J Korean Acad Nurs.  2019 Dec;49(6):760-770. 10.4040/jkan.2019.49.6.760.

The Scope of Practice for Registered Nurses in 64 South Korean Laws

• Choi S
• Jang SG
• Lee W

• KMID: 2505804
• DOI: http://doi.org/10.4040/jkan.2019.49.6.760

Abstract

Purpose
The role of registered nurses is expanding in scope as the healthcare paradigm shifts from acute, hospital-based care to community and population-based care. Given this paradigm shift, this study explores the legal aspects of the role of a registered nurse.
Methods
We used document analysis for extracting laws and legal orders related to nursing from the entirety of Korean law. Using textualism approach, we examined the contents utilizing a framework that was developed based on the role classification of community nurses by Clark in this study.
Results
A total of 119 items related to nursing were derived from 64 laws. Of these, 71.4 % can be performed by people in multiple types of occupations including nurses. As a result of analyzing required qualifications, 45.4% of 119 items required additional qualifications besides registered nurse license. Analysis of workplace and activity type demonstrated that 26.1% of the 119 items were related to medical institutions, with nurses performing mostly “Client-oriented role.” More than half (68.9%) were non-medical institutions, with nurses performing mostly “Delivery-oriented role.” Some, however, did not stipulate the nurse’s roles clearly.
Conclusion
Therefore, to match the enhanced scope and responsibilities of registered nurses and to appropriately recognize, guide, and hold these nurses accountable, laws and policy must reflect these changes. In doing so, these updated laws and policies will ultimately serve as a basis for improving the quality and safety of nursing services.

Keyword

Nurse’s Role; Policy; Legislation; Nursing; Republic of Korea

Figure

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  Figure 1 Flow chart of the search protocol.

Reference

1. Clarke D. Chapter 10. Law, regulation and strategizing for health. In : Schmets G, Rajan D, Kadandale S, editors. Strategizing National Health in the 21st Century: A Handbook. Geneva: World Health Organization;2016. p. 1–18.

2. Gostin LO, Wiley LF. Public health law: Power, duty, restraint. 3rd ed. Oakland (CA): University of California Press;2016. p. 73–225.

3. Holcombe RG. Eliminating scope of practice and licensing laws to improve health care. The Journal of Law, Medicine & Ethics. 2003; 31(2):236–246. DOI: 10.1111/j.1748-720X.2003.tb00084.x.

4. Organization for Economic Co-operation and Development (OECD). Health workforce policies in OECD countries [Internet]. Paris: OECD;c2016. cited 2019 Jul 12. Available from: https://www.oecd.org/health/health-systems/Health-workforce-policies-in-oecd-countries-Policy-brief.pdf.

5. Dower C, Moore J, Langelier M. It is time to restructure health professions scope-of-practice regulations to remove barriers to care. Health Affairs. 2013; 32(11):1971–1976. DOI: 10.1377/hlthaff.2013.0537.

6. Berry JM, Wilcox C. The interest group society. 6th ed. New York: Taylor & Francis;2018. p. 1–18.

7. Fairman JA, Rowe JW, Hassmiller S, Shalala DE. Broadening the scope of nursing practice. The New England Journal of Medicine. 2011; 364(3):193–196. DOI: 10.1056/NEJMp1012121.

8. International Council of Nurses (ICN). Scope of nursing practice and decision-making framework toolkit [Internet]. Geneva: ICN;c2010. cited 2019 Mar 30. Available from: https://www.icn.ch/nursing-policy/regulation-and-education.

9. World Health Organization (WHO). Nursing and midwifery in the history of the World Health Organization 1948-2017 [Internet]. Geneva: WHO;c2017. cited 2019 Mar 30. Available from: https://www.who.int/hrh/resources/Nursing-and-Midwifery-in-History-of-WHO/en/.

10. Yoder-Wise PS. Leading and managing in nursing. 6th ed. St. Louis (MO): Elsevier Mosby;2015. p. 167–182.

11. International Council of Nurses (ICN). Nursing regulation [Internet]. Geneva: ICN;c2013. cited 2019 Jan 30. Available from: https://www.icn.ch/sites/default/files/inline-files/B04_Nsg_Regulation.pdf.

12. Korea Health Industry Development Institute (KHIDI). A study on the improvement plan of the labor standards act [Internet]. Cheongju: KHIDI;c2013. cited 2018 Jun 1. Available from: https://www.khidi.or.kr/board/view?pageNum=21&rowCnt=10&menuId=MENU00085&maxIndex=00001006629998&minIndex=00001005599998&schType=0&schText=&categoryId=&continent=&country=&upDown=0&boardStyle=&no1=581&linkId=100655.

