Scaling the journey towards nurse practitioner independence in Kenya: A comparative deduction from California Assembly Bill 890

Abstract

Background. A scope of practice is a set of regulations and permissions granted to qualified personnel. In the field of nursing, it delineates the parameters within which nursing services are provided in healthcare. In Kenya, this is determined by the legislative and regulatory framework established by the Nursing Council of Kenya (NCK). Restrictions on nursing autonomy remain, particularly on prescriptive authority.

Objectives. This short communication compares the nursing scope of practice in Kenya with that in California, with the aim of examining the extent to which the nursing scope of practice in Kenya aligns with international standards and comparing the evolution of the Kenyan nursing scope of practice with California’s Bill 890 and provide recommendations.

Method. The Kenyan draft proposal seeks to expand the scope of practice for different nurse categories, but its implementation remains limited. In California, the introduction of Bill 890 (2020) has paved the way for increased autonomy for registered nurses through the transition-to-practice (TTP), which prepares nurses to work independently.

Conclusion. To address the healthcare challenges in Kenya, it is crucial to expand the nursing scope of practice. Particularly during doctor shortages in various geodemographic locations, nurses can effectively fill the gaps. Learning from California’s legislative milestone, Kenya should consider introducing a similar TTP. This would provide nurses with adequate training and experience to work independently while ensuring patient safety and quality healthcare. By embracing an expanded scope of practice, Kenya can improve healthcare accessibility and meet the evolving healthcare needs of its population.