This Gap Analysis tool is designed to help you determine whether there is a gap between current roles and responsibilities of RNs and of RPNs within your primary care setting and what full scope of practice entails, based on the RN and RPN role descriptions included in the Primary Solutions for Primary Care Report. The goal of this tool is to help you reach the highest levels of utilization, e.g. level V, for primary care RNs and RPNs. A gap analysis should be carried out separately for RNs and for RPNs in your practice. It is important to engage point-of-care providers in the gap analysis and use the following questions to guide the process:
- Are there gaps between current roles and full scope of practice for RNs?
- Where and to what extent do the gaps exist for RNs?
- Are there gaps between current roles and full scope of practice for RPNs?
- Where and to what extent do the gaps exist for RPNs?
The “Gap Analysis” tool will help you determine answers to these questions and will be useful to:
- Identify what current role activities are already being carried out at full scope as indicated in Primary Solutions for Primary Care.
- Identify role activities that are not consistently being carried out at full scope as indicated in Primary Solutions for Primary Care recommendations and would be good first targets for role and responsibilities changes.
- Identify role activities that are not at all being carried out as part of full scope of practice, as indicated in Primary Solutions for Primary Care, and may require longer term role and responsibilities change strategies.
- Identify those roles that are being carried out by RNs and roles being carried out by RPNs that are not part of the nursing scope of practice, and begin discussions as to how to address these areas in the overall process of maximizing full scope of practice. For example secretarial roles carried out by nurses may be considered here.
- Identify who is carrying out those roles that are part of the RN’s scope of practice or in the RPN’s scope of practice, but not in their current role descriptions.
- Outline in the action section, what needs to happen to support full scope of practice utilization based on the results. Such actions could include, developing a plan for change; providing education to RNs; providing education to RPNs; providing education to other staff who may also have role changes as a result of the gap analysis, developing policy to support full scope of practice utilization; developing communication to staff/clients/partners regarding role changes to support full scope of practice utilization; engaging in team building efforts
It is important to start with those roles and responsibilities changes that can be made easily, or are crucial to client and staff safety. Start by reinforcing success and focusing on early successes. The Gap Analysis is a quick and easy method of confirming how some of the recommended roles and responsibilities related to RN and RPN full scope utilizations are being met, either consistently or not and of gaining a snapshot view of how much work there is to be carried out to attain full scope of practice. Acknowledging the starting point with this activity and successes along the way are critical to effective change in this area.
Once the gap analysis is complete, it is necessary to take action related to the ratings determined. For example: for role components that are not consistently met, it must be decided what should happen to enable Registered Nurses and Registered Practical Nurses to meet those components of their role that are within their scope, but not consistently part of their current role. The “not part of my role at all” role components may be most challenging to address. However, it may be a short list after taking a closer look at both the current position description, and what actually happens in the workplace as well as current policies and practitioner knowledge and skill levels. Sometimes, current policies are in place but organizational culture has maintained the status quo and not embraced policy changes.