ACNP Fact Sheets

This Fact Sheet covers the following topics:

  • Clinical Collaboration
  • Scope of Practice and credentialling
  • Collaborative arrangements

Download a copy of the Clinical Collaboration Fact Sheet

This Fact Sheet covers the following topics:

  • What is required to be a NP?
  • Ongoing education and continuing professional development

Download a copy of the Education Fact Sheet

 

This Fact Sheet covers the following topics:

  • Working in rural and remote areas
  • Importance of NP's as colleagues

Download a copy of the Rural Remote Fact Sheet

 

Position Statements

ADVANCED PRACTICE IN NURSING

 

Download the ACNP Position Statement Advance Practicein Nursing to read about what they can do and the background.

The nurse practitioner role is the most advanced of the clinical nursing roles in Australia . Advanced practice is often a poorly understood concept, even within nursing. This position statement clarifies advanced practice as it relates nursing in Australia. Terms commonly used include ‘extended' ‘expanded' and ‘advanced' practice.

The only regulated advanced practice role in Australia is the role of a nurse practitioner (NP). Nurse practitioners are advanced practice nurses whose registration is endorsed by the Nursing and Midwifery Board of Australia (NMBA) to enable practise within their scope using the title, which is protected by Law.

Nurses practicing at an advanced practice level incorporate professional leadership, education and research into their practice. Their practice includes relevant expertise, critical thinking, complex decision making, autonomous practice, and is effective and safe. They work within a generalist or specialist context and they are responsible and accountable in managing people who have complex healthcare requirements.

Advanced practice is a 'level' of practice rather than a particular role or specialist area. Nurses practising at an advanced level develop their practice and build expertise over time. Advanced practice does not directly refer to clinical or technical skills that a nurse may develop.

Advanced practice may involve generalist and/or specialist practice. Generalist practice encompasses a wider spectrum of activities, across a broad range of health care settings. Specialist practice may focus on a specific population or context. It is important to recognise that while there are many nurse specialist roles at the advanced practice level, specialisation alone does not characterise an advanced level of practice.

Advanced practice may be developed by a combination of formal education, exposure to relevant clinical experience, and continuing professional development. Development towards advanced practice is therefore likely to differ for individual nurses. Advanced practice always incorporates high-level assessment, decision making and autonomous practice. Progression to advanced practice will depend on the quality and complexity of developmental experiences, rather than merely the length of time spent in an area of service.

The ACNP supports the minimum formal educational preparation for advanced nursing practice is a relevant Master’s degree in nursing. However, advanced practice is not demonstrated by completing a postgraduate degree alone and arises from a combination of graduate education and clinical experience that results in the development of the skills and attributes required to practice at an advanced level.

Key points:

  • Advanced practice is not defined by a role or title, but by the level of expertise, critical thinking, complex decision making, and autonomous practice
  • Nurse practitioners are the only regulated advanced practice role in Australia
  • Advanced practice may involve generalist and/or specialist practice
  • Advanced practice may be developed by a combination of formal education, continuing professional development, and must include significant relevant clinical experience
  • Each pathway to advanced practice may differ, however advanced practice must include the key elements of critical thinking, complex decision making, clinical reasoning, advanced assessment skills, and clinical expertise.

This position statement is endorsed by the Australian College of Nurse Practitioners Board on 2nd December 2019, and will reviewed by 2nd December 2021.

 

Download the ACNP Position Statement Advance Practicein Nursing to read about what they can do and the background.

If you have any questions or need more information please contact Bernie McPhee:     
     admin@acnp.org.au
     ACNP
     www.acnp.org.au
     1300 433 660
     P: 03 8657 4355, M: 0487 009 042

COLLABORATION IN CLINICAL PRACTICE

Download the statment about Nurse Practitioners and Collaboration as a PDF

 

Nurse Practitioners practice collaboratively with health professionals, patients, carers and families in order to provide person-centred high-quality health care.  

Collaboration is embedded within all nursing roles. Most health professions practice collaborative care, and recognise it as essential in both improving and maximising patient outcomes, and ensuring efficiency and sustainability in provision of high-quality health care.

Collaboration in clinical practice should be used to support clinical outcomes, not as a barrier to accessing health services. The mandated requirement for nurse practitioners (NP) to form collaborative arrangements, in accordance with the National Health (Collaborative arrangements for NPs) Determination relates solely to patient access to both the Medicare Benefits Scheme, and the Pharmaceutical Benefits Scheme for subsidised care or medicines when provided by a NP. If ‘Collaborative Arrangements’ are not in place in accordance with the Determination, the patient cannot access a rebate or subsidy.

