Nursing Practice Updates

Updates focus on changes to legislation, SRNA bylaws, and the introduction of new standards and guidelines.

RN(NP)

RN(NP) Practice Update: RN(NP)s Prescribing for Opioid Use Disorder (OUD) and Methadone for Pain

On March 27, 2019, SRNA Council passed the two policies that allow RN(NP)s, who regularly see people with Opioid Use Disorder (OUD) or who require methadone for pain, to apply to the SRNA to receive approval to prescribe medications such as suboxone and methadone. These regulatory processes are in follow up to the Bylaw passed by SRNA membership at the 2018 SRNA Annual Meeting. Based on this Bylaw, the SRNA has worked with provincial and national partners, including the Saskatchewan Health Authority, the Ministry of Health, the College of Physicians and Surgeons of Saskatchewan, Interdisciplinary Advisory Committees, and RN(NP) Advisory Committee, to develop the education and clinical practicum requirements, and regulatory processes.

The SRNA has developed regulatory processes to minimize harm to the public and develop expectations for safe prescribing. In accordance with the SRNA mandate to set standards for competence and govern prescribing, RN(NP)s must meet all requirements prior to receiving approval to prescribe drug therapeutics for OUD and methadone for pain. The RN(NP) prescribing of these additional medications will be monitored through the existing Prescription Review Program.

Advancing the RN(NP) Scope of Practice by enabling RN(NP)s to prescribe drug therapeutics for OUD will increase the number of approved prescribers in Saskatchewan; thereby providing increased access for clients.

Eligible RN(NP)s can begin the application process as of April 2, 2019.

RN(NP)

Update on RN(NP) Authority to Prescribe Medication for Opioid Use Disorder (OUD) and Methadone for Pain.

The SRNA is completing final edits to Council Policies to enable RN(NP)s to prescribe for Opioid Use Disorder (OUD) and Methadone for pain. These Council Polices will be going out for final consultation to targeted key partners and are scheduled to be presented to SRNA Council for approval March 27, 2019.

Please watch for additional communication following the March 27, 2019 Council meeting.

RN(NP)

Interpretation of Common Medical Disorders

The SRNA is pleased to introduce a new interpretation of Common Medical Disorders as originally defined in Council Governance Policy 3.15. RN(NP) practice has evolved over time to provide better access to quality and timely health care in a variety of settings, therefore the SRNA is broadening the interpretation of Common Medical Disorders.

The new draft interpretation was presented by SRNA staff and approved by Council at the November 2018 Council meeting. This new policy assists RN(NP)s, the public and health care partners to understand the evolving scope of diagnosing and treating Common Medical Disorders. There is recognition in the policy that some medical disorders may be uncommon for some RN(NP)s, but common for others in their RN(NP) practice. Additionally, RN(NP)s competency progresses through their career, therefore disorders may become more common.

  • The Principles of Common Medical Disorders determine what RN(NP)s must adhere to when completing assessments that lead to diagnosing and treating Common Medical Disorders:
  • RN(NP)s need to consider their area of specialty practice, the diverse populations encountered, and the variety of clinical practice settings.
  • RN(NPs) require continuing professional development to ensure safe and competent diagnosis and treatment of the common medical disorders within their practice.
  • RN(NP)s must consider the trajectory of clients’ health needs across the lifespan as well as the nature of a team-based approach, including collaborative relationships with other health care providers.
  • RN(NP)s must be able to provide applicable health services considering The Registered Nurses Act, 1988, the bylaws, the standards and competency documents and the polices of council of the SRNA.

You can view the updated policy here.

SRNA Nursing Advisors are available to discuss practice questions about Common Medical Disorders. To contact the SRNA for practice advice, please call: 1-800-667-9945 or 306-359-4200 (ask to speak to a practice advisor), or you can email at practiceadvice@srna.org

RN(NP)

RN(NP)s Can Prescribe Medical Cannabis

With the legalization of recreational cannabis on October 17, 2018, new Cannabis Regulations have replaced the Access to Cannabis for Medical Purposes Regulations (ACMPR). Under the new regulations, a nurse practitioner is defined as an authorized health care provider and is not restricted, under the laws of the province in which they practise, from authorizing the use of cannabis.  The Saskatchewan Registered Nurses Association (SRNA) has determined that it is within the RN(NP)s scope of practice whom have the appropriate knowledge, skills and competencies to safely authorize the use of medical cannabis for Saskatchewan clients.

It is important RN(NP)s educate clients on the risks, side effects, safe transportation and storage of medical cannabis. RN(NP)s are required to adhere to employer policy for authorizing the use of medical cannabis. Clients authorized by their health care provider are still able to access cannabis for medical purposes by:

Additional resources for RN(NP)s:

SRNA Nursing Advisors are available to discuss practice questions about cannabis. To contact the SRNA for practice advice, please call: 1-800-667-9945 or 306-359-4200 (ask to speak to a practice advisor), or you can email at practiceadvice@srna.org

RN(NP)

RN(NP)s Can Prescribe Mifegymiso

Mifegymiso is an antihormonal medication consisting of two medications (mifepristone and misoprostol) that work together to block the effects of progesterone for termination of early pregnancy.

Health Canada recently broadened the interpretation of Mifegymiso prescriber to include prescribing health professional, resulting in Nurse Practitioners having the legal authority to prescribe Mifegymiso within Canada. The Saskatchewan Registered Nurses Association (SRNA) has determined that it is within the RN(NP)’s scope of practice whom have the appropriate knowledge, skills and competencies to prescribe Mifegymiso to Saskatchewan patients.

Additional resources for RN(NP)s:

RN(NP)

Drug Therapeutics for Opioid Use Disorder and Methadone for Pain

An interdisciplinary advisory group is working with SRNA staff to develop council policy that fully defines the educational, practicum, monitoring and audit requirements. The projected timeline to have policies approved by SRNA Council is by Dec. 31, 2018. SRNA will provide updates as the work progresses.

RN(NP)

Health Canada – New Requirements for Dispensing Opioids

Starting on October 23, 2018, Health Canada has amended the Food and Drug Regulations to require a warning sticker and patient information handout be provided when dispensing Class A opioids. These requirements will ensure that all Canadians receive consistent information about the risks and safe use of opioids.

Currently in Saskatchewan, RN(NP)s licensed with the SRNA are the only authorized practitioners who can dispense opioids. When dispensing Class A opioids, the practitioner is required to ensure:

  • The opioid warning sticker be affixed to the opioid bottle, container or package.
  • The Opioid Patient Information handout must be given directly to the patient from the practitioner dispensing the opioid.

For more information, visit the Government of Canada’s website.

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