All registrants engaged in virtual care are accountable for practicing in accordance with their respective standards of practice, code of ethics, relevant provincial or federal legislation and policies as in-person client care.
This practice scenario has been developed to help registrants understand their accountabilities when working virtually with an authorized prescriber (AP).
Q. What considerations do I need to be aware of when working virtually with an AP?
Virtual care has been defined as any interaction between clients and members of their circle of care, occurring remotely, using any form of communication or information technologies, with the aim of facilitating or maximizing the quality and effectiveness of client care.
APs can conduct assessments, provide advice, diagnosis and order treatments, medications, devices and diagnostic tests, including prescriptions, via electronic means.
NSCN advises nurses to confirm with their employer the expectations of this role when working virtually with an AP and to follow employer processes. Clearly defined accountabilities, scope of employment and policies to support practice are essential.
Registrants should consider the following when working with a virtual AP:
- Confirm that a prescriber residing in another province is licensed and authorized to prescribe before enacting any order.
- Know how to contact the prescriber when questions arise regarding orders or care
- Process for arranging for bloodwork and diagnostic tests when the order is received from a virtual authorized prescriber. *NSCN does not direct, manage or regulate processes related to labs tests and location numbers
- Know how to arrange consultation with another provider when the clients needs exceeds the nurse’s scope of practice.
- Know how to manage care of client when virtual care no longer meets client’s needs and requires immediate care or in person assessment.
- Process for obtaining informed consent (verbal, written, recorded)
- Documentation requirements
To discuss the legal implication of working virtually with an NP, NSCN advises registrants to reach out to their liability provider.
- RNs, RPNs and NPs to contact the Canadian Nurse Protective Society (CNPS)
- LPNs to contact Navacord
For further information on anything contained within this practice support tool, please contact an NSCN Practice Consultant at practice@nscn.ca.
Suggested Reading:
For more information, please see the NSCN’s Virtual Care Practice Guideline.
