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Iowa Board of Nursing Meeting Review

October 11, 2022

During the Iowa Board of Nursing meeting on October 5, 2022, representatives from Iowa Healthcare Association and Leading Age Iowa discussed broadening the scope of practice for LPNs to include admission assessments and change of condition assessments. It was suggested to the board that a one-time course be offered to current LPNs to enhance their assessment skills and certify them in these assessments, similar to the current IV certification course. Discussion included the current workforce shortage and the statistic that only 10% of RNs work in long-term care. Based on the current regulation pertaining to RN coverage of a minimum of 8 consecutive hours per day (leaving a potential of 16 hours per day without an RN at the facility) and the importance of the initial assessment occurring upon the resident arriving at the facility, adding admission assessments to the LPN scope of practice would ensure better continuity of care. Additionally, LPNs can conduct routine assessments, and most LPNs are doing a fine job.

The questions from the Board as the issues were explored consisted of the following:-  Would the course involve practical experience with direct supervision to complete? If admission assessment is mandated to be completed within 24 hours and facilities are required to staff an RN for 8 hours out of the 24 hours, is this a hardship? Have there been issues where hospitals cannot discharge patients due to the lack of an RN at the facility for the initial assessment? Are we getting to the point where we just need to support the nurses to get their RN? If expanding the scope of practice, how do we differentiate between the two, and is higher education just a better service to the public? A question we will get is that long-term care facilities are not the only ones hurting. If we do this course for long-term care, the next ask will be for a different facility. The Board agreed that, if approved, there would need to be a committee that would work together and comes back with recommendations on what the course would look like. They discussed the length of employment as an LPN before the course, or perhaps the course being mandated within a specific time period into employment, much like the LPN supervisory course in long-term care.  The board approved a motion to pursue this action further by establishing a committee to present further class details.

From the Desk of Laurissa Martin LPN, LNHA Litigation Nurse


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