Australian Capital Territory
Health (Nurse Practitioner Position and Scope of Practice) Approval 2015 (No 2)*
Notifiable instrument NI2015-169
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 2015 (No 2).

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 a new nurse practitioner position within Calvary Health Care ACT -Diabetes Service. The scope of practice statement for this 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 Health prior to being posted on the ACT Nursing & Midwifery Office website. 

Dr Peggy Brown
Director-General

13 August 2014

Local Title	Nurse Practitioner - Diabetes	
Classification	RN 4.2	
Department/ Ward	Diabetes/Endocrinology Calvary Health Care ACT	
Position number(s)	I	Type I	I	Fortnightly hours I	76	
	I	Ins. No. I	I	Cost Centre I	

Attachment A  Position details

Scope of Practice Statement

		Line responsibility
I authority I
accountability	Operational/
Clinical Professional

Legislative	Nursing Director Medicine

Nursing Director & Lead Endocrinology Staff Specialist
Nursing and Midwifery Board of Australia
Calvary Health Care ACT
Health Regulation 2004 (Health Act 1993 (ACT))
Health Practitioner Regulation National Law Act 2010
Nurse Practitioner Legislation Amendment Act 2004	

 	Reporting details	 	 Supervises

Nurse Practitioner
Role	•	A Nurse Practitioner (NP) is a Registered Nurse with advanced knowledge, skills and recognised clinical competence, endorsed by the Australian Health Practitioner Regulation Agency
•	The NP is a recognised specialist nurse in diabetes and its complications and has specific knowledge and expertise in the specialty. This includes specialised diabetes care, education and management of people 16 years and above
•	The NP will practice professionally, working within a multidisciplinary team and functioning autonomously, within the scope of practice.
•	The NP will initiate and utilise research findings in the provision of clinical services, contribution to the development and delivery of speciality related education programs and procedures.
•	The NP participates in the strategic and operational planning processes within the diabetes department.
•	The NP is active in the education of other nursing staff.
•	The NP displays a commitment to the professional development of both themselves and their colleagues.
•	The NP provides health care services within a framework guided by professional guidelines of practice through assessment, diagnosis and management of health issues in stable, complex and unpredictable environments.	
	•	The NP is authorised to provide an expert level of coordinated clinical care, health assessment and management for inpatients, outpatient and community services of Calvary Health Care ACT; within a framework guided by professional guidelines of practice through assessment, diagnosis and management of acute, complex and chronic health issues.	
Aim	•	To provide appropriate, timely care to people with diabetes and pre diabetes, individually and as part of a multidisciplinary health care team.
•	Develop the advanced nursing role, working autonomously, within a scope of practice, with measurable quality outcomes as outlined in the key performance indicators for the role.	
Environment	•	The NP will be based in the Diabetes Education Dept.
•	The NP practices autonomously and collaboratively, within a varied environment which includes but is not limited to hospitals, outpatient clinics, community health centres, private homes and telephone consultation.
•	The NP has the knowledge, expertise and authorisation to support referral to other health care professionals.	

Formulary	•	The NP is authorised to prescribe medications from the formulary approved and endorsed as part of the clinical practice guidelines. This formulary will be prescribed within a framework of clinical  guidelines specific to clinical practice within acute and chronic disease areas and those established and accepted as best practice such as therapeutic guidelines.	
Ordering Diagnostic Tests	•	The Nurse Practitioner is authorised to order appropriate investigation within diagnostic radiology and laboratory services as determined by practice guidelines.	
Process of Care	The NP responds to referrals for patient assessment made by medical, nursing and allied health staff throughout the hospital and community.
The NP will undertake the following process of care Assessment of health status including;
•	Advanced physical assessment
•	Health history attainment
•	Identification of health risks
•	Application of emergency intervention when indicated

Diagnosis
•	Formulates appropriate differential diagnosis based on clinical findings
•	Identifies individual requirements to access health data from relevant persons
•	Identifies individual requirements to access health care services to support the implementation of care

Development of a Treatment Plan
•	Priorities are established and a plan of care is devised to maximise the health potential of the individual. This includes:
> Ordering appropriate diagnostic tests;
>	Prescribing appropriate pharmacological agents;
> Analysing patienUfamily education needs;
>	Establishing treatment plans based on evidence-based best practice
standards

Implementation of Treatment Plan
•	Interventions are based upon priorities and clinical guidelines
•	Treatment is individual and specific to the patient.
•	Treatment is based on scientific principles, theoretical knowledge and clinical expertise

Intervention Actions
•	Providing episodic health care including:
> Accurately conducting and interpreting diagnostic tests;
>	Prescribing pharmacological agents;
>	Prescribing non-pharmacological therapies;
>  Making appropriate referrals to other health care professionals;
>	Providing relevant patient and/or family health promotion/restoration
education.
Follow Up
•	Follow up and evaluation of outcome of episodic health care.	
Categories of Care	•	The NP will provide specialised care, education and management for patients who are referred under the referral criteria and in accordance with the Clinical Practice Guidelines.	
Role Evaluation	•	Regular Nurse Practitioner role effectiveness in terms of health outcome measures will be assessed by the professional Nurse Supervisor through annual performance appraisal as measured against the key performance indicators for the role.	
Approved Service Director:		
		
Approved HR Department