title: Scope creep: when nursing practice moves beyond traditional boundaries: an evidence-based example using procedural sedation.
abstract: The finite boundaries of the scope of nursing practice are constantly changing. One could expect that with new technology and advances in science, the interventions and assessments nurses perform will change over time. The practice of nursing is governed by nursing, however, it is often challenged by our partners in medicine, and frequently driven by time constraints or reimbursement issues. This article reviews a case example in which nurses were asked to expand their practice to assume responsibility for duties that were once traditionally performed by physicians. An evaluation of a practice problem using an evidence-based approach applying the PICO (population, intervention, comparison, outcome) method is explored. Proposed steps to minimize risk and staff moral distress are also described.
authors.affiliation: Scripps Mercy Hospital, San Diego, Calif 92103, USA. Davidson.Judy@scrippshealth.org
authors.forename: Judy E
authors.initials: JE
authors.lastname: Davidson
authors.forename: Dianne
authors.initials: D
authors.lastname: Bloomberg
authors.forename: Lori
authors.initials: L
authors.lastname: Burnell
mesh_terms: D000046:Academic Medical Centers; D001291:Attitude of Health Personnel; D002140:California; D002568:Certification; D002983:Clinical Competence; D016292:Procedural Sedation / Q000451:nursing*; D003422:Critical Care; D032022:Delegation, Professional; D004509:Education, Nursing, Continuing / Q000458:organization & administration; D004636:Emergency Service, Hospital; D019317:Evidence-Based Medicine / Q000458:organization & administration*; D006801:Humans; D016365:Liability, Legal; D024802:Nurse's Role; D015403:Nursing Evaluation Research / Q000458:organization & administration*; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration* / Q000523:psychology; D016134:Organizational Policy; D017063:Outcome Assessment, Health Care; D017009:Professional Autonomy; D017751:Safety Management; D012955:Societies, Medical / Q000458:organization & administration; D012956:Societies, Nursing / Q000458:organization & administration