PAN B test 1 - Lecture notes 1-7 PDF

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PAN B test 1Week 1 college of nurses of OntarioRegulatory Bodies A regulatory body is a public authority or government agency responsible for exercising autonomous authority over some area of human activity in a regulatory or supervisory capacity.  This is the CNOLegislation and Regulation for Nur...

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PAN B test 1

Week 1 college of nurses of Ontario Regulatory Bodies 



A regulatory body is a public authority or government agency responsible for exercising autonomous authority over some area of human activity in a regulatory or supervisory capacity. This is the CNO

Legislation and Regulation for Nursing • • • • • •

Legislation is: Regulated Health Professions Act (RHPA) 1991 Nursing Act 1991 (guide the regulatory body) Regulatory body: CNO 1963  1 profession with 2 categories: • RPN • RN - includes NP/RN(EC)

The Regulated Health Professions Act  

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Every profession under the act has a scope of practice statement and a list of controlled acts that the practitioner can perform. The scope of practice: is not protected in the sense that it does not prevent others from performing the same activities. Rather, it acknowledges the overlapping scope of practice of the health professions. Controlled Acts: activities that are considered to be potentially harmful if performed by unqualified persons. They are not authorized to nursing by the legislation, but which may be performed by a nurse when the procedure has been delegated by a person who is authorized by legislation to perform it. Delegation: the formal process by which a regulated health professional, who is authorized and competent to perform a procedure under one of the controlled acts, delegates the performance of that procedure to someone, regulated or unregulated, who is not authorized by legislation to perform it. Sometimes nurses are delegated to

perform acts that normally are performed by a physician. Sometimes a nurse delegates an act to an unregulated health care provider.

The Nursing Act works in conjunction with the RHPA •

The RHPA contains the procedural code that applies to all regulated professions.

•

The Nursing Act is SPECIFIC TO NURSES and establishes the mandate of the College of Nurses of Ontario.

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It defines the scope of practice for nursing. It also contains regulations about registration, i.e. classes of registration, entry-to-practice requirements, title protection, controlled acts, quality assurance and professional misconduct.

The Nursing Act Scope of Practice Statement: 

The practice of nursing is the promotion of health and assessment. It is the provision of care for and the treatment of health conditions by supportive, preventive, therapeutic, palliative and rehabilitative means in order to attain or maintain optimal function.

2 categories of nurses •

RN’s

•

RPN’s

General class •

Successful meet the nursing education requirement

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Provide evidence of nursing practice

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Successfully complete the national registration examination

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Successfully complete the jurisprudence exam

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Demonstrate language proficiency in either French or English

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Provide proof of citizenship, permanent residency or authorization under the immigration and Refugee Protection Act (Canada) to engage in the practice of nursing in Ontario

•

Complete a Declaration of Registration Requirements.

Title protection 1. Registered Nurse 2. Registered Practical Nurse 3. Nurse Practitioner These titles are protected under the Nursing Act, meaning it is illegal to state you are either one of these if you are not. This can lead to prosecution under the Nursing Act and RHPA

Controlled acts The RHPA lists 13 controlled acts that are considered potentially harmful if performed by an unqualified person. The Nursing Act authorizes nurses to perform these acts when ordered or permitted by the regulations 1. Performing a prescribed procedure below the dermis or mucous membrane 2. Administering a substance by injection or inhalation 3. Putting an instrument, hand or finger: 1. Beyond the external ear canal 2. beyond the point in the nasal passages where they normally narrow 3. beyond the larynx 4. beyond the opening of the urethra 5. beyond the labia majora 6. beyond the anal verge 7. into and artificial opening in the body. 4. Dispensing a drug. The Nursing act gives RN’s and RPN’s who meet certain conditions the authority to initiate specific controlled acts. This means that these RNs and RPNs may independently decide that a specific procedure is required and initiate the procedure without a specific order or directive from a physician.

Professional Misconduct Regulations  

An act or omission that breaches accepted ethical and professional standards of conduct Regulation under the Nursing Act defines professional misconduct for nurses as an act or omission that breaches accepted ethical and professional standards of conduct.

This can include a breach of Standards or Code of Conduct •

CNO handles professional misconduct •

Weighs offence against Nursing Act

•

i.e. lying on renewal re: QA completion

Quality Assurance 

The program that assists nurses to maintain competence and continually evaluate their practice.

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Program that assists nurses in maintaining competence and continually evaluate their practice.

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Annual requirement for renewal- inclusive of SMART goals and reflection, plus professional development and staying up to date with BPG

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Submitted through the CNO

CNO vision: Leading in regulatory excellence CNO mission: Regulating nursing in the public interest

CNO regulates nursing by •

Setting criteria for becoming a nurse 

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Establishing standards 

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Practice Standards, guidelines, and Code of Conduct

Administering QA 

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followed by College and Universities- set mandatory courses, outcomes, clinical hours, and ETP Competencies

Annual requirement (reflection and learning plan)

Enforcements of standards and practice of conduct

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by means above plus disciplinary hearing and/or review of conduct

What do I do as a professional? This is the QA cycle: (also the learning plan cycle) •

it is a continual process.

