Nurse Prescriber CPD Requirements in Ireland: What NMBI Expects

What is prescriptive authority for nurses and midwives in Ireland?

Prescribing is an expanded role for a registered nurse or midwife. To prescribe, you complete an NMBI-approved education programme and are registered in the prescriber division of the Register, as a Registered Nurse Prescriber (RNP) or Registered Midwife Prescriber (RMP). NMBI states that on entry to that division you are acknowledged to have attained the competencies of prescriptive authority through your programme. NMBI's education standards for prescribing programmes already expect a prescriber to identify a mechanism to support continuing professional development needs to ensure continued competence. Everything after that point is about keeping those competencies current.

These figures come from NMBI's State of the Register 2025, which uses data as of 1 June 2025. With the prescriber divisions growing every year, more registrants are now carrying a competence duty that the general nursing and midwifery register does not spell out in the same way.

Your authority depends on your setting

Prescriptive authority is not a free-standing licence. Under Regulation 5A of the medicines prescription regulations, as amended in 2007, a registered nurse may issue a prescription only if they are employed by a health service provider in a hospital, nursing home, clinic or other health service setting, the medicine would be given in the usual course of that service, and the prescription is in fact issued in the usual course of that service. For controlled drugs, the Misuse of Drugs Regulations 2017 limit nurse and midwife prescribers to the drugs, purposes and routes listed in Schedule 8, which is split into five parts: pain relief in hospital, palliative care, midwifery, neonatal care, and mental health or intellectual disability.

Because your authority is defined by a setting and a service, your CPD must keep pace with that service's medicines, patients and local policies.

NMBI Practice Standard 11: what each part asks of you

NMBI's Practice Standards and Guidelines for Nurses and Midwives with Prescriptive Authority (4th edition) sets out 11 practice standards, from clinical decision-making to Standard 11, "Continuing professional development and competency". The edition came into effect on 7 October 2019 and describes itself as an interim document while NMBI's updated requirements and standards are awaited.

Standard 11 is short. It is written as a few short statements and a rationale rather than a checklist, which is why many prescribers are unsure what it actually requires. NMBI describes the practice standards as the overarching mechanism for registered nurse and midwife prescribers. The table below breaks it into its parts.

The standard links to two of the five competency domains in the guidance: Domain 4 (4.1, managing care) and Domain 5 (5.1, personal and professional development). Under 5.1, the expected behaviours include a commitment to lifelong learning, keeping up with advances in prescribing and medication management, developing links with others practising in the same specialist area, and using audit outcomes to improve the service. Domain 1.2 adds self-audit of practice incorporating reflection, maintaining current knowledge of pharmacotherapeutics and emerging safety concerns, and consulting a medical practitioner or pharmacist when you recognise limits in your prescribing knowledge.

Who sets prescriber CPD requirements: NMBI, your employer or you?

Much of the confusion about prescriber CPD comes from mixing three layers. Keeping them separate makes planning easier.

On the regulatory side, NMBI's Professional Competence Scheme page says Part 11 of the Nurses and Midwives Act 2011 is yet to be enacted, a pilot has taken place, and the finalised scheme is expected to be published in November 2026. NMBI does not encourage organisations or individuals to adopt the pilot model in the meantime. That page does not mention prescriber-specific requirements. What the scheme means for all registrants is covered in our guide to the NMBI professional competence scheme pilot, and the wider picture for nurses and midwives is on our page on NMBI CPD requirements for nurses and midwives.

On the organisational side, the HSE's National Nurse and Midwife Medicinal Product Prescribing Guideline (dated May 2020) replaced the 2018 national policy. It requires registered nurse and midwife prescribers to commit to, and undertake, CPD to maintain their competence for prescriptive authority, and makes the Director of Nursing or Midwifery responsible for arranging access to CPD for all prescribers. The Misuse of Drugs Regulations also confirm that an employer may prohibit certain prescribing or attach extra conditions.

The third layer is your own judgement: neither NMBI nor the HSE tells you which topics to study in a given year.

What happened to collaborative practice agreements?

Many hospital policies, older training materials and search results still refer to the collaborative practice agreement (CPA). Under the earlier framework, the CPA was agreed between the nurse or midwife, a registered medical practitioner and the employer, and set the limits of prescriptive authority. NMBI notes that it could require multiple signatures from collaborating medical practitioners.

The NMBI Board approved the removal of the CPA on 17 April 2018. Clinical governance of prescribing is now determined by the local health service provider's medicinal product prescribing policy, procedures, protocols or guidelines. The HSE guideline confirms there is no legislative requirement for a CPA to be in place before a nurse or midwife can be registered as a prescriber. It allows providers to develop addenda for local governance, and the Director of Nursing or Midwifery signs a Site Declaration Form committing to safe management, practice development and audit structures.

How to audit your nurse prescribing practice

Audit is the part of Standard 11 most prescribers find hardest to organise. The 4th edition says prescribers must audit their practice as required by their local health service provider, and that results must be documented and reported to the person with overall responsibility for governance, normally the Director of Nursing or Midwifery or their designee. Standard 3 adds that regular audit of documentation is integral to maintaining quality prescribing practice.

The HSE guideline does not fix a national audit frequency. It says the provider should conduct regular audits and act on recommendations, and that the prescribing site coordinator supports audit locally. ONMSD publishes adaptable tools, including a sample audit tool, a medication appropriateness index tool, a clinical audit report template and a quality improvement plan template.

