NURSING COMPETENCIES

NURSING COMPETENCIESFOR LICENSED PRACTICAL NURSESIN MANITOBA463 St. Anne’s RoadWinnipeg, MB R2M 3C9info@clpnm.caT: 204-663-1212TF: 1-877-663-1212

AcknowledgmentThe College of Licensed Practical Nurses of Manitoba would like to acknowledge thededication, passion, and commitment of all those who contributed their knowledge,insight, and expertise in the development of the Nursing Competencies for LicensedPractical Nurses in Manitoba.Contact InformationCollege of Licensed Practical Nurses of Manitoba463 St. Anne’s RoadWinnipeg, ManitobaR2M 3C9Telephone: 204-663-1212Toll Free: 1-877-663-1212Web: www.clpnm.caNursing Competencies for Licensed Practical Nurses in ManitobaUpdated: January 20191

Table of ContentsPurpose . 4How to Interpret this Document . 4Background. 5The Practice Setting . 6The Client . 6The Nurse . 6Assumptions . 7Overview of the Competencies . 91. People-Centred Care. 121.11.21.31.4Communication and Relational Skills . 13Respect, Dignity, and Human Rights . 15Information Sharing and Capacity-Building . 17Partnership with the Client . 192. Collaborative Care . 212.1 Collaboration . 223. Reflective Nursing Practice . 253.1 Critical Thinking . 263.2 Evidence-Based Practice. 283.3 Nursing Process . 304. Knowledge-Based Nursing Practice . 344.1 Pharmacology . 364.2 Inflammation and Wound Healing . 404.3 Genetics . 454.4 Immune System . 474.5 Infection and Communicable Diseases . 514.6 Cancer . 554.7 Fluid, Electrolyte, and Acid-Base Imbalances . 604.8 Preoperative Care . 654.9 Intraoperative Care. 684.10 Postoperative Care . 714.11 Visual and Auditory System . 744.12 Integumentary System . 784.13 Respiratory System . 834.14 Hematological System . 904.15 Cardiovascular System . 944.16 Gastrointestinal System . 994.17 Urinary System . 1054.18 Endocrine System . 1094.19 Female Reproductive System . 1134.20 Male Reproductive System . 1174.21 Nervous System . 1214.22 Musculoskeletal System . 126Nursing Competencies for Licensed Practical Nurses in ManitobaUpdated: January 20192

4.234.244.254.264.274.284.294.304.31End of Life Care . 130Mental Health Nursing . 133Community Health Nursing . 139Maternal Health . 144Neonate Health . 150Pediatric Health . 155Emergency Nursing . 160Nursing Nephrology . 164Nursing Foot Care . 1655. Safe and Ethical Care . 1665.15.25.35.45.5Integration of Professional Standards. 167Documentation and Reporting . 169Risk Management . 171Safety . 173Emergency Preparedness and Disaster Planning . 1776. Leadership . 1796.1 Management and Organizational Leadership . 1806.2 Clinical Leadership . 1826.3 Leadership in Education . 184Glossary of Terms . 187References . 193Nursing Competencies for Licensed Practical Nurses in ManitobaUpdated: January 20193

Nursing Competencies for Licensed Practical Nurses in ManitobaPurposeThis document serves as a reference for Licensed Practical Nurses (LPNs), the public,employers, and other stakeholders about the Practical Nursing profession’s scope ofpractice in Manitoba. It replaces the Competency Profile for Licensed Practical Nurses inManitoba (v. May 2007).The term “scope of practice” refers to the outer range of activities that members of aregulated profession are educated and legally authorized to provide. The legal authorityfor the Practical Nursing profession’s scope of practice is found in Manitoba’s LicensedPractical Nurses Act (the LPN Act).Section 2 of the LPN Act states:The practice of practical nursing is the provision of nursing services for thepurpose of assessing and treating health conditions, promoting health,preventing illness, and assisting individuals, families and groups to achievean optimal state of health.While this scope of practice statement appears broad, readers must be aware that thepractice of the profession is guided, at all times, by the Standards of Practice, Code ofEthics and Practice Directions of the College of Licensed Practical Nurses of Manitoba(CLPNM). All LPNs are accountable for adhering to their professional standards, whichexist to ensure that LPN practice is carried out in a manner that serves and protects thepublic interest.How to Interpret this DocumentThe Standards of Practice for the Practical Nursing profession in Manitoba require thatall LPNs “practice within [their] own level of competence.” Therefore, while thisdocument sets out a range of competencies that fall within the scope of the profession,it must not be interpreted in isolation of other documents that guide and establish limitson LPN practice. Furthermore, this document must not be interpreted as a guide to anyone LPN’s individual scope of competence. All beginning practitioners will demonstratethe entry-to-practice competencies of the profession, which are set out in theEntry-Level Competencies for the Licensed Practical Nurse in Manitoba, 2016. Beyondthose, the competencies of each individual LPN will fall within the outer boundaries oftheir professional scope, but will vary based on the individual’s post-basic education andtraining, employer policies, and experience.Nursing Competencies for Licensed Practical Nurses in ManitobaUpdated: January 20194

