You have been asked to investigate a new procedure that physicians would like nurses to adopt in the hospital. Discuss the process you would apply to determine whether the procedure falls within the RN scope of practice and how you would go about introducing the new procedure with physicians and fellow nurses. When it comes to investigating a new procedure, a systematic approach should be applied. It is imperative to determine whether a given procedure is within the nursing scope of practice before deciding to adopt or implement it.
Some standard steps that must always be followed are based on the Nurse Practice Act, the ANA Standards of Practice, rights of patients, and safe nursing practice. According to Anderson (2013), determining if a new procedure is within the scope of nursing practice can be accomplished in three steps. First, define the issue, which means clarifying what exactly is being asked and what the new procedure entails. This step also includes gathering any additional information such as conducting a competency assessment to perform the task, as well as any previous experience, current knowledge and skill.
Evidence-based practice and nursing research must also support the adoption of any new procedure.
Secondly, since evidence is not the only component, the Nurse Practice Act and the policies of the workplace must also be considered. Nurses may be limited by the facility policies/standards to perform certain tasks even though the tasks are allowed by the BON (Anderson, 2013). Likewise, nurses may not be legally permitted to perform certain tasks that are commonly performed in the facility.
These policies can vary within the same state and even within the same facility. For example, ICU nurses may be permitted to perform a certain procedure that nurses on the other unit are not. Additionally, consider other resources such as professional organizations for more information.
Many states also have algorithms that help to determine whether task is within the scope of practice. Thus, in the process of investigating a new procedure, review laws and other documents and follow institutional policies or the chain of command to make inquiries, as necessary. For example, if learned that the BON permits nurses to perform the given procedure then the next step is to determine what conditions must be met in order to comply with the Board, such as additional training or education. The final step, according to Anderson (2013), is to make a decision. For a task/procedure to be within the scope of nursing practice, it must be consistent with the Nurse Practice Act, institutional policies, and supported by research or professional organizations.
Most importantly, the primary concern must always be safe environment and patient care (Anderson, 2013). Before introducing and implementing the new procedure, research of evidence-based guidelines, literature from professional organizations, and other resources must be reviewed to determine whether the procedure will result in improved patient outcomes. Hearing the perspective of the staff involved can also help to “develop and refine the proposal for change” (Seagraves, 2009, p.18).
The competence, knowledge, and experience with the procedure must also be taken into consideration in order to determine if additional training may be necessary. If any training is required, then a plan must be made of what the training should entail, how long it will take, along with other details such as when and where. When it is time to introduce the new procedure, “you’ll need to be prepared to be a leader and expert in the change process” (Seagraves, 2009, p.19).
To reduce the possibility of resistance it is also important to share with the staff the research findings about the procedure and receive feedback, thereby gaining support.
Anderson, L. (2013). Understanding the different scope of nursing practice . Retrieved from http://www.nursetogether.com/understanding-the-different-scope-of-nursin Seagraves, K. (2009). How to be a catalyst for change. Nursing:2009, 39, 18-19. http://dx.doi.org/10.1097/01.NURSE.0000365017.08493.08
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