Nurses Act 1991 NURSES (GENERAL) REGULATION 1997 - Made under the Nurses Act 1991 - As at 2 September 2002 - Reg 455 of 1997 TABLE OF PROVISIONS TABLE OF PROVISIONS PART 1 - PRELIMINARY 1. Name of Regulation 2. Commencement 3. Definition 4. Notes PART 2 - REGISTRATION 5. Qualifications for registration in List “B”: section 19 6. Functions not requiring registration: section 25 7. Roll of nurses: section 26 8. Enrolment in List “A”: section 27 9. Enrolment in List “B”: section 28 10. Duplicate certificates 11. Alterations of Register or Roll PART 3 - INFECTION CONTROL STANDARDS 12. Infection control standards PART 4 - MISCELLANEOUS 13. Fees 14. Forms 15. Recognition of institutions and qualifications: section 10 16. Notice of incapacity: section 35 17. Badges: sections 5 and 37 18. Letters after name 19. Payment of members of Committee: section 51 20. Appeals against decisions of Committee: section 57 21. Appeals against decisions of Committee: section 58 22. Payment of ordinary members of Tribunal: section 59 23. Payment of Chairperson and Deputy Chairperson of Tribunal: section 60 24. Appeals against decisions of Tribunal: section 67 25. Repeal SCHEDULE 1 SCHEDULE 2 NURSES (GENERAL) REGULATION 1997 - REG 1 Name of Regulation 1 Name of Regulation This Regulation is the Nurses (General) Regulation 1997. NURSES (GENERAL) REGULATION 1997 - REG 2 Commencement 2 Commencement This Regulation commences on 1 September 1997. NURSES (GENERAL) REGULATION 1997 - REG 3 Definition 3 Definition In this Regulation: "the Act" means the Nurses Act 1991. NURSES (GENERAL) REGULATION 1997 - REG 4 Notes 4 Notes The explanatory note and table of provisions do not form part of this Regulation. NURSES (GENERAL) REGULATION 1997 - REG 5 Qualifications for registration in List “B”: section 19 5 Qualifications for registration in List “B”: section 19 For registration under section 19 of the Act: (a) the prescribed qualification is a certificate issued by a recognised hospital or other institution, and (b) the prescribed period of attendance is a minimum period of 2 years. NURSES (GENERAL) REGULATION 1997 - REG 6 Functions not requiring registration: section 25 6 Functions not requiring registration: section 25 For the purposes of section 25 of the Act, the following functions are prescribed: (a) functions exercised to meet the needs of organ transplant patients and patients donating organs, (b) functions exercised as a member of a retrieval team that enters New South Wales to pick up a patient, (c) functions exercised while a nurse is on escort duty accompanying a patient on a journey that begins or ends outside New South Wales. NURSES (GENERAL) REGULATION 1997 - REG 7 Roll of nurses: section 26 7 Roll of nurses: section 26 For the purposes of section 26 (3) of the Act, the prescribed manner of entry on the Roll is inclusion on an electronic database or such other manner as the Board determines. NURSES (GENERAL) REGULATION 1997 - REG 8 Enrolment in List “A”: section 27 8 Enrolment in List “A”: section 27 (1) For the purposes of section 27 of the Act, the prescribed age is 18 years. (2) For the purposes of section 27 (a) (i) of the Act: (a) the prescribed certificate is the certificate of attendance issued by each hospital and institution where the person received the training referred to in that subparagraph, and (b) the prescribed period is a minimum period of 12 months (not including any period by which the person’s total leave of absence (if any) exceeded 5 weeks). (3) For the purposes of section 27 (a) (ii) of the Act: (a) the prescribed tuition is the training in nursing given by the hospital or institution which the person attended, and (b) the prescribed examination is that conducted for the purposes of that subparagraph by: (i) the TAFE Commission, or (ii) any accredited providers of vocational training or higher education that are approved by the Board. (4) For the purposes of subclause (3) (b), "accredited" means accredited by a government department or public authority of the Commonwealth, or a State or Territory, with responsibility for vocational training or higher education. NURSES (GENERAL) REGULATION 1997 - REG 9 Enrolment in List “B”: section 28 9 Enrolment in List “B”: section 28 (1) For the purposes of section 28 of the Act, the prescribed age is 18 years. (2) For the purposes of section 28 (a) of the Act: (a) the prescribed certificate is the certificate of attendance issued by each hospital, home for children, or similar institution whose practice the person attended as referred to in that paragraph, and (b) the prescribed period is a minimum period