title: Registered nurse scope of practice and ED complaint-specific protocols.
abstract: BACKGROUND
  The use of complaint-specific protocols (CSPs) by emergency registered nurses (RNs) can improve ED efficiency. However, RN practice is influenced by regulatory environments that may facilitate or inhibit the use of protocols. The purpose of this policy analysis was to explore the language of state boards of nursing scope-of-practice documents related to the use of RN-initiated CSPs in the ED setting.
  
  
  METHODS
  A qualitative descriptive design was used to investigate how the RN's scope of practice relates to the use of CSPs in ED settings across states. Data were collected from state boards of nursing Web site documents.
  
  
  RESULTS
  Three major themes emerged: cautiously within scope, intentionally vague/silent, and outside scope. Seven states (Connecticut, Illinois, Kansas, Louisiana, New Jersey, New York, and Oklahoma) were identified where RN-initiated CSPs appear to be currently outside the RN's scope of practice. Therefore 18% of the US population, or 55,973,900 people, resides in states where CSPs are not allowed.
  
  
  CONCLUSIONS
  State-to-state inconsistencies in the RN's scope of practice may interfere with the implementation of practices that enhance ED efficiency. RNs in all states must ensure that they have the requisite knowledge, skill, and documented competency to implement CSPs, if supported by their employing facility. Efforts to standardize ED RN education and policy are warranted. Continued research is needed assess the impact of RN-initiated CSPs on the efficiency of ED care.
authors: University at Buffalo School of Nursing, Buffalo, NY, USA. jcastner@buffalo.edu
authors: Jessica
authors: J
authors: Castner
authors: Susan
authors: S
authors: Grinslade
authors: Jennifer
authors: J
authors: Guay
authors: A Zach
authors: AZ
authors: Hettinger
authors: Jin Young
authors: JY
authors: Seo
authors: Lenore
authors: L
authors: Boris
mesh_terms: D017598:Efficiency, Organizational; D016529:Emergency Nursing / Q000379:methods*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006801:Humans; D024802:Nurse's Role; D017410:Practice Guidelines as Topic; D014481:United States