APPENDIX B –
NEW ZEALAND AND UNITED KINGDOM: LEGISLATION AND POLICY
(Appendices N.Z. - 35 to U.K. -41)
SCOPE OF PRACTICE FOR REGISTERED NURSES IN THE EXTENDED CLASS (NURSE PRACTITIONERS): A JURISDICTIONAL REVIEW - NOVEMBER 2007
TABLE OF CONTENTS
Page
NZ – 35 Nursing Council of New Zealand: Scope of Practice………….. 3
NZ – 36 Nurse Council of New Zealand: Nurse Practitioner Endorsement – Guidelines for Applicants …………….………… 9
NZ – 37 Extract from New Zealand Gazette, 10/11/2005, No. 188 p. 4750: Medicines (Designated Prescriber: Nurse Preactitioners) Notice 2005 .…………………….………………………………….. 34
NZ – 38 Regulations of New Zealand: Medicines (Designated Prescriber: Nurse Practitioners) Regulation 2005 - Schedule Substances That are Nurse Practitioner Medicines if They are Prescription Medicines ………………………….……...…………. 35
UK – 39 Nursing and Midwifery Council: Advanced Nursing Practice Update 19, June 2007……………………………………..………. 71
UK – 40 Nursing and Midwifery Council: Nurse Prescribing and the Supply and Administration of Medication Position Statement..…………………………………………………….……. 73
UK – 41 Nursing and Midwifery Council: Guidelines for the Administraion of Medicine Nurse , January 2004…………………………………………………………..……... 82
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Appendix N.Z.- 35
Nurs(n9 Counci,t of New ZeaLand
Scopes of practice
:_;, On 18th September 2004 the current registers were replaced by four scopes of practice under the Health Practitioners ._...... Competence Assurance Act 2003. There has been a smooth .... transition for nurses to the new scopes of practice. Every nurse who was on the register or roll was transferred onto the new _ register with the appropriate scope and conditions on 18 September. These are outlined in the table below.
The four scopes of practice are" registered nurse, nurse ._.... practi!;ioner, nurse assistant and enroJted nurse.
...... The new scopes and qualifications are described below. Please ,_ note that these qualifications relate to nurses applying for registration in a scope under the new Act. Nurses previously :, registered under the Nurses Act 1977 were automatically transferred into these scopes of practice.
_ NURSING COUNCIL OF NEW ZEALAND
Jn_,, ....." NOTICE OF SCOPES OF PRACTICE AND RELATED QUALIFICATIONS PRESCRIBED BY THE NURSING COUNCIL , OF NEW ZEALAND0
Pursuant to section 11 (1) of the Health Practitioners Competence Assurance Act 2003 ("the Act"), the Nursing Council specifies the ...... following scopes of practice. Pursuant to section 12 of the Act, the ....._ following qualifications are prescribed for each scope of practice.
1. Scope of Practice - Registered Nurse
Registered Nurses utilise nursing knowledge and complex nursing judgement to assess health needs and provide care, and to advise and support people to manage their health. They practise independently and in collaboration with other health professionals, perform general nursing functions and delegate to and direct Enrolled Nurses and Nurse Assistants. They provide comprehensive nursing assessments to develop, implement, and evaluate an integrated plan of health care, and provide nursing interventions that require substantial scientific and professional knowledge and skills. This occurs in a range of settings in
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partnership with individuals, families, whanau and communities. Registered Nurses may practise in a variety of clinical contexts depending on their educational preparation and practice experience. Registered Nurses may also use this expertise to manage, teach, evaluate and research nursing practice. There will be conditions placed on the scope of practice of some Registered Nurses according to their qualifications or experience limiting them to a specific area of practice.
The Nursing Council Competencies for Registered Nurses describe the skills and activities of Registered Nurses.
Qualifications
New Zealand Graduates
a) A Bachelor degree in nursing (or an equivalent qualification) approved by the Nursing Council of New Zealand, AND
b) A pass in an assessment of Nursing Council Competencies for Registered Nurses by an approved provider, AND
c) A pass in an Examination for Registered Nurses.
Registered Nurses from Overseas
a) Registration with an overseas regulatory authority, AND
b) An equivalent international qualification, OR
c) A pass in an assessment of the Nursing Council Competencies for Registered Nurses by an approved provider, AND/OR
d) Successful completion of a programme approved by Nursing Council for the purpose of assessing Competencies for Registered Nurses.
2. Scope of Practice - Nurse Practitioner
Nurse Practitioners are expert nurses who work within a specific area of practice incorporating advanced knowledge and skills. They practise both independently and in collaboration with other health care professionals to promote health, prevent disease and to diagnose, assess and manage people's health needs. They provide a wide range of assessment and treatment interventions, including differential diagnoses, ordering, conducting and interpreting diagnostic and laboratory tests and administering therapies for the management of potential or actual health needs. They work in partnership with individuals, families, whanau and
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communities across a range of settings. Nurse Practitioners may choose to prescribe medicines within their specific area of practice. Nurse Practitioners also demonstrate leadership as consultants, educators, managers and researchers and actively participate in professional activities, and in local and national policy development.
The Nursing Council competencies for Nurse Practitioners describe the skills, knowledge and activities of Nurse Practitioners.
Quafifications
a) Registration with the Nursing Council of New Zealand in the Registered Nurse Scope of Practice, AND
b) A minimum of four years of experience in a specific area of practice, AND
c) Successful completion of a clinically focused Masters Degree programme approved by the Nursing Council of New Zealand, or equivalent qualification, AND
d) A pass in a Nursing Council assessment of Nurse Practitioner competencies and criteria. Nurse Practitioners seeking registration with prescribing rights are required to have an additional qualification:
e) Successful completion of an approved prescribing component of the clinically-focused Masters' programme relevant to their specific area of practice.
3. Scope of Practice - Nurse Assistant
Nurse Assistants assist registered nurses to deliver nursing care to individuals in community, residential and hospital settings. They perform delegated interventions from the nursing care plan to provide care and comfort for individuals and groups, assist and support clients with activities of daily living, observe and report changes in individual/group conditions and behaviours, safe guard dignity and promote independence and health and safety. The Nurse Assistant does not undertake independent nursing assessments or plan and evaluate nursing interventions. Nurse Assistants may be required to practise in a specific area based on the area of focus in their education programme and designated on their practising certificate.
The Nursing Council competencies for Nurse Assistants describe the skills, knowledge and activities of Nurse Assistants.
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Quafifications
New Zealand Graduates
a) Successful completion of a programme approved by the Nursing Council, leading to a certificate at level 4 on the New Zealand Qualification Authority - National Qualifications Framework, AND
b) A pass in an assessment of the Nursing Council Competencies for Nurse Assistants by an approved provider, AND
c) A pass in an examination for Nurse Assistants
Second level nurses from overseas
a) Registration/enrolment with an overseas regulatory authority, AND
b) An equivalent international qualification, OR
c) A pass in an assessment of the Nursing Council Competencies for Nurse Assistants by an approved provider, AND/OR
d) Successful completion of a programme approved by the Nursing Council for the purpose of assessing Competencies for Nurse Assistants.
4. Scope of Practice - Enrolled Nurse
Enrolled Nurses practise under the direction of a Registered Nurse or Midwife to implement nursing care for people who have stable and predictable health outcomes in situations that do not call for complex nursing judgement. The responsibilities of Enrolled Nurses include assisting clients with the activities of daily ' living, recognising the changing needs of clients and performing delegated interventions from the nursing or midwifery care plan.
Qualification
Completion of a programme and examination approved by the Nursing Council of New Zealand leading to enrolment as a nurse successfully completed before 2000. This scope is not open for new applicants from New Zealand or overseas from 18 September 2004. Applicants from that date will be registered as Nurse Assistants.
How nurses were transferred into the new scopes.
6
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The following table outlines how registration under the Nurses Act translated to the new scopes of practice.
Scope of Practice under Registration the new Act under the Nurses Conditions Act 1977 (effective from 18 September 2004)
Registered Comprehensive Registered Nurse Nurse
Registered May practise only in General & Registered Nurse general and Obstetric Nurse obstetric nursing
May practise only in Registered Registered Nurse mental health Psychiatric Nurse nursing
May practise only in Registered settings which Psychopaedic Registered Nurse consumersprovide serviceswith for Nurse intellectual disabilities
May practise only in RegisteredGeneral Nurse Registered Nurse general nursing
May practise only within a maternity
ObstetricRegisteredNurse Registered Nurse directionsetting underof a the midwife or a medical practitioner
Enrolled Nurse (educated before Enrolled Nurse 2000)
Enrolled Nurse May practise only in (educated after Nurse Assistant a specific 2000) designated area of practice
May practise (and
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prescribe) only Nurse Practitioner Nurse Practitioner within a specific designated area of practice
Registration - Annual practising Curtificates Ed_ucation- ivlidw_fer;.,- Corporate -.,Publications News.and iss_._.s- Links - Cont_:_ctDetaiis- Homepage
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9 ABC000002009
NURSE PRACTITIONEff " ENDORSEMENT
GUIDELINES FOR APPLICANTS
10 ABC0oooo2 o10
ISBN 0---90P,662-.10----C_ 11 ..... ABc()-o00o2o11
!i fill!!!i i !_!i!_:i!i/!!!!_i?ii!
Page
Message from the Chair 5
Introduction 7
Overview of the Assessment Process 7
Applications 9
° Application Criteria 9
• Tips for Portfolios 9
• Content 10
Desk Audit 12
Educational Ectuivaience 12
Preparation for Panel Assessment 14
Panel/-\ssessment 1.5
Nursing Council Decision 16
• Review process 16
Appendices
• Appendix 1: Application Process:Detailed Flow Diagram 17
• Appendix 2: Nurse Practitioner TMCompetencies 19
• Appendix 3: Application Form 22
• Appendix 4: Evi(lence Recorcl (excerpt! 23
12 ABC000002012
13 ABC000002013
New Zealand's first nurse practitioners have now been recognised by the Nursing CoL_ncil, transforming a policy direction into a new real ity of hea Ith s(,rvice delivery.
