Advanced Practice Resources


Regulations Amending the Food Drug Regulations (Distribution of Drugs as Samples)

  • Memo from CRNNL regarding the new Amendments to the Food and Drug Regulations that permits NPs to distribute drugs as samples under certain conditions and within their individual competence.

Click here to view the memo.


Sublocade (Extended-Release Buprenorphine) Information Bulletin

This Bulletin provides information on Sublocade® for prescribers, pharmacists, and nurses, including:

• available education and training;

• guidance on how to prescribe, order, and dispense; and

• instructions for submitting a special authorization request to the NL Prescription Drug Program (NLPDP).

Sublocade® has a Health Canada indication for the treatment of moderate to severe opioid use disorder in adult patients who have been inducted and stabilized on sublingual buprenorphine/naloxone. In June 2020, the Newfoundland and Labrador Prescription Drug Program made Sublocade® coverage available under the Special Authorization Request process.

Please click here to review the Sublocade Bulletin.


Health Canada Health Product Risk Communication Re: Methadone Treatment of Opioid Dependence and Potential Differences In Product Effect

Health Canada has released a Health Product Risk Communication related to Methadone treatment of opioid dependence. For further information click here. NPs should ensure they sign up for appropriate alerts from e.g., Health Canada, to receive up to date, evidence-informed clinical information.


Nurse Practitioners (NPs) Engaging in Dispensing

This memo is in response to a number of inquiries related to the dispensing of medications by NPs in Newfoundland and Labrador. NPs can dispense medications. This memo outlines the expectations for NPs contemplating engaging in dispensing. To view the memo, please click here.


Medical Assistance in Dying (MAID) Reporting Requirements

The Regulations for the Monitoring of Medical Assistance in Dying (the Regulation) that come into force on November 1, 2018 require physicians, nurse practitioners and pharmacists to provide information related to requests for, and the provisions of, MAID, through the Canadian Data Collection Portal.

Applicable Links:

Guidance Document for MAID Reporting Requirements which includes information on Reporting Timelines at a Glance and Reporting Checklists:
Regulations for the Monitoring of Medical Assistance in Dying (the Regulation):
Information Requirements for Federal Monitoring of Medical Assistance in Dying
Health Canada: Reporting Requirements for Medical Assistance in Dying


Prescription Monitoring Program

By June 30, 2018, all prescribers in the province who are writing prescriptions for opioids as part of their care plan will be required to review a patient’s medication profile using HEALTHe NL before writing a prescription on the tamper resistant prescription pad. This is a part of the Provincial Government’s new Prescription Monitoring Act legislation. If you do not yet have access to HEALTHe NL, you can contact NLCHI at or 1(877) 752-6006 or (709) 752-6006.

Frequently Asked Questions and Answers

Prescription Monitoring Program - NL:  Information for Prescribers and Dispensers


New Tamper Resident Prescription Pads

The Prescription Monitoring Act came into effect on January 2, 2018. The Act provides the legislative authority for the Prescription Monitoring Program – NL.

The purpose of the Program is to help prescribers and dispensers make the most informed decisions when choosing to administer or dispense a monitored drug. Subsection 7(2) of the Act, the provision requiring prescribers to view a patient’s medication profile prior to prescribing a monitored drug (opioid and tramadol), comes into effect on June 30, 2018.

Utilizing the provincial electronic health record, HEALTHe NL, health professionals have access to up-to-date and accurate patient medications profiles that supports clinical decision-making and their patients’ health care needs. The Newfoundland and Labrador Centre for Health Information provides access to HEALTHe NL. If you require an account, please contact NLCHI at or 1 (877) 752-6006 or (709) 752-6006.

To aid in the utilization of the provincial electronic health record, the Department of Health and Community Services (HCS) has updated the Tamper Resistant Prescription Pads to include a check box allowing the health provider to verify that the provincial electronic health record was reviewed and the time of day the review occurred. 

The Department of Health and Community Services (HCS) will either send you the new TRPPs or you will be required to order these from HCS. For further information or to access the request form please click here.



Certifying Applications for the Disability Tax Credit

Nurse practitioners can now fill out and sign Form T2201, Disability Tax Credit Certificate. This ensures more options for Canadians who want to apply for the disability tax credit (DTC), making the application process easier and more accessible.

Through Budget 2017, the Government has made a change to recognize nurse practitioners as one of the medical practitioners who can certify Form T2201. With over 4,500 nurse practitioners across Canada who can certify patients for the DTC, this change is going to have a positive impact for Canadians living with a disability.

