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Australian law and legislation applicable to nursing and GP nursing Legal Compliance and Clinical Governance Health Care and Nursing Laws and Legislation National Laws and Legislation Health Practitioner Regulation National Law (the national law) 2009 Controlled Substances Act 1984 Therapeutic Goods Act 1989 The Privacy Act 1988 Australian and New Zealand College Mental Health Nurses Standards My Health Records Act 2012 Family Law Act 1975 National Health Act 1953 Human Services (Medicare) Act 1973 Health Legislation Amendment (Improved Medicare Compliance and Other Measures) Act 2018 States and Territories Children's Protection Act 1993 Consent to Medical Treatment and Palliative Care Act 1995 Coroners Act 2003 Drugs Act 1908 Freedom of Information Act 1991 Guardianship and Administration Act 1993 Health & Community Services Complaints Act 2004 Juries Act 1927 Mental Health Act 2009 Health Care Act 2008 Supported Residential Facilities Act 1992 Therapeutic Goods Act 1989 Therapeutic Goods Regulations 1990 Aged Care Act 1997 Crimes Act 1914 Abortion Reform Act 2008 Standards, Codes and Guidelines Nurse Practitioner Standards for Practice 2021 Registered Nurse Standards for Practice 2016 Enrolled Nurse Standards for Practice 2016 National Practice Standards for the Nurse in General Practice 2014 National School Nursing Professional Practice Standards 2nd edn 2009 National Standards of Practice for Maternal, Child & Family Health Nurses in Australia 2017 ASHHNA Competency Standards for Sexual and Reproductive Health and HIV Nurses 2nd edn 2011 Mental Health Practice Standards for Nurses in Australian General Practice 2018 Standards for Providing Quality Palliative Care for all Australians 2005 Code of conduct for Nurses 2018 Code of Ethics for Nurses 2012 Social Media Policy 2014 National Safety and Quality Primary and Community Healthcare Standards 2024 National Safety and Quality Health Service Standards 2nd edn 2017 Australian Guidelines for the Prevention and Control of Infection in Healthcare (2019) Framework Decision Making Framework 2013 Career & Education Framework for Nurses in Primary Health Care SA Health Clinical Services Capability Framework (CSCF) 2016 Paediatric and Adolescent Palliative Care Model of Care Framework Nursing Regulators, Professional Bodies and Industry Experts Nursing Regulators, Professional Bodies and Industry Experts Australian Health Practitioner Regulation Agency (AHPRA) (regulatory body for health professionals) Nursing and Midwifery Board of Australia (NMBA) (Professional Codes and Guidelines) Australian Nursing and Midwifery Federation (ANMF) (National Practice Standards for Nurses in Primary Health) Australian Nursing and Midwifery Federation (ANMF) (National School Nursing Professional Practice Standards - being revised) Australian Nursing Midwifery Federation SA (ANMFSA) (union, PII and CPD) Australian Primary Health Care Nurses Association (APNA) (Industry Expert, PII, CPD) Australian College of Nursing (ACN) (membership, events and higher education services) The Australian College of Mental Health Nurses (ACMHN) ( professional organisation and credentialing body for mental health nurses in Australia) Royal Australian College of General Practitioner (RACGP) (professional body responsible for maintaining standards for quality clinical practice, education and training, and research in Australian general practice) Australian Medical Association (AMA) (membership organisation representing registered medical practitioners and medical students of Australia) Nurses Award 2010 (updated 2019) Nurses Award 2010 Pay Guide (updated 2019) Nursing and Midwifery Public Sector Pay Rates (2019) APNA Workforce Survey (2017) APNA Workforce Survey (2018) APNA How to read the Nurses Award (levels and scope) Work, Health and Safety Laws and Legislation National Work, Health & Safety Laws and Legislation Civil Liability Act 1936 (SA) Fair Work Act 2009 Superannuation Guarantee (Administration) Act 1992 Australian Human Rights Commission Act 1986 Age Discrimination Act 2004 Disability Discrimination Act 1992 Racial Discrimination Act 1975 Sex Discrimination Act 1984 The Equal Opportunity Act 2010 (1984) The Racial and Religious Tolerance Act 2001 The Charter of Human Rights and Responsibilities Act 2006 Mutual Recognition (SA) Act 1993 Mutual Recognition Act 1992 (Commonwealth ) administered by all Australian Dangerous Substances Act 1979 Dangerous Substances (General) Regulations 2017 States and Territories Trans-Tasman Mutual Recognition (SA) Act 1999 Occupational, Health Safety and Welfare Act 1986 Ombudsman Act 1972 Public and Environmental Health Act 1987 Racial Vilification Act 1996 Road Traffic Act 1961 Whistleblowers Protection Act 1993 Work Health and Safety Act 2012 Work Health and Safety Regulations 2012 Workplace Injury Rehabilitation and Compensation Act 2013 Standards, Codes and Guidelines First aid in the workplace (March 2019) Hazardous manual tasks – code of practice How to manage work health and safety risks (March 2019) Labeling of workplace hazardous chemicals Managing risks of hazardous chemicals in the workplace (March 2019) (Mercury/LN2) Preparation of safety data sheets for hazardous chemicals (March 2019) Work health and safety consultation, co-operation and co-ordination (March 2019) National Code of Practice for Chemicals of Security Concern Code of Practice: Managing Risks of Hazardous Chemicals in the Workplace. National Code of Practice for Labelling of Workplace Substances Managing risks of hazardous chemicals in the workplace - Code of Practice Labeling of workplace hazardous chemicals - Code of Practice Preparation of safety data sheets for hazardous chemicals - Code of Practice Managing the Work Environment and Facilities - Code of Practice: Code of Practice: Hazardous manual tasks How to manage work health and safety risks - Code of Practice Managing risks of hazardous chemicals in the workplace - Code of Practice Managing the work environment and facilities - Code of Practice Work health and safety consultation, co-operation and co-ordination - Code of Practice Managing the risk of plant in the workplace Safe design of structure code of practice Work-related psychological health and safety A systematic approach to meeting your duties National guidance material Framework Principles of good working design How to determine what is reasonably practicable to meet a health and safety duty WHS Regulators, Governing Bodies and Compliance Safework SA (Regulator for WHS and online learning) Return to Work SA ( work injury insurance and regulating the South Australian Return to Work scheme.) Community Workers (WHS guidelines) Fair Work Commission (Australian industrial relations tribunal) Fair Work Ombudsman (Awards, Pay, Entitlements, Unfair/Unlawful Dismissal) Fair Work Ombudsman Employee vs Contractor (Sham Contracting) Australian Human Rights Commission (Human Rights and Equal Opportunity) Australian Competition & Consumer Commission (national competition, consumer, fair trading and product safety regulator) Nurses Award 2010 (updated 2019) Nurses Award 2010 Pay Guide (updated 2019) VET Laws and Legislation National Laws and Legislation National Vocational Education and Training Regulator Act 2011 National Vocational Education and Training Regulator (Consequential Amendments)Act 2011 National Vocational Education and Training Regulator (Transitional Provision)Act 2011 Standards, Codes and Guidelines Standards for Registered Training Organisations 2015 Nurse Educator Core Competencies 2016 Standards for VET Regulators 2015 Standards for VET Accredited Courses 2012 Standards for Training Packages 2013 Framework Australian Core Skills Framework (ACSF) Australian Quality Framework (AQF) Regulators, Governing Bodies and Compliance Australian