Can a LVN perform an “initial” assessment?
The answer depends on many factors, as with most practice questions. Board Rule 217.11, Standards of Nursing Practice, refers to focused assessments performed by LVNs [Board Rule 217.11(2)(A)] and comprehensive assessments performed by RNs [Board Rule 217.11(3)(A)]. Nothing in the Board’s rules refers to initial assessments; therefore, the Texas Board of Nursing does not define nor does it determine whether a LVN may complete an initial assessment. Board staff recommends contacting the agency that regulates the specific type of practice setting to determine if other laws and regulations apply. If other regulations require that a RN perform the initial patient/client assessment, then the LVN cannot perform the assessment for the RN.
In situations requiring comprehensive assessments by a RN, the LVN cannot begin by performing a focused assessment and have the RN follow up with an assessment of only those parameters not assessed by the LVN. A comprehensive assessment is a different level of assessment requiring that the RN use his/her own independent nursing judgment. Board Rule 217.11(1) (T) clarifies that a nurse is responsible for accepting assignments based on the nurse’s individual educational preparation, experience, knowledge, skills and abilities. Likewise, when a nurse makes assignments to another person(s), the nurse must consider the educational preparation, experience, knowledge, and skills of the person(s) receiving the assignment [Board Rule 217.11(1)(S)].
Updated August 2013