3-standar competency of nurse

8/6/2019 3-Standar Competency of Nurse

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Competency Standards

An Australian Nursing Federation project funded by the Australian Government Department of Health and Ageing

for nurses in general practice


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Competency standards for nurses in general practice

An Australian Nursing Federation project unded by the Australian Government Department o Health and Ageing.The competency standards or nurses in general practice were developed by a University o South Australia projectteam led by Terri Gibson and Marie Heartfeld.

First published August 2005

Design by John Thrit Publishing

Printing by Agency Printing (Australia) Pty Ltd

Copyright 2006 Australian Nursing Federation

All rights reserved. No material may be reproduced, translated or reproduction or otherwise utilised without permissionrom the publisher.

ISBN: 0909599521


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Competency Standardsfor nurses in general practice

An Australian Nursing Federation project funded by the Australian Government Department of Health and Ageing


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Table of contents

1. Preamble ____________________________________________________________________ 5

2. Introduction__________________________________________________________________ 7

2.1 Generalpractice___________________________________________________________ 7

2.2 Nursesandgeneralpractice_________________________________________________ 8

2.3 Competencystandards_____________________________________________________ 10

2.4 Otherdenitions__________________________________________________________ 11

3. Competencystandardsorregisterednurses1ingeneralpractice______________________ 13

3.1 Overview_________________________________________________________________ 13

3.2 Rolestatementortheregisterednurseingeneralpractice_______________________ 14

3.3 AustralianNursingandMidwieryCouncilsnationalcompetency standardsortheregisterednurse____________________________________________ 16

3.4 Competencystandardsortheregisterednurseingeneralpractice________________ 16

3.5 Competencystandardsortheadvancedregisterednurse________________________ 16

4. Competencystandardsorenrollednurses2ingeneralpractice________________________ 25

4.1 Overview_________________________________________________________________ 25 4.2 Rolestatementortheenrollednurseingeneralpractice ________________________ 26

4.3 AustralianNursingandMidwieryCouncilsnationalcompetency standardsortheenrollednurse_____________________________________________ 27

4.4 Competencystandardsortheenrollednurseingeneralpractice__________________ 27

5. Resources____________________________________________________________________ 33

1Registerednurse(division1)inVictoria

2Registerednurse(division2)inVictoria


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Competency standards or nurses in general practice

Preamble

Theprojecttodevelopcompetencystandardsornursesingeneralpracticewasundedbythe

AustralianGovernmentDepartmentoHealthandAgeingandmanagedbytheAustralianNursing

Federation.AprojectteamromtheUniversityoSouthAustraliaandRoyalCollegeoNursing

Australia,ledbyMsTerriGibsonandDrMarieHearteld,developedthecompetencystandards.

Aprojectsteeringgroupguidedtheprojectandthemembershipincluded:

Julie Porritt AustralianDivisionsoGeneralPractice

Lyn LeBlanc AustralianNursingandMidwieryCouncil

Lynne Walker AustralianPracticeNursesAssociation

Maryanne Craker NationalEnrolledNurseAssociation

Victoria Gilmore AustralianNursingFederation

ThegeneralpracticeprojectwascompletedinFebruary2005andthecompetencystandardsare

nowavailableoruseinworkplaces,educationsettingsandotherproessionalenvironments.They

shouldbeusedasarameworkornursestobothassesstheirpracticeandtoguidetheirproessional

development.Thespecialistcompetencystandardsmustbeusedinconjunctionwiththecore

competencystandardsdevelopedbytheAustralianNursingandMidwieryCouncilandendorsed

bythenurseregulatoryauthorityineachstateandterritory.NursesinallsettingsincludinggeneralpracticeusetheAustralianNursingandMidwieryCouncilsCodeoProessionalConductor

NursesandMidwivesinAustraliaaswellastheCodeoEthicsorNursesandMidwivesinAustralia

(developedundertheauspicesotheAustralianNursingFederation,theAustralianNursingand

MidwieryCouncilandRoyalCollegeoNursingAustralia).

Theprocessordevelopingthecompetencystandardsornursesingeneralpracticeincluded:

consultationwithnursesandotherkeystakeholdersincitiesandtownsaroundAustralia;

reviewothecompetencystandardsortheadvancednurse;

observationonursesworkinginarangeogeneralpracticesettings;and

meetingswithexperiencedenrollednursesworkinginothersettingssuchaspublichospitals,

agedcareacilitiesandthecommunity.

Followinganalysisothedatacollectedduringtheconsultationandobservationphases,drat

standardswerepreparedandvalidatedduringaseriesomeetingsthatincludedrepresentatives

onursesworkingingeneralpractice,theiremployersandotherswithwhomtheyworksuchas

othergeneralpractitioners.Thiswasanessentialstepintheprocesstoconrmthatthecompetency

standardsrefecttheproessionalpracticeonursesworkingingeneralpractice.

Thecompetencystandardsornursesingeneralpracticearenowreadytobeused.Theyareauseul

rameworkrefectingnursingpracticeinthegeneralpracticesetting.

1.


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Introduction

Theollowingsectionsdescribethecontextinwhichnursingingeneralpracticetakesplaceand

thereisalsosomediscussionaboutthewaythatprimaryhealthcareprovisioninthegeneralpractice

settingisdeveloping.Anychangeswillinvolvenursesworkingingeneralpracticeandpreparationby

allhealthcareprovidersneedstobehappeningnow.

