Week 5 (Class 2) - Knowing More About the Profession of Nursing Flashcards
What is the Regulated Health Professions Act (RHPA), 1991?
Regulates scope of practice for 28 health professions within Ontario
Lists controlled acts authorized to regulated health professions (14) as well as those specifically authorized to RNs, RPNs and NPs
Health Professions Procedural Code
- Outline of the structure of what each professional college should look like
- Must include a council
Who does the RHPA cover? What does it not include?
Audiologists Chiropodists Chiropractors Dental Hygienists Dental Technologists Dentists Denturists Dietitians Homeopaths Kinesiologists Massage Therapists Medical Laboratory Technologists Medical Radiation Technologists and Sonographers Midwives Naturopaths Nurses Occupational Therapists Opticians Optometrists Pharmacists Pharmacy Technicians Physicians Physiotherapists Podiatrists Psychologists Psychotherapists Respiratory Therapists Speech-Language Pathologists Traditional Chinese Medicine Practitioners and Acupuncturists
*PSW, osteopaths, paramedics, phys. assistants
- Not included
-
What is the nursing’s scope of practice statement?
The practice of nursing is the promotion of health and the assessment of, the provision of, care for, and the treatment of, health conditions by supportive, preventative, therapeutic, palliative and rehabilitative means in order to attain or maintain optimal function - Nursing Act 1991
Under the Nursing Act, what are the two categories of nurses?
What are the several classes within the 2 categories?
Types of nurses:
1) RN
2) RPN
Classes:
1) General Class
2) Extended Cass
- Ex. NP
3) Temporary Class
- Ex. RN, RPN
4) Special assignment class
What are other components of the nursing act?
1) Entry to practice
2) Controlled acts authorized to nursing
3) Professional misconduct regulations
4) Title protection
5) Quality assurance
What are the 5 intentions of the RHPA?
1) Protect and serve the public interest
2) Transparent system of self-governance
3) Modern framework for the work of health professionals
4) Provides consumers with freedom of choice
5) Mechanisms to improve quality of care
Within RHPA, what is the Health Professions Regulatory Advisory Council?
Independent advisory body to the Minister of Health and LT-care
- Advise on issues of regulations
What are entry to practice?
Entry to practice are competencies that nurses are required to demonstrates in order to be admitted to practice
- 101 competencies
What is title protection?
Only members of the College of Nurses of Ontario can use the titles ‘nurse, Registered Nurse (RN), Registered Practical Nurse (RPN)’
Only nurses in the RN-EC can use the title ‘Nurse Practitioner (NP)’
OLD model vs. NEW model of entry to practice (Slide 8)
study the categories of nursing
- 101 competencies are organized under these categories
What is a controlled act for RNs and RPNs?
Authorized to RNs and RPNs
Performing a prescribed procedure below the dermis or mucous membrane
Administering a substance by injection or inhalation
Putting an instrument, hand or finger:
- beyond the external ear canal
- beyond the point in the nasal passages where they normally narrow
- beyond the larynx
- beyond the opening of the urethra
- beyond the labia majora
- beyond the anal verge, or
- into an artificial opening in the body
Dispensing a drug
What are controlled acts for NPs?
- Communicating a diagnosis
- Applying or ordering the application of a prescribed form of energy
- Setting or casting a fracture or joint dislocation
- Prescribing, dispensing, selling or compounding medication in accordance with regulations
When were RNs allowed to prescribe medications?
May 2017, the Nursing Act was changed to permit RNs to prescribe medications and communicate a diagnosis for the purpose of prescribing
- Not approved yet
- Areas of concern for debate
What is quality assurance?
QA program assists nurses in maintaining competence and continually evaluating their practice
- Self-assessment: Annual requirement in which you need to reflect on practice and to develop/maintain a learning plan that is kept for 2y
- Practice assessment: Random audit where you are asked to submit your learning plan and MC test online, and clinical assessment
- Peer assessment: Choose a random to review you
What is professional misconduct?
Since nursing is a self-regulated profession, the government has delegated to the professional nursing to regulate itself for the purpose of protecting the public
- An act or omission that breaches ethical and professional standards of practice
- There are 37 types
- Discipline committee
What is initiation and delegation of controlled acts?
Completed a task that is not in an RN scope of practice
- Must meet certain conditions related to knowledge, skills and judgment
- NPs have additional controlled acts authorized to their class
- Delegation must be done by one who is authorized and competent to delegate to someone who is not authorized by legislation to perform it
What are nurses accountable for?
Nurses are accountable for:
- their own actions and decisions
- knowing and understanding the roles and responsibilities of other team members
- taking action to ensure client safety, including informing the employer of concerns related to others
- collaborating with clients, with each other and with members of the interprofessional care team
What is fitness to practice?
Fitness requirements are relevant to all RHPs:
- CNO is the regulatory body that reviews nurses’ fitness to practice
- CNO has the legal authority to suspend your license in order to protect the public
- legislation/protocol/policy/standards are breached
Like what?
- Ex. Come into work and cannot function properly
- Ex. Unwell and able to carry out full scope of practice
- Ex. Under the influence at work
What are practice standards?
Practice guidelines are documents that help nurses understand their responsibilities and legal obligations to enable them to make safe and ethical decisions when practicing; they provide and outline of professional accountabilities and relevant legislation
- CNO
What is the three-factor framework
1) Client factors
2) Environment factors
3) Nurse factors
Describe Client Factors:
- Influenced by?
- What must be considered?
1) Complexity of PT situation
- Ask: Care needs well defined? Multiple issues? Overlapping? Freq. monitoring or reassessment? At risk for negative outcomes? Support systems in place? Are they stable?
2) Predictability of outcomes of client care
- Ask: Possible changes in health conditions?
3) Risk of negative outcomes in response to care
- Ask: Signs and symptoms predictable? Negative outcomes?
- Mild or moderate
All must considered when determining the appropriate category of nurse required to provide the care
Describe Environment Factors:
1) Practice supports
2) Consultation resources
3) Stability and predictability of the environment
Less stable = unclear/unidentified protocols, procedures, less expert nurses, unregulated staff, etc.
Describe Nurse Factors:
1) Differences in autonomous practice
- The ability to make decisions and work independently directly related to knowledge
2) Differences in education
- Cognitive ability gained through foundational knowledge
- NP > RN > RPN
How do practicing nurses participate in self-regulation?
Nurses practice according to standards
Know and understand best practice guidelines
Continue to stay current with knowledge and skills
Attend conferences
Continuing education and specialities
Advocating
