Risk Prevention Nurse Clinic project


The Risk Prevention Nurse Clinic project ran from August 2019 to June 2020 and supported four general practices to establish nurse clinics focusing on risk prevention and healthy lifestyles. Funded by the Victorian Department of Health and Human Services, successful organisations received $10,000 grant funding.

The project implemented a pre-determined model, intended to increase nurse-led multi-disease risk screening, improve the documentation of risk factors and promote the early detection of chronic disease, within 4 general practices located in Western Victoria. Preventative health nurse clinics (PHNC) were established as the primary means to facilitate chronic disease risk screening the practice population using the My Health Check Tool (MHCT)[1]. Screened patients were connected to general practitioners (GP), practice nurses (PN), and other referred services, to undertake health assessment, diagnostic interventions and manage risk factors. Patients identified with a chronic disease or at high risk, were provided a with a GP Management Plan (GPMP) or Team Care Arrangement (TCA) (subject to eligibility) and were supported to manage their own health more effectively through attending the PHNC for health coaching and care co-ordination.   

[1] The My Health Check Tool (MHCT), developed in 2017 by DHHS Victoria, is an integrated self assessment tool providing an overall risk score and  risk scores for common chronic conditions including, diabetes, heart disease, kidney disease and osteoporosis. 

Project Aims

  • To improve risk assessment for chronic disease in patients through the use of the Health Check tool 
  • To increase patients’ interest in a healthier lifestyle through nurse clinic support
  • To embed health coaching as a key skill to engage patients in healthy living 

The full Project Case Study can be found on the APNA nurse clinic page.

Patient Flow Chart





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