APPENDIX B – NEW ZEALAND AND UNITED KINGDOM: LEGISLATION ... · PDF fileappendix b – new zealand and united kingdom: legislation and policy (appendices n.z. - 35 to u.k. -41) scope

APPENDIX B –

NEW ZEALAND AND UNITED KINGDOM: LEGISLATION AND POLICY

(Appendices N.Z. - 35 to U.K. -41)

SCOPE OF PRACTICE FOR REGISTERED NURSES IN THE EXTENDED CLASS (NURSE PRACTITIONERS): A JURISDICTIONAL REVIEW - NOVEMBER 2007

TABLE OF CONTENTS

Page NZ – 35 Nursing Council of New Zealand: Scope of Practice………….. 3 NZ – 36 Nurse Council of New Zealand: Nurse Practitioner

Endorsement – Guidelines for Applicants …………….………… 9 NZ – 37 Extract from New Zealand Gazette, 10/11/2005, No. 188 p.

4750: Medicines (Designated Prescriber: Nurse Preactitioners) Notice 2005 .…………………….………………………………….. 34

NZ – 38 Regulations of New Zealand: Medicines (Designated

Prescriber: Nurse Practitioners) Regulation 2005 - Schedule Substances That are Nurse Practitioner Medicines if They are Prescription Medicines ………………………….……...…………. 35

UK – 39 Nursing and Midwifery Council: Advanced Nursing Practice

Update 19, June 2007……………………………………..………. 71 UK – 40 Nursing and Midwifery Council: Nurse Prescribing and the

Supply and Administration of Medication Position Statement..…………………………………………………….……. 73

UK – 41 Nursing and Midwifery Council: Guidelines for the

Administraion of Medicine Nurse , January 2004…………………………………………………………..……... 82

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Scopes of Practice Page 1 of 6

Appendix N.Z.- 35

Nurs(n9 Counci,t of New ZeaLand

Scopes of practice

:_;, On 18th September 2004 the current registers were replaced byfour scopes of practice under the Health Practitioners

._...... Competence Assurance Act 2003. There has been a smooth.... transition for nurses to the new scopes of practice. Every nurse

who was on the register or roll was transferred onto the new_ register with the appropriate scope and conditions on 18

September. These are outlined in the table below.

The four scopes of practice are" registered nurse, nurse._.... practi!;ioner, nurse assistant and enroJted nurse.

....... The new scopes and qualifications are described below. Please,_ note that these qualifications relate to nurses applying for

registration in a scope under the new Act. Nurses previously:, registered under the Nurses Act 1977 were automatically

transferred into these scopes of practice.

_ NURSING COUNCIL OF NEW ZEALANDJn_,,

....." NOTICE OF SCOPES OF PRACTICE AND RELATEDQUALIFICATIONS PRESCRIBED BY THE NURSING COUNCIL

, OF NEW ZEALAND0

Pursuant to section 11 (1) of the Health Practitioners CompetenceAssurance Act 2003 ("the Act"), the Nursing Council specifies the

........ following scopes of practice. Pursuant to section 12 of the Act, the....._ following qualifications are prescribed for each scope of practice.

1. Scope of Practice - Registered Nurse

Registered Nurses utilise nursing knowledge and complex nursingjudgement to assess health needs and provide care, and toadvise and support people to manage their health. They practiseindependently and in collaboration with other health professionals,perform general nursing functions and delegate to and directEnrolled Nurses and Nurse Assistants. They providecomprehensive nursing assessments to develop, implement, andevaluate an integrated plan of health care, and provide nursinginterventions that require substantial scientific and professionalknowledge and skills. This occurs in a range of settings in

http ://www.nursingcouncil.org.nz/scopes.html 10/23/2007

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partnership with individuals, families, whanau and communities.Registered Nurses may practise in a variety of clinical contextsdepending on their educational preparation and practiceexperience. Registered Nurses may also use this expertise tomanage, teach, evaluate and research nursing practice. There willbe conditions placed on the scope of practice of some RegisteredNurses according to their qualifications or experience limitingthem to a specific area of practice.

The Nursing Council Competencies for Registered Nursesdescribe the skills and activities of Registered Nurses.

Qualifications

New Zealand Graduates

a) A Bachelor degree in nursing (or an equivalent qualification)approved by the Nursing Council of New Zealand, AND

b) A pass in an assessment of Nursing Council Competencies forRegistered Nurses by an approved provider, AND

c) A pass in an Examination for Registered Nurses.

Registered Nurses from Overseas

a) Registration with an overseas regulatory authority, AND

b) An equivalent international qualification, OR

c) A pass in an assessment of the Nursing Council Competenciesfor Registered Nurses by an approved provider, AND/OR

d) Successful completion of a programme approved by NursingCouncil for the purpose of assessing Competencies forRegistered Nurses.

2. Scope of Practice - Nurse Practitioner

Nurse Practitioners are expert nurses who work within a specificarea of practice incorporating advanced knowledge and skills.They practise both independently and in collaboration with otherhealth care professionals to promote health, prevent disease andto diagnose, assess and manage people's health needs. Theyprovide a wide range of assessment and treatment interventions,including differential diagnoses, ordering, conducting andinterpreting diagnostic and laboratory tests and administeringtherapies for the management of potential or actual health needs.They work in partnership with individuals, families, whanau and


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communities across a range of settings. Nurse Practitioners maychoose to prescribe medicines within their specific area ofpractice. Nurse Practitioners also demonstrate leadership asconsultants, educators, managers and researchers and activelyparticipate in professional activities, and in local and nationalpolicy development.

The Nursing Council competencies for Nurse Practitionersdescribe the skills, knowledge and activities of NursePractitioners.

Quafifications

a) Registration with the Nursing Council of New Zealand in theRegistered Nurse Scope of Practice, AND

b) A minimum of four years of experience in a specific area ofpractice, AND

c) Successful completion of a clinically focused Masters Degreeprogramme approved by the Nursing Council of New Zealand, orequivalent qualification, AND

d) A pass in a Nursing Council assessment of Nurse Practitionercompetencies and criteria. Nurse Practitioners seekingregistration with prescribing rights are required to have anadditional qualification:

e) Successful completion of an approved prescribing componentof the clinically-focused Masters' programme relevant to theirspecific area of practice.

3. Scope of Practice - Nurse Assistant

Nurse Assistants assist registered nurses to deliver nursing careto individuals in community, residential and hospital settings. Theyperform delegated interventions from the nursing care plan toprovide care and comfort for individuals and groups, assist andsupport clients with activities of daily living, observe and reportchanges in individual/group conditions and behaviours, safe guarddignity and promote independence and health and safety. TheNurse Assistant does not undertake independent nursingassessments or plan and evaluate nursing interventions. NurseAssistants may be required to practise in a specific area based onthe area of focus in their education programme and designated ontheir practising certificate.

The Nursing Council competencies for Nurse Assistants describethe skills, knowledge and activities of Nurse Assistants.


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Quafifications

New Zealand Graduates

a) Successful completion of a programme approved by theNursing Council, leading to a certificate at level 4 on the NewZealand Qualification Authority - National QualificationsFramework, AND

b) A pass in an assessment of the Nursing Council Competenciesfor Nurse Assistants by an approved provider, AND

c) A pass in an examination for Nurse Assistants

Second level nurses from overseas

a) Registration/enrolment with an overseas regulatory authority,AND

b) An equivalent international qualification, OR

c) A pass in an assessment of the Nursing Council Competenciesfor Nurse Assistants by an approved provider, AND/OR

d) Successful completion of a programme approved by theNursing Council for the purpose of assessing Competencies forNurse Assistants.

4. Scope of Practice - Enrolled Nurse

Enrolled Nurses practise under the direction of a RegisteredNurse or Midwife to implement nursing care for people who havestable and predictable health outcomes in situations that do notcall for complex nursing judgement. The responsibilities ofEnrolled Nurses include assisting clients with the activities of daily 'living, recognising the changing needs of clients and performingdelegated interventions from the nursing or midwifery care plan.

Qualification

Completion of a programme and examination approved by theNursing Council of New Zealand leading to enrolment as a nursesuccessfully completed before 2000. This scope is not open fornew applicants from New Zealand or overseas from 18September 2004. Applicants from that date will be registered asNurse Assistants.

How nurses were transferred into the new scopes.

http://www.nursingcouncil.org.nz/scopes.html 10/23/2007........

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The following table outlines how registration under the Nurses Acttranslated to the new scopes of practice.

Scope ofPractice under

Registration the new Actunder the Nurses ConditionsAct 1977 (effective from

18 September2004)

RegisteredComprehensive Registered NurseNurse

Registered May practise only inGeneral & Registered Nurse general andObstetric Nurse obstetric nursing

May practise only inRegistered Registered Nurse mental healthPsychiatric Nurse nursing

May practise only in

Registered settings whichPsychopaedic Registered Nurse provide services forconsumers withNurse intellectual

disabilities

May practise only inRegistered Registered Nurse general nursingGeneral Nurse

May practise onlywithin a maternity

Registered Registered Nurse setting under theObstetric Nurse direction of amidwife or a medicalpractitioner

Enrolled Nurse

(educated before Enrolled Nurse2000)

Enrolled Nurse May practise only in(educated after Nurse Assistant a specific2000) designated area ofpractice

May practise (and

http://www.nursingcouncil.org.nz/scopes.html 10/23/2007.................

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prescribe) onlywithin a specificNurse Practitioner Nurse Practitionerdesignated area ofpractice

Registration - Annual practising CurtificatesEd_ucation- ivlidw_fer;.,- Corporate -.,Publications

News.and iss_._.s- Links - Cont_:_ctDetaiis- Homepage

http://www.nursingcouncil.org.nz/scopes.html 10/23/2007

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NURSEPRACTITIONEff "ENDORSEMENT

GUIDELINES FOR APPLICANTS

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ISBN 0---90P,662-.10----C_

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!i fill!!!i i !_!i!_:i!i/!!!!_i?ii!

Page

Message from the Chair 5

Introduction 7

Overview of the Assessment Process 7

Applications 9

° Application Criteria 9

• Tips for Portfolios 9

• Content 10

Desk Audit 12

Educational Ectuivaience 12

Preparation for Panel Assessment 14

Panel/-\ssessment 1.5

Nursing Council Decision 16

• Review process 16

Appendices

• Appendix 1: Application Process:Detailed Flow Diagram 17

• Appendix 2: Nurse Practitioner TMCompetencies 19

• Appendix 3: Application Form 22

• Appendix 4: Evi(lence Recorcl (excerpt! 23

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New Zealand's first nurse practitioners have now been recognisedby the Nursing CoL_ncil, transforming a policy direction into a newreal ity of hea Ith s(,rvice delivery.

Our new nurse practitioners join the tradition of innovation in New

Zealand nursing. Council acl<nowledges the courage of these first

applicants in being prepared to put themselves forward and in taking

on a challenging new role. Council has no doubt that these expertnurses and their future colleagues will add to the growing body of

evidence internationally that nurse practitioners achieve improvedhealth outcomes fo_ their client populations.

The regulatorv fiame_:ork rot nurse practitioners has been developedto support Counc, ii in meeting its public safety mandate under theNurses Act 1977, ensuring that New Zealanders receive safe healthcare from registered nurses. With the endorsement of our first successful

applicants, Council has taken the opportunity to further develop

policy supporting the assessment process for nurse practitioner TM

applicants. These guidelines reflect this development and are designedto inform anct assist applicants through the assessment process.

AnnetteHuntingtonChair

Nursing Council of New Zealand

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lhese guidelines h,lve been (te_el_tped to assist nurses who are considering Inakingan application to hecome a nurse t)ractitioner r''. llqe guidelines provide information

about submitting an apl)',i(:ation and the pro(:essol:assessment {or nurse practitioner r'.'endorsement.

Intending applicants should also read '-rhe Nurse t)ractitionerrM: Responding toHealth Needs in New Zealand' fSeptember 2002) for further information on nursepractitioners in New Zealand.

The flow diagram beiow out[i nes tile appli(:ation and assessment process for nursepractitioner ],'_enclorsernent _

Alq:_LICATION ASSESSMENI F _Ei A :.A(t(:)N N_IRSINGWITH DESK OF F(.__ P,,,N [iL COUNCIl°

PORTFOLIO AUDIT EDUCATIONAl. ASSIi'.:_SM f.N TEQUIVALENCE ASSESSM_NT DECISION

° Appli(ation • Review of ° l)oesthe • Review of • Assessn;_m! ° (:ouncil

comple(ed portfolio for a[u_licanl I).:_rtf(_iio int,'rvim,.. (.onsi(ler,tti_n

• Suim]ission ol _ompletenuss dumou<rate • Ruferuu the(ks • l)eli ter, diorl and aml decisionp(_rtfolio • Liaison with equivalence? • L,lis_,_ _vithin ,le(isior_

applicant [}: x._ • Re{ ornr_m'n(]atior/

t(, NLlr'-;i_;g( ouncil

,,_,pplicam ( oum.i Council Pa,,.,l Panel NuE.dng Council

_liA detailecl diagranl or the asse.',sment )rocess is attached as/xppundi',: 1.

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The aim of the assessment process is to provide for streamlined peer evaluationof the applicant's nursing practice. The key questiof_ addressed by the assessmentprocess is:

"Does" the at;p#c_nt meet the criteria and' defined competen_ie_

for a nurse p_'a(/itione_' _-_.t_,

The c_n_petencies recl_ir_,_:]ol n_JrseF)ra_titi()ners are included as Appendix 2.

