Scope Based Practice

Scope of practice is a model which allows healthcare services provided by a physician or other
healthcare practitioner to be performed based on the level they are authorized to practice. Such
scope for a health care practitioner is defined based on the education, training, experience, and
demonstrated clinical competencies. As a health care professional, one must keep within his /her
scope of practice to ensure that he/she is practicing safely, effectively and legally. Every institution is
expected to outline its services and establish a scope of practice manual at least on the national
focus areas of surgical service with emphasis on Operation Theater, neonatal intensive care unit,
outpatient case team/ directorate and emergency Unit within its facilities. The scope of practice
manual should be established after assessment of facilities‟ available human resource and services
with special emphasis on the aforementioned national focus areas. The manual should address level
of knowledge and experience of clinical professionals such as nurses‟ involvement based on
specialty/ seniority, interns, general practitioners, residents & consultants when engaging with the
units, interdepartmental consultations, and level of care by specialists and subspecialists. By
implementing scope of practice, a health facility shall expect an improvement in clinical outcome of
patients, efficiency, patient and staff satisfaction and reduced professional liability.

Developing Scope based clinical practice

Activities Time Responsible remark

frame body
Define Scope for a. Each All scopes should
Different levels of department be based on
physicians - 4 levels of and DC scientific
care (Intern, GP and background and
Junior residents, Senior local
residents, Consultants) and international
Define scope of Specialists Each experiences
and sub-specialists in department
order for preventing head and DC
fragmentation of care
Define scope for different Nursing A/
level of nurses based on director
specialty, year of
experience
Prepare Inpatient All consultations
Interdepartmental A/director are carried out by
consultations protocol senior residents
 and above.
-Consultation
requests, request
time, responses &
response time
should
be recorded
appropriately
-All elective
surgeries should
be done in the
presence of the
senior
Physician.
Develop non- emergency Outpatient Triage has to be
triage protocol A/director done by at least
Develop emergency ECCD and GPs and above
triage protocol emergency
department

N.B

Patients referred from other facilities should be seen by at least 1

step higher professional from referring clinician.

Referral clinics should be covered by the responsible specialist or

subspecialist.