Podcast
Questions and Answers
What is one possible reason for the increased use of complementary and alternative medicine (CAM) among Canadians?
What is one possible reason for the increased use of complementary and alternative medicine (CAM) among Canadians?
Which of the following is NOT a component of the regulation of health care professions?
Which of the following is NOT a component of the regulation of health care professions?
What are controlled acts intended to prevent?
What are controlled acts intended to prevent?
Which situation allows unregulated individuals to perform controlled acts?
Which situation allows unregulated individuals to perform controlled acts?
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What is the role of the practitioner's scope of practice?
What is the role of the practitioner's scope of practice?
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Which of the following is considered a controlled act?
Which of the following is considered a controlled act?
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Which of the following factors might influence a person’s preference for CAM?
Which of the following factors might influence a person’s preference for CAM?
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What is the purpose of a formal complaints process in health care regulation?
What is the purpose of a formal complaints process in health care regulation?
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What characterizes a delegated act?
What characterizes a delegated act?
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Which entities share responsibility for a delegated act?
Which entities share responsibility for a delegated act?
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What is a defining characteristic of nonregulated occupations?
What is a defining characteristic of nonregulated occupations?
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What is essential for effective interprofessional collaboration?
What is essential for effective interprofessional collaboration?
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Which statement is true about interprofessional relationships?
Which statement is true about interprofessional relationships?
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What is one critical element of collaboration?
What is one critical element of collaboration?
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How do guidelines for delegation of medical acts generally characterize the delegated act?
How do guidelines for delegation of medical acts generally characterize the delegated act?
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In the context of delegated acts, what does the term 'legal authority' refer to?
In the context of delegated acts, what does the term 'legal authority' refer to?
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What is a key component of cooperation in an interprofessional setting?
What is a key component of cooperation in an interprofessional setting?
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Which aspect is essential for shared decision-making?
Which aspect is essential for shared decision-making?
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What characterizes partnerships in an interprofessional context?
What characterizes partnerships in an interprofessional context?
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What does interprofessional education primarily aim to achieve?
What does interprofessional education primarily aim to achieve?
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Which is a documented outcome of interprofessional collaboration according to the 2007 synthesis?
Which is a documented outcome of interprofessional collaboration according to the 2007 synthesis?
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In the context of interprofessional collaborative practice, what is critical for achieving positive outcomes?
In the context of interprofessional collaborative practice, what is critical for achieving positive outcomes?
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What is the role of care providers in interprofessional collaborative practice?
What is the role of care providers in interprofessional collaborative practice?
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Which concept encompasses learning with, from, and about each other in healthcare?
Which concept encompasses learning with, from, and about each other in healthcare?
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Which of the following settings is NOT considered a practice setting in healthcare?
Which of the following settings is NOT considered a practice setting in healthcare?
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What percentage of Canadians reportedly did not have a family physician in 2014?
What percentage of Canadians reportedly did not have a family physician in 2014?
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What approach is labeled as evidence-informed or evidence-based, particularly in the context of treatments?
What approach is labeled as evidence-informed or evidence-based, particularly in the context of treatments?
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Which of the following is NOT a category of health care providers?
Which of the following is NOT a category of health care providers?
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Which term is frequently associated with conventional medicine?
Which term is frequently associated with conventional medicine?
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Which method is one of the strategies regions are using to enhance primary care delivery?
Which method is one of the strategies regions are using to enhance primary care delivery?
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What is a common belief held by critics of alternative medicine?
What is a common belief held by critics of alternative medicine?
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Which of the following is NOT an example of an allied health professional?
Which of the following is NOT an example of an allied health professional?
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What percentage of the regulated nursing workforce do Registered Practical Nurses make up?
What percentage of the regulated nursing workforce do Registered Practical Nurses make up?
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Which of the following is NOT a designation for regulated nursing in Canada?
Which of the following is NOT a designation for regulated nursing in Canada?
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When was the first requirement for registration of Registered Practical Nurses established?
When was the first requirement for registration of Registered Practical Nurses established?
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Which type of nursing role was first established during WWII?
Which type of nursing role was first established during WWII?
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What is the main purpose of interprofessional collaboration?
What is the main purpose of interprofessional collaboration?
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What type of education is typically required for Nurse Practitioners in Canada?
What type of education is typically required for Nurse Practitioners in Canada?
