NURSE PRACTITIONER
ORIENTATION
Guidelines
Revision 2012
Updated June 8, 2011
-1-
Table of Contents
OPERATIONS .....................................................................................................................................................3
ELEMENTS OF NP ORIENTATION: .........................................................................................................................3
ELEMENTS OF NP ORIENTATION - CONTINUED: .....................................................................................................4
AFTER OFFER ....................................................................................................................................................4
SITE/SETTING OPERATIONAL LOGISTICS ..............................................................................................................4
FINANCE.............................................................................................................................................................5
PROFESSIONAL PRACTICE AND INTEGRATION .......................................................................................................5
FRASER HEALTH PRACTITIONER ENCOUNTER REPORTING ....................................................................7
INTRODUCTION ...................................................................................................................................................7
COMPLETING DAILY ENCOUNTER RECORDS .........................................................................................................7
DIAGNOSTIC SERVICES .......................................................................................................................................9
EXCELLERIS LAUNCHPAD ................................................................................................................................. 10
NP NEW HIRE CHECKLIST ................................................................................................................................ 11
APPENDIX ........................................................................................................................................................ 12
APPENDIX 1 ..................................................................................................................................................... 12
Nurse Practitioner Learning Plan ............................................................................................................... 12
APPENDIX 2 ..................................................................................................................................................... 17
Example of Prescription Information .......................................................................................................... 17
APPENDIX 3 ..................................................................................................................................................... 18
Nurse Practitioner Office and Exam Room Equipment and Supplies ....................................................... 18
APPENDIX 4 ..................................................................................................................................................... 23
Fraser Health Nurse Practitioner Encounter Report Summary ................................................................. 23
APPENDIX 5 ..................................................................................................................................................... 24
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Professional Practice & Integration
Purpose:
The purpose of this document is to guide orientation for Nurse Practitioners (NPs) in Fraser
Health. It is intended to be used by Nurse Practitioners and hiring Directors or Managers to
ensure that a suitable orientation is provided for each NP new to Fraser Health. NP
orientation is managed by the hiring Director, Manager, or designee.
Operations
Prior to hiring an NP please review all the following documents in the NP Resource
Center located on the FH website under Professional Practice and Integration. These
documents include:
1. NP Role Implementation Planning Tool
2. NP Job Description
3. Hiring Guidelines
http://fhpulse/clinical_support_services/professional_practice/practice/scope_of_practice_a
nd_regulations/nursing/Pages/NursePractitioners.aspx
Elements of NP orientation:
1.
New employee orientation:
Fraser Health is committed to ensuring all new employees are supported through an
orientation as they integrate into the organization. The Online New Employee
Orientation covers Fraser Health’s vision, Purpose and Values, the Emergency
Codes, Quality and Patient Safety issues, Infection Prevention and Control issues,
plus an overview of the roles of the departments a typical employee is likely to come in
contact with during the first weeks of work.
https://fhaneo.primesignal.com/ATutor/mods/terms_and_conditions/terms_and_conditions.
php
2.
NPs are Excluded Staff. It is the responsibility of each new NP to be familiar with the
Terms and Conditions of Excluded Staff.
http://fhpulse/benefits_and_people_resources/paying_you/Management%20%20Mana
gement%20Support%20Excluded/29October%2010,%202010%20Terms%20and%20Conditions%20Excluded.pdf
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Professional Practice & Integration
Elements of NP orientation - continued:
3. Orientation to work setting/location
4.
NP clinical role – this section focuses on unique aspects of NP practice such as
encounter reporting
5.
NP – self-assessment of learning needs in NP role; for completion by NP then
discussed with manager/director and possibly the collaborating physician. NP self –
assessment is based on the CRNBC NP standards
https://www.crnbc.ca/Pages/Default.aspx and are incorporated as part of the NP’s
Performance Plan http://fhapps/fha_perfman_nw/perf_plan/perf_plan.asp
For example of learning plan – see Appendix 1
After Offer
Site/Setting Operational Logistics
1.
Tour of work area
2.
Keys/access card
3.
Office space & supplies
4.
Computer

