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Scope of Practice Guidelines (LNA)

A nursing assistant is responsible for knowledge listed in; the approved curriculum for nursing assistants found in Nur 704.09. In addition, nursing assistants can be educated to perform functions over and above the basic curriculum of the; nursing assistant education program and these functions can be delegated when:

  • The task has been properly delegated to the nursing assistant by the supervising licensed nurse. (Hegner, Acello, & Caldwell, 2008).
  • Additional training and competency is obtained when needed and required under Nur 404.12. (formerly Nur 305.01 (c) & (d) regulation.
  • The task has not been made exempt from nursing assistant practice by a prior Board of Nursing ruling and as described in the Administrative Rules; and
  • The facility policy and procedure allows this function.

The below lists should not be considered all inclusive

List of not approved

The Board has approved the following activities as within the Licensed Nursing Assistant Scope of Practice as long as the nursing assistant has met the Nur 404.12 (formerly Nur 305.01 (c) & (d);

  • Administer fleets enema
  • Administer non-medicated suppositories (5/2011)
  • Alternative Therapies (6/1998)
  • Application of TENS unit (10/2003)
  • Assist with oxygen therapy (Spring 2003)
  • Bladder, Colostomy, and NG Irrigations (9/2004)
  • Bladder scan or Dopple;
  • Blood glucose monitoring (Fall 2000)
  • Change the collar that holds a tracheostomy tube in place as delegated by the nurse (6/2004)
  • Chest physiotherapy (Spring 2000)
  • Collection of Flu and Strep Swabs (2/2013)
  • Colostomy irrigations
  • EKGs with competencies
  • Feeding tubes ( Fall 2000, Spring 2001)
  • Feedings via pump (3/2011)
  • Finger stick PT/INR testing (8/2005)
  • Foley irrigations
  • Foot Care to Diabetics (1/2005)
  • Incentive spirometry (Spring 2000)
  • LNAs educated and certified by a board approved program may assist, observe, and document medications taken b a client residing in a residential care setting or in their home as delegated by the licensed nurse and supported by facility/agency policy and procedures. (3/2007, 2/2008)
  • Medicated lotions, ointments and creams related to skin care (not nitropaste) (3/1995, Spring 2000)
  • Oral suctioning of mouth and nares only (Spring 2000)
  • Perform Sweat Tests (3/2012)
  • Peripheral vein IV removal;
  • Phlebotomy with competencies (Spring 2000)
  • Pulse oximetry
  • Reminding clients to take their medications
  • Removal of foley catheters (3/2010)
  • Routine stable wound care (9/2004)
  • Saline Nasal Lavage (3/2012)
  • Straight urinary catheters
  • Stump Wrapping (1/2005)
  • Test stool for occult blood
  • Transcribing medical orders
  • Urine Dip (5/2011)
  • Use of GS Vibracare Persussor (1/2012)
  • Vagus nerve stimulation (Spring 2001)

The Board has opined that it is not within the scope of practice for a Licensed Nursing Assistant to engage in the following activities:

  • Administer Botox (12/2006)
  • Administer non-ablative laser treatments (12/2006) and
  • Administer OTC Medication in a home setting (3/2011)
  • Administer/apply Lidocaine jelly (12/2011)
  • Administration of Nystatin mouthwash (11/2005)
  • Apply Ankle Foot Orthosis & Thoracolumbosacral Orthosis Braces (2/2013)
  • Calling in prescribing practitioners orders to the pharmacy (4/2004)
  • Check (assess) for G tube placement (7/2011)
  • Clamp NG Tube (1/2013)
  • Co-sign narcotic order (2/2008)
  • Empty a Supra-pubic Catheter clamped and not attached to a drainage bag (1/2013)
  • Flu and Sweat Test Swabs (2/2013)
  • Handling Medications ( 6/2009)
  • Hyperalimentation (9/2004)
  • Insertion of G tubes or any feeding tubes
  • Insertion of indwelling urinary catheters (9/2004)
  • Insertion of intravenous catheters (1/2004)
  • LNA scrub for C-Section (Sterile Technique) (4/2008) (6/2008)
  • LNA suture removal (5/2008)
  • Laser treatments (12/2006)
  • Medication Pick-up from Pharmacy (6/2009)
  • Medication preparation when acting in the role of an LNA-MC (12/2012)
  • Parafin Wax Treatments (1/2012)
  • Patient Teaching (1/2012)
  • Perform sterile technique (4/2008)
  • Perform Thermal Stimulation to CVA Patient (Spring 1988, Spring 2000)
  • Priming of IV's (03/2010)
  • Pro-oxygenate a patient for Trach Suctioning (8/1988)
  • Regulate Oxygen Therapy Flow Rate (9/2004)
  • Sign for Medications delivered by the Pharmacy (3/2012)
  • Spiking and priming IV fluids (12/209)
  • Telephone triage (6/2006)
  • Thermal Stimulation (Spring 1998, Spring 2000)
  • To pull femoral/venous arterial sheath post cardiac catheterization (11/2007)
  • Use of a nail dremel (electric nail file) (4/2008)

References: Dugan, D. (2008). Successful Nursing Assistant Care 2nd Ed New Mexico, Albuquerque. Hartman Publishing Inc.
Hegner, B., Acello B., & Caldwell, E. (2008). Nursing Assistant A Nursing Process Approach. 10th ed. Thomson Delmar Learning.


New Hampshire Board of Nursing
121 South Fruit Street   |  Concord, NH 03301
Nursing (603) 271-2323  |  Nursing Assistant (603) 271-6282
Fax (603) 271-6605