Scope of Practice for Nurse Practitioners

Nurse practitioners (NPs) practice in nearly every health care setting, including clinics, hospitals, Veterans Affairs and Indian Health Care facilities, emergency rooms, urgent care sites, private physician or NP practices (both managed and owned by NPs), nursing homes, schools, colleges, retail clinics, public health departments, nurse-managed clinics, homeless clinics and home health. NP practice includes, but is not limited to, assessment; ordering, performing, supervising and interpreting diagnostic and laboratory tests; making diagnoses; initiating and managing treatment, including prescribing medication and non-pharmacologic treatments; coordinating care; counseling; and educating patients, their families and communities.

As licensed, independent practitioners, NPs practice autonomously and in coordination with health care professionals and other individuals. NPs provide a wide range of health care services, including the diagnosis and management of acute, chronic and complex health problems; health promotion; disease prevention; health education; and counseling to individuals, families, groups and communities. They may also serve as health care researchers, interdisciplinary consultants and patient advocates.

The NP role is consistent with the APRN Consensus Model, practicing in the population foci of Family/Individual Across Lifespan, Pediatrics, Women’s Health/Gender Related, Adult-Gerontology, Neonatal and Psychiatric Mental Health. NP scope of practice is not setting-specific and is based on the needs of the patient.

Education

NPs are advanced practice registered nurses (APRNs) who obtain graduate education at the masters, post-master’s or doctoral level and obtain national board certification. Academic NP programs follow established educational standards, which ensure the attainment of the APRN, role and population core competencies. Educational preparation provides NPs with specialized knowledge and clinical competency, which enable them to practice in various health care settings. National accreditation requirements for NP education programs and competency-based standards ensure NPs are equipped to provide safe, high-quality, cost-effective, patient-centered care upon graduation. Clinical practice competency and professional development are hallmarks of NP education.

Accountability

Each NP is accountable to patients, the nursing profession and their state board of nursing. NPs are expected to practice consistent with an ethical code of conduct, national certification, evidence-based principles and current practice standards.

Responsibility

The patient-centered nature of the NP role requires a commitment to meet the evolving needs of society and advances in health care science. NPs are responsible to the public and adaptable to the dynamic changes in health care. As leaders in health care, NPs combine the roles of provider, mentor, educator, researcher, advocate and administrator. NPs take responsibility for their continued professional development, involvement in professional organizations and participation in health policy activities at the local, state, national and international levels. Five decades of research affirm that NPs provide safe, high-quality, cost-effective, patient-centered care.