SCOPE OF PRACTICE FOR NURSES AND MIDWIVES IN GHANA

General Roles and Responsibilities for Nurse/Midwife Specialists

Communication and Working relationships

• Be an advocate for patient rights.

• Communicate effectively with staff and clients/patients to enhance optimum customer care and quality of service.

• Cooperate and collaborate effectively with all other health professionals in the service delivery area to ensure holistic patient care.

• Be diligent, accessible and available for consultation at all times

Personal and People Development

• Develop and maintain continuing personal and professional development to meet the changing demands in the area of addictions nursing services.

• Monitor own performance against agreed objectives and standards.

• Keep up-to-date on job related issues as appropriate.

• Play active role in the induction of new personnel.

• Conduct continuous professional education.

• Take responsibility to ensure personal professional development plans are agreed with senior management.

• Promote an enabling environment for staff development and training to meet required standards.

• Provide leadership and mentorship for nursing, other health care professionals and trainees

• Maintain a stable and enthusiastic learning environment.

Management

• Ensure accurate documentation and utilisation of specialty materials to promote accountability.

• Participate in the preparation of proposals, concept notes, annual plans and budget for the institution.

• Contribute to the determination of equipment and logistical needs of the unit.

• Identify innovations towards improved job efficiency.

• Utilize the nursing process (problem solving approach) to providing individualised and holistic care to patients/clients.

Research

• Identify, plan, conduct and or participate in operational research

• Apply evidence-based clinical practice.

• Participate in mobilizing funding for research.

• Disseminate research finding.

Health and Safety Responsibilities

• Ensure and comply with existing health and safety policies and procedures of GHS/MOH.

• Ensure personal, staff and clients/patients’ safety.

• Observe the Standard Precaution guidelines for infection prevention and control.

Quality Assurance

• Act as a role model in quality improvement.

• Institutionalise quality management systems in the unit.

• Promote and participate in quality improvement measures such as multidisciplinary audit and quality initiatives.

• Regularly monitor activities against quality standards and take effective action to address them.

Scope of Practice for Clinical Nurse/Midwife Specialist Addictions Nurse Specialist

To provide comprehensive specialist, evidence-based addictions nursing services and facilitate capacity building programmes for nursing or midwifery residents/students and other health professionals.

The Addiction Nurse Specialist:

1. provides quality specialised and evidence-based addictions nursing care

2. manages clients with complex health problems related to substance use utilising the nursing process which includes assessment, diagnosis, prescription and administration of appropriate treatments according to standards and protocols

3. conducts nurse-led specialised clinics to cater for individuals with substance use disorders

4. participates in inter/multi-professional clinical sessions to promote inter-professional learning

5. initiates and implement regular clinical/technical meetings/updates in addictions nursing

6. provides mentorship and supportive supervision in the area of addiction care

7. provides follow up care (clinical and community-based)

8. evaluates addictions nursing practice and develop innovative strategies for better outcomes

9. promotes quality improvement in addictions nursing care

10. organize/facilitates continuing professional development in addictions nursing

11. collaborates with other health professionals to promote mental health and wellbeing including the provision of community-based addictions nursing services

12. participates in the development of policies, guidelines, protocols and standards of care in addictions nursing

13. participates in monitoring and evaluation

14. undertakes research in the area of addictions nursing and disseminate findings

15. conducts performance appraisal of junior colleagues under his/her supervision

16. makes input into planning and budgeting of the facility

17. documents, and/or ensure proper documentation of all activities performed

18. performs any other official duties that may be assigned

Scope of Practice for the Emergency Nurse Specialist

To provide comprehensive specialist, evidence-based emergency nursing services and facilitate capacity building programmes for nursing or midwifery residents/students and other health professionals.

The Emergency Nurse Specialist:

1. provides quality specialised and evidence-based emergency nursing care

2. manages clients with complex health problems related to emergencies which includes assessment, diagnosis, prescription and administration of appropriate treatments according to standards and protocols.

3. conducts nurse-led specialised clinics to cater for individuals with emergencies

4. participates in inter/multi-professional clinical sessions to promote inter-professional learning

5. initiates and implement regular clinical/technical meetings/updates in emergency nursing

6. provides mentorship and supportive supervision in the area of emergency care

7. provides follow up care (clinical and community-based)

8. evaluates emergency nursing practice and develop innovative strategies for better outcomes

9. promotes quality improvement in emergency nursing care.

10. organize/facilitates continuing professional development in emergency nursing

11. collaborates with other health professionals to promote health and wellbeing including the provision of community-based emergency nursing services

12. participates in the development of policies, guidelines, protocols and standards of care in emergency nursing

13. participates in monitoring and evaluation

14. undertakes research in the area of emergency nursing and disseminate findings

15. conducts performance appraisal of junior colleagues under his/her supervision

16. makes input into planning and budgeting of the facility

17. documents, and/or ensure proper documentation of all activities performed

18. performs any other official duties that may be assigned

Scope of Practice for the Oncology Nurse Specialist

To provide comprehensive specialist, evidence-based oncology nursing services and facilitate capacity building programmes for nursing or midwifery residents/students and other health professionals.

The Oncology Nurse Specialist:

1. provides quality specialised and evidence-based oncology nursing care

2. manages clients with complex health problems related to cancers which includes assessment, diagnosis, prescription and administration of appropriate treatments according to standards and protocols

3. conducts nurse-led specialised clinics to cater for individuals with cancers.

4. participates in inter/multi-professional clinical sessions to promote inter-professional learning

5. initiates and implement regular clinical/technical meetings/updates in oncology nursing

6. provides mentorship and supportive supervision in the area of oncology nursing care

7. provides follow up care (clinical and community-based)

8. evaluates oncology nursing practice and develop innovative strategies for better outcomes

9. promotes quality improvement in oncology nursing care.

10. organize/facilitates continuing professional development in oncology nursing

11. collaborates with other health professionals to promote health and wellbeing including the provision of community-based oncology nursing services

12. participates in the development of policies, guidelines, protocols and standards of care in oncology nursing

13. participates in monitoring and evaluation.

14. undertakes research in the area of oncology nursing and disseminate findings

15. conducts performance appraisal of junior colleagues under his/her supervision

16. makes input into planning and budgeting of the facility

17. documents, and/or ensure proper documentation of, all activities performed

18. performs any other official duties that may be assigned

Scope of practice for the Palliative Care Nurse Specialist

To provide comprehensive specialist, evidence-based palliative care nursing services and facilitate capacity building programmes for nursing or midwifery residents/students and other health professionals.