Backgroundinormationisalsoprovidedaboutotherissuessuchasthescopeopracticeornurses,

proessionalsupervisionoenrollednurses,andthemeaningotermssuchascompetencystandards.

2.1 General practiceGeneralpracticeisthecentreoprimaryhealthcareinAustralia.Generalpracticecontinuestohave

aocusonthehealthandwell-beingoindividuals,howevertherearegeneralpracticesthatare

expandinghealthservicesmorebroadly:(a)togroupsopeoplesuchasthoselivinginagedcare

acilitiesorpeoplelivinginthecommunitywithadiseasesuchasdiabetesmellitus;and(b)toa

population/publichealthapproachsuchasimmunisationprogramsandmanagementoinectious

illnessesinthecommunity.

PrimaryhealthcareinthissettingisprovidedtoAustraliansrombirthtodeath.Generalpractice

remainstherstpointocontactorthemajorityoAustralianswhentheyhaveanillnessoran

injury.Generalpractitionersplayanimportantroleinreerringpeopleorspecialistservicesincluding

medical,nursingandalliedhealthcare.

Ongoingcaretopeoplewithchronicillnessesanddisabilitiesisprovidedingeneralpracticeandit

maybeprovidedinconjunctionwithnursesandotherhealthcareemployeesworkinginthegeneral

practice.Thiscarecanalsobeprovidedinpartnershipwithspecialistmedicalpractitionersandwith

otherhealthcareproessionalssuchasnursesandalliedhealthcareprovidersineitherthepublicor

privatehealthcaresystems.

Otherprimaryhealthcareservicesthatareoeredingeneralpracticeincludehealthpromotionandillnesspreventioninterventionssuchashealthscreening,immunisation,andsmokingcessation

advice.Generallytheseareprovidedonanindividualbasisbutopportunitiesarebeingtakentooer

servicesinotherwaysaswellincludinggroupeducationsessionsandimmunisationclinics.

Qualitymanagementstrategiessuchasusingevidencebasedhealthcaretoimproveclinicaloutcomes

areincreasinglyeaturesohealthcareinthegeneralpracticesettingorbothnursesandgeneral

practitioners.Nursesandgeneralpractitionershoweverneedtheappraisalandevaluationskillsso

thattheycaneectivelyandecientlyusetheevidencebasedresourcesthatareavailabletothem.

2.


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Themajorityogeneralpracticesaresmallbusinesseswithgeneralpractitionersasthebusiness

owners.Somegeneralpracticesareownedbycorporationswhereallthoseworkinginthegeneral

practiceareemployeesorcontractedworkersincludingthegeneralpractitioners.

Fundingorgeneralpracticeisromamixopublicandprivatesources.Australiahasauniversal

insuranceschemeknownasMedicare.Generalpracticeshavetheoptiono:(a)bulk-billingpatients

ortheserviceprovidedandclaimingtheMedicarepaymentdirectlyromMedicareAustralia;or

(b)chargingthepatientaeeortheservicebeorethepatientmakesaMedicareclaim.Thiseemay

begreaterthantheamountclaimableromMedicaresothepatientmayberequiredtopaythegap.

2.2 Nurses and general practice

Bothregisteredandenrollednurseshavebeenemployedinsomegeneralpracticesormanyyears.

Nursesingeneralpracticehaveotenworkedinisolationromtheirnursingpeersalthoughthey

havebuiltstrongproessionalrelationshipswiththegeneralpractitionerswithwhomtheywork.This

nursingisolationpresentednurseswithchallengessuchasaccesstoinormationaboutavailableand

relevanteducationandresearchndingsthatsupportthedynamichealthcareenvironmentinwhich

theywork.Generalpracticecontinuestoevolveandnursingingeneralpracticehasalsoevolvedand

expandedandnursesinthatsettinghavetondwaystokeepupandmaintaintheircompetence.

Thescopeonursingpracticeisdenedasnursingpracticeorwhichnursesareeducated,

competentandauthorisedtoperorm3.Thehealthneedsoindividualsorgroups,theplacewhere

nursingcareisbeingprovidedsuchasingeneralpractice,theeducationothenurseprovidingthe

care,thepoliciesandprotocolsothehealthcareprovider,andrelevantlegislation,allinfuencethescopeopracticeornurses.

Registerednurseshavearangeoskillsandknowledgetheyuseinanyhealthcaresetting.Theskills

includepatientassessment,healthcareplanningandevaluationaswellastheabilitytoprovide

healthcareinterventions.Thebreadthopresentationsinageneralpracticesettingmayrequire

nursestoexpandtheirscopeopractice.

For example

Anexperiencedagedcarenursestartsworkingeneralpracticebutidentiesthatskillsand

knowledgeinchildhealthareneededasthegeneralpracticeprovidesservicestoapopulation

thatincludesmanyyoungamiliesaswellasolderpeople.Growthanddevelopment,

managementochildhooddiseases,immunisation,andasthmamanagementmaybesomeothe

areasinwhichthenurseidentiestheyhavelimitedskillsandknowledge.Thenursecoulduse

anyotheollowingtoassistwithdevelopingcompetenceinthechildhealtharea:

educationcourses;

supervisedclinicalexperience,and/or

refectivepracticeinconjunctionwithpersonalstudy,etc.

