Concurrent Sessions

D2 – Full scope nursing in primary care = Access, Improvement & Innovation

Theme 2. Healthy relationships, healthy teams

Presentation Details

  • Date: Thursday October 25, 2018
  • Concurrent Session D
  • Time: 9:45-10:30am
  • Room: Harbour B
  • Style: Presentation (information provided to audience, with opportunity for audience to ask question)
  • Focus: Practical (e.g. Presentation on how to implement programs and/or practices in the team environment)
  • Target Audience: Leadership (ED, clinical lead, board chair, board member, etc.), Clinical providers, Administrative Staff, Representatives of stakeholder/partner organizations

Learning Objectives

This presentation provides an overview of the improvements possible with implementation of a full scope nursing role in a primary care practice.  Participants will:

  1. Learn about the process of implementation, including educational supports, space needs accommodations, practice support processes.
  2. Appreciate how interdisciplinary care based on understanding of scope, trust between providers, and clear communication practices improves patient access to increased primary care nursing and physician services.
  3. Understand how practice improvements lead to improved access (same day care), improved continuity, and reduced emergency room visits and hospital readmissions within 30 days


This presentation will outline the process of increasing nursing scope in a primary care setting, beginning with outlining education that was provided to supplement nurses’ existing base of knowledge and skills.

We will then review the areas of practice in which full scope nursing was utilized, such as Preventive Care (well baby care, prenatal, well woman care); Chronic disease prevention and management (lifestyle counselling, smoking cessation, asthma, COPD and diabetes care); Elder care(cognitive screening, advanced directives planning, palliative care); Acute care (UTIs, respiratory illnesses, wound care); Care coordination (prenatal patients, trans care); Specialized care (trans care, ADHD assessments and support); Procedures (injections, immunizations, spirometry).

We will review the supports we put in place to support full scope nursing, including development of medical directives, communication practices to ensure access to timely physician consultation.  Incorporating full scope nursing allowed our patients access to an increased range of low threshold, barrier free services in house, and improved access to nursing and physician care.  This in turn resulted in same day access to primary care, improved continuity and reduced ER visits and hospital readmissions.


  • Lindsay Chmarney, RN, Primary Care Nurse, Greater Peterborough FHO (Dr Lokanathan’s office)
  • Brittany Murray, RN, Primary Care Nurse, Greater Peterborough FHO (Dr. Lokanathan’s office)
  • Kelly Pensom, RN, Primary Care Nurse, Greater Peterborough FHO (Dr. Lokanathan’s Office)

Authors & Contributors

  • Rhonda Vanderwal, MOA, Dr. Lokanathan’s Office
  • Alison Welsh, MOA, Dr. Lokanathan’s Of