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LPN role in ambulatory areas

  • 1.  LPN role in ambulatory areas

    Posted 06-13-2022 13:55
    Ambulatory Colleagues,

    I am interested in learning about the LPN role in ambulatory services. Do you utilize the LPN role? In what settings? What is your RN/LPN staffing ratio in clinics? I appreciate any information you have about the LPN role.

    Much appreciated,

    Anne Mork
    CNO Ambulatory & Patient Support Services
    UW Health Madison WI

    ------------------------------
    Anne Mork
    VP Ambulatory CNO
    UW Health
    Madison WI
    (608)215-3653
    ------------------------------


  • 2.  RE: LPN role in ambulatory areas

    Posted 06-17-2022 11:51
    I am very interested in this topic as well. We are needing to revamp our care team model due to staff availability and the hiring environment. Any successful examples/models would be appreciated!

    ------------------------------
    Melissa Quaid BSN RN NE-BC
    Ambulatory Nursing Practice Manager
    Kootenai Health
    Coeur d'Alene ID
    ------------------------------



  • 3.  RE: LPN role in ambulatory areas

    Posted 06-17-2022 14:25
    We use LPNs for a lot of our in clinic nursing coverage, in addition to Medical Assistants. In our state they are able to do most of what an RN could do in clinic, including administering medications, replacing tubes (NG, GT) and providing patient education. Where our nursing scope differs is for the telehealth capabilities. Most of our telehealth teams are comprised of RNs to be able to follow caregiver initiated protocols for refilling meds, giving medical advise and triaging patient calls. This is not within the scope of LPNs in our state.  So for most of our departments we have MAs and LPNs seeing our patients in clinic along side the providers, and then a team of RNs handling clinical phone calls outside of appointments for medical advice, refills, prior authorizations, etc.

    ------------------------------
    Brandy Williamson BSN RN CPN
    Ambulatory Nursing Manager
    Children's Healthcare-Atlanta
    Atlanta GA
    (404)785-8978
    brandy.williamson@choa.org
    ------------------------------



  • 4.  RE: LPN role in ambulatory areas

    Posted 06-20-2022 09:08
    We are looking at how to use LPNs in our clinics.  I recently posted (in which SIG, I can't remember) and you can check the search box for LPNs and nurse led protocols.  I attached a document to that post that lists how we were thinking we could use LPNs.

    ------------------------------
    Michaelene Wolff, BSN, RN, OCN, AMB-BC
    Coordinator, Clinical Programs
    Chair, Ambulatory Telephone Protocol Committee
    University of Colorado Hospital
    Aurora CO
    ------------------------------



  • 5.  RE: LPN role in ambulatory areas

    Posted 06-20-2022 11:28
    Thank you Michaelene! I had come across your document and found it insightful. I appreciate your response!

    ------------------------------
    Melissa Quaid BSN RN NE-BC
    Ambulatory Nursing Practice Manager
    Kootenai Health
    Coeur d'Alene ID
    ------------------------------



  • 6.  RE: LPN role in ambulatory areas

    Posted 06-20-2022 11:56
    Hello Anne

    We currently have LVNs in our primary care setting and some of our specialty clinics (depending on services provided). We use them to carry out task that is outside of the scope of an MA such as medication verification, med refills, IV insertion, f/c care, etc. We currently do not have a staffing ratio that identifies how many LVNs are needed, it is really based on the need of the clinic. I have an LVN Scope of Practice policy that I developed a few years back (2018). I tried to locate the most recent but hopefully it can guide you in some capacity. I am in California so of course your state's scope is different. I tried to attached but can't figure it out. if you send me an email, i can share it with you. kristyl.mccray@pihhealth.org.

    ------------------------------
    Kristyl McCray MSN RN-BC
    RN Clinical Director, Education & Prof. Practice
    PIH Health Physicians
    Whittier CA
    (562)698-0811
    ------------------------------



  • 7.  RE: LPN role in ambulatory areas

    Posted 06-22-2022 12:10

    We have a role delineation grid for all disciplines working in ambulatory.  We also have a task list for the RN, LPN and MA.  We are creating a policy for the LPN in the acute and outpatient setting.  I am happy to share the policy when it is approved.

