Nurse Protocols and Quality Assurance/Quality Improvement


The Georgia statute, O. C. G. A. § 43-34-23, enacted in 1989, authorizes registered professional nurses (RNs) in public health, who are adequately prepared, to perform certain delegated medical acts under the authority of nurse protocol. Since the passage of this important legislation, the Department of Public Health has provided direction and guidance relative to public health nursing practice under nurse protocol.


The Office of Nursing, in collaboration with the Office of Pharmacy, has provided training, technical assistance, and consultation regarding the use of nurse protocols in public health since this legislation was enacted in 1989. Since the early 1990s, the Office of Nursing has coordinated the process of reviewing, updating, producing and disseminating nurse protocols for all of the public health programs that use nurse protocols. The overall goal of developing all nurse protocols as a coordinated production is to assure consistency across programs and to assure compliance with all current laws, rules and regulations and best practices.

Overview and Process

The programs currently using nurse protocols include Immunization, Emergency Preparedness, and Response, Children’s Health, Women’s Health, Sexually Transmitted Diseases, HIV/AIDS, TB, and Infectious Diseases. The Office of Nursing leads the ongoing review process for developing nurse protocols in collaboration with the Offices of Pharmacy and Nutrition, the State Public Health Laboratory, each of the above-named programs, and leadership from the public health districts.

The current process for biannual development of the manual, Nurse Protocols for Registered Professional Nurses in Public Health, runs from January to December of odd-numbered years. At its meeting in May of each odd-numbered year, the Nurse Protocol Committee approves the manual for the following calendar year. The manual is distributed in an electronic format and hard copy by December of that year. It is posted in a PDF format. Public Health districts review, revise and update nurse protocols annually, for use beginning of each year.

Quality Assurance/Quality Improvement

The Office of Nursing (OON) maintains the vision to advance public health nursing practice, assures public health nurses are competent to practice under nurse protocol statute and builds capacity to translate quality improvement into practice to improve care and outcomes for Georgians. The goal of the Quality Assurance/Quality Improvement Program is to institutionalize a culture of quality across the state focusing on public health nursing. The program provides a foundation and formal system of quality assurance and continuous quality improvement to address practice and policy issues impacting the provision of quality health services.

The Quality Assurance/Quality Improvement for Public Health Nursing Practice Manual provides the specific clinical orientation, training, and measurement tools necessary for a PHN to practice under nurse protocols. In this way, we have a statewide, standardized and comprehensive QA/QI system that is developed at the state level and implemented at the local level to assure that all PHNs (RNs and APRNs) practicing under the Nurse Protocol Statute are adequately trained, competent and provide care consistent with the Georgia Nurse Practice Act, all relevant rules and regulations, standards of care and best practices. In addition, it is a system for evaluating, improving and assuring the quality of public health nursing practice in Georgia.

Related File(s)

Page last updated 9/22/2020