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Nurse practitioner suggests use of clinical guidelines.

ONE ISSUE we must face early in our new advanced roles as nurse practitioners (NPs) is our scope of practice, vis-a-vis medical colleagues, in terms of treating common illnesses/conditions.

Few primary care websites in New Zealand actually use, or refer to any updated clinical guidelines, resulting in great variance in the quality of care provided. This will probably lead to dozens of nurses putting in hundreds of hours to try to a) ensure optimum care is provided; and b) make boundaries clear, in terms of providing consistent care within a work setting, and when the need for referral and consultation are mutually agreed by the NP and doctor.

I would like to suggest a reference point which I will certainly be using. Public health nurses and other community nurses working on developing Standing Orders will also find them invaluable. Barmarrae Books ( have put out clinical guidelines for child health, family practice and adult health. All have 2003 versions. These guidelines are developed and updated by NPs, are widely used, not only in graduate schools and preceptorships, but in many clinical settings and by community-based doctors in the United States. They are succinct, include pathogenesis, history, assessment and treatments, including pharmacotherapy. A few drug brand names are different and a few may not be available, but the principles are all the same. The layout, some examples of conditions and tables of contents are all online, as is ordering information.

Paula Renouf, RN, MS, NP (child and

adolescent health)

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Title Annotation:letters
Author:Renouf, Paula
Publication:Kai Tiaki: Nursing New Zealand
Article Type:Letter to the Editor
Date:Nov 1, 2003
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