Certified Practices Decision
Support Tool (DST) Review Policies
College of
Registered Nurses
of British Columbia
2855 Arbutus Street
Vancouver, BC
Canada V6J 3Y8
T: 604.736.7331
F: 604.738.2272
Toll-free: 1.800.565.6505
POLICIES FOR THE REVIEW OF CERTIFIED PRACTICE DECISION SUPPORT TOOLS
Table of Contents
Preface
3
Certified practices approval committee
4
1. Policy Definitions
6
2. Frequency of Reviews
7
3. Certified Practices DST Standards
7
4. DST Development and Review Process
7
5. Committee Decision about New or Revised DSTs
8
6. Notification and Effective Dates of New or Revised DSTs
9
7. Discontinuation of DSTs
9
8. Decision by the Board about New or Revised Competencies
9
Resources
10
2855 Arbutus Street
Vancouver, B.C. V6J 3Y8
Tel. 604.736.7331 or
1.800.565.6505
www.crnbc.ca
Copyright CRNBC/April 2015
Pub. No. 800
College of Registered Nurses of British Columbia
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POLICIES FOR THE REVIEW OF CERTIFIED PRACTICE DECISION SUPPORT TOOLS
PREFACE
The authority for CRNBC’s Board to establish standards, limits or conditions for registrants’
practice can be found in section 19(1)(k) of the Health Professions Act. Section 8 of the
Nurses (Registered) and Nurse Practitioners Regulation specifically mandates CRNBC to
oversee certified practices. Section 1.26 of the CRNBC Bylaws sets out the duties and
composition of CRNBC‘s Certified Practices Approval Committee and provides the context for
these policies. The authority of the Certified Practices Approval Committee with respect to
Decision Support Tools (DSTs) flows from these bylaws and is excerpted below.
College of Registered Nurses of British Columbia
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POLICIES FOR THE REVIEW OF CERTIFIED PRACTICE DECISION SUPPORT TOOLS
C E R T I F I E D P R A C T I C E S A P P R O V A L COMMITTEE
1.26
(1)
(2)
The certified practices approval committee is established consisting of
at least nine persons appointed by the board, including
(a)
at least four registered nurse registrants, at least two of whom
must hold current certified practice designation,
(b)
at least one nurse practitioner registrant,
(c)
one person who must be nominated by health care employers, to
represent health care employers,
(d)
one medical practitioner who must be confirmed by the College
of Physicians and Surgeons of British Columbia to be suitable for
membership on the committee, and
(e)
one pharmacist who must be confirmed by the College of
Pharmacists of British Columbia to be suitable for membership on
the committee.
The committee members appointed under subsection (1)(a) and (b) must
include
(a)
at least one nurse educator from a nursing education program,
(b)
at least one clinical nurse educator,
(c)
at least one nurse administrator, and
(d)
at least one registrant who is employed or engaged in direct
clinical practice.
(3)
The certified practices approval committee may consult, as it considers
necessary or appropriate, with registrants or other persons who have
expertise relevant to a certified practice course or any other matter
considered by the committee.
(4)
The certified practices approval committee must
(a)
review certified practice courses, in accordance with any
applicable criteria or policies established by the board,
(b)
review, to the extent the committee considers appropriate, new or
changed certified practice courses, in accordance with any
applicable criteria or policies established by the board,
(c)
report to the board and make recommendations about certified
practice courses to be approved for the purpose of certified practice
designation, and any terms and conditions of approval,
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POLICIES FOR THE REVIEW OF CERTIFIED PRACTICE DECISION SUPPORT TOOLS
(d)
regularly review and recommend policies and procedures
pertaining to the review of certified practice courses,
(e)
review the competencies required for any certified practice, and
make recommendations to the board for approval of such required
competencies, and
(f)
review and approve certified practice DSTs for use by registrants
with a certified practice designation.
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POLICIES FOR THE REVIEW OF CERTIFIED PRACTICE DECISION SUPPORT TOOLS
1. POLICY DEFINITIONS
Approval means the status granted by the committee to the certified practices DSTs that
meet the standards set by the Committee, and approved in Board policy.
Certified practices means restricted activities that are subject to regulatory provisions under
Section 8 of the Nurses (Registered) and Nurse Practitioners Regulation. These provisions
require registered nurses to successfully complete a certification program approved by
CRNBC before carrying out the restricted activities designated as certified practices. Certified
practices are also referred to as CRNBC certified practices to distinguish them from activities
that employers or other organizations certify.
Committee means the Certified Practices Approval Committee provided for in section 1.26 of
the CRNBC Bylaws under the Nurses (Registered) and Nurse Practitioner Regulation.
Competencies means statements about the knowledge, skills, attitudes and judgment
required to perform safely and ethically within an individual’s nursing practice or in a
designated role or setting.
DSTs means evidence-based documents used by registered nurses to guide the assessment,
diagnosis and treatment of client-specific problems.
Guidelines for development, review and revision of DSTs means those statements
developed by the committee to supplement Board policy by describing the details of how
the policies will be operationalized to facilitate the development, assessment and revision
of the DSTs.
Restricted activities means higher risk clinical activities that must not be performed by any
person in the course of providing health services, except a member of a regulated profession
that has been granted specific legislative authority to do so, based on their education and
competencies.
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POLICIES FOR THE REVIEW OF CERTIFIED PRACTICE DECISION SUPPORT TOOLS
2. FREQUENCY OF REVIEWS
2.1
2.2
The DSTs shall be reviewed at least once every four years.
