Quality Practice - A resource for nurses and nurse leaders

  August 2019 | Volume 18, issue 4
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Putting the public first

On July 31, 2019, Commissioner Eileen Gillese released her Long-Term Care Homes Public Inquiry Report. We are fully supportive of all the Commissioner’s recommendations. You can read our statement about the inquiry report here.

As reflected in Commissioner Gillese’s report, when we learned of something that could be done to improve the long-term care system, if the matter was within our control, we acted immediately. Of the 10 recommendations specifically for the College, we have already implemented or are in the process of implementing virtually all of them, and are committed to fully implementing them all.

You can read more about the work that we have already done to enhance and strengthen our ability, and the ability of employers, to address the issues raised at the Inquiry on this website.


Scope of practice for NPs and RPNs to expand

Recently, the Ministry of Health and Long-Term Care asked us to begin the work required to expand the scope of practice for NPs and RPNs. This change will increase patients’ choice of and access to health care services.

Read Scope of practice for NPs and RPNs to expand in the July issue of The Standard to learn more about what these changes are, when they will take effect and the process leading to the implementation of these upcoming regulations.


A code of conduct for nurses

To promote and maintain the public’s trust, we have developed a Code of Conduct for the public and nurses. This new practice standard came into effect on Feb. 4, 2019.

The Code is an overarching practice standard all nurses are accountable to regardless of their role, position or practice setting. But unlike other practice standards, the Code is written for the public and explains what they can expect from a nurse when receiving care. Six principles inform the Code:

  1. Nurses respect the dignity of patients and treat them as individuals
  2. Nurses work together to promote patient well-being
  3. Nurses maintain patients’ trust by providing safe and competent care
  4. Nurses work respectfully with colleagues to best meet patients’ needs
  5. Nurses act with integrity to maintain patients’ trust
  6. Nurses maintain public confidence in the nursing profession

Each principle has statements that explain the professional obligations. As with all practice standards, nurses are expected to know and meet the standards. Failing to do so could lead to disciplinary action.

While most of the accountabilities in the Code come from current practice standards, we have added a few new ones to reflect current evidence, legislation, technology and situations nurses may encounter in different practice settings. For example, expectations related to social media, providing timely nursing care, and gaps impacting patient care and health outcomes in different communities.

As employers, you are accountable for preserving the public’s right to safe and ethical patient care. You can uphold the standards of the Code within your organization by:

  • informing patients or their family members of what to expect of nurses
  • educating nurses about the expectations within the code
  • reporting incidents of sexual abuse, incompetence or incapacity

To help educate nurses on how to apply the Code, we have developed FAQs and a document showing how the Code’s accountabilities link to other CNO practice standards and guidelines. We also have a new webcast that shows how the Code of Conduct applies to situations nurses may encounter in their everyday nursing practice.

Visit www.cno.org/codeofconduct to learn more about the Code and access the resources. If you have specific questions related to the Code, contact Practice Support.

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Preventing sexual abuse of patients by nurses

Sexual abuse of patients is one of the most harmful events that can occur in nursing practice. While most nurses do not harm their patients, the fact that sexual abuse by nurses exists tells us that we need more education and prevention.

Over a year ago, we began a research study with the goal of identifying common trends that can lead to abuse. Through our research, we learned that it’s the most vulnerable patients, such as those with mental health issues and the elderly, who are most likely to be victims. We also learned that abusers use grooming techniques to draw in their victims, such as the abuser paying special attention to or sharing personal information with the patient. To learn more about this research and our findings, visit our Sexual Abuse page.

The outcomes learned from our research are helping us to develop interventions to prevent sexual abuse before it happens. By understanding what sexual abuse is, what the warning signs are, and why and how to maintain appropriate boundaries with patients, the more prepared we are to stop abuse before it happens.

Over the coming months we will be publishing a series of new prevention tools and resources based on our research that employers, nurses and others involved in patient care can use. Including learning tools you can use in meetings or training sessions with nurses.

Look for this new information in our Trending Topics page and on our Facebook, Twitter, LinkedIn and Instagram feeds.

By sharing what we learn, we can work together to prevent sexual abuse.

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How we changed and grew in 2018

Our 2018 Annual Report, titled “Partners in Safety,” is out now! It highlights the many ways CNO collaborated with and reached out to nurses, patients, members of the public, nurse employers, academics and others over the last year. We all need to work together to uphold safe nursing care for the people of Ontario.

The easy-to-read, visually impactful report includes a review of our five biggest accomplishments in 2018:

  • The new Code of Conduct for nurses. The Code helps the public understand what to expect from you when receiving care. It describes the behaviour and conduct all nurses are professionally accountable to provide. We translated the Code into six languages to make sure it is accessible to more Ontarians.
  • The Nurses’ Health Program. This best-in-class program encourages nurses with substance use and/or mental health disorders to seek treatment early. We collaborated with the Ontario Nurses’ Association, Registered Nurses’ Association of Ontario and Registered Practical Nurses Association of Ontario to develop it. We believe that with the right support and opportunity for education, treatment and recovery, nurses can continue or return to safe nursing practice.
  • We put the registration process for new nurses online. This new tool is letting applicants register with CNO faster and more efficiently.
  • We launched a new way of assessing and approving Nursing Education Programs. The process helps us to ensure that all nursing graduates in Ontario are ready to practice safely when they start to work.
  • We collaborated more with patients, nurse employers, academics and other experts who could help us learn and improve. Diverse input improves the ways we deal with public safety concerns.

In the report, you’ll also find statistics and facts, such as how many applications we received last year, and how much faster we can register internationally educated RPNs now.

Take a few minutes to read our 2018 Annual Report, then share your comments and questions with us.

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