- Rural and isolated practice endorsed registered nurses (RIPERNs) are registered nurses with a scheduled medicines endorsement.
- To be authorised to work as a RIPERN in rural and regional Victoria, registered nurses must complete a study program that has been accredited by the Nursing and Midwifery Board of Australia.
- Nurses with Scheduled Medicines (Rural and Isolated Practice) endorsement may possess and supply specified Schedule 2, 3, or 8 medicines under certain conditions.
Contact Rural and Regional Health for implementation advice
Legislative issues for nurses
- Nurses and midwives - key legislative requirements in Victoria
- Nurse practitioners - key legislative requirements in Victoria
- Authorised registered nurses - rural and isolated practice
Rural and isolated practice
The endorsement authorises Rural and Isolated Practice Endorsed Registered Nurses (RIPERN) to administer or supply a limited range of medicines where there is no, or limited, access to medical practitioners, nurse practitioners, paramedics or pharmacists.
Approval of the Minister
The Approval of the Minister for authorised registered nurses in rural and isolated practice applies only to the following conditions:
- The nurse is a registered nurse (Division 1) whose registration is endorsed for Scheduled Medicines (Rural and Isolated Practice); and
- The nurse is employed and practising within a health service or class of health services included on the list of health services approved by the Minister for Health; and
- The nurse is acting under the clinical circumstances approved by the Minister for Health. The clinical circumstances incorporate relevant Health Management Protocols that set out the conditions and restrictions applying to the use and supply of medicines as described in the Primary Clinical Care Manual 9th .
Approved health services, clinical circumstances and medicines
The Minister for Health has approved specific health services in relation to authorised registered nurses.
Each approved health service has a Health Services Permit, issued with conditions. It authorises the health service to obtain and possess Schedule 2, Schedule 3, Schedule 4 or Schedule 8 poisons for the provision of health services.
Health services should notify Drugs and Poisons Regulation in the Department of Health and Human Services of their intention to engage authorised registered nurse(s) by using the online form 'Propose changes or review an EXISTING licence or permit'. A health service completing the form should select 'nurse with a rural and isolated practice endorsement' as being a health practitioner who may initiate administration in the 'Health practitioner activities' section. The form is available on the Licences and Permits for industry and health page.
Note: Health Services Permit documentation is specific to the establishment to which it applies. It describes how that permit holder has undertaken to comply with legislative requirements; its provisions may be more stringent than those contained in the Drugs, Poisons and Controlled Substances Regulations 2017. The Director of Nursing commonly manages the Health Services Permit documentation.
Clinical Circumstances and Medicines
- Two Schedule 8 poisons, morphine and fentanyl, may now be used by authorised registered nurses in accordance with the Primary Clinical Care Manual 9th edition.
- Some of the Schedule 2, 3, 4 and 8 poisons in the Primary Clinical Care Manual 9th edition are approved only for administration and not for supply. The Schedule 8 poisons may only be administered by an authorised registered nurse within the urgent care setting and not supplied to the patient.
- In the event of an inconsistency between the Approval of the Minister and information published by the Nursing and Midwifery Board of Australia, the Victoria Government Gazette notice of 4 January 2018 represents the lawful situation for authorisation of RIPERNs in relation to Schedule 2, 3, 4 and 8 poisons in Victoria.
- Supply of a Schedule 4 poison (regulation 39)
- Administration of a Schedule 4 and a Schedule 8 poison (regulation 92)
- Administration or supply of a Schedule 3 poison (regulation 142)
Rural health services - checklist
- ensure that the health service has been approved by the Minister for Health as one in which medicines can be administered or supplied by an authorised registered nurse
- ensure that the registered nurse has a current endorsement for Scheduled Medicines (Rural and Isolated Practice) under section 94 of the Health Practitioner Regulation National Law
- ensure that the Health Services Permit documentation reflects the endorsed nurse function
- develop and follow policy that identifies which health management protocols are relevant to the authorised registered nurse scope of practice in relation to administering and supplying the medicines approved by the Minister for Health
- make readily available in the emergency or urgent care area(s) the current controlled version of the Primary Clinical Care Manual 9th edition to support the authorised registered nurse practice
- ensure that, if the authorised registered nurse is unable to contact a medical practitioner or nurse practitioner, the nurse administers and supplies only those medicines approved by the Minister for Health, in accordance with the relevant health management protocol in the Primary Clinical Care Manual 9th edition
- ensure that the authorised registered nurse maintains their competency and evidence of competency, sufficient to meet the annual declaration of competency/recency relevant to their clinical scope of practice.
Reviewed 20 December 2021