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Criteria for a Collaborative Practice Agreement

The Nursing and Midwifery Board of Ireland (NMBI), formerly An Bord Altranais, developed the Collaborative Practice Agreement (CPA) criteria based upon the review of the literature and international experiences. The national policies for the nurse/midwife prescribing initiative have also been considered.

The CPA should include the following:

Section A: Details the:

  • Description of the specific clinical area and the practice setting of the RNP. This should include the patient population and health conditions for which the RNP has responsibility. This information outlines the scope of practice of the individual RNP;
  • Listing of specific medicines (generic names) and treatment indications the RNP is authorised to prescribe. Off-label prescribing of authorised medicines outside the terms of its product authorisation should also be detailed within this section1;
  • Amendments to the list of medicines must be agreed with the Collaborating Medical Practitioner/s reviewed by the Drugs and Therapeutics Committee and approved by the Director of Nursing/Midwifery/Public Health Nursing/Service Manager;
  • Conditions that the Health Service Provider has placed on the RNP’s prescriptive authority (as provided for in the 2007 Regulations);
  • RNP’s audit process of their prescriptive practice;
  • Date for the CPA review based on local Health Service Provider policy

Section B: Details the:

  • Collaborating Medical Practitioner/s information.

Section C: Details the:

  • Candidate/RNP declaration.

Section D: Provides the:

  • Information and signature of the Director of Nursing/Midwifery/Public Health Nursing /Service Manager or the authorised representative of the Health Service Provider.

NMBI supports the use of the HSE RNP guidance document for off-label prescribing by RNPs or similar tool which provides a detailed template for RNPs and Health Service Providers for the governance structures required. The HSE document can be accessed on this section of the HSE website.



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