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Nursing Act, 1991
Loi de 1991 sur les infirmières et infirmiers

ONTARIO REGULATION 275/94

GENERAL

Historical version for the period October 1, 2011 to June 21, 2012.

Last amendment: O. Reg. 387/11.

This Regulation is made in English only.

CONTENTS

   

Sections

PART I

DEFINITIONS

0.1

PART II

REGISTRATION

 
 

Certificates of Registration

1-5

 

General Certificates of Registration

6-8.2

 

Mutual Recognition for Registered Nurses in the Extended Class

8.3

 

Temporary Certificates of Registration

9

 

Special Assignment Certificates of Registration

10

 

Transitional Certificates of Registration

11

 

Extended Certificates of Registration

11.1-11.3

 

Titles

11.4

 

Examinations

11.5

 

Examination

12

 

Retired Class

12.1

 

Reinstatement

13-13.1

PART III

CONTROLLED ACTS

 
 

Interpretation

13.2

 

Procedures

14-15.1

 

Prescribing, Dispensing, Selling and Compounding a Drug

16

 

Prescribing

17

 

Dispensing

18

 

Compounding

19

 

Selling

19.1

 

Administration of a Substance by Injection or Inhalation

20

PART IV

QUALITY ASSURANCE

 
 

General

21-23

 

Member Assessment

24-26

 

Practice Assessment and Remediation

27-31

Schedule 1

 
     

PART I
DEFINITIONS

0.1 In this Regulation,

“registered nurse in the extended class” means a member who holds an extended certificate of registration as a registered nurse;

“registered nurse in the general class” means a member who holds a general certificate of registration as a registered nurse;

“registered practical nurse in the general class” means a member who holds a general certificate of registration as a registered practical nurse. O. Reg. 115/96, s. 1; O. Reg. 39/98, s. 1 (2); O. Reg. 190/06, s. 1.

PART II
REGISTRATION

Certificates of Registration

1. (1) The following are prescribed as classes of certificates of registration for registered nurses:

1. General.

2. Temporary.

3. Special Assignment.

4. Transitional.

5. Extended.

6. Retired. O. Reg. 275/94, s. 1 (1); O. Reg. 39/98, s. 2; O. Reg. 212/00, s. 1; O. Reg. 433/04, s. 1.

(2) A registered nurse may not hold more than one class of certificate of registration as a registered nurse at one time. O. Reg. 275/94, s. 1 (2).

2. (1) The following are prescribed as classes of certificates of registration for registered practical nurses:

1. General.

2. Temporary.

3. Special Assignment.

4. Transitional.

5. Retired. O. Reg. 275/94, s. 2 (1); O. Reg. 212/00, s. 2; O. Reg. 433/04, s. 2.

(2) A registered practical nurse may not hold more than one class of certificate of registration as a registered practical nurse at one time. O. Reg. 275/94, s. 2 (2).

3. (1) A person may apply for a certificate of registration in any class other than the extended class by completing an application form supplied by the Executive Director and submitting it along with the required application fee. O. Reg. 39/98, s. 3; O. Reg. 158/00, s. 1 (1).

(2) A person may apply for a certificate of registration for the extended class in the category of registered nurse by completing an application form supplied by the Executive Director and submitting it along with the required application fees. O. Reg. 39/98, s. 3; O. Reg. 158/00, s. 1 (2).

(3) Upon receipt of the required registration fee, the Executive Director shall issue a certificate of registration to a person,

(a) if the Executive Director proposes to register the person under clause 15 (1) (a) of the Health Professions Procedural Code; or

(b) if authorized or directed by a panel of the Registration Committee to issue the certificate to the person. O. Reg. 39/98, s. 3; O. Reg. 158/00, s. 1 (3).

4. (1) A member may resign any class of certificate of registration by giving written notice of intention to resign. O. Reg. 275/94, s. 4 (1).

(2) A member who resigns shall pay any fee outstanding at the date of resignation. O. Reg. 275/94, s. 4 (2).

5. (1) The following are the registration requirements for a certificate of registration of any class other than a retired class:

1. The applicant must not have been found guilty of a criminal offence or an offence under the Controlled Drugs and Substances Act (Canada) or the Food and Drugs Act (Canada).

2. The applicant must not have been the subject of a finding of professional misconduct, incompetence or incapacity, whether in Ontario or in another jurisdiction and whether in relation to the nursing profession or another health profession.

3. The applicant must not currently be the subject of proceedings for professional misconduct, incompetence or incapacity, whether in Ontario or in another jurisdiction and whether in relation to the nursing profession or another health profession.

4. The applicant must not suffer from a physical or mental condition or disorder that makes it desirable in the public interest that he or she not practise nursing. O. Reg. 275/94, s. 5 (1); O. Reg. 115/96, s. 3 (1); O. Reg. 212/00, s. 3 (1); O. Reg. 433/04, s. 3 (1).

(2) An applicant or member shall be deemed not to have satisfied the requirements for a certificate of registration of any class if the applicant or member knowingly made a false or misleading statement or representation in his or her application. O. Reg. 275/94, s. 5 (2); O. Reg. 212/00, s. 3 (2).

(3) It is a condition of a certificate of registration of any class that the member provide the College with details of any of the following that relate to the member and that occur or arise after the initial registration of the member:

1. A finding of guilt for a criminal offence or an offence under the Controlled Drugs and Substances Act (Canada) or the Food and Drugs Act (Canada).

2. A finding of professional misconduct, incompetence or incapacity, whether in Ontario or in another jurisdiction and whether in relation to the nursing profession or another health profession.

3. A proceeding for professional misconduct, incompetence or incapacity, whether in Ontario or in another jurisdiction and whether in relation to the nursing profession or another health profession. O. Reg. 275/94, s. 5 (3); O. Reg. 115/96, s. 3 (2); O. Reg. 433/04, s. 3 (2).

General Certificates of Registration

6. (1) Prior to January 1, 2005, the following are non-exemptible registration requirements for a general certificate of registration as a registered nurse:

1. The applicant,

i. must have graduated from a nursing program in Ontario that was, at the time the applicant graduated,

A. approved by the Minister of Education and Training, in the case of a program offered by a college of applied arts and technology, or

B. approved by the Approval Committee of the Council of Ontario University Programs in Nursing and approved by the Senate or Governing Council of the university that offered the program, in the case of a program offered by a university,

ii. must have graduated from a nursing program in another province or territory in Canada that was, at the time the applicant graduated, accepted by the regulatory body for nursing in that province or territory,

iii. must have graduated from a nursing program outside Canada that the Registration Committee determines was, at the time the applicant graduated, equivalent to a nursing program in Ontario that is currently approved in accordance with sub-subparagraph A or B of subparagraph i, or

iv. must have graduated from a nursing program outside Canada and, if the Registration Committee does not make the determination referred to in subparagraph iii with respect to the program, must also satisfy the Registration Committee that he or she has obtained additional nursing education or experience that, together with the education provided by the nursing program from which he or she graduated, is equivalent to the education provided by a nursing program in Ontario that is currently approved in accordance with sub-subparagraph A or B of subparagraph i.

2. At the time of successfully completing all other requirements for registration as a registered nurse in the general class or at the time of application, whichever is later, the applicant must satisfy the Registration Committee,

i. that he or she graduated from a program described in subparagraph i, ii or iii of paragraph 1 within the past five years,

ii. that he or she has no need for additional education or experience based on evidence of safe nursing practice during the past five years, or

iii. that he or she has successfully completed the additional education or obtained the additional experience that the Registration Committee determines is necessary to enable him or her to practise safely as a registered nurse in the general class in the future.

3. The applicant must have passed the examination for registration as a nurse set by or administered by the College or an examination approved as equivalent by the Registration Committee. O. Reg. 275/94, s. 6 (1); O. Reg. 115/96, s. 4 (2); O. Reg. 212/00, s. 4 (1); O. Reg. 433/04, s. 4 (1).

(1.1) Subject to subsections (1.3) and (1.3.1), after December 31, 2004, the following are non-exemptible registration requirements for a general certificate of registration as a registered nurse:

1. The applicant,

i. must have received a baccalaureate degree in nursing granted by a university in Ontario whose program was, at the time the applicant graduated, approved by a body or bodies designated by the Council or by the Council itself,

ii. must have received a baccalaureate degree in nursing granted by a university in another province or territory in Canada that, at the time the applicant graduated, was, in the opinion of the Registration Committee, equivalent to the degree described in subparagraph i,

iii. must have graduated prior to January 1, 2005 from a nursing program in another province or territory in Canada that was, at the time the applicant graduated, accepted by the regulatory body for nursing in that province or territory and been registered with that regulatory body or another regulatory body for nursing in a province or territory in Canada in an equivalent class prior to January 1, 2005,

iv. must have graduated from a nursing program outside Canada that the Registration Committee determines was, at the time the applicant graduated, equivalent to a nursing program in Ontario that is currently approved in accordance with subparagraph i, or

v. must have graduated from a nursing program other than one referred to in subparagraph i, ii, iii or iv and must also satisfy the Registration Committee that he or she has obtained additional nursing education or experience that, together with the education provided by the nursing program from which he or she graduated, is equivalent to the education provided by a nursing program in Ontario that is currently approved in accordance with subparagraph i.

2. At the time of successfully completing all other requirements for registration as a registered nurse in the general class or at the time of application, whichever is later, the applicant must satisfy the Registration Committee,

i. that he or she graduated from a program described in subparagraph 1 i, ii, iii or iv within the past five years,

ii. that he or she has no need for additional education or experience based on evidence of safe nursing practice during the past five years, or

iii. that he or she has successfully completed the additional education or obtained the additional experience that the Registration Committee determines is necessary to enable him or her to practise safely as a registered nurse in the general class in the future.

3. The applicant must have passed the examination for registration as a nurse set by or administered by the College or an examination approved as equivalent by the Registration Committee. O. Reg. 212/00, s. 4 (2); O. Reg. 433/04, s. 4 (2, 3).

(1.2) Subparagraph 1 i of subsection (1.1) shall not be interpreted to prevent a college of applied arts and technology from collaborating with a university in delivering a nursing program graduation from which is recognized by the granting by the university of a baccalaureate degree. O. Reg. 212/00, s. 4 (2).

(1.3) Subsection (1.1) applies to any application for a general certificate of registration as a registered nurse unless,

(a) the applicant applied for and met all of the requirements for that certificate prior to January 1, 2005, including meeting the requirements of subsection (1);

(b) the applicant met all of the requirements for that certificate prior to January 1, 2005, other than the examination requirement of paragraph 3 of subsection (1), and,

(i) the applicant met that examination requirement prior to November 1, 2005, and

(ii) the Registration Committee determined that the applicant had practised safely as a registered nurse during the five years immediately prior to the applicant’s meeting that examination requirement;

(c) the applicant, while holding a transitional certificate of registration as a registered nurse, successfully completed an educational program which resulted in the applicant meeting the requirements of paragraph 1 of subsection (1.1); or

(d) the applicant meets the requirements of section 8.1. O. Reg. 433/04, s. 4 (4).

(1.3.1) The requirements set out in subsection (1) continue to apply to an applicant described in clause (1.3) (b). O. Reg. 433/04, s. 4 (4).

(1.4) Subsection (1.1) shall not be interpreted to affect in any way,

(a) the right of a member who, on December 31, 2004, holds a general or extended certificate of registration as a registered nurse to continue to be a member in that class; or

(b) the right of a former member who held a general or extended certificate of registration as a registered nurse to have his or her certificate of registration reinstated. O. Reg. 212/00, s. 4 (2).

(2) Prior to January 1, 2005, the following are non-exemptible registration requirements for a general certificate of registration as a registered practical nurse:

1. The applicant,

i. must have graduated from a practical nurse or nursing assistant program in Ontario that was, at the time the applicant graduated,

A. approved by the Minister of Education and Training, in the case of a program offered by a college of applied arts and technology or a secondary school, or

B. approved by the Ministry of Health,

ii. must have graduated from a practical nurse or nursing assistant program in another province or territory in Canada that was, at the time the applicant graduated, accepted by the regulatory body for practical nurses or nursing assistants in that province or territory,

iii. must have graduated from a practical nurse or nursing assistant program outside Canada that the Registration Committee determines was, at the time the applicant graduated, equivalent to a practical nurse or nursing assistant program in Ontario that is currently approved in accordance with sub-subparagraph A or B of subparagraph i,

iv. must have graduated from a practical nurse or nursing assistant program outside Canada and, if the Registration Committee does not make the determination referred to in subparagraph iii with respect to the program, must also satisfy the Registration Committee that he or she has obtained additional practical nurse or nursing assistant education or experience that, together with the education provided by the nursing program from which he or she graduated, is equivalent to the education provided by a practical nurse or nursing assistant program in Ontario that is currently approved in accordance with sub-subparagraph A or B of subparagraph i, or

v. must have graduated from one of the nursing programs referred to in paragraph 1 of subsection (1) or paragraph 1 of subsection (1.1) and must also satisfy the Registration Committee that he or she has obtained additional practical nurse or nursing assistant education or experience that, together with the education provided by the nursing program from which he or she graduated, is equivalent to the preparation provided by a practical nurse or nursing assistant program in Ontario that is currently approved in accordance with sub-subparagraph A or B of subparagraph i.

2. At the time of successfully completing all other requirements for registration as a registered practical nurse in the general class or at the time of application, whichever is later, the applicant must satisfy the Registration Committee,

i. that he or she graduated from a program described in subparagraph i, ii or iii of paragraph 1 within the past five years,

ii. that he or she has no need for additional education or experience based on evidence of safe practice as a practical nurse or nursing assistant during the past five years, or

iii. that he or she has successfully completed the additional education or obtained the additional experience that the Registration Committee determines is necessary to enable him or her to practise safely as a practical nurse or nursing assistant in the future.

3. The applicant must have passed the examination for registration as a practical nurse or nursing assistant set by or administered by the College or an examination approved as equivalent by the Registration Committee. O. Reg. 275/94, s. 6 (2); O. Reg. 115/96, s. 4 (3); O. Reg. 212/00, s. 4 (3); O. Reg. 376/04, s. 1 (1); O. Reg. 433/04, s. 4 (5).

(2.1) Subject to subsections (2.2) and (2.2.1), after December 31, 2004, the following are non-exemptible registration requirements for a general certificate of registration as a registered practical nurse:

1. The applicant,

i. must have received a diploma in practical nursing granted by a College of Applied Arts and Technology in Ontario whose program was, at the time the applicant graduated, approved by a body or bodies designated by the Council or by the Council itself,

ii. must have received a diploma in practical nursing granted in another province or territory in Canada that, at the time the applicant graduated, was, in the opinion of the Registration Committee, equivalent to the diploma described in subparagraph i,

iii. must have graduated prior to January 1, 2005 from a practical nursing program in another province or territory in Canada that was, at the time the applicant graduated, accepted by the regulatory body for practical nursing in that province or territory and been registered with that regulatory body or another regulatory body for practical nursing in a province or territory in Canada in an equivalent class prior to January 1, 2005,

iv. must have graduated from a practical nursing program outside Canada that the Registration Committee determines was, at the time the applicant graduated, equivalent to a practical nursing program in Ontario that is currently approved in accordance with subparagraph i,

v. must have graduated from a practical nursing program other than one referred to in subparagraph i, ii, iii or iv and must also satisfy the Registration Committee that he or she has obtained additional practical nursing education or experience that, together with the education provided by the practical nursing program from which he or she graduated, is equivalent to the education provided by a practical nursing program in Ontario that is currently approved in accordance with subparagraph i, or

vi. must have graduated from one of the nursing programs referred to in paragraph 1 of subsection (1) or paragraph 1 of subsection (1.1) and must also satisfy the Registration Committee that he or she has obtained additional practical nursing education or experience that, together with the education provided by the nursing program from which he or she graduated, is equivalent to the preparation provided by a practical nursing program in Ontario that is currently approved in accordance with subparagraph i.

2. At the time of successfully completing all other requirements for registration as a registered practical nurse in the general class or at the time of application, whichever is later, the applicant must satisfy the Registration Committee,

i. that he or she graduated from a program described in subparagraph 1 i, ii, iii or iv within the past five years,

ii. that he or she has no need for additional education or experience based on evidence of safe practice as a practical nurse or nursing assistant during the past five years, or

iii. that he or she has successfully completed the additional education or obtained the additional experience that the Registration Committee determines is necessary to enable him or her to practise safely as a registered practical nurse in the general class in the future.

3. The applicant must have passed the examination for registration as a practical nurse set by or administered by the College or an examination approved as equivalent by the Registration Committee. O. Reg. 376/04, s. 1 (2); O. Reg. 433/04, s. 4 (6, 7).

(2.2) Subsection (2.1) applies to any application for a general certificate of registration as a registered practical nurse unless,

(a) the applicant applied for and met all of the requirements for that certificate prior to January 1, 2005, including meeting the requirements of subsection (2);

(b) the applicant met all of the requirements for that certificate prior to January 1, 2005, other than the examination requirement of paragraph 3 of subsection (2), and,

(i) the applicant met that examination requirement prior to November 1, 2005, and

(ii) the Registration Committee determined that the applicant had practised safely as a registered practical nurse during the five years immediately prior to the applicant’s meeting that examination requirement;

(c) the applicant, while holding a transitional certificate of registration as a registered practical nurse, successfully completed an educational program which resulted in the applicant meeting the requirements of paragraph 1 of subsection (2.1); or

(d) the applicant meets the requirements of section 8.2. O. Reg. 433/04, s. 4 (8).

(2.2.1) The requirements set out in subsection (2) continue to apply to an applicant described in clause (2.2) (b). O. Reg. 433/04, s. 4 (8).

(2.3) Subsection (2.1) shall not be interpreted to affect in any way,

(a) the right of a member who, on December 31, 2004, holds a general certificate of registration as a registered practical nurse to continue to be a member in that class; or

(b) the right of a former member who held a general certificate of registration as a registered practical nurse to have his or her certificate of registration reinstated. O. Reg. 376/04, s. 1 (2).

(3) The following are registration requirements for a general certificate of registration as a registered nurse or a registered practical nurse:

1. The applicant is able to demonstrate the ability to speak and write either English or French with reasonable fluency.

2. The applicant is a Canadian citizen or a permanent resident of Canada or authorized under the Immigration and Refugee Protection Act (Canada) to engage in the practice of nursing.

3. An applicant who graduated from a program referred to in subparagraph 1 ii, iii or iv of subsection (1) or (2) or a program referred to in subparagraph 1 ii, iv or v of subsection (1.1) or (2.1) must show,

i. in the case of an applicant for a certificate of registration as a registered nurse, proof of registration or eligibility for registration as a registered nurse in the jurisdiction in which the nursing program was located, or

ii. in the case of an applicant for a certificate of registration as a registered practical nurse, proof of registration or eligibility for registration as a registered practical nurse in the jurisdiction in which the practical nurse or nursing assistant program was located.

4. A registered practical nurse applicant who graduated from a nursing program referred to in subparagraph 1 v of subsection (2) or subparagraph 1 vi of subsection (2.1) must show proof of registration or eligibility for registration as a registered nurse in the jurisdiction in which the nursing program was located.

5. The applicant must not have been refused registration in the nursing profession in another jurisdiction. O. Reg. 275/94, s. 6 (3); O. Reg. 115/96, s. 4 (4, 5); O. Reg. 212/00, s. 4 (4); O. Reg. 376/04, s. 1 (3-5).

7. (1) A member holding a temporary certificate of registration for a particular membership class is entitled to a general certificate of registration of the same class if the member,

(a) passes the applicable examination that is a requirement for a general certificate of registration, or an examination approved as equivalent by the Registration Committee; and

(b) meets the requirements of subsection 5 (1) and paragraph 2 of subsection 6 (3). O. Reg. 275/94, s. 7 (1); O. Reg. 443/04, s. 5 (1).

(2) A member holding a transitional certificate of registration as a registered nurse is entitled to a general certificate of registration as a registered nurse if the member successfully completes an educational program which results in the member meeting the requirements of paragraph 1 of subsection 6 (1.1). O. Reg. 443/04, s. 5 (2).

(3) A member holding a transitional certificate of registration as a registered practical nurse is entitled to a general certificate of registration as a registered practical nurse if the member successfully completes an educational program which results in the member meeting the requirements of paragraph 1 of subsection 6 (2.1). O. Reg. 443/04, s. 5 (2).

8. (1) Subject to subsection (2), a person who formerly held a general or extended certificate or a certificate under Part IV of the Health Disciplines Act, and who applies for a certificate of registration under the Act in the same membership class, shall be deemed to have met the requirements set out in section 6 or 11.1 that are applicable to the class of certificate equivalent to the one that the person previously held, if he or she satisfies the Executive Director that he or she,

(a) graduated within the past five years from a program in nursing that was a requirement for the issuance of his or her previous certificate of registration;

(b) has no need for additional education or experience based on evidence of safe nursing practice during the past five years; or

(c) has successfully completed any additional educational requirements that may be determined by the Registration Committee. O. Reg. 22/06, s. 1.

(2) Subsection (1) does not apply to a person whose certificate of registration was revoked or suspended by the Executive Director in accordance with an order of the Discipline Committee, the Fitness to Practise Committee, the Registration Committee, or a panel of any of those committees. O. Reg. 22/06, s. 1.

(3) An application referred to in subsection (1) shall be treated, in all other respects, as an initial application for registration. O. Reg. 22/06, s. 1.

8.1 (1) Subject to subsection (3), an applicant who meets all of the following requirements shall have met the requirements for a general certificate of registration as a registered nurse:

1. The applicant must, prior to January 1, 2005, have been registered to practise nursing in another province or territory in Canada with a certificate or licence considered by the Registration Committee to be equivalent to a general certificate of registration as a registered nurse.

2. The applicant must provide written confirmation from the regulatory body for nursing in each province or territory in Canada in which the applicant practised during the five years prior to the date of application verifying that the applicant, while registered, met that regulatory body’s continuing competence or quality assurance requirements.

3. The applicant,

i. in the opinion of the Executive Director or the Registration Committee, as the case may be, must have no additional need for education or experience based on evidence of safe nursing practice during the preceding five years, or

ii. must have successfully completed such additional education requirements as shall be determined by the Registration Committee.

