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Scope of practice Myocardial infarct

by heoidasoulfly heoidasoulfly (New) New


I´m an austrian nurse and currently writing a paper comparing the austrian and american critical care nurse competencies in managing the acute myocardial infarct.

I´m especially interressted in further roles/competencies a registred nurse can get after doing her CCRN certification. As far as i know has every U.S. state its own care act which regulates the roles of (critical care) nurses.

Have special trained nurses with CCRN certification an extended scope of nursing in the ICU setting? For example at the care of an acute myocardial infarction like insertion of centralvenous catheders, assistance in the corangiography or echocardiography? Can you provide me some useful links/ressorces?

Thanks for your time, excuse my not-so-flawless english and thanks for your help


Robert Zeilinger, Critical Care Nurse


Rose_Queen, BSN, MSN, RN

Specializes in OR, education. Has 16 years experience.

CCRN is a certification that demonstrates the holder has expertise in critical care nursing. It does not provide any form of an expanded scope of practice. In order to have a increased scope of practice, a nurse must complete an advanced practice program such as nurse practitioner or clinical nurse specialist.

Ok thanks a lot. So can you please list me some examples for increased scope of practice regarding the acute myocardial infarction/standard of care for an nurse practitioner? Is there anybody who can hook me up with some guide/standard of his coronary care unit/ICU/CCU?

nurse2033, MSN, RN

Specializes in ER, ICU.

Rose Queen is right of course. The CCRN only certifies that the nurse has demonstrated advanced knowledge. But in practical terms, it doesn't provide any advancement in scope of practice. Some organizations will give a small increase in pay for a certification, but the nurse still has the exact same duties. Advanced cardiac care mostly takes place in the Cath Lab, where angiography is performed. This is separate from the ICU, although the patient will almost always leave the Cath lab to the ICU afterwards. A nurse will assist in preparing a patient for angiography, but this is (as far as I know) always done by a physician. Nurse Practitioners have a scope of practice higher than an RN, but not the equal of a physician, especially in critical interventions.

The AACN publishes an Essentials of Critical Care Nursing that details the skills most ICU nurses perform. It is true every state has its own Nurse Practice Act but they are very similar in scope. Since the US uses a single exam (NCLEX) nursing practice is very similar across the US. I hope that answers your question.


Specializes in critical care: cardiac cath lab/ER/ICU. Has 7 years experience.

Cath lab RN here and future AGACNP. My suggestion is to check out the AACN website (American Association of Critical-Care Nurses)- they provide a handbook on scope and standards including that of nurse practitioners. An AGACNP can insert central venous catheters and arterial lines but cannot perform coronary angiograms.