Working with Unregulated Care Providers Resource

The CRNS, RPNAS and SALPN are pleased to share a collaborative document developed to guide your decision-making when working with Unregulated Care Providers. Regulated nurses are expected to utilize the nursing process, their knowledge, critical thinking, and judgement when making client care decisions. Not all scenarios can be captured in a document, and the responsibility remains with the regulated nurse to make decisions in the client’s best interest.  

When there are ongoing concerns, the regulated nurse is responsible for working with the health care team to resolve them. Involvement of nursing management and senior administration may be required. Entry-Level Competencies, Practice Standards, and Code of Ethics are resources to guide the discussion. Nursing Advisors are also available to assist.
 
Read the Working with Unregulated Care Providers Resource here.

For those currently working with Unregulated Care Providers, please review this resource and consider how it may relate to your practice. 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

Aesthetics Nursing Resource

The Aesthetics Nursing resource has been developed for RNs and NPs in response to the evolution of aesthetics nursing and the many questions CRNS registrants have asked regarding this practice area. In this resource, you will find information about the legislated scope of practice, personal competence, education, accountabilities, and expectations for using the nursing process in this area of nursing. In addition, you will find information on the process for obtaining recognition of practice and engaging in self-employed practice for aesthetic nursing.

For those currently practicing or planning to practice aesthetics nursing, please review this resource and consider how it may relate to your practice. 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

Ending the NP-Client Relationship Resource

The CRNS is pleased to announce the release of the NP practice resource Ending the NP-Client Relationship CRNS, 2023. This resource has been developed to support the professional practice of registrants of the CRNS by providing considerations for NPs on ending the NP-client relationship. You will find the resource under NP Practice Resources.

Please review this document and consider how it may relate to your practice. If you have any questions, please get in touch with a CRNS Nursing Advisor by phone at 1.800.667.9945 or 306.359.4227 or by email at practiceadvice@crns.ca.

Northumberland Pharmacy Closure

Be advised that Northumberland Pharmacy at Unit F3 924 Northumberland Avenue Saskatoon has been closed by Saskatchewan College of Pharmacy Professionals (SCPP) as of the beginning of business day February 28, 2023.

Due to the sudden closure of the pharmacy, patients will not have access to their prescription(s), or the pharmacy-specific records maintained at the pharmacy. Records of filled prescriptions will be available on the Pharmaceutical Information Program (PIP).

Prescriptions which were faxed to Northumberland Pharmacy will no longer be accessible to either the patient or another pharmacy if they were not processed by the pharmacy prior to the closure. This could include new refill authorizations and acute care medications. As such, SCPP staff will be faxing prescriptions with a cover letter back to the practitioner as the patients will need to be contacted to see where they would like their prescription(s) sent. The SCPP apologizes for any inconvenience this may cause.

The pharmacy provides OAT medications to ten patients. The SCPP is working with the Drug Plan and Extended Benefits Branch (DPEBB) and Non-Insured Health Benefits (NIHB) to ensure the transition of care in terms of adjudication of prescriptions.

Pharmacists are enabled under the Controlled Drugs and Substances Act (CDSA) section 56 exemption and SCPP Prescriptive Authority Bylaws to continue existing prescriptions to maintain continuity of care for the patients.

SCPP has also provided an email to pharmacists to assist them with managing the situation. Signage has also been placed on the pharmacy exterior doors to assist patients with the name, location, and phone number of surrounding pharmacies to assist them, which includes pharmacies that provide OAT services.

While SCPP has put as many provisions as possible in place to be able to manage this unfortunate situation, they wish to alert CRNS registrants to the possibility of increased requests for prescriptions for patients of Northumberland Pharmacy.

Thank you for your attention to this matter and any questions or concerns from practitioners can be addressed to Deputy Registrar Lori Postnikoff at lori.postnikoff@saskpharm.ca or by contacting 306-584-2292.

NPs Enabled to Order or Request Medical Imaging

In the 2022 updated regulatory bylaws that were approved and published in the September 9, 2022, Saskatchewan Gazette and came into effect on November 1, 2022, it included an update to Bylaw VI Categories of Practice, Section 3 Nurse Practitioner Category, which enables NPs to order or request medical imaging. This involves the application or detection of forms of energy for diagnostic and screening purposes and to receive and interpret reports, or to perform ultrasound imaging for the sole purpose of point-of-care diagnostic assistance when it is in the best interest of the client, in accordance with their practice standards and code of ethics, when they have the competence and judgment to safely do so, when it is in alignment with best practice evidence and when agency policy permits.

In our work to facilitate RNs and NPs practicing to their full scope, we’ve worked with the Saskatchewan Health Authority (SHA) to minimize disruptions and fully support NPs with equal opportunity to order diagnostic imaging exams SHA provides to General Practitioners (GP).

This allows access to almost all diagnostic testing services.

For MRI and PET/CT exams, NPs and GPs may require additional documentation of approval following a discussion with a radiologist, or a recommendation for such an exam in a previous medical imaging diagnostic report.

If an NP is experiencing challenges ordering diagnostic imaging, please get in touch with Jordan Vercaigne, Manager of Provincial Diagnostic Imaging Standards and Operations, at 306.491.8220.

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

Saskatchewan Biosimilars Initiative Update 

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 latest update includes clarifications and resources to support health care providers and patients. Some reminders: 

  • A new Exception Drug Status (EDS) application is not required for patients to start using a biosimilar. 
  • Where applicable, EDS coverage for the listed biosimilars has been added for patients who have current EDS coverage for an affected reference biologic. EDS coverage for the reference biologic will be terminated on April 30, 2023. 
  • Biosimilars are not listed as interchangeable with the reference biologic on the Saskatchewan Formulary. They cannot be substituted at the pharmacy level. 
  • Prescriptions must clearly indicate the biosimilar brand to be dispensed by the pharmacy. 

This update from the Ministry of Health includes Insulin coverage updates, exemptions and extensions, and patient notification requirements.

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

Visit the Biosimilars Initiative website for the most current and up-to-date news regarding this initiative.

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.

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