Week 6 Professional Development The CNO Part 1 student PDF

Week 6 Professional Development I Module 6: The College of Nurses of Ontario (CNO) Part 1  Land Acknowledgement Mohawk College derives its name from the Mohawk Nation, one of the Six Nations of the Haudenosaunee Confederacy. The Confederacy marks a union of peace and friendship, and Mohawk Coll...

Week 6 Professional Development I Module 6: The College of Nurses of Ontario (CNO) Part 1  Land Acknowledgement Mohawk College derives its name from the Mohawk Nation, one of the Six Nations of the Haudenosaunee Confederacy. The Confederacy marks a union of peace and friendship, and Mohawk College honours that union by recognizing the Six Nations of the Grand River and the Mississauga’s of the Credit First Nation. We acknowledge that the territories on which Mohawk College and its campuses are situated are governed by the Between the Lakes Treaty, the Dish with One Spoon Wampum Agreement, and the Upper Canada Treaty Agreement. These agreements are binding to this day and represent our mutual commitment to maintain healthy, reciprocal and respectful relationships with the many Indigenous nations and peoples of this area. We acknowledge this and iterate our dedication to inclusivity, to friendship and to valuing the ongoing contributions of Indigenous peoples and communities. Agenda 01 02 03 The College of Housekeeping Learning Nurses of Outcomes Ontario 04 Scope of 05 06 Practice & ETP Coming Up Questions? Guidelines Learning Outcomes 1 2 Examine the purpose of the College Identify the regulatory requirements of Nurses of Ontario and legislation pertaining to nursing self-regulation 3 4 Analyze the scope of practice and Examine practice standards and controlled acts that nurses are able competency expectations set by the to perform College of Nurses of Ontario  0 Week 6 The College of Nurses of Ontario 3  The College of Nurses of Ontario Governing body for Registered Nurses (RNs), Registered Practical Nurses (RPNs), and Nurse Practitioners (NPs) in Ontario, Canada Nursing profession has been self-regulating since 1963 Self-regulation is a privilege granted to professions that have shown they can put the interests of the public ahead of their own professional interests CNO Recognizes that nurses have the knowledge and expertise to regulate themselves as individual practitioners and to regulate their profession through the College (CNO, 2023)  The College of Nurses of Ontario The College of Nurses of Ontario (the College) is the regulatory body for the province’s approximately 150,000 nurses. Works to protect the public interest by setting entry-to-practice requirements, developing and enforcing standards of practice and providing programs to help nurses maintain competence throughout their careers. The College is not a school and is not involved in students’ admittance to nursing education programs. Upon completion of their nursing program, students apply to the College for membership, which is required of anyone who wants to practise nursing in Ontario. (CNO, 2012) The College of Nurses of Ontario The College fulfils its role by: ○ Establishing requirements for entry to practice ○ Articulating and promoting practice standards ○ Administering its Quality Assurance Program ○ Enforcing standards of practice and conduct (CNO, 2023) The College of Nurses of Ontario Establishing Requirements for Entry to Practice All RNs, RPNs, and NPs who are practicing in Ontario are members of the CNO Only members of the CNO are allowed to refer to themselves as nurses Require a valid certificate of registration from CNO to practice nursing and perform the procedures in the Controlled Acts that are authorized to nursing (CNO, 2023) The College of Nurses of Ontario Articulating & Promoting Practice Standards CNO has created a set of practice standards and guidelines that apply to all nurses regardless of their role, job description, or area of practice Some documents to support nurses apply practice standards are: ○ Standards & Guidelines ○ Practice Support &FAQs ○ Scope of Practice & Proposed Changes ○ CNO Documents (CNO, 2023) The College of Nurses of Ontario Administering Quality Assurance (QA) Program QA program assures the public nurses’ commitment to continuing competence by continually improving their nursing practice Being self-reflective and committed to life-long learning is a critical part of providing the safest and highest quality care to patients All nurses engage in daily practice reflection and participate in QA activities throughout their career All nurses are accountable to reflect on practice to determine learning needs Nurses are responsible to develop a Learning Plan to update their knowledge (CNO, 2023) The College of Nurses of Ontario Enforcing Standards of Practice & Conduct Patient safety is a collective responsibility, CNO shares responsibility for keeping patients safe Patients and their family members can make a complaint Employers or those who work with nurses can file a report The public has access to a nurse’s working status, as well as any discipline hearings and decisions (CNO, 2023) The College of Nurses of Ontario The College supports regulation of nursing in the public interest by: ○ Participating in the legislative process ○ Sharing statistical information about Ontario’s nurses (CNO, 2023) The College of Nurses of Ontario Participating in the Legislative Process CNO develops and implements policies and changes to its nursing legislation with the goal of protecting the public interest through the regulation of nursing practice Policy development involves identifying trends or issues that may have n impact on nursing regulation CNO creates policies which turn into College by-laws with support from; ○ Government Legislation ○ Direction from Council ○ Various external factors (CNO, 2023) The College of Nurses of Ontario Participating in the Legislative Process By-Laws: ○ The College by-laws are the rules that govern how the College operates. Government legislation authorizes Council to make by-laws related to the College’s governance, administration and regulatory functions Legislation Governing Nursing: ○ The Nursing Act, 1991 and the Regulated Health Professions Act, 1991 determine how the nursing profession is regulated in Ontario (CNO, 2023) The College of Nurses of Ontario Sharing statistical information about Ontario’s nurses CNO has the most comprehensive information on nurses in the province ○ Nursing Data Dashboard ○ Registrant Statistics ○ Applicant Statistics ○ Latest Reports ○ Mailing Address & Data Services (CNO, 2023) CNO Fact Sheet Skills & Responsibilities Document intended to provide information for prospective nursing students, guidance counselors, educational institutions, and nursing programs Highlights general demands and performance expectations of nurses in Ontario At the completion of their nursing educational program all student nurses must demonstrate the capacity to meet the College of Nurses of Ontario’s (CNO) Entry-to-Practice Competencies for Ontario Registered Practical Nurses (CNO, 2012) CNO Fact Sheet Skills & Responsibilities Meeting ETP competencies require skills and abilities 7 categories have been identified as capturing components necessary for practice 1. Cognitive 2. Communication 3. Interpersonal 4. Behavioural 5. Psycho-motor 6. Sensory (CNO, 2012) 7. Environmental CNO Fact Sheet Skills & Responsibilities 1. Cognitive Requirements: Ability to perform skills that demonstrate thinking capacity ○ Remember information from past experiences ○ Demonstrate problem-solving skills ○ Demonstrate concentration skills ○ Apply arithmetic skills and ability to add, subtract, multiply, and divide (CNO, 2012) CNO Fact Sheet Skills & Responsibilities 2. Communication Requirements Ability to express and receive written, verbal and/or non-verbal language and the ability to interact with others in a respectful and professional manner ○ Speak, read, listen and write in English and/or French at a level that provides safe and accurate understanding of words and meanings ○ Recognize own non-verbal signals and interpret those received from others ○ Elicit and respond to information from clients, colleagues, and others (CNO, 2012) CNO Fact Sheet Skills & Responsibilities 3. Interpersonal Requirements Ability to create good relationships between oneself and other people ○ Develop professional relationships and support other people ○ Recognize the importance of maintaining interpersonal boundaries ○ Recognize the needs of clients and colleagues (CNO, 2012) CNO Fact Sheet Skills & Responsibilities 4. Behavioural Requirements Ability to conduct oneself in a professional manner ○ Manage own behaviour well enough to provide safe, competent and ethical care ○ Respond appropriately in situations that are stressful or involve conflict ○ React appropriately appropriately to giving and receiving physical touch ○ Fulfill responsibility as part of a team ○ Manage time appropriately (CNO, 2012) CNO Fact Sheet Skills & Responsibilities 5. Psycho-motor Requirements Ability to perform each of the following requisites well enough to provide client care and participate in education activities ○ Stand and maintain balance ○ Manual dexterity ○ Move with limited space ○ Perform repetitive movements ○ Carry objects ○ Walk, climb, bend, and reach (CNO, 2012) CNO Fact Sheet Skills & Responsibilities 6. Sensory Requirements Ability to utilize each of the following senses well enough to provide care and participate in educational activities ○ Sight ○ Hearing ○ Touch ○ Smell (CNO, 2012) CNO Fact Sheet Skills & Responsibilities 7. Environmental Requirements Ability to function in the presence of each of the following commonly encountered and unavoidable environmental factors ○ Noxious smells ○ Disease agents ○ Distractions ○ Noise ○ Chemicals ○ Unpredictable behaviour of others (CNO, 2012) CNO Fact Sheet Skills & Responsibilities Anyone considering a career in nursing should review the Requisite Skills and Abilities (RSA) Should there be any reservations about the ability to meet the RSA the individual should engage in discussions as early as possible with their academic institution (CNO, 2012)  0 Week 6 Scope of Practice & Entry to Practice 4 Competencies Standards & Guidelines CNO provides practice standards and guidelines to support nurses in providing safe and ethical nursing care Practice Standards: Outline expectations for nurses that contribute to public protection Inform nurses of their accountabilities and the public of what to expect of nurses Apply to all nurses regardless of their roles, job description or area of practice Practice Guidelines: Address specific practice-related issues Help nurses understand their responsibilities and how to make safe, ethical decisions (CNO, 2023) Practice Standards 1. Code of Conduct 2. Scope of Practice 3. Confidentiality & Privacy: Personal Health Information 4. Documentation 5. Medication 6. Nurse Practitioner 7. Therapeutic Nurse-Client Relationship (CNO, 2023) Practice Guidelines Practice guidelines address specific practice-related issues, help nurses understand their responsibilities and how to make safe and ethical decisions in their practice 1. Consent 2. Conflict Management & Prevention 3. Guidance on Nurses’ Roles in Medical Assistance in Dying 4. Pandemic Planning 5. Independent Planning 6. Directives 7. Telepractice 8. Working with Unregulated Care Providers (CNO, 2023) Entry to Practice Competencies Entry-to-practice competencies are the foundation for nursing practice The ETP document outlines the competencies measured for Registered Practical Nurses (RPNs) upon initial registration with CNO and entry to practice in Ontario The competencies also guide the assessment of nurses’ continuing competence for maintaining registration with CNO The document is a guide to entry-level practice expectations for RPNs in Ontario and includes a glossary of terms and references to help readers understand and interpret the document. (CNO, 2019) Entry to Practice Competencies Competency framework: The 79 entry-level competencies are organized in five categories: 1. Professional Practice 2. Legal Practice 3. Ethical Practice 4. Foundations of Practice 5. Collaborative Practice (CNO, 2019) Entry to Practice Competencies Competency Statements: Professional Practice “Registered Practical Nurses (RPNs) adhere to practice standards. They are responsible and accountable for safe, competent and ethical nursing practice. They are expected to demonstrate professional conduct as reflected through personal attitudes, beliefs, opinions and actions. RPNs focus on personal and professional growth. RPNs are expected to use knowledge, critical thinking, critical inquiry and research to build an evidence- informed practice” (Covers ETP 1-19) (CNO, 2019) Entry to Practice Competencies Competency Statements: Ethical Practice “RPNs use ethical frameworks (e.g. Code of Ethics, ethical standards) when making professional judgments and practice decisions. They engage in critical thinking and critical inquiry to inform decision-making and use self-reflection to understand the impact of personal values, beliefs and assumptions in the provision of care” (Covers ETP 20 – 28) (CNO, 2019) Entry to Practice Competencies Competency Statements: Legal Practice “RPNs adhere to applicable provincial/territorial and federal legislation and regulations, professional standards and employer policies that direct practice. They engage in professional regulation by enhancing their competence, promoting safe practice and maintaining their fitness to practise. RPNs recognize that safe nursing practice includes knowledge of relevant laws and legal boundaries within which RPNs must practise” (Covers ETP 29 – 36) (CNO, 2019) Entry to Practice Competencies Competency Statements: Foundations of Practice “RPNs use critical thinking, reflection