The Palliative Care Nurse Specialist:

1. provides quality specialised and evidence-based palliative nursing care

2. manages clients with complex health problems related to palliative care needs utilising the nursing process which includes assessment, diagnosis, prescription and administration of appropriate treatments according to standards and protocols

3. conduct nurse-led specialised clinics to cater for individuals with palliative care needs

4. participates in inter/multi-professional clinical sessions to promote inter-professional learning

5. initiates and implement regular clinical/technical meetings/updates in palliative care nursing

6. provides mentorship and supportive supervision in the area of palliative care

7. provides follow up care (clinical and community-based)

8. evaluates palliative nursing practice and develop innovative strategies for better outcomes

9. promote quality improvement in palliative nursing care.

10. organize/facilitates continuing professional development in palliative care nursing

11. collaborates with other health professionals to promote health and wellbeing including the provision of community-based palliative care nursing services

12. participates in the development of policies, guidelines, protocols and standards of care in palliative care nursing

13. participates in monitoring and evaluation

14. undertakes research in the area of palliative nursing and disseminate findings

15. conducts performance appraisal of junior colleagues under his/her supervision

16. makes input into planning and budgeting of the facility

17. documents, and/or ensure proper documentation of, all activities performed

18. performs any other official duties that may be assigned

Scope of Practice for the Paediatric Nurse Specialist

To provide comprehensive specialist, evidence-based paediatric nursing services and facilitate capacity building programmes for nursing or midwifery residents/students and other health professionals.

The Paediatric Nurse Specialist:

1. provides quality specialised and evidence-based paediatric nursing care

2. manages clients with complex health problems related to children and adolescents utilising the nursing process which includes assessment, diagnosis, prescription and administration of appropriate treatments according to standards and protocols

3. conducts nurse-led specialised clinics to cater for children and adolescents

4. participates in inter/multi-professional clinical sessions to promote inter-professional learning

5. initiates and implement regular clinical/technical meetings/updates in paediatric nursing

6. provides mentorship and supportive supervision in the area of paediatric care

7. provides follow up care (clinical and community-based)

8. evaluates paediatric nursing practice and develop innovative strategies for better outcomes

9. promotes quality improvement in paediatric nursing care

10. organize/facilitates continuing professional development in paediatric nursing

11. collaborates with other health professionals to promote mental health and wellbeing including the provision of community-based paediatric nursing services

12. participates in the development of policies, guidelines, protocols and standards of care in paediatric nursing

13. participates in monitoring and evaluation

14. undertakes research in the area of paediatric nursing and disseminate findings

15. conducts performance appraisal of junior colleagues under his/her supervision

16. makes input into planning and budgeting of the facility

17. documents, and/or ensure proper documentation of, all activities performed

18. performs any other official duties that may be assigned

Scope of Practice for the Haematology Nurse Specialist

To provide comprehensive specialist, evidence-based haematology nursing services and facilitate capacity building programmes for nursing or midwifery residents/students and other health professionals.

The Haematology Nurse Specialist:

1. provides quality specialised and evidence-based haematology nursing care

2. manages clients with complex health problems related to blood disorders utilising the nursing process which includes assessment, diagnosis, prescription and administration of appropriate treatments according to standards and protocols

3. conducts nurse-led specialised clinics to cater for individuals with blood disorders

4. participates in inter/multi-professional clinical sessions to promote inter-professional learning

5. initiates and implement regular clinical/technical meetings/updates in haematology nursing

6. provides mentorship and supportive supervision in the area of haematology care

7. provides follow up care (clinical and community-based)

8. Evaluate haematology nursing practice and develop innovative strategies for better outcomes

9. promotes quality improvement in haematology nursing care.

10. organize/facilitates continuing professional development in haematology nursing

11. collaborates with other health professionals to promote health and wellbeing including the provision of community-based haematology nursing services

12. participates in the development of policies, guidelines, protocols and standards of care in haematology nursing

13. participates in monitoring and evaluation

14. undertake research in the area of haematology nursing and disseminate findings

15. conducts performance appraisal of junior colleagues under his/her supervision

16. makes input into planning and budgeting of the facility

17. documents, and/or ensure proper documentation of all activities performed

18. performs any other official duties that may be assigned

Scope of Practice for the Neuroscience Nurse Specialist

To provide comprehensive specialist, evidence-based neuroscience nursing services and facilitate capacity building programmes for nursing or midwifery residents/students and other health professionals.

The Neuroscience Nurse Specialist:

1. provides quality specialised and evidence-based neuroscience nursing care

2. manages clients with complex health problems related to substance use utilising the nursing process which includes assessment, diagnosis, prescription and administration of appropriate treatments according to standards and protocols

3. conducts nurse-led specialised clinics to cater for individuals with neuroscience related disorders.

4. participates in inter/multi-professional clinical sessions to promote inter-professional learning

5. initiates and implement regular clinical/technical meetings/updates in neuroscience nursing.

6. provides mentorship and supportive supervision in the area of neuroscience nursing care

7. provides follow up care (clinical and community-based)

8. evaluates neuroscience nursing practice and develop innovative strategies for better outcomes

9. promotes quality improvement in neuroscience nursing care.

10. organize/facilitates continuing professional development in neuroscience nursing

11. collaborates with other health professionals to promote health and wellbeing including the provision of community-based neuroscience nursing services

12. participates in the development of policies, guidelines, protocols and standards of care in neuroscience nursing

13. participates in monitoring and evaluation

14. undertakes research in the area of neuroscience nursing and disseminate findings

15. conducts performance appraisal of junior colleagues under his/her supervision

16. makes input into planning and budgeting of the facility

17. documents, and/or ensure proper documentation of, all activities performed

18. performs any other official duties that may be assigned

Scope of Practice for the Neonatal Nurse Specialist

To provide comprehensive specialist, evidence-based neonatal nursing care services and facilitate capacity building programmes for nursing or midwifery residents/students and other health professionals.

The Neonatal Nurse Specialist :

1. provides quality specialised and evidence-based neonatal nursing

2. manages clients with complex health problems related to neonatal nursing utilising the nursing process which includes assessment, diagnosis, prescription and administration of appropriate treatments according to standards and protocols

3. conducts nurse/midwife-led specialised clinics to cater for individuals with neonatal disorders

4. participates in inter/multi-professional clinical sessions to promote inter-professional learning

5. initiates and implement regular clinical/technical meetings/updates in neonatal nursing

6. provides mentorship and supportive supervision in the area of neonatal nursing care

7. provides follow up care (clinical and community-based)

8. evaluates neonatal nursing practice and develop innovative strategies for better outcomes

9. promotes quality improvement in neonatal nursing care.

