JointPositionStatement
(There are several other good documents on this site, as well. This one
is sort of an introduction to writing a Scope of Practice)
from:
http://www.eicp-acis.ca/en/toolkit/regulation/skills.asp
SCOPES OF PRACTICE April 2003
Canada’s physicians, nurses, pharmacists and other health professionals
recognize that a sustainable health workforce
is a key challenge facing our health care system. In this regard, scopes
of practice is an important issue that
needs to be addressed.
The Canadian Medical Association (CMA), the Canadian Nurses Association
(CNA) and the Canadian
Pharmacists Association (CPhA) have approved the following principles
and criteria for the determination of
scopes of practice. The primary purposes of such determinations are to
meet the health care needs of Canadians,
and to serve the interests of patients and the public safely,
efficiently and competently.
The CPhA, CNA and CMA believe that policy decisions taken in this area
must put patients first. Secondly, they
should be grounded in principles that reflect our commitment to
professionalism, lifelong learning and patient safety.
Thirdly, that there be recognition of the need for legislative and
regulatory changes to support evolving scopes of
practice. Moreover, we believe that health professionals must be
involved in decision-making processes in this area.
PRINCIPLES
Focus: Scopes of practice statements should promote safe, ethical,
high-quality care that responds to the needs of
patients and the public in a timely manner, is affordable and is
provided by competent health care providers.
Flexibility: A flexible approach is required that enables providers to
practise to the extent of their education, training,
skills, knowledge, experience, competence and judgment while being
responsive to the needs of patients and
the public.
Collaboration and cooperation: In order to support interdisciplinary
approaches to patient care and good health outcomes,
physicians, nurses and pharmacists engage in collaborative and
cooperative practice with other health care
providers who are qualified and appropriately trained and who use,
wherever possible, an evidence-based approach.
Good communication is essential to collaboration and cooperation.
Coordination: A qualified health care provider should coordinate
individual patient care.
Patient choice: Scopes of practice should take into account patients’
choice of health care provider.
CRITERIA
Accountability: Scopes of practice should reflect the degree of
accountability, responsibility and authority that the
health care provider assumes for the outcome of his or her practice.
Education: Scopes of practice should reflect the breadth, depth and
relevance of the training and education of the
health care provider. This includes consideration of the extent of the
accredited or approved educational
program(s), certification of the provider and maintenance of competency
Competencies and practice standards: Scopes of practice should reflect
the degree of knowledge, values, attitudes and
skills (i.e., clinical expertise and judgment, critical thinking,
analysis, problem solving, decision making, leadership)
of the provider group.
Quality assurance and improvement: Scopes of practice should reflect
measures of quality assurance and improvement
that have been implemented for the protection of patients and the public.
Risk assessment: Scopes of practice should take into consideration risk
to patients.
Evidence-based practices: Scopes of practice should reflect the degree
to which the provider group practices are based
on valid scientific evidence where available.
Setting and culture: Scopes of practice should be sensitive to the
place, context and culture in which the practice
occurs.
Legal liability and insurance: Scopes of practice should reflect case
law and the legal liability assumed by the health
care provider including mutual professional malpractice protection or
liability insurance coverage.
Regulation: Scopes of practice should reflect the legislative and
regulatory authority, where applicable, of the health
care provider.
Principles and criteria to ensure safe, competent and ethical patient
care should guide the development of scopes of
practice of health care providers.
This document is based on a January 2002 policy developed by the
Canadian Medical Association, which has
been endorsed by the Canadian Nurses Association and the Canadian
Pharmacists Association. We welcome the
support of other health care providers for these principles and criteria
regarding scopes of practice.
Reaffirmed by the Canadian Nurses Association's Board of Directors, June
2003.
PS 66
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