Clinics GRP Nursing pathway
A structured older-person nursing assessment to identify current clinical priorities, risks, required follow-up, communication needs and an appropriate review plan.
Care can occur inClinic, inHome, inCommunity or inCare, subject to referral information, clinical fit, location or facility arrangements, equipment, accepted scope and nurse availability. Digital supports access and coordination rather than universal online treatment. This is not an emergency or 24-hour response service.
Who it may suit
What nursing can include
The first visit confirms what can be safely delivered, what needs monitoring and who must be informed if the clinical picture changes.
Select a step to explore the detail.
Clarify why the assessment has been requested and who needs the outcome.
Complete a structured nursing review focused on relevant clinical risks, function, supports and changing needs.
Document priorities, recommended next steps, review timing and escalation responsibilities.
Expected review points
Scope and boundaries
Call Triple Zero (000) for a life-threatening situation. Sudden or severe deterioration, heavy bleeding, acute obstruction, chest pain, severe breathlessness or new stroke-like symptoms require urgent medical assessment rather than a routine website enquiry.
Nurse allocation
Intake confirms the registration, competence and authorised scope required before allocating a nurse.
Communication
With consent, relevant findings and escalation can be communicated to family, GPs, hospitals, providers and other clinicians.
Funding and access
If eligible nursing is included in an approved Support at Home plan, a 0% participant contribution applies to that clinical service. The service still uses available programme funding and remains subject to the service agreement, registered-provider arrangements and accepted nursing scope.
Assessment-led nursing support for acute and chronic wounds, skin tears, pressure injuries and postoperative wound needs, with documented review and escalation when the clinical picture changes.
View pathwayTime-limited nursing follow-up after hospital, illness or surgery, connected with rehabilitation when wounds, medicines, monitoring, mobility or confidence need coordinated attention.
View pathwayNursing support for authorised medication administration, adherence, injections and clinically indicated observations, with communication to the relevant GP, pharmacist or provider.
View pathwayAustralian nursing standards and WHO older-person guidance support comprehensive, person-centred assessment, care planning, monitoring and review across relevant clinical and functional domains.
Clinical sources
How to read this evidence
Evidence guides care but does not establish that a service is suitable for every person or guarantee an outcome. Assessment, goals, health conditions, functional capacity, consent and identified risks shape individual care.
Reviewed by: Clinics GRP Clinical Review Team, Clinical review and governance
Last reviewed: 2026-08-15
It is tailored to the referral and may consider current clinical issues, skin, medicines, continence, cognition, mobility, falls, nutrition, supports and escalation needs.
A written report or structured communication can be included when it is agreed in the referral pathway and consent permits sharing with the relevant care team.
Yes. Where mobility, falls, strength or recovery also need attention, the nurse can coordinate an intake handover to the appropriate rehabilitation pathway.
Explore the questions behind nursing assessment, wound review, medicines support and recovery at home.
When a broader nursing assessment can clarify changing needs, ongoing care and next steps for an older person, family or home-care provider.
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How nursing assessment fits a change in an older person’s health, when medical review is needed and how to choose an appropriate next step.
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When nursing and physiotherapy may need to coordinate around an older person’s priorities, and what makes a shared care plan useful.
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