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Includes reflection of practice and SMART goal creation. •

Start by reflecting on your practice and discovering what your strengths and learning needs are.

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Assessing your learning needs is your first step toward improving your nursing practice.

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For example, while reflecting on your practice you may have identified a need to manage conflict in your workplace more effectively. This learning need will guide you toward developing a goal around improving your conflict management skills

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Students should be following this cycle since Semester 1, building upon learning and making connections, rather than working semester to semester

Practice reflection •

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“CNO acknowledges the exceptional circumstances the pandemic continues to bring to the nursing profession. During these difficult and challenging times, nurses have been asked to adapt quickly and do more than ever before. This has likely impacted your practice in unexpected ways. Reflection is a part of your professional QA obligations. The following questions are intended to help you reflect on your experience this year and support you in identifying areas in your practice for your continued learning.” (CNO, 2020)

Week 3 using best practice guidelines RNAO • • • • •

Influences Informs Advocates Connects Protects

•

Inspires

RNAO • • •

Professional association of registered nurses, nurse practitioners and nursing students in Ontario, Canada the strong, credible voice leading the nursing profession to influence and promote healthy public policy, and Clinical Excellence the best practice guidelines is a signature program of RNAO

International affairs and best practice guidelines centre • •

funded by the Ontario Ministry of Health and long-term care since 1999 develop, disseminate, and actively support the uptake of evidence based clinical and healthy work environment best practice guidelines and to evaluate their impact in patient/ organizational and health system outcomes

LTG Best practices program Mission: to improve resident care outcomes, in Ontario long term care homes, through systematic approaches to the implementation and sustainability of evidence-based practices.

What is a RNAO BPG? systematically developed statements (based on best available evidence) to assist practitioner and patient decisions about appropriate health care for specific clinical practice circumstances

Why use RNAO BPGs? • • • • • • • •

Contribute to strong client outcomes reduce the variation in care transfer research evidence into practice promote nursing knowledge assist with clinical decision making identify gaps in research stop interventions that have little effect or are harmful reduced cost

use available BPG resources • • • • • •

The best practices toolkit educators resource implementation tools evaluation tools health education factsheets condensed guidelines for personal digital assistants (PDAs)

levels of evidence

Week 4 the workplace Why a Labour Union? • • •

People moved from rural areas to urban areas for work. Many industries exploited the labour with low wages, long hours, unsafe working conditions, and child labour. Workers banded together to improve their lot

The Collective Agreement •

Formed through union negotiations called “collective bargaining”

• • • •

Through collective bargaining the management of the organization and the official union form a collective agreement. This provides clarity for both sides. Its clauses outline rules that both management and labour follow. Common unions in nursing include: CUPE (mostly hospital), OPSEU  Clear for all parties (employees/employers) to understand their role & responsibility  Advantages: assurance that union and employer have come to an agreement that benefits both the employee and the organization  Disadvantages: sometimes a lengthy process

Some Common Clauses • • • • •

Management rights Grievance rules Hours of work Scheduling Leaves of absence

• • • • • •

Vacations Seniority Hiring rules Safety Labour management committee Pay scale

Related Terms

Arbitration:

dispute settlement through an independent person

Grievance:

a real or imagined wrong which is a cause for complaint- violation of collective agreements including application, administration, or interpretation.

Mediation:

Unbiased individual helping to resolve conflict between two parties

Strike:

mass refusal for work / stoppage

Whistle blower:

a person who exposes information which is deemed illegal, unethical, or incorrect within an organization

Difference between Arbitration and Mediation: •

Arbitration is a method of resolving disputes, where an arbitrator makes the final decision.

•

Mediation involves the intervention of a third-party professional who acts as a facilitator for the parties to help them reach their own agreement.

Who does what? 

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Union Steward: responsible for ensuring that employers who do not violate the terms of their contract. It’s their job to inform employees of their rights in the workplace. It is also their responsibility to support workers through the grievance process or defend them when they are abused or victimized. Union Representative: are SEIU Healthcare staff members who always have your back. From negotiating at the bargaining table to helping you file a grievance, our highly dedicated team of union representatives know the ins and outs of everything there is to know about labour relations. Union Member: Through empowerment, we encourage you to be involved and engaged in your union. Whether it’s teaching useful skills through the Leadership Academy, getting everyone together at a BBQ event or supporting you at your workplace, we are determined to show off our purple pride! Employers: working with the College in building and maintaining quality nursing workplaces, preserving the public’s right to safe and ethical nursing care

Dynamics of the Workplace  

In order to be efficient, effective, and safe we want to create positive workplace dynamics. We want to support our place of work and be treated fairly.