10. organize/facilitates continuing professional development in neonatal nursing care

11. collaborates with other health professionals to promote neonatal care and wellbeing including the provision of community-based Neonatal nursing services

12. participates in the development of policies, guidelines, protocols and standards of care in Neonatal nursing

13. participates in monitoring and evaluation

14. undertakes research in the area of Neonatal nursing and disseminate findings

15. conducts performance appraisal of junior colleagues under his/her supervision

16. makes input into planning and budgeting of the facility

17. documents, and/or ensure proper documentation of, all activities performed

18. performs any other official duties that may be assigned

Scope of Practice for the Women’s Health Specialist

To provide comprehensive specialist, evidence-based Women’s Health services and facilitate capacity building programmes for nursing or midwifery residents/students and other health professionals.

The Women’s Health Specialist:

1. provides quality specialised and evidence-based women’s health care

2. manages clients with complex health problems related to women’s health utilising the nursing process which includes assessment, diagnosis, prescription and administration of appropriate treatments according to standards and protocols

3. conducts nurse/midwife-led specialised clinics to cater for individuals with women’s health disorders

4. participates in inter/multi-professional clinical sessions to promote inter-professional learning

5. initiates and implement regular clinical/technical meetings/updates in women’s health care

6. provides mentorship and supportive supervision in the area of women’s health

7. provides follow up care (clinical and community-based)

8. evaluates women’s health practice and develop innovative strategies for better outcomes

9. promotes quality improvement in women’s health care

10. organize/facilitates continuing professional development in women’s health.

11. collaborates with other health professionals to promote women’s health and wellbeing including the provision of community-based midwifery services

12. participates in the development of policies, guidelines, protocols and standards of care in women’s health care

13. participates in monitoring and evaluation

14. undertakes research in the area of women’s health and disseminate findings

15. conduct performance appraisal of junior colleagues under his/her supervision

16. makes input into planning and budgeting of the facility

17. documents, and/or ensure proper documentation of, all activities performed

18. performs any other official duties that may be assigned

PRACTICE OF NURSES

Treatments which a Nurse may perform without instructions from a Doctor

1. Care and cleanliness of all nursing equipment

2. Sterilization of surgical equipment

3. Washing of patient

4. Prevention and treatment of bedsores

5. Cleaning patient of pediculi

6. Making of patient’s bed

7. Cooking and serving patient’s food

8. Cleaning mouth of patient. Administration of mouth washes and gargles

9. Giving treatments for reduction of pyrexia, tepid and cold sponging but not administration of anti-pyretic drugs, except aspirin, phenacetin

10. Administration of evacuant enemata, soap and water, olive oil, glycerine

11. Administration of evacuant suppository, viz: glycerine but not of suppositories containing dangerous drugs or poisons

12. Administration of drugs for relief of flatulence.

13. Administration of common drugs for the relief of pain – aspirin, but not of any drug listed in the Pharmacy and Drugs Act as a dangerous drug

14. Giving of moist inhalation for laryngititis, tracheitis, pharyngitis or nasal sinus infections.

15. Application of simple liniments

16. Irrigation of eyes

17. Application of cold to a part – cold compress, ice bag

18. Application of heat to a part – hot water bottles, electric pad, medical fomentation

19. Surgical fomentation

20. Preparation of any part of the body for an operation

21. Make blood films for diagnosis of malaria. (The nurse may not, without sanction of a Doctor, withdraw blood through a hollow needle or any other contrivance for the purpose of making blood tests)

22. Disinfection of utensils, clothing, bedding, furniture, excreta of patients

23. Give usual nursing and first aid treatments for relief of shock – warmth; elevation of legs

24. Withdraw urine by rubber catheter

25. Arrest haemorrhage by use of pad and bandage, digital pressure or tourniquet

26. Give first aid treatment for cleaning of a wound

27. Apply first aid to fractures, sprains, muscle injuries, by using splints, slings, bandages or sandbags

28. Performance of artificial respiration in an emergency

29. First aid treatment for removal of foreign body from eye

30. Giving of first aid treatment for snake bite or insect stings

31. Giving of first aid to a woman in labour if no midwife or Doctor is available

32. Giving of first aid to patients having fits or convulsions

33. Administration of demulcent drinks; common antidotes and antagonists against poisons and administration of such stimulants as coffee in cases of collapse following poisoning

34. Giving first aid treatment for burns but not applying sclerosing agents to burnt areas without sanction of Doctor

35. Performance of last offices

36. Keeping of the various charts and records

Treatment which a Nurse may perform only with sanction of a Registered Medical Practitioner (not necessarily in his presence), given in writing and dated on the patient’s treatment form

37. Artificial feeding by oesophageal or nasal routes

38. Administration of any drug ordered by a Registered Medical Practitioner. This includes:

1. oral and rectal administration

2. hypodermic, intra-muscular and intravenous injection;

3. applications to eyes, ears, throat, vagina, uretha and skin;

4. administration by inhalation (but not anaesthetics except in the presence of a Registered Medical Practitioner)

A nurse may not administer drugs or anaesthetics by the intrathecal route.

39. Obtaining of specimens of infective material from throat, nose, eyes, urethra, cervix; using appliances for the purpose

40. Examination of urine with a view to providing data for doctor to form a diagnosis

41. Performance of minor operations such as incision of boils or insertion of sutures in wounds

42. Application of strapping or Elastoplast or other skin adherent for temporary treatment of fractures. Putting on of Plaster of Paris

43. Application of radiant heat

44. Lavage of stomach, colon, bladder

45. Vaginal douching

46. Dressing of operation and other wounds including removal of stitches, clips, drainage tubes, etc.

Treatment which Nurses may perform only in presence of a Registered Medical Practitioner and with his sanction

47. Administration of anaesthetics

Practice of Public Health Nurses

1. To supervise the welfare of infants from seven days old (when the Midwife ceases to visit) to five years old; each infant to be visited monthly for first twelve months, then at three monthly intervals until the age of three years and at six monthly intervals from three years to five years.