of 12 months (not including any period by which the person’s total leave of absence (if any) exceeded 5 weeks). NURSES (GENERAL) REGULATION 1997 - REG 10 Duplicate certificates 10 Duplicate certificates (1) The Registrar may, on application by a nurse and on payment of the relevant fee set out in clause 13, issue a duplicate certificate if satisfied that a certificate issued to the nurse under the Act has been lost or destroyed or the information that it certifies is no longer correct. (2) The Registrar may require an application under this clause for a duplicate of a lost or destroyed certificate to be verified by a statutory declaration as to the circumstances in which the certificate was lost or destroyed. NURSES (GENERAL) REGULATION 1997 - REG 11 Alterations of Register or Roll 11 Alterations of Register or Roll The Registrar may require such evidence as the Registrar thinks necessary before altering an entry in the Register or Roll. NURSES (GENERAL) REGULATION 1997 - REG 12 Infection control standards 12 Infection control standards (1) An accredited nurse must not, without reasonable excuse, fail to comply with the infection control standards set out in Schedule 1 to the extent that they apply to the nurse in the practice of nursing. (2) In determining whether or not an accredited nurse has a reasonable excuse for failing to comply with a standard, particular consideration is to be given to the following: (a) whether the circumstances involved the provision of emergency treatment, (b) whether the nurse’s employer failed to provide the necessary equipment, including providing access to it and training in its use, that would have enabled the nurse to comply with the standard (and whether the failure to provide such equipment was reported by the nurse to the Director-General of the Department of Health). NURSES (GENERAL) REGULATION 1997 - REG 13 Fees 13 Fees The fees set out below are prescribed for the purposes of the following provisions of the Act and this Regulation: ____________________________________________________________________ |_______________________________________________________________| |____________________________________________________________________| |____________________________________________________________________| |Section 18 (c) or (d), if the place referred to in the relevant|$45 | |____________________________________________________________________| |Section 18 (c) or (d), if the place referred to in the relevant|$50 | |____________________________________________________________________| |____________________________________________________________________| |Section 19 (c) or (d), if the place referred to in the relevant|$45 | |____________________________________________________________________| |Section 19 (c) or (d), if the place referred to in the relevant|$50 | |____________________________________________________________________| |____________________________________________________________________| |____________________________________________________________________| |____________________________________________________________________| |____________________________________________________________________| |____________________________________________________________________| |____________________________________________________________________| |____________________________________________________________________| |____________________________________________________________________| |____________________________________________________________________| |_______________________________________________________________| |____________________________________________________________________| Note: There is no fee prescribed for the purposes of section 23 (1) (d) or section 26 (3) of the Act. NURSES (GENERAL) REGULATION 1997 - REG 14 Forms 14 Forms The forms set out in Schedule 2 are prescribed for the purposes of the following provisions of the Act: _____________________ |_____________________| |_____________________| |_____________________| |_____________________| NURSES (GENERAL) REGULATION 1997 - REG 15 Recognition of institutions and qualifications: section 10 15 Recognition of institutions and qualifications: section 10 (1) A hospital, a nursing home or an educational or other institution (together with the curriculum for its course and the diploma, certificate or other qualification awarded by it) may be recognised by the Board under section 10 (1) (h) of the Act if and only if: (a) curriculum details of the course that it offers or to which it contributes instruction, clinical experience or