Legislation and policy drivers in competence requirements for Nurses in New Zealand
Supervisors: Mary Chiarella & Denise Dignam
The enactment of the Health Practitioners Competence Assurance (HPCA) Act 2003 (NZ) (the HPCA Act) in New Zealand in 2003 heralded a significant change for all health practitioners, including nurses. This new legislation brought 15 health professional groups under one Act and repealed previous separate statutes relating to individual regulatory bodies. The principal purpose of the HPCA is to protect the health and safety of members of the public by providing for mechanisms to ensure that health practitioners are competent and fit to practise their professions (HPCA Act 2003, s1).
Little research exists around the implementation of the HPCA Act and the subsequent Nursing Council of New Zealand requirements to ensure “competent and fit to practise” nursing professionals. The legislation previously regulating the registration of nurses in New Zealand, the Nurses Act 1977 (NZ) and amendments, was the last iteration of legislation regulating nurses, and stemmed from the Nurses Registration Act 1901 (NZ). Between 1901 and 1977 this legislation, although addressing public safety, was silent on the issue of competence (Papps 2002; Burgess 2008). Instead, it referred to other terms such as fitness and properness. These terms are possibly more associated with the notion of suitability rather than capability or ability, which is the focus of competence, and were not clearly defined under the Nurses Act 1977 (NZ) as they were considered matters for judgment by the Nursing Council.
In contrast the HPCA Act is specific in its definition of what constitutes competence, fitness to practise and quality assurance, and clearly specifies the legislative functions of the 15 regulatory authorities, including the Nursing Council of New Zealand. There is a requirement that all authorities specify scopes of practice (HPCA Act 2003, s11) and the requisite qualifications for each scope (HPCA Act 2003, (NZ) s12). The Nursing Council specified and gazetted four scopes of nursing practice, each with their own registration and competency requirements Nurse Assistant, Enrolled Nurse, Registered Nurse and Nurse Practitioner.
In addition to the administrative functions of the regulatory authority is the requirement “to set standards of clinical competence, cultural competence, and ethical conduct to be observed by health practitioners of the profession” (HPCA Act 2003 (NZ), s118(i)). The Nursing Council of New Zealand has defined competence as “the combination of skills, knowledge, attitudes, values and abilities that underpin effective performance as a nurse” Nursing Council of New Zealand (2007). The continuing competence framework established by the Nursing Council of New Zealand was implemented in 2004: four years on it is now timely for its effectiveness to be evaluated.
The purpose of my research is to explore, evaluate and determine if the Nursing Council of New Zealand ‘Continuing Competence Framework’ provides the mechanisms to ensure that nurses are competent and fit to practise their profession, as stipulated in section 1 of the HPCA Act 2003 (NZ). The research being undertaken utilises a sequential mixed-method evaluation research design, and will be completed in four phases.