Developing National Practice Standards for Nurses in Australian General Practice

Background: Nursing is in many ways a diverse profession and the roles and educational preparation of individual nurses differ. Practice standards provide an opportunity for the profession to clearly articulate the scope of practice of a nurse in a particular setting. Additionally standards contribute to clinical governance and quality assurance, thus ensuring quality patient care. The development of standards for practice is complex, necessitating the synthesis of multiple views and ideas, as well as balancing the evidence base with service delivery needs. Most countries have general practice standards defined by a regulatory authority. However, nurses who work in specific areas of practice often require additional skills and knowledge unique to the setting in which they practice. This presentation provides an example of the development of practice standards for nurses working in Australian general practice to illustrate the process of standards development for a specific area of practice.

Aim: This paper seeks to explore the development of professional practice standards for nurses in primary care.

Methods: This mixed methods study used two online surveys of nurses and a series of fourteen focus groups conducted around Australia to collect data from nurses in general practice. Interviews were also undertaken with general practitioners and practice managers. A Project Steering group comprising of a range of key stakeholders provided oversight and input into the Project. The Reference Group, comprised of expert clinical nurses, participated in the data analysis and development of the draft standards and their associated performance indicators.

Findings:A total of 561 survey responses were received across the two surveys and 200 nurses participated in the focus groups. The final 22 Practice Standards were divided into four domains; 1) Professional practice, 2) Nursing Care, 3) General Practice Environment and 4) Collaborative Practice. Professional Practice encompasses the nurses' role and responsibilities as a health professional. Nursing care incorporates the delivery of nursing care within the general practice setting. The unique organisational environment of general practice is recognised within the General Practice environment, which highlights the additional work undertaken by nurses in this area of practice. Finally, Collaborative Practice acknowledges the importance of the nurse in developing connections within both the specific general practice and across the broader primary health care team. These standards reflect the aspects of nursing that are unique to the context of general practice and are beyond those expected of nurses' in other clinical settings.

Relevance to policy, research and/or practice needs: Professional practice standards are an important way of defining the role and scope of practice of a profession to both consumers and other professionals, as well as being a guide for curriculum development and measurement of performance. They have clear relevance to policymakers, researchers and those in clinical practice as they provide role clarity that will optimise the contribution of nurses to the clinical setting. Understanding how standards are developed can ensure that future standards are robust and reflect the nursing profession.