Protecting the public through excellent nursing practice

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Protecting the public through excellent nursing
practice
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Protecting the public through excellent nursing
practice

• An Overview of the
• Nurse Practitioner Project
• in Tasmania

M Laverty 27 June 2006
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Patient focussed care
Protecting the public through excellent nursing
practice

• 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?

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What is a Nurse Practitioner ANMC Definition
Protecting the public through excellent nursing
practice

• 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 professions
  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.

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The Regulatory Background
Protecting the public through excellent nursing
practice

• 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

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The Regulatory Background (continued)
Protecting the public through excellent nursing
practice

• 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.

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Authorisation under the Nursing Act 1995
Protecting the public through excellent nursing
practice

• 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

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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.

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Protection of the Title Nurse Practitioner
Protecting the public through excellent nursing
practice

• 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.

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Underlying Principles
Protecting the public through excellent nursing
practice

• 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

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Developing Nationally Consistent Standards for
the Nurse Practitioner Role
Protecting the public through excellent nursing
practice

• 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

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An Overview of the Nurse Practitioner Role
Protecting the public through excellent nursing
practice

• 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 NPs.

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Range of Practice for Authorised NPs
Protecting the public through excellent nursing
practice

• Mental Health Diabetes emergency care Womens
  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

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Whats Happening Nationally
Protecting the public through excellent nursing
practice

• New South Wales
• 69 authorised NPs in positions
• 2 Midwife Practitioner positions
• 1 Aboriginal Nurse Practitioner 2003.
• Australian Capital Territory
• 3 registered nurse practitioners
• Completed trial of NP in Aged Care - report
  available on the ACT website.

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Protecting the public through excellent nursing
practice

• Northern Territory
• In principle endorsement of the scope of the
  Nurse Practitioner role
• Nursing and Midwifery Board completed the
  Authorisation process
• Palliative care alcohol special care nursery,
  rural remote, school health and Renal.
• Queensland
• Legislative and policy changes being progressed
• 20 government scholarships for Masters in Nurse
  Practitioner Scholarships

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Protecting the public through excellent nursing
practice

• South Australia
• 11 registered nurse practitioners
• Currently working in acute care and community
  settings within the metropolitan area.
• Keen to support the development of rural and
  remote nurse practitioner

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Protecting the public through excellent nursing
practice

• Victoria
• 4 nurse practitioners endorsed
• 4 NP Candidates, 3 in womens health 1
  Emergency commenced their applications
• 4 further in palliative care approaching final
  approval
• Further 13 candidates in emergency

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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 NP
• 4 NP courses leading to registration as an NP in
  WA

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Whats Happening in Tas
Protecting the public through excellent nursing
practice

• Goals
• To develop a framework for the nurse practitioner
  role in Tasmania
• Recognition of the role
• Defined scope of practice
• Regulation
• To develop and pilot nurse practitioner models in
  collaboration with professional and regulatory
  bodies.

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Whats Happening in Tas
Protecting the public through excellent nursing
practice

• Outcomes
• Better access to specialist nursing services that
  are responsive to the needs of the population
• Strengthen multidisciplinary care
• Improved utilisation of nurses with advanced and
  extended clinical skills

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Protecting the public through excellent nursing
practice

• Phase 1 Phase 2-looking at
• Rural Health Sexual Health
• Mental Health Forensic nursing

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Protecting the public through excellent nursing
practice

• Completed or under development
• Business case Template
• Nurse Practitioner Pilot Guide
• Guidelines for Mentors
• Criteria for scope of practice
• Legislative changes

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Protecting the public through excellent nursing
practice

• Agency Policy for endorsement of clinical
  guidelines
• Guidelines for clinical privileges and clinical
  reviews
• Authorisation process
• Statement of Duties

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Protecting the public through excellent nursing
practice
Pathways Leading to Authorisation as a Nurse
Practitioner
Pathway 3
Pathway 2
Pathway 1
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)
Nurse holding Master of Nursing (Nurse
Practitioner) qualification, supported by a
portfolio demonstrating clinical experience and
expertise
Submission of completed Nurse Practitioner
Application Package
Submission of completed Nurse Practitioner
Application Package
Interview
Interview
If approved
Interim authorisation by Board
If not approved
Undertake and complete required academic
education as determined and accredited by Board
Authorisation by Board
Appeal Process Section 72 of the Nursing Act 1995
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www.nursingboardtas.org.au
Protecting the public through excellent nursing
practice