Differentiating Scopes of Practice in Nursing Homes: Collaborating for Care


Hospitalizations of nursing home residents are costly and adversely affect the health of already vulnerable residents, and reducing avoidable hospitalizations has been identified as a priority quality and safety outcome by the U.S. government. However, existing interventions to reduce hospitalizations do not account for differences in scopes of practice among licensed nursing staff. This article describes the development of an educational innovation for nursing home staff members to learn to collaborate in ways that differentiate registered nurse and licensed practical/vocational nurse scopes of practice and strengthen connections among licensed and unlicensed nurses to improve detection and management of conditions associated with avoidable hospitalizations. The innovation was developed using situated learning theory and facilitated unfolding case discussions, reflecting the actual care environment. Evaluation data indicated the feasibility of this approach to staff education.

Kristen N. Corazzini, PhD, FGSA, Eleanor S. McConnell, PhD, RN, GCNS-BC, Lisa Day, PhD, RN, CNE, Ruth A. Anderson, PhD, RN, FAAN, Christine Mueller, PhD, RN, FGSA, FAAN, Amy Vogelsmeier, PhD, RN, Susan Kennerly, PhD, RN, Bronda Walker, BSN, RN, Jill T. Flanagan, MS, and Maureen Haske-Palomino, MSN,
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Long-term Care, Patient Safety, Practice, Regulation, Research
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