2.4 How to determine the roles for the
practice nurse
‘Nurses are key members of general practice teams and play
a pivotal role in maintaining quality and safety systems in
the practice.
The actual scope of an individual nurse’s practice is influenced
by the:
• changes and differences in the context in which they practice
• patient health needs
• level of competence, education and qualifications of the
individual nurse
• practice policy, quality and risk management framework.5
To identify the roles a nurse will undertake in your practice
you will need to consider the particular circumstances of the
practice, the practice population and the skills and experience
of the nurse/s employed. To develop selection criteria for the
nurse position in your practice a template has been included for
assistance. Templates are appended at part 2.11 of this ‘For the
employer’ section of the resource.
Common practice nurse roles
The following is not an exhaustive list but is designed to provide an indication of some of the common duties and roles
undertaken by nurses in general practice.6
Immunisation
• administers vaccines according to NHMRC schedule (accreditation required in some states)
• maintains patients immunisation records
• completes ACIR recording requirements
• checks monthly ACIR statements to follow up
incomplete payments
• follows up GPII020A report quarterly
• orders vaccines
• maintains vaccine fridge according to NHMRC
recommendations
• completes daily vaccine fridge monitoring
• maintains vaccine recall system for children under 7
years of age
• maintains flu and pneumococcal vaccine recall system
for over 65s
• completes annual flu acquittal form
• maintains practice immunisation rate above 90%.
Health Assessments
• maintains over 75s recall system
• undertakes information collection component of health
assessment
• documents health assessments on computer or as
determined
• arranges GP appointment with patient to complete health
assessment
• ensures Health Assessment Medicare item number claimed.
GP Management Plans
• identifies appropriate patient/s
• maintains a recall system for GP Management Plans (GPMPs) and Team Care Arrangements (TC As)
• participates in preparation of GPMPs and TC As
• can fulfill the role as a ‘‘counted member’’ of the GPMP/TCA
where the practice nurse is independently providing ongoing
treatment or
• services to the patient
• ensures GPMP/TC A Medicare item numbers claimed.
Diabetes
• compiles database of all patients with diabetes
• ensures each diabetes patient record has annual cycle of
care documentation
• maintains diabetes recall system
• transfers diabetes pathology results to recall list
• undertakes diabetes education as deemed appropriate
• undertakes diabetes foot assessments
• ensures patient has a full eye examination at least every
two years
• undertakes blood pressure, height, weight and calculates BMI
• undertakes BGLs as when appropriate
• takes bloods for Hb A1c, cholesterol, triglycerides &
HDL monitoring
• ensures micro albuminuria check attended
• checks smoking status
• establishes Diabetes Clinic
• maintains Diabetes Education Centre (DEC ) patient
record card
• refers patients with diabetes when appropriate eg. podiatry
services and diabetes centre
• ensures Diabetes Cycle of Care Medicare item number
claimed when completed
• ensures practice’s diabetes care rates meet requirements for
PIP Outcome Payment.
Asthma
• develops practice asthma register
• investigates and orders resources
• undertakes spirometry as deemed appropriate
• checks smoking status
• develops individual patient asthma action plans in
conjunction with GP
• provides asthma education to patients
• maintains contractual recall systems for patients undertaking
the Asthma Cycle of Care
• encourages self-monitoring — demonstrates how to
perform peak flow expiratory flow rate and maintains a
symptoms/peak flow diary
• ensures Asthma Cycle of Care Medicare item number
claimed when completed.
Cervical screening
• maintains cervical screening recall register
• undertakes pap smears, pelvic examinations and breast
awareness education (note: check nurse has undertaken
accredited training
• required to perform this role, and check your indemnity coverage.)
• develops and maintains practice cervical screening
pathology follow up register
• ensures adequate sampling of squamous columnar junction
• ensures Cervical screening Medicare item number claimed
when completed
• ensures practice’s cervical screening rates meet requirement
for PIP Outcome Payment.
Venipuncture
• undertakes blood collection
• develops systems for the collection of blood by
pathology service
• maintains blood collection register
• follows up blood collection results on a weekly basis.
Minor procedures/wound care
• maintains minor procedures appointment system
• prepares patient for minor procedure
• prepares consulting room/s for minor procedures
• removes sutures and surgical clips
• assesses and attends to wound care.
Antenatal care
• maintains antenatal register
• maintains birth register
• investigates and orders resources
• undertakes urinalysis, weight, BP, foetal hearts,
• foetal lie & presentation as deemed appropriate (note:
check nurse has undertaken accredited training required to
perform this role)
• provides antenatal education (note: check nurse has
undertaken accredited training required to perform this role).
Accreditation
• develops protocols and procedures relevant to nursing
duties to ensure safety and quality of care
• attends practice clinical meetings
• is responsible for infection control within the practice
• maintains appropriate waste disposal and waste
collection requirements
• maintains appropriate sharps disposal and sharps
collection requirements
• provides education to staff regarding infection control and
cleaning requirements.
Sterilisation of instruments
• ensures that all used instruments are cleaned according to
the RACGP guidelines
• ensures that the practice has a designated ‘dirty’ basin
• develops and maintains sterilisation protocol for the practice
• records all batches of sterilised instruments in a designated
’Sterilisation Book’ according to RACGP guidelines
• ensures the steriliser meets all of the AS 4187 requirements
• ensures batch numbers are recorded in patient records
• arranges annually for the steriliser to be calibrated
& validated
• ensures all sterilised stock is rotated and
stored appropriately
• orders and replaces protective equipment as required
• maintains spills kit.
General duties
• triages patients on arrival to practice
• maintains and rotates medication supplies on a
fortnightly basis
• maintains practice S8 drug register/s
• gives injections
• undertakes EC Gs
• undertakes urinalysis
• restocks medical supplies in consulting rooms
• syringes ears
• maintains cryotherapy equipment
• orders nitrous oxide and O2 as required
• completes health summary documents on all new patients
and maintains existing records
• undertakes audiometry as deemed appropriate
• checks and restocks emergency equipment weekly or
after use
• conducts spirometry testing
• performs continence assessments, education and referral
• undertakes medicals for diving, Centrelink, Workcover as
deemed appropriate by the GP
• undertakes ‘eye washing’ as necessary
• assists with plastering and removal of plasters.
|
