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Volume 52, No. 8

B.C. Reg. 157/2009

The British Columbia Gazette,

Part II

April 21, 2009

B.C. Reg. 157/2009 , deposited April 9, 2009, pursuant to the HEALTH PROFESSIONS ACT [Section 12 (2)]. Ministerial Order M131/2009, dated April 8, 2009.

I, George Abbott, Minister of Health Services, order that the Nurses (Registered) and Nurse Practitioners Regulation, B.C. Reg. 284/2008, is amended as set out in the attached appendix.

— G. ABBOTT, Minister of Health Services .

Appendix

Section 1 of the Nurses (Registered) and Nurse Practitioners Regulation, B.C. Reg. 284/2008, is amended

(

a) in the definition of "compound" by striking out " 6 (1) (k) " and substituting " 6 (1) (k) (

i) and (l) (i) ", by striking out " 7 (1) (f) " and substituting " 7 (1) (f) (i) ", by striking out " 7 (1) (g) " and substituting " 6 (1) (m) " and by striking out " of a therapeutic diet ",

(

b) by repealing the definition of "design" ,

(

c) by striking out the definition of "dispense" and substituting the following:

"dispense" has the same meaning as in the Pharmacy Operations and Drug Scheduling Act ,

(

a) excluding a sale as defined in that Act, and

(

b) including receipt of payment on behalf of a registrant's employer for a drug dispensed or administered by the registrant, if the registrant's employer lawfully requires payment for that drug from a person in respect of the individual for or to whom it is dispensed or administered; ,

(

d) in paragraph (

a) of the definition of "health professional" by adding " , naturopathic medicine " after " midwifery ",

(

e) in the definition of "order" by striking out " or perform " after " to provide ", " or provision " after " performance " and " or performing " after " providing ",

(

f) by repealing the definition of "pharmacist" ,

(

g) by repealing the definition of "prescribe" and substituting the following:

"prescribe" means to issue a prescription as defined in the Pharmacy Operations and Drug Scheduling Act ; ,

(

h) in the definition of "substance" by striking out " air or " and substituting " air and " and by adding " but excludes a drug specified in

Schedule I, IA, II or IV of the Drug Schedules Regulation, B.C. Reg. 9/98 " after " water ", and

(

i) by adding the following

definitions:

"enteral instillation" means instillation directly into the gastrointestinal tract;

"parenteral instillation" means instillation directly into the blood stream; .

2 The following

section is added:

Restricted and provisional registrant classes

5.1

(1) Effective December 1, 2010, the college is authorized to establish, under

section 19 (1) (

i) of the Act, a class of restricted registrants for the purposes of

section 20 (4.2) of the Act.

(2) The college is authorized to establish, under

section 19 (1) (

i) of the Act, a class of provisional registrants, for the purposes of

section 20 (4.3) of the Act.

Section 6 (1) is amended

(

a) by adding " do any of the following: " after " practising nursing may ",

(

b) in paragraph (

a) by striking out " the individual " and substituting " an individual ",

(

c) in paragraph (

b) by adding " including suturing of skin lacerations, " after " wound care, ",

(

d) in subparagraph (ii) of paragraph (

d) by adding " parenteral " before " instillation " and striking out " through a parenteral method ",

(

e) by striking out paragraph (

e) and substituting the following:

(

e) administer

(

i) the following by inhalation:

(

A) oxygen or humidified air;

(

B) a mixture of oxygen and nitrous oxide, for the purpose of pain management during labour,

(ii) nutrition by enteral instillation, or

(iii) purified protein derivative by injection, for the purpose of tuberculosis screening; ,

(

f) in paragraph (

f) by striking out " assessing an individual " and substituting " assessment ", adding " enteral " before " instillation " and striking out " through an enteral method ",

(

g) in paragraph (

g) by striking out " assessing an individual " and substituting " assessment ",

(

h) in paragraph (

h) by striking out " assessing an individual " and substituting " assessment " and adding " equal to or less than the pressure " before " created ",

(

i) in paragraph (

j) by striking out " using an automatic external defibrillator " and substituting " for the purpose of defibrillation in the course of emergency cardiac care ",

(

j) by repealing paragraph (

k) and substituting the following:

(

k) in respect of a drug specified in

Schedule II of the Drug Schedules Regulation,

(

i) compound the drug,

(ii) dispense the drug, or

(iii) administer the drug by any method; ,

(

k) by repealing paragraph (

l) and substituting the following:

(

l) in respect of a drug specified in

Schedule I of the Drug Schedules Regulation,

(

i) compound the drug,

(ii) dispense the drug, or

(iii) administer the drug by any method

for the purposes of

(iv) treating

(

A) anaphylaxis,

(

B) cardiac dysrhythmia,

(

C) opiate overdose,

(

D) respiratory distress in a known asthmatic,

(

E) hypoglycemia, or

(

F) post-partum hemorrhage, or

(

v) preventing disease using immunoprophylactic agents and post-exposure chemoprophylactic agents; , and

(

l) by adding the following paragraphs:

(h.1) manage labour in an institutional setting if the primary maternal care provider is absent;

(j.1) in the course of assessment, issue an instruction or authorization for another person to apply, to a named individual,

(

i) ultrasound for diagnostic or imaging purposes, including any application of ultrasound to a fetus, or

(ii) X-rays for diagnostic or imaging purposes, except X-rays for the purpose of computerized axial tomography;

(

m) if nutrition is administered by enteral instillation, compound or dispense a therapeutic diet.

