ABSTRACT
Appropriateness of care must be based upon having evidence-based research/practice to ensure that there are well justified criteria with which to determine what amounts to best practice. This will enable processes and systems involved to be defended most effectively if things do go wrong, and will provide the quality assurance standards necessary for a controlled environment of care. This must be achieved in line with clinical and cost effectiveness, to ensure that we are using our scarce resources to achieve the balance and not practising defensive medicine to cover our backs and for fear of litigation. Nurses can demonstrate how they provide the care by using Multidisciplinary Pathways of Care, effective communication and good record keeping. Then they can demonstrate the outcomes achieved and show that their practices work for the patient and their family as well as amounting to success within the terms of the guideline’s own criteria of success. Not having models of good nursing practices, quality improvements and ways of demonstrating appropriateness, clinical effectiveness and efficiency can result in unnecessary risk exposure through lack of recognition, poor team working, and the inability to apply ongoing risk assessments and modification of highrisk exposures.
