DISCUSSION PAPER Comparative analysis of nursing and midwifery regulatory and professional bodies’ scope of practice and associated decision-making frameworks: a discussion paper Catriona Kennedy, Pauline O’Reilly, Gerard Fealy, Mary Casey, Anne-Marie Brady, Martin McNamara, Geraldine Prizeman, Daniela Rohde & Josephine Hegarty Accepted for publication 24 February 2015 Correspondence to C. Kennedy: e-mail: catriona.kennedy@ul.ie Catriona Kennedy PhD DN RN Professor of Nursing and Midwifery Department of Nursing and Midwifery, University of Limerick, Ireland Pauline O’Reilly MA PhD RN Head Department of Nursing and Midwifery, University of Limerick, Ireland Gerard Fealy BNS PhD RN Associate Professor UCD School of Nursing, Midwifery & Health Systems, University College Dublin, Ireland Mary Casey MMedSci PhD RN Associate Dean for Taught Graduate and CPD Programmes UCD School of Nursing, Midwifery & Health Systems, University College Dublin, Ireland Anne-Marie Brady MSc PHD RN Director of Centre for Practice and Healthcare Innovation School of Nursing & Midwifery, Trinity College Dublin, Ireland Martin McNamara BSc EdD RN Dean and Head of School UCD School of Nursing, Midwifery & Health Systems, University College Dublin, Ireland KENNEDY C., O’REILLY P., FEALY G., CASEY M., BRADY A.-M., MCNAMARA M., PRIZEMAN G., ROHDE D. & HEGARTY J. (2015) Comparative analysis of nursing and midwifery regulatory and professional bodies’ scope of practice and associated decision-making frameworks: a discussion paper. Journal of Advanced Nursing 71(8), 1797–1811. doi: 10.1111/jan.12660 Abstract Aims. To review, discuss and compare nursing and midwifery regulatory and professional bodies’ scope of practice and associated decision-making frameworks. Background. Scope of practice in professional nursing and midwifery is an evolving process which needs to be responsive to clinical, service, societal, demographic and fiscal changes. Codes and frameworks offer a system of rules and principles by which the nursing and midwifery professions are expected to regulate members and demonstrate responsibility to society. Design. Discussion paper. Data sources. Twelve scope of practice and associated decision-making frameworks (January 2000–March 2014). Implications for nursing. Two main approaches to the regulation of the scope of practice and associated decision-making frameworks exist internationally. The first approach is policy and regulation driven and behaviour oriented. The second approach is based on notions of autonomous decision-making, professionalism and accountability. The two approaches are not mutually exclusive, but have similar elements with a different emphasis. Both approaches lack explicit recognition of the aesthetic aspects of care and patient choice, which is a fundamental principle of evidence-based practice. Conclusion. Nursing organizations, regulatory authorities and nurses should recognize that scope of practice and the associated responsibility for decision- making provides a very public statement about the status of nursing in a given jurisdiction. © 2015 John Wiley & Sons Ltd 1797 continued on page 1798