Over-the-counter (OTC) medications do not require a prescription and nurses may recommend or administer them to a client. However, in some practice settings, legislation or organizational policy might require an order. Additionally, prescriptions may be requested so clients can be reimbursed by insurance.
If you decide to recommend an OTC medication, you are accountable for the recommendation and for any outcomes of that recommendation. Whether you should recommend or administer OTCs depends on the following factors:
Although OTCs usually do not require a prescription, some practice settings may have legislation which requires an order. For example, the Fixing Long-Term Care Act, 2021 requires an order from an authorized prescriber for all medication.
Nurses are accountable for being familiar with and practicing under relevant legislation that applies to their practice setting. This accountability is outlined in principle 3.9 of the Code of Conduct.
Employers determine the roles and responsibilities of their employees, including whether nurses can recommend and administer OTCs to clients. Nurses are accountable to comply with organizational policy and, if needed, work with their employers to develop policies that align with CNO’s standards of practice and are in the interest of client safety.
If legislation and employer policy permit nurses recommending and administering OTCs, nurses must have the knowledge, skill and judgment to do so safely and ethically. This includes reviewing that the recommended OTC product does not interact or pose a contraindication to the client’s ongoing medications or medical conditions.
Nurses are accountable to the Medication practice standard and must ensure their medication practices are informed by evidence This includes assessing whether the medication is appropriate by considering the client and the environment. Nurses should also educate the client about the medication.
For more information on determining whether a procedure or activity, such as recommending and administering OTCs, is within your scope of practice, see the Ask Practice FAQ: Understanding Your Scope of Practice and your nursing accountabilities.
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