December 2020

News

Message from the Chair
NMBA news
Registration
- Do you employ recently registered internationally qualified nurses and/or midwives?
National Scheme news
Keep in touch with the NMBA

Message from the Chair

Firstly, I’d like to thank Associate Professor Lynette Cusack for her exemplary leadership and invaluable contribution to supporting safe nursing and midwifery practice during her time as Chair.

I’m very much looking forward to continuing the NMBA’s work with nurses and midwives and the community over the next three years as Board Chair.

Secondly, on behalf of the NMBA I’d like to thank all of you for your patience and hard work in 2020. As you will all be aware, 2020 has been the Year of the Nurse and the Midwife. A year where we have all seen the incredible contribution of nurses and midwives to the health of people across the world. Nurses and midwives are often the first, and sometimes the only, health practitioner that people see for their healthcare needs.

The impact of the COVID-19 pandemic has highlighted to the community the critical role nurses and midwives fulfil. As Lord Nigel Crisp, Nursing Now co-Chair, said: ‘The evidence is clear. Invest in nursing and midwifery and you will provide healthcare for all. Investing in nursing and in midwifery will make an enormous contribution to the rapid, cost-effective and high quality scaling up of universal health care.’

During this extraordinary year you have served your communities with great compassion, dedication and professionalism through extreme challenges. You should all be extremely proud of the difference you make to the health of the Australian community.

Wishing you all a safe and happy festive season.

Adjunct Professor Veronica Casey, registered nurse and midwife
Chair, Nursing and Midwifery Board of Australia

NMBA news

Nurse practitioners: get to know your revised standards for practice

The NMBA has published an advance copy of the revised Nurse practitioner standards for practice (revised standards). Nurse practitioners (NPs) can get to know their profession’s revised standards before they take effect on 1 March 2021.

Where can I view the revised standards?

Visit the Professional standards section of the NMBA website to get to know the revised standards.

What are the standards used for?

The Nurse practitioner standards for practice build on, and expand upon, the practice standards required of a registered nurse and set the expectations of NP practice in all contexts. The standards inform the education accreditation standards for NPs, the regulation of NPs and determine an NP’s capability for practice. The standards are used to guide consumers, employers and other stakeholders on what to reasonably expect from an NP regardless of their area of practice or their years of experience.

What’s changed in the revised standards?

Recent developments in the theory and practice of NPs, including the key concepts and definitions, have been incorporated into the revised standards.

The revised standards also include culturally safe and respectful practice. The revised standards consider the impacts the standards could have on people’s health and safety, particularly vulnerable members of the community, and Aboriginal and Torres Strait Islander Peoples.

The presentation of the revised standards has been improved and aligns with the presentation of the Registered nurse standards for practice and the Midwife standards for practice.

How were the standards revised?

The revised standards were developed through an evidence-based review, which included:

an exploration of relevant Australian and international literature and regulatory guidelines
an internal review and analysis of the current Nurse practitioner standards for practice
preliminary consultation with key stakeholder groups, and
a public consultation phase.

Where can I go for more information?

An advance copy of the revised standards can be viewed on the Professional standards section of the NMBA website.

The Nurse practitioner standards for practice should be read in conjunction with the NMBA's Safety and quality guidelines for nurse practitioners and Recency of practice registration standard.

Further information on the consultation process for the revised standards can be viewed on the Past Consultations section of the NMBA website.

Ahpra’s clinical input team

This month we chat to Kellie, a registered nurse and manager of the nursing and midwifery clinical input team at Ahpra. Read our interview to find out more about how Ahpra and the NMBA use the advice of nurse and midwife clinical advisors to make good decisions.

What does the Ahpra clinical input team do?

The nursing and midwifery clinical input team comprises of a small team of registered nurses and midwives who provide clinical input to support regulatory advisors in other areas such as the registration, notification, compliance or legal areas.

Clinical input is the application of knowledge, skills and experience of the clinical advisors in supporting regulatory staff to identify concerns or issues, assess risk, interpret clinical matters and reference profession-specific guides, standards and codes. The team also represents Ahpra and the Board at various stakeholder engagements like nursing and midwifery conferences or forums.

What kind of advice and projects do you work on for nursing and midwifery?

The bulk of the clinical advisor’s role includes providing clinical input in to notification matters, particularly those that relate to performance issues, and assisting regulatory staff to ask relevant questions of the practitioner which are specific to the notification. It is always useful to see how a practitioner has reflected and learnt from their experience, and what corrective action they may have undertaken, such as completing education in a subject relevant to the notification.

We also manage the application processes for the nurse practitioner endorsement and the midwifery scheduled medicine endorsement.

We assist regulatory staff with re-entry to practice applications, specifically where an applicant may have allowed their registration to lapse and do not meet the NMBA’s Registration standard: Recency of practice. Sometimes an applicant has worked in a nursing role where the title of ‘RN’ or ‘Midwife’ is not evident, so we can look at a statement of service and inform the regulatory staff whether it is a nursing/midwifery related role, or if further information is required.