PC & Printer

Profile and log-in: Complete on-line “Information Services – Request Access for a
New User”. Allow 2 weeks for processing.
http://fhpulse/sites/IMServiceCatalogue/Lists/Service%20Items/DispForm.aspx?ID
=859&RootFolder=%2fsites%2fIMServiceCatalogue%2fLists%2fService%20Items
&Source=http%3A%2F%2Ffhpulse%2Fsites%2FIMServiceCatalogue%2Fdefault%
2Easpx

Arrange VPN Access
http://myfh/sites/IMServiceCatalogue/Lists/Service%20Items/DispForm.aspx?ID=8
63&RootFolder=%2fsites%2fIMServiceCatalogue%2fLists%2fService%20Items

Arrange Meditech access and training as mentioned in the Hiring Guidelines.
http://fhpulse/education_and_professional_development/meditech_clinical_training
/Pages/Default.aspx
5.
Parking
6.
Communications

Team/staff communication
– Communication book/board
– Staff meetings
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Professional Practice & Integration
–
Patient/resident/client conferences (rounds)

Telephone
– #, local
– Voicemail
– Phone list
– On-line directory

E-mail
– Internal
– OWA

Blackberry
http://fhpulse/computers_and_technology/online_resources/PDA%20How%20Tos/
BlackBerry%208310%20-%20New%20or%20Replacement.pdf
7.
Picture ID
http://fhpulse/benefits_and_people_resources/photo_id/Pages/Default.aspx
8.
Prescription Pads see example in Appendix 2
9.
Business cards
http://fhpulse/graphics_and_printing/business_cards/Pages/Default.aspx
10. Order a stamp with NP name, title, MSP number and prescribing number
11. Notification of privileges: Lab, pharmacy, diagnostics as appropriate per setting
Finance
1.
Payroll
 Timekeeper
 Pay cheque
2.
Expense reimbursement
 Review policy regarding allowable expenses
 Expense submission – Employee Expense Report
3.
Education Funds
 Your Operations Director manages the funds designated for NP professional
development and related forms.
4.
Examination room space and equipment – see Appendix 3.
Professional Practice and Integration
Professional Practice and Integration (PPI) represents inter-professional teams whose work
advances the strategic imperatives of integration and standardization.
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Professional Practice & Integration
In collaboration and partnership with internal and external stakeholders, PPI advances
scope optimization, best practice, clinical education and quality practice environment as per
Fraser Health regional initiatives. As an NP within Fraser Health you have a professional
reporting matrix to the Executive Director PPI, and Chief Nursing Officer (CNO). PPI will
also assist and support you with professional issues such as:

Legislation/regulation interpretation

Liaison with Ministries, regulatory bodies

Liaison with Fraser Health services e.g. Programs, HR

Practice consultations

Manage Professional Development Funds

NP Contacts: Executive Director, PPI/CNO and Director, Professional Practice –
Nursing
Community of Practice:
All NPs in Fraser Health have a collective Community of Practice (CoP) which meets
monthly. The purpose of the CoP is to create a forum that allows Nurse Practitioners to
regularly connect in person or via teleconference to promote best practice and build
capacity in the Fraser Health Authority. For a complete copy of the Terms of Reference for
the CoP
http://fhpulse/clinical_support_services/professional_practice/practice/scope_of_practice_a
nd_regulations/nursing/Pages/Default.aspx
The above link and document is currently being revised and will need to be updated in the
manual.
To be added to the Fraser Health NP distribution list please contact the Administrative
Assistant to the Executive Director/CNO of Professional Practice.,
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Professional Practice & Integration
Fraser Health Practitioner Encounter Reporting
All NP new are required to have their MSP number prior to the offer of employment.
Introduction
Nurse Practitioners can not bill the Medical Services Plan (MSP) for the services they
provide to BC residents.
To monitor services provided, the Ministry of Health requires Nurse Practitioners (NP)
required to submit encounter records to MSP. The Encounter Record is considered the
same as a medical claim submitted by other health care providers.
For more information regarding MSP, go to Section 2 of the Ministry of Health Nurse
Practitioner Resource Manual.
http://www.health.gov.bc.ca/msp/infoprac/np/
Encounter Record Submission Authorization
Once the NP has received their practitioner number, they must complete and sign the HIBC
“Encounter Record Submission Authorization” form HLTH2871 which is available on the
MSP website
Shortcut: https://www.health.gov.bc.ca/exforms/mspprac/2871fil.pdf
Often the form will be included with your MSP Number letter.
Forward the completed form to: Ian Perry, Finance, 5th floor, Sherbrooke Centre, RCH
Completing Daily Encounter Records
Paper Record:
There are three options:
i)
Day sheet:
If you receive a computer listing of your clients on a daily basis, it can be
modified and used as your encounter record. The following information should
be included: PHN number, last name and first initial. You need to add two
columns to the sheet, one for the Encounter Code and one for ICD9 codes.
ii)
Fraser Health Nurse Practitioner Record Summary: (see Appendix 4)
This sheet is useful if you have client’s labels that you can attach to sheet. The
sheet can be modified to include your site’s particular information e.g. Payee
number, location code and Practitioner MSP number:
iii)
Nurse Practitioner Encounter Form (see Appendix 5)
You need to hand-write in all the information. The following information is
required for an encounter code to be processed by MSP:
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Professional Practice & Integration







Practitioner Number (MSP number)
Payee number
Last name, first initial and Personal Health Number (PHN) of the patient
Number of services
Date of service
Location code
Diagnostic code
Electronic Recording
If your office has electronic billing system in place, the Medical Office Assistant (MOA)
should be able to send your billing information to the Ministry. It is the same system used
to bill for the physician services. You can record each patient’s encounter codes and ICD
9 codes on the day sheet.
NP Encounter
Authorization.pdf
For a guideline on encounter codes, ICD 9 codes and how to submit please check:
http://www.health.gov.bc.ca/msp/infoprac/np/msp_resource_np.pdf
Monthly, send your encounter codes to:
Omega:
c/o Burnaby Hospital Medical Administration
3935 Kincaid Street
Burnaby, BC
V5G 2X6
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Professional Practice & Integration
Diagnostic Services
The Laboratory Services Guidelines are divided into two sections:
1. Laboratories
2. Reporting results and follow-up system
Nurse Practitioner Clients may access laboratory services either on site (if available) or at a
near by community lab. Any service provided on site must meet the standards for
processing specimens, transportation and have reporting system in place.
1. Laboratories:
 The following section will look at the provincial laboratories the Nurse Practitioner
will be accessing. Contact client services at each of the above agencies to
register as a provider and to enable you to receive test results. Client services
will need your provider information including your name, MSP provider number, and
clinic and contact information.
The following laboratories will be included:
a)
b)
c)
d)
a)
Provincial Health Services Authority Laboratories
i. British Columbia Centre for Disease Control
ii. British Columbia Cancer Agency
iii. Children’s & Women’s Health Centre of British Columbia
Fraser Health
BC Biomedical Services
Life Labs British Columbia
Provincial Health Services Authority Laboratories
For healthcare provider contact information, services and supplies click on:
http://www.phsa.ca/AgenciesAndServices/Services/PHSA-Labs/Contacts.htm
 British Columbia Centre for Disease Control
 British Columbia Cancer Agency
 Cervical screening program
 Children’s & Women’s Health Centre of British Columbia
All maternal screening is done at Children’s and Women’s Health.
Testing includes:
 Quad marker screen
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Professional Practice & Integration



