crpnbc scope of practice update education day 2015
TRANSCRIPT
CRPNBC Scope of Practice Update
Education Day 2015
Agenda Poll Q&As applying the following
concepts: Scope of Practice and Regulation Controls on RPN practice CRPNBC Standards, Limits and
Conditions SOP education
SOP Poll question #1
On a scale of 1-10 (0 being nothing and 10 being almost everything), how much do you know about RPN scope of
practice?
a. 0-2b. 3-5c. 6-8d. 9-10
SOP Poll question #2
Identify the first level of control on RPN Scope of Practice:
a. The Health Professions Act (HPA)b. The HPA and Nurses (Registered Psychiatric)
Regulationc. CRPNBC Standards, Limits and Conditionsd. Employer Policies
RPN Scope of Practice
Health Professions Act (Umbrella)
Health Professions Act (1996)
LPN Regulation
OT Regulation
Pharmacy Regulation
PT Regulation
RN & NP Regulation
RPN Regulation
(2008)
SOP Poll question #3
Complete the sentence. RPN Scope of Practice (SOP), based on the proposed 2015 SOP statement:
a. Does not overlap with other health professionalsb. Are activities that RPNs are educated and
authorized to performc. Includes only restricted activitiesd. Includes restricted activities that all RPNs must be
competent to perform in order to be registered as an RPN
e. Includes all of the above
Level 1 – HPA and Regulation
Scope of practice of regulated professions may overlap, or be shared, with other regulated professions
Supports interprofessional practice, consumer choice, and maintains patient safety and public protection
Level 1: Proposed Nurses (Registered Psychiatric) Regulation
Reserved titles Registered psychiatric nurse Psychiatric nurse Nurse
Scope of practice Restricted activities
Proposed Nurses (Registered Psychiatric) Regulation:http://www2.gov.bc.ca/assets/gov/health/practitioner-pro/professional-regulation/redline_proposed-new-rpn-reg-march-23-2015.pdf
Proposed Scope of Practice Statement
Psychiatric nursing is the profession in which a person provides:a) Health care for the promotion, maintenance, and restoration
of health, with a focus on psychosocial, mental or emotional health;
b) Prevention, treatment and palliation of illness and injury, with a focus on psychosocial, mental or emotional disorders or conditions and associated or comorbid physiological conditions, byi) Assessing health statusii) Planning, implementing and evaluating interventions,
and iii) Coordinating health services
SOP Poll question #4
The 2015 Proposed Nurses (Registered Psychiatric) Regulation:
15
a. Authorizes RPNs to prescribe some Schedule I and II medications
b. Authorizes RPNs to perform Section 8 Certified Practice
c. Is presently in effectd. Authorizes RPNs to order a chest x-
ray for the purpose of TB screeninge. a, df. a, c, d
a. b. c. d. e. f.
0% 0% 0%0%0%0%
Nurses (Registered Psychiatric) Regulation
Restricted Activities
• List of invasive, higher risk activities • performed by members of a regulated
profession – that has been granted specific authority to do
so in their regulations
– based on their education and competence.
RPN Scope of Practice
Self- Regulation and Protecting the Public
Level 2: Self-Regulation
CRPNBC has the authority, under the Health Professions Act, to:
Determine which activities are considered the practice of psychiatric nursing within the scope of practice set out in the Regulation.
Establish, monitor and enforce any standards, limits and conditions (SLC) that apply to RPN practice.
SOP Poll question #5
CRPNBC has the authority under the HPA to establish, monitor and enforce any Standards, Limits and Conditions (SLC) that apply to RPN practice. Choose the most accurate statement below:
15
a. A standard is the achievable level of performance against which the highest standard in practice is compared.
b. A limit is what an RPN can do with additional education.
c. A condition is the circumstance under which RPNs may carry out an activity; education, competencies, decision support tools.
d. None of the abovee. All of the above
a. b. c. d. e.
0% 0% 0%0%0%
CRPNBC Standards, Limits and Conditions
Standard: A desired and achievable level of performance against which actual performance can be compared. It provides a benchmark below which performance is unacceptable.
Practice Standards Professional Standards Scope of Practice Standards
CRPNBC Standards, Limits and Conditions
Limit: specifies what an RPN is not permitted to do related to a nursing activity.
Condition: the circumstances under which RPNs may carry out an activity. There are three types of conditions; education, competencies, and decision support tools.
Limits and conditions often focus on: Autonomous practice Areas beyond entry to practice competencies
CRPNBC Limits and Conditions
https://www.crpnbc.ca/nursing-standards/
SOP Poll question #6
Which of the following CRPNBC Practice standards best informs RPNs on activities related to Section 6 of the Proposed Nurses (Registered Psychiatric) Regulation?
15
a. Consentb. Documentationc. Duty to Reportd. Acting Without an Ordere. None of the above
a. b. c. d. e.
0% 0% 0%0%0%
CRPNBC Practice Standards
Acting with an Order Acting without an Order Appropriate Use of Title Boundaries in Nurse-Client Relationships Consent
CRPNBC Practice Standards
Dispensing Medication Documentation Duty to report under the HPA Medication Administration Privacy and Confidentiality
Acting With an Order
Ensure order is Client specific Given by authorized HP
Ensure activity is: Within SOP (Regulation) Congruent with CRPNBC Limits and
Conditions Consistent with employer policy
Acting With an Order (cont.)
