Key Findings, Conclusions, and Recommendations Summary and Conclusions This final chapter provides a summary of key findings from the four components of this research study on LPNs and their scope of practice, including the review of the literature, the provincial LPN survey, the cross-case analysis, and the policy study. Using the Scope of Practice Factors Model as an organizing structure, a summary of triangulated findings is presented that confirms, contradicts, or expands on key literature to date. The fact that the same research questions elicited similar findings across different methods of inquiry and different populations provides an in-depth perspective on this important topic. Individual LPN Factors Scope utilization of LPNs. Scope of practice is much more than a set of skills, yet most nurses define scope in terms of daily tasks (Besner et al., 2005; White et al., 2008). Some Canadian studies (Allard et al., 2010; CUPE, 2003; White et al., 2008) indicated that LPNs perceived that they used approximately 50% of their competencies. While findings in this study were only slightly higher, the survey unpacked these subjective perceptions of scope utilization to examine actual competencies practiced within specific care settings. Our study revealed that there is a gap between LPNs’ perception of skill utilization and their actual practice. Approximately half of the LPNs perceived that they used all of their competencies. Those who did not estimated that they used 67% of the competencies required within their care context; however, an objective measure of competencies based on the survey data revealed that in fact they were using 78% of possible competencies. This suggests that when comparing their perception of scope utilization to a more objective measure, in practice LPNs used more competencies than they perceived to be the case. Overall, 20% of LPNs underestimated their
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Final Report: Understanding Licensed Practical Nurses’ Full Scope of Practice September 28, 2012