Decision Making Guidelines

In evaluating a certain nursing practice or activity as within the scope of practice for an LPN, RN or advanced practice nurse, the following considerations shall apply: 
1. A description of the practice or activity to be performed.
2. Is the practice specifically permitted or prohibited in any existing statute or regulation?
If permitted, proceed to #3
If prohibited, the decision is complete
If unsure, proceed to #3
3. Does the basic educational preparation of the nurse provide the necessary knowledge base and skills to engage in the practice or perform the activity?
If YES, the activity may be within the scope of practice of the RN or LPN. Proceed to #4;
If NO, documentation of additional educational preparation, training and experience for the RN or LPN may be required, or it may be an act within the scope of practice of a nurse authorized to practice in an advanced role. Proceed to #4.
4. Is the act or practice consistent with the scope of practice based on one of the following factors?
a. standards of practice of a national nursing organization;
b. supporting data from nursing literature and research;
c. are there agency/facility policies and procedures in place which outline performance criteria for the activity?
If YES, proceed to #5.
If NO, it is not within the nurse's scope of practice (or scope, within a particular facility).
5. Does the nurse have documented evidence of knowledge and competence, including continued competence, to perform the activity or engage in the practice?
If YES, proceed to #6.
If NO, it is not within the nurse's scope of practice.
6. Is this practice within an accepted standard of care which would be provided by a reasonable and prudent nurse with similar education and experience?
If YES, proceed to #7.
If NO, it is not within the nurse's scope of practice.
7. Does the nurse have the ability/resources to respond to complications in such a way that patient safety and quality of care are assured?
If YES, proceed to #8.
If NO, it is not within the nurse's scope of practice and may place both the patient and nurse at risk.
8. Is the nurse prepared to accept the consequences of performing the activity or engaging in the practice?
If YES, the nurse may perform the activity, based on a valid order when required, and in accordance with established policies, procedures and standards of care.
If NO, it is not within the nurse's scope of practice.