2. To attend and supervise Child Welfare Centres where children are weighed and inspected; to give mothers advice on feeding, weaning and dietary requirements of the growing child and so to encourage mothers to make full use of the Welfare Centre by attending regularly.

3. To advise with regard to domestic and personal hygiene when visiting mothers in their homes.

4. To teach mothers to recognize and notice early signs and symptoms of disease and to obtain early medical advice.

5. To advise parents and expectant mothers as to the best means of promoting their health and that of their families.

6. To organize and attend ante-natal and family planning clinics and to advise mothers on general pre-natal care and diet.

7. To organize and attend school clinics, carrying out general inspection of all scholars; to supervise minor ailments clinics and to visit school children at home when occasion demands.

8. To organize and give nursing services to sick persons, invalids and those requiring nursing in their own homes.

9. To prevent infection by immunization and vaccination programmes.

10. To follow-up cases of infectious diseases and give advise with regard to prevention of spread of diseases; special emphasis on “follow-up” of contacts of Tuberculosis. Veneral Disease and Leprosy.

11. To refer to the appropriate authorities persons suffering from mental illness or subnormality and to advise and assist such persons in recuperation and rehabilitation.

12. To follow up cases of mental illness and subnormality discharge from hospitals and treatment centres.

13. To visit and inspect all motherless and orphaned children monthly up to five years and then at three monthly intervals to the age of ten years.

14. To follow-up children discharged from hospital, to give advice regarding diet and general after-care etc.

15. To keep all the necessary records and ledgers and to send in monthly returns to the Medical Officer of Health.

Scope of Practice for the Registered Mental Health Nurse (RMN)

The scope of practice for the Registered Mental Health Nurse is based on the WHO’s QualityRights of patients and ICN competences for Mental health nursing. The RMN:

1. assesses client for relevant health history, with emphasis on mental health issues

2. observes and document changes in mood, perception and behavior etc. (mental status examination)

3. applies standardized taxonomy systems to the nursing diagnosis of mental health problems and interventions using the current ICD and DSM

4. facilitates proper communication with the patient/relatives and build a therapeutic relationship

5. demonstrates ability for continuous professional development and life-long learning in a changing society

6. conducts admission and discharge procedures of patients

7. monitors patients’ health status and note changes where necessary

8. administers psychotropic and related medications, monitor its side effects, adverse reactions, changes in patient's mood or behavior and follow procedures regarding the documentation and storage

9. practices pharmacovigilance

10. de-escalate/administers PRN medications to aggressive patients when the nurse considers the likelihood of the patient harming self or others

11. facilitates the protection of patient and others against any form of stigma, abuse or harm

12. engages patient in coaching through advocacy, mentoring and teaching

13. facilitates the care of patients with specific needs such as Dementia, Suicidal ideations, Epilepsy, Eating Disorders, Violent Behavior and Intellectual Disabilities

14. develops and implement social, individual, group and family psychotherapeutic interventions including that of child protection and abuse

15. encourages patients to take part in art, drama or occupational therapy where appropriate

16. organizes social events aimed at developing patient’s social skills and helping to reduce feelings of isolation

17. formulates and implement interventions in areas of physical need to promote personal hygiene, nutrition, sleep, exercise etc. as well as managing any related physical ailments

18. prepares patient for therapies e.g. ECT, CBT and provide care for patient during and after recovery from therapy

19. supports the patient to develop a sense of purpose and hope in his/her current life experience

20. initiates mental health practices, support and educate communities, schools, workplaces and manage or refer where necessary

21. cares for patients experiencing acute and chronic mental disorders

22. demonstrates leadership and administrative capabilities in managing health care units within the framework of the national health policy and the regulatory framework using reflective/journaling practice

23. contributes to policy formulation, implementation and supervision for mental health services

24. educates trainee nurses/midwives in mental health care practices, enforce sanctions and documentation where necessary

25. participates in the conduct of research in mental health related issues

26. demonstrates and apply entrepreneurial skills in Nursing

27. works with patient’s family and other caregivers, helping to educate them and the patient about their health problems and promote recovery based approach to care

28. incorporates the use of nursing informatics using the latest versions of available software in the care of patients and the analysis of data generated to improve care outcomes

29. demonstrates and apply innovation in practice

30. collaborates with other health professionals to ensure continuity of care

31. cares for the dying in accordance with nursing standards

Scope of Practice for the Registered Midwife (RM)

The scope of practice as prescribed for the Registered Midwife is premised on the WHO’s Labour Care Guide and Respectful Maternity Care within the landscape of Midwifery Services Framework and the ICM competencies. The midwife:

1. obtains client’s medical and obstetric history and conduct physical examination

2. demonstrates ability for continuous professional development and life-long learning in a changing society

3. promotes and maintain an environment which assures physical and mental well-being of mother and child by reassurance of mother, father, child, family, group and community

4. promotes and maintain hygiene and physical comfort; care and cleanliness of all midwifery equipment and sterilization of surgical equipment

5. provides pre-conceptual care

6. provides pre-natal and family planning services

7. monitors progress of pregnancy, identify and manage minor disorders, medical conditions and complications of pregnancy and refer when necessary

8. provides intra partum care; monitor progress of labour, identify complications and refer to a higher level of care

9. provides post-partum care; monitor progress of puerperium; identify and manage post- partum complications or refer when necessary

10. prevents complications relating to labour and puerperium by performing

episiotomy, suturing first and second degree tears or episiotomy and administration of local anaesthetics/anaesthesia

11. performs emergency life-saving procedures including augmentation of

labour, vacuum delivery and manual removal of placenta

12. provides child care including resuscitation and examination of the new born (head to toe) and promotion of breast feeding

13. monitors and manage reaction of mother and child to condition, trauma, stress,

medication and other forms of treatment

14. provides care for mother and child in obstetric emergencies; and refer complications of pregnancy

15. provides Comprehensive Abortion Care (CAC) and Post Abortion Care (PAC)

16. identifies abnormal obstetrical condition and seek prompt medical interventions to a higher level of care

17. administers medicine used in midwifery to mother and child and monitor its effects

18. educates and counsel individuals, families and communities to prevent maternal and infant morbidity and mortality

19. promotes antenatal and postnatal exercises

20. administers and monitor supply of oxygen to the mother and child

21. maintains fluid, electrolyte and acid base balance of mother and child

22. improves and maintain the nutritional status of mother and child

23. promotes effective communication between care givers, clients and significant others

24. ensures infection prevention while carrying out clinical procedures

25. prepares and assist surgical operation, diagnostic and therapeutic interventions for mother and child

26. keeps accurate records of all activities or interventions performed on mother and child

27. obtains specimen for diagnostic investigations (blood, urine, stool etc.)

