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Skilled Nursing Services and Nursing Practice

Requires every nurse to hold a current Texas license or multistate privilege and to practice within the Texas Board of Nursing standards, sets out what RNs and LVNs each do, requires LVNs to work under RN supervision, and sets the rules for clinical notes, reporting changes in condition, clarifying orders, and nursing procedures.

Preview: full text with a package
About this policy
Policy number
TX-HH-CS-02
Version
1.0
Main rule
26 TAC §558.299
Library
Texas home health · 56 policies
Category
Clinical tasks
Sections
20

In short

  • Your nursing license must be current before every visit. Tell your supervisor at once if anything changes with your license.
  • LVNs work under RN supervision. Only an RN does the comprehensive assessment, writes the nursing plan, and delegates tasks.
  • Write a timed and dated note for every patient contact on the day of the visit.
  • If the patient’s condition changes, give the care needed, call 911 if it is an emergency, and tell the practitioner and your supervisor.
  • If an order looks wrong, check it with the practitioner before you carry it out, and write down what you did.

What's inside

20 sections. The full text comes with the One-time Policy Pack.

Full text with a package
  • Terms of Reference
  • 1. Purpose
  • 2. Scope
  • 3. Definitions
  • 4. Policy Statement (26 TAC §558.299)
  • 5. RN and LVN Roles
  • 6. License Verification and Practice Within Scope
  • 7. Responsibilities of Nurses as Skilled Professionals
  • 8. Nursing Visits and Clinical Notes
  • 9. Supervision of LVNs
  • 10. Reporting Changes in Condition and Clarifying Orders
  • 11. Nursing Procedures and Competency
  • 12. Nursing Peer Review and Duty to Report
  • 13. Responsibilities
  • 14. Records and Compliance Monitoring
  • 15. Staff Training
  • 16. References
  • 17. Related Policies and Forms
  • 18. Approval
  • 19. Revision History

An inspector may ask

  • Show me how you verified this nurse’s license before her first visit and how you track expiration.
  • Who supervises your LVNs, and how do you show it?

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