The College of Nurses of Ontario presents the Nurse Practitioner Learning Module: Dispensing.

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1 The College of Nurses of Ontario presents the Nurse Practitioner Learning Module: Dispensing.

2 Dispensing is the selection, preparation and transfer of one or more prescribed medication doses to a client, or a client s representative, for administration at a later time. Dispensing differs from administration in that, when dispensing a medication, the drug is not immediately taken by the client. Most medication dispensing in the Ontario health care system is done by pharmacists.

3 Nurse Practitioners only dispense medication when it is appropriate for nursing practice. Therefore, they can dispense medication when, according to their assessment of the client, it is established that: the client does not have reasonable or timely access to a pharmacy the client would not otherwise receive the medication the client does not have the financial resources to obtain the medication elsewhere the medication is dispensed as part of a health promotion initiative, or the medication is dispensed for the purpose of testing the client s therapeutic response to the treatment. When one or more of these circumstances occur, an NP has the authority to dispense a medication. If none of the circumstances apply, then an NP is not authorized to dispense.

4 Another way that NP dispensing differs from pharmacist dispensing is that NPs may only dispense medication they prescribe, or medication that has been prescribed by a colleague on their health care team, such as another NP or a physician. Nurse Practitioners cannot dispense a medication prescribed by a health care professional who is not part of their immediate team. For example: Sandra is an NP at a university student health clinic. Her practice includes dispensing, free of charge, oral contraceptives to sexually active clients who cannot afford to purchase the medication. During an appointment, Beth, a client, presents a prescription to Sandra for birth control pills that were prescribed by her family doctor. Sandra assesses Beth and determines that while Beth can afford to purchase the contraception from a local pharmacy, she thought it would be more convenient to obtain the medication from Sandra during this appointment. Based on this, Sandra determines that Beth's situation does not meet any of the circumstances that are permitted for NP dispensing. Therefore, Sandra advises Beth that she cannot dispense the medication to her.

5 When dispensing, the package and label must be appropriate. The medication must be: in a container that meets the needs of the client and maintains the integrity of the medication and labelled with the information needed to properly use and store the medication.

6 The following information must be on the medication label: the client s name the date the name of the medication if applicable, the strength of the medication the dose, route of administration and frequency the client must take it if applicable, the duration of therapy the quantity of medication dispensed the expiry date any special instructions that the client needs to know about taking or storing the medication the NP s name, protected title, business address and phone number. Depending on the NP s practice setting, an identification number may also be assigned to medications dispensed to clients. And, the name of the medication manufacturer must be added to the label if the NP has the information. This helps with tracing the medication to a client if there is a medication recall.

7 You have now completed this chapter. To continue the learning module, close this presentation, return to the Learning Centre and select the chapter of your choice. If you have a question for a Practice Consultant, click on the link in the upper righthand corner.