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Page 1 of 24 Lynne DAY, ACNP: CPGs [October 2015]
NURSE PRACTITIONER: Lynne Day
CLINICAL PRACTICE GUIDELINES: October 2015
Health Service: Private Nurse Practitioner (Aged Care) Consultation Service
Area of Specialty: Community and Residential Aged Care
Setting:
The Consultant Aged Care Nurse Practitioner service operates to provide home based access to health and wellbeing services for aged people and their carers living in the community or Residential Aged Care Facilities.
Main areas of care activity include:
client's private home
retirement villages, supported living accommodation
Residential aged care facilities
GP practices or clinics.
Nurse Practitioner Role:
The Aged Care Nurse Practitioner (ACNP) works collaboratively by liaising with patients and their families, allied health professionals, general practitioners (GP's), specialists, pathologists, pharmacists, aged care service providers, nurses and autonomously, by being responsible for a complete and holistic episode of care. A complete episode of care encompasses comprehensive and/or targeted assessment, requesting of diagnostics, developing treatment/management care plans, coordinated implementations alongside recommendations to meet health goals, risk management strategies, monitoring, education (patient, family, staff),and timely evaluation with eventual discharge.
The ACNP works within the primary health setting to prevent unnecessary hospital presentations due to exacerbation of health conditions. To achieve that goal of care, the APNP ut i l ises guidance for self-management of chronic conditions, evidence-based education techniques for optimal adherence to health management interventions, comprehensive health assessment, and aged care advocacy and planning.
The ACNP is responsible and accountable for making professional judgments about the patient's condition and a timely referral to a medical officer as required.
Page 2 of 24 Lynne DAY, ACNP: CPGs [October 2015]
As a Nurse Practitioner, I comply with my responsibilities for maintaining individual professional development at an expert level.
Client/Patient Population:
Males and females aged 65 years and older residing in the community (Including Residential Aged Care Facilities)
Aboriginal and Torres Strait Islander peoples approximately 45 years and over.
Date of Approval: 28 January 2016
Date for Future Review: 28 January 2019
Page 3 of 24 Lynne DAY, ACNP: CPGs [October 2015]
CONTENTS Page
Clinical Practice Guideline Advisory Committee: Members and Signatures 3
Evidence of Additional Health Professional and/or stakeholder consultation 3
INTRODUCTION 5
ASSESSMENT 5-7
Define Nurse Practitioner Assessments Physical Examination 6
TRANSFER 6-7
Conditions for Urgent Transfer to Emergency Department 6
Conditions for Semi Urgent Transfer 7
REFERRAL 7
Conditions for Referral to other Health Professionals 7
MANAGEMENT 7-12
Treatment Options and Conditions for Nurse Practitioner 7
Diagnostic Investigations 9
Health Promotion/Illness Prevention Strategies and Referrals 9
Implementation of Treatment Plan 9
Non Pharmacological Management Approaches 10
Pharmacological Management 11
Prescribing Arrangements 12
Continuing Therapy Only 12
Shared Care Model 12
Follow Up Care 12
CLINICAL PRACTICE GUIDELINES 13
Plans for Dissemination of Clinical Practice Guidelines 13
Plans for Review and Revision of Clinical Practice Guidelines 13
MEDICATION FORMULARY 14-21
Medications 22
Schedule 8 Drugs 22
REFERENCES 23-24
CLINICAL PRACTICE GUIDELINES CHECKLIST 25
Page 4 of 24 Lynne DAY, ACNP: CPGs [October 2015]
Clinical Practice Guideline Advisory Committee Members (CPGAC): Local Service Area
CPGAC team members, area of speciality/practice, signature and review dates:
Page 5 of 24 Lynne DAY, ACNP: CPGs [October 2015]
INTRODUCTION
This C l i n i c a l P r a c t i ce G u i d e l i n e ( CPG) outlines the Aged Care Nurse Practitioner's (ACNP) role in providing a clear continuum of health and care, potentially reducing unnecessary hospital admissions for the elderly and a continuum of care for improved health outcomes.
The ACNP works autonomously and collaboratively within a multi disciplinary team which includes a general practitioner, registered nurse or NP and a pharmacist.