other training have been forwarded to the Board, and (b) the objective of the course is the achievement by students of levels of educational and clinical competence approved by the Board, and (c) the course itself is approved by the Board. (2) The Board is to notify its recognition in writing directly to the hospital, home or institution. (3) The hospital, home or institution is to notify the Board of any change of curriculum that occurs after details have been forwarded under this clause. (4) The Board may, by writing to the hospital, home or institution, revoke or vary its recognition if it is satisfied: (a) that the course is not being conducted in accordance with any conditions to which the recognition is subject, or (b) that the course is not being conducted in accordance with the details received by the Board under this clause immediately before the Board granted recognition to the hospital, home or institution. NURSES (GENERAL) REGULATION 1997 - REG 16 Notice of incapacity: section 35 16 Notice of incapacity: section 35 (1) For the purposes of section 35 of the Act, the person required to cause notice of mental incapacity of an accredited nurse to be forwarded to the Board is: (a) if the nurse is a patient at an institution because of that incapacity, the director of the institution, or (b) if the nurse has become a protected person, the Protective Commissioner. (2) Notice for the purposes of section 35 of the Act is to be given by telephone within one day, and posted within 7 days, after the nurse starts attending the institution or becomes a protected person. NURSES (GENERAL) REGULATION 1997 - REG 17 Badges: sections 5 and 37 17 Badges: sections 5 and 37 For the purposes of sections 5 (2) and 37 of the Act, the prescribed design for a badge is one having on it the words “NURSES REGISTRATION BOARD”, a representation of the State arms of New South Wales, and appropriate letters or symbols to convey information as to the wearer’s registration, enrolment or authorisation. NURSES (GENERAL) REGULATION 1997 - REG 18 Letters after name 18 Letters after name Accredited nurses may indicate their accreditation by placing after their names the following letters: (a) in the case of a registered nurse—“R.N.”, (b) in the case of a nurse enrolled in List A of the Roll—“E.N.”, (c) in the case of a nurse enrolled in List B of the Roll—“E.N. (M’craft)”, (d) in the case of a registered nurse authorised to practise midwifery—“C.M.” (standing for “certified midwife”) as well as, or instead of, the letters “R.N.”. NURSES (GENERAL) REGULATION 1997 - REG 19 Payment of members of Committee: section 51 19 Payment of members of Committee: section 51 For the purposes of section 51 (5) of the Act, a member of a Committee is entitled to be paid such remuneration as the Minister may from time to time determine. NURSES (GENERAL) REGULATION 1997 - REG 20 Appeals against decisions of Committee: section 57 20 Appeals against decisions of Committee: section 57 For the purposes of section 57 (1) of the Act, the prescribed time within which an appeal may be made to the Tribunal against any finding or exercise of power referred to in that subsection is the time ending 21 days after notice of the reasons for the finding or exercise of power is given to the appellant. NURSES (GENERAL) REGULATION 1997 - REG 21 Appeals against decisions of Committee: section 58 21 Appeals against decisions of Committee: section 58 (1) An appeal referred to in section 58 (2) of the Act is to be made: (a) by causing a notice of appeal, specifying the grounds on which the appeal is made, to be given to the Chairperson (or, if a Deputy Chairperson is nominated under that subsection in that regard, to the Deputy Chairperson so nominated), and (b) by causing a copy of the notice of appeal to be given to each other party to the proceedings from which the appeal has arisen. (2) For the purposes of section 58 (2) of the Act, the prescribed time within which an appeal on a point of law may be made to the Chairperson (or, if a Deputy Chairperson is nominated under that subsection in that regard, to the Deputy Chairperson so nominated) is the time between the referral of the complaint and the commencement of the inquiry. NURSES (GENERAL) REGULATION 1997 - REG 22 Payment of ordinary members of Tribunal: section 59 22 Payment of ordinary members of Tribunal: section 59 For the purposes of section 59 (8) of the Act, a member of the Tribunal (other than the Chairperson or Deputy Chairperson) is entitled to be paid such remuneration as the Minister may from time to time determine. NURSES (GENERAL) REGULATION 