4. The applicant must meet the requirements of section 5. O. Reg. 433/04, s. 6.

(2) Where the Executive Director is not satisfied that the applicant meets the requirements of subparagraph 3 i of subsection (1), the Executive Director shall refer the application to the Registration Committee to consider what additional education would need to be taken by the applicant to meet the requirements of subparagraph 3 ii of subsection (1). O. Reg. 433/04, s. 6.

(3) Subsection (1) is not applicable to an applicant,

(a) who, at any time, was the subject of a proceeding for professional misconduct, incompetence or incapacity in relation to the nursing profession or another health profession, other than a proceeding which was completed based upon its merits;

(b) who, at any time, was the subject of an inquiry or investigation by or on behalf of a regulatory body governing nursing in a province or territory in Canada, which was not completed on its merits or which resulted in the resignation of the applicant as a member of that regulatory body;

(c) who, at the time of the application, was the subject of an outstanding order or decision of a regulatory body governing nursing in a province or territory in Canada;

(d) who, at the time of the application, was in breach of an order or in violation of a decision of a regulatory body governing nursing in a province or territory in Canada;

(e) who, at any time, was in breach of any written agreement with or undertaking provided to a regulatory body governing nursing in a province or territory in Canada; or

(f) whose right to practise in a province or territory in Canada was, at the time of the application, subject to terms, conditions or limitations, other than those applicable to all members of the class of certificate of registration which the applicant held. O. Reg. 433/04, s. 6.

(4) The requirements of paragraphs 1, 2 and 3 of subsection (1) are non-exemptible. O. Reg. 433/04, s. 6.

8.2 (1) Subject to subsection (3), an applicant who meets all of the following requirements shall have met the requirements for a certificate of registration as a registered practical nurse:

1. The applicant must, prior to January 1, 2005, have been registered to practise nursing in another province or territory in Canada with a certificate or licence considered by the Registration Committee to be equivalent to a general certificate of registration as a registered practical nurse.

2. The applicant must provide written confirmation from the regulatory body for nursing in each province or territory in Canada in which the applicant practised during the five years prior to the date of application verifying that the applicant, while registered, met that regulatory body’s continuing competence or quality assurance requirements.

3. The applicant,

i. in the opinion of the Executive Director or Registration Committee, as the case may be, must have no additional need for education or experience based on evidence of safe nursing practice during the preceding five years, or

ii. must have successfully completed such additional education requirements as shall be determined by the Registration Committee.

4. The applicant must meet the requirements of section 5. O. Reg. 433/04, s. 6.

(2) Where the Executive Director is not satisfied that the applicant meets the requirements of subparagraph 3 i of subsection (1), the Executive Director shall refer the application to the Registration Committee to consider what additional education would need to be taken by the applicant to meet the requirements of subparagraph 3 ii of subsection (1). O. Reg. 433/04, s. 6.

(3) Subsection (1) is not applicable to an applicant,

(a) who, at any time, was the subject of a proceeding for professional misconduct, incompetence or incapacity in relation to the nursing profession or another health profession, other than a proceeding which was completed based upon its merits;

(b) who, at any time, was the subject of an inquiry or investigation by or on behalf of a regulatory body governing nursing in a province or territory in Canada, which was not completed on its merits or which resulted in the resignation of the applicant as a member of that regulatory body;

(c) who, at the time of the application, was the subject of an outstanding order or decision of a regulatory body governing nursing in a province or territory in Canada;

(d) who, at the time of the application, was in breach of an order or in violation of a decision of a regulatory body governing nursing in a province or territory in Canada;

(e) who, at any time, was in breach of any written agreement with or undertaking provided to a regulatory body governing nursing in a province or territory in Canada; or

(f) whose right to practise in a province or territory in Canada was, at the time of the application, subject to terms, conditions or limitations, other than those applicable to all members of the class of certificate of registration which the applicant held. O. Reg. 433/04, s. 6.

(4) The requirements of paragraphs 1, 2 and 3 of subsection (1) are non-exemptible. O. Reg. 433/04, s. 6.

Mutual Recognition for Registered Nurses in the Extended Class

8.3 (1) Subject to subsections (3) and (5), an applicant who meets all of the following requirements shall have met the requirements for an extended certificate of registration as a registered nurse:

1. The applicant must have been registered to practise nursing in another province or territory in Canada with a certificate or licence considered by the Registration Committee to be one which was equivalent to an extended certificate of registration as a registered nurse.

2. The applicant must satisfy either the Executive Director or the Registration Committee that the applicant previously practised one of the specialties in nursing recognized by this Regulation, in another province or territory in Canada.

3. If any of the nursing programs which the applicant completed in order to be permitted to practise one of the specialties in nursing recognized by this Regulation were not university programs, the applicant must have successfully completed any additional education and training determined by the Registration Committee.

4. The applicant must have successfully completed the examinations for that specialty in the extended class referred to in subparagraph 3 i of subsection 11.1 (1).

5. The applicant must provide written confirmation from the regulatory body for nursing in each province or territory in Canada in which the applicant practised during the five years prior to the date of application verifying that the applicant, while registered, met that regulatory body’s continuing competence or quality assurance requirements.

6. The applicant,

i. in the opinion of the Executive Director or the Registration Committee, as the case may be, must have no additional need for education or experience based on evidence of safe nursing practice in a specialty in nursing recognized by this Regulation during the preceding year, or

ii. must have successfully completed any additional education requirements determined by the Registration Committee.

7. The applicant must meet the requirements of section 5. O. Reg. 502/07, s. 1.

(2) Where paragraph 3 of subsection (1) is applicable to an applicant, the applicant shall, if requested by the Registration Committee, undergo an assessment of his or her competence using a process approved by the Registration Committee so as to permit the Registration Committee to determine what additional nursing education, training or experience, if any, is required in order for the applicant to meet the requirements of that paragraph. O. Reg. 502/07, s. 1.

(3) Subsection 11.1 (5) applies to an applicant under this section. O. Reg. 502/07, s. 1.

(4) Where the Executive Director is not satisfied that the applicant meets the requirements of subparagraph 6 i of subsection (1), the Executive Director shall refer the application to the Registration Committee to consider what additional education would need to be taken by the applicant to meet the requirements of subparagraph 6 ii of subsection (1). O. Reg. 502/07, s. 1.

(5) Subsection (1) is not applicable to an applicant,

(a) who, at any time, was the subject of a proceeding for professional misconduct, incompetence or incapacity in relation to the nursing profession or another health profession, other than a proceeding which was completed based upon its merits;

(b) who, at any time, was the subject of an inquiry or investigation by or on behalf of a regulatory body governing nursing in a province or territory in Canada, which was not completed on its merits or which resulted in the resignation of the applicant as a member of that regulatory body;

(c) who, at the time of the application, was the subject of an outstanding order or decision of a regulatory body governing nursing in a province or territory in Canada;

(d) who, at the time of the application, was in breach of an order or in violation of a decision of a regulatory body governing nursing in a province or territory in Canada;

(e) who, at any time, was in breach of any written agreement with or undertaking provided to a regulatory body governing nursing in a province or territory in Canada; or

(f) whose right to practise in a province or territory in Canada was, at the time of the application, subject to terms, conditions or limitations, other than those applicable to all members of the class of certificate of registration which the applicant held. O. Reg. 502/07, s. 1.

(6) The requirements of paragraphs 1, 2, 3, 4, 5 and 6 of subsection (1) are non-exemptible. O. Reg. 502/07, s. 1.

Temporary Certificates of Registration

9. (1) Revoked: O. Reg. 433/04, s. 7 (1).

(2) The following are non-exemptible registration requirements for a temporary certificate of registration:

1. The applicant must not have previously held,

i. a temporary certificate of registration as a registered nurse, in the case of a registered nurse applicant, or

ii. a temporary certificate of registration as a registered practical nurse, in the case of a registered practical nurse applicant.

2. The applicant must meet the educational requirements for a general certificate of registration which are set out in,

i. paragraph 1 of subsection 6 (1), in the case of a registered nurse applicant who applies and satisfies all of the other requirements for a temporary certificate of registration prior to January 1, 2005 or paragraph 1 of subsection 6 (1.1) in the case of any other registered nurse applicant, or

ii. paragraph 1 of subsection 6 (2), in the case of a registered practical nurse applicant who applies and satisfies all of the other requirements for a temporary certificate of registration prior to January 1, 2005 or paragraph 1 of subsection 6 (2.1) in the case of any other registered practical nurse applicant.

2.1 Since meeting the educational requirements mentioned in paragraph 2, the applicant must not have failed an examination that, if passed, would have met the examination requirement for registration in the general class. This paragraph only applies to an applicant whose application for registration in a temporary class is received after it comes into force.

3. The applicant must have a written offer of employment with an Ontario facility described in Schedule 1 or approved by the Registration Committee,

i. as a registered nurse in the case of a registered nurse applicant, or

ii. as a registered practical nurse in the case of a registered practical nurse applicant.

4. Revoked: O. Reg. 433/04, s. 7 (6).

O. Reg. 275/94, s. 9 (2); O. Reg. 39/98, s. 4; O. Reg. 212/00, s. 5 (1); O. Reg. 376/04, s. 2 (1); O. Reg. 433/04, s. 7 (2-6).

(3) The following are registration requirements for a temporary certificate of registration:

1. The applicant is able to demonstrate the ability to speak and write either English or French with reasonable fluency.

2. The applicant is a Canadian citizen or a permanent resident of Canada or authorized under the Immigration and Refugee Protection Act (Canada) to engage in the practice of nursing.

3. An applicant who graduated from a program referred to in subparagraph 1 ii, iii or iv of subsection 6 (1) or (2) or a program referred to in subparagraph 1 ii, iv or v of subsection 6 (1.1) or (2.1) must show,

i. in the case of an applicant for a certificate of registration as a registered nurse, proof of registration or eligibility for registration as a registered nurse in the jurisdiction in which the nursing program was located, or

ii. in the case of an applicant for a certificate of registration as a registered practical nurse, proof of registration or eligibility for registration as a registered practical nurse in the jurisdiction in which the registered practical nurse or registered nursing assistant program was located.

4. A registered practical nurse applicant who graduated from a nursing program referred to in subparagraph 1 v of subsection 6 (2) or subparagraph 1 vi of subsection 6 (2.1) must show proof of registration or eligibility for registration as a registered nurse in the jurisdiction in which the nursing program was located.

5. The applicant must not have been refused registration in the nursing profession in another jurisdiction.

6. An applicant for a certificate of registration as a registered nurse must,

i. have graduated, not more than one year prior to the date of his or her application, from a program described in subparagraph 1 i, ii or iii of subsection 6 (1) or a program described in subparagraph 1 i, ii, iii or iv of subsection 6 (1.1), or

ii. satisfy the Registration Committee that within the year immediately preceding the date of his or her application he or she has practised safely in nursing as a registered nurse.