3FromQueenslandNursingCouncil1998Scopeonursingpractice:DecisionmakingrameworkQNCBrisbane


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Generalpractitionersandotheremployerscanworktogetherwithnursestoidentiywhenthe

nursesscopeopracticeneedstobeexpandedandhowthatexpansionwilltakeplaceegthe

generalpracticeplanningornursestoprovidewomenshealthserviceswouldworkwiththenurses

toensurethattheyarecompetentincludingcompletionotherequiredcourses,orexample,in

cervicalscreening.

ManyothenurseregulatoryauthoritiesinAustraliaaredevelopingdecisionmakingrameworks

toassistnursesandtheiremployerstoidentiythescopeonursingpracticeandexpanditwhere

necessary.4Decisionmakingrameworkscanalsoassistwithidentiyingtheproessionalsupervisory

arrangementsneededorenrollednursingwork.

Asrequiredinlegislation,enrollednursesworkingingeneralpracticearesupervisedbyregistered

nurses5.Supervisioncanbedirect,wheretheregisterednurseispresent,observes,workswithand

directstheenrollednurses,orindirectwheretheregisterednurseiseasilycontactablebutdoesnotdirectlyobservetheactivities.Thelevelosupervisionrequireddependsuponanumberoactors

including:theskillsandknowledgeotheenrollednurse;theacuityandstabilityotheperson

receivingthenursingcare;andthecomplexityothenursingcarebeingprovided.

Theseproessionalsupervisoryarrangementsmustbeinplaceirrespectiveoanyothersupervision

includingthatprovidedbyanemployinggeneralpractitioner.Ingeneralpracticesemployingenrolled

nurses,arrangementsorproessionalsupervisionshouldbedevelopedandguidelinespreparedto

assistboththeenrollednurseandthesupervisingregisterednurse.

Whilecollaborationwithhealthcarecolleaguesandwithindividualsandgroupsrequiringnursingcareisthehallmarkonursingpracticeinanysettingincludinggeneralpractice,registerednursesare

autonomoushealthcareproessionals.Bothregisteredandenrollednurseshavelawsandregulations

thatguidetheirpractice.Nurses,aslicensedproessionals,arerequiredtobeaccountableand

responsibleortheirownactionsandtheymustbeabletoidentiythenursingcareorwhichthey

havetheknowledgeandskillstoprovide.Itisalsoimportantthatnursesingeneralpracticeseek

outappropriateopportunitiestodevelopknowledgeandskillswhenthecareingeneralpracticeis

changingsuchasmoreresponsibilityortheeducationopeoplewithdiabetesandbeingprepared

orthisbycompletinganaccreditedcourse.

SignicantAustralianGovernmentsupportornursescommencedwiththeannouncementincluded

inthe2001/02AustralianGovernmentBudgetthatpracticeincentivepaymentswouldbeavailable

oreligiblepracticesemployingnursesingeneralpractice.Eligiblegeneralpracticeswereinrural

4Seewww.anmc.org.auorlinkstotheweb-sitesothenurseregulatoryauthorities

5NotethatinSouthAustralia,enrollednursescanapplytothenurseregulatoryauthorityorauthorisationtoworkwithoutthesupervisionoaregisterednurse


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10 Competency standards or nurses in general practice

andremoteareas,andinurbanareasoworkorceneediewherethereareshortagesogeneral

practitioners.FundswerealsoallocatedinthatBudgetorstrategiessuchas:

developmentoactsheetsaboutnursingingeneralpractice;

developmentomentoringresourcesornursesingeneralpractice;

supportornursingthroughtheDivisionsoGeneralPracticenetworkandtheAustralian

PracticeNursesAssociation;

provisionoup-skillingandre-entrynursingscholarships;

astudytoscopenursingingeneralpracticeincludingeducationalopportunities;and

developmentocompetencystandardsornursesingeneralpractice.

Nursesingeneralpracticeareoteninvolvedinthebusinessactivitiesothesmallbusiness.They

needtohaveknowledgeaboutthebusinessrequirementsincludingMedicareunding.Thisbusiness

knowledgeisnotacommoneatureonursingpracticeinmostothersettingsandnursesingeneral

practiceneedtoseekknowledgeromawiderangeosourcesincludingnetworksestablishedto

assistgeneralpractitionerswiththeirbusinessactivities.

Itmustbenotedthattheworkundertakenbynursesingeneralpracticeisshapedbythewaythat

servicesareremuneratedinthatsetting.Forexample,atthetimeowriting,thereareonlyalimited

numberonursingservicesorwhichMedicareclaimscanbemadeingeneralpractice6.

2.3 Competency standards

Nurseshaveusedcompetencystandardsastheirproessionalrameworksincethelate1980swhencompetencystandardsorregisterednursesandorenrollednursesweredevelopedbythepeak

nationalbodyresponsibleornursingregulationwhichisnowknownastheAustralianNursingand

MidwieryCouncil7.

Inthenursingproession,competencystandardsareusedorexampleby:

nursesastheproessionalrameworkagainstwhichtomeasuretheirownperormanceand

prepareaproessionaldevelopmentplansothatcompetenceismaintainedandenhanced;

nurseregulatoryauthoritiesineachstateandterritorytodeterminetheeligibilityopeople

applyingoralicencetopracticeasanurseandtoassessnursesrequiredtodemonstrate

continuingcompetence;

educationprovidersinboththehighereducationandvocationaleducationsettingsasthe

rameworkorcoursedevelopmentpurposes;and

employersorpositiondescriptionandperormanceassessmentpurposes.

