Australian Capital Territory
Health (Nurse Practitioner Position and Scope of Practice) Approval 2011 (No 1)*
Notifiable instrument NI2011-594
made under the
Health Regulation 2004 - section 8 (approval of Nurse practitioner positions) 

1	Name of instrument

This instrument is the Health (Nurse Practitioner Position and Scope of Practice) Approval 2011 (No 1).

2	Commencement

This instrument commences on the day after notification.

3	Scope of Practice for nurse practitioner positions

Under section 8, approval of nurse practitioner positions, I have approved the establishment of Wendy’s Aged Care Nurse Practitioner position within the aged care private sector of ACT.

The scope of practice statement for the nurse practitioner position is attached.
As this position is ‘new’, the clinical practice guidelines and medication formularies are a work in progress.  These will be finalised within the first three months of the position being established and after they are endorsement by the local Clinical Practice Guideline Advisory Committee.  The endorsed Clinical Practice Guidelines will then be submitted for final approval and endorsement by the ACT Chief Nurse and Director-General ACT Government Health Directorate.

Ian Thompson 
Acting Director-General

7 October 2011

Scope of Practice Statement for 
Wendy’s Aged Care Nurse Practitioner Service

The Aged Care Nurse Practitioner will provide a consultation service to the elderly in their home or in residential aged care facilities. They will work in collaboration with a Geriatrician and General Practitioner. The service provided will aim to respond in a timely manner to prevent admission into the acute hospital setting. It will also promote a wellness model by providing a monthly appointment to review the client. Emergency appointments will also be available to address any acute decline in condition or cognition. 

The Aged Care Nurse Practitioner (ACNP) will work in a trans-boundary model that works collaboratively by liaising with the clients and their families, General Practitioner, Specialist Consultants, Allied Health Professionals, Pathologists, Pharmacists, Aged Care Service Providers, and Community Nursing to provide a complete and holistic episode of care.

This includes but is not limited to comprehensive geriatric assessment, targeted assessment, requesting of diagnostics, treatment and management of conditions in extended scope of practice, coordination of treatment and care plans.

This includes maintaining links with hospital-based services to compliment the client’s management at home. These include but are not limited to Hospital in the Home (HITH), Community Care Program (CACP). 

The ACNP will also provide follow-up monitoring following the discharge of one of their clients from the hospital.

Education of staff and families, both formally and informally. 

The ACNP acts as an advocate for the client to negotiate and manage the most appropriate treatment plan.

With a focus on wellness and where applicable self-management of chronic conditions, the ACNP in collaboration with the Geriatrician and GP aims to avoid unnecessary hospital admissions.

The ACNP is responsible and accountable for making professional decisions about the patient’s condition and timely referral to a medical officer.

The scope of practice is but not limited to:

•	Pain Management
•	Continence issues including constipation
•	Diagnosis and management of delirium
•	Management of congestive heart failure
•	Management of chronic obstructive airways disease
•	Wound management
•	Management of uncomplicated cellullitis
•	Uncomplicated pneumonia
•	Urinary tract infections
•	Management of behaviours in dementia
•	Three monthly reviews of clients
•	Medication reviews in conjunction with GP and pharmacist 
•	Advanced Care Directives, in conjunction with family and client
•	End of life care