Nursing Legislation and Standards (NURS 72050)

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Questions and Answers

What is the primary purpose of defining controlled acts in nursing practice?

To provide a framework for financial compensation

To establish a hierarchy among healthcare professionals

To limit the number of nurses in practice

To outline the specific nursing activities that require specialized knowledge (correct)

What is a requirement for a nurse when delegating controlled acts?

The delegate must have at least 5 years of experience before accepting any task

The nurse does not need to supervise the delegate once instructions are given

The delegate must have undergone the same education as the nurse

The nurse must ensure the delegate has appropriate knowledge, skills, and judgment (correct)

Which of the following statements represents an element that should be included in the documentation of delegation?

The specific instructions given to the delegate (correct)

A history of the delegate's past tasks

The nurse's qualifications and certifications

The delegate's personal opinion on the task

In the context of nurse supervision during delegation, which action is essential?

Offering consistent support and monitoring throughout the task Signup and view all the answers

What is meant by the delegation process in nursing?

The assignment of responsibilities from one professional to another along with oversight Signup and view all the answers

What distinguishes the practice of nursing from other healthcare professions?

Nursing has its own scope of practice and controlled acts Signup and view all the answers

Which of the following is true regarding members who have had their nursing certificate revoked?

They cannot use the title 'nurse' or practice nursing Signup and view all the answers

What constitutes professional misconduct in the context of nursing practice?

Continuing to practice nursing while under suspension Signup and view all the answers

Which of the following actions by Sarah represents a violation of the CNO standards on medication administration?

Administering medication without checking for allergies Signup and view all the answers

What was an ethical issue presented in Sarah's interactions with John?

Inappropriate disclosure of personal struggles to a patient Signup and view all the answers

In terms of delegation requirements, what must a nurse ensure before delegating a controlled act?

The delegatee is competent to perform the task Signup and view all the answers

What must be documented in the patient's chart when a nurse delegates a controlled act?

The date, time, controlled act, and delegate's name Signup and view all the answers

Which of the following best describes the documentation required during the delegation process?

The task must be noted in the patient's chart Signup and view all the answers

What is a primary responsibility of a nurse in the context of delegation supervision?

To ensure the task is carried out according to standards Signup and view all the answers

Which of the following is NOT a requirement for the delegation of controlled acts?

The RN must be present during the administration of the act Signup and view all the answers

What does the CNO regulate regarding nursing practice?

The entering of the profession and ensuring safe care Signup and view all the answers

Which aspect of interprofessional communication is critical for effective team collaboration?

Affinity among team members Signup and view all the answers

When a registered nurse (RN) decides to delegate medications to another nurse, what is a critical step in the process?

Verify that the delegate is competent to administer those medications Signup and view all the answers

How should a nurse act to promote client-centered interprofessional collaborative practice?

Involving clients in decision-making processes Signup and view all the answers

What does the new standard for discontinuing or declining care address?

The process of documentation when care is declined Signup and view all the answers

What should a nurse do if they observe that a team member is not valuing contributions made by others?

Address the behavior directly with the individual Signup and view all the answers

In the context of delegation, what is meant by 'supervision requirements'?

The RN is responsible for ensuring that the delegated act is done correctly without direct supervision Signup and view all the answers

Which factor does NOT affect the decision to delegate a controlled act?

The personal relationship between the RN and the delegate Signup and view all the answers

Why is it critical for the RN to document the delegation of controlled acts?

To provide evidence of compliance for regulatory bodies Signup and view all the answers

Study Notes

Scopes and Standards (NURS 72050)

Course agenda items include Nursing Legislation, Regulatory Bodies, Enforcement/Complaints, Discipline, Interprofessional Practice, and Group Assignment.
Canadian nursing legislation is specific to each province/territory.
Nursing Regulatory Bodies have a duty to protect public interest.
Oversight includes categories of nurses, education, and entry into the profession, scope of practice, standards of practice, complaint and reporting processes, and disciplinary processes.
Legislation and regulation govern the use of the title "nurse".
Students are asked to choose at least 4 provinces/territories and examine the nursing practice legislation and registration requirements for each.

Legislative Process

Nursing is self-regulating.
Nursing Regulatory Bodies are responsible for overseeing practice, education, and standards of behaviour.
Legislation defines scope of practice and nursing categories.
Legislation holds regulatory bodies accountable for standards and practice.
Legal processes include complaint and reporting, and disciplinary processes.

Typical Organizational Structure

Regulatory bodies have a board of directors/council, CEO/executive director/registrar.
These bodies oversee professional conduct (complaints, fitness to practice, discipline, and hearings).
Professional practice and quality, entry to registration and practice, practice and education, and quality assurance are also managed.

Using the Nursing Title

Provinces/territories restrict the use of nursing titles and practice.
Nurses in good standing, or retired, suspended or revoked certificate holders can use the title.
Continuing practice while under suspension is considered professional misconduct.
RN is the common title.

Scope of Practice

A framework outlines nursing practice.
Clear distinction between nursing and other health professions.
Aids in interpreting professional responsibilities.
Establishes standards for misconduct findings.
Defines controlled acts.

