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Factors to Be Considered If Actions Are Within the Domain of Nursing Practice

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What factors need to be considered when determining whether or not identified actions are within the domain of nursing practice?

One’s scope of practice is ever evolving as experience is gained working in an area of expertise. The American Nurses Associate gives a simple description when thinking about determining scope of practice it is the “who," "what," "where," "when," "why," and "how" of nursing practice.
Consideration must be given to the guidelines of the Nurse Practice Act, rules/regulations/guidelines of the state in which the nurse is working, the policy and procedures of the facility in which the nurse is working, community standards of professional organizations, the nurses own educational preparation and clinical experience. Texas Board of Nursing has an algorithm to assist nurses in making a determination of an activity falls in the general scope of practice called the Six-Step Decision-Making Model for Determining Nursing Scope of Practice (TBON, 2010).

Six-Step Decision-Making Model for Determining Nursing Scope of Practice
1. Is the activity consistent with the Nursing Practice Act (NPA), Board Rules, and
Board Position Statements and/or Guidelines?
Yes → Continue No → STOP
2. Is the activity appropriately authorized by valid order/protocol and in accordance with established policies and procedures?
Yes → Continue No → STOP
3. Is the act supported by either research reported in nursing and health-related literature or in scope of practice statements by national nursing organizations?
Yes → Continue No → STOP
4. Do you possess the required knowledge and have you demonstrated the competency required to carry out this activity safely?
Yes → Continue No → STOP
5. Would a reasonable and prudent nurse perform this activity in this setting?
Yes → Continue No → STOP
6. Are you prepared to assume accountability for the provision of safe...

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