DECISION MAKING MODEL FOR SCOPE OF PRACTICE

DECISION-MAKING MODEL FOR DETERMINING 
LPN/RN/APRN LEGAL SCOPE OF PRACTICE IN NORTH DAKOTA 
                                
1. Describe the act being performed.

2. Is the act expressly permitted/prohibited by the North Dakota Nurse Practices Act?
 This may be all the information you need to make your decision.  If not, continue to the next step.

3. Does the act require you to have substantial specialized knowledge, skill and independent judgment?
 If you answer NO to this question, the act may be within the basic scope of practice for a RN, LPN, or APRN.
 If you answer YES, it may be an act within the legal scope of practice of the nurse whose knowledge, skills, judgment and competence is documented in the personnel record.

4. Is the act consistent with the scope of practice based upon the following factors?
 a. Standards of Practice of a national nursing organization.
  OR
  Positive and conclusive data in nursing literature and research.
  AND
  
 b. Appropriately established policy and procedure of employing facility.
  If you answer NO to this question, the act is NOT within your legal scope of practice.
  If the answer is YES, continue to the next step.

5. Do you personally possess the depth and breath of knowledge to perform the act safely and effectively as demonstrated by knowledge acquired in a pre-licensure program, post-basic program, or continuing education program?
 If you answer NO, the act is NOT within your legal scope of practice.
 If you answer YES, maintain documented evidence and continue to the next step.
  
6. Do you personally possess current clinical competence to perform the act safely?
 If you answer NO, the act is NOT within your current legal scope of practice unless competence is achieved.
 If you answer YES, continue to the next step.

7. Do you personally possess the knowledge, skills, and judgment to respond appropriately to complications and/or untoward effects of the procedure?
 If you answer NO, the act is NOT within your legal scope of practice.
 If you answer YES, continue to the next step.

8. Do you have qualified nursing and/or medical back up available?
 If you answer NO, the act is NOT within your legal scope of practice.
 If you answer YES, continue to the next step.

9. Is the performance of the act within the accepted “standard of care” which would be provided in similar circumstances by reasonable and prudent nurses who have similar education and experience?
 If you answer NO, the act is NOT within your legal scope of practice.
 Performance of the act may place both the nurse and patient at risk.
 If you answer YES, continue to the next step.

10. Are you prepared to accept the consequences of your action?
 If you answer NO, the act is NOT within your legal scope of practice.
   If you answer YES, then:
a. Perform the act - based upon valid order when necessary, and in accordance with appropriate established policies and procedures.
 b. Assume accountability for provision of safe care.

The North Dakota Board of Nursing acknowledges the contributions of the Florida, Kentucky, North Carolina, Pennsylvania, South Dakota, and Texas State Boards of Nursing.