Serum Integrated Prenatal Screen (parts one and two)
Maternal Serum AFP
b
Excelleris Launchpad
The Excelleris Launchpad program will deliver lab results from Life Lab British Columbia
(formerly MDS), BC Bio, VCH, FHA, Valley Medical Labs and a few additional hospital labs
to your computer. It will speed up your access to lab results, allow you to search a lab
history on any of your patients and give you the ability to run a cumulative chart on any
tests you choose.
There is no cost to Nurse Practitioner for access to Launchpad, and currently have
almost 4500 physicians & Nurse Practitioners across the province using the program to
access their results.
To get the program running at your location Excelleris has to install a digital certificate on
your computer and create a connection to our site which will allow any users with an active
user ID & Password access to an inbox with all of your current labs. From that point you
can view results on screen, print out selected results, search lab history on any patients
and chart any test using the cumulative function.
Launchpad also offers a PharmaNet link which at this point only allows Physicians to pull
up a drug history and drug interaction profile on any of their patients. If your office is looking
at going to an EMR, currently Excelleris is able to import into all of the major EMR’s
operating in the province.
To set up access to Excelleris Launchpad you will need to contact Excelleris @ 1-866-7284777 and provide you contact information and MSP billing number and they will contact you
to arrange for a set up date. The program takes about 5-10 minutes to set up and training
takes about 20 minutes.
You can access more information on the program via their web site at http://excelleris.com
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Professional Practice & Integration
NP New Hire Checklist
Operations Responsibilities:

Immediately arrange e-mail - internal (need employee number)
o
OWA

VPN Access

Order Business Cards (confirm name and initials to be used)

Order Blackberry

Order laptop

Photo ID

Multi-site parking if appropriate to setting (Director to sign and employee to complete and submit

Arrange time with appropriate person to: review timesheets, payroll submission, expenses (including
mileage, parking), vacation requests, sick calls
Employee:

On-line New Employee Regional Orientation (refer to Employment Letter for link)

NP Encounter Authorization

Photo ID (complete remainder of form and arrange for photo)

Multi-site parking pass (complete remainder of form and submit to Parking)

Completion: “Addition to Provider Dictionary”. See Guidelines in the NP Resource Center.

Meditech Access and training - Click on the hyperlink and follow the registration instruction.

Performance Planning In-service
(refer to Employment Letter- already booked in, please inform MOA so that she may note this in your
clinic schedule)
Clinic MOA:

Order self-inking stamp with name, title, MSP number and prescribing number. Confirm with NP what
title to use.
Name (first, last), MN NP(F)
Nurse Practitioner Prescribing #
MSP #
Clinical Orientation:

