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May 24, 2009
Discipline & Regulation• Aug 29, 2007 CNO Press Release
– CNO will regulate 4 NP specialties…NP(A)• Scope of Practice, RN(EC)
– 3 controlled acts within RN scope + 4 additional controlled acts
– Self-regulating– Authorizing mechanisms (directives)
• PHA (reg 965) – NPs in ambulatory to full scope….does not apply to in-patients
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May 24, 2009
CNPI Core Competency Framework
• Canadian Nurse Practitioners (Jan 2005)• Health Assessment & Diagnosis• Health-Care Management & therapeutic
Intervention• Health Promotion & Prevention of Illness, Injury &
Complications• Professional Role & Responsibilities
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May 24, 2009
APN National Framework (CNA ’08)
• Minimum education = graduate degree in nursing
• Roles focus on clinical practice• Competencies
– Clinical, research, leadership– Consultation & collaboration
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May 24, 2009
Clinical Activities…
• Start with patient & program needs– Patient flow, patient safety, QI
• Identify gaps– Patient satisfaction, best practices
• Build on strengths of teams– Maximize expertise & experience– Accept overlap and distinct focus
• Identify evaluation measures
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May 24, 2009
Collaborative Practice
• Dynamic process & outcome • Shared interest • Involves synthesis of different
perspectives to understand complexity• Develops integrative solutions• More that the sum of the parts
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May 24, 2009
10 Lessons in Collaboration
• Know thyself• Manage diversity• Conflict resolution• Win-win solutions• Master interpersonal & process skills• It’s a journey
• Shared decision making• Structure & spontaneous• Balance autonomy & unity• Not for all decisions
(D. Gardner, 2009)
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May 24, 2009
Innovation = Our future
• 1988 – 1NNP….2009 74NPs• “not sure where this will land exactly…
but…we’re willing and possibilities will emerge”
• “we have to work together…new systems…new models…new ways”
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May 24, 2009
Progress• Regulations exist• Commitment to teams and new models• Advisory Group, Courses launched,
Students engaged• Preceptors poised• Organizations willing• 1st graduates December ’09• Next cohort….
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May 24, 2009
Nurses in Anesthesia Care Around the World
• 106 Countries• Role varies• Title varies• Regulations vary
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May 24, 2009
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May 24, 2009
NPs on the Anesthesia Care Team
FIRST IN CANADAMay 24, 2009