Expansion Of Post Basic Competencies For LPNs

The Newfoundland and Labrador College of Nurses¹ is responsible to set the scope of practice for Licensed Practical Nurses (LPNs). The College supports the expansion of post-basic competencies for LPNs employed in Provincial Health Authorities (PHAs) when the PHA employer follows the College’s required processes identified in this document.

PHA employers must use the College’s required process (outlined in this document) prior to authorizing LPNs to expand their practice to include activities not already within their scope of practice but will be expectations of practice² for LPNs, and that are part of nursing practice for other regulated nurses (e.g., Registered Nurses) in those settings.

Activities previously authorized in PHA settings via an established delegation³ through the College and that are part of nursing practice for other regulated nurses in that setting may now be considered for approval via this process.

Authorization of competencies for LPNs practicing outside of a Health Authority may require a delegation. Non-PHA employers and LPNs are advised to consult the College regarding delegation.

Assumptions

The College required process is supported by the following assumptions:

• The decision to include any activity into the scope of practice of an LPN is in response to an identified client need.
• The responsibility to establish the extent of the scope of practice for LPNs lies with the Newfoundland and Labrador College of Nurses.
• The Nurses Act and the Nurses Regulations provide authority for the College Board to identify requirements for LPN practice.
• The individual LPN is responsible and accountable for their practice.
• The expansion of post-basic competencies build upon the LPNs existing nursing knowledge.
• The PHA employers have resources to identify:
  • best practices;
  • required education;
  • the activities they will authorize, and in what practice areas; and,
  • required supports and resources to safely expand competencies.

The NL College of Nurses Required Process

The College authorizes PHA employers to expand post-basic competencies for LPNs in their employment settings when the PHA employer completes the following steps:

1. Contacts the College to:
   • discuss the proposed expansion;
   • confirm appropriateness, and/or necessity of utilizing the expansion process;
   • identify the anticipated timeline before implementation; and,
   • determine the method for notifying the College when the expansion is implemented.
2. Identifies a process for the submission, review, and approval of expansion of post-basic competency requests within the PHA.
3. Validates there is an identified client need for the competency.
4. Confirms that the competency is not restricted in legislation from inclusion in LPN scope of practice.
5. Confirms that the competency is currently authorized to be performed by other regulated nurses (e.g., registered nurses) in the practice area.
6. Identifies the required education⁴, including theory and practice.
7. Validates that the required education builds on the body of nursing knowledge of the LPN.
8. Identifies a mechanism for the LPN to obtain the required education.
9. Identifies a method to evaluate that the competency has been attained, and/or maintained by the LPN.
10. Identifies required clinical supports (e.g., human, technical).
11. Identifies the plan for the LPN to manage the anticipated and unexpected outcomes of care.
12. Provides authorization and support for the LPN to include the competency into their scope of practice in the employment setting.
13. Identifies the mechanism to evaluate the effectiveness of this intervention being carried out by LPNs.
14. As the final step of implementation, the PHA must notify the College when the new competency has been added to an LPN’s scope of practice via this process. The notification process will be determined in step #1 (e.g., Nursing Professional Practice to e-mail the College’s Practice team to indicate that the competency discussed in #1 above has been implemented).

Questions related to the process to advance post-basic competencies for LPNs should be directed to the College’s Practice Team.