For more information on how to fill out Form T2201, please visit:

You can also view a recording of the CNA webinar explaining the changes on You Tube.



eConsult is a secure, web-based tool that allows primary care providers to submit non-urgent, patient-specific questions to a participating specialty. Relevant diagnostic testing, images, photos, letters or any other documentation to help inform the consult process may be included. The request is processed and assigned to an appropriate consultant, who is asked to respond within seven days.

See the eConsult Fact Sheet or visit the NLMA website for more information. 

To access the eConsult service, please contact:
Jean Cook, CSF Project Coordinator, NLMA
709-722-3344 or 800-563-2003 ext. 300


Quality of Care NL & Choosing Wisely NL

Quality of Care Newfoundland and Labrador is a provincial initiative aimed at improving health care in our province by looking for new ways to make sure people get the care they need, when they need it.  Quality of Care NL works with Choosing Wisely Canada to implement their recommendations on reducing unnecessary care, here in Newfoundland and Labrador. These projects are known as Choosing Wisely NL projects.


For more information, visit the Quality of Care NL website.


Quality of Care NL/Choosing Wisely NL Campaigns

A generic version of the Antibiotic Awareness Campaign for NPs is available here.

    • A new local campaign to highlight the need for further antibiotics awarness was launched during World Antibiotics Awareness Week (November 12-18, 2018).

A generic version of the Proton-Pump Inhibitor (PPI) Utilization for NPs is available here.

A generic version of the Blood Urea Testing Campaign for NPs is available here.

To access Choosing Wisely NL and Quality Care NL Practice Point Reports, please click here.

Eastern Health's New Antimicrobial Stewardship Spectrum APP.  Please click here for further details.


Choosing Wisely Canada

Choosing Wisely Canada is a campaign to help clinicians and patients engage in conversations about unnecessary tests and treatments, and make smart and effective care choices.


Developed by professional societies representing different clinical specialties in Canada, these recommendations identify tests and treatments commonly used in each specialty that are not supported by evidence, and could expose patients to harm. The recommendations are not intended to be used to establish payment and coverage decisions. Rather, they are meant to spur conversation about what is appropriate and necessary treatment. As each patient situation is unique, clinicians and patients could use the Choosing Wisely Canada materials to determine an appropriate treatment plan together.

In September 2017, Nine Things Nurse Practitioners and Patients Should Question was published.

Choosing Wisely Talks

Choosing Wisely Talks is a webinar-based education series.  Webinars typically occur on the first Thursday of the month and are available for viewing after the event.  For more information, visit their Events page.

For more information visit the Choosing Wisely Canada website.


Provincial Laboratory Services Notifications

Communiques from the Department of Laboratory Medicine are posted as they are shared by the Provincial Laboratory.

Caliper Reference Interval Database, April 8, 2019

Alert Concerning Interference by Biotin in Some Laboratory Tests, March 29, 2019

On-Site Urinary 5-HIAA and HVA/VMA Mass Spectrometry Testing 

Interference of the Drug Mifepristone with Estradiol Assay, February 15, 2019

Using Urinalysis Wisely: Interpretation of Urinary Epithelial Cells, February 4, 2019

List of Critical Limits for Clinical Chemistry Tests, June 18, 2018

Harmonization of Routine Microscopy Urinalysis in Eastern Health & Labrador Grenfell Regions, May 29, 2018

Urinalysis Measured at Rural Community Health Centres & By Point of Care Testing, May 28, 2019

Update - Effective Utilization of Therapeutic Drug Monitoring, March 5, 2018

Changes to Laboratory Test Panels for Eastern Health, February 5, 2018

Harmonization of Routine Microscopy Urinalysis in Eastern  Health Region, February 2, 2018

Fasting No Longer Required for Lipid Testing, January 30, 2018


Office of the Chief Medical Officer Notifications

Duty to Report - Notifiable Diseases List, July 2019

Communicable Disease Control Update: Syphilis, February 2019

Department of Health & Community Services CDC update: Sexually Transmitted and Blood Borne Infections (STBBIs), October 19, 2018 

Lyme Disease in Newfoundland and Labardor, June 2018

Department of Health & Community Services CDC update: Mumps outbreak at Eastern Health, June 19, 2018




Other Resources

Abuse and Diversion of Controlled Substances: A Guide for Health Professionals

Advanced Nursing Practice: A National Framework (CNA, 2008)

Advanced Nursing Practice Data Collection Toolkit (CHSRF/CIHR)

Atlantic Mentorship Network Pain & Addiction

Nurse Practitioner Association of Canada

Newfoundland & Labrador Nurse Practitioner Association

National Association of Clinical Nurse Specialists

Clinical Nurse Specialist Resources (CNA)


CMPA/CNPS Joint Position Statement on Liability Protection for Nurse Practitioners and Physicians in Collaborative Practice (CNPS, 2013)


©2014 Association of Registered Nurses of Newfoundland and Labrador