Podiatrists Regulation

Podiatrists Regulation, M.R. 99/2006 The Podiatrists Act , C.C.S.M. c. P93 Regulation 99/2006 Registered April 21, 2006 bilingual version (HTML) Table of Contents Section 1 Definitions REGISTERS 2 Additional registers 3 Additional information in podiatrists register REGISTRATION AS A PODIATRIST 4 Eligibility for registration as a podiatrist 5 Application for registration as a podiatrist NON-PRACTISING PODIATRISTS 6 Eligibility for registration as a non-practising member TEMPORARY PRACTICE IN MANITOBA 7 Application for temporary practice DISCLOSURE OF INFORMATION 8 Disclosure on application CONVERTING REGISTRATION 9 Conversion from practising to non-practising 10 Conversion from non-practising to practising RENEWAL 11 Renewal 12 Renewal of practising registration 13 Renewal of non-practising membership 14 Changes in requirements do not affect right to renew CANCELLATION FOR NON-PAYMENT OF FEES 15 Cancellation for non-payment of fees REINSTATEMENT 16 Reinstatement INCLUDED PRACTICE 17 Injectable substances 17.1 Prescribing by podiatrists CONTINUING COMPETENCE 18 Continuing competence LIABILITY PROTECTION AND STANDARDS 19 Liability protection 20 Standards of practice COMMITTEES 21 Membership in standing committee REGULATION REVIEW 22 Review of regulation REPEAL AND COMING INTO FORCE 23 Repeal 24 Coming into force Schedule A Designated injectable substances A.1 Drugs that a podiatrist may prescribe B Standards of practice Definitions 1 The following definitions apply in this regulation. "Act" means The Podiatrists Act . («  Loi  ») "course of instruction" means a refresher, remedial, re-entry or upgrading podiatry course or program approved by the council and includes an educational course or program designed specifically for an individual. (« cours de formation ») "examination" means an examination approved by the council. (« examen ») REGISTERS Additional registers 2 In addition to the registers of podiatrists and podiatrists having surgical privileges referred to in section 7 of the Act, the registrar shall maintain the following registers: (a) [repealed] M.R. 26/2023; (b) a non-practising register; (c) a temporary practice register. M.R. 26/2023 Additional information in podiatrists register 3(1) For the purpose of clause 7(2)⁠(e) of the Act, the following additional information is to be kept in the register of podiatrists for each member: (a) home address and telephone number; (b) date of birth; (c) registration number and date of registration; (d) an order made by a panel under section 41 of the Act. Notation — authorized to administer substances by injection 3(1.1) For the purpose of clause 7(2)⁠(e) of the Act, the register of podiatrists must contain the notation "authorized to administer substances by injection" for each podiatrist who has the qualifications approved by the council to inject substances into the foot. Notation — authorized to prescribe drugs 3(1.2) For the purpose of clause 7(2)⁠(e) of the Act, the register of podiatrists must contain the notation "authorized to prescribe drugs" for each podiatrist who has the qualifications approved by the council to prescribe drugs. Information to be kept in other registers 3(2) The following information is to be kept in the registers required by section 2 for each member: (a) name, business address and business telephone number; (b) home address and telephone number; (c) date of birth; (d) registration number and the date of registration; (e) the conditions imposed on a certificate of registration; (f) a notation of a cancellation, suspension or non-renewal of a certificate of registration; (g) the result of a disciplinary proceeding in which a panel has made a finding under section 40 of the Act; (h) an order made by a panel under section 41 of the Act. Public information 3(3) The information referred to in clauses 1(c) and (d) and subsections (1.1), (1.2) and (2), other than clauses (2)⁠(b) and (c), is public information for the purpose of clause 7(3)⁠(d) of the Act. M.R. 26/2023 REGISTRATION AS A PODIATRIST Eligibility for registration as a podiatrist 4 In addition to the requirements of section 9 of the Act, the requirements for registration as a podiatrist are as follows: (a) the applicant must have satisfactorily completed one of the following: (i) a program of studies in podiatry acceptable to the council, (ii) an assessment process, approved by the council, of the applicant's ability to perform the core competencies of podiatry; (b) where required to do so in accordance with policies established by the council, the applicant must have taken and passed the examination; (c) the applicant must not suffer from a physical or mental condition, disorder, or addiction to alcohol or drugs that makes it desirable in