Ontario University Consortium RN Prescribing Education Program

This module introduces the roles and responsibilities associated with the scope of practice for registered nurses in the General Class. The course emphasizes the therapeutic care of clients using a prescribing framework within the context of discipline standards, guidelines, and competencies.

Learning Outcomes

After completion of this module the learner will:

1. Review the prescribing conditions as stated in the Nursing Act (1991) for registered nurses in the General Class.
2. Consult with others from the healthcare team when the client’s healthcare needs are beyond the scope of practice of a prescribing registered nurse.
3. Identify medications that are approved for dispensing by registered nurses in the General Class (Schedule 4, Nursing Act, 1991).
4. Understand the definition, scope of practice, and professional responsibilities and accountabilities required of registered nurses in the general class as seen in the CNO standards, guidelines, and competencies and the CNA prescribing framework.
5. Demonstrate the role of the prescribing registered nurse within a healthcare team and healthcare organization.
6. Implement a prescribing framework as a guide to therapeutic interventions.
7. Demonstrate correct processes for informed consent, prescription writing, reporting of adverse events, and documentation.
8. Discuss ethical decision-making when prescribing medications.
9. Explain the difference between diagnosing, prescribing, dispensing, delegating, selling, and compounding substances.
10. Consider processes that can be used for self-reflection that can be used by registered nurses in their prescribing roles and responsibilities.

This module on pharmacological principles encourages learners to use an evidence-informed approach to understanding and synthesizing foundational pharmacological principles as they relate to drug therapy. Learners will apply evidence-informed knowledge regarding factors that impact drug therapy as they relate to medication prescribing.

Learning Outcomes

After completion of this module, the learner will:

1. Define common terms used in pharmacology.
2. Discuss the application of pharmaceutics, pharmacokinetics, and pharmacodynamics in drug therapy.
3. Explain the properties of various drug dosage forms.
4. Identify the advantages and disadvantages of drug dose forms and delivery systems used in drug therapy.
5. Discuss the relevance of the four branches of pharmacokinetics (absorption, distribution, metabolism, and excretion) to nursing practice for a variety of patients and healthcare settings.
6. Discuss the role of evidence-informed practice related to drug interaction and medication prescribing.
7. Develop a collaborative plan of care that considers general pharmacological principles in carrying out drug therapy.
8. Recognize the importance of medication reconciliation in the prescribing process.
9. Demonstrate understanding of the legislated scope of practice of the registered nurse, including relevant laws and College of Nurses of Ontario standards and guidelines.

This module encourages learners to use an evidence-informed approach to assess and treat (pharmacological and non-pharmacological) various wounds. Learners will apply evidenced-based knowledge regarding factors that impact wound management and the indication for medications and advanced dressings.

Learning Outcomes

After completion of this module, the learner will:

1. Apply knowledge of pathophysiology, healing, risk factors, comorbidities, and factors that impact healing when assessing clients.
2. Apply critical thinking, clinical reasoning, and clinical judgement to plan, prioritize and evaluate care in collaboration with clients and health care providers.
3. Integrate critical inquiry and diagnostic reasoning when choosing focused subjective and objective assessments.
4. Demonstrate critical inquiry and diagnostic reasoning when choosing appropriate pharmacological and non-pharmacological options from various sources within the legal scope of practice.
5. Determine appropriate education to provide the client regarding medication using the ICANPRESCRIBE framework.
6. Demonstrate critical inquiry and diagnostic reasoning to synthesize and integrate relevant health information to establish and communicate probable diagnoses within the legal scope of practice.
7. Integrate client and societal factors (e.g., social determinants of health, beliefs, culture, spirituality) when developing a collaborative plan with clients.
8. Complete an accurate prescription(s) in accordance with legal requirements.

This module will integrate knowledge of vaccine development, indications, funded schedules, and age to determine initial eligibility. Competency will be demonstrated in assessing whether past clinical history and current clinical status will impact vaccine eligibility. Students will be able to recommend and prescribe appropriate immunization(s), and work with the patient and family to discuss concerns about immunization and side effects and intervene should an anaphylactic event occur.

Learning Outcomes

After completion of this module the learner will:

1. Understand the differences between viruses and bacteria, various types of vaccine design, vaccine components, and general principles related to protection and nomenclature.
2. Recognize how beliefs can influence vaccine hesitancy and demonstrate knowledge and communication skills to use evidence and compassion to discuss hesitancy.
3. Understand the right to refuse considering age and capacity to consent, and how to work with the family unit in decision-making.
4. Recognize the significance of variations between the Ontario publicly funded immunization schedule and NACI recommendations.
5. Understand Ontario’s routine immunization, and where to locate updated information.
6. Understand the differences between schedules and requirements for: infants and children, school age including School Pupils Act, adolescents, and adults.
7. Demonstrate competency understanding immunization and indication in special populations such as pregnancy/breastfeeding, immunocompromised, the elderly, and travellers. Understand how catch-up immunization is assessed and facilitated.
8. Apply knowledge from collecting relevant past medical history including allergies, medical contraindications, and medication contraindications to determine is safe to prescribe.
9. Demonstrate understanding in collaborative decision-making to determine whether benefits may outweigh risks, and education on how the immunization works, what side-effects may occur, and how to store if applicable.
10. Complete an accurate prescription(s) in accordance with legal requirements.
11. Recognize and be prepared to intervene to prevent harm should anaphylaxis occur.

This module will assist learners to use an evidence-informed approach in choosing appropriate pharmacological treatments for clients seeking contraception for pregnancy prevention. By the end of these modules learners will be able to assess clients for the indications and contraindications for initiating contraception and differentiate between therapeutic uses for systemic versus intravaginal contraception.

