Can a LVN perform an “initial” assessment?
As with most practice questions, the answer depends on many factors. Texas Board of Nursing's (BON) Rule 217.11, Standards of Nursing Practice, refers to focused assessments performed by LVNs [§ 217.11(2)(A)] and comprehensive assessments performed by RNs [§ 217.11(3)A)]. Nothing in Board Rule refers to initial assessments; therefore, the BON does not define nor does it determine whether a LVN may complete an initial assessment. 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 by proxy 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. Rule 217.11(1)(S) and (T) clarifies that a nurse is responsible for accepting assignments within his/her individual educational preparation, experience, knowledge, skills and abilities. Likewise, these same factors must be considered when nurses make assignments to other nurses