Scope of Practice is a terminology used by national and state/provincial licensing boards for various professions that defines the procedures, actions, and processes that are permitted for the licensed individual. The scope of practice is limited to that which the law allows for specific education and experience, and specific demonstrated competency. Each jurisdiction has laws, licensing bodies, and regulations that describe requirements for education and training, and define scope of practice.
Governing, licensing, and law enforcement bodies are often at the sub-national (e.g. state or province) level, but federal guidelines / regulations also often exist. For example, in the United States, the National Highway Traffic Safety Administration in the Department of Transportation has a national scope of practice for emergency medical services.
Scope of practice can be easily identified by three categories. If requirements for practicing a skill or profession satisfy all three requirements then it is within that persons scope of practice:
Education and training — Has the person been educated academically or on-the-job and have documentation proving education to do the item in question?
Governing body — Does your state, district, province or federal government that oversees the skill or profession allow (or not explicitly disallow) the item in question?
Institution — Does the institution allow a person or their profession to do the item in question?
Registered respiratory therapist — All states and provinces who recognize registered respiratory therapist licensure allow for RRTs to provide extracorporeal membrane oxygenation (ECMO) support. Despite this, some institutions do not permit RRTs to provide ECMO support. For the registered respiratory therapists working at the institutions whom allow RRTs to provide ECMO support it is within their scope of practice. The RRTs who are not permitted by their institution to provide this skill are unable to include the support in their scope of practice.
Paramedic — In some states and provinces a paramedic is allowed to perform percutaneouscricothyrotomy if all other airway management fails. In the states and provinces that do not allow this intervention it is not within the scope of practice of the paramedic to perform.