On Monday, March 1, 2027, changes to CNO’s Scope of Practice and Medication practice standards will come into effect.
The updated standards are now available for viewing on our Standards & Guidelines page.
The changes include new requirements for nurses providing aesthetic services, as well as broader updates related to authorizing mechanisms that apply across all nursing practice settings. The updated standards will help clarify nurses’ accountabilities and support public safety in nursing across Ontario.
“These changes put client safety first by setting clearer expectations for nurses and strengthening safeguards wherever nursing care is provided,” said Silvie Crawford, RN, CNO’s Registrar & CEO. “Ontarians should be able to feel confident that their care is based on their individual needs and delivered with appropriate oversight.”
Why the standards are changing
Safe care starts with understanding each client’s needs. The revised standards clarify expectations for assessments, care planning, delegation and client-specific orders, helping nurses make informed decisions based on each client’s needs, circumstances and treatment goals. They also introduce specific requirements for aesthetic services, including a requirement for a nurse to be onsite when they delegate a controlled act. Together, these measures strengthen oversight and help protect the public.
What is changing?
Effective Monday, March 1, 2027, the updated standards will require nurses practicing in aesthetic services to:
- use client-specific orders instead of directives for aesthetic services involving prescription drugs or controlled acts
- be onsite for the entire delegated procedure. For example, this applies when a nurse delegates a controlled act for an aesthetic procedure to someone who does not have the authority to perform it, such as an unregulated care provider
The updated standards also clarify expectations across all practice settings, including:
- the expectation for authorized providers to complete an initial client assessment and establish a plan of care with follow-up before issuing client-specific orders
- clearer delegation requirements
What is staying the same?
As always, nurses must continue to assess clients and have the knowledge, skill and judgment needed to provide safe care. Nurses who delegate remain responsible for ensuring the person accepting the delegation can perform the procedure safely. They also remain accountable for the client’s ongoing care. Registered Nurses (RNs) and Registered Practical Nurses (RPNs) do not need delegation to perform specified controlled acts (for example, injecting a substance) that they are already authorized to perform.
How nurses can prepare for upcoming changes
CNO is here to support nurses as they prepare. Over the coming months, we will provide additional information and resources. Nurses with questions about their accountabilities or how to apply CNO standards to their practice are encouraged to contact CNO through the Practice Support Form.
Learn more at our upcoming webinar
Join CNO on Thursday, Dec. 3, 2026, from 12-1 p.m. (EST), for a webinar about nursing practice in aesthetics. The webinar will explore how CNO’s standards and guidelines apply to aesthetic services, provide an overview of the changes and give participants an opportunity to ask questions. Recording will be made available after the webinar.