127-603 / Advanced Nurse Competence: protocol for collaborative prescription by nurses

GOP Information
Organisation sharing the GOP
Related practices from PaSQ database
Andalusian Regional Ministry of Health and Social Welfare


Clinical guidelines or pathways
Professional learning program on quality and safety
Medication / IV Fluids
GOP Description
Implementation level
Clinical settings
Primary Care
Hospital Care
-To Ensure continuity of care and patient safety
-To improve accessibility of patients and / or caregivers
-To improve Health Effective management and fulfillment with the therapeutic plan
-To encourage a Shared Demand Management
-To optimize service times, the use of professional resources and appropriate use of medicines
Chronic patient monitoring in nursing consultation and / or home care with prescribed drug therapy. Collaborative Prescription is based in protocol defined. Protocols allow nurses variations of the treatment prescribed, based on criteria of evidence and proper use of medication
-Pharmacological Monitoring protocol design
-Training and Professional Accreditation
-Implementation of the practice in Andalusian Health System Centers (communication plan, adequacy of tools for monitoring: Medical Records-prescribing module …)
-Integration of the practice in the daily life interventions
Timeframe implementation
One year
Implementation tools available
Pharmacological Collaborative Monitoring Protocols:
-Oral anticoagulation
-Cardiovascular Risk (Antihypertensive and Lipid)
-Palliative sedation
-Chronic Pain (in press)
-Communication plan
-Medical Records-prescribing module
Implementation cost
Design and digital publication of monitoring protocols for collaborative nursing prescription: 6,000 euros
Accredited Training (22 Activities for 430 nurses): 30,000 euros
Accreditation process to professional advanced competence:
Adapting Digital History and information systems for recording and tracking: 8,000 to 10,000 euros
Method used to measure the results
Results of the implementation process:
*Monitoring data Training
*Advanced Competence Accreditation System in the Andalusian Agency for Healthcare Quality (ACSA)
430 Nurses performed accredited training
(22 accredited training)
72 nurses have completed the accreditation process to implement collaborative prescribing.
Analysis of the results
These nurses are already serving in consultation with more than 40% of patients that could be followed in collaborative prescribing protocols implemented.

According to data obtained by the registration system of integrated care processes, it is estimated that the number of patients eligible for referral for drug monitoring by nurses are approx. 18,000 Chronic patients (January 2012)
The review and analysis of results is performed periodically by Management Care Strategy of Andalusia / ACSA

Review of the implementation process to improve the accessibility of professional training process and streamline the accreditation to expand the number of accredited

Implementation barriers
Did you find implementation barriers?
Please describe implementation barriers
Training and accreditation system: need to improve accessibility to training and streamline the accreditation process for advanced competence in collaborative prescribing by nurses
– Recording System: Review the Digital prescribing Module in the patient history (Diraya) to improve functions that enable the development and proper monitoring of the practice.
Describe the strategies used to overcome the barriers (If needed)
Ongoing review of results by the Andalusian Care Strategy Direction
Evaluation of the first phase of implementation and design phase 2 beside the review of:
The Implementation and development of the Practice Process: communication plan to the centers, training and accreditation process, monitoring indicators and registration system and data mining.
Other information
Other information about the GOP that you would like to add (Link or attached document)
This practice involves the collaboration of nurse practitioners with medical professionals and dentists from the Andalusian Health System in programs of Protocolized monitoring individualized drug treatment (Decree 307/2009)
The prescription of medical devices from nurses aims to improve the accessibility and continuity of care for both patients and caregivers, providing comprehensive care, optimizing the time of care and resource use . This practice is based on therapeutic criteria of scientific evidence demonstrated, efficiency and teamwork.615_115_GOP_ PRESCRIPCION COLABORATIVA.rar