A nurse is teaching a class about providing care within the legal scope of practice to a group of nurses. The nurse should include which of the following procedures is outside the legal scope of practice for an RN?

Inserting a tunneled central venous catheter is outside the legal scope of practice for a registered nurse because it is a surgical procedure that requires a provider's (physician's or advanced practice provider's) order and skill set. Tunneled catheters — such as Hickman or Broviac lines — require a surgical insertion technique that goes beyond standard RN competency; this procedure is performed by a physician or advanced practice provider. RNs may assist during insertion and care for existing central lines, but they do not perform the insertion itself. The remaining options all fall within the legal scope of RN practice. Irrigation of an external ear canal is a standard nursing procedure performed to remove cerumen or a foreign body. Administering a platelet transfusion is within RN scope because blood and blood product administration is a core nursing skill. Changing the inner cannula on a tracheostomy is a routine airway management task that RNs routinely perform. Understanding scope of practice is essential for safe, legally sound nursing care, and nurses must recognize when a procedure requires a higher level of licensure or a physician's technical skill to avoid placing themselves and their clients at risk.