Glossary

• A
• B
• C
• D
• E
• F
• I
• N
• O
• R
• S
• T

A​​​​

​​Acc​ountability

The obligation to answer for the professional, ethical and legal responsibilities of one’s activities and actions.

​Additional education

Structured education (e.g., a workshop, course or program of study) designed so that LPNs can attain the competencies required to carry out a specific activity as part of LPN practice. Additional education builds on the entry-level competencies of LPNs, identifies the competencies expected of LPNs, includes both theory and application to practice and includes an objective, external evaluation of LPNs’ competencies

Appropriate action

Getting more information from the client, consulting with a colleague or manager or questioning the health professional who gave the order.

Assessment​

A process of observation and evaluation of the physical or mental status of an individual. Assessment may involve observing symptoms, but does not include identifying a condition as the cause of these symptoms.

Authorized health professional​​

A health professional who is regulated,  and authorized by the Nurses (Licensed Practical) Regulation to give client-specific orders for the performance of activities listed in section 7. Authorized health professionals are dentists, midwives, naturopaths, physicians, podiatrists, pharmacists, registered nurses, registered psychiatric nurses, and nurse practitioners. An authorized health professional must be registered to practise in British Columbia, except where the client has been transferred from Alberta, Yukon or the Northwest Territories for emergency treatment in British Columbia. In addition, an order for a licensed practical nurse to cast a fracture of a bone may only ever be given by a physician or nurse practitioner who is registered in British Columbia

Available

The LPN has access to an authorized health professional who is:

• a) physically present at the point of care,
• b) not physically present at the point of care, but available within the same location, or
• c) not physically present at the point of care, but available by phone or other electronic means
  

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B​

​Botulinum Toxin Type A products​​

Includes Botox Cosmetic ®, Xeomin ® and Dysport ®. Botulinum Toxin Type A products are considered Schedule I drugs and require a prescription for sale. They are provided to the public by a pharmacist following the diagnosis and professional intervention of a practitioner.

​BCCNM condition

The circumstances under which LPNs may carry out an activity.

BCCNM limit​​​

In the context of LPN scope of practice, what LPNs are limited to doing or what they are not permitted to do.

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C​

Clinical judgment

Processes that rely on critical thinking and an analysis of evidence to reflect the complex, intuitive and conscious thinking strategies that guide nursing decisions.​

Competence

The integration and application of the professional attributes required to perform in a given role, situation or practice setting.

Competencies

The knowledge, skills, attitudes and judgment required to provide safe and ethical care.

Compound

To mix a drug with one or more other ingredients for the purposes of dispensing or administering the drug, or to mix two or more ingredients of a therapeutic diet for the purpose of dispensing or administering the therapeutic diet.

Condition​​​​​

A condition (e.g., hypoglycemia) may result from a known disease (e.g., diabetes) or disorder (e.g., inability to metabolize glucose) or its treatment.

Conservative sharp wound debridement (CSWD)​​​​​

The removal of loose, soft, necrotic tissue at the interface between non-viable and viable tissue using instruments (e.g., scalpel, scissors, curette) to create a clean wound bed.

Critical inquiry​​​​​

A process of purposeful thinking and reflective reasoning whereby practitioners examine ideas, assumptions, principles, conclusions, beliefs and actions in the context of nursing practice.

Critical thinking

An active and purposeful problem-solving process that requires LPNs to advance beyond the performance of skills and interventions to provide the best possible care, based on evidence-informed practice (identifying and prioritizing risks and problems, clarifying and challenging assumptions, using an organized approach to assessment, checking for accuracy and reliability of information, weighing evidence, recognizing inconsistencies, evaluating conclusions and adapting thinking).

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D

Decision support tools

Evidence-based documents used by LPNs and other health care professionals to guide their assessment, diagnosis and treatment of client-specific clinical problems.

Delegation​​​​​

Delegation, under the Health Professions Act, refers to delegation of a restricted activity by one regulated health professional to another regulated health professional. Delegation to regulated health professionals occurs when an activity is within the scope of the delegating professional and outside the scope of the professional receiving the delegation. Before the delegation can occur, BCCNM and the regulatory body of the delegating professional must both agree that the activity is appropriate for delegation to LPNs.​

Dermal fillers

Some dermal fillers are considered to be substances (i.e., Juvederm, Restylane and other hyaluronic acid, polylactic acid and calcium based dermal fillers), while others are Schedule II drugs (i.e., hyaluronic acid and its salts – preparations in concentrations of 5% or more).

Disease​​​​​

Any deviation from, or interruption of, the normal structure or function of any body part, organ or system that is manifested by a characteristic set of symptoms and signs and whose etiology, pathology and prognosis may be known or unknown.

Disorder​​​​​

A disturbance in physical or mental health or functions, malady or dysfunction (i.e., a mild stomach disorder).

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​​E

Emergency exemption

In situations involving imminent risk of death or serious harm that arise unexpectedly, LPNs are ethically obligated to provide the best care they can, given the circumstances and their individual competence. Employers and LPNs should not rely on the emergency exemption when an activity is considered common and expected LPN practice in that setting.

Evidence

Data derived from various sources including research, national guidelines, regulation, policies, consensus statements, expert opinion, historical and experiential information.

Evidence-based (evidence-informed practice)

The identification, evaluation and application of evidence to guide practice decisions.

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​​F

Formal post-basic education​​​​​

Structured education that builds on the entry-level LPN competencies. Formal post-basic education is delivered:

• by an educational institution that teaches a BCCNM-recognized practical nursing education program or equivalent, or
• throu​gh a collaborative arrangement between an employer that employs LPNs in post-basic areas and a school that teaches a BCCNM-recognized practical nursing education program or equivalent

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​​I

Immediately available​​​​​

The LPN has access to an authorized health professional who is physically available at the point of care.

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​​N

Nursing diagnosis​​​​​

A clinical judgment of an individual’s mental or physical condition to determine whether the condition can be ameliorated or resolved by appropriate interventions of the LPN to achieve outcomes for which the LPN is accountable.

​​O

Other supports

BCCNM uses this condition to describe other kinds of supports required to promote safe LPN practice. For example, the condition for taking electrocardiograms reads, “LPNs only take electrocardiograms (ECGs) when a health care professional authorized to read the ECG is immediately available.” Decision support tools (DSTs) may also be a condition set by BCCNM.

​​R

​​S

Scope of practice

The activities that LPNs are educated and authorized to perform as set out in the Nurses (Licensed Practical) Regulation and complemented by BCCNM standards, limits and conditions.

​

Standards​​​​​

Expected behaviours and levels of performance against which actual behaviour and performance can be compared.​

​​T

Team approach​​​​​

When the care needs of a client include activities that are outside LPN scope of practice or the individual competencies of the LPN, the LPN seeks out other members of the health care team to jointly review the client’s care needs and determine how the care needs will be met between them. Where relevant, the registered nurse or registered psychiatric nurse may be the most appropriate team member for the LPN to seek consultation and collaboration with regarding client care needs.

​

Team nursing approach​​​​​

When the nursing care needs of a client include activities that are outside LPN scope of practice or the individual competencies of the LPN, the LPN seeks out the registered nurse or registered psychiatric nurse to jointly review the client’s care needs and determine how the care needs will be met between them.

Tracheostomy care

This includes instilling a substance into the tracheostomy to loosen respiratory secretions, suctioning the tracheostomy, changing tracheostomy ties and changing the tracheostomy cannula.