How to Write a Nursing Department’s Scope of Service?

If you are a nursing department leader, it is important to have a clear understanding of what services your department provides and the scope of service that you provide to your patients. This document can help you stay on top of changes with the medical industry and ensure that your patients always receive the best possible care.

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Introduction: describe the purpose of a nursing department’s scope of service

A nursing department’s scope of service defines the specific services that the department provides. The scope of service can include a wide range of services, from providing basic medical care to providing more specialized care. It’s important for nursing departments to have a clear scope of service so that patients know what to expect when they go to the department. Additionally, the scope of service can help nurses and other staff members understand what services they are responsible for providing.

The nursing department is a multinational, multicultural group of nursing personnel with a mix of professional nurses, specialty technicians, and nurse aides/assistants. At present, our department operates with the following personnel:

Registered nurses
Anesthesia assistants
Basic emergency medical technicians
Nursing aides/health aides
Ward/clinic aides
Porters

Nursing department provides holistic nursing care to all patients having acute and chronic medical and surgical conditions. The nursing department covers the services provided in the following areas:

Hemodialysis Unit
Emergency Room
Operating Room
Outpatient Department including Dermatology, Nuclear Medicine, Neurophysiology
Laboratory, Dental, Radiology and Plaster Room
Pediatric Ward
Newborn Nursery, Special Care Baby Unit & Neonatal Intensive Care Unit
Labor & Delivery
OB Gyne Ward
Extended Care
Elite Care/Luxury Suites
Intensive Care (Medical, Surgical and Coronary Care)
Step Down Unit
Male Orthopedic Ward
Male & Female Surgical Wards
Male & Female Medical Wards
Male & Female Private Wards
Day Surgery Unit (Endoscopy, Dental & Ophthalmic, Pain Management)
Assisted Fertilization Unit
Oncology Unit

Nursing care is provided in the following settings:

Inpatient
Ambulatory areas
Emergency room
Dressing and vaccination rooms
Plaster rooms
Operating and recovery room
Day surgery unit
Hemodialysis
Radiology for diagnostic imaging and special procedures (this department does not have direct line accountability to the director of nursing, but the required nursing care is provided by the nursing service department staff).

Nursing scope of service highlights

Care

provided by trained, competent staffs functioning according to their job descriptions. They are part of the multidisciplinary team in patient care and are able to give health teaching and counseling related to the patient’s conditions.

All nursing staffs are mandated to be certified in BLS and registered nurses for ACLS, PALS and NRP advantageous for critical/specialized areas at least the head nurse and or the shift leader.

Policy

To provide a high degree of services, the nursing department staffs are following a process / policy in any patient care issues and staffing issues in a prompt manner with respect and
compassion.

Teamwork

Maintaining an excellent nursing care, the nursing department complete work force continue its process working together in meeting the needs of every staff and patient health needs in accordance with regulatory standards: local and international adhering to the organizational and departmental policy and procedures.

Refresher

A mandatory orientation (mandatory/departmental/unit specific) is conducted to new hires, case presentations year-round is done, and competencies are checked regularly.

For the staff development, a continuous nursing education: updates, trainings and seminars either in-service or outside facilities are offered to the nursing staffs including inter-unit cross training for increased skills in all the specialties.

Scope

Scope of services is developed for each clinical area reviewed at least annually and updated as changes occur.

Patient care is staffed with skilled, competent unit supervisor where applicable, head nurse, staff nurses, nursing aides, ward aides, porters and technicians working in all inpatient units including emergency room 24 hours a day 7 days a week.

Nursing department areas description

Emergency room

The emergency department (ED) is a vital part of the healthcare system. It is a place where people with urgent or serious medical problems can go to get help. The ED is open 24 hours a day, 7 days a week. It is staffed by doctors and nurses who are specially trained to deal with emergencies.

Patients of all ages that present to er for a non-scheduled visit and are seeking care shall receive a medical screening exam that includes providing all necessary testing and on-call services within the capability of the hospital to reach a diagnosis. It is staffed with qualified and expert nurses in dealing with emergencies/ urgent cases and additional support personnel are being provided based on the influx, acuity, and assessment of patient care needs.

Intensive Care Units (Medical and Surgical)

The intensive care unit (ICU) is a hospital department that provides specialized care for patients who are critically ill or injured. The ICU team includes physicians, nurses, respiratory therapists, pharmacists, and other healthcare professionals who are specially trained in the care of critically ill patients. The ICU provides a high level of medical and nursing care around the clock to help these patients recover from their illness or injury.