The ACNP Private Consultation service is able to provide a complete episode of primary health care to patients presenting via a personal request for service, general practice referral, residential aged care facility or Community Aged Care Service referral or specialist referral. NPs are legally and professionally accountable for their own practice. They work to complement existing services, and refer patients who fall outside their scope of practice, directly to the GP or local emergency department as required.
ASSESSMENT
The ACNP utilises advanced practice knowledge and skills to manage care delivery, undertaking a thorough health assessment of individual patients by use of the following as appropriate:
performing a comprehensive health assessment including psychosocial needs and health literacy
review of body systems
performing an appropriate physical examination, including vital signs, mental status and targeted system assessment according to client presentation
performing a comprehensive care planning assessment including environmental and caregiver needs, functional assessment, coping and adaptation strategies, formal and informal support networks
identifying individual requirements to access health data from relevant persons
identifying health risks
identifying prioritised problem lists associated with health and quality of life, wellbeing and environment
applying crisis intervention when indicated
evaluating patient's adherence and response to the plan of care.
If the assessment reveals that the care the patient / family require is beyond the scope of the ACNP, the patient will be referred to a GP or Emergency Department.
Page 6 of 24 Lynne DAY, ACNP: CPGs [October 2015]
Defining Nurse Practitioner Assessments:
Physical Examination
This could include but not be limited to:
vital sign assessment
mental status assessment
respiratory assessment
musculoskeletal assessment: falls assessment
abdominal assessment
genitourinary assessment
lymphatic assessment
musculoskeletal assessment
neurologic assessment
cranial nerve assessment
skin assessment
ear examination
eye examination.
TRANSFER
Conditions for Urgent Transfer to Emergency Department (ED)
An enacted Advance Health Directive may preclude urgent referral to ED in consultation with the patient/family and other health professionals.
This could include but not be limited to clients presenting with:
medical emergency e.g. Acute Coronary Syndrome
drug reaction (life threatening)
loss of consciousness: Clients receiving palliative/terminal care who have an Advanced Care Directive in place may preclude urgent referral to ED)
cerebro-vascular accident
life threatening depression/psychosis/delirium
acute decline in respiratory function
pulmonary embolism I deep vein thrombosis.
Page 7 of 24 Lynne DAY, ACNP: CPGs [October 2015]
Conditions for Semi Urgent Transfer
This could include but not be limited to clients presenting with:
cardiac failure
gross heamaturia
acute abdomen
acute urinary retention (with no immediate access to catheterisation)
fracture (suspected)
unexplained or uncontrolled pain
Chronic Obstructive Pulmonary Disease (COPD), exacerbation not responding to empiric treatment.
REFERRAL
Conditions for referral to other Health Professionals:
Referral to a GP: Compromising exacerbation or new presentation
This could include but not be limited to clients presenting with:
diabetes
severe & malignant hypertension
Parkinson's disease & Parkinsonism
behavioural disorders of dementia
psychosis
arthritis
depression
delirium
urinary tract infection presentation in males, after recent instrumentation or recurrence
COPD
post herpetic neuralgia unrelieved with Formulary Treatment.
MANAGEMENT
Treatment Options and Conditions for Nurse Practitioner Management
Clients who present or are referred with sub acute or non-acute conditions will be managed by the ACNP. Consultation with a GP will occur as required.
These presentat ions may include:
advanced and comprehensive health and wellbeing assessment
Page 8 of 24 Lynne DAY, ACNP: CPGs [October 2015]
acute alteration in cognitive status
urinary tract infections (uncomplicated)
pain management (acute & chronic)
constipation and faecal incontinence
continence promotion & management, urinary incontinence: stress/ urgency/retention/functional/mixed
community acquired pneumonia
COPD exacerbation
shingles (post herpetic neuralgia)
soft tissues infection: folliculitis/cellulitis/impetigo
wound infection
fungal infections such as candidiasis
cerumen blockage of auditory canal
conjunctivitis
chronic disease management (in collaboration with other appropriate health providers)
lifestyle modification and health promotion
monitoring glycaemic control (diabetes type ii): HBA1C
malnutrition/unintended weight loss
dehydration
delirium management: reversible causes
dementia (management of behaviours associated with)
poly pharmacy, medication review (in consultation with the GP and Pharmacist)
peg tube care
supra-pubic catheter care
subcutaneous fluid administration
falls prevention/osteoporosis education vitamin. d deficiency/bone mineral density
palliative pathway/end of life care
pressure area prevention and management
community liaison/navigation for community care support, residential placement
screening assessment (falls, dementia, depression, caregiver burden, skin integrity, continence, under nutrition, functional assessment)
review and renewal of drugs prescribed by GP
vaccination
Page 9 of 24 Lynne DAY, ACNP: CPGs [October 2015]
care planning/coordination
case management (as indicated).
