What Is the LPN Scope of Practice? Overview and FAQ
All nursing professionals are responsible for carrying out duties that align with their level of education, licensure, and training. While licensed practical/vocational nurses (LPNs/LVNs) and registered nurses (RNs) often appear to have similar duties, distinguishing between the RN and LPN scope of practice is integral to protecting patient safety and meeting standards of care.
If you’re a facility leader who wants to enforce proper care protocols among your staff, you may be wondering, what is the scope of practice for an LPN? In this article, we’ll provide an overview and answer frequently asked questions about how LPN duties are defined and carried out.
What Is the LPN Scope of Practice?
The LPN scope of practice is a regulatory framework defining what LPNs can and cannot do based on their education and training. Broadly speaking, “LPN” (also referred to as “LVN” in some states) is a license that qualifies a nurse to provide patient care under the direction of an RN.
The LPN/LVN scope of practice is more limited than that of an RN because the education needed to receive RN licensure is longer and more comprehensive. Defining scope of practice ensures that nurses across all levels are qualified to deliver the care that they’re assigned, which helps keep patients safe from harm.
Does the Scope of Practice for LPNs Differ by State?
Each board of nursing has authority over how nursing professionals practice, which means there are differences in the LPN scope of practice by state. For example, LPNs in Illinois can’t infuse through central lines, whereas LPNs in Arizona can only infuse through central lines using the “piggyback” method.
Beyond state-by-state differences, facilities may also implement policies that influence how LPNs can practice. For instance, some facilities might limit what information LPNs can chart or have different guidelines on what tasks must be supervised by an RN.
LPN vs. RN Scope of Practice: How Do They Differ?
The exact differences between the LPN and RN scope of practice depend on each state’s laws. In some states like Texas, there are fewer differences between what LVNs and RNs can do compared to more restrictive states like California (both states use the term “LVN”). Below is a chart that outlines general comparisons between the LVN/LPN and RN scope of practice. However, you should check your state’s Nurse Practice Act (NPA) to get more specific information.
| Works under RNs or APRNs
Conducts focused assessments to help determine a patient’s health status Administers oral medications (and in some states, IV medications with supervision) Aids with ambulating, bathing, toileting, and other comfort care tasks Collects and charts vital signs/blood sugar levels |
Works relatively independently
Conducts more comprehensive assessments on patient conditions and symptoms Administers both oral and IV medications without supervision Works closely with physicians and other healthcare professionals to formulate a patient’s treatment plan Conducts a wider range of diagnostic tests |
What Happens if LPNs Step Outside of Their Scope of Practice?
LPNs who step outside of their scope of practice can face a range of potential consequences. If LPNs carry out duties they’re neither trained nor qualified to do, this can endanger their patients and compromise care quality. This can also subject LPNs to legal penalties (as determined by their state’s board of nursing), which may include anything from educational remediation to license revocation.
How Can Facilities Help LPNs Stay Within Their Scope of Practice?
While nursing professionals are expected to be familiar with their own scope of practice, facilities are also responsible for shaping care protocols and enforcing compliance with state laws. Facility leaders can follow these three tips to help LPNs/LVNs stay within their scope of practice.
1. Provide Ongoing Staff Training
It’s important to provide continuous training to help your nursing staff understand all federal-, state-, and facility-level policies impacting their practice. This training might involve going over common scenarios that LPNs might encounter on the job, and how they should handle these scenarios to stay within their scope of practice.
For example, you might ask your LPNs what they would do if an RN asked them to administer IV push medications. A case-scenario like this allows you and your staff to discuss different actions that fall inside and outside of the LPN scope of practice. Medication administration laws can look quite different from state to state, so your LPNs should understand how various modes of administration should be coordinated with the rest of the care team.
2. Foster a Collegial Environment
Fostering strong teamwork is an important way to encourage staff members to openly communicate with each other. To avoid preventable practice violations, LPNs must feel comfortable speaking up when they’re inappropriately delegated duties. Similarly, RNs must feel confident in providing guidance to LPNs who require supervision.
3. Stay Informed of Your State’s Nurse Practice Act
To shape and enforce appropriate institutional care protocols, facility leaders should familiarize themselves with their state’s Nurse Practice Act. The NPA is a set of state-specific laws that govern everything related to nursing practice. These laws also change based on evolving standards of care, so it’s important to stay updated through your state’s board of nursing.
Get More Resources About the LPN Scope of Practice and Beyond
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