28. advocates for mother and child to obtain optimum quality health care including child protection and abuse

29. collaborates with other health personnel to provide care for mother and child

30. identifies training needs of students and staff and impact knowledge, skills and principles of reproductive health to meet those needs

31. demonstrates leadership and administrative capabilities in managing health care units within the framework of the national health policy and the regulatory framework using reflective/journaling practice

32. plans and coordinate the use of supplies and services

33. prescribes medication within her jurisdiction

34. practices pharmacovigilance

35. administers medication ordered by a Registered Medical Practitioner

36. initiates research, share relevant research findings and provide evidence-based practice

37. demonstrates and apply entrepreneurial skills in Nursing and Midwifery

38. incorporates the use of nursing informatics using the latest versions of available software in the care of patients and the analysis of data generated to improve care outcomes

39. observes and report behavioural changes in patients

40. notifies births, maternal and neonatal death and conduct maternal and neonatal death audit

41. demonstrates and apply innovation in practice

42. cares for stillborn infants and dead neonates

43. cares for the dying in accordance with midwifery standards

Scope of Practice for the Public Health Nurse (PHN)

The scope of practice for the Public Health Nurse among others is anchored on the concepts of the Universal Health Coverage (UHC) and the Sustainable Development Goals (SDGs). The PHN:

1. performs professional core functions as a member of the District Health Management Team (DHMT)/Sub District Health Team (SDHT)

2. demonstrates ability for continuous professional development and life-long learning in a changing society

3. contributes to and promote Primary Health Care Services/CHPS in the community especially the vulnerable population and high-risk groups

4. conducts community assessment, diagnosis, plan, implement and evaluate community programmes towards preventive, promotive and rehabilitative services

5. provides emergency obstetric care and refer patients/clients with conditions beyond his/her competence to appropriate authority

6. plans and conduct health promotion programmes based on community diagnosis and prevailing health issues

7. implements national health policies and apply its relevance to nursing and midwifery

8. participates in the disease surveillance in the community

9. collaborates with other members of the SDHT and other health related agencies in the community to plan, implement and monitor health activities

10. provides Family Planning, Testing and Counseling, STI’s/HIV and AIDS, Adolescent, Geriatric, Maternal and Child health services

11. assesses the physical and mental health needs of individuals, diagnose and treat specified diseases and make referrals when necessary

12. identifies nutritional needs, health and social resources available in the community and mobilize the community to utilize them

13. undertakes logistics management

14. practices pharmacovigilance

15. demonstrates leadership and administrative capabilities in managing health care units within the framework of the national health policy and the regulatory framework using reflective/journaling practice

16. plans, organize, coordinate and implement national immunization programmes and Child Welfare Clinics

17. plans and implement School Health Programmes/Services

18. manages financial resources in accordance with relevance financial regulations

19. liaises with stakeholders and community leaders to advocate for Positive behavioural change in harmful cultural practices

20. implements rehabilitative activities in the community

21. plans and conduct routine and special home visits to families

22. supervises the work of Nurse Assistants (Preventive)

23. demonstrates and apply entrepreneurial skills in Nursing

24. incorporates the use of nursing informatics using the latest versions of available software in the care of patients and the analysis of data generated to improve care outcomes

25. participates in the conduct of research in public health related issues

26. demonstrates and apply innovation in practice

27. keeps all necessary records, ledgers and transmit accordingly

28. offers end of life palliative care in accordance with nursing standards

Scope of Practice for the Registered General Nurse (RGN)

The scope of practice for the Registered General Nurse is basically premised on the International Council of Nurses (ICN) competencies for patient care and the Practice for Nurses as enshrined in the Nurses Regulation LI 683, 1971. The RGN, in addition to the forty-seven (47) practice of nurses/functions stated in the Nurses Regulation LI 683, 1971:

1. uses knowledge acquired in the principles of homeostasis to meet patients’ needs by monitoring vital signs of patient and their reaction to disease conditions, trauma, stress, anxiety, medication, treatment and documentation

2. administers prescribed medication to patients

3. practice pharmacovigilance

4. demonstrates skills and abilities for imparting knowledge and principles of health to student nurses, patients and relatives by participating in the teaching of patients and mentoring nursing students

5. contributes to, and promote primary health care services, child protection and abuse in the community; recognize, manage and refer clients/patients where necessary

6. plans and carry out health education based on identified health needs of the community by teaching and counseling individuals and groups of persons

7. demonstrates leadership and administrative capabilities in managing health care units within the framework of the national health policy and the regulatory framework using reflective/journaling practice

8. demonstrates understanding of national policies and their relevance to nursing

9. demonstrates ability for continuous professional development and life-long learning in a changing society

10. coordinates the health care activities provided for the patient by other categories of health care providers

11. demonstrates and apply entrepreneurial skills in Nursing

12. incorporates the use of nursing informatics using the latest versions of available software in the care of patients and the analysis of data generated to improve care outcomes

13. observes and report behavioural changes in patients

14. facilitate proper communication with the client and build therapeutic relationship

15. initiates research, share relevant research findings and provide evidence-based practice

16. demonstrates and apply innovation in practice

17. cares for the dying in accordance with nursing standards

18. assists patients family through the grieving process

Scope of Practice for the Registered Community Mental Health Nurse (RCMN)

The scope of practice for the RCMN is birthed on the WHO’s QualityRights of patients, UHC, SDGs and ICN’s competencies. The RCMN:

1. assesses client for relevant health history, with emphasis on mental health

2. observes and document changes in mood, perception and behavior

3. applies standardized taxonomy systems to the nursing diagnosis of mental health problems and interventions using the current ICD and DSM

4. facilitates proper communication with the client and build a good relationship

5. monitors clients’ health status and note changes and refer where necessary

6. contributes to and promote Primary Health Care Services/CHPS in the community especially the vulnerable population and high-risk groups

7. conducts community diagnosis, plan, implement and evaluate community programmes towards preventive, promotive and rehabilitative services

8. administers prescribed psychotropic and related medications, monitor its side effects, adverse reactions, changes in patient's mood or behavior and refer for follow procedures regarding the documentation and storage

9. practice pharmacovigilance

10. participates in disease surveillance in the community

11. collaborates with other members of the SDHT and other health related agencies and the community to plan, implement and monitor health activities at the community level