Competition & Consumer Commission Australian Human Rights Commission Australian Skills Quality Authority (ASQA) Australian Industry and Skills Committee (AISC) Training.gov.au (Nationally Recognised Training) Skills Service Organisations (SSOs) Industry Referencing Committee (IRC) South Australian Skills Commission VET Regulators, Governing Bodies and Compliance Training.gov Current Courses and Approved Providers Training.gov provides information on the current and superseded (previous) qualifications nationally recognised in Australia and RTO's (Registered Training Organisations) approved to deliver these courses. Training.gov also provides a list of core and elective units required to achieve the qualification, unit of competency and assessment criteria details. ASQA Nationally Accredited Training Registration ASQA (Australian Skills Quality Authority) is the national regulator for Australia's vocational education and training sector. ASQA regulates courses and training providers to ensure nationally approved quality standards are met. Training Advocate Information, Support and Issue Resolution Charter of Functions; The Training Advocate will continue to support clients or prospective clients, including international students, with their questions or concerns about the education and training system. The Training Advocate will carry out functions described in a Charter in accordance with Part 2 Division 4 Section 21 of the Training and Skills Development Act 2008 (the Act). Services are available for; domestic and international students, organisations, trainees and apprentices and adult community education. ANMAC Nationally Accredited Training ANMAC (Australian Nursing and Midwifery Accreditation Council) is the independent accrediting authority for nursing and midwifery education under Australia's National Registration and Accreditation Scheme. ANMAC helps to protect the health and safety of the Australian community by establishing high-quality standards of nursing and midwifery education, training and assessment. ANMAC is responsible for facilitating the development of content for accreditation standards in consultation with our stakeholders and representatives from the professions. ANMAC is also responsible for determining whether programs of study for nurses and midwives seeking to practice in Australia meet the required accreditation standards. AHPRA Approved and Inactive Programs of Study AHPRA (Australian Healthcare Practitioner Regulation Agency) Governs the 15 National boards responsible for registering health practitioners and students. AHPRA also allows the public to search for approved programs of study and providers of these approved programs by profession, education provider or program of study name. NMBA Regulator for Australia's Nurses and Midwives NMBA (Nursing and Midwifery Board of Australia) is responsible for; Registering nursing and midwifery practitioners and students (criminal history, English language, CPD, recency of practice and PII). Developing standards, codes and guidelines for the nursing and midwifery profession (standards of practice, code of conduct, code of ethics, decision making framework and re-entry to practice). Handling notifications, complaints, investigations and disciplinary hearings (conditions, undertakings and reprimands). Assessing overseas trained practitioners who wish to practice in Australia. Approving accreditation standards and accredited courses of study. SSOs Skills Service Organisations (SSOs) are independent, professional service organisations that support Industry Reference Committees (IRCs) in their work developing and reviewing training packages. There are six SSOs funded by the Australian Government Department of Education and Training. SSOs support industry engagement while remaining independent from both industry and the training sector. Each SSO provides agreed services to several IRCs. This includes providing secretariat services and travel and accommodation support, preparing documents such as the skills forecast and proposed schedule of work, and assisting with developing and reviewing training packages. SSOs are also a key access point for other industry stakeholders who want to play a part in the development of training packages. AISC The Australian Industry and Skills Committee (AISC) was established by the COAG Industry and Skills Council in May 2015 to give industry a formal role in approving vocational education and training (VET) training packages for implementation. Professor John Pollaers chairs the AISC. Members include industry leaders nominated by Commonwealth and state and territory ministers responsible for skills and training, a peak body representative (rotating between the Australian Chamber of Commerce and Industry, the Business Council of Australia and the Australian Industry Group), and two ex-officio members (senior government officials). IRCs Industry Reference Committees (IRCs) are the formal channel for considering industry skills requirements in the development and review of training packages. In 2017 all IRCs were reviewed and followed the Guiding Principles developed by the Australian Industry and Skills Committee (AISC). Each IRC is made up of people with close links to industry. They are leaders in their own sectors from big business to small enterprise and peak bodies to unions, who understand the skills needs of their sector, industry or occupation. IRCs advise the AISC about the skills needs of their industry sector. IRCs ensure training packages meet the needs and concerns of employers, employees, training providers, and people seeking training qualifications. To make sure industry’s voice is heard, IRCs gather information from their industry sector - including challenges, opportunities, trends and industry requirements for training - to advise on training packages. They use this information to develop and review training packages to help make sure the national training system provides the qualifications, knowledge and skill sets that industry needs. IRCs also promote the use of vocational education and training in the industry sectors they represent. Each IRC is supported by a Skills Service Organisation (SSO) to help them in their work. COAG The Council of Australian Governments (COAG) is the peak intergovernmental forum in Australia. The members of COAG are the Prime Minister, state and territory First Ministers and the President of the Australian Local Government Association (ALGA). The Prime Minister chairs COAG. COAG was established in 1992. Its role is to manage matters of national significance or matters that need co-ordinated action by all Australian governments. COAG Councils support COAG and allow it to focus on key national priorities. Councils provide a forum for intergovernmental collaboration and decision-making. They progress COAG priorities and referrals of work, along with other issues of national significance. In addition, the Councils develop policy reforms and other advice for COAG consideration and oversee the delivery and review of reforms agreed by COAG There are eight COAG Councils: Federal Financial Relations Council Disability Reform Council Transport and Infrastructure Council Energy Council Industry and Skills Council Council of Attorneys-General Education Council Health Council. VetNet Training Packages The Department of Education and Training commissioned a national repository system called VETNet to store documents relating to Vocational Education and Training (VET). VETNet provides a central storage facility for relevant current and historical materials relating to the national VET sector, in particular companion volumes implementation guides . VETNet has been designed to allow you to find information about the VET sector quickly and easily, just by using the search function. You will find information