the public interest that he or she not practise podiatry; (d) if the applicant's first language is not English or French, the applicant must be able to speak and write either English or French in accordance with the language fluency criteria established by the council. Application for registration as a podiatrist 5(1) An applicant for registration as a podiatrist must submit the following to the registrar: (a) a completed application form; (b) satisfactory proof of identity and current legal name; (c) evidence that he or she meets the eligibility requirements set out in section 4 and in subsection 9(1) of the Act; (d) evidence that he or she meets the liability insurance requirements of section 19; (e) a completed criminal record review authorization form; (f) the fee provided for in the by-laws. Application expiry 5(2) An application for registration expires 12 months after the date on which the applicant receives written notification from the registrar of the applicant's eligibility for registration. NON-PRACTISING PODIATRISTS Eligibility for registration as a non-practising member 6(1) An applicant is eligible for registration on the non-practising register if he or she meets the criteria set out in section 4 and in subsection 9(1) of the Act and does not intend to practise podiatry. Application for registration as a non-practising member 6(2) An applicant for registration on the non-practising register must submit the following to the registrar: (a) a completed application form; (b) satisfactory proof of identity and current legal name; (c) evidence that he or she meets the eligibility requirements set out in section 4 and in subsection 9(1) of the Act; (d) a completed criminal record review authorization form; (e) the fee provided for in the by-laws. TEMPORARY PRACTICE IN MANITOBA Application for temporary practice 7(1) An applicant qualified to practise podiatry in another jurisdiction who wishes to provide podiatry service to the public in Manitoba for a specific purpose and for a limited time period as approved by the council may apply for registration on the temporary practice register by (a) submitting a written application to the registrar, stating the specific purpose and the proposed length of time that he or she wishes to practise; (b) providing evidence satisfactory to the registrar that he or she is qualified to practise podiatry in the other jurisdiction and has a level of competence appropriate to the specific purpose; (c) providing evidence that he or she meets the liability insurance requirements of section 19; and (d) providing any additional information that the registrar may require in the form and within the time set by the registrar. Registration on temporary practice register 7(2) On receiving an application under subsection (1), if the registrar is satisfied that it is in the public interest to allow the applicant to practise on a temporary basis, the registrar shall enter the applicant's name on the temporary practice register. DISCLOSURE OF INFORMATION Disclosure on application 8(1) An applicant for registration under section 5, 6 or 7, or renewal of that registration under section 12 or 13, must disclose to the registrar the following information about himself or herself and his or her practice of podiatry or of any other profession, whether in Manitoba or in another jurisdiction: (a) a finding by any professional regulatory body of professional misconduct, conduct unbecoming, incompetence, an incapacity or lack of fitness to practise, or any similar finding; (b) a current proceeding by a professional regulatory body in relation to professional misconduct, conduct unbecoming, incompetence, an incapacity or lack of fitness to practise, or any similar current proceeding; (c) a denial of registration by a professional regulatory body, including reasons for the denial; (d) a conviction for an offence under (i) the Criminal Code (Canada), the Controlled Drugs and Substances Act (Canada) or the Food and Drugs Act (Canada), or (ii) a criminal or penal statute of a jurisdiction outside Canada that is, or may be, relevant to his or her suitability to practise. Membership in good standing in other jurisdictions 8(2) An applicant who is or has been registered to practise podiatry in another jurisdiction must submit the following to the registrar: (a) written verification by the original jurisdiction in which he or she is or was registered, that the applicant is or was in good standing; (b) written verification by every other jurisdiction in which the applicant is or has been registered during the previous seven years, confirming that the applicant is or was in good standing. CONVERTING REGISTRATION Conversion from practising to non-practising 9 A podiatrist is entitled to have