RNs More Likely to Spot Medication Discrepancies than LPNs

Researchers at the University of Missouri (MU) have found that registered nurses (RNs) are more likely to identify high-risk medication discrepancies than licensed practical nurses (LPNs). The study, published in the Journal of Nursing Regulation (2015;6(3):48-56), suggests that RNs are better equipped to assess and identify medication errors that could pose risks to residents’ safety.

Almost 66% of all adverse events experienced by nursing home residents—such as falls, delirium, and hallucinations—could be prevented, in part, by monitoring medications more closely. In nursing homes, both RNs and LPNs perform medication reconciliation, a safety practice during which health care professionals review patients’ medications to reduce the likelihood of preventable adverse drug events.

Amy Vogelsmeier, assistant professor at MU’s Sinclair School of Nursing, and her colleagues examined the extent to which licensure (RN or LPN) relates to the detection of medication discrepancies. Thirty-two RNs and 70 LPNs from 12 nursing homes in Missouri participated in the study. The researchers found that RNs detected medication order discrepancies involving high-risk medications significantly more often than LPNs. 

“Nursing home work is hard,” Vogelsmeieir said. “The ability to manage patients’ care and keep them stable is a clinical challenge that requires highly educated, clinically savvy nurses. Currently, RNs are not functioning in nursing homes to the full scope of their practice. RNs and LPNs are assigned the same responsibilities; yet, earlier research findings show that LPNs are more focused on tasks, whereas RN are more focused on comprehensive assessment and resident safety.”

Distinguishing the differences in how RNs and LPNs perform similar responsibilities, and making sure nurses complete the tasks for which they are trained, could improve patient care for nursing home residents, many of whom are frail and require specialized care. 

“RNs and LPNs contribute to resident safety in different ways,” said Vogelsmeier. “They both serve important roles; however, nursing home leaders must understand the distinct contributions of each role. For example, during a process such as medication reconciliation, which is executed differently by RNs and LPNs, understanding the differences will allow for the nurses’ different skill sets to be more appropriately utilized.”—Amanda Del Signore