Application for prescribing rights for registered nurses practising in primary health and specialty teams

20 October 2014

The Nursing Council has submitted an application for designated prescribing rights for registered nurses practising in primary health and specialty teams. The application will be considered by the Ministry of Health before further steps are taken to introduce a regulation enabling further registered nurses to prescribe.  This application builds on the Councils consultation for “specialist nurse prescribing” in 2013.  This proposal was strongly supported by submitters with many considering there would be clear benefits for patients.

Some registered nurses can already prescribe in diabetes health.  This application is for a broader group of registered nurses who work with patients with long term and common conditions in primary health and in specialty teams in outpatient settings.  These registered nurses will have appropriate clinical experience and education including a practicum with a prescribing mentor before they would be able to prescribe commonly used medicines in their specialty area.

The reason the Council has developed this application for further registered nurse prescribing is to improve patient care without compromising patient safety; to make it easier for patients to obtain the medicines they need; and make better use of the skills of health professionals. 

The Council has proposed that registered nurses who apply for this prescribing authority will be required to complete

a postgraduate diploma in registered nurse prescribing for long-term and common conditions

which includes advanced knowledge of pathophysiology, pharmacology, assessment and diagnostic reasoning in relation to the clinical management and prescribing for patients with long term and common conditions in New Zealand. The programme must include a prescribing practicum of at least 150 hours of clinical practice under the supervision of a designated authorised prescriber in a collaborative health team environment.  The registered nurse will be required to continue to be supervised during the first 12 months of prescribing practice.

Working with a multidisciplinary team will enable registered nurse prescribers to consult other prescribers or refer more complex patients to a medical or nurse practitioner.  They will have to meet the  Competencies for nurse prescribing

(as well as the competencies for the registered nurse scope of practice).

More details about the Council’s proposal and application can be found below.  It is not known how long the granting of prescribing rights will take or if changes to the proposal might be required. 

The Council also intends to develop the proposal for community nurse prescribers that it consulted on in 2013.

Information for registered nurses interested in gaining prescribing rights

The Council is aware that many nurses have completed  papers towards a clinical masters’ degree that are similar to those outlined in the

Education standards for the postgraduate diploma in registered nurse prescribing for long term and common conditions

When the legislative changes are in place, the Council will implement a process to recognise postgraduate education in pathophysiology, clinical assessment and pharmacology, and prescribing practicum.  Depending on the content and or recency of the completed papers/ programme, the registered nurses may be required to complete further education or supervised prescribing practice.  The Council is unable to confirm individual papers or qualifications until the application has been agreed by the Government.  Transition arrangements for Diabetes registered nurse prescribers will also be outlined at this time.

Registered nurses who have yet to commence or complete a programme of study are advised to seek guidance from a school of nursing that provides a clinical masters’ programme. 

Application for registered nurse prescribing primary health and specialty teams (PDF, 460 KB)

Appendix 1 Consultation Document Two proposals registered nurse prescribing (PDF, 1 MB)

Appendix 2 Analysis of Submissions (PDF, 1 MB)

Appendix 3 Standards for the Postgraduate diploma for registered nurse prescribing for long-term and common conditions (PDF, 200 KB)

Competencies for nurse prescribing (PDF, 236 KB)

Appendix 5 Guidelines for Prescribing Practicum for DN Priority 2014 (PDF, 743 KB)

Appendix 5 Guideline Medical Supervision of Diabetes Nurse Prescribers Priority 2014 (PDF, 428 KB)

Appendix 6 Indicative list of prescription medicines according to NZ Formulary therapeutic groups (PDF, 269 KB)

Appendix 7 Medicines report (PDF, 1 MB)

Appendix 8 List of devices (PDF, 33 KB)

Appendix 8 Non-prescription subsidised medicines (PDF, 225 KB)

Appendix 9 Non Prescription medicines non subsidised (PDF, 154 KB)

Appendix 10 Letter from PHARMAC re non prescription medicines (PDF, 372 KB)

Appendix 11 Consultation email and List of organisations sent to (PDF, 329 KB)

Appendix 12 List of submitters Consultation on two proposals for registered nurse prescribing (PDF, 167 KB)

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