his or her registration converted from the register of podiatrists to the non-practising register by providing any information that the council may require in the form and within the time set by the council, and paying the fee provided for in the by-laws. Conversion from non-practising to practising 10 A non-practising member is entitled to have his or her registration converted from the non-practising register to the register of podiatrists if he or she (a) provides any information that the council may require in the form and within the time set by the council; (b) pays the fee provided for in the by-laws; (c) provides evidence of continuing competency in accordance with the requirements of section 18; (d) provides evidence that he or she meets the liability insurance requirements of section 19; and (e) provides evidence that he or she is fit to engage in the safe practice of podiatry, where he or she applies for conversion after holding non-practising registration for more than one year and is required to do so in accordance with policies established by the council. RENEWAL Renewal 11 Each member must renew registration with the council at such time or times as required by the council. Renewal of practising registration 12(1) A practising podiatrist is entitled to have his or her registration renewed by (a) providing any information that the council may require in the form and within the time set by the council; (b) paying the fee provided for in the by-laws; (c) declaring that he or she has not been convicted of an offence described in clause 8(1)⁠(d) within the current registration period; (d) providing evidence of continuing competency for renewal of registration in accordance with the requirements of section 18; and (e) providing evidence that he or she meets the liability insurance requirements of section 19. Renewal subject to terms and conditions 12(2) If an applicant for renewal does not meet the requirements of clause (1)⁠(d), the registrar may renew the registration subject to terms and conditions for up to one year. Removal of terms and conditions 12(3) Where a member believes that he or she has satisfied any terms or conditions that have been placed on the member's registration, other than those imposed under Part 6 of the Act, and he or she wishes to have these terms or conditions varied or removed, the member must (a) provide any information that the council may require in the form and within the time set by the council; (b) pay the fee provided for in the by-laws; (c) provide evidence of continuing competency for renewal of registration in accordance with the requirements of section 18; and (d) provide evidence in accordance with policies established by the council that he or she is fit to engage in the safe practice of podiatry with the restriction or condition varied or removed as requested by the applicant. If the registrar is satisfied that the criteria have been met, the registrar must approve the request. Renewal of non-practising membership 13 A non-practising member is entitled to have his or her registration renewed by providing any information that the council may require in the form and within the time set by the council, and paying the fee provided for in the by-laws. Changes in requirements do not affect right to renew 14 No change in the educational requirements for registration affects a person's eligibility to renew his or her registration or right to practise, if the person was registered with the college before the change was made. CANCELLATION FOR NON-PAYMENT OF FEES Cancellation for non-payment of fees 15(1) When a member is in default in the payment of his or her renewal fee for a period of at least 14 days, the registrar must send a letter by personal delivery or registered mail or another service that provides the sender with proof of delivery addressed to the member at his or her address on the records of the council, notifying the member of his or her default. If the default continues for a further 30 days after the date of the letter, the registration of that member is automatically cancelled. Notice required 15(2) When a member's registration is cancelled under subsection (1), the registrar must notify the member by personal delivery or registered mail or another service that provides the sender with proof of delivery addressed to the member at his or her address on the records of the council and must send a copy of the notification, by registered mail, to the member's employer, if any, listed on the records of the council. REINSTATEMENT Reinstatement 16(1) The council may, on application by a person whose registration has been cancelled, direct the registrar to reinstate the person's name in the register, subject to any terms and conditions that