This requirement under the National Health Determination has not been found to improve outcomes, or improve safety or quality of care, and has added barriers to patients accessing health care. The Determination has restricted access of care to vulnerable Australians due to interpretation variables of different health care providers.  

Enabling full scope of practice without barriers such as the Collaborative Arrangements or limited access to MBS will improve deficits in primary health care 1. The NP role does increase access to care, is cost efficient and influences social change from a health care perspective2. NPs are unique in their transformative approach to health care, they shape and develop services according to the needs of their patients from a holistic perspective 3.  

NPs are professionally accountable for their own practice, as determined by the Nursing and Midwifery Board of Australia. Collaboration will continue and could improve as NPs are enabled to work to their full scope of practice. Removing this restriction could significantly improve Commonwealth savings 4, 5, as well as potentially increasing access to care in regional and remote areas.


1 Poghosyan, L, Boyd, D. R., & Clarke, S. P. (2016). Optimizing full scope of practice for nurse practitioners in primary care: Aproposed conceptual model. Nursing Outlook, 64(2), 146-155. Doi:https://doi.org/10.1016/j.outlook.2015.11.015
2 Grant, J, Lines, L, Darbyshire, P, & Parry, Y. (2017). How do nurse practitioners work in primary health care settings? A scoping review. International Journal of Nursing Studies , 75, 51-57. Doi:https://doi.org/10.1016/j.ijnurstu.2017.06.011
3 Carryer, J, & Adams, S. (2017). Nurse practitioners as a solution to transformative and sustainable health services in primary health care: A qualitative exploratory study. Collegian, 24(6), 525-531. Doi:https://doi.org/10.1016/j.colegn.2016.12.001
4 Oliver, G.M., Pennington, L., Revelle, S. & Rantz, M. (2014) Impact of nurse practitioners on health outcomes of Medicare and Medicaid patients. Nursing Outlook 62(6):440-7. Doi: 10.1016/j.outlook.2014.07.004.
5 Smith, T., McNeil, K., Mitchell, R., Boyle, B. & Ries, N. (2019) A study of macro-, meso- and micro-barriers and enablers affecting extended scopes of practice: the case of rural nurse practitioners in Australia BMC Nursing. 18(14)

Download the statment about Nurse Practitioners and Collaboration as a PDF

 

If you have any questions or need more information please contact Bernie McPhee:     
     admin@acnp.org.au
     ACNP
     www.acnp.org.au
     1300 433 660
     P: 03 8657 4355, M: 0487 009 042

Recruitment and Selection of Nurse Practitioners and Advance Practice Nurses

 

Download the statment about Recruitment and Selection of Nurse Practitioners and Advance Practice Nurses as a PDF

 

The Australian College of Nurse Practitioners (ACNP) position on the recruitment process for Nurse Practitioner (NP), Nurse Practitioner Candidate (NPC)/ Transitional Nurse Practitioner (TNP) and Advanced Practice Nurse (APN) positions, is that recruitment panels must have an experienced and qualified NP or APN participating in recruitment and selection.

Panels interviewing and selecting candidates for employment must be comprised of at least two members with a minimum of one external panel member. An external panel member must be from outside the employing branch or work area, and may be from another specialty area, division, health service or Government agency.  All panel members must understand the requirements of the role, and at least one member must have detailed knowledge.

Panel members should be at an equivalent or higher classification than the vacancy level. However, one panel member may be at the same or lower classification level if they are required to contribute specialist knowledge of the role to the panel.

The ACNP can offer expert knowledge and assistance in all areas of recruitment and for selection panels of NPs, NPCs, and APNs. (Contact via: admin@acnp.org.au)

The rationale for experienced and qualified NPs or APNs participating in the recruitment and selection of NP, NPC/ TNP or APN positions is as follows:

  • To ensure a consistent approach to recruitment, selection and employment for NP, NPC/TNP and APN positions.

The ACNP believes in the value of Nursing and Midwifery Clinicians participating in all relevant Recruitment and Selection panels, particularly in relation to advanced practice roles. 

Health Service providers and employers are encouraged to reference or use this position statement in the development and application of their policies and procedures in relation to the recruitment and selection process of Nurse Practitioners, Advanced Practice Nurses, and Nurse Practitioner Candidates/ Transitional Nurse Practitioners.

