1. What does an NP ‘look’ like? Michelle Thomas Nurse Policy Officer Policy, Research and Practice Standards

2. 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

3. What is a Nurse Practitioner?

5. What they are not…

7. 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!

8. 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

9. 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

10. 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

11. The Two Pillars…

12. 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

13. 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

14. Get a copy of them and make them your own

15. 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

16. Where to start? Guidelines: Scope of Nursing & Midwifery Practice …equivalent to expanding scope of practice

17. 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

18. 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?

19. SOP Pre Endorsement Hazards? Policies and Procedures Organisational Change Model development Steering committees P&Ps CPGs Acceptable level of education? Level of supervised Practice? Process for assessing competency? Ongoing education to maintain competence Masters NP ANMC Standards CPD Guidelines Performance management

20. 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

21. How do you develop a model? Identified service need best met by NP IN What clients? When? When not? Where? By whom? OUT Referrals? Admission? Discharge? Transfer? HOW, WHAT? Advanced assessment Diagnostics? Therapeutic interventions Advanced technical skills CPGs & Policies What learning needs does the NPC have? How do you meet these?

23. How do I get endorsed? Michelle Thomas Nurse Policy Officer Policy, Research and Practice Standards

24. 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

25. Candidacy

26. 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

27. What happens when we move to national registration?

28. 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

29. 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

30. 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)

31. 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

32. 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

33. 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

34. 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)

35. 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

36. 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

37. 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

38. 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

39. 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

40. 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 profession- specific requirements  Requirements in existence at 30 June 2010 will satisfy initial annual renewal requirements  Self declaration upon renewal  Annual audit

41. 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

42. We need to focus on what is similar not different…. Look out for consultation

43. Contact Details Nurses Board of Victoria Websitewww.nbv.org.auwww.nbv.org.au Phone 03 8635 1200 STD callers 1300 362 309 Nursing and Midwifery Board of Australia Website www.nursingmidwiferyboard.gov.au www.nursingmidwiferyboard.gov.au Victorian Practitioner Regulation website Website www.health.vic.gov.au/pracreg/natdev www.health.vic.gov.au/pracreg/natdev