The Ontario Ministry of Health determines when nursing regulation needs to be changed in the province.

CNO's role is to protect the public, so when the Ministry of Health identifies that a regulation change is needed to the Nursing Act, 1991, CNO works to identify if changes to our regulatory mechanisms are needed to ensure nurses can still practice safely and competently if the proposed changes become law.

This review of our regulatory mechanisms includes examining our entry-to-practice requirements, practice standards, professional conduct and Quality Assurance program. We also conduct a review of the models or methods used by other jurisdictions, and of the current research and literature related to the proposed changes. We work closely with government, nurses, educators, academics and others to understand their needs and perspectives about the proposed changes.

CNO presents Council with the outcomes of the research and reviews, and the feedback from government, nurses, educators, academics and other stakeholders. Council reviews these outcomes and feedback, then directs CNO to begin drafting a proposal. This proposal (a draft of the new regulation) is then circulated broadly to the public and all nurses for feedback.

After the consultation period, Council reviews the data and feedback received. Council then determines if the proposed regulation as drafted protects the public or if the draft requires amendments. If Council has concerns about the public's safety, the proposed regulation is reviewed, amended, and those amendments re-circulated for feedback.

Once Council determines the proposed regulation as drafted is in the public's interest, Council and CNO send the drafted regulation to the Ministry for their review and approval.