Standing Order Definition in Community Health Nursing

Standing orders and protocols allow patient care to be shared among non-clinical members of the healthcare team, such as physician assistants and nurses. In keeping with Key Factor 4: Create and Support Highly Functional Teams to Provide High-quality, Evidence-Based Care, this overview explains how standing orders empower clinical and non-clinical staff in care teams. The resource includes examples of standing orders for various medical scenarios detailing how evidence-based recommendations can be integrated into the practice workflow, and supports Key Factor 1: Find, select and adjust the best evidence for use by practice. INTRODUCTION Standing orders are used by many general practices in New Zealand. They allow a nurse practitioner to assess patients and administer and/or dispense medication without the need for the intervention of a general practitioner. OBJECTIVE To examine the views of the organization`s strategic stakeholders on the application of the permanent mission in general practice at the country level. METHODS Eight semi-structured in-person qualitative interviews were conducted with participants representing key primary care stakeholders in nursing, medicine and pharmacy. Data were analysed using a qualitative inductive thematic approach. RESULTS Three key issues emerged: lack of understanding of the use of standing orders in general practice, legal and professional concerns, and the impact on the workforce and clinical practice.

Standing orders were seen as an extension of nursing practice and seen as a useful tool for providing patients with safe and timely access to medications. DISCUSSION The variability in understanding the definition and use of the Regulations appears to be related to a lack of leadership in this area. Leaders should facilitate the necessary development of standardized resources and quality assurance measures to support implementation. If these aspects are addressed, standing orders will continue to be a useful tool in general practice, allowing patients to access health care and, where appropriate, medicines without having to consult a general practitioner. Note: This resource must be downloaded in PDF format cepc.ucsf.edu/standing-folders. Ursprungsinstitution: University of California, San Francisco (UCSF) Center of Excellence in Primary Care Copyright Information: 2013 Die Regenten der University of California BUCHTITEL: © Essentials in Community Health Nursing Practice.