Our new nurse practitioners join the tradition of innovation in New Zealand nursing. Council acl The regulatorv fiame_:ork rot nurse practitioners has been developed to support Counc, ii in meeting its public safety mandate under the Nurses Act 1977, ensuring that New Zealanders receive safe health care from registered nurses. With the endorsement of our first successful applicants, Council has taken the opportunity to further develop policy supporting the assessment process for nurse practitioner TM applicants. These guidelines reflect this development and are designed to inform anct assist applicants through the assessment process. AnnetteHuntington Chair Nursing Council of New Zealand 14 ABC000002014 15 ABC000002015 lhese guidelines h,lve been (te_el_tped to assist nurses who are considering Inaking an application to hecome a nurse t)ractitioner r''. llqe guidelines provide information about submitting an apl)',i(:ation and the pro(:ess ol:assessment {or nurse practitioner r'.' endorsement. Intending applicants should also read '-rhe Nurse t)ractitionerrM: Responding to Health Needs in New Zealand' fSeptember 2002) for further information on nurse practitioners in New Zealand. The flow diagram beiow out[i nes tile appli(:ation and assessment process for nurse practitioner ],'_enclorsernent _ Alq:_LICATION ASSESSMENI F _Ei A :.A(t(:)N N_IRSING WITH DESK OF F(.__ P,,,N [iL COUNCIl° PORTFOLIO AUDIT EDUCATIONAl. ASSIi'.:_SM f.N T EQUIVALENCE ASSESSM_NT DECISION ° Appli(ation • Review of ° l)oesthe • Review of • Assessn;_m! ° (:ouncil comple(ed portfolio for a[u_licanl I).:_rtf(_iio int,'rvim,.. (.onsi(ler,tti_n • Suim]ission ol _ompletenuss dumou ,,_,pplicam ( oum.i Council Pa,,.,l Panel NuE.dng Council _liA detailecl diagranl or the asse.',sment )rocess is attached as/xppundi',: 1. @ 16 ABC000002016 The aim of the assessment process is to provide for streamlined peer evaluation of the applicant's nursing practice. The key questiof_ addressed by the assessment process is: "Does" the at;p#c_nt meet the criteria and' defined competen_ie_ for a nurse p_'a(/itione_' _-_.t_, The c_n_petencies recl_ir_,_:]ol n_JrseF)ra_titi()ners are included as Appendix 2. The role of the Nursing C()url(. i] ]FIapproving nursu practitioner T,v,endorsements is to project pubiic sal:etyby erlsuring that the asses_;mentprocess conforrns to set standards, including the requirements of the Medicines Act 1981 for those applicants seeking prescribing rights. The Council a]so I:acilitates the process of assessment for both applicant alld __ssessm,ent panel. Assessment panels have the key role ol undertal,,ing a peer evaluation of an applicar_t's practice and mal Assessment panels are drawn irom nonlirlations by the nursing proi:ession and may also, if appropriate, i_/( lucle a consumer _._rother heaith professional working in an area ot practice closely aiignecl to thc:,al)plicant's defined scope of practice. Applicani.s Seeking Prescribing Rights The overall assessment process for applicants seeking prescribing rights is the same as for those applying to become nurse practitioners who do not wish to be able to prescribe. However, applicants seeking prescribing rights will have to demonstrate that they meet all nurse practitioner r,'_competencies related to prescribing and all relevant regulatory and educational requlrements. Nurse practitioners who later decide to af}ply for prescribing rights will not be required to re-submit Hleir portfolios but will undertake an approval process related to the competencies k_r prescribing only 17 ABC000002017 lb apply you must c+_m[>[etethe official app[k:ation form, which includes a statutory deciaratk)n (Appendix _,+. A pc_rtfo]+odescribing and veri{\ ing your l>r<:cticemust accompany your application. The f;,url_()sc:! (it the i_<_rl_oiic__sto ensure If/at: • Your application _s ready t:or formal review t)v the assessment panel • The assessment panel has all the inforn'lation it needs to assessyour application. There is also an application fee of $200.-flits fee has been set for the 2002/03 year and is likely to change annually. II ''l-':__"licali(;)rl[.,t77;Ti_,r<:s The foil In addition to lhe al)tJv.:_.,the 2 k_,_,a' ,reas on which assessment oi: al.)plications is based are that the applicant: • Holds a Clinical Masters degree or recognised equivalent, and ,' Demonstrates the competencies for advanced practice. The portfolio is your opportunity to describe and provide evidence of your nursing practice/_' There is no set format, t [owever, iriformati_n should be clearly presented in sections, divide{t bv tabbed inserts. Use an ind_--,xand page r_umbering. Remember that assussment p,_nels will need t¢>be able t_ easily find illl:ormation within the portfol to. Documents included iil your i.)oiltolio as &k_._i[[t <_',l:_pl,? /. examples of your practice shc;ulclbe signed The NursingCouncil welcomes inquiries by y()urseli:and by '_ Asseml')lir_ga portfolio is .,i_il 18 ABC000002018 When you forward your portfolio, please do not inctude original documents - use photocopies that have I_een\.erifiect as copies of _.>r[ginals. Portfolios should be a_,sembled with the need for photocopying in mind. ]his means that plastic sleeves (page protectors) should not be used and no spiral or other binding apart from a sturdy ring binder. (:()re areas ()f d(_(u _(nrati,_rl tu I)e included in y_ur portfolio inclu(le: • ,i !_; {,;_ ,,__.It_e (.()_nl_iet_,(Nursing Council application form which includes a statutory dec]arali,)n venl;ing your professional standing. • ..,_,,...... ', ,, -,_,,t{_I._,{.,._;{, ,-,; _ : !,ra, ti,..,-:_This should include identification of the range and parameters oi: your practice an(] your area of specialty/sul)specialty if applicable. The scope shuuld reflect the dynamic nature of health care and nursing and advanced l)ra(_tice coml)etencies. It should reflect collaboration with nursing and other co'leagues working in the same scope. You shuuld als() identify strategi_,_ !ha! \.ou I/ave in place to maintain and devel() i) your coml.)etence wilhin VOLIr S(._(}[) :' (H" practice. • i,:{-;__e,:;_"The names and c_n{act Note: If you include an established details of 2 confidential referees able scope statementdeveloped by a group to comment on your current nursing of nursing colleagues (for example, those developed for nurseprescribing), practice must be provided, You may you should describe how your own also wish to include written letters practice relates to this scope. of support/references supporting you r application. This is a good idea but does not replace the requirement for names of confidential referees with an up to date km_vvledgu {)f ,,,our nursing practice. • _;:_:.: , _ . ' ," TI]c,_)utc()mes _t-pr{)l:e._si()na]performance review/peer evalLJations {optic)n_lJ. • i:ilu, ,_!_{::,,al,..,,,...... :;: ,'i_, _,_:This must inclucle evidence of programmes completed- - If you have completed an approved Clinical Masters Programrne you will need to forward a verified certificate and transcript. You may also wish to include evidence of other programmes undertaken relevant to your practice. --- If y'ou are seel • /\ CLirli(:'l[LilY_ ,.._ ,;_-{):ill i : '_i _,!,'d_ 'V.)FI.: iqiS!t,_'. Where your practice has developed over a range oi_nursing positions held, it is helpful for assessment purposes if the curriculum vitae summarises key achievements in individual positions (and related to the competencies for nurse practitioners) to highlight the development of practice over time and with cumulative experience. 19 ABC000002019 Examples of these might include: Remir_der! --- Case studies Youshould signtheseitems Exemplars and havethem verified by --- Quality devel_pm_u/t _nitia!iv_s incIuclin_ policies a second person able to cleveIoped _ attest to their accuracy. C-.]ientcase notes '..i_l_luding annotated interpretation Note otcontentasal:.)prol)riate_ Verifications should - Educational programmes delivered inc ude the signature of the person verifying the -- A diary of a typic:a[ working week, outlining your content, their role (e.g. range (.)l:activities etc. colleague,patientetc)and the date. When developing the above, you shoulct include analysis inclicating reflective :_ractic:e and knowledge of legal and professional requirements. • = :/ - LabellingYour t_orffotio - Publications including bibliographical references (onlen! - Research" A synol.)S soi: research undertaken, Labelling is important! The including the t_rolx_saJ,_tesign,results and Ohltcomes shouldcontentbeofreferencedyour portfoliosothat .... Presentations/teaching activity including details of the assessmentpanel can the contexts in which i)resenta!ions were delivered, understandhow a particular item relatesto yourpractice. ° Mentbershi[_ anti rl\'r)lvuitqent in proi:essi_na[ Forinstance, ifyou include a policy or protocol, attach orgal_ization,_ and activ]t _:_(!_)r example working a reference that describes part_:...,,slocal regic_n,_l_r nalional committees etc). how/when itwasdeveiopect Include information that clescri[_esyour contribution and your role in its to professional _rga nizations, development. - Current practising c_:._rtificale -- Qualifications ,._chJeved - Where relevant, oulcomes _f other professional credentialing processes e.g. PND/CCP ieve[. Please note that a nursling focus must be evident within the portfolio. Thisincludes reflection of nursing values and beliefs, and nursing perspectives rather than just a task or skill based approach. N,_ed t4eil.tt_,'ith your Application? The four majorprofessionalnursingorganisationswhich makeup NPAC-NZare available [o support nursepractitioner t'_ applicants: • College of NursesAotearoa • New Zealand NursesOrgantsation • Australia, New Zeatand College of Mental Health Nurses • National Councit of Maori Nurses NPAC-NZ(the NursePractitionerAdvisory Committee of New Zealand) is a new group that will undertake a leadership role for the strategic development of the nurse practitionerT_ role in thiscountry.The group will also havean important role in advising Nursing Council on the develeprnent of supporting processesfor nursepractitioner r,'_ endorsement and in researchand evaluation related to implementation of the nurse practitionerT'_ model. 20 ABC000002020 Once completed applications and portfolios are received by the Nursing Council, a desk audit is completed by Council staff. The purpose of the desk audit is to carry out a preliminary assessment of the portro[io to: • C:(mfirm the g_)(_:ti):oI_ss_c:_rla]standing of the aj)l)[i_:ant • Assist applicants to provide all _equired information for review by the assessment pane[ • Confirm that the applicant's practice apl:)ears to meet the coml)etencies for advanced pra(:tice • Confirm that the applicant's (.[inica[ educational [)reparatkm is at Masters or equivalent level. Initiaily, the sulm_Jue(I t_orm:_[i_,is cllecke(I for compleleness by Coun(;il staff. 