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Aged Care Amendment (Registered Nurses Ensuring Quality Care) Bill 2021

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2019-2021

 

 

 

 

 

THE PARLIAMENT OF THE COMMONWEALTH OF AUSTRALIA

 

 

 

 

 

 

SENATE

 

 

 

 

 

 

Aged Care Amendment (Registered Nurses Ensuring Quality Care) Bill 2021

 

 

 

EXPLANATORY MEMORANDUM

 

 

 

 

 

Circulated by authority of

Senator Rex Patrick

 

 

 

 

 



 

AGED CARE AMENDMENT (REGISTERED NURSES ENSURING QUALITY CARE) BILL 2021

 

 

OUTLINE

 

The Bill amends the Aged Care Act 1997 to require all approved aged care facilities to have at least one registered nurse on duty at all times within an aged care facility. The registered nurse will be required to provide care and supervise the provision of care to residents of an approved aged care facility.

 

Currently in Australia, there is no nationwide requirement that nursing homes must have at least one registered nurse on duty at all times as confirmed by the recent Royal Commission into Aged Care Quality and Safety. This inconsistent approach leads to variations on the level of care and quality afforded to residents and negatively impacts the working lives of staff providing that care within Australia.

 

Nursing home residents are older, frailer, and have high rates of complex comorbidities and polypharmacy [1] . There are also large numbers of cognitively impaired residents (i.e. dementia) [2] and residents with mental ill health [3] . This means that there is a need for staff with strong clinical knowledge and skills in gerontology, the physiological processes of ageing and their implications for wellbeing in later life [4] . Registered nurses are well placed to holistically care for residents with needs across each of these domains [5] .

 

Many residents of aged care facilities are not receiving the level of care they require, this is largely due to the increased levels of underqualified staff trying to provide care. And in many instances without the supervision of qualified registered nurses. This puts residents at unnecessary risk of illness, injury and preventable death.

 

Nurses provide safe, person-centred and evidence-based practice to support and improve the health and wellbeing of residents and, in partnership with the person, promote shared decision-making and care delivery between each individual resident, nominated partners, family, friends and health professionals. Registered nurses are educated to a minimum standard and are bound by their professional standards and code of conduct to provide person-centred care; a core tenet of nursing practice [6] . Person-centred care helps to ensure better outcomes [7] , satisfaction with care [8] , that each individual resident is cared for in accordance with their unique needs and preferences [9] .

 

The amendment will mean that all approved aged care facilities in Australia must have at least one registered nurse on duty at all times.  

 

Financial Impact

The Bill will have no financial impact.



 

NOTES ON CLAUSES

 

Clause 1: Short title

 

1.         This clause is a formal provision and specifies that the short title of the Act may be cited as the Aged Care Amendment (Registered Nurses Ensuring Quality Care) Act 2021 .

 

Clause 2: Commencement

 

2.         This clause provides for the commencement of the whole of the Act to be the day after the Bill receives Royal Assent as prescribed in the table.

 

Clause 3: Schedules

 

3.         This clause states that legislation specified in the Schedule to this Bill is amended or repealed as is set out in the applicable items in the Schedule, and any other item in a Schedule to this Act has effect according to its terms.

 

Schedule 1—Amendments

 

Item 1—After paragraph 54-1(1)(b)

 

4.         Item 1 inserts new paragraph 54-1(1)(ba) to provide that the responsibilities of an approved provider, in relation to the quality of aged care, include ensuring at least one registered nurse is on duty at all times in a residential facility where the type of aged care is residential care or flexible care provided in a residential setting. The registered nurse is to provide care to residential care recipients and supervise the provision of care to residential care recipients.

 

5.         The intent of the amendment is to ensure that at least one registered nurse is on duty at all times in an approved aged care facility that provides residential care or flexible care.

 

Item 2—At the end of section 54-1

 

6.         Item 2 inserts new subsection 54-(3) to define the term ‘registered nurse’ to mean a person who is registered in the nursing profession as a nurse under the legislation applicable to their residential State or Territory.

 

7.         For a person registered in a State or Territory, except Western Australia, they must be registered under the Health Practitioner Regulation National Law as set out in the Schedule to the Health Practitioner Regulation National Law Act 2009 (Qld), as it applies in that State or Territory.

 

8.         For a person registered in Western Australia, they must be registered under the Health Practitioner Regulation National Law Act 2010 (WA) as far as that Act corresponds to the National Health Practitioner Regulation National Laws set out in the Schedule to the Health Practitioner Regulation National Law Act 2009 (Qld).