Diagnostic Investigations
The ACNP accurately conducts and interprets diagnostic tests to inform diagnosis including.
UEC, FBC, LFT, CRP Vit. D, TFTs, Glycosylated Haemoglobin, Iron Studies, Coagulation Studies, FOBT, Lipid Studies, 812, Red Cell folate
dementia screening
microbiology culture and sensitivity of urine, sputum, wound swabs, stool, cervical and vaginal pathology
medical imaging (plain axial skeleton and chest, UltraSound: various).
Health Promotion/Illness Prevention Strategies and Referrals
The ACNP will aim to develop and implement a management plan to achieve evidence-based treatment targets, addressing any barriers identified in partnership with the patient and health team. The NP:
prescribes non-pharmacological therapies
prescribes pharmacological agents
identifies individual requirements to access health care services that support the implementation of care
makes appropriate referrals to other health care professionals and community agencies
provides relevant health promotion, restoration, lifestyle modification and prevention education to the patient/carer.
Implementation of Treatment Plan
Interventions are based upon priorities identified in consultation with client and/or advocate.
Treatment is individualised and specific to the client’s situation I active condition.
Treatment is based on scientific principles, theoretical knowledge and clinical expertise that has a sound contemporary evidence basis
Priorities are established, and a mutually acceptable plan of care is devised to maximise the health potential of the individual.
Non-Pharmacological Management
The ACNP acknowledges that nursing implementations to meet identified goals importantly includes the use of evidence-based non-pharmacological approaches. Accordingly the ACNP may include the following management approaches, including:
Page 10 of 24 Lynne DAY, ACNP: CPGs [October 2015]
individually tailored evidence-based programs (assessment, intervention and monitoring)
education
monitoring
carer education and support
medication review
exercise programs
weight loss strategies
pain management strategies
mobility, independence and safety aid information
dietary information
home safety assessment
home modification information
behavioural modification strategies
information and/or referral to community services
symptom management strategies
coordination and provision of carer support
case management/case conference
pressure relieving techniques
advance health planning, advocating for Enduring Power of Attorney
(EPOA) advocacy information
provision of consumer health promotion literature
elder abuse information
referral/linkages with support organisations residential care options
wound care
nursing care plan support
pelvic floor exercises
sleep programs
continence care/Bowel Management.
Page 11 of 24 Lynne DAY, ACNP: CPGs [October 2015]
Pharmacological Management
See Formulary for detailed list.
Conditions the ACNP could consider for pharmacological management include:
dementia
delirium
anxiety disorders
depression
insomnia
restless legs syndrome
gout
osteoarthritis
fall prevention
osteoporosis
dyslipidaemia
oedema
orhthostatic hypotension
asthma
chronic obstructive pulmonary disease
chronic cough
community acquired pneumonia
nursing home acquired pneumonia
influenza
immunisation
dyspepsia
gastro-oesophageal reflux disease
peptic ulcer disease
nausea and vomiting
malnutrition
non acute dehydration
constipation
diarrhoea
peri-anal conditions
urinary tract infections
iron deficiency anaemia
Page 12 of 24 Lynne DAY, ACNP: CPGs [October 2015]
conjunctivitis
dry eyes
eyelid problems
ear wax
otitis media and externa
rhinitis
sinusitis
scabies
herpes zoster (shingles)
skin infections
dry itchy inflamed skin
pain management
palliative care issues.
Prescribing Arrangements
Pharmaceutical Benefits Scheme (PBS) prescribing is limited by a Nurse Practitioner's scope of practice and State/Territory prescribing rights.
