What does an NP ‘look’ like?
Michelle Thomas
Nurse Policy Officer
Policy, Research and Practice Standards
Role of NBV (any regulator)
The Nurses Board of Victoria’s purpose
under the Health Professions
Registration Act 2005 is to safeguard
the public.
• Approve Masters and Therapeutic
Medication Management Units
• Endorsement process
• Conduct oral examinations
What is a Nurse Practitioner?
What they are not…
Another thing NP endorsement
is not…
It is not a badge of honour awarded for a
nurse’s hard work
It is an ‘expert’ advanced practice nurse
moving to a ‘novice’ autonomous
nurse practitioner to meet a service
need
It is not about you!
The acknowledged definition…
A nurse practitioner is a registered nurse
educated and authorised to function
AUTONOMOUSLY and
COLLABORATIVELY in an advanced
and extended clinical role
The NP role includes ASSESSMENT and
MANAGEMENT of clients using nursing
knowledge and skills and may include
but is not limited to the direct
referral of patients to other health
care professionals, prescribing
medications and ordering diagnostic
investigations
The NP role is grounded in the nursing
profession’s values, knowledge,
theories and practise and provides
innovative and flexible health care
delivery that complements other health
care providers.
The scope of practice of the NP is
determined by the context in which the
NP is authorised to practise.
ANMC 2004
The Two Pillars…
National Competency
Standards for the Nurse
Practitioner
Dynamic practice that incorporates
application of high level knowledge and
skills in extended practice across stable,
unpredictable and complex situations
Professional efficacy whereby practice is
structured in a nursing model and enhanced
by autonomy and accountability
Clinical leadership that influences and
progresses clinical care, policy and
collaboration through all levels of health
care
How are these standards used?
Accepted standards for practice of
NPs in Victoria
Basis for standards for course
approval
Basis for equivalency assessments
Basis for course assessments
Basis for oral examinations
assessment
Professional conduct
CPD
Get a copy of them
and make them
your own
Nurse practitioner vs. other
advanced nursing roles
Competency standards are a
continuum
NP standards are built on the RN,
ARN standards
A vital exercise….
Map the model of care against the ARN and
NP competency standards and ensure the
NP components are clear
Where to start?
Guidelines: Scope of Nursing
& Midwifery Practice
…equivalent to expanding
scope of practice
The Guidelines were developed to assist
registered nurses with and without
endorsement to:
• Determine their current scope of
practice and identify own level of
competence
• Manage changes and expansion to
scope of practice
• Practice according to agreed principles
of supervision and delegation
SOP Pre Endorsement
Legislation
Professional standards
HPRA 2005
DP&CSA 1981
ANMC NP
Competency standard
NP Endorsement process
Will the increase in SOP
lead to an
increase in health
outcomes
of the health consumer?
What is the service
need and is it a
NP you need?
SOP Pre Endorsement
Hazards?
Policies and Procedures
Organisational Change
Acceptable level
of education?
Level of supervised
Practice?
Process for assessing
competency?
Ongoing education to
maintain competence
Model development
Steering committees
P&Ps
CPGs
Masters NP
ANMC Standards
CPD Guidelines
Performance
management
SOP Pre Endorsement
Are you educationally prepared and
competent to perform the activity?
Are you confident of your ability
to perform the activity safely?
Apply for endorsement
How do you develop a model?
Identified service need
best met by NP
IN
What clients?
When? When not?
Where?
By whom?
HOW, WHAT?
Advanced assessment
Diagnostics?
Therapeutic interventions
Advanced technical skills
CPGs & Policies
What learning needs
does the NPC have?
How do you meet these?
OUT
Referrals?
Admission?
Discharge?
Transfer?
How do I get endorsed?
Michelle Thomas
Nurse Policy Officer
Policy, Research and Practice Standards
The endorsement process
Education
- Masters level
- Approved Masters
-Equivalent Masters
-Therapeutic Medication
Modules
Candidacy
- service need
- model of care
-identifying mentors
- employment agreements
Endorsement
Application
- paperwork
- expert panel oral exam
Candidacy
Pathways for Endorsement
Pathway 1
Masters commenced
2009
Approved against 2008
course approval
standards
Model of care
Formulary
Case Studies
Organisation support
Professional indemnity
insurance
Pathway 2
Masters approved against
‘’old” course approval
standards OR
Masters deemed
equivalent
Model of care
Formulary
Case Studies
Organisation support
Professional indemnity
insurance
CV
Detailed evidence against
competency standards
What happens when
we move to national
registration?