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Which of the following roles is exclusive to certain provinces, including Manitoba and Alberta?
Which of the following roles is exclusive to certain provinces, including Manitoba and Alberta?
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What distinguishes intraprofessional collaboration from interprofessional collaboration?
What distinguishes intraprofessional collaboration from interprofessional collaboration?
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Which of the following is a key component of interprofessional collaboration?
Which of the following is a key component of interprofessional collaboration?
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Which Canadian province was the first to legislate nurse practitioners' authority?
Which Canadian province was the first to legislate nurse practitioners' authority?
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What outcome was associated with interprofessional collaboration among team members in terms of patient care?
What outcome was associated with interprofessional collaboration among team members in terms of patient care?
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Which group of patients was shown to have greater knowledge of their health conditions if they had access to additional professionals?
Which group of patients was shown to have greater knowledge of their health conditions if they had access to additional professionals?
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What significant statistic reflects the effectiveness of interprofessional teams regarding appointment wait times?
What significant statistic reflects the effectiveness of interprofessional teams regarding appointment wait times?
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What is one identified barrier to effective interprofessional collaborative partnerships?
What is one identified barrier to effective interprofessional collaborative partnerships?
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What is suggested as necessary for interprofessional education and practice?
What is suggested as necessary for interprofessional education and practice?
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What percentage more likely were Canadians with additional professional access to rate their health care as good or better?
What percentage more likely were Canadians with additional professional access to rate their health care as good or better?
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What was one effect of interprofessional services on emergency room use?
What was one effect of interprofessional services on emergency room use?
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What area requires further evaluation and research within interprofessional practice?
What area requires further evaluation and research within interprofessional practice?
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Study Notes
Course Information
- Course title: Health Professionals & Interprofessional Collaborative
- Course code: NURS 3001 B
- Week: 6
Agenda
- Online class via zoom (link provided on eclass)
- Scholarly paper and group presentations
- Roles and Structure: Regulated Nursing in Canada
- Interprofessional Collaboration
- Delivery of care and practice settings
- Control Acts and Delegated Acts
- Interprofessional Education
Who Delivers Healthcare?
- Continual change in who delivers healthcare and where it occurs
- Diverse providers in Canada:
- Conventional (mainstream) medical practitioners
- Practitioners of complementary and alternative medicine
- Informal workers (volunteers, community organizations, friends and family)
Roles and Structures in Canada
- Four designations across Canada:
- Registered/Licensed Practical Nurse (RPN/LPN)
- Registered Psychiatric Nurse (RPN)
- Registered Nurse (RN)
- Nurse Practitioner/Registered Nurse, Extended Class (Ontario [NP/RN(EC)])
- Need for clearer roles and addressing historical power structures that impact interprofessional and intraprofessional collaboration
Registered/Licensed Practical Nurses
- 29% of regulated nursing workforce in Ontario (rest of Canada is LPN)
- First established in late 1930s
- Manitoba first to require registration in 1946
- Education is a diploma
- In 2022, Ontario and BC will use a regulatory exam instead of the Canadian Practical Nurses Registration Exam (Quebec is an exception)
- Jurisprudence is required in Alberta, Manitoba, Ontario, NB, and NS
Registered Psychiatric Nurses
- Primarily in Manitoba, Saskatchewan, Alberta, BC, and Yukon
- Makes up 1.4% of regulated nursing workforce
- First established during WWII (early 1940s)
- Saskatchewan first required registration in 1948
- Education is a baccalaureate or diploma
- Registered Psychiatric Nurses of Canada examination is used (except in Yukon, where must go to another province)
- Jurisprudence is not required
Registered Nurse
- Found in all provinces and territories
- Makes up 68% of regulated nursing workforce
- Indigenous healers were the first nurses in Canada
- Manitoba first to require registration in 1913
- Education is a baccalaureate (Quebec also offers a diploma)
- NCLEX is used as the registration examination (except in Quebec)
- Jurisprudence is required in BC, Alberta, Ontario, NB, NS, and PEI
Nurse Practitioner/Registered Nurse, Extended Class
- Found in all provinces and territories
- Makes up 1.4% of regulated nursing workforce
- Expanded roles in the 1890s in northern/remote communities in Canada
- Ontario and BC were first to legislate nurse practitioners' authority and scope of practice in 1997
- Education is a Masters
- Registration examination is PHC, Paediatrics, and Adult (except Quebec)
- Jurisprudence required in Ontario and NS
Interprofessional Collaboration
- Socialization
- Clarification of roles
- Access to prevention, promotion, and management of health problems based on provider, time, place
- Patient safety
- Respecting different knowledge, skills, and perspectives
- Identifying appropriate interventions to meet patient needs
Intraprofessional vs Interprofessional
- Intraprofessional: nurses only
- Interprofessional: multiple health care providers across disciplines. (e.g., sociology, engineering, IT, law)
Practice Settings
- Hospitals
- Residential care facilities
- Rehabilitation centres
- Community care facilities
- Hospices
- Clinics, offices
- Primary care settings
- Home
Inpatient Hospitalization Rates (2010-2011 and 2017-2018)
- Data provided in a table by province/territory; this includes 7-year change percentage.
