Licensed Practical Nurses (LPNs) operate under a defined scope of practice, which varies by state regulations and employer policies. There are specific procedures and tasks that fall outside of their authorized responsibilities. These limitations often involve advanced assessments, complex medical decision-making, and specialized interventions. For example, an LPN typically cannot independently initiate or titrate certain medications, perform specific types of central line insertions, or interpret complex diagnostic tests without the direct supervision of a Registered Nurse (RN) or physician.
Understanding the boundaries of an LPN’s role is crucial for patient safety and legal compliance within healthcare settings. It ensures that patients receive appropriate care from qualified professionals. Historically, these limitations have been established to differentiate the training and expertise of LPNs from those of RNs and physicians, reflecting the levels of complexity and autonomy associated with different healthcare roles. Delineating these boundaries also provides a framework for safe delegation of tasks and responsibilities.
The subsequent sections will detail specific areas where an LPN’s practice is limited. This will include a discussion of restrictions related to intravenous (IV) therapy administration, blood product administration, critical care interventions, and patient assessment responsibilities. Understanding these specific limitations is vital for LPNs to function effectively within their authorized scope of practice and contribute to a collaborative and safe healthcare environment.
1. Advanced assessments
Advanced patient assessments represent a critical area delineating the scope of practice for Licensed Practical Nurses (LPNs). While LPNs are skilled in gathering patient information and performing focused assessments, the interpretation of complex data and the formulation of comprehensive diagnoses typically exceed their authorized responsibilities.
-
Complexity of Data Interpretation
LPNs collect vital signs, document patient symptoms, and observe patient behavior. However, interpreting complex patterns within this data, such as subtle indicators of neurological decline or early signs of sepsis, requires advanced clinical judgment and knowledge. An LPN’s training generally does not equip them to independently analyze such nuanced information to make critical clinical decisions.
-
Comprehensive Diagnostic Formulation
Formulating a complete differential diagnosis based on a patient’s presentation involves integrating diverse assessment findings with a deep understanding of pathophysiology and pharmacology. LPNs contribute to this process by providing valuable observations, but the responsibility for synthesizing this information into a definitive diagnosis rests with Registered Nurses (RNs), Nurse Practitioners (NPs), or physicians.
-
Independent Decision-Making in Unstable Situations
In rapidly changing or unstable patient conditions, advanced assessments are essential for guiding immediate interventions. While LPNs are trained to recognize and report critical changes, they typically do not possess the authority to independently order or implement significant changes in treatment protocols. Rapid decision-making often requires a level of clinical autonomy that is outside the LPN scope of practice.
-
Use of Specialized Assessment Tools
Certain assessment tools, such as neurological scales (e.g., Glasgow Coma Scale), cardiac monitoring interpretation, or advanced respiratory assessments, require specialized training and expertise. While LPNs may be trained to assist with these tools, the final interpretation and clinical application typically fall to RNs or advanced practice providers.
The limitations placed on LPNs regarding advanced assessments reflect the need for a higher level of clinical training and expertise in complex patient care scenarios. Understanding these boundaries ensures that patients receive appropriate and timely interventions from healthcare professionals with the requisite qualifications, contributing to improved patient outcomes and safety.
2. Independent medication titration
Independent medication titration is a key element in defining the boundaries of an LPN’s scope of practice. It represents a responsibility that typically exceeds their authorized capabilities due to the complexities of pharmacological management and patient assessment involved. The process requires nuanced clinical judgment and a deep understanding of potential adverse effects, solidifying its place within the domain of what an LPN is generally restricted from performing.
-
Complexity of Pharmacological Knowledge
Medication titration often involves adjusting dosages based on a patient’s physiological response, requiring a comprehensive understanding of pharmacokinetics and pharmacodynamics. LPN curricula focus on basic medication administration principles, but the intricacies of dose adjustment based on changing patient conditions generally fall outside this scope. For instance, titrating vasoactive medications in a critical care setting demands an understanding of blood pressure regulation that surpasses standard LPN training.
-
Assessment Skills and Clinical Judgment
Effective medication titration necessitates continuous patient monitoring and assessment to identify subtle changes indicating the need for dosage adjustments. LPNs are trained to collect patient data, but the interpretation of complex clinical indicators and the subsequent decision-making process often require the advanced assessment skills of an RN or physician. An example would be titrating pain medication; while an LPN can administer the medication, adjusting the dose based on pain scores and side effects would typically require an RN’s assessment.
