Nursing Scope of Practice

Posted: March 12th, 2025

Nursing Scope of Practice | Discuss the evolving scope of nursing practice and how it enhances patient care and healthcare accessibility.

Scope of Practice Scope of practice describes the services that a qualified health professional is deemed competent to perform and permitted to undertake – in keeping with the terms of their professional license. It serves as a regulatory framework that ensures consistency in healthcare delivery while maintaining patient safety and professional accountability. The scope of practice in nursing is dynamic, evolving in response to new healthcare needs and advancements in medical knowledge.

Scope of Practice Defined in Nursing

The Nursing Scope and Standards of Practice describe the “who,” “what,” “where,” “when,” “why,” and “how” of nursing practice. These aspects help define the professional roles and responsibilities of nurses, ensuring a structured approach to patient care. Understanding these elements is essential for both nurses and policymakers to optimize healthcare outcomes.

• Who: Registered Nurses (RN) and Advanced Practice Registered Nurses (APRN) comprise the “who” constituency and have been educated, titled, and maintain active licensure to practice nursing. Their roles differ based on education and certification, but both categories play crucial roles in delivering patient-centered care.
• What: Nursing is the protection, promotion, and optimization of health and abilities; prevention of illness and injury; facilitation of healing; alleviation of suffering through the diagnosis and treatment of human response; and advocacy in the care of individuals, families, groups, communities, and populations. This definition emphasizes the comprehensive and compassionate nature of nursing care, highlighting the necessity of a holistic approach in the profession.
• Where: Wherever there is a patient in need of care. From hospitals to community health centers and home-based care, nurses are present in diverse healthcare environments, adjusting their practice to suit patient needs.
• When: Whenever there is a need for nursing knowledge, compassion, and expertise. The flexibility and adaptability of nursing professionals allow them to provide essential services in various circumstances, including emergencies, long-term care, and rehabilitation settings.
• Why: The profession exists to achieve the most positive patient outcomes in keeping with nursing’s social contract and obligation to society. By maintaining high standards of practice, nurses contribute to enhancing the quality of healthcare services globally.

When each of these questions is answered, the complex considerations in scope of practice become clear. In a profession as dynamic as nursing, and with evolving healthcare demands, changes in scope of practice and overlapping responsibilities are inevitable in our current and future healthcare system. These changes often require ongoing education and policy adjustments to accommodate advancements in medical treatments and technologies.

Newly-Revised: Nursing: Scope and Standards of Practice, 4th Edition

This resource informs and guides nurses in their vital work providing safe, quality, and competent care. Nurses rely on updated standards to navigate ethical dilemmas, maintain professional accountability, and adapt to healthcare advancements. Regular revisions ensure that nursing practices remain evidence-based and aligned with current healthcare expectations.

Nursing Specialty Recognition, Scope and Standards Review, Affirmation of Competencies

The American Nurses Association has an established review program for recognition of a nursing specialty, approval of a specialty nursing scope of practice statement, acknowledgment of specialty nursing standards of practice, and affirmation of focused practice competencies. These processes validate professional expertise and ensure that nurses maintain competency in their respective specialties. Details about each component of this program, specialty characteristics, review criteria, and submission process are described here, offering clear guidelines for nurses seeking career advancement and specialization.

Healthcare Licensure

Currently, all healthcare licensure is state-based, and there is some variability between the qualifications for licensure and re-licensure for each state. Variations in state regulations highlight the importance of staying informed about local licensing requirements to ensure compliance and continued professional practice.

Defining scope of practice is generally a two-step process:

• Step 1: The state legislature passes a law, known as a “nurse practice act.” This legislation outlines the legal framework that governs nursing practice within the state.
• Step 2: Regulatory bodies then create and implement rules and regulations intended to protect the public. These governing entities ensure that nursing practice adheres to safety standards and ethical considerations, minimizing risks to patients.

Choice in Healthcare Providers

The American Nurses Association (ANA) believes that patients’ interests are best served by a healthcare system in which many different types of qualified professionals are available, accessible, and working together – collaboratively. This multidisciplinary approach to healthcare enhances service delivery, reduces patient wait times, and ensures comprehensive patient care. Therefore, it is important for scope of practice to reflect a professional’s true expertise and allow nurses to operate at the highest level of their training.

ANA is a founding member of the Coalition for Patients’ Rights (CPR), which was established to improve patients’ access to the healthcare providers of their choice and the range of services those providers offer. The CPR consists of more than 35 organizations representing a variety of licensed healthcare professionals, each providing a diverse array of safe, effective, and affordable care. Increasing accessibility to healthcare services can significantly improve patient outcomes and reduce disparities in medical care.

Protecting and Advancing Scope of Practice

Protecting and advancing scope of practice for nurses is a major initiative for ANA. As healthcare systems continue to evolve, ensuring that nurses can perform their duties without unnecessary restrictions is critical. In the fast-moving world of healthcare, it is vital that nurses are able to practice to the full extent of their education and abilities in order to deliver the most efficient, quality care to patients.

There is a growing body of evidence to support the safe and cost-effective provision of care by APRNs, and a national call to remove all barriers to full practice authority. Studies have shown that expanding nurses’ scope of practice can enhance patient satisfaction, increase healthcare efficiency, and reduce costs. ANA remains committed to monitoring and advocating for legislative and regulatory changes relating to scope of practice, with the aim of removing practice barriers for nurses and improving access to care. Legislative support for nurses is essential in addressing workforce shortages and meeting the increasing demand for healthcare services.

Sample Topics:

Advancing Nursing Roles: The Importance of Scope of Practice in Patient Care

Examine the role of APRNs in modern healthcare and the call for removing practice barriers

Explain the impact of regulatory frameworks on the nursing profession and patient care quality.

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