Scope Of Professional Practice Research Articles

Enhancing vision care integration: 1. Development of practice algorithms

Background: Appropriate access to the best quality of vision care is enhanced when patients receive eye care services from the right professional, at the right time, and in the right place. This paper, the first in a two-part series, describes the development of an integrated framework for vision care delivery. Specifically, two patientcentred vision care algorithms for the multidisciplinary management of diabetic retinopathy and the red eye are outlined, and the process that resulted in their development is described.Methods: The method used relies on a description of a multidisciplinary collaboration that occurred among ophthalmologists, optometrists, general practitioners and representatives of the Nova Scotia Department of Health with the aim of developing an integrated patient-focused multidisciplinary framework for vision care delivery.Results: The process of collaborative negotiation among the four groups resulted in the development of multidisciplinary algorithms for the screening of patients with diabetes mellitus and the treatment of those presenting with a red eye.Interpretation: Professional scope of practice has always been a contentious issue among health care professions. However, where parties agree to work within an atmosphere of respect and to accept guidance in areas of disagreement from a third party respected by all, compromise is possible.The result was the development of two vision care algorithms and ongoing efforts on the development of other algorithms.

The educational preparation of nursing staff undertaking pre-assessment of surgical patients – a discussion of the issues

This article discusses the education and training needs of nursing staff undertaking the pre-assessment of surgical patients in the context of role development within health care. The authors undertook this piece of work as part of a project to inform the development of a competency framework for use by registered nurses working in the field of pre-assessment screening and preparation of surgical patients. A selective review of the literature on the education and training needs of pre-assessment nurses, and nurses undertaking expanded roles has been undertaken and some of the emerging issues are debated. The nature of current preparation for these roles and the apparent lack of any consistent approach to education and training for staff adjusting their scope of professional practice is debated. A brief review of the nature of competence and some of the different models including occupational competence models are presented. Finally, the implications of these for the development of a strategy for the acquisition and demonstration of knowledge and skills in pre-assessment nursing staff are presented.

Clinical supervision in primary care

Clinical supervision has already been well established in many disciplines. The models are varied and may have differing functions, but professionals working in areas such as social work, psychotherapy, counselling, child protection and midwifery have well developed frameworks for the provision of clinical supervision. The drive for supervision in general nursing has come from several sources such as the developments in pre- and post-registration education and the UKCC publications: Exercising Accountability (1989); Scope of Professional Practice (1992); Position Statement on Clinical Supervision (1996).

Audiology Scope of Practice Expands as Profession Grows

Audiology Scope of Practice Expands as Profession Grows

The development of telephone triage: historical, professional and personal perspectives

The authors examine the concept of nurse led services: professional, theoretical, developmental, and ethical implications for the nursing profession, patients, and their families. In the UK, the Scope of Professional Practice (1992) cleared the way for registered nurses to expand their role, ultimately to provide a better service and to develop the profession. The nursing profession has a strong tradition of adapting to change and responding positively to new health care needs ( DOH 1999). This nursing strategy for England makes particular reference to nurse led initiatives and direct reference to National Health Service (NHS) Direct; the 24-h nurse led telephone help and advice service available across England and Wales. Particular attention will be focused on a nurse led telephone triage which was developed in the authors’ own area of elective orthopaedics.

Physical assessment of the newborn: a holistic approach

The role of the midwife encompasses holistic care of the mother and baby in the antenatal, intranatal and postnatal periods. Midwives carry out the initial examination of the newborn infant at birth to rule out any obvious abnormalities. The baby is usually examined again at the time of discharge. Traditionally this role has been performed by the paediatric or obstetric senior house officer. When babies are born at home, the general practitioner should examine the baby at least once during the postnatal period. With the implementation of the Scope of Professional Practice (UKCC, 1992) midwives are now in a position to undertake all the examinations of neonates in their care. This would further enable midwives to provide seamless care to the family unit.

A model for implementing the "Scope of Professional Practice".

