A nurse practitioner (NP) is a registered nurse (RN) who has satisfied the requirements of the Nursing and Midwifery Board of Australia (NMBA) to be endorsed in accordance with the Health Practitioner Regulation National Law Act. Endorsement allows the NP to initiate diagnostic investigations, prescribe medications and make referrals. NPs work at an advanced practice level that demands:
- expert clinical knowledge
- advanced specialised education
- complex decision making skills
- clinical reasoning and diagnostic skills
- ability to initiate and evaluate therapeutic management plans
Importantly, being an expert-by-experience in a specialty is not on its own sufficient for NP endorsement. Nor is accepting more delegated medical tasks or technical procedures.
The Australian Nursing and Midwifery Accreditation Council (ANMAC) defines NP practice as:
'A NP is a RN educated and authorised to function autonomously and collaboratively in an advanced and extended clinical role. 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. The NP role is grounded in the nursing profession's values, knowledge, theories and practise and provides innovative and flexible health care delivery that compliments other health care providers. The scope of practice of the NP is determined by the context of practice.'
Nurse Practitioner resources
What is the role of a NP?
Due to increasing nursing specialisation and the need to address inequalities in access to healthcare, the role of the NP is centred on patient and population needs, thereby improving health outcomes. Career opportunities for nurses have changed, due to increased demands and because nurses have demonstrated their competence in a variety of extended practice roles. NPs value clinical nursing and provide a much-needed addition to the clinical career paths for the nursing profession.
Extensive national and international studies provide evidence of clinical and financial effectiveness of NPs. The research consistently demonstrates the positive performance of NPs in relation to increasing health care access, cost effectiveness and that the NPs role is safe, effective and highly acceptable to the patient population.
Endorsement as a NP
Guidelines and resources regarding endorsement as a nurse practitioner are available on the NMBA website Endorsement and Notations.
Evaluation of NP services
Evaluation is one of the critical elements in the implementation of NP services. Effective evaluation ensures the delivery of quality care that is responsive to the needs of the community.
The evaluation of the NP service in each local health district should include ongoing monitoring and review of the service consistent with the principles of continuous quality improvement, performance management and local health district evaluation strategies.
This evaluation should be based on the quality dimensions of safety, effectiveness, appropriateness, consumer participation, access and efficiency.
NSW Health have guidance for implementing the role of the nurse practitioner including the service analysis and planning tool.
If you would like further information contact the Nurse Practice and Informatics Principal Advisor Matthew Lutze via email at Matthew.Lutze@health.nsw.gov.au or contact the Nursing and Midwifery Office via phone on (02) 9391 9528