Why national registration?
Protection of the public
Workforce mobility
Access to services provided by health
practitioners
To enable the continuous
development of a flexible, responsive
[innovative] and sustainable Australian
health workforce
National Registration and
Accreditation Scheme
 National system for health practitioner
regulation
 Public national register for 10 health
professions
 Independence of course accreditation
Functions (NB already the case in Victoria)
 National boards to exercise regulatory
functions
 Australian Health Practitioner Regulation
Agency (AHPRA) provides operation side
National Registration and
Accreditation Scheme
 Medical practitioners
 Nurses and Midwives
 Pharmacists
 Physiotherapists
 Podiatrists
 Psychologists
 Osteopaths
 Chiropractors
 Optometrists
 Dentists (including dental hygienists,
dental prosthetists and therapists)
Key New Elements
 Criminal history and identity checks
 Mandatory reporting
 Professional indemnity insurance
 Student registration
 Independent course accreditation
processes
Complaints access for health consumers
 Mandatory continuing professional
development
Changes for Nurses and Midwives
 Registration cost – unknown*
 Renewal date – 31 May commencing 2011
 Renewal period – 12 months + one month
 Two registers:- Nursing (RN and EN) &
Midwifery
 Nurses Board of Victoria (NBV) will become
a state committee of the Nursing and
Midwifery Board of Australia
http://www.nursingmidwiferyboard.gov.au
Registration Standards
 Criminal history
 Same standards for all health professions
 English language skills
 Initial course not taught or assessed in English
 IELTS 7 or OET B
 Professional indemnity insurance
 arrangements
 Self declaration
 Continuing Professional Development (CPD)
 20 hours annually
 If endorsed 10 hours of the 20 hours must be related
to endorsement
 Evidence verified
 Mandatory activities can be included
Registration Standards
 Recency of Practice
 Five year period
 Practice period of three months full time over
five
years or equivalent
 Endorsement Standards
 Nurse practitioner
 Scheduled medicines (eligible midwives)
 Scheduled medicines (registered nurse)
Criminal History and Identity
Checks
From 1 July 2010 boards to complete
criminal and identity history checks for all
health practitioners registering for the first
time in Australia
All other registrants to make an annual
declaration on criminal history matters
when renewing
Boards to have power to conduct ad hoc
criminal history and identity checks
Professional Indemnity Insurance
Must not practice unless the nurse or
midwife is covered in the conduct of their
practice by appropriate professional
indemnity insurance arrangements
All registrants to make an annual
declaration that insurance is or will be
when they practice in place.
Nurse and midwives responsibility to
understand the nature of the cover under
which they are practicing
Mandatory Reporting
 Registered Health Practitioners and employers
(e.g. hospitals) must report a registrant who
they believe has engaged in reportable conduct.
 Reportable conduct is: Practising while intoxicated by drugs or alcohol
 Engaging in sexual misconduct in professional
practice
 Placing the public at risk of substantial harm
through practitioners physical or mental impairment
 A significant departure from accepted professional
standards
For Students
 A student who has an impairment that during clinical
placement may place the public at substantial risk of
harm
Student Registration
National boards will register students
Each board will decide the point in the
program from which students must be
registered according to level of risk for the
public
From 2011 all boards will register students
Complaints Arrangements
Single point of contact for members of the
public with assistance provided where
required – National Agency
Complaints passed to the relevant board
Board and Health Complaints Commissioners
must attempt to reach agreement with
most serious action prevailing
Role of individual Health Complaints
Commissioners continues
Mandatory Continuing
Professional Development
Continuing professional development (CPD)
to be a condition of practice for all
registrants other than non-practising and
students
National boards to determine professionspecific requirements
Requirements in existence at 30 June 2010
will satisfy initial annual renewal
requirements
Self declaration upon renewal
Annual audit
But where does this leave NP
endorsement?
 ANMC definition and standards
 Masters level of education
 Different timing for endorsement
 Prescribing authority in Victoria
linked to the individual
 Prescribing authority in other
states linked to role with
protocols/CPGs
We need to focus on
what is similar not
different….
Look out for
consultation
Contact Details
Nurses Board of Victoria
Website
www.nbv.org.au
Phone
03 8635 1200
STD callers
1300 362 309
Nursing and Midwifery Board of
Australia
Website www.nursingmidwiferyboard.gov.au
Victorian Practitioner Regulation website
Website www.health.vic.gov.au/pracreg/natdev