in respect of a drug specified in Schedule I of the
Drug Schedules Regulation,
prescribe the drug,
compound the drug,
dispense the drug, or
administer the drug by any method;
for the purposes of
respiratory distress in a known asthmatic,
post-partum hemorrhage, or
conditions that are symptomatic of influenza-like illness, or
preventing disease using immunoprophylactic agents and post-exposure chemoprophylactic agents
in respect of a drug specified in Schedule II of the Drug Schedules Regulation,
prescribe the drug,
Under the Regulation, registered nurses are permitted to prescribe those medications that are within their autonomous scope of practice to compound, dispense or administer. This includes Schedule II medications, as well as the limited number of Schedule I medications that registered nurses are authorized to compound, dispense, or administer for specific purposes without an order1
Registered nurses who prescribe medications, including Schedule I, II, III, or unscheduled medications must:
Prescribe only when they are recognized by their organization/employer as a prescriber.
Successfully complete additional education that supports safe, competent, and ethical practice of that activity.
Prescribe only when organizational/employer policies, processes and resources are in place that outline:
The accountability and responsibility of the prescribing nurse.
Processes for consulting with and/or referring to other health professionals (e.g. prescribers, pharmacists) about the prescribing decision as needed to meet the client’s needs.
Processes for ensuring continuity of care for the client, including:
responding to questions from the client (or their substitute decision-maker) or health care team members about the prescription or the need to make changes to the prescription,
consultation and referral pathways such as for diagnostic testing results, and
management and evaluation of client outcomes including monitoring, managing intended and unintended outcomes, and follow-up with respect to the prescribed medication.
For registered nurses who prescribe Schedule I medications, their additional education must include:
Basic prescribing competencies;
condition(s)2 for which the medication is being prescribed; and
The medication to be prescribed.
Registered nurses who prescribe Schedule I medications must have access to PharmaNet.
In addition, registered nurses who prescribe any Schedule I or II medication must comply with
all other applicable limits and conditions that apply to the administration of that medication by a registered nurse without an order.
These limits and conditions for prescribing for opioid use disorder apply when registered nurses, within their autonomous scope of practice:
Registered nurses who prescribe a controlled drug or substance are limited to prescribing only for the purpose of treating opioid use disorder.
Registered nurses who prescribe for the treatment of opioid use disorder must:
additional education that includes basic prescribing competencies and the medication to be prescribed; and
the additional education and preceptorship requirements established by the British Columbia Centre on Substance Use (BCCSU) related to prescribing for the treatment of opioid use disorder.
the registered nurse to refer for diagnostic testing care, and
the review and follow-up of diagnostic testing, and
for the registered nurse to consult with, refer to and/or transfer care to physician, nurse practitioner, or addiction specialist.
Storing all controlled prescription pads and personalized prescription pads in a secure and locked area,
Reporting all loss, theft or misuse of personalized prescription pads or controlled prescription pads to BCCNM, PharmaNet Support Services, the police, and, if any client information is contained on the missing pad, the Information and Privacy Commissioner for British Columbia,
Returning controlled prescription pads to BCCNM if no longer practising in British Columbia, if licensure status changes to non-practising or inactive, information printed on the pad is not current, or BCCNM staff instruct that pads must be returned, and
Storing the duplicate copy of a controlled prescription with the client health record, not within the controlled prescription pad.
In addition, registered nurses who prescribe for the treatment of opioid use disorder must comply with all other applicable BCCNM standards, limits and conditions that apply to the prescribing of medications.
While the Order of the Provincial Health Officer is in place, it creates a temporary exception to the usual restriction against registered nurses prescribing Schedule I or Schedule IA drugs, or compounding, dispensing, or administering Schedule I or Schedule IA drugs without an order from an authorized health professional.
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