6

AsatFebruary2005theseincludeitemsorwoundcare,immunisationandsomecervicalscreeningservices7Seewww.anmc.org.auorurtherinormationabouttheAustralianNursingandMidwieryCouncil


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Competency standards or nurses in general practice 11

TheAustralianNursingandMidwieryCouncilusesadenitionadaptedromthe2003glossaryin

theInternationalCounciloNursesrameworkocompetenciesorthegeneralistnursetodene

competenceasthecombinationoskills,knowledge,attitudes,values,andabilitiesthatunderpin

eectiveperormanceinaproessional/occupationalarea8.

TheAustralianNationalTrainingAuthoritywhichwas,untilJune2005,thenationalbodyresponsible

orvocationaleducationandtrainingusedtheollowingdenitions:

Competency(alsocompetence)theabilitytoperormtasksanddutiestothestandardexpected

inemployment;

Competency standardanindustry-determinedspecicationoperormancewhichsetsoutthe

skills,knowledgeandattitudesrequiredtooperateeectivelyinemployment;

Unit o competencyacomponentoacompetencystandard.Aunitocompetencyisa

statementoakeyunctionorroleinaparticularjoboroccupation.9

Competencystandardsusedbythenursingproessioncompriseadomainwhichistheoverarching

titleoraclusterocompetencyunitswithasimilartheme,andtheunitsocompetencyor

competencystandard.TheAustralianNursingandMidwieryCouncilsnationalcompetencystandards

includecompetencyelementswhicharesub-unitsotheunitocompetency.

Thecompetencystandardsortheadvancedregisterednurse,theregisterednurseingeneralpractice,

andtheenrollednurseingeneralpracticeincludecuesoreachotheunitsocompetencyand

thesearedesignedtoassistwithunderstandingthecompetencystandard.Thecuesincludedwiththecompetencystandardsshouldnotbeusedasachecklistalthoughtheyareaveryuseulguideto

assistwithassessingcompetenceieisthestandardbeingmetorwhatisrequiredtodemonstratethat

therequiredlevelocompetencyisbeingachieved?

2.4 Other defnitions

Thephrase,individualandgroup,hasbeenusedinthecompetencystandardssothatthereis

consistencywiththeAustralianNursingandMidwieryCouncilsnationalcompetencystandards.Itis

acknowledgedthatthetermgenerallyusedingeneralpracticeispatient,althoughinsomegeneral

practicesettings,clientisthepreerredterm.

8ANMC2004CommoncompetenciesorregisterednursesinWesternPacicandSouthEastAsianRegionANMCCanberra

9Seeglossaryonwww.anta.gov.au.TheAustralianGovernmentannouncedin2004thatANTAwouldbeabolishedandresponsibilitiestranserredbacktotheDepartmentoEducation,ScienceandTraining


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Competency standards for

registered nurses in generalpractice

3.1 Overview

RegisterednursesingeneralpracticemustmeettheAustralianNursingandMidwieryCouncils

nationalcompetencystandardsorregisterednurses.Inadditiontheyshouldmeetthecompetency

standardspreparedbythenursingproessionorregisterednursesingeneralpractice.

Someregisterednursesingeneralpracticewillbeworkingatahigherlevelandtheycanreerto

thecompetencystandardsortheadvancedregisterednurseinadditiontotheothertwosetso

competencystandardsrelevanttoregisterednursesingeneralpractice(iethenationalcompetency

standardsorregisterednursesandcompetencystandardsorregisterednursesingeneralpractice).

Registerednursesingeneralpracticewhoarepreparingtheirproessionaldevelopmentplanmayuse

thissetostandardsasaramework.

Otherregisterednursesingeneralpracticemayndthenursepractitionercompetencystandards

beingpreparedbytheAustralianNursingandMidwieryCounciltobeauseulrameworkagainst

whichtomeasureordeveloptheircompetence10.

Registerednursesingeneralpracticeworkingwithenrollednursesshouldbeawareotherelevant

competencystandardsorenrollednurses.Theymustalsoknowtherequirementsrelatingto

supervisionanddelegationonursingcare.Thisinormationcanbeobtainedromthenurse

regulatoryauthorityinthestateorterritoryinwhichthenurseinworking11.

3.

10SeeGardnerGCarryerJDunnSandGardnerA2005ReporttotheAustralianNursingandMidwieryCouncil:NursePractitioner

StandardsProjectANMCCanberra11Reertothelistoresourcesinsection5orcontactdetailsorthenurseregulatoryauthorities


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3.2 Role statement or the registered nurse in general practice12

Theregisterednurseingeneralpracticedemonstratescompetenceintheprovisionoprimary

healthcarecentredonindividualsandgroups,inaccordancewiththeireducationalpreparation,

proessionalnursingstandards,relevantlegislationandgeneralpracticecontextinanenvironmentcharacterisedbyunpredictabilityandindividualdiversityacrosstheliespan.

