Administration of medications by enrolled nurses : perceptions of metropolitan and non-metropolitan registered nurses and nursing unit managers

Objective: The objective of this study was to investigate the views and current practices of registered nurses (RNs) and nurse unit managers (NUMs) working in metropolitan and non-metropolitan health facilities relating to medication administration by enrolled nurses (ENs). Background: The advanced scope of practice role relating to medication administration is one area currently challenging Registered and Enrolled Nurses from the perspectives of the education, knowledge and skills required to support competence in this area of practice. Method: A self-administered survey comprising questions on participant demographics, their perceptions and their current practices relating to ENs administering medications was completed by 272 RNs and Nums from metropolitan and non-metropolitan health care facilities within Australia. Results: There were statistically significant differences among metropolitan and non-metropolitan based RNs relating to their views on the various routes by which ENs should be allowed to administer medications. Significantly more RNs from metropolitan hospitals indicated that they asked ENs to administer S3, S4 and S4D medications. Overall, a large proportion of RNs were opposed to ENs administering injectable medications. Conclusion: This study describes the current practices and view points of RNs relating to administration of medications by ENs. While the findings suggest that practice change could be slow, appropriate ongoing education for and consultation with RNs will support change of practice at the clinical level. Further formalising a medication administration role for ENs that acknowledges current practice will have potential organisational and patient safety benefits.