1997 - REG 23 Payment of Chairperson and Deputy Chairperson of Tribunal: section 60 23 Payment of Chairperson and Deputy Chairperson of Tribunal: section 60 For the purposes of section 60 (5) of the Act, the Chairperson or a Deputy Chairperson of the Tribunal is entitled to be paid at the same rate as a witness who gives expert evidence in the Supreme Court. NURSES (GENERAL) REGULATION 1997 - REG 24 Appeals against decisions of Tribunal: section 67 24 Appeals against decisions of Tribunal: section 67 For the purposes of section 67 (1) and (5) of the Act, the prescribed time within which an appeal may be made to the Supreme Court against a decision or exercise of power referred to in that subsection is the time ending: (a) on the date occurring 21 days after the date on which notice of the Tribunal’s reasons for the finding or exercise of power is given to the appellant, or (b) on such later date as the Supreme Court may allow in a particular case. NURSES (GENERAL) REGULATION 1997 - REG 25 Repeal 25 Repeal (1) The Nurses Regulation 1992 is repealed. (2) Any act, matter or thing that, immediately before the repeal of the Nurses Regulation 1992, had effect under that Regulation continues to have effect under this Regulation. NURSES (GENERAL) REGULATION 1997 - SCHEDULE 1 SCHEDULE 1 – Infection control standards (Clause 12) Part 1 - Preliminary 1 Definitions (1) In this Schedule: "body substance" includes any human bodily secretion or substance other than blood. "invasive procedure" means any one or more of the following: (a) surgical entry into body tissue, cavities or organs, (b) surgical repair of injuries, (c) cardiac catheterisation and angiographic procedures, (d) vaginal or caesarean delivery or any other obstetric procedure during which bleeding may occur, (e) the manipulation, cutting, or removal of any oral or peri-oral tissue, including tooth structure, during which bleeding may occur. "patient" includes (but is not limited to) a person who is accessing medical or health services or who is undergoing any medical or health procedure. "sharps" means any objects capable of inflicting penetrating injury, and includes hollow bore needles, suture needles, scalpel blades, wires, trocars, auto lancets, stitch cutters and broken glassware. (2) The requirements set out in this Schedule apply to a nurse who is assisting in performing a procedure in the same way as they apply to a nurse who is actually performing the procedure. Part 2 - General standards applying to nurses 2 General precautions and aseptic techniques (1) Precautions must be taken to avoid direct exposure to a patient’s blood or other body substance. This requirement applies regardless of whether there is any perceived risk of infection. (2) Aseptic techniques must be used in the course of complying with the requirements of this Schedule. 3 Hand and skin cleaning (1) Hands must be cleaned immediately before and after any direct patient care. This requirement does not apply in circumstances where medical treatment is required to be performed urgently and cleaning facilities are not readily available. (2) Hands may be cleaned by: (a) using washing facilities involving water and a soap or antiseptic, or (b) if any of the items specified in paragraph (a) are unavailable, using non-water cleansers or antiseptics. (3) Hands or other skin surfaces that are contaminated with a patient’s blood or other body substance must be cleaned as soon as it is practicable to clean them. (4) The requirement to clean hands applies regardless of whether gloves are also required to be worn. 4 Protective gowns and aprons A gown or apron made of impervious material must be worn while performing any procedure where there is a likelihood of clothing being splashed or contaminated with blood or other body substances. 5 Gloves (1) Gloves must be worn while handling blood or other body substances. (2) In particular, gloves must be worn: (a) during any procedure where direct contact is anticipated with a patient’s blood or other body substance, mucous membranes or non-intact skin, and (b) while suctioning a patient, and (c) while handling items or surfaces that have come into contact with blood or other body substances, and (d) while performing an invasive procedure, venipuncture or a finger or heel stick. (3) Sterile gloves must be worn if the procedure involves contact with tissue that would be sterile under normal circumstances. (4) Gloves must be changed and discarded: (a) as soon as they are torn or punctured, and (b) after contact with each patient. (5) Gloves must also be changed if separate procedures are being performed on the same patient and there is a risk of infection from one part of the body to another. 