Vlasic V, McKay C, Bisnaire D, Doyle-Pettypiece P, Keizer M, Krawiec F, Ridley J
Can J Nurs Adm. 1998 Sep-Oct;11(3):9-24.
The following article describes the process by which a group of acute care nurse practitioners sought to address the legal challenges of working beyond the traditional scope of nursing practice. It was necessary to establish mechanisms for communicating a diagnosis, as well as for ordering diagnostic tests, treatments and procedures. Medical directives were viewed as an approach to address components of practice involving controlled acts not authorized to nursing. The process of developing medical directives began with a description of the components of a medical directive. Algorithms were then developed based on the College of Nurses of Ontario's decision tree (Purvis, 1995) for the performance of procedures. These algorithms were broad and applicable across all clinical programs. The final step, required each nurse practitioner/clinical nurse specialist in collaboration with physician colleagues, to develop individual appendices specific to each clinical program. Health care administrators may find the information provided of assistance in addressing legal concerns that arise when new opportunities for nursing involve movement beyond traditional boundaries.
以下文章描述了一群急症护理执业护士试图应对超出传统护理实践范围工作的法律挑战的过程。建立诊断沟通机制以及订购诊断测试、治疗和程序的机制很有必要。医疗指令被视为一种解决涉及护理未经授权的受控行为的实践组成部分的方法。制定医疗指令的过程始于对医疗指令组成部分的描述。然后根据安大略省护士学院的决策树（Purvis，1995年）开发了用于执行程序的算法。这些算法范围广泛，适用于所有临床项目。最后一步要求每位执业护士/临床护理专家与医生同事合作，为每个临床项目制定特定的个人附录。医疗保健管理人员可能会发现所提供的信息有助于解决当护理新机会涉及超越传统界限时出现的法律问题。