1his stage of the assessment process may involve some ongoing dialogue between '>,ourself and Nursing Council staff as yo_Jworl< to finalise presentation of '>,_)ur practice for formal panel assessment. iiiii_iiliiiii iiliiiiiiiililiI _ iliiiIliiiiii _ iI :...... Educationalequivalenceisassessedby theEducationCornmitteeofthe Nursing Council. The processforde.terrniningedu_ationa[equivalencerecognisesthatnLlrses r11a'>,' actnieve advan / ...... , ,, _, ', eDucatIoNalIREI} ) ARATI()N IPRACIICE :,::: Courses undertaken -Jr- Within an identified _> relevant to identifiecI scope scope of practice :: : ...... , " .... _ Developmentof Practice..... @ 21 ABC000002021 In sumrnary, tile concept ol e(la_atJonal equivalence acknowledges the dewqopment of practice to an a(Ivav_c_,dieve! via a mix ol: clinical experience, educational programmes undertaken and reflection on practice. When assessing educational equivalence, evidence is required of the applicant's ability to integrate theory, research and practice. The applicant must be able to demonstrate the app[i(:atic:ul of nursing frameworks to her/his practice and the application of critical thinking and evidence as the basis of clinical decision making. These are the sorts of questions education Any MastersProgrammewith reviewersmightaskwhen assessingeducational direct relevance to an equivalence: _ applicant's scopeof practice Clinical Mastersprogramrne.Does this relateto equivalency. her/hiscurrent scopeof practice? Has thetheapplicantapplicantcompletedcompletedanotheran approvedMasters / can be considered as part of Prograrnme?Is the applcant's Mastersdegree directly relevant lu her his scope of practice? ,_f ...... Has the applicant developed her/his practice through a rnix of attending relevantpostgraduate _,. , educationprogrammes/experienceandreflection _" "\"-_ ..._ on practice? Has the af)plicant-been involved in other activities such as participation in research?Isthe outcome a practitioner who is practising at an advanced level? r...... 22 ABC000002022 i ',,'1,tII E'I| ,] IIe] .... I When all requirecl documentalion is prusent and an applicant has established her/his readiness for formal assessment, an assessment panel is convened. The role of the assessment panel is to fully evaluate applications against the competencies for a nurse practitioner _,'4. R_ do this the panel works through a number of tasks prior to the assessment interview iilcluding: • _:-"_ti_ir l,:!:<::,. i__ Full review of theai)plicant'_l)Orlfolio. Panels mav request adcli_ional inf_urr_,_ti_m fi-_ut_ a!_plicant_,. • i.,. i,:r;,r_, _, C:_n_iduntia] reteree's report_, tr_:>mindwiduals norninated by the al)plicant. Fhe panel may also requust permission to seek further rei:erences. • -:,if,,::,vi,,it,-,: A nominated panel member may undertake a visit to the applicant's workplace before and/or following the assessment interview. The panel will decide if a site visit is necessary. The purpose of site visits is to observe the applicant's scope oi: practice in her/his usual practice setting. Assessment Pa[1_e[s Generally panels will have around four members. Some roles may be Each assessment panel mav include members combined. For example, the with the following roles: advanced practice nurse may also • A professional nurse leader with be from the same scope of practice national/international understanding of as the applicant. advanced nursing practice • A nurse with expertise in education. experienced in the assessment of advanced competenc_es • A nurse practising at a_lvanced level with ability to critique practice • A peer from the samu clinical scope as the applicant, not necessarily a nurse • Another member as appropriate, for example, a consumer. Right _3fAppeal: You may elect to challenge a panel Note: Up to 2 Nursing Council staff will also member if you believe that (s)he be present at panel assessments to provide may have a conflict in relation to administrative support and to ensure consistency, your application 23 ABC000002023 The purpose of the ass ,ssment inlervievv ;sto give ,,ou at7opportunity to present you r practice and \o,,l_ a,hi,,_ _,n_ent of l_urse practitioner _'' competent ies. Tlle interview also ailov,,s tl_e t>aneJt(> explore with yC_LIthe content oI your portfoI (_ and to clarify in more{lei_th ;.'_ur scope ,,>fnursing practice. Key areas of focus within the interview may incIu(le: • Defining your scope ol prac:tice (.independent and c_)'[aborative' S_i)[;v.:_rJ:fc_rApplicants including bounciarius ,/r_(l ho;\ Youare welcome to bring a support person you bring the unique to your assessment interview.' Usually the ' role of the Support person is that of support perspective of nursing to your for theapplicant rather than taking an active practice role in the interview process. • Strategies used ior_ssussn_erTt Howeveb should you wish to de so,you may of client/patient he.l[tt_ lleed,, formally request that your supporter(s)rnay (groups/individuals) address the assessmentpanel prior to the • Application of nursing commencement of the panel interview. knowledge and eviclence based practice • Reflective practice • Innovation in practice and developmer_t of new nursing I A date is set for the assessment intervie,.;, in consultation with the applicant, once the panel's preparat_)r\'w(_rk :scompIete. You should expect theformal panel interview to take al)()ut tvv_ hoLlrs. The panel will tnilor inter-vi(*v_ questions aloul_d t"e E,,,idenc_-Record competencies {oi a nu_e The evidence record is the tool used by practitioned ''_,so as t_>;)e able to assessmentpanels to evaluate:whether an explore in depth the various applicant has demonstrated achievement of advanced nursing competencies. aspects of your clinical practice. You may be asked to t)resent a Thetool outlines possiblesourcesof evidence relating to each competency. Forinstance,a particular aspect of your practice competency may be demonstrated through and to respond to simulated responsesatinterviewand/orthroughwritten scenarios related to your scope ot evidence in a portfolio and/or via referee's practice. You rnav also rectuest the reports. opportunity to pre_(-,nt.in ar_,a_)_ T(_)illustrate the process,part of theevidence your practice l_ the I<._e]. :_r record usedby assessmentpanelsis included as Appendi'<4. example, a researd7 t;roj_,_.t tl_at you have undertaken. Following completion oI: the assessment interview, the assessment panel completes its formal evaluation using the evidence record 'which is based on defined nurse practitioner T'v'competencies. If panel nTembersare not satisfied that they have enough 24 ABC000002024 information to cumpk:,tc, tt_eir e_aiuation, they may request tile applicant to pro\,'ide further information and/or con_plete l:urther rel:{:,rencechecking and/or a site visit. When the assessment panel has completecl its cteliberations, the outcome of the assessment is documented in a report and a recommendation is made for the consideration of the Nursirlg Council. The report of the asse,_,_mentpanel ,,rill be considered by the Nursing Council at its next meeting. Successful applications will be granted nurse practitioner ;'_ endorsement with either -- Nurse Practition_,r _': (_,cope o! practic(_) enterecl against their registration - Nurse Practiti_ner _'_ sc,)pe of practice) with endorsement lor prescribing entered against their registration. A certificate denoting nurse l)ractitioner r,'' endorsement will be issued. An updated practising certificate with nurse practitioner _Mendorsement will be issued on return of a current practising c{:trtil:icate. The endorsement will normally be valid for five years. Nurse practitioners will be required to maintain an up to date portfolio for five },earl}, review and will also be subject to rand(_m audil once competency based practising certificates are introduced. "' Review pro(:es_ Unsuccessful api,)licanls will I:)egiven the, opp(_rtunity to request a review of the assessment decisi(_n. Reviews will be heard !)v the Nurse Practitioner f'' Review I_u-_el,an independent panel established hv 1he NursiJ_g Council. • That there are issue,_o[ iustice and fairness relaled to the assessment process • 1-hatthe decision is clearly incorrect in fact. Applicants must n{_til:v their intention to seek a review within 28 days of being notified by Council tl_at tl_,., were unsucc essl:ul. A i:eeoi: $50.00 is payable to the Nursing Council. Review submissions may be presented in writing or in person by the applicant. Reviews may not be I)ased o_ [)resentation of new information relatect to an applicant's practice. If a { andida,,e wouht like new ini:ormation t_ be considered in support of their app]i(.ation, tills becomes part of a new application process. The Nurse Practitioner ]_'_Review Panel reports its decision to the Nursing Council who will formally notify the applicant o{ the outcome. 25 ABC000002025 NLJt{.S_::PRAC1ITIC)t'-_I!!!Rr'_ Pl¢;()Ci:.!_;:qDEI-All !!!!Dfl"-'...... _"...... _\',' i),tAG P " _"" O Application and Portfolio submitted Desk audit of portfolio "_ Portfolio "qu Required documentation Received within \_i_ :i_i!_0_i_: complete? _ requested from applicant 6 months? -- _ : i:_.!!!iiii!!!_::i:!i_i,_ " !i:_ l ..... ; ,,,q Nursing Council ",, _Z_ Assessment o7 ...... _ Sufficien information --_ Information provided ApprovedM asters?Clinical educational equivalenc_ " .... in portfolio? q by' applicant Proceeds to assessment __ ...... Applicant demonstrates panel Educationa I equ ira lence? ,1n • Panel convenes to assess portfolio Ap_lican_ declifi_d • Reference checks _d no_i_ie¢i o_ completed rev'_!ew_:'_process_".... • Requirement for site visit assessed Panel assessment _-_ Panel has sufficient _' Applicant _:_."k_" Recommendation to interview inforrnat on to make ...... *" meets criteria Nursing Council decision? Further evidence . A Nursing Council gathering as required. Site : _- Decision visit may be arranged at / this stage >.,; .[ v,.... 26 ABC000002026 27 ABC000002027 () " _" m .... _--tli(ti.... )_ ,: f:r"_trsi_2_ il]r,._(!.CO and its ]he nurse practitioner r,'',is able to: • del:ine the scope o independerlt/co]lal)orative nursing practice in health promotion, maintc!n , i 1 _ I Si-,_ I;: :,:1 ',, _tli\ i);/[l]_:'"!_'- -[he nurse pra(:titi_nel _' ' • demonstrates culturally sale practice • uses professional judgement to: ..... assessthe client's health status - make differential diagrlc_ses,"implernent nursing nterventions/treatments - refer the client to o!her health l)rofessi_nals • develops a crealivc:,, inr_a!w_ approach to client care and nursing practice • illallLi_es Cc)llll);(!t ,,,}[u !!i[ 28 ABC000002028 -File nLir. • takes a leadership role in complex situations across settings and disciplines • demonstrates skil[ecl mentoring/coaching and teaching • leads case review and debriefing activities • initiates change and responds proactivelv to changing systems • is an effective nursing res_)circ(._ • participates in profe<_siona[<_Ul-)ervision. I )(.7.(:. (.)_):;,,:tri(! i _1__1(:"](.c_:':.S" i3, '7:Ii ....h/:_;( _c 3()-(2_;()f/()!1-1ic [)() i( l( '<:, ,,:.:_r_cir)ra_: :' _ Jc:,(:ala,(.l _-_,._!i_:,r);Tilevel The nurse practitioner'_'_: • contributes t<>and t),_rticip. 5 ,(.) ...... qh()w <:,<....-,_,;:,,,,<,ri7 i_'<"'--<:'_".....r(;it in(:_cii r_ __l(_ nursi n<::>aI:)ra'::ti'::e. The nurse practitioner r,'_ • evaluates health outc:<,rr_es and in response helps to shape nursing practice • cletermines evidenc<;-hasect practice through sctlolarship and practice • reflects and critiques the practice of self and others • influences purchasing and allocation through utilising evidence-based research findings. 29 AB6000002029 6 {) l;_r¢_scrii;_-_: ir,..-1_::_,'_'_ ¸' ' ______,,, ...... I _ The nurse practifi_ner ',',_seeki_g t_re_cribing rights: • uses proi:essional judgement to prescribe • collaborates and consulls with, and provides accurate information to, the client, the client's l:ami[y and other health professionals about prescribing relevant interventions, appliances, treatments or nledicaiions • prescribes and aclministers n/edicati_ns within legislation, codes, scope of practice and acc:ording t_ Ihe established prescribirlg process and guidelines • un(ierstarld_, the_ u_,e, irr_i_i <::,_tions,c_)ntr,._--incli(_ations,and inlera__t[ons of prescription r_le([i( tti,.._n<._',\'i!h eacl_ _'_thera_d with a!ternatiw#traditi(mal/ complementary m<:_dicine and over-the-cout_ter r-ne_lications/appl[ances • understands the agu-re[ated implications of prescriptive practke on clients vvithir_ the particular scope • evaluates the effectiveness of the client's response to prescribed medications, and mon itors dec isions about prescribi ng, ta king rer'nedial action and/or referring accordingly • demonstrates an abilhy to limit and manage adverse reacti_;ns/ernergenc es/crises • recognises situati{.Jns of drug misuse and acts appropriately • understands the regulatory i:ramework associated with l)rescribing, including the legislation, conlra{:tua[ eiwironment, subsidies, professi{)na[ ethics, and roles ot: key g_wernr,_ent agent. ies. 30 ABC000002030 m /_l::_l:_il_..,.!'_{l{)_ i__ _'!';. _:._!i_I_I li )_"_i.,. _:I_,_II_)I_(!'__._F_I Surname: Given Names: Address: Phone(hl: ...... l_h_ne!,w): ...... Mobile: Emai[ _-\ccress: Date of Birth:_ Registratic)n Number: Purpose of .