Key messages

  • Rural and isolated practice endorsed registered nurses (RIPERN) 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 Primary Clinical Care Manual (PCCM) 9th edition.
  • Rural communities may not have a general practitioner present or a pharmacy open when urgent care is required.
  • RIPERN have been operating successfully in Victoria since 2012 and in Queensland for many years.
  • RIPERN are authorised nurses that can administer and supply medicines in health services that have been approved by the Minister for Health under a gazette notice.

Rural and isolated practice endorsed registered nurses (RIPERN) provide an important addition to rural and remote clinical services. A RIPERN has additional training and accreditation and can supply and administer medicines from Schedules 2, 3, 4 and 8 in accordance with the clinical guidelines set out in the 9th edition PCCM, (State of Queensland (Queensland Health) and the Royal Flying Doctor Service (Queensland Section) 2016).

FAQs

  • Why do rural communities need this model?
    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 are able to provide a wider range of primary care and emergency services from rural health services.
  • Will patients go to hospital instead of their local pharmacist or GP?
    Rural hospital staff will continue the current practice of referring people as appropriate to their local GP or pharmacist when these services are available.
  • Is this model safe?

    Registered nurses with a Scheduled Medicines Endorsement have been operating safely in Queensland for many years, with more than 600 RIPERN practising in rural and isolated practice settings.

    The Victorian RIPERN 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

    For the complete RIPERN evaluation  report, see RIPERN evaluation on this web site.

    RIPERN undertake a National Midwifery Board of Australia (NMBA) approved program of training including pharmacology and clinical assessment. They are assessed as competent to determine which patients they are able to manage and when the administration or supply of medicines is indicated.

    In Victoria RIPERN use the health management protocols contained within Queensland’s PCCM 9th edition 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 RIPERN on Queensland's PCCM editorial review committee

  • How can Victorian nurses access RIPERN training to become endorsed?

    The NMBA has approved two programs of study that prepare registered nurses to apply for the endorsement:

    • the Postgraduate Certificate in Advanced Nursing Practice (Rural and Remote) offered by the University of Southern Queensland (this program is eligible for support under the Postgraduate Nurse Scholarships)
    • the Cunningham Centres Rural and Isolated Practice Health (Drugs and Poisons) Regulation 1996 Registered Nurse course through Queensland Health.
     

Medicines management FAQs

  • What medicines can RIPERN administer and supply?
    In Victoria the approved medicines that can be administered and supplied by RIPERN are Schedules 2, 3, 4 and 8 in accordance with the 9th edition PCCM.

    In cases where alternative management is indicated in the PCCM, the RIPERN must arrange for the patient to be seen by a doctor or nurse practitioner.
  • Can RIPERN prescribe medicines?
    RIPERN are not able to write prescriptions. A RIPERN can only supply or administer medicines in accordance with the health management protocols in the 9th edition of the PCCM.
  • Can RIPERN supply medicines ordered over the phone?

    A RIPERN 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 RIPERN is not able to supply Schedule 8 medications which is in accordance with the 9th edition of the PCCM.

  • How can the community be confident that the administration and supply of medicines by RIPERN is safe?

    Controls on the handling of the approved medicines for registered and endorsed nurses are included in the Drugs, Poisons and Controlled Substances Regulations 2006 (the Regulations) under the controls for authorised registered nurses.

    RIPERN 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 RIPERN 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 RIPERN must be maintained for medication recalls and to monitor compliance with the 9th edition of the PCCM. All medicines supplied are required to be labelled in accordance with the Regulations.

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