Regulation Changes to support NPs to Admit and Discharge from Hospital and Perform Admission Assessments in Long-Term Care

On August 29, 2024, changes to the both The Attending Health Professionals Amendment Regulations and The Special-care Home Regulations were approved. The Orders in Council can be accessed here. The changes in these regulations provide the legislative authority for NPs to:

  • Admit and discharge a person as an in-patient; and,
  • Perform admission assessments for residents being admitted to a special-care home.

NPs require employer policies and processes and individual competence prior to adding these areas to their practice. Practice information about admitting and discharging from acute care can be found here.

Questions about this update can be directed to the Nursing Advisors, Practice & Education at practiceadvice@crns.ca or by calling 1-800-667-9945.

External Consultation Self-Employed Practice Guideline and Aesthetic Nursing Resource

The CRNS is updating advertising direction to its members who are self-employed and/or practice aesthetics nursing. The CRNS seeks feedback on two documents from members and external stakeholders, including the public, 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 the following surveys and will be accepted until Friday, September 16, 2024, at 4:00 pm.

Self-Employed Practice Guideline Survey

Self-Employed Practice Guideline Survey

  • Please note, that the focus of this survey is to seek feedback on the advertising and compensation sections of the Guideline and did not include a full review of the document content, however, minor changes have been made throughout. A full review of the document will be coming up in the future.
  • For ease of providing feedback on the revised sections of the Guideline, in the survey these sections are required to answer(marked with an asterisk), and the other sections can be reviewed, and skipped if you have no further feedback.

Aesthetic Nursing Resource

Aesthetic Nursing Resource Survey

Questions or comments are welcome and can be directed to Shayna Moore at smoore@crns.ca and/or Virginia Deobald at vdeobald@crns.ca.

Prescribing Intravenous Iron – Provincial Program Roll-Out

The Saskatchewan Health Authority began the launch of the provincial Iron Deficiency Anemia (IDA) Management program on June 3, 2024. Implementation of the program involves a mandatory outpatient IV iron order set that can be accessed here. The order set is scheduled to be gradually rolled out across the province in the coming months. A memo containing a more detailed site-specific timeline can be found here. The program will affect ALL OUTPATIENT IV iron prescribing once implemented in your community.

IDA Management Program Pharmacists are available to answer your questions. Please find their info below. Live virtual education sessions will be offered for those interested. Dates to follow.

Ben Kinsley (Regina/South)                          Brent Vanin (Saskatoon/North)

Ph: 306 766 2896                                           Ph: 306 655 6077

Ben.kinsley@saskhealthauthority.ca         brent.vanin@saskhealthauthority.ca

Advertising Nursing Services

RNs and NPs are professionally accountable for how they convey their self-employed practice/business to the public through advertising. The purpose of advertising is to provide information so the public can make an informed decision when selecting registered nursing services from a self-employed registrant. Registrants may engage in advertising their nursing services for the purpose of promoting, maintaining or restoring health; and, preventing illness and alleviating suffering.

Registrants who advertise nursing services shall:

  • comply with federal, provincial and CRNS legislation; 
  • present information in a manner consistent with the current practice standards, entry-level competencies and the code of ethics;
  • advertise services only within the legislated scope of the registrant; 
  • state full name and protected title in the advertisement;
    • CRNS designation may only be used once you obtain Recognition of Practice (ROP) approval, or if the nursing services are designated nursing activities as interpreted by the Act; 
  • provide an accurate written description of the services provided, including risks and benefits of the service; 
  • address any actual, potential or perceived conflict of interest;
  • obtain informed consent and always maintain client privacy and confidentiality;
  • use reasonable and appropriate illustrations, images, representations or claims; 
  • keep a copy of all advertisements for a reasonable time (suggested 5-year retention, or as suggested per legal counsel) for your record keeping;
  • only provide and advertise health services or products that are authorized for sale in Canada by Health Canada;
  • avoid comparative statements that claim or imply superiority over others or include promotional/sale advertising;
  • ethically manage the potential risks associated with endorsements, refraining from endorsing products, product line or health care services that are not related to the care or services provided;
  • do not mislead the public with exaggerated claims of the effectiveness of the service being provided; and,
  • ensure advertisements are presented in a manner that maintains the public’s trust and are accurate, factual, evidence-based, verifiable, ethical and professional. 

CRNS Nursing Advisors are available to answer your questions. They can be contacted by phone at 1.800.667.9945 or 306.359.4227 or by email at practiceadvice@crns.ca

Resources

Aesthetics Nursing Resource

Self Employed Practice Guideline

Recognition of Practice (ROP) Information Page

The Canadian Code of Advertising Standards

The Registered Nurses Act, 1988

Joint Statement on Long-Term Care – Authorized Prescriptions

There have been several questions and requests for clarification in follow up to the Long-Term Care – Authorized Prescriptions joint statement that was sent out by CPSS, CRNS, CLPNS and SCPP. Legislation requirements were included in the original joint statement. This second joint statement has been issued to provide further clarity regarding the use of verbal/telephone orders to dispense a prescription in a Long-Term Care (LTC) setting.

