This notice is given pursuant to sections 11 and 12 of the Health Practitioners Competence Assurance Act 2003, and the Medicines (Designated Prescriber – Registered Nurses) Regulations 2016 made under sections 105 and 105B of the Medicines Act 1981, and comes into effect on 20 September 2016.

On 20 September 2016 it replaces the Notice of Replacement by the Nursing Council of New Zealand of Scope of Practice and Prescribed Qualifications for Registered Nurses, published in the New Zealand Gazette, 9 July 2015, Issue No. 74, Notice No. 2015-gs3932, and on 30 November 2016 it replaces the Medicines (Designated Prescriber – Registered Nurses Practising in Diabetes Health) Notice 2011, as published in the New Zealand Gazette, 31 March 2011, No. 41, page 1006.

Dated at Wellington this 18th day of August 2016.

CAROLYN REED, Registrar, Nursing Council of New Zealand.

Explanatory note

Introduction

Under the Medicines (Designated Prescriber – Registered Nurses) Regulations 2016 made under the Medicines Act 1981, the Nursing Council of New Zealand (“Council”) may set qualifications, training and assessment requirements for registered nurses commencing to prescribe for the first time and other training and assessments to be completed at specified times. These are outlined in the notice titled Medicines (Designated Prescriber – Registered Nurses) Notice 2016, published in the New Zealand Gazette, 18 August 2016, Issue No. 72, Notice No. 2016-gs4683.

Under sections 11(2) and 12 the Health Practitioners Competence Assurance Act 2003, the Nursing Council of New Zealand is required to describe the scopes of practice for nursing in New Zealand and prescribe the qualifications for each scope of practice.

Changes coming into effect on 20 September 2016

In February 2013, the Council proposed that some suitably qualified and experienced registered nurses working in primary health and specialist teams be able to prescribe some prescription medicines. Previously prescribing was restricted to suitably qualified nurses in diabetes health.

The Council sought the views of stakeholders, including nurses, nurse practitioners, nursing organisations, medical organisations, pharmacist organisations, regulatory authorities and PHARMAC, district health boards, primary health organisations, Māori and Pacific health providers, and consumer groups. The consultation document was also available on the Council website for public comment. One hundred and ninety seven submissions were received with the majority in favour of this proposal. In October 2014, the Council applied to the Ministry of Health for designated prescribing rights for registered nurses practising in primary health and specialty teams. The proposal was agreed to by the Government in November 2015 and the Medicines (Designated Prescriber – Registered Nurses) Regulations 2016 and Misuse of Drugs Amendment Regulations 2016 were made by the Executive Council in June 2016.

The Council is also amending the scope of practice to allow some registered nurses to prescribe prescription medicines and including the education and training requirements for registered nurses prescribing in primary health and specialty teams as additional prescribed qualifications for registered nurses. This means that the Council is able to approve and monitor these programmes under section 12 of the Health Practitioners Competence Assurance Act 2003 and aligns the scope of practice and prescribed qualifications for registered nurses with the requirements of the Medicines (Designated Prescriber – Registered Nurses) Regulations 2016.

When registered nurses apply to the Council and meet the requirements to prescribe for the first time a condition/authorisation will be included in their scope of practice, on their practising certificates and the public register (on the Council’s website) to specify that they may prescribe within primary health and specialty teams.

The Medicines (Designated Prescriber – Registered Nurses practising in Diabetes Health) Regulations 2011 will be revoked on 30 November 2016. Registered nurses authorised to prescribe in diabetes health will be notified that they are authorised under the new regulation from 30 November 2016 and continue to have a condition in their scope of practice stating their specific area of practice (diabetes health) and that they must practise under the supervision of a medical practitioner. The Council has included registered nurses prescribing in diabetes health in the notice under the Medicines (Designated Prescriber – Registered Nurses) Regulations 2016 so that nurses who have commenced this qualification may continue to be authorised to prescribe for a period of 12 months (until 30 November 2017).

In August 2016, the Council will notify registered nurses prescribing in diabetes health affected by these changes and include information on its website.

