Proposed amendments to the designated registered nurse prescriber specified prescription medicines list

Registered nurse prescribers in primary health and specialty teams have met specific requirements and are authorised to prescribe by Nursing Council.  They must work in collaborative multidisciplinary health care teams and only prescribe medicines within their specific area of practice.

Nursing Council has proposed an update to the current list (PDF, 38 KB) to increase the medicines registered nurses can prescribe. In many cases registered nurse prescribers are seeing patients who have already been diagnosed and commenced on a medicine by an authorised prescriber, for example, a doctor or a nurse practitioner. An increase in the medicines registered nurses can prescribe would enable them to deliver care without requesting an authorised prescriber to prescribe some medicines.

In addition, new medicines have become available in New Zealand to which wider access would benefit patients.

The proposal also extends nurse prescribing to include more specialised medicines including more antibiotics, immunosuppressants, medicines for multiple sclerosis, antiarrhythmics, dermatologicals, medicines for tuberculosis, antivirals, antiepileptics and antipsychotics, and more eye medicines. We have presented the Nursing Council’s rationale alongside the medicines. The Council has suggested that some medicines will be identified in their Guidance for registered nurse prescribing in primary health and speciality teams (PDF, 309 KB).

Following work with registered nurse prescribers and the Ministry, Nursing Council recommends 190 medicines, and four medicine classes should be added to the schedule of the Medicines (Designated Prescriber—Registered Nurse Prescribers) Regulations 2016.

Schedule 1A of the Misuse of Drugs Regulations 1977 specifies 18 controlled drugs that may be prescribed by designated registered nurse prescribers. It is proposed that three controlled drugs should be added to this schedule, and the current restrictions on six controlled drug be removed.

To become a registered nurse prescriber in primary health and specialty teams, registered nurses must meet the following requirements determined by Nursing Council. The registered nurse must:

• be registered with Nursing Council, meeting the competency standards for the registered nurse scope of practice
• have a minimum of three years full-time practice in the area they intend to prescribe in with at least one year of the total practice in New Zealand or a similar healthcare context
• completed a Nursing Council approved postgraduate diploma in registered nurse prescribing for long-term and common conditions, or equivalent as assessed by the Nursing Council
• the course of study must include advanced assessment and diagnostic reasoning, pathophysiology, pharmacology science and therapeutics
• completion of a practicum with an authorised prescriber (senior doctor or nurse practitioner), which demonstrates knowledge to safely prescribe specified prescription medicines and knowledge of the regulatory framework for prescribing
• satisfactory completion of an assessment of competencies for nurse prescribers completed by the prescribed mentor (authorised prescriber)
• work within a collaborative team which includes an authorised prescriber who will continue to provide mentorship and support, and
• complete recertification every three years, including evidence of a minimum of 20 hours of prescribing related professional development out of the 60 hours of required professional development every three years and a letter from an authorised prescribing mentor to confirm completion of 40 days (320 hours) of prescribing practice annually and maintenance of prescribing competence.

Additional information on designated registered nurse prescribers can be found on the Nursing Council website.