---_,pptica{io_,:t:)e_:ta_a{,io__:: Thisapplication and declmation he/o_, must accompan> your portfolio. I declare that: a) the ini:ormation given by me in support of mv application for Nurse Practitioned ,'_ erlclorsernerH _strue and { orrect; and I)) that I am in q(J_(i l)r,:)fi,%i,:;_la[standini4 as ,_reqister_,ctnurse; and c) that I am not curren[ly subject t() any charge(s) including professional misconduct and/or been convicted oi: any offence against the tavv (apart from minor traffic convictions). If you are subject to an,,,.,of the above, please provide details below: I also give my authorisation {o the, Nursing Council to seek i:urther information as to my standing within n_y scope oI practice, if this is considered necessary. Yes/No Declaration I make this solemn declaration conscientiously believing the same to be true and by virtue of the Oaths and Declarations Act 195 _. Declared at this day of 2002 And signed by me In the i)resenc:e _)i tustice of the Peace. Solicitor./Notary Pub//c, Registrar of the Court, or other officer authorised to take .Statutorv l:)ecla,ratior_.srplease indicate c,.Itegorv). In accordancewith thePrivac_,'Act 1993,thepersoualinformationcollectedby theNursingCouncil of NewZealandiscontidentialto theCouncilandisusedforthepurposeof processingan application forendorsemento{thetitle NursePractitionerunde_Section24 of theNursesAct 1!)77and Nurses Regulations1986.TheCouncilmaydis{.Iosetheinl'ormaliorltoa third[)artyforprocessing/administrative purposesThe. applicanthasfi_eright{,Im c_-.ssto amJcorrectionof personalinformationhehtI%..the NursingCouncil. @ 31 ABC000002031 32 33 ABC000002033 Appendix N.Z. - 37 Extract from New Zealand Gazette, 10/11/2005, No. 188, p. 4750 Medicines (Designated Prescriber: Nurse Practitioners) Notice 2005 Pursuant to the Medicines Amendment Act 1999, the Misuse of Drugs Act 1975 and the Medicines (Designated Prescriber: Nurse Practitioners) Regulations 2005, the Nursing Council of New Zealand gives the following notice. Notice 1. Title and commencement--This notice is the Medicines (Designated Prescriber: Nurse Practitioners) Notice 2005 and comes into force on 8 December 2005. 2. The purpose--The Schedule to this notice sets out tile requirements that the Nursing Council of New Zealand ("nursing council") has determined must be met by nurse practitioners who wish to prescribe prescription medicines. These requirements are imposed under Regulations 6, 7 and 8 of the Medicines (Designated Prescriber: Nm-sc Practitioners) Regulations 2005. Schedule A Requirements for commencing prescribing (Regulation 6) The nursing council requirements for training that nurse practitioners must undertake before commencing prescribing for the first time are as follows: (a) (i) The completion of an approved clinical master's programme which includes demonstration of the competencies, to the satisfaction of the nursing council, for advanced nursing practice and prescribing applied within the defined area of practice of the nurse practitioner. The programme must include relevant theory, research and concurrent practice; or (b) (i) the completion of an equivalent overseas qualification which meets the requirements specified in paragraph (i) above; and (ii) passing an assessment against tile nurse practitioner competencies by an approved panel. B Other training to be undertaken (Regulation 7) Nurse practitioners authorised to prescribe within their defined area of practice, must undertake: (a) a minimum of 40 hours per year of professional development aggregated over a five year period; and (b) a minimum of 40 days per year ongoing nursing practice aggregated over a five-year period within their defined area of practice. C Assessments of competence to be completed (Regulation 8) Nurse practitioners authorised to prescribe must provide to the nursing council each year with their application for a practising certificate, evidence that they have maintained their competence. As part of this assessment, all nurses authorised to prescribe must provide the nursing council with evidence that they have completed the ongoing training required by paragraph B above; competence assessment; and evidence of ongoing multidisciplinary peer review of their prescribing practice. Dated at Wellington this 1st day of November 2005. MARION CLARK, Registrar, Nursing Council of New Zealand. gs7428 34 N_TI(":.I:: bin. 742R ABC000002034 Regulations of New Zealand Page 1 of 36 Appendix N.Z. - 38 M Medicines (Designated Prescriber: Nurse Practitioners) r,eF_....v,.I,at,._,.n::_:_005 Schedule Substances that are nurse practitioner medicines if they are prescription medicines Schedule Substancesthat are nurse practitionermedicines if they are prescriptionmedicines r4 Substances listed in this schedule are nurse practitioner medicines only if, and only in the forms and for the purposes that, they are declared to be prescription medicines by- " regulations made under the Act; or • a notice given under section !06 of the Act. 1 19-norandrostenedione 2 , 2,4-d initroch Ioro benzene 3 4-aminopyridine 4 4-chlorotestosterone 5 Abacavir 6 Abciximab 7 Acamprosate 8 Acarbose 9 Acebutolol 10 Acepromazine 11 Acetanilides 12 Acetarsol 13 Acetazolamide 14 Acetohexamide 15 Acetylcarbromal 16 Acetylcholine 17 Acetylcysteine 18 Acetyldigitoxin 19 Acetylmethyldimethyloximidophenylhydrazine 20 Aciclovir 21 Acipimox 22 Acitretin 23 Aconitum spp. 24 Acrivastine 25 Adalimumab 26 Adapalene 27 Adefovir 28 Adenosine 29 Adiphenine 35 http://www.legislation.govt.nz/libraries/contents/om_isapi.dll?clientlD=718422344&hits... 10/22/2007 ABC000002035 Regulations of New Zealand Page 2 of 30 30 Adonis vernalis 31 Adrenal extract 32 Adrenaline 33 Agalsidase 34 Alatrofioxacin 35 Albendazole 36 Albumin 37 Alclofenac 38 Alclometasone 39 Alcohol 40 Aldosterone 41 Alefacept 42 Alendronic acid 43 Alfacalcidol 44 Alfuzosin 45 Alglucerase 46 Alkyl sulfonals 47 Allergens 48 AIIopurinol 49 Allyloestrenol 50 Alosetron 51 Alphadolone 52 Alphaxalone 53 Alprenolol 54 Alprostadil 55 Alseroxylon 56 AIteplase 57 Amantadine 58 Ambenonium 59 Ambucetamide 60 Ambutonium 61 Amcinonide 62 Amethocaine 63 Amfebutamone 64 Amidopyrine 65 Amifostine 66 Amikacin 67 Amiloride 68 Aminocaproic acid 36 http://www._egis_ati_n.g_vt.nz/_ibraries/c_ntents/_n_ isapi.d_?c_ient_D=7_8422344&hits... 10/22/2007 ABC000002036 Regulations of New Zealand Page 3 of 30 69 Aminophenazone 70 Aminophylline 71 Aminosalicylic acid 72 Amiodarone 73 Amiphenazole 74 Amisulpride 75 Amitriptyline 76 Amlodipine 77 Ammi visnaga 78 Ammonium bromide 79 Amodiaquine 80 Amorolfine 81 Amoxapine 82 Amoxycillin 83 Amphomycin 84 Amphotericin 85 Ampicillin 86 Amprenavir 87 Amrinone 88 Amyl nitrite 89 Amylocaine 90 Anakinra 91 Ancrod and its immunoglobulin antidote 92 Anecortave 93 Angiotensinamide 94 Anistreplase 95 Antazoline 96 Antibiotic substances 97 Antigens 98 Antihistamines 99 Antimony 100 Antisera 101 Antithrombin III 102 Apocynum spp. 103 Apomorphine 104 Apraclonidine 105 Aprepitant 106 Aprotinin 107 Aripiprazole 37 http://www._egis_ati_n.g_vt.nz/_ibraries/c_ntents/_m-isapi.d__?c_ientID=7__422344&hits... 10/22/2007 ABC000002037 Regulations of New Zealand Page 4 of 36 108 Arsenic 109 Artemether 110 Articaine 111 Astemizole 112 Ataza navir 113 Atenolol 114 Atomoxetine 115 Atorvastatin 116 Atosiban 117 Atovaquone 118 Atropa belladonna 119 Atropine 120 Atropine methonitrate 121 Auranofin 122 Aurothiomalate sodium 123 Aviptadil 124 Azacyclonol 125 Azapropazone 126 Azaribine 127 Azatadine 128 Azath ioprine 129 Azelaic acid 130 Azelastine 131 Azithromycin 132 Azlocillin 133 Aztreonam 134 Bacampicillin 135 Bacitracin 136 Baclofen 137 Balsalazide 138 Bambuterol 139 Bamethan 140 Bamipine 141 Becaplermin 142 Beclamide 143 Beclomethasone 144 Bemegride 145 Benactyzine 146 Benazepril 38 http://www._egis_ati_n.g_vt.nz/_ibraries/c_ntents/_m-isapi.d__?c_ient_D=7_8422344&hits... 10/22/2007 ABC000002038 Regulations of New Zealand Page 5 of 36 147 Bendrofluazide 148 Benethamine penicillin 149 Benorylate 150 Benperidol 151 Benserazide 152 Benzathine penicillin 153 Benzatropine 154 Benzhexol 155 Benzilonium 156 Benzocaine 157 Benzoyl metronidazole 158 Benzoyl peroxide 159 Benzthiazide 160 Benzydamine 161 Benzytpenicillin 162 Bepridil 163 Beractant 164 Beta carotene 165 Betahistine 166 Betamethasone 167 Betaxolol 168 Bethanechol 169 Bethanidine 170 Bevantolol 171 Bezafibrate 172 Bifonazole 173 Bimatoprost 174 Biperiden 175 Bismuth 176 Bisoprolol 177 Bivalirudin 178 Blood clotting factors 179 Blood corpuscles 180 Blood, whole 181 Bolenol 182 Bosentan 183 Botulinum toxins 184 Bretylium 185 Brimonidine 39 http://www._egis_ati_n.g_vt.nz/_ibraries/c_ntents/_m_isapi.d__?c_ientID=7_8422344&hits... 10/22/2007 ABC000002039 Regulations of New Zealand Page 6 of 36 186 Brinzolamide 187 Bromocriptine 188 Bromoform 189 Brompheniramine 190 Bromvaletone 191 Buclizine 192 Budesonide 193 Bufexamac 194 Bumetanide 195 Buphenine 196 Bupivacaine 197 Bupropion 198 Buserelin 199 Buspirone 200 Butacaine 201 Butoconazole 202 Butorphanol 203 Butyl aminobenzoate 204 Butylchloral hydrate 205 Cabergoline 206 Calcipotriol 207 Calcitonin 208 Calcitriol 209 Calcium carbimide 210 Calcium polystyrene sulphonate 211 Camphorated oil 212 Candesartan 213 Candicidin 214 Capreomycin 215 Captodiame 216 Captopril 217 Capuride 218 Caramiphen 219 Carbachol 220 Carbamazepine 221 Carbaryl 222 Carbazochrome 223 Carbenicillin 224 Carbenoxolone 40 http://www.legislation.govt.nz/libraries/contents/om isapi.dll?clientID=718422344&hits... 10/22/2007 ABC000002040 Regulations of New Zealand Page 7 oF 36 225 Carbetocin 226 Carbidopa 227 Carbimazole 228 Carbocromen 229 Carbromat 230 Carbutamide 231 Carbuterol 232 Carindacillin 233 Carisoprodol 234 Carprofen 235 Carvedilol 236 Caspofungin 237 Catalin 238 Cefacetrile 239 Cefaclor 240 Cefaloridine 241 Cefamandole 242 Cefapirin 243 Cefazolin 244 Cefepime 245 Cefetamet 246 Cefixime 247 Cefodizime 248 Cefonicid 249 Cefoperazone 250 Cefotaxime 251 Cefotetan 252 Cefotiam 253 Cefoxitin 254 Cefpirome 255 Cefpodoxime 256 Cefsulodin 257 Ceftazidime 258 Ceftibuten 259 Ceftriaxone 260 Cefuroxime 261 Celecoxib 262 Celiprolol 263 Cephalexin 41 http://www._egis_ati_n.g_vt.nz/_ibraries/c_ntents/_nl-isapi.d_.c_ientID=7_84_)_344&hits... 10/22/2007 ABC00000204 ] Regulations of New Zealand Page 8 of 36 264 Cephalothin 265 Cephazolin 266 Cephradine 267 Cerivastatin 268 Cetirizine 269 Cetrorelix 270 Chenodeoxycholic acid 271 Chloral hydrate 272 Chloralose 273 Chloramphenicol 274 Chlorcyclizine 275 Chlormerodrin 276 Chlormethiazole 277 Chlormezanone 278 Chloroquine 279 Chlorothiazide 280 Chlorotrianisene 281 Chloroxyd ienon e 282 Chlorpheniramine 283 Chlorpromazine 284 Chlorpropamide 285 Chlorprothixene 286 Chlorquinaldol 287 Chlortetracycli ne 288 Chlorthalidone 289 Chlorzoxazone 290 Cholera vaccine 291 Chymopapain 292 Ciclacillin 293 Ciclesonide 294 Ciclopirox 295 Cidofovir 296 Cilastatin 297 Cilazapril 298 Cimetidine 299 Cinacalcet 300 Cinchocaine 301 Cinoxacin 302 Ciprofloxacin 42 http://www._egis_ati_n.g_vt.nz/_ibraries/c_ntents/_m_isapi.d__?c_ientID=7_8422344&hits... 10/22/2007 ABC000002042 Regulations of New Zealand Page 9 of 36 303 Cisapride 304 Citalopram 305 Clarithromycin 306 Clavulanic acid 307 Clemastine 308 Clemizole 309 Clidinium 310 Clindamycin 311 Clioquinol 312 Clobetasol 313 Clobetasone 314 Clocortolone 315 Clodronic acid 316 Clofazimine 317 Clofibrate 318 Clomiphene 319 Clomipramine 320 Clomocycline 321 Clonidine 322 Clopamide 323 Clopidogrel 324 Clorexolone 325 Clostebol 326 Clotrimazole 327 Cloxacillin 328 Clozapine 329 Cobalt 330 Co-dergocrine 331 Colchicine 332 Colchicum 333 Colecalciferol 334 Colestipol 335 Colestyramine 336 Colfosceril 337 Colistin 338 Collagen 339 Corticosterone 340 Cortisone and other steroidal hormones of the adrenal cortex 341 Co-trimoxazole 43 http://www.legislati_n.g_vt.nz/libraries/c_ntents/_m-isapi.dl_?clientID=7_8422344&hits... 10/22/2007 ABC000002043 Regulations of New Zealand Page 10 of 36 342 Coumarin 343 Crystal violet 344 Cyclandelate 345 Cyclizine 346 Cyclobenzaprine 347 Cyclofenil 348 Cycloheximide 349 Cyclopenthiazide 350 Cyclopentolate 351 Cyclopropane 352 Cycloserine 353 Cyclosporin 354 Cyclothiazide 355 