Appendix of this document. Additional law, rules or position statements may be developed after the publication of this document. The nurse must assure that current publications are referenced when using the Models in this publication.<br /> <br /> Changes in health care delivery are occurring in health care organizations throughout West Virginia and the nation. These changes could lead to role confusion. In view of the mandates of the West Virginia Board of Examiners for Registered Professional Nurses and the West Virginia State Board of Examiners for Licensed Practical Nurses to act in the best interest of public safety and health, the respective boards support professional collaboration to deliver competent care and treatment of the client in a safe, professional and cost effective manner.<br /> <br /> The guidelines contained in this document provide comprehensive criteria and examples for use in the decision Making process required to determine acts that are appropriate to nursing at various levels, and acts appropriate for delegation to the licensed practical nurse as well as to determine those acts appropriate for assignment to unlicensed assistive personnel. The guidelines, however, do not have the force and effect of law except as provided through the Legal Standards of Practice, WV §19 CSR10 and WV§ 10 CSR 3.<br /> <br /> Many nurses would like a “yes” or “no” answer to questions about the delegation of nursing practice; however, in most cases it is not that simple. In reality, the answer to most questions is “it depends.” It depends upon the complexity of the task to be delegated. It depends upon the care needs of the client, as assessed by the registered professional nurse. It depends upon the educational preparation, skills, and ability of the licensed practical nurse or unlicensed person to whom the task is to be delegated/assigned. And, it depends upon the availability and accessibility of essential resources, including supervision, while the task is being performed. Nursing judgment is the essential element in every delegation or assignment decision.<br /> <br /> Licensees are expected to read the scope and delegation information and then refer back to the portions that will assist in making a final decision. Therefore, this information is best used when an individual has the time to review all related information so the foundation for decision-making is present when a quick decision is required.<br /> <br /> Definitions<br /> <br /> Accountability - Being responsible or answerable for actions or inactions of self or others in the context of delegated or assigned duties.<br /> <br /> Advanced Practice Nurse - A registered professional nurse practicing nursing at a level which requires substantial theoretical knowledge in a specialized area of nursing practice and proficient clinical utilization of the knowledge in implementing the nursing process. The competencies of specialists include but are not limited to the ability to assess, conceptualize, diagnose, analyze, plan, implement and evaluate complex problems related to health.<br /> <br /> Assignment -Designating nursing activities to be performed by another nurse or nursing assistive personnel that are consistent with his/her scope of practice (licensed person) or role description (unlicensed person). (NCSBN)<br /> <br /> Competence-Possessing verifiable knowledge and skill to perform an activity or task safely and effectively.<br /> <br /> Delegation - Transferring to a competent individual the authority to perform a selected nursing task in a selected situation. (NCSBN)<br /> <br /> Licensed Practical Nurse - “Practical Nursing” means the performance for compensation of selected nursing acts in the care of the ill, injured or infirm under the direction of a registered professional nurse or licensed physician or licensed dentist, and not requiring the substantial specialized skill, judgment and knowledge Required in professional nursing. (Code of WV §30-7A-1)<br /> <br /> §30-7A-2. Use of titles. (a) Any person licensed pursuant to this article may use the title “licensed practical nurse,” “practical nurse” and the abbreviation “L.P.N” or the term “nurse.” Except as otherwise provided in article seven of this chapter, no other person may assume such title, or use such abbreviation, or any other words, letters, figures, signs, or devices to indicate that the person using the same is a licensed practical nurse or a practical nurse.<br /> <br /> Registered Professional Nurse - “Registered professional nursing” shall mean the performance for compensation of any service requiring substantial specialized judgment and skill based on knowledge and application of principles of nursing derived from biological, physical and social sciences, such as responsible supervision of a patient requiring skill in observation of symptoms and reactions and the accurate recording of the facts, or the supervision and teaching of other persons with respect to such principles of nursing, or in the administration of medications and treatments as prescribed by a licensed physician or a licensed dentist, or the application of such nursing procedures as involve understanding of cause and effect in order to safeguard life and health of a patient and others. (Code of WV §30-7-1)<br /> <br /> §30-7-10. Use of titles. - Any person licensed pursuant to this article may use the title “registered nurse” and the abbreviation “R.N.” or the term “nurse.” Except as otherwise provided in article seven-a of this chapter, no other person may assume a title or use abbreviations or any other words, letters, figures, signs, or devices to indicate that the person using the same is a registered professional nurse.<br /> <br /> Responsible - Liable to legal review or in the case of fault to penalties; able to answer for one’s conduct or obligation; able to choose for one’s self right from wrong.<br /> <br /> Unlicensed Assistive - Personnel (UAP) Any unlicensed person, regardless of title, to whom nursing tasks are delegated or assigned.
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