Standards of Practice and Educational Competencies of Graduates of Practical/Vocational Nursing Programs

The following Standards of Practice and Educational Competencies of Graduates of Practical/Vocational Nursing Programs were approved and adopted by the National Association for Practical Nurse Education and Service, Inc. (NAPNES) Board of Directors on May 6, 2007, and are being reproduced with the express written consent of NAPNES.

These standards and competencies are intended to better define the range of capabilities, responsibilities, rights, and relationships to other healthcare providers for scope and content of practical/vocational nursing education programs. The guidelines will assist:

• Educators in development, implementation, and evaluation of practical, vocational nursing curricula.
• Students in understanding expectations of their competencies upon completion of the educational program.
• Prospective employers in appropriate utilization of the practical/vocational nurse.
• Consumers in understanding the scope of practice and level of responsibility of the practical/vocational nurse.

Professional Behaviors

Professional behaviors, within the scope of nursing practice for a practical/vocational nurse, are characterized by adherence to standards of care, accountability for one’s own actions and behaviors, and use of legal and ethical principles in nursing practice. Professionalism includes a commitment to nursing and a concern for others demonstrated by an attitude of caring. Professionalism also involves participation in lifelong self-development activities to enhance and maintain current knowledge and skills for continuing competency in the practice of nursing for the licensed practical/vocational nurse (LP/VN), as well as individual, group, community, and societal endeavors to improve healthcare.

Upon completion of the practical/vocational nursing program the graduate will display the following program outcome:

Demonstrate professional behaviors of accountability and professionalism according to the legal and ethical standards for a competent LP/VN.

Competencies which demonstrate this outcome has been attained:

1. Comply with the ethical, legal, and regulatory frameworks of nursing and the scope of practice as outlined in the LP/VN Practice Act of the specific state in which licensed.
2. Utilize educational opportunities for lifelong learning and maintenance of competence.
3. Identify personal capabilities and consider career mobility options.
4. Identify own LP/VN strengths and limitations for the purpose of improving nursing performance.
5. Demonstrate accountability for nursing care provided by self and/or directed to others.
6. Function as an advocate for the healthcare consumer, maintaining confidentiality as required.
7. Identify the impact of economic, political, social, cultural, spiritual, and demographic forces on the role of the LP/VN in the delivery of healthcare.
8. Serve as a positive role model within healthcare settings and the community.
9. Participate as a member of a practical/vocational nursing organization.

Communication

Communication is defined as the process by which information is exchanged between individuals verbally, non-verbally, and/or in writing or through information technology. Communication abilities are integral and essential to the nursing process. Those who are included in the nursing process are the LP/VN and other members of the nursing and healthcare team, client, and significant support person(s). Effective communication demonstrates caring, compassion, and cultural awareness, and is directed toward promoting positive outcomes and establishing a trusting relationship.

Upon completion of the practical/vocational nursing program the graduate will display the following program outcome:

Effectively communicate with patients, significant support person(s), and members of the interdisciplinary healthcare team incorporating interpersonal and therapeutic communication skills.

Competencies which demonstrate this outcome has been attained:

1. Utilize effective communication skills when interacting with clients, significant others, and members of the interdisciplinary healthcare team.
2. Communicate relevant, accurate, and complete information.
3. Report to appropriate healthcare personnel and document assessments, interventions, and progress or impediments toward achieving client outcomes.
4. Maintain organizational and client confidentiality.
5. Utilize information technology to support and communicate the planning and provision of client care.
6. Utilize appropriate channels of communication.

Assessment

Assessment is the collection and processing of relevant data for the purpose of appraising the client’s health status. Assessment provides a holistic view of the client which includes physical, developmental, emotional, psychosocial, cultural, spiritual, and functional status. Assessment involves the collection of information from multiple sources to provide the foundation for nursing care. Initial assessment provides the baseline for future comparisons in order to individualize client care. Ongoing assessment is required to meet the client’s changing needs.

Upon completion of the practical/vocational nursing program, the graduate will display the following program outcome:

Collect holistic assessment data from multiple sources, communicate the data to appropriate healthcare providers, and evaluate client responses to interventions.

Competencies which demonstrate this outcome has been attained:

1. Assess data related to basic physical, developmental, spiritual, cultural, functional, and psychosocial needs of the client.
2. Collect data within established protocols and guidelines from various sources including client interviews, observations/measurements, healthcare team members, family, significant other(s), and review of health records.
3. Assess data related to the client’s health status, identify impediments to client progress, and evaluate response to interventions.
4. Document data collection, assessment, and communicate findings to appropriate member/s of the healthcare team.

