
Consider the reasons why 
you feel unable to accept 
responsibility and 
accountability and discuss 
with senior nurse or 
midwife manager/other 
HCP/NMBI.
Consider what 
measures you need 
to take to develop 
and maintain your 
competence.
Proceed
Carry out the role or activity and 
document the details.
Ensure patient needs are 
met. This may be through 
collaboration or referral to 
other HCP.
Discuss with senior nurse or 
midwife manager/other 
HCP/NMBI 
If PPPGs are not available 
consider what needs to 
happen to put the necessary 
PPPGs/supports in place.
Ensure patient needs are met. This may 
be through collaboration or referral to 
other HCP.*
You are outside your 
scope of practice.
Discuss with senior nurse or 
midwife manager/other 
HCP/NMBI and consider 
what measures you need to 
take to develop and maintain 
your competence.
You are outside your 
scope of practice.
You are outside your 
scope of practice.
UNSURE/NO
Ensure patient needs 
are met. This may be 
through collaboration 
or referral to other 
HCP.
Are you willing to accept 
responsibility and accountability for 
your role or activity?
Have you the necessary competence 
to carry out the role/activity? 
Does the role/activity fit in with 
definitions and values that underpin 
nursing and midwifery as outlined in 
the Code of Professional Conduct 
and Ethics and Scope of Practice?
*HCP – Healthcare Professional PPPGs – Policies, Procedures, Protocols and Guidelines 
Is the role/activity supported in your 
practice setting?  
For example through relevant 
legislation, national or local PPPGs* 
or evidence based resources.  
Is the role/activity you plan to undertake respectful of the patients' rights and will they derive an overall benefit from your actions?
Scope of Practice Decision-Making Flowchart 
Think about Your Nursing or Midwifery Role or Activity
PATIENT SAFETY FIRST