the council may impose, and may order the person to pay any costs arising from the imposition of such terms and conditions. Reinstatement where registration cancelled for non-payment of fees and application made within one year 16(2) Despite subsection (1), an applicant who applies for reinstatement of registration within one year after the date his or her registration was cancelled for non-payment of fees is entitled to have his or her registration reinstated by (a) providing any information that the council may require in the form and within the time set by the council; (b) paying the fee provided for in the by-laws; and (c) providing evidence of continued competency in accordance with the requirements of section 18. INCLUDED PRACTICE Injectable substances 17(1) For the purposes of clause 2(3)⁠(b) of the Act, the substances that a podiatrist who has the qualifications approved by the council may inject into the foot are set out in Schedule A. Exception — injection under supervision 17(2) Despite subsection (1), a podiatrist who does not have the qualifications approved by the council to inject substances into the foot may inject a substance set out in Schedule A into the foot if the podiatrist performs the injection (a) as part of a course of instruction; and (b) under the direct supervision of a podiatrist who has the qualifications approved by the council. M.R. 26/2023 Prescribing by podiatrists 17.1 For the purpose of clause 2(3)⁠(c) of the Act, the drugs that a podiatrist who has the qualifications approved by the council may prescribe are set out in Schedule A.1. M.R. 26/2023 CONTINUING COMPETENCE Continuing competence 18(1) To satisfy the requirement of continuing competence for renewal of registration on the register of podiatrists, a member must (a) have practised as a registered podiatrist for a minimum of 1,125 hours in the five-year period immediately before the registration year for which renewal is sought; or (b) within the four-year period immediately before the registration year for which renewal is sought, must have successfully completed a podiatric education program in accordance with criteria established by the council. Continuing competence: conversion of registration 18(2) To satisfy the requirement of continuing competence to convert registration from the non-practising register to the register of podiatrists or to be reinstated on the register of podiatrists, an applicant must (a) meet the requirements of subsection (1); or (b) complete an assessment of prior learning and, if required, based upon the results of the assessment, successfully complete a course of instruction set by the council. Requirements set out in Schedule B 18(3) Members must comply with the continuing competency requirements set out in Schedule B. LIABILITY PROTECTION AND STANDARDS Liability protection 19(1) A member who provides patient care services must obtain and maintain at least the minimum amount of liability protection that is approved by the council. Signed declaration of compliance 19(2) When applying for renewal of registration, an applicant must sign a declaration that he or she complies with subsection (1). Evidence of compliance 19(3) A member must keep available in his or her office, for inspection by the council, evidence that he or she complies with subsection (1). Standards of practice 20 The standards of practice for a member are set out in Schedule B. Failure to comply with a standard may constitute professional misconduct and may result in a proceeding against a member in accordance with the Act. M.R. 26/2023 COMMITTEES Membership in standing committee 21(1) The standing committee referred to in clause 6(7)⁠(a) of the Act must consist of at least the following three members: (a) two persons appointed by the council who are members of the college; (b) one person who is a public representative appointed by the council. Staggered terms of appointment 21(2) One of the persons first appointed under clause (a) must be appointed for a one-year term and the other person must be appointed for a two-year term. The person appointed under clause (b) must serve for a two-year term. Thereafter, all members are to serve for a two-year term. Limit on consecutive terms 21(3) No person may serve as a member of the committee for more than three consecutive terms. Re-appointment after one-year absence 21(4) A person who has served on the committee for three consecutive terms may be re-appointed for another term or terms after an absence of one year. Criteria and process for selecting public representative 21(5) The committee must develop the criteria and the process for recruiting and selecting public representatives to serve on the council and committees of the council. REGULATION REVIEW Review of