-
Legal and Regulatory Considerations
State nursing practice acts and institutional policies typically restrict LPNs from independently titrating medications. These regulations are in place to ensure patient safety and to align responsibilities with the appropriate level of training and expertise. Violating these restrictions can have legal ramifications for both the LPN and the employing healthcare facility.
-
Supervision and Collaboration
While LPNs may assist in medication titration under the direct supervision of an RN or physician, the ultimate responsibility for these decisions rests with the supervising professional. This collaborative approach allows LPNs to contribute to patient care while ensuring that decisions regarding medication adjustments are made by individuals with the necessary expertise. This collaboration often involves clear protocols and communication channels to ensure that patient safety remains the priority.
These facets highlight the critical role of independent medication titration in defining the limits of an LPN’s professional practice. The complexity of pharmacological knowledge, the necessary assessment skills, and the legal considerations all converge to emphasize that this task typically falls outside the scope of what an LPN can independently perform. This limitation is crucial for maintaining patient safety and ensuring appropriate levels of care within healthcare settings.
3. Certain Central Line Insertions
The performance of specific central line insertion procedures represents a significant aspect of defining what falls outside the scope of practice for Licensed Practical Nurses (LPNs). These procedures involve inherent risks and require a level of specialized knowledge and skill typically beyond the standard LPN curriculum. Consequently, restrictions on LPN involvement in these procedures are crucial for patient safety and regulatory compliance.
-
Complexity of Anatomical Knowledge and Technical Skill
Central line insertions require a detailed understanding of vascular anatomy and sterile technique to minimize the risk of complications such as pneumothorax, arterial puncture, and infection. LPN training focuses on basic nursing skills and does not provide the extensive anatomical knowledge and procedural experience necessary to safely perform these complex insertions. The successful placement of a central line demands a level of technical precision and expertise that typically resides with physicians, advanced practice nurses, or specially trained Registered Nurses.
-
Risk of Complications and Management Protocols
Central line insertions carry a significant risk of potentially life-threatening complications. Managing these complications requires advanced clinical judgment and the ability to perform immediate interventions. While LPNs are trained to recognize signs of complications, they generally lack the authority and expertise to independently manage them. Prompt and effective management of complications necessitates a level of decision-making and intervention skills that is beyond the LPN scope of practice.
-
Regulatory and Legal Restrictions
State nursing practice acts and healthcare facility policies typically prohibit LPNs from independently performing central line insertions. These regulations are in place to protect patients and to ensure that these procedures are performed by qualified healthcare professionals with the appropriate training and experience. Violating these restrictions can result in legal consequences for the LPN and the healthcare facility.
-
Advanced Assessment and Patient Monitoring Requirements
Post-insertion, patients require close monitoring for signs of complications, including infection, thrombosis, and catheter malfunction. While LPNs are competent in basic patient monitoring, the interpretation of subtle indicators of these complications and the implementation of appropriate interventions often require the advanced assessment skills of an RN or physician. The management of central lines necessitates a comprehensive understanding of potential complications and the ability to respond effectively to changing patient conditions, which is typically beyond the LPN scope of practice.
The limitations surrounding central line insertions underscore the importance of clearly defined roles and responsibilities within the healthcare team. These restrictions reflect the inherent risks associated with these procedures and the need for specialized training and expertise. By understanding these limitations, LPNs can contribute effectively to patient care while adhering to established standards of practice and ensuring patient safety.
4. Complex diagnostic interpretation
The inability to independently perform complex diagnostic interpretation is a significant determinant of the LPN’s scope of practice. This restriction arises from the level of specialized knowledge required to accurately analyze diagnostic test results, such as electrocardiograms (ECGs), radiological images (X-rays, CT scans), and laboratory values, and to integrate these findings into a comprehensive patient assessment. Accurate interpretation often necessitates an understanding of advanced physiology, pathology, and pharmacology, areas where the LPN’s training is less intensive than that of a Registered Nurse (RN) or physician. For example, while an LPN might recognize an abnormal lab value, determining the underlying cause and its clinical significance typically falls outside their purview. The consequences of misinterpreting diagnostic data can lead to incorrect treatment decisions, potentially jeopardizing patient safety. Therefore, this limitation is a critical safeguard.
