Fact sheet: Nurse practitioner standards for practice

The Nursing and Midwifery Board of Australia (NMBA) undertakes functions as set by the Health Practitioner Regulation National Law, as in force in each state and territory (the National Law). The NMBA regulates the practice of nursing and midwifery in Australia, and one of its key roles is to protect the public. The NMBA does this by developing registration standards, professional codes, guidelines and standards for practice which together establish the requirements for the professional and safe practice of nurses and midwives in Australia.

NPs are required to practise within the relevant NMBA approved standards, codes, guidelines – including the Safety and quality guidelines for nurse practitioners, and frameworks.

The following questions answer common queries about the revised Nurse practitioner standards for practice (2021) (the standards).

The standards set the expectations, responsibilities and accountabilities for NPs. They build on and expand upon the registered nurse (RN) standards for practice. The standards are used to:

  • communicate to the general public, employers and other stakeholders the standards that can be expected of NPs
  • set the expectations of NPs in all contexts of practice
  • determine the eligibility for those seeking endorsement as an NP
  • determine the eligibility for those seeking endorsement as an NP who have completed courses overseas, and
  • assess NPs who need to show that they are competent to practise at the NP level.

These standards replace the Nurse practitioner standards for practice (2014).

The standards have been developed following:

  • an exploration of literature and regulatory guidelines
  • an analysis of the 2014 standards for practice, and
  • consultation with key stakeholder groups including consumers, education providers, NPs, nurses and midwives.

The Nurse practitioner standards for practice (2021):

  • comprise of four domains
    • clinical
    • education
    • research, and
    • leadership
  • include four clinical standards that are integrated across the domains, each standard has criteria that specify how the standard is demonstrated, are indicative of NP behaviours, are not exhaustive and are example of activities that demonstrate the statement for that standard
  • are for all NPs across all areas of practice
  • are designed to be read in conjunction with NMBA standards, codes and guidelines
  • have an expanded glossary to understanding how key terms are used in the standards
  • are aligned in their presentation to the Registered nurse standards for practice and the Midwife standards for practice specifically:
    • the heading of ‘cues’ has been replaced with a lead statement of ‘the nurse practitioner’ to clearly identify the criteria by which the standard is demonstrated by an NP
    • the practice expectations (previously known as cues) are numbered
    • lead statements are included under each standard
  • include culturally safe and respectful practice and the importance of Aboriginal and Torres Strait Islander people’s healthcare.

Standard 4 describes the advanced practice activities and functions of NPs under the new heading ‘supports health systems’. This clinical domain is linked to the advanced practice activities and principles of ‘support of systems’ which is a contemporary feature of advanced practice. The definition of ‘supports health systems’ and ‘support of systems’ is provided in the glossary.

The NMBAs definition of advanced practice applies to all nurse practitioners endorsed in Australia as part of their professional requirements. It is the definition used in the regulation of nursing in Australia and meets the broader needs of the registered nursing and midwifery professions, and the regulation of nurse practitioners.

The NMBAs definition of advanced practice is embedded and communicated across multiple NMBA publications. The NMBA definition guides the application of the National Law for:

  • advanced practice requirements for registered nurses seeking to apply for registration as an NP
  • NPs ongoing advanced practice requirements as reflected in the Nurse practitioner standards for practice
  • registration renewal as an NP to meet recency of practice at an advanced practice level, and
  • requirements of programs of study that lead to endorsement as a nurse practitioner.

You may see other advanced practice definitions use by national and international professional nursing organisations. These definitions are commonly linked to a tertiary level qualification to enable advanced practice and/or relate to a position title.

The following definitions are taken from the glossary of the standards and relate to the use of these terms in the standards.

Advanced practice is where nurses incorporate professional leadership, education, research and support of systems into their practice. Their practice includes relevant expertise, critical thinking, complex decision-making, autonomous practice and is effective and safe. They work within a generalist or specialist context and they are responsible and accountable in managing people who have complex healthcare requirements.

Advanced practice in nursing is demonstrated by a level of practice and not by a job title or level of remuneration.

Advanced practice for the purpose of the nurse practitioner endorsement requires 5,000 hours clinically-based advanced practice in the past six years.

Independence in these standards is the defining characteristic of NP practice that recognises the educational and advanced practice attributes beyond the Registered nurse standards for practice. This independence is inherent in the NP standards for practice and integrates aspects of the often-complex nursing practice for which the NP initiates and is responsible. NPs work collaboratively as part of a healthcare team and have the authority to diagnose and implement treatments without oversight from another health practitioner.

Nurse practitioner (NP) is a registered nurse endorsed as an NP by the NMBA. The NP practices at a clinical advanced level, meets and complies with the Nurse practitioner standards for practice, is able to practice independently and has direct clinical contact. NPs practice collaboratively in multi-professional environments. The NP practices within their scope under the legislatively protected title ‘nurse practitioner’ under the National Law.

Supports health systems is a clinical domain in the NP standards framework and describes the advanced practice activities and functions of NPs as described in ‘support of system’s (see below).

Support of systems is a practice domain of the Strong Model of Advanced Practice and is a contemporary feature of advanced practice. It is described as activities that promote quality and safe patient care and facilitate the optimal progression of patients through the healthcare system. NPs demonstrate the advanced practice activities in this domain that include:

  • actively participate in the assessment, development, implementation, and evaluation of quality improvement programs in collaboration with healthcare teams
  • provide clinical leadership in the development, implementation, and evaluation of standards of practice, policies and procedures
  • serve as a mentor
  • advocate the role of the nurse, and
  • serve as a spokesperson for nursing and the health system when interacting with other professionals, patients, families, and the public.
 
 
 
Page reviewed 16/03/2021