Scope of practice
The Scope of Practice describes the procedures, actions, and processes that a healthcare practitioner is permitted to undertake in keeping with the terms of their professional license. The scope of practice is limited to that which the law allows for specific education and experience, and specific demonstrated competency. Each jurisdiction has laws, licensing bodies, and regulations that describe requirements for education and training, and define scope of practice.
In most jurisdictions, health care professions with scope of practice laws and regulations include any profession within health care that requires a license to practice such as physicians, surgeon's assistant, nurses, dietitians, respiratory therapists, physical therapists, occupational therapists and dentists among many others.
Governing, licensing, and law enforcement bodies are often at the sub-national (e.g. state or province) level, but federal guidelines / regulations also often exist. For example, in the United States, the National Highway Traffic Safety Administration in the Department of Transportation has a national scope of practice for emergency medical services.
Scope of practice can be easily identified by three categories. If requirements for practicing a skill or profession satisfy all three requirements then it is within that persons scope of practice:
- Education and training — Has the person been educated academically or on-the-job and have documentation proving education to do the item in question?
- Governing body — Does your state, district, province or federal government that oversees the skill or profession allow (or not explicitly disallow) the item in question?
- Institution — Does the institution allow a person or their profession to do the item in question?
- Registered respiratory therapist — All states and provinces who recognize registered respiratory therapist licensure allow for RRTs to provide extracorporeal membrane oxygenation (ECMO) support. Despite this, some institutions do not permit RRTs to provide ECMO support. For the registered respiratory therapists working at the institutions whom allow RRTs to provide ECMO support it is within their scope of practice. The RRTs who are not permitted by their institution to provide this skill are unable to include the support in their scope of practice.
- Paramedic — In some states and provinces a paramedic is allowed to perform percutaneous cricothyrotomy if all other airway management fails. In the states and provinces that do not allow this intervention it is not within the scope of practice of the paramedic to perform.
- AOSW Scope of Practice, Association of Oncology Social Work.
- CA LAc Scope of Practice summary, Acupuncturists & related alternative health fields.
- Sherwood, Gwen D., et al. (1997). "Defining Nurse Practitioner Scope of Practice: Expanding Primary Care Services", The Internet Journal of Advanced Nursing Practice, 1(20), 1997. (ISSN 1523-6064)
- Final Draft of the National EMS Scope of Practice Model, September 2005.[dead link]
- Emergency Medical Services Division, NHTSA, U.S. Department of Transportation.