Expanded role for registered nurses to improve access to safe and timely healthcare

11 Dec 2024

Health Ministers approve designated RN prescribing in partnership with health practitioners

Australians will have improved access to safe and timely healthcare following an expansion in the scope of practice for qualified registered nurses (RNs) to prescribe medicines.

On Friday, Health Ministers approved a new Registration standard: Endorsement for scheduled medicines – designated registered nurse prescriber (the standard), which enables suitably educated and qualified RNs to prescribe Schedule 2, 3, 4 and 8 medicines in partnership with an authorised health practitioner¹ under a prescribing agreement. 

The endorsement will enhance access to high-quality, reliable medicines for all Australians, especially those in rural and remote areas. It will also help alleviate pressure points in both acute and primary care, where access to appointments is a challenge for healthcare consumers.

Registered nurses form the largest healthcare workforce in Australia. Enabling appropriately educated RNs to prescribe Schedule 2, 3, 4 and 8 medicines in a partnership agreement will contribute to patients having timely, affordable access to healthcare.

This prescribing model can improve resource use and enhance care coordination by allowing designated RN prescribers to manage medications, freeing up other healthcare professionals to focus on more complex areas of patient care.

Manager of the Wimmera Cancer Centre at Grampians Health and nurse practitioner, Carmel O’Kane, said ‘designated registered nurse prescribing can make care more accessible and improve the healthcare experience for consumers.’

‘It means more nurses can adjust medicine doses for end-of-life care and prescribe other supportive medicines for cancer patients without unnecessary delays. This ensures people get the care they need quickly, without the stress of waiting for a GP.’

The Nursing and Midwifery Board of Australia (NMBA) has collaborated with the Australian Nursing and Midwifery Accreditation Council (ANMAC) to develop the new Registered Nurse Prescribing Accreditation Standards to ensure that designated RN prescribers meet the National Prescribing Competencies Framework.

NMBA Chair Adjunct Professor Veronica Casey AM said the Board was confident that RNs who are educated and authorised to prescribe will do so safely within their scope of practice.

‘Australia is well-positioned to follow the lead of comparable healthcare systems where RN prescribing is already delivering successful outcomes.’ Adj Professor Casey said. 

“Creating an environment where medicines are used safely and optimally, with a focus on informed choice and coordinated, person-centred care, enables equitable access to medicines without compromising public safety.’

To apply for the endorsement, RNs must meet stringent requirements, including completing postgraduate qualifications and demonstrating adequate clinical experience. The added requirement of a six-month period of clinical mentorship with an authorised health practitioner post-endorsement provides an additional safeguard enabling designated RN prescribers to develop confidence in prescribing.

A key component of the new model is the prescribing agreement, a written document approved by the health organisation, service, or employer that formalises the partnership between the designated RN prescriber and the authorised health practitioner.

The agreement defines the roles and responsibilities of both parties and outlines any conditions within the designated RN prescriber’s scope of practice. To ensure clarity and transparency, communication materials will be developed to inform health professionals and the public about the designated RN prescriber role.

Health services looking to implement designated RN prescribing will need to establish governance frameworks that comply with Quality Use of Medicines (QUM) principles.

Governments will need to work toward harmonising state and territory drugs and poisons legislation to facilitate consistent access to medicines for consumers.

An advance copy of the standard will be published on the NMBA website in March 2025.

The endorsement, registration standard and guidelines will take effect mid-2025.

Contact us

• Media enquiries: (03) 8708 9200 or media@ahpra.gov.au
• For registration enquiries, please phone 1300 419 495 (within Australia) +61 3 9125 3010 (overseas callers).

^{1 An authorised health practitioner is a registered health practitioner who is an authorised autonomous prescriber for example a medical practitioner or a nurse practitioner (more than one authorised health practitioner may work with the designated registered nurse prescriber).}