A critical care nurse practitioner's prescribing using standing orders and authorised prescribing when performing a critical care outreach role: A clinical audit

Summary 

Objective

This paper assesses the frequency of prescribing and the types of medications prescribed by a New Zealand critical care nurse practitioner (NP) whilst performing a critical care outreach role.

Method

A before and after audit was conducted from June 2006 to July 2008. Audit data were collected prospectively and analysed retrospectively. Data collected between July 2006 and June 2007 when standing orders were used were compared to data collected between July 2007 and June 2008 when the NP was authorised to prescribe. Data were analysed using count, chi-square, the Fisher's Exact Test and Phi.

Findings

The NP completed 1061 patient visits. When compared to using standing orders, the NP prescribed a greater number and a wider range of medications when authorised to prescribe (χ²=9.280, p=.002, Φ=.094). Electrolytes and analgesics were the most common medications prescribed in both audit periods.

Conclusion

The results provide insight into critical care NP prescribing practice to better inform future critical care workforce development.

Keywords: Nurse practitioner, Nurse prescribing, Critical care outreach