Whiletheroleotheregisterednurseingeneralpracticevariesaccordingtothepopulation

proleothegeneralpractice,thegeneralpracticestructure,andemploymentarrangements,the

registerednurseprovidesacombinationodirectclinicalcareandmanagementoclinicalcare

systemsinanenvironmentwhichisotenisolatedromothernurses.Thisrequiresthats/heworks

collaborativelywithothers,internalandexternaltothegeneralpractice,topromotehealthcare

centredonindividualsandgroups.

Insomegeneralpractices,theregisterednurseautonomouslyconductsclinics,healthassessmentsandchronicdiseasemanagementprogramsaswellascollaboratingwithgeneral

practitionersandothermembersothemultidisciplinaryhealthcareteamasdeterminedbythe

needsoindividualsandgroups,andtheregisterednursesscopeopracticeandemployment

arrangement.Theregisterednursemayundertaketheirnursingrolebothwithinandexternal

tothegeneralpractice,conductingassessmentsandhealthvisitsinthehomeand/oranother

communitysetting.

Therelationshipsbetweennursesingeneralpracticeandtheindividuals/groupsrequiringnursing

careusuallyextendsbeyondsingleepisodesocaretomeetingchanginghealthcareneedsand

prioritiesacrosstheliespan.

Theregisterednurseplaysapivotalroleinhealthpromotion,healthmaintenanceandprevention

oillnessthroughprovisionoevidencebasedinormationandeducationtoindividuals,groups

andcommunities.Thisrequiresabroadknowledgeoresourcesavailablewithinthecommunity

andhealthcaresectorstoacilitatecaretoindividuals/groupsandtheskillstocommunicateand

educate.

Theregisterednurseingeneralpracticealsorequireshighlydevelopedinormationliteracy,

managementandcoordinationskillstoenablethedevelopmentandmanagementosystemsthat

ensuresaetyandquality.Thisincludesrecall,inectioncontrolandqualityimprovementsystems.

Allnurseshavearesponsibilitytoknowandpractisewithintheirscopeopracticerelevantto

theireducationandqualications.

12PreparedaspartothecompetencystandardsprojectbytheUniversityoSouthAustraliaprojectteam


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Registerednursesingeneralpracticehavearesponsibilitytoseekoutandengageinongoing

educationandproessionaldevelopmenttomaintainthecompetenciesthatarespecicto

nursingingeneralpracticesettings.

Someregisterednursesingeneralpracticewillbeworkingatanadvancedlevelandtheadvanced

registerednursemighttypicallybedescribedas:

beingpreparedorevidencebasedpracticethroughpostregistrationqualications/

education;

anactivememberothenursingproession;

acceptingresponsibilityorcomplexsituationswhichmayencompassclinical,managerial,

educationalorresearchcontexts;

demonstratingleadershipandinitiatingchange;

practisingcomprehensivelyasaninterdependentteammember;

practisingoutsideosinglecontextsorepisodesocare;

havingparticularbreadthordepthoexperienceandknowledge;

ocusedonoutcomesorindividualsandgroups.


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3.3Demonstratespro

fciencyintheuseo

inormationmanagem

enttechnologyandsystems

toinormc

linicalcare

management.

Examplesmayinclude:

Understandsthe

unding,billingandbusiness

systemsusedinth

egeneralpractice;

Participatesinpracticeaccreditationprocesses;

Updatespracticeandclinicalpoliciesand

procedures.

3.4Managesresource

stopromoteoptimalclient

care.

Examplesmayinclude:

Understandspublicandprivatehealthcareservices;

Maintainsclinicaldataentryandretrieval;

Develops/maintain

sclinicalreports;

UnderstandstheimplicationsoHealthInsurance

Commissioninormationorcareoutcomesor

individualsandgroups.

3.Collectsinormationaboutpracticepopulation

proflestoinormhea

lthpromotionandillness

preventionstrategies.

Examplesmayinclude:

Develops/maintain

sclinicalreports;

Compilesstatisticstocontributetolocalpopulation

healthproles.

Collaborativepractice

Registerednursesingen

eralpracticebuildandengage

inabroadrangeocollaborativeandnegotiated

relationshipswithindividuals,groups,thegeneral

practiceteamandotherprimaryhealthcareandservice

providerstoachievepositiveoutcomesorindividualand

groups.

Competencystandard11

Actsasamentorandrolemodelornurses

andother

healthproessionals.

Theadvancedregisterednurse:

Recognisesthenecessityormutualre

specto

colleaguesintheworkplaceandproe

ssion;

Makestimeavailabletolistentocolleagues

proessionalconcernsandrequests;

Providesadviceandconstructivecriticismwhere

appropriate.


Contributestodevelopmentonursingknowledge,

standardsandresourcesthroughactiveparticipationat

thebroaderproessionallevel.


Participatesinorganisationaland/orp

roessional

committees,boards,workingpartiesororums;

Contributestowrittensubmissionsab

out

organisationalorproessionalissues.


Facilitateseducationoindividualsandgrou

ps,students,

nursesandothermembersothehealthcareteam.


Sharesinormationandideas;

Takesonateachingroleorlessexperiencedsta.


Actsasaresourceorothernursesandmem

bersothe

healthcareteam


Ensuresresearchndingsaredissemin

atedto

colleagues;

Sharesadepthoknowledgegainedthrough

continuingeducationandnursingexp

eriences.


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4.1Ensuresclinicalnu

rsingdecisionsare

communicatedtothe

generalpracticeteam.