contact ________________________________________ to arrange

see attached schedule- clinical contact: _______________________
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Appendix
Appendix 1
Nurse Practitioner Learning Plan
NURSE PRACTITIONER LEARNING PLAN
KEY For ratings:
NLP = Needs Learning &
Practice
KNP = Knowledgeable but needs
Practice
CP = Competent Practice
PP = Proficient Practice
CATEGORY 1: ASSESSMENT & DIAGNOSIS OF CLIENT HEALTH/ILLNESS STATUS
1.1 Performs an advanced, comprehensive & holistic health assessment.
 health history & complete physical examination.
 considers the psychosocial, emotional, ethnic, cultural & spiritual dimensions of health
 involves underst&ing with clients the meaning of their health/illness experiences & how their daily living is
affected
1.2 Synthesizes health assessment information & uses critical thinking & clinical reasoning skills to
 identify health concerns & risks
 identify normal & abnormal states of health
 make differential diagnoses.
1.3 In the process of making a diagnosis, combines client assessment findings with the application of scientific &
experiential knowledge, considering such things as:
 developmental stages;
 behavioural sciences;
 lived human experiences & personhood;
 pathophysiology & psychopathology;
 epidemiology & infectious diseases;
 multiple etiologies; &
 clinical manifestations of acute illnesses/injuries, chronic diseases, emergency health needs & normal health
events.
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XP = Expert Practice
Professional Practice & Integration
1.4 Orders appropriate screening & diagnostic investigations. Interprets reports of these investigations based on sound
clinical reasoning, scientific evidence & critical thinking. Examples include laboratory tests, x-rays, & ultrasound.
1.5 Diagnoses diseases, disorders & conditions while attending to clients’ responses to the illness experience.
1.6 Communicates with clients about health findings &/or diagnoses. Discusses health outcomes & prognosis.
Collaborates with clients to identify & choose treatment or care options.
1.7 Supports & counsels clients with their personal responses to diseases, disorders or conditions while creating an
environment in which effective learning can take place.
1.8 Initiates timely, effective collaboration with &/or consultation with/referral to physicians, other health care & social
service providers as appropriate to assess & diagnose client health/illness status.
1.9 Documents timely, accurate & relevant clinical data, findings & conclusions.
CATEGORY 2: HEALTH CARE MANAGEMENT, PHARMACOTHERAPEUTICS & THERAPEUTIC INTERVENTIONS
2.1 Collaborates with clients &, where applicable, their families & other members of the health care team to set
priorities for the management of diseases, disorders, or conditions. Intervenes appropriately, including initiating
effective emergency care & crisis intervention.
2.2 Critically appraises & applies current, relevant research findings in decision- making about health care management
& therapeutic interventions.
2.3 Initiates timely, efficient collaboration with &/or consultation with/referral to physicians, other health care providers
& other sectors as appropriate to manage clients’ diseases, disorders or conditions.
2.4 Collaborates with clients to share decision-making in the provision of care & monitoring diseases, disorders or
conditions by:
 using relevant knowledge about humanities, behavioural sciences & lived human experiences to help clients
adopt health practices that will achieve their desired state of wellness;
 negotiating with clients a plan of care that integrates clients’ wishes, scientific rationale & evidence-based
practice guidelines;
 writing orders for treatment based upon evidence-based practice for the specific client population;
 advocating with or on behalf of clients to ensure their health needs are met;
 helping clients throughout the teaching/ learning process to plan, follow & evaluate therapeutic regimes;
 monitoring with clients the effect of the chosen treatments & recommending adjustments to the client as
necessary (treatments include traditional & complementary or alternative health therapies as well as products
that clients use);
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Professional Practice & Integration
 using sound clinical reasoning skills & established outcome criteria to evaluate & document the initial &
ongoing outcomes of the plan of care
 negotiating ongoing contact to help clients monitor & evaluate their plan of care & health/illness status.
2.5 Applies knowledge of pharmacology, including pharmacokinetics, pharmaco-dynamics & evidence-based practice, in
selecting, prescribing & monitoring drugs to treat diseases, disorders or conditions & injuries. Carries out these
competencies as appropriate for the NP’s scope of practice & clinical practice setting.
Additional competencies required by NPs for prescriptive authority are:

consults and/or collaborates with and/or refers to physicians and pharmacists as appropriate;

selects drug therapy based on knowledge of pharmacology, drug interactions, client health history and
disease, disorder or condition;

uses health teaching principles when prescribing, educating and supporting clients in recommended
drug use;

prescribes drug therapies while considering the active participation of clients, best outcomes, and cost
effectiveness;

considers the power dynamics and marketing strategies of the pharmaceutical industry when
prescribing drugs;

writes prescriptions that meet both provincial and federal standards and legislative requirements
including responsibilities relevant to prescription and management of controlled substances;

monitors with clients their response and adherence to drug therapy, and recommends any changes
needed to achieve desired effects;

identifies when misuse of drugs by clients occurs and takes steps to prevent further misuse; and

