Nurse Practitioner
Orientation
Guidelines
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Table of Contents
Purpose ......................................................................................................................................................... 3
Operations .................................................................................................................................................... 3
Elements of NP Orientation .......................................................................................................................... 3
Site/Setting Operational Logistics ................................................................................................................. 4
Finance .......................................................................................................................................................... 4
Professional Practice and Integration (PPI) .................................................................................................. 5
FHA Nurse Practitioner Encounter Reporting ............................................................................................... 6
Completing Daily Encounter Records ........................................................................................................... 6
Diagnostic Services........................................................................................................................................ 7
Excelleris Launchpad ..................................................................................................................................... 8
Appendix 1 NP New Hire List ........................................................................................................................ 9
Appendix 2 Nurse Practitioner Learning Plan ............................................................................................. 10
Appendix 3 Example of Prescription Information....................................................................................... 15
Appendix 4 NP Office and Exam Room Equipment and Supplies ............................................................... 16
Appendix 5a Fraser Health Nurse Practitioner Manual Encounter Report Summary ................................ 21
Appendix 5b Fraser Health Nurse Practitioner Electronic Encounter Report Summary ............................ 22
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Purpose
The purpose of this document is to guide orientation for Nurse Practitioners (NPs) in Fraser Health
Authority (FHA). It is intended to be used by NPs and hiring Directors or Managers to ensure that a
suitable orientation is provided for each NP new to FHA. NP orientation is managed by the hiring
Director, Manager, or designate.
Operations
Prior to hiring an NP, please review all of the following documents in the NP Resource Centre located
on the FH website under Professional Practice and Integration. These documents include:
1.
2.
3.
4.
NP Role Implementation Planning Tool
NP Job Description
Hiring Guidelines
NP New Hire Checklist
Elements of NP Orientation
1.
New employee orientation:
FHA is committed to ensuring all new employees are supported through an orientation as they
integrate into the organization. The Online New Employee Orientation covers FHA’s vision,
purpose and values, emergency codes, quality and patient safety issues, infection prevention
and control issues, plus an overview of the roles of the departments a typical employee would
be likely to come in contact with during the first few weeks of work.
New Employee Orientation – CCRS Online Learning Course
2. NPs are Excluded Staff. It is the responsibility of each new NP to be familiar with the Terms and
conditions of Excluded Staff.
Terms of Conditions and Employment – Excluded Staff
3. Orientation to work setting and 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 and is incorporated as part of the NP’s performance plan in Performance
Link. For an example of a learning plan, see Appendix 2
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Site/Setting Operational Logistics
Your operational Director or Manager designate coordinates the following items per their cost centres
and/or in partnership with the Divisions of Family Practice, as applicable to your position:
1.
2.
3.
4.
Tour of work area
Keys or access cards
Office space and supplies
Computer
 PC/laptop and printer
 Profile and log in – New User Access must be fully completed and requires a ten day
processing period
 VPN Access
 Meditech Access and Training as mentioned in the hiring guidelines.
5. Parking
6. Communications
 Team/staff communication
o Communication book/board
o Staff meetings
o Patient/resident/client conferences (rounds)
 Telephone
o Telephone numbers, locals
o Voice Mail
o Phone List
o On-line Directory
 Email
o Internal
o Outlook Web Access - OWA
 Blackberry
 Photo Identification
 Prescription Pads (see example in Appendix 3)
 Business Cards
 Order stamp with NP name, title, MSP number and prescribing number
 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
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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 4)
Professional Practice and Integration (PPI)
In collaboration and partnership with internal and external stakeholders, PPI advances scope
optimization, best practice, clinical education and quality practice environment as per FHA initiatives.
PPI services include supporting organizational initiatives, the Clinical Programs, profession-specific and
interprofessional collaboration, optimization of role/scope/functions, clinical education, and quality
practice environments through practice consultations, the Practice Start Transition program, Clinical
Policy Office and On-Line Learning. For more information, see the PPI website.
As an NP within FHA, you have a professional reporting matrix to the Chief Nursing Officer (CNO). PPI
will also assist and support you with professional issues such as:
 Legislation/regulation/policy interpretation and development
 Liaison with Ministries, regulatory bodies
 Liaison with FHA services such as Clinical Programs, HR
 Practice consultations
Community of Practice
All NPs in FHA have a collective Community of Practice (CoP) which includes a business meeting every
second month. Meeting space is booked for the alternate months to support Shared Work and Project
Teams working on various initiatives, and to provide designated time for professional development
activities.
The purpose of the CoP is to create a forum that allows NPs to regularly connect in person or via
teleconference to promote best practice and build capacity in FHA.
2013 NP CoP Schedule
NP CoP Terms of Reference
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FHA Nurse Practitioner Encounter Reporting
All new NPs are required to have their MSP number prior to the offer of employment.
Introduction
NPs cannot bill the Medical Services Plan (MSP) for the services they provide to B.C. residents.
To monitor services provided, the Ministry of Health (MoH) requires NPs to submit encounter records to
MSP for every interaction. The Encounter Record is considered the same as a medical claim submitted
by other health care providers.
For more information regarding MSP, go to the Medical Services Plan of B.C. website.
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. Often the form will be included with your MSP
number letter. Forward the completed form to Ian Perry ([email protected]), Finance
Department, 5th floor, Sherbrooke Centre, RCH.
Completing Daily Encounter Records
Paper Record
There are three records.
1. 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.
2. Nurse Practitioner Encounter Form (see Appendix 5a)
You need to hand-write in all the information. The following information is required for an
encounter code to be processed by MSP:
 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
3. FHA Nurse Practitioner Record Summary (see Appendix 5b)
This sheet is useful if you have client’s labels that you can attach to the sheet. The sheet can be
modified to include your site’s particular information, e.g. payee number, location code and
Practitioner MSP number.
