A standing order is a written instruction issued by a medical practitioner or dentist. It authorises a specified person or class of people (eg, paramedics, registered nurses) who do not have prescribing rights to administer and/or supply specified medicines and some controlled drugs. The intention is for standing orders to be used to improve patients’ timely access to medicines; for example, by authorising a registered nurse in a primary health care setting.
Currently, medical practitioners and dentists are the only prescribers who can issue standing orders.
The purpose of these guidelines is to provide guidance for health professionals working with standing orders, to assist issuers to comply with the regulations when developing a standing order, and to assist people administering and/or supplying under standing orders.
The use of standing orders is governed by the Medicines (Standing Order) Regulations 2002 (Standing Order Regulations). This regulation sits within the broader health regulatory regime that includes: the Medicines Act 1981 and Medicines Regulations 1984 the Misuse of Drugs Act 1975 and Regulations 1977 the Health Practitioners Competence Assurance Act 2003 the Health and Disability Commissioner (Code of Health and Disability Services Consumers’ Rights) Regulations 1996.
Please Note:
- ←All Nurses using standing orders must accept that they are responsible, accountable and therefore legally liable for their actions. Standing Orders cannot cover every clinical ramification and it is expected that the nurses’ professional judgement and experience will be used. There is no obligation for practice nurses to use these guidelines and those nurses who conclude that using standing orders is outside their scope of practice are to consult with a medical practitioner before dispensing any treatment.
- ← A standing order does not allow a person to generate a prescription and provide it to a patient to take to a pharmacy to be dispensed (with the prescription signed later by the issuer of the standing order). Pharmacies cannot lawfully dispense unsigned prescriptions. Nor does a standing order allow a person to provide a patient with a prescription that has been ‘pre-signed’ by the medical practitioner or dentist who issued the standing order.
Copies of standing orders will be available from all treatment rooms via this site and/or in a paper copy in each treatment room where nurses or medical practitioners affected by them are operating.
- ←Nurses supplying medicines according to the standing orders must write up the assessment and treatment of the patient (including any adverse reactions) and if necessary, any monitoring or follow-up of the patient’s treatment. The issuing medical practitioner must be informed asap (but within 96 hours) of the medicine being supplied.
- ←Any adverse events associated with these standing orders should be reported to the issuing medical practitioner who will review the individual situation and assess the operation of the standing orders.
If you have any questions about these instructions, please contact the Practice Manager for clarification.