This notice is given under sections 11 and 12 of the Health Practitioners Competence Assurance Act 2003 and comes into effect on 6 April 2017.
On 6 April 2017 it replaces the notice published in the New Zealand Gazette, 29 May 2014, Issue No. 56, page 1590.
Under the Health Practitioners Competence Assurance Act 2003, the Nursing Council of New Zealand (“Council”) is required to describe the scopes of practice for nursing in New Zealand and prescribe the qualifications for each scope of practice.
Nurse practitioners are registered nurses who have completed further education and clinical training to enable them to be responsible for providing advanced nursing care and diagnosing and treating health conditions. Nurse practitioners were first registered in 2001. In 2014 the restrictions on nurse practitioner prescribing rights were removed and they became authorised prescribers under the Medicines Act 1981.
Changes coming into effect on 6 April 2017
In December 2014, the Council proposed broadening the nurse practitioner scope of practice to ensure it remains safe, flexible and appropriate to meet health needs; describes the health services the nurse practitioner provides; and differentiates the nurse practitioner from advanced registered nurse roles (including prescribing).
The Council also proposed that the requirement to restrict a nurse practitioner’s scope of practice to a specific area of practice be removed. The reason for this was to allow greater flexibility for nurse practitioner roles as health services change to meet health needs. The Council believes that nurse practitioners as advanced clinicians are able to ensure they practise within their area of competence and experience.
The Council also proposed that the educational programmes for nurse practitioners have standardised outcomes and specified clinical learning time to improve a student’s readiness for registration as a nurse practitioner on completion of the programme. The Council also proposed that the postgraduate diploma in registered nurse prescribing for long-term and common conditions be a prerequisite for the nurse practitioner Masters’ education programmes thereby creating a clearer qualification and career pathway for registered nurses who wish to become nurse practitioners.
The Council sought the views of stakeholders including nurses, nurse practitioners, education programme providers, health professional organisations, regulatory authorities and consumer groups. The consultation was also available on the Council’s website for public comment. The majority of submitters (77%) supported a broad generic scope of practice on the basis that the broad scope would increase flexibility to meet future health needs, increase understanding and acceptance of the role, increase nurse practitioner utilisation in health services and improve access for hard to reach populations. There was strong support for the focus on leadership in the scope of practice to be on clinical practice as the role is seen as being primarily clinically focused.
The majority of submitters (75%) supported a more standardised education programme and supported Council specifying dedicated clinical learning time (72%). The postgraduate diploma in registered nurse prescribing for long-term and common conditions as a prerequisite was not supported by 54% of submitters as potentially creating an unnecessary barrier for students.
In September 2015, the Council approved changes to the nurse practitioner scope of practice and agreed to introduce new education standards for nurse practitioner education programmes incorporating the programme outcomes of the postgraduate diploma in registered nurse prescribing for long-term and common conditions, and specified clinical learning time. The Council also agreed that registered nurses undertaking nurse practitioner programmes could still register with a condition to practise in a specific area for a period of 18 months until 30 September 2018. The change to the scope of practice and prescribed qualifications was delayed until the Council completed a consultation on the education programme standards and competencies.
The Council also consulted on removing the prescribed qualification to pass an assessment against the nurse practitioner competencies by a Council approved panel. This proposal was only supported by a minority of submitters (17%) with most submitters believing Council should remain involved. The Council decided to retain the panel assessment of competence at this time.
Some nurse practitioners who do not prescribe will continue to have a condition included in their scope of practice that they may not prescribe as an authorised prescriber. These conditions will be endorsed on their practising certificate and on the public register available on the Council’s website at www.nursingcouncil.org.nz.
The Council last published the scope of practice and prescribed qualifications for nurse practitioners in the New Zealand Gazette, 29 May 2014, Issue No. 56, page 1590.
Dated at Wellington this 27th day of February 2017.
CAROLYN REED, Registrar, Nursing Council of New Zealand.
Scope of Practice – Nurse Practitioner
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.
- Registration with the Nursing Council of New Zealand in the registered nurse scope of practice; and
- a minimum of four years of experience in an area of practice; and
- the completion of an approved clinical Master’s degree programme for the nurse practitioner scope of practice. The programme must include relevant theory and a minimum of 300 hours of clinical learning; and/or
- the completion of an equivalent overseas clinically focused Master’s degree qualification which meets the requirements specified in c. above; and
- passing an assessment against the nurse practitioner competencies by a Council approved panel.