S: Clinic Based Nursing

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S: Clinic Based Nursing Alberta Licensed Practical Nurses Competency Profile 181

Competency: S-1 Knowledge of S-1-1 S-1-2 S-1-3 S-1-4 S-1-5 Demonstrate ability to apply critical thinking and clinical judgement throughout the nursing process in clinic based nursing. Demonstrate knowledge and ability to provide clinic based nursing services such as: health promotion illness prevention health maintenance home support community rehabilitation pre-hospital community coordination and referral. Demonstrate ability to work as a liaison between client and other health care providers. Demonstrate ability to utilize effective time management skills. Demonstrate ability to maintain confidentiality. 182 Alberta Licensed Practical Nurses Competency Profile

Competency: S-2 Assessment and Prioritizing of Client Needs S-2-1 S-2-2 S-2-3 Demonstrate ability to participate in the triage and screening of clients as per clinic policy. Demonstrate knowledge and ability to provide full health assessment of the client including, but not limited to: (See Competency Band B) admission of client to clinic determine reason for visit prioritizing care collect assessment data prepare client for physician examination collect and send specimens follow clinic protocol and routines document and report findings. Demonstrate knowledge and ability to ascertain if client s basic needs are being met such as: clothing food shelter safety transportation. Alberta Licensed Practical Nurses Competency Profile 183

Competency: S-3 Nursing Interventions S-3-1 Demonstrate knowledge and ability to provide and assist in a variety of office procedures such as: obtain verbal or written physician / nurse practitioner orders application of dressings, splints, slings, tensors application of oxygen assist with minor surgical procedures blood glucose monitoring eye irrigations initiate CPR inhalation therapy injections and immunizations (Immunization Specialty-see Competency Band GG) medication administration monitoring blood and test results participate in the triage and screening of clients pre-lab instructions pre-operative teaching removal of casts specimen collection wart treatments i.e., liquid nitrogen various examinations: o visual acuity o physical / mental assessments o assist with pelvic examinations o diagnostic testing as ordered by the physician 184 Alberta Licensed Practical Nurses Competency Profile

Competency: S-3 Nursing Interventions Page: 2 S-3-1 Demonstrate knowledge and ability to assist and / or provide a variety of office procedures such as: (continued) application of casts (Orthopaedic Specialty-see Competency Band Y) allergy / skin testing (on-site supervision by physician) dermatology and schlerotherapy treatments (on-site supervision by physician) electrocardiogram (ECG) initiate intravenous infusion (see Competency Band V) perform pap smears (on-site supervision by physician) assisting with procedures and tests such as: o preparation of slides for microscopic examination o sigmoidoscopy o vasectomy o circumcision o biopsy. Alberta Licensed Practical Nurses Competency Profile 185

Competency: S-4 Coordinate Client Referral S-4-1 Demonstrate ability to perform client referral: assess and respond to urgency of referral access available resources arrange for appropriate transfer if necessary process forms for referral to a variety of agencies / services arrange for client information to be communicated to referral agency communicate referral information to client and family. 186 Alberta Licensed Practical Nurses Competency Profile

Competency: S-5 Support and Teaching S-5-1 Demonstrate knowledge and ability to provide support and teaching to client, family, and public through means such as: determining educational needs of clients utilizing resources within clinic for public education developing presentations and seminars as necessary participating in presentation of seminars and information sessions, as appropriate evaluating effectiveness of education providing support throughout teaching process. Alberta Licensed Practical Nurses Competency Profile 187

Restricted Activity Authorization Competency: S-6 HPA Authorization to Perform Ear Syringing S-6-1 Demonstrate understanding of restricted activity in LPN Regulations 2003 (14) authorizing ear syringing: Regulated members may provide the restricted activity of inserting in the ear canal a liquid under pressure for the purposes of removing wax from ears if the regulated member has been specifically authorized to perform that restricted activity and the regulated member only performs the restricted activity when a person who is authorized to perform the restricted activity is available to provide assistance. Health Professions Act LPN Regulation 2003 Note: LPNs who perform ear syringing have received additional on the job education regarding syringing the ear. 188 Alberta Licensed Practical Nurses Competency Profile

Restricted Activity Authorization Competency: S-7 Ear Syringing S-7-1 S-7-2 S-7-3 Demonstrate knowledge of the anatomy of the ear. Demonstrate knowledge of the purpose for the ear syringing. Demonstrate the ability to perform ear syringing: check physicians order or protocol prepare supplies explain procedure to the client prepare and position client position drainage basin appropriately cleanse outer aspects of ear as necessary position ear canal to straighten the auditory canal by pulling the pinna: o down and back for an infant o up and back for an adult insert fluid appropriately: o direct a steady stream of solution against the roof of the auditory canal o use only sufficient force to remove secretions do not occlude auditory canal with the irrigating nozzle: o allow solution to flow out unimpeded o allow ear canal to drain appropriately o place cotton ball loosely in auditory meatus have client lie on side of affected ear using absorbent pad if necessary document irrigation, appearance of drainage and clients response. Alberta Licensed Practical Nurses Competency Profile 189