✅ YES — it serves all three levels
Coach Katie's Clinical Club — Scope & Sequence for CNA · LPN · RN
An analysis of how the 57-unit series plus the Part 2 tools map onto the three US licensure levels, and a proposed logical scope and sequence — one content library, three role paths.
The short answer
Yes. And it isn't a stretch — the way each unit is built already matches the way the three licenses differ.
The exams and boards draw the CNA/LPN/RN line at cognitive demand, not at topic. The topics overlap heavily; what changes is what the learner is expected to do with the same clinical situation:
| Level | What the license expects (per boards / NCLEX) | The verb |
|---|
| CNA | Fundamental care under supervision: measure vitals, perform ADLs, move and position safely, keep the patient clean and comfortable, and observe & report changes. Not med administration, assessment, or interpretation. | Do · Observe · Report |
| LPN / LVN | Safe, fundamental care for stable/predictable patients under RN/provider direction: focused data collection (not comprehensive assessment), administer & monitor standard meds, reinforce teaching, recognize normal vs. abnormal, and escalate. "Coordinated Care." | Collect · Monitor · Reinforce · Escalate |
| RN | Full nursing process: comprehensive assessment & interpretation, nursing diagnosis and care planning, analyze labs / decide to hold-titrate, prioritize, delegate & supervise, and manage complex/unpredictable patients. "Management of Care." | Assess · Judge · Prioritize · Delegate · Manage |
Why the format already does this
Every unit ships in layers, and the layers line up with the three verbs above.
| Unit layer | What it trains | Serves most |
|---|
| Skills Arcade (4 mini-games) & Skills Lab device sims | Psychomotor + recognition drills: the hands and the "normal vs. abnormal" eye. | CNA LPN |
| Deeper Dive · Live It | Do the skill correctly, step by step — the procedure itself. | CNA LPN |
| Deeper Dive · Learn It | The why under the skill — physiology, thresholds, reference values. Scales in depth. | LPN RN |
| The Challenge ("What if…" branching) + the built-in escalation / judgment cues | Clinical reasoning: choose, see the consequence, decide when to escalate. | LPN RN |
| Deeper Dive · Share It + The Whole Nurse block | Professionalism, teaching, ethics, communication — shared across all levels. | CNA LPN RN |
The design insight: the same unit can be a CNA competency (play the Arcade + Live It, master the device, learn observe-and-report) and an RN competency (run the Challenge for judgment, use Learn It for interpretation, own the escalation) — without rewriting the content. You differentiate by which layers you assign and how far into Learn It you go.
Level-mapping matrix
● Core — they own/perform it
◐ Contributing depth — focused / monitor / reinforce
○ Awareness / context only
| Block / area | CNA | LPN | RN | Where the line sits |
|---|
| Intro · Low BP · The Bed | ◐ | ● | ● | All recognize & position; LPN/RN add the escalation fork (the sepsis-vs-simple-hypotension call). |
| A · First Look (Vitals, Pain, Weight, Golden Minute) | ● | ● | ● | CNA measures; LPN does focused pain data + monitors; RN interprets trends & decides. True shared core. |
| B · Hygiene, Skin & Dignity | ● | ● | ◐ | CNA-owned territory (ADLs, skin observation, oral care); RN oversees & delegates. |
| C · Mobility, Falls & Positioning | ● | ● | ● | CNA does the hands (transfers, positioning); RN owns the post-fall assessment & work-up. |
| D · Infection Control | ● | ● | ● | Hand hygiene / PPE / isolation = everyone; sepsis recognition & escalation = LPN/RN. |
| E · Elimination | ◐ | ● | ● | CNA does I&O, toileting, ostomy emptying, report; catheter care/insertion & bladder-scan decision = LPN/RN. |
| F · Nutrition & Hydration | ● | ● | ● | Feeding assist + aspiration precautions = all; the dysphagia/NPO judgment = LPN/RN. |
| G · Breathing & Oxygen | ◐ | ● | ● | CNA: pulse ox, positioning, encourage spirometry, report. O₂ titration & the "silent chest" call = LPN/RN. |
| H · Heart & Circulation | ◐ | ● | ● | CNA recognizes & reports, takes orthostatics, "don't massage." ACS/nitro judgment = RN. |