Learning Outcomes

After completion of this module, the learner will be able to:

1. Apply knowledge of reproductive physiology for male, female, and transgendered populations across the lifespan and chooses appropriate pharmacologic contraception through this understanding.
2. Integrate critical inquiry and diagnostic reasoning when choosing focused subjective and objective assessments required for initiating and monitoring contraceptive care.
3. Use critical thinking to identify contraindications to initiating contraception through assessment data.
4. Apply critical thinking, clinical reasoning, and clinical judgement to plan, initiate, and evaluate care in collaboration with clients.
5. Determine appropriate health teaching required regarding initiation and monitoring of contraceptive use using the ICANPRESCRIBE framework.
6. Recognize when a clients’ health care needs in relation to contraceptive care is outside of the legal scope of practice for the Registered Nurse and requires collaboration with the healthcare team.
7. Reflect on personal values and beliefs in relation to contraceptive methods.
8. Complete an accurate prescription(s) in accordance with legal requirements for initiating contraception.

This module will provide a review of the epidemiology, transmission of, and natural history of traveller's diarrhea and malaria and prepare registered nurses (RNs) to optimally support travellers to identify their individual risk for traveller’s diarrhea malaria and to implement appropriate prevention and treatment strategies for traveller’s diarrhea. In addition, this module will prepare RNs to synthesize multiple elements of patient information with consideration of patient values and preferences to select appropriate therapeutic choices that best meet the patient’s needs, write a legal prescription, and document the encounter.

Learning Outcomes

After completion of this module, the learner will be able to:

1. Identify and assess multiple critical information points related to epidemiology, pathophysiology and patient information including reason for the encounter, travel plans and health needs to be able to evaluate and communicate client risk for malaria and traveller’s diarrhea.
2. Synthesize multiple sources of information, in collaboration with the client and considering their values and preferences, to determine and help clients fully comprehend the appropriate pharmacological and non-pharmacological options for prevention, prophylaxis, and treatment for malaria and traveller’s diarrhea.  
3. Apply knowledge from collecting relevant past medical history including allergies, medical contraindications, and medication contraindications to determine appropriate medications for malaria and traveller’s diarrhea.
4. Demonstrate the knowledge and skill required to effectively educate clients regarding medication indications, interactions, contraindications, administration adverse effects, expected effects, storage in various climates, and how to proceed when symptoms do not respond or escalate.
5. Complete an accurate prescription(s) in accordance with legal requirements for the treatment of Malaria and Traveller’s Diarrhea.
6. Apply understanding of RN prescribing role in different environments such as for-profit and not-for-profit, and the bias introduced should people pay for care and medication.

This module will examine the role of pharmacologic aids such as Varenicline and Bupropion in supporting clients with smoking cessation goals and will integrate core knowledge and skills in the safety prescribing, management, and evaluation of clients prescribed pharmacologic smoking cessation aids.

Learning Outcomes

After completion of this module, the learner will:

1. Apply clinical reasoning to synthesize and integrate health information, health history and collaborate with the client regarding their preferences and goals for smoking cessation to determine the appropriateness of prescribing pharmacologic smoking cessation aids as well as non-pharmacologic aids.
2. Determine what key health teaching and information is necessary to discuss with clients regarding smoking cessation pharmacologic options and resources and supports necessary for clients on pharmacologic smoking cessation aids regarding rationale for medication selected, potential side effects, and precautions.
3. Apply critical reasoning when considering appropriateness of pharmacologic smoking aids using the ICANPRESCRIBE Framework to assess safety, monitoring, and evaluation considerations in relation to the client’s history, goals, and health status.
4. Demonstrate knowledge of key monitoring considerations and ongoing support that may be needed to support clients initiated on smoking cessation pharmacotherapeutic aids inclusive of strategies to mitigate any risk of harm or mis-use.
5. Integrate findings of screening, assessment and on-going monitoring of clients initiated on pharmacotherapeutic smoking cessation aids into documentation and planning and monitoring and to recognize if/when client’s care needs may change.
6. Apply critical thinking, clinical reasoning, and clinical judgement to plan, prioritize and evaluate care in collaboration with clients and health care providers.
7. Integrate client, and societal factors (e.g., social determinants of health, beliefs, culture, spirituality) when developing a collaborative plan with clients.
8. Complete an accurate prescription(s) in accordance with legal requirements.

This module on over-the-counter medication recommendation encourages learners to use an evidence-informed approach to assess and treat various health conditions. Learners will apply evidence-based knowledge to develop the skills to safely, effectively, and ethically assess, diagnose, and recommend over-the-counter medications.

Learning Outcomes

After completion of this module, the learner will be able to:

1. Demonstrate an understanding of the role of the RN with prescribing authority and can communicate the role when interacting with clients and their families.
2. Demonstrate understanding of professional accountability associated with prescribing OTC medication, including the awareness that these accountabilities cannot be delegated to another individual.  
3. Manage expectations and pressure to prescribe OTC medications from multiple sources.
4. Apply critical thinking, clinical reasoning, and clinical judgement to provide care in collaboration with clients and health care providers.
5. Integrate critical inquiry and diagnostic reasoning when choosing focused subjective and objective assessments.
6. Demonstrate critical inquiry and diagnostic reasoning when choosing appropriate pharmacological options from various sources within the legal scope of practice.
7. Determine appropriate education to provide to the client regarding medication recommendation or prescription.
8. Demonstrate critical inquiry and diagnostic reasoning to synthesize and integrate relevant health information to establish and communicate probable diagnoses within the legal scope of practice.
9. Integrate client and societal factors (e.g social determinants of health, beliefs, culture, spirituality) when developing a collaborative plan with the client.
10. Complete an accurate over-the-counter medication recommendation/prescription in accordance with legal requirements.