Scope of Practice
In the practice of nursing, professional issues and practice questions arise that require the nurse to apply education, experience and professional judgment and to be legally responsible and accountable for the outcome(s). The role of the Board of Nursing is to establish minimum standards for education, licensure and practice and to provide information to practicing nurses. The Licensure Unit ensures that standards have been met prior to issuance of a license; however, the Licensure Unit cannot and should not make scope of practice decisions for its licensees.
Decision-Making Framework
In an effort to ensure safe, competent nursing services to the public, as well as to educate and provide direction to nurses to facilitate clinical decision-making in determining legal scope of practice, the Nebraska Board of Nursing adopted a Decision-Making Model for Determining RN/LPN Scope of Practice on April 14, 2016. The model was designed to be utilized in conjunction with applicable Nebraska nursing laws and regulations in a given practice situation.
Recognizing the evolution of nursing practice and thought regarding scope of practice decisions, the APRN Board and Board of Nursing adopted a shared next generation model in 2017. The Scope of Nursing Practice Decision-Making Framework was developed by the Tri-Council for Nursing in collaboration with the National Council of the State Boards of Nursing (NCSBN). The framework was devised to include all licensed nurses at all experience levels in all practice settings practicing in a variety of roles.
The decision to provide any nursing care should be based upon self-assessment of competency, following an assessment of the client and environment. A licensed nurse is accountable to be competent for all nursing care that he/she provides. Competence means the ability of the nurse to apply interpersonal, technical and decision-making skills at the level of knowledge consistent with the prevailing standard for the nursing activity being applied. Accountability also includes acknowledgment of personal limitations in knowledge and skills and communication of the need for specialized instruction prior to providing any nursing activity.
Scope of Practice Decision-Making Framework
Note: On the Decision-Making Framework document, Nurse Practice Act is abbreviated NPA.