1.

Registered nurses are accountable and responsible when they make a decision that the client’s condition¹  would benefit from an activity and act within autonomous scope of practice to perform the activity.

2.

Registered nurses acting within autonomous scope of practice ensure that the activity they will perform is:

a.

Within the scope of practice for RNs acting without a client-specific order as set out in the Nurses (Registered) and Nurse Practitioners Regulation,

b.

Consistent with BCCNM’s standards of practice including standards, limits, and conditions,

c.

Consistent with organizational/employer policies, processes, restrictions, and

d.

Within the nurse’s individual competence.

3.

Registered nurses acting within autonomous scope of practice ensure they have the competence to: 

a.

Make decisions about whether the client would benefit from the activity, having considered:

i.

the known risks and benefits to the client,

ii.

the predictability of outcomes of performing the activity, and

iii.

other relevant factors specific to the client or situation,

b.

Carry out the activity safely and ethically, and 

c.

Safely manage the intended and unintended outcomes of performing the activity. 

4.

Registered nurses acting within autonomous scope of practice identify the effect of their own values, beliefs, and experiences in decision-making, recognize potential conflicts, and take action for the needs of the client to be met. 

5.

Registered nurses acting within autonomous scope of practice use current evidence to support their decision-making and the activity to be performed. 

6.

Registered nurses acting within autonomous scope of practice follow a clinical decision-making process when they:

a.

Assess the client’s health status,

b.

Make a nursing diagnosis² of a client condition³  that can be prevented, improved, ameliorated, or resolved through nursing activities,

c.

Determine a plan of care,

d.

Determine an activity to be performed,

e.

Implement an activity to prevent, treat, or palliate an illness or injury and/or improve, ameliorate, or resolve a condition,

f.

Change or cancel a client-specific order for activities within the nurse’s autonomous scope of practice,

g.

Give a client-specific order,

h.

Manage the intended and unintended consequences of carrying out the activity,

i.

Manage and evaluate the outcomes of the activity.

7.

Registered nurses acting within autonomous scope of practice communicate and collaborate with the client (or their substitute decision-maker) about nursing diagnoses, decisions, actions, and outcomes to support the client to be an active participant in making informed decisions about the care to meet the client’s needs.

8.

Registered nurses acting within autonomous scope of practice communicate and collaborate with the health care team about nursing diagnoses, decisions, actions, and outcomes.

9.

Registered nurses acting within autonomous scope of practice communicate and collaborate with the health care professional who gave the order (or their delegate), the client, and other members of the health care team when changing or cancelling a client-specific order for activities that are within the nurse’s autonomous scope of practice and individual competence.

10.

Registered nurses acting within autonomous scope of practice consult with, or refer clients to, other health care professionals when:

a.

The needs of the client exceed their scope of practice or individual competence,

b.

Required by organizational/employer policies or processes, or

c.

Client care would benefit from the expertise of other health care professionals. 

11.

Before performing an activity within autonomous scope of practice, registered nurses consider available resources and human and system factors to safely perform the activity and to manage intended and unintended outcomes of the activity.