Revised: December 1, 2016
Midwifery standards of practice refer to the minimum standard of professional behavior and clinical practice expected of BC registered midwives when prescribing and administering drugs.
Midwives must have the necessary knowledge, skills and judgment to prescribe drugs from the list of designated drugs in the midwives regulations.
Midwives can prescribe drugs that are within their scope of practice.
- Assess the client, conduct necessary laboratory and diagnostic investigations;
- Comply with relevant federal and provincial legislation;
- Adhere to all relevant standards, guidelines or policies established by agencies or organizations such as public health units or blood banks involved in the provision or control of any of the authorized drugs or substances;
- Provide a written, or when necessary, a telephone or verbal prescription order;
- Consider whether the drug is a safe and effective treatment option for the specific client circumstances;
- Provide the client and/or client representative with the necessary information about the drug prescribed such as expected therapeutic effect, potential side effects, contraindications and precautions;
- Consider drug resistance, medication errors, infection control and safety when prescribing and/or administering any substance from the regulation;
- Ensure that there are adequate systems in place to prevent prescription fraud;
- Ensure proper reporting of drug reactions and medication errors;
- Monitor client response to the drug therapy after prescribing, and continue, adjust dosage or discontinue the drug therapy as appropriate.
- Obtain a health history and document the symptoms and/or conditions being treated;
- Review and obtain a full comprehension of the drugs the client is taking;
- Document in the client record, in a timely manner, all telephone or verbal prescription orders;
- Provide a follow-up care plan as appropriate, and document in the client record;
- Document the client’s response to the drug therapy;
- Ensure proper recognition and management of medication errors including documentation and reporting;
- Ensure proper risk management reporting when drug reactions or medication errors occur.
A prescription prepared by a midwife must include:
- Full date;
- Client’s name;
- Client’s address;
- Name of drug, drug strength when applicable, dose and the quantity of the prescribed drug;
- Full instructions/directions for use of the prescribed drug;
- Refill instructions, if any;
- Printed name of the midwife prescriber with telephone number and address;
- CMBC registration number and the professional designation;
- Midwife’s signature;
- May not prescribe “for office use”.
Midwives obtaining consults and providing inter-professional care, relating to prescriptions:
- May not delegate the act of prescribing a drug;
- Must notify any relevant health care provider involved in the client’s care when clinically appropriate and document this action;
- Consult with appropriate health care professional if the client’s response to the drug therapy is other than anticipated.
When midwives continue drug therapy initiated by another health care professional, they must:
- Provide and document ongoing assessments;
- Monitor and document the client’s response to the drug therapy;
- Communicate the client’s response and change to or discontinuation of drug therapy to the initiating health care provider as appropriate;
- Consult with the appropriate health care professional at any point for continuing drug therapy as appropriate.