Registered nurse prescribing in primary health and specialty teams
These pages provide information for nurses, prescribing mentors, employers and educators.
Nurses who prescribe work in collaborative teams within primary health care and specialty services, including general practice, outpatient clinics, family planning, sexual health, public health, district and home care, and rural and remote areas.
The team setting is important so the nurse can consult a doctor or nurse practitioner when they need advice on diagnosis or treatment, if the patient’s health concerns are more complex than they can manage.
The specific common and long-term conditions nurses can prescribe for include diabetes and related conditions, hypertension, respiratory diseases including asthma and COPD, anxiety, depression, heart failure, gout, palliative care, contraception, vaccines, common skin conditions and infections. They prescribe from a restricted list of medicines.
Registered nurses who wish to prescribe in primary health and speciality teams are required to have additional qualifications:
- A minimum of three years full-time practice in the area they intend to prescribe in with at least one year of the total practice in New Zealand or a similar healthcare context;
- The completion of a Council-approved postgraduate diploma in registered nurse prescribing for long term and common conditions or equivalent as assessed by the Nursing Council
- A practicum with an authorised prescriber, which demonstrates knowledge to safely prescribe specified prescription medicines and knowledge of the regulatory framework for prescribing;
- Satisfactory assessment of the competencies for nurse prescribers completed by an authorised prescriber.
The programme outcomes for the postgraduate diploma in registered nurse prescribing for long-term and common conditions and Competencies for nurse prescribers(2016) are embedded in the education programme standards for nurse practitioner master’s programmes. This means the Postgraduate diploma may be credited to a nurse practitioner master’s programme. It also ensures a consistent educational foundation for both types of prescribers.
The following guideline has been developed to provide advice on maintaining safe prescribing practice within a collaborative team. It outlines the registered nurse’ prescribing authority and accountabilities, the legal limitations for designated prescriber, the requirement for team based care.
The Prescribing Practicum
The prescribing practicum is the final component of the Postgraduate diploma in registered nurse prescribing for long term and common conditions. It consists of at least 150 hours of clinical practice under the supervision of a prescribing mentor in a collaborative health team environment. The practicum includes opportunities to develop diagnostic skills, patient consultation and assessment skills, clinical decision-making and monitoring skills.
The Nursing Council has developed guidelines to inform registered nurses and prescribing mentors the requirements for the practicum including demonstrating learning outcomes, the role of the prescribing mentor and evidence of competence to prescribe.
Applying for authorisation to prescribe
There are two pathways for nurses wanting to prescribe:
- Nurses who have successfully completed the postgraduate diploma in registered nurse prescribing in primary health and specialty teams
- Nurses who have completed a postgraduate diploma or clinical masters that demonstrates equivalence to the education programme standards for the postgraduate diploma in registered nurse prescribing for long-term and common conditions
Information for employers
Nurse prescribing takes place in association with an organisation with clinical governance structures such as a District Health Board or a Primary Health Organisation. These organisations are responsible for providing support through nominating a senior clinician who co-ordinates the introduction of registered nurse prescribing and provides links to committees that oversee quality and risk and medicines review.
Employer and clinical team support is essential to make nurse prescribing work effectively. Nurses need to work in a position that actively supports their prescribing and where authorised prescriber mentors (senior registered doctors or nurse practitioners) are available for consultation and advice about prescribing decisions, if the patient’s presenting health concerns are more complex than the nurse can safely manage independently. Employers and senior clinical need to ensure this support is available.
Prescribing nurses should also have sufficient time and resources allocated to allow effective assessment, diagnosis and consultation with patients to ensure safe and appropriate prescribing decisions.
The Nursing Council has developed guidelines to inform registered nurses and employers on the preparation and ongoing requirements for nurses who are designated prescribers. This sets out the clinical governance and support that needs to be in place for registered nurse prescribing.
For more information see: