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

Abstract

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.

Developing and sustaining specialist and advanced practice roles in nursing and midwifery: A discourse on enablers and barriers

“…Evidence of both nurses’ and midwives’ experiences in role expansion indicates that many embrace role expansion and perform effectively in expanded scope‐of‐practice roles (Fealy et al., ); however, nurses and midwives may experience scope of practice as either enabling or restricting (Casey et al., ). Several individual‐level factors have been identified as barriers to role expansion; among these intrinsic barriers include self‐perceived lack of role clarity, concerns over role boundaries and self‐perceived level of clinical autonomy in assuming expanded scope‐of‐practice roles (Brady et al., ; Fealy et al., ).…”

“…The study reported on the barriers and facilitators to the development of advanced nursing roles in general practice. Enabling and inhibiting factors were related to increasing awareness and attractiveness of practice nursing, health reform activities, practice limitations, education and professional development 4 Casey et al (2015) The paper reports on the findings from the qualitative element of a mixed-methods study to review the nursing and midwifery scopeof-practice framework in Ireland…”

Enablers and challenges to advanced nursing and midwifery practice roles

“…“advanced practice nursing”. Evidence of nurses’ and midwives’ experiences in role expansion indicates that many embrace role expansion and that they function effectively in expanded roles; however, nurses and midwives may experience scope of practice as either enabling or restricting (Casey et al, ). As advanced practice is a level of practice rather than a specific role (Ryley & Middleton, ), one strategy to develop a more efficient and effective health service is to advance the level of the practice of nurses and midwives by expanding their knowledge and skills to enable them to work within their full scope of practice while ensuring that accountability, and governance regarding patient safety are maintained.…”

Nurses', midwives' and key stakeholders' experiences and perceptions on requirements to demonstrate the maintenance of professional competence

“…However, similar to scope of practice frameworks, continuing professional competency frameworks ‘should enable role expansion within and with reference to the core functions and values of nursing and midwifery and the best interest of the patient’ (Casey et al . ). Without this consideration, there is a danger of a behaviourist reductionist approach where competency development is linked to clinical tasks.…”

“…At the same time, the individual nurse/midwife is aware of the boundaries of his/her own competence with reference to his/her scope of practice, patients' needs, workplace requirements and areas of specialization. However, similar to scope of practice frameworks, continuing professional competency frameworks 'should enable role expansion within and with reference to the core functions and values of nursing and midwifery and the best interest of the patient' (Casey et al 2015). Without this consideration, there is a danger of a behaviourist reductionist approach where competency development is linked to clinical tasks.…”