6 Masks and protective eye wear (1) A mask and protective eye wear must be worn while performing any procedure where there is a likelihood of splashing or splattering of blood or other body substances. (2) In cases where a mask is required to be worn, it must be worn and fitted in accordance with the manufacturer’s instructions. (3) A mask must be discarded once it has been worn and it must not be used again. (4) In cases where protective eye wear is required to be worn, it must be worn and fitted in accordance with the manufacturer’s instructions. (5) Protective eye wear must be discarded once it has been worn and not used again unless it is reusable in which case it is to be cleaned in accordance with the manufacturer’s instructions. 7 Sharps (1) Sharps must not be passed by hand between a nurse and any other person. However, this requirement does not apply if, in any case involving an invasive procedure, the proper conduct of the procedure would be adversely affected. (2) A puncture-resistant tray must be used to transfer sharps. (3) A needle must not be removed from a disposable syringe for disposal, or be purposely broken or otherwise manipulated by hand, unless: (a) it is necessary to remove the needle for technical reasons, or (b) the nurse is performing a procedure in which the needle is required to be bent. (4) A needle must not be bent after it is contaminated with blood or other body substances. (5) In any case where resheathing of a needle is required: (a) the needle must be properly recapped, and (b) the sheath must not be held in the fingers, and (c) either a single-handed technique or forceps, or a suitable protective guard designed for the purpose, must be used. (6) Reusable sharps must, immediately after being used, be placed in a puncture-resistant container specially kept for that purpose and labelled as such. (7) Non-reusable sharps must, immediately after being used, be disposed of in a puncture-resistant container. 8 Management of waste (1) Clinical waste must be properly packaged to protect against potential exposure to infectious agents and to facilitate the proper handling, storage and treatment or disposal of the waste. (2) Splashing or contamination of skin while disposing of blood or other body substances must be avoided as far as practicable. Part 3 - Specific standards applying to nurses 9 Sterile medications and solutions (1) A medication or solution may be taken from a multi-dose vial or ampoule (or other similar container) only if the medication or solution is not readily available in another form. (2) If any medication or solution is taken from a multi-dose vial or ampoule (or other similar container), a sterile needle and syringe must be used to withdraw the contents. (3) The needle and syringe must be discarded once they have been used. (4) Precautions must be taken to ensure that the injection of contaminated material or fluid into a multi-dose vial or ampoule (or other similar container) does not happen. 10 Anaesthetic breathing circuits (1) This clause applies in any case where an anaesthetic breathing circuit is used. (2) If the breathing circuit uses a filter: (a) the filter must be discarded after each patient, and (b) the part of the breathing circuit between the patient and the filter must be discarded, or cleaned and disinfected, after each patient, and (c) the part of the breathing circuit between the carbon dioxide absorber and the filter must be discarded, or be cleaned and disinfected, at the end of each procedure list. (3) If the breathing circuit does not use a filter, the breathing circuit must be discarded, or be cleaned and disinfected, after each patient. 11 Invasive procedures (1) In cases where it is technically feasible, retractors must be used for exposure and access during invasive procedures. (2) Fingers must not be used for the purposes of an invasive procedure to expose or increase access for the passage of a suture. (3) Only one sharp at a time is to be placed in a sharps tray that is being used in connection with an invasive procedure. Part 4 - Processing of instruments and equipment 12 Cleaning of instruments and equipment (1) Any instrument or equipment that comes into contact with intact skin must be cleaned before it is used. (2) Any instrument or equipment that is required under this Part to be sterilised or disinfected must be cleaned before it is sterilised or disinfected. (3) The process of cleaning must involve water and mechanical or physical action (such as washing machines) and a cleaning agent. (4) All cleaning agents must be removed from instruments and equipment by rinsing prior to further processing. (5) In this clause, "cleaning agent" means a detergent and includes proteolytic enzyme substances. 