Safe and effective administration of intravenous therapy to children is essential. The training, education and assessment (TEA) programme aimed to integrate the essence of the Scope of Professional Practice with a competency based approach to teaching and assessing essential skills. The TEA programme was developed to reflect the Scope of Professional Practice, individual accountability, and current best evidence. A significant part of the programme is the development of an innovative assessment document providing individuals with documented evidence of related knowledge and skills which can form part of their Professional Portfolio. The TEA programme has been implemented within the trust in line with trust clinical governance strategy. The framework for implementing this programme has also been used for developing TEA for other expanded roles within the trust. Further comprehensive evaluation of the programme through areas such as audit of practice and clinical incidence analysis is needed. Further research to broaden the evidence base for practice is also needed. These will be initiated through established clinical governance frameworks.

The extended role of the nurse — Opportunity or threat?

Nursing practice is undergoing changes that are both exciting and controversial. The UKCC Scope of Professional Practice has encouraged nurses to re-evaluate their practice and, as a result, nurses from various fields have expanded their roles to meet the changing needs of patients and the profession. Published evidence shows that nurses can be as effective as doctors within these expanded roles, but that there is a danger that gender issues will cloud the debate because of the assumption that all nurses are female and all doctors are male. This problem is especially evident when female nurses perform an extended role involving male patients, although female doctors are in a similar position and work with the same patients without undue comment. The roles of doctors and nurses should complement each other, and all practitioners should work for the benefit of patients in their care, rather than defending traditional roles and hierarchy. There is confusion surrounding accountability of nurses who work in an extended role between the medical and the nursing profession, and both the Royal College of Nursing and the British Medical Association need to clarify the situation. This article looks at the arguments for and against the extended role of the nurse specialist and discusses current opinions within the nursing and medical fields. The article also describes how nurses at Midland Fertility Services have successfully extended their role to encompass ultrasound-guided oocyte retrieval and surgical sperm recovery.

Reviewing the scope of professional practice.

Recently, I had the pleasure of launching the Irish Scope of Nursing and Midwifery Practice Framework for An Bord Altranais (An Bord Altranais, 2000), the statutory body responsible for the regulation of the practice of nursing and midwifery in Ireland. The timing of the Irish launch was very appropriate, given that the UKCC has recently published a report (UKCC, 2000) into the application and impact of The Scope of Professional Practice (Scope), which was launched in 1992 (UKCC, 1992).

Nurse who pretended to be a paramedic to treat crash victims

When the UKCC published The Scope of Professional Practice (Scope) in 1992 this document was regarded as having the potential to liberate nursing's professional development by helping nurses respond more quickly and flexibly to patients' needs. In the past, the Department of Health had placed restrictions on nurses extending their roles. Furthermore, there was too much unnecessary reliance on certification for extended tasks. It was therefore decided that developments in the nursing role should only be limited by the individual, accountable practitioner's own knowledge and competence.

Recognising advancing nursing practice: evidence from two observational studies

Debates over title, grades and relationships across the profession has tended to dominate the literature in advancing nursing practice. Fewer research projects have attempted to study the activities of nurses who are designated as undertaking advancing nursing roles. One study evaluating Masters courses for Clinical Nursing Practice and a second addressing the impact of the ‘Scope of Professional Practice’ (United Kingdom Central Council for Nursing, Midwifery & Health Visiting, 1992) document by this team of authors afforded these research opportunities. In this paper empirical data from ‘reflective’ observation with 19 nurses (including midwives and health visitors) are presented to illustrate the range and type of functions undertaken by a small group of practitioners developing their practice. A number of characteristic features emerged. Assessment of individual and group needs, positive motivation to constantly improve practice, inter-disciplinary and cross agency working for planned change and an ability to identify and prioritise service requirements were recognised in these nurses’ roles. Certain personal attributes were seen to be essential for successful role development such as confidence, commitment and problem solving powers combined with a positive working environment and supportive managers.

The Scope of Professional Practice: A literature review to determine the document's impact on nurses' role

Following the UKCC's publication of The Scope of Professional Practice (Scope) in 1992, it commissioned a study to investigate the document's impact. As part of the study, a review of the literature relating to Scope and its application was undertaken. Given the association of expanded practice using Scope, with new nursing roles and titles, the British and American literature relating to clinical nurse specialists and advanced practice was included in the review. This was undertaken because of the considerable influence from America on developments in this area in Britain.

