PRACTICE POLICY

AUTHORIZED RESTRICTED ACTIVITIES FOR

LICENSED PRACTICAL NURSES
The legislative mandate of the College of Licensed Practical Nurses of Alberta (CLPNA) is to serve and protect the public by
ensuring its members deliver safe, competent and ethical nursing care. Practice policies outline expectations of behaviour that
are established, monitored and enforced by the CLPNA. Practice policies may link with Standards of Practice, Code of Ethics,
legislation, regulation or by-laws relevant to nursing practice. They can also link to supportive documents that help members
meet these policy expectations.

This document is linked to legislation: Health Professions Licensed Practical

Act Nurses Profession
Regulation
This document is linked to other documents that Standards of Practice Competency Profile Temporary
direct expectations of professional behavior and Registration
requirements for practice: Code of Ethics Professional
Responsibility and Specialized Practice
Accountability Areas

WHAT ARE RESTRICTED ACTIVITIES? activity. When performing restricted activities, an LPN must
always abide by Section 20 of the LPN Regulation:
Restricted activities are high risk activities performed as part
of providing a health service that require specific
competencies and skills to be carried out safely. Health Despite any of the authorizations to provide
professionals are authorized to perform these restricted restricted activities, regulated members must restrict
activities under the profession’s regulation and because they themselves in performing restricted activities to those
have the required education and training to competently do activities that the member is competent to perform
so. Restricted activities include health services such as cutting and to those that are appropriate to the member's
body tissue below the dermis, administering anything by area of practice and the procedures being performed.
invasive procedure, performing surgery, prescribing drugs,
ordering x-rays and many more. A complete list of health DEVELOPING COMPETENCIES TO PERFORM RESTRICTED
services restricted activities are set out in Schedule 7.1 of the ACTIVITIES
Government Organization Act (GOA).
1. Competencies to perform basic restricted activities are
acquired through base practical nursing education
THE LPN’S LEGAL AUTHORITY TO PERFORM RESTRICTED
programs. Some restricted activities require additional
ACTIVITIES
post-basic education or employer training as identified
LPNs are authorized through the Health Professions Act (HPA) by the shaded areas in The Competency Profile for LPNs.
and the Licensed Practical Nurses Profession Regulation (LPN The Competency Profile and information about post-
Regulation) to perform certain restricted activities. Schedule basic education are available on the CLPNA website at
10, section 3 of the HPA states that LPNs provide restricted www.clpna.com.
activities authorized by the regulations.
2. Competencies to perform specialized restricted
Sections 13 to 19 of the LPN Regulation specifically outline activities are acquired through specialized post-basic
which restricted activities LPNs are authorized to perform education programs approved or recognized by the
and the level of supervision required. Council of the CLPNA. Currently, there are 5 recognized
specialty areas: immunization, advanced foot care,
LPN COMPETENCIES REQUIRED TO PERFORM RESTRICTED perioperative, dialysis, and advanced orthopedic. LPNs
ACTIVITIES require authorization from the Registrar to practice in a
specialty area.
Although an LPN may be authorized to perform a restricted
activity, the LPN is responsible to ensure they possess the
knowledge, skills, and competence to perform the restricted
PERFORMANCE OF BASIC RESTRICTED ACTIVITIES Examples of these competencies include but may not be
limited to: urinary catheterization, administering vaginal
Basic restricted activities are high-risk health services creams, anal suppositories and enemas, tube feeds,
which LPNs learn through their basic practical nurse suctioning a tracheotomy, and insertion of nasal gastric
education program, post-basic LPN educational tubes.
program or employer certification.
3. LPNs may insert liquid under pressure into the ear canal
All LPNs who have developed the competencies to remove ear wax.
required to perform one or more of the basic  supervision requirement – indirect: the authorized
restricted activities, may perform the following practitioner is readily available on site for
restricted activities independently or under consultation and guidance. The authorized
supervision as set out in the LPN Regulation. practitioner is not required to be physically present
at the point of care.
The basic restricted activities for LPNs are:
 Example: an LPN working in a physician’s clinic or outpatient-
1. LPNs may administer anything by an invasive procedure emergency unit may carry out an order to syringe ears where
on body tissue below the dermis. the physician or another authorized practitioner is available
to provide assistance if required.
 LPNs who obtained their diploma after June 1,
1
2001 , may independently perform:
4. LPNs may administer diagnostic imaging contrast agents.
o subcutaneous injections
o intramuscular injections  supervision requirement – indirect: the authorized
o intradermal injections practitioner has provided an order and is readily
o IV initiation available on site for consultation and guidance. The
o IV medication/fluid administration authorized practitioner is not required to be
physically present at the point of care.
These LPNs are authorized to administer any drugs via these
routes keeping within their competencies, and practicing in Example: LPNs working in a diagnostic imaging clinic with
accordance with the CLPNA’s Standards of Practice and Code other health professionals or on a medical unit prior to a
of Ethics. Employers may have specific policies to guide LPNs diagnostic procedure with access to an authorized
in medication administration. Vaccine administration is practitioner if required.
authorized under the Immunization Specialty.
5. LPNs may administer nitrous oxide for the purposes of
2. LPNs may independently insert or remove instruments, anesthesia or sedation.
devices, fingers or hands:  supervision requirement – direct: the authorized
• beyond the pharynx practitioner is physically present at the point of care.
• beyond the opening of the urethra Example: LPNs working closely with a physician who is
• beyond the labia majora resetting a fracture.
• beyond the anal verge
• into an artificial opening of the body 6. LPNs may perform psychosocial intervention as a member
• beyond the point in the nasal passages where they of a multi-disciplinary team (i.e. team of more than one
normally narrow. person).
 supervision requirement – indirect remote: the
authorized practitioner is available for consultation
and guidance through technology. The authorized
1
practitioner is not required to be physically present
Regulated members who have completed their practical nurse at the point of care.
education program before June 1, 2001 will have met this
standard through the mandatory education upgrading Note: A psychosocial intervention is when there is an
completed in 1999, post basic programs and employer expectation of treating a substantial disorder of thought,
certification offered in these areas.
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 mood, perception, orientation or memory that grossly impairs artificial opening into the body for the purpose of
judgment, behavior, capacity to recognize reality, or ability to performing dialysis.
1
meet the ordinary demands of life.
Example: LPNs who are hired into a dialysis setting receive
training through the Alberta Renal Program and are
PERFORMANCE OF SPECIALIZED RESTRICTED ACTIVITIES
specifically trained in the specialized clinical competency to
3
provide treatment in dialysis nursing.
Specialized Restricted Activities require completion
of an advanced post-basic education program 11. LPNs with the Advanced Orthopedic Specialty and a
approved or recognized by the Council of the CLPNA verbal or written order may perform the setting or
and authorization from the Registrar to practice in resetting of a fracture of a bone for the purposes of
that specialty area. inserting and removing orthopedic devices and applying
casts.
7. LPNs with an Immunization Specialty may administer
 supervision requirement - indirect: the authorized
vaccines to clients 5 years of age or older with employer
practitioner is readily available on site for
protocols in place. A protocol is defined as an
consultation and guidance. The authorized
organizationally-approved guide for practice that is to be
practitioner is not required to be physically present
implemented by healthcare professionals managing
2 at the point of care.
specific client health needs in their practice environment.
Note: LPNs who have completed Council approved education in
 supervision requirement – indirect remote: the
Orthopedic nursing may practice within multiple settings
authorized practitioner is available for consultation
including but not limited to outpatient, emergency or cast
and guidance through technology. The authorized
clinic settings.
practitioner is not required to be physically present
at the point of care.
LEARNING A RESTRICTED ACTIVITY
Note: LPNs who have completed a Council approved
LPNs in an advanced post-basic education program can learn
Immunization Certification Course may work within any
and perform an authorized specialized restricted activity in
setting administering vaccines to clients 5 years of age and
accordance with the supervision requirements indicated
older. 4
above.
8. LPNs with the Advanced Foot Care Specialty may Note: LPNs with a temporary registration practice permit must
independently remove a body tissue, administer anything practice under supervision regardless of the authorization to
by invasive procedure on body tissue or perform surgical perform some basic restricted activities independently as
5
or other invasive procedures on body tissue below the indicated above. LPNs with a temporary registration practice
dermis for the purposes of removing a corn or callus as permit are not authorized to perform specialized restricted
part of the provision of foot care. activities.