13 Disinfection of instruments and equipment (1) Any instrument or equipment that comes into contact with non- sterile tissue (other than intact skin) must be disinfected before it is used with a disinfectant specified in the Australian Register of Therapeutic Goods, and the relevant manufacturer’s instructions must be followed. (2) The process of disinfection must involve either thermal or chemical methods. Chemical disinfection may only be used in cases where thermal methods are unsuitable. 14 Sterilisation of instruments and equipment (1) Any instrument or equipment used to enter, or that is capable of entering, tissue that would be sterile under normal circumstances, or the vascular system of a patient, must be sterilised before it is used. (2) The method of sterilisation must be compatible with the particular type of instrument or equipment. (4) If a steriliser is used (whether it is a benchtop/portable steriliser or a permanently plumbed or wired steriliser), the following criteria must be met: (a) the relevant manufacturer’s instructions must be followed, (b) an ongoing monitoring program must be followed which reflects the requirements of Table 7.1 “STERILIZER TESTS AND TEST FREQUENCIES” of Australian Standard AS 4187- 1998. NURSES (GENERAL) REGULATION 1997 - SCHEDULE 2 SCHEDULE 2 – Forms Form 1 - Certificate of registration (Clause 14) Certificate of registration Nurses Act 1991 (section 17 (a)) This is to certify that the name of who has satisfied the Nurses Registration Board under sectionof the Nurses Act 1991 was entered on Listof the Register of Nurses under that Act on This certificate was issued at Sydney on Form 2 - Certificate of authorisation to practise midwifery (Clause 14) Certificate of authorisation to practise midwifery Nurses Act 1991 (section 17 (b)) This is to certify that who has satisfied the Nurses Registration Board under section 20of the Nurses Act 1991 has been authorised under that Act to practise midwifery in New South Wales from This certificate was issued at Sydney on Form 3 - Certificate of temporary registration (Clause 14) Certificate of temporary registration Nurses Act 1991 (section 24) This is to certify that the Nurses Registration Board has temporarily registered under the Nurses Act 1991 as a nurse on Listof the Register, and has authorised that person to practise midwifery,* subject to the following conditions: from to This certificate was issued at Sydney on * Delete the words “and has authorised that person to practise midwifery” if they are not appropriate. Form 4 - Certificate of enrolment* (Clause 14) Certificate of enrolment* Nurses Act 1991 (section 29) This is to certify that the name of who has satisfied the Nurses Registration Board under sectionof the Nurses Act 1991 was entered on Listof the Roll of Nurses under that Act on This certificate was issued at Sydney on * Insert “(MOTHERCRAFT)” if appropriate. NURSES (GENERAL) REGULATION 1997 - NOTES Reprint history: Reprint No 1 23 April 2002 NURSES (GENERAL) REGULATION 1997 - NOTES Historical notes The following abbreviations are used in the Historical notes: _____________________________________________________________ |_____________________________________________________________| |_____________________________________________________________| |_____________________________________________________________| |_____________________________________________________________| |_____________________________________________________________| |_____________________________________________________________| |_____________________________________________________________| Table of amending instrumentsNurses (General) Regulation 1997 published in Gazette No 95 of 29.8.1997, p 7124 and amended as follows: Nurses (General) Amendment (Infection Control Standards) Regulation 1998 (GG No 115 of 31.7.1998, p 5785) Nurses (General) Amendment (Nurse Practitioners) Regulation 1999 (GG No 124 of 29.10.1999, p 10273) Nurses (General) Amendment Regulation 2000 (GG No 81 of 30.6.2000, p 5434) Nurses (General) Amendment Regulation 2001 (GG No 138 of 14.9.2001, p 7724) Table of amendments _____________________________________ |_____________________________________| |_____________________________________| |_____________________________________| |_____________________________________| |_____________________________________|