2019/20 annual summary

Snapshot of the nursing profession

  • 415,433 nurses
    • Up 8.3% from 2018/19
    • 51.8% of all registered health practitioners
    • 29,736 also hold registration in midwifery
  • The number of dual registered nurses and midwives is up 7.3% from last year
  • 1.3% of nurses and midwives identified as Aboriginal and/or Torres Strait Islander
  • Nurses, including dual registered, 88.5% female, 11.5% male
  • Nurse-only registered, 87.8% female; 12.1% male

Age

Age: 4.8% < 25, 25.1% 25-34, 21.2% 35-44, 20.5% 45-54, 20.5% 55-64, 7.5% 65-74, 0.5% > 75

Audit outcomes for nurses and midwives

Audit: 63.8% fully compliant, 4.6% compliant (through education), 8.0% non-compliant, 23.6 % no audit action required

Divisions, dual registration and endorsements

Nurses by division

  • 415,433 total
  • 73,310 enrolled nurses
  • 9,371 enrolled nurses and registered nurses
  • 332,752 registered nurses

Nurses and midwives

  • 29,736 total
  • 110 enrolled nurses and midwives
  • 80 enrolled nurses and registered nurses and midwives
  • 29,546 registered nurses and midwives

Nurses with endorsements

  • 3,306 total
  • 2,069 nurse practitioners
  • 1,237 scheduled medicines

Regulating the nursing profession

Notifications

  • 1,872 notifications lodged with Ahpra
    • 2,266 registered nurses Australia-wide, including HPCA and OHO data, had notifications made about them 
    • 0.5% of the profession 

Sources of notifications

Sources of notifications: 26.5% employer, 26.0% patient, relative or member of the public, 14.9% other practitioner, 6.5% HCE, 3.2% Board’s own motion, 23.0% other

  • 209 immediate actions taken
  • 533 mandatory notifications received 
    • 294 were about professional standards

Most common types of complaint

Most common types of complaint: 23.6% clinical care, 18.9% health impairment, 10.5% behaviour, 8.5% medication, 8.3% offence against other law, 30.1% other

Notifications closed

Notifications closed: 1,624 notifications closed (16.3% conditions imposed on registration or an undertaking accepted, 6.7% received a caution or reprimand, 1.5% registrationsuspended or cancelled, 6.9% referred to another body or retained by a health complaints entity, 68.7% no further action)

Monitoring

  • 1,011 practitioners monitored for health, performance and/or conduct during the year 
  • 1,404 cases being monitored at 30 June: 
    • 80 for conduct
    • 239 for health reasons
    • 130 for performance
    • 197 for prohibited practitioner/student
    • 758 for suitability/eligibility for registration

Criminal offence complaints

  • 82 criminal offence complaints made 
  • 61 about title protection
  • 1 about practice protection
  • 16 about advertising breaches
  • 4 directing or inciting unprofessional conduct/ professional misconduct
  • 81 were closed 

Referrals to an adjudication body

  • 41 matters decided by a tribunal
  • 5 matters decided by a panel
  • 21 appeals by nurses, 4 by dual registered nurses and midwives

Snapshot of the midwifery profession

  • 36,045 midwives
    • Up 7.8% from 2018/19
    • 4.5% of all registered health practitioners
    • 6,309 hold registration as midwife only, 0.8% of all registered health practitioners
  • The number of practitioners who are registered as a midwife only is up 10.2% from last year
  • 1.3% of midwives and nurses identified as Aboriginal and/or Torres Strait Islander
  • Midwives including dual registered 98.5% female; 1.5% male
  • Midwife-only registered 99.7% female; 0.3% male

Age

Age: 2.5% < 25, 17.6% 25-34, 16.3% 35-44, 19.8% 45-54, 30.9% 55-64, 12.1% 65-74, 0.8% > 75

Endorsements

Midwives with endorsements

  • 629 total
  • 1 midwife practitioner 
  • 628 scheduled medicines 

Regulating the midwifery profession

Notifications

  • 85 notifications lodged with Ahpra
    • 122 registered midwives Australia-wide, including HPCA and OHO data, had notifications made about them 
    • 0.3% of the profession 

Sources of notifications

Sources of notifications: 34.1% patient, relative or member of the public, 22.4% employer, 11.8% other practitioner, 10.6% HCE, 5.9% Board’s own motion, 15.3% other

  • 8 immediate actions taken
  • 23 mandatory notifications received 
    • 11 were about professional standards

Most common types of complaint

Most common types of complaint: 58.8% clinical care, 8.2% offence against other law, 7.1% health impairment, 4.7% breach of non-offence provision National Law, 3.5% behaviour, 17.6% other

Notifications closed

Notifications closed: 56 notifications closed (10.7% conditions imposed on registration or an undertaking accepted, 7.1% received a caution or reprimand, 3.6% referred to another body or retained by a health complaints entity, 78.6% no further action)

Monitoring

  • 21 practitioners monitored for health, performance and/or conduct during the year 
  • 31 cases being monitored at 30 June: 
    • 2 for conduct
    • 2 for health reasons
    • 7 for performance
    • 1 for prohibited practitioner/student
    • 19 for suitability/eligibility for registration

Criminal offence complaints

  • 9 criminal offence complaints made 
    • 8 about title protection
    • 1 about advertising breaches
  • 8 were closed 

Referrals to an adjudication body

  • No matters decided by a tribunal
  • No matters decided by a panel
  • No appeals by midwives, 4 by dual registered nurses and midwives

A report from the Chair 

New international assessment 

The Nursing and Midwifery Board of Australia (NMBA) launched its new model of assessment for internationally qualified nurses and midwives (IQNMs) this year. The process includes a self-check tool which enables IQNMs interested in applying for registration in Australia to have their qualifications assessed and receive advice about next steps towards applying for registration. 