Before carrying out any nursing activity described in this document, LPNs must selfassess and accept responsibility for ensuring they have acquired the comprehensiveknowledge, judgment and skill needed to perform the activity safely, appropriately, andin the client’s best interest. Readers who require further details on how to determineappropriate roles for LPNs should refer to Determining Appropriate LPN Practice: AGuide to Decision-Making.Readers are also advised that, while this document generally describes both thetheoretical knowledge and nursing competencies of the Practical Nursing profession inManitoba, it should not be interpreted as an exhaustive list of all the competencies thatmay fall within the full scope of the profession. Health care is dynamic, and as newtechniques, technology, and training opportunities arise, an individual LPN’s knowledgebase and skills may grow to include competencies not listed, while still remainingconsistent with the scope of practice statement of the profession.All competencies listed in this document are transferable across diverse practice settingsand provide the foundation for reasonable and prudent nursing practice. Many of themare also identified as “reserved acts” in section 4 of Manitoba’s Regulated HealthProfessions Act (RHPA). Although the profession is moving towards the RHPA, at thetime of publishing, the Practical Nursing profession continues to be regulated under theLPN Act. Once the profession has completed its transition to the RHPA, the NursingCompetencies may need to be revised for clarity and consistency with the language inthe RHPA. Readers reviewing a printed version of this document are encouraged tocheck the CLPNM website for updates.BackgroundContemporary nursing requires that the LPN possess the theoretical and practicalknowledge for a variety of roles and responsibilities. Scientific advances, technologicaldevelopments, socio-cultural values, ethics, population and demographic changes,political forces, and economic pressures all affect the role of the LPN in Manitoba. Aswell, practice settings continue to change rapidly and new opportunities and challengescontinue to emerge. Whatever the setting, the LPN actively participates in the healthcare team (including the intraprofessional and the interprofessional team) to ensure thebest care and services for each client.The formal education, experience, and ongoing professional development of LPNsenable them to provide health care services to the full extent of the scope of practiceand their individual competencies. The context of practice, as described below, providesthe frame of reference for the practice of the LPN.Nursing Competencies for Licensed Practical Nurses in ManitobaUpdated: January 20195

The Practice SettingThe LPN has a broad range of skills and knowledge for providing nursing care in avariety of health care settings including unpredictable, complex, and unfamiliarenvironments. These settings include, but are not limited to: hospitalsemergency departments and operating roomsdialysisobstetrics and gynecologypediatricspublic healthhome carecommunity health centrescommunity nursing agenciesprivate practices and clinicspersonal care homesoccupational healthphysicians’ officesadult day care centres and private homesschools, child care centres, and children’s campscorrectional facilities, andFirst Nations health centres.The ClientThe “client” is the person or persons with whom the LPN is engaged in a professionaltherapeutic relationship. The LPN recognizes that each client is unique and has complexholistic health needs. The client is a partner in his or her health care delivery and isessential in establishing and reaching health care goals. LPNs care for clients of all agesacross the lifespan, whose health care needs vary in complexity, within stable,unpredictable, complex, and unfamiliar environments. “Client” may refer to anindividual, family, group/aggregate, or community. ”Client” may also include the supportpersons and/or substitute decision-makers for the individual client.The NurseAs of 2010, LPNs in Manitoba graduate from a two-year diploma program. Entry-levelpractical nurses at the beginning of their career are able to provide nursing care in avariety of settings to clients with a range of complex health conditions across thelifespan. They have the theoretical background and practical experience necessary toidentify meaningful patterns and recurrent aspects of many clinical situations, and areable to perform the entry-level competencies safely and confidently.Nursing Competencies for Licensed Practical Nurses in ManitobaUpdated: January 20196