regulation 22 Not later than five years following the day this regulation comes into force, the council must (a) review the effectiveness of the operation of this regulation, and in so doing, must consult with such persons affected by the regulation as the council considers appropriate; and (b) if it considers it advisable, amend or repeal this regulation. REPEAL AND COMING INTO FORCE Repeal 23 The Local Anaesthetics Regulation , Manitoba Regulation 10/98, is repealed. Coming into force 24 This regulation comes into force 30 days after it is registered under The Regulations Act . SCHEDULE A (Section 17) DESIGNATED INJECTABLE SUBSTANCES Designated local anesthetics 1(1) A podiatrist who has the qualifications approved by the council may administer the following local anesthetic agents, either with or without epinephrine, by injection into the foot for nerve block or subcutaneous infiltration: (a) lidocaine; (b) prilocaine; (c) mepivacaine, including Carbocaine; (d) bupivacaine. 1(2) In the event of anaphylaxis following injection of a local anesthetic agent, a podiatrist may administer up to two doses of 0.3 ml of epinephrine (1:1000 solution). M.R. 26/2023 Other designated substances 2(1) A podiatrist who has the qualifications approved by the council may administer the following substances by injection into the foot: (a) allograft adipose matrix; (b) betamethasone sodium phosphate and betamethasone acetate; (c) denatured alcohol 4% (ethyl alcohol); (d) dexamethasone sodium phosphate; (e) diphenhydramine; (f) epinephrine; (g) hyaluronic acid; (h) hydrocortisone sodium succinate; (i) methylprednisolone acetate; (j) sterile saline solution; (k) triamcinolone acetonide; (l) vitamin B12 (cyanocobalamin). 2(2) Corticosteroids must not be administered intravenously. M.R. 26/2023 SCHEDULE A.1 (Section 17.1) DRUGS THAT A PODIATRIST MAY PRESCRIBE Designated drugs 1 A podiatrist who has the qualifications approved by the council may prescribe the following drugs: Antibiotics for Topical Use Bacitracin Bacitracin/neomycin sulphate Erythromycin Framycetin sulfate Fusidic acid Gentamicin sulfate Mupirocin Neomycin sulphate/polymyxin B sulphate/bacitracin Neomycin sulphate/polymyxin B sulphate/gramicidin Silver sulfadiazine Antifungals for Topical Use Ciclopirox olamine Clotrimazole Ketoconazole Miconazole nitrate Nystatin Terbinafine hydrochloride Tolnaftate Undecylenic acid Analgesics for Topical Use Benzocaine Capsaicin Diethylamine Salicylate Lidocaine/prilocaine Astringent for Topical Use Aluminum Chloride hexahydrate Caustics for Topical Use Cantharidin podophyllin salicylic acid combination (1% or less cantharidin with 2% or less podophyllin with 30% or less salicylic acid) Salicylic acid (70% or less) Salicylic acid/lactic acid combination (salicylic acid 16.7% and lactic acid 16.7% in flexible collodion) Salicylic acid/lactic acid/formalin combination (salicylic acid 25%, lactic acid 10%, formalin 5%) Silver nitrate (95% or less) 5-fluorouracil (5% or less) Immune Response Modifier for Topical Use Imiquimod Wound-healing Agents or Dressings for Topical Use Becaplermin Santyl collagenase Antibiotics for Oral Use Amoxicillin trihydrate Amoxicillin trihydrate/clavulanate potassium Azithromycin dihydrate Cefadroxil Cephalexin monohydrate Ciprofloxacin hydrochloride Clindamycin hydrochloride Cloxacillin sodium Erythromycin Sulfamethoxazole/trimethoprim Tetracycline hydrochloride Non-steroidal Anti-inflammatories for Oral Use Diclofenac potassium Diclofenac sodium Diclofenac sodium/misoprostol Diflunisal Ibuprofen Indomethacin Ketorolac tromethamine Meloxicam Naproxen Naproxen sodium Tiaprofenic acid Anxiolytics for Oral Use Diazepam Hydroxyzine hydrochloride Lorazepam M.R. 26/2023 SCHEDULE B (Section 20) STANDARDS OF PRACTICE Standard 1: Patient Health Records 1(1) For each patient, a member must (a) maintain a patient health record, an appointment schedule and a financial record, in accordance with policies established by the council; (b) keep a confidential record that includes the patient's name, contact information, date of birth, information regarding the patient's relevant medical history and assessment, diagnosis, plan of care, intervention strategy, ongoing evaluation and care modification plan and any additional information set out in policies established by the council; and (c) ensure that the information documented in the patient's health record is accurate and objective and that it is documented as care is provided to the patient or as soon as possible after the care is provided. 