Non-medical prescribing as a nursing quality improvement strategy

Nursing Quality Improvement Activities

Providing quality nursing care is the foundation of professional ethics for nurses. Nurses have a moral obligation to not only provide quality care, but to also to constantly strive for excellence in the quality of the care they furnish.

Non-medical prescribing is increasingly being seen as a cost-effective option, quality improvement option by both the U.S. government and professional nursing societies. The employment of potentially dangerous preparations in an array of clinical settings is not without risks, however.

There are other considerations for quality improvement in nursing -- including:

Nursing considerations for prescribed drugs.

Review of practice and practice outcomes.

New nursing standards, and guidelines.

Clinical audits.

Quality improvement is a formal approach to the analysis of performance and systematic efforts to improve it. There are numerous models used.

Main Body

Providing quality nursing care is the foundation of professional ethics for nurses. Nurses have a moral obligation to not only provide quality care, but to also to constantly strive for excellence in the quality of the care they furnish.

Non-medical prescribing is increasingly being seen as a cost-effective option, quality improvement option by both the U.S. government and professional nursing societies. The employment of potentially dangerous preparations in an array of clinical settings is not without risks, however.

There are other considerations for quality improvement in nursing -- including:

Nursing considerations for prescribed drugs.

Review of practice and practice outcomes.

New nursing standards, and guidelines.

Clinical audits.

Quality improvement is a formal approach to the analysis of performance and systematic efforts to improve it. There are numerous models used.

In my opinion, non-medical prescribing is the biggest quality improvement issue facing the nursing profession. But I will address other, relevant topics first, before delving deeply into my hypothesis.

Review of practice and practice outcomes

The evidence from the scientific literature demonstrates that nursing record systems desingned to fix a specific problem, like reducing lost nursing notes, reducing the time required for data entry, or the volume of paper files, may be quite successful at helping to review practice and improve nursing outcomes.

New Nursing Standards and Guidelines

The emergence of new nursing specialties -- like the certified nurse anesthetist -- have shown that in order to improve quality, standards and guidelines are crucial. Nurse anesthetists have been providing care in America for close to 150 years. According to the American Association of Nurse Anesthetists, nurse anesthetists are the oldest nurse specialty group in the U.S. There is a set of standards and guidelines that these CNAs must follow to get certified -- ones which ensure total quality of services.

Nurse anesthetists, for example, initially complete a bachelor's degree in a science or nursing. They must then pass the examinations to become a registered nurse. Candidates are required to have a minimum of one year of full-time nursing experience in an acute care setting, i.e. A medical intensive care unit. Following this, applicants apply to a Council on Accreditation (COA) accredited program of nurse-anesthesia. The training is offered on a masters degree or doctor degree level and the program length spans from 24 to 36 months. The curricula of nurse-anesthesia programs are governed by the Council on Accreditation (COA) standards and provide students the scientific, clinical, and professional foundation upon which to build sound and safe, and high-quality practice. Clinical residencies provide supervised experiences for students during which time they are able to learn anesthesia techniques, apply theory, and knowledge to clinical situations. Students work with patients of all ages who require medical, surgical, obstetrical, and pediatric interventions. Many require study in methods of scientific inquiry and statistics, as well as active participation in student-generated and faculty-sponsored research. In my opinion, if rigorous training like this were required for all nursing specialities, there would be a huge improvement in overall quality of nursing care. I also believe that ongoing, continuing education programs, given at the hospital, the place of employment, are vital to improving the skills of nursing generalists.

Clinical Audits

A Clinical audit is a total quality management process that has been defined as "a process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria and the implementation of change."

The key element of clinical audit is that performance is reviewed to ensure that what should be done is being done, and if not it provides a general outline to enable improvements to be made, continually. Clinical audits have been formally incorporated in the healthcare systems of a number of countries.

Now that we've gone through