Cyproheptadine 356 Cyproterone 357 Cysteamine 358 Dalfopristin 359 Dalteparin 360 Danaparoid 361 Danthron 362 Dantrolene 363 Dapsone 364 Darbepoetin 365 Datura spp. 366 Deanol 367 Debrisoquine 368 Deferiprone 369 Deflazacort 370 Dehydrocorticosterone 371 Delavirdine 372 Demeclocycline 373 Deoxycortone 374 Deoxyribonuclease 375 Desferrioxamine 376 Desipramine 377 Desirudin 378 Deslanoside 379 Desloratadine 380 Desmopressin 44 http://www.legislation.govt.nz/libraries/contents/om_isapi.dll?clientID=718422344&hits... 10/22/2007 ABC000002044 Regulations of New Zealand Page 11 of 36 381 Desogestrel 382 Desonide 383 Desoximetasone 384 Dexamethasone 385 Dexchlorpheniramine 386 Dexfenfluramine 387 Dextromethorphan 388 Dextrorphan 389 Diazoxide 390 Dibenzepin 391 Dibrompropamidine 392 Dichloralphenazone 393 Dichlorophen 394 Dichlorphenamide 395 Diclofenac 396 Dicloxacillin 397 Dicyclomine 398 Didanosine 399 Dienoestrol 400 Dienogest 401 Diethazine 402 Diethylcarbamazine 403 Diflorasone 404 Diflucortolone 405 Diflunisal 406 Digitalis lanata 407 Digitalis purpurea 408 Digitoxin 409 Digoxin 410 Digoxin-specific antibody fragment 411 Dihydralazine 412 Dihydroergotoxine 413 Dihyd rotachyste rol 414 Diltiazem 415 Dimenhydrinate 416 Dimercaprol 417 Dimethindene 418 Dimethothiazine 419 Dimethyl sulphoxide 45 http://www.legislation.govt.nz/libraries/contents/om isapi.dll?clientID=718422344&hits... 10/22/2007 ABC00000Z045 Regulations of New Zealand Page 12 of 36 420 Dinoprost 421 Dinoprostone 422 Diperodon 423 Diphemanil 424 Diphenhydramine 425 Diphenidol 426 Diphenylpyraline 427 Diphtheria toxoid 428 Dipivefrin 429 Dipyridamole 430 Dirithromycin 431 Disopyramide 432 Distigmine 433 Disulfiram 434 Disulphamide 435 Ditiocarb 436 Dobutamine 437 Dofetilide 438 Dolasetron 439 Domperidone 440 Donepezil 441 Dopamine 442 Dopexamine 443 Dornase 444 Dorzolamide 445 Dothiepin 446 Doxantrazole 447 Doxapram 448 Doxazosin 449 Doxepin 450 Doxycycline 451 Doxylamine 452 Droperidol 453 Drospirenone 454 Drotecogin 455 Duloxetine 456 Dutasteride 457 Dyd rogesterone 458 Econazole 46 http://www._egis_ati_n.g_vt.nz/_ibraries/c_ntents/_m-isa_i.d_?c_ientID=7_8422344&hits... 10/22/2007 ABC000002046 Regulations of New Zealand Page 13 of 36 459 Ecothiopate 460 Ectylurea 461 Edetic acid 462 Edoxudine 463 Efalizumab 464 Efavirenz 465 Eflornithine 466 Eformoterol 467 Eletriptan 468 Emepronium 469 Emetine 470 Emtricitabine 471 Enalapril 472 Enfuvirtide 473 Enoxacin 474 Enoxaparin 475 Enoximone 476 Entacapone 477 Entecavir 478 Epinastine 479 Eplerenone 480 Epoetins 481 Epoprostenol 482 Eprosartan 483 Eptifibatide 484 Ergocalciferol 485 Ergometrine 486 Ergot 487 Ergotamine 488 Ergotoxine 489 Ertapenem 490 Erysimum spp. 491 Erythromycin 492 Erythropoietin 493 Escitalopram 494 Esmolol 495 Esomeprazole 496 Estropipate 497 Etanercept 47 http://www._egis_ati_n.g_vt.nz/_ibraries/c_ntents/_m-isapi.d__?c_ientID=718422344&hits... 10/22/2007 ABC000002047 Regulations of New Zealand Page 14 oF 36 498 Ethacrynic acid 499 Ethambutol 500 Ethanolamine 501 Eth inyloestrad iol 502 Ethionamide 503 Ethoheptazine 504 Ethopropazine 505 Ethotoin 506 Ethyl chloride 507 Ethynodiol 508 Etidocaine 509 Etidronic acid 510 Etilefrine 511 Etodolac 512 Etofenamate 513 Etoricoxib 514 Etretinate 515 Everolimus 516 Ezetimibe 517 Factor VIII inhibitor bypassing fraction 518 Famciclovir 519 Famotidine 520 Felodipine 521 Fenbufen 522 Fenclofenac 523 Fenfluramine 524 Fenofibrate 525 Fenoldopam 526 Fenoprofen 527 Fenoterol 528 Fenpipramide 529 Fexofenadine 530 Fibrin 531 Fibrinogen 532 Fibrinolysin 533 Filgrastim 534 Finasteride 535 Flecainide 536 Fleroxacin 48 http://www._egis_ati_n.g_vt.nz/_ibraries/c_ntents/_m -isapi.d__?c_ient_D=7 _8422344&hits... 10/22/2007 ABC000002048 Regulations of New Zealand Page 15 of 36 537 Floctafenine 538 Fluanisone 539 Fluclorolone 540 Flucloxacillin 541 Fluconazole 542 Flucytosine 543 Fludrocortisone 544 Flufenamic acid 545 Flumazenil 546 Flumethasone 547 Flumethiazide 548 Flunisolide 549 Fluocinolone 550 Fluocinonide 551 Ftuocortin 552 Fluocortolone 553 Fluorescein 554 Fluorides 555 Fluorometholone 556 Fluoxetine 557 Flupenthixol 558 Fluphenazine 559 Flurandrenolone 560 Flurbiprofen 561 Fluroxene 562 Fluspirilene 563 Fluticasone 564 Fluvastatin 565 Fluvoxamine 566 Folic acid 567 Folinic acid 568 Follicle stimulating hormone 569 Follitropin 570 Fondaparinux 571 Formestane 572 Formoterol 573 Fosamprenavir 574 Foscarnet 575 Fosinopril 49 http://www__egis_ati_n_g_vt_nz/_ibraries/c_ntents/_m-isapi_d__?c_ientID=7_8422344&hits___ 10/22/2007 ABC000002049 Regulations of New Zealand Page 16 of 36 576 Fosphenytoin 577 Framycetin 578 Frusemide 579 Furazolidone 580 Fusidic acid 581 Gabapentin 582 Galantamine 583 Galanthus spp. 584 Ganciclovir 585 Ganirelix 586 Gatifloxacin 587 Gemeprost 588 Gemfibrozil 589 Gemifloxacin 590 Gentamicin 591 Gestodene 592 Gestonorone 593 Gestrinone 594 Glatiramer acetate 595 Glibenclamide 596 Glibornuride 597 Gliclazide 598 Glimepiride 599 Glipizide 600 Glisoxepide 601 Glutathione 602 Glyceryl trinitrate 603 Glyco pyrron ium 604 Glymidine 605 Goserelin 606 Gramicidin 607 Grainsetron 608 Grepafloxacin 609 Griseofulvin 610 Guaiphenesin 611 Guanabenz 612 Guanethidine 613 Hachimycin 614 Haematin 50 http://www._egis_ati_n.g_vt.nz/_ibraries/c_ntents/_m-isapi.d__?c_ientID=7_8422344&hits... 10/22/2007 ABC000002050 Regulations of New Zealand Page 17 of 36 615 Haemophilus influenzae vaccine 616 Hatcinonide 617 Halofantrine 618 Halofenate 619 Haloperidol 620 Halquinol 621 Hemerocallis 622 Heparins 623 Hepatitis A vaccine 624 Hepatitis B vaccine 625 Hetacillin 626 Hexachlorophane 627 Hexetidine 628 Hexobendine 629 Hexoprenaline 630 Histamine 631 Homatropine 632 Human protein C 633 Hyaluronic acid 634 Hydralazine 635 Hydrargaphen 636 Hyd roch ioroth iazid e 637 Hydrocortisone 638 Hydrocyanic acid 639 Hyd roll umeth iazid e 640 Hydroquinone 641 Hydroxychloroquine 642 Hydroxyephedrine 643 Hydroxyphenamate 644 Hydroxyprogesterone 645 Hydroxyzine 646 Hylan polymer 647 Hyoscine 648 Hyoscine butylbromide 649 Hyoscyamine 650 Hyoscyamus niger 651 Hypothalamic releasing factors 652 Hypromellose 653 Ibandronic acid 51 httpi//www._egis_ati_n.g_vt.nz/_ibraries/c_ntents/_m-isapi.d__?c_ientID=7_8422344&hits... 10/22/2007 ABC000002051 Regulations of New Zealand Page 18 of 36 654 Ibuprofen 655 Ibuterol 656 Ibutilide 657 Idoxuridine 658 Iloprost 659 Imiglucerase 660 Imipenem 661 Imipramine 662 Imiquimod 663 Immunoglobulins 664 Indapamide 665 Indinavir 666 Indomethacin 667 Indoramin 668 Infliximab 669 Influenza and coryza vaccines 670 Insulins 671 Ipecacuanha 672 Ipratropium 673 Iprindole 674 Iproniazid 675 Irbesartan 676 Iron 677 Isoaminile 678 Isoamyl nitrite 679 Isobutyl nitrite 680 Isocarboxazid 681 Isoconazole 682 Isoetarine 683 Isometheptene 684 Isoniazid 685 Isoprenaline 686 Isoprinosine 687 Isopropamide 688 Isosorbide dinitrate 689 Isosorbide mononitrate 690 Isotretinoin 691 Isoxicam 692 Isoxsuprine 52 http://www.legislation.govt.nz/libraries/contents/om isapi.dll?clientID=718422344&hits... 10/22/2007 ...... ABC000002052 Regulations of New Zealand Page 19 oF36 693 Isradipine 694 Itraconazole 695 Ivermectin 696 Kanamycin 697 Ketanserin 698 Ketoconazole 699 Ketoprofen 700 Ketorolac 701 Ketotifen 702 Khellin 703 Labetalol 704 Lacidipine 705 Lamivudine 706 Lamotrigine 707 Lanatosides 708 Lanreotide 709 Lansoprazole 710 Laronidase-rch 711 Latamoxef 712 Lata nop rost 713 Lauromacrogol 714 Lead 715 Leflunomide 716 Lenograstim 717 Lepirudin 718 Leptazol 719 Lercanidipine 720 Leucovorin 721 Leuprorelin 722 Levamisole 723 Levetiracetam 724 Levobunolol 725 Levobupivacaine 726 Levocabastine 727 Levocetirizine 728 Levodopa 729 Levonorgestrel 730 Levosimendan 731 Lidoflazine 53 http://www._egis_ati_n_g_vt.nz/_ibra_es/c_ntents/_m-isapi.d__?c_ientID=7_8422344&hits... 10/22/2007 ...... ABC000002053 Regulations of New Zealand Page 20 of 36 732 Lignocaine 733 Lincomycin 734 Lindane 735 Linezolid 736 Liothyronine 737 Liquorice deglycyrrhizinised 738 Lisinopril 739 Lisuride 740 Lithium 741 Lofexidine 742 Lomefloxacin 743 Loperamide 744 Lopinavir 745 Loracarbef 746 Loratadine 747 Losartan 748 Loxapine 749 Lumefantrine 750 Lumiracoxib 751 Luteinising hormone 752 Lymecycline 753 Mafenide 754 Maprotiline 755 Measles vaccine 756 Mebeverine 757 Mebhydrolin 758 Mebutamate 759 Mecamylamine 760 Mecillinam 761 Meclocycline 762 Meclofenamate 763 Meclofenoxate 764 Meclozine 765 Medigoxin 766 Medroxyprogesterone 767 Medrysone 768 Mefenamic acid 769 Mefloquine 770 Mefruside 54 http://www._egis_ati_n.g_vt.nz/_ibraries/c_ntents/_m-isapi.d_?c_ient_D=7_8422344&hits... 10/22/2007 ABC000002054 Regulations of New Zealand Page 21 of 36 771 Megestrol 772 Melagatran 773 Melatonin 774 Melengestrol 775 Melia azedarach 776 Meloxicam 777 Memantine 778 Meningococcal vaccine 779 Menotrophin 780 Me ?acrine 781 Me ?enzolate 782 Me 3henesin 783 Me ?hentermine 784 Me _indolol 785 Me 3ivacaine 786 Me 3tazinol 787 Mepyramine 788 Mequitazine 789 Meropenem 790 Mesatazine 791 Mesna 792 Mesterolone 793 Mestranol 794 Metaraminol 795 Metergoline 796 Metformin 797 Methacholine 798 Methacycline 799 Methanthelinium 800 Methazolamide 801 Methdilazine 802 Methicillin 803 Methimazole 804 Methixene 805 Methocarbamol 806 Methohexitone 807 Methoin 808 Methotrexate 809 Methotrimeprazine 55 http://ww_._egis_ati_n.g_vt.nz/_ibraries/c_ntents/_m-isapi.d__?c_ientID=7__422344&hits... 10/22/2007 ABc0-o0002055 Regulations of New Zealand Page 22 of 36 810 Methoxamine 811 Methoxsalen 812 Methoxyflurane 813 Methsuximide 814 Meth ycloth iazid e 815 Methyl aminolevulinate 816 Methyldopa 817 Methylene blue 818 Meth ylergometrin e 819 Methylpentynol 820 Methylprednisolone 821 Methyltestosterone 822 Methylthiouracil 823 Methysergide 824 Metoclopramide 825 Metolazone 826 Metoprolol 827 Metrifonate 828 Metronidazole 829 Mexiletine 830 Mezlocillin 831 Mianserin 832 Mibefradil 833 Miconazole 834 Midodrine 835 Mifepristone 836 IVliglitol 837 Milrinone 838 Minocycline 839 Minoxidil 840 Mirtazapine 841 Misoprostol 842 Moclobemide 843 Modafinil 844 Molgramostim 845 Molindone 846 Mometasone 847 Monobenzone 848 Montelukast 56 http://www.legislati_n.g_vt.nz/libraries/c_ntents/_m_isapi.d__?c_ientID=7l8422344&hits... 10/22/2007 ...... ABC000002056 Regulations of New Zealand Page 23 of 36 849 Moperone 850 Morazone 851 Moricizine 852 Motrazepam 853 Motretinide 854 Moxifloxacin 855 Mumps vaccine 856 Mupirocin 857 Muraglitazar 858 Nabumetone 859 Nadolol 860 Nadroparin 861 Nafarelin 862 Naftidrofuryl 863 Nalbuphine 864 Nalidixic acid 865 Nalorphine 866 Naloxone 867 Naltrexone 868 Naproxen 869 Naratriptan 870 Natamycin 871 Nateglinide 872 Nebacumab 873 Nedocromil 874 Nefazodone 875 Nefopam 876 Nelfinavir 877 Neomycin 878 Nerium oleander 879 Nesiritide 880 Netilmicin 881 Nevirapine 882 Nialamide 883 Nicardipine 884 Nicergoline 885 Nicofuranose 886 Nicorandil 887 Nicotine 57 http://www._egis_ati_n.g_vt.nz/_ibraries/c_ntents/_m._isapi.d__?c_ientID=7_8422344&hits... 10/22/2007 ABC000002057 Regulations of New Zealand Page 24 of 36 888 Nicoumalone 889 Nifed ipine 890 Nifenazone 891 Nikethamide 892 Nimesulide 893 Nimodipine 894 Nimorazole 895 Niridazole 896 Nisoldipine 897 Nitrendipine 898 Nitrofurantoin 899 Nitrofurazone 900 Nitrous oxide 901 Nitroxoline 902 Nizatidine 903 Nomifensine 904 Noradrenaline 905 Norelgestromin 906 Norethisterone 907 Norfloxacin 908 Norgestrel 909 Nortriptyline 910 Nux vomica 911 Nystatin 912 Octamylamine 913 Octatropine 914 Octocog alfa 915 Octreotide 916 Octyl nitrite 917 ©estradiol 918 Oestriol 919 Oestrogen s 920 Oestrone 921 Ofloxacin 922 Olanzapine 923 Oleandomycin 924 ©leandrin 925 Olopatadine 926 Otsalazine 58 http://www._egis_ati_n.g_vt.nz/_ibraries/c_ntents/_m_isapi.d__?c_ientID=7_8422344&hits... 10/22/2007 .... ABC000002058 Regulations of New Zealand Page 25 of'36 927 Omaizumab 928 Omeprazole 929 Ondansetron 930 Opipramol 931 Orciprenaline 932 Orlistat 933 Ornidazole 934 ©rnipressin 935 Orphenadrine 936 Oseltamivir 937 Ouabain 938 Oxacillin 939 Oxaprozin 940 Oxcarbazepine 941 ©xedrine 942 Oxetacaine 943 Oxitropium 944 Oxolamine 945 Oxolinic acid 946 Oxpentifylfine 947 Oxprenolol 948 Oxybuprocaine 949 Oxybutynin 950 