1.
|
Registered psychiatric nurses are accountable and responsible for their prescribing decisions.
|
2.
|
Registered psychiatric nurses prescribe only those medications as allowed by:
|
|
a.
|
The
Nurses (Registered Psychiatric) Regulation1,
|
|
b.
|
Other relevant provincial or federal regulations,
|
|
c.
|
BCCNM standards, limits, and conditions,
|
|
d.
|
Organizational/employer policies and processes, and
|
|
e.
|
the nurse’s individual competence.
|
3.
|
Before prescribing, registered psychiatric nurses ensure they have the competence to:
|
|
a.
|
Assess the client health status, including conducting an accurate health history and clinical evaluation,
|
|
b.
|
Make or confirm a nursing diagnosis of a condition that can be improved or resolved within the context of the client’s overall health status and care needs by prescribing a medication within the registered nurse’s scope of practice,
|
|
c.
|
Prescribe the medication safely, including knowing the medication’s therapeutic use, indications, dosages, precautions, contraindications, side effects, adverse effects, potential interactions between the medication and foods/medications/substances, medication forms and routes for administration, and
|
|
d.
|
Manage, monitor, and evaluate the client’s response to the prescribed medication.
|
4.
|
Registered psychiatric nurses use current evidence to support decision-making when prescribing medications.
|
5.
|
When prescribing, registered psychiatric nurses:
|
|
a.
|
Assess the client in person, or, if clinically appropriate, through a virtual health care encounter with a visual assessment. If a visual assessment is not possible, registered nurses prescribe without a visual assessment only after determining that it is clinically appropriate and only:
|
|
|
i. if the client is known to the nurse, and/or
|
|
|
ii. the client is being assessed in person by another health care provider.
|
|
b.
|
Consider the client’s health history related to the condition or health concern such as age, sex, past medical history, family history, social history and the client’s understanding, beliefs, and values,
|
|
c.
|
Undertake and document an appropriate clinical evaluation such as a physical examination or a review of relevant diagnostic tests and specialist reports,
|
|
d.
|
Obtain the best possible medication history for the client, including the client’s use of non-prescription medications and natural health products, as outlined in organizational/employer requirements (using PharmaNet when access is available and other sources),
|
|
e.
|
Review the medication history and follow organizational policies and processes for any identified discrepancies to be addressed,
|
|
f.
|
Ask about the client’s medication allergies and ensure medication allergy information is accurately and appropriately documented,
|
|
g.
|
Assess for difficulties in the client’s ability to pay for and/or access medications, and the potential need to refer the client to available provincial medication access programs,
|
|
h.
|
Document the medication prescribed to the client and the indication(s) for the medication,
|
|
i.
|
Establish a plan for reassessment/follow-up with respect to the prescribed medication, either by the registered psychiatric nurse themselves or by another prescriber, and
|
|
j.
|
Monitor and document the client’s response to the medication being prescribed (as applicable).
|
6.
|
Registered psychiatric nurses complete prescriptions for medications, legibly, accurately, and completely, including:
|
|
a.
|
The date the prescription was written,
|
|
b.
|
Client name, address (if available) and date of birth,
|
|
c.
|
Client weight (if required),
|
|
d.
|
Name, strength, and dose of the medication,
|
|
e.
|
The quantity prescribed and quantity to be dispensed,
|
|
f.
|
Dosage instructions (e.g. the frequency, maximum daily dose, route of administration, duration of medication therapy), and
|
|
g.
|
Prescriber’s name, work address, work telephone number, written/electronic signature, and prescriber number.
|
7.
|
Registered psychiatric nurses using order sets (pre-printed or electronic) to prescribe a medication:
|
|
a.
|
Make the order specific for that individual client,
|
|
b.
|
Include any necessary changes based on an assessment of the client, and
|
|
c.
|
Date and sign with their written/electronic signature.
|
8.
|
Registered psychiatric nurses follow organizational/employer policies and processes, (including security, privacy, and confidentiality measures), when transmitting a prescription to a pharmacy by phone, facsimile, or other electronic means.
|
9.
|
Registered psychiatric nurses collaborate, communicate, and/or consult with the client and with other health care professionals when prescribing medications, including:
|
|
a.
|
Consideration of the broader plan of care for the client developed by the health care team including other prescribers,
|
|
b.
|
The plan for reassessment/follow-up with respect to the prescribed medication,
|
|
c.
|
When the prescribing decision would benefit from the expertise of other health care professionals,
|
|
d.
|
When the needs of the client exceed the nurse’s scope of practice or individual competence, and
|
|
e.
|
Documenting the plan of care and communication with the health care team to meet the client’s care needs.
|
10.
|
Registered psychiatric nurses do not provide any person with a blank, signed prescription.
|
11.
|
Registered psychiatric nurses do not prescribe medications for themselves, or anyone else who is not their client.
|
12.
|
Registered psychiatric nurses participate in required and relevant provincial and/or national reporting programs.
|