Scope of Practice Registered Nurse
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Linda Haskins Institute Director Of Nursing – OR/ CSSD/ED/UCC/ ONSA
Sheikh Khalifa Medical City Chair of Scope of Practice Committee UAE NMC
21 March 2013
Team SOP Scientific Committee
Scope of practice is nation-wide and to be adopted by all Nurses and healthcare organizations in the country
Dr Fatimah Al Rifai/ Dr Lauren Arnold • Linda Haskins (Chair)
• Ghada Cherry (Secretary)
• Brigitte Peetz
• Jane Abdulali
• Majella Hooper
• Muna Kujuk
• Naeema Rajab
• Rajakumari Ravi
• Zahra Al Jabry
• Salma Awad
• Samia Al Mamari
• Salima Mohamed
• Mirriele Maalouf (ad hoc)
• Dr Fatma Abdullah
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Objectives
Scope of Practice is nation-wide and to be adopted by all Nurses and healthcare organizations in the country
BY the end of this presentation, you will be able to
1. Have overall understanding of RN/ RM & PN/PM Scope of Practice 2. Understand the framework of competency 3. Explain the three domains of competency
• Professional, Ethical and Legal Practice • Care Provision and Management • Professional, Personal & Quality Development
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Scope of Practice
The Scope of Practice is the range of roles, functions, responsibilities, and activities which a nurse is educated for, competent in accountable for and authorized to perform. It defines the accountability and limits or boundaries of professional practice.
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Definition
Scope of Practice
5 Scope of Practice is nation-wide and to be adopted by all Nurses and healthcare organizations in the country
The scope of practice is not limited to specific
tasks, functions or responsibilities but includes
direct care giving and evaluation of its impact,
advocating for patients and for health, supervising
and delegating to others, leading, managing,
teaching, undertaking research and developing
health policy for health care systems.
Scope of Practice
Scope of Practice is nation-wide and to be adopted by all Nurses and healthcare organizations in the country 6
In developing the scope of practice document, national consensus was sought and several resources were utilized including, but not limited to:
MOH Professional Code of Conduct for Nurses (2001)
The MOH Scope of Practice for Registered Nurses (2009)
The MOH Core Practice Standards for Registered Nurse/Midwife (2005)
ICN publications
The MOH Midwifery Scope of Practice (2008)
The HAAD Registered Nurses’ Scope of Practice (2007)
DHA Registered Nurses Scope of Practice.
Resources
Scope of Practice
Factors which influence Scope of Practice
1. Task shifting 2. Health workforce shortage 3. Workforce planning 4. New Nursing Candidates 5. Technology and health care delivery
7 Scope of Practice is nation-wide and to be adopted by all Nurses and healthcare organizations in the country
Scope of Practice
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Scope of Practice and Competency Framework
It can be used to:
Identify common competencies for nurses by regulatory bodies.
Align licensing procedures accordingly.
Develop curriculum and evaluate student competencies by educational institutions .
Use practice settings as a foundation for nursing roles, professional development and
performance appraisal.
The scope of practice identifies the competencies expected of a generalist nurse at the point of entry into professional practice.
By meeting performance criteria, the professional nurse has the knowledge, skills and attitudes to safely and competently provide evidence-based client care.
Written as a Competency Framework
Organized by role domains.
Scope of Practice is nation-wide and to be adopted by all Nurses and healthcare organizations in the country
Scope of Practice
Scope of practice is a nation-wide and to be adopted by all Registered Nurses and healthcare organizations in the country 9
Scope of Practice
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A nurse who functions at a level below the scope of practice standards in one or more areas is to be considered not competent. A nurse who functions at a level beyond the benchmark is to be recognized as functioning at a higher level.
Competencies should not be regarded as prescriptive
Competencies may
Need further expansion
To some extent not applicable
Need to be further elaborated
Scope of Practice is nation-wide and to be adopted by all Nurses and healthcare organizations in the country
Scope of Practice
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Domain one:
This domain reflects the registered nurse’s professional accountability, ethical and legal
practice towards clients, families, community and society, under relevant UAE regulations in
relation to professional practice.
Domain One
Professional
Legal Ethical
Scope of Practice is nation-wide and to be adopted by all Nurses and healthcare organizations in the country
Scope of Practice
Scope of practice is a nation-wide and to be adopted by all Registered Nurses and healthcare organizations in the country 12
Domain Two
Promotion of Health
Provision of Care
Therapeutic and
Interpersonal Relationships
Leadership and
Management
Domain two:
Care Provision and Management
This domain encompasses the key principles of the registered nurse’s role in health promotion, illness
prevention, care provision, leadership and management, as well as therapeutic and interpersonal
relationships pertaining to clients, families, community and society utilizing the nursing process.
Scope of Practice
Scope of practice is a nation-wide and to be adopted by all Registered Nurses and healthcare organizations in the country 13
Domain Three
Professional Development
Enhancement of the
Profession
Development of Others
Quality Management
Domain three:
•Professional, Personal & Quality Development
Registered nurses are required to maintain professional standards to provide quality health care. They have a professional
obligation to develop themselves, and to support other nursing colleagues and healthcare providers, in their professional
development.
Scope of Practice User Guide
Scope of Practice is nation-wide and to be adopted by all Nurses and healthcare organizations in the country 14
Nurses today work in a dynamic health care environment. • Their roles and functions are constantly evolving and changing to meet patient
needs as well as incorporating service needs such as workforce shortages, skill mix issues and budget constraints.
• If nurses are not supported in making scope of practice decisions, this has the potential to impact negatively on both the quality of patient care and the profession of nursing.