Download the statment about Recruitment and Selection of Nurse Practitioners and Advance Practice Nurses as a PDF

 

If you have any questions or need more information please contact Bernie McPhee:     
     admin@acnp.org.au
     ACNP
     www.acnp.org.au
     1300 433 660
     P: 03 8657 4355, M: 0487 009 042

Nurse Practitioner's Scope of Practice 

Download the statment about Nurse Practitioners Scope of Practice to read about what they can do.


All health professionals have a ‘scope of practice’. It describes the skills, knowledge and attributes of an area and context of practice in which they are competent to practice autonomously.

Australian nurse practitioners have extensive post-graduate clinical experience and have completed mandatory prescribed education at a Master’s level. They provide complete episodes of health care, using an  advanced nursing model of care. 

Nurse practitioners possess the legal authority to practice both independently and autonomously at a level of practice that is beyond that of a registered nurse. It is within a nurse practitioner’s ability to assess and diagnose health problems, order and interpret diagnostic investigations, formulate and assess response to treatment plans, prescribe medicines and refer to other health professionals within their individual areas of competence. Nurse practitioners may also admit and discharge consumers from health services, including hospital settings.

Nurse practitioners practice collaboratively with other health professionals to improve access to healthcare for Australian communities through health promotion, disease prevention, and health management strategies. They improve health outcomes for specific patient populations or communities. 

Although nurse practitioners can practice as part of a larger healthcare team, nurse practitioners may also form partnerships with health consumers and their families to act as their primary health provider. Nurse practitioners combine advanced nursing knowledge and skills with advanced diagnostic reasoning and therapeutic knowledge to provide person-centred care. They can diagnose and manage health consumers with common and complex health conditions. As clinical leaders, they practice across healthcare settings to influence health service delivery and the wider profession.

Background
Nurse practitioners have been providing healthcare in Australia since 2000, and practice across all States and Territories1. The initial focus of the nurse practitioner role was to increase access to care for marginalised and/or vulnerable populations, such as those living in rural and remote areas, persons experiencing homelessness and the aged2. Nurse practitioners practice in a wide variety of clinical settings, ranging from hospital to community and primary care settings3. Since 2010, nurse practitioners have been eligible providers of care that is subsidised through the Medicare Benefits Schedule (MBS) and the Pharmaceutical Benefits Scheme (PBS). 

A nurse practitioner’s beginning scope of practice is expected to evolve and expand with time, education and experience4. Role expansion and scope of practice decisions are guided by the Nursing and Midwifery Board of Australia’s (NMBA) Decision-Making Framework (2019) and best available evidence, such as the Australian NP Metaspecialty Framework5. In accordance with NMBA requirements, nurse practitioners are also expected to undertake relevant education and clinical training in order to demonstrate competence in an expanded scope of practice.


This position statement is endorsed by the Australian College of Nurse Practitioners Board on 2nd December 2019, and will reviewed by 2nd December 2021.


1 Nursing and Midwifery Board of Australia. (2019). Nurse and Midwife Registrant Data (June). Melbourne, VIC: Australian Health Practitioner Regulation
Agency.
2 Foster, J. (2010). A History of the Early Development of the Nurse Practitioner Role in New South Wales, Australia. (Doctor of Philosophy). University of
Technology, Sydney, NSW.
3 Middleton, S., Gardner, A., Gardner, G., & Della, P. (2011). The status of Australian nurse practitioners: the second national census. Australian Health Review,
35(4), 448-454. doi:10.1071/AH10987
4 Cashin, A., Buckley, T., Donoghue, J., Heartfield, M., Bryce, J., Cox, D., . . . Dunn, S. V. (2015). Development of the Nurse Practitioner Standards for Practice
Australia. Policy, Politics, & Nursing Practice, 16(1-2), 27-37. doi:10.1177/1527154415584233
5 Gardner, A., Gardner, G., Coyer, F., Gosby, H., & Helms, C. (2019). The nurse practitioner clinical learning and teaching framework: A toolkit for students and
their supervisors. Canberra. doi: 10.6084/m9.figshare.9733682.v2

 

Download the statment about Nurse Practitioners Scope of Practice to read about what they can do.

 

If you have any questions or need more information please contact Bernie McPhee:     
     admin@acnp.org.au
     ACNP
     www.acnp.org.au
     1300 433 660
     P: 03 8657 4355, M: 0487 009 042