An Exploratory Study to Shape a Disaster Nurse Practitioner Scope of Practice

Sunday, 17 November 2013: 11:00 AM

Frances Eleanor Dunniway, DNP, RN, MSN
School of Nursing, California Baptist University, Riverside, CA

Learning Objective 1: Discuss and describe the multidisciplinary findings from the first round exploratory research seeking understanding about the disaster NP role.

Learning Objective 2: Discuss how one clearly defined and understood disaster NP scope of practice could benefit health care services for disaster victims during a catastrophic event.

The impact and devastation from national disasters pose imminent risk to large populations. If trained in disaster response and following evidence-based practices, the Nurse Practitioner (NP) could work in any setting or surrounding and be prepared to adapt, utilizing their full educational and health care training. Currently individual state regulations guide the practice of an NP and there are no written guidelines during disasters to manage the various clinical conditions across state boundaries. Using a Delphi technique, this exploratory first round study investigated the multidisciplinary understanding about the Disaster NP role.

Key findings included: 1. Across all four groups of respondents, there was confusion about the disaster NP role, indicating a need for role clarity.

2. Among NP respondents, there was a good level of agreement that their practice was limited in a disaster compared to everyday practice, identifying no scope of practice and lack of role knowledge as causes. 3. Among the types of training to help understand the disaster NP role, the most highly valued was simulation with groups in field training and the least was individual training titled responder e-learn.  4. Among the four groups the most valued statements regarding services delivered were the NPs ability to perform urgent services with competence and skill, NPs ability to recognize need to triage to higher level of care and NPs acknowledging emergent skill limitations. Nationally during deployments, Disaster NPs may be limited by the absence of a guide that would serve to communicate the advanced practice abilities. Having one defined scope of practice would establish boundaries for practice, which reduces the legal risk to NPs, eliminate role confusion for other health care providers, and improve victim access to care.