ADMINISTRATION OF MEDICINES BY EMERGENCY NURSE PRACTITIONERS ACCORDING TO PROTOCOLS IN AN ACCIDENT AND EMERGENCY DEPARTMENT

Objective-To present the legal and professional issues related to nurs e administration of drugs according to protocols, and describe the imp lementation and initial audit findings of such a scheme. Setting-Accid ent and emergency (A&E) department of a district general hospital. Met hods-Analysis of legal and professional opinion. Protocols acceptable to the medical, nursing, and pharmacy professions were developed acros s a wide range of drugs appropriate for administration by accident and emergency nurse practitioners (ENPs). The first six months of the sch eme were audited. Audit initially addressed general compliance with pr otocols and later the specific areas of tetanus immunisation and emerg ency contraception. Results-ENPs assessed 2925 patients in six months (10.9% of all new patients); 455 patients (15.5% of the ENP patients) were given drugs according to protocols. There were no breaches of the protocols. Subsequent audit of tetanus immunisation showed 94-100% co mpliance with protocol standards and 71-100% compliance for emergency contraception. Conclusions-There are no legal or professional obstacle s to the development of protocols for the administration of drugs to p atients by nurses without reference to a doctor, providing the protoco ls meet all the requirements of the UKCC and have the support of consu ltant medical staff. Such a system must be subject to regular audit to promote a dynamic approach to protocols and training. The system safe ly enhanced the quality of care of patients treated by ENPs in A&E.