and links to other useful websites about t he sector. SkillsIQ SkillsIQ Ltd is a not-for-profit, independent Skills Service Organisation supporting a range of Industry Reference Committees (IRCs) to undertake training product development that ensures skills meet future industry needs SkillsIQ objectives include facilitating IRCs to advise the Australian Government via the Australian Industry and Skills Committee (AISC) on positioning Australia to respond to additional demands for services as our population ages and to capitalise on synergies across the services sector to increase career pathways and mobility and recruitment of young people. NCVER The National Centre for Vocational Education Research (NCVER ) is the national professional body responsible for collecting, managing, analysing and communicating research and statistics on the Australian vocational education and training (VET) sector The National Centre for Vocational Education Research (NCVER) helps promote better understanding and discussion within the vocational education and training (VET) sector, and assists policymakers, practitioners, industry, training providers, and students to make informed decisions. ACSQHC This page provides an overview of the Australian Commission on Safety and Quality in Health Care (the Commission) – including its purpose and accountability. The Commission works in four priority areas: Patient safety Partnering with patients, consumers and communities Quality, cost and value Supporting health professionals to provide care that is informed, supported and organised to deliver safe and high-quality care. The Commission has also produced; The National Safety and Quality Health Service (NSQHS) Standards to protect the public from harm and improve the quality of health service provision. The NSQHS Standards provide a nationally consistent statement about the level of care consumers can expect from health services. CRICOS The Commonwealth Register of Institutions and Courses for Overseas Students (CRICOS) is the official Australian Government website that lists all Australian education providers that offer courses to people studying in Australia on student visas and the courses offered. This is the official Australian Government website for international students to search for courses, institutions and scholarships, read about studying and living in Australia, watch stories from other students, and learn about Australian education.

GP Nursing provides free access to current industry information and reputable sites for enrolled nurses, division 2 nurses, EN, to help them transition into Primary Health and GP Nursing WELCOME TO GP Nurse Training "We all started somewhere and it wasn't easy for most of us, imagine if someone was there to guide and support you and the difference that would have made." "Inspire, Motivate and Lead by Example" - Kristin Myall Primary and Community Health Care Settings Primary and community health care often only referrs to walkin or non-referral healthcare providers, secondary care often referrs to a specialist service that may or may not require a referral and tertiary care often referrs to a hospital setting. Aged care is was previously associated with tertiary care however, in recent descussions there is more of a shift to reclassify aged care as part of primary or community care or as it's own area. Recently there has been discussion around levels of access to care and care settings with a shift towards classification as primary and community care (non hospital), acute and emergency care (hospital) and where specialty care should be situated. Specialty care fall under primary, secondary and tertiary care depending on acute, chronic or complex presentations and the treatments required as this can vary throughtout the patinet health and illness continuum. Secondary care or specialty area nurses often miss out on education, training, mentoring and other opportunities available to nurses in other areas of nursing however there are many similarities between general practice and other specialists clinics. General p ractice falls under primary health care although general practitioners are classified as specialists however you do not require a referral to see one and in some other specialty clinics a referral is preferred but not essential. Primary and Community Health Care Nursing This website is designed to assist Division 1 and 2 nurses working in Primary and Community Health (and other healthcare fields), new or prospective primary health care nurses and nursing students to locate and access resources from current and reputable sources. This website has restricted access and log in details or passwords may be required to access hidden features, access can be requested through the sign up page and may be granted or revoked without notice as per site policy. GP Nurse training does not receive any funding or have any sponsors, this website is free to use and is not paid to promote other businesses, GP Nurse training recommends you subscribe and follow external links to reputable websites and follow their site policies.

Role and Responsibilities of a Practice Nurse GP Nursing General Practice Nursing is one of the most common primary health care and specialty area of nursing. General Practitioners hold specialist qualifications and registration with AHPRA just like other Medical Specialists and they have additional skill, knowledge and scope of practice in their specialty area. GP's just like GP nurses and nurses working in other primary, community and specialty areas may not find a post graduate course that covers all their education and training needs and will require ongoing education, training and CPD in their specialty area. Often the hardest part of expanding your scope of practice in a specialty area is not knowing where to start, what skills, knowledge and experience is required or event what these specialty areas involve. Roles and Responsibilities of a GP Nurse Clinical Perform clinical duties within the required level of clinical competency, according to best available evidence. Explain procedures to patients, providing them with support and reassurance. Duties include triage, immunisations and other injections, wound management, chronic disease management, Health Assessments, ECG’s and collection of pathology samples. Assist doctors with clinical procedures and maintain clinical documentation. Patient Services Assist with triage, data management, diagnostic services, networking with other providers, planning & management of patient care and patient advocacy. Telephone patients with test results to book a follow up appointment as directed by medical staff. Improvement of Patient Health OutcomesConduct preventative/screening procedures; assist with patient education and community health promotion activities. Co-ordinate patient recall and outreach programs and GP management plans and team care arrangement. Patient Visits Escort patients home and provide home/hospital visits as required for monitoring & support, including antenatal and post-natal care & health assessments if required and agreed with the employer. Equipment and Supplies Ensure sterilization and maintenance of clinical equipment. Maintain stocks of clinical supplies, including correct storage (such as refrigeration), removal of out-of-date stock and ordering supplies. Provide input in purchasing relevant clinical equipment and supplies. Compliance Maintain awareness of current and new legislation to ensure the business is complying with all statutory and regulatory obligations including infection control, sterilization, hazardous materials & safe handling/disposal of medical waste, records management, WHS, and accreditation. Ensure relevant personnel is kept informed and changes are made to systems and procedures as required. Professional Act within