Optimizing nursing scope of practice within a primary health care context: linking role accountabilities to health outcomes

With the increasing focus on collaborative, interprofessional models of service delivery in many parts of the world, it is crucial that nurses be able to demonstrate confidence in the value they add to the health system. As the largest group of health professionals, nurses must serve as change agents in strengthening health systems and influencing the development of appropriate health policy. This requires that nurses have a solid understanding of what is their unique role in contributing to attainment of desired health outcomes in the populations they serve. In this article, the role of nurses in health care is reviewed, with commentary on some areas in which nurses are currently underutilized in health care delivery, whether employed in community or institutional settings. Data from research conducted in Canada suggest that nurses have a tendency to define themselves by the tasks or activities they perform and seem unable to clearly articulate their special role in health care. Strong leadership and a willingness by nurses to re-orient their practice will be required to ensure that the potential for harnessing the knowledge, experience, capabilities and commitment of nurses in advancing health care reform shifts from rhetoric to reality. PUBLICATION ABSTRACT]