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Restricted activities that do not require an order

Part 4: Restricted activities for licensed practical nurses

While LPNs are solely responsible and accountable for their own practice, they have a greater responsibility when acting within autonomous scope of practice (performing an activity without an order from an authorized he​alth professional). LPNs follow BCCNM's Standards for Acting within Autonomous Scope of Practice.

LPNs may choose to seek advice from other health professionals even when an activity, such as making a nursing diagnosis or performing wound care, is within the Autonomous Scope of Practice of LPNs. 

​Restricted Activities without Orders​

​Limits and Conditions
​1.

M​​​ake a nursing diagnosis identifying a condition as the cause of the signs and symptoms of an individual

None​

​2.

For the purpose of wound care other than the suturing of skin lacerations, perform a procedure on tissue below the dermis or below the surface of a mucous membrane

LPNs ​provide wound care if a wound care treatment plan is in place.

LPNs probe, irrigate, pack or dress a tunneled wound:

  1. ​​​​After successfully completing additional educ​​ation

  2. ​​By following decision support tools

LPNs do not carry out any form of sharps debridement including conservativ​​​e sharps wound debridement (CSWD).

​LPNs donot carry out Ankle-brachial Index (ABI) testing.

​3.

​Administer, by inhalation, oxygen or humidified air

LPNs administer oxygen:

  1. After successfully completing additional education

  2. By foll​​owing decision support tools

​4.

​Administer purified protein derivative by injection, for the purpose of tuberculosis screening

LPNs administer purified protein derivative (PPD), read the results and refer the client to an appropriate health professional when they:

  1. Possess the competencies for tuberculosis (TB) screening established by BC Centre for Disease Control (BCCDC)

  2. Foll​ow BCCDC decision support tools

​5.

For the purpose of assessment, put an instrument, or a device or finger

  • into the external ear canal up to the ear drum, or​
  • ​​​beyond the anal verge
None
​6.

​For the purpose of assessment or ameliorating or resolving a condition, put an instrument or a device or finger beyond the anal verge

LPNs carry out digital stimulation or rectal disimpaction:

  1. After ​successfully completing additional education

  2. By fol​​lowing decision support tools

​7.

​For the purpose of providing personal hygiene care, put an instrument or a device, hand or finger beyond the labia majora up to the cervix

None
​8.

​​Put a wearable hearing instrument, or part of or an accessory for it, into the external ear canal, up to the eardrum

None
​9.

​For the purpose of assessment, put into the external ear canal, up to the eardrum, air that is under pressure no greater than the pressure created by the use of an otoscope

LPNs assess the integrity of the eardrum after successfully comple​​​ting additional education

Also see Restricted Activities with Orders #9 and #16

​10.

Apply ultrasound for the purpose of

  • bladder volume measurement; or
  • ​​blood flow monitoring
LPNs donot carry out Ankle-br​achial Index (ABI) testing.
​11.

​​Apply electricity using an automatic external defibrillator, for the purpose of defibrillation in the course of emergency cardiac care

LPNs use automated external defibrillators (AEDs) after successfully completing a cardiopulmonary resuscitation (CPR) course for health professionals that includes the use of AEDs.
​12.

​​Apply electricity for the purpose of providing transcutaneous electrical nerve stimulation

LPNs apply transcutaneous electrical nerve stimulation (TENS) after successfully co​​mpleting additional education

.

​13.

​In respect of a drug specified in Schedule I or II of the Drug Schedules Regulation, compound, dispense or administer the drug by any method for the purpose of treating anaphylaxis

LPNs diagnose and treat anaphylaxis:

  1. ​After successfully completing additional education
  2. By following decision support tools

LPNs only administer Epinephrine to treat anaphylaxis.

​14.

​In respect of a drug specified in Schedule I or II of the Drug Schedules Regulation, compound, dispense or administer the drug by any method for the purpose of treating respiratory distress in a known asthmatic

LPNs treat respiratory distress in a known asthmatic:

  1. In​ a team ​​approach

  2. With an order f​rom an authorized health professional

​15.

​​In respect of a drug specified in Schedule I or II of the Drug Schedules Regulation compound, dispense or administer the drug by any method for the purpose of treating hypoglycemia

LPNs who make a nursing diagnosis and treat hypo​glycemia follow decision support tools

LPNs only administer Glucagon to treat hypoglycemia.

16.​

In respect of a drug specified in Schedule I or II of the Drug Schedules Regulation compound, dispense or administer the drug by any method for the purpose of preventing disease using immunoprophyla​ctic agents

LPNs who autonomously compound or administer immunoprophylactic agents, in a team ​approach, for the purpose of preventing disease:

  1. ​Administer immunoprophylactic agents to clients four years of age ​and older who have stable or predictable states of health.

  2. Successfully complete the additional education established by the BC Centre for Disease Control.

  3. ​Follow the decision support tools established by the BC Centre for Disease Control.

  4. LPNs do not autonomously com​​pound, dispense or administer immunoprophylactic agents for the purpose of preventing disease in travelers.

​17.

​​In respect of a drug specified in Schedule II of the Drug Schedules Regulation compound, dispense or administer the drug orally, intranasally or by intramuscular or subcutaneous injection​

LPNs compound, dispense or administer Schedule II drugs to treat a disease or disorder with an or​​​​​der from an authorized health professional.

LPNs do not carry out sclerotherapy.​


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