Continuing Therapy Only (CTO)
Continuing therapy occurs when the patient's treatment and prescribing of a medicine has been initiated by a Medical Practitioner and further prescribing is continued by the Nurse Practitioner. No titration or cessation of the medication is allowed without prior consultation with the GP.
Shared Care Model (SC)
A shared care model of practice occurs when care is shared between a NP and a medical practitioner via a formalised arrangement, in a patient-centred model of care. The details surrounding shared care arrangements will depend on the practitioners involved, patient needs and the health care context. Medication initiation, titration and/ or cessation may occur autonomously by the NP in the context of the formalised, patient-centred agreement, on a patient by patient basis.
Follow Up Care
The ACNP is responsible for follow up and evaluation of appropriate episodic health care issues, managing abnormal results within scope of practice, and monitoring progress.
Frequency of ACNP follow up is determined by individual patient requirements and the treatment plan. Actions taken by the NP are communicated to the GP and/or allied health professionals as indicated.
Page 13 of 24 Lynne DAY, ACNP: CPGs [October 2015]
This document reflects current safe clinical practice. However, as in all clinical situations there may be factors which cannot be governed or guided by a single set of guidelines. This document does not replace the need for application of expert clinical judgement to each individual presentation.
CLINICAL PRACTICE GUIDELINES
Plan for Dissemination of Clinical Practice Guidelines
A copy of the ACNP CPGs will be:
posted on the ACT Health website held at the Nursing and Midwifery Office, ACT Health held at Aged Health and Care Consulting Pty Ltd
Plan for Review and Revision of Clinical Practice Guidelines
This CPG will be reviewed and evaluated on a regular basis through a local collaborative team to ensure that it meets the needs of the patients, the NP and the GP.
Formal review and evaluation of the CPGs is required within a three year period. Any changes to the CPGs will be notified to the Office of the Chief Nursing Officer to ensure that they remain current.
Page 14 of 24 Lynne DAY, ACNP: CPGs [October 2015]
MEDICATION FORMULARY
This formulary provides for the poisons and restricted substances that may be possessed, used, supplied or prescribed by the ACNP.
Medication Class Medication Form/Concentration Notes
Anti-infectives Nitrofurantoin Capsule
Ketoconazole Tablet, cream, shampoo
Antibiotics/Antifungals/
Antihelmintics
Aciclovir Tablet, cream
Amoxycillin Trihrdrate Tablet, capsule, oral liquid
Amoxycillin trihydrate with potassium clavulante Tablet, liquid
Azithromycion Tablet, liquid
Cephalexin Capsule, liquid
Chloramphenicol 0.5% Eye drop, ointment
Clindamycin Capsule
Clotrimazole 1% Cream, vaginal cream
Ciprotloxacin Tablet
Clarithromycin Tablet, liquid
Dicloxaciollin sodium Capsule
Doxycycline Tablet, capsule
Erythromycin Tablet, capsule, liquid, gel (80mg.ml)
Famciclovir Tablet
Flucloxacillin Capsule, oral liquid: 50mg/ml
Fluconazole Capsule, liquid
Framycetin Dexamethazone, gramicidin (Sofradex) Ear drops
Lyermectin Tablet
Metronidazole Tablet, liquid, cream
Miconazole 2% Cream, liquid, spray, powder or shampoo,
Page 15 of 24 Lynne DAY, ACNP: CPGs [October 2015]
vaginal cream.