7. An applicant for a certificate of registration as a registered practical nurse must,

i. have graduated, not more than one year prior to the date of his or her application, from a program described in subparagraph 1 i, ii, iii or v of subsection 6 (2), or a program described in subparagraph 1 i, ii, iii, iv or vi of subsection 6 (2.1), or

ii. satisfy the Registration Committee that within the year immediately preceding the date of his or her application he or she has practised safely in nursing as a registered practical nurse, registered nursing assistant or registered nurse. O. Reg. 275/94, s. 9 (3); O. Reg. 115/96, s. 5 (2-4); O. Reg. 212/00, s. 5 (2, 3); O. Reg. 376/04, s. 2 (2-5); O. Reg. 433/04, s. 7 (7, 8).

(4) An applicant must meet all the requirements for a temporary certificate within one year following the date of his or her application. O. Reg. 275/94, s. 9 (4); O. Reg. 433/04, s. 7 (9).

(5) The following are conditions of a temporary certificate of registration:

1. The member shall practise the profession only within the facility referred to in paragraph 3 of subsection (2) and only within the scope of his or her employment with that facility.

2. The member’s practice must be monitored and directed by a member of the College holding a general or extended class certificate of registration.

3. The member shall not perform a controlled or authorized act, including one which is delegated to him or her, unless the act is ordered,

i. pursuant to clause 5 (1) (b) of the Act, or

ii. by a registered nurse in the general class or a registered nurse in the extended class.

4. The member shall not supervise, monitor or direct the performance of a controlled or authorized act or the practice of another member in any class.

5. The member shall not delegate to another member or any other person the authority to perform a controlled or authorized act.

6. The member shall at all times when providing nursing services identify himself or herself as a temporary member.

7. The member shall be restricted to the use of the following title:

i. in the case of the holder of a temporary certificate of registration as a registered nurse, “Registered Nurse (Temporary)” or “RN (Temp)”, or

ii. in the case of the holder of a temporary certificate of registration as a registered practical nurse, “Registered Practical Nurse (Temporary)” or “RPN (Temp)”. O. Reg. 433/04, s. 7 (10).

(6) Subject to subsection (7), a member’s temporary certificate of registration is automatically revoked on the happening of any of the following events:

1. The expiry of six months from the date the certificate was issued.

2. The issuance of a general certificate of registration in the same class as the temporary certificate of registration.

3. Receipt of notification of the failure of an examination that, if passed, would have satisfied the examination requirement for registration in the general class for the class of nurse for which the temporary certificate was issued. O. Reg. 433/04, s. 7 (10).

(7) The provisions of subsection (6) do not apply to a holder of a temporary certificate of registration who met all of the requirements for the issuance of that certificate prior to the coming into force of Ontario Regulation 433/04. O. Reg. 433/04, s. 7 (10).

(8) The provisions of subsections 9 (6) and (7) of this Regulation, as they read immediately before the coming into force of Ontario Regulation 433/04, continue to apply to the holder of a temporary certificate of registration who met all the requirements for the issuance of that certificate prior to the coming into force of that regulation. O. Reg. 433/04, s. 7 (10).

(9) Where the member obtains alternate or additional employment as a nurse in the same class for which the temporary certificate of registration was issued, the member may only practise the profession under that employment if,

(a) the employment is with an Ontario facility that is described in Schedule 1 or approved by the Registration Committee; and

(b) the member has first filed with the College a written offer of employment from that facility. O. Reg. 433/04, s. 7 (10).

Special Assignment Certificates of Registration

10. (1) The following are non-exemptible registration requirements for a special assignment certificate of registration as a registered nurse:

1. The applicant must satisfy the Registration Committee that he or she,

i. has successfully completed a nursing program that was recognized or approved in the jurisdiction in which the program was offered as qualifying the applicant to practise in that jurisdiction,

ii. has practised safely in nursing within the five years immediately preceding the date of application,

iii. has not previously been registered with the College as a registered nurse except as the holder of a special assignment certificate,

iv. has not previously held a special assignment certificate for the same assignment or appointment approved by the Registration Committee,

v. has an appointment or special assignment as a registered nurse with an Ontario facility described in Schedule 1 or another assignment approved by the Registration Committee.

2. The applicant must sign an undertaking with the College in which the applicant agrees to observe any term, condition or limitation imposed by the Registration Committee. O. Reg. 275/94, s. 10 (1); O. Reg. 115/96, s. 6 (2); O. Reg. 39/98, s. 5 (1).

(2) The following are non-exemptible registration requirements for a special assignment certificate of registration as a registered practical nurse:

1. The applicant must satisfy the Registration Committee that he or she,

i. has successfully completed a practical nurse or nursing assistant program that was recognized or approved in the jurisdiction in which the program was offered as qualifying the applicant to practise in that jurisdiction,

ii. has practised safely as a practical nurse or nursing assistant within the five years immediately preceding the date of application,

iii. has not previously been registered with the College as a registered practical nurse or registered nursing assistant except as the holder of a special assignment certificate,

iv. has not previously held a special assignment certificate for the same assignment or appointment approved by the Registration Committee,

v. has an appointment or special assignment as a registered practical nurse with an Ontario facility described in Schedule 1 or another assignment approved by the Registration Committee.

2. The applicant must sign an undertaking with the College in which the applicant agrees to observe any term, condition or limitation imposed by the Registration Committee. O. Reg. 275/94, s. 10 (2); O. Reg. 115/96, s. 6 (3); O. Reg. 39/98, s. 5 (2).

(3) The following are registration requirements for a special assignment certificate of registration:

1. The applicant is able to demonstrate the ability to speak and write either English or French with reasonable fluency.

2. An applicant who graduated from a program referred to in subparagraph i of paragraph 1 of subsection (1) or (2) must show,

i. in the case of an applicant for a certificate of registration as a registered nurse, proof of registration or eligibility for registration as a registered nurse in the jurisdiction in which the nursing program was located, or

ii. in the case of an applicant for a certificate of registration as a registered practical nurse, proof of registration or eligibility for registration as a registered practical nurse in the jurisdiction in which the practical nurse or nursing assistant program was located.

3. The applicant must not have been refused registration in the nursing profession in another jurisdiction. O. Reg. 275/94, s. 10 (3); O. Reg. 115/96, s. 6 (4).

(4) It is a condition of a special assignment certificate of registration that the member practise the profession only within the scope of his or her appointment or special assignment with the facility named in the certificate and within the terms, conditions and limitations set out in his or her certificate. O. Reg. 275/94, s. 10 (4).

(5) A special assignment certificate expires on the earliest of the following:

1. The date specified in the certificate.

2. The last day of the appointment or special assignment.

3. The day that is one year after the day the member was notified that he or she qualified for a special assignment certificate. O. Reg. 275/94, s. 10 (5).

(6) If a member who holds a special assignment certificate of registration does not receive a certificate of another class before the expiry of the certificate, he or she shall be deemed to have resigned at the end of the last day the certificate is valid. O. Reg. 275/94, s. 10 (6).

Transitional Certificates of Registration

11. (1) Subject to subsection (3), an applicant who meets all of the following requirements shall have met the requirements for a transitional certificate of registration as a registered nurse:

1. The applicant must have applied for a transitional certificate of registration as a registered nurse after December 31, 2004.

2. At the time of application for that certificate, the applicant must have been registered in another province or territory in Canada as a registered nurse with a certificate or licence considered by the Registration Committee to be equivalent to a general certificate of registration as a registered nurse.

3. The applicant must provide written confirmation from the regulatory body for nursing in each province or territory in Canada in which the applicant practised during the five years prior to the date of application verifying that the applicant while registered met that regulatory body’s continuing competence or quality assurance requirements.

4. The applicant must provide evidence of safe nursing practice during the preceding five years that is satisfactory to the Executive Director or the Registration Committee, as the case may be.

5. The applicant must have enrolled in a course or courses or program, successful completion of which would result in the applicant meeting the requirements of paragraph 1 of subsection 6 (1.1) or have signed an undertaking with the College, in a form acceptable to the Registration Committee, to enrol in the required course or courses or program within a reasonable period of time.

6. The applicant must meet the requirements of section 5. O. Reg. 433/04, s. 8; O. Reg. 387/06, s. 1.

(2) Subject to subsection (3), an applicant who meets all of the following requirements shall have met the requirements for a transitional certificate of registration as a registered practical nurse:

1. The applicant must have applied for a transitional certificate of registration as a registered practical nurse after December 31, 2004.

2. At the time of application for that certificate, the applicant must have been registered in another province or territory in Canada as a registered practical nurse with a certificate or licence considered by the Registration Committee to be equivalent to a general certificate of registration as a registered practical nurse.

3. The applicant must provide written confirmation from the regulatory body for nursing in each province or territory in Canada in which the applicant practised during the five years prior to the date of application verifying that the applicant while registered met that regulatory body’s continuing competence or quality assurance requirements.

4. The applicant must provide evidence of safe nursing practice during the preceding five years that is satisfactory to the Executive Director or the Registration Committee, as the case may be.

5. The applicant must have enrolled in a course or courses or program, successful completion of which would result in the applicant meeting the requirements of paragraph 1 of subsection 6 (2.1) or have signed an undertaking with the College, in a form acceptable to the Registration Committee, to enrol in the required course or courses or program within a reasonable period of time.

6. The applicant must meet the requirements of section 5. O. Reg. 433/04, s. 8; O. Reg. 387/06, s. 1.

(3) Subsections (1) and (2) are not applicable to an applicant,

(a) who, at any time, was the subject of a proceeding for professional misconduct, incompetence or incapacity in relation to the nursing profession or another health profession, other than a proceeding which was completed based upon its merits;

(b) who, at any time, was the subject of an inquiry or investigation by or on behalf of a regulatory body governing nursing in a province or territory in Canada, which was not completed on its merits or which resulted in the resignation of the applicant as a member of that regulatory body;

(c) who, at the time of the application, was the subject of an outstanding order or decision of a regulatory body governing nursing in a province or territory in Canada;

(d) who, at the time of the application, was in breach of an order or in violation of a decision of a regulatory body governing nursing in a province or territory in Canada;

(e) who, at any time, was in breach of any written agreement with or undertaking provided to a regulatory body governing nursing in a province or territory in Canada; or

(f) whose right to practise in another province or territory in Canada was, at the time of the application, subject to terms, conditions or limitations, other than those applicable to all members of the class of certificate of registration which the applicant held. O. Reg. 433/04, s. 8.

(4) The requirements of paragraphs 1, 2, 3, 4 and 5 of subsection (1) are non-exemptible. O. Reg. 433/04, s. 8.

(5) The requirements of paragraphs 1, 2, 3, 4 and 5 of subsection (2) are non-exemptible. O. Reg. 433/04, s. 8.

(6) A transitional certificate of registration is subject to the following terms, conditions and limitations:

1. The member shall provide information to the Executive Director verifying the member’s enrolment in the course or courses or program referred to in paragraph 5 of subsection (1), in the case of a registered nurse, or paragraph 5 of subsection (2), in the case of a registered practical nurse, when requested in writing to do so by the Executive Director, and on the Annual Payment Form sent each year by the College to the member.

2. A transitional certificate of registration is automatically revoked on the date the member receives a general certificate of registration of the same membership class as the transitional certificate of registration, unless one of the following occurs first, in which case the transitional certificate of registration is revoked on the occurrence:

i. In the case of a transitional certificate of registration as a registered nurse, the date which is four years after the issuance of that transitional certificate of registration.

ii. In the case of a transitional certificate of registration as a registered practical nurse, on the date which is two years after the issuance of that transitional certificate of registration.