| I · Glucose, Fluids & Labs | ◐ | ● | ● | CNA: glucometer (per role), daily weights, I&O, report symptoms. Lab interpretation & insulin hold/titrate = RN. |
| J · Wounds & Skin Breakdown | ● | ● | ● | CNA prevents & reports (does not stage); dressing changes & staging = LPN/RN per scope. |
| K · Medication Safety | ○ | ● | ● | Med administration = LPN/RN; the independent double-check & high-alert judgment is an RN emphasis. |
| L · Neuro & Mental Status | ◐ | ● | ● | Recognize the change & keep safe = all; stroke-alert / status-epilepticus judgment = LPN/RN → RN. |
| M · Communication | ● | ● | ● | Report, document, therapeutic communication = everyone. SBAR-to-provider & leading hand-off scale up. |
| N · The Whole Nurse | ◐ | ● | ● | Scope/ethics/self-care = all; delegation authority & full prioritization is the RN capstone. |
| Part 2 · Assignment Bank | ○ | ◐ | ● | Prioritize + delegate across an assignment — the defining RN exercise (LPN delegates to UAP only). |
| Part 2 · Skills Lab (BP, Pulse Ox, Scale, Suction, O₂, IV Pump) | ● | ● | ● | BP / pulse ox / scale = all levels; O₂ regulator & IV pump lean LPN/RN (set/monitor per order). |
Scope varies by state and facility — this reflects the common US pattern. The units already frame the boundary cases correctly (e.g., "recognize & report" vs. "assess," and "per facility policy"), which is exactly what makes them safe to reuse across levels.
Proposed scope & sequence
A single spine of 8 phases, foundational → complex. Each level walks the same spine but stops at a different depth (see the role lanes below). Order is by dependency (you can't judge deterioration before you can measure a vital).
Phase 0 · Orientation
Becoming a safe caregiver
Golden Minute · Scope & Professionalism · Therapeutic Communication · Hand Hygiene · Documentation · Self-Care & Burnout
Who am I, what's my lane, how do I keep myself and the patient safe, how do I communicate and chart. CNA LPN RN
Phase 1 · The body & comfort
Vital signs, hygiene, nutrition
Vitals · Daily Weight · Pain · Bath · Heel & Foot · Moisture/Skin · Oral Care · The Bed · Nutrition · Dehydration · Skills Lab: BP · Pulse Ox · Scale
The measurable basics and the comfort core. This is the whole CNA foundation and everyone's starting block.
Phase 2 · Move & protect
Mobility, falls, pressure injury
Safe Transfer · Gait Change · Fall in Room 4 · The Long Lie · Pressure Injury/Staging (prevent) · positioning & the 30° rule
Keep the patient safe in space. CNA owns the hands; LPN/RN add the post-fall assessment.
Phase 3 · Elimination & hydration systems
Bladder, bowel, fluids
Urinary Retention · Foley/CAUTI · Bowel/Ileus · Ostomy · Fluid Balance · Dysphagia (aspiration)
Routine systems care with the first real "recognize & escalate" moments (retention volumes, ileus vs. constipation, silent aspiration).
Phase 4 · Recognize deterioration
The first signs something's wrong
Low BP · Fever/Sepsis · Desaturation · Respiratory Distress · Incentive Spirometer · Cough/Airway · Skills Lab: O₂ Regulator · Suction
The pivot from routine care to rescue. CNA recognizes & reports; LPN/RN own the escalation and the oxygen/airway decisions.
Phase 5 · Systems in trouble
Cardiac · glucose & labs · neuro
Chest Pain · Tachycardia · DVT · Orthostatic · Hypoglycemia · Hyperglycemia/DKA · Reading Labs · Delirium · Stroke/BE-FAST · Seizure · Confusion & Safety
The high-judgment core. Recognition is for everyone; interpretation (labs, ACS, stroke-alert) is the RN layer.
Phase 6 · Wounds & infection control
Skin breakdown, surgical care, isolation
Wound Care · Surgical Incision/SSI · Dehiscence · Isolation & PPE · C. diff
Protecting and healing the barrier. CNA prevents/observes; LPN/RN assess, dress, and stage.
Phase 7 · Medication safety
Giving drugs without harm
Med Rights · High-Alert Meds · Anaphylaxis · Insulin & Anticoagulant · Skills Lab: IV Pump
Primarily LPN/RN. The independent double-check, high-alert judgment, and hold/titrate decisions are RN-weighted.
Phase 8 · Put it together
Think like a nurse
Prioritization & Delegation · Ethics & Advocacy · Part 2: The Assignment Bank
The capstone. Manage a whole assignment, prioritize by ABCs/acuity, delegate safely — the defining RN competency; LPN version is delegate-to-UAP + coordinate.