The User Guide is part of a learning package that describes the policy framework, relevant concepts, key stakeholders and processes fundamental to any discussion, development and implementation of the scope of nursing practice in any country or jurisdiction.
Purpose for User Guide
Scope of Practice is nation-wide and to be adopted by all Nurses and healthcare organizations in the country 15
The User Guide will describe:
• The policy framework, relevant concepts, key stakeholders and processes fundamental to any discussion, development and implementation of the scope of nursing practice in any jurisdiction.
• The key components of decision making frameworks and tools currently in use around the world.
• Examples how to apply Scope in every day setting
Scope of Practice User Guide
Implementation
Develop Comprehensive and targeted education program
Articulate relationship between the framework and standards and policies
Develop supporting publications and resources
Involve stakeholders
Design educational resources
16 Scope of Practice is nation-wide and to be adopted by all Nurses and healthcare organizations in the country
Scope of Practice User Guide
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ICN, 1985
Scope of Practice is nation-wide and to be adopted by all Nurses and healthcare organizations in the country
Defining terms used on toolkit: Examples off
• Outcomes:
Something that follows from an action, dispute, situation etc.; result, consequence
• Knowledge of:
The state of fact of knowing; familiarity, awareness, or understanding gained through experience or study
• Skills Proficiency, facility, or dexterity
that is acquired or developed
through training and experience • Clinical competencies: A core competency is fundamental
knowledge, ability, or expertise in
a specific subject area or skill set • Education: The delivery of knowledge, skills
and information from teachers to
students. The process of receiving or giving systematic instructions
Reference
Scope of Practice User Guide - DRAFT
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User Guide for Scope of Practice: Domain 2: Care Provision and Management
This domain encompasses the key principles of the Registered Nurse’s/ Registered Midwife’s role in health promotion, illness prevention, care provision, leadership
and management as well as therapeutic and interpersonal relationships pertaining to clients/patients , families, community and society utilizing the nursing /midwifery
process that is supported by evidence based practice.
Competency 2.2 Provision of Care
Provides skilled, safe, holistic and culturally competent nursing and midwifery care to clients/patients, families, community and society, in collaboration with clients and
other health care professionals in a variety of healthcare settings.
Performance Criteria Examples of Outcomes Evidence Guide Examples Examples Related to Skills,
Competences and Education
2.2.1 Performs a comprehensive and
systematic nursing /midwifery assessment for
client/ patients.
Collects subjective and objective data from
interviews, examinations, observations and
client records in an accurate, meaningful and
timely manner
Shares and documents findings accurately
and in a timely manner
2.2.2 Analyses assessment data to determine
health care needs with clients/patients.
2.2.3 Identifies client/patient problems that
serve as a basis for care planning.
2.2.4 Implements a prioritized plan of care by:
Providing care
Assisting with care
Assigning, delegating and supervising care
Teaching clients/patients, family members
and/or significant others
Utilizing appropriate resources
Enabling and promoting independent self-
care
Utilizing a range of effective and appropriate
communication and engagement skills.
Client/patient assessment
(physical and health) conducted in
an organised and systematic way
Applies relevant up to date
research to underpin
nursing/midwifery assessment
Utilises relevant up to date
research relating to health risk
factors for patient /family education
Utilises a range of effective and
appropriate communication and
engagement skills
Consults with patient and clients
to identify their need and desire for
health promotion advice and
education
Recognises when to negotiate
with, or refer to other healthcare or
service providers
Knowledge of:
Physical assessment
Patient health assessment
Patient education strategies /
resources
Up to date evidence based practice
Major determinants of health
Healthy lifestyle behaviours
Positive workplace environment
Physical, mental, social and spiritual
health factors
Healthcare Systems
Health promotion strategies
Roles and responsibilities of various
models of interdisciplinary health
teams
Principles of Infection Control
Environmental hazards
Disaster planning
Risk management
Relevant Policy, Procedures and
Guidelines
Nursing and midwifery processes
Skills:
Physical Assessment
Patient and Family education
Critical appraisal of evidence
Effective communication
Research
Clinical Competencies:
Vital signs
Physical Assessment
Medication Administration
CTG monitoring
Abdominal palpation
Perineal suturing
Obstetric Emergencies
Breast Feeding
Education:
Incident reporting systems
Infection control
Continuing Nurse /Midwife
Education
Imparting knowledge with
colleagues teaching
Self professional
development
Scope of Practice
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Questions
Thank you
Scope of Practice
21 Scope of practice is a nation-wide and to be adopted by all Registered Nurses and healthcare organizations in the country
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www.anmc.org.au/userfiles/file/competency_standards/Competency_standards_RN.pdf
Australian Nursing and Midwifery Council. (2006a). Competency standards for nurses in general practice. Melbourne: Australian Nursing Federation
Australian Nursing and Midwifery Council. (2006b). National competency standards for the nurse practitioner. Retrieved February 10, 2008, from
www.dhhs.tas.gov.au/__data/assets/pdf_file/0017/30680/ANMC_NPCompetency_Standards_2006.pdf
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http://www.crnns.ca/documents/standards2004.pdf
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http://www.dha.gov.ae/EN/Pages/default.aspx
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International Council of Nurses.
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International Council of Nurses. (2008). Nursing care continuum framework and
competencies. Geneva: Author.
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Abu Dhabi: Author.
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http://findarticles.com/p/articles/mi_qa3915/is_199908/ai_n8861001
The Free Dictionary. Retrieved from http://legal-dictionary.thefreedictionary.com
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Uys L. R. (2003). Competency in nursing. Geneva: World Health Organization.
Western Pacific and South East Asian Region. (2006). Common competencies for registered nurses. Retrieved July 10, 2007, from
http://icn.ch/WPSEARcompetencies.pdf