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Resolving Professional Practice Issues Update

The CRNS is pleased to announce the release of the updated Resolving Professional Practice Issues: A Toolkit for Registered Nurses/Nurse Practitioners that was approved by the CRNS Executive Director on August 27, 2024.

The resource was updated to include Nurse Practitioners (NP), NP Practice Standards and NP Entry-Level Competencies. Reviewing this document may help to support RNs and NPs when addressing professional practice issues. 

CRNS Practice and Education Nursing Advisors are available to answer your questions. They can be contacted by phone at 1.800.667.9945 or 306.259.4227 or by email at practiceadvice@crns.ca.

Clinical Decision Tool Updates and RN(AAP) Scope of Practice Reminder 

Updates to two Clinical Decision Tools (CDT) are effective October 1, 2024:

  • Urinary Tract Infection (Cystitis and Pyelonephritis): Adult has been updated and now requires immediate consultation for pregnant patients presenting with a suspected urinary tract infection (UTI). There are clinical decisions that go beyond the CDT that may be important when treating pregnant clients who seemingly have a UTI and therefore consultation is required. 
  • Atopic Dermatitis: Adult and Pediatric CDT has had examples of signs and symptoms of systemic infection added to the immediate consultation section.

Reminders regarding scope of practice for RN(AAP)s

  • The CDTs contain the additional actions that RN(AAP)s are authorized to take when permitted by the employer. RN(AAP)s are responsible for immediately consulting with a Nurse Practitioner (NP) or physician when required in a CDT. 
  • Outside of the CDTs, RN(AAP)s are practicing within the RN role and scope of practice and must consult with an NP or physician to be authorized to perform activities such as administering medications, ordering tests or determining a course of treatment. Examples of this are the care and treatment of people living with diabetes and other chronic health conditions or emergency situations. 
  • RN Clinical Protocols developed using the RN Specialty Practices framework can provide the authority to provide care for clients in situations outside of the CDTs. CDTs and RN Clinical Protocols together can support many situations an RN(AAP) may be presented with in their practice.

All CDTs can be accessed here. CRNS Practice & Education 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. 

Prescription Review Program Quality Initiative

Saskatchewan Nurse Practitioners (NPs) are authorized in accordance with provincial and federal legislation to prescribe and/or dispense drugs listed in Schedules I, II and III of The Drug Schedules Regulations, 1997, as amended from time to time. The CRNS participates in the Prescription Review Program (PRP) established in Saskatchewan, and all practicing NPs engage in a reflective practice assessment specific to PRP from time to time. The primary objective of the CRNS’s PRP is ensuring patient safety through safe prescribing practices. 

The Prescription Review Program quality initiative (QI) helps to confirm that the NP’s prescribing practice is aligned with the relevant standards and guidelines. Many NPs find the opportunity to reflect on their prescribing practice as a valuable investment. This program will be launching this fall and you may be randomly chosen to participate. More information can be accessed here (add link to webpage).

Questions can be directed to the PRP Nursing Advisor at prp@crns.ca.

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.

Nurse Practitioner Practice Standards (2024)

The CRNS is pleased to announce the release of the 2024 revision of the Nurse Practitioner (NP) Practice Standards. The NP Practice Standards will come into force and into effect on July 24, 2024.

The NP Practice Standards document is intended to identify the expectations and level of NP practice in Saskatchewan. A practice standard is an expected and achievable level of professional practice performance. The NP Practice Standards inform practitioners of the expectations for making informed, safe and effective decisions; guide employers in what to expect of NPs as employees; and, advise the public of the level of care they can expect to receive from NPs.  

  • View the revised 2024 NP Practice Standards here. 
  • For more information, a Question & Answer document is available here.
  • Watch CRNS Advisors discuss the revised NP Practice Standards here. 

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. 

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.

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