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Nurse Practitioner Standards of Practice

Welcome to the Nurse Practitioner Standards of Practice. Launched on February 1 2018, the Nurse Practitioner Standards of Practice outlines the new professional and legal obligations and accountabilities of NPs and provides a common understanding of NP practice expectations in Nova Scotia.

Overall, the standards are used to:

  • Guide the professional knowledge, skills and judgment needed to practise nursing safely
  • Identify the performance levels that NPs are required to achieve in practice
  • Sets the professional and legal boundaries for NP practice

As self-regulated professionals, NPs in Nova Scotia are also accountable to both the 2017 Standards of Practice for Registered Nurses and the Canadian Nurse’s Association Code of Ethics for Registered Nurses.

If you have any questions, contact practice@crnns.ca.

ONLINE EDUCATION

To mark the release of the Nurse Practitioner Standards of Practice on February 1, the CRNNS team has developed online education to support NPs, stakeholders and the public in understanding and applying the standards in practice.

Our online education, available live or as an online presentation, is an opportunity to learn more about:

  • Changes between the 2014 and 2018 NP Standards of Practice
  • New or revised professional and legal obligations of NPs
  • Highlights from the 2018 Nurse Practitioner Standards of Practice

Register for Live Webinar: Join us on February 8 from 2-3 p.m. to ask questions and interact with others in an online forum. Registration is required. Click here to register.

View the Online Presentation: If you cannot attend the webinar or prefer to learn at your own pace, click here to view the online presentation.


The Standards

Standard 1: Responsibility and Accountability

Nurse practitioners are accountable to provide safe, competent, compassionate and ethical care within their legislated scope of practice, educational preparation and individual competence. In their role, nurse practitioners are accountable to critically appraise evidence and to apply best practice in their client care.

Nurse practitioners:

1.1 Practise according to ethical, legal and professional standards, competencies and guidelines that reflect their increased level of responsibility, accountability and scope of practice.

1.2 Practise autonomously as a member of an interprofessional team.

1.3 Meet all requirements for licensure, quality assurance and auditing programs.

1.4 Communicate with clients in a sensitive, honest and respectful manner that anticipates and responds to their questions and concerns.

1.5 Collaborate with clients to develop their plan of care, including discussing the rationale, benefits and risks of investigations, interventions, management and follow-up.

1.6 Confirm clients’ understanding of their plan of care.

1.7 Document client care as required by federal and provincial legislation, regulations and organizational policies.

1.8 Use a systematic and timely process to receive, document, track and communicate results of diagnostic tests and referrals.

1.9 Maintain, store and transfer personal health information and client health records according to federal and provincial legislation, regulations and organizational policies.

1.10 Engage in education and professional development activities to maintain their competence.

1.11 Arrange with health care team members and/or employer for ongoing client care when absent from or leaving the practice setting.

Standard 2: Leadership and Advocacy

Nurse practitioners have a leadership and advocacy role in the health care system to enhance quality of care, to influence policy decisions and to improve the delivery of health services.

Nurse practitioners:

2.1 Develop, implement and evaluate initiatives to promote health and to prevent injury and illness.

2.2 Contribute to the development of federal and provincial legislation, standards, policies and practice guidelines related to client care and nurse practitioner practice.

2.3 Apply the best evidence in practice, engage in research and/or quality improvement, share information and provide education to peers, other health professionals and clients.

2.4 Act as role models and mentors to registered nurses, other nurse practitioners, students and other health professionals.

Standard 3: Assessment and Diagnosis

Using a holistic client-centred approach, nurse practitioners assess and diagnose clients, including those with acute and/or chronic health conditions and potential life threatening/emergent situations. Assessment and diagnosis are guided by the best available evidence and the determinants of health.

Nurse practitioners:

3.1 Perform comprehensive or focused assessments appropriate to clients’ situations.

3.2 Determine clients’ health risks and differential diagnoses based on findings of assessments and investigations.

3.3 Select screening and diagnostic tests based on the best available evidence, provincial and organizational policies and standards.

3.4 Discuss the rationale as well as the potential benefit(s) and risk(s) of screenings and diagnostic tests with clients.

3.5 Formulate differential diagnosis/diagnoses, including potential implications, treatment options and expected outcomes/prognoses.

3.6 Explain the diagnosis/diagnoses, potential implications, treatment plans, expected outcomes and overall prognosis with clients.

Standard 4: Client Care Management

Client care management is guided by the best available evidence and the determinants of health.

Nurse practitioners:

4.1 Prescribe medications according to federal and provincial legislation, regulations and organizational policies.

4.2 Prescribe pharmacological and non-pharmacological therapies, including controlled drugs and substances, using best evidence and considering potential therapeutic benefit(s) and risk(s).

4.3 Advise clients of the appropriate use of prescription and non- prescription medications and required follow-up.

4.4 Monitor and evaluate clients’ response(s) to the treatment plan and adjust accordingly.

4.5 Document and report harmful incidents, near misses and no-harm incidents, including those associated with pharmacological and non-pharmacological therapies, according to federal and provincial legislation, regulations and organizational policies.

4.6 Perform both non-invasive and invasive interventions for which they have developed and maintained competence.

4.7 Obtain and document clients’ informed consent prior to performing interventions.

4.8 Use available drug information systems2 to verify history of clients’ prescribed medications, including controlled drugs and substances, when initiating, changing or discontinuing medications.

4.9 Comply with federal3 and provincial regulations related to prescribing controlled drugs and substances as required under the Controlled Drugs and Substances Act and New Classes of Practitioners Regulations.

4.10 Do not prescribe for themselves or family members except in an urgent or emergent situation when there is no other prescriber available.

Standard 5: Collaboration, Consultation and Referral

Nurse practitioners establish collaborative relationships with other health professionals. They initiate and accept consultations and referrals related to client care. Consultations and referrals may occur in person, by telephone, in writing or electronically, as appropriate to individual situations.

Nurse practitioners:

5.1 Communicate with the most appropriate health professional(s) for consultation or referral when clients’ health care needs go beyond the nurse practitioner’s individual or regulated scope of practice or when another professional’s expertise is required.

5.2 Evaluate advice and recommendations for treatment from other health professionals.

5.3 Communicate recommendations from consultations or referrals with clients and appropriate members of the health care team.

5.4 Provide consultations and accept referrals from other health professionals when appropriate.

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