Nursing Administration: Scope and Standards of Practice

American Nurses Association

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The American Nurses Association (ANA) is a national professional association. This ANA publication, Nursing Administration: Scope and Standards of Practice, 2nd Edition, reflects the thinking of the nursing profession on various issues and should be reviewed in conjunction with state board of nursing policies and practices. State law, rules, and regulations govern the practice of nursing, while Nursing Administration: Scope and Standards of Practice, 2nd Edition guides nurses in the application of their professional knowledge, skills, and responsibilities.

The American Nurses Association (ANA) is the only full-service professional organization representing the interests of the nation’s 3.4 million registered nurses through its constituent member nurses associations and its organizational affiliates. ANA advances the nursing profession by fostering high standards of nursing practice, promoting the rights of nurses in the workplace, projecting a positive and realistic view of nursing, and lobbying the Congress and regulatory agencies on healthcare issues affecting nurses and the public.

Cataloging-in-Publication Data on file with the Library of Congress

Copyright ©2016 American Nurses Association. All rights reserved. Reproduction or transmission in any form is not permitted without written permission of the American Nurses Association (ANA). This publication may not be translated without written permission of ANA. For inquiries, or to report unauthorized use, email [email protected].

ISBN-13: 978-1-55810-645-1 SAN: 851-3481 06/2016

First published: June 2016

Contents

Contributors

Scope of Practice of Nursing Administration

Function of the Scope Statement

Introduction

Definitions

Evolution of Nursing Administration Practice

Administration of Nursing Schools

Administration of Public Health Nursing

Administration of Nursing in Hospitals

Magnet Recognition Program®

Institute of Medicine Report

Practice Settings and Span of Influence

System-Wide Influence

Organization-Wide Influence

Service, Department, or Program Influence

Unit- or Team-Wide Influence

Role Accountabilities

Safety, Quality, and Risk Management

Patient and Population Health Advocacy

Clinical Care Delivery and Optimal Patient Outcomes

Healthy Work Environment

Strategic, Financial, and Human Resource Management

Legal and Regulatory Compliance

Networking, Partnering, and Collaborating

Role Qualifications

Education

Certification

Some Certification Opportunities for Nurse Administrators

Competencies

Knowledge, Skills, and Abilities

Ethics in Nursing Administration

Provision 1

Provision 2

Provision 3

Provision 4

Provision 5

Provision 6

Provision 7

Provision 8

Provision 9

Trends, Issues, and Opportunities

Improving the Patient Care Experience

Advancing the Health of Populations

Reducing Per-Capita Cost of Health Care

Standards of Nursing Administration Practice

Standards of Practice for Nursing Administration

Standard 1. Assessment

Standard 2. Identification of Problems, Issues, and Trends

Standard 3. Outcomes Identification

Standard 4. Planning

Standard 5. Implementation

Standard 5A. Coordination

Standard 5B. Promotion of Health, Education, and a Safe Environment

Standard 6. Evaluation

Standards of Professional Performance for Nursing Administration

Standard 7. Ethics

Standard 8. Culturally Congruent Practice

Standard 9. Communication

Standard 10. Collaboration

Standard 11. Leadership

Standard 12. Education

Standard 13. Evidence-Based Practice and Research

Standard 14. Quality of Practice

Standard 15. Professional Practice Evaluation

Standard 16. Resource Utilization

Standard 17. Environmental Health

Glossary

References

Appendix A: ANCC Certification Assessment Content

Appendix B: Nursing Administration: Scope and Standards of Practice (2009)