The implications of this restriction extend to various clinical settings. In a cardiac unit, an LPN might monitor a patient’s ECG rhythm and report changes, but the detailed analysis of complex arrhythmias and their treatment implications are typically reserved for RNs or physicians. Similarly, in a medical-surgical unit, an LPN might note abnormal electrolyte levels on a lab report, but the interpretation of these imbalances in the context of the patient’s overall condition and the initiation of corrective actions are usually the responsibility of a more highly trained professional. This delineation ensures that diagnostic interpretations are performed by individuals with the requisite expertise to make informed clinical judgments. The practical significance of this understanding is evident in preventing errors in patient care and promoting optimal outcomes. It also prevents legal liabilities.
In summary, the limitation on complex diagnostic interpretation is a cornerstone of the LPN’s scope of practice, driven by the need to ensure accurate and informed clinical decision-making. This restriction, rooted in the level of specialized training required, serves as a crucial safeguard for patient safety across diverse healthcare settings. Challenges remain in ensuring clear communication and collaboration between LPNs and other healthcare professionals to facilitate comprehensive patient care while respecting the boundaries of each role. A clear understanding of these boundaries promotes a collaborative and safe healthcare environment.
5. Initiating blood transfusions
The commencement of blood transfusions represents a critical intervention that typically falls outside the authorized scope of practice for Licensed Practical Nurses (LPNs). This restriction is predicated on the complexity of the procedure, the potential for severe adverse reactions, and the level of advanced assessment skills required for safe administration.
-
Assessment and Compatibility Verification
Initiating a blood transfusion necessitates a comprehensive patient assessment, including verification of blood product compatibility and patient identification. LPNs, while proficient in basic patient assessment, often lack the advanced training to independently interpret complex compatibility reports and manage the immediate and potential reactions. The ultimate responsibility for ensuring accurate patient and blood product matching generally rests with a Registered Nurse (RN) or physician.
-
Management of Transfusion Reactions
Blood transfusions carry the risk of acute reactions, such as allergic reactions, febrile non-hemolytic reactions, and, in rare cases, life-threatening hemolytic reactions. Recognizing and responding to these reactions requires rapid assessment skills, critical thinking, and the ability to implement appropriate interventions, including the administration of emergency medications. The level of independent decision-making and advanced intervention required is typically beyond the LPN scope of practice.
-
Documentation and Monitoring Requirements
Detailed documentation and continuous patient monitoring are essential during blood transfusions. This includes meticulous recording of vital signs, infusion rates, and any adverse reactions. LPNs are competent in documenting patient data, but the interpretation of complex monitoring parameters and the authority to make independent adjustments to the transfusion based on these parameters generally reside with RNs or physicians. This ensures a higher level of oversight and expertise during the procedure.
-
Legal and Regulatory Constraints
State nursing practice acts and institutional policies often explicitly prohibit LPNs from independently initiating blood transfusions. These regulations are in place to protect patient safety and to ensure that complex medical procedures are performed by healthcare professionals with the appropriate training and expertise. Non-compliance with these regulations can result in legal ramifications for both the LPN and the healthcare facility.
Consequently, the inability to initiate blood transfusions serves as a clear delineation of the LPN’s scope of practice, underscoring the need for a collaborative approach to patient care where the expertise of RNs and physicians is utilized for complex interventions. This restriction safeguards patient well-being and ensures adherence to established standards of practice within the healthcare environment. This further defines “what can an LPN not do”.
6. Managing unstable patients
The management of unstable patients is intrinsically linked to the limitations defining the scope of practice for Licensed Practical Nurses (LPNs). Patient instability implies a dynamic clinical condition characterized by rapidly changing vital signs, compromised physiological functions, or an acute threat to life or limb. These situations demand immediate and decisive interventions based on advanced assessment skills, complex diagnostic interpretation, and the authority to implement rapid treatment adjustments. Because LPN training focuses on basic nursing care and data collection, the independent management of unstable patients typically exceeds their authorized responsibilities. For example, an LPN can identify a patient experiencing a rapid decline in blood pressure and initiate established protocols, but independently titrating vasoactive medications to restore hemodynamic stability generally requires the expertise of a Registered Nurse (RN) or physician.
