LPN News

Registrants and other stakeholders can contact the Practice Department at the College of Licensed Practical Nurses of Alberta (CLPNA) to receive clarification on Licensed Practical Nurse (LPN) practice.

In Practice Corner, we’ll share some frequently asked questions and our answers.

What Activities Require a Medical Order or Protocol?

LPNs need an order from an authorized practitioner, or to follow a medically approved protocol, for any prescribed intervention. For example, LPNs need a complete medical order from an authorized prescriber, or a medically approved protocol, when administering any medications, including over-the-counter medications such as Tylenol.

LPNs also need an order, or to follow a protocol, when performing any restricted activities.

What Are Restricted Activities?

Restricted activities are high-risk health services defined under the Health Professions Act. LPNs are authorized to perform the restricted activities outlined in the Health Professions Restricted Activity Regulation. The restricted activities that LPNs are authorized to perform, along with any education and supervision requirements, can be found in the Standards of Practice on Restricted Activities, Advanced Practice, and Supervision.

Who Is an Authorized Practitioner?

Before performing a restricted activity, an LPN needs a complete, patient-specific order from an authorized practitioner. To be considered an authorized practitioner, an individual must meet the following requirements:

• Be a member of a regulated profession that is authorized to perform the restricted activity.
• Have the knowledge, skills, and abilities to perform the restricted activity.

In the case of protocols and orders, LPNs are not considered authorized practitioners. Examples of authorized practitioners include physicians and nurse practitioners.

Authorized Prescribers

LPNs also require an order from an authorized prescriber before administering medication to a client, even if the medication administration route is not a restricted activity. An authorized prescriber is a person who is regulated under the Health Professions Act and authorized to prescribe a Schedule 1 drug. See the Medication Management policy for more information.

What Is an LPN’s Role in Implementing Protocols?

While an order is a patient- and procedure-specific set of instructions, a protocol is a pre-defined, medically approved guide for managing certain client needs in the practice environment.

Before implementing a protocol, an LPN is expected to ensure that the protocol is clear and complete. The precise information needed in a protocol may vary slightly depending on the activity being performed. In general, protocols include clearly stated information related to the intervention, the client, the practice environment, the healthcare provider who is performing the intervention, documentation requirements, and expected outcomes.

Example: Suture Protocol

An LPN is implementing a protocol stating that sutures are to be removed five days post-operative. In this case, the LPN needs to ensure that the protocol includes assessment criteria, inclusion and exclusion criteria, and any follow-up directions. The protocol may say to remove alternate sutures and apply Steri-Strips. It might also say to leave the sutures intact and contact the physician if signs of infection are present. Before implementing this protocol, the LPN would visibly assess the wound for uniform closure of the wound edges and absence of draining, redness, and swelling.