Oxyphenbutazone 951 Oxyp hencycl im ine 952 Oxyphenisatin 953 Oxyphenonium 954 Oxytetracycline 955 Oxytocin 956 Palivizumab 957 Palonosetron 958 Pamidronic acid 959 Pancreatic enzymes 960 Pantoprazole 961 Papaverine 962 Paracetamol 963 Paraldehyde 964 Paramethasone 965 Parecoxib 59 http://www.legislati_n.g_vt.nz/libraries/c_ntents/_m_isapi.d_l?clientID=7_8422344&hits... 10/22/2007 ABC000002059 Regulations of New Zealand Page 26 of 36 966 Paromomycin 967 Paroxetine 968 Pefloxacin 969 Pegaptanib 970 Pegfilgrastim 971 Penbutofol 972 Penciclovir 973 Penicillamine 974 Pentaerythrityl tetranitrate 975 Pentamidine 976 Pentazocine 977 Penthienate 978 Pentosan polysulfate sodium 979 Pen toxifyl Iine 980 Pergolide 981 Perhexiline 982 Pericyazine 983 Perindopril 984 Permethrin 985 Perphenazine 986 Pertussis antigen 987 Phenacemide 988 Phenazone 989 Phenazopyridine 990 Phenelzine 991 Pheneticillin 992 Phenformin 993 Phenindione 994 Pheniramine 995 Phenisatin 996 Phenol 997 Phenolphthalein 998 Phenoxybenzamine 999 Phenoxymethylpenicillin 1000 Phensuximide 1001 Phentolamine 1002 Phenylbutazone 1003 Phenylephrine 1004 Phenylpropanolamine 60 http://www._egis_ati_n.g_vt.nz/_ibraries/c_ntents/_m-isa_i.dll?clientID=7_8422344&hits... 10/22/2007 ...... ABc000002060 Regulations of New Zealand Page 27 of 36 1005 Phenyltoloxamine 1006 Phenytoin 1007 Phthalylsulphathiazole 1008 Physostigmine 1009 Pilocarpine 1010 Pimecrolimus 1011 Pimozide 1012 Pinacidil 1013 Pindolol 1014 Piogl itazone 1015 Pipemidic acid 1016 Pipenzolate 1017 Piperacillin 1018 Piperidine 1019 Piperidolate 1020 Pipothiazine 1021 Piracetam 1022 Pirbuterol 1023 Pirenzepine 1024 Piretanide 1025 Pirfenoxone 1026 Piroxicam 1027 Pivampicillin 1028 Pizotifen 1029 Plasma 1030 Plasma protein fraction 1031 Plasmin 1032 Plasminogen activator 1033 Platelets 1034 Pneumococcal vaccine 1035 Podophyllotoxin 1036 Podophyllum emodi 1037 Podophyllum peltatum 1038 Poliomyelitis vaccine 1039 Polyestrad iol 1040 Polylactic acid 1041 Polymyxin 1042 Polythiazide 1043 Poractant alpha 61 http://www.legislation.govt.nz/libraries/contents/om isapi.dll?clientlD=718422344&hits... 10/22/2007 ABC000002061 Regulations of New Zealand Page 28 of 36 1044 Posaconazole 1045 Potassium bromide 1046 Practolol 1047 Pral idoxim e 1048 Pramipexole 1049 Pramocaine 1050 Prasterone 1051 Pravastatin 1052 Praziq uantel 1053 Prazosin 1054 Prednisolone 1055 Prednisone 1056 Pregabalin 1057 Pregnenolone 1058 Prenalterol 1059 Prenylamine 1060 Prilocaine 1061 Primaquine 1062 Primidone 1063 Probenecid 1064 Probucol 1065 Procainamide 1066 Procaine 1067 Procaine penicillin 1068 Prochlorperazine 1069 Procycl idine 1070 Progesterone 1071 Progestogens 1072 Proglumide 1073 Proguanil 1074 Prolintane 1075 Promazine 1076 Promethazine 1077 Propafenone 1078 Propamidine 1079 Propanidid 1080 Propantheline 1081 Propionibacterium acnes 1082 Propranolol 62 http://www.legislation.govt.nz/libraries/contents/onl isapi.dll?clientlD=718422344&hits... 10/22/2007 ABC000002062 Regulations of New Zealand Page 29 of 36 1083 Propylthiouracil 1084 Propyphenazone 1085 Proquazone 1086 Proscillaridin 1087 Prostaglandins 1088 Protamine sulphate 1089 Prothionamide 1090 Prothipendyl 1091 Protoveratrines 1092 Protriptyline 1093 Proxymetacaine 1094 Pulmonaria spp. 1095 Pyrazinamide 1096 Pyridinolcarbamate 1097 Pyridostigmine 1098 Pyridoxine 1099 Pyrimethamine 1100 Quazepam 1101 Quebracho 1102 Quetiapine 1103 Quinagolide 1104 Quinapril 1105 Quinethazone 1106 Quinidine 1107 Quinine 1108 Quinisocaine 1109 Qu inupristin 1110 Rabeprazole 1111 Rabies vaccine 1112 Raloxifene 1113 Ramipril 1114 Ranitidine 1115 Rasburicase 1116 Rauwolfia serpentina 1117 Rauwolfia vomitoria 1118 Reboxetine 1119 Remoxipride 1120 Repaglin ide 1121 Reserpine 63 http://www.legislati_n.g_vt.nz/libraries/c_ntents/_m_isapi.dll?clientID=7_8422344&hits... 10/22/2007 ABC000002063 Regulations of New Zealand Page 30 of 36 1122 Reteplase 1123 Rifabutin 1124 Rifampicin 1125 Rifa mycin 1126 Rifapentine 1127 Rim iterol 1128 Risedronic acid 1129 Risperidone 1130 Ritodrine 1131 Ritonavir 1132 Rivastigmine 1133 Rizatriptan 1134 Rofecoxib 1135 Rolitetracycline 1136 Ropinirole 1137 Ropivacaine 1138 Rosiglitazone 1139 Rosoxacin 1140 Rosuvastatin 1141 Roxithromycin 1142 Rubella vaccine 1143 Sabad ilia 1144 Salbutamol 1145 Salcatonin 1146 Salmeterol 1147 Saquinavir 1148 Selegiline 1149 Sertindole 1150 Sertraline 1151 Serum, dried human 1152 Sevelamer 1153 Sex hormones and all substances having sex hormone activity 1154 Sibutramine 1155 Sildenafil 1156 Silicones 1157 Silver sulfadiazine 1158 Simvastatin 1159 Sirolimus 1160 Sisomicin 64 http:_/www._egis_ati_n.g_vt.nz/_ibraries/c_ntents/_m_isapi.d__?c_ientID=7_8422344&hits... 10/22/2007 ABC000002064 Regulations of New Zealand Page 31 of 36 1161 Sodium bromide 1162 Sodium cellulose phosphate 1163 Sodium cromoglycate 1164 Sodium morrhuate 1165 Sodium nitroprusside 1166 Sodium phosphate 1167 Sodium polystyrene sulphonate 1168 Sodium tetradecyl sulphate 1169 Solifenacin 1170 Somatostatin 1171 Somatropin 1172 Sotalol 1173 Sparfloxacin 1174 Spectinomycin 1175 Spiramycin 1176 Spirapril 1177 Spironolactone 1178 Stavudine 1179 Steroid hormones 1180 Stilboestrol 1181 Streptodornase 1182 Streptokin ase 1183 Streptomycin 1184 Strontium ranelate 1185 Strophanthin 1186 Strophanthin-k 1187 Strophanth us 1188 Strychnos spp. 1189 Sulbactam 1190 Sulconazole 1191 Sulfacetamide 1192 Sulfadiazine 1193 Sulfadimethoxine 1194 Sulfad imidine 1195 Sulfadoxine 1196 Sulfafu razole 1197 Sulfaguanidine 1198 Sulfamerazine 1199 Sulfamethizole 65 http://www.legislati_n.g_vt.nz/libraries/c_ntents/_m-isapi.d_l?client_D=718422344&hits... 10/22/2007 ABC000002065 Regulations of New Zealand Page 32 of 36 1200 Sulfamethoxazole 1201 Sulfamethoxydiazine 1202 Sulfamethoxypyridazine 1203 SuIfam etrole 1204 Sulfamonomethoxine 1205 Sulfamoxole 1206 Sulfaphenazole 1207 Sulfapyridine 1208 Sulfasalazine 1209 Sulfathiazole 1210 SuIfatroxazole 1211 Sulfin pyrazone 1212 Sulfomyxin 1213 Sulfon methane 1214 Sulindac 1215 Sultamicillin 1216 Sulthiame 1217 Sumatriptan 1218 Suprofen 1219 Sutilains 1220 Tacrine 1221 Tacrolimus 1222 Tadalafil 1223 Tamoxifen 1224 Tamsulosin 1225 Tanacetum vulgare 1226 Tazarotene 1227 Tazobactam 1228 Tegaserod 1229 Teicoplanin 1230 Telithromycin 1231 Telmisartan 1232 Tenecteplase 1233 Tenofovir 1234 Tenoxicam 1235 Terazosin 1236 Terbinafine 1237 Terbutaline 1238 Terfenadine 66 http://www.legislation.govt.nz/libraries/contents/om isapi.dll?clientID=718422344&hits... 10/22/2007 ABC000002066 Regulations of New Zealand Page 33 of 36 1239 Terlipressin 1240 Teropterin 1241 Tetanus antitoxin 1242 Tetanus toxoid 1243 Tetrabenazine 1244 Tetracycline 1245 Tetraethylammonium 1246 Tetroxoprim 1247 Thenyldiamine 1248 Theophylline 1249 Thevetia peruviana 1250 Thevetin 1251 Thiethylperazine 1252 Th ioacetazo ne 1253 Thiocarlide 1254 Thioproperazine 1255 Thioridazine 1256 Thiothixene 1257 Thiouracil 1258 Thrombin 1259 Thymoxamine 1260 Thyroid 1261 Thyroxine 1262 Tiagabine 1263 Tiaprofenic acid 1264 Tiaramide 1265 Tibolone 1266 Ticarcillin 1267 Ticlopidine 1268 Tiemonium 1269 Titetamine 1270 Tiludronic acid 1271 Timolol 1272 Tinidazole 1273 Tinzaparin 1274 Tioconazole 1275 Tiotropium 1276 Tirilazad 1277 Tirofiban 67 http://www._egis_ati_n.g_vt.nz/_ibraries/c_ntents/_m-isapi.d__?clientID=7_8422344&hits... 10/22/2007 • _...... ABC000002067 Regulations of New Zealand Page 34 of 36 1278 Tobramycin 1279 Tocainide 1280 Tolazamide 1281 Tolazoline 1282 Tolbutamide 1283 Tolcapone 1284 Tolfenamic acid 1285 Tolmetin 1286 Tolonium 1287 Tolrestat 1288 Tolterodine 1289 Topiramate 1290 Torasemide 1291 To remifen e 1292 Toxoids 1293 Tramadol 1294 Trandolapril 1295 Tranexamic acid 1296 Tranylcypromine 1297 Travoprost 1298 Trazodone 1299 Trep rostin il 1300 Tretinoin 1301 Triacetyloleandomycin 1302 Triamcinolone 1303 Triamterene 1304 Trichlormethiazide 1305 Trichloroacetic acid 1306 Trichloroethylene 1307 Triclofos 1308 Tricyclamol 1309 Tridihexethyl 1310 Triflu operazine 1311 Trifluperidol 1312 Triflu promazine 1313 Trimep razin e 1314 Trimetaphan 1315 Trimethoprim 1316 Trimipramine 68 http://www__egis_ati_n_g_vt_nz/_ibraries/c_ntents/_m-isapi_d__?c_ientID=718422344&hits___ 10/22/2007 ...... ABC000002068 Regulations of New Zealand Page 35 of 36 1317 Trioxysalen 1318 Triple antigen vaccine 1319 Triprolidine 1320 Triptorelin 1321 Troglitazone 1322 Trometamol 1323 Tropicamide 1324 Tropisetron 1325 Trovafloxacin 1326 Troxidone 1327 Tryptophan 1328 Tulobuterol 1329 Typhoid vaccine 1330 Unoprostone 1331 Urapidil 1332 Urofollitropin 1333 Urokinase 1334 Ursodeoxycholic acid 1335 Vaccines 1336 Valaciclovir 1337 Valdecoxib 1338 Valganciclovir 1339 Valnoctamide 1340 Valproic acid 1341 Valsartan 1342 Vancomycin 1343 Vardenafil 1344 Varicella vaccine 1345 Vasopressin 1346 Venlafaxine 1347 Verapamil 1348 Veratrum 1349 Verteporfin 1350 Vidarabine 1351 Vigabatrin 1352 Viloxazine 1353 Vincamine 1354 Vinyl ether 1355 Vip ryn ium 69 http://www._egislati_n.g_vt.nz/_ibraries/c_ntents/_m_isapi.d_l?clientID=7_8422344&hits... 10/22/2007 ABC000002069 Regulations of New Zealand Page 36 of 36 1356 Virginiamycin 1357 Visnadine 1358 Vitamin A 1359 Vitamin D 1360 Voriconazole 1361 Warfarin 1362 Xamoterol 1363 Xanthinol nicotinate 1364 Ximelagatran 1365 Xipamide 1366 Yohimbine 1367 Zafirlukast 1368 Zalcitabine 1369 Zaleplon 1370 Zanamivir 1371 Zidovudine 1372 Zinc 1373 Ziprasidone 1374 Zoledronic acid 1375 Zolmitriptan 1376 Zolpidem 1377 Zopiclone 1378 Zoxazolarnine 1379 Zuclopenthixol Diane Morcom, Clerk of the Executive Council. 70 9 http://www'legislati°n'g°vt'nz/libraries/c°ntents/°m isapidllclientlD=718422344&hits"" 10/22/2007 ABC000002070 NMC Internet Page 1 of 2 . AppendixU.K.- 39 NF1C Ted ,_!iv T._e !:;d aV, 2 3 () ct .,'."__::"r 20 0 7 _ome Advanced Nursing F::: <:!i_ ,, u pdate i9 Oti_er Articles About _s June 2007 A,:._,_.,.__,_,-_<:,_ ; A,-.Zof Advice t:'r, Equality and Diversity knowledge and cortnpetence, but ,,,_.he: dc:__ot: possess such i::'_es(r b _ i T _ ::iii ,? Europe knowledge and competenc:e. ;r_ ad Jit,or . t_/(::_rpracti Registration doctors. (:cha"_"_,,ian_ -A._...d_:, _.::_. Search The Register Therefore, a national consultatio_ _,,as t_ndertaken d _ring the (::,_s_!t_.,;or _ Specialist Community montt_s of Decernber 2004 -- February 2005 foltow_ng which ttt,.,e,,t::_ Public Health Nurse external analysis was undertakers an<:: r:...... pol _@_ to lu qe Jobs at t_.e NrqC Council 2005. Council agreeci that advanced nurse P,"Ot:( ctlii ] t;'_" [:'t:.£:; ;_ Links practitioner' should be a registrable qualification and that the P_hh:_:i with C}t_!(J ei_ To implement the Council's deosions of 9 .]une 2005 regarding the outcome of the _:{:,_s,._lt/tsti,:}rfor the framework for the standard for post-reg_ The NHC's mandate is set out w_tf_'_ t:he iegistation of the Nursing and Midwifery Order (2001.) therefore the Privy Council has been seeking the v,e ;*:; of ti_e Depa_me _t of Health (England), which takes the :ead (;r_ reg_, tarot\, ma,tters relating to healthcare professions -:_cross the UK. The NFIC has been awaiting the response from ti"e Privy Council. Current Position: Following an interval of very i;tt!_.., ncvem,:nt, the NI'4C has now been very encouraged t(:" tea(: ,;, thn t:t".erecent White Paper Trust, Assurance and Saf_?Cy - _he. ,Reguiation of Health Professionals in the 21st Century (2007), that; 'The Government agrees that the regulatory body for each non--medical profession should be in charge of approving the standards which registrants wiii rw,,-edt:o meet t:o mai ]tain their registration on a regular bas_s. Where appropriate, common standards and systems si_ouid be developed across professional groups where this 'wo,_ki benefit: patient safety The Department will ask the Coun::ii for Heaiti_care Regulatory Excellence (CHRE) t:) ,/.,o!.: ',.;t! :2,:2ulators, tke professions and those work _{! o_ !:.u ::'t e,_n :_n(i ir_terlati,:::nai standards to support this work,. ]t s _,!i er]cornpass t:he 71 http ://www. nmc-uk, org/aArtic le. aspx ?Artic leID--2528 10/23/2007 ABC000002071 NMC Intemet Page 2 of 2 development of standards for h_gher ievels of practice, particularly for advanced practice in nursing, AHPs a{ld healthcare scientists. '[he Department: wili discuss w_:h t:he Nursing and Midwifery Council t:he out:c.ome of their consultation on advanced nursing practice to agree r'ext steps (2.30)'. r',-,,,_c.i,_,,.,j_has.,. interpreted th,: ,_,;,rj [: )_ t -.._i,, _::__!.....look _ ':,_...... _.,..,_:_r:! t:o working ir_ partnership _,__t:__i t:_e e e,a_ t stakei:oiders to progress this and we are (:'._rrendy :_,',T_ti_., g fdrthE!r det:_il from the White Paper Irnplen'enta:io_ Piar_ (WP[P). Please note that it is impossible to pre-en_pt: ar,,y debate on tile progression of this work until we have looked at the WP[P in totality, as the work from rrlany aspects of the White Paper will cross over to the work on advanced nursing practice such as revalidation. !'i,':_dli_/ I /_d_OLit: {..i_::.i Webs;t:e_:'_::_:t:=:_:';i <:':Nursing Midwifery ..']o_ncil All _,_:I'tb:(-.;e:'el 72 http ://www.nmc-uk. org/aArticle, aspx?ArticlelD=2528 10/23/2007 ABC000002072 AppendixU.K.