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Changes to Nursing Policy Documents

March 31, 2022

Upon government proclamation, new and revised nursing policy documents will come into effect due to Bill 46, the Health Statutes Amendment Act, 2020 (No. 2). These documents outline the College of Registered Nurses of Alberta (CRNA) expectations of registrants.

New Documents

The continuing competence program provisions have moved from the Registered Nurses Profession Regulation into standards of practice. The standards outline the minimum expectations for registrants participating in the continuing competence program. There are no changes to the requirements registrants need to complete; however, while nurse practitioner registrants still need to complete a learning plan based on the practice standards, they no longer need to complete a second learning plan based on the NP entry-level competencies.

Registrants who wish to renew their practice permit must meet the requirements set out in the Continuing Competence Standards. In addition to the standards, a Continuing Competence Program Manual will outline further details. The program manual will be made available upon request.

 

Revised Documents

This document (previously titled Practice Standards for Regulated Members), underwent a full review for currency and relevancy, including removal of association-focused language, restructured from five standards to four standards to increase clarity, updated indicators to clarify expectations of each standard, and removed appendices; these changes were approved at the December 2022 Council meeting.

In addition, wording and indicators to address female genital mutilation (FGM) and to align with the Health Professions (Protecting Women and Girls) Amendment Act, 2022 (formerly Bill 10), which regulatory colleges were required to develop.

Revisions were made to the foundational document to remove association content and align with new legislation and evidence-informed practices. This document was previously known as Practice Standards for Regulated Members (2013).

In addition to being updated to reflect the changes required by legislation, this document was restructured into three standards: accountability, communication and safe provision of care and security. This document was previously known as Documentation Standards for Regulated Members (2013).

A clearly defined scope of practice is crucial for nurse practitioners. Sections have been removed or clarified to reduce perceived barriers and to be relevant to current practice.

 

Revisions to Align with Legislation

The Health Statutes Amendment Act, 2020 (Bill 46) amends multiple health regulations including the Health Professions Act (2000). It aims to streamline regulatory processes, improve governance and accountability, and ensure the health-care system and health professionals to serve in the interest of Albertans. There are no changes to registrants' practice.

All nursing policy documents were reviewed for alignment. Common changes made across all standards, competencies, and scope of practice documents as necessary:

  • Replaced "CARNA" with "CRNA" and "College and Association of Registered Nurses of Alberta" with "College of Registered Nurses of Alberta".
  • Added or updated an authority statement to outline the authority of the CRNA to establish standards under the "purpose" section.
  • Replaced reference to Schedule 7.1 of the Government Organization Act and the Registered Nurses Profession Regulation with the new Health Professions Restricted Activity Regulation.
  • Minor wording changes made throughout the documents for flow, clarity, consistency and/or accuracy.
  • All glossary terms were reviewed and compared across documents and where necessary were updated to ensure alignment with legislation and consistent terminology throughout the CRNA documents. New terms and definitions were added where necessary to provide clarity.
  • The citations and references were reviewed for currency and accuracy and updated as needed. All reference links/digital object identifiers (DOIs) were updated as needed.

Standards, Competencies and Scope of Practice

Standards, competencies, and the scope of practice describe the minimum expectations that registrations must meet. Fifteen nursing policy documents received minor revisions to align with the legislative changes required under the Health Statutes Amendment Act, 2020 (Bill 46). Based on our assessment and consultation feedback received, the revisions were made to:

  • Advertising Standards
  • Cannabis for Medical Purposes: Standards for Nurse Practitioners
  • Competencies for Registered Nurse Prescribing Schedule 1 Drugs and Ordering Diagnostic Tests
  • Complementary & Alternative Health Care and Natural Health Products Standards
  • Infection Prevention and Control Standards
  • Medication Management Standards
  • Nursing Education Program Approval Standards
  • Prescribing Standards for Nurse Practitioners
  • Privacy and Management of Health Information Standards
  • Protection of Patients from Sexual Abuse and Sexual Misconduct Standards
  • Registered Nurse Prescribing Schedule 1 Drugs and Ordering Diagnostic Tests: Requirements and Standards
  • Restricted Activities Standards
  • Scope of Practice for Registered Nurses
  • Supervision Standards
  • Use of Title Standards

Guidelines

Nine guideline documents have been revised to align with changes made to the within the standards of practice, competencies, and scope of practice documents. There are no changes to registrants' practice.

Guidelines help to identify principles, provide direction, clarify roles and responsibilities, and provide a framework for decision-making. Guidelines help registrants apply the standards to their practice. Based on our assessment and consultation feedback received, the revisions were made to:

  • Camp Nursing Guidelines
  • Coordination of Client Care Guidelines
  • Incorporating a Restricted Activity into Practice: Guidelines
  • Problematic Substance Use: Guidelines
  • Professional Boundaries: Guidelines for the Nurse-Client Relationship
  • Pronouncement of Death Guidelines
  • Registered Nurse Prescribing Schedule 1 Drugs and Ordering Diagnostic Tests: Guidelines
  • Requisite Skills and Abilities for Becoming a Registered Nurse in Alberta
  • Working Extra Hours: Guidelines on Fitness to Practice and the Provision of Safe, Competent, Ethical Nursing Care