March 05, 2024

Dear CNO

We explain how regulation changes impact your medication practices.

I heard there were some regulation changes that impact medication practices for all nurses, is that true?

Yes, there are! There are some important medication practice changes that affect all nurses due to recent regulatory changes. It’s important for all nurses to be aware of these changes as the updates may impact your practice.

What’s new for RNs and RPNs?

The Scope of Practice standard was updated to include the expanded scope of RNs with prescribing authority. This means that some RNs can now prescribe certain medications for their clients, and that RNs and RPNs can now follow orders from these RNs to dispense or administer medications by injection or inhalation. Of course, you still need to make sure that RN prescribing is permitted in your practice setting by checking with your employer and any relevant legislation related to your setting.

What’s new for all nurses?

The Medication practice standard has also been revised for all nurses who dispense medications or administer medication by injection or inhalation, regardless of the authorizing provider. The Medication standard states that nurses must

  • have a therapeutic nurse-client relationship when engaging in all medication practices

  • only dispense or administer medication by injection or inhalation for therapeutic purposes

  • label the medication container with all the information listed in Appendix A of the Medication standard when dispensing medication, and document and retain a copy of the label information in the client’s health record

What’s new for NPs?

Certain dispensing conditions have been removed from the Nurse Practitioner standard so that it is now the same for all nurses when dispensing medication. Previously, NPs were permitted to only dispense medication in specific circumstances; for example, if the client did not have access to a pharmacy. This change makes it easier for the public to access care and further contributes to client safety.

What do these changes mean for you?

These changes ensure all nurses follow the same safety standards when engaging in medication practices.

Lastly, if you are an RN in the General Class interested in prescribing, you should talk to your employer to see if RN prescribing is permitted in your practice setting. Visit cno.org to find out more on how to become authorized to prescribe, including approved education programs and FAQs. Be sure to review the RN Prescribing standard or watch a recording.

Thanks for writing, 
Cathy Tersigni, RN, BScN, MN, Advanced Practice Consultant

 

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About CNO

The College of Nurses of Ontario (CNO) is the regulator of the nursing profession in Ontario. It is not a school or a nursing association. CNO acts in the public interest by:

  • assessing qualifications and registering individuals who want to practice nursing in Ontario.
  • setting the practice standards of the profession that nurses in Ontario are expected to meet.
  • promoting nurses' continuing competence through a quality assurance program.
  • holding nurses accountable to those standards by addressing complaints or reports about nursing care.

The College was founded in 1963. By establishing the College, the Ontario government was acknowledging that the nursing profession had the ability to govern itself and put the public's well-being ahead of professional interests.

For the latest information, please see our Nursing Statistics page.

Anyone who wants to use a nursing-related title — Registered Nurse (RN), Registered Practical Nurse (RPN) or Nurse Practitioner (NP) must become a member of CNO.

Frequently Asked Questions

Go to the public Register, Find a Nurse, to conduct a search for the nurse. Contact us if you can't find the person you are looking for.

All public information available about nurses is posted in the public Register, Find a Nurse, which contains profiles of every nurse in Ontario. Publicly available information about nurses include their registration history, business address, and information related to pending disciplinary hearings or past findings.

Unregistered practitioners are people who are seeking employment in nursing or holding themselves out as being able to practice nursing in Ontario, but who are not qualified to do so. They are not registered members of CNO. Only people registered with CNO can use nursing-related titles or perform certain procedures that could cause harm if carried out by a non-registered health professional. CNO takes the issue of unregistered practitioners seriously. See Unregistered Practitioners for more information.

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Information obtained during an investigation will become public if the matter is referred to a disciplinary hearing. If a complaint is not referred to a hearing, no information will be available publicly.

See CNO's hearings schedule, which is updated as hearing dates are confirmed. Hearings at CNO are open to the public and the media. For details on how to attend a hearing, contact the Hearings Administration Team.

A summary of allegations and the disciplinary panel outcomes can be found on the public Register, Find a Nurse. Full decisions and reasons are also available.

Where a disciplinary panel makes a finding of professional misconduct, they have the authority to reprimand a nurse, and suspend or revoke a nurse's registration. Terms, conditions and limitations can also be imposed on a nurse's registration, which restricts their practice for a set period. Nurses can also be required to complete remedial activities, such as reviewing CNO documents and meeting with an expert, before returning to practice.

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