3. A transitional certificate of registration is automatically revoked if the member fails to provide information referred to in paragraph 1, as of the date that is 30 days after written notice is given to the member of the failure.

4. A transitional certificate of registration is automatically revoked if the member fails to satisfy either the Executive Director or the Registration Committee, as the case may be, that the member is making reasonable efforts to complete the course or courses or program referred to in paragraph 5 of subsection (1) in the case of a member holding a transitional certificate of registration as a registered nurse or the course or courses or program referred to in paragraph 5 of subsection (2), in the case of a member holding a transitional certificate of registration as a registered practical nurse. O. Reg. 433/04, s. 8; O. Reg. 387/06, s. 2.

Extended Certificates of Registration

11.1 (1) The following are non-exemptible registration requirements for an extended certificate of registration as a registered nurse:

1. The applicant,

i. must hold or have held a general certificate of registration as a registered nurse, issued by the College, or

ii. must satisfy the Registration Committee,

A. that he or she meets the registration requirements for a general certificate of registration as a registered nurse as set out in paragraphs 1 and 3 of subsection 6 (1.1), or

B. that the applicant graduated from a program of nursing prior to January 1, 2005 and that, had the applicant applied prior to January 1, 2005, he or she would have met the registration requirements for a general certificate of registration as a registered nurse, or

iii. must hold or have held a certificate of registration as a registered nurse in another jurisdiction which the Registration Committee is satisfied is equivalent to an extended certificate of registration as a registered nurse.

2. The applicant,

i. must have graduated from an Ontario university program for preparing registered nurses for a specialty in the extended class which program was, at the time the applicant graduated, approved by Council,

ii. must have graduated from a university program in another province or territory in Canada or one of the United States of America for preparing registered nurses for a specialty in the extended class which program was, at the time the applicant graduated, approved by Council,

iii. must have graduated from a university nursing program that the Registration Committee is satisfied was, at the time the applicant graduated, equivalent to a current Ontario university program referred to in subparagraph i, or

iv. subject to subsection (4), must have graduated from a nursing program other than one referred to in subparagraphs i, ii or iii and satisfied the Registration Committee that he or she has obtained additional nursing education, training or experience that, together with the education provided by the nursing program from which he or she graduated, is equivalent to the education currently provided to a graduate of an Ontario university program referred to in subparagraph i.

3. At the time of successfully completing all other requirements for registration as a registered nurse in the extended class or at the time of application, whichever is later, the applicant must,

i. successfully complete,

A. whatever examinations are approved by Council for that specialty in the extended class for which the applicant had successfully completed the program referred to in paragraph 2, or

B. whatever examinations are set by or administered by the College for that specialty in the extended class for which the applicant had successfully completed the program referred to in paragraph 2, and

ii. satisfy the Registration Committee that, during the past five years,

A. he or she has practised nursing for at least two years,

B. his or her nursing practice was performed safely, and

C. for at least one of those years, he or she practised in a nursing role that required him or her to use advanced knowledge and decision-making skills in assessment, diagnosis and health care management. O. Reg. 502/07, s. 2.

(2) An applicant who graduated from an Ontario university program for preparing registered nurses in the extended class that was, at the time the applicant graduated, approved by the Council of Ontario University Programs in Nursing and by the Senate or Governing Council of the University that offered the program, is deemed to have met the requirement of subparagraph 2 i of subsection (1). O. Reg. 502/07, s. 2.

(3) The following are additional registration requirements for an extended certificate of registration as a registered nurse:

1. The applicant is able to demonstrate the ability to speak and write either English or French with reasonable fluency.

2. The applicant is a Canadian citizen or a permanent resident of Canada or authorized under the Immigration and Refugee Protection Act (Canada) to engage in the practice of nursing.

3. An applicant who graduated from a program referred to in subparagraph ii, iii or iv of paragraph 2 of subsection (1) must, if the program was located outside Ontario, show proof of registration, or eligibility for registration, as the equivalent of a registered nurse in the extended class, in the jurisdiction in which the program was located.

4. The applicant must not have been refused registration in the nursing profession in another jurisdiction. O. Reg. 502/07, s. 2.

(4) An applicant who graduated from a program referred to in subparagraph iv of paragraph 2 of subsection (1) shall, if requested by the Registration Committee, undergo an assessment of his or her competence using a process approved by the Registration Committee so as to permit the Registration Committee to determine what additional nursing education, training or experience, if any, is required in order for the applicant to meet the requirements of that subparagraph. O. Reg. 502/07, s. 2.

(5) If an applicant for an extended certificate of registration fails to successfully complete the examinations referred to in subparagraph i of paragraph 3 of subsection (1), the applicant must, as an additional non-exemptible registration requirement,

(a) if requested by the Registration Committee, undergo an assessment of his or her competence using a process approved by the Registration Committee; and

(b) successfully complete such additional education and obtain such additional training and experience as the Registration Committee determines is necessary to enable the applicant to practise safely in a specialty recognized by this Regulation, before resubmitting to the examinations referred to in subparagraph i of paragraph 3 of subsection (1). O. Reg. 502/07, s. 2.

11.2 (1) There shall be in the extended class the non-acute care specialty of Primary Health Care. O. Reg. 502/07, s. 2.

(2) There shall be in the extended class the following acute care specialties:

1. Paediatrics.

2. Adult.

3. Anaesthesia. O. Reg. 502/07, s. 2.

(3) An applicant being issued an extended certificate of registration shall also be issued a specialty certificate for that specialty for which the applicant successfully completed the examinations referred to in subparagraph i of paragraph 3 of subsection 11.1 (1). O. Reg. 502/07, s. 2.

(4) A member holding an extended certificate of registration on August 27, 2007 shall be issued a Primary Health Care specialty certificate. O. Reg. 502/07, s. 2.

(5) A member holding a specialty certificate is entitled to the issuance of a specialty certificate in another specialty upon meeting all of the requirements that would otherwise have been applicable to the member had he or she been an initial applicant for the issuance of an extended certificate of registration in relation to that other specialty. O. Reg. 502/07, s. 2.

(6) For greater clarity, a specialty certificate is not a class of certificate of registration. O. Reg. 502/07, s. 2.

11.3 (1) Where a member’s extended certificate of registration is suspended or revoked, any specialty certificate issued to the member is automatically suspended or revoked until the suspension or the revocation is lifted or removed. O. Reg. 502/07, s. 2.

(2) Where a former member’s extended certificate of registration is reinstated, any specialty certificate the former member held at the time of the suspension or revocation shall also be reinstated unless otherwise directed by the committee that determined that the reinstatement should take place. O. Reg. 502/07, s. 2.

(3) Where a member holding an extended certificate of registration resigns that certificate, any specialty certificate issued to the member is automatically revoked. O. Reg. 502/07, s. 2.

Titles

11.4 (1) Subject to subsections (2), (3), (4) and (5), a member holding an extended certificate of registration shall use the title “Nurse Practitioner” or the abbreviation “NP” or the title “Registered Nurse Extended Class” or the abbreviation “RN(EC)”, when practising in that role. O. Reg. 502/07, s. 2.

(2) A member holding a Primary Health Care specialty certificate may use the title “Nurse Practitioner — Primary Health Care” or the abbreviation “NP — PHC”, when practising in that role. O. Reg. 502/07, s. 2.

(3) A member holding a Paediatrics specialty certificate may use the title “Nurse Practitioner — Paediatrics” or the abbreviation “NP — Paediatrics”, when practising in that role. O. Reg. 502/07, s. 2.

(4) A member holding an Adult specialty certificate may use the title “Nurse Practitioner — Adult” or the abbreviation “NP — Adult ”, when practising in that role. O. Reg. 502/07, s. 2.

(5) A member holding an Anaesthesia specialty certificate may use the title “Nurse Practitioner — Anaesthesia” or the abbreviation “NP — Anaesthesia”, when practising in that role. O. Reg. 502/07, s. 2.

(6) Except as permitted by the Act or this Regulation, no other title, designation, variation or abbreviation shall be used by a member holding an extended certificate of registration. O. Reg. 502/07, s. 2.

(7) No member shall use the title “Nurse Practitioner”, any variation or abbreviation thereof, or the designation “Registered Nurse Extended Class”, or any variation or abbreviation thereof, unless the member holds an extended certificate of registration. O. Reg. 502/07, s. 2.

(8) No member shall refer to himself or herself as a specialist in any of the specialties referred to in section 11.2 unless the member holds a specialty certificate in that specialty. O. Reg. 502/07, s. 2.

Examinations

11.5 (1) A person who meets the following requirements is entitled to attempt the examinations that must be successfully completed as a requirement for the issuance of an extended certificate of registration as a registered nurse:

1. The person must file a completed examination application form with the College at least 90 days before the commencement of the examinations.

2. The person must pay the required examination fee to the College at least 90 days before the commencement of the examinations.

3. The person must meet the requirements of paragraph 1 of subsection 11.1 (1).

4. The person must meet the requirements of paragraph 2 of subsection 11.1 (1) for that specialty to which the examinations relate.

5. Where the person previously attempted but failed to successfully complete the examinations referred to in subparagraph 3 i of subsection 11.1 (1), the person must have met the requirements of subsection 11.1 (5).

6. The person must not have attempted on three previous occasions the examinations for a specialty which would, if successfully completed, have met the examination requirement for registration in the extended class. O. Reg. 502/07, s. 2.

(2) For greater clarity, examinations taken prior to the applicant’s successful completion of the program referred to in paragraph 2 of subsection 11.1 (1) shall not be considered in determining eligibility pursuant to paragraphs 5 or 6 of subsection (1). O. Reg. 502/07, s. 2.

Examination

12. (1) The College shall ensure that the examination that is a requirement for a general certificate of registration in each of the membership classes is held in Ontario at least once every six months. O. Reg. 433/04, s. 10.

(2) Subject to subsection (3), a person who meets the following requirements is entitled to take the examination that is a requirement for a general certificate of registration as a registered nurse:

1. The person must file a completed examination application form with the College at least 90 days before the day of the examination.

2. The person must pay the required examination fee to the College at least 90 days before the day of the examination.

3. The person must meet the requirements of paragraph 1 of subsection 6 (1), in the case of an applicant who applied for a general certificate of registration as a registered nurse prior to January 1, 2005, or meet the requirements of paragraph 1 of subsection 6 (1.1), in the case of an applicant who applied for a general certificate of registration as a registered nurse after December 31, 2004.

4. The person must not be ineligible to take the examination as a result of subsection (6). O. Reg. 433/04, s. 10.

(3) An applicant who applied for a general certificate of registration as a registered nurse prior to January 1, 2005 and who met the requirements of paragraph 1 of subsection 6 (1) but who does not meet the requirements of paragraph 1 of subsection 6 (1.1) shall only be eligible to take the examination until the earlier of,

(a) November 1, 2005; or

(b) in the case of an applicant,

(i) who met the requirement of subparagraph 2 i of subsection 6 (1), the expiry of five years from the completion of the program referred to in that subparagraph,

(ii) who met the requirement of subparagraph 2 ii of subsection 6 (1), the expiry of five years from the date the applicant last practised safely, as determined by the Registration Committee, or

(iii) who met the requirement of subparagraph 2 iii of subsection 6 (1), the expiry of five years from successful completion of the additional education or additional experience referred to in that subparagraph. O. Reg. 433/04, s. 10.

