Australian Capital Territory
Health (Nurse Practitioner Position and Scope of Practice) Approval 2015 (No 4)*
Notifiable instrument NI2015-172
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 4).

2	Commencement

This instrument commences on the day after notification.

3	Approval

Under section 8, approval of nurse practitioner positions, I have approved the establishment of a new private Primary Health Care nurse practitioner position. 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 and endorsed by the local Clinical Practice Guideline Advisory Committee within the first three months of the position being established.  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

25 November 2014

Detailed Scope of Practice statement - Primary Health Care Nurse Practitioner position

The Primary Health Care NP (PHC-NP) is a generalist healthcare provider with specialist expertise in sexual health and aesthetic nursing and the role of the PHC-NP will be dynamic and as she completes additional education and training it is anticipated that their case mix will diversify in keeping with service delivery requirements within the scope of her acquired skills and expertise.

The PHC-NP is responsible for maintaining an up-to-date scope of practice and is expected that practice, in line with other health professionals, will be based on sound clinical judgement using best practice guidelines and the latest available evidence.

The PHC-NP will work within multi-disciplinary healthcare teams, and will provide primary, secondary, and tertiary disease prevention and health promotion activities in the context of acute care for minor illnesses and injuries and ongoing care for the management of chronic, stable health conditions. This is a primary health care role.

Primary Prevention management strategies are health promotion activities that target individuals, population groups and communities. These strategies explore and acknowledge the gaps in care provision, strengthen existing solutions, and create innovative strategies which are informed by the consumer and the community to which they belong. They include, but are not limited to:
•	Intersectoral and interprofessional health promotion activities
•	Provision of evidenced-based educational resources
•	Safer sex education, advice and the provision of barrier protection
•	Immunisations
•	Community lifestyle modification programs

Secondary Prevention management strategies may include, but are not limited to:
•	Sexually transmitted infection screening
•	Pregnancy testing and the provision of birth control
•	Periodic determination of blood pressure and/or other vital signs
•	Weight loss, smoking, exercise and dietary counselling
•	Screening for chronic diseases

Tertiary Prevention management strategies may include, but are not limited to:
Disease management of common acute and chronic illnesses which require treatment to alleviate suffering, ensure rapid return to workforce and/or to improve overall health.

Appropriate referral will be made for conditions requiring ongoing investigation, treatment, complex contact tracing, and follow-up.

Acute conditions may include, but are not limited to:
•	Head, ears, eyes, nose, throat (otitis media and externa, conjunctivitis, sinusitis, tonsillitis, minor dental issues, minor epistaxis, foreign bodies)
•	Respiratory (upper / lower respiratory infections, asthma, bronchitis)
•	Gastrointestinal (dyspepsia, gastroenteritis, constipation, nausea, vomiting)
•	Genitourinary (urinary tract infections, candidiasis)
•	Sexual & reproductive health (unplanned pregnancy, mastitis, sexually transmitted infections, emergency contraception, hyperemesis gravidarum)
•	Musculoskeletal (sprains/strains, contusions, plantar fasciitis, epicondylitis, bursitis, acute gout, torticollis, uncomplicated back pain)
•	Immunology and toxicology (allergic reaction, minor insect bites and marine stings)
•	Neurology (migraine with previous history)
•	Skin (acne, wound care, minor thermal and chemical burns, lacerations, bites, acute minor wounds, wound infections, boils/carbuncles, dermatitis, shingles, minor cellulitis, rosacea, aesthetics).

Chronic conditions may include, but are not limited to:
•	Cardiovascular (hypertension, chronic heart failure, atrial fibrillation/flutter, anticoagulation, and coronary heart disease)
•	Endocrine and metabolic (diabetes, dyslipidaemia, vitamin/nutritional deficiencies, and hypothyroidism)
•	Musculoskeletal (osteoarthritis, osteoporosis, gout, and back/joint pain)
•	Psychiatric (depression and anxiety)
•	Respiratory (asthma and chronic obstructive pulmonary disease)
•	Other (psoriasis, dermatitis, GORD, anaemia)