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 2 ABC000002002 Scopes of Practice Page 1 of 6 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 3 http ://www.nursingcouncil.org.nz/scopes.html 10/23/2007 ABC000002003 Scopes of Practice Page 2 of 6 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 4 http ://www.nursingcouncil.org.nz/scopes.html 10/23/2007 ............ ABc0-00002004 Scopes of Practice Page 3 of 6 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. 5 http ://www.nursingcouncil.org.nz/scopes.html 10/23/2007 ABC000002005 Scopes of Practice Page 4 of 6 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 http://www.nursingcouncil.org.nz/scopes.html 10/23/2007 ........ ......... ABC0-00002006 Scopes of Practice Page 5 of 6 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