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.

Can LPNs Administer Medications via IV Direct Push?

At the CLPNA, we get a lot of questions about whether LPNs can perform certain activities. It’s important to remember that scope of practice is complicated and individual, and the answer to these kinds of questions is not a simple yes or no.

An activity only falls within an LPN’s scope if it is included in their regulatory, employer, and individual scope of practice.

Regulatory Scope of Practice

Administering medications via IV direct push is in the LPN regulatory scope of practice. This activity is listed in the Standards of Practice on Restricted Activities, Advanced Practice, and Supervision. It falls within the restricted activity in Standard 4.

However, just because this activity is listed in these Standards of Practice doesn’t mean that all LPNs can perform it in all situations. Administering medications via IV direct push is a restricted activity. This means that it is a higher risk activity that can only be performed by authorized professionals, such as LPNs, who meet specific requirements. These requirements are listed in Standard 4 of the Standards of Practice on Restricted Activities, Advanced Practice, and Supervision.

If an LPN meets these requirements, there are still other factors to consider.

Employer Scope of Practice

Employer scope of practice defines the LPN role in a specific practice setting through policies, guidelines, and job descriptions. To determine if administering medication via IV direct push is in their employer scope of practice, an LPN should refer to these documents.

Scope of practice is set by the regulator, and employers work within that regulatory scope of practice to define the LPN role in their specific setting. If something is in an LPN’s regulatory scope but not their employer scope, then the LPN can’t perform that activity in that particular setting.

Individual Scope of Practice

LPNs bring their own knowledge, skills, experience, and abilities to every client they see. This is individual scope of practice. For administering medications via IV direct push to be in an LPN’s scope of practice, the LPN needs to have the knowledge, skills, and individual competence to perform this activity safely.

If an activity is in an LPN’s regulatory and employer scope of practice, but they don’t have the individual competence to perform it safely, then the LPN would be expected to pursue training to perform this activity.

Decision Making: The Three-Factor Framework

An activity may fall in LPN scope of practice, but it may not be appropriate for the LPN to perform it under specific circumstances. When considering whether it’s appropriate to administer medications via IV direct push, reflect on the following factors.

• Nurse factors, including an LPN’s knowledge, skills, and abilities and their individual competence.
• Client factors, including age, acuity, comorbidities, potential complications, and predictability of outcomes.
• Environmental factors, including equipment, training, policies, and the support of the health care team.

LPNs should consult with the rest of the client’s care team to ensure safe, quality care is provided.