A practical audit cycle for one prescriber

1. Agree scope and timing locally

   Ask your prescribing site coordinator or line manager what your provider expects: frequency, tool, sample and who receives the report. Local rules come first.

2. Choose criteria from the standards

   Useful criteria come straight from the guidance: documentation made during or immediately after the consultation (retrospective entries only in exceptional circumstances, within 24 hours); consultations signed; NMBI PIN stated on prescriptions; prescribing within scope and the local policy; controlled drugs limited to Schedule 8 drugs and routes; and separation of prescribing from administering and supplying.

3. Collect and compare

   Review your records against each criterion. Where the tool allows, add a clinical appropriateness measure rather than only documentation checks.

4. Report and reflect

   Document the results and report them through your local governance line. Write a short reflection on what the findings say about your practice.

5. Act and re-audit

   Turn any gap into a CPD objective or a practice change, then re-audit. Domain 5.1 expects you to use audit outcomes to improve service provision.

The HSE prescribing data collection system is used by prescribers if they wish to, or if their local health service provider requires it. If your service uses it, it can make audit sampling much easier. If you want structured help designing audit criteria and re-audit, our clinical audit and quality improvement course walks through the full cycle. Several of the documentation criteria above are also covered in documentation for healthcare professionals, and our list of practice review and clinical audit examples, written for doctors' PCS, includes audit designs you can adapt for a prescribing service.

Peer review for nurse prescribers: the overlooked part of Standard 11

Peer review is named alongside CPD and audit in the Standard 11 rationale, yet it is the element prescribers are least likely to record. The HSE guideline expects prescribers to reflect on their own and others' practice and act on feedback, and lists peer review feedback among supporting tools. It also refers to CPD days, master classes and a national conference held in alternate years. ONMSD also runs eNetworks for prescribers, candidates and prescribing site coordinators to share and discuss prescribing matters.

Keep a one-line note of each peer review activity: date, who was involved, what was discussed and what you will do differently.

What CPD should a nurse prescriber do?

The practice standards give a ready-made syllabus. Each topic below is drawn from a standard or competency in the NMBI guidance, so CPD in these areas maps directly onto what you are expected to know.

On controlled drugs, Standard 4 is precise: you have no legal authority to prescribe a Schedule 2 or 3 drug not listed in Schedule 8, or to write for a route not listed for that drug, and controlled drug prescriptions cannot be repeated, though they may be dispensed in instalments. Our controlled drugs prescribing and dispensing course covers the 2017 Regulations in more depth.

Appendix 1 expects you to comply with requirements for reporting adverse drug reactions. It names the Irish Medicines Board, which now operates as the HPRA. The HPRA asks nurses and other healthcare professionals to report suspected adverse reactions, especially those that are serious, involve newly authorised medicines or medicines under additional monitoring (marked with an inverted black triangle), or occur in pregnancy, children or older adults. For the wider error-prevention side, see our medication safety and error prevention course.

Nurse prescriber CPD plan: a 12-month example

Because there are no fixed hours, the most defensible approach is a written plan that shows all three Standard 11 mechanisms (CPD, audit and peer review) and links them to your actual prescribing. The example below shows one way to do it.

If you want a framework for turning learning needs into measurable objectives, our supervision and development planning course covers that process. Keep your plan and evidence somewhere you control, so it moves with you if you change employer.

Common mistakes nurse prescribers make with competence

• Treating general nursing CPD as prescribing CPD. Standard 11 refers to CPD relating to assurance of competency for prescribing. Mandatory training rarely covers this on its own.
• Doing CPD but no audit or peer review. NMBI names all three mechanisms. A file of certificates with no audit is only one-third of the picture.
• Relying on an old CPA. The CPA was removed as a requirement in 2018. Your local PPPG and addendum now define your prescribing governance.
• Assuming authority moves with you. Prescriptive authority is tied to employment by a health service provider and the usual course of that service. A new role or employer means checking the new provider's policy before you prescribe.
• Prescribing for family or yourself "just this once". Standard 5 prohibits prescribing for self, family and significant others.
• Accepting commercially driven education uncritically. Standard 10 says prescribers should not be influenced by financial support from pharmaceutical or healthcare interests, and the Code addresses gifts and incentives.

If a prescribing error or concern has already been raised with NMBI, the priority shifts from routine CPD to remediation; our guide to NMBI remediation courses explains how targeted learning and reflection fit that process.

What to do in the next 30 days

• Download and re-read Standard 11 and Appendix 1 of the 4th edition practice standards.
• Get the current version of your local prescribing policy and any addendum for your area.
• Ask your prescribing site coordinator when your next audit is due and which tool to use.
• List the medicines you prescribe most often and the Part of Schedule 8 that applies to you, if any.
• Write three prescribing-specific learning objectives for the next 12 months.
• Book one peer review activity and note it in your diary.
• Set up a single folder for certificates, audit reports, reflections and peer review notes.

Your NMBI annual renewal is a natural moment to check this folder each year; our guide to NMBI annual registration renewal and the other Irish regulators explains the renewal cycle itself. To fill gaps in your 12-month plan, you can filter our online CPD courses for nurses and midwives by topic.

Checked against the official sources above in October 2026. Rules and policies change, so confirm current requirements with NMBI and your health service provider.