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Expanding RN Scope of Practice to Include Lumbar Puncture

Ernst, Jennifer, MS, MSN, APRN, GCNS-BC; Aliory, Christine, D., MSN, RN, ONC, CURN; Yows, Catherine, R., MSN, RN, CGRN

AJN The American Journal of Nursing: March 2018 - Volume 118 - Issue 3 - p 54–60
doi: 10.1097/01.NAJ.0000530939.26984.6c
Cultivating Quality

The competing demands of caring for high-acuity patients, reducing health care costs, and improving access to specialty care are complex challenges facing all health care providers. One approach—empowering nurses to expand their scope of practice—has been successfully employed for two decades by the nurse and physician leadership of a neurology department in an urban academic medical center. This article discusses the department's implementation of a quality improvement initiative to enhance access to neurology services in an ambulatory clinic by extending nursing practice to include lumbar puncture. Outcomes data from 2005 to 2016 demonstrate that through the department's comprehensive instructional program, RNs have competently and safely acquired new skills that have led to an expansion of their traditional roles, improved patient access to specialty care, and reduced costs.

The authors present a quality improvement initiative that enhanced access to neurology services in an ambulatory clinic by teaching nurses to perform lumbar puncture.

Jennifer Ernst is a clinical nurse specialist in the Department of Nursing at the Mayo Clinic in Scottsdale, AZ, where Catherine R. Yows is a nurse administrator. Christine D. Aliory is an RN in the Department of Nursing at the Mayo Clinic Hospital in Phoenix. The authors wish to thank Michelle A. Larson, DNP, RN, NE-BC, for assistance with data analysis and Jenifer M. Hart, RN, PCCN, for assistance with data mining. Contact author: Jennifer Ernst, ernst.jennifer@mayo.edu. The authors have disclosed no potential conflicts of interest, financial or otherwise.

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