Examplesmayinclude:

Appropriatelyree

rsclientstogeneralpractitioners;

Collaborateswith

generalpractitionerstodevelop

guidelinesandpro

tocols;

Isactivelyinvolved

incommunitymeetings,case

conerencesandc

areplanning.

4.2Participatesinsha

reddecisionmakingabout

caredeliverywithind

ividuals,groupsandmembers

othegeneralpracticeteam.

Examplesmayinclude:

Attendsandcontributestopracticemeetings;

Addressessaetya

ndqualityissuesorindividuals,

groups,andother

sworkinginthegeneralpractice.

4.3Recogniseswhentoseekadviceromo

ther

membersothegeneralpracticeteamorother

healthserviceprovide

rsaboutthecareo

individualsandgroup

s.

Examplesmayinclude:

Seeksadvicewhentheneedsoindividualsand

groupsarebeyondownabilitiesandeducation;

Understandsther

olesothealliedhealthcare

team;

Understandsther

olesocommunityagenciesand

serviceproviders.

Continuedover

Competencystandard1

Providesnursingasaresourcetoothersthroughtheir

capacitytopracticeoutsidesinglecontextsandepisodes

opractice.


Facilitatescare/supportgroupsorindividualsand

groups;

Answersinquiriesaboutcurrentpracticeinareao

expertise.


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4.4Sharesinormatio

nwiththegeneralpractice

team.

Examplesmayinclude:

Communicatesne

w

inormationandresearch

evidence;

Communicatestestresults;

Accuratelydocum

entstheprovisiononursing

care.

4.Monitorslocal,co

mmunityandpopulation

healthdevelopments

andresourcesorintegration

intothecareoindividualsandgroups.

Examplesmayinclude:

Staysinormedo

localinectiousdiseases

outbreaks;

Sharesinormationwithrelevantcommunity

groupsinconjunc

tionwithpublichealthservices

(egprimaryschoo

ls);

Incorporatescurre

ntclinicalguidelinesinto

practice.

4.Liaiseswithreleva

ntcommunityandhealthcare

agenciesorcommun

itydevelopmentpurposesand

toacilitatecontinuityocareorindividualsand

groupsinthatcommu

nity.

Examplesmayinclude:

Liaiseswithhealth

careservicesandproviders;

Developspartners

hipswithotherhealthservices

whereindividuals

andgroupsarereerred;

Managesinternal

andexternalreerralprocesses

andprocedures.


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Competency standards for

enrolled nurses in generalpractice

4.1 Overview

EnrollednursesingeneralpracticemustmeettheAustralianNursingandMidwieryCouncilsnational

competencystandardsorenrollednurses.Inadditiontheyshouldmeetthecompetencystandards

preparedbythenursingproessionorenrollednursesingeneralpractice.

Enrollednursesingeneralpracticemustbeawareothesupervisoryarrangementsthatneedtobe

inplaceandtheirresponsibilitieswhennursingcareisdelegatedtothem.Thisinormationcanbe

obtainedromthenurseregulatoryauthorityinthestateorterritoryinwhichthenurseinworking.14

4.

14Reertothelistoresourcesinsection5orcontactdetailsorthenurseregulatoryauthorities


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4.2 Role statement or the enrolled nurse in general practice15

Nursesingeneralpracticedemonstratecompetenceintheprovisionoprimaryhealthcare

centredonindividualsandgroups,inaccordancewiththeireducationalpreparation,proessional

nursingstandards,relevantlegislationandpracticecontextinanenvironmentcharacterisedbyunpredictabilityandindividualdiversityacrosstheliespan.

Whiletheroleothenursevariesaccordingtothepracticeclientpopulation,practicestructure,

employmentarrangementandcategoryonurse,mostnursesprovideacombinationodirect

clinicalcareandmanageclinicalcaresystemsinanenvironmentwhichisotenisolatedrom

othernurses.Thisrequiresthatthenursepromoteshealthcarecentredonindividualsandgroups

byworkingcollaborativelywithothersbothinandoutsidethegeneralpractice.

Theenrollednurseislegallyrequiredtobesupervisedbyaregisterednurseandisaccountable

andresponsibleorallaspectsodelegatedcare16.

Therelationshipbetweennursesingeneralpracticeandindividuals/groupsusuallyextends

beyondsingleepisodesocaretomeetingchanginghealthcareneedsandprioritiesacrossthe

liespan.

Bothregisteredandenrollednursesplayapivotalroleinhealthpromotion,healthmaintenance

andpreventionoillnessthroughprovisionoevidencebasedinormationandeducationto

individuals,groupsandcommunities.Thisrequiresknowledgeoresourcesavailablewithinthe

communityandhealthcaresectorstoacilitatecareorindividualsandgroupsandtheskillsto

communicateandeducate.

Allnursesingeneralpracticeneedcomputerliteracyskills.Enrollednursesneedtobeabletouse

andmaintainrecall,inectioncontrolandqualityimprovementsystems.

Allnurseshavearesponsibilitytoknowandpractisewithintheirscopeopracticerelevant

totheireducationandqualications.Theenrollednurseingeneralpracticecanassume

responsibilitiesaccordingtotheireducation,experienceandtheavailabilityoregisterednurse

supervision.

Allnursesingeneralpracticehavearesponsibilitytoseekoutandengageinongoingeducationandproessionaldevelopmenttomaintainthecompetenciesthatarespecictonursingin

generalpracticesettings.

