STANDARDS FOR APPLYING THE NURSING PROCESS FOR LPNs

[This section covers the OAC 4723-4-08, Standards for applying the nursing process as a licensed practical nurse.]

Licensed practical nurses contribute to the nursing process as set forth in division (F) of section 4723.01 of the ORC and rules of the board. The steps of the nursing process are cyclic in nature, so that the patient’s changing status affects the action of nurses as they assess, plan, implement, and evaluate the patient’s status. The LPN collaborates, as appropriate, with the patient, family, significant others, and members of the healthcare team. The licensed practical nurse shall use the following standards for applying the nursing process.

Assessment

The LPN contributes to the nursing assessment of a patient. In an accurate and timely manner, LPNs collect and document objective and subjective data related to the patient’s health status and report the data to the directing registered nurse or healthcare provider and other members of the healthcare team. The subsequent analysis and reporting of this data, however, is not part of the LPN’s role.

Planning

In an accurate and timely manner, LPNs contribute to the development, maintenance, or modification of the nursing component of the care plan and communicate the nursing care plan and all modifications of the plan to appropriate members of the healthcare team.

Implementation

Licensed practical nurses implement the nursing care plan in an accurate and timely manner as follows:

  • Provide nursing interventions
  • Collect and report patient data as directed
  • Administer medications and treatments prescribed by an authorized individual
  • Provide basic nursing care at the direction of an RN, advanced practice registered nurse, or licensed physician, dentist, optometrist, chiropractor, or podiatrist
  • Collaborate with other nurses and members of the healthcare team
  • Delegate tasks as directed, including medication administration, only in accordance with the OAC (see also “Delegation Guidelines” earlier in this course)

Evaluation

In an accurate and timely manner, LPNs contribute to the evaluation of patient responses to nursing interventions, document and communicate patient responses to nursing interventions to appropriate members of the healthcare team, and contribute to the reassessment of the patient’s health status and to modifications of any aspect of the nursing plan of care.

CASE
Nursing Process

Jeffrey is a registered nurse supervising the care for Henry, who is one day post total hip replacement. This afternoon Judy, the LPN providing direct nursing care for Henry, reports to Jeffrey that Henry has developed chest discomfort and shortness of breath. Jeffrey gathers data that includes Henry’s appearance, vital signs, oxygen saturation, heart sounds, and breath sounds (assessment).

Jeffrey then analyzes the collected data, determines Henry has impaired gas exchange (nursing diagnosis), and contacts the physician to report the findings and receive direction (analysis/reporting).

Jeffrey and Judy together modify Henry’s nursing care plan to reflect the care required of a patient with either a suspected pulmonary or fat embolism. The plan includes measures to address Henry’s chest discomfort and shortness of breath (planning). They communicate the plan of care to other members of the nursing team.

Judy carries out the modified nursing care plan, providing direct patient care and/or delegating nursing tasks to other members of the team as needed (implementation).

Throughout the day, Jeffrey and Judy evaluate Henry’s status frequently and find that Henry’s chest discomfort and dyspnea are improving (evaluation).