The role of the Nursing C()url(. i] ]FIapproving nursu practitioner T,v,endorsements

is to project pubiic sal:etyby erlsuring that the asses_;mentprocess conforrns to set

standards, including the requirements of the Medicines Act 1981 for those applicantsseeking prescribing rights. The Council a]so I:acilitates the process of assessment

for both applicant alld __ssessm,ent panel.

Assessment panels have the key role ol undertal,,ing a peer evaluation of an

applicar_t's practice and mal<int_a recomn_erldatior_ to Nursing Council based ontheir ass_tss[ller]t(); ar_,_pj_',(,l_]t's practicc..

Assessment panels are drawn irom nonlirlations by the nursing proi:ession and mayalso, if appropriate, i_/( lucle a consumer _._rother heaith professional working in

an area ot practice closely aiignecl to thc:,al)plicant's defined scope of practice.

Applicani.s Seeking Prescribing Rights

The overall assessment process for applicants seeking prescribing rights is the

same as for those applying to become nurse practitioners who do not wish tobe able to prescribe.

However, applicants seeking prescribing rights will have to demonstrate that

they meet all nurse practitioner r,'_competencies related to prescribing and all

relevant regulatory and educational requlrements.

Nurse practitioners who later decide to af}ply for prescribing rights will not be

required to re-submit Hleir portfolios but will undertake an approval processrelated to the competencies k_r prescribing only

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lb apply you must c+_m[>[etethe official app[k:ation form, which includes a statutorydeciaratk)n (Appendix _,+.

A pc_rtfo]+odescribing and veri{\ ing your l>r<:cticemust accompany your application.The f;,url_()sc:! (it the i_<_rl_oiic__sto ensure If/at:

• Your application _s ready t:or formal review t)v the assessment panel• The assessment panel has all the inforn'lation it needs to assessyour application.

There is also an application fee of $200.-flits fee has been set for the 2002/03 yearand is likely to change annually.

II ''l-':__"licali(;)rl[.,t77;Ti_,r<:s

The foil<wring are Ifi( _Ill nill-ltii/', cliterJa lha{ mtiS[ be rm,t by all applicants applyingIor nurse practiti(;r_er _', el_ch)r.<_en_.er/[:

• Registration as <._liorse ill New Zealand appropriate tc_the intended sc:(q.)eof practice

• Possession of a current annual practising certifi(ate• Good professional and persona[ standing

• At least four years Fie>stregistration experience within the nominated scope• Completion ot the application form/statutory declaration• Payment of the presc:rit)ed fee

• _ubr_lission oi: a i)ra,:tice l;{_rtfc)lio t() tl;e Nursing Council oi: New Ze<lland.

In addition to lhe al)tJv.:_.,the 2 k_,_,'a,reas on which assessment oi: al.)plications isbased are that the applicant:

• Holds a Clinical Masters degree or recognised equivalent, and

,' Demonstrates the competencies for advanced practice.

The portfolio is your opportunity to describe and provide evidence of your nursing

practice/_' There is no set format, t [owever, iriformati_n should be clearly presented

in sections, divide{t bv tabbed inserts. Use an ind_--,xand page r_umbering. Rememberthat assussment p,_nels will need t¢>be able t_ easily find illl:ormation within theportfol to.

Documents included iil your i.)oiltolio as &k_._i[[t <_',l:_pl,/.?examples of your practice shc;ulclbesigned The NursingCouncil welcomes inquiriesby y()urseli:and by <isecond party to verify from nurseswanting to know moreabout

how to apply.their accuracy (for example, a (olleague,

client/patient or n]allag_r as appropriate). Justcontact the RegistrationsAdviser atthe Nursing Council on:

Verification of content t:_,'_tse(:<)n,.Ii:)arty

assistsy<)uto evklence t}3atV(ILJr portfolio Pimne: (04) 802 0242E-mail: [email protected]]), ie[lc:'(:ts q()tlr t)ractice.

'_ Asseml')lir_ga portfolio is .,i_il<lrtcJtl_e!>rocessre_luirod I:or (linical CareerPattl_.x.<lv/Profcs.qur_atDevelopmentPathassessmenlora.'.part_)fyourl)repara',ionio_conU)clencvbasedpractisingcortific_<_tos.

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When you forward your portfolio, please do not inctude original documents - use

photocopies that have I_een\.erifiect as copies of _.>r[ginals.

Portfolios should be a_,sembled with the need for photocopying in mind. ]his

means that plastic sleeves (page protectors) should not be used and no spiral orother binding apart from a sturdy ring binder.

(:()re areas ()f d(_(u _(nrati,_rl tu I)e included in y_ur portfolio inclu(le:

• ,i !_; {,;_ ,,__.It_e (.()_nl_iet_,(Nursing Council application form which includes

a statutory dec]arali,)n venl;ing your professional standing.

• ..,_,,................', ,, -,_,,t{_I._,{.,._;{, ,-,; _ : !,ra, ti,..,-:_This should include identification of the

range and parameters oi: your practice an(] your area of specialty/sul)specialtyif applicable. The scope shuuld reflect the dynamic nature of health care and

nursing and advanced l)ra(_tice coml)etencies. It should reflect collaboration

with nursing and other co'leagues working in the same scope. You shuuld als()

identify strategi_,_ !ha! \.ou I/ave in place to maintain and devel() i) yourcoml.)etence wilhin VOLIr S(._(}[) :' (H" practice.

• i,:{-;__e,:;_"The names and c_n{actNote: If you include an established

details of 2 confidential referees able scope statementdevelopedby a groupto comment on your current nursing of nursing colleagues (for example,

those developed for nurseprescribing),practice must be provided, You may you should describe how your ownalso wish to include written letters practice relates to this scope.of support/references supporting you rapplication. This is a good idea but

does not replace the requirement for names of confidential referees with an upto date km_vvledgu {)f ,,,our nursing practice.

• _;:_:.: , _ . ' ," TI]c,_)utc()mes _t-pr{)l:e._si()na]performance review/peerevalLJations {optic)n_lJ.

• i:ilu, ,_!_{::,,al,..,,,.......:;: ,'i_, _,_:This must inclucle evidence of programmes completed-

- If you have completed an approved Clinical Masters Programrne you will need

to forward a verified certificate and transcript. You may also wish to include

evidence of other programmes undertaken relevant to your practice.

--- If y'ou are seel<ing recog_lili()_ of educational equivalence y()u ,,viii need tot:orward verified { _.,rtifi{_,.l{.,_,)l pr{)gran_n_esundertaker], inforn_ation ab()ut the

appr(wa! status _I: f_,cq.,ra,Y_'.._e,<their length a_ct cor_tent I(:OLtr_e outlines;,, thequaiificatio_, oI lu,_ :h:_g _,(,_fietc..

• /\ CLirli(:'l[LilY_ ,.._ ,;_-{):ill i : '_i _,!,'d_ 'V.)FI.: iqiS!t,_'. Where your practice hasdeveloped over a range oi_nursing positions held, it is helpful for assessment

purposes if the curriculum vitae summarises key achievements in individual

positions (and related to the competencies for nurse practitioners) to highlight

the development of practice over time and with cumulative experience.

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Examples of these might include:

Remir_der!--- Case studies Youshould signtheseitems

Exemplars and havethem verified by

--- Quality devel_pm_u/t _nitia!iv_s incIuclin_ policies a second person able tocleveIoped _ attest to their accuracy.

C-.]ientcase notes '..i_l_luding annotated interpretation Noteotcontentasal:.)prol)riate_ Verifications should

- Educational programmes delivered inc ude the signature ofthe person verifying the

-- A diary of a typic:a[ working week, outlining your content, their role (e.g.range (.)l:activities etc. colleague,patientetc)and

the date.

When developing the above, you shoulct include

analysis inclicating reflective :_ractic:e and knowledge of legal and professionalrequirements.

• = :/ -

LabellingYour t_orffotio- Publications including bibliographical references (onlen!

- Research" A synol.)S soi: research undertaken, Labelling is important! The

including the t_rolx_saJ,_tesign, results and Ohltcomes content of your portfolioshould be referencedsothat.... Presentations/teaching activity including details of the assessmentpanel can

the contexts in which i)resenta!ions were delivered, understandhow a particularitem relatesto yourpractice.

° Mentbershi[_ anti rl\'r)lvuitqent in proi:essi_na[ For instance, ifyou includea policy or protocol, attach

orgal_ization,_ and activ]t _:_(!_)r example working a reference that describespart_:...,,slocal regic_n,_l_r nalional committees etc). how/when itwasdeveiopect

Include information that clescri[_esyour contribution and your role in itsto professional _rga nizations, development.

- Current practising c_:._rtificale-- Qualifications ,._chJeved

- Where relevant, oulcomes _f other professional credentialing processes e.g.PND/CCP ieve[.

Please note that a nursling focus must be evident within the portfolio. Thisincludes

reflection of nursing values and beliefs, and nursing perspectives rather than justa task or skill based approach.

N,_ed t4eil.t t_,'ith your Application?

The four majorprofessionalnursingorganisationswhich makeup NPAC-NZare available[o support nursepractitioner t'_ applicants:

• College of NursesAotearoa• New Zealand NursesOrgantsation• Australia, New Zeatand College of Mental Health Nurses• National Councit of Maori Nurses

NPAC-NZ(the NursePractitionerAdvisory Committee of New Zealand) is a new groupthat will undertake a leadership role for the strategic development of the nursepractitionerT_ role in thiscountry.The group will also havean important role in advisingNursing Council on the develeprnent of supporting processesfor nursepractitioner r,'_endorsement and in researchand evaluation related to implementation of the nursepractitionerT'_ model.

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Once completed applications and portfolios are received by the Nursing Council,a desk audit is completed by Council staff. The purpose of the desk audit is to carry

out a preliminary assessment of the portro[io to:

• C:(mfirm the g_)(_:ti):oI_ss_c:_rla]standing of the aj)l)[i_:ant

• Assist applicants to provide all _equired information for review by the assessmentpane[

• Confirm that the applicant's practice apl:)ears to meet the coml)etencies foradvanced pra(:tice

• Confirm that the applicant's (.[inica[ educational [)reparatkm is at Masters orequivalent level.

Initiaily, the sulm_Jue(I t_orm:_[i_,is cllecke(I for compleleness by Coun(;il staff. 1his

stage of the assessment process may involve some ongoing dialogue between

'>,ourself and Nursing Council staff as yo_Jworl< to finalise presentation of '>,_)urpractice for formal panel assessment.

iiiii_iiliiiii iiliiiiiiiililiI _ iliiiIliiiiii _

iI :........................

Educationalequivalenceisassessedby theEducationCornmitteeofthe NursingCouncil.

The processforde.terrniningedu_ationa[equivalencerecognisesthatnLlrses r11a'>,'

actnieve advan<ed l)ractice tt_r()ugh other pathways than via formal Masters

preparation. Equi_,ale_ e _'._a\'t)e demonstratecl by al)plkLants who have completed

other eclucation p_ogra;n_nes anti achieved nurse practitioner r_'*competencies in

other way's. The process is outlin_-,d in the diagram below and seeks to minimise

barriers l:or nurses practising at an advancect lew_l who have not yet had the

opl_ortunity to coral)fete a formal clinical masters programme.

/ ..................................... ,

,,_, ',

eDucatIoNal :,:::} )IREIARATI()N IPRACIICE

Courses undertaken -Jr- Within an identified _>relevant to identifiecI scope

scope of practice :: : ........

,

" .... _ Developmentof Practice.....

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In sumrnary, tile concept ol e(la_atJonal equivalence acknowledges the dewqopmentof practice to an a(Ivav_c_,dieve! via a mix ol: clinical experience, educationalprogrammes undertaken and reflection on practice.

When assessing educational equivalence, evidence is required of the applicant's

ability to integrate theory, research and practice. The applicant must be able to

demonstrate the app[i(:atic:ul of nursing frameworks to her/his practice and the

application of critical thinking and evidence as the basis of clinical decision making.

These are the sorts of questions education Any MastersProgrammewithreviewersmightaskwhen assessingeducational direct relevance to an

equivalence: _ applicant's scopeof practice

Has the applicant completed an approved / can be considered as part of

Clinical Mastersprogramrne.Does this relate to equivalency.her/hiscurrent scopeof practice?

Has the applicant completed another Masters

Prograrnme?Is the applcant's Mastersdegree

directly relevant lu her�his scope of practice? ,_f .........................

Has the applicant developed her/his practicethrough a rnixof attending relevantpostgraduate _,. ,educationprogrammes/experienceandreflection _" "\"-_ ..._on practice? Has the af)plicant-been involvedin other activities such as participation inresearch?Isthe outcome a practitioner who ispractising at an advanced level?

r.............................................................................................................................................................................................................................................................................

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i ',,1',tII E'I| ,] IIe] .... I

When all requirecl documentalion is prusent and an applicant has established

her/his readiness for formal assessment, an assessment panel is convened.

The role of the assessment panel is to fully evaluate applications against the

competencies for a nurse practitioner _,'4. R_ do this the panel works through a

number of tasks prior to the assessment interview iilcluding:

• _:-"_ti_ir l,:!:<::,. i__ Full review of theai)plicant'_l)Orlfolio. Panels mav request

adcli_ional inf_urr_,_ti_m fi-_ut_ a!_plicant_,.

• i.,. i,:r;,r_, _, C:_n_iduntia] reteree's report_, tr_:>mindwiduals norninated by

the al)plicant. Fhe panel may also requust permission to seek further rei:erences.

