Measuring Scope of Practice Enactment Among Primary Care Registered Nurses

Abstract

Background Scope of practice enactment is poorly understood in the primary care setting. Purpose The following research objectives were addressed: (1) to revise and adapt the Actual Scope of Practice (ASCOP) questionnaire for use in the primary care setting, and (2) to determine internal consistency, construct validity, and sensitivity of the modified instrument. Methods To address the first objective, a narrative literature review and synthesis and an expert panel review was conducted. To address the second objective, a cross-sectional survey of 178 registered nurses who worked in primary care was conducted. Results The ASCOP, with few modifications, addressed key attributes of nursing scope of practice in the primary care setting. The modified instrument yielded acceptable alpha coefficients ranging from 0.66 to 0.91. Total mean score of 4.8 (SD = .67) suggests that registered nurses within interprofessional primary care teams almost always engage in activities reflected in the modified instrument. Conclusions The modified instrument is the first instrument validated to measure nursing scope of practice enactment in the primary care setting. Findings from this study support the use of the modified ASCOP questionnaire as a reliable and valid measure of scope of practice enactment among primary care registered nurses.

Actual Scope of Nursing Practice in Saudi Ministry of Health Hospitals

“…For example, a Canadian study conducted by Déry et al [3] had an overall mean score for ASCOP of 3.21 out of 6, indicating that, on average, nurses occasionally performed nursing skills measured by the ASCOP scale. In another study carried out in Canada, a higher overall item mean score of 4.8 (out of 6.0) was reported [17]. Furthermore, D'Amour et al [14] conducted a study where the overall mean score for the ASCOP was 3.47 out of 6.…”

“…Braithwaite [17] studied 178 nurses in primary healthcare institutions in Canada, using the ASCOP questionnaire with some adjustments to be appropriate for measuring the scope of nursing practice in primary healthcare institutions. The results revealed that the average score of subjects was 5.16 out of 6, indicating that nurses almost always carry out activities related to the enactment of nursing scope of practice [17].…”

“…Braithwaite [17] studied 178 nurses in primary healthcare institutions in Canada, using the ASCOP questionnaire with some adjustments to be appropriate for measuring the scope of nursing practice in primary healthcare institutions. The results revealed that the average score of subjects was 5.16 out of 6, indicating that nurses almost always carry out activities related to the enactment of nursing scope of practice [17]. An exploratory study conducted in rural areas with low medical services in Tanzania also reported that nurses performed activities beyond their scope of practice, such as prescribing medication and carrying out minor surgical procedures [18].…”

Impact of the Work Environment on Nurse Outcomes: A Mediation Analysis

“…7,13,24 Nurses' scope of practice is defined as the standards of care that are set by regulatory bodies, reflecting the knowledge and skills expected of nurses. 31,32 In the context of a global nursing shortage, nurses' practice should be optimized to ensure efficiency and continuity of care. 33,34 However, many work characteristics have a significant impact on nurses' scope of practice.…”

Assessing the fulfillment of nurses' full potential in diverse geriatric settings—moving towards change

“…Nursing homes, which can be private, or run by the Health Maintenance Organization, or government, offer services to older adults who need assistance with their daily function. This type of facility often has wings based on the level of function: moderate to severe decrease in daily function; severe disability with permanent mobility limitation; and mentally frail with functional limitation other than cognitive deterioration that requires supervision and aid in daily care (Braithwaite et al, 2021; Schmitz & Stroka‐Wetsch, 2020).…”