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Page modified February 02, 2010

RPNs conducting admission assessments

Q

Can RPNs conduct an admission assessment on a client arriving at a hospital unit?

A

Yes, RPNs can conduct an admission assessment at a hospital, but an RN must conduct triage assessments in the emergency room.
The Entry-to-Practice Competencies for Ontario Registered Practical Nurses states:

That for a client assignment to be appropriate for an entry level RPN, the acuity of the client’s condition must be determined by an individual with the competence to assess the client and make this determination.

This assessment can be accomplished by analyzing the client information supplied by the department or health care professional transferring the client. The person receiving this information should be a nurse who has the knowledge, skill and judgment to determine the client’s care needs and the complexity of the health care needs based on the client’s demographics, signs and symptoms, and/or the diagnosis. The category of nurse that’s required to do the assessment is determined by considering the client’ health condition, including the stability, predictability and the complexity of the client care needs, the depth of assessment data required, and the variety of techniques and methods required to conduct a complete assessment.

RPNs can practise autonomously (in the absence of an RN to consult with and with no support tools such as standardized assessment forms) and can be expected to complete a client assessment when it has been determined that the client’s health condition is stable, that the client’s health status can be predicted or anticipated, and when the client health outcomes can reasonably be expected to follow an anticipated path.

The RN practises autonomously in all situations including those in which the client’s health status is unstable and fluctuating and there are atypical responses. Often the care is complex and requires frequent assessment, interventions and modifications. Interventions may have unpredictable outcomes and/or risks. RNs have the knowledge and education to conduct a more in-depth assessment using a variety of techniques and methods (for example, breast examination and triage).

During an admission assessment, an RPN may determine that the client’s care needs and/or the client requires a more in-depth assessment. Then, the RPN would consult with an RN and transfer the care or aspects of the care to the RN. A system must be in place to ensure that an RPN can immediately transfer care to an RN when the RPN determines that client care needs are beyond her or his competencies. In addition to an RN to consult with, resources that support RPN practice include guidelines and/or standardized assessment forms which can be individualized, and educational resources, including opportunities for ongoing learning and competency development specific to the client population.

Last Updated Feb. 2010

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