• -:,if,,::,vi,,it,-,: A nominated panel member may undertake a visit to the applicant's

workplace before and/or following the assessment interview. The panel will

decide if a site visit is necessary. The purpose of site visits is to observe the

applicant's scope oi: practice in her/his usual practice setting.

Assessment Pa[1_e[s Generally panels will have aroundfour members. Some roles may be

Each assessment panel mav include members combined. For example, thewith the following roles: advanced practice nurse may also

• A professional nurse leader with be from the same scope of practicenational/international understanding of as the applicant.advanced nursing practice

• A nurse with expertise in education.experienced in the assessment of advancedcompetenc_es

• A nurse practising at a_lvanced level withability to critique practice

• A peer from the samu clinical scope as theapplicant, not necessarily a nurse

• Another member as appropriate, forRight _3fAppeal:example, a consumer.

You may elect to challenge a panelNote: Up to 2 Nursing Council staff will also member if you believe that (s)hebe present at panel assessments to provide may have a conflict in relation toadministrative support and to ensureconsistency, your application

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The purpose of the ass ,ssment inlervievv ;sto give ,,ou at7opportunity to presentyou r practice and \o,,l_ a,hi,,_ _,n_ent of l_urse practitioner _'' competent ies. Tlle

interview also ailov,,s tl_e t>aneJt(> explore with yC_LIthe content oI your portfoI (_and to clarify in more{lei_th ;.'_ur scope ,,>fnursing practice. Key areas of focuswithin the interview may incIu(le:

• Defining your scope ol prac:tice(.independent and c_)'[aborative' S_i)[;v.:_rJ:fc_rApplicantsincluding bounciarius ,/r_(l ho;\ Youare welcome to bring a support personyou bring the unique to your assessment interview.' Usually the' role of the Support person is that of supportperspective of nursing to your for theapplicant rather than taking an activepractice role in the interview process.

• Strategies used ior_ssussn_erTt Howeveb should you wish to de so,you mayof client/patient he.l[tt_ lleed,, formally request that your supporter(s) rnay(groups/individuals) address the assessmentpanel prior to the

commencement of the panel interview.• Application of nursing

knowledge and eviclencebased practice

• Reflective practice

• Innovation in practice and developmer_t of new nursing I<nowledge• Cultural safety

• Clinic:al judger_lunt ,_nd r_a_a,4ement (_tconlpiex situatkms

• t-_rofessional leadersl_il,, teach,ng an(t _ole modc,lling

• Engagement with <tl,d ,ontr:bLItion to the ',.,,id,;r proiession and health seutor

• Your strategies f(_rmain!aining and developing nurse practitioner ''_ compelencies

• Competencies re]at(.d to l)res( ribing for applicants seeking prescribing rights.

A date is set for the assessment intervie,.;, in consultation with the applicant, once

the panel's preparat_)r\'w(_rk :scompIete. You should expect theformal panelinterview to take al)()ut tvv_ hoLlrs.

The panel will tnilor inter-vi(*v_

questions aloul_d t"e E,,,idenc_-Record

competencies {oi a nu_e The evidence record is the tool used bypractitioned ''_,so as t_>;)e able to assessmentpanels to evaluate:whether an

explore in depth the various applicant hasdemonstratedachievement ofadvanced nursing competencies.

aspects of your clinical practice.

You may be asked to t)resent a Thetool outlines possiblesourcesof evidencerelating to each competency. For instance,a

particular aspect of your practice competency may be demonstrated throughand to respond to simulated responsesatinterviewand/orthroughwrittenscenarios related to your scope ot evidence in a portfolio and/or via referee's

practice. You rnav also rectuest the reports.

opportunity to pre_(-,nt .in ar_,a_)_ T(_)illustrate the process,part of theevidencerecord usedby assessmentpanelsis includedyour practice l_ the I<._e]. :_ras Appendi'<4.

example, a researd7 t;roj_,_.t tl_at

you have undertaken.

Following completion oI: the assessment interview, the assessment panel completesits formal evaluation using the evidence record 'which is based on defined nurse

practitioner T'v'competencies. If panel nTembersare not satisfied that they have enough

ABC000002023

24

information to cumpk:,tc, tt_eir e_aiuation, they may request tile applicant to pro\,'idefurther information and/or con_plete l:urther rel:{:,rencechecking and/or a site visit.

When the assessment panel has completecl its cteliberations, the outcome of the

assessment is documented in a report and a recommendation is made for theconsideration of the Nursirlg Council.

The report of the asse,_,_mentpanel ,,rill be considered by the Nursing Council atits next meeting.

Successful applications will be granted nurse practitioner ;'_ endorsement with either

-- Nurse Practition_,r _': (_,cope o! practic(_) enterecl against their registration

- Nurse Practiti_ner _'_ sc,)pe of practice) with endorsement lor prescribingentered against their registration.

A certificate denoting nurse l)ractitioner r,'' endorsement will be issued.

An updated practising certificate with nurse practitioner _Mendorsement will beissued on return of a current practising c{:trtil:icate.

The endorsement will normally be valid for five years. Nurse practitioners will be

required to maintain an up to date portfolio for five },earl}, review and will also

be subject to rand(_m audil once competency based practising certificates areintroduced.

"' Review pro(:es_

Unsuccessful api,)licanls will I:)egiven the, opp(_rtunity to request a review of theassessment decisi(_n.

Reviews will be heard !)v the Nurse Practitioner f'' Review I_u-_el,an independentpanel established hv 1he NursiJ_g Council.

• That there are issue,_o[ iustice and fairness relaled to the assessment process

• 1-hatthe decision is clearly incorrect in fact.

Applicants must n{_til:v their intention to seek a review within 28 days of beingnotified by Council tl_at tl_,., were unsucc essl:ul. A i:eeoi: $50.00 is payable to theNursing Council.

Review submissions may be presented in writing or in person by the applicant.Reviews may not be I)ased o_ [)resentation of new information relatect to an

applicant's practice. If a { andida,,e wouht like new ini:ormation t_ be considered

in support of their app]i(.ation, tills becomes part of a new application process.

The Nurse Practitioner ]_'_Review Panel reports its decision to the Nursing Councilwho will formally notify the applicant o{ the outcome.

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25

NLJt{.S_::PRAC1ITIC)t'-_I!!!Rr'_ Pl¢;()Ci:.!_;:qDEI-All !!!!Dfl"-'_"............._\',' i),tAG P " _""

OApplication and Portfolio

submitted

Desk audit of portfolio "_

Portfolio "qu Required documentation Received within \_i_ :i_i!_0_i_:

complete? _ requested from applicant 6 months? -- _ : i:_.!!!iiii!!!_::i:!i_i,_ " !i:_

l ..... ; ,,,qNursing Council ",,

_Z_ Assessment o7 ......._ Sufficien information --_ Information providedApproved Clinical educational equivalenc_ .... in portfolio? q by applicantM asters? " '

Proceeds to assessment __ .................. Applicant demonstrates

panel Educationa I equ ira lence? ,1n

• Panel convenes to

assess portfolio Ap_lican_ declifi_d• Reference checks _d no_i_ie¢i o_

completed rev'_!ew_:'_process_"....• Requirement for site

visit assessed

Panel assessment _-_ Panel has sufficient _' Applicant _:_."k_" Recommendation tointerview inforrnat on to make ...... *" meets criteria Nursing Council

decision?

Further evidence . A Nursing Councilgathering as required. Site : _- Decisionvisit may be arranged at /

this stage >.,; .[ v,....

ABC000002025

26

ABC000002026

27

m () " _"........ _--t li(ti )_ ,: f:r"_trsi_2_ il]r,._(!.CO and its

]he nurse practitioner r,'', is able to:

• del:ine the scope o independerlt/co]lal)orative nursing practice in health

promotion, maintc!n<tnceand restoration of hea[th, preventarive care, rehabilitationand/or palliative care

• describe diagnostic enquiq, processes, respond to actual and potential he<_lth

needs and (bar.toter s!i_s of the paitictJlar population gr{_up

• explain the applicaliorUadaf)tation o[ advanced nursirlg knowledge, expertiseand evidence basecl care k) improve the health c_utc:omesfor clients across the

care continuum within the scope of practice

• generate new approaches to the extension of nursing knowledge and delivery

of expert care with the client groups in different settings.

, i 1 _ I Si-,_ I;: :,:1 ',, _tli\ i);/[l]_:'"!_'-

-[he nurse pra(:titi_nel _' '

• demonstrates culturally sale practice

• uses professional judgement to:..... assessthe client's health status

- make differential diagrlc_ses,"implernent nursing nterventions/treatments- refer the client to o!her health l)rofessi_nals

• develops a crealivc:,, inr_a!w_ approach to client care and nursing practice• illallLi_es Cc)llll);(!t ,,,}[u<i{iq)lit,

• rapidly anticipat_::,sstciati<,u_.,.

• models expert skills within lhe c:linical practice area

• applies critical reascJning to nursing practice issues/decisions

• recognises [traits to own practice and consults appropriately facilitating theclient's access to apt:_ropriate ir_tervent_ons and lherapies

• uses and interprets laboratory and diagnostic tests

• operates within a framework of current best practice and applies knowledge

of pathophysiology, pharmacology, pharmokinetics and pharmacodynamics tonursing practice a.,>ses,me _t.,d_.( s_onsand interventions

• accurately d{_cumutl_ts ,_r_(la(iminist(-.n<_assess_T_ents,diagnosis, interw-,ntion,

treatm(mts an,i i,:,[[ )_.-Li l) W fl_in legislati_,n, co_Jes anct sc_)pe of practice

• eVail.lates the (til<.:Tc.t,,(.,_-.,s<_( --t- -, n . >{ii_:, client's -e<_)(__s_-,to prescribed interventions,

appliances, treatmunts and _ne_lications and monitors decisions, I:aking remedial

action and/or referri ng accordingly

• collaborates and consults with the cliel_t, fanlily and other health professionals

providing accurate ir_formation about relevant interventions, appliances andtreatments.

!!i[

ABC000002027

28

-File nLir.<iepractitioner_',,:

• takes a leadership role in complex situations across settings and disciplines

• demonstrates skil[ecl mentoring/coaching and teaching• leads case review and debriefing activities

• initiates change and responds proactivelv to changing systems• is an effective nursing res_)circ(._

• participates in profe<_siona[<_Ul-)ervision.

I )(.7.(:. (.)_):;,,:tri(! i _1__1(:"](.c:.S_:' " i3, '7:Ii ....h/:_;( _c 3()-(2_;()f/()!1-1ic [)() i( l( '<:,

,,:.:_r_cir)ra_: :' _ Jc:,(:ala,(.l _-_,._!i_:,r);Tilevel

The nurse practitioner'_'_:

• contributes t<>and t),_rticip.<tt+_sin national and local health/socioeconomic pc>licv• demonstrates cc_m_,_itn_er_lto)quality, risk man,_gen_ent and resource utilisation

• challenges alld de'_.lot_s c:linica[ standards

° plans and i"acilitates audit i)rocesses

• evaluates heahh oulcomes and in response helF_sto shape policy.

5 ,(.) .........qh()w<:,<-,_,;:,....,,,<, ri7 i_'<"'--<:'_".....r(;it in(:_cii r_ __l(_ nursi n<::>aI:)ra'::ti'::e.

The nurse practitioner r,'_

• evaluates health outc:<,rr_es and in response helps to shape nursing practice

• cletermines evidenc<;-hasect practice through sctlolarship and practice• reflects and critiques the practice of self and others

• influences purchasing and allocation through utilising evidence-basedresearch findings.

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6 {) l;_r¢_scrii;_-_: ir,..-1_::_,'_'_ ¸' ' ___ _ _ _ ,,,....... I _

The nurse practifi_ner ',',_seeki_g t_re_cribing rights:

• uses proi:essional judgement to prescribe

• collaborates and consulls with, and provides accurate information to, the client,

the client's l:ami[y and other health professionals about prescribing relevantinterventions, appliances, treatments or nledicaiions

• prescribes and aclministers n/edicati_ns within legislation, codes, scope of

practice and acc:ording t_ Ihe established prescribirlg process and guidelines• un(ierstarld_, the_ u_,e, irr_i_i <::,_tions,c_)ntr,._--incli(_ations,and inlera__t[ons of

prescription r_le([i( tti,.._n<._',\'i!h eacl_ _'_thera_d with a!ternatiw#traditi(mal/

complementary m<:_dicine and over-the-cout_ter r-ne_lications/appl[ances• understands the agu-re[ated implications of prescriptive practke on clients

vvithir_ the particular scope

• evaluates the effectiveness of the client's response to prescribed medications,

and mon itors dec isions about prescribi ng, ta king rer'nedial action and/or referringaccordingly

• demonstrates an abilhy to limit and manage adverse reacti_;ns/ernergenc es/crises

• recognises situati{.Jns of drug misuse and acts appropriately

• understands the regulatory i:ramework associated with l)rescribing, includingthe legislation, conlra{:tua[ eiwironment, subsidies, professi{)na[ ethics, androles ot: key g_wernr,_ent agent. ies.

AB6000002029

30

m /_l::_l:_il_..,.!'_{l{)_ i__ _'!';. _:._!i_I_I li )_"_i.,. _:I_,_II_)I_(!'__._F_I

Surname:

Given Names:

Address:

Phone(hl: ........................................l_h_ne!,w): .................................Mobile:

Emai[ _-\cc ress:

Date of Birth:_ Registratic)n Number:

Purpose of .---_,pptica{io_,:t:)e_:ta_a{,io__::Thisapplication and declmation he/o_, must accompan> your portfolio.