IQNMs who proceed to applying for registration have access to an interactive orientation package, including aspects of cultural safety education, to support them working in Australia. The orientation will support IQNMs to transition to the Australian healthcare context. The cultural safety aspects of the package were developed in partnership with the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives. 

Decision-making framework

NMBA’s new Decision-making framework for nursing and midwifery (DMF) took effect in February.

The DMF supports decision-making about nursing or midwifery practice and delegation of nursing or midwifery care. We encourage all nurses and midwives, managers and employers to use the DMF in practice. The DMF is particularly helpful for making decisions in clinical practice about delegation from registered nurses and midwives to enrolled nurses and other health workers. 

We also released DMF summaries for the professions of nursing and midwifery. These one-page summaries guide nurses and midwives step-by-step through making a safe decision in practice.

The DMF was developed from an evidence-based review of the previous National framework for the development of decision-making tools for nursing and midwifery practice.

Engaging students

In May, the NMBA sent its e-newsletter to students of nursing and midwifery for the first time, alongside their registered colleagues who receive the newsletter throughout the year. 

We had previously done qualitative engagement research with students and recent graduates of nursing and midwifery approved programs of study through focus groups across the country in 2018. The aim of this research was to benchmark students’ understanding of their future professional responsibilities and identify areas for improvement in communications between students and new graduates and the NMBA.

The outcomes of this research indicated strong interest from student nurses and midwives for direct communication with their Board, including receiving e-newsletters. New graduates also indicated a desire for further support in their transition from study to complex practice environments. 

We are trialling sending our monthly e-newsletter to nursing and midwifery students for the purpose of directly engaging students with their future professional requirements, supporting their transition to practice and establishing an early positive relationship with the National Scheme. As part of this trial, a new section of the newsletter was developed specifically for students and new graduates. 

We will develop further guidance and support for students and new graduates, to be communicated through the e-newsletter, throughout 2020 and beyond. The NMBA will evaluate the impact of this initiative against the 2018 benchmark. 

Supporting the health system during COVID-19

In April eligible midwives and nurses were added to pandemic sub-register to assist with the health system’s response to COVID-19. At 30 June 2,971 midwives and 21,849 nurses remained on the register.

Supporting the professions during COVID-19

The NMBA is supporting nurses, midwives and employers through the COVID-19 pandemic by adapting its policies and processes, as well as developing new guidance for practitioners. 

Registration renewal

The annual renewal of registration for nurses and midwives fell during the pandemic (April–May). We developed a payment plan to support nurses and midwives who were experiencing financial hardship to be able to renew their registration. 

Continuing professional development

We encouraged nurses and midwives to meet their continuing professional development (CPD) requirements for the 2019/20 registration period and advised that COVID-19 training and research could count towards CPD hours. However, to further support the professions during the pandemic, the NMBA committed to not take action against any nurse or midwife who declared at annual renewal that they had been unable to complete the required CPD hours. 

Other policy/guidance

We also developed specific COVID-19 policy guidance for the professions, including on issues such as scope of practice, education, accreditation and clinical placements. The NMBA and Ahpra worked with government and the Commonwealth and state and territory Chief Nursing and Midwifery Officers to provide coordinated updates to nurses and midwives during the pandemic. 

Pandemic sub-register

To ensure adequate numbers of experienced and qualified health practitioners were available to respond to the COVID-19 pandemic, a pandemic response sub-register was launched by Ahpra and National Boards on 6 April. This sub-register enabled nurses and midwives who had recently been registered with the NMBA to practise in the short-term (for up to 12 months) if they met certain criteria such as being able to get professional indemnity insurance and having no changes to their criminal history since they were last registered.

Registered nurse accreditation standards

In October, the NMBA approved the new Registered nurse accreditation standards, which programs of study must meet to become an NMBA-approved program leading to registration. The new standards were developed and widely consulted on by the NMBA’s independent accrediting authority, the Australian Nursing and Midwifery Accreditation Council (ANMAC). The new standards ensure that future registered nurses have the knowledge, skills and capability to provide safe and effective nursing care.

ANMAC reviews its standards every five years and the review sought to ensure the standards could meet contemporary workforce requirements and emerging trends such as an ageing population, a significant increase in chronic disease and co-morbidities, and the diverse needs of multicultural Australians. Regular critical appraisal of the standards is required to support the next generation of registered nurses to be well equipped to provide healthcare and meet future workforce challenges. The new standards are contemporary, evidence-based and aligned with the NMBA Registered nurse standards for practice

Associate Professor Lynette Cusack, Chair

National Scheme thanks long-term NMBA Chair

The NMBA and Ahpra wish to thank Associate Professor Lynette Cusack for her leadership as Chair of the NMBA for the past six years and as a member since 2009. In that time, Associate Professor Cusack has overseen the development of national standards for Australia’s 400,000-plus nurses and midwives, including leading the NMBA in partnership with the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives to include cultural safety requirements in the NMBA codes of conduct. Lynette finishes her role as Chair in October 2020.

 
 
Page reviewed 12/11/2020