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Last modified October 13, 2006

Connecting with Council
September 2006

This document highlights key decisions made at the September 27/28 Council meeting. Read the motions that passed at council.

Areas of discussion include:

Legislative and regulatory amendments to facilitate Nurse Practitioner practice

Over the past four years, the College has developed a framework to regulate Acute Care Nurse Practitioners (Adult, Paediatrics and Anaesthesia) as members of the Extended Class.

The goal of the framework is to promote positive changes in the delivery of care by all Nurse Practitioners (Primary and Acute Care). The proposed changes will facilitate the delivery of comprehensive up-to-date treatment and protect the public from unqualified practitioners.

In June, the College forwarded its proposed Nursing Act, 1991, changes to the Ministry of Health and Long-Term Care and asked the Ministry to begin the process of revising the Nursing Act and other legislation and regulations that restrict Nurse Practitioner practice, such as regulation 965 of the Public Hospitals Act.

Proposed changes to the controlled acts and registration regulations as well as a new mutual recognition regulation for Nurse Practitioners were included with the June 2006 Standard, and members were asked for feedback on the proposals.

Council received a report on the feedback and approved the regulations which will be submitted to the Ministry of Health and Long-Term Care for final approval.

 

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Proposed Practice Standard: Performance of Controlled Acts by Nurse Practitioners

The proposed legislative and regulatory changes approved by Council in June and September establish a broad, enabling regulatory framework for Nurse Practitioner practice.

To ensure the needed regulatory rigour and guide the practice of members of the Extended Class with respect to extended controlled acts, the College developed Proposed Practice Standard: Performance of Controlled Acts by Nurse Practitioners [Français].

This standard is cited in the proposed controlled acts regulation so will have the force of regulation. It was circulated to membership with the September 2006 Standard and posted on the College website for feedback. Council will receive a report on the consultation and will make a decision on the practice standard in December.

 

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RN(EC) drug, laboratory test and diagnostic test lists

It is in the public interest that the clients of Primary Health Care Nurse Practitioners, Registered Nurses in the Extended Class [RN(EC)s], have access to the most up-to-date therapeutic agents. The drugs, laboratory tests and diagnostic tests that RN(EC)s can prescribe or order are listed in regulation and legislation. To keep these lists as up-to-date as possible, they are reviewed regularly. Through an extensive consultative process involving RN(EC)s and members of other professions, including medicine and pharmacy, a list of proposed changes was identified and published in the June 2006 Standard.

Council received a report on the feedback and approved the lists for forwarding to the Ministry of Health and Long-Term Care for final approval.

 

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Delegation regulations

Delegation is a formal process by which a regulated health care professional with access to a controlled act transfers her or his legal authority to perform the act to another person. Delegation allows someone who does not have access to a controlled act by means of a profession-specific act (for example, the Nursing Act) or through an exemption (for example, an emergency situation) to access it.

Given that a client is at high risk of harm if a controlled act is performed by an unqualified person, the College has developed regulations [Français] to guide nurses in accepting delegation of controlled acts and in delegating them to others. While broad and enabling, the proposed regulations establish conditions that must be in place to delegate or accept delegation. Established to enhance public protection, the regulations will also provide nurses with clear direction and support in practice.

The delegation regulation has been approved for the purposes of consultation and was circulated to members with the September 2006 Standard and posted on the College website. In December, Council will review a report on the feedback and decide whether to forward the regulations to the Ministry of Health and Long-Term Care.

 

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Quality Assurance Program

The requirement for each health regulatory college to have a Quality Assurance Program is one of the four key public-protection elements of the Regulated Health Professions Act. The legislation requires regulatory colleges to establish programs that assure the quality of the practice of the profession and promote the ongoing competence of members.

The College of Nurses of Ontario has received a great deal of member feedback on Practice Review. After participating in Practice Review, some members have suggested that the assessment be more relevant to the individual nurse's practice. This feedback, combined with new best practices with respect to regulatory Quality Assurance, has led Council to approve a new philosophical model for Quality Assurance. The new model is based on the philosophical assumption underlying the College's existing program; namely, that all nurses are competent and the Quality Assurance Program should provide support, learning and remedial opportunities for nurses.

The philosophical model will be the basis for the revision of the College's Quality Assurance regulations. Council will review draft regulations in December and circulate the proposed regulations to members for feedback.

 

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Changes in Council membership

Atoosa Mahdavian has resigned as a Council member. David Bockman has been appointed a public member of Council.

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