15PreparedaspartotheprojectbytheUniversityoSouthAustraliaprojectteam

16NotethatinSouthAustralia,enrollednursescanapplytothenurseregulatoryauthorityorauthorisationtoworkwithoutthesupervisionoaregisterednurse


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Recognisesthatcommunica

tionoinormationsuchastestresultsmay

impacton

thewellbeingoindividuals

andgroups;

Recognisesthatthecompre

hensionoindividualsandgroupsmayvary

withhealth

conditionandwellbeing.

2.Liaiseswiththeregistered

nurseandgeneralpractitionerinprovid

ing

evidence-basedhealthpromot

ionandillnessmanagementinormationto

individuals,groupsandtheiramilies.

Examplesmayinclude:

Recognisestheneedtoprovideinormationtoimproveormaintainhea

lth;

Usesresourcesavailablewithinthepracticetomeettheneedsoindivid

ualsand

groups;

Providesinormationandresourcesaccordingtotheneedsoindividualsandgroups;

Contributestothereviewandupdateoinormationresourcesorindiv

idualsand

groups.

Managementoclinicalcaresystems

Enrollednursesingeneralpractice

administerandmaintainthesystemsandp

rocesses

whichassistindividuals,groupsan

dthegeneralpracticeteamtoanticipateandmanage

healthcareinterventionsandpotentialriskstoacilitatequalityclientoutcomes.

3.1Usesrelevantguidelines,protocolsandsystemsasevidenceorpractice.

Examplesmayinclude:

Usesguidelines,protocolso

rtemplatesdevelopedbyregisterednurses/general

practitioners;

Collaborateswithregistered

nursesandgeneralpractitionersindevelop

mentand

review

oguidelinesandpro

tocols.

3.2Maintainsprograms,regist

ersandsystemstoensureappropriatec

linicalcare

provision.

Examplesmayinclude:

Understandstheunding,billingandbusinesssystemsingeneralpractice;

Understandstheimportanceanduseorecallregisters,pathologysystemsand

documentationsystemstoa

ssistinthecareoindividualsandgroups;

Usesguidelines,protocolso

rtemplatesdevelopedbythegeneralpracticeteam;

Participatesinqualityimprovementandgeneralpracticeaccreditationp

rocesses;


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Updatesgeneralpracticeregistersocommunityresourcesandhealthservice

personnel.

3.3Managesresourcestoprom

oteoptimalcareorindividualsandgroups.

Examplesmayinclude:

Managesstocksandstores;

Monitorscoldchainsystems;

Managessterilisationproceduresandmaintainsstandards;

Documentstocomplywithstandardssuchasthoserequiredorcoldch

ainand

sterilisationsystems.

3.4Demonstratesprofciencyintheuseoinormationmanagementt

echnology

andsystemstoinormc

linicalcaremanagement.

Examplesmayinclude:

Eectivelyusesadministrativesystemsdesignedtoassistwiththecareo

individuals

andgroups;

Maintainsclinicaldatasystemsincludingentryandretrievalprocesses.

Collaborativepractice

Enrollednursesingeneralpractice

buildandengageinabroadrangeocolla

borativeand

negotiatedrelationshipswithindividuals,groups,thegeneralpracticeteamandother

primaryhealthcareandservicepr

oviderstoachievepositiveoutcomesorind

ividualsand

groups.

4.1.Consultswiththeregisterednurseandgeneralpracticeteaminm

aking

clinicaldecisions.

Examplesmayinclude:

Appropriatelyreersclientstoaregisterednurseorgeneralpractitioner;

Collaborateswithregistered

nursesorgeneralpractitionerstodevelopguidelines

andprotocols.

4.2Participatesinshareddecis

ionmakingaboutcaredeliverywithind

ividuals,

groupsandmembersothege

neralpracticeteam.

Examplesmayinclude:

Attendsandcontributestogeneralpracticemeetings.


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4.3Recogniseswhentoseekadviceromt

heregisterednurseandgen

eral

practitioneraboutthecareoindividualsandgroups.

Examplesmayinclude:

Seeksadvicewhentheneed

soindividualsandgroupsarebeyondown

abilitiesand

education;

Understandstherolesothealliedhealthcareteam;

Understandstherolesocommunityagenciesandserviceproviders.

4.4Sharesinormationwithth

egeneralpracticeteam.

Examplesmayinclude:

Seeksoutandevaluatesinormationandresources;

Advisesothersaboutenrolle

dnursesscopeopractice;

Seeksconstructiveeedback

aboutperormance;

Accuratelydocumentscareprovision.

4.Liaiseswithrelevantcomm

unityandhealthcareagenciestoacilit

ate

continuityocareorindividua

lsandgroups.

Examplesopracticemayinclude:

Isawareolocalreerralpro

cessesandprocedures;

Contributestothedevelopm

entopartnershipswithotherhealthserviceswhere

individualsandgroupsarereerred;

Undertakesdelegatedreerralactivities.


