Introduction
Diagnostic services that nurse practitioners order include:
- laboratory,
- miscellaneous services (such as cardiac stress tests, echocardiograms, Holter monitoring, amniocentesis, etc.), and
- imaging (including X-ray, ultrasound, nuclear medicine, computerized tomography scans and magnetic resonance imaging)
Standards
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1.
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Nurse practitioners order diagnostic services, provide appropriate follow-up, diagnose and manage diseases, disorders and conditions within the scope of practice for nurse practitioners and their individual competence.
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2.
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Nurse practitioners engage in evidence informed diagnosing and management considering best practice guidelines and other relevant guidelines and resources.
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3.
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Nurse practitioners:
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a.
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provide the appropriate clinical information when ordering diagnostic tests
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b.
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establish mechanisms within their practice setting(s) to track and follow-up on diagnostic test results
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c.
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ensure clients are informed, in a timely manner, of diagnostic test results, implications and needed follow-up
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d.
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communicate, as needed, diagnostic test results with key providers involved in the client’s care
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4.
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Nurse practitioners document follow-up (and follow-up attempts) with the client and key providers on significant diagnostic test results, next steps and the care and treatment needed.
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Limits and Conditions
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Nurse practitioners apply X-rays1 only after completing additional education,2 and when organizational supports, including policies and procedures, are in place to support the safe application of X-rays.
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2.
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Nurse practitioners applying X-rays also follow the standards for Advanced Procedures and Activities.
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3.
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Nurse practitioners apply X-rays in an appropriate clinical setting that is suitable to safely perform the procedure and includes the equipment and supplies needed to manage any emergency situations.
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4.
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Nurse practitioners only use Health Canada-approved devices when applying X-rays.
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5.
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Nurse practitioners do not take responsibility for the final interpretation of medical imaging studies. Nurse practitioners may initiate appropriate treatment while waiting for the final interpretation from a diagnostic radiologist.
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Footnotes
1.
| Per the Nurses (Registered) and Nurse Practitioners Regulation, nurse practitioners do not apply X-rays for the purpose of computerized axial tomography.
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2.
| Additional education is structured education (e.g. workshop, course, program of study) designed so that nurse practitioners can attain the competencies required to carry out a specific activity as part of nurse practitioner practice. Additional education builds on the entry-level competencies of nurse practitioners, identifies the competencies expected of learners on completion of the education, includes both theory and application to practice, and includes an objective, external evaluation of learners’ competencies on completion of the education. The term does not refer to a course or program approved by BCCNM for BCCNM certified practice.
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