I declare that:

a) the ini:ormation given by me in support of mv application for Nurse Practitioned ,'_erlclorsernerH _strue and { orrect; and

I)) that I am in q(J_(i l)r,:)fi,%i,:;_la[standini4 as ,_reqister_,ctnurse; and

c) that I am not curren[ly subject t() any charge(s) including professional misconductand/or been convicted oi: any offence against the tavv (apart from minor trafficconvictions).

If you are subject to an,,,.,of the above, please provide details below:

I also give my authorisation {o the, Nursing Council to seek i:urther information asto my standing within n_yscope oI practice, if this is considered necessary. Yes/No

Declaration

I make this solemn declaration conscientiously believing the same to be true andby virtue of the Oaths and Declarations Act 195 _.

Declared at this day of 2002

And signed by me

In the i)resenc:e _)i

tustice of the Peace. Solicitor./Notary Pub//c, Registrar of the Court, or other officerauthorised to take .Statutorv l:)ecla,ratior_.srplease indicate c,.Itegorv).

In accordancewith thePrivac_,'Act 1993,thepersoualinformationcollectedby theNursingCouncilof NewZealandiscontidentialto theCouncilandisusedforthepurposeof processinganapplicationforendorsemento{ thetitle NursePractitionerunde_Section24of theNursesAct 1!)77and NursesRegulations1986.TheCouncilmaydis{.Iosetheinl'ormaliorltoa third[)artyforprocessing/administrativepurposes.Theapplicanthasfi_eright{,Im c_-.ssto amJcorrectionof personalinformationhehtI%..theNursingCouncil.

@

ABC000002030

31

ABC000002031

32

33

Appendix N.Z. - 37

Extract from New Zealand Gazette, 10/11/2005, No. 188, p. 4750

Medicines (Designated Prescriber: NursePractitioners) Notice 2005

Pursuant to the Medicines Amendment Act 1999, the Misuseof Drugs Act 1975 and the Medicines (Designated Prescriber:Nurse Practitioners) Regulations 2005, the Nursing Councilof New Zealand gives the following notice.Notice

1. Title and commencement--This notice is theMedicines (Designated Prescriber: Nurse Practitioners)Notice 2005 and comes into force on 8 December 2005.

2. The purpose--The Schedule to this notice sets out tilerequirements that the Nursing Council of New Zealand("nursing council") has determined must be met by nursepractitioners who wish to prescribe prescription medicines.These requirements are imposed under Regulations 6, 7and 8 of the Medicines (Designated Prescriber: Nm-scPractitioners) Regulations 2005.Schedule

A Requirements for commencing prescribing(Regulation 6)

The nursing council requirements for training thatnurse practitioners must undertake before commencingprescribing for the first time are as follows:

(a) (i) The completion of an approved clinical master'sprogramme which includes demonstration ofthe competencies, to the satisfaction of thenursing council, for advanced nursing practiceand prescribing applied within the definedarea of practice of the nurse practitioner.The programme must include relevant theory,research and concurrent practice; or

(b) (i) the completion of an equivalent overseasqualification which meets the requirementsspecified in paragraph (i) above; and

(ii) passing an assessment against tile nursepractitioner competencies by an approvedpanel.

B Other training to be undertaken (Regulation 7)Nurse practitioners authorised to prescribe within theirdefined area of practice, must undertake:

(a) a minimum of 40 hours per year of professionaldevelopment aggregated over a five year period; and

(b) a minimum of 40 days per year ongoing nursingpractice aggregated over a five-year period withintheir defined area of practice.

C Assessments of competence to be completed(Regulation 8)

Nurse practitioners authorised to prescribe must provideto the nursing council each year with their applicationfor a practising certificate, evidence that they havemaintained their competence.As part of this assessment, all nurses authorised toprescribe must provide the nursing council with evidencethat they have completed the ongoing training requiredby paragraph B above; competence assessment; andevidence of ongoing multidisciplinary peer review oftheir prescribing practice.

Dated at Wellington this 1st day of November 2005.

MARION CLARK, Registrar, Nursing Council ofNew Zealand.gs7428

N_TI(":.I:: bin. 742R

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34

Regulations of New Zealand Page 1 of 36Appendix N.Z. - 38

M

Medicines (Designated Prescriber: Nurse Practitioners) F_.... ,,.r,ev,.I,at._n::_:_005Schedule Substances that are nurse practitioner medicines if they are prescription medicines

Schedule

Substancesthat are nurse practitionermedicines if they are prescriptionmedicines

r4

Substances listed in this schedule are nurse practitioner medicines only if, and only in the forms and for thepurposes that, they are declared to be prescription medicines by-

" regulations made under the Act; or

• a notice given under section !06 of the Act.

1 19-norandrostenedione

2 , 2,4-d in itroch Ioro benzene

3 4-aminopyridine

4 4-chlorotestosterone

5 Abacavir

6 Abciximab

7 Acamprosate

8 Acarbose

9 Acebutolol

10 Acepromazine

11 Acetanilides

12 Acetarsol

13 Acetazolamide

14 Acetohexamide

15 Acetylcarbromal

16 Acetylcholine

17 Acetylcysteine

18 Acetyldigitoxin

19 Acetylmethyldimethyloximidophenylhydrazine

20 Aciclovir

21 Acipimox

22 Acitretin

23 Aconitum spp.

24 Acrivastine

25 Adalimumab

26 Adapalene

27 Adefovir

28 Adenosine

29 Adiphenine

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ABC000002034

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Regulations of New Zealand Page 2 of 30

30 Adonis vernalis

31 Adrenal extract

32 Adrenaline

33 Agalsidase

34 Alatrofioxacin

35 Albendazole

36 Albumin

37 Alclofenac

38 Alclometasone

39 Alcohol

40 Aldosterone

41 Alefacept

42 Alendronic acid

43 Alfacalcidol

44 Alfuzosin

45 Alglucerase

46 Alkyl sulfonals

47 Allergens

48 AIIopurinol

49 Allyloestrenol

50 Alosetron

51 Alphadolone

52 Alphaxalone

53 Alprenolol

54 Alprostadil

55 Alseroxylon

56 AIteplase

57 Amantadine

58 Ambenonium

59 Ambucetamide

60 Ambutonium

61 Amcinonide

62 Amethocaine

63 Amfebutamone

64 Amidopyrine

65 Amifostine

66 Amikacin

67 Amiloride

68 Aminocaproic acid

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ABC000002035

36


69 Aminophenazone

70 Aminophylline

71 Aminosalicylic acid

72 Amiodarone

73 Amiphenazole

74 Amisulpride

75 Amitriptyline

76 Amlodipine

77 Ammi visnaga

78 Ammonium bromide

79 Amodiaquine

80 Amorolfine

81 Amoxapine

82 Amoxycillin

83 Amphomycin

84 Amphotericin

85 Ampicillin

86 Amprenavir

87 Amrinone

88 Amyl nitrite

89 Amylocaine

90 Anakinra

91 Ancrod and its immunoglobulin antidote

92 Anecortave

93 Angiotensinamide

94 Anistreplase

95 Antazoline

96 Antibiotic substances

97 Antigens

98 Antihistamines

99 Antimony

100 Antisera

101 Antithrombin III

102 Apocynum spp.

103 Apomorphine

104 Apraclonidine

105 Aprepitant

106 Aprotinin

107 Aripiprazole

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108 Arsenic

109 Artemether

110 Articaine

111 Astemizole

112 Ataza navir

113 Atenolol

114 Atomoxetine

115 Atorvastatin

116 Atosiban

117 Atovaquone

118 Atropa belladonna

119 Atropine

120 Atropine methonitrate

121 Auranofin

122 Aurothiomalate sodium

123 Aviptadil

124 Azacyclonol

125 Azapropazone

126 Azaribine

127 Azatadine

128 Azath ioprine

129 Azelaic acid

130 Azelastine

131 Azithromycin

132 Azlocillin

133 Aztreonam

134 Bacampicillin

135 Bacitracin

136 Baclofen

137 Balsalazide

138 Bambuterol

139 Bamethan

140 Bamipine

141 Becaplermin

142 Beclamide

143 Beclomethasone

144 Bemegride

145 Benactyzine

146 Benazepril

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147 Bendrofluazide

148 Benethamine penicillin

149 Benorylate

150 Benperidol

151 Benserazide

152 Benzathine penicillin

153 Benzatropine

154 Benzhexol

155 Benzilonium

156 Benzocaine

157 Benzoyl metronidazole

158 Benzoyl peroxide

159 Benzthiazide

160 Benzydamine

161 Benzytpenicillin

162 Bepridil

163 Beractant

164 Beta carotene

165 Betahistine

166 Betamethasone

167 Betaxolol

168 Bethanechol

169 Bethanidine

170 Bevantolol

171 Bezafibrate

172 Bifonazole

173 Bimatoprost

174 Biperiden

175 Bismuth

176 Bisoprolol

177 Bivalirudin

178 Blood clotting factors

179 Blood corpuscles

180 Blood, whole

181 Bolenol

182 Bosentan

183 Botulinum toxins

184 Bretylium

185 Brimonidine

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186 Brinzolamide

187 Bromocriptine

188 Bromoform

189 Brompheniramine

190 Bromvaletone

191 Buclizine

192 Budesonide

193 Bufexamac

194 Bumetanide

195 Buphenine

196 Bupivacaine

197 Bupropion

198 Buserelin

199 Buspirone

200 Butacaine

201 Butoconazole

202 Butorphanol

203 Butyl aminobenzoate

204 Butylchloral hydrate

205 Cabergoline

206 Calcipotriol

207 Calcitonin

208 Calcitriol

209 Calcium carbimide

210 Calcium polystyrene sulphonate

211 Camphorated oil

212 Candesartan

213 Candicidin

214 Capreomycin

215 Captodiame

216 Captopril

217 Capuride

218 Caramiphen

219 Carbachol

220 Carbamazepine

221 Carbaryl

222 Carbazochrome

223 Carbenicillin

224 Carbenoxolone

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Regulations of New Zealand Page 7 oF 36

225 Carbetocin

226 Carbidopa

227 Carbimazole

228 Carbocromen

229 Carbromat

230 Carbutamide

231 Carbuterol

232 Carindacillin

233 Carisoprodol

234 Carprofen

235 Carvedilol

236 Caspofungin

237 Catalin

238 Cefacetrile

239 Cefaclor

240 Cefaloridine

241 Cefamandole

242 Cefapirin

243 Cefazolin

244 Cefepime

245 Cefetamet

246 Cefixime

247 Cefodizime

248 Cefonicid

249 Cefoperazone

250 Cefotaxime

251 Cefotetan

252 Cefotiam

253 Cefoxitin

254 Cefpirome

255 Cefpodoxime

256 Cefsulodin

257 Ceftazidime

258 Ceftibuten

259 Ceftriaxone

260 Cefuroxime

261 Celecoxib

262 Celiprolol

263 Cephalexin

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264 Cephalothin

265 Cephazolin

266 Cephradine

267 Cerivastatin

268 Cetirizine

269 Cetrorelix

270 Chenodeoxycholic acid

271 Chloral hydrate

272 Chloralose

273 Chloramphenicol

274 Chlorcyclizine

275 Chlormerodrin

276 Chlormethiazole

277 Chlormezanone

278 Chloroquine

279 Chlorothiazide

280 Chlorotrianisene

281 Chloroxyd ienon e

282 Chlorpheniramine

283 Chlorpromazine

284 Chlorpropamide

285 Chlorprothixene

286 Chlorquinaldol

287 Chlortet racycli ne

288 Chlorthalidone

289 Chlorzoxazone

290 Cholera vaccine

291 Chymopapain

292 Ciclacillin

293 Ciclesonide

294 Ciclopirox

295 Cidofovir

296 Cilastatin

297 Cilazapril

298 Cimetidine

299 Cinacalcet

300 Cinchocaine

301 Cinoxacin

302 Ciprofloxacin


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42


303 Cisapride

304 Citalopram

305 Clarithromycin

306 Clavulanic acid

307 Clemastine

308 Clemizole

309 Clidinium

310 Clindamycin

311 Clioquinol

312 Clobetasol

313 Clobetasone

314 Clocortolone

315 Clodronic acid

316 Clofazimine

317 Clofibrate

318 Clomiphene

319 Clomipramine

320 Clomocycline

321 Clonidine

322 Clopamide

323 Clopidogrel

324 Clorexolone

325 Clostebol

326 Clotrimazole

327 Cloxacillin

328 Clozapine

329 Cobalt

330 Co-dergocrine

331 Colchicine

332 Colchicum

333 Colecalciferol

334 Colestipol

335 Colestyramine

336 Colfosceril

337 Colistin

338 Collagen

339 Corticosterone

340 Cortisone and other steroidal hormones of the adrenalcortex

341 Co-trimoxazole

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342 Coumarin

343 Crystal violet

344 Cyclandelate

345 Cyclizine

346 Cyclobenzaprine

347 Cyclofenil

348 Cycloheximide

349 Cyclopenthiazide

350 Cyclopentolate

351 Cyclopropane

352 Cycloserine

353 Cyclosporin

354 Cyclothiazide

355 Cyproheptadine

356 Cyproterone

357 Cysteamine

358 Dalfopristin

359 Dalteparin

360 Danaparoid

361 Danthron

362 Dantrolene

363 Dapsone

364 Darbepoetin

365 Datura spp.

366 Deanol

367 Debrisoquine

368 Deferiprone

369 Deflazacort

370 Dehydrocorticosterone

371 Delavirdine

372 Demeclocycline

373 Deoxycortone

374 Deoxyribonuclease

375 Desferrioxamine

376 Desipramine

377 Desirudin

378 Deslanoside

379 Desloratadine

380 Desmopressin

http://www.legislation.govt.nz/libraries/contents/om_isapi.dll?clientID=718422344&hits... 10/22/2007