uses Pharmanet for the purpose of documentation or acquiring information.
2.6 Carries out counselling and other advanced therapeutic interventions, such as minor surgical and invasive
procedures, essential for the clinical management of diseases, injuries, disorders or conditions.
2.7 Uses and evaluates current technologies appropriate to the delivery of health care services.
2.8 Facilitates and fosters active communication, learning, partnerships, and collaboration among clients and
appropriate resources.
2.9 Develops, uses and evaluates follow-up and information systems within the practice setting to ensure clients receive
coordinated health services, to demonstrate client outcomes and to contribute to nursing knowledge.
2.10 Consults and/or collaborates with members of the health care team about variations in health outcomes at the
individual and systems levels to develop quality improvement and risk management strategies.
2.11 Demonstrates facilitation, conflict resolution, coalition building and change management skills when working with
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Professional Practice & Integration
clients and other health care providers.
CATEGORY 3: HEALTH PROMOTION AND ILLNESS/INJURY PREVENTION
3.1 Collaborates with clients to identify and assess trends or patterns that have health implications for families, groups
or communities. This involves working with other health care providers to gather and synthesize qualitative and
quantitative information from a variety of sources about determinants of health.
3.2 Participates with other health care providers and other sectors to plan and develop health promotion/prevention
programs based on client needs, culture, evidence-based strategies and available resources. Such programs include
implementing evidence-based screening for populations-at-risk and harm-reduction strategies that are populationbased.
3.3 Participates in the implementation, monitoring and evaluation of health promotion and illness/injury prevention
programs in partnership with other health care providers, communities, social and public service sectors.
3.4 Collaborates with other health care providers and other sectors to use knowledge of determinants of health and
principles of community development to help groups or entire communities obtain the services they need to meet
their health goals.
3.5 Advocates for and creates an environment that facilitates learning and maximizes client participation and control of
their own health, including living with chronic disease and meeting their own health needs.
3.6 Advocates for health promotion at the policy level and promotes healthy public
policy by participating in legislative and policy-making activities that influence health services and practices.
3.7 Recognizes that culture influences health/illness experiences and client use of health care services. Adapts practice
to meet the needs of an ethnically and culturally diverse population.
CATEGORY 4: NURSE PRACTITIONER PROFESSIONAL RESPONSIBILITIES & ACCOUNTABILITIES
4.1 Understands the changes in scope of practice from that of registered nurse practice and how this affects
responsibilities and accountabilities when assuming the title and role of nurse practitioner.
4.2 Understands and incorporates the additional professional and legal standards and ethical decision-making involved
in the diagnosis and treatment of acute and chronic illnesses, including prescribing medications.
4.3 Defines the specific area(s) of practice and the client population for whom she/he is competent to provide health
care services in the nurse practitioner role. Provides only those services and refers clients who require health
services beyond the individual nurse practitioner’s competence.
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Professional Practice & Integration
4.4 Assumes responsibility and accountability for formally requesting consultation and referring clients to physicians or
other members of the health care team at any point in the assessment and management of client health/illness
status. This is essential whenever the client’s condition requires care beyond the nurse practitioner scope of practice
or the individual nurse practitioner’s competence.
4.5 Practises in accordance with legislative acts, regulations and bylaws relevant to the nurse practitioner’s area of
practice and client population served.
4.6 Explains the role and responsibilities of the nurse practitioner including own area(s) of expertise, to clients, other
