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Part 6: Certified practice

Limits and conditions

BCCN​M Limits and Conditions for Certified Practice Registered Psychiatric Nurses

Registered Psychiatric Nurses (Certified) are allowed within their autonomous scope of practice to diagnose opioid use disorder and treat by prescribing, compounding, dispensing, administering, or ordering medications for the treatment of opioid use disorder. Certified practice registered psychiatric nurses may also diagnose and treat conditions that are within the autonomous scope of general registered psychiatric nurse practice and the nurse’s individual competence.

  I. Certi​​fied practice registered psychiatric nurses must:

  1. Successfully complete the relevant certified practice education program approved by BCCNM (see Table 1).
  2. Diagnose and treat only those diseases, disorders, or conditions outlined in the competencies of the BCCNM recognized education program for their certified practice designation and as set out in​ Table 214.

  3. Follow the decision support tools managed by the British Columbia Centre on Substance Use (BCCSU) for their certified practice designation, and only diagnose and treat diseases, disorders, or conditions, including the prescribing, compounding, dispensing, administering, or ordering medications, and ordering diagnostic tests as outlined in the decision support tools for their certified practice designation. 

  4. Complete additional education15 and ensure ​they are c​​ompetent 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.

  5. Diagnose and treat diseases, disorders, or conditions as outlined for their certified practice designation, including prescribing, compounding, dispensing, administering, or ordering medications, and ordering diagnostic tests only when policies, processes and/or resources are in place for: 

​​

​a.

​Ensurin​g continu​​ity 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, referring to, or transferring care to other health professionals (e.g., nurse practitioners, medical practitioners, addiction specialists, pharmacists, primary care providers) about the treatment plan or as needed to meet the client's needs.

 II. Certified prac​​tice registered psychiatric nurses who prescribe16 medications for the treatment of opioid use disorder must also:

  1. Have a BCCNM-assigned prescriber number.

  2. Prescribe only when they have the approval or are recognized by their organization/employer17 as a prescriber.

  3. Successfully complete certified practice education approved by BCCNM for their certified practice designation that includes competencies that align with BCCNM prescribing standards, limits, and conditions.  

  4. ​Prescribe for the treatment of Opioid Use Disorder only when they successfully complete the British Columbia Centre on Substance Use (BCCSU) Provincial Opioid Addiction Treatment Support Program: Registered Nurses and Registered Psychiatric Nurses course.

  5. Prescribe only those medications as outlined within the decision support tools for their certified practice designation.

  6. Have access to PharmaNet and document review of the client’s PharmaNet medication profile when prescribing controlled drugs and substances.

​Tab​le 1:​  RPN Certified Practice Education Programs Required and Approved by BCCNM

CERTIFIED PRACTICE
CERTIFIED PRACTICE EDUCATION PROGRAM ​ 
​Opioid Use Disorder
  • ​British Columbia Centre on Substance Use (BCCSU): Provincial Opioid Addiction Treatment Support Program– Registered Nurses and Registered Psychiatric Nurses​


​Table 2:  The Diagnosis and Treatment of Diseases, Disorders, Conditions by Certified Practice RPNs in Accordance with Decision Support Tools

CERTIFIED PRACTICE
DISEASES, DISORDERS, CONDITIONS
DRUG SCHEDULES18  AND THERAPEUTIC CLASSES
Opioid Use Disorder
​May diagnose and treat opioid use disorder

​​​Schedule IA (as per certified practice decision support tools):

  • Opiate Agonist
  • Opiate Partial Agonist

Schedu​le I (as per certified practice decision support tools):

  • Alpha-Adrenergic Agonist

Schedule II/III/unscheduled: as per certified practice decision support tools


Footnotes

14
Certified practice registered psychiatric nurses may also diagnose and treat conditions that are within the autonomous scope of general RPN practice and the ‎nurse’s individual competence.
​15
​Additional education is structured education (e.g., a workshop, course, or program of study) designed so that registered psychiatric nurses can attain the competencies required to carry out a specific activity as part of registered psychiatric nursing practice. Additional education builds on the entry-level competencies of registered psychiatric nurses; identifies the competencies expected of learners on completion of their education; includes both theory and application to practice; and includes an objective, external evaluation of learners’ competencies on completion of the education.
​16
​In these standards, the term “prescribing” is used to describe the issuance of a prescription for a medication to be dispensed by a pharmacist or pharmacy. 
17
​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.​
18
​Drug schedules and definitions for Unscheduled, Schedule I, Schedule II, Schedule III:  Drug Schedules Regulation.

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