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Appendix C. RN Nursing Skills for Possible Delegation (continued)

  Nursing Student—4 Year BSN program Nursing Student—2 year Program Respiratory Therapy Student Respiratory Therapist

Orthopedics

Record/describe

       

 - Circulation checks

x Year 3 x Semester 2    

 - Gait

x Year 3 x Semester 2    

 - Range of motion

x Year 3 x Semester 2    

 - Skin

x Year 3 x Semester 2    

Care of a patient with:

       

 - Cast

x Year 3 x Semester 2    

 - Prosthesis/Amputation

x Year 3 x Semester 2    

 - Pinned fractures

x Year 3 x Semester 2    

 - Splints

x Year 3 x Semester 2    

 - Pressure relief devices

x Year 3 x Semester 2    

 - Total hip replacement

x Year 3 x Semester 2    

 - Total knee replacement

x Year 3 x Semester 2    

Hoyer lift

x Year 3 x Semester 2    

Gastrointestinal

Record/describe:

       

 - Bowel sounds

x Year 3 x Semester 2    

 - Fluid balance

x Year 3 x Semester 2    

 - Nutritional status

x Year 3 x Semester 2    

Care of a patient with:

       

 - Bowel obstruction

x Year 3 x Semester 2    

 - GI bleed

x Year 3

x Semester 4

   

 - Hepatitis

x Year 3 x Semester 2    

 - NG tube care and feedings

x Year 3 x Semester 2    

 - Colostomy

x Year 3 x Semester 2    

 - Gastronomy tube and feedings

x Year 3 x Semester 4    

Medications:

       

 - Antiemetics

x Year 3      

 - Antispasmodic

x Year 3      

Genitourinary

Insertion of Foley catheter:

  x Semester 2    

 - Male

x Year 3      

 - Female

x Year 3      

Care of a patient with:

       

 - Acute renal failure

x Year 3 x Semester 2    

 - Peritoneal lavage

No

x Semester 2, if have experience    

 - Urinary tract infection

x Year 3 x Semester 2    

 - Ileostomy

x Year 3 x Semester 2    

 - Nephrostomy tube

x Year 3 x Semester 2    

 - GU irrigation

x Year 3 x Semester 2    

 - Suprapubic tube

x Year 3 x Semester 4    

Endocrine

Record/describe

       

 - S/S hyperglycermia

x Year 3 x Semester 2    

 - S/S hypoglycemia

x Year 3 x Semester 2    

Blood glucose monitoring

       

 - Electronic monitoring device

x Year 3 x Semester 2    

 - Finger stick

x Year 3 x Semester 2    

Care of a patient with:

       

 - Diabetic ketoacidosis

x Year 4 x Semester 4    

Medications

       

 - Insulin

x Year 3 -SC only

x Semester 2, with instructor supervision

   

 - Oral hypoglycemics

x Year 3

x Semester 2, with instructor supervision

   

Infectious Disease

Care of a patient with:

       

 - Fever

x Year 3 x Semester 2    

 - Isolation

x Year 3 x Semester 2    

 - AIDS

x Year 3

x Semester 4, but depends on clinical experience

   

Medications/IV Therapy

Medication calculation

x Year 3

x Semester 2, simple ones

   

Reconstitution

x Year 3, with direct supervision

x Semester 2    

Oral administration

x Year 3 x Semester 2    

Eye administration

x Year 3 x Semester 2    

IM administration

x Year 3 x Semester 2    

SQ administration

x Year 3 x Semester 2    

Rectal administration

x Year 3 x Semester 2    

Starting IVs

No

     

IV medication administration

With restrictions

After school

   

Drawing venous blood

x Year 4 from central line

After school

   

Care of a patient with:

       

 - Broviac/Hichman line

x Year 3 x Semester 4    

 - Groshong

x Year 3 x Semester 4    

 - PICC

x Year 3 x Semester 4    

 - Portacath

x Year 3 x Semester 4    

Pumps

x Year 3 x Semester 2    

Total Parenteral Nutrition

x Year 3 x Semester 4    

*The nurse practice act in each State would have to be reviewed for any legal limitations imposed on LPNs.
Sources: Check list items identified/selected from several sample medical surgical and long-term care skills checklists found at:

  • http://www.professionalnurse.com/download/skills_medsurg.pdf
  • http://www.dblhealthcare.com/forms/medical-surgical-nursing-skills-checklist.htm
  • http://www.musc.edu/nursing/student_life/SkillsCheckList1.pdf

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