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1200W - Foundations of Nursing Practice > Week 5 (Class 2) - Knowing More About the Profession of Nursing > Flashcards

Week 5 (Class 2) - Knowing More About the Profession of Nursing Flashcards

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1
Q

What is the Regulated Health Professions Act (RHPA), 1991?

A

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
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2
Q

Who does the RHPA cover? What does it not include?

A 
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
-

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3
Q

What is the nursing’s scope of practice statement?

A

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

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4
Q

Under the Nursing Act, what are the two categories of nurses?

What are the several classes within the 2 categories?

A

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

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5
Q

What are other components of the nursing act?

A

1) Entry to practice
2) Controlled acts authorized to nursing
3) Professional misconduct regulations
4) Title protection
5) Quality assurance

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6
Q

What are the 5 intentions of the RHPA?

A

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

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7
Q

Within RHPA, what is the Health Professions Regulatory Advisory Council?

A

Independent advisory body to the Minister of Health and LT-care
- Advise on issues of regulations

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8
Q

What are entry to practice?

A

Entry to practice are competencies that nurses are required to demonstrates in order to be admitted to practice
- 101 competencies

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9
Q

What is title protection?

A

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)’

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10
Q

OLD model vs. NEW model of entry to practice (Slide 8)

A

study the categories of nursing

- 101 competencies are organized under these categories

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11
Q

What is a controlled act for RNs and RPNs?

A

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

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12
Q

What are controlled acts for NPs?

A
  • 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
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13
Q

When were RNs allowed to prescribe medications?

A

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
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14
Q

What is quality assurance?

A

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
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15
Q

What is professional misconduct?

A

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
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16
Q

What is initiation and delegation of controlled acts?

A

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
17
Q

What are nurses accountable for?

A

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
18
Q

What is fitness to practice?

A

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
19
Q

What are practice standards?

A

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

20
Q

What is the three-factor framework

A

1) Client factors
2) Environment factors
3) Nurse factors

21
Q

Describe Client Factors:

  • Influenced by?
  • What must be considered?
A

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

22
Q

Describe Environment Factors:

A

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.

23
Q

Describe Nurse Factors:

A

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

24
Q

How do practicing nurses participate in self-regulation?

A

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

25
Q

What is Jurisprudence? Purpose?

A

Jurisprudence is the philosophy of law and the legal system.

A registration requirement,as ofJan. 1, 2013 - Assesses an applicant’s knowledge and understanding of:

  • regulations and by-laws that impact nursing practice in Ontario
  • laws that govern nursing practice in Ontario
  • nursing practice standards & guidelines

*Passing this examination is a requirement

26
Q

What does the Jurisprudence exam test (5)?

What does it asses (3)?

A

1) Knowledge about self-regulation
2) Scope of practice
3) Professional accountability and responsibility
4) Nurse and client relationship
5) Ethical Practice
* Assess competence in 3 levels:

1) Knowledge and comprehension
- Ability to recall and understand relevant content

2) Application
- Ability to apply knowledge in a straight forward situation

3) Critical Thinking
- Ability to apply knowledge and comprehension through analytic problem solving

27
Q

How can RNs be represented as skilled professionals trained to deal with a high level of patient complexity?

A

Appearances matter

- Perceptions and values

28
Q

What are nursing liabilities?

A

Get through RNAO registration

  • RHPA - dictates our legal scope of practice
  • Liability protection
29
Q

What is nursing professionalism and the impact of ONA

A

Ontario Nurses’ Association
- union representing 68,000 RNs/HCP

supporting professionalism through:

  • Public perception
  • Advocacy campaigns
  • Member representation
30
Q

Professional Practice Clause?

A

Professional Practice Clause is a mechanism for dealing with workload concerns built right into ONA members’ collective agreements

  • Use your voice
  • Dealing with work load concerns
31
Q

In reflection …

A

Reflect on the state of your understanding of the ‘big picture’ of the nursing profession.

1200W - Foundations of Nursing Practice (11 decks)

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