Role Guidelines for the Nurse Employed by an Ambulatory Care Practice

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Ambulatory care settings employ about 25% of registered nurses in the United States. Of these 25%, 33% have a Masters degree or higher (ANA). Most licensed nurses employed by an ambulatory care practice are primarily clinic-based. Some, however, may work totally or periodically in other ambulatory, long-term care facilities, or hospital settings. Their roles can include practice management, triage, care coordination, education, care transitions, health promotion and disease prevention, as well as chronic disease management.

Regardless of setting, all licensed nurses have a responsibility to ensure optimal patient safety and welfare. To achieve this goal, the following guidelines should be adopted:

  1. Only licensed nurses holding a current license to practice in Ohio should assume the role of a nurse employed by an ambulatory care practice who provides care in a setting in which they are not employed. Licensed nurses must function within their scope of practice as stated in the Ohio Revised Code 4723.01 and 4723.43 and according to the standards of nursing practice as set forth in the Ohio Administrative Code.
  1. The ambulatory care practice- employed nurse must adhere to all facility policies and procedures regarding credentialing, quality assurance, competency assessment/annual review(s), fingerprinting or other security measures if required, employee health assessment, the delivery of patient care, documentation of that care, and communication with other members of the health care team.
  1. Ambulatory care practice –employed advanced practice nurses must adhere to all facility policies and procedures regarding any additional credentialing requirements associated with advanced practice or prescriptive authority.

References:

ANA Code of Ethics

American Academy of Ambulatory Care Nursing Position Paper: The Role of the Registered Nurse in Ambulatory Care. copyright 2012.

American Hospital Association White Paper: Workforce Roles in a Redesigned Primary Care Model. 2013.

National Advisory Council on Nurse Education and Practice (NACNEP): The Roles of Nurses in Primary Care. Tenth annual report to the Secretary of the United States Department of Health and Human Services and the United States Congress.

California Healthcare Foundation: RN Role Reimagined: How Empowering Registered Nurses Can Improve Primary Care.  2015.