Literature Review

Literature gaps

In order to maximise full scope of practice utilisation, it is important to understand what full scope of practice is, why it is important, and what are the potential barriers and facilitators to the processi. The literature review revealed that there were critical gaps identified in the literature. Specifically, the conceptual understanding of scope of practice and the factors influencing it were noted. The majority of the literature focused on the roles of advanced practice nurses such as clinical nurse specialists and nurse practitioners, as well as acute care nurses practicing in the hospital setting. Consistent with the findings of othersii, there was limited literature focused on the roles of registered nurses (RN) and registered practical nurses (RPN) practising in primary care settings. Thus, in order to enhance the understanding about the factors influencing full scope of practice, this literature will be consulted. It is important to consider that the generalizability of study findings from this literature review may be limited; thus, application of findings to the primary care setting should be made with a lens of caution.  

The literature related to the conceptual understanding of scope of practice is more descriptive in nature, and focuses on role functions, nurses' abilities to perform delegated tasks, or issues regarding role overlap. There is both a lack of definition in scope of practice terminology, as well as a lack of consistency. White et al. (2008) distinguish between scope of practice, which is understood as the expectations of the nursing role that nurses are educated and legislated to perform, and role enactment, which is the performance of tasks associated with that role. There is also a gap in the literature with respect to the barriers and enablers to maximizing nurses’ full scopev and limited emphasis on how these factors affect full scope of practice maximisation from the perspective of health care professionals themselves working in primary care.