     

    Felicia Menefee, RN, MSN, BC, ANP, ACNS,

    Chief Nursing Officer

    Ambulatory Nursing & Advanced Practice Providers

    816-932-1560 (0)

    816-932-2979 (f)

    fmenefee@saint-lukes.org

    _________________________________________

    901 E. 104th Street, Mailstop 300S

    Kansas City, MO 64131

     

     

     

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  • 8.  RE: LPN role in ambulatory areas

    Posted 06-22-2022 12:30
    Hello Felicia

    I would be interested in seeing the role delineation grid that you mentioned for all disciplines. What is the function of this grid?

    ------------------------------
    Kristyl McCray MSN RN-BC
    RN Clinical Director, Education & Prof. Practice
    PIH Health Physicians
    Whittier CA
    (562)698-0811
    ------------------------------



  • 9.  RE: LPN role in ambulatory areas

    Posted 06-23-2022 10:46
    Hello Felicia,

    I would also be interested in that grid.

    We have the equivalent of LPN working at our clinic in my University Hospital but we are looking to formalise the separation our roles and to have a policy about tiering of care. In our clinic we have LPN, LN, RN and sometimes NP practicing in the same clinics. We want to promote the use to the full extend of everyone's scope of practice and orient the patient to the right type of nurse. Is that something that is adress in your grid?

    Thanks!

    ------------------------------
    Phebe Gagnon-Courville, M. Sc.
    Advanced practice nurse - Transformation of the nursing practice in ambulatory care
    Centre Hospitalier de l'Université de Montréal
    Montreal, Quebec, Canada
    phebe.gagnon-courville.chum@ssss.gouv.qc.ca
    1(514)890-8000, 35916
    ------------------------------



  • 10.  RE: LPN role in ambulatory areas

    Posted 06-28-2022 19:34
      |   view attached

    My apologies for the delayed response.  Attached is our role delineation grid.  I am also sharing how we outline the task expectation of various roles in the clinic setting.

     

    Felicia Menefee, RN, MSN, BC, ANP, ACNS,

    Chief Nursing Officer

    Ambulatory Nursing & Advanced Practice Providers

    816-932-1560 (0)

    816-932-2979 (f)

    fmenefee@saint-lukes.org

    _________________________________________

    901 E. 104th Street, Mailstop 300S

    Kansas City, MO 64131

     

     

     




    Attachment(s)



  • 11.  RE: LPN role in ambulatory areas

    Posted 06-29-2022 08:44
    Thanks for sharing Felicia!

    ------------------------------
    Phebe Gagnon-Courville, M. Sc.
    Advanced practice nurse - Transformation of the nursing practice in ambulatory care
    Centre Hospitalier de l'Université de Montréal
    Montreal, Quebec, Canada
    phebe.gagnon-courville.chum@ssss.gouv.qc.ca
    1(514)890-8000, 35916
    ------------------------------



  • 12.  RE: LPN role in ambulatory areas

    Posted 06-23-2022 12:46
    Felicia,

    I too would be very interested in your grid.

    ------------------------------
    Dotty Parker
    Director Nursing- Ambulatory Clinical Quality
    Montage Medical Group
    Monterey CA
    (831)265-3989
    ------------------------------



  • 13.  RE: LPN role in ambulatory areas

    Posted 06-24-2022 10:23
    Hello Felicia,

    Thank you for being willing to share. I look forward to reviewing your grid as well!

    Rachel Franz, RN, ONC

    ------------------------------
    Rachel Franz
    Doctor on Demand
    Delaware OH
    ------------------------------



  • 14.  RE: LPN role in ambulatory areas

    Posted 06-24-2022 11:22
    Felicia,

    Our organization is currently in the process of reviewing and defining the roles of the MA, LPN, and RN in the ambulatory care setting. I would be interested in seeing the documents you have as well as the policy when it is finished.

    ------------------------------
    Heide Brooks MSN RN
    Ambulatory Nursing Practice Specialist
    Kootenai Health
    Coeur D Alene ID
    (208)625-3867
    ------------------------------



  • 15.  RE: LPN role in ambulatory areas

    Posted 08-03-2022 16:47
    If you would share your role delineation grid and policy when complete I'd be most appreciative.  Thank you, Joanne
    Jhogan@southshorehealth.org

    ------------------------------
    Joanne Hogan DNP RN
    Associate Chief Nurse, Ambulatory Division
    South Shore Health System
    Hingham MA
    (617)710-5811
    ------------------------------



  • 16.  RE: LPN role in ambulatory areas

    Posted 08-04-2022 11:25

    Hello Felicia,

     

    Could you also share a copy of your role delineation grid and task list for RN, LPN and MA's with me, I'm working on similar. 

