Scope of Practice

Scope of practice describes the services that a qualified health professional is deemed competent to perform, and permitted to undertake – in keeping with the terms of their professional license.

Scope of practice defined in nursing

The Nursing Scope and Standards of Practice describe the “who,” “what,” “where,” “when,” “why,” and “how” of nursing practice:

• Who: Registered Nurses (RN) and Advanced Practice Registered Nurses (APRN) comprise the “who” constituency and have been educated, titled, and maintain active licensure to practice nursing.
• What: Nursing is the protection, promotion, and optimization of health and abilities; prevention of illness and injury; facilitation of healing; alleviation of suffering through the diagnosis and treatment of human response; and advocacy in the care of individuals, families, groups, communities, and populations.
• Where: Wherever there is a patient in need of care.
• When: Whenever there is a need for nursing knowledge, compassion, and expertise.
• Why: The profession exists to achieve the most positive patient outcomes in keeping with nursing’s social contract and obligation to society.

When each of these questions is answered, the complex considerations in scope of practice become clear. In a profession as dynamic as nursing, and with evolving health care demands, changes in scope of practice and overlapping responsibilities are inevitable in our current and future health care system.

Newly-Revised: Nursing: Scope and Standards of Practice, 4th Edition

This resource informs and guides nurses in their vital work providing safe, quality, and competent care.

Nursing Specialty Recognition, Scope and Standards Review, Affirmation of Competencies

The American Nurses Association has an established review program for recognition of a nursing specialty, approval of a specialty nursing scope of practice statement, acknowledgment of specialty nursing standards of practice, and affirmation of focused practice competencies. Details about each component of this program, specialty characteristics, review criteria, and submission process are described here.

Health care licensure

Currently, all health care licensure is state-based, and there is some variability between the qualifications for licensure and re-licensure for each state.

Defining scope of practice is generally a two-step process:

• Step 1: The state legislature passes a law, known as a “nurse practice act.”
• Step 2: Regulatory bodies then create and implement rules and regulations, intended to protect the public.

Choice in health care providers

The American Nurses Association (ANA) believes that patients’ interests are best served by a health care system in which many different types of qualified professionals are available, accessible, and working together – collaboratively. Therefore, it is important for scope of practice to reflect a professional’s true expertise.

ANA is a founding member of the Coalition for Patient’s Rights (CPR), which was established to improve patients’ access to the health care providers of their choice, and the range of services those providers offer. The CPR consists of more than 35 organizations representing a variety of licensed health care professionals, each providing a diverse array of safe, effective, and affordable care.

Protecting and advancing scope of practice

Protecting and advancing scope of practice for nurses is a major initiative for ANA. In the fast-moving world of health care, it is vital that nurses are able to practice to the full extent of their education and abilities, in order to deliver the most efficient, quality care to patients.

There is a growing body of evidence to support the safe and cost-effective provision of care by APRNs, and a national call to remove all barriers to full practice authority. ANA remains committed to monitoring and advocating for legislative and regulatory changes relating to scope of practice, with the aim of removing practice barriers for nurses and improving access to care.