Nurse-patient ratio depending on the patient acuity and nurse skill and knowledge continuously providing maximum care to all types, patient age group from 14 years old related to critical cases requiring close monitoring, mechanical ventilation and patients requiring immediate intervention of acute problems. Nurses are competent and quick to respond in any emergencies, trained to execute life-saving measures.

Coronary Care Unit (Cardiology Critical Patients)

The coronary care unit (CCU) or cardiology critical patients department is a specially designated area in a hospital that provides intensive care for people who have heart problems. The CCU staff is specially trained to treat patients with heart attacks, heart failure, and other cardiac emergencies.
Nursing staffs providing the maximum care to patients requiring cardiovascular monitoring and observation.

Nursing staffs capable of providing the maximum care to adult patients requiring cardiovascular monitoring, intervention of acute problems, patients on mechanical ventilation and trained to execute life saving measures to any emergencies. Nurse patient ratios depending on the patient acuity and nurse skill, and knowledge to provide the required health needs of all patients admitted in this unit.

Step Down Unit

A unit that caters to adult cardiology patients requiring observation and management of the conditions like stable ST Elevation Myocardial Infarction with no evidence of ongoing life-threatening arrhythmias, high grade AV blocks and hypotension; unstable angina and non-ST Elevation MI who are hemodynamically stable, patient for assessment of chest pain, to rule out acute coronary syndrome, chronic heart failure without symptoms of shock and patient for elective cardiac procedures.

The unit also serves patients that require peripheral nerve block analgesia, epidural analgesia and IV narcotic analgesia. Nursing staffs provide the maximum care to patients requiring cardiovascular and hemodynamic monitoring and observation.

The hospital step down unit department is a place in the hospital where patients who are ready to leave the hospital, but not yet ready to go home, can stay. Patients in the step down unit are usually monitored by nurses and doctors who will make sure that they are getting better before they are released from the hospital. The step down unit can be a great place for patients to recover before they go home.

Male and Female Surgical Wards

Equipped with rooms with negative pressure. The units serve all age group population of orthopedic, general surgery, ENT, ophthalmology, urology and dental. Nursing staff are skilled in the assessment and care for acute trauma, cases for conservative treatment, cases that need surgical interventions and reconstructive surgeries. They can provide effective and efficient care pre and post operatively.

Male and Female Medical Wards (Adult with acute and chronic cases)

Some of the other diagnoses like Sickle Cell Disease, Hypertension, Diabetes Mellitus, Chronic Renal Failure, respiratory disease, and cardiac and nervous system disease are cared for in these units. Nurses are effective and efficient in caring for such patients as per their assessment and formulated plan of care.

Male and Female Private Wards

These areas cater to patients aged from 8 years old and above with all specialties like but not limited to medical, surgical, orthopedic, and dental and OB Gyne requiring private room. Nursing staff are skilled in the assessment and provision of individualized care based on patient needs and condition. They are effective and efficient in caring for such patients as per their assessment and formulated plan of care.

Extended Care Units

A combined unit for Male and female patients. A hemodialysis outlet for patients on regular dialysis is available in the rooms of ECU. The unit is equipped with the best equipment, which enables the nurses to provide care immediately in case of an emergency. Types of patients served are adults and geriatric requiring care from chronic and multiple medical conditions. Nursing staffs are well trained and effectively executing nursing care considering the patient’s physical, psychological, social and emotional wellbeing promoting maximal function of their activities of daily living as tolerated.

Nurses are prompt and competent in the care of patients on ventilator, tracheostomy, PEG tube, NGT and patients with multiple bed sores. Multidisciplinary team members are involved in the assessment and care of the patients.

Operating Room

Operation services are 8 hours/day from 0800 to 1600 hours and on call coverage 24 hours. All elective and emergency surgical operations, in patient and day case under General Anesthesia, Local Anesthesia, Spinal, Epidural, Regional and Sedation, are catered to this unit.

All General Surgery, Orthopedic, Ophthalmology, ENT, Urology, OB/Gyne, Dental Surgery serving all age groups from children to adult, all gender, surgical delivery are types of patients served, including post anesthesia care. The unit has operating theaters and post anesthesia recovery area.

Physical assessment, laboratory and other diagnostic procedures, pre anesthesia evaluation, pre induction assessment, Modified Aldrete Score, pain score, operating theatre checklist, anesthesia plan, surgical plan, availability of instruments, implants, equipment and competent staffs, sensory/motor assessment (epidural), time out are the methods for assessing and meeting patient care needs.

