 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
Telephone:
416 928-0900
Toll Free in Ontario:
1 800 387-5526
Fax:
416 928-6507
Nursing Practice > Ask Practice
Page modified February 02, 2010
Nursing Standards
Outreach Program
RPNs Initiating Wound Care
Q
Can RPNs initiate wound care when caring for clients in the community?
A
Yes, initiation regulations allow nurses to independently carry out controlled acts in the absence of directives, policies or procedure. Nurses have the authority to perform the three controlled acts authorized to nursing. One of the controlled acts is performing a procedure below the dermis. RPNs have the authority in these regulations to cleanse, soak and dress wounds as long as they have the competence and knowledge to perform the procedures safely. Although RPNs have the authority to initiate this controlled act without a medical order, they must consider the agency’s policy and determine if cleansing, soaking and dressing are appropriate for the client at a particular time. Nurses demonstrate competence by possessing the necessary knowledge, skill and judgment to assess the client and the situation, manage the client during the procedure and perform the procedure safely. They must also be able to manage potential negative outcomes or have access to resources to help them manage those outcomes.
The College’s Decisions About Procedures and Authority, Revised 2006 practice standard outlines decision-making factors for initiating and/or performing procedures.
An RPN can provide care independently when the client’s care needs are not complex, the outcomes are predictable and there is a low risk of negative outcomes associated with care. If the client’s care needs are complex and/or the RPN cannot manage the outcomes, the RPN should not provide the care unless resources, such as an RN to consult with, are immediately available. If the care required is beyond the RPN’s competencies an RN must assume care of the client.
By taking courses on wound care, RPNs can add to their foundational knowledge and integrate other aspects and techniques into the care they provide. In addition, employers should ensure that nurses have opportunities to maintain competence, and that appropriate supports and resources are in place.
Nurses practising in a hospital are subject to the Public Hospitals Act, which necessitates an order from a physician to initiate wound care.
Resources:
- Utilization of RNs and RPNs practice document
- RNs and RPNs — Working Together
- Decisions About Procedures and Authority, Revised 2006 practice document
Last Updated Feb. 2010
[top]