It is within the scope of practice of an appropriately trained and competent registered nurse to perform an endoscopy, sigmoidoscopy, or colonoscopy procedures, including obtaining biopsies, following clinical practice standards. Standing orders from an authorized health care practitioner may be used to order the procedure and for follow-up actions based on the results. The registered nurse should use the Scope of Practice Decision Tree to determine if specific activities are within the registered nurse’s legal and individual scope of practice. Facility policies, accreditation organizations (such as the Joint Commission), and Federal regulations (such as the Centers for Medicare and Medicaid Services) may limit or restrict the scope of practice of registered nurse performing this procedure.