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Feedback Needed on Amended Standards and Competencies
Revisions have been made to 14 nursing policy documents to align with the legislative changes required under the Health Statutes Amendment Act, 2020 (Bill 46). The College of Registered Nurses of Alberta (CRNA) is looking for your feedback on the changes.
Feedback deadline: June 13, 2022.
Replaced ‘CARNA’ with ‘CRNA’ and ‘College and Association of Registered Nurses of Alberta’ with ‘College of Registered Nurses of Alberta’.
Added an authority statement to outline the authority of the CRNA to establish standards under the ‘Purpose’ section.
In the section ‘Standards for Advertising’ in the standards statement added the word ‘minimum’ before ‘expectations’ to clearly indicate that the standards outline the minimum expectations.
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.
Replaced ‘CARNA’ with ‘CRNA’, and ‘College and Association of Registered Nurses of Alberta’ with ‘College of Registered Nurses of Alberta’.
Removed ‘Appendix A’ section which quoted the cannabis legislation. This legislation is referenced in the body of the document, refers to the applicable section, and remains noted in the reference list.
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.
Replaced ‘CARNA’ with ‘CRNA’, ‘College and Association of Registered Nurses of Alberta’ with ‘College of Registered Nurses of Alberta’, and ‘regulated member’ with ‘registrant’.
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.
Replaced ‘CARNA’ with ‘CRNA’, ‘College and Association of Registered Nurses of Alberta’ with ‘College of Registered Nurses of Alberta’, and ‘regulated member’ with ‘registrant’.
Added an authority statement to outline the authority of the CRNA to establish standards as well as referencing relevant legislation specific to natural health products under the ‘Purpose’ section.
Following the bullets under the ‘Purpose’, we removed the following from the opening section:
Regulated member in all areas of practice have encountered situations, questions, or concerns related to CAHC and NHPs. Schedule 24 of the Health Professions Act (HPA) (2000) states in their practice, regulated members “…assist individuals, families, groups and communities to achieve their optimal physical, emotional, mental, and spiritual health and well-being”.
Moved the ‘Complementary and Alternative Health Care’ section up before the section ‘Risks to Consider if Using CAHC and NHPs’ for better flow of reading.
The section ‘Complementary and Alternative Health Care and Natural Health Products Initiated by Clients’ has been removed as information within this section was repetitive as it was already stated within the section ‘Complementary and Alternative Health Care’ and within existing criteria. The bulleted information within the section ‘Complementary and Alternative Health Care and Natural Health Products Initiated by Clients’ that were not already criteria have been developed into the following criteria 2.3, 3.1, and 3.3.
Added a describing statement for each standard.
Criterion 1.7 - changed ‘adverse effects’ to ‘adverse reactions’ for consistency with term used in other CRNA documents.
Added definitions for ‘client’ and ‘adverse reaction’ for consistency with the CRNA Medication Management Standards.
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.
‘Appendix A’ was removed as it referenced outdated content from a withdrawn 2005 CARNA document.
Replaced ‘CARNA’ with ‘CRNA’, ‘College and Association of Registered Nurses of Alberta’ with ‘College of Registered Nurses of Alberta’, and ‘regulated member’ with ‘registrant’.
Added an authority statement to outline the authority of the CRNA to establish standards under the ‘Purpose’ section.
The second paragraph in the introduction section was removed to avoid duplication as the concepts from this paragraph were already embedded throughout the document and within the criteria.
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.
Replaced ‘CARNA’ with ‘CRNA’, ‘College and Association of Registered Nurses of Alberta’ with ‘College of Registered Nurses of Alberta’, and ‘regulated member’ with ‘registrant’.
Areas where the new HPA Restricted Activity Regulation will need to be cited have been highlighted in yellow to replace the reference to Schedule 7.1 of the Government Organization Act and the Registered Nurses Profession Regulation as applicable.
Added an authority statement to outline the authority of the CRNA to establish standards as well as referencing relevant legislation specific to medication management under the ‘Purpose’ section.
Removed examples at the end of the definitions for ‘compounding’ and ‘dispense’.
The definitions ‘adverse reaction’ and ‘medication administration record’ were revised.
Added a definition for ‘serious adverse drug reaction’ and ‘medical device incidents’.
Under ‘Appendix B’, moved the opening paragraph to the end and added a sentence about the Alberta Exceptions list for 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.
Replaced ‘CARNA’ with ‘CRNA’ and ‘College and Association of Registered Nurses of Alberta’ with ‘College of Registered Nurses of Alberta’.
Did not change ‘Regulated Member’ to ‘Registrant’ in this standard because throughout the document expectations and content include information about other jurisdictions or other regulated health professions within Alberta.
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.
Replaced ‘CARNA’ with ‘CRNA’, ‘College and Association of Registered Nurses of Alberta’ with ‘College of Registered Nurses of Alberta’, and ‘regulated member’ with ‘registrant’.
The second part of criterion 1.6 was moved into existing criterion 1.7 to clearly distinguish between the development of the plan of care, and the assessment of whether a trial of medication therapy would be included in the plan of care.
In criterion 1.13, the word ‘verify’ was replaced with ‘evaluate’ to provide clarity.
In criteria 4.2, updated the program name ‘Triplicate Prescription Program’ to the new program name of ‘TPP Alberta | Tracked Prescription Program’ and removed the footnoted term and updated the term in the ‘Glossary’.
In criterion 5.3a and 5.4a, deleted the word ‘module’, as it is no longer applicable to the Alberta ODT Virtual Training Program.
In ‘Appendix A’ the CRNA documents Medication Management Standards and Complementary and Alternative Health Care and Natural Health Products Standards have been added to the table.
