Designated registered nurse prescribing

Registered nurses are the largest group of healthcare workers in Australia. Enabling suitably qualified and endorsed RNs to prescribe certain medicines under a prescribing agreement can improve access to timely, affordable, and safe healthcare. Only RNs who are endorsed by the NMBA and authorised locally may prescribe.

Health Ministers approved designated Registered Nurse (RN) prescribing in December 2024 following extensive national consideration and consultation.

The Nursing and Midwifery Board of Australia (NMBA) released the Endorsement for scheduled medicines - designated registered nurse prescriber standard on 30 September 2025. It enables registered nurses to prescribe Schedule 2, 3, 4 and 8 medicines in partnership with an authorised health practitioner (e.g. medical practitioner or nurse practitioner).

NSW Health is developing the governance and guidance required to support the safe implementation of designated RN prescribing across NSW Health.

Why has the NMBA developed this standard?

Supports access to timely and effective healthcare across Australia
Particularly benefits rural and remote communities.
Helps reduce pressure on hospitals and general practice.

National implementation Oversight Group (IOG)

A National Implementation Oversight Group (IOG) has been established to guide the national roll-out of designated RN prescribing.

The IOG includes representatives from national and jurisdictional Chief Nursing and Midwifery Officers, Ahpra and Australian Nursing and Midwifery Accreditation Council. It provides quarterly updates to the National Health Workforce Taskforce and works to support nationally consistent implementation.

NSW Health Implementation

Service based need - designated RN prescribing will be implemented only where there is demonstrated service need. Not all services will require designated RN prescribers. Note: RNs should speak with their line manager before enrolling in study. Completing a program or gaining endorsement does not authorise prescribing in NSW Health or guarantee employment as a designated RN prescriber.
Statewide Governance - Executive Steering Committee has been established to guide statewide implementation, chaired by the NSW Chief Nursing and Midwifery Officer.
Policy Directive - NSW Health will release a new Policy Directive to support safe and consistent designated RN prescribing.
Tools and Templates - Principles and a template for the prescribing and clinical mentorship agreements required by the NMBA standard will be provided to support consistency across NSW.

Endorsement eligibility criteria

To be eligible, an RN must:

Hold current general registration as an RN with no conditions or undertaking relevant to this endorsement.
Have 5,000 hours clinical experience within the past six years (equal to three years full-time experience).
Have completed approved programs of study that lead to the endorsement or have completed equivalent units approved by NMBA.

Legislative and regulatory requirements

Endorsement - Endorsement by the NMBA demonstrates the RN has met requirements to prescribe Schedule 2, 3, 4 and 8 medicines with an authorised health practitioner.
NSW Legislative Alignment - Designated RN prescribing in NSW must comply with the NSW Poisons and Therapeutic Goods Act and Regulations. In NSW Health only RNs endorsed by the NMBA and authorised by their employer may prescribe.

Scope of practice

Prescribing must match the RN’s individual scope of practice in a relevant clinical context.
The RN’s position description must specify prescribing as part of the role.
Designated RN prescribers are responsible and accountable for their prescribing decisions.

Prescribing agreement and mentorship

Prescribing agreement - a formal prescribing agreement is required between the designated RN prescriber and an authorised health practitioner (e.g. medical or nurse practitioner), approved by the Local Health District / Specialty Health Network.
Clinical mentorship - a six-month clinical mentorship with an authorised health practitioner is required post-endorsement to support safe prescribing practice.