     

    Thank you!

    Jami Kyle BSN, RN, AMB-BC

    University of Kentucky Healthcare

    Family and Community Medicine

     

    Sent from Mail for Windows

     






  • 17.  RE: LPN role in ambulatory areas

    Posted 08-05-2022 09:43

    Good morning,

     

    I would appreciate it if you could share a copy of your role delineation grid with me also.

     

    Thank you

     

    Tamera Gibson RN

    Clinical Nurse Supervisor

    Pawnee Indian Health Center

    1201 Heritage Circle

    Pawnee, OK 74058

    918-762-6537

     

     






  • 18.  RE: LPN role in ambulatory areas

    Posted 08-08-2022 12:43

    Hi Felicia –

     

    Would also welcome you sending the grid/policy.  Like other we are working on similar. 

     

    Erin

     

    Erin Slay, MHA, BSN, RN

    Director of Nursing UHPS

    University Hospitals

    11100 Euclid Ave.

    Cleveland, OH  44106

    216 789-2131 (cell)

    216 855-8569 (office)

     

    Erin.Slay@UHhospitals.org

     

     

     

     


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  • 19.  RE: LPN role in ambulatory areas

    Posted 06-20-2022 12:14
      |   view attached
    Okay. I've figured it out :)

    ------------------------------
    Kristyl McCray MSN RN-BC
    RN Clinical Director, Education & Prof. Practice
    PIH Health Physicians
    Whittier CA
    (562)698-0811
    ------------------------------



  • 20.  RE: LPN role in ambulatory areas

    Posted 06-22-2022 10:44
    Kristyl,

    Thank you so much for sharing! This was incredibly helpful for me as I am currently in the beginning stages of building ambulatory nurse (LVN, RN) services for our clinics which also includes TCM and CM.

    ------------------------------
    Dotty Parker
    Director Nursing- Ambulatory Clinical Quality
    Montage Medical Group
    Monterey CA
    (831)265-3989
    ------------------------------



  • 21.  RE: LPN role in ambulatory areas

    Posted 06-22-2022 12:19
    Glad I was able to assist. Please don't hesitate to reach out to me for anything else you may need.

    ------------------------------
    Kristyl McCray MSN RN-BC
    RN Clinical Director, Education & Prof. Practice
    PIH Health Physicians
    Whittier CA
    (562)698-0811
    ------------------------------



  • 22.  RE: LPN role in ambulatory areas

    Posted 06-24-2022 11:52
    Good afternoon!

    Great topic and interest in this- so much so that LPN role in ambulatory areas will be our July Community Live Zoom Call! Join us Tuesday, July 26 at 7:00pm Eastern for a Zoom call to chat about the topic and share information. The original author of this post, Anne Mork, will facilitate the call. We'll have more information about content and a link to join as we get closer. Get those ideas and questions ready!

    Have a great weekend!
    Jennie

     

     




    ------------------------------
    Jennifer Stranix
    Director Membership & Association Services
    AAACN
    Pitman NJ
    (856)256-2326
    ------------------------------



  • 23.  RE: LPN role in ambulatory areas

    Posted 07-26-2022 14:22
    Good afternoon!

    I just want to make sure you all know that the call that was originally scheduled for tonight, July 26 is now Tuesday, August 2 at 7:00pm Eastern.

    Topic: Community Live: LPN role in ambulatory areas
    Time: Aug 2, 2022 07:00 PM Eastern Time (US and Canada)

    Join Zoom Meeting

    Meeting ID: 820 454 4237
    One tap mobile
    +19292056099,,8204544237# US (New York)
    +13017158592,,8204544237# US (Washington DC)

    Jennie


    ------------------------------
    Jennifer Stranix
    Director Membership & Association Services
    AAACN
    Pitman NJ
    (856)256-2326
    ------------------------------



  • 24.  RE: LPN role in ambulatory areas

    Posted 07-05-2022 13:06
    Here at our clinic (outpatient clinic) we are set up in teams, each team has a MD/DO, RN Case Manager and LPNs. Our Provider to LPN ratio is 1:2 because we do Team Based Care (nurse goes in to the room with the provider to complete the visit note, allowing the provider more face time with the patient and less time spent documenting). Each team has one RN Case Manager. We also have Integrated Pharmacy (pharmacist is in clinic and accessible to staff to assist with any needs that may arise during clinic) which is fairly new for us but it is working out VERY well! Additionally each team has a MFT (Medical Family Therapist) that assists,  unfortunately they have been having an extreme staffing shortage so we have not had them in clinic as much the last several months. Would love to have MA's but haven't gotten that approved in our budget yet! :-)

    ------------------------------
    Krystal Lewis RN
    Chickasaw Nation
    Ardmore OK
    (580)220-7720
    ------------------------------



  • 25.  RE: LPN role in ambulatory areas

    Posted 07-26-2022 07:34
    Good morning,

    Will there still be a discussion this evening regarding the LPN role in ambulatory? If so, when will the link be posted?


