The use of Standard Treatment Guidelines and Essential Medicines List by professional nurses at primary healthcare clinics in the uMgungundlovu District in South Africa Umritha Raj Sooruth a , Maureen Nokuthula Sibiya b,⇑ , Dudu Gloria Sokhela b,1 a KwaZulu-Natal College of Nursing, Pietermaritzburg 3200, South Africa b Department of Nursing, Durban University of Technology, PO Box 1334, Durban 4000, South Africa article info Article history: Received 13 September 2014 Received in revised form 21 July 2015 Accepted 1 August 2015 Available online 8 August 2015 Keywords: Primary healthcare South African Nursing Council Standard Treatment Guidelines and Essential Medicine List abstract One of the major challenges for the Department of Health in South Africa today is inequity and the need to provide quality integrated health care for all its citizens. Primary healthcare (PHC) has been declared as the way to achieve this goal, through the District Health System. Standard Treatment Guidelines (STGs) and the Essential Medicines List (EML) have been developed and are used at PHC clinics and hospitals. This study explored the use of STGs and the EML by professional nurses at PHC clinics in the uMgungundlovu District, province of KwaZulu-Natal in South Africa. A quantitative descriptive research design was used. Questionnaires were used to collect data from respondents at the PHC clinics. The researcher also reviewed the professional nurse’s registers retrospectively on the rational use of drugs. The findings of the study revealed that the respondents had a good understanding of the use of the STGs and the EML. There was no evidence of polypharmacy, and medications were prescribed according to the STGs and the EML guidelines. Areas that were suboptimal were related to prescription writing, in writing of schedules and routes of medication as indicated in facility records. The results further showed that training on the use of the STGs and EML were inadequate, which implies the need for strengthening of training programmes. Ó 2015 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). 1. Introduction The quality of healthcare services is very important for people of a country. In South Africa, an individual’s first stop is at a primary healthcare (PHC) clinic, when in search of health services (Dennill, King, & Swanepoel, 1998). It is vital that the PHC practi- tioners render the best service to the consumers of healthcare. There are guidelines and protocols that assist the professional nurses whilst working at the clinic, in assessing, diagnosing, prescribing and treating clients seeking health care, the main ones being the PHC STGs and EML. Essential medicines have been defined as ‘those that satisfy the priority health-care needs of the population’ and this is one of the eight elements of PHC as stated in the Declaration of Alma-Ata (WHO, 1978). The idea behind an essential medicines is that a list of a few selected medicines will help meet the priority health needs of populations, resulting in better health care, improved medicine management, better use of financial resources and greater access to care (Quick, 2003). In South Africa, a National Essential Drug Programme was introduced in 1996. This was followed by the presentation of the Essential Drug List (EDL) and STGs for PHC, which was revised in 1998 (Department of Health, 2000). It catered for the most common diseases that patients were treated for at PHC clinics. Following the introduction of PHC, a policy document was formulated by the South African Department of Health in 1996, called ‘‘Restructuring the National Health System for Universal Primary Health Care”. This document stated that a specialised group of professional nurses would function independently as frontline providers of clinical PHC services within the public health facilities. This group of nurses were previously known as primary healthcare nurses (Department of Health, 1996). This is an extended role of the professional nurse and is recognised and regulated by the South African Nursing Council (SANC) through the Nursing Act, No. 33 of 2005 as amended (Republic of South Africa, 2005). The http://dx.doi.org/10.1016/j.ijans.2015.08.001 2214-1391/Ó 2015 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). ⇑ Corresponding author. Tel.: +27 31 373 2606. E-mail addresses: umritharaj@gmail.com (U.R. Sooruth), nokuthulas@dut.ac.za (M.N. Sibiya), dudus@dut.ac.za (D.G. Sokhela). 1 Tel.: +27 31 373 2292. International Journal of Africa Nursing Sciences 3 (2015) 50–55 Contents lists available at ScienceDirect International Journal of Africa Nursing Sciences journal homepage: www.elsevier.com/locate/ijans