1. | Nurses perform only those medication-related activities as allowed by: |
| a. | Relevant provincial or federal legislation or regulations, |
| b. | BCCNM standards, limits, and conditions, |
| c. | Organizational/employer policies and processes, and |
| d. | The nurse’s individual competence.
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2. | Nurses follow relevant provincial or federal legislation or regulations, organizational/employer policies and processes, and BCCNM standards, limits, and conditions when performing any medication related activity3.
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3. | Nurses use current evidence to support their decision-making about medications and their medication practices.
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4. | Nurses follow infection prevention and control principles when performing medication-related activities.
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5. | Before performing any medication-related activity, nurses know the medication’s:
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| a. | Therapeutic use/indications, |
| b. | Expected effects,
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| c. | Dosage(s),
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| d. | Precautions,
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| e. | Contraindications,
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| f. | Form (e.g. tablet, liquid), and route for administration,
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| g. | Interactions, |
| h. | Side effects, and |
| i. | Adverse effects.
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6. | Nurses assess the appropriateness of the medication for the client before administering, dispensing, or prescribing a medication.
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7.
| Nurses assess and respect the client’s values, beliefs, personal preferences, language, learning needs, abilities, mental state, and level of understanding, to support the client (or their substitute decision-maker) to be an active participant in making informed decisions about the medication.
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8. | Nurses educate the client (or their substitute decision-maker) about the medication they are receiving, including, as applicable:
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| a.
| The reason the client is receiving the medication,
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| b.
| The expected action of the medication,
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| c.
| The duration of the medication therapy,
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| d.
| Specific precautions or instructions for the medication,
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| e. | Potential side-effects and adverse effects (e.g. allergic reactions) and action to take if they occur,
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| f. | Potential interactions between the medication and certain foods, other medications, or substances,
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| g. | Handling and storage requirements,
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| h.
| Recommended follow-up.
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9. | Nurses identify the effect of their own values, beliefs, and experiences on their clinical decision-making about medication-related activities; recognize potential conflicts and take action for the client’s needs to be met.
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10.
| Nurses take action when a medication does not seem:
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| a. | Appropriate, because the client’s condition, needs, or wishes have changed, |
| b. | Evidence-informed, or |
| c. | Reflective of the client’s individual needs, characteristics, values/beliefs, or personal preferences. |
11. | Nurses collaborate, communicate, and/or consult with the health care team in making decisions about medication-related activities, including: |
| a. | Consideration of the broader plan of care for the client developed by the health care team, |
| b. | The follow-up needed with respect to medication when the client’s care is transferred to another health professional, or when the client transfers to another clinical or care setting or to their home, |
| c. | When the client’s care would benefit from the expertise of other health care professionals, |
| d. | When the needs of the client exceed the nurse’s individual competence or scope of practice, and |
| e. | Documenting the plan of care. |
12. | When a pharmacist has not reviewed and verified a medication’s pharmaceutical and therapeutic suitability, or if it is unclear whether this has occurred, nurses take steps to ensure pharmaceutical and therapeutic suitability before administering or dispensing a medication by: |
| a. | Reviewing the client’s best available medication history and other personal health information, |
| b. | Assessing the client’s known allergies and ensuring medication allergy information is documented, |
| c. | Considering potential medication interactions, contraindications, therapeutic duplications, side effects, adverse effects, and any other potential problems, |
| d. | Using current, evidence-informed resources to support their clinical decision-making, and |
| e. | Considering the client’s ability to follow the medication regimen.
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13. | Nurses administer, dispense, or prescribe medications only for clients under their care, except in an emergency. |