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The nursing profession comprises Australia's largest regulated health workforce yet its practice boundaries are poorly understood. The ambiguity surrounding the practice scope of nurses limits the profession's ability to fully respond to Australia's current and emerging health system challenges. The aim of this review is to explore the concept of scope of practice of registered nurses (RN) in Australia, as reflected in contemporary literature. An integrative review of literature relating to the scope of practice of the Australian registered nurse published between 2007 and 2014 was conducted. Twenty primary papers and nine secondary source papers were included in the review. Themes that arose from the analysis are: Scope of practice - an elusive concept; Scope of practice and context; Scope of practice and boundaries; and Scope of practice and advanced practice. Discussion of these themes includes consideration of the professional, legal and ethical significance of scope of practice for the RN, as well as the legislative, professional and contextual influences on, and challenges to, defining scope of practice at both a professional and individual level. For the Australian registered nursing workforce to continue to be a significant and influential contributor to Australia s dynamic healthcare context, a clearly articulated scope of practice is both necessary and overdue.
Keywords: advanced practice; registered nursing role; role boundaries; scope of practice
Introduction
The aging population, growing consumer expectations, changing disease patterns, increased availability and cost of health-related technology and medicines are straining the Australian health system. The nursing profession represents Australia's largest regulated health workforce yet its practice boundaries are poorly understood. A dynamic nursing workforce practicing to its full scope can assist in addressing current and future health system demands. Before this can occur, a clearer understanding and national application of the nursing scope of practice is required. This paper presents a review of contemporary literature on the scope of practice of registered nurses (RN) in Australia. The findings of the review will be discussed with reference to the implications for nursing practice and healthcare, both in Australia and internationally.
Background
Nursing functions in Australia are addressed in documents such as practice standards and codes of professional conduct (Nursing and Midwifery Board of Australia [NMBA], 2008, 2016a, 2016b) and policy statements produced by professional bodies such...