the practice and nursing code of ethics & appropriate level of clinical competence at all times. Maintain awareness of current evidence and research on clinical practices and inform/educate other practice staff. Change systems and procedures to ensure compliance with best available evidence as applicable. WHS Consistently be aware of WHS requirements and comply with them. General Delegation of tasks to other medical and non medical staff. Provide direct and indirect supervision to Division 2 Nurse/s. Assist with other practice duties as required. Professional Behaviour and Personal Attributes Ability to prioritise and organise, with attention to detail.Ability to work cooperatively and independently. Be always well-presented, friendly, courteous and obliging. Demonstrate a knowledge of and compliance with all relevant legislation and common law obligations affecting nursing. Demonstrate knowledge of policies and procedural guidelines that have legal implications, for example, ensure documentation conforms to legal requirements. Demonstrated commitment to the ongoing professional development. Demonstrated patient-focused approach in service provision with genuine empathy and interest in their needs. Discharge of duty of care in the course of practice including meeting practice standards, and accountability for nursing actions. Excellent interpersonal and communication skills across all ages and social groups. Have a vigilant attitude to accuracy, being prepared to double check as necessary. Identify and respond to unsafe practice, for example, implement interventions to prevent unsafe practice and/or contravention of the law. Maintain absolute confidentiality regarding patient and practice information. Possession of current driver’s license (include only if essential to perform the job, such as home visits). Practice only within the limits of their educational preparation, competence and scope of practice. Represent the practice in a confident and positive manner at all times.This position requires physical ability to occasionally lift and/or move patients. Undertake all duties in a diligent manner, with honesty and integrity. Education, Qualifications and Industry Experience Essential: Appropriate tertiary qualification & registration certificate.Professional indemnity cover. Minimum of one year nursing experience, preferably in a community-based role. Demonstrated understanding of the needs of the general practice and interest in community-based nursingincluding patient education and health promotion. Knowledge of current immunisation schedules, diabetes management, asthma management, enhancedprimary care items, infection control, CPR and emergency resuscitation techniques, equipment & drugs. National Police Clearance and DCSI (3 yearly)Senior First Aid and CPR (3 yearly). CPR (annually)Manual Handling (annual). Hand hygiene (annual). Desirable: Competence in the use of relevant equipment (ECG, Spirometry, ABI doppler, venepuncture, ear syringing). Experience with Clinical Software (Best Practice, ZedMed, Medical Director/PracSoft, Pen CS). Experience in a similar role as practice nurse or community-based nursing. Experience with specific social groups serviced by practice, such as infants, children, adolescents, aged care, migrant or refugee groups, Aboriginals & Torres Strait Islanders, CALD, etc. Additional qualifications such as Accredited Women’s Health Certificate (Pap Smears, Implanon), Diabetes Education, Asthma Education, Mental Health, Urine Drug Screening, etc.Training or experience in Medicare/DVA item numbers & health funds.Member of APNA, ANMF, etc. GP Nursing Professional Portfolio How to build a Professional Portfolio Qualifications, Credentials and Endorsements (ONCE ONLY) This includes; Certificate Diploma Undergraduate/Bachelor's Degree Post Graduate Certificate Post Graduate Diploma Post Graduate Degree Masters Degree Doctorate Degree (Formal Qualifications) Education, Training and Annual Updates (ROUTINE RE-ASSESSMENT) This includes; Senior First Aid/Basic Life Support (3 yearly) National Police Clearance & DCSI (3 yearly) CPR (annual) Manual Handling (annual) Infection Control/Hand Hygiene (annual) Medication Safety and Drug Calculations (annual) Registration, Membership and CPD (ONGOING REQUIREMENTS) This includes; Hours worked in the field per year (450 hours in past 5 years ) Criminal History Disclosure (mandatory ) English Language Skills (mandatory ) Professional Indemnity Insurance (mandatory ) Continual Professional Development Hours (20 CPD points annually, 30 if S8 endorsed or dual EN/RN/RM and NP )

Role and Responsibilities of a Practice Nurse Advanced Nursing Practice Advanced practice is where nurses incorporate professional leadership, education, research and support of systems into their practice. Their practice includes relevant expertise, critical thinking, complex decision-making, autonomous practice and is effective and safe. They work within a generalist or specialist context and they are responsible and accountable in managing people who have complex healthcare requirements. Advanced practice in nursing is demonstrated by a level of practice and not by a job title or level of remuneration. Advanced practice for the purpose of the nurse practitioner endorsement requires 5,000 hours clinically-based advanced practice in the past six years. Generalist practice encompasses a comprehensive spectrum of activities. It is directed towards a diversity of people with different health needs, takes place in a wide range of health care settings, and it is reflective of a broad range of knowledge and skills. Generalist practice may occur at any point on a continuum from novice to advanced. (Figure 1). Specialist practice The term ‘specialist’ defines roles focused within a specific context, for example, a particular population or skill set. Specialist practice follows and builds on a base of generalist preparation. Nurse specialists demonstrate in-depth knowledge, skills and expertise in their area of specialised nursing practice. Expertise in a particular specialty may be developed by undertaking formal education, exposure to relevant clinical experience in the practice area and continuing professional development. There are many nurse specialist roles at the advanced practice level, however, specialisation alone does not characterise an advanced level of practice. Specialist practice may also occur at any point on a continuum from beginning to advanced and is on one pole of the ‘specialist-generalist’ continuum, rather than on the developmental continuum from ‘novice’ to ‘advanced.' Advanced Nursing Practice - Guidelines for the Australian Context by Chief Nursing & Midwifery Officers Australia 2020 Advanced Nursing Practice - Guidelines for the Australian Context by Chief Nursing & Midwifery Officers Australia 2020 Advanced Nursing Practice Domains Education Uses knowledge and skills to educate those receiving care, peers and colleagues. Nurse practitioner standards for practice - Effective from 1 March 2021 Activities that contribute to improving health literacy and to supporting self-management of illness. Activities also develop and educate self and others across the health care community. Evidence of meeting requirements in this area may include: Advocates for and contributes to a culture of continuous professional development and evidence-based practice Identifies learning needs of various populations and contributes to the development of education programs/resources Demonstrates active involvement in the development of educational activities at a regional or broader level Participates in the delivery of postgraduate education programs Demonstrates reflective practice and develops this practice in others Conducts in-service education for senior nurses/ junior doctors/ management Evaluate