title: 'Am I covered?': an analysis of a national enquiry database on scope of practice.
abstract: OBJECTIVE
  Analysis of a national database of enquiries to a professional body pertaining to the scope of nursing and midwifery practice.
  
  
  BACKGROUND
  Against a backdrop of healthcare reform is a demand for flexibility in nursing and midwifery roles with unprecedented redefinition of role boundaries and/or expansion. Guidance from professional regulatory bodies is being sought around issues of concern that are arising in practice.
  
  
  METHODS
  Qualitative thematic analysis.
  
  
  METHODS
  The database of telephone enquiries (n = 9818) made by Registered Nurses and midwives to a national regulatory body (2001-2013) was subjected to a cleaning process and examined to detect those concerns that pertained to scope of practice. A total of 978 enquiries were subjected to thematic analysis.
  
  
  RESULTS
  Enquiries were concerned with three main areas: medication management, changing and evolving scope of practice and professional role boundaries. The context was service developments, staff shortages and uncertainty about role expansion and professional accountability. Other concerns related to expectations around responsibility and accountability for other support staff.
  
  
  CONCLUSIONS
  Efforts by employers to maximize the skill mix of their staff and optimally deploy staff to meet service needs and/or address gaps in service represented the primary service context from which many enquiries arose. The greatest concern for nurses arises around medication management but innovation in healthcare delivery and the demands of service are also creating challenges for nurses and midwives. Maintaining and developing competence is a concern among nurses and midwives particularly in an environment of limited resources and where re-deployment is common.
authors.affiliation: School of Nursing & Midwifery, Trinity College Dublin, Ireland.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Brady
authors.affiliation: School of Nursing, Midwifery & Health Systems, University College Dublin, Ireland.
authors.forename: Gerard
authors.initials: G
authors.lastname: Fealy
authors.affiliation: School of Nursing, Midwifery & Health Systems, University College Dublin, Ireland.
authors.forename: Mary
authors.initials: M
authors.lastname: Casey
authors.affiliation: School of Nursing and Midwifery, University College Cork, Ireland.
authors.forename: Josephine
authors.initials: J
authors.lastname: Hegarty
authors.affiliation: School of Nursing and Midwifery, University of Limerick, Ireland.
authors.forename: Catriona
authors.initials: C
authors.lastname: Kennedy
authors.affiliation: School of Nursing, Midwifery & Health Systems, University College Dublin, Ireland.
authors.forename: Martin
authors.initials: M
authors.lastname: McNamara
authors.affiliation: Department of Nursing and Midwifery, University of Limerick, Ireland.
authors.forename: Pauline
authors.initials: P
authors.lastname: O'Reilly
authors.affiliation: University College Dublin, Ireland.
authors.forename: Geraldine
authors.initials: G
authors.lastname: Prizeman
authors.affiliation: University College Dublin, Ireland.
authors.forename: Daniela
authors.identifier: http://orcid.org/0000-0001-8834-2539
authors.initials: D
authors.lastname: Rohde
mesh_terms: D011307:Drug Prescriptions; D006801:Humans; D054539:Medication Therapy Management; D008880:Midwifery / Q000592:standards*; D024802:Nurse's Role; D009729:Nursing / Q000592:standards*; D032024:Personnel Delegation; D017009:Professional Autonomy; D011364:Professional Practice / Q000592:standards*; D012941:Social Responsibility
keywords: competency; nursing and midwifery practice; professional concerns; professional issues; regulation; role boundaries; scope of practice