Nursing Leadership

Nursing Leadership 32(1) March 2019 : 42-59.doi:10.12927/cjnl.2019.25849
Special Focus on Nursing Scope of Practice

Optimizing Licensed Practical Nurses in Home Care: Their Role, Scope and Opportunities

Kimberly Fraser, Neelam Saleem Punjani, Beth Wilkey, Susan Labonte, Sarah Lartey, Janine Gubersky, Kimberly Nickoriuk, Szjermae Joseph, Sarah Younus and John Miklavcic


This research examined the role and scope of licensed practical nurses (LPNs) in home care (HC) and case management. Case management is relatively new to LPNs in Alberta having been added to their list of competencies in 2015. The extent to which LPNs are performing functions and the circumstances or criteria that shape their reported case management functions and role are not clear. Our research questions were: a) What roles do LPNs play within HC and case management? and b) What roles could LPNs play within HC and case management given their scope of practice to achieve optimal client outcomes and system efficiencies? We used a mixed methods multiple case study design to engage LPNs in case management practice, their managers and HC leaders from rural, urban and suburban HC offices. Approaches for data collection included semi-structured interviews, participant observation, focus groups, document review and survey.

Our findings indicate that there is role variation among LPNs in HC across the three sites in this case study. In HC, the two main roles for LPNs are direct care provision and case management functions. Whether or not LPNs have a designated "case manager" role, all LPNs perform at least some case management functions, such as collaboration, referrals, negotiation and case plan management, as part of their nursing role.



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