Scope of Practice Elaine Harris Clinical Placement Coordinator Our Lady’s Children’s Hospital, Crumlin, Dublin 12

Definition of Scope of Practice  The range of roles, functions responsibilities and activities, which a registered nurse is educated, competent, and has authority to perform (An Bord Altranais, 2000)

Competence  ‘Competence is the ability of the registered nurse to practice safely and effectively within his/her scope of practice’ (ABA, 2000)

Competence  Not static  Developmental  Specific skill may be learned, but knowledge may change over time  Acknowledge any limitation of competence

Determining Competence  The assessment of one’s own competence includes: The recognition of one’s own abilities Practicing within the limits of one’s own abilities and qualifications but not beyond the scope of practice  In accordance with legislation and The Code of Professional Conduct

Accountability  Being answerable for the decisions made in the course of one’s own professional practice  Applies to both actions and omissions

Responsibility  ‘A charge for which one is answerable’ (Batey and Lewis, 1982)

5 rights of delegation  Right task  Right circumstance  Right person  Right directions or instructions  Right supervision (Davidson and Scott, 1999)

Emergency Situations  ‘Nothing can be construed as preventing a nurse from taking appropriate action in the case of an emergency’ (ABA, 2000)  Best interest of the patient must be served by appropriate nursing intervention in emergency situations

Nurse Scope of Practice Decision – Making Framework  This framework supports and guides nurses

Scenario 1  A Seconded Student is working on an infant ward and is asked by a mother to bath her infant on her 1 st day  She has bathed adults while on General Placement and is nervous about bathing an infant  She is not sure of she is competent or not  What should she do?

Scenario 2  A 4 Year Seconded Student working in a surgical paediatric unit is asked by the CNM if she would collect a patient from theatre.  She has done this while on General Placements.  What should she do?