Md. Code Regs. 10.27.10.03

Current through Register Vol. 51, No. 22, November 1, 2024

Section 10.27.10.03 - Standards of Professional Performance

A. Quality of Care.

(1) The LPN shall participate in evaluating the quality and effectiveness of nursing practice.

(2) Measurement Criteria. The LPN shall:

(a) Assist in collecting quality data; and

(b) Participate in activities related to implementing changes designed to improve care.

B. Performance Appraisal.

(1) The LPN shall be accountable for evaluating the LPN's own nursing practice on a regular basis in relation to:

(a) Relevant professional practice standards; and

(b) Relevant statutes and regulations governing licensed practical nursing.

(2) Measurement Criteria.

(a) The LPN shall:

(i) Participate in peer review as appropriate; and

(ii) As necessary, seek guidance, support, education, and supervision.

(b) The LPN shall demonstrate knowledge of and comply with:

(i) Relevant professional practice standards;

(ii) Relevant statutes and regulations governing licensed practical nursing; and

(iii) The policies and procedures of the practice setting.

C. Education.

(1) The LPN shall acquire and maintain current knowledge and continued competency in the practice of licensed practical nursing.

(2) Measurement Criteria. The LPN shall:

(a) Participate in educational opportunities and experiences to maintain professional competence; and

(b) Obtain knowledge and skills appropriate to the practice setting.

D. Collegiality.

(1) The LPN shall support the professional development of the:

(a) Licensed practical nurse;

(b) Certified nursing assistant;

(c) Certified medication technician; and

(d) Unlicensed personnel.

(2) Measurement Criteria.

(a) As directed by the RN, the LPN shall share knowledge and skills with:

(i) Other LPNs;

(ii) Certified nursing assistants;

(iii) Certified medication technicians; and

(iv) Unlicensed personnel.

(b) The LPN shall contribute to a supportive and healthy work environment.

E. Ethics.

(1) The licensed practical nurse's decisions and actions shall reflect ethical principles.

(2) Measurement Criteria. The LPN shall:

(a) Comply with the Code of Ethics as described in COMAR 10.27.19;

(b) Maintain client confidentiality within legal and regulatory standards;

(c) Act as a client advocate;

(d) Deliver care in a nonjudgmental and nondiscriminatory manner that is sensitive to client diversity;

(e) Deliver care in a manner that preserves the client's;

(i) Autonomy;

(ii) Dignity; and

(iii) Rights;

(f) Communicate with the RN regarding potential ethical issues; and

(g) Communicate to the RN, observations of actions by other health care providers which may jeopardize the client's safety and well being.

F. Collaboration.

(1) The LPN shall participate with the client, the client's family, significant others, the RN, and other health care providers in providing care.

(2) Measurement Criteria. The LPN shall:

(a) Participate with the client, the client's family, significant others, the RN, and other health care providers by contributing to:

(i) The development of overall goals;

(ii) The nursing plan of care; and

(iii) Decisions related to care and the delivery of services; and

(b) Consult with the RN and other health care providers regarding client care.

G. Research.

(1) The LPN shall support research activities appropriate to the LPN's scope of practice.

(2) Measurement Criteria. The LPN shall:

(a) Have knowledge of the client's rights related to research;

(b) Participate in data collection; and,

(c) Utilize established facility-approved research protocols.

H. Resource Utilization.

(1) The LPN shall consider factors related to safety and cost when participating in client care planning and implementing client care.

(2) Measurement Criteria. The LPN shall:

(a) Assist the client, the client's family, and significant others to identify:

(i) Unmet client needs; and

(ii) Potential services to meet any unmet needs; and

(b) Evaluate factors related to client safety and cost when performing or delegating client care.

I. Delegation and Supervision.

(1) When the delegation does not jeopardize the client's welfare, the LPN may delegate nursing tasks to a certified nursing assistant, medication technician, or an unlicensed person who is competent to perform those acts or tasks.

(2) Measurement Criteria.

(a) When delegating a nursing task, the LPN shall assess the client and determine that the delegation is consistent with COMAR 10.27.11.

(b) When delegating nursing tasks, the LPN shall assess the capabilities, experience, and competency of a person working under the LPN's supervision.

(c) When delegating a nursing task to a certified nursing assistant, medication technician, or an unlicensed person, the LPN shall:

(i) Instruct;

(ii) Direct;

(iii) Regularly evaluate the performance of nursing tasks by the certified nursing assistant, medication technician, or unlicensed person;

(iv) Rectify a situation in which the certified nursing assistant, medication technician, or unlicensed person under the LPN's supervision is performing nursing tasks that are inconsistent with generally accepted professional standards and notify the registered nurse leader of the nursing team; and

(v) Prohibit the continued performance of the certified nursing assistant, medication technician, or unlicensed person who is performing the delegated nursing task or tasks incompetently and notify the registered nurse leader of the nursing team.

J. Refusal.

(1) The LPN has the right and the responsibility to refuse to perform, or delegate nursing acts.

(2) Measurement Criteria.

(a) The LPN has the right and responsibility to refuse to perform a nursing act which is beyond the parameters of the LPN's:

(i) Education;

(ii) Capabilities;

(iii) Clinical competency; and

(iv) Scope of practice.

(b) The LPN shall obtain appropriate education, training, and supervision as required to perform nursing functions which are within the LPN's scope of practice but are beyond the parameters of the licensee's clinical competency.

(c) The LPN has the right to refuse to accept responsibility and accountability for supervising, monitoring, instructing, or evaluating a certified nursing assistant, certified medication technician, or an unlicensed person performing a nursing task that has not been delegated by that licensee.

Md. Code Regs. 10.27.10.03

Regulation .03 amended effective October 25, 1993 (20:21 Md. R. 1655)
Regulations .03 adopted effective May 2, 2011 (38:9 Md. R. 553)