Mupirocin Ointment or cream
Norfloxacin Tablet
Nystatin Oral drops, tablet, capsule, cream
Oseltamivir Capsule
Phenoxymethylpenicillin Tablet, capsule, liquid
Pytantel Tablet, liquid
Roxithromycin Tablet
Silver Sulfadiazine Cream
Terbinafine Tablet, cream, liquid, gel
Trimethoprim/sulfamethoxole Tablet, liquid
Valaciclovir Tablet
Analgesia Asprin Soluble tablet
Paracetamol Tablet, liquid, suppository
Paracetamol: controlled release Tablet
Paracetamol 500 mgs & codeine 8mg Tablet
Paracetamol 500 mgs & codeine 15mg Tablet
Paracetamol 500 mgs & codeine 30mg Tablet
Non-steroidal anti-inflamatories Diclofenac Tablet, suppository, topical gel
Ibuprofen (adult) Tablet, suppository, topical gel
Meloxicam Tablet, capsule
Opioid analgesia Tablet, capsule
Buprenorphine Patch
Fentanyl Patch, lozenge, oral liquid
Morphine HCL Liquid
Morphine Sulphate Ampoule, capsule, oral liquid
Tablet: controlled release
Page 16 of 24 Lynne DAY, ACNP: CPGs [October 2015]
Oxycodone Tablet, Tablet: controlled release, capsule, liquid, suppository, granules
Hydromorphine Injection
Cardiovascular Drugs Spiranolactone Tablet CTO
Frusemide Tablet
Bumetanide Tablet CTO
Nitrates (lsosorbide di/mononitrate, Glyceryl Trinitrate) Tablet CTO
Thiaizides (Hydrochlorthiazide with/ without Triamterene, lndapamide)
Tablet CTO
ACE Inhibitors (Enalapril, Trandolapril, Perindopril, Rampiril, Lisinopril, Fosinopril, Quinapril, Captopril) C
Tablet CTO
Sartans (Eprosartan, Telmisartan, lrbesartan, Candesartan, Valsartan, Olmesartan, Karvezide)
Tablet CTO
Calcium Channel Blockers (Amlodipine, Diltiazem, Lercandipine, Verapamil)
CTO
Beta Blockers (Propranolol, Metoprolol succinate and tartrate , Atenolol, Bisoprolol , Carvedilol)
Tablet CTO
Prazosin Tablet CTO
Clonidine Tablet CTO
Anti-arrhythmics (Digoxin, Amiodarone, Sotalol) Tablet CTO
Statins (Simvastatin, Pravastatin, Rosuvastatin, Atorvastatin, Fluvastatin)
Tablet CTO
Bile Acid Binding Resins (Colestipol, Cholestyramine)
Tablet CTO
Fibrates (Fenofibrate, Gemfibrozil) Tablet CTO
Ezetimibe Tablet CTO
Statins (Simvastatin, Pravastatin, Rosuvastatin, Atorvastatin, Fluvastatin)
Tablet CTO
Bile Acid Binding Resins (Colestipol, Cholestyramine)
Tablet CTO
Fibrates (Fenofibrate, Gemfibrozil) Tablet CTO
Page 17 of 24 Lynne DAY, ACNP: CPGs [October 2015]
Benzodiaiazepines Midazolam Ampoule
Lorazepam Tablet, wafer
Laxative & anti-diarrhoel Drugs Loperamide Tablet or capsule
Macrogol(Movicol) Sachet
Lactulose Oral liquid
Docusate (Coloxyl) Tablet
Docusate & Senna Tablet
Sodium Citrate, sodium laurel sulfoacetete, sorbitol and sorbic acid (Microlax enema)
Squeeze bottle solution
Fleet enema Squeeze bottle solution
Fluid Therapy Sodium Chloride 0.9% Intravenous fluid
Oral Rehydration Salts (Gastrolyte) Powder for liquid
Blood & electrolytes Heparin Sodium Subcutaneous CTO
Warfarin Tablet CTO
Clopidogrel Tablet CTO
Dabigitran Capsule CTO
Apixaban Tablet CTO
Rivaroxaban Tablet CTO
Potassium Chloride Tablet
Magnesium Aspartate Tablet
Folic Acid Tablet
Iron Tablet
Vitamin 812 Tablet/intramuscular
Ear, nose & throat Drugs Betahistine Table
Cerumenolytics Drop
Tramcinolone, Neomycin, Nystatin and Gramicidin Drop/ointment
Page 18 of 24 Lynne DAY, ACNP: CPGs [October 2015]
Betahistine Table
Endocrine Drugs Sulfonylureas (Glipizide, Glimepiride, Cliclazide,
Glibenclamide)
Tablet CTO
Thiazolidinediones (Rosglitazone, Pioglitazone) Tablet CTO
Metformin Tablet CTO
Insulins Subcutaneous CTO
Thyroxine Sodium Tablet CTO
Alendronate Tablet CTO
Vitamin D Tablet/capsule
Calcium Tablet
Carbimazole Tablet CTO