Planning

Planning encompasses the collection of health status information, the use of multiple methods to access information, and the analysis and integration of knowledge and information to formulate nursing care plans and care actions. The nursing care plan provides direction for individualized care, and assures the delivery of accurate, safe care through a definitive pathway that promotes the clients and supports progress toward positive outcomes.

Upon completion of the practical/vocational nursing program, the graduate will display the following program outcome:

Collaborate with the registered nurse or other members of the healthcare team to organize and incorporate assessment data to plan/revise patient care and actions based on established nursing diagnoses, nursing protocols, and assessment and evaluation data.

Competencies which demonstrate this outcome has been attained:

1. Utilize knowledge of normal values to identify deviation in health status to plan care.
2. Contribute to formulation of a nursing care plan for clients with non-complex conditions and in a stable state, in consultation with the registered nurse, and as appropriate in collaboration with the client or support person(s) as well as members of the interdisciplinary healthcare team using established nursing diagnoses and nursing protocols.
3. Prioritize nursing care needs of clients.
4. Assist in the review and revision of nursing care plans with the registered nurse to meet the changing needs of clients.
5. Modify client care as indicated by the evaluation of stated outcomes.
6. Provide information to client about aspects of the care plan within the LP/VN scope of practice.
7. Refer client as appropriate to other members of the healthcare team about care outside the scope of practice of the LP/VN.

Caring Interventions

Caring interventions are those nursing behaviors and actions that assist clients and significant others in meeting their needs and the identified outcomes of the plan of care. These interventions are based on knowledge of the natural sciences, behavioral sciences, and past nursing experiences. Caring is the “being with” and “doing for” that assists clients to achieve the desired outcomes. Caring behaviors are nurturing, protective, compassionate, and person-centered. Caring creates an environment of hope and trust where client choices related to cultural, religious, and spiritual values, beliefs, and lifestyles are respected.

Upon completion of the practical/vocational nursing program, the graduate will display the following program outcome:

Demonstrate a caring and empathic approach to the safe, therapeutic, and individualized care of each client.

Competencies which demonstrate this outcome has been attained:

1. Provide and promote the client’s dignity.
2. Identify and honor the emotional, cultural, religious, and spiritual influences on the client’s health.
3. Demonstrate caring behaviors toward the client and significant support person(s).
4. Provide competent, safe, therapeutic, and individualized nursing care in a variety of settings.
5. Provide a safe physical and psychosocial environment for the client and significant other(s).
6. Implement the prescribed care regimen within the legal, ethical, and regulatory framework of practical/vocational nursing practice.
7. Assist the client and significant support person(s) to cope with and adapt to stressful events and changes in health status.
8. Assist the client and significant other(s) to achieve optimum comfort and functioning.
9. Instruct client regarding individualized health needs in keeping with the licensed practical/vocational nurse's knowledge, competence, and scope of practice.
10. Recognize client’s right to access information and refer requests to appropriate person(s).
11. Act in an advocacy role to protect client rights.

Managing

Managing care is the effective use of human, physical, financial, and technological resources to achieve the client-identified outcomes while supporting organizational outcomes. The LP/VN manages care through the processes of planning, organizing, and directing.

Upon completion of the practical/vocational nursing program, the graduate will display the following program outcome:

Implement patient care, at the direction of a registered nurse, licensed physician, or dentist through performance of nursing interventions or directing aspects of care, as appropriate, to unlicensed assistive personnel (UAP).

Competencies which demonstrate this outcome has been attained:

1. Assist in the coordination and implementation of an individualized plan of care for clients and significant support person(s).
2. Direct aspects of client care to qualified UAPs commensurate with abilities and level of preparation and consistent with the state’s legal and regulatory framework for the scope of practice for the LP/VN.
3. Supervise and evaluate the activities of UAPs and other personnel as appropriate within the state’s legal and regulatory framework for the scope of practice for the LP/VN as well as facility policy.
4. Maintain accountability for outcomes of care directed to qualified UAPs.
5. Organize nursing activities in a meaningful and cost effective manner when providing nursing care for individuals or groups.
6. Assist the client and significant support person(s) to access available resources and services.
7. Demonstrate competence with current technologies.
8. Function within the defined scope of practice for the LP/VN in the healthcare delivery system at the direction of a registered nurse, licensed physician, or dentist.