Nurses', midwives' and key stakeholders' experiences and perceptions of a scope of nursing and midwifery practice framework.

Abstract

This paper reports on the qualitative findings from a national review of a nursing and midwifery scope of practice framework. Scope of professional practice frameworks offers a system of rules and principles to regulate its members and demonstrate its responsibility to society. Key issues in reviewing the scope of practice include notions of specialist and advanced practice, accountability, autonomy, competence, supervision, continuing professional development and delegation. Evaluation of scope of practice frameworks has particular application value to nurses, midwives, regulatory bodies and healthcare employers across the globe. A mixed methods approach was used. This included a national survey of nurses and midwives and focus groups and interviews with key stakeholders. The qualitative data are reported in this paper. Focus groups and interviews were conducted among a convenience purposive sample of key stakeholders, including nurses and midwives working in the widest range of services and settings in 2014. The participants contributed to thirteen focus groups and thirteen interviews. Six global themes, as follows: Evolution of the nursing and midwifery professions and practice; Scope of practice: understanding and use; Expanding scope of practice; Professional competence; Practice setting and context; Reflections on the current framework. Practitioners understand the scope of professional practice and while some see it as empowering others see it as potentially restrictive. Nurses and midwives are generally willing to expand their scope of practice and see it as resulting in improved patient care, improvement in overall quality of standards and increased job satisfaction.