Gastrointestinal Drugs Ondansetron Tablet/wafer/I iquid
Anorectal Products Supp/liquid
Antacids Tablet, /liquid
Bisacodyl Tablet, /suppository
Bulking Agents Cap/granule/powder
Docusate Tablet
Domperidone Tablet
Ginger Tablet, capsule
Hyoscine butylbromide Tablet, SCI
Lactulose Liquid
Loperamide Tablet, capsule
Metoclopromide Tablet, injection
Oral Rehydration Salts Powder for liquid
Peppermint Oil Capsule
Polyethylene glycol laxatives Powder for oral liquid
Page 19 of 24 Lynne DAY, ACNP: CPGs [October 2015]
Prochlorperazine Tablet/injection
Musculoskeletal Drugs NSAIDS (Sulindac, Meloxicam, Piroxicam,
Ketoprofen)
Tablet, capsule
Methotrexate Tablet CTO
Allopurinol Tablet CTO
Neurological drugs for Parkinsonism Amantadine Tablet CTO
Entacapone Tablet CTO
Levodopa with benserazide or carbidopa Tablet CTO
Rasaqiline Tablet CTO
Seleqiline Tablet CTO
Apomorphine CTO
Pramipexole CTO
Rotigitine CTO
Cabergoline CTO
Anticholinesterases in Alzheimer’s disease
Donepezil Tablet CTO
Galantamine Tablet, capsule CTO
Rivastiqmine Tablet, patch CTO
Anti-epileptic Drugs Gabapentin Tablet, capsule CTO
Phenytoin Tablet, capsule CTO
Pregabalin Tablet, capsule CTO
Valproate Tablet, liquid CTO
Psychotropic Drugs SSRIs (fluvoxamine, Citalopram, Escitalopram, Sertaline, Paroxetine, Fluoxetine)
Tablet, capsule CTO
Amitriptyline Tablet CTO
Other anti-depressants (duloxetine, mirtazapine, venlafaxine, desvenlafaxine)
Tablet, capsule CTO
Respiratory Drugs Salbutamol Solution, inhaler
Page 20 of 24 Lynne DAY, ACNP: CPGs [October 2015]
Ipratropium-bromine Solution, inhaler
Oxygen Inhaled gas
Ocular Drugs Hypromellose 0.5% Eye drops
Polyvinyl alcohol 1.4% Eye drops
Carbomer 980 0.2% Eye drops
Anaesthetic agents Lignocaine 1% Injection
Prilocaine & Lignocaine (EMLA) Cream or patch
Antipsychotic Drugs Haloperidol Tablet, oral liquid, injection
Risperidone Tablet, oral disintegrating tablet, oral liquid
Genitourinary system drugs Oxybutynin Hydrochloride Tablet
Solifenacin Tablet
Urinary Alkalinisers Sachet
Immunomodulation Betamethasone 0.5% Cream, lotion, ointment, lotion
Hydrocortisone 1% Cream, spray
Prednisone/Prednisolone Tablet
Mometasone Cream, ointment, lotion
Methylprednisolone Cream, lotion, ointment
Emergency Drugs Adrenaline Injection 1mg/ml
Glucagon Injection
Glyceryl Trinitrate Tablet, spray
Immunisations as per National Immunization Schedule
Diptheria, tetanus and pertussis (ADT) Injection
Influenza Vaccine Injection
Pneumococcal Vaccine (23 valent) Injection
Miscellaneous Glucosamine Tablet
Cranberry Tablets Tablet, capsule
Urinary Alkaliniser Sachet
Page 21 of 24 Lynne DAY, ACNP: CPGs [October 2015]
Medications
Drugs will be carried by the ACNP as per the emergency list, for administration to persons in private homes as required.
If attending residents in a residential aged care facility drugs will be used from the residents' own supply or from the Drug Imprest maintained by the facility. Should the RACF not have a stock of the drug(s) required, the ACNP may utilise the stock carried by them if it is not possible to have a prescription dispensed in an appropriate time frame for initiation of treatment.
Schedule 8 Drugs
Should a patient in the community be suffering severe pain, the Ambulance Paramedics will be called to attend the patient.
Any scheduled drugs (requiring a prescription) will be locked securely in the nominated place of practice of the ACNP or in a locked, temperature appropriate container in the boot of the ACNPs car if in transit to see a patient in the community.