(4) Subject to subsection (5), a person who meets the following requirements is entitled to take the examination that is a requirement for a general certificate of registration as a registered practical nurse:

1. The person must file a complete examination application form with the College at least 90 days before the day of the examination.

2. The person must pay the required examination fee to the College at least 90 days before the day of the examination.

3. The person must meet the requirement of paragraph 1 of subsection 6 (2), in the case of an applicant who applied for a general certificate of registration as a registered practical nurse prior to January 1, 2005, or meet the requirements of paragraph 1 of subsection 6 (2.1), in the case of an applicant who applied for a general certificate of registration as a registered practical nurse after December 31, 2004.

4. The person must not be ineligible to take the examination as a result of subsection (6). O. Reg. 433/04, s. 10.

(5) An applicant who applied for a general certificate of registration as a registered practical nurse prior to January 1, 2005 and who met the requirements of paragraph 1 of subsection 6 (2) but who does not meet the requirements of paragraph 1 of subsection 6 (2.1) shall only be eligible to take the examination until the earlier of,

(a) November 1, 2005; or

(b) in the case of an applicant,

(i) who met the requirement of subparagraph 2 i of subsection 6 (2), the expiry of five years from the completion of the program referred to in that subparagraph,

(ii) who met the requirement of subparagraph 2 ii of subsection 6 (2), the expiry of five years from the date the applicant last practised safely, as determined by the Registration Committee, or

(iii) who met the requirement of subparagraph 2 iii of subsection 6 (2), the expiry of five years from successful completion of the additional education or additional experience referred to in that subparagraph. O. Reg. 433/04, s. 10.

(6) Subject to subsection (7), a person is ineligible to take the examination if after meeting the requirements referred to in paragraph 3 of subsection (2) or paragraph 3 of subsection (4),

(a) the person successfully completed an examination which met the requirement for registration in that general class;

(b) the person was the subject of a decision from the Registration Committee respecting the person’s eligibility to take the examination and the person is no longer eligible under that decision to take the examination; or

(c) the person is a person not referred to in clause (b) and the person failed on three or more previous occasions an examination which would have met the examination requirement for registration in that general class. O. Reg. 433/04, s. 10.

(7) Without in any way limiting the provisions of subsections (3) and (5), the provisions of clause (6) (c) shall not apply to a person who was eligible to take the applicable examination prior to the coming into force of Ontario Regulation 433/04 until the person is no longer eligible to take the examination under the provisions that existed immediately before the coming into force of that regulation. O. Reg. 433/04, s. 10.

(8) For greater clarity, an examination taken prior to the applicant’s successful completion of the program referred to in paragraph 1 of subsection 6 (1) or (1.1), in the case of a registered nurse, or paragraph 1 of subsection 6 (2) or (2.1), in the case of a registered practical nurse, shall not be considered in determining eligibility pursuant to subsection (6). O. Reg. 433/04, s. 10.

Retired Class

12.1 (1) The following are registration requirements for a retired certificate of registration as a registered nurse:

1. The applicant must,

i. be 65 years of age or older,

ii. be a member of the College holding a general or extended class certificate of registration as a registered nurse or have previously been a member of the College holding a general or extended class certificate of registration as a registered nurse,

iii. not have been found guilty of a criminal offence or offence under the Controlled Drugs and Substances Act (Canada) or the Food and Drugs Act (Canada),

iv. in the case of an applicant who was not a member at the time of the application, not have resigned or otherwise ceased to be a member of the College at a time when,

A. the member was in default of payment of fees,

B. the member was the subject of proceedings for professional misconduct, incompetence or incapacity, whether in Ontario or in another jurisdiction whether in relation to the nursing profession or another health profession,

C. the member was the subject of an outstanding order of a Committee, a panel of a Committee or a board of inquiry of the College,

D. the member was in breach of an order of a Committee, a panel of a Committee or a board of inquiry of the College,

E. the member was in violation of a decision of a panel of the Complaints Committee requiring the member to attend to be cautioned,

F. the member was the subject of an ongoing inquiry or investigation by the Registrar, a Committee, a panel of a Committee or a board of inquiry of the College, and

v. in the case of an applicant who, at the time of the application, is a member,

A. not be in default of payment of fees,

B. not be the subject of proceedings for professional misconduct, incompetence or incapacity, whether in Ontario or in another jurisdiction whether in relation to the nursing profession or another health profession,

C. not be the subject of an outstanding order of a Committee, a panel of a Committee or a board of inquiry of the College,

D. not be in breach of an order of a Committee, a panel of a Committee or a board of inquiry of the College,

E. not be in violation of a decision of a panel of the Complaints Committee requiring the member to attend to be cautioned,

F. not be the subject of an ongoing inquiry or investigation by the Registrar, a Committee, a panel of a Committee or a board of inquiry of the College. O. Reg. 212/00, s. 8.

(2) The following are registration requirements for a retired certificate of registration as a registered practical nurse:

1. The applicant must,

i. be 65 years of age or older,

ii. be a member of the College holding a general class certificate of registration as a registered practical nurse or have previously been a member of the College holding a general class certificate of registration as a registered practical nurse,

iii. not have been found guilty of a criminal offence or offence under the Controlled Drugs and Substances Act (Canada) or the Food and Drugs Act (Canada),

iv. in the case of an applicant who was not a member at the time of the application, not have resigned or otherwise ceased to be a member of the College at a time when,

A. the member was in default of payment of fees,

B. the member was the subject of proceedings for professional misconduct, incompetence or incapacity, whether in Ontario or in another jurisdiction whether in relation to the nursing profession or another health profession,

C. the member was the subject of an outstanding order of a Committee, a panel of a Committee or a board of inquiry of the College,

D. the member was in breach of an order of a Committee, a panel of a Committee or a board of inquiry of the College,

E. the member was in violation of a decision of a panel of the Complaints Committee requiring the member to attend to be cautioned,

F. the member was the subject of an ongoing inquiry or investigation by the Registrar, a Committee, a panel of a Committee or a board of inquiry of the College, and

v. in the case of an applicant who, at the time of the application, is a member,

A. not be in default of payment of fees,

B. not be the subject of proceedings for professional misconduct, incompetence or incapacity, whether in Ontario or in another jurisdiction whether in relation to the nursing profession or another health profession,

C. not be the subject of an outstanding order of a Committee, a panel of a Committee or a board of inquiry of the College,

D. not be in breach of an order of a Committee, a panel of a Committee or a board of inquiry of the College,

E. not be in violation of a decision of a panel of the Complaints Committee requiring the member to attend to be cautioned,

F. not be the subject of an ongoing inquiry or investigation by the Registrar, a Committee, a panel of a Committee or a board of inquiry of the College. O. Reg. 212/00, s. 8.

(3) The registration requirement in subparagraphs 1 i and ii of subsection (1) and subparagraphs 1 i and ii of subsection (2) are non-exemptible. O. Reg. 212/00, s. 8.

(4) The following are conditions of a retired certificate of registration as a registered nurse or as a registered practical nurse:

1. The member shall not practise the profession of nursing.

2. Except as permitted by subsection 29 (1) of the Regulated Health Professions Act, 1991, the member shall not perform a controlled act, including one which is delegated.

3. The member shall not hold himself or herself out as a person qualified to practise in Ontario as a nurse, registered nurse, practical nurse, registered practical nurse or in any speciality of nursing.

4. The member shall be restricted to the use of the following title:

i. in the case of a holder of a retired certificate of registration as a registered nurse, “Registered Nurse, Retired”, “RN Retired” or an equivalent in another language, or

ii. in the case of a holder of a retired certificate of registration as a registered practical nurse, “Registered Practical Nurse, Retired”, “RPN Retired” or an equivalent in another language.

5. If no annual fee is payable by the member, the member shall confirm when requested by the College that he or she wishes to continue to be the holder of a retired certificate of registration. O. Reg. 212/00, s. 8.

(5) Any certificate of registration held by the member shall automatically be revoked immediately upon the issuance of a retired certificate of registration. O. Reg. 212/00, s. 8.

(6) A member holding a retired certificate of registration as a registered nurse or as a registered practical nurse may apply for the reinstatement of the general or extended class certificate that he or she previously held by submitting a completed application to the Executive Director in the form provided by the Executive Director. O. Reg. 22/06, s. 2.

(7) The Executive Director shall reinstate the general or extended class certificate that the member previously held upon the approval of and subject to any terms, conditions or limitations that the Registration Committee considers appropriate, if the member,

(a) has paid the required reinstatement fee;

(b) has paid the annual fee applicable to the class of certificate being reinstated for the year in which the reinstatement occurs, less any amount previously paid by the member as an annual fee for that year; and

(c) has satisfied the Executive Director that he or she,

(i) has no need for additional education or experience based on evidence of safe nursing practice during the past five years, or

(ii) has successfully completed any additional education requirements determined by the Registration Committee. O. Reg. 22/06, s. 2.

Reinstatement

13. (1) A former member who resigned as a member or whose certificate of registration was suspended for failure to pay a required fee may apply for the reinstatement of the general or extended class certificate which he or she previously held by submitting a completed application to the Executive Director in the form provided by the Executive Director. O. Reg. 22/06, s. 3.

(2) Subject to subsection (3), the Executive Director may reinstate the former member’s certificate of registration if,

(a) the former member has paid the following amounts:

(i) the required reinstatement fee,

(ii) the annual fee for the year in which the certificate of registration is to be reinstated, if not previously paid,

(iii) any other money owing to the College at the date the application for reinstatement is submitted, including any penalty fees that were due at the time that he or she ceased to be a member; and

(b) the former member has satisfied the Executive Director that he or she,

(i) graduated within the past five years from a program in nursing that was a requirement for the issuance of the certificate of registration that is the subject of the application for reinstatement,

(ii) has no need for additional education or experience based on evidence of safe nursing practice during the past five years, or

(iii) has successfully completed any additional education requirements that may be determined by the Registration Committee. O. Reg. 22/06, s. 3.

(3) A former member is ineligible for reinstatement under subsection (2) if he or she,

(a) is the subject of a proceeding for professional misconduct, incompetence or incapacity in Ontario or in another jurisdiction in relation to the nursing profession or another health profession, or was the subject of such a proceeding, other than a proceeding that was completed on its merits;

(b) is the subject of an inquiry or investigation by the Executive Director, a committee, a panel of a committee or a board of inquiry of the College, or was the subject of such an inquiry or investigation, that was not completed on its merits or which resulted in the member’s resignation;

(c) was, at the time he or she ceased to be a member, the subject of an outstanding order of a committee, a panel of a committee, or a board of inquiry of the College;

(d) was, at the time he or she ceased to be a member, in breach of an order of a committee, a panel of a committee, or a board of inquiry of the College;

(e) was, at the time he or she ceased to be a member, in violation of a decision of a panel of the Complaints Committee, including a decision requiring the member to attend to be cautioned;

(f) was, at the time he or she ceased to be a member, in breach of any written agreement with or undertaking provided to the College; or

(g) had, at the time he or she ceased to be a member, terms, conditions or limitations on his or her certificate of registration, other than those applicable to all members of the class of certificate of registration previously held by the former member. O. Reg. 22/06, s. 3.

