General Prescribing Standards

Midwives: 

  1. Prescribe therapeutics within their scope of practice, and in compliance with relevant federal and provincial legislation and organizational policies.
  2. Are accountable for their prescribing decisions.
  3. Adhere to relevant guidelines when prescribing.
  4. Prescribe according to best evidence.
  5. Before prescribing, ensure they are competent to:
    1. establish or confirm a diagnosis for the client;
    2. manage the treatment and care of the client; and
    3. monitor and manage the client’s response to the therapeutic.
  6. When prescribing:
    1. consider the client’s health history and other relevant factors (e.g. age, gender, lifestyle, the client’s perspective);
    2. undertake and document an appropriate clinical evaluation (e.g. physical examination, review of relevant tests, imaging and specialist reports);
    3. obtain the best possible medication history for the client using PharmaNet (when access is available) and other sources;
    4. review the medication history and act to address any discrepancies;
    5. ask about the client’s drug allergies and ensure drug allergy information is accurate;
    6. appropriately document the therapeutics prescribed and their indication(s) in the client’s medical record;
    7. establish a plan for reassessment/follow-up; and
    8. monitor and document the client’s response to the therapeutic prescribed (as appropriate).
  7. When prescribing, provide information to clients about:
    1. potential benefits and risks of the therapeutic;
    2. the expected action of the therapeutic;
    3. the duration of therapy;
    4. specific precautions or instructions for the therapeutic;
    5. potential side-effects and adverse effects and action to take if they occur;
    6. potential interactions between the therapeutic and certain foods, other drugs, or substances; and
    7. recommended follow-up.
  8. Complete prescriptions accurately and completely, including:
    1. the date the prescription was written;
    2. client name, address (if available), PHN (if available) and date of birth;
    3. client weight (if required);
    4. name, strength and dose of the therapeutic;
    5. the quantity prescribed and quantity to be dispensed;
    6. dosage instructions (i.e. frequency or interval, maximum daily dose, route of administration, duration of therapy);
    7. refill authorization if applicable, including number of refills and interval between refills;
    8. their name, address, telephone number, written (not stamped) signature, and CMBC number;
    9. date of transmission, the name and fax number of the pharmacy intended to receive the transmission, and their fax number if the prescription is being faxed; and
    10. directions to the pharmacist not to renew or alter if a pharmacist-initiated adaption would be clinically inappropriate.
  9. Document all verbal orders and telephone prescriptions accurately, contemporaneously and legibly in the client record.
  10. Undertake medication reconciliation to ensure accurate and comprehensive medication information is communicated consistently.
  11. Report adverse drug reactions to the Canada Vigilance Program[1].
  12. Manage, document, report and disclose any medication errors.
  13. Do not prescribe therapeutics for themselves or a family member except in an urgent or emergent situation when there is no other prescriber available.
  14. Do not provide anyone with a blank, signed prescription.

[1] Health Canada’s surveillance program that collects and assesses reports of suspected adverse reactions to health products marketed in Canada.