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Supply, Demand, and Use of Licensed Practical Nurses
 

Appendix C

C1.  Restrictiveness Scale Scores Sorted by Most Restrictive

 

Review 1

Review 2

Review 3

Restrictiveness
Final

Iowa

4

4

3

4

Virgin Islands

4

4

4

4

Alaska

3

3

2

3

Arizona

4

3

3

3

Arkansas

3

3

3

3

California

4

3

3

3

Colorado

2

3

3

3

Illinois

3

3

3

3

Kansas

4

3

3

3

Maine

4

3

3

3

Nebraska

3

3

3

3

Utah

3

3

3

3

Washington, D.C.

4

3

3

3

Alabama

2

2

2

2

Connecticut

2

2

3

2

Delaware

2

2

3

2

Georgia

1

2

2

2

Idaho

1

2

2

2

Kentucky

1

2

2

2

Maryland

1

2

2

2

Mississippi

1

2

2

2

Missouri

2

2

3

2

Montana

1

2

2

2

Nevada

2

2

2

2

New Hampshire

1

2

2

2

New York

1

2

2

2

North Dakota

1

2

2

2

Ohio

3

2

2

2

Oregon

2

2

2

2

Pennsylvania

2

2

2

2

South Carolina

3

2

2

2

South Dakota

2

2

3

2

Tennessee

2

2

2

2

Virginia

2

2

2

2

West Virginia

1

2

2

2

Wisconsin

2

1

2

2

Wyoming

2

2

3

2

Florida

1

1

1

1

Hawaii

1

1

1

1

Indiana

1

1

1

1

Louisiana

1

1

1

1

Massachusetts

2

1

1

1

Michigan

2

1

1

1

Minnesota

1

1

1

1

New Jersey

1

1

1

1

New Mexico

1

1

2

1

North Carolina

1

1

1

1

Oklahoma

1

1

1

1

Rhode Island

1

1

1

1

Texas

1

1

1

1

Vermont

1

1

2

1

Washington

1

1

1

1

C2.  Specificity Scale Scores Sorted by Most Specific

 

Review 1

Review 2

Review 3

Specificity
Final

California

4

4

4

4

Idaho

4

4

4

4

Iowa

4

4

4

4

Kansas

4

4

3

4

Maine

4

3

4

4

Montana

3

4

4

4

Nebraska

4

4

4

4

New Jersey

3

4

4

4

Ohio

4

4

4

4

Pennsylvania

3

4

4

4

South Carolina

4

4

3

4

South Dakota

3

4

4

4

Alaska

4

3

3

3

Illinois

4

3

3

3

Mississippi

2

3

3

3

Nevada

4

3

3

3

New Hampshire

1

3

3

3

Oregon

3

3

2

3

Alabama

3

2

2

2

Arkansas

2

2

2

2

Colorado

1

2

2

2

Delaware

3

2

2

2

Kentucky

1

2

2

2

Louisiana

1

2

2

2

Missouri

1

2

2

2

New Mexico

1

2

2

2

New York

1

2

2

2

North Carolina

1

2

2

2

North Dakota

1

2

2

2

Rhode Island

1

2

2

2

Tennessee

1

2

2

2

Utah

2

2

2

2

Vermont

1

2

2

2

Washington

1

2

2

2

Washington, D.C.

1

2

2

2

Wisconsin

2

2

2

2

Wyoming

1

2

2

2

Virgin Islands

1

2

2

2

Arizona

1

1

1

1

Connecticut

2

1

1

1

Florida

1

1

1

1

Georgia

1

1

2

1

Hawaii

1

1

1

1

Indiana

1

1

2

1

Maryland

1

1

1

1

Massachusetts

2

1

1

1

Michigan

1

1

1

1

Minnesota

1

1

1

1

Oklahoma

1

1

1

1

Texas

1

1

1

1

Virginia

1

1

1

1

West Virginia

1

1

1

1

C3.  LPN Scopes of Practice

Scope of Practice

State

Tubes

Dressings

Nursing Care Planning

Supervisors

IV meds

Cancer agents

Central lines

Blood

Hyperal

Venus blood draw

Arterial blood draws

Insert IV

Insertion

Maintenance

Changes

Reinforcement

Documentation

Assessment

Data collection

Observation

Verbal and phone orders

Documentation co-signed

Teaching

Standardized Procedures/ Expanded practice

Restrictive

Specific

Other Procedures

Alabama

RN, MD

x

    

Alaska

x

x

x

x

no

RN, MD, Dentist

x

    

Arizona

x

x

x

x

  
   

Arkansas

x*

no

RN, MD, Dentist, APN
   

California

x*

x

x*

x

x

x

x

RN, MD

4

4

Colorado

x*

no

x*

no

x

x

no

x

x

RN,MD,APN,Dentist, Podiatrist

x

3

3

Connecticut

x*

x*
 
   

Delaware

x

x*

x

x

  
 

1

Florida

x

RN,MD,DO, Podiatrist,dentist
 

1

Georgia

x

x

x

  
 

