It has been more than 7 years since the release of the pre-established medical process by nurse practitioners in 1994. The promotion and practice of the pre-established medical process has encountered clinical challenges. As the supervisor of a nurse practitioners, the author puts forward his own views on the difficulties in the formulation, informatization, quality management and index establishment of the pre-established medical process and provides suggestions on the difficulties faced in the promotion of pre-established medical process. Hoping that through the promotion of the pre-established medical process can further improve the quality of care provided by nurse practitioners in Taiwan.