Scope of Practice Registered Nurse

1

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

3

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

Canadian Nursing association. (2007). Framework for the practice of registered nurses in Canada. Retreived June 24, 2008, from http://www.cna-

aiic.ca/CNA/documents/pdf/publications/RN_Framework_Practice_2007_e.pdf

College of Registered Nurses of Nova Scotia. (2003). Standards for nursing practice. Retrieved September 17, 2009, from

http://www.crnns.ca/documents/standards2004.pdf

Dubai Health Authority, UAE. (2008). Registered Nurses scope of practice. Dubai. Retrieved February 10, 2009,from

http://www.dha.gov.ae/EN/Pages/default.aspx

Federal Department of Nursing, MOH, UAE. (2005). Core practice standards for the registered nurse and/or midwife. Abu Dhabi: Author.

Federal Department of Nursing, MOH, UAE. (2008). Scope of practice for registered midwives. Abu Dhabi: Author.

Federal Department of Nursing, MOH, UAE. (2009). Scope of practice for registered nurses. Abu Dhabi: Author.

Health Authority of Abu Dhabi. (2007). Scope of practice: Registered nurses. Retrieved February 10, 2008, from

www.haad.ae/HAAD/Portals/0/Private_Sector/Health_Pro_Lice/Policies&Circulars/Final%20RN%20scope%20July_07.pdf

International Council of Nurses. (2003). ICN framework of competencies for the generalist nurse: Report of the development process and consultation. Geneva:

International Council of Nurses.

International Council of Nurses. (2005a). Guidelines on shaping effective health policy. Retrieved September 12, 2009, from http://icn.ch/guideslines_shaping.pdf.

International Council of Nurses. (2005b). Regulation terminology, (version 1). Retrieved March 26, 2008, from http://www.icn.ch/Regulation_Terminology.pdf

International Council of Nurses. (2008). Nursing care continuum framework and

competencies. Geneva: Author.

Ministry of Health, UAE. (2001). Professional code of conduct for nurses.

Abu Dhabi: Author.

Nursing Council of New Zealand. (2007). Competencies for registered nurses. Retrieved March 12, 2008, from www.nursingcouncil.org.nz

Skill and lifelong learning: The link for quality nursing. (1999). Concern 28 (3): 14-15. Retrieved March 18, 2008, from

http://findarticles.com/p/articles/mi_qa3915/is_199908/ai_n8861001

The Free Dictionary. Retrieved from http://legal-dictionary.thefreedictionary.com

Nursing and Midwifery Council, UAE. (2011). UAE NMC Terminology. Author.

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