Section 6 (2) is amended by striking out " or performance " after " to the provision " and striking out " provision or " after " includes the ".

Section 7 (1) is amended

(

a) by adding " do any of the following: " after " practising nursing may ",

(

b) in paragraph (

b) by striking out " other than a drug that is specified in a

Schedule of the Drug Schedules Regulation, B.C. Reg. 9/98, " and repealing subparagraph (

v) and substituting the following subparagraphs:

(

v) by enteral instillation or parenteral instillation, or

(vi) by using a hyperbaric chamber; ,

(

c) by adding the following paragraph:

(d.1) apply ultrasound for diagnostic or imaging purposed, including application of ultrasound to a fetus; ,

(

d) in paragraph (

e) by striking out paragraphs (

i) to (iv) and adding " destroying tissue or affecting activity of the heart or nervous system; " after " purposes of ", and

(

e) by repealing paragraphs (

f) to (

j) and substituting the following:

(

f) in respect of a drug specified in

Schedule I or IA of the Drug Schedules Regulation,

(

i) compound the drug,

(ii) dispense the drug, or

(iii) administer the drug by any method;

(

g) conduct challenge testing for allergies

(

i) that involves injection, scratch tests or inhalation, if the individual being tested has not had a previous anaphylactic reaction, or

(ii) by any method, if the individual being tested has had a previous anaphylactic reaction;

(

h) conduct desensitizing treatment for allergies

(

i) that involves injection, scratch tests or inhalation, if the individual being treated has not had a previous anaphylactic reaction, or

(ii) by any method, if the individual being treated has had a previous anaphylactic reaction.

Section 7 (2) is repealed and the following substituted:

(2) A registrant May provide a service that includes the performance of an activity described in subsection (1) only if

(

a) the registrant provides the service for the purpose of complying with an order, and

(

b) at the time of the provision of the service by the registrant

(

i) the health professional who gives the order is authorized under an enactment to provide the service, and

(ii) the registrant is authorized under the Act to provide the service.

Section 8 (1) is amended

(

a) by adding " do any of the following: " after " practising nursing may ",

(

b) in paragraph (

a) by striking out " provide or ", and

(

c) by striking out paragraphs (

c) and (d).

Section 8 (2) is amended by striking out " or performance " after " to the provision " and striking out " provision or " after " includes the ".

Section 8 (3) is repealed and the following substituted:

(3) A registrant May provide a service that includes the performance of an activity described in subsection (1) only if, before providing the service, the registrant has successfully completed a certification program established, required or approved under the bylaws to ensure that registrants are qualified and competent to provide that service in the practice setting in which it is to be provided by the registrant.

Section 9 (1) is amended

(

a) by adding " do any of the following: " after " practising nursing may ",

(

b) in paragraph (

a) by striking out " provide or " and by striking out " B.C. Reg. 9/98, ",

(

c) in paragraph (

b) by striking out " to (d) ",

(

d) in paragraph (

d) by striking out " apply X-ray " and substituting " apply X-rays ",

(

e) in paragraph (

e) by repealing subparagraph (ii) and substituting the following:

(ii) X-rays, for diagnostic or imaging purposes, including X-rays for the purpose of computerized axial tomography;

(iii) laser for the purpose of destroying tissue; ,

(

f) in paragraph (

f) by striking out " that is " after " drug ", and

(

g) by adding the following paragraph:

(

g) if nutrition is administered by enteral instillation or parenteral instillation, select ingredients for a therapeutic diet.

Section 9 (2) is amended by striking out " or performance " after " to the provision " and striking out " provision or " after " includes the ".

Section 9 (3) and (4) are repealed and the following substituted:

(3) A nurse practitioner May provide a service that includes the performance of an activity described in subsection (1) only if

(

a) standards, limits or conditions have been established, under

section 19 (1) (

k) or (

l) of the Act, respecting the activity, and

(

b) the standards, limits and conditions described in paragraph (

a) are established on the recommendation of a committee that

(

i) is established under

section 19 (1) (

t) of the Act, and

(ii) has the duty and power to develop, review and recommend those standards, limits or conditions.

(4) A registrant May provide a service that includes the performance of an activity described in subsection (1) (

c) to (

f) only if the registrant is a nurse practitioner.

Section 10 (1) is amended

(

a) in paragraph (

c) by striking out " provided or ",

(

b) in paragraph (d) (

i) by striking out " requires, on the date this regulation comes into force " and substituting " required, on August 19, 2005 " and by striking out " provided or ", and

(

c) in paragraph (d) (ii) by striking out " has declared to the minister, on or before the date that is 30 days after the date this regulation comes into force " and substituting " declared to the minister, on or before September 18, 2005 " and by striking out " provided or ".

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