    ------------------------------
    Tomika Green MSN,RN,AMB-BC
    Nurse Clinician
    VCU Medical Center
    Henrico VA
    (804)647-0199
    ------------------------------



  • 26.  RE: LPN role in ambulatory areas

    Posted 08-02-2022 16:23
    Edited by Brandy Williamson 08-02-2022 16:23
    The call was rescheduled for tonight. sharing the information posted above from Jennie as its easy to lose updates and replies in these threads. Hope you can join!

    Good afternoon!

    I just want to make sure you all know that the call that was originally scheduled for tonight, July 26 is now Tuesday, August 2 at 7:00pm Eastern.

    Topic: Community Live: LPN role in ambulatory areas
    Time: Aug 2, 2022 07:00 PM Eastern Time (US and Canada)

    Join Zoom Meeting

    Meeting ID: 820 454 4237
    One tap mobile
    +19292056099,,8204544237# US (New York)
    +13017158592,,8204544237# US (Washington DC)

    Jennie


    ------------------------------
    Jennifer Stranix
    Director Membership & Association Services
    AAACN
    Pitman NJ
    (856)256-2326

    ------------------------------
    Brandy Williamson BSN RN CPN
    Ambulatory Nursing Manager
    Children's Healthcare-Atlanta
    Atlanta GA
    (404)785-8978
    brandy.williamson@choa.org
    ------------------------------



  • 27.  RE: LPN role in ambulatory areas

    Posted 08-05-2022 10:11
    Unfortunately i missed the call on Tuesday, August 2. Was it recorded or were there notes to review? 
    Historically our clinics relied on the LPN role as our primary licensed staff member, but hiring and retention have been major challenges.  We've developed role delineation in our primary care clinics and lean strongly on a remote team of RNs supporting a reduced on ground team of LPN and MA staff.  
    We've long had a remote refill center staffed by an LPN team that work off a standing order set approved by our medical executive team that takes the pressure off of that body of work. 
    Including a high level snap shot of our delineation:


    ------------------------------
    Toni Wendling MSN, RN
    Administrative Director of Primary Care
    Stormont Vail Health
    Topeka KS
    785-354-0558
    twendlin@stormontvail.org
    ------------------------------



  • 28.  RE: LPN role in ambulatory areas

    Posted 08-05-2022 10:23
    Hi Toni,

    I'm sorry you weren't able to attend the Community Live call on Tuesday but no worries, the call was recorded and I'm filing the recording and a copy of the chat with any links that were sent.

    Look for the post this afternoon!
    Jennie



    Jennifer Stranix 
    Director of Membership & Association Services

    American Academy of Ambulatory Care Nursing (AAACN)
    e: jennifer@aaacn.org | p: 856.256.2326







  • 29.  RE: LPN role in ambulatory areas

    Posted 08-05-2022 11:40

    Great. Thank you!

     






  • 30.  RE: LPN role in ambulatory areas

    Posted 08-10-2022 18:12
    Is this now posted? Thank you!

    ------------------------------
    Lynsi Hinrichsen MSN RN
    Ambulatory Education Coordinator
    OSF St. Francis Medical Center
    Peoria IL
    (309)683-5318
    ------------------------------



  • 31.  RE: LPN role in ambulatory areas

    Posted 08-11-2022 07:33
    Good morning Lynsi,

    Yes, this is filed in the Open Forum Community Library: COMMUNITY LIVE folder/LPN role in ambulatory areas.

    When you open the link for the library- click the triangle next to the folder: COMMUNITY LIVE



    Once you click the triangle, you'll see a folder for each of the calls we've held, click the call that you're interested in and you'll find the recording and chat from the call.


    Let me know if you have any questions, have a great day!
    Jennie




    Jennifer Stranix 
    Director of Membership & Association Services

    American Academy of Ambulatory Care Nursing (AAACN)
    e: jennifer@aaacn.org | p: 856.256.2326