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Top-of-License Nursing Practice: Describing Common Nursing Activities and Nurses' Experiences That Hinder
Jacalyn Buck1, Jacqueline Loversidge, Esther Chipps
1Author Affiliations: Administrator of Health System Nursing Quality, Research, Education & EBP (Dr Buck), The Ohio State University Wexner Medical Center; Assistant Professor of Clinical Nursing (Dr Loversidge), The Ohio State University College of Nursing; Clinical Nurse Scientist and Associate Professor of Clinical Nursing (Dr Chipps), The Ohio State University Wexner Medical Center and The Ohio State University College of Nursing; Director of Center for Transdisciplinary Evidence-based Practice, Senior Director of Helene Fuld Health Trust National Institute for EBP in Nursing and Healthcare, and Clinical Associate Professor (Dr Gallagher-Ford), The Ohio State University College of Nursing; Associate Director of Nursing (Ms Genter), The Ohio State University Wexner Medical Center; and Assistant Clinical Professor and Director of BMI Summer Internship Program (Dr Yen), Department of Biomedical Informatics, The Ohio State University College of Medicine, Columbus.
Nurses perform a wide range of activities, some aligning with top-of-license (TOL) practice and others not. This study identifies barriers and proposes models to support nurses practicing at their full potential.
Area of Science:
- Nursing Practice
- Healthcare Management
- Professional Development
Background:
- The Advisory Board Company defined 8 core top-of-license (TOL) nursing responsibilities.
- No prior empirical research explored staff nurses' perceptions of TOL practice.
Purpose of the Study:
- To describe nurses' perceptions of their daily activities.
- To analyze these activities for consistency with top-of-license (TOL) practice.
Main Methods:
- Qualitative study utilizing focus groups.
- Analysis of nursing activities to identify themes in typical work shifts.
Main Results:
- Nurses' work encompasses both TOL-consistent activities and non-nursing tasks.
- A model was developed illustrating the total scope of nursing work.
- Barriers hindering nurses from practicing at TOL were identified.
Conclusions:
- Study findings can guide leadership in developing sustainable nursing practice models.
- Supports the advancement of nursing practice to its highest potential (TOL).
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