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Standards for general practices (4th edition)

including Interpretive guide for Aboriginal and Torres Strait Islander health services

Standard 3.2 Education and training

Our practice supports and encourages quality improvement and risk management through education and training.

Criterion 3.2.2

Qualifications of clinical staff other than medical practitioners

Other members of our clinical team are appropriately qualified and trained, have relevant current Australian registration and participate in continuing professional development.

Indicators

► A. All our nurses and allied health professionals have:

  • current national registration where applicable
  • appropriate credentialing and competence
  • work within their current scope of practice
  • actively participate in continuing professional development relevant to their position in accordance with their professional organisation’s requirements.

► B. Our other team members involved in clinical care have appropriate qualifications, training and competence and participate in continuing professional development relevant to their role.

► C. Our other team members involved in clinical care have undertaken training in CPR in accordance with the requirements of the relevant registration Act or professional organisation or at least every 3 years.

Explanation

Key points

  • Members of the clinical team must be suitably qualified and trained
  • Members of the clinical team should work within their scope of practice and competencies
  • Members of the clinical team should maintain the necessary knowledge and skills to provide good clinical care and to responsibly undertake delegated duties as required
  • Cardiopulmonary resuscitation training needs to be undertaken at least every 3 years.

Other clinical staff

Practices are increasingly employing clinical staff in addition to GPs. This may include general practice nursing staff, medical students, allied health professionals, Aboriginal health workers or other clinical staff who provide clinical care. These health professionals are responsible for maintaining their own knowledge and skills and working within the limits of their competence and scope of practice.

Delegation

The RACGP Position statement on delegation of tasks (General practitioners and their Teams) is available.

The principles of task delegation include:

  • respect and support for the patient-doctor relationship
  • clearly defined roles that are aligned with licensing requirements, competency, education and training of the individual in that role
  • practice systems that enable the provision of safeguards against error and harm
  • mechanisms for ensuring provision of relevant patient information including the meeting of the ethical and legal requirements of the patient consent process
  • availability of effective medical indemnity insurance
  • availability of resources
  • acceptability to the people – healthcare providers, patients and the broader community.

Nurses in general practice

For information regarding employment and professional standards of practice nurses, refer to the following:

  • Australian Nurses and Midwifery Council has produced a suite of competency standards for registered nurses, midwives, nurse practitioners and enrolled nurses and details are available at: www.anmc.org.au
  • Australian Practice Nurses Association has produced a number of resources specific to nursing in general practice, such as the ‘A guide for the supervision of enrolled nurses in general practice’. For further information email admin@apna.asn.au or telephone 1300 303 184 (freecall).
  • The Australian General Practice Network position statement on nursing in general practice is available at: www.aGPn.com.au/__data/assets/pdf_file/0010/4420/Nursing-in-General-Practice.pdf.

Continuing professional development requirements

Other members of the clinical team are expected to comply with the professional development requirements of the relevant professional organisation, whether or not the individual is a member of the organisation.

Codes of conduct

Other clinical team members are expected to comply with the code of conduct of the relevant professional organisation, whether or not the individual is a member of the organisation.

Training

Training may be gained through participation in external courses or ‘on the job’ training at the practice. This criterion relates only to other clinical staff employed by the practice and not to co-located independent health practitioners who are not employed directly by the practice.

CPR training

The RACGP recognises that CPR skills are used infrequently and will thus diminish over time. As other clinical staff may be present during a medical emergency, they need to be trained in CPR to assist the medical team. Cardiopulmonary resuscitation training for other clinical staff may be conducted by medical staff and the RACGP encourages practices to use medical staff who have a current CPR instructor’s certificate that complies with ARC guidelines on instructor competencies. Alternatively, CPR training for other clinical staff may be conducted by an accredited training provider. Cardiopulmonary resuscitation training that is solely online does not meet ARC requirements for the physical demonstration of skills by trainees at the completion of the CPR course.

Although indicator C does not mandate CPR training more frequently than 3 yearly, many general practice professionals believe CPR training should be conducted on a more frequent basis, preferably annually.

Standard 3.2 Education and training

Our practice supports and encourages quality improvement and risk management through education and training.

Criterion 3.2.2

Qualifications of clinical staff other than medical practitioners

Other members of our clinical team are appropriately qualified and trained, have relevant current Australian registration and participate in continuing professional development.

In a nutshell

All members of your clinical team are required to be suitably qualified and trained, and to have maintained their skills through participation in the CPD requirements of their relevant profession. Clinical team members are required to undertake CPR training at least every 3 years.

Key team members

  • Health service manager
  • Clinical team
  • Medical staff with training responsibilities

Key organisational functions

  • Human resources management
  • Staff records
  • Staff training and CPD calendar and records

Indicators and what they mean

Table 3.6 explains each of the indicators for this criterion. Refer to Criterion 3.2.2 Qualifications of clinical staff other than medical practitioners of the Standards for general practices for more information and explanations of some of the concepts referred to in this criterion. 