Outside of the COVID pandemic restrictions, we endeavour to attend professional body conferences, either as attendees or as representatives of the NMBA and Ahpra. It’s a great opportunity to meet the wonderful nursing and midwifery practitioners and engage directly with them.

We also work closely with the NMBA’s Strategy & Policy team and have a great working relationship.

What’s your favourite part of the job?

My favourite part of the job is working with a great bunch of like-minded professionals who really care about the impact that our work has on the nursing profession and the midwifery profession. We are all passionate about our professions and this really comes across in our work ethic and commitment to quality improvement within Ahpra.

It is always rewarding for us when we have the privilege of assessing and finalising a nurse practitioner endorsement or an endorsement for scheduled medicines for midwives. We appreciate the great work that these nurses and midwives do and the commitment and effort they have put in to achieving their goal, as well as how their great work will impact on the Australian community. It’s always a pleasure to call a nurse or midwife to congratulate them on their endorsement.

What do you think the team’s biggest achievement has been this year?

The team has worked extraordinarily hard this year from a remote environment. We have kept our sense of humour and strong work ethic during this time. One big achievement is that we have endorsed over 170 nurse practitioners and over 100 endorsements for scheduled medicines for midwives – these practitioners are such valuable assets to the Australian community and health sector. This is on top of notifications, registration, and compliance work. It is certainly a busy but rewarding role.

Updates from recent NMBA meetings

At its most recent meetings the NMBA:

noted the release of the Productivity Commission Mental Health – Inquiry Report Vol 1 No.95 30 June 2020
provided feedback through the Australian College of Nursing to the International Council of Nurses draft proposed Code of ethics
reviewed the NMBA’s committee structure and reassigned NMBA members to the committees, and
agreed a revised Memorandum of Understanding with the Nursing Council of New Zealand, that reflects future regulatory opportunities between the Council and the Board.

The NMBA also considered issues related to Aboriginal deaths in custody and in particular recent coronial inquests held into a number of these deaths. The NMBA is considering these issues and its further response.

At its December 2020 meeting, the NMBA approved the revised Midwife Accreditation Standards and acknowledged the work of the Australian Nursing and Midwifery Accreditation Council in reviewing the standards.

Each month the NMBA makes decisions on approved programs of study leading to registration and endorsement. To see the up-to-date, searchable list of approved programs, please visit the Approved programs of study section of the NMBA website.

Nurse Practitioner Day

The NMBA would like to acknowledge the important milestone of 20 years of the endorsement for nurse practitioners (NPs) and to thank NPs for their contribution to the nursing profession and to their communities.

Leanne Boase, President of the Australian College of Nurse Practitioners, said that Nurse Practitioner Day is held on 12 December each year to celebrate the first nurse practitioners who were endorsed in Australia.

‘In 2000, the first NPs were endorsed in Australia, and now over 1,900 NPs work as key members of the healthcare team and collaborate with other nurses and healthcare professionals including GPs, medical and surgical specialists, physiotherapists, dieticians, occupational therapists. NPs work in a variety of locations, both in hospital and community settings.’

To find out more about NPs, please see the Endorsements section of the NMBA website or visit the Australian College of Nurse Practitioners.

Registration

Do you employ recently registered internationally qualified nurses and/or midwives?

The NMBA has released new guidelines for employers on best practice for orienting internationally qualified nurses and midwives (IQNMs) to the Australian healthcare context.

The evidenced-based guidance is designed to support employers, managers and people and culture directorates. Using the NMBA guidelines to shape the content of local (employer-based) orientation programs will enable IQNMs to have the best opportunity to commence practice in Australia safely, effectively and professionally.

The guidelines, An employer and manager’s guide to registration and orientation for internationally qualified nurses and midwives, are available on the Orientation Part 1 and Part 2 section of the NMBA website.

National Scheme news

Ahpra 2019/20 annual report: regulating during a pandemic

Ahpra has released the 2019/20 annual report highlighting our regulatory work with National Boards and our response to the unprecedented challenges of the COVID-19 pandemic.

Ahpra and National Boards have worked closely with accreditation authorities, governments and our partners to ensure we play our part fully in supporting health practitioners and the wider health system response to COVID-19.

2020 marked the tenth year of national registration. Australia now has more than 800,000 registered health practitioners. This figure includes around 35,000 recently retired health practitioners in eight professions who were returned to registration as part of our pandemic sub-register to support the health system response to COVID-19.

Regulation can never stand still. COVID-19 meant that Ahpra became a virtual organisation within weeks. We also worked with National Boards to introduce many changes to allow our regulatory work to continue and provided flexibility where it was safe. This included updated guidance about issues such as telehealth services, scope of practice and CPD requirements.

