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Postgraduate nursing «�Any Registered Nurse should be authorised to perform immunisation autonomously.’Evaluate and critically discuss this statement.You should consider legal, ethical and professional perspectives.Your answer should be Essay Example

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Any Registered Nurse should be authorized to perform immunization autonomously

The Australian Technical Advisory Group on Immunization is an advisory committee appointed by the Minister for Health and Ageing and is given with the responsibility of revising and developing the Australian Immunization handbook. According to National Health and Medical Research Council (NHMRC), (2008), the handbook was devised as a general guideline to inform a broad target audience of professionals in the health sector on the most effective and the safest vaccination strategies utilizing the highest quality evidence available. In order to understand if any registered nurse in Queensland should be authorized to perform immunization autonomously, it is important to look at the laid done regulation in the Australia immunization handbook spelt out from pages 8-14 in the 9th edition of the book. The regulations commences with the definitions of basic terms. Vaccination is defined as the administering of a vaccine and if the vaccination turns out to be successful it occasions immunity. Immunization is the process by which immunity is induced to an infectious agent by the administration of a vaccine. The venue where the vaccination occurs is simply referred to as on-site. The terms immunization and vaccination are usually used interchangeably although they do not mean exactly the same thing (Nurses Board of Victoria (NBV), 2007).

It is stipulated that all providers of immunization should utilize standard procedures as a foundation in the formulation of their own procedures and policies for practice in the sessions of immunization. It is further stated that a valid consent is needed before any medical procedure including immunization. According to Anthony, Standing, and Hertz (2001), consent that is duly valid should be obtained for any particular vaccination immediately prior to the administering of that given vaccine AFTER the guardian/parent/vaccine has gotten adequate information to come up with an informed decision and AFTER establishing that there no medical conditions that go against or contrast the vaccination. The valid consent should be communicated to the person administering the vaccination preferably in written form.

Accordingly, any accredited registered nurse should be authorized to perform immunization autonomously (NBV, 2007). The basic procedures and regulations laid down for the administering of vaccination or immunization have been met by precisely all the registered nurses who are accredited by the Queensland Nursing Council. So long as the nurses have followed the required preparation and assessment for administering of immunization or vaccination, then they should be subsequently allowed to perform immunization autonomously. The administration and possession of a particular substance is determined or decided by the Drugs, Poisons and Controlled Substances Act 1981 and the Drugs, Poisons and Controlled Substances Regulation 2006 (Anthony, Standing, & Hertz,2001).

An authorized person is further defined as a person who can administer drugs that are for prescription only. The drugs refer to other drugs and vaccines used in the anaphylactic reactions treatment to the vaccines utilized in the immunization programs of the local government. It is moreover stipulated by what it means when they refer to an authorized person in this setting. An authorized person is a: Division 1 registered nurse who is a nurse immunizer appropriately endorsed, Division 1 registered nurse having a medical practitioner on site who has seen or come in contact with the client and ordered the administration of the vaccine and remains on site for fifteen minutes post vaccination or is simply a medical practitioner.

It is also stated that any environmental officer of health appointed or employed by the municipal council may possess but not administer drugs necessary for immunization program; this exclusion does not entail the registered nurses who are given the authority to perform immunization autonomously since they understand all the procedures necessary for administering immunization. Division 1 registered nurses who are referred to as endorsed nurse immunizers are employed or contracted by a municipal council, health service permit holder who contracts or employs a medical officer, or a medical practitioner (ANMC, 2007).

The nurse immunizer must have completed successfully an accredited nurse immunizer training program to qualify. The immunizers are not allowed to administer immunization for travel purposes. According to Health Professional Registration Act 2005, all the Division 1 registered nurses even endorsed nurse immunizer must make sure that they are safe and competent to adhere to and practice the prevailing acceptable standards and guidelines in their particular field of practice. The Division 1 registered nurse administering the vaccine should obtain the vaccine they are to administer to make sure that they have adhered to the rights of safe medication and hence their duty of care to the client. It has been summarized that the registered nurse practices interpedently and independently assuming responsibility and accountability for their own actions and any delegation of care to enrolled nurses and healthcare workers. A person who can obtain valid consent prior to immunization practice is the person giving the vaccination who may include medical officers, nurse immunizers, or Division 1 nurses with a medical officer on-site (NHMRC, 2003).

Medical Practitioner Vaccine Administration Orders permit GPs to delegate responsibilities of immunization and empower practice nurses to provide vaccination to children less than five years of age, devoid of asking foe a mandatory GP examination. The application of orders for vaccine administration can accelerate the practice of GP immunization rates and subsequently save the valuable time of GP while at the same time it provides the protection to the patients. The Medical Practitioner Vaccine Administration Orders (MPAOS) were designed by the Immunization Section of Western Australia Department of Health for application by practice nurses in Western Australia who provides immunization services. The orders are consistent with NHMRC Australian Immunization handbook; 9th Edition 2008 to help immunization nurses as best practice principles. RNs utilizing the MPVAOS must be safe and competent to take part in immunization as it is not sufficient enough to adhere to MPVAOs alone without having the required knowledge and skills in this field (Milson-Hawke & Higgins, 2004).

