Quality Practice - A resource for nurses and nurse leaders
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Regulation changes affect entry exams and declaration of nursing practice

On Dec. 21, 2016, the Ontario government released changes to the registration regulation under the Nursing Act, 1991.

Now, RN applicants have no limit to the number of times they can write the entry-to-practice exam, NCLEX-RN. For more information, read Q&As about the NCLEX-RN for exam writers.

Also, nurses no longer have to have practised nursing in Ontario during the past three years to renew their memberships in the General or Extended classes. For more information, read declaration of practice FAQs.


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Pilot project on Practice Support

The College is piloting a process to respond to nurses’ practice-related questions and provide them with resources that better meet their needs.

We have closed the Practice Line while we explore how technology can help us better provide nurses and other stakeholders with the information they need. Instead, nurses and others can submit their practice questions using an intake form or by email. They will receive a response from our Practice Support team within three business days.

Using the form, or email, allows us to provide nurses with a consistent and comprehensive response to their practice questions. It also allows us to track the types of questions we receive. We will use this information to develop new resources and respond to emerging practice issues shared with us.

We welcome your feedback on this new approach. Please send your comments to practicesupport@cnomail.org.

We will share our new ways to deliver practice support by Spring 2017.

Read more about Practice Support

Renewal 2017: deadline and Nurse Renewal Check

Nurses have until Tuesday, Feb. 21, 2017 to pay all fees and renew their membership with the College for 2017.

The College will suspend the memberships of nurses who do not renew by that date. This means they will not be able to practise nursing in Ontario until they pay all fees owed to the College. They must also complete an online form and provide the College with a valid email address.

Nurses who are suspended can lift the suspension by renewing or resigning their memberships by Thursday, March 23, 2017. After that date, the College will revoke their memberships.

To confirm if nurses at your facility are registered to practise, use Nurse Renewal Check.

Nurse Renewal Check (formerly Automated Annual Verification of Renewal of Membership or AAVR) is a service the College provides to nursing employers, facility operators and others. It quickly and efficiently checks the membership status of nurses you employ on a full-time, part-time, casual or contractual basis.

The service is an efficient alternative to manually reviewing each nurse’s membership status by phone or using Find a Nurse. This makes it ideal for organizations that employ a large number of nurses.

Nurses can renew their memberships online at www.cno.org/mym. They can also call 1 866 573-5405 (in North America) or 416 849-6135 (outside North America), or email renewal@cnomail.org from Monday to Friday, 8:30 a.m. to 7 p.m. EST.

Nurses can start 2017 Learning Plan

It’s time for nurses to get started on creating their annual Learning Plan for the College’s Quality Assurance (QA) Program. Involvement in QA is a continuous requirement throughout their career as a nurse.

For a complete list of resources nurses need to complete their Learning Plan, go to Quality Assurance (QA) Program.

Future change: NPs prescribing controlled substances

The College is currently consulting with stakeholders on proposed regulation changes that would allow NPs to prescribe controlled substances. You have until Tuesday, Feb. 14, 2017 to send us your feedback.

If Council and the government approve the regulation changes, the College will work with the Ministry of Health and Long-Term Care to implement them by the end of March 2017. We will inform all stakeholders once we know the exact implementation date.

Read more on the NPs and Prescribing Controlled Substances page.

Controlled substances education

In anticipation of the regulation changes being approved, NPs have been asked to complete a Council-approved course before they are allowed to prescribe controlled substances. NPs should complete one of two online courses by Friday, March 10, 2017. The course content builds on existing NP competencies and is broader than prescribing. For example, it includes an overview of federal laws, ethical considerations, misconceptions and client stigmatizations. Even if an NP is not prescribing controlled substances, learning the foundational competencies related to controlled substances is in the interest of clients.

NPs who do not complete a course will have a restriction on the Register the day the regulations take effect. Current employers will also be notified by mail of the restriction.

For more information on the education requirement, read Q&As: Controlled Substances Education Requirement. NPs can only prescribe controlled substances once the regulations take effect and once they complete the approved education.

New entry-level competencies for NPs

Starting January 2018, Nurse Practitioners (NPs) will have new competencies that will be defined in the Entry-Level Competencies for Nurse Practitioners document. The College released the document one year early to give stakeholders time to prepare for the new competencies. For example, universities can use the time to update their curricula.

In 2017, NPs and applicants will continue to be assessed by the Canadian Nurse Practitioner Core Competency Framework. 

The Canadian Council of Registered Nurse Regulators developed the new NP competencies. They will be used in jurisdictions across Canada.

Learn more about the current and new NP competencies.

Q: As an RN, can I administer botulinum toxin (e.g. Botox)?

A: Yes, you may administer botulinum toxin if there is an appropriate order in place. 

Administering botulinum toxin falls under the controlled act of administering a substance by injection. This is one of the controlled acts that RNs and RPNs are allowed to perform with an order from an authorized health care professional, such as a physician. The order can be a direct order or a directive.

Having the authority to perform a procedure does not necessarily mean it is appropriate to do so. For example, the Medication practice standard requires you to consider the client, the medication and the environment when assessing if it is appropriate to administer a drug.

Decisions About Procedures and Authority includes a decision tree to help you decide if you should perform a procedure. It asks questions such as: 

  • Are you the appropriate care provider to perform this procedure?
  • Is there an order in place?
  • Do you have the knowledge, skill and judgment to perform and manage all possible outcomes of performing the procedure?

In addition to using the College’s standards, you are accountable for having the knowledge, education and/or experience that is needed to safely perform any treatment or procedure.