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The Nursing and Midwifery Council's Standards of Proficiency

In 2018, the NMC published future nurse proficiencies for registered nurses (NMC, 2018b) and for nursing associates (NMC, 2018b) along with a range of other revised and updated standards. The standards of proficiency provide the education and training standards that underpin all aspects of nurse education delivery and management.

The standards make significant changes to proficiencies for nurses, introducing a new education framework. The standards of proficiency are designed to enable nurses to meet the changing health needs of the population, to provide them with more clinical autonomy where appropriate, and to prepare them for leadership roles in the sphere of care provision ensuring the nurse is fit for purpose. The standards are based on the following requirements (platforms) to:

be an accountable professional;

promote health and prevent ill health;

assess needs and plan care;

provide and evaluate care;

lead and manage nursing care and work in teams;

improve safety and quality of care;

coordinate care.

As well as understanding the principles of safe and effective administration and optimisation of medicines and adhering to local and national policies, the nurse must also demonstrate proficiency and accuracy when they are calculating dosages of prescribed medicines. The nurse has to demonstrate knowledge of pharmacology and the ability to recognise the effects of medicines, allergies, drug sensitivities, side effects, contraindications, incompatibilities, adverse reactions, prescribing errors and the impact of polypharmacy – and also over‐the‐counter medication usage. See Table 1.1 for the procedural competencies for nurses (registered and associate) that are essential for best practice, evidence‐based medicines administration and efficacy.

Table 1.1 Registered nurse procedural competencies and the procedural competencies required by the nursing associate

Source: Adapted, NMC (2018b).

The registered nurse	The nursing associate
Undertake initial and continued assessments of people receiving care and their ability to self‐administer their own medications.Understand the various procedural routes under which medicines can be prescribed, supplied, dispensed and administered; and the laws, policies, regulations and guidance that underpin them.Make use of the principles underpinning safe remote prescribing and directions for the administration of medicines.Undertake accurate drug calculations for a variety of medications.Undertake accurate checks, including transcription and titration, of any direction to supply or administer a medicinal product.Apply professional accountability so as to ensure the safe administration of medicines to those who are receiving care.Administer injections using intramuscular, subcutaneous, intradermal and intravenous routes and manage injection equipment.Administer medications using a range of routes.Administer and monitor medications using vascular access devices and enteral equipment.Recognise and respond to adverse or abnormal reactions to medications.Undertake safe storage, transportation and disposal of medicinal products.	Continually assess people who are receiving care and their ongoing ability to self‐administer their own medications.Know when and how to escalate any concerns.Perform accurate drug calculations for a variety of medications.Use professional accountability in order to ensure the safe administration of medicines to those receiving care.Administer medication via oral, topical and inhalation routes.Administer injections using subcutaneous and intramuscular routes and manage injection equipment.Administer and monitor medications using enteral equipment.Administer enemas and suppositories.Manage and monitor effectiveness of symptom relief of medications.Recognise and respond to adverse or abnormal reactions to medications and know when and how to escalate any concerns.Undertake safe storage, transportation and disposal of medicinal products.

The registered nurse

The nursing associate

Undertake initial and continued assessments of people receiving care and their ability to self‐administer their own medications.Understand the various procedural routes under which medicines can be prescribed, supplied, dispensed and administered; and the laws, policies, regulations and guidance that underpin them.Make use of the principles underpinning safe remote prescribing and directions for the administration of medicines.Undertake accurate drug calculations for a variety of medications.Undertake accurate checks, including transcription and titration, of any direction to supply or administer a medicinal product.Apply professional accountability so as to ensure the safe administration of medicines to those who are receiving care.Administer injections using intramuscular, subcutaneous, intradermal and intravenous routes and manage injection equipment.Administer medications using a range of routes.Administer and monitor medications using vascular access devices and enteral equipment.Recognise and respond to adverse or abnormal reactions to medications.Undertake safe storage, transportation and disposal of medicinal products.

Continually assess people who are receiving care and their ongoing ability to self‐administer their own medications.Know when and how to escalate any concerns.Perform accurate drug calculations for a variety of medications.Use professional accountability in order to ensure the safe administration of medicines to those receiving care.Administer medication via oral, topical and inhalation routes.Administer injections using subcutaneous and intramuscular routes and manage injection equipment.Administer and monitor medications using enteral equipment.Administer enemas and suppositories.Manage and monitor effectiveness of symptom relief of medications.Recognise and respond to adverse or abnormal reactions to medications and know when and how to escalate any concerns.Undertake safe storage, transportation and disposal of medicinal products.

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