- 40 Nurse prescribing and the Supply and Administration of Medication Position Statement Introduction 1 Prescribing by certain groups of nurses began on 3 October 1994. Since this time, the numbers and categories of nurses who can prescribe have grown significantly and is expected to continue. In addition, new legislation has been introduced that enables nurses and midwives in addition to a wide range of health professionals to supply and administer medicines via Patient Group Directions. This is a notification of the Council's current position on nurse prescribing and the supply and administration of medicines via Patient Group Directions. Legislation 2 Primary legislation permitting nurse prescribing is set out in the Medicinal Products: Prescription by Nurses, Midwives and Health Visitors Act 1992. 3 The implementation was enabled by the secondary legislation Medicinal Products: Prescription by Nurses, Midwives and Health Visitors Act 1992 (Commencement No 1) Order 1994 which came into effect 3 October 1994. 4 Amendments to NHS Regulations enabled the introduction of supplementary prescribing for first level registered nurses, midwives and registered pharmacists from April 2003. 5 Amendments Home Office Misuse of Drug Regulations and NHS Regulations 2004. (Awaiting implementation). 6 Guidance on the use of PGD's is set out in Health Service Circular 2000/026. 7 SI 2004/922. Foreshortens the definition so that, by 2004 an independent nurse prescriber was defined as a person 'registered in the Nursing and Midwifery Register, and in respect of whom an annotation signifying that he is qualified to order drugs and appliances from Nurse Prescribers Formula13,Jor District Nurses alld Health Visitors .... or The Nurse Prescribers Extended Formula_... ' 8 Medicinal Products: Prescription by Nurses etc., Act 1992 (Commencement No) Order 1994 (SI 1994No 2408) in which the definition referred to a first level nurse has subsequently been amended to refer simply to a registered nurse or midwife as a result of amendments to Section 58 of the Medicines Act 1968. 9 Although legislation that permits the extension of prescribing responsibilities applies across the UK, the pace of implementation varies in response to decisions made by the devolved administrations in Scotland, Wales and Northern Ireland. Definitions 9 Independent prescribing means that the prescriber takes responsibility for the clinical assessment of the patient, establishing a diagnosis and the clinical Page t of 9 73 ABC000002073 management required, as well as the responsibility for prescribing where necessary and the appropriateness of any prescription. 10 Supplementary prescribing is defined as a voluntary partnership between and independent prescriber (doctor/dentist) and a supplementary prescriber, to implement an agreed patient-specific Clinical Management Plan with the patient's agreement. Who can prescribe? 11 There are two main groups of nurses who may prescribe, independent and supplementary prescribers. Independent nurse prescribers are subsequently further divided into two groups: Independent Nurse Prescribers 10.1 Until the amendments SI 2004/922 and SI1994No 2408 referred to above, were introduced independent prescribers were either district nurse (DN), health visitor (HV) or practice nurse (PN) with a DN/HV qualification. Or first level registered nurses/midwives who have completed Extended Accredited Nurse Prescribing Programme. 10.2 As a result of these amendments all 1stlevel nurses and midwives may undertake preparation for training to prescribe from the restricted formulary (formerly known as DN/HV formulary). At this present time there is no training programme validated for this group, those undertaking specialist practice qualification may undertake Mode 2 integrated programme as part of the course. The NMC will be looking to develop the criteria and curricula for this group of nurses/midwives as part of the work on Standards in Prescribing. Supplementary Nurse Prescribers 10.2 Supplementary nurse prescribers are 1stlevel registered nurses/midwives as above (6.1.2), but who have undertaken approved additional training as supplementary prescribers. 11 In order for nurses, midwives and health visitors to prescribe they must: • have successfully completed an Nursing and Midwifery Council (NMC) approved programme of preparation • have their prescribing status entered onto the register • be employed by a NHS Trust or independently but have a SLA with a NHS Trust to access a prescribing budget • be currently working in a designated prescribing post. What can be prescribed? Independent Nurse Prescribers ( District Nurses, Health Visitors, Practice Nurses) 12 All specialist practitioners (formerly district nurses and health visitors), on completion of an NMC accredited training may prescribe from a limited formulary of products designed to meet the needs of their patients (Nurse Prescriber's Formulary for District Nurses and Health Visitors). This consists of dressings, appliances and some medicines, including a small number of prescription only Page 2 of 7 74 ABc000002074 medicines. Details of the Formulary are set out in both the British National Formulary and Part XV11B(i) of the Drug Tariff. Specialist practitiones (formerly district nurses and health visitors) may prescribe for any patient within the PCT area for which they are employed. In addition, practice nurses who hold a district nurses or health visitor qualification may also undertake the training and prescribe for patients registered with the practice for which they work, a a result of amendments to legislation practice nurses no longer need to be qualified district nurses or health visitors if they have completed the Specialist Practice Qualification. Training for prescribing from this formulary is now incorporated into the Specialist Practice training for all specialist practitioners with a proviso that there is a clinical need (this formulary is very limited and it may not be considered appropriate for all specialist practitioners). Independent Nurse Prescribers - Extended Formulary Nurse Prescribers 13 All first level registered nurses and registered midwives may now train to prescribe from the Nurse Prescriber's Extended Formulary (NPEF). The extended formulary includes: • all licensed Pharmacy(P) medicines and all General Sales List (GSL) medicines prescribable at NHS expense (with some exclusions) and • range of approximately 180 Prescription Only Medicines (POMs) -including some specified controlled drugs. 14 Details of the NPEF are set out in both the British National Formulary and Part XVl 1B(ii) of the Drug Tariff. These should be regularly referred to for amendments to the Formulary. In addition, Extended Formulary Nurse Prescribers should restrict their prescribing of POMs and PtGSL medicines to the treatment of specific medical conditions as set out in Part XVl 1B(ii) of the Drug Tariff. 15 Nurses should not prescribe independently outside of these listed conditions. Additionally, nurses prescribing may be limited by locally agreed formularies, prescribing outside of formulary may mean nurses would not be covered by their employers vicarious liability and would also be a criminal offence. In prescribing, as in other areas of practice, nurses and midwives must prescribe only within their competence and thus should only prescribe from sections of the NPEF relevant to the areas of their clinical expertise. Supplementary Prescribers 16 Supplementary prescribers must have successfully completed both Extended and Supplementary Prescribing approved courses. There is no specific formulary or list of medicines for supplementary prescribing. Provided medicines are prescribable by a doctor or dentist at NHS expense, a supplementary prescriber may undertake to change the drug, dosage, frequency and timing of a patient's medication as agreed within the Clinical Management Plan (CMP). Prescribable medication includes:- - all General Sales List (GSL) medicines and all Pharmacy (P) medicines with exception controlled drugs • appliances and devices prescribable by GP's • foods and other borderline substances Page 3 of 7 75 ABC000002075 • all Prescription Only Medicines (POMs) - currently with the exception of controlled drugs (awaiting Amendment to Regulations) • medicines for use outside their licensed indications (e.g. 'off-label' prescribing), 'black triangle' drugs and drugs marked 'less suitable for prescribing' in the BNF and • unlicensed drugs providing they form part of a clinical trial that has a clinical trial certificate or exemption. 17 The CMP is a voluntary agreement between the patient, the Independent Prescriber (IP) and the Supplementary Nurse Prescriber (SNP). At any point in time, the Supplementary Nurse Prescriber may ask the Independent Prescriber to review the patient, but review must be undertaken annually between the Independent Prescriber, Supplementary Nurse Prescriber and patient. 18 Nurses/midwives who prescribe as supplementary prescribers without a clinical management plan are committing a criminal offence and would be in breach of the Professional Code of conduct performance and ethics 18 Training for supplementary prescribers is the same as for extended nurse prescribers with the addition of an approved short module covering the context and concept of supplementary prescribing. Patient Group Directions 19 Definition - a Patient Group Direction (PGD) is defined as a written instruction for the supply or administration of medicines to groups of patients who may not be individually identified before presentation for treatment. It is NOT a form of prescribing and there is no specific training that health professionals must undertake before supplying medicines in this way. However, many individual Trusts specify local training and assessment of competence. The majority of clinical care should be undertaken on an individual patient specific basis and the use of PGD's should be confined to those limited situations where there is an advantage for patient care without compromising patient safety. PGDs should be drawn up by a multi-disciplinary team and must be signed off by a senior doctor and pharmacist and must be authorised by the StriA, NHS Trust or PCT. Since 2003 the following non-NHS organisations have been able to use PGD's:- • Independent hospital agencies and clinics registered under the Care Standards Act 2000 • Prison healthcare services • Police services • Defence medical services PGD's are not suitable where a range of different medicines need to be given at the same time. They may only be used by a defined range of health care professionals, which includes nurses and midwives. Under a PGD the medicine is to be both supplied and administered by a registered nurse or midwife. Non -registered staff cannot administer using a PGD. Supply and Administration of Controlled Drugs Page 4 of 7 76 ABC000002076 Nurses and Midwives can supply some controlled drugs(CD's) under the terms of a PGD following amendment of the Misuse of Drugs Regulations in October, 2003. Since then, nurses have been able to use PGD's for the supply and