education programs and recommend revision Serve as a clinical preceptor for other nurses/medical doctors Identify learning needs of various populations and contribute to the development of educational resources Serves as an informal educator to staff whilst providing direct care activities Provides patient and family education Advanced Nursing Practice- Guidelines for the Australian context by Chief Nursing and Midwifery Officers 2020 Australia Department of Health The Australian Advanced Practice Nursing self-appraisal tool QUT Research Research includes the creation of new knowledge and/or the use of existing knowledge in a new and creative way so as to generate new concepts, methodologies, inventions and understandings. This could include synthesis and analysis of previous research to the extent that it is new and creative: (Australian Code for the Responsible Conduct of Research, 2018, p.5) Activities that support a culture of inquiry and innovative problem solving to improve health outcomes and health care delivery systems. This includes conducting clinical research and translating evidence into clinical practice and policy development. Evidence of meeting requirements in this area may include: Evidence of active participation in research projects Publications Active participation/ leadership regarding quality audits Translating evidence into clinical practice and policy development Leads investigations to monitor and improve the quality of patient care practices Recommends policy changes when integrating theory into practice Advanced Nursing Practice- Guidelines for the Australian context by Chief Nursing and Midwifery Officers 2020 Australia Department of Health The Australian Advanced Practice Nursing self-appraisal tool QUT Leadership Uses clinical leadership that influences and progresses clinical care, policy and collaboration through all levels of health service. Nurse practitioner standards for practice - Effective from 1 March 2021 Activities that promote sharing and dissemination of knowledge, promote the profession and disseminate nursing knowledge. Demonstrate leadership in the role of consultant within and external to the profession and across health care settings. Evidence of meeting requirements in this area may include: Demonstrates high-level communication skills in disseminating nursing knowledge through presentations or publication at local, regional, national or international levels Serves as a resource or committee member in a professional organisation Demonstrates professional judgement and leadership in managing clinical care in complex clinical environments or across multiple service or patient populations Evaluating or initiating new patient services Initiating or introducing new clinical practices Clinical practice guidelines development, review and implementation Advanced Nursing Practice- Guidelines for the Australian context by Chief Nursing and Midwifery Officers 2020 Australia Department of Health The Australian Advanced Practice Nursing self-appraisal tool QUT Clinical Standard 1: Assess using diagnostic capasity Statement 1.1 NPs demonstrate complex and critical thinking to conduct comprehensive, relevant and holistic health assessments 1.1.1 demonstrates extensive knowledge of human sciences and health assessment 1.1.2 demonstrates comprehensive and systematic skill in obtaining relevant, appropriate and accurate data that inform differential diagnoses 1.1.3 assesses the complex and/or unstable healthcare needs of the person receiving care through synthesis and prioritisation of historical and available data 1.1.4 assesses the impact of comorbidities, including the effects of co-existing, multiple pathologies and prior treatments in the assessment of the person receiving care 1.1.5 demonstrates comprehensive skill in clinical examination including physical, mental health, social, ethnic and cultural dimensions 1.1.6 consistently and accurately synthesises and interprets assessment information specifically history, including prior treatment outcomes, physical findings and diagnostic data to identify normal, at risk and abnormal states of health, and 1.1.7 critically evaluates the impact of social determinants of health on both the individual person and the population. Statement 1.2: NPs demonstrate accountability in the timely and considered use of diagnostic investigations to inform clinical decision making 1.2.1 makes decisions about the use of person-focused diagnostic investigations that are informed by clinical findings and research evidence 1.2.2 demonstrates accountability in considering access, cost, clinical efficacy and the informed decision of the person receiving care when requesting diagnostic investigations 1.2.3 requests and/or performs selected screening and diagnostic investigations 1.2.4 is responsible and accountable for the interpretation of results and for following-up the appropriate course of action, and 1.2.5 uses effective communication strategies to inform the person receiving care and relevant health professionals of the health assessment findings and diagnoses. Statement 1.3: NPs integrate theoretical and practical knowledge to apply diagnostic reasoning to formulate diagnoses 1.3.1 synthesises knowledge of developmental and life stages, epidemiology, pathophysiology, behavioural sciences, psychopathology, environmental risks, demographics and societal processes when making a diagnosis 1.3.2 considers the person’s expectations of assessment, diagnosis and cost of healthcare 1.3.3 acts to prevent and/or diagnose urgent, emergent and life-threatening situations, and 1.3.4 determines clinical significance in the formulation of an accurate diagnosis from an informed set of differential diagnoses through the integration of the person’s history and best available evidence. Standard2: Plans care and engages others Statement 2.1: NPs critically and ethically translate and integrate evidence-based knowledge into planning care 2.1.1 takes personal responsibility to critically evaluate and integrate relevant research findings into decision making about healthcare management and interventions 2.1.2 ethically explores therapeutic options considering implications for care through the integration of assessment information, the person’s informed decision and best available evidence, and 2.1.3 is proactive and analytical in acquiring new knowledge related to NP practice Statement 2.2: NPs educate and support others to enable their active participation in care The NP: 2.2.1 respects the rights of the person to make informed decisions throughout their health/illness experience or episode, whilst ensuring access to accurate and appropriately interpreted information 2.2.2 uses appropriate teaching/learning strategies to provide diagnostic information that is relevant, theory-based and evidence-informed 2.2.3 communicates about health assessment findings and/or diagnoses, including outcomes and prognosis, and 2.2.4 works to meet identified needs for educating others regarding clinical and ongoing care. Statement 2.3: NPs consider quality use of medicines and therapeutic interventions using their comprehensive knowledge when planning care 2.3.1 develops an individual plan of care and communicates this to appropriate members of the healthcare team and relevant agencies 2.3.2 exhibits a comprehensive knowledge of pharmacology and pharmacokinetics related to NP scope of practice 2.3.3 works in partnership with the person receiving care to determine therapeutic goals and options 2.3.4 verifies the suitability of evidence-based treatment options including medicines, in regard to commencing, maintaining/titrating or ceasing interventions, and 2.3.5 demonstrates accountability in considering access, cost and clinical efficacy when planning treatment. Statement 2.4: NPs collaborate and consult for care