Nurse Practitioner Regulation Framework Implementation Plan Project (NPR-FIPP)

As a member of the national steering committee, the SRNA is participating in the Nurse Practitioner Regulation Framework Implementation Plan Project (NPR-FIPP). This project is a multi-year, multi-faceted initiative commissioned by the Canadian Council of Registered Nurse Regulators (CCRNR).

The goal of NPR-FIPP is to implement the recommendations endorsed by CCRNR regarding six basic elements of a model for Nurse Practitioner regulation in Canada. These six elements include entry level education programs, the creation of one national entry-level examination for all NPs across Canada, common standards of practice, continuing competence, one NP registration category based on entry-level competencies and common principles for re-entry to practice. The first-year priority will focus on beginning work on an entry level examination and entry level education programs.

For additional information about the project, visit the CCRNR website.

If you have any questions about the project and/or the SRNA’s role, please contact Donna Cooke, Nursing Advisor, Regulatory Services at dcooke@srna.org or phone 1-800-667-9945 (ext. 202) or 306-359-4202.

24 Hour RN Coverage Resources

With the recent transition towards a single mandate organization, the SRNA Council has made the decision to discontinue the use of position statements. Thus, updated resources are being provided in replacement of previous position statements.

The 24 Hour RN Coverage in Special-Care Homes resource document will replace the 24 Hour Registered Nurse Coverage position statement. It is recognized that RNs are one health care provider within the larger health system, and there are many factors that lead to better outcomes for residents. This resource provides an at-a-glace connection to standards, competencies, ethical responsibilities and evidence for RNs practising in special-care homes.

Please review this document and consider how it may relate to your practice.

Updated Requirements for NP Hours

As of December 1, 2020, Nurse Practitioners in Saskatchewan will no longer be required to complete 600 clinical hours to maintain eligibility for registration. According to SRNA Bylaw VI subsection 3(7), NPs are required to work in nurse practitioner activities approved by the association in one of the four specialties for at least 900 hundred hours in the three years immediately preceding application. However, there is no longer a requirement for clinical hours.

This modification was made in recognition of changes in NP practice acknowledging the increasing diversity with many NPs working in various domains of practice outside of a clinical setting.

For any questions regarding this change, please email Leah White, RN Nursing Advisor (lwhite@srna.org)

Prescription Review Program (PRP): Codeine Use in Pediatrics

In response to an updated Health Canada advisory warning that patients under 18 years of age should not use non-prescription pain relief products containing codeine, the Prescription Review Program (PRP), Saskatchewan’s prescription monitoring program, has released correspondence to assist practitioners with the management of pediatric pain and provide guidance in regards to the use of codeine products. 

The update by Health Canada also included warnings regarding the use of prescription cough and cold products containing opioids in patients under 18 years of age. Research has suggested that early exposure to opioids may put young patients at risk for opioid-related adverse events throughout their life. 

Given it’s perceived safety, codeine was previously a preferred opioid drug in pediatrics, it has since been recommended that practitioners do not initiate treatment with codeine if the patient hasn’t been prescribed the drug for a chronic condition in the past. 

Correspondence shared by the Prescription Review Program, elaborates on the above topics further, outlines non-opioid and non-pharmacological options in pediatric pain management and highlights important reminders if an opioid prescription is deemed necessary in a pediatric patient. 

Review this document here

If you have any questions, please contact Susan Furman-Pelzer, NP Nursing Advisor PRP (prp@srna.org). 

NPs Prescribing Cosmetics

Nurse Practitioners (NP) in Saskatchewan can prescribe bioactive agents and medical fillers for cosmetic purposes when:

  • the patient condition for which they are prescribing the agents fall within the individual NP common medical disorders and
  • the NP has the knowledge, skills and competence to safely assess, treat, prescribe and/or administer the product in accordance with bylaws, standards and competencies and federal legislation.

NPs work within a collaborative team of physicians, registered nurses (RN) and other health care providers to implement the nursing process including assessment, care planning, implementation and evaluation. Considerations for NPs when practicing in an interdisciplinary setting:

  • Recognition of practice is required for NPs who practice in the most responsible practitioner role. Contact regulation@srna.org for further information.
    • The most responsible practitioner is responsible to:
      • conduct an initial assessment of the client at each visit;
      • establish a treatment plan for the injection;
      • assess that the RN providing the injection is competent to perform the task; and,
      • be available to provide assistance in the event of an untoward event.
    • RN Clinical Protocols are required to provide guidance to RNs who are administering these products under the authority of NPs. The four essential components for RN Specialty Practices must be incorporated into the RN Clinical Protocol.

