Variability in Nursing Roles and Responsibilities within Veterans Health Administration Primary Care Settings
By
Chelsea McConnell
Elvira E. Jimenez
Charlene Pope
Rong Guo
Traci Solt
Laura Coyle
Jami Falk
Evelyn T. Chang
August 28, 2026
Clinical Scorecard: Variability in Nursing Roles and Responsibilities within Veterans Health Administration Primary Care Settings
At a Glance
Category Detail
Condition Nursing Roles in Primary Care Key Mechanisms Patient-centered medical homes and Patient Aligned Care Teams (PACTs) Target Population Veterans receiving primary care services Care Setting Veterans Health Administration primary care
Key Highlights
RNs and LPN/LVNs have distinct scopes of practice within PACTs. RNs reported higher involvement in care coordination and administrative tasks. LPN/LVNs more frequently performed immunizations and health care screenings. Both groups reported limited time allocated to chronic disease management. Nursing activities generally aligned with the VHA PACT handbook. Guideline-Based Recommendations
Diagnosis
Management
Monitoring & Follow-up
Risks
Patient & Prescribing Data
Veterans in primary care settings
Nurses practice below their full scope, impacting care delivery.
Clinical Best Practices
Optimize nursing roles to align with training and scope. Enhance understanding of assigned responsibilities among nursing staff. Implement strategies to improve chronic disease and population management. Related Resources & Content
