Scope of practice
Beyond structural factors focused on the characteristics
of nursing resources and their mix, another major factor
in our framework is the type and scope of services
provided by nurses. This aspect of nursing care
organization is often described in the literature in terms
of nursing care processes or nursing work content and
refers to activities in which nursing staff engage to deliver
care to patients and their families [21]. It indicates
what nurses do for, with or on behalf of patients in
their daily work, which encompasses the scope of nursing
interventions for each domain of care and category
of processes. From this perspective, the nurse’s scope of
practice is a significant component of any nursing care
organization model and includes not only the provision
of comprehensive care that meets patients’ needs, but
also the extent to which job design enables nursing
staff to use the full extent of their professional knowledge
and skills and to cover their whole practice domain.
The integration of scope of practice into our
framework is an attempt to fill a gap in the existing literature.
Although the above-mentioned theoretical frameworks
[17-20] attest to the importance of work
content as a core feature of nursing care organization,
this importance has been consistently ignored in operational
definitions of nursing care organization models,
due in part to having few reliable and valid measures to
adequately evaluate the diverse dimensions of nursing
work content.