Certified practice registered nurses do not require a client-specific order from a listed health professional for a restricted activity listed in section 8 of the RN Regulation that is within the autonomous scope of the nurse’s certified practice designation and the nurse’s individual competence.
|
8
|
(1)
|
A registrant in the course of practising nursing may do any of the following:
|
|
|
|
(a)
|
perform an activity described in section 7 (1)(a) or (b) to (h);
|
|
|
|
(a.1)
|
in respect of a drug specified in Schedule I of the Drug Schedules Regulation,
|
|
|
|
|
(i)
|
prescribe the drug,
|
|
|
|
|
(ii)
|
compound the drug,
|
|
|
|
|
(iii)
|
dispense the drug, or
|
|
|
|
|
(iv)
|
administer the drug by any method;
|
|
|
(b)
|
make a diagnosis identifying a disease, disorder or condition as the cause of the signs or symptoms of the individual.
|
BCCNM Limits and Conditions for Certified Practice Registered Nurses
Certified practice RNs are allowed within their autonomous scope of practice to diagnose a disease, disorder, or condition and treat by prescribing, dispensing, administering, or ordering Schedule I medications.
These limits and conditions apply to certified practice registered nurses who are authorized to perform certain restricted activities within their autonomous scope of practice in one or more of the following certified practice areas:
- Reproductive Health (Contraceptive Management) Certified Practice
- Reproductive Health (Sexually Transmitted Infections) Certified Practice
- Remote Practice Certified Practice
- RN First Call Certified Practice.
I. Certified practice registered nurses must:
- Successfully complete the relevant certified practice education program approved by BCCNM (see Table 1).
-
Diagnose and treat only those diseases, disorders, or conditions or provide contraceptive management as outlined in the competencies of the BCCNM recognized education program for their certified practice designation and as set out in
Table 21.
-
Follow the decision support tools managed by the
Nurses and Nurse Practitioners Association of British Columbia (NNPBC) for their certified practice designation, and only diagnose and treat diseases, disorders, or conditions, including the administration, dispensing, or prescribing of medications, as outlined in the decision support tools for their certified practice designation.
-
Ensure they are competent before performing a new activity added to their certified practice designation and as identified within their certified practice decision support tools such as diagnosing or treating a new disease, disorder, condition, or providing a new treatment.
-
Diagnose and treat diseases, disorders, or conditions or provide contraceptive management as outlined for their certified practice designation, including prescribing, dispensing, administering, or ordering medications, and ordering diagnostic tests only when policies, processes an/or resources are in place for:
|
a.
|
Ensuring continuity of care for the client, including appropriate follow-up of diagnostic testing results, questions about the prescription, and the monitoring and management of client outcomes related to their treatment plan.
|
| |
b.
|
Consulting with other health professionals (e.g., nurse practitioners, medical practitioners, pharmacists, primary care providers) about the treatment plan or as needed to meet the client's needs.
|
II. Certified practice registered nurses who prescribe medications associated with their certified practice area
(to be dispensed by a pharmacist)2 must also:
-
Have a BCCNM-assigned prescriber number.
-
Prescribe only when they are recognized by their
organization/employer3 as a prescriber.
-
Successfully complete certified practice education approved by BCCNM that includes competencies that align with BCCNM prescribing standards, limits, and conditions.
Table 1: RN Certified Practice Education Programs Required and Approved by BCCNM
CERTIFIED PRACTICE
|
CERTIFIED PRACTICE EDUCATION PROGRAM RESOURCES |
|
Reproductive Health: Contraceptive Management
|
- British Columbia Institute of Technology (BCIT): Contraceptive Management
|
|
Reproductive Health: Sexually Transmitted Infections
|
- British Columbia Centre for Disease Control (BCCDC): Sexually Transmitted Infections Management
OR
- British Columbia Institute of Technology (BCIT): Sexually Transmitted Infections
|
| Remote Practice |
- University of Northern British Columbia (UNBC): Remote Nursing
|
RN First Call
|
- University of Northern British Columbia (UNBC): RN First Call
|
Table 2: The Diagnosis and Treatment of Diseases, Disorders, Conditions by Certified Practice RNs in Accordance with Decision Support Tools
CERTIFIED PRACTICE
|
DISEASES, DISORDERS, CONDITIONS
|
DRUG SCHEDULES4 AND THERAPEUTIC CLASSES
|
|
Reproductive Health - Contraceptive Management |
May prescribe or dispense hormonal contraception.
|
Schedule I:
- Sex Hormones (hormonal contraception)
|
|
Reproductive Health –
Sexually Transmitted Infections
|
May diagnose and treat the following diseases and disorders:
- Chlamydia Trachomatis
- Neisseria Gonorrhea
- Mucopurulent Cervicitis
- Trichomoniasis
- Bacterial Vaginosis
- Urethritis
- Recurrent Urethritis
- Lower Urinary Tract Infection
- Genital Warts
Treatment of sexually transmitted infections contacts
|
Unscheduled:
- Liquid Nitrogen
- Trichloroacetic Acid
Schedule I:
- Antibacterials
- Antivirals
- Antiprotozoals
- Antimitotics
Schedule II/III:
- Topical Anaesthetics
- Lidocaine
|
|
Remote Practice
|
May diagnose and treat the following diseases, disorders, and conditions for pediatric and adult clients unless indicated as adult only:
- Eye: conjunctivitis, minor corneal abrasion
- Ear-Nose-Throat: acute otitis media, pharyngitis, ceruminosis (adult only), dental abscess (adult only)
- Genitourinary: urinary tract infection
- Respiratory: acute bronchitis (adult only)
- Integumentary: abscess and furuncle (adult only), cellulitis, impetigo, bites,
- Pain: use of nitrous oxide/oxygen for pain management (adult only)
|
Unscheduled:
- Nitrous oxide/oxygen for pain management
Schedule I:
- Antibacterials
- Antivirals
- Antiprotozoals
- Antihistamines
- Bronchodilators
Schedule II/III:
- Analgesics
- Antibacterials
- Antihistamines
- Topical anaesthetics
|
|
RN First Call |
May diagnose and treat the following diseases and disorders and conditions for pediatric and adult clients unless indicated as adult only:
- Eye: Conjunctivitis, minor corneal abrasion;
- Ear-Nose-Throat: Acute otitis media, pharyngitis, dental abscess (adult only);
- Urinary Tract: Lower urinary tract infection (adult only).
|
Schedule I:
- Antibacterials
- Antivirals
- Antiprotozoals
- Antihistamines
Schedule II/III:
- Analgesics
- Antibacterials
- Antihistamines
- Topical Anaesthetic
|
Footnotes
1
|
Certified practice registered nurses may also diagnose and treat conditions that are within the autonomous scope of general RN practice and the nurse's individual competence.
|
2
|
These additional limits and conditions for prescribing only apply when a certified practice RN prescribes a medication to be dispensed by a pharmacist. They do not apply when a certified practice RN gives a client-specific order for compounding, dispensing or administering a medication to be acted on by another nurse (RN, LPN or RPN) or other health professional, other than a pharmacist.
|
3
|
For nurses working for non-health authority agencies or organizations or who are otherwise engaged with a third-party, the “organization/employer" refers to the agency or organization with primary responsibility for the care of the client.
|
4
|
Drug schedules and definitions for Unscheduled, Schedule I, Schedule II, Schedule III: Drug Schedules Regulation.
|