Controlled Acts

Specific medical actions and procedures are defined by law in most provinces/territories.
Individuals and those who may delegate them.
Exemptions allow non-regulated individuals to assist people with routine activities or spiritual means.

Delegating Controlled Acts

Controlled Acts require specialized training, skills, and judgment.
Ontario's controlled acts include medications, invasive procedures, and specific health assessments.
Delegation is transferring task responsibility from one professional to another.
CNO Standards set regulations for delegating controlled acts.
This helps maintain patient safety and public trust.

Essential Requirements for Delegating Acts

Competence: The delegate must have the necessary skills, knowledge, and judgment.
Supervision: Proper supervision and guidance are required to understand risks and responsibilities.
Communication: Clear instructions, dosage, route, and potential side effects must be communicated.
Documentation: Delegation must be documented in patient charts with date, time, controlled act, and delegate's name.

Critical Thinking (Case Study)

A registered nurse (RN) is assigned to a patient requiring multiple medications (including controlled substances) via central line.
High patient to nurse ratio causing overwhelm.
RN chooses to delegate to a practical nurse (RPN).
Students must analyse if delegation requirements were met.

Mandate of Regulatory Bodies

Regulatory bodies oversee the entry of candidates into nursing.
They ensure candidates possess necessary knowledge and competencies for safe and effective care.
Regulatory bodies approve education programs and set practice standards.
They conduct background checks.

Practice Support

Groups review links related to CNO's approach to supporting changes in nursing practice.
This includes prescribing and new practice standards for discontinuing/declining care.
Resources from CNA are available.
Students are prepared to share their learnings.

Practice Standards

Established by Canadian regulatory bodies.
Reflect nursing philosophy and ethical codes.
Relevant to malpractice and negligence.
Criteria for judging a nurse's conduct in legal or disciplinary proceedings is outlined. Evidence of care is required.

Continued Competence

Nursing regulatory bodies ensure ongoing nurse competence.
Examples include reflective practice, peer reviews, quality assurance programs, minimum practice hours, and personal practice reviews.

Enforcement

Disciplinary proceedings are not criminal proceedings.
Nursing regulatory bodies govern disciplinary actions.
Ensures nurses' conduct adheres to ethical codes/regulations.

Enforcement: Addressing Complaints

Complaints procedures: submission of complaint, interim investigation, full investigation, and disciplinary committee hearings.

Complaints

Complaints, in written form and signed/dated, must name the professional, outline misconduct facts.
Complaints may be filed by several parties.

Managing Complaints

Students examine CNO process for complaints.

Investigations

Members notified immediately of investigation.
Must submit documents/information.
Legal duty to cooperate with investigation.
Immediate lawyer consultation recommended.
Investigations may lead to committees/hearings.
Patient safety/security allegations may lead to immediate suspension.

Disciplinary Committee

After investigation, the committee can find the nurse innocent of wrongdoing, potentially incapacitated, incompetent/lacking skill, guilty of misconduct, or impaired by drugs.

Penalties and Appeals

Penalties: reprimand, conditions on practice, suspension, licence revocation.
Appeals: possible depending on province. This could involve a provincial court.
Penalties/appeals are usually decided by relevant boards/committees.

Discipline

Students review CNO Summarized Decisions to understand the code of conduct and professional practice standards

Class Tribunal

Groups 1,3,5,7 lead in disciplinary decision-making.
Tribunal examines standards/code of conduct violation.

Case Study 1

RN (Sarah) gives medication to patient (John) with known allergy.
Patient experiences anaphylaxis.
Students analyze if delegation requirements were met.

Case Study 2

RN (Sarah) discloses personal issues to a patient (John who is convalescing from a stroke).
Patient reciprocates with offers of friendship/support.
Students evaluate how this interaction might impact professional practice standards.

Interprofessional Practice

Nurses understand their roles within interprofessional teams and client-centered care.
Collaboration is teamwork by healthcare providers.
Partnership, participation, coordination, and shared decision-making are part of Interprofessional collaborative practice.

Interprofessional Communication

Four key aspects include affinity (valuing contributions), immediacy (attention to message), respect (competent member value), and control (limiting persuasive power).

Interprofessional Collaboration

Role clarification (generic, focal, functional roles), team functioning (norms, interdependencies, shared responsibilities, and goals), and collaborative leadership (teamwork including clients and family; shared judgment) are essential components.

Interprofessional team Case Analysis

Review case health history.
Identify appropriate healthcare providers for involvement.
Assess each professional's priority.
Identify opportunities for interprofessional collaboration.

Group Assignment

Students select real-world cases with ethical dilemmas.
Cases can be from experience or a reputable source.
Ensure case approval with faculty.

Plan for Next Week

The next week focuses on ethical considerations and the group assignments.

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Description

This quiz explores the key elements of nursing legislation and regulatory standards across Canadian provinces and territories. Students will examine the enforcement, complaint processes, and the role of nursing regulatory bodies in protecting public interest. Engage with the specifics of scope of practice, professional categories, and entry requirements in nursing.