Patient group directions: The application and integration of knowledge in advancing nursing practice

Abstract

Background: The introduction of Patient Group Directions (PGD) has changed significantly the way in which nurses can now administer prescription only medicines as a one-off for patients requiring this level of service. PGD's are a written authority to administer drugs to patients that are not identified at the time of treatment.Aim: The aim of this project was to develop a PGD for use within an Outreach team to administer colloid boluses to patients presenting with hypovolemia.Method: Using a case exemplar this paper will discuss the development of a PGD using aspects of transitional change theory to highlight the potential barriers that were encountered. Implications for Practice:The implications for this PGD are wide reaching. First it now enables members from the nursing Outreach team to administer colloid fluid boluses to a prescribed patient cohort without the need for prescription. Second, it ensures the deteriorating patient has interventions initiated in a timely and appropriate manner to reduce inadvertent admission to high care areas. Last, it will improve inter-professional team-working and communication so much so that collaborative patient care reduces health costs and identifies earlier those patients requiring substantially greater nursing and medical input. Conclusion:The experience of developing a working PGD for fluid administration has meant that the Outreach team is able to respond to patients in a more effective way. In addition, it is the experience of developing this PGD that has enabled the team to contemplate other PGD's in the execution of Outreach work.

Developing capacity to care for clients at risk for delirium and for acutely delirious clients

“…Christensen [37] offered a case exemplar regarding advance practice nurses' development of "Patient Group Directions (PGDs)", a form of a medical directive in Australia for treatments to be carried out by nurses. In particular, a team of Outreach nurses developed a PGD about provision of fluid boluses to patients encountered in their outreach practice without the need for individuals to seek a prescription first.…”