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Measuring Actual Scope of Nursing Practice: A New Tool for Nurse Leaders

D’Amour, Danielle PhD, RN; Dubois, Carl-Ardy PhD; Déry, Johanne MSN, PhD(c), RN; Clarke, Sean PhD, RN, FAAN; Tchouaket, Éric PhD; Blais, Régis PhD; Rivard, Michèle PhD

Journal of Nursing Administration: May 2012 - Volume 42 - Issue 5 - p 248–255
doi: 10.1097/NNA.0b013e31824337f4

Objective: This project describes the development and testing of the actual scope of nursing practice questionnaire.

Background: Underutilization of the skill sets of registered nurses (RNs) is a widespread concern. Cost-effective, safe, and efficient care requires support by management to facilitate the implementation of nursing practice at the full scope.

Methods: Literature review, expert consultation, and face validity testing were used in item development. The instrument was tested with 285 nurses in 22 medical units in 11 hospitals in Canada.

Results: The 26-item, 6-dimension questionnaire demonstrated validity and reliability. The responses suggest that nurses practice at less than their optimal scope, with key dimensions of professional practice being implemented infrequently.

Conclusions: This instrument can help nurse leaders increase the effective use of RN time in carrying out the full scope of their professional practice.

Author Affiliations: Full Professor (Dr D’Amour); Associate Professor (Dr Dubois); Doctoral Candidate (Ms Déry), Faculty of Nursing, University of Montréal, Canada; RBC Chair in Cardiovascular Nursing Research and Deputy Director (Dr Clarke), Nursing Health Services Research Unit, University of Toronto and University Health Network, Canada; Postdoctoral Fellow (Dr Tchouaket), Faculty of Medicine, University of Sherbrooke, Quebec, Canada; Full Professor (Dr Blais), Faculty of Medicine, Department of Health Administration, University of Montreal, Canada; Professor (Dr Rivard), Department of Social and Preventive Medicine, University of Montreal, Quebec, Canada.

The authors declare no conflict of interest.

Funding: This study was funded by the Canadian Institutes of Health Research and by the Quebec Ministry of Health and Social Services.

Correspondence: Dr D’Amour, University of Montreal, 2375 Côte-Ste Catherine, Quebec, Canada H3C3J7 (

© 2012 Lippincott Williams & Wilkins, Inc.