9. LPNs with the Perioperative Specialty may administer Further information for temporary registrants is available on
anything or perform invasive procedures on body tissue the CLPNA website at www.clpna.com.
below the dermis.
Further information regarding continuing education,
 supervision requirement – direct: the authorized specialization and available courses is available on the
practitioner performing the surgery is physically Continuing Education webpage at
present at the point of care during the surgical https://www.clpna.com/members/continuing-education/.
procedure.
Any LPN or employer with questions regarding LPN restricted
Note: LPNs who have completed Council approved education in activities or any area of LPN practice is encouraged to contact
Perioperative nursing may practice within any surgical setting. the Practice Department at the CLPNA.
10. LPNs with the Dialysis Specialty may independently insert
or remove instruments, devices, fingers or hands into an

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REFERENCES

1
Government Organization Act, RSA 2000, c G-10, s 2(1)(p).
2
Rona F Levin and Seon Lewis-Holmon, “Developing Guidelines for Clinical Protocol Development,” Research
Theory for Nursing Practice: An International Journal 25, no. 4 (2011), 235.
3
College of Licensed Practical Nurses of Alberta (CLPNA), Competency Profile for Licensed Practical Nurses (June 2015), 230,
https://www.clpna.com/wp-content/uploads/2013/02/doc_Competency_Profile_for_LPNs_3rd_Ed_2015_COMPLETE.pdf.
4
Licensed Practical Nurses Profession Regulation, Alta Reg 81/2003, s21(1).
5
LPN Regulation, s6(6).

Approval Date December 6, 2018

Approver Council

© College of Licensed Practical Nurses of Alberta, 2018

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