NP/MP Scope of practice
Clinical guidelines | Approved clinical guidelinesA scope of practice is how a NP describes their practice and includes reference to the population service group in which they are authorised to practice. Clinical guidelines are approved by the Area Health Service Chief Executive, separate from the authorisation process.
- health needs of people
- level of competence and experience of the NP
- policy requirements of the health service in which they work.
- age range of patients/clients
- presenting symptoms or complaints
- actual disease state or diagnosis
- severity of symptoms
- geographical location of the patient/clients.
Guidelines are intended as neither a cookbook nor textbook. They can assist health care professionals in making decisions about appropriate and effective care for patients. The NP, along with a local multidisciplinary team develops and takes responsibility for the clinical content of the clinical guidelines.
The Nurses and Midwives Act 1991 makes provision for the NSW Director-General of Health to approve guidelines. The approval of the NP guidelines has been delegated by the Director-General, NSW Department of Health to the Chief Executive of each Area Health Service.
The scope of practice/clinical guidelines is required by law to provide a framework to guide the clinical practice of the Nurse Practitioner. An infringement of the approved guidelines may constitute "professional misconduct or unsatisfactory professional conduct" under the Nurses and Midwives Act 1991.
Other points of interest
NPs do not have access to PBS prescriber numbers or unlimited prescribing of medications. Any initiation of medication will relate to the NPs scope of practice/clinical practice guidelines.
Clinical guidelines
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scope of practice, ie. context and level of practice
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diagnostic tests that will be used and a list of medications (formulary) that will be prescribed, including the related clinical condition
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existing clinical practice guidelines that are relevant to their practice.
The AHS is to ensure that each NP/MP has defined their guideline/scope of practice and that this is evidence-based and in accordance with AHS policy requirements (eg. Codes of Conduct and Ethics, etc.).
The approval of these NP guidelines (including the scopes of practice) has been delegated by the NSW Department of Health Director-General to Chief Executives of each Area Health Service.
In order to ensure consistency across NSW a guidelines and formulary approval proforma is appended to the Policy Directive: Nurse/Midwife Practitioners in NSW.
Additionally, prior to final Chief Executive signoff, the Area or hospital Drug Committee needs to approve the drugs that are identified for use by the NP/MP in the formulary to ensure clinical appropriateness and consistency with local policy.
The signed agreement must include the Area Director of Clinical Operations and the Area Director of Nursing and Midwifery Services.
Approved clinical guidelines
When a NP clinical practice guideline is approved by an Area Health Service the Chief Nursing and Midwifery Officer is sent a copy of the guideline, local signatories and the formulary and it is published here.
This web page is managed and authorised by Nursing & Midwifery Office of the NSW Department of Health. Last updated: 31 March, 2009