Pharmacists

  • Must receive orders to dispense a prescription directly from a physician, NP, RN (AAP), dentist and other authorized prescribers.
  • May accept a verbal/phone or faxed original prescription written and signed by an authorized prescriber.
  • May receive a faxed transcribed order from a nurse as a means of communication so the pharmacist can expect an order from the authorized prescriber and alerts the pharmacist to follow up with the prescriber if the prescription is not received.

Physicians

  • May provide nurses with a telephone/verbal order to facilitate timely patient care.
  • Must provide pharmacists with an order directly to authorize the pharmacist to dispense a prescription.

Nurses

  • May take telephone/verbal orders from an authorized prescriber and may fax the transcribed order to the pharmacist for communication purposes.
  • Cannot act as a third party in the direct communication required between the authorized prescriber and the pharmacist when there is an order to dispense a prescription.

CRNS Nursing Advisors are available to answer your questions. They can be contacted by phone at 1.800.667.9945 or 306.359.4227 or by email at practiceadvice@crns.ca.

Extension to the Temporary Exclusion of Eligibility for MAiD 

On February 2, 2023, the Ministers of Justice and Health of the Government of Canada introduced legislation, Bill-39, to extend the temporary exclusion of eligibility for MAiD where a person’s sole medical condition is a mental illness until March 17, 2024. The one-year extension would provide the federal government with additional time to prepare for the safe and consistent assessment and provision of MAID where the person’s sole underlying medical condition is a mental illness. 

The CRNS will continue to monitor updates from the Federal government, work with Saskatchewan Health Authority MAiD program partners and provide updates as they become available.

More information is available from the Department of Justice Canada website, MAiD Media Release.

If you have any questions, please get in touch with Practice Advice at practiceadvice@crns.ca

Antibiotic Suspension Shortage

Health Canada has declared a Tier 3 shortage for several antibiotic suspensions. Tier 3 is the most critical level and is expected to impact the health care system significantly. Many antibiotic suspensions are unavailable or sporadically available in extremely limited supply.

There may be a current supply of certain antibiotic suspensions, but we should expect these to become depleted as prescribing shifts. Tablets and capsules are currently available. This message addresses:

  • Strategies for conserving antibiotic suspensions
  • Resources for managing this shortage
  • Resources to help your patients understand the shortage

Note: All RN(AAP)s can only prescribe and dispense the medications that are identified in a CDT. Review the appropriate CDT prior to prescribing and dispensing any medication. Due to the suspension shortage, consult with a physician or NP as needed to receive orders for medications not included in the CDT.

Read the joint statement regarding the Antibiotic Suspension Shortage

UPDATE: Saskatchewan Biosimilars Initiative

The Saskatchewan Biosimilars Initiative was announced on October 20, 2022, to improve the uptake of biosimilar drugs. The Biosimilars Initiative means that patients will be covered for a biosimilar version of their biologic medication where one is available.

The Biosimilars Initiative includes ten drugs listed on the Saskatchewan Formulary: adalimumab (Humira®), enoxaparin (Lovenox®), etanercept (Enbrel®), filgrastim (Neupogen®), glatiramer (Copaxone®), infliximab (Remicade®), insulin aspart (NovoRapid®), insulin glargine (Lantus®), insulin lispro (Humalog®), and rituximab (Rituxan®). The policy will also apply to future reference biologics as new biosimilars are launched and listed on the Saskatchewan Formulary.

Established patients already receiving a reference biologic drug (or “originator” biologic) with an available biosimilar version will be required to use a biosimilar version by April 30, 2023, in order to maintain coverage under the Saskatchewan Drug Plan.

Physicians, NPs and pharmacists are asked to approach patient questions with evidence-based information to help build patient confidence in the data supporting biosimilar use and transition.

Additional resources:

November 18, 2022: Letter to Health Care Providers – Patient Communications and Patient List Request Form

October 20, 2022: Letter to Health Care Providers Regarding Saskatchewan Biosimilars Initiative

Guide for Patients

Patient List Request Form

For the most current and up-to-date news regarding this initiative, visit the Biosimilars Initiative website.

Amendment: Pharmacists Prescribing for Acetaminophen to Support Accessing Compounded Supplies During the Pediatric Analgesic Shortage

This is an update to the October 12, 2022, Nursing Practice Update. The provincial Collaborative Practice Agreement to support accessing compounded supplies during the pediatric analgesic shortage has been updated to include ibuprofen.

There is a demand surge for pediatric analgesic and antipyretic dosage forms which is creating an ongoing supply issue for patients. Pharmacists have been supporting patients by assisting with advice on alternate products, different dosage forms, repackaging bulk supplies when able, and compounding. 

To support patient access during the pediatric analgesic shortage, the College of Physicians and Surgeons of Saskatchewan, the College of Registered Nurses of Saskatchewan, and the Saskatchewan College of Pharmacy Professionals have created a short-term solution in the form of a provincial CPA which would then enable pharmacists to prescribe for pediatric acetaminophen and ibuprofen. 

Read the full statement here.

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