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Electronic Recording
If your office has an electronic billing system in place, the Medical Office Assistant (MOA) should be able
to send your billing information to the MoH. 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 check the MSP website.
Send your encounter codes to:
Omega
c/o Burnaby Hospital Medical Administration
3935 Kincaid Street
Burnaby, B.C. V5G 2X6
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 nearby
community lab. Any service provided on site must meet the standards for processing specimens,
transportation and have a reporting system in place.
1. Laboratories
The following section will look at the provincial laboratories the NP 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:
 Provincial Health Services Authority Laboratories
o B.C. Centre for Disease Control
o B.C. Cancer Agency
o Children’s and Women’s Health Centre of B.C.
 Fraser Health Authority
 B.C. Biomedical Services
 Life Labs of B.C.
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Provincial Health Services Authority Laboratories
For healthcare provider contact information, services and supplies, please see this Agencies and Services
website.
 B.C. Centre for Disease Control
 B.C. Cancer Agency
 Cervical Screening Program
 Children’s and Women’s Health Centre of B.C.
All maternal screening is done at Children’s and Women’s Health Centre of B.C. Testing includes:
 Quad marker screen
 Serum Integrated Prenatal Screen (Parts 1 and 2)
 Maternal Serum AFP
Excelleris Launchpad
The Excelleris Launchpad program will deliver lab results from Life Labs of B.C. (formerly MDS), B.C.
Biomedical Services, Vancouver Coastal Health Authority (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 NPs for access to Launchpad, and currently there are almost 4,500 physicians and
NPs across the province using the program to access their results.
To get the program running at your locations, Excelleris must install a digital certificate on your
computer and create a connection to their site which will allow any users with an active User ID and
Password access to an Inbox with all of your current lab results. From that point, you can view results
on screen, print out selected results, search lab history on any patients and chart any tests 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 EMRs operating in the province.
To set up access to Excelleris Launchpad, you will need to contact Excelleris at 1-866-728-4777 and
provide your contact information and MSP billing number. They will contact you for a set up date, the
program takes five to ten minutes to set up and training takes about twenty minutes.
You can access more information on the program through Excelleris.
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Appendix 1
NP New Hire Checklist
Operations Responsibilities
□ Immediately arrange email – internal (need employee number, contact Service Desk)
 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 (EARL)
Employee Responsibilities
□
□
□
□
□
□
□
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)
Completion: “Addition to Provider Dictionary”. See Guidelines in the NP Resource Centre
Meditech Access and training
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 number
MSP number
Clinical Orientation
□ Contact ____________________ to arrange
□ See attached schedule – Clinical Contact ____________________
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Appendix 2
Nurse Practitioner Learning Plan
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 understanding 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.
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.
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CATEGORY 2: HEALTH CARE MANAGEMENT, PHARMACOTHERAPEUTICS AND
THEREAPEUTIC 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);
 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, pharmacodynamics & 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;
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 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 counseling 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 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, evidencebased strategies and available resources. Such programs include implementing
evidence-based screening for populations-at-risk and harm-reduction strategies that
are population-based.
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
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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 AND
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.
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 Practices 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.
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LEARNING PRIORITIES
Focus
Activities/ Strategies
1..
2.
3.
4.
5.
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Completion
date
Appendix 3
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
3
4
5
EVERY___DAYS
NO REPEAT
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Appendix 4
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 e.g. 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, e.g. 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 versus 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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Office Equipment and supplies
 FHA web link for ordering supplies
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.)
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
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
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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Medical equipment
Medical supplies
colour chart
Woods lamp
Doppler & pulse attachments
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
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
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Pediatric
Equipment
Infant & Child BP cuff
Infant scale
Pediatric ambu bag
Pediatric mouth pieces
Measuring tape
Measuring box ( for measuring length of infant
scale
Laboratory Supplies
Laboratory testing
Tourniquets
Refrigerator
*Centrifuge ( Rural setting)
Microscope
Cooler for transportation
Ongoing supplies
Diaper wipes
Diapers
Stickers
Bubbles solution
Immunization records
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
Geriatric
Geriatric
Monofilaments
Neurologic hammer
Goniometer
Triceps skin fold caliper
Emergency equipment
Low Risk Office
Urban area
Close to emergency
department
No parental medications
given
No procedures done in
Mini Mental Exam
Moderate Risk
Invasive procedure done in office
Delay or no EMS access
Walk in clinic
High volume of clients
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High Risk
Rural or remote location
No local Hospital
Invasive procedure done in
office
Delay or no EMS access
Walk in clinic
Low Risk Office
office
Low volume of patients
Few sick patients
Moderate Risk
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 %
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High Risk
High volume of clients
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, 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
Appendix 5a
Fraser Health Nurse Practitioner Encounter Report Summary
Practitioner Number (MSP#): ___________________
Payee Number:
 Fraser Health:
13375
 Non-Fraser Health: _____________
Location:
Month/year:
Name/PHN/DOB
Date
21 | P a g e
Encounter
Code
Encounter
Code
ICD9
codes
Appendix 5b
Fraser Health Nurse Practitioner Electronic Encounter Report Summary
OMEGA COMPUTER SERVCES LTD.
Payee Number:
T0900
13375
Batch
Claim Entry
Practitioner Number:
BCMSP/ PHN
© Notice
De
p
No.
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
22 | P a g e
ICD-9
MVA
Write Claims
LOC
SURNAME
INIT
© Notice
BT
1
REF#
1
BT
2
REF#
2
ICBC
FAC.
ORIG
DATA
CNT
ORIG.
SEQ
NUM
ORIG.
DATE
REC'D
COMMENT