12. de-escalates aggressive patients and refer client and family when the nurse considers the likelihood of the client harming self or others

13. facilitates the protection of client and others against any form of abuse

14. engages client in coaching through advocacy, mentoring, and teaching

15. facilitates the care of clients with specific needs such as Dementia, Suicidal ideations, Epilepsy, Eating Disorders, Violent Behavior, Intellectual Disabilities and Substance use

16. develops and implement social, individual, group and family psychotherapeutic interventions

17. encourages clients to take part in art, drama or occupational therapy where appropriate

18. organizes social events aimed at developing client’s social skills and helping to reduce feelings of isolation

19. formulates and implement interventions in areas of physical need to promote personal hygiene, nutrition, sleep, exercise etc. as well as manage any related physical ailments

20. initiates mental health practices, support and educate communities, schools and workplaces and manage or refer where necessary

21. contributes to policy formulation, implementation and supervision for mental health services

22. educates trainee nurses in mental health care practices and enforce sanctions and documentation where necessary

23. participates in the conduct of research in community mental health related issues

24. work with client’s family and other caregivers, helping to educate them and the client about their health problems and promote recovery based approach to care

25. incorporates the use of nursing informatics using the latest versions of available software in the care of patients and the analysis of data generated to improve care outcomes

26. requests and manage supplies, commodities and services

27. plans and implement school health programmes/services

28. manages financial resources in accordance with relevant financial regulations

29. advocates for Positive behavioural change in harmful cultural practices

30. implements rehabilitative activities in the community

31. plans and conduct routine and special home visits

32. demonstrates and apply entrepreneurial skills in Nursing

33. demonstrates ability for CPD and life-long learning

34. demonstrates and apply innovation in practice

35. collaborates with stakeholders to care for the dying in accordance with nursing standards

Scope of Practice for Registered Nurse Assistant (Clinical) (RNAC)

The Registered Nurse Assistant (Clinical) under the supervision of a Registered Nurse/Midwife:

1. facilitate proper communication with the client and build therapeutic relationship

2. assists in admission and discharge procedures of patients on the ward

3. assists in giving all forms of medication ordered

4. observes and report adverse events of medications

5. carries out spoon feeding of patient

6. demonstrates ability for continuous professional development and life-long learning in a

changing society

7. maintains personal hygiene of patient

8. maintains clean ward and clinical environment

9. checks vital signs, records and reports appropriately

10. assists in carrying out pain assessment and management of patients

11. ensures client/patient safety on the ward

12. processes used equipment, instruments and medical devices

13. assists in the conduct of health related research

14. receives and orient patients and relatives to the ward

15. conducts emergency deliveries and refer patients/clients to appropriate authority

16. carries out other nursing duties within their regulatory competence as assigned by the

Registered Nurse/Midwife

Scope of Practice for the Registered Nurse Assistant (Preventive) (RNAP)

The Registered Nurse Assistant (Preventive) under the supervision of the Public Health nurse:

1. works with members of the Sub District Health Team (SDHT) and the community to plan, implement and monitor health activities at the community level

2. contributes to and promote Primary Health Care Services/CHPS in the community especially the vulnerable population and high-risk groups

3. assists in the conduct of community diagnosis, planning, implementing and evaluating community programmes towards preventive, promotive and rehabilitative services

4. conducts emergency deliveries and refer patients/clients to appropriate authority

5. demonstrates ability for continuous professional development and life-long learning in a changing society

6. provides first aid services and refer patients/clients to appropriate authority

7. assists in the planning and conduct of health promotion programmes

8. assists in the management of health care units

9. participates in the implementation of national health policies and apply its relevance to practice

10. performs routine data collection on health activities

11. participates in identifying health problems in the community

12. participates in the provision of Family Planning, STI’s, HIV and AIDS, Adolescent, Maternal and Child health services

13. participates in the implementation of national immunization programmes

14. participates in the planning and implementation of school health programmes

15. facilitate proper communication with the client and build a good relationship

16. assists in planning and conducting of routine and special home visits

17. assists in the conduct of health related research

18. documents and report all activities to the Public Health Nurse (appropriate authority)

19. carries out other nursing duties within their regulatory competence as

assigned by the Public Health Nurse

Scope of Practice for Public Health Nurses

1. Apply nursing process within their scope in the care of individuals, families and communities

2. Organize and run clinics (Child Welfare, School Health Services, Adolescent Health Clinics, Maternal Health, Family Planning and Testing and Counselling (TC) Services) in the health facilities and communities

3. Promote Primary Health Care Services in the community

4. Work in partnership to support and empower individuals, their families/groups and communities to participate in decisions concerning their health

5. Conduct community needs assessment, diagnose, plan, implement and evaluate programmes towards preventive, promotive, rehabilitative and regenerative services

6. Provide emergency obstetric care and refer patients/clients with conditions beyond their capacity to the appropriate authority

7. Provide basic emergency procedures, prescribe and administer emergency therapies

8. Encourage community participation and work in partnership with voluntary workers in health enhancing activities

9. Assume administrative and leadership roles in managing health care units

10. Demonstrate an understanding of national health policies and apply its relevance to Public Health Nursing

11. Collect, analyse and interpret routine data on health events in the community for an informed decision

12. Work with other members of the Health Team and the community to plan, implement and monitor health activities at the community level

13. Assess the physical and mental health needs of individuals, diagnose and treat specific diseases and make appropriate referrals

14. Interpret services and resources available in the community to the people to help them maintain maximum health standards, prevent disabilities and premature deaths

15. Design programmes and activities to train health workers and non-health workers in the community

16. Assess the health and social needs of the school child and use the resources available to meet such needs

17. Attend to the health needs of the adolescent, the aged and clients with special needs

18. Provide counselling services to clients

19. Foster patient advocacy and patient safety roles

20. Demonstrate knowledge and skills in the prevention and control of communicable and non-communicable diseases

21. Demonstrate responsibility, accountability and ethical behavior in the performance of roles

22. Create and keep proper records of patient care, administrative and managerial activities in collaboration with other team members

23. Develop, implement, evaluate health promotion and health education strategies

24. Collaborate with other health professionals to design and implement various educational programs aimed at addressing emerging health issues in the area of practice

25. Conduct appraisal of immediate supervisees, analyse outcomes and make appropriate recommendation for training/capacity building