Imaging Technologies per Million Population (2017)
- Data in table format listing various imaging technologies per province/territory.
ICT Development Index (2010 & 2017)
- Data in table comparing Canada and other countries.
Trends in Healthcare Delivery
- In 2014, 4.5 million Canadians lacked a family physician.
- Regions are experimenting with different healthcare delivery models:
- Patient's Medical Home (PMH)
- Interprofessional collaboration
- Community-based care
Categories of Health Care Providers
- Conventional: Physicians, nurse practitioners, midwives, nurses, dentists, dental hygienists, dietitians, optometrists, psychologists
- Complementary and alternative: Indigenous healers, naturopathic doctors, massage therapists
Conventional Medicine
- Frequently referred to as orthodox, mainstream, traditional, or Western medicine.
- Practitioners diagnose health problems, and administer technical, therapeutic, or supportive care using scientifically proven therapies, medication, and surgery.
Alternative Medicine
- Critics believe treatments should be scientifically proven before use.
- Many Canadians use CAM (complementary and alternative medicine) for a variety of reasons, including: Disillusionment with conventional treatment, difficulty accessing appointments, cultural influences/beliefs, and readily available internet info.
Regulation of Health Care Professions
- Educational standards
- Provincial/territorial examinations
- Scope of practice
- Curbing practices when standards aren't met
- Formal public complaints process
- Complaints investigation and follow-up
- Title protection
- Competence and quality assurance
Performing Controlled Acts
- May cause harm to a patient if performed by an unqualified practitioner.
- Controlled acts are defined by the regulated health professions act in each jurisdiction.
- Examples: giving injections, setting or casting fractures, passing nasogastric tubes, and prescribing medication.
Exceptions to Controlled Acts
- Most provinces allow competent, unregulated individuals to perform controlled acts in specific circumstances:
- People with emergency assistance/training
- Students supervised by qualified professionals
- Individuals with specialized training (e.g., caregivers of individuals with diabetes)
- Religious practices
Delegated Acts
- Regulated health professional transfers legal authority for a controlled act.
- Procedures that are not controlled acts do not require delegation.
- Guidelines and protocols, clearly defined, and are essential across all provinces.
- Responsibility for delegated acts is shared by the delegating professional, delegate, facility, and environment.
Nonregulated Professions and Occupations
- Lack federal or provincial legislation.
- Professional organizations still award certification after completing written or practical exams.
Interprofessional Practice & Education
- Defined as occasions where professionals learn from and with each other, improving interprofessional collaboration and quality of care.
- Interprofessional health care using the term "professional" includes all professional learning in academic and work settings before and after qualification
Interprofessional Collaborative Practice: The Evidence
- Positive outcomes: patients/clients, providers, and systems when interprofessional collaboration supported. (e.g. weight loss with physician and clinical dieticians)
- Improved team effectiveness and lower wait times in many settings.
- Improving satisfaction and reducing ER use.
Interprofessional Collaborative Practice: The Evidence
Key messages to support interprofessional practice especially for management of chronic disease.
- Some evidence and support for interprofessional practice, including need to clarify definitions and understandings as well as education
- Need for competencies for all professions involved.
- Better evaluation and research needed.
Interprofessional Collaborative Practice & Education: Key Questions.
- Present status of interprofessional education
- Interprofessional education supports interprofessional practices
Next Week's Topics
- Chapter 5: Organizational Culture
- Practitioners and workplace settings.
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