Module 1: Professional Accountability and Prescribing
Provincial and Territorial Regulatory Resources
In June of 2013, ARNNL Council adopted the legislation permitting NPs to prescribe controlled drugs and substances in accordance with applicable legislation once they have completed the requirements approved by the ARNNL Council. In addition to the Act and Regulations discussed previously, RN and NP practice in Newfoundland and Labrador is guided by the Standards for Nurse Practitioner Practice in Newfoundland & Labrador (2013), Standards of Practice for Registered Nurses (2013) , and ARNNL Bylaws (2016).
In addition, individuals applying for NP licensure with ARNNL must provide proof of completion of an approved controlled drugs and substances course and the Tamper Resistant Prescription Pad Program education.
RNs and NPs in Prince Edward Island are guided by standards of practice, competencies, policies and guidelines. The Nurse Practitioner Medication Prescription Guidelines (2012) were amended in 2015 to acknowledge the addition of controlled drugs and substances to the NP prescriptive authority once specific conditions are met.
CRNNS has developed resources, including competencies and standards for RNs and NPs to guide their practice when managing controlled drugs and substances. The Standards of Practice for Registered Nurses (2012) and the Entry-level Competencies for Registered Nurses in Nova Scotia support RN practice. Similarly, the Nurse Practitioner Competency Framework (2011) and Nurse Practitioner Standards of Practice (2014) guide NP practice. The latter was revised to include specific statements and indicators related to the prescription of controlled drugs and substance when Nova Scotia NPs received authority to prescribe these agents in 2014. NPs in Nova Scotia are required to complete an approved CDS education course as well as the RN and NP jurisprudence examinations to be licensed in NS. NPs are also required to register with the Nova Scotia Prescription Monitoring Program to obtain duplicate prescription pads and the ability to access the eAccess portal which is used to check patient medication profiles.
- Entry-Level Competencies for Nurse Practitioners in Canada – adopted by CRNNS (2016)
- Nurse Practitioner Standards of Practice (2014)
- Controlled Drugs & Substances (CDS) Toolkit
- Standards of Practice for Registered Nurses (2012)
- Entry-level Competencies for Registered Nurses in Nova Scotia
- Medication Guidelines for Registered Nurses (2011)
The competencies and standards for RNs and NPs in New Brunswick are developed by NANB to support nursing practice. NPs licensed by NANB must provide proof of completion of their approved CDS education course.
Regulation of RN and NP practice in Quebec differs from the rest of Canada in that many aspects of practice have links to the College of Medicine and other government agencies.
NPs in Ontario do not yet have authority to prescribe controlled drugs and substances but the standards and guidelines in place for RNs apply to NPs as well. Visit the CNO website to explore the full collection of documents concerning RN and NP practice as it relates to controlled drugs and substances in Ontario.
NPs in Manitoba were among the first in Canada to be authorized to prescribe controlled drugs and substances. Standards and competencies for both RNs and NPs are listed below.
SRNA Standards and Competencies documents for both RNs and RN(NP)s as well as the Bylaws define the scope and accountabilities of nursing practice related to the prescription of controlled drugs and substances. The Prescription Review Program webpage is structured like a toolkit and contains numerous links to important resources. RNs may also wish to review the resources on this page to ensure they are fully informed of the collaborative role of providers on the team.
- SRNA Registered Nurse (Nurse Practitioner) RN (NP) Standards and Competencies (2011)
- Registered Nurse (Nurse Practitioner) Controlled Drugs and Substances Practice Guidelines (2014)
- RN(NP) Prescribing Controlled Drugs and Substances FAQ (2015)
- SRNA Bylaws (2014); specifically Sections 3 and 4 which provide important information about the NP role and the Prescription Review Program
- SRNA Standards and Foundation Competencies for the Practice of Registered Nurses (2011)
Nursing practice in Alberta is governed by regulations under the Health Professions Act as well as standards and guidelines developed by CARNA. The document entitled Prescribing CDS Requirements outlines CARNA requirements for NPs to fulfill before being authorized to prescribe CDS, and the Prescribing CDS for Nurse Practitioners webpage has numerous resources to support Nps in prescribing controlled drugs and substances.
- Entry-Level Competencies for Nurse Practitioners in Canada (Dec 2016)
- Prescribing Standards for Nurse Practitioners (NPs)
- The document entitled Prescribing CDS Requirements outlines CARNA requirements for NPs to fulfill before being authorized to prescribe CDS.
- The Prescribing CDS for Nurse Practitioners webpage has numerous resources to support NPs in prescribing controlled drugs and substances.
- Entry to Practice Competencies for the Registered Nurses Profession
- Registered Nurse or Registered Psychiatric Nurse Decision Support Tool for Prescribing Take Home Naloxone (THN) Kit
- Health Professions Act: Standards for Registered Nurses in the Performance of Restricted Activities (2005)
CRNBC is accountable under the Health Professions Act to define professional standards, practice standards and scope of practice standards (standards, limits and conditions) to guide RN and NP practice. The structure and organization of the CRNBC standards are highlighted on the Professional Standards webpage.
This page also contains links to specific RN and NP resources developed to guide the prescription and management of controlled drugs and substance.
The Controlled Drugs and Substances (CDS) Prescribing webpage contains information on requirements and resources for NPs who prescribe CDS in British Columbia.
While RNs and NPs in Northwest Territories and Nunavut are regulated by a single association, government legislation that governs practice is separated along the territorial boundary. It is critical for RNs and NPs to be aware of the requirements specific to the community in which their practice is based, as the scope of practice and legislation may be different. The Nurse Practitioners webpage contains important information for NPs working in the Northwest Territories and Nunavut.
The links provided below contain information on standards for RN and NP practice in the Yukon. Learners with specific questions or seeking additional information should contact the YRNA offices for further information.