Methods
We applied the Donabedian SPO model to evaluate the
safety and quality of nurse practitioner service. The nurse
practitioner service is both a clinical care model and a service
innovation; accordingly, evaluation included (1) the
setting for nurse practitioner service (Structure); (2) the
clinical service provided by the nurse practitioner (Process)
and (3) the influence of nurse practitioner service on
patients (Outcome). Data were collected, analysed and
reported related to these three elements guided by the
following audit questions:
1 To what extent was the service/facility prepared to incorporate
nurse practitioner service in terms of the multidisciplinary
team (MDT) and the organisation of the service
structure?
2 What impact does the nurse practitioner role have on service
quality and processes including the use of diagnostic
resources, prescribing practices and perceived impact on
service indicators?
3 Does nurse practitioner practice meet standards of safety
and quality of patient care in terms of perceptions of
clinical competence, patient satisfaction with care, conformity
to scope of practice and best evidence