A new scope of practice to be introduced next year
Following extensive consultation the Council has confirmed it will make changes to the nurse practitioner scope of practice and the education programmes that prepare nurse practitioners, to meet future health needs of New Zealanders. These changes will come into effect when the Council has completed work on new education programme standards and competencies for nurse practitioners in April 2017.
The scope of practice has been broadened and the requirement to restrict nurse practitioners to a specific area of practice has been removed. Nurse practitioners as advanced clinicians will be expected to self-regulate and practice within their area of competence and experience. These changes will allow greater flexibility and utility for nurse practitioners to meet future health needs of New Zealanders, including rural and other underserved and diverse and aging populations. The revised scope of practice also makes the role and contribution of nurse practitioners clearer to employers and the public, and differentiates the nurse practitioner from advanced registered nurse roles.
The Council has also decided to refocus the education programmes to prepare nurse practitioners. These programmes will have more specific programme outcomes and include 300 hours of protected clinical learning time. These changes will lead to greater consistency and breadth in nurse practitioner preparation and improve readiness for registration on completion of the programme.
New scope of practice for nurse practitioners from April 2017
Nurse practitioners have advanced education, clinical training and the demonstrated competence and legal authority to practise beyond the level of a registered nurse. Nurse practitioners work autonomously and in collaborative teams with other health professionals to promote health, prevent disease, and improve access and population health outcomes for a specific patient group or community. Nurse practitioners manage episodes of care as the lead healthcare provider in partnership with health consumers and their families/whānau. Nurse practitioners combine advanced nursing knowledge and skills with diagnostic reasoning and therapeutic knowledge to provide patient-centred healthcare services including the diagnosis and management of health consumers with common and complex health conditions. They provide a wide range of assessment and treatment interventions, ordering and interpreting diagnostic and laboratory tests, prescribing medicines within their area of competence and admitting and discharging from hospital and other healthcare services/settings. As clinical leaders they work across healthcare settings and influence health service delivery and the wider profession.
What does this mean for nurse practitioner applicants?
Applicants should continue to use the existing guidelines and competencies. You will be able to register with a condition describing your specific area of practice until November 2018. New guidelines will be issued when the competencies are finalised by the Council.
What does this mean for existing nurse practitioners?
Your scope statement will change but you will retain your existing conditions. Further information will be available in 2017 if you wish to apply to have a condition removed.
More background information on these changes can be found here
Current scope of practice and application process
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 administrating therapies for the management of potential or actual health needs. They work in partnership with individuals, families, whanau and communities across a range of settings. Nurse practitioners 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.
Nurse practitioners are authorised prescribers under the Medicines Amendment Act 2013
The Misuse of Drugs Amendment Regulations 2014 allows nurse practitioners to prescribe controlled drugs within their scope of practice for:
- Up to one month’s supply for Class A and B controlled drugs
- Up to three months’ supply for Class C controlled drugs.
Guidelines for nurses wishing to apply for registration in the nurse practitioner scope of practice are available from the downloads box in the right hand corner of this page.
The Medicines (Standing Order) Amendment Regulations 2016, extended the definition of who are permitted to issue standing orders to include optometrists and nurse practitioners. This means from 17 August 2016, nurse practitioners can issue standing orders and must comply with the regulatory requirements for monitoring and audit of the standing orders they issue ( Standing Order Guidelines 2012, Ministry of Health).
Nurse practitioners having the ability to issue standing orders will improve access to medicines and effective treatment and allows nurse practitioners to work to the full extent of their scope.
Nurse Practitioner qualifications
Nurse Practitioner qualifications
To register in the nurse practitioner scope of practice, the following qualifications are required:
- Registration with the Nursing Council of New Zealand in the registered nurse scope of practice; and
- A minimum of 4 years experience in a specific area of practice; and
- The completion of an approved clinical master’s degree programme which includes demonstration of the competencies for advanced practice and prescribing applied within a defined area of practice of the nurse practitioner. The programme must include relevant theory and concurrent practice; or
- The completion of an equivalent overseas clinically focused master’s degree qualification which meets the requirement specified above; and
- Passing an assessment by an approved panel against the nurse practitioner competencies.
Nurse Practitioner Competencies
Nurse Practitioner competencies
The Nursing Council’s competencies for nurse practitioners describe the skills, knowledge and activities of nurse practitioners. This document is also downloadable from the downloads box top right.
Continuing competence requirements
Continuing competence requirements
Every 3 years prescribing nurse practitioners will be required to provide evidence that they have maintained competence, when they apply for their practising certificate. This evidence includes:
- Ongoing peer review of their prescribing practice by an authorised prescriber; and
- A minimum of 40 hours per year of professional development over a 3 year period; and
- A minimum of 40 days per year of ongoing nursing practice over a 3 year period within their defined area of practice.
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