Providing cosmetic services and procedures has evolved over the past several years and includes unique liability risks that NPs should understand prior to engaging in this area of practice. It is strongly recommended that NPs contact the Canadian Nurses Protective Society (CNPS) to discuss liability risks associated with cosmetic nursing.

Questions? Contact an SRNA Practice Advisor by phone: 1-800-667-9945 or 306-359-4227 or by email: practiceadvice@srna.org.

Advanced Foot Care for Registered Nurses

Infection Prevention and Control Canada has released an updated document on the use, cleaning, disinfection, sterilization and storage of foot care devices. The document outlines the required equipment and devices for client treatment, as well as stipulations for the purchasing and reusing of foot care devices, and options for guaranteed sterilization of the devices if items are being reused.

It is your duty as the Registered Nurse administering care to ensure that the client is not placed at risk of infection when foot care devices are being used. The level of sterilization of foot care instruments and supplies must be at the level of a health professional. RNs should evaluate their current practices against the recommended infection prevention and control practices within the document and adjust, as necessary.

With the rise of instances of chronic diseases increasing the need for advanced foot care, this document is to ensure that all Registered Nurses with this added certification are up-to-date on the best practices for safe foot care treatment, and are educated on the options available to ensure infection does not occur.

Read the full document here.

External Consultation Graduate Nurse Practice Guideline

The SRNA is currently reviewing the Graduate Nurse Practice Guideline and is seeking feedback on the content. This guideline provides information about topics such as the professional expectations, scope of practice and supervision requirements for Graduate Nurses (GN).

SRNA staff have reviewed and revised the existing document and are now seeking feedback from the public, partners and members as part of the external consultation process. This process is in place to ensure relevant information is clearly presented. Feedback can be provided by accessing this survey by August 7, 2020. All feedback will be reviewed and incorporated as appropriate.

Final approval occurs through the SRNA Executive Director and SRNA Council. The guideline will take effect on the SRNA Council approval date.

Questions or comments are welcome and can be directed to practiceadvice@srna.org.

Updated Clinical Decision Tools for RNs with Additional Authorized Practice

As of November 5, 2019, the updated Clinical Decision Tools (CDTs) for RNs with Additional Authorized Practice [RN(AAP)s] have been adopted by SRNA Council and will be in effect beginning December 1, 2019. As of this date, the older versions of the CDTs will no longer be in effect.

The evidence and best practice guidelines have been reviewed and incorporated into the updated CDTs with in-text sources included. The Interprofessional Advisory Group (IPAG) reviewed, revised and approved all of the CDTs. During this process, it was determined that some Pediatric and Adult CDTs could be merged to streamline the processes. Additionally, charts and tables have been added to support effective and clear messaging about pharmacology options and other information within the CDTs. Language has been updated to reflect non-binary genders, for example people of reproductive age rather than women of childbearing age, and reproductive health rather than women’s health.

While the literature review is complete and all CDTs are updated for evidence-informed best practice for RN(AAP)s to diagnose, treat and prescribe for limited common medical disorders, there are no significant practice changes and no new CDTs.

It is important RN(AAP)s review all CDTs to ensure they are informed about the latest evidence for their practice.

SRNA Practice Advisors may be contacted for answers to your practice questions by email at practiceadvice@srna.org or by phone 306.359.4200 or 1.800.667.9945 (toll free within Canada).

Telehealth Nursing Practice

We have received a number of calls lately about telehealth and the ability to provide this service. Telehealth connects patients and health care providers who provide health services over the phone, computer or any other form of information and communication technologies (ICT).

Providing telehealth to a Saskatchewan resident

To provide telehealth to a Saskatchewan resident, you must be registered and hold a practicing license with the SRNA. The Registered Nurses Act, 1988 in Saskatchewan outlines the need to be registered to engage in the practice of registered nursing and to use protected titles. Information about registration can be found here.

Questions about registration can be directed to Regulatory Services by email at register@srna.org or by calling 306.359.4200 or 1.800.667.9945 (toll free within Canada).

Providing telehealth to clients who are residents of another province or territory

Each province/territory and country is governed by differing legislation/regulations/bylaws. We encourage you to contact the nursing regulator in that jurisdiction before providing telehealth services to their residents.

A national discussion is currently underway to examine the delivery of telehealth services across the country. We will provide updates on this issues as further information becomes available.

For a confidential consultation about a practice issue, please contact a Practice Advisor by email at practiceadvice@srna.org or call 306.359.4200 or 1.800.667.9945 (toll free within Canada).

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