Nurse Prescribing

Registered Nurse Prescribing

Prescribing by registered nurses makes it easier for New Zealanders to get the medicines and health care they need.

There are three levels of prescribing authority for nurses and each level has its own educational requirements:

  1. Nurse practitioners are authorised to prescribe any prescription medicine
  2. Registered nurse prescribing in primary health and specialty teams -prescribe from a schedule of common medicines for common and long-term condition
  3. Registered nurse prescribing in community health -prescribe from a limited schedule of medicines. This is being trialed in 2017

You can check on the Register of Nurses to see if a nurse is authorised to prescribe.

Read more...

The following chart sets out the prescribing authority, scope of practice and required preparation for each model/level of prescribing.

Comparison of nurse prescribing models in New Zealand

 

Registered nurse prescribing

in community health

(Being trialed and evaluated in 2017)

Registered nurse prescribing

in primary health and specialty teams 

(Introduced in 2016 and includes Registered Nurses prescribing in diabetes health)

Nurse practitioner

Prescribing authority

 

Designated prescriber: Able to prescribe from a limited schedule of medicines.

Designated prescriber:

Able to prescribe from a schedule of common prescription medicines.

Authorised prescriber:

Able to prescribe any prescription medicine. 

Scope of practice

Must be credentialed on a recertification programme for registered nurse prescribing in community health.

Uses clinical pathways/ guidelines to treat a small number of conditions for normally health people.

Must work in a collaborative team with an authorised prescriber available for consultation.

Able to diagnose and treat long-term and common conditions (e.g. asthma, diabetes, hypertension) within a collaborative team. 

Able to independently assess, diagnose and treat a range of conditions for a population group in an area of practice.  May work autonomously or within a health care organisation.  Consults with health professional colleagues when relevant.
Additional qualification Recertification programme including education, supervision in practice and credentialing. Post graduate diploma in registered nurse prescribing for long-term and common conditions. Clinical Master’s degree for the nurse practitioner scope of practice.

Benefits

The ability of suitably- qualified nurses to prescribe makes better use of the skills of nurses and increases their contribution to health promotion, disease prevention and the assessment and treatment of ailments and illnesses.

Prescribing by registered nurses provides flexibility to meet different patient needs and particularly the needs of growing numbers of New Zealanders with lifestyle and chronic health conditions. It also improves access to health care for those groups who find it difficult to access services, including those with lower socioeconomic resources, children, youth, Maori, Pacific peoples and those in remote and rural locations. 

The range of prescribing authority enables the educational preparation of nurses to be effectively tailored to the level of prescribing.

Background

The expansion of registered nurse prescribing builds on the success of registered nurse prescribing in diabetes health, which has been occurring since 2011. This has been found to be safe and has been well-received by patients and by doctors who have appreciated being freed up to work with more complex cases.

The two levels of Registered Nurse prescribing (under Nurse Practitioner prescribing) have been developed following a consultation completed by the Nursing Council in 2013.

Overseas experience in Australia, Canada and the UK shows that nurse prescribing is safe and acceptable to consumers. The evidence also indicates that nurses are conservative prescribers and tend to prescribe in line with recommended best practice.

In New Zealand registered nurses prescribe in accordance with the Medicines (Designated Prescriber – Registered Nurses) Regulations 2016 made under sections 105 and 105B of the Medicines Act 1981, which came into force in September 2016.

Return to top ^