(4) Nothing in this section prevents a former member who resigned as a member or whose certificate of registration was suspended for failure to pay a required fee from making an application for a new certificate of registration. O. Reg. 22/06, s. 3.

13.1 If a former member’s certificate of registration is ordered to be reinstated by a panel of the Discipline Committee or the Fitness to Practise Committee, the Executive Director shall reinstate the certificate of registration upon payment of,

(a) the required reinstatement fee; and

(b) the annual fee for the year in which the certificate of registration is to be reinstated, if not previously paid. O. Reg. 22/06, s. 3.

PART III
CONTROLLED ACTS

Interpretation

13.2 In this Part,

“controlled substance” means a controlled substance within the meaning of the Controlled Drugs and Substances Act (Canada);

“electronic signature” means electronic information that a person creates or adopts in order to sign a document and that is in, attached to or associated with the document;

“signature” includes an electronic signature. O. Reg. 387/11, s. 1.

Procedures

14. All procedures on tissue below the dermis or below the surface of a mucous membrane are prescribed for the purposes of paragraph 1 of section 4 of the Act. O. Reg. 387/11, s. 1.

15. (1) For the purposes of clause 5 (1) (a) of the Act, a registered nurse in the general class may perform a procedure set out in subsection (4) if he or she meets all of the conditions set out in subsection (5). O. Reg. 387/11, s. 1.

(2) For the purposes of clause 5 (1) (a) of the Act, any member may perform a procedure set out in subsection (4) if the procedure is ordered by a registered nurse in the general class. O. Reg. 387/11, s. 1.

(3) No registered nurse in the general class shall order a procedure set out in subsection (4) unless he or she meets all of the conditions set out in subsection (5). O. Reg. 387/11, s. 1.

(4) The following are the procedures referred to in subsections (1), (2) and (3):

1. With respect to the care of a wound below the dermis or below a mucous membrane, any of the following procedures:

i. cleansing,

ii. soaking,

iii. irrigating,

iv. probing,

v. debriding,

vi. packing,

vii. dressing.

2. Venipuncture to establish peripheral intravenous access and maintain patency, using a solution of normal saline (0.9 per cent), in circumstances in which,

i. the individual requires medical attention, and

ii. delaying venipuncture is likely to be harmful to the individual.

3. A procedure that, for the purpose of assisting an individual with health management activities, requires putting an instrument,

i. beyond the point in the individual’s nasal passages where they normally narrow,

ii. beyond the individual’s larynx, or

iii. beyond the opening of the individual’s urethra.

4. A procedure that, for the purpose of assessing an individual or assisting an individual with health management activities, requires putting an instrument or finger,

i. beyond the individual’s anal verge, or

ii. into an artificial opening into the individual’s body.

5. A procedure that, for the purpose of assessing an individual or assisting an individual with health management activities, requires putting an instrument, hand or finger beyond the individual’s labia majora. O. Reg. 387/11, s. 1.

(5) The following are the conditions referred to in subsections (1) and (3):

1. The registered nurse has the knowledge, skill and judgment to perform the procedure safely, effectively and ethically.

2. The registered nurse has the knowledge, skill and judgment to determine whether the individual’s condition warrants performance of the procedure.

3. The registered nurse determines that the individual’s condition warrants performance of the procedure, having considered,

i. the known risks and benefits to the individual of performing the procedure,

ii. the predictability of the outcome of performing the procedure,

iii. the safeguards and resources available in the circumstances to safely manage the outcome of performing the procedure, and

iv. other relevant factors specific to the situation.

4. The registered nurse accepts accountability for determining that the individual’s condition warrants performance of the procedure. O. Reg. 387/11, s. 1.

15.1 (1) For the purposes of clause 5 (1) (a) of the Act, a registered practical nurse in the general class may perform a procedure set out in subsection (2) if he or she meets all of the conditions set out in subsection (3). O. Reg. 387/11, s. 1.

(2) The following are the procedures referred to in subsection (1):

1. With respect to the care of a wound below the dermis or below a mucous membrane, any of the following procedures:

i. cleansing,

ii. soaking,

iii. dressing.

2. A procedure that, for the purpose of assisting an individual with health management activities, requires putting an instrument,

i. beyond the point in the individual’s nasal passages where they normally narrow,

ii. beyond the individual’s larynx, or

iii. beyond the opening of the individual’s urethra.

3. A procedure that, for the purpose of assisting an individual with health management activities, requires putting a hand or finger beyond the individual’s labia majora.

4. A procedure that, for the purpose of assessing an individual or assisting an individual with health management activities, requires putting an instrument or finger beyond the individual’s anal verge. O. Reg. 387/11, s. 1.

(3) The following are the conditions referred to in subsection (1):

1. The registered practical nurse has the knowledge, skill and judgment to perform the procedure safely, effectively and ethically.

2. The registered practical nurse has the knowledge, skill and judgment to determine whether the individual’s condition warrants performance of the procedure.

3. The registered practical nurse determines that the individual’s condition warrants performance of the procedure, having considered,

i. the known risks and benefits to the individual of performing the procedure,

ii. the predictability of the outcome of performing the procedure,

iii. the safeguards and resources available in the circumstances to safely manage the outcome of performing the procedure, and

iv. other relevant factors specific to the situation.

4. The registered practical nurse accepts accountability for determining that the individual’s condition warrants performance of the procedure. O. Reg. 387/11, s. 1.

Prescribing, Dispensing, Selling and Compounding a Drug

16. (1) A member shall not engage in conduct that results, directly or indirectly, in a personal or financial benefit that conflicts with his or her professional or ethical duty to a patient as a result of prescribing, dispensing, selling or compounding a drug. O. Reg. 387/11, s. 1.

(2) A member who prescribes, dispenses, sells or compounds a drug shall comply with all applicable federal and provincial law related to prescribing, dispensing, selling or compounding a drug. O. Reg. 387/11, s. 1.

(3) A member who is authorized to prescribe, dispense, sell or compound a drug shall not delegate the performance of prescribing, dispensing, selling or compounding a drug to any other person. O. Reg. 387/11, s. 1.

(4) A member who is authorized to prescribe, sell or compound a drug shall not prescribe, sell or compound a controlled substance. O. Reg. 387/11, s. 1.

Prescribing

17. For the purposes of paragraph 8 of subsection 5.1 (1) of the Act, a member may only prescribe a drug if all of the following conditions are met:

1. The member must have a nurse-patient relationship with the patient for whom the drug is prescribed.

2. The member must prescribe the drug for therapeutic purposes only.

3. The member must ensure that the following information is recorded on the prescription:

i. the name and address of the person for whom the drug is prescribed,

ii. the name, strength (where applicable) and quantity of the drug that is prescribed,

iii. the directions for use,

iv. the member’s name, address, telephone number, title and registration number issued by the College,

v. the member’s signature,

vi. the date on which the drug is prescribed, and

vii. the number of refills, if applicable.

4. The member must retain a copy of the information recorded on the prescription required under paragraph 3 as part of the patient’s health record. O. Reg. 387/11, s. 1.

Dispensing

18. (1) For the purposes of paragraph 8 of subsection 5.1 (1) of the Act, a member may only dispense a drug if all of the following conditions are met:

1. The member must have a nurse-patient relationship with the patient for whom the drug is dispensed.

2. The member must not dispense a drug pursuant to a prescription issued by any other person.

3. The member must provide the drug directly to the patient or the patient’s representative.

4. The member must dispense the drug for therapeutic purposes only.

5. The member must have made reasonable inquiries and be satisfied that,

i. the patient does not have reasonable or timely access to a pharmacy,

ii. the patient would not otherwise receive the drug,

iii. the patient does not have the financial resources to obtain the drug if it is not dispensed by the member,

iv. the drug is being dispensed for a patient in conjunction with a health promotion initiative, or

v. dispensing the drug is necessary to test the patient’s response to the drug.

6. The member must dispense a reasonable quantity of the drug having regard to the information provided by the patient in response to the inquiries under paragraph 5.

7. The member must have reasonable grounds to believe that the drug has been obtained and stored in accordance with any applicable legislation.

8. The member must be satisfied that the drug has not expired and will not expire before the date on which the patient is expected to take the last of the drug.

9. The member must ensure that the container in which the drug is dispensed is marked with,

i. an identification number, if applicable,

ii. the member’s name and title,

iii. the name, address and telephone number of the place from which the drug is dispensed,

iv. the identification of the drug as to its name, its strength (where applicable) and, if available, its manufacturer,

v. the quantity of the drug dispensed,

vi. the date the drug is dispensed,

vii. the expiry date of the drug, if applicable,

viii. the name of the patient for whom the drug is dispensed, and

ix. the directions for use.

10. The member must retain a copy of the information set out under paragraph 9 on the container in which the drug was dispensed in the patient’s health record, along with the information provided by the patient in response to the inquiries under paragraph 5. O. Reg. 387/11, s. 1.

(2) A registered nurse in the extended class shall not describe himself or herself orally or in writing as a person who is authorized to dispense a drug unless he or she sets out in writing or orally the inquiries that must be made by the member before dispensing a drug to a patient under paragraph 5 of subsection (1). O. Reg. 387/11, s. 1.

Compounding

19. For the purposes of paragraph 8 of subsection 5.1 (1) of the Act, a member may only compound a drug if all of the following conditions are met:

1. The member must only compound two or more non-sterile creams or ointments to produce a compounded cream or ointment.

2. The member must ensure that the compounded cream or ointment is for topical use only and for therapeutic purposes.

3. The member must have a nurse-patient relationship with the patient for whom the cream or ointment is compounded.

4. The member must dispense the compounded cream or ointment to the patient or his or her representative or apply it directly to the patient.

5. The member must have made reasonable inquiries and be satisfied that,

i. the patient does not have reasonable or timely access to a pharmacy,

ii. the patient would not otherwise receive the compounded cream or ointment, or

iii. the patient does not have the financial resources to obtain the compounded cream or ointment if it is not compounded by the member.

6. The member must have reasonable grounds to believe that the creams or ointments used in the compounding have been obtained and stored in accordance with any applicable legislation.

7. The member must be satisfied that the creams or ointments used in the compounding have not expired and will not expire before the date on which the patient is expected to apply the last of the compounded cream or ointment.

8. The member must ensure that the container holding the compounded cream or ointment is marked with,

i. an identification number, if applicable,

ii. the name and title of the member,

iii. the name, address and telephone number of the place in which the compounded cream or ointment was compounded,

iv. the identification of the substances used in the compounded cream and ointment, their names, strength and manufacturer,

v. the percentage of each of the creams or ointments used to make the compounded cream or ointment and the quantity placed in the container,

vi. the date the compounded cream or ointment was compounded and the date the compounded cream or ointment was dispensed, if different from the former date,

vii. the expiry date of the compounded cream or ointment,

viii. the name of the patient for whom the cream or ointment was compounded, and

ix. the directions for use.

9. The member must retain a copy of the information set out under paragraph 8 in the patient’s health record, along with the information provided by the patient in response to the inquiries under paragraph 5. O. Reg. 387/11, s. 1.

