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Limits and conditions on prescribing medications

Part 2: Scope of practice standards

Limits and Con​ditions on Prescribing Medications

​1.
​​​​Registered psy​chiatric nurses only presc​ribe medications (to be dispensed by a ​pharmacist) when they:​​​​

a.​​
​Are recogn​​ized by th​eir organization/employer as a pr​escriber​; AND​

​b.
Have a BCCNM-assign​​ed prescriber number; AND

​c.

Meet the requi​rements to prescribe for the treatment of ​opio​id​ use disorder.

Limits and Conditions for the Diagnosis and Treatment of Opioid Use Disorder​

These limits and conditions apply when registered psychiatri​c nurses, within their aut​onomous scope of practice, diagnose and treat opioid use disorder by:

  • Prescribing a medication for a client for the treatment of opioid use disorder (to be dispensed by a pharmacist),
  • Compounding a medication for a client for the treatment of opioid use disorder,
  • Dispensing a medication to a client for the treatment of opioid use disorder,
  • Administering a med​​ication to a client for the treatment of opioid use disorder​.​​

​1.
Registered psychiatric nurses may only compound, dispense, or administer controlled drugs and substances within their autonomous scope of practice and may only prescribe any medications within their autonomous scope of practice (including controlled drugs and substances), for the t​reatment of​ opioid use disorder.​​​​​
​2.
​​​​​​​Registered psychiatric nurses who, within their autonomous scope of practice, diagnose and treat opioid use disorder must: ​
​a.
​​​​​Prescribe, compound, dispense, or administer only those medications identified by the British Columbia Centre on Substance Use (BCCSU) for the treatment of opioid use disorder and as allowed by their employer.​

​b.
​​​​​​Meet the employment requirements set out in the Order of the Provincial Health Officer: Registered Nurse and Registered Psychiatric Nurse Public Health Pharmacotherapy.​​​ ​​

​c.
​Be recognized by their organization/employer as a prescriber for the treatment of opioid use disorder.​

​d.
​Successfully complete​​:


​i.
​​​​​additional​ education that includes basic prescribing competencies and the medication to be prescribed; and


​ii.
​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 dis​​order.
​e.
​​​​​​Follow the clinical guidelines and protocols established by BCCSU related to the diagnosis and treatment of opioid use disorder. ​

​f.
​Prescribe for the treatment of opioid use disorder only when there are established policies and processes:
​i.
​​​​​For the registered psychiatric nurse to order or refer for diagnostic testing, and for the review and follow-up of diagnostic testing results, and​


​ii.
​​​for the registered psychiatric nurse to consult with, refer to, and/or transfer care to a physician, nurse practitioner, or addiction specialist.​​

​g.
​Prescribe controlled drugs and substances in accordance with the British Columbia Controlled Prescription Program, including:​​ ​​​


​i.
​ ​Storing all controlled prescription pads and personalized prescription pads in a secure and locked area,​ ​
​ii.
​​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,​​​


​iii.
​Returning controlled prescription pads to BCCNM if licensure status changes to non-practicing or inactive, information printed on the pad is not current, or BCCNM staff instruct that pads be returned, and

​iv.
​Storing the duplicate copy of a controlled prescription with the client health record, not   within the controlled prescription pad.

​h.
​​​​​​​Have access to PharmaNet for documenting review of the client’s PharmaNet medication profile, medication reconciliation and prescription monitoring.

​i.

​Diagnose a​​nd treat opioid use disorder within their autonomous scope of practice only while the Order of the Provincial Health Officer: Registered Nurse and Registered Psychiatric Nurse Public Health is in effect.​

​ ​​ In addition, registered psychiatric nurses who prescribe diagnose and treat opioid use disorder must comply with all other applicable BCCNM standards, limits and conditions that apply to the prescribing, dispensing, and administration of medications.

While the Order of the Provincial Health is in place, it creates a temporary exception to the usual restriction against registered psychiatric nurses prescribing any Schedule I or Schedule IA drugs, or compounding, dispensing or admin​istering Schedule I or Schedule IA drugs without an order from an authorized health professional.​​​​​​​​

900 – 200 Granville St
Vancouver, BC  V6C 1S4
Canada

info@bccnm​.ca
604.742.6200​
​Toll-free 1.866.880.7101 (within Canada only) ​


With great respect, we acknowledge that BCCNM’s office is located on the unceded territories of the hən̓q̓əmin̓əm̓ speaking peoples – xʷməθkʷəy̓əm (Musqueam), and sel̓íl̓witulh (Tsleil-Waututh) Nations, and the Sḵwx̱wú7mesh-ulh Sníchim speaking peoples - Sḵwx̱wú7mesh Úxwumixw (Squamish Nation) whose historical relationships with the land continue to this day.​