health care providers, social and public service sectors, the public, legislators, and policy-makers.
4.7 Anticipates and engages clients and other health care providers and other sectors to manage legal, ethical, moral
and clinical issues relevant to health care provision at the client or organizational level.
4.8 Takes part in regular professional development and accepts personal responsibility for maintaining nurse
practitioner competence, including, but not limited to, continuing education related to prescriptive authority.
LEARNING PRIORITIES
Focus
Activities/ Strategies
1..
2.
3.
4.
5.
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Completion date
Appendix 2
Example of Prescription Information
Name of clinic
[LOCATION]
[ADDRESS]
[CITY], BC
[POSTAL CODE]
Fax: 604 [#]
Phone: 604 [#]
Date:______________________________________
Name:_______________________________________
Address: ______________________________________
Date of Birth: _____________PHN_________________
Please Label Contents
Rx
Signature:____________________________________
(NP/MD )
Prescriber Number: _________________________
REPEAT
1
2
Updated June 8, 2011
3
4
5
EVERY___DAYS
NO REPEAT
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Professional Practice & Integration
Appendix 3
Nurse Practitioner Office and Exam Room Equipment and Supplies
The following Office and exam room list is a guideline.
I.
There are several key factors to consider when consider the equipment and supplies.
Key factors:
1) Location:
a. Urban vs. rural
b. Pre-existing space eg. Hospital, medical office, community services
c. New space to be designed
2) Other team members
a. Pre-existing members and systems in place
b. New team members and new program
c. Offsite team members
3) Supportive services
a. Pre-existing and onsite
b. Laboratory services eg. Onsite, home visiting services, publicly funded services, private lab
c. Transportation of specimens
d. Access to printer , fax machine, refrigerator, public washrooms, waiting room, sink, clean
and dirty utility room
4) Population to be served:
a. Geriatrics
b. Wheel chair ( movable examine table, more space needed in exam room)
c. Children ( play area, increased safety issues)
d. High risk- difficulty accessing off site services
5) Disposable verus autoclave equipment
a. costs consideration
b. space,
c. equipment
d. experiences support staff
e. access to autoclave services
II.
The equipment charts will be listed in the following tables
a. Office Equipment
b. Exam equipment
c. Procedures
d. Women’s Health
e. Pediatric
f. Laboratory specimens
g. Geriatric
h. Emergencies equipment, supplies and medications
i. Home visiting bag
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Professional Practice & Integration
a) Office Equipment and supplies
 FHA web link for ordering supplies
http://fhpulse/capital_finance_and_purchasing/purchasing/Documents/Office%20Supplies%20Gran
d%20and%20Toy%20(3).doc
One time expense
Desk with computer drawer and filing drawers
Filing cabinet
Computer Chair
Small table with chairs ( counseling and/or
student space)
Book shelves
Bulletin board
Cabinet for locking client files or space at MOA
Cabinet for locking up medications
Stapler
Paper clip holder
Three hole punch
Ruler
Binders
Hanging file folder (label requisitions)
Desk lamp
Coat hook
Desk organizers( pencils, files etc.)
Ongoing supplies
Chart supplies (charts, label system, dividers)
Paper, (legal, letter, letterhead)
Pens, black, red
Pencils
Paper clips
Staples
Post-its
File folders, hanging folders
Labels holders for file folders
CDs
Markers
Push pins
Envelopes, (legal, letter)
Phone book
Business cards
Prescription pads
b) Examination room
Medical equipment
Exam room
Exam table
Stool
Exam light
Chair
Foot tools
Garbage can with foot step
Utility cart or OR tray
Set of ophthalmoscope, BP & thermometer, ear
speculum holder with wall transformer
Adults scale
Reflex hammers, Tuning forks
Safety goggles, Mask ( should be fit tested)
Peak flow meter
Sundry glass jars set of 5 ( to hold exam
*glucomometer
*Doppler & pulse attachments
*Oximeter, Peek flow meter
BP cuffs small adult, large cuff
Stethoscope
Snellen Visual chart &
Rosenbaum chart, Illiterate E chart, Ishihara
colour chart
Woods lamp
Doppler & pulse attachments
Updated June 1, 2011
Medical supplies
Disposable dressing trays
Tongue depressors
Cotton swabs
Ear speculums size 2.5mm 4mm
Sterile water, Distilled water
Peak flow meter covers
Thermometer probe covers
Sterile Q tips
Thermometer probe covers
Cleaning solution
syringe 10 cc ( 10),syringe 3 cc
syringe TB syringe 26 g
