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Government approves RPN initiation regs

The College of Nurses of Ontario (CNO) protects the public through the promotion of safe nursing practice. This includes providing regulatory oversight to ensure changes in nursing scope of practice are implemented safely.  

The Ontario government has approved regulations granting RPNs the authority to initiate, independently, certain controlled acts in certain practice settings without needing an order from an authorized health care professional. The regulations take effect Saturday, July 1, 2023. They are available to view on e-laws, which provides online access to Ontario’s statutes and regulations. 

The authority to perform these controlled acts is not new. RPNs could always do this with an order. The difference is that RPNs who have the relevant competence can now initiate these procedures without an order. These changes are intended to increase access to timely health care services and reduce barriers to care.

“CNO’s role is to protect the public and ensure any changes within nursing scope of practice are implemented safely for all,“ says Carol Timmings, Chief Quality Officer and Deputy Registrar. “Recognizing that many RPNs have the expertise to initiate these controlled acts, helps increase access to health care.”

This change only applies in certain practice settings. For example, RPNs who practice in hospitals always will need an order. This is a requirement under the Public Hospitals Act.

CNO has started to develop resources to support nurses’ ability to apply these changes in practice. These resources include a new practice standard on legislated scope of practice. This practice standard will be brought to CNO council for approval in June 2023.

Page last reviewed May 17, 2023