The inability to independently manage unstable patients stems from multiple factors, including limitations in assessment skills, diagnostic interpretation, and the legal scope of practice. In an emergency scenario, such as a patient experiencing acute respiratory distress, an LPN can administer oxygen and monitor vital signs, but the decision to intubate or administer specific emergency medications typically requires the involvement of a more qualified professional. Furthermore, the development and modification of care plans for unstable patients necessitate a comprehensive understanding of pathophysiology and pharmacology, which is a focus of RN and physician training. The practical significance of this limitation lies in ensuring that patients receive appropriate and timely care from healthcare professionals with the requisite qualifications and expertise, thereby minimizing the risk of adverse outcomes.
In summary, the constraints on LPNs regarding the management of unstable patients reflect the inherent complexities and risks associated with these clinical scenarios. While LPNs play a vital role in monitoring and reporting changes in patient condition, the ultimate responsibility for making critical treatment decisions and implementing complex interventions rests with healthcare professionals possessing advanced training and a broader scope of practice. Recognizing these limitations is crucial for maintaining patient safety and promoting a collaborative healthcare environment where each member of the team contributes within their defined role.
7. Developing care plans
The construction of comprehensive patient care plans represents a task frequently beyond the authorized scope of Licensed Practical Nurses (LPNs). This limitation stems from the complexity inherent in integrating diverse patient data, formulating individualized goals, and outlining specific interventions. While LPNs contribute significantly to the data collection process by monitoring vital signs, documenting symptoms, and observing patient behavior, the synthesis of this information into a holistic, individualized plan typically requires a more advanced level of clinical judgment and theoretical knowledge. For example, an LPN might identify that a patient’s wound is not healing properly, but determining the underlying causes (such as poor nutrition, impaired circulation, or infection) and formulating a comprehensive wound care plan, including specific dressing changes and nutritional interventions, typically falls to a Registered Nurse (RN) or other qualified healthcare provider.
The practical significance of this restriction lies in ensuring that patient care plans are developed by professionals with the requisite training and expertise to address complex health needs. RNs and other advanced practitioners receive extensive education in pathophysiology, pharmacology, and care planning methodologies, enabling them to create comprehensive plans that are tailored to the unique needs of each patient. These plans not only address immediate health concerns but also incorporate long-term goals, preventive measures, and patient education. The input of an LPN during the care planning process is highly valuable, but the responsibility for the final formulation and implementation of the plan generally rests with those possessing a broader scope of practice.
In summary, the inability to independently develop care plans is a key aspect of defining the boundaries of LPN practice. This limitation safeguards patient well-being by ensuring that care plans are formulated by healthcare professionals with the necessary training and expertise to address complex health needs. While LPNs play a crucial role in collecting data and implementing aspects of the care plan, the overall responsibility for its development and modification resides with RNs or other qualified providers, fostering a collaborative and safe healthcare environment.
8. Administering chemotherapy
The administration of chemotherapy is a complex and high-risk procedure, typically reserved for healthcare professionals with specialized training and expertise. This restriction is a significant aspect of defining “what an LPN cannot do” within the scope of their practice, emphasizing patient safety and adherence to stringent medical protocols.
-
Specialized Knowledge and Training
Chemotherapy agents possess potent cytotoxic properties, necessitating a comprehensive understanding of their mechanisms of action, potential side effects, and appropriate management strategies. LPN curricula generally do not include the in-depth training required to safely handle and administer these medications. Specialized oncology certifications and ongoing education are typically prerequisites for healthcare professionals involved in chemotherapy administration.
-
Risk Management and Adverse Reaction Protocols
The administration of chemotherapy carries a significant risk of adverse reactions, ranging from mild nausea and vomiting to severe anaphylaxis and organ damage. Healthcare professionals administering chemotherapy must be proficient in recognizing and managing these reactions promptly and effectively. This requires advanced assessment skills, critical thinking, and the ability to implement complex intervention protocols, capabilities that typically exceed the LPN scope of practice.
-
Legal and Regulatory Restrictions
State nursing practice acts and institutional policies frequently prohibit LPNs from independently administering chemotherapy. These regulations are in place to protect patient safety and to ensure that complex medical procedures are performed by qualified healthcare professionals with the appropriate training and experience. Violating these restrictions can result in legal consequences for both the LPN and the healthcare facility.