1

Hawaii

x

x

  
 

1

Idaho

x

no

x*

x

x

x*

x

x

x

x

x

x

x

RN,MD,Dentist

x

2

4

Illinois

x

no

x

no

x

x

x

x

x

RN,MD,Dentist

x

3

3

Indiana

RN,MD,Dentist,Chiropractor,

Optometrist,Podiatrist

1

1

Iowa

x*

no

x

x*

x

x*

x

x

x

  

x

4

4

Kansas

x*

no

no

no

x*

x*

x*

x

RN

3

4

Kentucky

x*
 
   

Louisiana

x

x

x

x

x

x

x

x

x

x

RN,MD,Optometrist,Dentist,

Psychologist

x

1

2

Maine

x*

no

x

x*

x*

x

x

no

x

x

  

3

3

Maryland

x

x*
 
   

Massachusetts

x

x

x

x

  

x
 

2

Michigan

x*

no
 
 

1

Minnesota

x
 
 

1

Mississippi

x*

no

x*

no

x

x

x

RN,MD,Dentist

3

3

Missouri

x*

RN,MD
 

2

Montana

x

no

no

no

no

x

x

x

x

x

RN,MD,Dentist, OD,Podiatrist

x

2

2

Nebraska

x*

no

no

no

no

x*

no

x

x

x

x

RN

x

4

3

Nevada

x*

no

no

no

x

x

x

x

x

x

x

  

x

3

3

New Hampshire

x*

x

x

RN,MD,ARNP,Dentist
 

2

New Jersey

x

x

x

  
 

2

New Mexico

x

x

x
 
 

2

New York

x*

no

x*

x

x

  

x
 

2

North Carolina

x

x*

x

x

  

x
 

1

North Dakota

x

x

x

  

x
 

1

Ohio

x*

x

x

RN,MD,Dentist,Optometrist,Podiatrist

x
   

Oklahoma

x
 
 

1

Oregon

x

x

  

x
   

Pennsylvania

x*

no

no

x

x
 

x

3

3

Rhode Island

x
 
   

South Carolina

x*

x*

x*

x/*

x*

x*

x

x

  

4

5

South Dakota

x

no

x*

no

x

x

x

RN,MD

no

x

3

3

Tennessee

x

x

  
 

1

Texas

x*

x*

x*

x*

x

x

x

  

2

2

Utah

x*

x

x

RN,MD
 

2

Vermont

x

x

RN,MD,APRN,Dentist
 

1

Virginia

x*
 
 

1

Washington

x*

x*

x*

x*

x*

x

x

x

  

3

3

Washington, D.C.

x

x*

x

x

x

  
 

2

West Virginia

x*

x

x

  

x

x
 

1

Wisconsin

x

x

RN,MD,Podiatrist,Dentist,Optometrist

x
 

1

Wyoming

x*

x

x

RN,MD,Dentist
 

1

* with additional education
x = written
Y = verbal
non-specific-specific =1-5
unrestrictive-restrictive=1-5 (with 1 being the least and 5 being the most)

C4.  Model for Categorizing Scopes of Practice

Restrictive and Specific Scale Scoring Instructions

As demonstrated by the Web information, telephone interviews of the Boards, key informant interviews, and focus groups, please make the following judgments:

As a relative value, on a scale of 1-4, with 1 being the least restrictive and 4 being the most restrictive, categorize (by circling) each State’s LPN/LPN scope of practice.  Restrictive is defined as allowing or not allowing a level of autonomy/flexibility/independence in the practice of the LPN/LPN.

State Name  
  Least Restrictive Most Restrictive
  1   2 3   4

As a relative value, on a scale of 1-4, with 1 being the least specific and 4 being the most specific, categorize (by circling) each State’s LPN/LPN scope of practice.  Specific is defined as explicating defined parameters of practice of the LPN/LPN.

State Name  
  Least Specific Most Specific
  1   2 3   4

C5.  Telephone Interview Script for LPN Boards

Introduction:

I am------ and we were recently funded by HRSA to study LPN scope or practice in the 50 States.  We have collected information from your Web site and have several questions for clarification.  It will take about 20 minutes of your time. Would you answer the questions? Offer to read or fax the Information Letter.

  1. Are there other written documents, not on the Web site, that further explains the scope of practice for your State?
  2. How would you characterize the scope of practice in your State? From 1-5 with 1 being the most restrictive and 5 being the least restrictive?
  3. We have developed a chart of LPN activities.  As I go through the information, will you verify that it is correct?
  4. Have you changed your scope of practice in the last 5 years?  If yes, please describe.
  5. How many disciplinary actions has your board taken in the past year against LPNs?
    • Can you characterize the reasons for these actions?
    • What share of actions result from patient care violations/drug violations/etc.?
  6. What data does your State collect about LPNs? 
    • What information is collected with licensure?  Demographics, employment status?
    • Have you done any special surveys of LPNs in your State?  Do you do regular surveys?
    • What information do you have about your State’s LPN education programs?
    • Can you share any or all of these data with us?