Module 1: Professional Accountability and Prescribing

NPs in Newfoundland and Labrador received provincial authority to prescribe controlled drugs and substances in June 2013. Prescriptive authority in this province is based on section 14(1)(c) of the RN Regulations (2013). It authorizes NPs to prescribe a drug permitted by the standards or a drug that he or she is authorized to prescribe under a practice protocol. NPs prescribing controlled drugs and substances must participate in the Tamper Resistant Prescription Drug Pad Program.

The Registered Nurses Act (2008) governs the practice of nursing for RNs and NPs, including management of controlled drugs and substances within the specific role.

NPs in Prince Edward Island have had provincial authority to prescribe controlled drugs and substances since November 2015. Prescriptive practice of NPs in Prince Edward Island is defined in the NP Regulations (2014) under the Registered Nurses Act (2014). Authorization for specific classes of medications is further governed through regulatory policies and processes within the Association of Registered Nurses of Prince Edward Island.

In addition, the Narcotics Safety and Awareness Act was issued in September 2013. This predates NP authority to prescribe controlled drugs and substances in the province but has valuable information that applies to all prescribers.

NPs in Nova Scotia have been authorized to prescribe controlled drugs and substances since November 1, 2014. The authority at the provincial government level came through changes to the Nova Scotia Prescription Nova Scotia Prescription Monitoring Board Act and Regulations, which added CRNNS as a member of the Board and thus enabled its regulated NP members to prescribe controlled drugs and substances.

NPs in New Brunswick have been authorized to prescribe controlled drugs and substances since 2014. At the provincial level, prescribers are required to participate in the Prescription Monitoring Program, which is defined in the Prescription Monitoring Act and Regulations (2014).

NP practice in Quebec is governed through the Nurses Act (section 36.1) and Medical Act, specifically Chapter M-9, r. 13 – Regulation respecting the activities contemplated in section 31 of the Medical Act which may be engaged in by classes of persons other than physicians.

Prescriptive authority for NPs is defined within these legislative documents.

NPs in Ontario have been authorized to prescribe controlled drugs and substances since April 19, 2017. Prescriptive authority is defined in the College of Nurses of Ontario. Within their practice prescribing is governed by specific provincial legislation and regulation.

Manitoba NPs have been authorized to prescribe controlled drugs and substances since May 2013. Prescriptive authority is defined in the Registered Nurses Act and the Extended Practice Regulations.

Saskatchewan NPs were granted authority to prescribe controlled drugs and substances on January 13, 2015. At a provincial government level, NP prescriptive authority is defined by the Registered Nurses Act and the Prescription Review Program (PRP); developed by the College of Physicians and Surgeons of Saskatchewan. However, NPs now participate as prescribers of controlled drugs and substances.

NPs in Alberta were granted authority to prescribe controlled drugs and substances in February 2014. NP prescriptive authority is defined in the Registered Nurses Profession Regulation under the Health Professions Act.

British Columbia is the most recent jurisdiction to authorize NPs to prescribe controlled drugs and substances. The start date for this was July 26, 2016. NPs are required to register with PharmaNet, a program created by the Ministry of Health to track every prescription written and filled in BC.

NP practice in BC is also defined by the Nurses (Registered) and Nurse Practitioners Regulation under the Health Professions Act.

Northwest Territories and Nunavut NPs have been authorized to prescribe controlled drugs and substances since January 2014. NP practice in the Northwest Territories and Nunavut is governed by the Nursing Profession Act.

The  Registered Nurses Association of Northwest Territories and Nunavut Practice and Prescriptive Guidelines for Nurse Practitioners (2014) defines NP prescriptive authority.

NPs have only been regulated in the Yukon since 2012. NP practice in the Yukon is defined by the Registered Nurses Professions Act, accessible and Regulations.