Best Practices for Developing Specialty Nursing Scope and Standards of Practice

By Finnell, Deborah S.; Thomas, Elizabeth L. et al. | Online Journal of Issues in Nursing, May 2015 | Go to article overview

Best Practices for Developing Specialty Nursing Scope and Standards of Practice


Finnell, Deborah S., Thomas, Elizabeth L., Nehring, Wendy M., McLaughlin, Kris A., Bickford, Carol J., Online Journal of Issues in Nursing


The American Nurses Association (ANA) document, Nursing: Scope and Standards of Practice fin press), describes what nursing is, what nurses do, responsibilities for which nurses are accountable, and the outcomes ofthat practice. Nurses are responsible for the direct care delivery and the consequential outcomes, specified in that ANA foundational document. Grounded in the profession of nursing, areas of focused nursing practice have emerged as nursing specialties.

Associated nursing specialty organizations are designated stewards of specialty nursing knowledge and seek publication of the specialty nursing scope of practice statement and standards to delineate and guide that unique practice. Registered nurses at the national and international level, as well as other stakeholders engaged in legal, regulatory, administrative, education, and research activities, value scope and standards documents. These documents help to assure continued understanding and recognition of the diverse professional contributions of nurses.

Developing the scope and standards of specialty nursing practice can be a daunting task for the nurse experts leading the work. The purpose of this article is to demystify that process, whether to create new or revise existing specialty nursing scope and standards of practice. We discuss best practices incorporated in the developmental process for several recently published scope and standards of specialty nursing practice. These best practices are applicable to nursing specialty organizations publishing with ANA, as well as those that are not. This article addresses each of the following best practices in detail: utilizing structures and processes to initiate the process; identifying a lead writer for the process; convening experts with specific roles and functions; ensuring incorporation of foundational documents; establishing a realistic timeline; addressing strategies to overcome barriers; promoting facilitators for success; responding to reviewer feedback, and disseminating the Scope and Standards.

Best Practices for Scope and Standards Devclopment/Revision

Utilizing Structures and Processes to Initiate the Process

ANA has published a resource that outlines recommended steps for development of specialty nursing scope and standards documents, Acknowledgement of Specialty Nursing Standards of Practice and Acknowledgment of Practice Standards (ANA. 2010a). Thought leaders in specialty nursing organizations are advised to begin by addressing the following six key questions:

1. Who? Identify numbers of nurses, professional organization/society, and educational preparation.

2. What? Explain the unique contributions of generalist and advanced practice registered nurses.

3. When? Determine when these specialty nurses are needed.

4. Where? Describe practice environments in sufficient detail to understand specialty practice.

5. Why? Determine what niche or gap is filled; the historical perspective of the development of the specialty; current issues and future trends in health care that point to the need for the specialty.

6. How? Identify the process to become this type of nurse specialist, including development through formal education, continuing education, and practice experiences. Address use of the nursing process and the Code of Ethics (ANA, 2015).

Nursing specialty organizations may elect to partner with the ANA in this process. In this case, the organizations collaborate throughout the process of review and revision, leading to the intended outcome of a final approval by the ANA Board of Directors.

Some specialty organizations have a strong history in publishing nursing standards, predating their recognition by the ANA. For example, Lina Rogers Struthers, the first nurse assigned to schools from the Henry Street Settlement, published The School Nurse in 1917, only fourteen years after the beginning of school nursing in New York City (Struthers. …

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