administration of Schedule 4 & 5 CD's with the exception of anabolic steroids - plus diamorphine for the treatment of cardiac pain by nurses in accident and emergency departments and in coronary care units in hospital. Since early 2004, Extended Formulary nurse/midwife prescribers have been able to prescribe:- . Diazepam (restricted to palliative care) • Lorazepam (restricted to palliative care) • Midazolam (restricted to palliative care) • Codeine Phosphate (pain relief) • Dihydrocodeine tartrate (pain relief) • Co-phenotrope (pain relief) Nurses are also able to prescribe lower strength P (pharmacy) and GSL (General sales List) medicines containing codeine phosphate and dihydrocodeine tartrate. The Home Office are currently considering the prescribing of CD's including opoids by supplementary prescribers (nurses, midwives and pharmacists) in the context of The Shipman Inquiry Fourth Report - The regulation of controlled drugs in the community, published in July 2004. Specific Exemptions in Medicines Legislation for Supply and Administration of Medicines Nurses providing occupational health schemes and midwives have specific exemptions in medicines legislation to supply or administer medicines. Provided the requirements of any conditions attaching to those exemptions are met, a PGD as outlined above is not required. Current exemptions from requirement for a prescription for the supply of prescription only medicines (POM's) for nurses in occupational health scheme details can be found in Schedule 5 Part II of POM order and current exemptions from requirement from written directions of practitioner for parenteral administration of POM's is found in Schedule 5 Part III of POM order. Registered midwives have exemptions from requirement for a prescription for the sale or supply of prescription only medicines (POM's), details of which can be found in Schedule 5 Part I of POM order and current exemptions from requirement from written directions of practitioner for parenteral administration of POM's is found in Schedule 5 Part III of POM order. These include POM's that contain any of the following substances but no other POM substance: • Diamorphine • Ergometrine Maleate • Lignocanine • Lignocaine Hydrochloride ° Morphine • Naloxone Hydrochloride • Oxytocins, natural and synthetic • Pentazocine lactate • Pethidine hydrochloride Page 5 of 7 77 ABC00oo02077 • Phytomenadione • Promazine hydrochloride The administration shall only be in the course of their professional practice and in the case of Promazine hydrochloride, Lignocaine and Lignocaine Hydrochloride shall be only while attending a woman in childbirth. Patient Specific Direction 20 This is a written instruction from a doctor, dentist or nurse prescriber for a medicine, or appliance to be supplied or administered to a named patient. This may be a written instruction in patient's notes or on a patients drug chart. Where a PSD exists, there is no need for a PGD or a Clinical Management Plan. However, the nurse remains accountable for her actions and should only act in accordance with the NMC code of professional conduct, standards for conduct, performance and ethics. Education and Training 21 The NMC have produced a Standard for the Requirements for education and training for Extended Independent Nurse Prescribing and Supplementary Prescribing. This can be found under the QA section of the NMC Website. All courses are validated against this standard. Continuing Professional Development 22 Nurse prescribers are expected to keep up-to-date with best practice in the management of the conditions for which they may prescribe and in the use of medicines on the NPEF. Additional training and updating may be used in order to renew registration with the NMC. The National Prescribing Centre has produced a document 'Maintaining Competency in Prescribing: an outline framework to help nurse prescribers, this is available at www__n_a.nhs.uk. It may be used as a tool to reflect on practice and identify CPD needs. Good Practice and Accountability 23 Nurse Prescribers are individually and professionally accountable to the NMC for their prescribing practice. 24 Nurse Prescribing (NPs) must be undertaken in adherence with the NMC's code of professional conduct, standards for conduct, performance and ethics and in conjunction with local policies. Variations in Nurse Prescribing across devolved Administrations Scotland Page 6 of 7 78 ABC000002078 25 There are seven HEI's in Scotland who deliver the Extended and Supplementary nurse prescribing programme and the independent nurse prescribing programme as part of the health visitor/district nurse qualification. Funding is currently available and the initial target was to train 3,000 nurse prescribers by 2006, however, whether this funding is ongoing has yet to be determined. Individual nurses wishing to undertake the extended nurse prescribing programme discuss with their managers the appropriateness of the qualification to their current role and if considered appropriate the Trust applies to the Scottish Executive for a given number of places as determined by the Trust. Initially nurses being put forward were mainly from practice nursing and held fairly senior positions, they have seen increasing numbers of students over the last year from a wide range of backgrounds and skill level, but with the majority from a primary care programme. 26 Cohorts are generally full and in some areas in particular Stirling, which covers the Highlands, there are waiting lists to access the programme. 27 Although there have been discussions with providers of other non-medical prescribers namely pharmacists and radiographers, optometrists and podiatrists. To date, there are no joint programmes and no plans to run a multi-disciplinary programme. 28 Entry criteria for the programme meets NMC requirements. However, the delivery of the programme varies from distance learning pack with five days face- to-face teaching up to a 25 day face-to-face taught programme. There is an excellent resource of web based materials on the NES website which supports the programme. 29 Assessment has been modified by many of the institutions with all students undertaking an exam and a portfolio but with variations on the use of OSCE's. 30 A framework for Continuing Professional Development has been developed by NES complete with a CD Rom for student's use. The tool is used to assist prescribers to identify their CPD needs. Support networks for nurse prescribing have been developed in an ad hoc fashion and prescribing leads are not in post in all areas. 31 The recent circular from the Doll (England) giving approval, as a result of change in legislation to the prescribing of certain controlled drugs by supplementary nurse prescribers, as part of a Clinical Management Plan, is not being implemented by the Scottish Executive at this time. 32 An evaluation of nurse prescribing has been commissioned by the University of Stirling and is currently underway. 33 On completion of the course, nurses can prescribe as both extended and supplementary nurse prescribers. Wales 34 There are five HEI's in Wales who offer the extended and supplementary nurse prescribing programme, in addition, health visitors and school nurses undertake Page 7 of 7 79 ABc000002079 the independent nurse prescribing programme as part of their specialist qualification. 35 Funding for the course is via the Welsh Assembly and criteria for entry meets the NMC requirements. The nurses undertake the programme via shared learning with the Pharmacists undertaking supplementary nurse prescribing programme, where this programme runs. 36 Nurses in Wales must undertake a drugs calculation exam before being allowed to prescribe, and on completion of the Course, are only allowed to prescribe as supplementary prescribers using a Clinical Management Plan. There are no formal arrangements for CPD with nurses expected to identify their own needs and for this to be met at local level. Northern Ireland 37 Both the University of Ulster and Queens University offer the extended and supplementary nurse prescribing programme and Ulster as part of their specialist practice qualification for health visitors and district nurses. 38 Funding is direct from the Department for Health and SPSS, with the aim to train the number of nurses required to meet local need. There has been three cohorts going through the programme to date, a total of 160 nurse prescribers. Entry criteria meet the NMC requirements and on completion nurses may prescribe as both extended and supplementary nurse prescriber. There is no arrangement for multi-disciplinary non-medical prescribing training at present. 39 Initially nurses undertaking the programme were primarily from a primary care programme, however, as the programme has run, there have been increasing numbers from secondary care. 40 There is no formal continuing professional development for nurse prescribers, although nurses are directed to the National Prescribing Centre framework for CPD and support networks have developed across Northern Ireland. 41 Changes in legislation to the prescribing of certain controlled drugs by supplementary nurse prescribers as part of a Clinical Management Plan is being implemented on 14 April 2005. England 42 There are 51 HEI's who deliver the extended supplementary nurse prescribing programme and 52 HEI's who deliver independent prescribing as part of their specialist practice qualification for health visitors and district nurses. 43 All programmes meet the entry criteria for NMC requirements and the courses are funded by designated Workforce Development Confederations. The target is to train 10,000 nurse prescribers by 2006. 44 The programmes all run as stand alone modules, although some are uni- disciplinary and others are run jointly with the training for supplementary pharmacist prescribing. There is currently work being undertaken by Nottingham University to develop a multi-disciplinary non-medical prescribing programme for Page 8 of 7 80 ABC000002080 all non-medical prescribers. All students undertake a written exam and produce a portfolio of evidence, however, OSCE's in some institutions have been replaced or modified using other methods of assessment. 45 Prescribing leads are in most trusts, although their role varies in each trust. Networks of nurse prescribers have been developed. Continuing professional development is supported by the NPC framework, however, it has developed in a sporadic way. 46 All four countries use the National Prescribing Centre competencies for nurse prescribing to measure the outcomes and assess student's competence Legal Classification of Licensed Medicines Prescription only medicines (POM) POM's require a prescription to be written, usually by a doctor, dentist, nurse or other approved prescriber Pharmacy Medicine (P) P medicines can only be sold through a registered pharmacy under the personal supervision of a pharmacist i.e. the pharmacist needs to be present before a P medicine can be sold. General Sales List Medicine(GSL) GSL medicines are deemed even safer than P medicines and can be sold in general shops as well as through pharmacies, albeit often in small quantities. All of the products are sold in manufacturers' original packs. Over the Counter Medicine (OTC) Not a legal classification but a generic term that covers both GSL and P medicines Further Information Department of Health Website www.dh.gov.uk/_Loli__ PRODIGY produce patient information leaflets and lists drugs recommended by PRODIGY and links them to the condition and situation in which they are recommended www.prodi#y.nhs,uk Medicines and Healthcare products Regulatory Agency website contains information about the legal framework governing the prescribing, supply and administration of medicines www.mhra.qov.uk National Prescribing Centre www,npc.co.uk Medicines Partnership Programme www.medicines-partneshi_ Prescribing news www.nurse.prescriber.co.uk 12 April 2005 Page 9 of 7 81 82 ABC000002082 83 k ABc000002083 84 85 ...... ABC0000020I 86 ...... ABC0-60oo2o8 87 ...... ABC00000208[ 88 ...... " ABC00000208 89 ..... ABC000002088 .... 90 ABc000002090 91