What Can a Nurse Do? How to Make Scope-of-Practice Decisions

Carolyn Buppert, MSN, JD

Disclosures

September 11, 2018

Is This Within My Scope of Practice?

The National Council of State Boards of Nursing (NCSBN) has published an algorithm that may be helpful for any nurse, administrator, or employer who wonders whether a role, intervention, or activity is within nursing scope of practice.[3] Here are the questions to answer, according to the NCSBN decision-making framework:

  1. Is the role, intervention or activity prohibited by the Nurse Practice Act and its rules/regulations or any other applicable laws, rules/regulations or accreditation standards? If yes, stop doing or planning the role, intervention, or activity. If no, go on to question 2.

  2. Is performing the role, intervention, or activity consistent with professional nursing standards, evidence-based nursing, and healthcare literature? If no, stop. If yes, go on.

  3. Are practice-setting policies and procedures in place to support performing the role, intervention, or activity? If no, stop. If yes, go on.

  4. Has the nurse completed the necessary education to safely perform the role, intervention, or activity? If no, stop. If yes, go on.

  5. Is there documented evidence of the nurse's current competence (knowledge, skills, abilities, and judgments) to safety perform the role, intervention or activity? If no, stop. If yes, go on.

  6. Does the nurse have the appropriate resources to perform the activity in the practice setting? If no, stop. If yes, go on.

  7. Would a reasonable and prudent nurse perform the role, intervention, or activity in this setting? If no, stop. If yes, go on.

  8. Is the nurse prepared to accept accountability for the role, intervention, or activity for the related outcomes? If no, stop. If yes, you may perform the role, activity or intervention.

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