Registered nurses will soon be able to prescribe some medications alongside an authorised health practitioner under an expansion of their scope of practice.
The Endorsement for scheduled medicines – designated registered nurse prescriber registration standard aims to enhance access to medicines and relieve pressure points in acute and primary care, where access to appointments can be challenging.
It will allow designated registered nurses to prescribe Schedule 2, 3, 4 and 8 medicines, which include antibiotics, strong analgesics, opioid analgesics and some benzodiazepines.
The Australian Health Practitioner Regulation Agency (Ahpra) said the move will enhance care coordination by freeing up other healthcare professionals to focus on more complex areas of patient care.
AMA President Dr Danielle McMullen said that while prescribing should remain primarily with doctors, the move potentially allows for some safe models of shared care.
“Patients in Australia expect that the doctor is the primary care giver and is at least involved in their care,” she said.
“We do think for complex prescribing it needs to be done by a doctor. There may be some limited cases where a very clear shared care pathway could be outlined with a nurse in the team, but there has got to be clear training provided.
“This isn’t a broad opening up of prescriber responsibilities, because medicine safety is really important.”
The Nursing and Midwifery Board of Australia and the Australian Nursing and Midwifery Accreditation Council have developed new Registered Nurse Prescribing Accreditation Standards to ensure nurses designated as prescribers meet the National Prescribing Competencies Framework.
NMBA Chair Adjunct Professor Veronica Casey said the board was confident registered nurses who are authorised to prescribe will do so safely within their scope of practice.
“Australia is well-positioned to follow the lead of comparable healthcare systems where registered nurse prescribing is already delivering successful outcomes,” she said.
“Creating an environment where medicines are used safely and optimally, with a focus on informed choice and coordinated, person-centred care, enables equitable access to medicines without compromising public safety.”
Under the new standard, to be able to prescribe, nurses must have postgraduate qualifications and adequate clinical experience.
One approved for prescribing, they will be required to complete a six-month period of clinical mentorship with an authorised health practitioner as an additional safeguard.
Dr McMullen said more detail was needed on how nurses might assist with prescribing, but added the model might be better placed to ensure continuity of care than some pharmacy prescribing models that have been widely criticised by doctors.
Pharmacists in some states and territories have had their scope of practice expanded to allow them to prescribe some medications to treat mild conditions.
In WA an expanded role for community pharmacists was introduced in August this year allowing them to deliver care for a range of conditions including mild to moderate shingles, acne, dermatitis, musculoskeletal pain and inflammation, nausea and vomiting, urinary tract infections and wound management.