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Resources

Specialist nursing competency standards

Title Contactdetails

Addressdetails

StandardsopracticeormentalhealthnursinginAustralia,1995

AustralianandNewZealandCollegeoMentalHealthNurses

POBox126GreenacresSA5086F:0298072602E:[email protected]:www.anzcmhn.org

Competencystandardsoroccupationalhealthnurses

AustralianCollegeoOccupationalHealthNurses

POBox1205TullamarineVIC3043T:0393352577F:0393353454E:[email protected]:www.acohn.com.au

Nationalstandardsopracticeordiabeteseducators,2003

AustralianDiabetesEducatorsAssociation

POBox3570WestonACT2611T:0262874822F:0262874877E:[email protected]:www.adea.com.au

Competencystandardsorthespecialistpaediatricandchildhealthnurse,2000

AustralianConederationoMaternalandChildHealthNurses

POBox184MidlandWA6936

Competencystandardsorthecommunityhealthnurse

AustralianCounciloCommunityNursingServices

31AlmaRoadStKildaVIC3182E.accns@bigpond.com.auT.0395365379F.0395370287

Competencystandardsorcontinencenurseadvisers,2000

ContinenceFoundationoAustralia(VICBranch)

C/-StGeorgesHealthService283CothamRoadKewVIC3101T:0398168266F:0398168366E:[email protected]:www.continencevictoria.org.au

Competencystandardsortheadvancedgastroenterologynurse,2002

GastroenterologicalNursingCollegeoAustralia

POBox483BoroniaVIC3155T:1300788155F:0398016352E:[email protected]:www.genca.org

5.


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Competencystandardsorremoteareanurses,1999

CounciloRemoteAreaNursesAustralia

PMB203AliceSpringsNT0872T:0889535244F:0889535245E:[email protected]

W:www.crana.org.au

Competencystandardsorgeronticnurses GeriactionInc Suite308.282VictoriaAvenueChatswoodNSW2067T:0294122145F:0294116618E:[email protected]:www.crana.org.au

Advancedcompetencystandardsorsexualandreproductivehealthnurses,2002

AustralianSexualHealthNursesAssociation

328336LiverpoolRoadAsheldNSW2131T:0287524314F:0297165073W:www.ashna.com.au

Other resources

Organisation Contact

Chemotherapyclinicalpracticeguidelines CancerNursesSocietyoAustraliaMedicalFoundationBuildingLevel5,92ParramattaRoadCamperdownNSW2050T:0290363100F:0290363101E:[email protected]:www.cnsa.org.au

TheAustralianImmunisationHandbook

8thEdition,2003

W:http://www1.health.gov.au/immhandbook/

Note.PrintedcopiesotheAustralianImmunisationHandbook8thEdition,2003areavailableromthePublicationspageotheImmuniseAustraliawebsite;immunise.health.gov.au,bycontactingtheImmunisationInolineon1800671811orbyemailinghandbook@health.gov.au.

DepartmentoHealthandAgeing GPOBox9848CanberraACT2601T:0262891555E:[email protected]:www.health.gov.au

MedicareAustralia P:GPOBox9822inyourCapitalCityT:132011E:[email protected]

W:www.medicareaustralia.gov.au

AustralianNursingandMidwieryCouncil POBox873,DicksonACT2602T:0262577960F:0266577955E:[email protected]:www.anmc.org.au


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Nurse regulatory authorities

Austral ianCapitalTerritory POBox976,CivicSquareACT2608T:0262051595F:0262051602

W:www.nursesboard.act.gov.au

NewSouthWales POBoxK599,HaymarketNSW1238T:0292190222F:0292812030E:[email protected]:www.nursesreg.nsw.gov.au

Victoria Level2,595LittleCollinsStreet,MelbourneVIC3000T:0386351200F:0386351248W:www.nbv.org.au

Tasmania POBox847,SandyBayTAS7006T:0362243991

F:0362243995E:[email protected]:www.nursingboardtas.org.au

Queensland GPOBox2928,BrisbaneQLD4001T:0732235111F:0732235115W:www.qnc.gld.gov.au

NorthernTerritory GPOBox4221,DarwinNT0801T:0889994157F:0889994196E:[email protected]:www.nbwa.org.au

WesternAustralia LockedBag6,EastPerthWA6892T:0894211100F:0894211022W:www.nursesboard.sa.gov.au

SouthAustralia POBox7176,HuttStreet,AdelaideSA5000T:0882239700F:0882239707W:www.nursesboard.sa.gov.au


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Nursing organisations

AustralianNursingFederation POBox4239,KingstonACT2604T:0262326533F:0262326610

E:[email protected]:www.an.org.au

AustralianPracticeNursesAssociation Level1,595LittleCollinsStreet,MelbourneVIC3000T:0396147777F:0396147776E:[email protected]:www.apna.asn.au

TheCollegeoNursing(incorporatingtheNSWCollegeoNursing)

LockedBag3030,BurwoodNSW1805T:0297457500F:0297457502W:www.nursing.aust.edu.au

RoyalCollegeoNursingAustralia POBox219,DeakinWestACT2600

T:0262833400F:0262823565E:[email protected]:www.rcna.org.au

Medical organisations

AustralianDivisionsoGeneralPractice

POBox4308,ManukaACT2603T:0262280800F:0262280899E:[email protected]:www.adgp.com.au

RoyalAustralianCollegeoGeneralPractitioners 1PalmerstonCrescent,SouthMelbourneVIC3205T:03861990414F:0386990400E:[email protected]:www.racgp.org.au

RuralDoctorsAssociationoAustralia POBox5361,KingstonACT2604T:0262739303F:0262739308W:www.rdaa.com.au


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Notes


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Notes


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Notes


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Notes


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