1.
| Use of restraints |
a. Licensed practical nurses apply restraints only under a client-specific order.
|
| 2. | Take an electrocardiogram (ECG) |
a. Licensed practical nurses take electrocardiograms (ECGs):
i. After successfully completing additional education
ii. When a health care professional authorized to read the ECG is immediately available
b. Licensed practical nurses are not responsible for reading or interpreting ECG results.
|
3.
|
Procedures on tissue
-
Perform wound care except conservative sharps wound debridement
|
a. Licensed practical nurses act under a client-specific order to apply compression dressings, provide negative pressure wound therapy (vacuum assisted closure (VAC), or carry out maggot debridement therapy:
i. If a wound care treatment plan is in place
ii. After successfully completing additional education
iii. By following decision support tools
b. Licensed practical nurses
do not carry out any form of sharps debridement including conservative sharps wound debridement (CSWD).
|
4.
|
Procedures on tissue
Administer a substance
-
Peritoneal dialysis by irrigation
|
a. Licensed practical nurses act under a client-specific order to carry out peritoneal dialysis:
i. For clients with stable or predictable states of health
ii. After successfully completing additional education
|
| 5. |
Venipunctures
-
Collect blood sample or blood donation
|
a. Licensed practical nurses act under a client-specific order and perform phlebotomy:
i. To collect blood samples from clients 14 years of age and older
ii. After successfully completing additional education
iii. By following decision support tools
iv. By using a peripheral evacuated system
|
| 6. |
Venipuncture
-
Establish intravenous (IV) access
|
a. Licensed practical nurses act under a client-specific order to establish intravenous (IV) access:
i. After successfully attaining competence as part of an entry-level practical nursing program, OR
b. Licensed practical nurses establish IV access using a short peripheral device
|
7.
| Apply a cast for a fracture of a bone |
a. Licensed practical nurses apply casts for a fracture of a bone:
i. Under a client-specific order only from a medical practitioner or nurse practitioner
ii. After successfully completing additional education
|
| 8. | Care of clients under anesthesia and sedation |
a. Licensed practical nurses work in a
team nursing approach to provide care and monitor clients under:
i. General anesthesia
ii. Intrathecal anesthesia
iii. Epidural anesthesia
iv. Procedural sedation
|
| 9. |
Administer a substance by inhalation
-
Do not administer nitrous oxide
-
Do not monitor clients taking nitrous oxide
-
Do not administer substances for purposes of anesthesia or procedural sedation
|
a. Licensed practical nurses
do not:
i. Administer nitrous oxide
ii. Monitor clients taking nitrous oxide
iii. Administer inhaled substances for purposes of anaesthesia or procedural (conscious) sedation
|
10.
|
Administer a substance by mechanical ventilation
-
Care of clients requiring mechanical ventilation
-
Care of clients who use continuous positive airway pressure (CPAP) or bi-level positive airway pressure (BPAP)
|
b. Licensed practical nurses provide care to clients who use continuous positive airway pressure (CPAP) or bi-level positive airway pressure (BPAP) after successfully completing additional education.
|
11.
|
Administer a substance by irrigation
-
Irrigate percutaneous tubes
|
a. Licensed practical nurses act under a client-specific order and irrigate only those percutaneous tubes they are permitted to irrigate at entry-level.
|
12.
|
Administer a substance by irrigation
|
a. Licensed practical nurses
do not irrigate ostomies.
|
13.
|
Administer a substance by parenteral instillation
-
Administer parenteral solutions
-
Change IV bags
|
a. Licensed practical nurses act under a client-specific order to:
|
| 14. | Do not access central venous access devices (CVAD) or central venous lines2 |
a. Licensed practical nurses
do not access central venous access devices or central venous lines
|
15.
|
Administer a substance by parenteral instillation
-
Care of clients receiving blood or blood products
-
Do not start transfusions of blood or blood products
|
a. Licensed practical nurses monitor clients receiving blood or blood products in a team nursing approach.
b. Licensed practical nurses
do not start transfusions of blood or blood products
|
16.
|
Administer a substance by parenteral instillation
-
Do not administer radiopaque dyes by parenteral instillation
|
a. Licensed practical nurses
do not administer radiopaque dyes via parenteral instillation.
|
17.
|
Therapeutic diets
-
Care of clients receiving parenteral nutrition
-
Do not start or monitor parenteral nutrition
|
a. Licensed practical nurses provide care to clients receiving parenteral nutrition in a team nursing approach
b. Licensed practical nurses
do not start or monitor parenteral nutrition
|
18.
|
Insertion into the external ear canal
-
Do not insert a curette or other instrument into the external ear canal
|
a. Licensed practical nurses
do not insert a curette or other instrument into the external ear canal to remove:
i. Foreign objects
ii. Earwax
|
19.
|
Insertion beyond the point in the nasal passages where they normally narrow
-
Suction nasal passages beyond the point where they normally narrow
-
Do not insert nasogastric (NG) or orgastric tubes (OG)
-
Do not carry out nasopharyngeal washes
|
a. Licensed practical nurses act under a client-specific order to suction the nasal passages beyond the point where they normally narrow after successfully completing additional education.
