- Rural and isolated practice registered nurses (RIPRN) have additional training and accreditation and can supply and administer medicines from Schedules 2, 3, 4 and 8 in accordance with the health management protocols in the latest edition of the Primary Clinical Care Manual (PCCM).
- Rural communities may not have a general practitioner present or a pharmacy open when urgent care is required.
- RIPRN have been operating successfully in Victoria since 2012 and in Queensland for many years.
- RIPRN are authorised nurses that can administer and supply medicines in health services that have been approved by a Secretarial Approval.
RIPRN provide an important addition to rural and remote clinical services. A RIPRN has additional training and can supply and administer medicines from Schedules 2, 3, 4 and 8 in accordance with the clinical guidelines set out in the latest edition of the Primary Clinical Care Manual, (Queensland Health) and the Royal Flying Doctor Service (Queensland Section) 2016.
In Victoria, many small rural health services rely heavily on general practitioners (GP) to provide services to people who present at the urgent care centre. The doctor is frequently not on site when a patient arrives and may take some time to attend the hospital. In some communities there are no local GPs.
In many rural communities, pharmacies are not open after hours or weekends, or there is no pharmacy operating in the local town. People may need to travel long distances to receive treatment and medicines. For some communities, there are no local services at all.
Increasingly, nurses are undertaking additional training and can provide a wider range of primary care and emergency services from rural health services.
- Rural hospital staff will continue the current practice of referring people as appropriate to their local GP or pharmacist when these services are available.
Registered nurses with a Scheduled Medicines training have been operating safely in Queensland for many years, with more than 600 RIPRN practising in rural and isolated practice settings.
The Victorian RIPRN collaborative practice model was evaluated in 2014-2015 and some of the key findings were:
- increased skill and confidence of the endorsed nurses
- better work-life balance for participating general practitioners and improved collegial relationships between general practitioners and nurses working in urgent care centres
- broad acceptance of the model by the community
RIPRN are experienced nurses that undertake additional training including pharmacology and clinical assessment. They are assessed as competent by their employer to determine which patients they are able to manage and when the administration or supply of medicines is indicated.
In Victoria RIPRN use the health management protocols contained within Queensland’s latest edition of the PCCM as the clinical standard to guide their practice and reinforce safe and effective nursing practice.
The PCCM undergoes rigorous review every two years to ensure it is aligned to current medical, nursing and pharmacological practice. Since 2017, Victoria has been represented by one of its RIPRN on Queensland's PCCM editorial review committee.
There are two programs of study that prepare registered nurses with additional training:
- the Rural and Isolated Practice (Scheduled Medicines) Registered Nurse Course at Queensland Health’s the Cunningham Centre, or
- the Graduate Certificate of Health (Scheduled Medicines) at the University of Southern Queensland;
Medicines management FAQs
In Victoria the approved medicines that can be administered and supplied by RIPRN are Schedules 2, 3, 4 and 8 in accordance with the latest edition of the PCCM.
In cases where alternative management is indicated in the latest edition of the PCCM, the RIPRN must arrange for the patient to be seen by a doctor or nurse practitioner.
RIPRN are not able to write prescriptions. A RIPRN can only supply or administer medicines in accordance with the health management protocols in the latest edition of the PCCM.
A RIPRN is not legally able to supply a patient with any Schedules 2, 3 and 4 medicine to take home unless a doctor's order is given either in person or over the phone. A RIPRN is not able to supply Schedule 8 medications which is in accordance with the 9th edition of the PCCM.
Controls on the handling of the approved medicines for registered nurses are included in the Drugs, Poisons and Controlled Substances Regulations 2017 (the Regulations) under the controls for authorised registered nurses.
RIPRN are required to keep a written record of the patient’s episode of care, including any medications administered or supplied.
Every patient who is supplied medicines by the RIPRN receives current consumer information on that drug. All patients will be encouraged to arrange a follow-up appointment with their GP.
A central register of medicines used and supplied by RIPRN must be maintained for medication recalls and to monitor compliance with the latest edition of the PCCM. All medicines supplied are required to be labelled in accordance with the Regulations.
Reviewed 11 July 2023