26. Make inputs into the development and review of protocols, standard operating procedures and other relevant manuals

27. Serve as a preceptor for the training of public health nurses

28. Recognize the need for life-long learning and continued professional growth

29. Conduct research in nursing and use findings in the delivery of population-focused care

Scope of Practice for Nurse Practitioners

1. Apply nursing process within their scope in the care of individuals and families

2. Provide out-patient Nurse-Led consultation for patients of all age groups

3. Serve as a resource person in the provision of advanced nursing care in health facilities

4. Set up a General Practice Clinic and use leadership and managerial skills to manage the clinic in the delivery of health care to clients with diverse conditions

5. Conduct advanced health assessment of patients

6. Assess, diagnose, treat and evaluate patients with disorders

7. Obtain specimen for laboratory investigations

8. Request diagnostic imaging such as x-rays, ultrasound, CT scan, MRI, etc.

9. Analyse and interpret laboratory and other diagnostic results and put in appropriate interventions

10. Establish primary and differential diagnosis

11. Prescribe pharmacologic and non-pharmacologic treatment and interventions

12. Detain or admit patients to hospital for purposes of management of their condition

13. Refer patients to other healthcare team members or higher levels of care as required

14. Undertake minor surgical procedures such as incision of boils and suturing of minor wounds among others

15. Provide basic emergency procedures and administration of emergency therapies

16. Administer medical, nursing, pharmacological and other forms of therapy to patients

17. Review patients and conduct follow-up care as appropriate

18. Prescribe essential medicines and drugs in levels B1, B2 and C

19. Prescribe blood or blood products for patients as may be required

20. Provide care to patient with mental health disorders and behavioural problems and refer as appropriate

21. Provide pre-conceptional, antenatal, maternal, child health and family planning services

22. Conduct/participate in ward rounds, clinical meetings, morbidity/mortality meetings and staff durbars where appropriate

23. Demonstrate responsibility, accountability and ethical behavior in the performance of roles

24. Offer public health services such as health education and promotion to individuals, families and communities

25. Provide counselling services to clients

26. Foster patient advocacy and patient safety roles

27. Create and keep proper records of patient care, administrative and managerial activities in collaboration with other team members

28. Collaborate with other health professionals to design and implement various educational programs aimed at addressing emerging health issues in the area of practice

29. Conduct appraisal of immediate supervisees, analyse outcomes and make appropriate recommendation for training/capacity building

30. Make inputs into the development and review of protocols, standard operating procedures and other relevant manuals

31. Establish and maintain effective collaboration with public health units to ensure effective contact tracing

32. Serve as a preceptor for the training of nurse practitioners

33. Recognize the need for life-long learning and continued professional growth

34. Conduct research in nursing and use findings in the delivery of population-focused care

Scope of Practice for Ear, Nose and Throat Nurses

1. Apply nursing process within their scope in the care of individuals and families

2. Make technical input in the setup of ENT clinic where appropriate

3. Set up an ENT Clinic and use leadership and managerial skills to manage the clinic in the delivery of health care to clients with ENT conditions

4. Provide out-patient clinic Nurse-Led consultation

5. Perform physical examination of the ear, nose and throat of clients

6. Obtain specimen for laboratory investigations

7. Assess, diagnose, treat and evaluate patients with ENT disorders

8. Analyse and interpret laboratory and other diagnostic results and put in appropriate interventions

9. Prescribe medications for minor ENT disorders

10. Conduct/participate in ward rounds, clinical meetings, morbidity/mortality meetings and staff durbars where appropriate

11. Identify and manage ENT emergencies, and refer where appropriate

12. Perform non-invasive removal of foreign bodies from the ear, nose and throat

13. Prepare patients for surgeries

14. Assist in the performance of surgical procedures

15. Serve as ENT Scrub Nurse during major surgeries

16. Perform wicking of the ear to prevent stenosis

17. Instill/administer ENT, head and neck medications

18. Review patients and conduct follow-up care as appropriate

19. Collaborate with other health professionals to design and implement various educational programs aimed at addressing emerging health issues in the area of practice

20. Conduct appraisal of immediate supervisees, analyse outcomes and make appropriate recommendation for training/capacity building

21. Make inputs into the development and review of protocols, standard operating procedures and other relevant manuals

22. Establish and maintain effective collaboration with public health units to ensure effective contact tracing

23. Provide pre and post-operative management of ENT patients

24. Perform incision and drainage of minor E.N.T, head and neck abscesses

25. Perform minor ENT Surgeries

26. Carry out outreach clinics such as School Health Services

27. Identify ‘at-risk’ group, discuss problems with parents/teachers and refer for further management

28. Serve as a preceptor for the training of ENT nurses

29. Provide counselling services to clients

30. Foster patient advocacy and patient safety roles

31. Create and keep proper records of patient care, administrative and managerial activities in collaboration with other team members

32. Plan, organize and participate in rehabilitation of the early hearing, speech and language impairment

33. Demonstrate responsibility, accountability and ethical behavior in the performance of roles

34. Offer public health services such as health education and promotion to individuals, families and communities

35. Train other health personnel to assist in the delivery of ENT Healthcare

36. Recognize the need for life-long learning and continued professional growth.

37. Conduct research in ENT Nursing and use findings in the delivery of population-focused care

Scope of Practice for Ophthalmic Nurses

1. Apply nursing process within their scope in the care of individuals and families

2. Set up an Eye Clinic and use leadership and managerial skills to manage the clinic in the delivery of health care to clients with eye conditions

3. Make technical input in the setup of eye clinic where appropriate

4. Provide out-patient clinic Nurse-Led consultations

5. Assess, diagnose manage and evaluate patients with common eye conditions

6. Obtain specimen for laboratory investigations

7. Analyse and interpret laboratory and other diagnostic results and put in appropriate interventions

8. Prescribe medications for minor eye disorders

9. Conduct/participate in ward rounds, clinical meetings, morbidity/mortality meetings and staff durbars where appropriate

10. Select and prepare patients who require intra-ocular surgeries

11. Plan, organize and participate in rehabilitation of the visually challenged persons

12. Assist the Ophthalmologist during surgery

13. Serve as a Scrub Nurse during major surgeries

14. Carry out pre and post-operative management of clients

15. Administer topical eye medications

16. Administer periocular injections

17. Identify and manage ophthalmic emergencies, and refer where appropriate

18. Review patients and conduct follow-up care as appropriate

19. Carry out patient/family teaching and counselling

20. Foster patient advocacy and patient safety roles

21. Set various types of trolleys for ophthalmic procedures

22. Manage minor clinical/surgical eye health conditions such as lid surgery and evisceration

23. Carry out outreach clinics such as School Health Services

24. Participate as a member of a multidisciplinary health team to coordinate and/or manage the care of a community with eye health conditions

