Nurse practitioners
It was envisaged that the introduction of an NP model
of care would provide increased opportunities to
improve the disease treatment processes, target
lifestyle factors associated with hepatitis C and
increase the range of health settings for treatment
and prevention of the disease.
To ensure the success of the hepatology nurse
practitioner (HNP) role in the Liver Service at Royal
Perth Hospital (RPH), the incumbent was expected
to have postgraduate education and demonstrate
competence to practice at a level commensurate
with a nurse practitioner. In 2003, a postgraduate
degree in Clinical Specialisation commenced at the
School of Nursing and Midwifery, Curtin University
of Technology, Perth, WA. This course was approved
by the Nurses Board of Western Australia for
authorisation as a NP. The NP course includes a
clinical internship developed by the Liver Service
specifically for the HNP. In 2004, the current HNP
was awarded this degree in the clinical specialisation
of hepatology and was registered by the NBWA as a
nurse practitioner. The new title of HNP was the first
of its kind in Australia.
Following amendments to various acts and
regulations by the Western Australian Parliament
and Department of Health, a legislative framework
and a code of practice were produced which provided
the foundation for the HNP’s scope of practice. This
scope of practice was subsequently approved by the
Director of Nursing and Head of Liver Service at RPH.
A key part of the legal framework is that the HNP
must work within the approved clinical protocols that
guide the HNP’s scope of practice in the designated
area of the Liver Service.
The expanded scope of practice for nurse practitioner
includes:
• prescription of Schedule 1 and 4 medications
(as defined in the clinical protocols);
• Performance of advanced physical assessment;
• Initiation of routine pathology and diagnostic
tests; and
• Referrals to other members of the multidisciplinary
team.