 

Statement of Compatibility with Human Rights

 

Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011

 

Aged Care Amendment (Registered Nurses Ensuring Quality Care) Bill 2021

 

This Bill is compatible with the Human Rights and freedoms recognised or declared in the International instruments listed in section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011.

 

Overview of the Bill

 

The Bill amends the Aged Care Act 1997 to require all approved aged care facilities to have at least one registered nurse on duty at all times within an aged care facility. The registered nurse will be required to provide care and supervise the provision of care to residents of an approved aged care facility.

 

It is expected that requiring aged care facilities to have a registered nurse present at all times, will raise the level of care to residents, will attract and retain new graduate nurses and increase the skilled workforce to provide the required supervision and support. Importantly, having a registered nurse present in an approved aged care facility will improve the quality of end of life care; improve communication between the resident, family and other health care professionals; and promote preventative health and address wellbeing risks that contribute to restorative care.

 

In some circumstances, a person with significant disabilities or intensive care needs may be a resident in an approved aged care facility. The Bill will improve health outcomes for all residents, irrespective of their care needs or other personal attributes.

 

Human Rights implications

 

This Bill is compatible with International Human Rights and in particular the right to health. The Bill supports the right to health by ensuring residents within aged care facilities are provided medical services and medical treatment in the event of sickness so they may enjoy the highest attainable level of health.

 

This right is contained in the International Covenant on Economic, Social and Cultural Rights (ICESCR).

 

Articles 12(1) and (2)(c) and (d) of the ICESCR state:

1. The States Parties to the present Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.

2. The steps to be taken by the States Parties to the present Covenant to achieve the full realization of this right shall include those necessary for:

(c) The prevention, treatment and control of epidemic, endemic, occupational and other diseases;

(d) The creation of conditions which would assure to all medical service and medical attention in the event of sickness.

Further, Articles 1 and 25(b) of the Convention on the Rights of Persons with Disabilities states:

Article 1 - The purpose of the present Convention is to promote, protect and ensure the full and equal enjoyment of all human rights and fundamental freedoms by all persons with disabilities, and to promote respect for their inherent dignity.

Persons with disabilities include those who have long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others.

Article 25(b) - Provide those health services needed by persons with disabilities specifically because of their disabilities, including early identification and intervention as appropriate, and services designed to minimize and prevent further disabilities, including among children and older persons .

 

Conclusion

This Bill is compatible with international human rights and freedoms.




[1] Australian Institute of Health and Welfare (AIHW). People using aged care [Online]. Canberra: Australian Government. 2021.  Available: https://www.gen-agedcaredata.gov.au/Topics/People-using-aged-care (Accessed 12 August 2021).

[2] Harrison SL, Lang C, Whitehead C, Crotty M, et al. Trends in Prevalence of Dementia for People Accessing Aged Care Services in Australia. J Gerontol A Biol Sci Med Sci . 2020;75(2):318-325.

[3] Australian Institute of Health and Welfare (AIHW). Depression in residential aged care 2008-2012 [Online]. Canberra: Australian Government. 2013.  Available: https://www.aihw.gov.au/reports/aged-care/depression-in-residential-aged-care-2008-2012/contents/table-of-contents (Accessed 12 August 2021).

[4] Dementia Australia. Response to Counsel Assisting’s submissions on the future of the aged care workforce (Royal Commission into Aged Care Quality and Safety) [Online]. Melbourne: Dementia Australia. 2020. Available: https://agedcare.royalcommission.gov.au/system/files/2020-09/AWF.600.01628.0001.pdf (Accessed August 12 2021).

[5] Australian College of Nursing (ACN). Position Statement: The role of registered nurses in residential aged care facilities Position statement [Online]. Sydney: ACN. Available: https://www.acn.edu.au/wp-content/uploads/position-statement-role-rn-residential-aged-care-facilities.pdf (Accessed 12 August 2021).

[6] Nursing and Midwifery Board of Australia (NMBA). Code of conduct for nurses [Online]. Melbourne: NMBA. 2018. Available: https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx (Accessed 27 July 2021).

[7] Brownie S, Nancarrow S. Effects of person-centered care on residents and staff in aged-care facilities: a systematic review. Clin Interv Aging. 2013;8:1-10.

[8] Poey JL, Hermer L, Cornelison L, Kaup ML, et al. Does Person-Centered Care Improve Residents' Satisfaction With Nursing Home Quality? J Am Med Dir Assoc. 2017; 18(11):974-979.

[9] Ho P, Cheong RCY, Ong SP, Fusek C, Wee SL, Yap PLK. Person-Centred Care Transformation in a Nursing Home for Residents with Dementia. Dement Geriatr Cogn Dis Extra. 2021;11(1):1-9.