Prescription Review Program (PRP) Quality Initiative
Introduction and Purpose
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 responsibility to protect the public is maintained by approaches such as quality improvement initiatives. The quality initiative (QI) approach allows NPs to reflect on, re-evaluate PRP medication regimens and incorporate risk mitigation measures in their PRP prescribing. The PRP 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.
PRP Quality Initiative Overview
The screening tools and processes used in the PRP QI have been adapted from other medication safety tools across Canada. Core elements that influence the safety of prescribing PRP medications include but are not limited to:
- Assessment (initial);
- Treatment plan (initial), including treatment agreement;
- Monitoring, including mitigation strategies;
- Drug information;
- Provider education and competency, including ethics and scope of practice;
- Patient education; and,
- Communication between the provider, other team members and the patient.
What to Expect
The CRNS PRP wants to ensure that the PRP QI is a positive learning experience and an opportunity to improve PRP prescribing practices. Here is what can be expected during the process:
- Selection to Participate: A random sample of NP prescribers will be pulled from the database.
- Notification: If selected, the NP will receive an email from the CRNS PRP advising they have been chosen to participate in the PRP quality initiative. The email will include details about the process, the forms to complete and timelines.
- Practice profile questionnaire: The practice profile will ask for details regarding the NP’s practice in Primary Health Care, Adult, Pediatric, Neonatal settings. For example, type of employment, privileges, job description and/or agency policy. The NP will return the practice profile to prp@crns.ca within seven (7) days to be reviewed before the PRP QI will be sent to the NP.
- PRP Quality Initiative: What it entails:
- Self-assessment tool – Six (6) self-assessment 5-point scale questionnaire questions related to PRP and two (2) reflection questions.
- Snapshot Questions – Two (2) short answer questions related to PRP.
- Case study – A brief case study with specified criteria the NP will share an example of a real patient case within their case load that is prescribed PRP medications.
The self-assessment, snapshot questions and the clinical case scenario should take the NP at most 30 minutes to complete. The NP will complete the self-assessment questions, short answers, and clinical case scenario to the best of their ability. Incomplete submissions will be returned to the NP to be completed. Response is expected within 30 days.
- Self -Assessment Report: After the NP has completed the self-assessment and the case study, the Nursing Advisor, PRP, will prepare a report that the NP can read and reflect upon. This will include feedback about their practice and any suggestions for quality improvement for safe PRP prescribing. The report can be expected within 30 days.
- NP Feedback: When the process is complete, the Nursing Advisor, PRP, will send the NP a program evaluation questionnaire so the NP can share their experience with us. Constructive feedback is valuable as CRNS PRP continues to evolve based on valuable input. Feedback is expected within two (2) weeks.
Questions at any point during the PRP QI process can be directed to the PRP Nursing Advisor who is available to guide the NP and can be reached at prp@crns.ca.