Index

Contributors

Workgroup Members

Elaine Scott, PhD, RN, NEA-BC, Co-Chair

Kathleen M. White, PhD, RN, NEA-BC, FAAN, Co-Chair

Marie L. Ankner, PhD(c), RN, NEA-BC

Lillian (Toni) A. Bargagliotti, PhD, RN, ANEF, FAAN

Jean Barry, PhD, RN, NEA-BC

Linda Burnes Bolton, DrPH, RN, FAAN

Anita Catlin, DNSc, FNP, FAAN

Martha A. Dawson, DNP, RN, FACHE

Denise Deforest, MSN, RN, CRRN

Nancy M. Edtl, MBA, BSN, RN, NCSN

Melissa G. Evraets, MSN, RN, NE-BC

Helen Ewing, DHSc, MN, RN

Shelly Fischer, PhD, RN, NEA-BC, FACHE

Teresa C. Harris, MSN, RN, NE-BC

Mary E. Hartsell, DNP, MSN, FNP, PMHNP-F

Diane L. Huber, PhD, RN, NEA-BC, FAAN

Michael L. Jones, MSN, RN, MBA

Glynnis M. LaRosa, MPH, MSN, RN, APHN-BC, CPHQ

Sarah Lohman, MSN, RN

Brandi M. London, MSN, RN

Benny L. Lucas, BSN, MSHA, RN, HACP, NEA-BC

Sonia Martinez, ACNS-BC, RN

Deborah McQuilkin, DNP, RN, MEd, NEA-BC, FACMPE

Rachel Ramsey, MS, RN

Deborah A. Shelton, PhD, RN, NE-BC, CCHP, FAAN

Carol A. Walters, BSN, RN, NE-BC

American Nurses Association Staff

Carol J. Bickford, PhD, RN-BC, CPHIMS, FAAN—Content editor

Maureen Cones, JD—Legal counsel

Yvonne Humes, MSA—Project coordinator

Eric Wurzbacher—Project editor

ANA Committee on Nursing Practice Standards

Richard Henker, PhD, RN, CRNA, FAAN—Co-chair (03/2014–12/2015)

Tresha (Terry) L. Lucas, MSN, RN—Co-chair (07/2011–12/2014)

Danette Culver, MSN, APRN, ACNS-BC, CCRN

Deborah Finnell, DNS, PMHNP-BC, CARN-AP, FAAN

Renee Gecsedi, MS, RN

Deedra Harrington, DNP, MSN, APRN, ACNP-BC

Maria Jurlano, MS, BSN, RN, NEA-BC, CCRN

Carla A. B. Lee, PhD, APRN-BC, CNAA, FAAN, FIBA

Verna Sitzer, PhD, RN, CNS

About the American Nurses Association

The American Nurses Association (ANA) is the only full-service professional organization representing the interests of the nation’s 3.4 million registered nurses through its constituent member nurses associations and its organizational affiliates. ANA advances the nursing profession by fostering high standards of nursing practice, promoting the rights of nurses in the workplace, projecting a positive and realistic view of nursing, and lobbying the Congress and regulatory agencies on healthcare issues affecting nurses and the public.

Scope of Practice of Nursing Administration

Function of the Scope Statement

The scope of practice statement (pages 1–32) describes the who, what, where, when, why, and how of nursing administration practice. Each of these questions must be sufficiently answered to provide a complete picture of the practice, its boundaries, and its membership. The depth and breadth in which individual registered nurses engage in the total scope of nursing practice is dependent upon education, experience, role, and the population served.

Introduction

Nursing administration is a long-standing nursing specialty practice. The American Nurses Association (ANA) first published Standards for Organized Nursing Services and Responsibilities of Nurse Administrators Across All Settings in 1988, followed by a revision in 1991. The Scope and Standards for Nurse Administrators was published in 1995, with the second edition released in 2004. Both the 1995 and 2004 scope and standards resources conceptual the division of nursing administration into nurse manager and nurse executive levels.

The 2009 Nursing Administration: Scope and Standards of Practice content reflects the rapidly changing and evolving practice of the nurse administrator and classifies nursing administration practice as spheres of influence. The four spheres of influence include: organization-wide authority, unit-based or service-line-based authority, program-focused authority, and project- or specific task-based authority.

The nurse administrator of today practices in many different settings and in a variety of roles with varying degrees of influence. However, the core role accountabilities, no matter the setting, role, or title, remain the same. The core role accountabilities encompass clinical care delivery; healthy work environment; resource management, including human, financial, material, and technological; quality and safety; health outcomes; population health management; legal and regulatory compliance; and advocacy.

This new edition, Nurse Administration: Scope and Standards of Practice, Second Edition, defines practice settings and span of influence in keeping with contemporary terminology used in the organizational and administrative management literature. The practice settings and span of influence are: system-wide influence, organization-wide influence, service/department/program influence, and unit/team-wide influence.

The publication of Nurse Administration: Scope and Standards of Practice, Second Edition, is the culmination of an 18-month intense professional review and revision effort hosted by