Editing Infection Control and Safety (section)

== Scope of Practice Notes ==

'''Registered nurse.''' Performs the initial and ongoing assessment, formulates the plan of care, initiates precautions based on clinical suspicion, evaluates outcomes, and provides the required assessment before and during restraint use. In many jurisdictions a trained registered nurse may perform the one-hour face-to-face evaluation for violent restraint. The RN delegates tasks but never delegates assessment, teaching, evaluation, or the nursing judgment about an unstable patient.

'''Licensed practical or vocational nurse.''' Works under the direction of the registered nurse or provider. Applies standard and transmission-based precautions, performs sterile procedures such as urinary catheterization and dressing changes within state scope, reinforces teaching that the RN initiated, monitors stable patients, applies and monitors restraints per policy, and contributes data to the plan of care. The LPN or LVN must '''report changes and concerns to the RN''': new fever, new confusion, worsening drainage, a suspected exposure, an infection control breach, and any patient whose condition is deteriorating. Scope varies by state, so the state nurse practice act governs.

'''Unlicensed assistive personnel.''' May perform hand hygiene, apply PPE, transport, position, ambulate, take vital signs, and report findings, but may not assess, teach, or determine precautions.