Advanced Nurse Practitioner Scope of Practice

The Advanced Nurse Practitioner (ANP) Scope of Practice for Hamad Medical Corporation is a competency framework (Appendix 1) built on five domains intrinsic to the role of the ANP;

Each domain is described through competency standards and performance criteria that define the requirements for practice demanded of the (registered) ANP. This document is to be used as a foundation for all registered nursing roles, professional development and performance appraisal.

"An advanced nurse practitioner (ANP) is a registered nurse with advanced academic preparation and clinical experience and expertise in a specialized area of nursing, integrating their in-depth knowledge of advanced nursing practice and theory, health management, health promotion, disease/injury prevention and other relevant biomedical and psychosocial theories to provide comprehensive health services. Advanced Nurse Practitioners have the knowledge and skills to provide comprehensive health assessments, to diagnose and manage most common and many chronic illnesses, either independently or as part of a health care team. A nurse practitioner provides direct care, and may order and interpret diagnostic tests, perform procedures and prescribe medications under individually negotiated proctor agreements with senior consultants or specialists” (CNA, 2010).

Working in collaboration with a physician, an advanced nurse practitioner provides high-quality, cost-effective and individualized care for the lifespan of patient's special needs.

ANPs focus largely on health promotion, and disease prevention, the treatment and management of health conditions, counseling and patient education in a wide variety of settings. With a strong emphasis on primary care, nurse practitioners may be employed within subspecialty programs, which may include, but is not limited to neonatology, nurse-midwifery, pediatrics, oncology, diabetes/endocrinology, school health, family and adult health, women's health, mental health, home care, geriatrics and acute care.

Advanced Nurse practitioners (ANPs) may undertake a range of assessment and treatment interventions. ANPs may conduct physical exams; diagnose and treat a range of illnesses and injuries; provide immunizations; order and interpret X-rays and other lab tests; and counsel patients on adopting healthy lifestyles. These may include and this list is not exhaustive:  physical examinations, determining differential diagnoses, performing invasive interventions e.g. endoscopy, requesting and interpreting diagnostic and laboratory tests and administering therapies for the management of potential or actual health needs. Other duties and responsibilities depend on the ANP’s practice setting and the scope-of-practice regulations of the state and in accordance with practice privileges in acute, community or long term health care granted by the corporation.

ANPs are expert nurses who work within a specific area of practice incorporating advanced knowledge and skills. They practice both independently and in collaboration with other health care professionals to promote health, prevent disease and to diagnose, assess and manage people’s health needs. They provide a wide range of assessment and treatment interventions including differential diagnoses, ordering and interpreting diagnostic and laboratory tests and administering therapies for the management of potential or actual health needs. They work in partnership with individuals, families and communities across a range of settings. ANPs may choose to prescribe medicines within their specific area of practice. ANPs also demonstrate leadership as consultants, educators, managers and researchers and actively participate in professional activities and local and national policy development.

ANPs may undertake a range of tasks which have hitherto been within the exclusive domain of Physicians. The approval of ANPs to undertake these extended roles is through a process of ‘Privileging and Proctoring’ with the support of the Chair of the Medical department who will assign a proctor (see relevant policy).