Registered nurse prescribing in community health

The Associate Health Minister Hon Jenny Salesa has announced today a managed roll out of limited nurse prescribing of contraceptives and some short-term antibiotics for common conditions.

The Nursing Council, in partnership with Counties Manukau Health and Family Planning New Zealand, completed a trial and evaluation of a workplace-based education programme to prepare
registered nurses prescribing in community settings such as primary health care, schools, public health and sexual health.

Nurses completed a work-based education programme and supervision before applying to prescribe from a small list of common medicines rather than use standing orders or ask a doctor to sign the prescription.

Fifty-six nurses participated in the trial. These nurses were from Family Planning clinics around the country, as well as practice nurses, school nurses and public health nurses in Counties Manukau.

All nurses were authorised to prescribe by November 2017.

Their prescribing practice was evaluated for a minimum of three months. The evaluation concluded that:

  • registered nurses prescribed safely using treatment guidelines. 

  • nurse prescribing increased patient accessibility to medicines, decreased patients’ out-of-pocket expenses, and freed up time for doctors to see more patients.

  • nurses had high professional and job satisfaction and felt more valuable to the system.

  • education prepared nurses effectively for prescribing, and after the trial almost all nurses remained highly confident in their prescription abilities. 

  • most nurses felt well supported in clinics when they needed reassurance or help.

Some concerns were expressed about increasing the number of prescribers of antibiotics and Council is aware the benefits must be weighed against the risks for patients who presently have poor access to care.

Registered nurse prescribing in community health supports the New Zealand Health Strategy by enabling registered nurses to fully use their skills and training to provide the right care at the earliest opportunity.
The Council has focused nurse prescribing on areas where people find it difficult to access healthcare and to complement the roles of other health professionals.

More information about the managed roll out of work-based education programme by regional health provider organisations can be found on the Council website.