An evaluation of nurses' record-keeping skills and knowledge of using patient group directions for antibiotics at a walk-in centre

Patient group directions (PGDs) are now an integral feature of walk-in centres (WiCs), enabling nurses to supply and administer drugs to the generalised direction of a doctor rather than by means of a patient-specific prescription. The aims of the study described here were to assess nurses' record-keeping and knowledge with regard to PGDs for antibiotics implemented at a local WiC. The study methods included undertaking a clinical audit of patient records between October 2000 and March 2001 and an assessment of nurses' knowledge using multiple-choice questionnaires, vignettes and shadowing consultations. A total of 1,169 patients was supplied antibiotics, 72% of which were provided by nurses using a PGD. Nearly 100% of patients were supplied antibiotics correctly according to drug and dose; however, in only 63% of cases was there recorded evidence that allergy or contraindications were checked before the antibiotic was supplied. The study found that 51% of the required assessment criteria were recorded on the computer records. Nurses' knowledge at baseline resulted in a median score of 70%, which rose to 79% following educational interventions. The study suggests that nurses are knowledgeable and supply antibiotics judiciously in terms of drug and dose, but that in terms of clinical governance there is room for improvement in record-keeping.