The person administering vaccine in regard to MPAOs must possess the required competence in immunization service provision and the ability to demonstrate accountability and autonomy for nursing practice that is safe. At this point it can be seen that emphasis is put on competence, autonomy and accountability should be attained if one has to be allowed to perform immunization and depending on the state’s regulation, any registered nurse can be allowed to perform or administer immunization autonomously. Of course the basic conditions for successful immunization should be met. It is common knowledge in the health care that all vaccines providers should get education and competency-based training on administration of vaccine to the public. The nurse working in General Practice perform several tasks, that includes , but is not confined to immunization, triage, preparation of minor procedures, wound management and sterilization. Immunizations make up to five percent of a General Practice’s consultations (ANMC, 2005).

In accordance to Queensland law the DTP endorsed RN is authorized to use the Immunization Program Area DTP when the RN provides services in an Immunization Program which is approved by the District Health Officers. This is and should be consistent with the authority that the endorsed RN has under the Health (Drugs and Poisons) Regulation 1996. The scope and standards of Nursing Practice stipulates that ANF Competency Standards for Advanced Nurse together with the Framework outline the expected standards of practice of the RN following DTP endorsement. RNs are capable of meeting the population health needs by limiting or minimizing the preventable communicable disease transmission and opportunistic vaccination provision. Appropriate and timely vaccination is part of preventable health care for the child. The Queensland Nursing Council guidelines on standard of practice for registered Nurses with the Drug Therapy Protocol Endorsement lays down the rules to be followed during administration of immunization and it is in all respect consistent with the Australian immunization handbook, 2008 9th edition, pp. 8-14 (Queensland Nursing Council (QNC), 2005).

The scope expansion of practice with the application of DTP and the related Health Management Protocol does not contradict the Guiding Principles to expand scope of practice of registered Nurses in the scope of Nursing Practice Decision Making Framework. Preparing for the expanded role of a DTP endorsed RN happens through the completion of a course accredited by the Council. RNs add to their prevailing competence, knowledge and skills necessary to qualify for the DTP endorsement. In order to be eligible for application for a DTP endorsement on their Annual License Certificate, RNs must complete successfully a course that is accredited by the Queensland Nursing Council. Consequently any registered nurse that has duly received this accreditation should be able to perform an immunization autonomously in accordance to the rules stipulated in the Australian immunization handbook, 2008 9th edition. The expansion of scope of nursing practice in Queensland gives room for one to conclude that any registered nurse should be authorized to perform immunization autonomously (ACT Nursing and Midwifery Board, 2005).


This assignment has sought to clarify the statement that; ‘all registered nurses should be authorized to perform immunization autonomously’ with the specific reference with the Queensland Nursing Council legislation. The scope expansion for practice of nurse that allows a DTP endorsement gives authority to any accredited registered nurse to autonomously administer immunization so long as the guidelines and standards laid down in the Australian Immunization handbook have consistently been adhered to (QNC, 2006).


National Health and Medical Research Council (NHMRC), 2008, Australian Government: Department of Health and Ageing Australian Immunisation Handbook, 2008 9th edition, pp. 8-14

Australian Nursing and Midwifery Council (ANMC), 2007, A national framework for the development of decision making tools for nursing and midwifery practice. Canberra: Australian Nursing and Midwifery Council

Australian Nursing and Midwifery Council (ANMC), 2005, National Competency Standards for the Registered Nurse: Australian Nursing and Midwifery Council

Anthony MK, Standing TS, Hertz JE, 2001, Nurses beliefs about their abilities to delegate within changing models of care.
Journal of Continuing Education;

ACT Nursing and Midwifery Board, 2005, Regulation Policy 5: Medication administration by enrolled nurses. Canberra: ACT Nursing and Midwifery Board.

Milson-Hawke S, & Higgins I., 2004, The scope of enrolled nurse practice: A grounded theory study.
Contemporary Nurse.

Queensland Nursing Council (QNC), 2006, Enrolled nurse medication policy amendment (2006). Brisbane: Queensland Nursing Council.

National Health and Medical Research Council (NHMRC), 2003, The Australian national immunization handbook (8th ed.): National Health and Medical Research Council.

Nurses Board of Victoria (NBV), 2007, Guidelines Delegation and Supervision for registered nurses and extended scope of practice for the division 2 registered nurse. Melbourne: Nurses Board of Victoria.

Queensland Nursing Council (QNC), 2005, Condensed report of the review of the scope of practice framework. Brisbane: Queensland Nursing Council.