ABC000002043

44


381 Desogestrel

382 Desonide

383 Desoximetasone

384 Dexamethasone

385 Dexchlorpheniramine

386 Dexfenfluramine

387 Dextromethorphan

388 Dextrorphan

389 Diazoxide

390 Dibenzepin

391 Dibrompropamidine

392 Dichloralphenazone

393 Dichlorophen

394 Dichlorphenamide

395 Diclofenac

396 Dicloxacillin

397 Dicyclomine

398 Didanosine

399 Dienoestrol

400 Dienogest

401 Diethazine

402 Diethylcarbamazine

403 Diflorasone

404 Diflucortolone

405 Diflunisal

406 Digitalis lanata

407 Digitalis purpurea

408 Digitoxin

409 Digoxin

410 Digoxin-specific antibody fragment

411 Dihydralazine

412 Dihydroergotoxine

413 Dihyd rotachyste rol

414 Diltiazem

415 Dimenhydrinate

416 Dimercaprol

417 Dimethindene

418 Dimethothiazine

419 Dimethyl sulphoxide


ABC000002044

45


420 Dinoprost

421 Dinoprostone

422 Diperodon

423 Diphemanil

424 Diphenhydramine

425 Diphenidol

426 Diphenylpyraline

427 Diphtheria toxoid

428 Dipivefrin

429 Dipyridamole

430 Dirithromycin

431 Disopyramide

432 Distigmine

433 Disulfiram

434 Disulphamide

435 Ditiocarb

436 Dobutamine

437 Dofetilide

438 Dolasetron

439 Domperidone

440 Donepezil

441 Dopamine

442 Dopexamine

443 Dornase

444 Dorzolamide

445 Dothiepin

446 Doxantrazole

447 Doxapram

448 Doxazosin

449 Doxepin

450 Doxycycline

451 Doxylamine

452 Droperidol

453 Drospirenone

454 Drotecogin

455 Duloxetine

456 Dutasteride

457 Dyd rogesterone

458 Econazole

http://www._egis_ati_n.g_vt.nz/_ibraries/c_ntents/_m-isa_i.d_?c_ientID=7_8422344&hits... 10/22/2007

ABC00000Z045

46


459 Ecothiopate

460 Ectylurea

461 Edetic acid

462 Edoxudine

463 Efalizumab

464 Efavirenz

465 Eflornithine

466 Eformoterol

467 Eletriptan

468 Emepronium

469 Emetine

470 Emtricitabine

471 Enalapril

472 Enfuvirtide

473 Enoxacin

474 Enoxaparin

475 Enoximone

476 Entacapone

477 Entecavir

478 Epinastine

479 Eplerenone

480 Epoetins

481 Epoprostenol

482 Eprosartan

483 Eptifibatide

484 Ergocalciferol

485 Ergometrine

486 Ergot

487 Ergotamine

488 Ergotoxine

489 Ertapenem

490 Erysimum spp.

491 Erythromycin

492 Erythropoietin

493 Escitalopram

494 Esmolol

495 Esomeprazole

496 Estropipate

497 Etanercept

http://www._egis_ati_n.g_vt.nz/_ibraries/c_ntents/_m-isapi.d__?c_ientID=718422344&hits... 10/22/2007

ABC000002046

47

Regulations of New Zealand Page 14 oF 36

498 Ethacrynic acid

499 Ethambutol

500 Ethanolamine

501 Eth inyloestrad iol

502 Ethionamide

503 Ethoheptazine

504 Ethopropazine

505 Ethotoin

506 Ethyl chloride

507 Ethynodiol

508 Etidocaine

509 Etidronic acid

510 Etilefrine

511 Etodolac

512 Etofenamate

513 Etoricoxib

514 Etretinate

515 Everolimus

516 Ezetimibe

517 Factor VIII inhibitor bypassing fraction

518 Famciclovir

519 Famotidine

520 Felodipine

521 Fenbufen

522 Fenclofenac

523 Fenfluramine

524 Fenofibrate

525 Fenoldopam

526 Fenoprofen

527 Fenoterol

528 Fenpipramide

529 Fexofenadine

530 Fibrin

531 Fibrinogen

532 Fibrinolysin

533 Filgrastim

534 Finasteride

535 Flecainide

536 Fleroxacin

http://www._egis_ati_n.g_vt.nz/_ibraries/c_ntents/_m -isapi.d__?c_ient_D=7 _8422344&hits... 10/22/2007

ABC000002047

48


537 Floctafenine

538 Fluanisone

539 Fluclorolone

540 Flucloxacillin

541 Fluconazole

542 Flucytosine

543 Fludrocortisone

544 Flufenamic acid

545 Flumazenil

546 Flumethasone

547 Flumethiazide

548 Flunisolide

549 Fluocinolone

550 Fluocinonide

551 Ftuocortin

552 Fluocortolone

553 Fluorescein

554 Fluorides

555 Fluorometholone

556 Fluoxetine

557 Flupenthixol

558 Fluphenazine

559 Flurandrenolone

560 Flurbiprofen

561 Fluroxene

562 Fluspirilene

563 Fluticasone

564 Fluvastatin

565 Fluvoxamine

566 Folic acid

567 Folinic acid

568 Follicle stimulating hormone

569 Follitropin

570 Fondaparinux

571 Formestane

572 Formoterol

573 Fosamprenavir

574 Foscarnet

575 Fosinopril

http://www__egis_ati_n_g_vt_nz/_ibraries/c_ntents/_m-isapi_d__?c_ientID=7_8422344&hits___ 10/22/2007

ABC000002048

49


576 Fosphenytoin

577 Framycetin

578 Frusemide

579 Furazolidone

580 Fusidic acid

581 Gabapentin

582 Galantamine

583 Galanthus spp.

584 Ganciclovir

585 Ganirelix

586 Gatifloxacin

587 Gemeprost

588 Gemfibrozil

589 Gemifloxacin

590 Gentamicin

591 Gestodene

592 Gestonorone

593 Gestrinone

594 Glatiramer acetate

595 Glibenclamide

596 Glibornuride

597 Gliclazide

598 Glimepiride

599 Glipizide

600 Glisoxepide

601 Glutathione

602 Glyceryl trinitrate

603 Glyco pyrron ium

604 Glymidine

605 Goserelin

606 Gramicidin

607 Grainsetron

608 Grepafloxacin

609 Griseofulvin

610 Guaiphenesin

611 Guanabenz

612 Guanethidine

613 Hachimycin

614 Haematin

http://www._egis_ati_n.g_vt.nz/_ibraries/c_ntents/_m-isapi.d__?c_ientID=7_8422344&hits... 10/22/2007

ABC000002049

50


615 Haemophilus influenzae vaccine

616 Hatcinonide

617 Halofantrine

618 Halofenate

619 Haloperidol

620 Halquinol

621 Hemerocallis

622 Heparins

623 Hepatitis A vaccine

624 Hepatitis B vaccine

625 Hetacillin

626 Hexachlorophane

627 Hexetidine

628 Hexobendine

629 Hexoprenaline

630 Histamine

631 Homatropine

632 Human protein C

633 Hyaluronic acid

634 Hydralazine

635 Hydrargaphen

636 Hyd roch ioroth iazid e

637 Hydrocortisone

638 Hydrocyanic acid

639 Hyd roll umeth iazid e

640 Hydroquinone

641 Hydroxychloroquine

642 Hydroxyephedrine

643 Hydroxyphenamate

644 Hydroxyprogesterone

645 Hydroxyzine

646 Hylan polymer

647 Hyoscine

648 Hyoscine butylbromide

649 Hyoscyamine

650 Hyoscyamus niger

651 Hypothalamic releasing factors

652 Hypromellose

653 Ibandronic acid

httpi//www._egis_ati_n.g_vt.nz/_ibraries/c_ntents/_m-isapi.d__?c_ientID=7_8422344&hits... 10/22/2007

ABC000002050

51


654 Ibuprofen

655 Ibuterol

656 Ibutilide

657 Idoxuridine

658 Iloprost

659 Imiglucerase

660 Imipenem

661 Imipramine

662 Imiquimod

663 Immunoglobulins

664 Indapamide

665 Indinavir

666 Indomethacin

667 Indoramin

668 Infliximab

669 Influenza and coryza vaccines

670 Insulins

671 Ipecacuanha

672 Ipratropium

673 Iprindole

674 Iproniazid

675 Irbesartan

676 Iron

677 Isoaminile

678 Isoamyl nitrite

679 Isobutyl nitrite

680 Isocarboxazid

681 Isoconazole

682 Isoetarine

683 Isometheptene

684 Isoniazid

685 Isoprenaline

686 Isoprinosine

687 Isopropamide

688 Isosorbide dinitrate

689 Isosorbide mononitrate

690 Isotretinoin

691 Isoxicam

692 Isoxsuprine


ABC000002051

52

Regulations of New Zealand Page 19 oF36

693 Isradipine

694 Itraconazole

695 Ivermectin

696 Kanamycin

697 Ketanserin

698 Ketoconazole

699 Ketoprofen

700 Ketorolac

701 Ketotifen

702 Khellin

703 Labetalol

704 Lacidipine

705 Lamivudine

706 Lamotrigine

707 Lanatosides

708 Lanreotide

709 Lansoprazole

710 Laronidase-rch

711 Latamoxef

712 Lata nop rost

713 Lauromacrogol

714 Lead

715 Leflunomide

716 Lenograstim

717 Lepirudin

718 Leptazol

719 Lercanidipine

720 Leucovorin

721 Leuprorelin

722 Levamisole

723 Levetiracetam

724 Levobunolol

725 Levobupivacaine

726 Levocabastine

727 Levocetirizine

728 Levodopa

729 Levonorgestrel

730 Levosimendan

731 Lidoflazine

http://www._egis_ati_n_g_vt.nz/_ibra_es/c_ntents/_m-isapi.d__?c_ientID=7_8422344&hits... 10/22/2007

....... ABC000002052

53


732 Lignocaine

733 Lincomycin

734 Lindane

735 Linezolid

736 Liothyronine

737 Liquorice deglycyrrhizinised

738 Lisinopril

739 Lisuride

740 Lithium

741 Lofexidine

742 Lomefloxacin

743 Loperamide

744 Lopinavir

745 Loracarbef

746 Loratadine

747 Losartan

748 Loxapine

749 Lumefantrine

750 Lumiracoxib

751 Luteinising hormone

752 Lymecycline

753 Mafenide

754 Maprotiline

755 Measles vaccine

756 Mebeverine

757 Mebhydrolin

758 Mebutamate

759 Mecamylamine

760 Mecillinam

761 Meclocycline

762 Meclofenamate

763 Meclofenoxate

764 Meclozine

765 Medigoxin

766 Medroxyprogesterone

767 Medrysone

768 Mefenamic acid

769 Mefloquine

770 Mefruside

http://www._egis_ati_n.g_vt.nz/_ibraries/c_ntents/_m-isapi.d_?c_ient_D=7_8422344&hits... 10/22/2007

............ ABC000002053

54


771 Megestrol

772 Melagatran

773 Melatonin

774 Melengestrol

775 Melia azedarach

776 Meloxicam

777 Memantine

778 Meningococcal vaccine

779 Menotrophin

780 Me ?acrine

781 Me ?enzolate

782 Me 3henesin

783 Me ?hentermine

784 Me _indolol

785 Me 3ivacaine

786 Me 3tazinol

787 Mepyramine

788 Mequitazine

789 Meropenem

790 Mesatazine

791 Mesna

792 Mesterolone

793 Mestranol

794 Metaraminol

795 Metergoline

796 Metformin

797 Methacholine

798 Methacycline

799 Methanthelinium

800 Methazolamide

801 Methdilazine

802 Methicillin

803 Methimazole

804 Methixene

805 Methocarbamol

806 Methohexitone

807 Methoin

808 Methotrexate

809 Methotrimeprazine

http://ww_._egis_ati_n.g_vt.nz/_ibraries/c_ntents/_m-isapi.d__?c_ientID=7__422344&hits... 10/22/2007

ABC000002054

55


810 Methoxamine

811 Methoxsalen

812 Methoxyflurane

813 Methsuximide

814 Meth ycloth iazid e

815 Methyl aminolevulinate

816 Methyldopa

817 Methylene blue

818 Meth ylergometrin e

819 Methylpentynol

820 Methylprednisolone

821 Methyltestosterone

822 Methylthiouracil

823 Methysergide

824 Metoclopramide

825 Metolazone

826 Metoprolol

827 Metrifonate

828 Metronidazole

829 Mexiletine

830 Mezlocillin

831 Mianserin

832 Mibefradil

833 Miconazole

834 Midodrine

835 Mifepristone

836 IVliglitol

837 Milrinone

838 Minocycline

839 Minoxidil

840 Mirtazapine

841 Misoprostol

842 Moclobemide

843 Modafinil

844 Molgramostim

845 Molindone

846 Mometasone

847 Monobenzone

848 Montelukast

http://www.legislati_n.g_vt.nz/libraries/c_ntents/_m_isapi.d__?c_ientID=7l8422344&hits... 10/22/2007