-
Route and Delivery Method Competency
Chemotherapy can be administered through various routes, including intravenous (IV), oral, and intramuscular injections. Each route demands specific competencies in medication preparation, delivery techniques, and patient monitoring. IV chemotherapy, in particular, requires meticulous handling to prevent extravasation, a potentially serious complication where the drug leaks into surrounding tissues. The specialized training and experience necessary to competently manage these various delivery methods are not typically included in LPN training programs.
The restrictions surrounding chemotherapy administration highlight the importance of delineated roles and responsibilities within the healthcare team. These limitations reflect the inherent risks associated with these procedures and the need for specialized training and expertise. By understanding “what an LPN cannot do” in this context, healthcare professionals can ensure that patients receive appropriate and timely care from qualified individuals, contributing to improved outcomes and safety.
9. Specific IV push medications
The administration of certain intravenous (IV) push medications is a significant area delineating the boundaries of what an LPN is typically restricted from doing. This limitation arises from the rapid and potent effects of these medications, coupled with the advanced assessment and intervention skills required to manage potential adverse reactions. The decision to exclude LPNs from administering specific IV push medications is rooted in patient safety and the need to ensure that these interventions are performed by healthcare professionals with the requisite expertise.
-
Pharmacological Complexity and Rapid Action
IV push medications exert their effects quickly, often within seconds or minutes. This rapid onset of action necessitates a deep understanding of the drug’s pharmacology, potential side effects, and contraindications. Medications like adenosine, used to treat supraventricular tachycardia, or certain opioid analgesics for acute pain management, require immediate and precise administration. The potential for rapid physiological changes and adverse reactions demands a level of expertise that typically surpasses the LPN scope of training.
-
Advanced Assessment and Monitoring Skills
The administration of IV push medications requires continuous patient monitoring and assessment to detect and manage potential complications. This includes monitoring vital signs, assessing neurological status, and recognizing subtle signs of adverse reactions. For example, administering IV push furosemide requires close monitoring of blood pressure and urine output to prevent hypotension and electrolyte imbalances. LPNs are trained in basic monitoring, but the advanced clinical judgment required to interpret complex data and initiate appropriate interventions often falls outside their authorized practice.
-
Emergency Response Capabilities
Adverse reactions to IV push medications can be severe and life-threatening, requiring immediate intervention. Anaphylaxis, respiratory depression, and cardiac arrhythmias are potential complications that necessitate rapid assessment, airway management, and the administration of emergency medications. Healthcare professionals administering IV push medications must be proficient in advanced cardiac life support (ACLS) and possess the authority to initiate emergency protocols. LPN training generally does not include the comprehensive ACLS certification and advanced emergency management skills required for these situations.
-
Legal and Institutional Restrictions
State nursing practice acts and healthcare facility policies often explicitly restrict LPNs from administering specific IV push medications. These regulations are in place to protect patient safety and to ensure that complex medical procedures are performed by qualified healthcare professionals with the appropriate training and experience. These restrictions are not uniform across all jurisdictions, and some facilities may allow LPNs to administer certain IV push medications under the direct supervision of an RN or physician, provided they have received additional training and demonstrated competency.
In summary, the limitations surrounding the administration of specific IV push medications underscore the importance of clearly defined roles and responsibilities within the healthcare team. These restrictions reflect the inherent risks associated with these interventions and the need for specialized training and expertise. By understanding what an LPN cannot do in this context, healthcare professionals can ensure that patients receive appropriate and timely care from qualified individuals, contributing to improved outcomes and safety. The specific medications and the degree of restriction may vary by jurisdiction and institution, emphasizing the need for LPNs to be aware of their state’s nursing practice act and their employer’s policies.
Frequently Asked Questions
This section addresses common inquiries regarding the limitations on Licensed Practical Nurse (LPN) responsibilities. It aims to provide clarity on “what an LPN cannot do”, ensuring a comprehensive understanding of their defined scope of practice.
Question 1: Can an LPN independently manage a patient in acute respiratory distress?
An LPN can assess and initiate basic interventions, such as administering oxygen and monitoring vital signs. However, independent management, including intubation decisions or the administration of advanced respiratory medications, typically requires the expertise of a Registered Nurse (RN) or physician.
Question 2: Is an LPN authorized to administer blood products?