decisions to obtain optimal outcomes for the person receiving care 2.4.1 collaborates with other health professionals to make and accept referrals as appropriate, and 2.4.2 consults with and/or refers to other health services, disability services, maternity services, aged-care providers and community agencies at any point in the care continuum. Standard 3: Prescribes and implaments therapeutic interventions Statement 3.1: NPs use professional knowledge when prescribing indicated non-pharmacological and pharmacological interventions 3.1.1 contributes to health literacy by sharing knowledge with the person receiving care to achieve evidence-informed management plans 3.1.2 safely prescribes therapeutic interventions based on accurate knowledge of the characteristics and concurrent therapies of the person receiving care 3.1.3 demonstrates professional integrity and ethical conduct in relation to therapeutic product manufacturers and pharmaceutical organisations 3.1.4 safely and effectively performs evidence-informed invasive/non-invasive interventions for the clinical management and/or prevention of illness, disease, injuries, disorders or conditions, and 3.1.5 interprets and follows-up the findings of screening and diagnostic investigations in an appropriate time frame during the implementation of care. Statement 3.2: NPs manage episodes of care, establishing and maintaining respectful relationships with people at the centre of care 3.2.1 supports, educates, coaches and counsels the person receiving care regarding diagnoses, prognoses and self-management, including their personal responses to illness, injuries, risk factors and therapeutic interventions 3.2.2 advises the person receiving care on therapeutic interventions including benefits, potential side effects, unexpected effects, interactions, importance of compliance and recommended follow-up 3.2.3 shares information with others in consultation with the person receiving care 3.2.4 discloses the facts of adverse events to the person receiving care and other health professionals; mitigates harm, and reports adverse events to appropriate authorities in keeping with relevant legislation and organisational policy 3.2.5 advocates for improved access to healthcare, the healthcare system and policy decisions that affect health and quality of life 3.2.6 practises without the discrimination that may be associated with race, age, disability, sexuality, gender identity, relationship status, power relations and/or social disadvantage 3.2.7 practises in a way that respects that family and community underpin the health of Aboriginal and/or Torres Strait Islander people, and 3.2.8 conducts relationships within a context of collaboration, mutual trust, respect and cultural safety. Statement 3.3: NPs recognise their duty of care and practise in accordance with federal, state and territory legislation and professional regulation governing NP practice 3.3.1 defines duty of care in accordance with relevant legislation and regulation 3.3.2 remains informed of changes to legislation and professional regulations, and implements appropriate alterations to practice in response to such changes, and 3.3.3contributes to the development of policy and procedures appropriate to context and specialty. Standard 4: Supports health systems Statement 4.1: NPs engage in reflective practice and evaluate the outcomes of their practice 4.1.1 monitors, evaluates and documents treatments/interventions in accordance with person- determined goals and healthcare system outcomes 4.1.2 develops plans for appropriately ceasing and/or modifying treatment in consultation with the person receiving care and, when needed, other members of the healthcare team 4.1.3 applies the best available evidence to identify and select appropriate outcomes measures of practice 4.1.4 uses quality indicators to monitor and measure the effectiveness of strategies, services and interventions to promote safe practice 4.1.5 participates in clinical supervision and clinical practice review 4.1.6 implements research-based innovations for improving care, and 4.1.7 contributes to research that addresses identified gaps in the provision of care and/or services. Statement 4.2: NPs advocate for, participate in, or lead systems that support safe care, partnership and professional growth 4.2.1 advocates and provides evidence for expansion to NP service where it is believed that such an expansion will improve access to quality and cost-effective healthcare for populations in all locations and contexts, including those in regional and remote communities 4.2.2 demonstrates clinical leadership in the design and evaluation of services for individuals and communities in health promotion, health protection or the prevention of injury and/or illness 4.2.3 articulates and promotes the NP role in clinical, political and professional contexts 4.2.4 acts as an educator and/or mentor to students, nursing colleagues and others in the healthcare team 4.2.5 critiques healthcare policies for their implications on the NP role and the populations for whom they care, and 4.2.6 influences health, disability and aged-care policy and practice through leadership and active participation in workplace and professional organisations. Support of systems is a practice domain of the Strong Model of Advanced Practice and is a contemporary feature of advanced practice. It is described as activities that promote quality and safe patient care and facilitate the optimal progression of patients through the healthcare system. NPs demonstrate the advanced practice activities in this domain that include: actively participate in the assessment, development, implementation, and evaluation of quality improvement programs in collaboration with healthcare teams provide clinical leadership in the development, implementation, and evaluation of standards of practice, policies and procedures serve as a mentor advocate the role of the nurse, and serve as a spokesperson for nursing and the health system when interacting with other professionals, patients, families, and the public. Nurse practitioner standards for practice - Effective from 1 March 2021 Activities that contribute to the optimal performance of health systems including advocacy and mentorship, developing and implementing innovative models of care and improving access to high quality health care and health outcomes Evidence of meeting requirements in this area may include: Contribute to, consult or collaborate with other health care personnel on recruitment and retention activities Participant in strategic planning for the service, department or hospital Provide direction for and participate in unit/service quality improvement programs Provide leadership in the development, implementation, and evaluation of standards of practice, policies and procedures Serve as a mentor Serve as a spokesperson for nursing and the health facility when interacting with other professionals, patients, families and the public Demonstrates leadership in strategic planning for the service, department or hospital Manages complex projects or leads projects relating to significant practice change within the service or organisation Develops and undertakes quality activities to advocate for and demonstrate the contribution of advanced nursing practice roles to the healthcare team and the health system more broadly Advanced Nursing Practice- Guidelines for the Australian context by Chief Nursing and Midwifery Officers 2020 Australia Department of Health The Australian Advanced Practice Nursing self-appraisal tool QUT What is the difference between RN1, RN2, RN3 and Advanced Practice? Registered nurse—level 1 (RN1) (a) An employee at this level performs their duties: (i) according to their level of competence; and (ii) under the general guidance of, or with general access to a