Department of Health

Rural and isolated practice registered nurses (RIPRNs)

Key messages

  • Victoria has changed its drugs and poisons regulatory scheme to safeguard the rural and isolated practice registered nurse (RIPRN) model of care.
  • A legal mechanism, called a Secretary Approval enables scheduled medicines practice – including conditions (such as experience, qualifications, location, type of medicines and clinical circumstances).
  • There is no change to current rural and isolated practice endorsement (RIP) registered nurses who will continue to provide vital healthcare access to Victoria’s rural and isolated communities.
  • Following a post-implementation review in 2023, we have made minor changes to the policy guidance document. Some health services listed in the Secretary Approval have since changed their names, and we are currently updating them.

Rural and Isolated Practice Registered Nurses (RIPRNs)

Rural and Isolated Practice Registered Nurses (RIPRNs) are important to rural and remote communities where:

  • access to general practitioners (GPs) and pharmacy services is limited
  • when urgent health care is required.

Registered nurses can undertake additional training to provide rural Victorian communities with greater access to primary care and emergency services.

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.External Link

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.

RIPRNs are special registered nurses who work in Victoria's approved rural health services including:

RIPRNs can administer and supply medicines in health services that have department secretarial approval.

RIPRNs have been operating successfully in Victoria since 2012 and in Queensland for many years.

Rural hospital staff will continue the current practice of referring people to their local GP or pharmacist when these services are available.

RIPRN medicine administration and supply

Strict regulations apply around the administration and supply of medicines. A RIPRN:

  • Cannot write prescriptions.
  • Can only supply or administer medicines in accordance with the health management protocols in the latest edition of the Primary Clinical Care Manual (PCCM)External Link .
  • 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).
  • Is not able to supply Schedule 8 medications (in accordance with the PCCM).

RIPRN medicine safety handling

Controls on the handling of approved medicines by RIPRNs are included in the Drugs, Poisons and Controlled Substances Regulations 2017External Link . RIPRNs must:

  • Keep a written record of any patient they have seen – including details on episode of care, medications administered or supplied.
  • Provide every patient with current consumer information on medicines supplied.
  • Encourage patients to arrange a follow-up appointment with their GP.
  • Maintain a central register of medicines used and supplied for medication recalls and to monitor compliance with the latest edition of the PCCM.
  • Label all medicines supplied.

Regulatory and policy changes affecting RIPRN practice

The following regulatory and policy changes affecting Victoria's RIPRN model of practice include:

  • Continuation of the rural and isolated practice (RIP) endorsement model of care.
  • Secretary approval provision under the Drugs, Poisons and Controlled Substances Regulations 2017.
  • New updates to the RIPRN policy and guidance.

Changes to rural and isolated practice (RIP) endorsement

Updated legislation governs the practice of registered nurses in Victoria who currently hold a scheduled medicines Rural and Isolated Practice Endorsement (RIP endorsement) from the Nursing and Midwifery Board of Australia (NMBA)External Link .

Following national consultation, the NMBA has ceased the endorsement of registered nurses. Aspiring RIPRNs no longer need to apply to the NMBA for endorsement but will instead be subject to new Drugs, Poisons and Controlled Substances Regulations and Victorian Health Secretary Approval under the protocols of their health service.

From February 2022, Victoria changed its drugs and poisons regulatory scheme to safeguard the Rural and Isolated Practice Endorsed Registered Nurse (RIPERN) model of care.

RIPERNs are now referred to as RIPRNs.

These changes bring Victoria into line with other states and territories, ensuring national consistency to RN medicines practice and reducing regulation at a national level.

Medicines and poisons – Secretary Approval

The Drugs, Poisons and Controlled Substances RegulationsExternal Link includes a provision for the Secretary of the Department of Health to:

This is similar to previous circumstances, with additional conditions requiring evidence of professional experience and record keeping.

For authorising conditions and a list of approved health services, bush nursing centres and hospital sites refer to the Medicines and poisons – Secretary approvals webpage.

RIPRN policy and guidance changes

RIPRN policy and guidance has recently been updated (June 2023) to support approved health services and clinicians and to help them adopt the Rural and Isolated Practice Registered Nurse (RIPRN) function. The guide supports implementation that is collaborative, safe and compliant with the law. It outlines:

  • role and responsibilities
  • the new regulatory framework and what it means for competency, education, experience, and additional conditions
  • quality and safety
  • governance
  • supply and administration of medicines
  • medico-legal issues and resources for introducing the RIPRN model to an approved site
  • locations where RIPRNs can practice.

This document replaces the 2012 nurse endorsement policy framework and toolkit.

RIPRN model advantages

Registered nurses with scheduled medicines training have been practising safely in rural and isolated practice settings for many years. An evaluation of the Victorian collaborative practice model foundExternal Link :

  • increased skill and confidence of the endorsed nurses
  • better work-life balance for participating GPs
  • improved collegial relationships between GPs and nurses working in urgent care centres
  • broad acceptance of the model by the community.

RIPRN training

RIPRNs undertake additional training in pharmacology and clinical assessment. Two courses are available:

Reviewed 14 December 2023


Rural isolated practice registered nurse (RIPRN)

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