Administration of Medication by LPN

Administration of medication by Licensed Practical Nurses in long term care

ARNPEI supports the administration of medication by LPNs in long term care settings to patients/residents whose health care needs are not expected to change greatly from day to day.  RNs on PEI have traditionally been responsible for the administration of medications and this change in scope represents a shift in care delivery on PEI.

ARNPEI believes that the administration of medication is a complex nursing skill and is not simply “the passing of pills”. Assessment of patients/residents is fundamental to competent nursing care and a RN is required for critical assessment. Because the RN has a greater depth and breadth of knowledge, critical assessment, implementation and evaluation of the patient/resident must be done by a RN.

RNs with expertise in medication administration within long term care must play an active role in the change process, be involved in the restructuring of care delivery within long term care (including care coordination, program designing, decision-making, care planning, evaluation, resident/family care, etc.) and have input into identified indicators of success.

To achieve a successful change process, openness and transparency of communication is essential. A well-defined implementation plan with sufficient flexibility to accommodate adaptation as issues arise is necessary, and policies for medication administration and procedure for documentation including steps to follow upon discovery of an error must be in place.

Patient/resident safety is paramount in all areas of nursing care. The person administering the medication is expected to be knowledgeable about the health history and status of the patient/resident who receives the drugs, the expected actions, side effects and contraindications of the drug(s) being administered. The person also has a duty to question a medication order that is unclear or unusual. Without this information a patient/resident would be at risk.

To ensure efficient service delivery and role adaptation, RNs may require further educational preparation in system management, such as problem-solving, conflict resolution, leadership. Education in clinical areas such as physical assessment, poly-pharmacy issues, pain management, cognitive impairment, dementia/depression screening, risk assessment/mobility/injury prevention will also be necessary.

ARNPEI supports changes to scope of practice where the primary purpose is improvement in health for the patient/resident; ARNPEI does not support change for financial gains or when there is no evidence of best practice.

Approved by Council - February 2009