Practice Recommendations

Recommendation

Level of Evidence

1

Nurses incorporate specific skills and knowledge of addictions in their everyday practice.

IV

IV

IV

a) Nurses incorporate knowledge of maternal and child health related to opioid use.

b) Nurses consider the ethical, legal and social context of harm reduction/addiction treatment programming.

2

Nurses have knowledge of the impact of the social determinants of health on addictions.

Ib-IV

IV

a) Nurses consider the holistic needs of a client as integral to the success of a client’s treatment.

3

Nurses practice reflectively to maintain continued awareness of their current and evolving perceptions, attitudes and biases, values and beliefs when working with clients with addictions (including those on MMT).

IV

IV

a) Nurses provide care in keeping with the principles of cultural safety and cultural competence.

4

Nurses inform their clients of available treatment options for opioid dependency (including MMT) on an ongoing basis.

IV

5

Nurses need to be aware of the efficacy of MMT as a substitution therapy for opioid dependence.

IV

6

Nurses will have an understanding of the pharmacokinetics of methadone.

III-IV

III-IV

III-IV

a) Nurses will be aware of the pharmacodynamics of methadone.

b) Nurses integrate their understanding about the pharmacokinetics and pharmacodynamics of methadone to be aware of the side effects and drug to drug interactions that may occur.

7

Nurses will uphold standards of practice performing the “8 rights”, as appropriate, to ensure safe administration of methadone.

IV

IV

a) Nurses will be knowledgeable of the College of Physicians and Surgeons of Ontario criteria for take-home doses (carries) to reduce harm to the client and community.**

8

Nurses will have an understanding of the interpretation of urine drug screening results and their importance in the treatment of the client on methadone maintenance.

IV

9

Nurses will have an understanding of acute and chronic pain management for clients on MMT.

IV

10

Nurses provide referral, monitoring and health promotion interventions, as appropriate.

Ia - IV