ABc0-o0002055

56


849 Moperone

850 Morazone

851 Moricizine

852 Motrazepam

853 Motretinide

854 Moxifloxacin

855 Mumps vaccine

856 Mupirocin

857 Muraglitazar

858 Nabumetone

859 Nadolol

860 Nadroparin

861 Nafarelin

862 Naftidrofuryl

863 Nalbuphine

864 Nalidixic acid

865 Nalorphine

866 Naloxone

867 Naltrexone

868 Naproxen

869 Naratriptan

870 Natamycin

871 Nateglinide

872 Nebacumab

873 Nedocromil

874 Nefazodone

875 Nefopam

876 Nelfinavir

877 Neomycin

878 Nerium oleander

879 Nesiritide

880 Netilmicin

881 Nevirapine

882 Nialamide

883 Nicardipine

884 Nicergoline

885 Nicofuranose

886 Nicorandil

887 Nicotine

http://www._egis_ati_n.g_vt.nz/_ibraries/c_ntents/_m._isapi.d__?c_ientID=7_8422344&hits... 10/22/2007

....... ABC000002056

57


888 Nicoumalone

889 Nifed ipine

890 Nifenazone

891 Nikethamide

892 Nimesulide

893 Nimodipine

894 Nimorazole

895 Niridazole

896 Nisoldipine

897 Nitrendipine

898 Nitrofurantoin

899 Nitrofurazone

900 Nitrous oxide

901 Nitroxoline

902 Nizatidine

903 Nomifensine

904 Noradrenaline

905 Norelgestromin

906 Norethisterone

907 Norfloxacin

908 Norgestrel

909 Nortriptyline

910 Nux vomica

911 Nystatin

912 Octamylamine

913 Octatropine

914 Octocog alfa

915 Octreotide

916 Octyl nitrite

917 ©estradiol

918 Oestriol

919 Oestrogen s

920 Oestrone

921 Ofloxacin

922 Olanzapine

923 Oleandomycin

924 ©leandrin

925 Olopatadine

926 Otsalazine


ABC000002057

58

Regulations of New Zealand Page 25 of'36

927 Omaizumab

928 Omeprazole

929 Ondansetron

930 Opipramol

931 Orciprenaline

932 Orlistat

933 Ornidazole

934 ©rnipressin

935 Orphenadrine

936 Oseltamivir

937 Ouabain

938 Oxacillin

939 Oxaprozin

940 Oxcarbazepine

941 ©xedrine

942 Oxetacaine

943 Oxitropium

944 Oxolamine

945 Oxolinic acid

946 Oxpentifylfine

947 Oxprenolol

948 Oxybuprocaine

949 Oxybutynin

950 Oxyphenbutazone

951 Oxyp hencycl im ine

952 Oxyphenisatin

953 Oxyphenonium

954 Oxytetracycline

955 Oxytocin

956 Palivizumab

957 Palonosetron

958 Pamidronic acid

959 Pancreatic enzymes

960 Pantoprazole

961 Papaverine

962 Paracetamol

963 Paraldehyde

964 Paramethasone

965 Parecoxib

http://www.legislati_n.g_vt.nz/libraries/c_ntents/_m_isapi.d_l?clientID=7_8422344&hits... 10/22/2007

....

ABC000002058

59


966 Paromomycin

967 Paroxetine

968 Pefloxacin

969 Pegaptanib

970 Pegfilgrastim

971 Penbutofol

972 Penciclovir

973 Penicillamine

974 Pentaerythrityl tetranitrate

975 Pentamidine

976 Pentazocine

977 Penthienate

978 Pentosan polysulfate sodium

979 Pen toxifyl Iine

980 Pergolide

981 Perhexiline

982 Pericyazine

983 Perindopril

984 Permethrin

985 Perphenazine

986 Pertussis antigen

987 Phenacemide

988 Phenazone

989 Phenazopyridine

990 Phenelzine

991 Pheneticillin

992 Phenformin

993 Phenindione

994 Pheniramine

995 Phenisatin

996 Phenol

997 Phenolphthalein

998 Phenoxybenzamine

999 Phenoxymethylpenicillin

1000 Phensuximide

1001 Phentolamine

1002 Phenylbutazone

1003 Phenylephrine

1004 Phenylpropanolamine

http://www._egis_ati_n.g_vt.nz/_ibraries/c_ntents/_m-isa_i.dll?clientID=7_8422344&hits... 10/22/2007

ABC000002059

60


1005 Phenyltoloxamine

1006 Phenytoin

1007 Phthalylsulphathiazole

1008 Physostigmine

1009 Pilocarpine

1010 Pimecrolimus

1011 Pimozide

1012 Pinacidil

1013 Pindolol

1014 Piogl itazone

1015 Pipemidic acid

1016 Pipenzolate

1017 Piperacillin

1018 Piperidine

1019 Piperidolate

1020 Pipothiazine

1021 Piracetam

1022 Pirbuterol

1023 Pirenzepine

1024 Piretanide

1025 Pirfenoxone

1026 Piroxicam

1027 Pivampicillin

1028 Pizotifen

1029 Plasma

1030 Plasma protein fraction

1031 Plasmin

1032 Plasminogen activator

1033 Platelets

1034 Pneumococcal vaccine

1035 Podophyllotoxin

1036 Podophyllum emodi

1037 Podophyllum peltatum

1038 Poliomyelitis vaccine

1039 Polyestrad iol

1040 Polylactic acid

1041 Polymyxin

1042 Polythiazide

1043 Poractant alpha

http://www.legislation.govt.nz/libraries/contents/om isapi.dll?clientlD=718422344&hits... 10/22/2007

........ ABc000002060

61


1044 Posaconazole

1045 Potassium bromide

1046 Practolol

1047 Pral idoxim e

1048 Pramipexole

1049 Pramocaine

1050 Prasterone

1051 Pravastatin

1052 Praziq uantel

1053 Prazosin

1054 Prednisolone

1055 Prednisone

1056 Pregabalin

1057 Pregnenolone

1058 Prenalterol

1059 Prenylamine

1060 Prilocaine

1061 Primaquine

1062 Primidone

1063 Probenecid

1064 Probucol

1065 Procainamide

1066 Procaine

1067 Procaine penicillin

1068 Prochlorperazine

1069 Procycl id ine

1070 Progesterone

1071 Progestogens

1072 Proglumide

1073 Proguanil

1074 Prolintane

1075 Promazine

1076 Promethazine

1077 Propafenone

1078 Propamidine

1079 Propanidid

1080 Propantheline

1081 Propionibacterium acnes

1082 Propranolol

http://www.legislation.govt.nz/libraries/contents/onl isapi.dll?clientlD=718422344&hits... 10/22/2007

ABC000002061

62


1083 Propylthiouracil

1084 Propyphenazone

1085 Proquazone

1086 Proscillaridin

1087 Prostaglandins

1088 Protamine sulphate

1089 Prothionamide

1090 Prothipendyl

1091 Protoveratrines

1092 Protriptyline

1093 Proxymetacaine

1094 Pulmonaria spp.

1095 Pyrazinamide

1096 Pyridinolcarbamate

1097 Pyridostigmine

1098 Pyridoxine

1099 Pyrimethamine

1100 Quazepam

1101 Quebracho

1102 Quetiapine

1103 Quinagolide

1104 Quinapril

1105 Quinethazone

1106 Quinidine

1107 Quinine

1108 Quinisocaine

1109 Qu inupristin

1110 Rabeprazole

1111 Rabies vaccine

1112 Raloxifene

1113 Ramipril

1114 Ranitidine

1115 Rasburicase

1116 Rauwolfia serpentina

1117 Rauwolfia vomitoria

1118 Reboxetine

1119 Remoxipride

1120 Repaglin ide

1121 Reserpine

http://www.legislati_n.g_vt.nz/libraries/c_ntents/_m_isapi.dll?clientID=7_8422344&hits... 10/22/2007

ABC000002062

63


1122 Reteplase

1123 Rifabutin

1124 Rifampicin

1125 Rifa mycin

1126 Rifapentine

1127 Rim iterol

1128 Risedronic acid

1129 Risperidone

1130 Ritodrine

1131 Ritonavir

1132 Rivastigmine

1133 Rizatriptan

1134 Rofecoxib

1135 Rolitetracycline

1136 Ropinirole

1137 Ropivacaine

1138 Rosiglitazone

1139 Rosoxacin

1140 Rosuvastatin

1141 Roxithromycin

1142 Rubella vaccine

1143 Sabad ilia

1144 Salbutamol

1145 Salcatonin

1146 Salmeterol

1147 Saquinavir

1148 Selegiline

1149 Sertindole

1150 Sertraline

1151 Serum, dried human

1152 Sevelamer

1153 Sex hormones and all substances having sex hormoneactivity

1154 Sibutramine

1155 Sildenafil

1156 Silicones

1157 Silver sulfadiazine

1158 Simvastatin

1159 Sirolimus

1160 Sisomicin

http:_/www._egis_ati_n.g_vt.nz/_ibraries/c_ntents/_m_isapi.d__?c_ientID=7_8422344&hits... 10/22/2007

ABC000002063

64


1161 Sodium bromide

1162 Sodium cellulose phosphate

1163 Sodium cromoglycate

1164 Sodium morrhuate

1165 Sodium nitroprusside

1166 Sodium phosphate

1167 Sodium polystyrene sulphonate

1168 Sodium tetradecyl sulphate

1169 Solifenacin

1170 Somatostatin

1171 Somatropin

1172 Sotalol

1173 Sparfloxacin

1174 Spectinomycin

1175 Spiramycin

1176 Spirapril

1177 Spironolactone

1178 Stavudine

1179 Steroid hormones

1180 Stilboestrol

1181 Streptodornase

1182 Streptokin ase

1183 Streptomycin

1184 Strontium ranelate

1185 Strophanthin

1186 Strophanthin-k

1187 Strophanth us

1188 Strychnos spp.

1189 Sulbactam

1190 Sulconazole

1191 Sulfacetamide

1192 Sulfadiazine

1193 Sulfadimethoxine

1194 Sulfad imidine

1195 Sulfadoxine

1196 Sulfafu razole

1197 Sulfaguanidine

1198 Sulfamerazine

1199 Sulfamethizole

http://www.legislati_n.g_vt.nz/libraries/c_ntents/_m-isapi.d_l?client_D=718422344&hits... 10/22/2007

ABC000002064

65


1200 Sulfamethoxazole

1201 Sulfamethoxydiazine

1202 Sulfamethoxypyridazine

1203 SuIfam etrole

1204 Sulfamonomethoxine

1205 Sulfamoxole

1206 Sulfaphenazole

1207 Sulfapyridine

1208 Sulfasalazine

1209 Sulfathiazole

1210 SuIfatroxazole

1211 Sulfin pyrazone

1212 Sulfomyxin

1213 Sulfon methane

1214 Sulindac

1215 Sultamicillin

1216 Sulthiame

1217 Sumatriptan

1218 Suprofen

1219 Sutilains

1220 Tacrine

1221 Tacrolimus

1222 Tadalafil

1223 Tamoxifen

1224 Tamsulosin

1225 Tanacetum vulgare

1226 Tazarotene

1227 Tazobactam

1228 Tegaserod

1229 Teicoplanin

1230 Telithromycin

1231 Telmisartan

1232 Tenecteplase

1233 Tenofovir

1234 Tenoxicam

1235 Terazosin

1236 Terbinafine

1237 Terbutaline

1238 Terfenadine


ABC000002065

66


1239 Terlipressin

1240 Teropterin

1241 Tetanus antitoxin

1242 Tetanus toxoid

1243 Tetrabenazine

1244 Tetracycline

1245 Tetraethylammonium

1246 Tetroxoprim

1247 Thenyldiamine

1248 Theophylline

1249 Thevetia peruviana

1250 Thevetin

1251 Thiethylperazine

1252 Th ioacetazo ne

1253 Thiocarlide

1254 Thioproperazine

1255 Thioridazine

1256 Thiothixene

1257 Thiouracil

1258 Thrombin

1259 Thymoxamine

1260 Thyroid

1261 Thyroxine

1262 Tiagabine

1263 Tiaprofenic acid

1264 Tiaramide

1265 Tibolone

1266 Ticarcillin

1267 Ticlopidine

1268 Tiemonium

1269 Titetamine

1270 Tiludronic acid

1271 Timolol

1272 Tinidazole

1273 Tinzaparin

1274 Tioconazole

1275 Tiotropium

1276 Tirilazad

1277 Tirofiban

http://www._egis_ati_n.g_vt.nz/_ibraries/c_ntents/_m-isapi.d__?clientID=7_8422344&hits... 10/22/2007

• _...........

