Licensed practical nurses (LPNs) are important members of the healthcare team in both acute-care hospitals and long-term facilities. In both areas they may work with RNs and nursing assistants, while in long-term facilities they may also assume leadership roles. No matter where they practice LPNs can have a big impact on the quality of care patients receive.

LPN Practice

Each state governs the practice of nursing and determines the scope of practice for LPNs. In all states, however, the role of the LPN is typically that of a bedside nurse. However, in long-term facilities, many LPNs are shift or team leaders, supervising the practice of the nursing assistants who perform direct caregiving. LPNs are not considered an independent practitioner and must work under the supervision of a physician or RN. Most LPNs work in long-term facilities, followed by hospitals, doctors’ offices and home health. One way an LPN can help ensure and improve the quality in the work setting is to be thoroughly familiar with what the scope of practice is at the medical facility. This helps ensure the LPN will only perform tasks for which they are properly trained.

Individual Practice

Holding oneself to a high standard of practice has a big impact on quality. This begins with getting the most out of one’s education and taking every possible opportunity to learn more. As with any technical skill, nursing takes practice. Long hours in the lab translate into skillful patient care at the bedside. An LPN can ask experienced nurses to teach you, or they can volunteer for the difficult assignments. At the end of the shift, an LPN should spend a few minutes thinking of what they might have done differently to be better at their work.

Supervision

In long-term care, LPNs often have supervisory responsibilities. In addition to overseeing the work of nursing assistants and other LPNs, supervision means building a cohesive team. These are skills not usually taught in nursing school. Attend continuing education courses and spend time observing other supervising nurses to learn the skills you need. As a supervisor, they do less of the work themselves. This means they need to be able to work through others by using influence, teaching, being a good role model and occasionally through disciplinary action.

Team Work

No one in the nursing field works alone, especially in long term care. Building good relationships with other nurses and medical staff such as physical therapists, respiratory therapists and lab techs improves team work. Doctors who berate a night nurse for calling with a valid concern are less likely to get another call even when the patient is deteriorating. However, good teamwork improves communication and quality.

Improving Systems

No matter how high the level of the practice, the LPN works within a system. They need to pay attention to possibilities for improvement. Bring ideas and changes to the attention of the supervisor and ask for more supplies that will help patients. A minor expense can result in quicker recovery, prevent patient complications like blood clots and pneumonia, and help prevent injury to patients and staff alike.

Quality Assurance

All health care organizations have quality goals. These vary from preventing medication errors to outcomes including control of blood sugars in diabetic patients. An LPN should educate themselves on the organization’s goals. In many cases, achieving these goals means the organization saves money, is rewarded by insurance companies or Medicare and Medicaid. Many organizations share bonuses with staff as an incentive to improve care. When the LPN and their fellow staff members participate in quality initiatives, everyone can benefit.

Teaching Other Staff

Healthcare is a system that changes constantly. New medications, new techniques and new equipment show up all the time. Quality care means that everyone has to be taught about how to use these new things. As an LPN in a supervisory role, teaching new staff and long-term workers is one of their responsibilities. Set up an in-service for new equipment and give people some hands-on experience. Develop a poster or flyer on new medications or techniques. Offer a small incentive like a home-baked cake for the winner of a quiz on new procedures. During the work day, be on the alert for opportunities to teach coworkers better techniques, explain complicated procedures or answer questions.

Mentoring New Graduates

All new graduates benefit from a mentor. Nursing research indicates that the process from novice to expert nurse takes about five years. A new graduate needs teaching, support and help to improve their practice. Explain procedures, allowing plenty of time for questions. Supervise the new graduate in the performance of basic tasks until both of you feel confident of correct performance. Don’t forget emotional support. The new graduate may be fresh out of school who has never worked in the healthcare field. Nursing is an emotionally demanding job and an LPN’s colleague needs to talk through the feelings of losing a patient, having to cause pain with a dressing change and similar experiences.

Becoming an Expert

Because the healthcare system is so complex, no one can know or teach it all. We can all learn from expert practitioners. Perhaps an LPN is particularly skillful at certain psycho-motor tasks like starting an intravenous line. The LPN should share their knowledge with others through volunteering to do an in-service or working with a new nurse to perform tasks in which they have experience and expertise. Perhaps they had a sibling with a chronic disease, their insight on family dynamics can be helpful to their colleagues, especially new graduates. Team up with another nurse to role play handling a difficult patient.

Learn from Mistakes

There is no such thing as a nurse who has never made a mistake. Rather than berating oneself, the LPN should examine what happened and consider what they can do differently to prevent the same or a similar mistake in the future, it’s a teaching moment. One organization looking at medication errors discovered that the most common reason for their occurrence was interruptions. Nurses who made errors were more likely to go on from the point at which they were interrupted instead of starting over and re-checking the basics of the “five rights” – the right patient, the right drug, the right dose, the right route and the right time.

Final Thoughts

Quality in the nursing field doesn’t just happen. It takes time, attention, proper teaching, practice, constant learning and team effort. The strategies outlined above can help an LPN improve their own practice and help teach or lead their team mates to do the same.

Did learning about the role of an LPN in improving the quality care for patients? Are you ready to become a licensed practical nurse? Gwinnett Institute in Orlando offers a Practical Nursing diploma program that trains LPN students for positions delivering basic bedside care to patients.  The Practical Nursing diploma program provides the didactic and skills training needed to take the NCLEX-PN examination.*  

*While Gwinnett Institute provides test preparation and review assistance to college students, it cannot guarantee any college student will be able to take or pass any type of licensure exam.  College students must be mindful throughout their entire school training program that licensure is a required pre-requisite for employment as a nurse and to diligently prepare themselves to meet this important requirement.

Contact us today to learn more about becoming a license practical nurse at Gwinnett College.