Exam paper
Anascopes
Reagent strips, urine 4MD or 10
Reagent strips, blood glucose
Lancets
Lubricant
Cups & sterile urine bottles
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Professional Practice & Integration
c) Procedures
One time purchase equipment
Needle driver
Scalpel handle
Biopsy punches
Scissors ( suture removal, bandage)
Finger tube
Wet soak tray
Ear syringe
K-basin
Adson forceps
Tissue forceps
Sponge Forceps
Dressing forceps
Mosquito forceps
5mm dermal curette
2mm dermal curette
nasal speculum
nasal forceps
metzenbaum scissors
straight scissors
Curved scissors
Autoclave (Rural setting)
Ongoing supplies for procedures
Elastoplast tensor bandages 10 cm, 20 cm
Disposal scalpel with handle
Scalpel blades #15
Sutures nylon 3.0, 4.0, 5.0, chromic 3.0
Dermabond
Proxi strips
Disposal able ear curettes
2mm Punch biopsy
Disposable dressing trays
Disposable suture removal kits
Disposable staple removal
Small bottles of saline solution for cleaning
60 cc syringe ( 1 or 2)
Gauze 4X4 (sterile & non sterile)
Gauze 2X2
Bandage tape, (paper, water proof)
Lidocaine 1% and 2% with and without
adrenaline
Alcohol wipes
band aids
Sterile towels
Sharps containers
Non latex gloves, sterile & non sterile
d) Women’s Health
Equipment
*Metal speculums Large, extra small, different
shapes
Equipment for IUD insertion and/or
endometrial biopsy
Uterine Tenaculum
Uterine sound instrument
Speculum light
Doppler
Measuring tape
Ongoing supplies
Cytobrushes
Spatula
Pap smear slides & containers
Cytospray
pH paper
Pregnancy dip sticks
Disposable speculums
CT swabs
Doppler gel
endometrial biopsy*
Cytology solution*
Hand mirror
Baby’s Best Chance
e) Pediatric
Equipment
Infant & Child BP cuff
Infant scale
Pediatric ambu bag
Pediatric mouth pieces
Measuring tape
Measuring box ( for measuring length of infant
scale
Updated June 1, 2011
Ongoing supplies
Diaper wipes
Diapers
Stickers
Bubbles solution
Immunization records
- 20 -
Professional Practice & Integration
f) Laboratory Supplies
Laboratory testing
Tourniquets
Refrigerator
*Centrifuge ( Rural setting)
Microscope
Cooler for transportation
Supplies
Auto drop vacutainer
Vacutainer needles
Vacutainer butterfly needles
Alcohol swabs
Dot bandages
Blood tubes ( gold, green, purple, red, blue see
laboratory services)
Charcoal swabs
CT swabs
GC swabs
Viral swabs
Sterile urine bottles
Fungal slide
Pin worm bottles
O&P stool bottles
Sharps container
Plastic specimens bags
Slides
g) Geriatric
Geriatric
Monofilaments
Neurologic hammer
Goniometer
Triceps skin fold caliper
Mini Mental Exam
h) Emergency equipment.
Low Risk Office
Urban area
Close to emergency
department
No parental medications
given
No procedures done in
office
Low volume of patients
Few sick patients
Updated June 1, 2011
Moderate Risk
Invasive procedure done in office
Delay or no EMS access
Walk in clinic
High volume of clients
High Risk
Rural or remote location
No local Hospital
Invasive procedure done in office
Delay or no EMS access
Walk in clinic
High volume of clients
Low risk office supplies as well as:
Syringes 60ml, 10ml, 5ml, 3ml
Glucometer & strips
Medications:
Nitroglycerin spray 0.4mg
ECASA 80mg
Narcan
Lorazepam sublingual
Glucose solution 50 %
Moderate risk Office supplies as well as:
Intubation tray:
laryngoscopes ( 2 sizes, ) endotracheal
tubes (3-8),
magill forceps,
Suction equipment, tonsil tip
Oxygen supplies: nasal prongs, tubing,
rebreather bag, oxygen tank, pulse
oximeter
Intravenous supplies: tourniquets,
- 21 -
Professional Practice & Integration
catheters (14, 18, 22, 25), IV pole,
tubing
Obstetrical tray: delivery tray, cord
clamp, sterile towels
Aerosol therapy: nebulizer with mask
or areochamber ( 3 sizes), aerosol masks
Medications:
Oral and parenteral haloperidol (10mg),
loraxepam (4mg parental)
salbutamol, ipratropium bromide by
aersol metered dose inhaler or nebulizer
Updated June 1, 2011
- 22 -
Professional Practice & Integration
Appendix 4
Fraser Health Nurse Practitioner Encounter Report Summary
Fraser Health Nurse Practitioner Encounter Report Summary
Name:
Provider Number:
Employer Number:
Location:
Month/year:
Name/PHN/DOB
Updated June 1, 2011
Date
Encounter
Code
Encounter
Code
ICD9 codes
- 23 -
Appendix 5
OMEGA COMPUTER SERVCES LTD.
Payee Number:
T0900
13375
Batch
Claim Entry
Practitioner Number:
Clear Data
Write Claims
DATE
TO
DT
No.
Ser.
SC
FEE
ITEM
AMT
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Updated June 8, 2011
- 24 -
ICD-9
MVA
BCMSP/ PHN
De
p
No.
LOC
INIT
SURNAME
© Notice
BT
1
REF#
1
BT
2
REF#
2
ICBC
FAC.
ORIG
DATA
CNT
ORIG.
SEQ
NUM
ORIG.
DATE
REC'D
COMMENT