ABC000002066

67


1278 Tobramycin

1279 Tocainide

1280 Tolazamide

1281 Tolazoline

1282 Tolbutamide

1283 Tolcapone

1284 Tolfenamic acid

1285 Tolmetin

1286 Tolonium

1287 Tolrestat

1288 Tolterodine

1289 Topiramate

1290 Torasemide

1291 To remifen e

1292 Toxoids

1293 Tramadol

1294 Trandolapril

1295 Tranexamic acid

1296 Tranylcypromine

1297 Travoprost

1298 Trazodone

1299 Trep rostin il

1300 Tretinoin

1301 Triacetyloleandomycin

1302 Triamcinolone

1303 Triamterene

1304 Trichlormethiazide

1305 Trichloroacetic acid

1306 Trichloroethylene

1307 Triclofos

1308 Tricyclamol

1309 Tridihexethyl

1310 Triflu operazine

1311 Trifluperidol

1312 Triflu promazine

1313 Trimep razin e

1314 Trimetaphan

1315 Trimethoprim

1316 Trimipramine

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1317 Trioxysalen

1318 Triple antigen vaccine

1319 Triprolidine

1320 Triptorelin

1321 Troglitazone

1322 Trometamol

1323 Tropicamide

1324 Tropisetron

1325 Trovafloxacin

1326 Troxidone

1327 Tryptophan

1328 Tulobuterol

1329 Typhoid vaccine

1330 Unoprostone

1331 Urapidil

1332 Urofollitropin

1333 Urokinase

1334 Ursodeoxycholic acid

1335 Vaccines

1336 Valaciclovir

1337 Valdecoxib

1338 Valganciclovir

1339 Valnoctamide

1340 Valproic acid

1341 Valsartan

1342 Vancomycin

1343 Vardenafil

1344 Varicella vaccine

1345 Vasopressin

1346 Venlafaxine

1347 Verapamil

1348 Veratrum

1349 Verteporfin

1350 Vidarabine

1351 Vigabatrin

1352 Viloxazine

1353 Vincamine

1354 Vinyl ether

1355 Vip ryn ium

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1356 Virginiamycin

1357 Visnadine

1358 Vitamin A

1359 Vitamin D

1360 Voriconazole

1361 Warfarin

1362 Xamoterol

1363 Xanthinol nicotinate

1364 Ximelagatran

1365 Xipamide

1366 Yohimbine

1367 Zafirlukast

1368 Zalcitabine

1369 Zaleplon

1370 Zanamivir

1371 Zidovudine

1372 Zinc

1373 Ziprasidone

1374 Zoledronic acid

1375 Zolmitriptan

1376 Zolpidem

1377 Zopiclone

1378 Zoxazolarnine

1379 Zuclopenthixol

Diane Morcom,

Clerk of the Executive Council.

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NMC Internet Page 1 of 2

. AppendixU.K.- 39

NF1C Te d ,_!iv T ._e !:;d a V, 2 3 () ct .,'."__::"r 20 0 7

_ome Advanced Nursing F ::: <:!i_ ,, u pdate i9 Oti_er ArticlesAbout _s June 2007 A,:._,_.,._:,__,_,-_<;A,-.Zof Advice t:'r,<t:ic:a_t)c_,.e,.a

!:it_'es9 f-_ F: acbt(:. ,_t tl ,:=

Confirmation Services Previous Work: !:_,.:;r,tcf :eg strar rP_iicy P._.vie.v PCiliiSi,:,i

The Council For a considerable amount of time, a major concern of the

r.._.at._t,:_,1.... is the ex!stence N,.se _resc_@inut'r_:Jt:beEducation & Quality NI'qC, the public and many NHC "_"<_='_*< • "Supply a_!d,_tdrtli_i_str,{'ti(nAssurance of the plethora of job titles that de, not help the public to of Meciicatiot • P(:!:tit_( r_

Employers understand the level of care taat tr_ey can expect. There are [_.t(_t(:,,_t-.-.:tnurses who hold job titles that irr,,pty an advanced le...,.elof R :?i(::...;;:r,t mJfhC_t_:';

Equality and Diversity knowledge and cortnpetence, but ,,,_.he: dc:__ot: possess such i::'_es(r b _ i T _ ::iii ,?

Europe knowledge and competenc:e. ;r_ ad Jit,or . t_/(::_rpracti<te may :..!_nt8 ( ,fa'it,_Fitness to Practise not be subject to thescrutir_'/ oi a _o: _e prc::essiona as the

often act as _ndependent pract_t:_ot err:.Media and Public

Affairs The NMC also recognises that there are no,c,,significant

Hidwifery changes in the way that services are delivered to patients,

Nursing particularly following the General ,"4edical Services (GHS)contract and European Working Time Directive (EW]D).

Overseas Nurses, midwives and specialist corTm_unity public health Popular LinksProfessional Advisory nurses are undertaking treatment and care that was onc:e AZ ,:_:£,_'..i_:_Service the domain of other health care professionals, notably

Registration doctors. (:cha"_"_,,-:,ian_ A._...d__.:.:_

Search The Register Therefore, a national consultatio_ _,,as t_ndertaken d _ring the (::,_s_!t_.,;or _

Specialist Community montt_s of Decernber 2004 -- February 2005 foltow_ng which ttt,.,e,,t::_r:.pol _@ to lu qe Jobs at t_.e NrqCPublic Health Nurse external analysis was undertakers an<:: ..... _

Council 2005. Council agreeci that advanced nurseP,"Ot:( ctlii ] t;'_" [:'t:.£:; ;_

Links practitioner' should be a registrable qualification and that the P_hh:_:i<nsNMC should seek approval from the Privy Council for openinga further sub-part to the nurses' part of the register. Hicros_te

i:tt:er;_ ro fe'_sioi'a } ,._,:_r _

with C}t_!(J ei_

To implement the Council's deosions of 9 .]une 2005

regarding the outcome of the _:{:,_s,._lt/tsti,:}r for the frameworkfor the standard for post-reg_<trat_ }n qu_.t n L, a lett:e, was

sent to the Privy Council ill [i(_(" ? : :)e, c/i!/ addibonalinforrnation being sent in Jaruarv _0 6

The NHC's mandate is set out w_tf_'_ t:he iegistation of the

Nursing and Midwifery Order (2001.) therefore the PrivyCouncil has been seeking the v,e ;*:; of ti_e Depa_me _t of

Health (England), which takes the :ead (;r_ reg_, tarot\, ma,ttersrelating to healthcare professions -:_cross the UK. The NFIChas been awaiting the response from ti"e Privy Council.

Current Position:

Following an interval of very i;tt!_.., ncvem,:nt, the NI'4C hasnow been very encouraged t(:" tea(: ,;, thn t:t".e recent White

Paper Trust, Assurance and Saf_?Cy - _he. ,Reguiation of HealthProfessionals in the 21st Century (2007), that;

'The Government agrees that the regulatory body for each

non--medical profession should be in charge of approving thestandards which registrants wiii rw,,-edt:o meet t:o mai ]tain

their registration on a regular bas_s. Where appropriate,common standards and systems si_ouid be developed across

professional groups where this 'wo,_ki benefit: patient safetyThe Department will ask the Coun::ii for Heaiti_careRegulatory Excellence (CHRE) t:) ,/.,o!.: ',.;t! :2,:2ulators, tke

professions and those work _{! o_ !:.u ::'t e,_n :_n(i ir_terlati,:::naistandards to support this work,. ]t s _,!i er]cornpass t:he

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NMC Intemet Page 2 of 2

development of standards for h_gher ievels of practice,

particularly for advanced practice in nursing, AHPs a{ldhealthcare scientists. '[he Department: wili discuss w_:h t:he

Nursing and Midwifery Council t:he out:c.ome of theirconsultation on advanced nursing practice to agree r'ext

steps (2.30)'.

r',-,,,_c.i,.,j_.,._,, has interpreted th,: ,_,;,rj [: )_ t -.._i,, _::__!.....look _ ':,_._,..,_:_r:!......

t:o working ir_ partnership _,__t:__i t:_e e e,a_ t stakei:oidersto progress this and we are (:'._rrendy :_,',.,T_ti_ g fdrthE!r det:_ilfrom the White Paper Irnplen'enta:io_ Piar_ (WP[P). Please

note that it is impossible to pre-en_pt: ar,,y debate on tileprogression of this work until we have looked at the WP[P intotality, as the work from rrlany aspects of the White Paperwill cross over to the work on advanced nursing practicesuch as revalidation.

!'i,':_dli_/ I /_d_OLit: {..i_::.i Webs;t:e_:'_::_:t:=:_:';i<i !!4:i:

<:':Nursing Midwifery ..']o_ncil All _,_:I'tb:(-.;e:'el

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AppendixU.K.- 40

Nurse prescribing and the Supply and Administration of MedicationPosition Statement

Introduction

1 Prescribing by certain groups of nurses began on 3 October 1994. Since thistime, the numbers and categories of nurses who can prescribe have grownsignificantly and is expected to continue. In addition, new legislation has beenintroduced that enables nurses and midwives in addition to a wide range of healthprofessionals to supply and administer medicines via Patient Group Directions.This is a notification of the Council's current position on nurse prescribing and thesupply and administration of medicines via Patient Group Directions.

Legislation

2 Primary legislation permitting nurse prescribing is set out in the MedicinalProducts: Prescription by Nurses, Midwives and Health Visitors Act 1992.

3 The implementation was enabled by the secondary legislation MedicinalProducts: Prescription by Nurses, Midwives and Health Visitors Act 1992(Commencement No 1) Order 1994 which came into effect 3 October 1994.

4 Amendments to NHS Regulations enabled the introduction of supplementaryprescribing for first level registered nurses, midwives and registered pharmacistsfrom April 2003.

5 Amendments Home Office Misuse of Drug Regulations and NHS Regulations2004. (Awaiting implementation).

6 Guidance on the use of PGD's is set out in Health Service Circular 2000/026.

7 SI 2004/922. Foreshortens the definition so that, by 2004 an independent nurse

prescriber was defined as a person 'registered in the Nursing and MidwiferyRegister, and in respect of whom an annotation signifying that he is qualified to

order drugs and appliances from Nurse Prescribers Formula13,Jor District Nursesalld Health Visitors .... or The Nurse Prescribers Extended Formula_... '

8 Medicinal Products: Prescription by Nurses etc., Act 1992 (Commencement No)Order 1994 (SI 1994No 2408) in which the definition referred to a first level nurse

has subsequently been amended to refer simply to a registered nurse or midwife asa result of amendments to Section 58 of the Medicines Act 1968.

9 Although legislation that permits the extension of prescribing responsibilities

applies across the UK, the pace of implementation varies in response to decisionsmade by the devolved administrations in Scotland, Wales and Northern Ireland.

Definitions

9 Independent prescribing means that the prescriber takes responsibility for theclinical assessment of the patient, establishing a diagnosis and the clinical

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management required, as well as the responsibility for prescribing wherenecessary and the appropriateness of any prescription.

10 Supplementary prescribing is defined as a voluntary partnership between andindependent prescriber (doctor/dentist) and a supplementary prescriber, toimplement an agreed patient-specific Clinical Management Plan with the patient'sagreement.

Who can prescribe?

11 There are two main groups of nurses who may prescribe, independent andsupplementary prescribers. Independent nurse prescribers are subsequentlyfurther divided into two groups:

Independent Nurse Prescribers

10.1 Until the amendments SI 2004/922 and SI1994No 2408 referred toabove, were introduced independent prescribers were either district nurse(DN), health visitor (HV) or practice nurse (PN) with a DN/HV qualification. Orfirst level registered nurses/midwives who have completed ExtendedAccredited Nurse Prescribing Programme.

10.2 As a result of these amendments all 1st level nurses and midwives mayundertake preparation for training to prescribe from the restricted formulary(formerly known as DN/HV formulary). At this present time there is no trainingprogramme validated for this group, those undertaking specialist practicequalification may undertake Mode 2 integrated programme as part of thecourse. The NMC will be looking to develop the criteria and curricula for thisgroup of nurses/midwives as part of the work on Standards in Prescribing.

Supplementary Nurse Prescribers

10.2 Supplementary nurse prescribers are 1stlevel registered nurses/midwivesas above (6.1.2), but who have undertaken approved additional training assupplementary prescribers.

11 In order for nurses, midwives and health visitors to prescribe they must:

• have successfully completed an Nursing and Midwifery Council (NMC) approvedprogramme of preparation

• have their prescribing status entered onto the register• be employed by a NHS Trust or independently but have a SLA with a NHS Trust to

access a prescribing budget• be currently working in a designated prescribing post.

What can be prescribed?

Independent Nurse Prescribers ( District Nurses, Health Visitors, Practice Nurses)

12 All specialist practitioners (formerly district nurses and health visitors), oncompletion of an NMC accredited training may prescribe from a limited formularyof products designed to meet the needs of their patients (Nurse Prescriber'sFormulary for District Nurses and Health Visitors). This consists of dressings,appliances and some medicines, including a small number of prescription only

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medicines. Details of the Formulary are set out in both the British NationalFormulary and Part XV11B(i) of the Drug Tariff. Specialist practitiones (formerlydistrict nurses and health visitors) may prescribe for any patient within the PCTarea for which they are employed. In addition, practice nurses who hold a districtnurses or health visitor qualification may also undertake the training and prescribefor patients registered with the practice for which they work, a a result ofamendments to legislation practice nurses no longer need to be qualified districtnurses or health visitors if they have completed the Specialist PracticeQualification. Training for prescribing from this formulary is now incorporated intothe Specialist Practice training for all specialist practitioners with a proviso thatthere is a clinical need (this formulary is very limited and it may not be consideredappropriate for all specialist practitioners).

Independent Nurse Prescribers - Extended Formulary Nurse Prescribers

13 All first level registered nurses and registered midwives may now train toprescribe from the Nurse Prescriber's Extended Formulary (NPEF). Theextended formulary includes:

• all licensed Pharmacy(P) medicines and all General Sales List (GSL)medicines prescribable at NHS expense (with some exclusions) and

• range of approximately 180 Prescription Only Medicines (POMs) -includingsome specified controlled drugs.

