Key Takeaways
- Scope of practice defines what CNAs are legally authorized to do
- CNAs can perform personal care, vital signs, mobility assistance, and basic documentation
- CNAs cannot administer medications, insert catheters, or make nursing diagnoses
- Scope varies by state—always check your specific state regulations
- Performing tasks outside scope can result in loss of certification and legal liability
CNA Scope of Practice
The scope of practice defines what a Certified Nursing Assistant is legally permitted to do. Understanding your scope of practice is essential for providing safe patient care and protecting your certification.
What is Scope of Practice?
Scope of practice refers to the range of responsibilities and activities that a healthcare professional is legally authorized to perform based on their education, training, and certification. For CNAs, this scope is defined by:
- State nurse practice acts - Laws that define nursing roles
- State nursing board regulations - Specific rules for CNAs
- Facility policies - Additional restrictions at your workplace
- Federal regulations - OBRA requirements for nursing facilities
CNA Authorized Tasks
CNAs are trained to perform tasks under the supervision of licensed nurses. These include:
| Category | Authorized Tasks |
|---|---|
| Personal Care | Bathing, grooming, dressing, oral care, toileting |
| Mobility | Positioning, transfers, ambulation, range of motion |
| Nutrition | Feeding, measuring intake/output, passing trays |
| Vital Signs | Temperature, pulse, respirations, blood pressure |
| Safety | Fall prevention, answering call lights, bed positioning |
| Elimination | Bedpan/urinal, catheter care (external), output measurement |
| Documentation | Recording observations, ADLs, vital signs |
| Communication | Reporting changes, patient interaction |
Tasks OUTSIDE CNA Scope
CNAs are NOT authorized to perform certain tasks, regardless of who asks:
| Prohibited Task | Reason |
|---|---|
| Administering medications | Requires licensed nurse |
| Giving injections | Requires licensed nurse |
| Inserting IVs or catheters | Requires licensed nurse |
| Performing sterile procedures | Requires licensed nurse |
| Making nursing diagnoses | Requires RN assessment |
| Developing care plans | Requires RN judgment |
| Giving medical advice | Outside scope of practice |
| Adjusting oxygen flow rates | Requires physician order |
| Tube feedings (insertion) | Requires licensed nurse |
| Blood glucose testing | Varies by state—check regulations |
State Variations
Scope of practice can vary significantly by state:
- Medication aides: Some states allow additional training for medication administration
- Blood glucose monitoring: Permitted in some states with additional training
- G-tube care: Some states allow feeding through established tubes
- Tracheostomy suctioning: Permitted in some states with specialized training
Always check your state's specific regulations and facility policies.
The Importance of Staying Within Scope
Performing tasks outside your scope of practice can result in:
- Harm to the patient - Lack of training can cause injury
- Loss of certification - State board can revoke your CNA
- Legal liability - You can be sued for negligence
- Criminal charges - Serious violations may be prosecuted
- Termination - Employers must take action
What to Do if Asked to Perform an Unauthorized Task
If anyone asks you to perform a task outside your scope:
- Politely decline - "I'm not trained/authorized to do that"
- Explain your scope - "That requires a licensed nurse"
- Offer alternatives - "I can help you find the nurse"
- Document if needed - Record inappropriate requests
- Report concerns - Notify your supervisor
Which of the following tasks is WITHIN the CNA scope of practice?
What defines the legal limits of what a CNA can do?
A nurse asks you to give a patient their oral medication. What should you do?