Nursing staffs are trained and competent in providing pre, intra, post-operative care and with long standing expertise in dealing with emergencies.

Day Surgery Unit

Cases done are endoscopic procedures for diagnostic purposes and therapeutic intervention of the upper and lower gastro-intestinal tract with the aid of gastroscope and colonoscope under conscious sedation. Patients with problems of the upper and lower GIT complaining of epigastric pain, abdominal pain, vomiting, diarrhea, constipation and rectal bleeding with diagnostic of gastric ulcer, inflammation of tissue and presence of polyps.

Patients that are catered for dental cases in the Day Surgery Unit like surgical extraction, dental filling under general anesthesia and minor maxillofacial procedures.

Minor ophthalmic surgeries like PHACO, pterygium excision and done for patients.

Epidural New block procedures are also done for the adult patient population.

Pediatric Circumcision is also catered in this unit with patient age range from newborn to 2 months old.

Nurses are trained in assisting the clinician with the required intervention and competent in the care of patients during and after the procedure always ready to respond in any emergencies.

Pediatric Ward

Provides care to male and female patients’ age ranges from 1 day old to 14 years old that present with an acute illness. Nurses are keen in the safety and security of their patient’s giving emphasis on the family involvement of care and are skilled with the physical, psychological, social and emotional assessments and the nursing care involves multidisciplinary team approach.

Obstetrics and Gynecology Ward

Serving female adult in-patient for antenatal care with or without complication, post-partum by normal spontaneous vaginal delivery or by caesarian section or instrumental delivery and gynecological cases requiring surgical intervention or conservative treatment. It caters all normal and high-risk obstetric and gynecologic cases from different companies as well as cash patients.

Nurses provide quality and excellent care, a family centered care to all patients emphasizing newborn care and teaching, which includes but not limited to breastfeeding to all post-natal mothers.

Labor and Delivery Unit

Consists of different rooms:

Labor room but convertible to delivery room
High-risk labor & delivery room
Operating room for caesarian section
Recovery room with two beds provision
Post-natal room with two beds provision

The labor & delivery rooms are provided with automatic beds with a provision for patient delivery. An infant resuscitative is readily available and set up adjacent with complete resuscitation equipment for immediate care of a well or sick newborn.

Nurses are competent in caring for patients from the period of admission to the time; the mother is for transfer to the OB ward and baby to the neonatal unit. They are expert in assisting the obstetrician in the delivery and capable in monitoring the wellbeing of the mother and the baby ante-natal, intra and post-natal.

Newborn Nursery

Special care baby unit and neonatal intensive care unit offering full services, which includes:

Babies that need special care or require intensive care.
The intermediate care or requiring a more comprehensive observation.
Monitoring for the babies requiring routine newborn baby care.

The unit must be protected with a device to prevent abduction and it is equipped with advanced equipment (high frequency ventilators, transport ventilators, infusion pumps etc.) Maintained and readily available in any urgent or emergent cases.

Nurses are skilled and experts in providing care to all the neonates at all levels, always prioritizing their safety and security. Competent nurses in the delivery of care and in assisting the neonatologist/pediatricians in any procedure are what we have in this unit.

Hemodialysis Unit

Serving outpatients adult male and female patients. There is also a satellite room for inpatient dialysis. Nurses work 8 hours per day from Saturday — Thursday covered 24 hours by on call including Friday to respond to any emergency to admitted patients needing

Nurses’ plan of care is based in the assessment and the multidisciplinary team approach. They are competent in the care of patient pre dialysis, during dialysis and post dialysis. They are committed, skilled and continuously maintaining a safe environment for patients.

Ambulatory Care Services: Out-Patient Clinics

Area comprises of Clinics and Procedural Rooms. Nursing staffs assist patients recovering from acute illness and helping patients attain their maximum wellbeing through health teaching. They are competent in assisting patients to do such procedure so they can move on to their daily living. And as part of delivering comprehensive care, staff collaborates with the laboratory, radiology and other allied forces in the organization.

Nurses are trained to respond to any life-threatening situations.