14 Details of the NPEF are set out in both the British National Formulary and PartXVl 1B(ii) of the Drug Tariff. These should be regularly referred to foramendments to the Formulary. In addition, Extended Formulary NursePrescribers should restrict their prescribing of POMs and PtGSL medicines tothe treatment of specific medical conditions as set out in Part XVl 1B(ii) of theDrug Tariff.

15 Nurses should not prescribe independently outside of these listed conditions.Additionally, nurses prescribing may be limited by locally agreed formularies,prescribing outside of formulary may mean nurses would not be covered bytheir employers vicarious liability and would also be a criminal offence. Inprescribing, as in other areas of practice, nurses and midwives must prescribeonly within their competence and thus should only prescribe from sections ofthe NPEF relevant to the areas of their clinical expertise.

Supplementary Prescribers

16 Supplementary prescribers must have successfully completed both Extended andSupplementary Prescribing approved courses. There is no specific formulary orlist of medicines for supplementary prescribing. Provided medicines areprescribable by a doctor or dentist at NHS expense, a supplementary prescribermay undertake to change the drug, dosage, frequency and timing of a patient'smedication as agreed within the Clinical Management Plan (CMP).

Prescribable medication includes:-

- all General Sales List (GSL) medicines and all Pharmacy (P) medicines withexception controlled drugs

• appliances and devices prescribable by GP's• foods and other borderline substances

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• all Prescription Only Medicines (POMs) - currently with the exception ofcontrolled drugs (awaiting Amendment to Regulations)

• medicines for use outside their licensed indications (e.g. 'off-label'prescribing), 'black triangle' drugs and drugs marked 'less suitable forprescribing' in the BNF and

• unlicensed drugs providing they form part of a clinical trial that has a clinicaltrial certificate or exemption.

17 The CMP is a voluntary agreement between the patient, the IndependentPrescriber (IP) and the Supplementary Nurse Prescriber (SNP). At any point intime, the Supplementary Nurse Prescriber may ask the Independent Prescriberto review the patient, but review must be undertaken annually between theIndependent Prescriber, Supplementary Nurse Prescriber and patient.

18 Nurses/midwives who prescribe as supplementary prescribers without a clinicalmanagement plan are committing a criminal offence and would be in breach ofthe Professional Code of conduct performance and ethics

18 Training for supplementary prescribers is the same as for extended nurseprescribers with the addition of an approved short module covering the contextand concept of supplementary prescribing.

Patient Group Directions

19 Definition - a Patient Group Direction (PGD) is defined as a written instructionfor the supply or administration of medicines to groups of patients who may notbe individually identified before presentation for treatment. It is NOT a form ofprescribing and there is no specific training that health professionals mustundertake before supplying medicines in this way. However, many individualTrusts specify local training and assessment of competence. The majority ofclinical care should be undertaken on an individual patient specific basis andthe use of PGD's should be confined to those limited situations where there is

an advantage for patient care without compromising patient safety.

PGDs should be drawn up by a multi-disciplinary team and must be signed offby a senior doctor and pharmacist and must be authorised by the StriA, NHSTrust or PCT.

Since 2003 the following non-NHS organisations have been able to use PGD's:-

• Independent hospital agencies and clinics registered under the Care StandardsAct 2000

• Prison healthcare services• Police services• Defence medical services

PGD's are not suitable where a range of different medicines need to be given at thesame time. They may only be used by a defined range of health care professionals,which includes nurses and midwives. Under a PGD the medicine is to be both suppliedand administered by a registered nurse or midwife. Non -registered staff cannotadminister using a PGD.

Supply and Administration of Controlled Drugs

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Nurses and Midwives can supply some controlled drugs(CD's) under the terms of aPGD following amendment of the Misuse of Drugs Regulations in October, 2003. Sincethen, nurses have been able to use PGD's for the supply and administration of

Schedule 4 & 5 CD's with the exception of anabolic steroids - plus diamorphine for thetreatment of cardiac pain by nurses in accident and emergency departments and incoronary care units in hospital.

Since early 2004, Extended Formulary nurse/midwife prescribers have been able toprescribe:-

. Diazepam (restricted to palliative care)• Lorazepam (restricted to palliative care)• Midazolam (restricted to palliative care)• Codeine Phosphate (pain relief)• Dihydrocodeine tartrate (pain relief)• Co-phenotrope (pain relief)

Nurses are also able to prescribe lower strength P (pharmacy) and GSL (General salesList) medicines containing codeine phosphate and dihydrocodeine tartrate.

The Home Office are currently considering the prescribing of CD's including opoids bysupplementary prescribers (nurses, midwives and pharmacists) in the context of TheShipman Inquiry Fourth Report - The regulation of controlled drugs in the community,published in July 2004.

Specific Exemptions in Medicines Legislation for Supply and Administration ofMedicines

Nurses providing occupational health schemes and midwives have specific exemptionsin medicines legislation to supply or administer medicines. Provided the requirementsof any conditions attaching to those exemptions are met, a PGD as outlined above isnot required.Current exemptions from requirement for a prescription for the supply ofprescription only medicines (POM's) for nurses in occupational health schemedetails can be found in Schedule 5 Part II of POM order and current exemptionsfrom requirement from written directions of practitioner for parenteraladministration of POM's is found in Schedule 5 Part III of POM order.

Registered midwives have exemptions from requirement for a prescription for thesale or supply of prescription only medicines (POM's), details of which can befound in Schedule 5 Part I of POM order and current exemptions fromrequirement from written directions of practitioner for parenteral administrationof POM's is found in Schedule 5 Part III of POM order. These include POM's thatcontain any of the following substances but no other POM substance:

• Diamorphine• Ergometrine Maleate• Lignocanine• Lignocaine Hydrochloride° Morphine• Naloxone Hydrochloride• Oxytocins, natural and synthetic• Pentazocine lactate

• Pethidine hydrochloride

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• Phytomenadione• Promazine hydrochloride

The administration shall only be in the course of their professional practice andin the case of Promazine hydrochloride, Lignocaine and Lignocaine Hydrochlorideshall be only while attending a woman in childbirth.

Patient Specific Direction

20 This is a written instruction from a doctor, dentist or nurse prescriber for amedicine, or appliance to be supplied or administered to a named patient. Thismay be a written instruction in patient's notes or on a patients drug chart.Where a PSD exists, there is no need for a PGD or a Clinical ManagementPlan. However, the nurse remains accountable for her actions and should onlyact in accordance with the NMC code of professional conduct, standards forconduct, performance and ethics.

Education and Training

21 The NMC have produced a Standard for the Requirements for education andtraining for Extended Independent Nurse Prescribing and SupplementaryPrescribing. This can be found under the QA section of the NMC Website. Allcourses are validated against this standard.

Continuing Professional Development

22 Nurse prescribers are expected to keep up-to-date with best practice in themanagement of the conditions for which they may prescribe and in the use ofmedicines on the NPEF. Additional training and updating may be used in orderto renew registration with the NMC. The National Prescribing Centre hasproduced a document 'Maintaining Competency in Prescribing: an outlineframework to help nurse prescribers, this is available at www__n_a.nhs.uk. Itmay be used as a tool to reflect on practice and identify CPD needs.

Good Practice and Accountability

23 Nurse Prescribers are individually and professionally accountable to the NMC fortheir prescribing practice.

24 Nurse Prescribing (NPs) must be undertaken in adherence with the NMC's codeof professional conduct, standards for conduct, performance and ethics and inconjunction with local policies.

Variations in Nurse Prescribing across devolved Administrations

Scotland

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25 There are seven HEI's in Scotland who deliver the Extended and Supplementarynurse prescribing programme and the independent nurse prescribing programmeas part of the health visitor/district nurse qualification. Funding is currentlyavailable and the initial target was to train 3,000 nurse prescribers by 2006,however, whether this funding is ongoing has yet to be determined. Individualnurses wishing to undertake the extended nurse prescribing programme discusswith their managers the appropriateness of the qualification to their current roleand if considered appropriate the Trust applies to the Scottish Executive for agiven number of places as determined by the Trust. Initially nurses being putforward were mainly from practice nursing and held fairly senior positions, theyhave seen increasing numbers of students over the last year from a wide range ofbackgrounds and skill level, but with the majority from a primary care programme.

26 Cohorts are generally full and in some areas in particular Stirling, which coversthe Highlands, there are waiting lists to access the programme.

27 Although there have been discussions with providers of other non-medicalprescribers namely pharmacists and radiographers, optometrists and podiatrists.To date, there are no joint programmes and no plans to run a multi-disciplinaryprogramme.

28 Entry criteria for the programme meets NMC requirements. However, thedelivery of the programme varies from distance learning pack with five days face-to-face teaching up to a 25 day face-to-face taught programme. There is anexcellent resource of web based materials on the NES website which supportsthe programme.

29 Assessment has been modified by many of the institutions with all studentsundertaking an exam and a portfolio but with variations on the use of OSCE's.

30 A framework for Continuing Professional Development has been developed byNES complete with a CD Rom for student's use. The tool is used to assistprescribers to identify their CPD needs. Support networks for nurse prescribinghave been developed in an ad hoc fashion and prescribing leads are not in postin all areas.

31 The recent circular from the Doll (England) giving approval, as a result of changein legislation to the prescribing of certain controlled drugs by supplementary nurseprescribers, as part of a Clinical Management Plan, is not being implemented bythe Scottish Executive at this time.

32 An evaluation of nurse prescribing has been commissioned by the University ofStirling and is currently underway.

33 On completion of the course, nurses can prescribe as both extended andsupplementary nurse prescribers.

Wales

34 There are five HEI's in Wales who offer the extended and supplementary nurseprescribing programme, in addition, health visitors and school nurses undertake

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the independent nurse prescribing programme as part of their specialistqualification.

35 Funding for the course is via the Welsh Assembly and criteria for entry meets theNMC requirements. The nurses undertake the programme via shared learningwith the Pharmacists undertaking supplementary nurse prescribing programme,where this programme runs.

36 Nurses in Wales must undertake a drugs calculation exam before being allowedto prescribe, and on completion of the Course, are only allowed to prescribe assupplementary prescribers using a Clinical Management Plan. There are noformal arrangements for CPD with nurses expected to identify their own needsand for this to be met at local level.

Northern Ireland

37 Both the University of Ulster and Queens University offer the extended andsupplementary nurse prescribing programme and Ulster as part of their specialistpractice qualification for health visitors and district nurses.

38 Funding is direct from the Department for Health and SPSS, with the aim to trainthe number of nurses required to meet local need. There has been three cohortsgoing through the programme to date, a total of 160 nurse prescribers. Entrycriteria meet the NMC requirements and on completion nurses may prescribe asboth extended and supplementary nurse prescriber. There is no arrangement formulti-disciplinary non-medical prescribing training at present.

39 Initially nurses undertaking the programme were primarily from a primary careprogramme, however, as the programme has run, there have been increasingnumbers from secondary care.

40 There is no formal continuing professional development for nurse prescribers,although nurses are directed to the National Prescribing Centre framework forCPD and support networks have developed across Northern Ireland.

41 Changes in legislation to the prescribing of certain controlled drugs bysupplementary nurse prescribers as part of a Clinical Management Plan is beingimplemented on 14 April 2005.

England

42 There are 51 HEI's who deliver the extended supplementary nurse prescribingprogramme and 52 HEI's who deliver independent prescribing as part of theirspecialist practice qualification for health visitors and district nurses.

43 All programmes meet the entry criteria for NMC requirements and the coursesare funded by designated Workforce Development Confederations. The target isto train 10,000 nurse prescribers by 2006.

44 The programmes all run as stand alone modules, although some are uni-disciplinary and others are run jointly with the training for supplementarypharmacist prescribing. There is currently work being undertaken by NottinghamUniversity to develop a multi-disciplinary non-medical prescribing programme for

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all non-medical prescribers. All students undertake a written exam and produce aportfolio of evidence, however, OSCE's in some institutions have been replacedor modified using other methods of assessment.

45 Prescribing leads are in most trusts, although their role varies in each trust.Networks of nurse prescribers have been developed. Continuing professionaldevelopment is supported by the NPC framework, however, it has developed in asporadic way.

46 All four countries use the National Prescribing Centre competencies for nurseprescribing to measure the outcomes and assess student's competence

Legal Classification of Licensed Medicines

Prescription only medicines (POM)POM's require a prescription to be written, usually by a doctor, dentist, nurse or otherapproved prescriber

Pharmacy Medicine (P)P medicines can only be sold through a registered pharmacy under the personalsupervision of a pharmacist i.e. the pharmacist needs to be present before a Pmedicine can be sold.

General Sales List Medicine(GSL)GSL medicines are deemed even safer than P medicines and can be sold in generalshops as well as through pharmacies, albeit often in small quantities. All of theproducts are sold in manufacturers' original packs.

Over the Counter Medicine (OTC)Not a legal classification but a generic term that covers both GSL and P medicines

Further Information

Department of Health Website www.dh.gov.uk/_Loli__

PRODIGY produce patient information leaflets and lists drugs recommended byPRODIGY and links them to the condition and situation in which they arerecommended www.prodi#y.nhs,uk

Medicines and Healthcare products Regulatory Agency website contains informationabout the legal framework governing the prescribing, supply and administration ofmedicines www.mhra.qov.uk

National Prescribing Centre www,npc.co.uk

Medicines Partnership Programme www.medicines-partneshi_

Prescribing news www.nurse.prescriber.co.uk

12 April 2005

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