13. Kim J. A reasonable nursing resources reorganization plan through enactment of nurse act. Ilkam Law Review. 2015; 32:215–261.

14. Shin HW, Yeo NG. Current issues and tasks in health policy. Health and Welfare Forum. 2019; (267):44–57.

15. Lee S, Bae B. Nursing service R&D strategy based on policy direction of Korean government supported research and development. Journal of Korean Academy of Nursing Administration. 2016; 22(1):67–79. DOI: 10.11111/jkana.2016.22.1.67.

16. Bowen GA. Document analysis as a qualitative research method. Qualitative Research Journal. 2009; 9(2):27–40. DOI: 10.3316/QRJ0902027.

17. Manning JF. Textualism and legislative intent. Virginia Law Review. 2005; 91:419–450. DOI: 10.2139/ssrn.2853690.

18. Epstein L, Segal JA, Victor JN. Dynamic agenda-setting on the United States supreme court: An empirical assessment. Harvard Journal on Legislation. 2002; 39(2):395–433. DOI: 10.7910/DVN/WIBHTC.

19. Kim JG. Textualism in the U.S. supreme court opinions. Study on The American Constitution. 2010; 21(3):285–311.

20. International Council of Nurses (ICN). International Council of Nurses and nursing now welcome 2020 as international year of the nurse and the midwife [Internet]. Geneva: ICN;c2019. cited 2019 Jul 6. Available from: https://www.icn.ch/news/international-council-nurses-and-nursing-now-welcome-2020-international-year-nurse-and-midwife.

21. International Council of Nurses (ICN). Nursing definitions [Internet]. Geneva: ICN;c2019. cited 2019 Mar 30. Available from: https://www.icn.ch/nursing-policy/nursing-definitions.

22. Mallik M, Hall C, Howard D. Nursing knowledge and practice: Foundations for decision making. 3rd ed. Edinburgh: Baillière Tindall;2009. p. 20–40.

23. Clark MJD. Community health nursing: Advocacy for population health. 5th ed. Upper Saddle River (NJ): Pearson Prentice Hall;2008. p. 2–24.

24. World Health Organization (WHO). Training modules for the syndromic management of sexually transmitted infections [Internet]. Geneva: WHO;c2007. cited 2019 Aug 3. Available from: https://www.who.int/reproductivehealth/publications/rtis/9789241593407index/en/.

25. Hitchcock JE, Schubert PE, Thomas SA. Community health nursing: Caring in action. 2nd ed. Clifton Park (NY): Thomson/Delmar Learning;2003. p. 460–461.

26. American Nurses Association. Nursing: scope and standards of practice. 3rd ed. Silver Spring (MD): American Nurses Association;2015. p. 6–27.

27. Lee Y, Choi S, Kim I, Kang SJ. A study on reorganization of service and qualification management between nurse and nurse assistant: Focusing on policy stream model by Kingdon. Health and Social Welfare Review. 2018; 38(1):489–519. DOI: 10.15709/hswr.2018.38.1.489.

28. Keeney S, Hasson F, McKenna H, Gillen P. Nurses', midwives' and patients' perceptions of trained health care assistants. Journal of Advanced Nursing. 2005; 50(4):345–355. DOI: 10.1111/j.1365-2648.2005.03399.x.

29. Hwang JI, Ahn J. Teamwork and clinical error reporting among nurses in Korean hospitals. Asian Nursing Research. 2015; 9(1):14–20. DOI: 10.1016/j.anr.2014.09.002.

30. Grossmann M. Interest group influence on US policy change: An assessment based on policy history. Interest Groups & Advocacy. 2012; 1(2):171–192. DOI: 10.1057/iga.2012.9.

31. Ellenbecker CH, Fawcett J, Jones EJ, Mahoney D, Rowlands B, Waddell A. A staged approach to educating nurses in health policy. Policy, Politics, & Nursing Practice. 2017; 18(1):44–56. DOI: 10.1177/1527154417709254.

32. Wojnar DM, Whelan EM. Preparing nursing students for enhanced roles in primary care: The current state of prelicensure and RN-to-BSN education. Nursing Outlook. 2017; 65(2):222–232. DOI: 10.1016/j.outlook.2016.10.006.

33. Kim KR. Advanced practice nurse system and unlicensed medical practice. The Korean Society of Law and Medicine. 2010; 11(1):173–198.

34. Court of Korea. [25 March 2010 Important Ruling] A case regarding a specialized nurse in anesthesia (according to the 'medical service act') [Internet]. Seoul: Court of Korea;c2010. cited 2018 Jun 1. Available from: http://www.scourt.go.kr/portal/news/NewsViewAction.work?seqnum=2445&gubun=4&searchOption=&searchWord=.