Table 3.6 Criterion 3.2.2 Qualifications of clinical staff other than medical practitioners
IndicatorWhat this means and handy hints
▶ A. All our nurses and allied health professionals:
  • have current national registration where applicable
  • have appropriate credentialing and competence
  • work within their current scope of practice
  • actively participate in continuing professional development relevant to their position in accordance with their professional organisation’s requirements.
All your clinical team members who provide clinical care need to take responsibility for maintaining their own knowledge and skills, and to work within the limits of their competence and scope of practice. The role of the service is to ensure that this requirement is followed.

National registration for nurses and allied health professionals means registration with the appropriate board of the Australian Health Practitioners Regulation Agency. See Other information for Standard 3.2.
▶ B. Our other team members involved in clinical care have appropriate qualifications, training and competence and participate in continuing professional development relevant to their roles. Professional bodies have their own training requirements, professional standards of practice, continuing professional development and codes of conduct. Like doctors, other clinical team members need to have appropriate qualifications, training and competence and should participate in relevant continuing professional development.

It is advisable that your health service maintains records of appropriate qualification and continuing professional development that clinical staff participate in. All staff qualifications, training and professional development information should be kept with the relevant staff member’s files.

Clinical staff members need to be able to responsibly undertake delegated duties as required.
▶ C. Our other team members involved in clinical care have undertaken training in CPR in accordance with the requirements of the relevant registration Act or professional organisation or at least every 3 years. The RACGP recognises that CPR skills may diminish over time due to infrequent use, and CPR skills are therefore required to be refreshed every 3 years for all clinical staff. It is preferable that CPR training occur annually, where possible.

Training in CPR may be conducted by medical staff, preferably with a current CPR instructor’s certificate that complies with the ARC guidelines on instructor competencies. Training can also be conducted by an accredited training provider. Note: training that is solely online does not meet ARC requirements.

Case study

Below is a description of the ways in which an Aboriginal community controlled health service can ensure that other members of its clinical team are appropriately qualified and trained, have current Australian registration and participate in continuing professional development. Not all of these good practices are required by the Standards, but they illustrate the many practical and creative things that ACCHSs can do to ensure they deliver services of high safety and quality to their community.

All new clinical staff members are credentialed prior to being offered employment. The service’s clinical staff member employment files contain a training log and copies of certificates and qualifications.

Administrative staff access the AHPRA practitioner registration website (www.ahpra.gov.au) to ensure that all nurses, Aboriginal health practitioners and allied health professionals have current Australian registration, where required. Administration staff maintain a register of professional registration expiry dates for nurses and allied health professionals.

Note that the Aboriginal and Torres Strait Islander Health Practice Board (www.atsihealthpracticeboard.gov.au/Registration/Forms.aspx) advice is as follows:

   
Practitioners who intend on practicing as an Aboriginal and Torres Strait Islander health practitioner must apply for national registration. Those Aboriginal health workers who are not required by their employer to use the title “Aboriginal and Torres Strait Islander health practitioner”, “Aboriginal health practitioner” or “Torres Strait Islander health practitioner”, are not required to be registered, and can continue to work using their current titles (for example, “Aboriginal health worker”, “drug and alcohol worker” and “mental health worker”).

Position descriptions include formal designation of responsibility for specific roles. These might include complaints management, information technology, risk management, cleaning, infection control, sterilisation, vaccine management and quality improvement.

All staff members participate in an annual performance planning and review, which includes a discussion of training undertaken and the identification of training required or requested for the next year. Training for all clinical staff includes cultural safety training.

The health service’s strategic plan includes a staff training and development plan, with a budget. Training calendars from state health departments, Medicare Locals, local health services and NACCHO state or territory affiliates are available in varied locations within the service and are also distributed by email to staff.

Clinical supervision is provided to staff members when required.

New staff members are provided with a mentor to provide support and advice as required.

Staff members can describe their roles and responsibilities and this is consistent with documented position descriptions. In the smaller satellite clinics a number of these responsibilities are included in one staff member’s position description. The main clinic has a number of staff members who are allocated only one core responsibility and this is also included in position descriptions.

Administration staff maintain a register of all staff members’ CPR training and its expiry. The service organises annual CPR training for staff members.

Showing how you meet Criterion 3.2.2

Below are some of the ways in which an Aboriginal community controlled health service might choose to demonstrate how it meets the requirements of this criterion for accreditation against the Standards. Please use the following as examples only, because your service may choose other, better-suited, forms of evidence to show how it meets the criterion.

  • Keep employee files with current registration records.
  • Keep staff training logs.
  • Mention staff qualifications in job descriptions.
  • Conduct annual performance planning and keep review documents indicating identification of training needs and training completed.
  • Keep a training and professional development calendar.
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