Protecting the public through excellent nursing practice.

Protecting the public through excellent nursing practice

An Overview of the Nurse Practitioner Projectin Tasmania


M Laverty – 27 June 2006

Patient –focussed care

What does the patient need?Who is available to deliver those

needs?Are they appropriately skilled and

educated?Will they be supported in their work?Are there available resources to

enable them to give the quality of care required?


What is a Nurse Practitioner ANMC Definition

A registered nurse educated & authorised to function autonomously & collaboratively in an advanced and extended clinical role.

The role includes assessment and management of clients using nursing knowledge and skills and may include, but is not limited to;

Direct referral of patients to other healthcare professionals, prescribing medications and ordering diagnostic investigations.

The role is grounded in the nursing profession’s values, knowledge, theories and practise

Provides flexible health care delivery that compliments other health care providers.

The scope of practice is determined by the context in which the nurse practitioner is authorised to practice.


The Regulatory Background

• The Nursing Board of Tasmania acknowledges the contribution of Nurse Practitioners to the health care of the public by defining and endorsing the title and professional standards for Nurse Practitioners

• The Board has enacted its functions and powers under the Nursing Act 1995– To administer the scheme of

registration and enrolment


The Regulatory Background (continued)

– To monitor the standard and provision of nursing services in Tasmania

– To determine the activities that constitute or are included in the scope of nursing practice

– To monitor standards of nursing education.


Authorisation under the Nursing Act 1995

The Nursing Act 1995 refers to restricted areas of practice the Board has the power to require authorisation in. The following areas are restricted practice areas:– Midwifery;– Psychiatric nursing;– Such other areas of nursing

practice as may be prescribed


Authorisation under the Nursing Act 1995 (cont.)


On 28 November 2005 the following amendments were made to the Nursing Regulations 2005

• The area of practice of nurse practitioner to be a restricted practice area; and

• the area of nursing practice performed by a nurse practitioner is prescribed as a restricted practice area.

Protection of the Title “Nurse Practitioner”

Prescription of nurse practitioner as title.

The title of nurse practitioner is prescribed as a title under which a person, other than a registered nurse or an enrolled nurse, must not practise a profession or trade.


Underlying Principles

• The Nursing Board of Tasmania has the role and function to regulate the practice of nursing in the public interest

• The nature of advanced and extended practice is accepted, nationally and internationally as evident in the role of the nurse practitioner

• Clear authority for the advanced scope of practice in an extended nursing role is facilitated by the regulation of the practice of nursing in the public interest


Developing Nationally Consistent Standards for the Nurse Practitioner Role

The Australian Nursing and Midwifery Council (ANMC) commissioned a research project to develop a consistent national approach to national competency standards for nurse practitioners, which have been adopted by all States and Territories


An Overview of the Nurse Practitioner Role

The NP movement began in the United States (US) in 1965. The concept of NPs then spread to the United Kingdom (U.K.).

NPs are now established in Canada, Europe, Asia Pacific, New Zealand and Australia. It has been estimated that nearly 40 countries have established or have emerging NP roles.

In 2000 7.3% or 196,279 of the USA nurse workforce were advanced practitioners and of that number 88,186 were NP’s.


Range of Practice for Authorised NPs

Mental Health; Diabetes; emergency care; Women’s Health; Palliative Care

Neuro surgery; cardiology; continence; oncology; rural and remote care; respiratory; Aged care; wound management

Paediatric/Neonatal; Genetics; Alcohol and Other Drugs; Sexual Health; renal


What’s Happening Nationally:

New South Wales69 authorised NPs in positions2 “Midwife Practitioner” positions1 Aboriginal Nurse Practitioner

2003.

Australian Capital Territory 3 registered nurse practitionersCompleted trial of NP in Aged Care -

report available on the ACT website.


Northern TerritoryIn principle endorsement of the scope of

the Nurse Practitioner roleNursing and Midwifery Board completed

the Authorisation processPalliative care; alcohol; special care

nursery, rural remote, school health and Renal.

QueenslandLegislative and policy changes being

progressed20 government scholarships for Masters

in Nurse Practitioner Scholarships


South Australia

11 registered nurse practitionersCurrently working in acute care and

community settings within the metropolitan area.

Keen to support the development of rural and remote nurse practitioner


Victoria

4 nurse practitioners endorsed4 NP Candidates, 3 in women’s health

& 1 Emergency commenced their applications

4 further in palliative care approaching final approval

Further 13 candidates in emergency


Western Australia

23 Registered NPs Areas have to follow a business case

route for approval to site a NP4 NP courses leading to registration as

an NP in WA


What’s Happening in Tas

Goals To develop a framework for the nurse

practitioner role in TasmaniaRecognition of the role Defined scope of practice Regulation To develop and pilot nurse practitioner

models in collaboration with professional and regulatory bodies.


What’s Happening in Tas

OutcomesBetter access to specialist nursing

services that are responsive to the needs of the population

Strengthen multidisciplinary careImproved utilisation of nurses with

advanced and extended clinical skills


Phase 1 Phase 2-looking at

Rural Health Sexual HealthMental Health Forensic nursing


Completed or under developmentBusiness case TemplateNurse Practitioner Pilot GuideGuidelines for MentorsCriteria for scope of practiceLegislative changes


Agency Policy for endorsement of clinical guidelines

Guidelines for clinical privileges and clinical reviews

Authorisation processStatement of Duties


Nurse holding Master of Nursing (Nurse

Practitioner) qualification, supported by a portfolio demonstrating clinical

experience and expertiseSubmission of

completed Nurse Practitioner Application

Package

Interim authorisation by Board

Undertake and complete required academic education as determined and accredited by

Board

Authorisation by Board

Interview

Pathway 3

Pathway 2

Pathway 1

Submission of completed Nurse Practitioner

Application Package

Interview

If not approved

Appeal Process Section 72 of the Nursing Act 1995

If approved

Nurse possessing knowledge, skills and experience

applicable to the nurse practitioner role but without formal academic preparation

for the role

Nurse holding Clinical Masters

(Nursing) qualification (or

equivalent)

Pathways Leading to Authorisationas a Nurse Practitioner



www.nursingboardtas.org.au

Protecting the public through excellent nursing practice.

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