Specialty services available in the OPD are the following:

Internal Medicine which includes Nephrology, Cardiology, Gastroenterology, Neurology, Endocrinology and Oncology
General Surgery which includes Vascular Surgery, Neurosurgery, Urology
Pre-anesthesia
ENT
Ophthalmology
Orthopedics
Obstetrics and Gynecology
Dermatology
Pediatrics
Psychiatry
Dental
Nuclear Medicine and PET Scan
Radiology
Neuro Laboratory (EEG and EMG)
Personnel Reliability Program

Procedural Rooms are as follows:

CTG Room with 2 beds provision
Rooms for Derma Laser
Rooms for Derma Procedures
Vaccination Room
Pediatric Nebulization Room
Plaster Rooms with total of 4 beds provision
Urodynamic Room
Dressing Room (Surgical)
Dressing Room (Burn)
Minor Ophthalmic Room
Argon Laser Room

Assisted Reproduction Unit

The unit provides comprehensive treatment for fertility problems like but not limited to diagnosis and treatment of patients for a gamut of fertility problems, including hormone problems, uterine and fallopian tube disorders, poor sperm quality and unexplained infertility.

One service performed by the Unit is IVF In-vitro Fertilization – a drug treatment designed to stimulate the ovaries to produce an optimal number of eggs that develop into follicles.

The treatment involves a daily injection of gonadotropic hormones (hCG — a peptide hormone, one of the gonadotropes, produced by the placenta after ovulation and during pregnancy).
The treatment protocol and individual dosages are adjusted for each patient based on the latest available medical information.
Patients are monitored throughout the treatment through ultrasounds and blood estradiol tests.
Eggs are retrieved with precision timing through the vagina with the help of an ultrasound.
The sperm and any viable retrieved eggs are then mixed in a lab.

Oncology Unit

Provides care for adult patients with scheduled admission for chemotherapy given thru iv infusions, subcutaneous, intramuscular, oral and topical.

Some of these diagnoses include lymphoma, lung cancer, breast cancer, gastric cancer, acute and chronic leukemias.

Therapeutic and diagnostic procedures like ultrasound guided tapping and bone marrow aspiration are also facilitated in this unit.

Nursing care is focused on the assessment, diagnosis, planning, treatment and evaluation of patients requiring acute care.

Skills required to perform treatments/procedures, clinical parameters monitored, safety precautions initiated, and emergency events encountered.

Nursing activities consist of: medication managements; initiation of chemotherapy regimen, patient monitoring including pain management, blood product infusions, patient and family education including support services coordination like social services, dietician and rehabilitation.

Pediatric Intensive Care Unit

Nurse-patient ratio depending on the patient acuity and nurse skill and knowledge continuously providing maximum care to all patient with age group from 1 month and 1-day-old to 14 years old related with critical cases requiring close monitoring, mechanical ventilation and patients requiring immediate intervention of acute problems.

Nurses are competent and quick to respond in any emergencies, trained to execute life-saving measures.

Nurses are skilled, and experts in providing care to all pediatric patients prioritizing their safety and security. Competent nurses in the delivery of care and in assisting the Pediatricians in any procedure are what we have in this unit.

Diabetic Clinic

A specialty clinic for individuals with diabetes, who have been referred by their primary care physician.

Two diabetic nurse educators provide the following education services with a focus on:

Avoidance of hypoglycemia
Prevention of common heart and vascular complications
Prevention of complications such as eye disease, kidney dysfunction and neuropathies
Nutrition and exercise counseling in coordination with Dietician
Glucose monitoring
Medication education and insulin teaching

Patient Teaching Center (PTC)

This is a center for special educational services for patients provided by a multidisciplinary team which include designated educators.

Nurses assigned are involved in assessing educational and learning needs of patient/family, discuss identified disease related concerns, and provide instructions to the level of understanding to achieve and maintain good control of their diseases.

Nurses as patient educators are working with other health care providers to improve patient’s compliance with the plan of care.

Pain Management

Offers a comprehensive program of interdisciplinary services to patients presenting with wide range of pain disorder under the auspice of the Department of Anesthesiology with Registered Nurses assigned to function as Pain Management Nurse.

It provides rigorous training and strong commitment in education of healthcare providers, patients and patient’s relatives.

Pain management should be a priority of care for every patient, with freedom from pain as a basic human right. The process of pain management starts with an adequate assessment of pain as the fifth vital sign which includes but not limited to:

Nature of pain (including the use of appropriate pain tools)
Cause of pain
Personal context of pain, including how pain impacts daily function and quality of life.

Wound Care

The Wound Care Program help patients with difficult wound-healing problems. Chronic wound management demands a team approach.

Successful treatment requires highly specialized and closely coordinated care. The Wound Care Program provides an interdisciplinary approach to disease management.

Patients may be referred by a physician, health care worker, or self-referred. A physician will complete a history and physical, order diagnostic tests, if indicated, and determine a plan of care following established clinical practice guidelines.

Treatment Will focus on the causation of the wound, co-existing conditions that impact wound healing, and topical wound management. Services offered include: