Transforming and Supporting Patient Care - Health Professions ...

293Chapter 12 – Profession of Nursing• adjust dosage of the drug therapy, when appropriate; and• consult with an appropriate health care provider, whenappropriate.In Practice Standard:The authority of NPs to initiate a prescription for a drug is limited totreating conditions that they can diagnose and for which they canprovide the necessary counselling and ongoing management.ConclusionsOn balance, HPRAC is of the view that with the introduction of a new drugapprovals framework, many of the concerns about the regulation-makingprocess will be addressed. Classes of drugs would be designated in theregulation, and specific agents would be reviewed through a new andexpedited process.HPRAC contends that additions of new classes of drugs in the regulation willbe relatively rare and would merit extensive examination, since such requestsmay indicate that the profession is seeking a change in its scope of practice.Transparent standards of practice must be in place to ensure that only NPswith adequate knowledge and competencies are able to prescribe a drug orclass of drugs, and this is a key accountability given the number ofsubspecialties within NP practice. These standards of practice relating toprescribing drugs should be developed through a collaborative process asrecommended in the scope of practice review.Request 4: No Limits for NPs in Administering a Substanceby Injection or InhalationThe CNO and the NPAO are recommending that limitations on theauthorized act of administering a substance by injection or inhalation beremoved for NPs. Currently NPs may administer by injection or inhalation adrug that they have authority to prescribe, but require an order toadminister if a drug is prescribed by another health professional. Thisrequest was an adjunct to the request for open prescribing. 53Proponents’ RationaleGiven the proponents’ request for full prescribing authority, it has beencontended that the current restrictions on the administration of drugs andsubstances by injection or inhalation would continue to limit NPs’ ability toprovide care. 5453Nursing Act, 1991, c. 32, s.5.1(1)4.54NPAO. Submission to HPRAC: Review of Non-Physician Prescribing and Administration of Drugs.November 12, 2008: 7.HPRAC Critical Links January 2009