more competent registered nurse (RN) who provides work related support and direction. (b) An employee at this level is required to perform general nursing duties which include substantially, but are not confined to: • delivering direct and comprehensive nursing care and individual case management to patients or clients within the practice setting; • coordinating services, including those of other disciplines or agencies, to individual patients or clients within the practice setting; • providing education, counselling and group work services orientated towards the promotion of health status improvement of patients and clients within the practice setting; • providing support, direction and education to newer or less experienced staff, including EN’s, and student EN’s and student nurses; • accepting accountability for the employee’s own standards of nursing care and service delivery; and • participating in action research and policy development within the practice setting Registered nurse—level 2 (RN2) (a) An employee at this level: (i) holds any other qualification required for working in the employee’s particular practice setting; and (ii) is appointed as such by a selection process or by reclassification from a lower level when the employee is required to perform the duties detailed in this subclause on a continuing basis. An employee at this level may also be known as a Clinical nurse. (b) In addition to the duties of an RN1, an employee at this level is required, to perform duties delegated by a Clinical nurse consultant or any higher level classification. Duties of a Clinical nurse will substantially include, but are not confined to: • delivering direct and comprehensive nursing care and individual case management to a specific group of patients or clients in a particular area of nursing practice within the practice setting; • providing support, direction, orientation and education to RN1’s, EN’s, student nurses and student EN’s; • being responsible for planning and coordinating services relating to a particular group of clients or patients in the practice setting, as delegated by the Clinical nurse consultant; • acting as a role model in the provision of holistic care to patients or clients in the practice setting; and • assisting in the management of action research projects, and participating in quality assurance programs and policy development within the practice setting. Registered nurse—level 3 (RN3) (a) An employee at this level: (i) holds any other qualification required for working in the employee’s particular practice setting; and (ii) is appointed as such by a selection process or by reclassification from a lower level when that the employee is required to perform the duties detailed in this subclause on a continuing basis. An employee at this level may also be known as a Clinical nurse consultant, Nurse manager or Nurse educator. (b) In addition to the duties of an RN2, an employee at this level will perform the following duties in accordance with practice settings and patient or client groups: (i) Duties of a Clinical Nurse Consultant will substantially include, but are not confined to: • providing leadership and role modelling, in collaboration with others including the Nurse manager and the Nurse educator, particularly in the areas of action research and quality assurance programs; • staff and patient/client education; • staff selection, management, development and appraisal; • participating in policy development and implementation; • acting as a consultant on request in the employee’s own area of proficiency; for the purpose of facilitating the provision of quality nursing care; • delivering direct and comprehensive nursing care to a specific group of patients or clients with complex nursing care needs, in a particular area of nursing practice within a practice setting; • coordinating, and ensuring the maintenance of standards of the nursing care of a specific group or population of patients or clients within a practice setting; and • coordinating or managing nursing or multidisciplinary service teams providing acute nursing and community services. (ii) Duties of a Nurse Manager will substantially include, but are not confined to: • providing leadership and role modelling, in collaboration with others including the Clinical nurse consultant and the Nurse educator, particularly in the areas of action research and quality assurance programs; • staff selection and education; • allocation and rostering of staff; • occupational health; • initiation and evaluation of research related to staff and resource management; • participating in policy development and implementation; • acting as a consultant on request in the employee’s own area of proficiency (for the purpose of facilitating the provision of quality nursing care); • being accountable for the management of human and material resources within a specified span of control, including the development and evaluation of staffing methodologies; and • managing financial matters, budget preparation and cost control in respect of nursing within that span of control. (iii) Duties of a Nurse Educator will substantially include, but are not confined to: • providing leadership and role modelling, in collaboration with others including the Clinical nurse consultant and the Nurse manager, particularly in the areas of action research; • implementation and evaluation of staff education and development programs; • staff selection; • implementation and evaluation of patient or client education programs; • participating in policy development and implementation; • acting as a consultant on request in the employee’s own area of proficiency (for the purpose of facilitating the provision of quality nursing care); and • being accountable for the assessment, planning, implementation and evaluation of nursing education and staff development programs for a specified population. (Nurses Award, 2010) Advanced Practice Registered Nurse Advanced practice is not an employment classification or pay schedule, and is demonstrated though post graduate education, training and clinical experience allowing registered nurses to work to their full scope of practice within their clinical context. Advanced practice nurses possess the required skills, knowledge and experience to commence the Master of Nurse Practitioner program and work towards endorsement as a Nurse Practitioner. (Fact sheet: Advanced nursing practice and specialty areas within nursing) NATIONAL PRACTICE STANDARDS Australian Nursing and Midwifery Federation Standards funded by the Australian Government Department of Health 2014 This document was mapped against the National competency standards for the registered nurse 2006 and is now replaced by Fact sheet: Advanced nursing practice and specialty areas within nursing. However may still be useful in providing examples on how to contextualise Advanced Practice in General Practice Nursing. How do I become Advanced Practice to prepare for Nurse Practitioner Endorsement? The Registration standard: Endorsement as a nurse practitioner (the registration standard) state that a nurse seeking endorsement as an NP must be able to demonstrate the following: Current general registration as an RN in Australia with no conditions or undertakings on their registration relating to unsatisfactory professional performance or unprofessional conduct. The equivalent of three years’ (5,000 hours) full-time experience at an advanced practice level, within the past six years, from the date when the application seeking endorsement as an NP is received by the NMBA. (Note: Advanced practice hours that are part of an NMBA-approved program of study cannot be included as evidence towards the 5,000 hours of advanced practice Successful completion of: - Pathway 1: an NMBA-approved program of study leading to endorsement as an