Expanding the Scope of Nursing Practice: Attitudes and Quality of Care
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Purpose: To describe the differences in attitudes toward expanding the scope of nursing practice among nurses and physicians. To examine the correlation between attitudes regarding expansion of the scope of nursing practice and variables including job satisfaction, job burnout, professional autonomy, perceptions of quality care and quality care outcomes. Methods: Cross-Section Study. Eight hundred and thirty-three nurses together with 415 physicians from 89 departments at three large general hospitals completed structured questionnaires. Data on quality care outcomes was obtained from a computerized data and a survey. Results: In general, nurses and physicians reported positive attitudes toward expanding the scope of nursing practice. However, nurses and physicians reported less positive attitudes regarding interpretation of diagnostic tests in specified situations. Using linear regressions, we found that attitudes toward expanding the scope of nursing practice were significantly higher among males, nurses in management positions having achieved academic accreditation, and nurses with more comprehensive perceptions of professional autonomy together with inter-professional cooperation. A positive correlation was found between attitudes and quality care outcomes (performance of Norton, pain and fall assessment.). Conclusion: We are currently witnessing professional transitions toward expansion of the scope of nursing practice regarding accountability and decision-making authority pertaining to treatment. The study increased our understanding of nurses' and doctors' attitudes regarding the expansion of nursing practice, and the association between positive attitudes and improved nursing care performance. The findings indicate the necessity of redefining the scope of nursing practice within the current professional context.