Maintaining public safety remained paramount across all our regulatory work. We implemented changes to the National Law on mandatory reporting, initiated an independent review of our management of sexual boundary notifications and continued our work with Aboriginal and Torres Strait Islander partners to eliminate racism from the health system and ensure cultural safety.

Insights from the year include:

There were 801,659 registered health practitioners across 16 regulated professions, an increase of 7.7% on last year. This includes 35,000 health practitioners on the temporary pandemic sub-register.
Between 17 March and 30 June, the COVID 19 portal on the Ahpra website received over 158,000 unique page views. The updates page attracted over 115,000 (unique) views, the FAQs page over 82,000, and the pandemic sub-register over 60,000.
More than 82,500 applications for registration were finalised, including over 29,000 applications from new graduates. We halved the median time to finalise an application.
The largest growth in registrants was Aboriginal and Torres Strait Islander Health Practitioners +17.7%, paramedics +14.5% and midwives +10.2%.
Ahpra received more notifications in 2019/20 than in any other year (10,236), an increase of 9.6%. We closed more notifications than in previous years.
While the number of notifications is increasing the overall percentage of health practitioners with a notification stayed around the same level (1.6–1.7%).
The top three reasons for a notification were clinical care (43.5%), medication issues (9.9%) and communication (7.2%).
132 matters about professional misconduct were determined by tribunals: 100% resulted in disciplinary action.
Ahpra received 412 new offence complaints relating to title protection and 584 complaints about advertising.
Ahpra completed 11 proceedings in the Magistrates’ and Local Courts. All prosecutions resulted in guilty findings.

To view and download the 2019/20 annual report, visit the Ahpra website.

Resetting our approach to investigations

National Boards and Ahpra stand for safe, professional health care practice.

All health practitioners and their workplaces have roles to play in ensuring public safety. We are improving the way we manage our regulatory investigations about practitioners to better account for our collective responsibilities.

We know that the public are best protected when we support practitioners and their employers to improve safety and professionalism in the delivery of health services. Our efforts and resources should focus on matters where there are gaps in safe practice that create ongoing risk to the public.

Our revised approach, in place now, aims to improve the experience of notifiers and practitioners by completing most investigations faster. There is a stronger focus on speaking directly to the practitioner. This is so we can gather early information about the practitioner’s individual practice, reflection and their actions in response to notified events. This is key to:

closing concerns about low risk practitioners faster, and
concentrating our investigations on practitioners that represent higher risk.

Practitioners can help with this by:

engaging the supports they need through the process, including indemnifiers and/or professional associations and colleges
providing Ahpra with the information they need as early as possible, and
giving their employer permission to share information about them with Ahpra to help validate what the practitioner has told us.

We also want to understand what a practitioner’s workplace has done in response to the events.

The level of information we need to gather is more wide ranging when the concerns raised could constitute professional misconduct. This includes boundary violations, criminal and unethical behaviour, and significant departure from acceptable standards.

The National Board will take action in response to a concern, when the actions of an individual practitioner and/or their workplaces are not sufficient, to ensure we can prevent the same thing happening again.

Inaugural strategy to increase our Aboriginal and Torres Strait Islander workforce

Ahpra marked NAIDOC Week 2020 by releasing our inaugural Aboriginal and Torres Strait Islander Employment Strategy 2020-2025 (the Employment Strategy).

The goal of the Employment Strategy is to increase Aboriginal and Torres Strait Islander participation within Ahpra through the development of a culturally safe work environment that reflects the diversity of the communities in which we operate and serve. It is a major component of the National Scheme’s Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy 2020-25, which aims to improve cultural safety, increase workforce participation, strive for greater access and close the gap in health outcomes between Aboriginal and Torres Strait Islander Peoples and other Australians.

The Employment Strategy contains five priority areas to help achieve our goal:

build a sustainable talent pipeline through attraction and recruitment of Aboriginal and Torres Strait Islander candidates
implement programs and culturally safe work practices which foster the retention of Aboriginal and Torres Strait Islander employees
invest in developing the capabilities and careers of Aboriginal and Torres Strait Islander employees, including representation in leadership and senior roles
develop culturally safe workplaces through education and culturally safe work practices, and
know the Aboriginal and Torres Strait Islander workforce throughout Ahpra to encourage their engagement in the rollout of the Employment Strategy and achievement of its goals.

The Employment Strategy recognises the need to build the cultural capability of all Ahpra employees to enable a proactive and leadership approach. We have an opportunity to address systemic challenges now by investing in and nurturing long-term relationships. We encourage and support Aboriginal and Torres Strait Islanders to seek employment and a career with Ahpra.

Keep in touch with the NMBA

Visit the NMBA website for registration standards, codes, guidelines and FAQ.
Lodge an online enquiry form.
For registration enquiries, call 1300 419 495 (from within Australia) or +61 3 9275 9009 (for overseas callers).
Address mail correspondence to: Adjunct Professor Veronica Casey AM, Chair, Nursing and Midwifery Board of Australia, GPO Box 9958, Melbourne, VIC 3001.