Transforming and Supporting Patient Care - Health Professions ...

283Chapter 12 – Profession of Nursing“work around” inadequacies in legislation that fail to reflect the routinepractice of the profession. 22 The CNO argues that there comes a time whenthe delegated activities need to be subsumed within the receivingprofession. 23Proponents argue that authorizing mechanisms create uncertainty withregard to the accountability for the performance of the controlled act.Eliminating the requirement for delegation of dispensing drugs would bringaccountability for their practice to the regulatory authority of the CNO,which would then have the means to hold nurses accountable toestablished practice standards and guidelines.The CNO stated that allowing nurses to dispense drugs would clarify thelines of accountability for the controlled act. The CNO would set specificpractice expectations for its members through standards of practice. TheCNO would be able to monitor the actions of its members relating todispensing through its quality assurance program.Request 2: Authority for NPs to Sell and Compound DrugsThe CNO states that allowing NPs to compound and sell drugs would helpaddress access to medications for people unable to get to a pharmacy.Examples of the need for compounding drugs include reconstitutingmedications, such as antibiotic prescriptions for children, and mixingtopical medications, such as treatment for poison ivy. Residents of longtermcare homes and people living in remote communities would alsobenefit from the convenience of NPs having this authority.Standards of Practice for Dispensing, Selling or Compounding DrugsThe CNO’s Medication Practice Standard includes a number of requirementsto ensure safe medication practices and reduce errors, including indispensing drugs. The standard requires that systems be in place to track,address and learn from any adverse events that occur in practice settings.In addition, the CNO has prepared draft standards of practice for theproposed authorities, and educators have identified where curricula needto be expanded or have already incorporated strategies to enable graduatesto perform the new controlled acts.The CNO’s draft standard of practice for dispensing, selling andcompounding drugs is as follows:DispensingA NP shall dispense drugs in accordance with federal and provinciallegislation.22Ibid: 8.23CNO. Submission to HPRAC: Registered Nurse in the Extended Class: Scope of Practice Review.August 24, 2007: 16.HPRAC Critical Links January 2009