b. Licensed practical nurses
do not:
i. Insert nasogastric (NG) tubes
ii. Insert orogastric (OG) tubes
iii. Carry out nasopharyngeal washes
|
20.
|
Insertion beyond the pharynx
-
Do not insert laryngeal mask airways (LMAs)
|
a. Licensed practical nurses
do not insert laryngeal mask airways (LMAs).
|
| 21. |
Insertion beyond the opening of the urethra
-
Insert coude tip catheters
|
a. Licensed practical nurses act under a client-specific order to insert coude tip catheters after successfully completing additional education.
|
22.
|
Insertion beyond the labia majora:
-
Insert or remove pessaries
-
Do not insert vaginal packing
-
Do not carry out pelvic or vaginal examinations
-
Do not perform cervical cancer screening
-
Do not insert an instrument, substance or medication into or beyond the cervix
|
a. Licensed practical nurses act under a client-specific order to remove vaginal packing after successfully completing additional education.
b. Licensed practical nurses act under a client-specific order to insert or remove pessaries after successfully completing additional education.
c. Licensed practical nurses
do not:
i. Insert vaginal packing
ii. Carry out pelvic or vaginal examinations
iii. Perform cervical cancer screening
iv. Insert an instrument, substance or medication into or beyond the cervix
|
23.
|
Insertion beyond the anal verge
-
Insert tubes into the rectum
-
Do not insert or advance scopes for rectal/bowel examination
|
a. Licensed practical nurses act under a client-specific order to insert tubes into the rectum:
i. After successfully completing additional education
ii. By following decision support tools
b. Licensed practical nurses
do not insert or advance scopes for rectal/bowel examinations.
|
24.
|
Insertion into an artificial opening into the body
-
Care of clients with tracheostomies
|
a. Licensed practical nurses provide tracheostomy care to clients:
i. With well-established tracheostomies
ii. After successfully completing additional education
|
25.
|
Insertion into an artificial opening into the body:
-
Digital examination of colostomies
-
Insert Suprapubic catheters
-
Insert Gastrostomy tubes
|
a. Licensed practical nurses act under a client-specific order to carry out digital examination of colostomies for clients:
i. With well-established stomas
ii. After successfully completing additional education
b. Licensed practical nurses act under a client-specific order to insert suprapubic catheters and gastrostomy tubes for clients:
i. With well-established stomas
ii. After successfully completing additional education
|
26.
|
Hazardous energy
-
Do not perform fetal heart monitoring
|
a. Licensed practical nurses
do not carry out fetal heart monitoring using an intermittent Doppler, or any related activities including palpation and auscultation of the fetal heart.
|
27.
|
Hazardous energy
-
Do not apply electricity to destroy tissue or affect the heart or nervous system (except AED)
|
a. Licensed practical nurses
do not apply electricity to destroy tissue or affect the heart or nervous system except automated external defibrillators (AEDs)
|
28.
|
Hazardous energy
-
Do not apply laser that cuts or destroys tissue
|
|
29.
|
Administer a Schedule I, IA or II drug
|
a. Licensed practical nurses act under a client-specific order to administer IV medications:
i. After successfully attaining competence as part of an entry-level practical nursing program, OR
ii. After successfully completing additional education
b. Licensed practical nurses change IV bags containing potassium chloride (KCL) infusing via peripheral access (not central venous access), when the IV bag has been compounded commercially or by a pharmacy
|
30.
|
Administer a Schedule I, IA or II drug
Administer a substance by inhalation
-
Do not administer medications or substances by these routes or these purposes
|
a. Licensed practical nurses
do not administer:
i. IV push medications
ii. IV medications through a central venous access device
iii. Intrathecal medications
iv. Intra-osseous medications
v. Medications into epidural spaces
vi. Medications into perineural spaces
vii. Inhaled substances or medications for purposes of anaesthesia or procedural sedation
|
31.
|
Compound, dispense, administer a Schedule I, IA or II drug
|
a. Licensed practical nurses treat respiratory distress in a known asthmatic:
i. In a
team approach
ii. Under a client-specific order
|
| 32. |
Compound, dispense, administer a Schedule II drug to treat a disease or disorder
(Drug Schedules Regulation)
|
a. Licensed practical nurses compound, dispense or administer Schedule II drugs to treat a disease or disorder under a client-specific order.
|
33.
|
Allergies
-
Do not conduct challenge testing or desensitizing treatments
for allergies
|
a. Licensed practical nurses
do not administer allergy challenge testing or desensitization treatments.
|
34.
| Medical aesthetics3
|
a. Licensed practical nurses successfully complete additional education before providing medical aesthetic procedures.
b. Licensed practical nurses administering injectable drugs or substances or implantable devices for medical aesthetic purposes only do so:
i. Under a client-specific order, and
ii. when the ordering health professional, or another health professional who has assumed responsibility for the care of the client, is present within the facility when the procedure is being performed and immediately available for consultation.
|