25. Demonstrate responsibility, accountability, and ethical behavior in the performance of roles

26. Educate the public on eye care, health promotion and prevention of preventable eye diseases

27. Train other health personnel to assist in the delivery of eye healthcare

28. Recognize the need for life-long learning and continued professional growth

29. Promote national health policies and their relevance to eye health care

30. Conduct appraisal of immediate supervisees, analyse outcomes and make appropriate recommendation for training/capacity building

31. Make inputs into the development and review of protocols, standard operating procedures and other relevant manuals

32. Establish and maintain effective collaboration with public health units to ensure effective contact tracing

33. Create and keep proper records of patient care, administrative and managerial activities in collaboration with other team members

34. Train and supervise primary eye care personnel

35. Serve as a preceptor for the training of ophthalmic nurses

36. Conduct research in Ophthalmic Nursing and use findings in the delivery of population-focused care

Scope of Practice for Peri-Operative Nurses

1. Apply nursing process within their scope in the care of individuals and families

2. Make technical input to the setup of theatres in the hospitals

3. Prepare and set up the operating theatre for surgery

4. Manage theatre hygiene, asepsis and the different methods of disinfection and sterilisation

5. Conduct pre-operative assessment and ensure patient preparation throughout the peri-operative periods

6. Use systematic observation and assessment to identify an elevated risk or actual health decline at an early stage

7. Implement measures to prevent further development of deteriorating health and illness

8. Protect the patient against complications and injury in connection with assessment and treatment

9. Perform focused assessment of level of consciousness

10. Analyse and interpret laboratory and other diagnostic results and put in appropriate interventions

11. Demonstrate skillful techniques and safe maintenance in the use of surgical instruments and devices in the operating theatre

12. Demonstrate competence in the circulating and scrub roles in the operating theatre

13. Assess, diagnose and prescribe pharmacologic and non-pharmacologic treatment and interventions

14. Perform minor suturing of lacerations, wound toileting and surgical wound dressing under strict aseptic principles

15. Collaborate and liaise with other units and multidisciplinary team in the plan of care

16. Foster patient advocacy and patient safety during peri-operative care

17. Incorporate specialized PON nursing knowledge and skills into the care of patients undergoing operative and other invasive procedures and of their designated support persons

18. Provide basic emergency procedures and administration of emergency therapies

19. Initiate diagnostic studies relevant to the patient’s current status and plan operative or invasive procedures

20. Provide supportive and compensatory assistance in case of failure of the patient’s vital functions

21. Administer medical, nursing, pharmacological and other forms of therapy to patients in the recovery ward

22. Participate in recovery ward rounds

23. Demonstrate responsibility, accountability, and ethical behavior in the performance of roles

24. Take part in the administration and organisation of the theatre and in the management of multidisciplinary team

25. Offer public health services such as health education and promotion to individuals, families and communities

26. Provide counselling services to clients and significant others

27. Create and keep proper records of patient care, administrative and managerial activities in collaboration with other team members

28. Collaborate with other health professionals to design and implement various educational programs aimed at addressing emerging health issues in the area of practice

29. Conduct appraisal of immediate supervisees, analyse outcomes and make appropriate recommendation for training/capacity building

30. Make inputs into the development and review of protocols, standards operating procedures and other relevant manuals

31. Serve as a preceptor for the training of peri-operative nurses

32. Recognize the need for life-long learning and continued professional growth

33. Conduct research in nursing and use findings in the delivery of population-focused care

Scope of Practice for Critical Care Nurses

1. Apply nursing process within their scope in the care of individuals and families

2. Use systematic observation and assessment to identify an elevated risk or actual health decline at an early stage

3. Implement measures to prevent further development of deteriorating health and illness

4. Protect the patient against complications and injury in connection with assessment and treatment

5. Facilitate a health-promoting environment for the critical care patient and encourage well-being and quality of life

6. Assess, diagnose and prescribe pharmacologic and non-pharmacologic treatment and interventions

7. Analyse and interpret laboratory and other diagnostic results and put in appropriate interventions

8. Perform focused assessment and level of consciousness

9. Provide supportive and compensatory assistance in case of failure of the patient’s vital functions

10. Offer palliative and comfort measures to relieve symptoms and limit the patient’s burden in association with illness, injury and treatment

11. Provide counselling services to clients and significant others

12. Conduct/participate in ward rounds, clinical meetings and morbidity/mortality meetings

13. Set up systems to manage the transportation/evacuation of critically ill patients

14. Perform 12-lead ECG, interpret and intervene as appropriate

15. Provide basic emergency procedures and administration of emergency therapies

16. Administer medical, nursing, pharmacological and other forms of therapy to patients

17. Operate various types of technology in the Critical Care Setting for the care and

management of critically ill patients

18. Execute appropriate critical care nursing to special patient populations when confronted with such in the critical care practice/setting

19. Determine readiness, prepares for and perform weaning of critically ill patients from assistive technological devices in accordance with institutional protocols e.g. mechanical ventilation

20. Initiate diagnostic studies relevant to the patient’s current status and plan operative or invasive procedures

21. Provide specialized Nurse-Led care to the terminally ill or convalescent clients at home

22. Evaluate patients’ resources, conduct follow-up care as well as assist in rehabilitation

23. Establish a patient-and family-centred treatment environment in connection with critical care treatment

24. Demonstrate responsibility, accountability, and ethical behavior in the performance of roles

25. Offer public health services such as health education and promotion to individuals, families and communities

26. Provide counselling services to clients and significant others

27. Create and keep proper records of patient care, administrative and managerial activities in collaboration with other team members

28. Collaborate with other health professionals to design and implement various educational programs aimed at addressing emerging health issues in the area of practice

29. Conduct appraisal of immediate supervisees, analyse outcomes and make appropriate recommendation for training/capacity building

30. Make inputs into the development and review of protocols, standard operating procedures and other relevant manuals

31. Establish and maintain effective collaboration with public health units to ensure effective contact tracing

32. Serve as a preceptor for the training of critical care nurses

33. Recognize the need for life-long learning and continued professional growth

34. Conduct research in nursing and use findings in the delivery of population-focused care