How Is the Nursing Scope of Practice Determined?

Determining the scope of practice is important for every professional because it provides legal guidance for every professional.

For nurses, the scope of practice – professional nursing activities, is defined by law.

Each state has the Nurse Practice Act (NPA), which is regulated by the state’s Board of Nursing.

For a nurse, NPA determines which activities to take in different work environments and make sure that the practice is done according to the law.

Board of Nurses ensures that every nurse provides care following all regulations.

Each nurse should know the Nurse Practice Act for the state in which he or she does the nursing duties.

Even if the nurse violates the NPA by mistake, he or she can be charged accountable for actions.

Therefore, non-knowing the NPA isn’t the excuse and not a legal exculpatory circumstance.

There are various situations in which knowing even the smallest detail of the state NPA is important.

For example, in some states nurses are obliged to report when a person drove under the influence.

If a nurse violates the NPA and doesn’t report it, he or she can face some disciplinary actions from the board.

There are situations in which nurses can lose the license after violating the Act.

In states, NPA is concordant with other legislature.

However, NPA cannot stand alone, and each Board of Nurses creates and bring other regulations for further understanding of the nurses’ scope of practice.

Board of Nurses, therefore, can provide additional regulations, but that mustn’t go beyond the boundaries of the NPA.

Each state Board of Nursing is maintained by the National Council of State Boards of Nursing (NCSBN).

It is an institution that sets the Board standards and requirements and makes sure that everything is according to the state and federal laws.

The NCSBN set the following requirements for each NPA and each Board of Nursing:

  • State nursing board – duties and activities
  • Education program standards
  • Standards and scope of nursing practice
  • Types and titles of licenses
  • Qualifications for licensure
  • Grounds for disciplinary actions, other violations, and remediation

In short words, the NCSBN regulates all aspects of nursing practice with other authorities.

Those are the American Association of Colleges of Nursing (AACN), the American Nurse Association (ANA), the American Organization of Nurse Executives (AONE), and the National League for Nursing (NLN).

These authorities also define requirements of standards of care, but also interpret the NCSBN regulations.

The so-called standard of care differs from the Scope of Nursing Practice and isn’t to be confused in any way.

A standard of care refers to the actions of care consistent with nurses’ education, competency, and professional experience.

However, a standard of care and the scope of nursing practice are often used together, as two complementary regulations.

Also, the American Nursing Association often uses both of the regulations to further define nursing practice and interpret standards and requirements.

There is a useful tool for nurses to help them perform their nursing duties according to the NPA.

It is NCSB’s Scope of Practice Decision-Making Framework tool, which helps nurses to understand their responsibilities.

In general, NPA serves to protect the community from harm and to govern nurses’ actions through education, skills, and regulated decision-making process.

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