Nursing (NURS) 531

Overview

This course is part of a program of study leading to the Post-Master's Diploma: Nurse Practitioner, or the Master of Nursing (Nurse Practitioner) degree.

In Nursing 531 students study:

• Provincial and federal regulations governing prescription of narcotics and controlled substances;
• Standardized approaches to the assessment of clients for whom controlled drugs and substances may be prescribed
• Evidence-based, systemic approaches and tools for the prescription of narcotics and controlled substances
• Comprehensive, effective therapeutic treatment and management options including non- pharmacological alternative modalities
• Multidisciplinary approaches to care related to clients on narcotics and controlled substances including appropriate referral
• Addiction, drug tolerance, drug-seeking behavior and drug tapering

Outline

Module 1 – Introduction

Module 2 – Professional accountability
Module 2 discusses the philosophical tenets and ethical beliefs that underpin the prescription of controlled drugs and substances. The unit then focuses on the legislation and regulation of controlled drugs and substances in Canada. An overview of the federal and provincial documentation requirements for those who prescribe controlled substances is also presented.

Module 3 – Indications for CDS
Module 3 specifically addresses the pathophysiology of pain, anxiety and depression, insomnia, seizures, and attention deficit hyperactivity disorder (ADHD). It also focuses on the assessment of clients with these conditions and identifies evidence-based tools used in assessment and management of these clients.

Module 4 – Clinical Tools
Module 4 reviews the pharmacokinetics and pharmacodynamics of the most common CDS. The concepts of half-life, clearance, steady state, cumulating efficacy, potency, responsiveness and resistance are all important when prescribing opioids, and are discussed for a number of drugs in this class. Oral opioid analgesic conversion is presented.

Module 5 – Therapeutics
Module 5 specifically addresses the process of prescribing a CDS. The unit begins with a discussion on perspectives on pain followed by a focus on the treatment of persistent pain including opioid selection, risks, rotation, and tapering. This is followed by a discussion of prescribing benzodiazepines and psychostimulants. The specifics of writing a CDS prescription and client education are also described.

Module 6 – Monitoring and Evaluation
Module 6 explores the recommendations for monitoring and evaluating patients using CDS. It also outlines clinical tools that aid in prescribing controlled drugs and substances, including urine drug screening and opioid agreements. The student will be introduced to the differences between dependence and addiction, which will provide the prescriber with the necessary knowledge to safely prescribe opioids to a number of populations, including those who face chronic pain and addiction issues.

Module 7 – Opioid Use Disorder
Module 7 explores the assessment of clients at risk for opioid use disorder (OUD) and discusses the options for management of OUD.

Module 8 – Case Studies
In this unit students will use a case study approach to apply concepts related to the management of patients requiring narcotics or controlled drugs.

Learning outcomes

NURS 531 is an asynchronous online course. Students have 13 weeks to complete the course and must have completed this course prior to completion of NURS 530.

Objectives

After completing this course, students should be able to:

1. articulate the legislation and regulations governing the prescribing of controlled drugs and substances (CDS) in Canada;
2. discuss the pharmacology of a range of controlled drugs and substances;
3. review the pathophysiology of conditions that may require treatment with CDS;
4. assess and identify clients who are suitable for controlled drugs and substances, using recommendations from Canadian Guidelines;
5. identify clients who are at risk for addiction to, and misuse of, controlled drugs and substances;
6. explain the rationale for using a CDS agreement plan;
7. explain the rationale for including urine drug testing in an opioid maintenance care plan;
8. identify the legal requirements of prescribing narcotics and controlled substances;
9. safely conduct an opioid trial by following the Canadian Guideline recommendations;
10. monitor clients on long term CDS therapy by following the Canadian Guideline recommendations;
11. safely taper a client off CDS;
12. discuss potential non-pharmacologic, alternative modalities and multidisciplinary approaches to care;
13. outline appropriate documentation related to CDS prescribing including informed consent;
14. identify strategies to enhance patient and prescriber safety related to the prescription of controlled substances;
15. assess the evidence supporting the use of CDS.

Evaluation

The assessment structure for NURS 531 is based on a multiple choice exam completed at the end of the course. A minimum grade of 70 is required to achieve a passing grade on the course:

• Final Examination (minimum passing grade 70%)

Materials

There are no textbooks for this course.

Other Materials

Textbooks and readings from other Nurse Practitioner and Advanced Nursing Practice courses will be used as appropriate.

Technical Requirements

Computer System

In order to successfully complete this course, the student must own or have ready access to certain computer hardware and software programs. For complete and up-to-date information on the minimum computer requirements required to complete the graduate nursing courses, visit the Centre for Nursing and Health Studies technical site.

Students are expected to connect to an Internet Service Provider at their own expense and to secure audio speaker or headphones for the required Clinical Forum events in the course.

Important links

• Academic advising
• Program planning
• Request assistance
• Support services