and evidence integration to assess clients, plan care, implement interventions, and evaluate outcomes and processes. Foundational knowledge includes nursing theory, health sciences, humanities, pharmacology and ethics” (Covers ETP 37 – 62) (CNO, 2019) Entry to Practice Competencies Competency Statements: Collaborative Practice “RPNs work collaboratively with clients and other members of the health care team. They recognize that collaborative practice is guided by shared values and accountability, a common purpose or care outcome, mutual respect, and effective communication” (Covers ETP 63 – 79) (CNO, 2019) CNO & Scope of Practice Practice standard outlines the legislated scope of nursing practice and other key requirements for nurses when deciding whether to perform an activity for safe client care Scope of practice refers to a range of activities that nurses’ have the legislated authority to perform. Authority is defined in legislation, namely the Nursing Act, 1991 and the Regulated Health Professions Act, 1991 (RHPA). Employer policies and practice setting requirements, as well as the individual nurse’s competence, also impact nurses’ decisions and accountability related to scope of practice Standard outlines the expectations for all nurses when determining if they have the authority to perform a specific activity, if it is appropriate for them to perform and if they are competent to safely perform the activity (CNO, 2023) CNO & Scope of Practice To meet the expectations of this standard, a nurse must consider each of the following key concepts Authority: Nurses must know their legislated scope of practice, including controlled acts, and authorizing mechanisms. Context: Nurses must determine if their practice environment or setting supports the performance of an activity and has the available resources to support safe client care. Competence: Nurses must ensure they have the individual knowledge, skill and judgment to perform an activity. (CNO, 2023) CNO & Scope of Practice Proposed Changes for Registered Practical Nurse: The Ministry of Health has approved changes under the Nursing Act, 1991 that allow RPNs the authority to independently initiate the following controlled acts: Irrigating, probing, debriding and packing of a wound below the dermis or below a mucous membrane Venipuncture to establish peripheral intravenous access and maintain patency, in certain circumstances Putting an instrument, hand or finger beyond the individual’s labia majora for the purpose of assessing or assisting with health management activities Putting an instrument or finger beyond an artificial opening into the client’s body for the purpose of assessing or assisting with health management activities RPNs with relevant competence can currently perform these activities if they have an order. (CNO, 2023) References Astle, Duggleby, Potter, Perry, Stockert & Hall. (2023). Potter and Perry's Canadian Fundamentals of Nursing (7th edition). Toronto: Elsevier Canada College of Nurses of Ontario. (2012). Fact Sheet: Requisite skills and abilities for nursing practice in Ontario. Retrieved from https://www.cno.org/globalassets/docs/reg/41078- skillabilities- 4pager-final.pdf College of Nurses of Ontario. (2018). Introduction to the Nursing Act, 1991. Retrieved from http://www.cno.org/globalassets/docs/prac/41064_fsnursingact.pdf College of Nurses of Ontario. (2018). RHPA: Scope of Practice, Controlled Acts Model. Retrieved from https://www.cno.org/globalassets/docs/policy/41052_rhpascope.pdf College of Nurses of Ontario. (2018). RN and RPN practice: The client, the nurse, and the environment. https://www.cno.org/globalassets/docs/prac/41062.pdf References College of Nurses of Ontario. (2020). What is CNO. Retrieved from http://www.cno.org/en/what-is-cno/ College of Nurses of Ontario. (2022). Practice Standard: Professional Standards, Revised 2002. https://www.cno.org/globalassets/docs/prac/41006_profstds.pdf College of Nurses of Ontario. (2022). Scope of practice: proposed changes. Retrieved from https://www.cno.org/en/learn-about-standards-guidelines/scope-of- practice-- proposed-changes/ College of Nurses of Ontario. (2022). FAQs: Expanding RPN scope of practice. Retrieved from https://www.cno.org/en/learn-about-standards-guidelines/scope-of- practice-- proposed-changes/faqs-expanding-rpn-sop/ Coming up… Ensure you have completed 1 hour of asynchronous work for Module 6 Midterm exam – Friday March 8th 0930-1130 Room 301/366 IAHS campus, in person Prepare for Module 7 (Week 7) ○ Review module objectives ○ Begin required readings and activities and come prepared to engage in lecture