ArticleScope Creep When Nursing Practice Moves Beyond Traditional Boundaries An Evidence-Based Example Using Procedural SedationDavidson, Judy E. MS, RN, CCRN, FCCM; Bloomberg, Dianne MSN, RN; Burnell, Lori MSN, RNAuthor Information From Scripps Mercy Hospital, San Diego, Calif. Corresponding author: Judy E. Davidson, MS, RN, CCRN, FCCM, Scripps Mercy Hospital, 4077 5th Ave, MER 1, San Diego, CA 92103 (e-mail: [email protected]). Critical Care Nursing Quarterly: July 2007 - Volume 30 - Issue 3 - p 219-232 doi: 10.1097/01.CNQ.0000278922.21821.52 Buy Metrics Abstract The finite boundaries of the scope of nursing practice are constantly changing. One could expect that with new technology and advances in science, the interventions and assessments nurses perform will change over time. The practice of nursing is governed by nursing, however, it is often challenged by our partners in medicine, and frequently driven by time constraints or reimbursement issues. This article reviews a case example in which nurses were asked to expand their practice to assume responsibility for duties that were once traditionally performed by physicians. An evaluation of a practice problem using an evidence-based approach applying the PICO (population, intervention, comparison, outcome) method is explored. Proposed steps to minimize risk and staff moral distress are also described. © 2007 Lippincott Williams & Wilkins, Inc.