RN scope of practice refers to the functions that are legal for RNs to perform, according to their education level and training. Scope of practice changes according to the state. Rather than having a list of tasks that an RN is allowed to perform, the Washington State Department of Health (DOH) generally describes the RN's scope of practice as independently carrying out the nursing process, which includes nursing assessment, diagnosis, planning, implementation, and evaluation. The DOH also provides a decision tree that may be utilized when deciding if a task can be legally performed.

Access the Department of Health's description of the RN scope of practice here: https://www.doh.wa.gov/Portals/1/Documents/6000/NCAO13.pdf

While the DOH does not offer any specific guidelines for outpatient nursing, the American Academy of Ambulatory Care Nursing provides guidance and standards for nursing in this specialty.

RNs are vital to the outpatient team and evidence shows that outpatient nurses improve patient outcomes and satisfaction. Your role is so important! While your responsibilities may change from day to day, your role in the outpatient setting includes:

• Leadership. Nurses should be involved in ensuring the delivery of quality healthcare and implementing quality improvement efforts.
• Patient care. Working as a team, nurses should provide and coordinate patient care, engage in patient education, and strive to improve quality of care.
• Collaboration. Nurses must collaborate with providers, other nurses, external healthcare entities, and patients to provide efficient patient care.
• Organizational support. Managing conflict, optimizing the environment for patient care, addressing ethical and/or legal issues, and advocating for patients are important aspects of outpatient nursing.
• Dedication to evidence-based care. Nurses should maintain knowledge of updates, understand appropriate resources, and provide evidence-based care and recommendations for patients.

While the future may lead to an expansion of the role of RNs at CarePoint, current responsibilities include:

• Patient intake including vitals, inquiring about the patient's chief complaint, and updating the patient chart
• Administering screening tests such as the PHQ-9
• Performing point of care testing such as urine dipstick, flu swab, and rapid strep test
• Calling in prescriptions
• Inventorying and re-stocking supplies
• Sanitizing equipment between patients, maintaining equipment (ensuring that quality assurance tests are done and equipment is not expired)
• Providing patient education utilizing teach back and motivational interviewing, accessing and providing patients with health education materials
• Writing a shift summary
• Collaborating with other CarePoint volunteers regarding quality improvement projects and strategies to more effectively meet the community's needs
• Phone triage, returning patients' calls and addressing concerns, providing education to patients and determining when they should seek emergent care or have a follow up appointment

This is a short article written by a nurse. It addresses some of the challenges of transitioning from a hospital setting to the outpatient setting. https://www.registerednursing.org/answers/what-challenges-transition-hospital-nursing-clinic-ambulatory-care/

*The above information was derived from the Core Curriculum for Ambulatory Care Nursing, 4th edition, by Candia Laughlin & Stephanie Witwer. Used with permission of AAACN. Find more information at https://www.aaacn.org/

Other Sources

Washington State Department of Health - Advisory Opinion on RN & LPN Scope of Practice: https://www.doh.wa.gov/Portals/1/Documents/6000/NCAO13.pdf

Challenges Transitioning from Hospital Nursing to Clinic/Ambulatory Care Nursing: https://www.registerednursing.org/answers/what-challenges-transition-hospital-nursing-clinic-ambulatory-care

Image: https://clipartix.com/nurse-clip-art-image-22055/