Section R4-19-401. Standards Related to Licensed Practical Nurse Scope of Practice

A.      A licensed practical nurse shall engage in practical nursing as defined in A.R.S. § 32-1601 only under the supervision of a registered nurse or licensed physician.

B.       A LPN’s nursing practice is limited to those activities for which the LPN has been prepared through basic practical nurs- ing education in accordance with A.R.S. § 32-1637(1) and those additional skills that are obtained through subsequent nursing education and within the scope of practice of a LPN as determined by the Board.

C.      A LPN shall:

1.        Practice within the legal boundaries of practical nursing within the scope of practice authorized by A.R.S. Title 32, Chapter 15 and 4 A.A.C.19;

2.        Demonstrate honesty and integrity;

3.        Base nursing decisions on nursing knowledge and skills, the needs of clients, and licensed practical nursing stan- dards;

4.        Accept responsibility for individual nursing actions, deci- sions, and behavior in the course of practical nursing practice.

5.        Maintain competence through ongoing learning and application of knowledge in practical nursing practice.

6.        Protect confidential information unless obligated by law to disclose the information;

7.        Report unprofessional conduct, as defined in A.R.S. § 32- 1601(22) and further specified in R4-19-403 and R4-19- 814, to the Board;

8.        Respect a client’s rights, concerns, decisions, and dignity;

9.        Maintain professional boundaries; and

10.     Respect a client’s property and the property of others.

D.      In participating in the nursing process and implementing client care across the lifespan, a LPN shall:

1.        Contribute to the assessment of the health status of clients by:

a.         Recognizing client characteristics that may affect the client’s health status;

b.        Gathering and recording assessment data;

c.         Demonstrating attentiveness by observing, monitor- ing, and reporting signs, symptoms, and changes in client condition in an ongoing manner to the super- vising registered nurse or physician;

2.        Contribute to the development and modification of the plan of care by:

a.         Planning episodic nursing care for a client whose condition is stable or predictable;

b.        Assisting the registered nurse or supervising physi- cian in identification of client needs and goals; and

c.         Determining priorities of care together with the supervising registered nurse or physician;

3.        Implement aspects of a client’s care consistent with the LPN scope of practice in a timely and accurate manner including:

a.         Following nurse and physician orders and seeking clarification of orders when needed;

b.        Administering treatments, medications, and proce- dures;

c.         Attending to client and family concerns or requests;

d.        Providing health information to clients as directed by the supervising RN or physician or according to an established educational plan;

e.         Promoting a safe client environment;

f.         Communicating relevant and timely client informa- tion with other health team members regarding:

i.         Client status and progress,

ii.        Client response or lack of response to therapies,

iii.      Significant changes in client condition, and

iv.       Client needs and special requests, and

g.        Documenting the nursing care the LPN provided;

4.        Contribute to evaluation of the plan of care by:

a.         Gathering, observing, recording, and communicat- ing client responses to nursing interventions; and

b.        Modifying the plan of care in collaboration with a registered nurse based on an analysis of client responses.

E.       A LPN assigns and delegates  nursing activities. The LPN shall:

1.        Assign nursing care within the LPN scope of practice to other LPNs;

2.        Delegate nursing tasks to unlicensed assistive personnel (UAPs). In maintaining accountability for the delegation, the LPN shall ensure that the:

a.         UAP has the education, legal authority, and demon- strated competency to perform the delegated task;

b.        Tasks delegated are consistent with the UAP’s job description and can be safely performed according to clear, exact, and unchanging directions;

c.         Results of the task are reasonably predictable;

d.        Task does not require assessment, interpretation, or independent decision making during its performance or at completion;

e.         Selected client and circumstances of the delegation are such that delegation of the task poses minimal risk to the client and the consequences of performing the task improperly are not life-threatening;

f.         LPN provides clear directions and guidelines regard- ing the delegated task or, for routine tasks on stable clients, verifies that the UAP follows each written facility policy or procedure when performing the delegated task;

g.        LPN provides supervision and feedback to the UAP; and

h.        LPN observes and communicates the outcomes of the delegated task.

Historical Note

Former Section III, Part II; Amended effective February 20, 1980 (Supp. 80-1). Former Section R4-19-42 renum- bered as Section R4-19-401 (Supp. 86-1). Section repealed, new Section adopted effective July 19, 1995 (Supp. 95-3). Amended by final rulemaking at 14 A.A.R.

4621, effective January 31, 2009 (Supp. 08-4). Subsec- tion (C)(7) amended at request of Board, Office File No.

M11-423, filed November 18, 2011 (Supp. 11-4). Pursu- ant to authority of A.R.S. § 41-1011(C), Laws 2012, Ch. 152, § 1, provides for A.R.S. references to be corrected to reflect the renumbering of definitions. Therefore the

A.R.S. citation in subsection (C)(7) was updated. Agency request filed July 12, 2012, Office File No. M12-242

(Supp. 12-3).