Have competence to
carry out the activity safely and ethically manage the intended outcomes recognize and implement the plan related to
unintended outcomes
Take appropriate action if the order is not evidence-based
Obtain client consent
Practice Standard found at http://www.crpnbc.ca/wp-content/uploads/2014/04/acting-with-an-order.pdf
Acting Without an OrderActing With an Order plus:
Accept sole accountability. Assess client status and make a psychiatric
nursing diagnosis Interpret and use current evidence
Have competence to determine client’s condition warrants the activity by considering:
Known risks and benefits Predictability of outcomes Other factors specific to situation
Have competence to Manage outcomes
Practice Standard found at http://www.crpnbc.ca/wp-content/uploads/2014/04/acting-without-an-order.pdf
RPN Scope of Practice
SOP Poll question #7
As per the controls on RPN practice, if an activity is permitted by the Nurses (Registered Psychiatric) Regulation and CRPNBC, RPNs are authorized to perform that activity in the workplace setting.
15
a. Trueb. False
a. b.
0%0%
SOP Poll question #8
Employer policies can increase the scope of practice of an RPN.
15
a. Trueb. False
a. b.
0%0%
Level 3 - Employer Policies
Employers develops policies to guide their workforce. This may include:
If and in what setting a service is provided Who carries out a service and how
Employer policies may place further restrictions on a health professionals practice.
Employer policies can never increase the scope of practice of a health professional.
RPN Scope of Practice
SOP Poll question #9
Which of the following scenarios describes an RPN that is competent to carry out venipuncture?
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a. An RPN who has completed additional education and performed venipuncture over 10 years ago
b. An RPN who has recently attended the required additional education but has not yet carried out the activity
c. An RPN who feels competent with the technical skill, but not with the ability to manage unintended outcomes in their present work setting
d. All of the abovee. None of the above
a. b. c. d. e.
0% 0% 0%0%0%
Level 4 - Individual Competence
The integration and application of
Knowledge Skills Attitudes Judgment
That are required to perform nursing activities
Safely Ethically Appropriately
SOP Poll question #10
There will be a number of webinars and in-person education sessions that will be offered when the Proposed Nurses (Registered Psychiatric) Regulation comes into effect. What is your preferred method of receiving education related to scope of practice?
15
a. Webinarsb. In-person education in the
workplace settingc. On-line modulesd. Receiving reading material or
information via emaile. You prefer not to receive formal
education regarding scope of practice
a. b. c. d. e.
0% 0% 0%0%0%
SOP Poll question #11
If offered at different times and days, how likely are you to participate in a one-hour scope of practice webinar? Please rate on a scale of 1-10 (0-will not attend and 10-will definitely attend)
15
a. 0-2b. 3-5c. 6-8d. 9-10
a. b. c. d.
0% 0%0%0%
SOP Poll question #12 (A-C)
Please rate on a scale of 1-10 (0 being not interested and 10 being very interested) how much you would like to receive education on Understanding and Applying the Proposed Nurses (Registered Psychiatric) Regulation:
a. 0-2b. 3-5c. 6-8d. 9-10
a. b. c. d.
3%
51%
35%
11%
Please rate on a scale of 1-10 (0 being not interested and 10 being very interested) how much you would like to receive education on Overview of CRPNBC Standards, Limits and Conditions:
a. 0-2b. 3-5c. 6-8d. 9-10
a. b. c. d.
1%
54%
36%
8%
Please rate on a scale of 1-10 (0 being not interested and 10 being very interested) how much you would like to receive education on Specific CRPNBC Limits and Conditions Related to Restricted Activities (e.g. venipuncture, wound care, etc):
a. 0-2b. 3-5c. 6-8d. 9-10
a. b. c. d.
1%
68%
26%
5%
SOP Poll question #13 (A-G)
e.g. d,e,a,b,c,g,f
In the scope of practice education sessions, we are considering utilizing a variety of practice scenarios that RPNs can apply to the proposed Nurses (Registered Psychiatric) Regulation (when in effect) and CRPNBC Standards, Limits and Conditions. Choose in order of preference, which scenario topics you would like to see included:
a. Performing venipunctureb. Using restraint and seclusionc. Administering, compounding and dispensing
specific Schedule I drugs, without an order for the purpose of treating anaphylaxis, opiate overdose, respiratory distress and hypoglycemia
d. Ordering a chest x-ray for the purpose of TB screening
e. Administering, compounding and dispensing immunizations and chemoprophylactic agents, without an order
f. Performing wound careg. Another practice scenario topic that is not listed
here
a. b. c. d. e. f. g.
12%
17%
19%
10%
14%14%14%
Questions
Colleen Calderwood Practice Manager [email protected]
604.931.5200
Gail AncillPractice [email protected]
Resources
Province of British Columbia, Ministry of Health, Professional Regulation. 2015 http://www2.gov.bc.ca/assets/gov/health/practitioner-pro/professional-regulation/redline_proposed-new-rpn-reg-march-23-2015.pdf
CRPNBC website
http://www.crpnbc.ca/
References
Province of British Columbia, Ministry of Health, Professional Regulation. 2015 http://www2.gov.bc.ca/assets/gov/health/practitioner-pro/professional-regulation/redline_proposed-new-rpn-reg-march-23-2015.pdf
Health Professions Act [RSBC 1996] Chapter 183. http://www.bclaws.ca/EPLibraries/bclaws_new/document/ID/freeside/00_96183_01