Protecting the public through excellent nursing practice
An Overview of the Nurse Practitioner Projectin Tasmania
Protecting the public through excellent nursing practice
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?
Protecting the public through excellent nursing practice
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.
Protecting the public through excellent nursing 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
Protecting the public through excellent nursing practice
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.
Protecting the public through excellent nursing practice
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
Protecting the public through excellent nursing practice
Authorisation under the Nursing Act 1995 (cont.)
Protecting the public through excellent nursing practice
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.
Protecting the public through excellent nursing practice
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
Protecting the public through excellent nursing practice
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
Protecting the public through excellent nursing practice
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.
Protecting the public through excellent nursing practice
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
Protecting the public through excellent nursing practice
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.
Protecting the public through excellent nursing practice
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
Protecting the public through excellent nursing practice
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
Protecting the public through excellent nursing practice
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
Protecting the public through excellent nursing practice
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
Protecting the public through excellent nursing practice
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.
Protecting the public through excellent nursing practice
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
Protecting the public through excellent nursing practice
Phase 1 Phase 2-looking at
Rural Health Sexual HealthMental Health Forensic nursing
Protecting the public through excellent nursing practice
Completed or under developmentBusiness case TemplateNurse Practitioner Pilot GuideGuidelines for MentorsCriteria for scope of practiceLegislative changes
Protecting the public through excellent nursing practice
Agency Policy for endorsement of clinical guidelines
Guidelines for clinical privileges and clinical reviews
Authorisation processStatement of Duties
Protecting the public through excellent nursing practice
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
Protecting the public through excellent nursing practice
Protecting the public through excellent nursing practice
www.nursingboardtas.org.au