Scope of Practice Registered Nurse 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
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Team SOP Scientific Committee 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
Scope of practice is nation-wide and to be adopted by all Nurses and healthcare organizations in the country
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Objectives 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
Scope of Practice is nation-wide and to be adopted by all Nurses and healthcare organizations in the country
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Scope of Practice Definition 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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Scope of Practice 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 is nation-wide and to be adopted by all Nurses and healthcare organizations in the country
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Scope of Practice Resources 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. Scope of Practice is nation-wide and to be adopted by all Nurses and healthcare organizations in the country
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Scope of Practice Factors which influence Scope of Practice
1. 2. 3. 4. 5.
Task shifting Health workforce shortage Workforce planning New Nursing Candidates Technology and health care delivery
Scope of Practice is nation-wide and to be adopted by all Nurses and healthcare organizations in the country
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Scope of Practice Scope of Practice and Competency Framework Written as a Competency Framework It can be used to:
Organized by role domains.
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. By meeting performance criteria, the professional nurse has the knowledge, skills and attitudes to safely and competently provide evidence-based client care.
The scope of practice identifies the competencies expected of a generalist nurse at the point of entry into professional practice.
Scope of Practice is nation-wide and to be adopted by all Nurses and healthcare organizations in the country
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Scope of Practice
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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Scope of Practice 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 may Competencies should not be regarded as prescriptive
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
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Scope of Practice Professional
Domain One Ethical
Legal
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. Scope of Practice is nation-wide and to be adopted by all Nurses and healthcare organizations in the country
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Scope of Practice Promotion of Health
Leadership and Management
Domain Two
Provision of Care
Therapeutic and Interpersonal Relationships 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 is a nation-wide and to be adopted by all Registered Nurses and healthcare organizations in the country 12
Scope of Practice Professional Development
Quality Management
Domain Three
Enhanceme nt of the Profession
Development of Others
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 is a nation-wide and to be adopted by all Registered Nurses and healthcare organizations in the country 13
Scope of Practice User Guide 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.
Scope of Practice is nation-wide and to be adopted by all Nurses and healthcare organizations in the country
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Purpose for User Guide 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 is nation-wide and to be adopted by all Nurses and healthcare organizations in the country
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Scope of Practice User Guide Implementation
Develop Comprehensive and targeted education program Articulate relationship between the framework and standards and policies Design educational resources
Develop supporting publications and resources Involve stakeholders Scope of Practice is nation-wide and to be adopted by all Nurses and healthcare organizations in the country
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Scope of Practice User Guide
ICN, 1985
Scope of Practice is nation-wide and to be adopted by all Nurses and healthcare organizations in the country
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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 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 Client/patient assessment Knowledge of: Skills: systematic nursing /midwifery assessment for (physical and health) conducted in Physical assessment Physical Assessment client/ patients. an organised and systematic way Patient health assessment Patient and Family education Collects subjective and objective data from Applies relevant up to date Patient education strategies / Critical appraisal of evidence interviews, examinations, observations and research to underpin resources Effective communication client records in an accurate, meaningful and nursing/midwifery assessment Up to date evidence based practice Research timely manner Utilises relevant up to date Major determinants of health Clinical Competencies: Shares and documents findings accurately research relating to health risk Healthy lifestyle behaviours Vital signs and in a timely manner factors for patient /family education Positive workplace environment Physical Assessment 2.2.2 Analyses assessment data to determine Utilises a range of effective and Physical, mental, social and spiritual Medication Administration health care needs with clients/patients. appropriate communication and health factors CTG monitoring 2.2.3 Identifies client/patient problems that engagement skills Healthcare Systems Abdominal palpation serve as a basis for care planning. Consults with patient and clients Health promotion strategies Perineal suturing 2.2.4 Implements a prioritized plan of care by: to identify their need and desire for Roles and responsibilities of various Obstetric Emergencies Providing care health promotion advice and models of interdisciplinary health Breast Feeding Assisting with care education teams Education: Assigning, delegating and supervising care Recognises when to negotiate Principles of Infection Control Incident reporting systems Teaching clients/patients, family members with, or refer to other healthcare or Environmental hazards Infection control and/or significant others service providers Disaster planning Continuing Nurse /Midwife Utilizing appropriate resources Risk management Education Enabling and promoting independent selfRelevant Policy, Procedures and Imparting knowledge with care Guidelines colleagues teaching Utilizing a range of effective and appropriate Nursing and midwifery processes Self professional communication and engagement skills. development 19
Scope of Practice Questions
Thank you
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Scope of Practice References Australian Nursing and Midwifery Council. (2005). National competency standards for the registered nurse. Retrieved September 12, 2007, from 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.cnaaiic.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
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