Foundations of General Practice : A workbook for nurses
Ensure best patient outcomes with a rigorous approach to quality in your clinical practice
On this page:
- Develop a knowledge-base for clinical care
- Build consistent clinical guidelines
- Implement processes to deliver the highest quality care
Nurses setting up nurse clinics need to be able to:
- articulate a knowledge base for the clinic
- adapt theoretical knowledge and clinical skills to the clinic
- demonstrate clinical reasoning in the application of clinical guidelines, and
- use evidence-based principles and guidelines.
There may be an existing service you can use to model your own nurse clinic. Visiting other services and even shadowing a nurse can be useful in developing your own model of care.
Clinical guidelines and protocols help clinical staff make evidence-based decisions about the best care and treatment options for their patients.
Evidence-based clinical guidelines can be found in the following areas:
- Professional associations (e.g. National Evidence Based Guideline for Diagnosis, Prevention and Management of Chronic Kidney Disease in Type 2 Diabetes by Diabetes Australia and the National Health and Medical Research Council)
- Peak organisations (e.g. Nurse Home Visit Guideline by APNA)
- National Health and Medical Research Council Guidelines and Publications
- Academic literature, e.g. Australian National University Open Research Collection
When establishing your clinic, consider conducting a literature search to review best practice, current guidelines and protocols specific to the clinical care that will be provided by the clinic. Documenting these practices and sharing them with clinic staff increases your clinic’s ability to deliver consistent care of the highest quality.
“Having the guidelines in place has been important in getting everybody on board."
See the range of clinical guidelines used in the SKIP into Life clinic
Embedding a quality improvement approach when establishing a nurse clinic will contribute to the delivery of good patient care, health care planning and service delivery through the measurement of the efficiency, viability and effectiveness of services.
The Model for Improvement (MFI) is a well-established quality improvement approach which can be used as the framework for planning and implementing a nurse clinic. It can be applied to both small personal changes and large organisational changes, breaking down systems and processes into small steps which are then tested to ensure optimal performance.
Why use the Model for Improvement?
The MFI offers a number of benefits, including:
- providing a simple approach to making change that anyone can apply
- outlining a method to plan, develop and implement change
- reducing risk by testing small changes before wider implementation
- minimising resistance to change by starting small
- creating team unity around common goals
- maximising individual creativity and ideas from team members.
Use the strategies outlined below.
Define the problem:
Understanding what the problem actually is and thinking about why there is a problem helps with developing goals. There are quality improvement tools that can assist. Tools and templates can be found on the Institute for Healthcare Improvement's website.
Think small and test:
Think about testing a change with one health worker, one GP or a select group of patients. Knowledge gained from this small test will help determine if the change had the desired effect and is suitable for wider implementation, or whether other changes should be tested. Ultimately, this process will improve the chances of making a successful change.
Test each idea using a PDSA Cycle - template here
Use a whole-of-team approach:
To achieve effective change within any organisation, the individuals that will be affected by the change need to be involved throughout the process. The MFI empowers the entire team to work towards a common goal. Individual team members can contribute their ideas and, as a group, they can decide which ideas to test.
Share the successes as well as the failures.
The MFI is based on learning. In a team, it is important to share and celebrate successes. It is equally important to discuss the things that did not work so the team can learn and test new approaches.
Find out more about the Model for Improvement at the Institute for Healthcare Improvement
Visit the Australian Primary Care Collaborative where you'll find some good examples of aims, measures and change ideas.
Watch a video demonstration of the Model for Improvement
Answer the Three Fundamental questions to start your Model for Improvement