Collegian
Volume 14, Issue 1 , Pages 31-36, 2007

The Critical Elements Within a Journey Towards the Achievement of Quality Use of Medicines

  • Helen Bellchambers, RN PhD

      Affiliations

    • Uniting Care – Ageing, Cardiff, New South Wales
    • Corresponding Author InformationDr Helen Bellchambers
    • ,
  • Margaret McMillan, RN PhD (Faculty of Health)

      Affiliations

    • University of Newcastle, New South Wales

Article Outline

In Australia, as in much of the rest of the Western world, the changing demographics of the population has resulted in a need for the aged care industry and the nursing profession to modify their traditional skill mix in order to better respond to changes in the needs of older Australians. In particular, the role of the Enrolled Nurse (EN) in New South Wales (NSW) Australia has been under considerable scrutiny for the last decade resulting in a number of changes in the EN's scope of practice; notably the 2004 amendment to legislation and education that enabled ENs to administer medication. This changed scope of EN practice has resulted in a need to reconsider the role of all members of the aged care medication team.

Quality Use of Medicines (QUM) within a Residential Aged Care (RAC) facility is dependent upon systematic and evidence-based approaches underpinning the relevant structures and processes involved in the management of medications. Implementation of effective QUM systems and processes is particularly dependent upon the nature of relationships among members within the aged care medication team. Although there are numerous mechanisms to support QUM by nurses, the RAC sector in Australia lacks a tool that is both contemporaneous and context-specific and sup ports an expanded scope of practice for ENs who work in the RAC sector.

This paper reports on an action research project that aimed to enhance of the health of older Australians in one RAC facility by developing an implementation framework that supports ENs as practitioners involved in QUM. The research identified the enabling factors and barriers to the achievement of QUM within the aged care medication team.

The project encompassed a re-conceptualization and reconfiguration of local nursing medication-related practices and culminated in a conceptual framework to support quality medicine outcomes for older Australians. The outcomes of the research included a set of principles to guide the expanded role of the EN in RAC.

Key words:  quality use of medicines , residential aged care , enrolled nurse , implementation framework

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References 

  1. Australian Bureau of Statistics. (1999). Australia's older population: Past, present and future. Retrieved April 2, 2006 from http://www.abs.gov.au/
  2. Australian Department of Health and Aged Care  . A review of the current role of enrolled nurses in the aged care sector: Future directions . Canberra: Aged and Community Care Division.; 2001;
  3. Australian Nursing Council Inc  . An examination of the role and function of the enrolled nurse and revision of competency standards. (Commissioned project. No. 1) . Dickson, ACT: Australian Nursing Council Inc.; 2002;
  4. Australian Nursing and Midwifery Council. (2002). ANMC national competency standards for the enrolled nurse. Retrieved April 2, 2006 from http://www.anmc.org.au/?event=-1&query=website/Publications/National%20Standards
  5. Bellchambers, H. (2006). A quest for QUM: An action research project to integrate enrolled nurses as practitioners of quality use of medicines in residential aged care. Faculty of Health, University of Newcastle Australia: Unpublished doctoral thesis.
  6. Commonwealth of Australia. (2006). About the PBS. Retrieved October 3, 2006 from http://www.health.gov.au/internet/wcms/publishing.nsf/Content/health-pbs-general-aboutus.htm
  7. Commonwealth of Australia  . The patient profession: Time for action . Canberra: Senate Community Affairs Committee.; 2002;
  8. Department of Education Science and Training. (2001, 16 January 2002). Enrolled nurse education: final report to the National Review of Nursing Education. Retrieved April 2, 2006 from http://www.dest.gov.au/highered/eippubs/eip01_17/6.htm
  9. Department of Education, Science and Training. (2002). National review of nursing education 2002: Our duty of care. Canberra.
  10. McMillan, M., Conway, J., & Bellchambers, H. (2003). Report on a forum conducted by the NSW NRB: Enrolled nurse practice and education. Sydney: University of Newcastle.
  11. McMillan M , Conway J . A reflective piece . Australian Journal of Advanced Nursing . 2004;22(2):5
  12. Nurses & Midwives Board of NSW. (2006). Boundaries of professional practice: Guidelines for Registered Nurses, Registered Midwives and Enrolled Nurses. Retrieved April 2, 2006 from http://www.nmb.nsw.gov.au/Boundaries-of-Professional-Practice/default.aspx
  13. Runciman W , Roughead E , Semple S , Adams R . Adverse drug events and medication errors in Australia . International Journal for Quality in Health Care . 2003;15(Supplement 1):i49–i59

PII: S1322-7696(08)60545-4

doi:10.1016/S1322-7696(08)60545-4

Collegian
Volume 14, Issue 1 , Pages 31-36, 2007

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