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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.

NP Practice and the Radiology Information System (RIS)

Nurse Practitioners (NPs) provide excellent care in primary health care settings and a variety of specialized clinical contexts throughout Saskatchewan. CRNS has become aware of a clinical practice issue that is having negative impacts on patient outcomes and leading to potential patient privacy breaches due to misrouted medical imaging reports. Several of the identified causes are listed here:

  • Many NPs have more than one clinical site where they work. 
  • NPs may concurrently work within and outside of the SHA and order or request medical imaging studies for clients.
  • The CRNS database that verifies registration status of NPs does not contain clinic phone numbers, fax numbers or addresses. Therefore, it is not a resource that enables technologists to appropriately forward medical imaging reports.
  • The Radiology Information System (RIS) can only support one fax number per provider. Providers working at multiple sites must make arrangements with clinic staff at that site (the one with the distribution fax), to create a workflow so that the NP’s can receive their patient’s reports and booking notifications at any/all sites that they are providing patient care.
  • There are many different requisitions/ forms that are utilized when NPs order or request medical imaging studies in the various settings where they work.
  • Paper requisitions are not handled consistently by all SHA facilities. The SHA Medical Imaging Department cannot guarantee that the information on the requisition is translated through from request to finalization. The SHA Medical Imaging Department requires one fax for ALL reports and booking confirmations.

These factors can create barriers that lead to delays in care or privacy issues. CRNS is raising awareness of this issue and is recommending the following:

  • NPs ensure that clinic specific information is included on the medical imaging requisitions to enable more timely and accurate delivery of results to the appropriate location. 
  • NPs currently working only in one location may wish to ensure that their contact information is up to date.
  • NPs should update the RIS team each time they change their work location to ensure the best possible outcomes. 
  • NPs working in multiple sites should make arrangements with clinical staff to create a workflow to ensure that they are receiving all of their patient’s results in a timely manner.

Medical Assistance in Dying Guideline (2024)                 

The CRNS is pleased to announce the release of the updated Medical Assistance in Dying Guideline (2024). The Medical Assistance in Dying Guideline was approved by CRNS Council on February 23, 2024.

The guideline was updated to reflect best practices and standards as outlined in the nationally developed Model Practice Standard for Medical Assistance in Dying (MAID) and the Saskatchewan Health Authority (SHA) MAID program; Nurse Practitioner (NP) Entry-Level Competencies (ELC) were updated to the 2023 version; and the date in which people whose sole underlying medical condition is mental illness and wish to seek MAID was updated to reflect federal legislation and is March 17, 2027.

Reviewing this document will assist you in knowing the expectations of RN and NP practice in providing care to people seeking MAID. CRNS Practice 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.

Joint Statement: Long Term Care – Authorized Prescriptions                 

The SCPP, the CRNS, the CLPNS, and the CPSS have issued a joint statement regarding verbal orders generated from Long Term Care (LTC) Facilities. A pharmacist may only accept a verbal or faxed original order written and signed by an authorized prescriber e.g. physician, NP, dentist. A pharmacist may not accept a verbal or faxed written order (transcribed) from an RN. The full statement can be accessed 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. 

Cervical Cancer Screening Updates

Cervical cancer screening in Saskatchewan recently changed when the revised cervical cancer screening clinical practice guidelines were updated in November 2023. Key changes to the new guidelines include:

  • Screening will start at age 25 or three years after becoming sexually active, whichever is later;
  • Routine screening will now be every three years until the age of 69; and,
  • The addition of Human Papillomavirus (HPV) reflex testing. 

These new evidence-based changes ensure people continue to benefit from screening while avoiding unnecessary tests and follow-up treatment. 

Click here to find information about the guidelines, including the new guidelines document. (link to: http://saskcancer.ca/health-professionals-article/cancer-screening-guidelines-and-resources/cervical-cancer-screening)

The SCA has collaborated with the Department of Obstetrics and Gynecology and the Division of Continuing Medical Education to create a free accredited course on the guidelines. The course will be available until July 2024. It can be found here. (link to: https://cmelearning.usask.ca/learn-here/cme-online-courses/cervical_cancer_guidelines_online-course.php)

If any questions arise about the guidelines, please feel free to reach out to the Screening Program for Cervical Cancer at ED.Coordinator@saskcancer.ca.

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