Previous notices

The Council last published the scope of practice and prescribed qualifications for registered nurses in July 2015. The Council also published one notice under the Medicines (Designated Prescriber – Registered nurses practising in diabetes health) Regulation 2011. This Regulation will be revoked on 30 November 2016.

1. Notice of Replacement by the Nursing Council of New Zealand of Scope of Practice and Prescribed Qualifications for Registered Nurses, published in the New Zealand Gazette, 9 July 2015, Issue No. 74, Notice No. 2015-gs3932, which came into effect on 9 July 2015.
2. Medicines (Designated Prescriber – Registered nurses practising in diabetes health) Notice 2011, published in the New Zealand Gazette, 31 March 2011, No. 41, page 1006, outlined the requirements (qualifications and experience) for registered nurses practising in diabetes health who wish to prescribe prescription medicines. This notice came into effect on 1 April 2011.

Scope of Practice—Registered Nurses

Registered nurses utilise nursing knowledge and complex nursing judgment to assess health needs and provide care, and to advise and support people to manage their health. They practise independently and in collaboration with other health professionals, perform general nursing functions, and delegate to and direct enrolled nurses, health care assistants and others. They provide comprehensive assessments to develop, implement, and evaluate an integrated plan of health care, and provide interventions that require substantial scientific and professional knowledge, skills and clinical decision making. This occurs in a range of settings in partnership with individuals, families, whānau and communities. Registered nurses may practise in a variety of clinical contexts depending on their educational preparation and practice experience. Registered nurses may also use this expertise to manage, teach, evaluate and research nursing practice. Registered nurses are accountable for ensuring all health services they provide are consistent with their education and assessed competence, meet legislative requirements and are supported by appropriate standards. There will be conditions placed in the scope of practice of some registered nurses according to their qualifications or experience limiting them to a specific area of practice. Some nurses who have completed the required additional experience, education and training will be authorised by the Council to prescribe some medicines within their competence and area of practice.

The Nursing Council Competencies for Registered Nurses describe the skills and activities of registered nurses.

Prescribed Qualifications

New Zealand Graduates

1. A bachelor’s degree in nursing approved by the Nursing Council of New Zealand; or
2. a graduate nursing qualification at Level 7 on the New Zealand Qualifications Framework approved by the Nursing Council of New Zealand; or
3. a postgraduate nursing qualification at Level 8 on the New Zealand Qualifications Framework approved by the Nursing Council of New Zealand; and
4. a pass in an assessment of Nursing Council Competencies for Registered Nurses by an approved provider; and
5. a pass in an Examination for Registered Nurses set by the Nursing Council of New Zealand.

Registered Nurses from Overseas

1. Current registration with an overseas regulatory authority; and
2. successful completion of a nursing programme that is, in the Nursing Council’s opinion, equivalent to or as satisfactory as a bachelor’s degree programme in nursing at Level 7 on the New Zealand Qualifications Framework; or
3. successful completion of a graduate pre-registration nursing programme that is, in the Nursing Council’s opinion, equivalent to or as satisfactory as an approved New Zealand graduate nursing programme at Level 7 on the New Zealand Qualifications Framework that leads to registration in the registered nurse scope of practice; or
4. successful completion of a postgraduate pre-registration nursing programme that is, in the Nursing Council’s opinion, equivalent to or as satisfactory as an approved New Zealand postgraduate nursing programme at Level 8 on the New Zealand Qualifications Framework that leads to registration in the registered nurse scope of practice; and
5. two years’ post-registration nursing practice as a registered nurse of at least 2,500 hours within the five years immediately preceding the date of the application; and
6. at the direction of the Nursing Council, successful completion of a Nursing Council approved competence assessment programme.

Additional qualifications for registered nurses who wish to prescribe in primary health and specialty teams

1. A minimum of three years full-time equivalent 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;
2. the completion of a Council-approved postgraduate diploma in registered nurse prescribing for long-term and common conditions or equivalent as assessed by the Council, including
3. a practicuum with an authorised prescriber, which demonstrates knowledge to safely prescribe specified prescription medicines and knowledge of the regulatory framework for prescribing; and
4. satisfactory assessment of the competencies for nurse prescribers completed by an authorised prescriber.