The Lieutenant Governor in Council proclaimed amendments to the Registered Nurses Profession Regulation under the Health Professions Act that will further support nursing practice in Alberta. The changes will authorize registered nurses to prescribe common medications and order diagnostic tests such as x-rays. While nurse practitioners (NPs) already have broad prescribing ability for all medications appropriate to their stream of practice and competency, the regulation changes will establish authority for NPs to set bone fractures.
“This is not only a milestone for registered nursing practice in Alberta but an important step towards providing people with access to medications and tests when they need them,” says CARNA President Dennie Hycha. “These changes can improve access to timely, cost-effective health care by maximizing the contributions of registered nurses who are the largest group of health professionals working in our health system.”
This new authority for RNs represent a significant opportunity and change for the health system, but it will take time for widespread implementation. “Registered nurse prescribing and ordering tests will be introduced gradually, starting with three pilot sites within Alberta Health Services,” says Hycha. “Indigenous Services Canada is also interested in implementing registered nurse prescribing in rural and remote regions of the province to improve access to care.”
RN prescribing will be limited to specific clinical practice areas where the employer has policies to support RN prescribing and a clinical support tool to clearly guide prescribing decisions. An RN will only be able to prescribe the specific medication and dose identified in the clinical support tool. If the client’s symptoms do not meet the inclusion criteria, the RN will need to refer the client to a physician or a nurse practitioner (NP) for assessment.
RNs interested in becoming authorized to prescribe and order diagnostic tests will first need to complete a minimum of 3,000 clinical hours with 750 of them in the clinical practice area where RN prescribing will occur. They will also need to complete an approved nursing education program to be offered by Athabasca University.
The RN’s practice permit will identify the clinical practice area where they are authorized to prescribe and order tests. The RN will have a “prescribing ID” so that CARNA can inform the Alberta College of Pharmacy and Alberta Blue Cross that the RN is authorized to prescribe.
Other amendments in the regulation provide more flexibility for CARNA as a regulator in areas such as continuing competence and licensure requirements. Indirect supervision will be now be required for all those on the provisional register. Applicants will no longer be limited to three attempts at the entry-to-practice exam but must pass it within 24 months. Another important change is that CARNA can now require RNs and NPs to take mandatory courses as part of their continuing competence requirements.