1(2) A patient's health record must be retained for at least 10 years following (a) the patient's last visit; or (b) if the patient was less than 18 years old at the time of the last visit, the day the patient becomes, or would have become, 18 years old. 1(3) Members must comply with The Personal Health Information Act and the Personal Health Information Regulation regarding the collection, use and disclosure of a patient's personal health information and the storage and destruction of the patient's health record. M.R. 26/2023 Standard 1.1: Obtaining Patient Consent to Treatment 1.1 A member must (a) obtain written consent from a patient prior to treating the patient; and (b) obtain the consent in a form approved by the council. M.R. 26/2023 Standard 2: Discontinuance of Practice 2(1) Before discontinuing his or her practice, a member must make an appointment with the registrar to be held not later than 30 days after the discontinuance date to provide the following information in writing: (a) the date the practice was discontinued; (b) the member's forwarding address; (c) a request, if applicable, to convert his or her registration from the register of podiatrists to the non-practising register; (d) a copy of the information given to his or her patients about their health records; (e) the location where patient records are stored; (f) confirmation of his or her intent to maintain liability insurance in accordance with the liability insurance company's recommendations; (g) confirmation that he or she understands and will comply with the requirements of this standard. 2(2) At the appointment with the registrar required under subsection (1), the member must return his or her current certificate of registration and the name tag issued by the council. 2(3) It is the responsibility of the member to inform patients that the member is discontinuing his or her practice (a) by placing a notice in a newspaper published in the community in which the member practised; and (b) by sending a letter to each patient seen within the three years preceding the date of discontinuance of the practice, advising the patient that the member's practice has been discontinued and providing an address at which the patient, or his or her legal representative, is able to obtain a copy of the patient's health record. 2(4) Upon the death of a member, his or her legal representative must comply with the requirements of subsections (2) and (3). Standard 3: Continuing Competency The aim of this standard is to encourage all practising members to keep up to date and to be aware of changes in practice, the latest developments and best practices based on the current available evidence. 3(1) Commencing January 1, 2007, every member must complete the number of hours approved by council for continuing professional development (CPD) activity every two years, in accordance with the policies established by the council. 3(2) Commencing January 1, 2007, the two-year cycle begins January 1 of the first year and ends December 31 of the following year. 3(3) Despite subsection (1), if requested to do so by a member, the council may (a) review any extenuating circumstances that prevent the member from meeting the CPD requirements; and (b) in its discretion, waive or modify the CPD requirements for that member. 3(4) All members must be able to demonstrate that they are engaged in CPD. It is the responsibility of each member to maintain a current portfolio detailing all CPD activities undertaken. 3(5) Proof of actual attendance at an activity must be included in the CPD portfolio; proof of fee payment is not sufficient proof of actual attendance. 3(6) It is the responsibility of each member to ensure that the CPD Officer receives proof of the member's CPD activity within the required time period and in the format set out in the policies established by the council under subsection (1). Standard 4: Infection Control 4 Members must comply with the guidelines for infection control approved by the council. Standard 5: Administration of Injectable Substances (Including Local Anesthesia) The aim of this standard is to ensure that members use a safe technique when they administer an injectable substance. 5 A member must (a) only administer the injectable substance if he or she has a qualification to do so that is recognized by the council; (b) [repealed] M.R. 26/2023; (b.1) provide the patient or their legal representative with sufficient communication about the patient's condition and the nature of the treatment and an explanation of the reasonable and available treatment options, including the material risks, benefits and efficacy of the options in order to enable informed decision-making by the patient; (c) be proficient in the procedures to follow in the case of anaphylaxis or other clinical emergencies that can result from the administration of an injectable substance. The member must attend an update in CPR and first aid training at intervals designated by the