An audit of nurses using standing order directives to administer medications to children at risk of contracting rheumatic fever

N Z Med J. 2021 Dec 17;134(1547):63-70.

Abstract

Aim: The following article reports an audit, conducted between July 2014 and July 2017, of adherence to best practice in medication administration and documentation by nurses.

Method: A sample of 47 registered nurses' (RNs') documentation relating to the administration of 939 medications using standing order directives were examined and scored by seven senior nurses and a medical practitioner against an audit tool. The scores were divided into four quartiles with the top two quartiles demonstrating best practice in adherence to safety standards for the administration of medication.

Results: Forty-three RNs (91.5%) scored in the top two quartiles. The remaining four RNs (8.5%), following supervision by a senior nurse, subsequently demonstrated improvement in their documentation to the quartile one range of the audit tool. This audit demonstrates that, following education in diagnosis and treatment of common childhood conditions, the majority of nurses who were audited could diagnose simple conditions of childhood and safely administer medications to them. Moreover, two years after the programme was introduced, the serious sequelae of acute rheumatic fever (ARF) reduced in children aged 5-12 years.

Conclusion: RNs who took part in the audit used standing order directives to safely administer medications to children. RN prescribing throughout New Zealand should be explored as an effective means to provide timely treatment and improve patient outcomes.

MeSH terms

  • Child
  • Documentation
  • Humans
  • New Zealand
  • Nurses*
  • Pharmaceutical Preparations
  • Rheumatic Fever* / drug therapy
  • Standing Orders*

Substances

  • Pharmaceutical Preparations