All stock medication will be monitored for use-by-date and any signs of deterioration.
The ACNP will comply with all guidelines and legislation relating to the storage and disposal of medications.
Unused or out of date medications will be returned to the pharmacy for destruction.
Used equipment such as syringes and needles will be placed in an approved sharps safety container for high temperature incineration. This container will be taken to a local pathology collection centre, when full, for disposal.
Used opioid dermal patches which are removed from a patient will be disposed of in the sharps container or returned to pharmacy for destruction depending on the environment in which the NP is working at the time.
The NP will comply with Vaccination Policies and Procedures as informed by The Australian Immunisation Handbook (10th Edition 2013).
LEGISLATION:
Human Rights Act 2004
Health Practitioner Regulation National Law (ACT) Act 2010
Health Records (Privacy and Access) Act 1997
Medicines, Poisons and Therapeutic Goods Act 2008
Privacy Act 1988 (Cwlth)
Public Health Act 1997
Page 22 of 24 Lynne DAY, ACNP: CPGs [October 2015]
REFERENCES
Aged Care Emergency Manual. (2008). Aged care and Rehabilitation Services, Concord Hospital.
American Geriatrics Society Panel on the Pharmacological Management of Persistent Pain in Older Persons. (2009). Pharmacological Management of Persistent Pain in Older Persons. JAGS: 57, 8: 1331-1346.
Australian Doctor (2012). How to Treat: Depression. 2 November, pp25-32.
Australian Institute for Health and Welfare. (2010). Aged Care. Accessed 18/4/11 from: http://www.aihw.gov.au/aged-care-indigenous/
Australian Medicines Handbook. (2015). Adelaide: South Australia. (electronic version via subscription). https://shop.amh.net.au/
Behaviour Management: A guide to Good Practice Managing Behavioural and Psychological Symptoms of Dementia DBMAS.
AMH Drug Choice Companion: Aged Care. (2010). 3rd Edition. Australian Medicines Handbook Pty Ltd: Adelaide, South Australia. ( via electronic subscription).
Government of South Australia (nd). Metro homelink: Anaphylaxis Treatment Protocol.
NHMRC. Australian Immunisation Handbook (2013. 10th Ed. Available online at: http://www.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook-home
Department of Health and Human Services. (2008). Palliative Care, Care Management Guidelines: Pain Management. Tasmania. http://www.dhhs.tas.gov.au/__data/assets/pdf_file/0006/36951/Pain_Management_Final211209_PCSSubComm.pdf
Selby, W. & Corte, C. (2010). Managing constipation in Adults. Australian Prescriber, 33, 4. August.
Medicines Management Team. (2013). STOPP START Toolkit: Supporting Medication Review. NHS Cumbria.
The Royal Australian College of General Practitioners. (2006). Medical care of older persons in Residential aged care facilities. RACGP. Melbourne.
Page 23 of 24 Lynne DAY, ACNP: CPGs [October 2015]
WEBSITES:
Advance Care Planning Australia: ACT resources: http://advancecareplanning.org.au/resources/australian-capital-territory
Care Search: Clinical Evidence
http://www.caresearch.com.au/caresearch/tabid/132/Default.aspx
eTG complete [Internet]. Melbourne: Therapeutic Guidelines Limited. (via subscription)
National PrescriberService ( NPS) http://www.nps.org.au/health-professionals
palliAGED Decision Assist (via app). Telehealth resources funded by Australian Government Department of Health. http://www.caresearch.com.au/caresearch/tabid/3224/Default.aspx
Wolters Kluwer Health Clinical Solutions. Up to Date. (2015). (via subscription): http://www.uptodate.com/home/wolters-kluwer-health-clinical-solutions
Page 24 of 24 Lynne DAY, ACNP: CPGs [October 2015]
Clinical Practice Guidelines Checklist
Before submitting your Clinical Practice Guidelines for approval and endorsement by the ACT Chief Nurse and Director-General, please ensure all the following elements have been addressed, including:
Designated Logo on the Clinical Practice Guidelines if applicable
Description of the Patient/Client Population
Date and Version Number of the Clinical Practice Guidelines
Review Date Stated
Plan for Dissemination, Review & Evaluation of CPGs
Reference list included.
Recommended