council; (d) ensure needles, syringes and substances to be injected are sterile and not contaminated; (e) [repealed] M.R. 26/2023; (f) not allow the patient to leave the treatment area following administration of an injectable substance, until the member is satisfied that no adverse reactions or complications are likely to occur. If the patient insists on leaving before the member is so satisfied, the member must document the patient's decision to depart in the patient's health record; (g) [repealed] M.R. 26/2023; (h) dispose of sharps, including needles, syringes and vials in accordance with Standard 4; (i) maintain an emergency kit and oxygen supply in good order in the clinical suite and be trained in its use. The member must update his or her training on a regular basis; and (j) maintain up-to-date instructions for proper use of the emergency kit and oxygen supply in the office manual. For the purpose of clause (b.1), "material risks" are to be determined by the member having consideration for the potential seriousness of the risk for a person in the patient's particular circumstances. M.R. 26/2023 Standard 6: Prescribing of Drugs by Members 6(1) A member must (a) prescribe a drug only if the member has a qualification to do so that is recognized by the council; (b) have an established podiatrist-patient professional relationship with the patient in respect of which a prescription is issued; (c) make reasonable inquiries for the purpose of assessing whether the drug to be prescribed is safe and effective for the patient, including inquiries about (i) the patient's symptoms, (ii) co-existent disease states and chronic conditions, (iii) the patient's allergies and other contraindications and precautions, (iv) other medications the patient may be taking, (v) the patient's gender, age, weight and height, if applicable, and (vi) pregnancy and lactation status, if applicable; (d) be satisfied that the prescription is reasonably necessary to treat the patient; and (e) provide the patient or their legal representative with sufficient communication about the patient's condition and the nature of the treatment and an explanation of the reasonable and available treatment options, including the material risks, benefits and efficacy of the options in order to enable informed decision-making by the patient. For the purpose of clause (e), "material risks" are to be determined by the member having consideration for the potential seriousness of the risk for a person in the patient's particular circumstances. 6(2) If a member identifies that the condition for which the patient is being assessed is outside the member's scope of practice, the member must refer the patient to an appropriate health care practitioner. 6(3) Subject to subsection (6), a member may prescribe a drug set out in the first column of the following table only for the indicated maximum duration set out in the second column in the indicated maximum daily dosage set out in the third column: Drug Maximum duration Maximum daily dosage (oral) Ketorolac tromethamine 5 days 10 mg every 4-6 hours, as needed for pain, not to exceed 4 doses per day, or 40 mg in total 6(4) Subject to subsection (6), a member may prescribe a drug set out in the first column of the following table before the performance of any act that the member is authorized to perform only for the maximum of a single dose, in the maximum daily dosage indicated opposite in the second column: Drug Maximum daily dosage (oral) Diazepam 10 mg Hydroxyzine hydrochloride 50 mg Lorazepam 3 mg 6(5) A member must not store the drugs listed in subsection (4) in their practice location. 6(6) A member may prescribe a drug to a patient for more than the maximum duration or maximum daily dosage set out in subsection (3) or (4) if the member (a) first consults with the patient's primary care provider; and (b) retains a written record of that consultation in the patient's health record. 6(7) A member must not delegate the authority to prescribe a drug to any other person. 6(8) A member must not prescribe a drug for (a) themselves; (b) any family member; or (c) any other person with whom the member has a close personal relationship that would reasonably be expected to affect the member's professional judgment. 6(9) A prescription issued by a member must include (a) the date of the prescription; (b) the patient's name and address; (c) the diagnosis or expected outcome of the treatment prescribed; (d) the name of the drug prescribed, the strength, if applicable, and the quantity; (e) the directions for use; (f) the number of refills available to the patient; (g) the name, address, and telephone number of the member issuing the prescription; and (h) the member's signature and registration number. M.R. 26/2023