Selling

19.1 (1) For the purposes of paragraph 8 of subsection 5.1 (1) of the Act, a member may only sell a drug if all of the following conditions are met:

1. The member must have a nurse-patient relationship with the patient to whom the drug is sold.

2. The member must sell the drug for therapeutic purposes only and only if he or she dispenses the drug directly to the patient or the patient’s representative or the drug is administered to the patient.

3. The member must have made reasonable inquiries and be satisfied that,

i. the patient does not have reasonable or timely access to a pharmacy,

ii. the patient would not otherwise buy the drug,

iii. the patient does not have the financial resources to obtain the drug if it is not sold by the member, or

iv. the drug is sold in conjunction with a health promotion initiative.

4. The member must have reasonable grounds to believe that the drug has been obtained and stored in accordance with any applicable federal or provincial legislation.

5. The member must be satisfied that the drug has not expired and will not expire before the date on which the patient is expected to take the last of the drug.

6. The member must not sell a drug if the selling provides a profit to him or her or a direct or indirect personal or financial benefit, other than the actual cost of the drug.

7. The member must retain in the patient’s health record a record that the drug was sold to the patient, the price charged and the information provided by the patient in response to the inquiries under paragraph 3. O. Reg. 387/11, s. 1.

(2) A registered nurse in the extended class shall not describe himself or herself orally or in writing as a person who is authorized to sell a drug unless he or she sets out in writing or orally the inquiries that must be made by the member before selling a drug to a patient under paragraph 3 of subsection (1). O. Reg. 387/11, s. 1.

Administration of a Substance by Injection or Inhalation

20. For the purposes of paragraph 6 of subsection 5.1 (1) of the Act, a member may only administer a substance by injection or inhalation if,

(a) he or she has a nurse-patient relationship with the patient for whom the administration of a substance by injection or inhalation is performed; and

(b) the procedure is performed only for therapeutic purposes. O. Reg. 387/11, s. 1.

PART IV
QUALITY ASSURANCE

General

21. (1) In this Part,

“assessor” means an assessor appointed under section 81 of the Health Professions Procedural Code;

“Committee” means the Quality Assurance Committee of the College. O. Reg. 311/10, s. 1.

(2) Unless otherwise specified, this Part only applies to members holding a general, transitional or extended class certificate of registration. O. Reg. 311/10, s. 1.

22. (1) The Committee shall administer the quality assurance program of the College. O. Reg. 311/10, s. 1.

(2) Any of the powers of the Committee under this Part may be exercised by a panel of the Committee appointed under this section. O. Reg. 311/10, s. 1.

(3) The chair of the Committee may select a panel of at least three members from the members of the Committee. O. Reg. 311/10, s. 1.

(4) A panel shall include,

(a) at least one member who is both a member of the Council and a member of the College; and

(b) at least one person who is a member of the Council appointed to the Council by the Lieutenant Governor in Council. O. Reg. 311/10, s. 1.

(5) Three members of a panel shall constitute a quorum. O. Reg. 311/10, s. 1.

23. The quality assurance program shall include the following components:

1. Member assessment.

2. Practice assessment.

3. Remediation. O. Reg. 311/10, s. 1.

Member Assessment

24. (1) The purpose of the member assessment shall be to assist each member to promote continuing competence and continuing quality improvement of the member’s practice by assisting the member in,

(a) identifying the extent to which his or her practice meets current standards of practice of the profession;

(b) identifying changes in entry to practice competencies, practice environments and technology and the relevance of those changes to the member’s practice; and

(c) identifying actions which the member should take to maintain continuing competence and to continue quality improvement of the member’s practice. O. Reg. 311/10, s. 1.

(2) Each member to whom this Part applies shall participate in a member assessment in accordance with a program approved by Council. O. Reg. 311/10, s. 1.

(3) A member assessment shall include,

(a) a self assessment;

(b) a written learning plan; and

(c) if requested by the Committee or an assessor, the completion of,

(i) one or more written questionnaires, and

(ii) any other materials that, in the opinion of the Committee or an assessor, are relevant to the assessment. O. Reg. 311/10, s. 1.

(4) In order to promote continuing competence and continuing quality improvement of the member’s practice, each member shall prepare and update his or her learning plan at least once every 12 months and shall include in the learning plan a record of,

(a) the specific programs or activities that the member plans to undertake; and

(b) the specific programs or activities in which the member has participated. O. Reg. 311/10, s. 1.

25. (1) The member shall retain the learning plan as well as any written materials required to be completed as part of the member assessment for at least two years. O. Reg. 311/10, s. 1.

(2) The member shall, upon written request of the Committee, submit the learning plan and any written materials required to be completed as part of the member assessment within 30 days of receipt of that request. O. Reg. 311/10, s. 1.

(3) Each member shall at the time of payment of his or her annual fee, if requested, confirm whether or not he or she has completed the member assessment and prepared a learning plan in accordance with this Part in the previous 12 months. O. Reg. 311/10, s. 1.

26. (1) The Committee may require a member who fails to comply with subsection 24 (2), (3) or (4) or section 25, to undergo a practice assessment within the time specified by the Committee. O. Reg. 311/10, s. 1.

(2) The Committee shall give notice to the member described in subsection (1) that he or she may be required to participate in a practice assessment. O. Reg. 311/10, s. 1.

(3) If the Committee determines that the member should undergo a practice assessment, it will give notice of its determination to the member and the member shall be allowed at least 14 days to make submissions to the Committee. O. Reg. 311/10, s. 1.

(4) The Committee shall consider all information that is relevant, including the member’s submissions, and determine whether or not the member shall be required to undergo a practice assessment. O. Reg. 311/10, s. 1.

Practice Assessment and Remediation

27. The purpose of the practice assessment is to assess the knowledge, skill and judgment of the member and shall include peer assessment. O. Reg. 311/10, s. 1.

28. (1) The practice assessment shall include one or more of the following activities:

1. Requiring the member to complete one or more questionnaires.

2. Assessing the records required to be maintained by the member relating to the member assessment.

3. Requiring the member to answer questions relating to the standards of practice of the profession.

4. Requiring the member to demonstrate the application of standards of practice in clinical simulations.

5. Inspecting the member’s records, including without limitation, records relating to the care of patients.

6. Inspecting the member’s clinical practice in accordance with section 82 of the Health Professions Procedural Code.

7. Inspecting the premises where the member practises.

8. Requiring the member to participate in any other reasonable activity approved by the Committee to assess whether the member has satisfactory knowledge, skill and judgment. O. Reg. 311/10, s. 1.

(2) The Committee may require a member to undertake the same or different practice assessment activities as another member holding the same class of certificate of registration. O. Reg. 311/10, s. 1.

(3) The Committee may require a member to undertake one or more additional practice assessment activities if, in the opinion of the Committee, additional information is required to determine whether the member’s knowledge, skill and judgment are satisfactory. O. Reg. 311/10, s. 1.

29. (1) A member shall undergo a practice assessment,

(a) if required to do so by the Committee under section 26; or

(b) if the member’s name is selected in accordance with a process approved by Council. O. Reg. 311/10, s. 1.

(2) The Council may approve different processes for selection under clause (1) (b) for members holding different classes of certificate of registration. O. Reg. 311/10, s. 1.

30. (1) A member who is required to undergo a practice assessment shall co-operate fully with the Committee and any assessor. O. Reg. 311/10, s. 1.

(2) Subject to subsection (3), after a member who is required to undergo a practice assessment has completed it, an assessor shall submit a written report to the Committee respecting the assessment which shall state whether, in the assessor’s opinion, the member’s knowledge, skill and judgment are satisfactory. O. Reg. 311/10, s. 1.

(3) If, after a practice assessment the assessor believes that he or she has insufficient information to form an opinion about whether the member’s knowledge, skill and judgment are satisfactory, the assessor shall submit a written report to the Committee with recommendations about how to obtain sufficient information to enable the assessor to form his or her opinion. O. Reg. 311/10, s. 1.

(4) If, after a practice assessment has been completed, it is the opinion of the assessor that the member’s knowledge, skill and judgment are unsatisfactory, the assessor shall submit a written report to the Committee which shall include the basis for that opinion and recommendations about appropriate specified continuing education programs or remedial measures that may assist in enhancing the member’s knowledge, skill and judgment. O. Reg. 311/10, s. 1.

(5) The Committee shall provide to the member,

(a) a copy of any report made under subsection (2), (3) or (4) along with any other material received by the Committee that is relevant to the member’s assessment; and

(b) where the report was made under subsection (3) or (4), notice of the member’s right to give the Committee a written submission with respect to the assessor’s report within at least 14 days of receipt of a copy of the assessor’s report. O. Reg. 311/10, s. 1.

(6) After receiving an assessor’s report under subsection (3), the Committee shall decide what steps are needed to obtain sufficient information to complete the member’s practice assessment, including one or more of the following:

1. Appointing a new assessor.

2. Requiring the member to engage in the same or different practice assessment activities to complete the practice assessment.

3. Such steps that, in the Committee’s opinion, are appropriate to complete the member’s practice assessment. O. Reg. 311/10, s. 1.

(7) After considering all reports made by an assessor relating to the practice assessment and any other materials received by the Committee relevant to the assessment, including any written submissions made by the member, the Committee shall decide whether the member’s knowledge, skill and judgment are satisfactory. O. Reg. 311/10, s. 1.

(8) Where the Committee requires a member to participate in specified continuing education or remediation programs under section 80.2 of the Health Professions Procedural Code, it shall also specify the time period within which the requirement must be met. O. Reg. 311/10, s. 1.

(9) Where the Committee requires a member to participate in specified continuing education or remediation programs under section 80.2 of the Health Professions Procedural Code, it may also require the member to do one or both of the following:

1. Provide evidence satisfactory to the Committee that the member has complied with the requirement.

2. Undergo a practice reassessment. O. Reg. 311/10, s. 1.

(10) The Committee may appoint an assessor to assess or reassess a member, even if the assessor has conducted a previous assessment or reassessment respecting that member. O. Reg. 311/10, s. 1.

(11) An assessor who conducts a practice reassessment may review any and all assessment reports previously made respecting the member as well as any other material that is relevant to the assessment or reassessment of the member. O. Reg. 311/10, s. 1.

31. The provisions of sections 28 and 30 apply with necessary modifications to a practice reassessment provided that the Committee shall not require the member to undergo more than two practice reassessments without the member’s written consent. O. Reg. 311/10, s. 1.

SCHEDULE 1

Approved Charitable Homes for the Aged under the Charitable Institutions Act

Boards under the Education Act

Boards of Health under the Health Protection and Promotion Act

Homes for the Aged under the Homes for the Aged and Rest Homes Act

Independent Health Facilities under the Independent Health Facilities Act

Psychiatric Facilities under the Mental Health Act

Designated Institutions under the Mental Hospitals Act

Nursing Homes under the Nursing Homes Act

Public Hospitals under the Public Hospitals Act

Agencies, Boards and Commissions as defined by the Government of Ontario

Institutions funded by the Minister of Health as Community Health Centres (CHCs), Health Services Organizations (HSOs) or Comprehensive Health Organizations (CHOs)

Post Secondary Educational Institutions

O. Reg. 275/94, Sched.; O. Reg. 39/98, s. 12.

SCHEDULES 2, 3 Revoked: O. Reg. 387/11, s. 2.