We use: BOTH  

AND

i.e. Both being a professional AND supporting the union BOTH accomplishing the tasks of the job AND getting breaks, days off, and other personal needs met

OHSA: Occupational Health and Safety Act What rights does OHSA give to workers?

"right to participate" "right to know" "right to refuse work"

to be part of the process of identifying and resolving health and safety concerns. This right is expressed mainly in the requirements for Joint Health and Safety Committees and representatives.

about any hazards to which they may be exposed. The requirements of the Workplace Hazardous Materials Information System (WHMIS) are an important example.

that they believe is dangerous and, under certain circumstances, certified Joint Health and Safety Committee members can stop work that is dangerous. The Act prohibits reprisals being taken against workers who exercise these rights.

What are the workers duties under OHSA? Take responsibility for personal health and safety (which means they should not behave or operate equipment in a way that would endanger themselves or others) Work in compliance with the Act and regulations; Use any equipment, protective devices or clothing required by the employer; Tell the employer or supervisor about any known missing or defective equipment or protective device that may be dangerous; Report any known workplace hazard or violation of the Act to the employer or supervisor; Not remove or make ineffective any protective device required by the employer or by the regulations.

How do workers participate in workplace health and safety? •

•

The main way that workers can participate in workplace health and safety is through exercising their rights and duties in a responsible manner and by supporting their Joint Health and Safety Committee (JHSC). The JHSC is made up of workers and management representatives and has the power to…

    

Identify hazards Obtain information from employer Make recommendations to employer Investigate work refusals Investigate serious accidents

Occupational health & Safety act•

In Ontario, the OHSA establishes the right to refuse unsafe work without fear of reprisal.  Any equipment, machine, device or thing the worker is to use or operate is likely to endanger the worker or another worker;  The physical condition of the workplace or the part thereof in which the worker works or is to work is likely to endanger the worker; or  The physical condition of the workplace is in contravention of this Act or the regulations and such contravention is likely to endanger the worker or another worker;  Workplace violence is likely to endanger the worker;

WSIB: Workplace Safety and Insurance Board What if I have an injury?  

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If you are injured at work or become sick because of your job, tell your supervisor immediately. Workplace injuries also include many diseases. It is the law for the employer to tell the Workplace Safety and Insurance Board (WSIB) about the injury or illness within three days after learning about it. Make sure you complete, sign and return all forms the WSIB sends you if you claim benefits. When the claim is registered, the WSIB will send you a form so you can explain what happened and tell us that you want to claim benefits. If you are injured while working, you may get money to replace your lost wages. You may also receive health care treatments and prescription drugs for the injury. These services are free for workers. It is often possible for you to return to work while you recover. Your employer must try to give you modified work until you are better. See a doctor to get information about what you can and cannot do when you return to work.

Human Rights

Human Rights Code • • • • • • • • •

age ancestry citizenship colour creed (including Indigenous spiritual practices) disability ethnic origin family status gender identity

• • • • • • • •

gender expression marital status place of origin race receipt of public assistance (in housing only) record of offences (in employment only) sex (includes pregnancy and breastfeeding) sexual orientation.

Protected social areas are: • • • • • •

Accommodation (housing) Contracts Employment Goods, services and facilities Membership in unions, trade or professional associations. This right applies to health care services and facilities including hospitals, clinics, community care access centres, long-term care facilities, home care and health care programs

United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP)  

Adopted by the General Assembly on Thursday, 13 September 2007, by a majority of 144 states in favor, 4 votes against Canadian Federal government was one AGAINST

It addresses the rights of Indigenous peoples on issues such as: §

culture

§

identity

§

religion

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language

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health

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education

§

community

In what year were the Indigenous peoples included under the Human Rights Code of Canada? A- 1961 B- 1991 C- 2001 D- 2011

AODA: Accessibility for Ontarians with Disabilities Act What is “disability” The AODA uses the Ontario Human Rights Code definition of “disability” which is: •

• • • •

any degree of physical disability, infirmity, malformation or disfigurement that is caused by bodily injury, birth defect or illness and, without limiting the generality of the foregoing, includes diabetes mellitus, epilepsy, a brain injury, any degree of paralysis, amputation, lack of physical co-ordination, blindness or visual impediment, deafness or hearing impediment, muteness or speech impediment, or physical reliance on a guide dog or other animal or on a wheelchair or other remedial appliance or device a condition of mental impairment or a developmental disability a learning disability, or a dysfunction in one or more of the processes involved in understanding or using symbols or spoken language a mental disorder, or an injury or disability for which benefits were claimed or received under the insurance plan established under the Workplace Safety and Insurance Act, 1997 (“handicap”).

Disability MEDICAL •

From this perspective, disability covers a broad range and degree of conditions, some visible and some not visible. A disability may have been present from birth, caused by an accident, or developed over time. There are physical, cognitive, mental and learning disabilities, mental disorders, hearing or vision disabilities, epilepsy, drug and alcohol de...