Decisions support tools may be reviewed and revised more frequently upon
request.
3. CERTIFIED PRACTICES DST1 STANDARDS2
The following are the standards against which the Committee shall review the DSTs:
3.1
3.2
DSTs are developed, or assessed and revisions are proposed to the Committee by:
a. A content expert supported by an advisory group of key stakeholders, or,
b. An organization recognized for its expertise in the certified practices category
being developed or reviewed.
DSTs:
a. Are current, evidence-informed and benchmarked against best practices;
b. Set out reasonable expectations for independent certified practices registered
nurse activities;
c. Provide clear and sufficient direction for the assessment, diagnosis and
treatment/intervention of client-specific problems;
d. Identify the circumstances when the client must be referred to another health
professional, e.g., physician, nurse practitioner, or when another health
professional must be consulted; and
e. Identify outcomes certified practices nurses can expect following an
intervention.
DSTs follow a standardized format as set out in guidelines developed by the committee.
4. DST DEVELOPMENT AND REVIEW PROCESS
4.1 Request to Revise a DST
a. A request to revise a DST shall be assessed in a timely manner to determine
the urgency of the request and an appropriate review timeline by:

A registrant or other health professional who has content expertise and
practice experience in the certified practices category being addressed,
e.g., physician, pharmacist, or nurse practitioner; or,

A designated person from an organization recognized for its expertise in
the certified practices category being addressed.
b. The content expert3 shall submit in writing the assessment findings and
propose review timelines to CRNBC staff.
1 Hereafter, the word, DST, means a certified practices DST.
2 Hereafter, the word, standards, refers to the DST Standards.
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POLICIES FOR THE REVIEW OF CERTIFIED PRACTICE DECISION SUPPORT TOOLS
c. CRNBC staff shall make the final decision about the review timelines, in
consultation with the Committee as appropriate.
d. The process of reviewing a DST as a result of a request shall be the same as the
process used in the regular review of a DST.
4.2
Regular Review of a DST
a. The regular review of a DST is timed to prevent expiration of the DST.
b. A content expert shall be selected by CRNBC staff to develop, or assess and
propose revisions to the DST.
c. An advisory group shall be convened to provide feedback to the content
expert. The advisory group shall include certified practice registered nurses
who currently provide direct care in the certified practices category under
review, and may include other health professionals with relevant content
expertise and practice experience.
d. The content expert may consult, as necessary or appropriate, with other
registrants or health professionals who have content expertise and practice
experience relevant to the certified practices category being addressed.
e. The content expert, following consultation with the advisory group, and others
as necessary, shall submit the proposed DST, or the assessment findings and
proposed revisions, with rationale in a report to the committee.
f. The report shall adhere to the guidelines developed by the committee.
g. The committee shall discuss the report with the content expert and make a
determination about whether the proposed DSTs meet the standards.
5. COMMITTEE DECISION ABOUT NEW OR REVISED DSTS
5.1
5.2
5.3
5.4
The committee shall review each component of the DST as met or not met.
A component of a DST shall be reviewed as not met when it does not meet the
standards.
The content expert shall address improvements to any component(s) of the DST
that is reviewed as not met and submit these to the committee in a written report.
Once it is satisfied that the standards are met, the Committee shall approve the
DST for a period of up to four years.
3 Hereafter the term, content expert, refers to either a registrant who has content expertise and practice experience in the certified practices
category being addressed or a designated person from an organization recognized for its expertise in the certified practices category being
addressed.
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POLICIES FOR THE REVIEW OF CERTIFIED PRACTICE DECISION SUPPORT TOOLS
6. NOTIFICATION AND EFFECTIVE DATES OF NEW OR REVISED DSTS
6.1 CRNBC staff shall post the new or revised DST(s) on the CRNBC website and
shall inform by email, registered nurses certified in the relevant certified
practice category about the changes, on the same date.
6.2 Certified Practice nurses shall practice according to any new or revised DST
within 30 days of delivery of the email notification.
7. DISCONTINUATION OF DSTS
7.1 The content expert, following consultation with the advisory group, and
others as necessary, may propose the discontinuation of [a] DST[s].
7.2 When the content expert proposes the discontinuation of [a] DST[s], the
Committee shall review the proposal and:
a. Approve the proposal; or
b. Decline to approve the proposal.
7.3 CRNBC staff shall remove the DST from the CRNBC website and shall inform
by email, registered nurses certified in the relevant certified practice category
about the change, on the same date.
7.4 Certified Practice nurses shall no longer practice according to a discontinued
DST within 30 days of delivery of the email notification.
8. DECISION BY THE BOARD ABOUT NEW OR REVISED COMPETENCIES
Board approval is required for any new or revised competencies for certified practices that
involve the addition or deletion of any restricted activity outlined in Section 8 of the Nurses
(Registered) and Nurse Practitioner Regulation.
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POLICIES FOR THE REVIEW OF CERTIFIED PRACTICE DECISION SUPPORT TOOLS
RESOURCES
CRNBC Competencies for Remote Nursing Certified Practice
CRNBC Competencies for Sexually Transmitted Infections Certified Practice
CRNBC Competencies for RN First Call Certified Practice
CRNBC Competencies for Contraceptive Management Certified Practice
CRNBC Bylaws
Health Professions Act
Nurses (Registered) and Nurse Practitioners Regulation
College of Registered Nurses of British Columbia
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