title: Scope of practice decision making: findings from a national survey of Irish nurses and midwives.
abstract: OBJECTIVE
  The aim was to examine and describe aspects of the current scope of practice among nurses and midwives in Ireland. The objective was to describe practitioners' decision making associated with the scope of practice.
  
  
  BACKGROUND
  Regulatory frameworks on the scope of practice describe the roles and activities an individual registrant is permitted to undertake in the course of professional practice. Research into the scope of practice has examined practitioners' perspectives on particular frameworks or their experiences of practice expansion, and suggests that frameworks are helpful in guiding practitioners; however, local circumstances and practitioner competence often determine scope of practice.
  
  
  METHODS
  A national postal survey of registered nurses and midwives was conducted to elicit self-reports of current scope of practice.
  
  
  METHODS
  A stratified random sample of 2354 registered nurses and midwives in Ireland were surveyed using the Scope-Q, a 64-item self-report questionnaire.
  
  
  RESULTS
  While over half of the respondents consulted others when making scope of practice decisions, the majority relied on their own professional judgement, acted only when they believed that they were competent to act, and recognised the limitations of their own competence. Although a small number of statistically significant associations were observed between respondents' age and self-reported scope of practice, respondents' current scope of practice was independent of either grade or gender.
  
  
  CONCLUSIONS
  When making a decision about scope of practice, practitioners may consult other resources, including published frameworks, professional colleagues and line managers; however, most particularly, older, more experienced practitioners, rely on their own professional judgement when making scope of practice decisions.
  
  
  CONCLUSIONS
  While published scope of practice frameworks guide practitioners on how they may act in circumstances of uncertainty, regulatory authorities should continue to emphasise individual accountability and self-reliance in everyday decision making, so that practitioners' actions are grounded in local circumstances and self-assessed practitioner competence.
authors.affiliation: UCD School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin.
authors.forename: Gerard
authors.initials: G
authors.lastname: Fealy
authors.affiliation: UCD School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin.
authors.forename: Mary
authors.initials: M
authors.lastname: Casey
authors.affiliation: Royal College of Surgeons in Ireland, Dublin.
authors.forename: Daniela
authors.identifier: http://orcid.org/0000-0001-8834-2539
authors.initials: D
authors.lastname: Rohde
authors.affiliation: School of Nursing and Midwifery, Trinity College Dublin, Dublin.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Brady
authors.affiliation: Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork.
authors.forename: Josephine
authors.initials: J
authors.lastname: Hegarty
authors.affiliation: School of Nursing and Midwifery, University of Limerick, Limerick.
authors.forename: Catriona
authors.initials: C
authors.lastname: Kennedy
authors.affiliation: UCD School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin.
authors.forename: Martin
authors.initials: M
authors.lastname: McNamara
authors.affiliation: Department of Nursing and Midwifery, University of Limerick, Limerick.
authors.forename: Pauline
authors.initials: P
authors.lastname: O'Reilly
authors.affiliation: School of Nursing and Midwifery, Trinity College Dublin, Dublin.
authors.forename: Geraldine
authors.initials: G
authors.lastname: Prizeman
mesh_terms: D000328:Adult; D003657:Decision Making; D005260:Female; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D008880:Midwifery; D024802:Nurse's Role; D009726:Nurses; D011247:Pregnancy; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Ireland; decision making; framework; midwifery; nursing; scope of practice; survey