SUMMARY - Safe Medications Management project: Key issues and ...

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The Health Practitioner Regulation National Law referred to as The National Law has established anational scheme for the regulation of health practitioners and students undertaking programs ofstudy leading to registration as a health practitioner. It applied initially to 10 health professionalgroups from 1st July 2010.It is known as “an applied law” model as the legislative powers are with the states/territories.Queensland has initially enacted the National Law. All of the other states/territories are enactinglegislation to adopt and apply the National Law as a law of their own jurisdiction.The Commonwealth does not apply the National Law, but needs to make consequentialamendments to Commonwealth laws to ensure effective interface between the various agenciesand the national scheme.This Act will be reviewed by jurisdiction under the next section on the States and TerritoriesLegislation.2.1.2. States and Territories LegislationEvery jurisdiction, except Queensland, has a specific Act relating to medicines, poisons, drugs orcontrolled substances with corresponding Regulations. Queensland utilizes the Queensland HealthAct 1937 as its overarching Act and has specific drugs and poisons Regulations to spell out thedetail.The relevant Acts and Regulations have been reviewed for each State and Territory for theelements that are relevant to this project. Specific definitions relating to the health professionsare identified in the legislation and the steps in medication management, which relate to”prescribing, supplying, dispensing and administering”, are noted.A Summary Jurisdictional Table of the Acts and Regulations pertaining to medicines, drugs andpoisons and the Acts relating to Health Professionals are available in Appendix A. A jurisdictionalcomparative table relating to the elements of Medication Management is available in Appendix B.Detailed tables for each jurisdictional legislation can be found in Appendix C to J.2.1.2.1. Australian Capital TerritoryThe ACT Medicines, Poisons and Therapeutic Goods Act and Regulations 2008, (effective21/12/2010), and the most recent legislation amongst the jurisdictions.The Act and the Regulations refer to Health Professionals as defined in the Health PractitionerRegulations National Law (ACT) and the Health Professionals Act 2004 and defines a residentialaged care facility in accordance with the Aged Care Act 1997.The majority of detail is left to the Regulation to specify who can do what. The terminology of“doctor” is used rather than medical practitioner, with nurse practitioner, nurse, enrolled nurseand pharmacist identified with each role qualified viz.:“to the extent necessary to practice(medicine, nursing, pharmacy) and, if employed, within the scope of employment”.Of note is that:An Enrolled Nurse, under Schedule 1 Part 1.6, can obtain, possess and administermedicines.12
Directors of Nursing and Medical Superintendents for a RACF (Residential Aged CareFacility) under Schedule 1 Part 1.11 have particular activities relating to emergencyadministration of medicines.Assistants under Part 5.2 can administer medicines to an “assisted person” under specificconditions.The Health Practitioner Regulation National Law (ACT) effective 01/07/2010 refers to a healthpractitioner’s authorisation under the Act.2.1.2.2. New South WalesThe NSW Poisons and Therapeutic Goods Act 1966 (effective 1/07/2010), under Part 1.4specifically defines a nurse practitioner as per the Health Practitioner Regulation National Law andunder Part 3 s17A (1) details as a person authorised to possess, use, supply, prescribe a poison,restricted substance or drug of addiction. The Act also refers to a Nurse Practitioner beingauthorised in writing by the Director General to possess, use, supply or prescribe. Carers areidentified in the Act with regard to the possession and supply of drugs of addiction by carers whoare caring or assisting in the care of another.The Poisons and Therapeutic Good Regulation 2008 effective (27/08/2010) under Part 1 s3defines an authorised practitioner as a medical practitioner or a nurse. In Part 2 Div 3 it details thata Medical Practitioner can issue a prescription for a restricted substance and a nurse practitionercan only supply a restricted substance in the course of practising as a nurse practitioner.Of note is the reference to a Code of conduct for unregistered health practitioners referred to inthe Public Health Act 1991 and cross-referenced to the Health Care Complaints Act 1993.Under the Health Practitioner Regulation Act 2009 – Health Practitioner Regulation National Law(NSW) effective 27/08/2010 there is specific reference to a nurse practitioner as being qualified topractice as a nurse practitioner.2.1.2.3. Northern TerritoryThe Northern Territory Poisons and Dangerous Drugs Act (effective 07/07/2010) provides themajority of authority as to legislative roles and activities. Part 1 S6 defines medical practitioner asone who practices in the NT and a nurse and pharmacist as registered under the HealthPractitioners Regulation National Law.Under the Act Parts V and VA special reference is made to remote area nurses and aboriginalhealth workers to supply medicines and it notes that “there is no applicable legislation regardingthe practice of Enrolled Nurses in this regard”.The Act defines supply as including prescribe, administer and having in possession for the purposeof supply, prescription and administration. It makes specific reference under the Act to Aboriginalhealth worker with the right of practice under the Health Practitioners Act of the NT to possessand supply a Schedule 1, 2, 3, and 4 substance.There is nothing specific in the Poisons and Dangerous Drugs Regulations effective (01/07/2010)relevant to this project.The Health Practitioner Regulation National Law (NT) Act 2010 effective 02/07/2010 adopts theQueensland Health Practitioner Regulation National Law Act 2009.13
Page 1 and 2: The findings summarised in this doc
Page 3 and 4: Inconsistencies in achieving and ma
Page 5 and 6: Table 3: List of BarriersBarrier It
Page 7 and 8: It was apparent that some responden
Page 9 and 10: 2. Literature review of key documen
Page 11: The Therapeutic Goods Administratio
Page 15 and 16: Regulation 31I (2) refers to a “d
Page 17 and 18: The Health Practitioner Regulation
Page 19 and 20: management. These Guidelines have t
Page 21 and 22: The Centre for Policy on Ageing (UK
Page 23 and 24: Department of Health and Ageing doc
Page 25 and 26: a Workforce Framework which outline
Page 27 and 28: Longer-term work on establishing co
Page 29 and 30: Roundtable Discussion:Key issues id
Page 31 and 32: There is a need to establish whethe
Page 33: 8. SummaryA better medication syste

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