Taking it to the limit

A UKCC survey of 10,000 practitioners shows nurses have gained confidence through the scope of professional practice

Psychological Practice, Psychotherapy and Managed Care

Summary Using one practice whose history parallels the history of independent psychological practice in the U.S. as a case example, the article chronicles the major changes in practice patterns that have occurred in response to changes in reimbursement. It attempts to show how changes in reimbursement practices have altered and shaped the scope of professional practice as well as the nature of psychological care that is available to society. It is felt that the case example has heuristic value for understanding and documenting what is happening to the profession and where it may be going.

The impact of Scope-practitioners' views on its relevance and potential for service development

The United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) published The Scope of Professional Practice (Scope) in 1992. The research reported here is one strand of a large study commissioned by the UKCC to investigate the document's impact. This stage involved interviews with 53 practitioners, selected because they had reported that Scope had had an impact on their work. It focused on the nature of this impact on service delivery, how it operated in a multi-professional setting, how the Scope principles were viewed and what support was required to implement them effectively. It was clear that the practitioners interviewed had a great deal to say about how Scope was influencing their practice and about how it could enhance their work in the future. Their attitudes towards, and perceptions of, Scope were overwhelmingly positive. A small number detailed precisely how it was having an impact on their work and on the ways they were able to deliver care. Others were aware of the principles and were exploring what their potential might be. Scope, it was felt, could empower practitioners, facilitate personal and professional development and result in constructive levels of accountability. It could encourage innovation and provide safeguards for service development.

Seeing one's own limitations is vital

Alan Garratt's article (Art &Science March 31) highlights some major issues in relation to self and peer assessment following on from the UKCC's Scope of Professional Practice. In my experience, nurses do seek some form of validation or assessment of their practice in cases where they are new to a specialty or have taken a career break.

Is the Scope of Practice endangered by lack of vision?

When The Scope of Professional Practice was published in 1992 it was hailed as one of the UKCC's most influential documents, with the potential to revolutionize nursing by extending the boundaries of practice. Is the Scope being implemented as originally visualised--or it is going to fail because of a lack of vision and imagination?

Use of competencies in training fertility nurses in clinical practice

In this article, the value of clinical competencies in the role development of fertility nurses is discussed using the example of the Oxford Fertility Programme. Clinical competencies are incorporated into the training programme within the Oxford Fertility Unit to enable new staff to demonstrate their clinical ability and undergo assessment while learning new and expanded skills. New staff are required to explore both the theoretical and practical foundations that underpin clinical practice. Competencies are used in a structured programme in which staff have to provide evidence of the appropriate knowledge to perform new and expanded procedures. New staff work with a senior nurse, who is their lecturer and who assesses both their clinical and theoretical development. The new staff are also assigned a preceptor with whom they work on a daily basis to consolidate the practice explored with the lecturer. The Scope of Professional Practice produced by the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC, 1992) places the emphasis on professional development for individual practitioners. Within the Oxford Fertility Unit, the nurses work collectively and as autonomous practitioners, which enables them to provide a specialized and personal service to their patients. Professional profiles are an integral element of an individual's professional development and are used in the training programme. They provide an accurate record of a nurse's abilities and knowledge and how he or she relates them to practice.

Catheterisation: the scope of professional practice

Catheterisation: the scope of professional practice

Radiology nursing: legal issues surrounding the expanded role.

The annual conference for the Royal College of Nursing's Forum of Nurses in Radiology and Cardiology took place in Birmingham last year. Participants were asked to consider the ways in which their professional practice could develop within The Scope of Professional Practice (UKCC, 1992a) guidelines and the possible problems they feared could arise. The legal issues which arose from their answers were then analysed. The aim of this article is to examine, in the light of the legal issues, the chosen areas of expansion within the nurse's role and the concerns felt by the participants in order to draw up lessons for nursing generally.