Three role paths through the same spine
CNA path
Do · Observe · Report
- Phases 0–2 in full (the heart of CNA practice)
- Phase 1 Skills Lab: BP, Pulse Ox, Scale
- Phases 3–6: the Live It + Arcade layers + "recognize & report" only
- Skip: med administration, lab interpretation, staging, delegation, the Assignment Bank
- Endpoint: safe fundamental care + a sharp observe-and-report eye. Maps to NNAAP skill domains.
LPN / LVN path
Collect · Monitor · Reinforce · Escalate
- Everything in the CNA path, at greater Learn-It depth
- Add full Phases 3–7 (elimination, deterioration, systems, wounds, meds)
- Run the Challenges for focused reasoning + escalation
- Assignment Bank at the "prioritize + delegate to UAP" level
- Endpoint: safe care of stable patients + escalation. Maps to NCLEX-PN "Coordinated Care."
RN path
Assess · Judge · Prioritize · Delegate · Manage
- All 8 phases, all layers, deepest Learn It
- Emphasis on Challenges + escalation cues + Reading Labs + high-alert judgment
- Owns Phase 8: full Prioritization & Delegation + the Assignment Bank
- Adds the supervision/delegation lens over Phases 1–2 (what to delegate to CNA/LPN)
- Endpoint: clinical judgment + management of care. Maps to NCLEX-RN "Management of Care."
Standards it already lines up with
| Standard | Level | Where it lives in the Club |
|---|
| NNAAP skill domains (activities of daily living, restorative, safety/emergency, data collection/reporting, psychosocial/rights) | CNA | Phases 0–2 + the observe/report layer of every unit; Skills Lab BP/Pulse Ox/Scale. |
| NCLEX-PN — Coordinated Care, Safety & Infection Control, Health Promotion, Physiological Integrity (basic care, pharm, reduction of risk) | LPN | Phases 0–7; the Challenges + Learn It; Med Safety block; SBAR/Hand-Off. |
| NCLEX-RN (Next Gen) — Management of Care, clinical-judgment measurement model (recognize/analyze cues → prioritize → take action → evaluate) | RN | The branching Challenges are the clinical-judgment model in action; Phase 8 + Assignment Bank = prioritization & delegation. |
The "What if…" branching Challenge is, structurally, the Next-Gen NCLEX clinical-judgment loop (notice cues → interpret → act → see the outcome). That's a strong selling point for the RN market and worth naming explicitly in marketing.
How to package it (recommendations)
1 · Add a role selector on the home page. "I'm training as a… CNA / LPN / RN." It sets a role path that filters the Hub to that lane's phases/layers and badges. One library, three doors.
2 · Tag every unit with a level chip. A small CNALPNRN row on each unit card (mirroring the matrix above) so a learner or instructor sees at a glance what this unit is for them.
3 · Gate by layer, not by locking content. Keep everything open, but make the required set per role explicit (CNA = Arcade + Live It + report; RN = + Challenge + Learn It + escalation). Completion & the 57/57 celebration can be computed per role.
4 · Issue a certificate per tier. "CNA Foundations," "LPN Coordinated Care," "RN Clinical Judgment" — each a defined subset, so the same platform credentials three programs and supports the CNA→LPN→RN bridge (re-use, don't re-teach).
5 · Market the alignment. Name NNAAP / NCLEX-PN / NCLEX-RN explicitly, and pitch the Challenge as the Next-Gen NCLEX clinical-judgment model in gameplay form.
Honest gaps & considerations
State variation is real. Med administration, IV therapy, catheter insertion, and delegation authority differ by state and facility. The units already hedge with "per facility policy," which is the right pattern — but a role path should say "verify against your state's nurse practice act," especially for LPN med/IV scope.
A few areas are thin for a full RN program (they're a skills series, not a complete curriculum): pathophysiology depth, pharmacology breadth, OB/peds/psych/community, and care-plan writing. Position the Club as the clinical-skills & judgment spine that plugs into a program — not the whole program.
The CNA lane needs a couple of explicit "not your job" cues. Units already teach "recognize & report, don't stage / don't interpret," which is perfect — surfacing that as a CNA-lane callout ("your move here is to report, not treat") reinforces safe scope.
Part 2 skews RN. The Assignment Bank (prioritization + delegation) and the IV pump are RN-weighted; the BP / pulse ox / scale sims are genuinely all-level. That's fine — just place them by lane.