Polsinelli PC. In California, Polsinelli LLP
Nursing Care Delivery: Current
Challenges, Future Opportunities
Leading Age
2015 Senior Living Conference September 29, 2015 – 9:00 am
Licensure & Scope of Practice:
The Nurse Practice Act
225 ILCS 65 / et seq.
The Illinois Nurse Practice Act of 2007
establishes the licensure requirements for
nurses in Illinois
Also establishes grounds for disciplinary action
against nurses and against persons engaging in
unauthorized practice of nursing
real challenges. real answers.SM
Licensure & Scope of Practice: LPN
Licensed Practical Nurse (LPN)
– An LPN is a person who is specifically prepared in the
techniques of nursing, who is a graduate of an
accredited school of practical nursing and whose
qualifications have been examined by a state board of
nursing, and who has been legally authorized to
practice as a licensed practical nurse must have the
basic nursing knowledge, judgment, and skill acquired
by means of completion of an approved practical
nursing education program.
real challenges. real answers.SM
Licensure & Scope of Practice: LPN
Licensed Practical Nurse (LPN)
– Practical nursing includes assisting in the
nursing process as delegated by and under
the direction of a registered professional
nurse (“RN”).
– The practical nurse may also work under the direction
of a licensed physician, dentist, podiatrist, or other
health care professional
.real challenges. real answers.SM
Licensure & Scope of Practice: LPN
68 Ill. Admin Code 1300.250
1. Collecting data and collaborating in the assessment of the health status of a patient.
2. Collaborating in the development and modification of the registered professional nurse's or advanced practice nurse's comprehensive nursing plan of care for all types of patients.
3. Implementing aspects of the plan of care as delegated.
4. Participating in health teaching and counseling to promote, attain, and maintain the optimum health level of patients, as delegated.
5. Serving as an advocate for the patient by communicating and collaborating with other health service personnel, as delegated.
6. Participating in the evaluation of patient responses to interventions.
7. Communicating and collaborating with other health care professionals, as delegated.
Licensure & Scope of Practice: RN
– A RN is specifically prepared and promotes health
and the prevention of disease, and helps patients
cope with illness.
– When providing direct patient care they observe,
assess and record symptoms, reactions and
progress, assist physicians during surgery,
treatments, and examinations, administer
medications and help in the convalescence and
rehabilitation of patients.
real challenges. real answers.SM
Licensure & Scope of Practice: RN
RN Scope of Practice 68 Ill. Admin Code 1300.360
All aspects of LPN scope of practice, plus:
1. The comprehensive nursing assessment of the health status of patients that addresses changes to patient conditions.
2. The development of a plan of nursing care to be integrated within the patient-centered health care plan that establishes nursing diagnoses, and setting goals to meet identified health care needs, determining nursing interventions, and implementation of nursing care through the execution of nursing strategies and regimens ordered or prescribed by authorized healthcare professionals.
3. The administration of medication or delegation of medication administration to licensed practical nurses.
4. Delegation of nursing interventions to implement the plan of care.
5. The provision for the maintenance of safe and effective nursing care rendered directly or through delegation.
real challenges. real answers.SM
Licensure & Scope of Practice: RN
6. Providing input into the development of policies and procedures to support patient safety.
7. Advocating for patients.
8. The evaluation of responses to interventions and the effectiveness of the plan of care.
9. Communicating and collaborating with other health care professionals.
10.The procurement and application of new knowledge and technologies.
11.The provision of health education and counseling.
12.Participating in development of policies, procedures and systems to support patient safety.
real challenges. real answers.SM
Comparing the duties of LPN v. RN
Common LPN Duties
Monitoring patients' vitals
Administering basic patient care, like changing bandages
Helping patients bathe and dress
Maintaining patients' health records
Reporting patients' status to RNs and doctors
Common RN Duties
All of the LPN tasks, plus the following:
Administering medications and treatments
Establishing and maintaining patients' care plans
Performing diagnostic tests and analyzing results
Operating and monitoring medical equipment
Teaching patients and their families how to manage illnesses and injuries
Licensure & Scope of Practice: APN
Advanced Practice Nurse(APN)
– An APN is licensed as a registered professional nurse and meets the requirements for licensure as an advanced practice nurse.
– An APN cares for patients by using advanced diagnostic skills, the results of diagnostic tests and procedures ordered by the advanced practice nurse, a physician assistant, a dentist, a podiatrist, or a physician, and professional judgment to initiate and coordinate the care of patient.
– An APN can also order diagnostic tests, prescribe medications and drugs, and administer medications and drugs.
– Categories include certified nurse midwife (CNM), certified nurse practitioner (CNP), certified registered nurse anesthetist (CRNA), and certified clinical nurse specialist (CNS).
– Must have a Written Collaborative Agreement to describe working relationship with collaborating physician
real challenges. real answers.SM
Licensure & Scope of Practice: APN
APN Scope of Practice (68 Ill. Admin Code 1300.440)
Includes all aspects of LPN and RN scope of practice, plus:
1. Advanced nursing patient assessment and diagnosis.
2. Ordering diagnostic and therapeutic tests and procedures, performing those tests and procedures when using health care equipment, and interpreting and using the results of diagnostic and therapeutic tests and procedures ordered by the advanced practice nurse or another health care professional.
3. Ordering treatments, ordering or applying appropriate medical devices, and using nursing, medical, therapeutic, and corrective measures to treat illness and improve health status.
real challenges. real answers.SM
Licensure & Scope of Practice: APN
4. Providing palliative and end-of-life care.
5. Providing advanced counseling, patient education, health education, and patient advocacy.
6. Prescriptive authority as defined in Section 65-40 of the Act.
7. Delegating selected nursing activities or tasks to a licensed practical nurse, a registered professional nurse, or other personnel.
real challenges. real answers.SM
Discussion Points
Handling medications
Staffing
MMAI/ICP – Managed Care expectations
and care coordination
Resident acuity
Data tracking
Medical vs. Social model
QUESTIONS?
Meredith A. Duncan
Polsinelli, P.C.
161 N. Clark St., Ste. 4200
Chicago, Illinois 60601
312-873-3602
mduncan@polsinelli.com
real challenges. real answers.SM
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