Your Nurse Rulebook Just Changed: ANA Adds AI to Scope and Standards

The American Nurses Association (ANA) has published the fifth edition of Nursing: Scope and Standards of Practice, the foundational text that defines what nurses do, how they are expected to do it, and what they are professionally responsible for across every role and setting.

The update, published September 22, is the first revision since 2021. The new edition formally embeds innovation into professional nursing practice and gives nurses guidance on evaluating artificial intelligence through an ethical lens.

“As healthcare changes, ANA continues to guide the nursing profession with clarity, purpose, and integrity through this fifth edition of the Nursing: Scope and Standards of Practice,” Jennifer Mensik Kennedy, PhD, MBA, RN, NEA-BC, FAAN, president of the American Nurses Association, said in the release. “This new edition affirms that nurses are not passive recipients of change: they are essential leaders in shaping it. Whether advancing innovation, being the trusted voice providing bedside care, or evaluating evolving technology and its impact on patients, nurses must be confident in their clinical judgment, role on the healthcare team, and focused on safer, more equitable care for stronger and healthier communities.”

If you’ve ever been asked in nursing school, in a job interview, or in a deposition what the standard of care for a registered nurse looks like, this is one of the documents people point to.

Here’s what changed.

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According to ANA’s announcement, the new edition “formally embeds innovation into professional nursing practice, positioning it as a foundational component of contemporary nursing leadership and responsibility.”

The biggest changes include:

• Artificial intelligence: The fifth edition recognizes the growing role of AI in the nursing practice environment and provides guidance for evaluating emerging technologies through an ethical lens.
• Human-centered innovation as a professional responsibility: New content includes a shared definition of innovation, a framework, case studies, and practical actions that “nurses, organizations, and society can take to support collaborative changes and improve experiences for those receiving and providing care,” per ANA.
• Core ethics reaffirmed: The edition reaffirms nursing’s commitments to accountability, advocacy, equity, safety, human dignity, and person-centered care.

ANA says the text is meant to serve as a key reference for nurses, educators, employers, policymakers, and healthcare leaders.

The book is available for purchase through the ANA bookstore.

How This Fits Into ANA’s Bigger Push on AI and Ethics

The fourth edition, published in May 2021, laid out 18 standards of practice that describe the actions and behaviors every registered nurse is expected to competently perform, regardless of role, population, specialty, or setting. That edition was finalized before generative AI tools exploded into hospitals and clinics.

The fifth edition’s AI focus builds on earlier ANA guidance. ANA’s position statement on the ethical use of artificial intelligence in nursing practice, approved by its Board of Directors in December 2022, says nurses who integrate AI into their work are responsible for ensuring its validity, appropriate use, transparency, and ongoing evaluation for reliability. It also warns that advanced technologies must not compromise the human relationships at the center of nursing.

The update also follows ANA’s revised Code of Ethics for Nurses, released in January 2025, which added a new tenth provision on global ethics and separately addressed workplace safety and emerging technologies. Together, the Code and the Scope and Standards form the backbone of ANA’s professional guidance for nurses.

ANA has also been active in shaping nursing’s professional landscape in other ways this year, including recognizing patient blood management and men’s health nursing as new nursing specialties earlier this year.

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ANA is not telling nurses to defer to AI. Its 2022 position statement on AI in nursing practice is explicit that AI should support, not replace, professional nursing judgment, and that advanced technology must not compromise the human relationships at the center of nursing. The fifth edition fits inside that frame.

The Scope and Standards is not a state law. Your legal scope of practice is still set by your state’s nurse practice act and board of nursing. But ANA’s standards are widely used by employers, educators, specialty organizations, and even courts to describe what competent, professional nursing looks like. When a hospital writes a policy, a nursing program builds a curriculum, or an expert witness explains the standard of care, this document is often in the background.

That’s why the AI language matters. As health systems roll out AI documentation tools, predictive alerts, and virtual nursing models, the fifth edition signals that evaluating these technologies is part of a nurse’s professional responsibility, not something to leave solely to IT or administration. In practical terms, that can support nurses who question a tool that seems unsafe, push back on an algorithm that conflicts with their clinical judgment, or ask to be at the table when new technology is chosen.

A few takeaways for your day-to-day:

• Your clinical judgment still leads. ANA’s messaging makes clear that nurses must be confident in their judgment when evaluating technology and its impact on patients.
• Policy updates may follow. Employers and nursing schools that reference the ANA standards may revise policies, competencies, and curricula to reflect the new edition.

• Innovation is now part of professional nursing responsibility. Participating in quality improvement and practice change is framed as a professional responsibility, which could help nurses make the case for time, resources, and recognition for that work.

🤔 Has AI shown up on your unit yet, and do you feel like nurses had a say in how it was rolled out? Share your experience in the comments.