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Oversight

Introduction

Nurse practitioners (NPs) in B.C. have a broad scope of practice, which includes drug prescribing. In 2016, NPs in B.C. were granted new authority to prescribe many controlled drugs and substances (CDS) under federal legislation. In 2017, the CRNBC Board approved practice standards for NPs to undertake continuation prescribing of buprenorphine-naloxone (suboxone) for treatment of opioid addiction.

Establishing and implementing rigorous Quality Assurance Program processes for monitoring, assessing, and acting on sub-optimal prescribing practices is integral to meeting CRNBC’s public interest mandate. The Quality Assurance Program is overseenby the QA Committee.

Prescription Review Program

The QA Committee will monitor and review the prescribing of selected drugs or drug classes to identify concerns, trends or issues related to selected drugs and/or drug class prescribing practices, and provide information to

  • The Nurse Practitioner Standards Committee for consideration in the development of NP standards of practice and standards of professional ethics;  
  • The registrar for the purpose of commencing or conducting continuing competence audits; or
  • Selected groups of registrants or the profession as a whole for the purpose of promoting safe client care and high practice standards in relation to the prescribing of drugs.

CRNBC is working closely with our partners, the College of Physicians and Surgeons of BC (CPSBC), College of Pharmacists of BC, the BC Centre on Substance Use, the Ministry of Health, as well as NPs and employers, to establish and implement prescription review policy and operational processes that reflect provincial research, experience and evaluation.     

CRNBC’s Prescription Review Program will review NP prescribing practices to: 

  • Promote high practice standards for NP drug prescribing
  • Increase NP registrant awareness and understanding regarding CRNBC’s NP Scope of Practice Standards, Limits and Conditions, thereby
    • Reducing risks associated with sub-optimal  drug prescribing
    • Reducing diversion of prescription drugs
  • Identify possible sub-optimal prescribing: e.g. patients with multiple opioids, high morphine dose equivalents, moderate to large dispenses, co-prescribing opioids and benzodiazepines 
  • Intervene with individual registrants when it appears higher standards of prescribing could be achieved, by
    • Making recommendation(s) such as for education or remediation or follow-up interviews or chart reviews
    • Establishing voluntary prescription monitoring agreements

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