NP, or - Pathway 2: a program that is substantially equivalent to an NMBA-approved program of study leading to endorsement as an NP, as determined by the NMBA. Compliance with the NMBA Nurse practitioner standards for practice . Continum of Novice to Advanced Practice (recommendation): Bachelor of Nursing or registered as a Division 1 Nurse on AHPRA 12 months TPPP (recommended, not mandatory) 2 years in a specialty field (can include TPP) Graduate Certificate/Diploma in your specialty field or education and/or study relevant to specialist area of practice (target area for endorsement) 2-3 years Advanced practice in this specialty field (target area for endorsement) Master of Nurse Practitioner (target area for endorsement) 5000+ hours of Advanced Practice in the same specialty field (target area for endorsement) Common Specialty fields include: Ageing and Palliative Care Chronic and Complex Care Child and Family Health Care Emergency and Acute Care Mental Health Care Primary Health Care (General Practice, Prision, Dermatology, Womens/Sexual Health, Diabetes, etc) (ACNP) A 'Generalist' Advanced Practice Nurse or Nurse Practitioner may work across all specialty fields, levels of healthcare including primary, secondary and tertiary care and different settings (GP, specialist, OPD, aged care, acute care). The most common type of 'Generalist' Advanced Practice Nurse or Nurse Practitioner is categorised as 'Remote and Rural'. The 'Generalist' Nurse Practitioner scope and definition is not currently clear and has no exact criteria for endorsement. This 'Generalist' Nurse Practitioner endorsement process has been a struggle for many nurses attempting to receive endorsement. 'Generalist practice encompasses a comprehensive spectrum of activities. It is directed towards a diversity of people with different health needs, takes place in a wide range of health care settings, and it is reflective of a broad range of knowledge and skills. Generalist practice may occur at any point on a continuum from novice to advanced.' Currently ther is a governmental push towards Generalist Nurse Practitioners in Primary Health Care to improve access to care and reduce the burdon on the hospital systems. For Nurse Practitioners to provide comprehensive care to patients they require a broad 'Generalist' scope of practice especially for Nurse Practitioners working in General Practice or Nurse Led Clinics. 'South Australians will have more options for free primary health care as part of a new pilot program expanding the number of nurse practitioners working in GP clinics, which will also help ease pressure on busy emergency departments.' - The Hon Mark Butler MP "To allow NPs to best address these health needs, research highlights the need for Australian NP education to pivot toward a more generalist focus. This allows a broader scope of practice rather than a narrow and specialised skillset." - Nurse Practitioner Workforce Plan Some other helpful resources in understanding the Advanced Practice Generalist Nurse and Generalist Nurse Practitioner include; The National Rural and Remote Nursing Generalist Framework 2023-2027 Rural Nurse Practitioners A framework for services and training in NSW Health QUT: the australian advanced practice nursing self-appraisal tool APNA: A framework for Advancing general practice nursing (Novice - Advanced RN in General Practice - Nurse Practitioner) How do I become Advanced Practice to prepare for Nurse Practitioner Endorsement? Advanced Practice Domains Examples of Education Novice Practice Intermediate-Advanced Practice Advanced Practice Examples of Research Novice Practice Intermediate-Advanced Practice Advanced Practice Examples of Leadership Novice Practice Intermediate-Advanced Practice Advanced Practice Nurse Practitioner Clinical Domains Standard 1: Assess using diagnostic capacity Novice Practice Intermediate-Advanced Practice Advanced Practice Standard 2: Plans care and engages others Novice Practice Intermediate-Advanced Practice Advanced Practice Standard 3: Prescribes and implements therapeutic interventions Novice Practice Intermediate-Advanced Practice Advanced Practice Standard 4: Support Health Systems Novice Practice Intermediate-Advanced Practice Advanced Practice Examples of continuum from 'Novice to Advanced Practice' Novice Practice: New graduate (education, training, scope and critical thinking/rationals) Intermediate-Advanced Practice: Post graduate studies (additional education and training, expansion of scope and in depth understanding, critical thinking/rationals) Advanced Practice: Post graduate studies (additional education and training, expansion of scope and in depth understanding, critical thinking/rationals) and in depth understanding anatomy, physiology, pathophysiology, pharmacology, MBS, PBS and NP scope (assess, diagnose, prescribe, treat, refer and collaboration for continuity of care) Nurse practitioner standards for practice - Effective from 1 March 2021 Key Terms Advanced practice is where nurses incorporate professional leadership, education, research and support of systems into their practice. Their practice includes relevant expertise, critical thinking, complex decision-making, autonomous practice and is effective and safe. They work within a generalist or specialist context and they are responsible and accountable in managing people who have complex healthcare requirements. Advanced practice in nursing is demonstrated by a level of practice and not by a job title or level of remuneration. Advanced practice for the purpose of the nurse practitioner endorsement requires 5,000 hours clinically-based advanced practice in the past six years. Autonomous practice is having the authority to make decisions and the freedom to act in accordance with one's professional knowledge base (Skar 2010). Competence is the combination of skills, knowledge, attitudes, values and abilities that underpin effective and/or superior performance in a profession/occupational area. Refer to the NMBA Registered nurse standards for practice Independence in these standards is the defining characteristic of NP practice that recognises the educational and advanced practice attributes beyond the Registered nurse standards for practice. This independence is inherent in the NP standards for practice and integrates aspects of the often-complex nursing practice for which the NP initiates and is responsible. NPs work collaboratively as part of a healthcare team and have the authority to diagnose and implement treatments without oversight from another health practitioner. Scope of practice is the full spectrum of roles, functions, responsibilities, activities and decision-making capacity that individuals within that profession are educated, competent and authorised to perform. Some functions within the scope of practice of any profession may be shared with other professions or other individuals or groups. The scope of practice of all health professions is influenced by the wider environment, the specific setting, legislation, policy, education, standards and the health needs of the population. The scope of practice of an individual is that which the individual is educated, authorised and competent to perform. The scope of practice of an individual nurse or midw ife may be more specifically defined than the scope of practice of their profession. To practise within the full contemporary scope of practice of the profession may require individuals to update or increase their knowledge, skills or competence. Decisions about both the individual’s and the profession’s practice can be guided using the Decision-making framework (DMF). When making these decisions, nurses and midwives need to consider their individual and their respective profession’s scope of practice. Nurse practitioner standards for practice - Effective from 1 March 2021