LPNs generally cannot initiate blood transfusions independently. While they may assist with monitoring during the transfusion process, the decision to initiate and the primary responsibility for managing potential reactions rest with RNs or physicians.
Question 3: Can an LPN develop a patient’s care plan?
LPNs contribute to the care planning process through data collection and reporting observations. However, the development of a comprehensive care plan, including formulating goals and selecting specific interventions, typically falls under the purview of RNs or other advanced practice providers.
Question 4: Are LPNs permitted to administer chemotherapy medications?
The administration of chemotherapy is typically outside the LPN scope of practice. These medications require specialized training and expertise due to their cytotoxic nature and the potential for severe adverse reactions.
Question 5: May an LPN independently titrate medications based on patient response?
Independent medication titration is usually restricted for LPNs. Dosage adjustments based on patient response require advanced pharmacological knowledge and assessment skills, which are typically within the RN or physician’s scope.
Question 6: Can an LPN insert a central line catheter?
Central line insertions are complex procedures carrying a risk of complications. LPNs are generally not authorized to independently perform these insertions; the task usually falls to physicians or specially trained RNs.
Understanding these limitations ensures appropriate delegation of tasks and promotes patient safety. Collaboration between LPNs, RNs, and physicians is essential for effective patient care.
The next section will discuss resources available to LPNs for professional development and continued competency.
Navigating Scope of Practice
Adherence to the legally defined scope of practice is paramount for Licensed Practical Nurses. A comprehensive understanding of what constitutes “what an LPN cannot do” is crucial for maintaining patient safety, ensuring regulatory compliance, and fostering professional integrity.
Tip 1: Prioritize Patient Safety Above All Else. Patient well-being is the primary consideration in every clinical decision. When faced with a situation outside the LPN scope, promptly seek guidance from a Registered Nurse (RN) or physician to ensure appropriate care is delivered.
Tip 2: Maintain Thorough Documentation. Accurate and detailed documentation is essential for communicating patient status and interventions. Document any concerns regarding a task that may exceed the LPN scope of practice, and clearly state the rationale for seeking assistance or declining to perform the task.
Tip 3: Continuously Expand Knowledge and Skills. Engage in continuing education to stay abreast of changes in healthcare practices and regulations. Focus on areas where the LPN scope intersects with other disciplines to enhance collaborative skills and contribute effectively to the healthcare team. Understanding not only “what an LPN cannot do,” but also the ‘why’ behind it is critical.
Tip 4: Advocate for Clear Policies and Procedures. Actively participate in the development and implementation of clear policies and procedures within the healthcare facility. Ensure that these policies clearly define the LPN scope of practice and provide guidance on situations that require escalation to higher-level providers.
Tip 5: Seek Mentorship and Guidance. Establish a mentorship relationship with an experienced RN or other healthcare professional. Seek guidance on complex clinical scenarios and discuss potential ethical dilemmas that may arise related to scope of practice limitations.
Tip 6: Understand the State’s Nurse Practice Act. Familiarize yourself with the specific regulations governing LPN practice in the state of licensure. This is the definitive legal framework defining “what an LPN cannot do” and provides a foundation for safe and ethical practice.
Tip 7: Proactively Communicate Concerns. Open and honest communication with supervisors and colleagues is crucial for preventing errors and ensuring patient safety. Do not hesitate to voice concerns if asked to perform a task that feels unsafe or outside the defined LPN scope of practice.
By integrating these guidelines into daily practice, LPNs can effectively navigate the complexities of healthcare delivery while upholding the highest standards of patient care and professional responsibility.
The following concluding remarks will summarize the crucial aspects of “what an LPN cannot do” and its significance in healthcare.
Conclusion
This exploration has illuminated the parameters of “what an LPN cannot do”, emphasizing the limitations within their defined scope of practice. These limitations, including restrictions on advanced assessments, independent medication titration, certain invasive procedures, and complex diagnostic interpretations, are predicated on patient safety and the need for specialized training and expertise. The ability of LPNs to recognize and adhere to these boundaries is paramount.
Moving forward, a continued emphasis on clear communication, collaborative practice, and ongoing professional development will be essential. Healthcare institutions must foster environments where LPNs feel empowered to voice concerns, seek guidance, and contribute effectively within the parameters of their legally defined role. A commitment to understanding “what an LPN cannot do” is a commitment to enhancing the quality and safety of patient care across all healthcare settings.