Under ‘Appendix B', updated the bullet points to reflect the current requirements (as of Fall 2021) for the Alberta ODT Virtual Training Program.
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.
Replaced ‘CARNA’ with ‘CRNA’, ‘College and Association of Registered Nurses of Alberta’ with ‘College of Registered Nurses of Alberta’, and ‘regulated member’ with ‘registrant’.
Added an authority statement to outline the authority of the CRNA to establish standards under the ‘Purpose’ section.
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.
‘Appendix B: Assessment of Risk of Harm’, ‘Appendix C: Notice of Loss or Unauthorized access or Disclosure’, and ‘Appendix D: Notice to Commissioner of Decision Not to Give Notice’ were removed as these appendices quoted large sections of legislation which are already referenced in the body of the document.
Replaced ‘CARNA’ with ‘CRNA’, ‘College and Association of Registered Nurses of Alberta’ with ‘College of Registered Nurses of Alberta’, and ‘regulated member’ with ‘registrant’.
Under the ‘Glossary’ section, removed the word ‘agreement’ from the phrase ‘Adult interdependent partner agreement’ as only ‘Adult independent partner’ was used within the body of the document. The definition was not changed.
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.
Replaced ‘CARNA’ with ‘CRNA’, ‘College and Association of Registered Nurses of Alberta’ with ‘College of Registered Nurses of Alberta’, and ‘regulated member’ with ‘registrant’.
Areas where the new HPA Restricted Activity Regulation will need to be cited have been highlighted in yellow to replace reference to Schedule 7.1 of the Government Organization Act and the Registered Nurses Profession Regulation as applicable.
Added an authority statement to outline the authority of the CRNA to establish standards under the ‘Purpose’ section.
Under the ‘Purpose’ section, highlighted the following statement by moving it into the boxed section:
Regulated members on the provisional or courtesy register and certified graduate nurses are not eligible to apply for authorization to prescribe schedule 1 drugs and to order diagnostic tests.
Removed the sentence ‘the clinical support tool may be in the form of a protocol, algorithm, or clinical practice guideline’ from under the section ‘Clinical Support Tool’ and within the definition in the ‘Glossary’ section to provide consistency, enhance clarity, and align with the wording used to define and describe clinical support in the Registered Nurse Prescribing Schedule 1 Drugs and Ordering Diagnostic Tests Guidelines.
In Criterion 1.9 – revised the name of the program ‘Canadian Adverse Drug Reaction Reporting Program’ to the current name of national program ‘Canada Vigilance Program’.
Under Standard 3, changed ‘CRNA bylaws’ to ‘College Bylaws’.
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.
Replaced ‘CARNA’ with ‘CRNA’, ‘College and Association of Registered Nurses of Alberta’ with ‘College of Registered Nurses of Alberta’, and ‘regulated member’ with ‘registrant’.
Areas where the new HPA Restricted Activity Regulation will need to be cited have been highlighted in yellow to replace reference to Schedule 7.1 of the Government Organization Act and the Registered Nurses Profession Regulation as applicable.
Moved content within the ‘Purpose’ section for flow and clarity.
The new Standard 1 and criteria were developed to clearly outline which register category of registrants are authorized to perform specific restricted activities.
Criterion 2.4 was updated to include the word ‘competent’ for clarity.
In the Glossary the following terms and definitions were added for clarity and revised for consistency:
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.
Removed ‘Appendix A’ (specific clinical examples).
Replaced ‘CARNA’ with ‘CRNA’, ‘College and Association of Registered Nurses of Alberta’ with ‘College of Registered Nurses of Alberta’, and ‘regulated member’ with ‘registrant’.
Areas where the new HPA Restricted Activity Regulation will need to be cited have been highlighted in yellow to replace reference to Schedule 7.1 of the Government Organization Act and the Registered Nurses Profession Regulation as applicable.
Under the ‘Purpose’ section, the last paragraph and the bulleted information were revised to be consistent in wording and direction given in the Nursing Education Program Approval Standards (2021).
The section titled ‘Supervision of Restricted Activities’ was renamed to ‘Legislation’ to clearly highlight the legislative authority.
On page 8, under the section ‘Standard for Supervision of Registrants on the Provisional Register’, removed reference to the CRNA’s registration policy requirements as they are operational.
In the ‘Standard 3’ statement the term ‘health professions program of studies’ was changed to ‘health services program of studies’ to align with the wording in the Registered Nurses Profession Regulation.
‘Appendix A: Restricted Activities Authorized for Regulated Members’ and ‘Appendix B: Regulations for Students Performing Restricted Activities’ were removed as these sections of legislation are already cited in the body of the document.
The following terms and definitions in the glossary section were revised for consistency:
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.
Updated ‘regulated member’ to ‘registrant’ (except in the sections quoting legislation) and ‘CARNA’ to ‘CRNA’, and ‘College and Association of Registered Nurses of Alberta’ to ‘College of Registered Nurses of Alberta’ throughout the document.
Added an authority statement to outline the authority of the CRNA to establish standards under the ‘Purpose’ section.
Moved content within the ‘Purpose’ section for flow and clarity.
Criteria 1.1 and 2.1 were revised for clarity by replacing the terms ‘practice permit’ with ‘practicing permit’, to outline the expectation of requiring a practicing permit to use titles and aligns with terminology used within the CRNA registration department.
Under the ‘Glossary’ section, added the term and definition of ‘Regulated profession’ for clarity.
Removed ‘Appendix A: Health Professions Act Part 7’ as it quoted large sections of legislation which are already referenced in the body of the document.
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.