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O. Reg. 64/03: HOSPITAL MANAGEMENT

filed March 7, 2003 under Public Hospitals Act, R.S.O. 1990, c. P.40

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ONTARIO regulation 64/03

made under the

Public Hospitals Act

Made: February 12, 2003
Approved: March 5, 2003
Filed: March 7, 2003
Printed in The Ontario Gazette: March 22, 2003

Amending Reg. 965 of R.R.O. 1990

(Hospital Management)

1. (1) Subsection 1 (1) of Regulation 965 of the Revised Regulations of Ontario, 1990 is amended by adding the following definition:

“chief nursing executive” means the senior nurse employed by the hospital who reports directly to the administrator and is responsible for nursing services provided in the hospital;

(2) The definition of “extended class nursing staff” in subsection 1 (1) of the Regulation is revoked and the following substituted:

“extended class nursing staff” means those registered nurses in the extended class in a hospital,

(a) who are employed by the hospital and are authorized to diagnose, prescribe for or treat out-patients in the hospital, and

(b) who are not employed by the hospital and to whom the board has granted privileges to diagnose, prescribe for or treat out-patients in the hospital;

2. (1) Subsection 2 (3) of the Regulation is amended by striking out “and” at the end of clause (d) and by adding the following clause:

(d.1) in the case of a hospital whose by-laws provide for a nursing advisory committee, appoint the chief nursing executive as chair of the nursing advisory committee; and

(2) Clause 2 (3) (e) of the Regulation is amended by striking out “medical staff, staff nurses” in the portion before subclause (i) and substituting “medical staff, chief nursing executive, staff nurses”.

3. (1) Clause 4 (1) (a) of the Regulation is amended by striking out “and” at the end of subclause (vi) and by adding the following subclauses:

(viii) procedures for the appointment by the administrator of a nurse as the chief nursing executive of the hospital, and

(ix) the functions and responsibilities of the chief nursing executive;

(2) Subsection 4 (1) of the Regulation is amended by adding the following clause:

(b.1) in the case of a hospital whose by-laws provide for a nursing advisory committee, provide for the election or appointment of members of the nursing advisory committee and for the duties of the committee;

(3) Subclause 4 (1) (f) (i) of the Regulation is amended by striking out “the participation of nurses who are managers and staff nurses” at the beginning and substituting “the participation of the chief nursing executive, nurses who are managers and staff nurses”.

(4) Subclause 4 (1) (f) (ii) of the Regulation is amended by striking out “the participation at the committee level of staff nurses” at the beginning and substituting “the participation at the committee level of the chief nursing executive and of staff nurses”.

4. Clause 5 (1) (d) of the Regulation is revoked and the following substituted:

(d) the chief nursing executive or another person representing nurses who are managers;

5. (1) Subclauses 7 (2) (a) (v) and (vi) of the Regulation are revoked and the following substituted:

(v) the quality of care provided in the hospital by the medical staff, dental staff, midwifery staff and by the extended class nursing staff, and

(2) Clause 7 (2) (b) of the Regulation is revoked and the following substituted:

(b) supervise the practice of medicine, dentistry, midwifery and extended class nursing in the hospital;

(3) Section 7 of the Regulation is amended by adding the following subsection:

(2.1) Despite subclauses (2) (a) (i), (ii) and (iv), the duties of the medical advisory committee described in those subclauses that relate to the extended class nursing staff of a hospital shall only be performed with respect to those members of the extended class nursing staff who are not employees of the hospital and to whom the board has granted privileges to diagnose, prescribe for or treat out-patients in the hospital.

6. The Regulation is amended by adding the following section:

Nursing Advisory Committee

7.1 (1) If a hospital’s by-laws provide for a nursing advisory committee, the committee shall be comprised of,

(a) the chief nursing executive; and

(b) such other members of the nursing staff as are elected or appointed in accordance with the hospital’s by-laws.

(2) In subsection (1),

“nursing staff” means, with respect to a hospital, all nurses employed or otherwise engaged by the hospital to provide services in the hospital and all members of the hospital’s extended class nursing staff, and includes nurses who are managers and the chief nursing executive for the hospital.

(3) The nursing advisory committee shall carry out such duties as may be established by by-law.

7. (1) Clause 11 (3) (a) of the Regulation is amended by striking out “medical or midwifery staff” at the end and substituting “medical staff, midwifery staff or extended class nursing staff”.

(2) Clause 11 (3) (c) of the Regulation is revoked.

8. Subsection 18 (3) of the Regulation is revoked and the following substituted:

(3) Where an administrator believes that a person who is a member of the medical, dental, midwifery or extended class nursing staff is unable to perform the person’s professional duties with respect to a patient in the hospital, the administrator shall notify,

(a) the chief of staff or the chair of the medical advisory committee;

(b) in the case of a member of the medical staff, the president or the secretary of the medical staff; and

(c) in the case of a member of the extended class nursing staff, the chief nursing executive.

9. (1) Clause 19 (5) (a) of the Regulation is amended by striking out “dentists and midwives” and substituting “dentists, midwives and registered nurses in the extended class”.

(2) Clause 19 (5) (c) of the Regulation is revoked and the following substituted:

(c) records of all examinations carried out on the out-patient in the hospital by members of the medical, dental, midwifery and extended class nursing staff;

(3) Clause 19 (5) (h) of the Regulation is revoked and the following substituted:

(h) records of all treatment carried out on the out-patient in the hospital by members of the medical, dental, midwifery and extended class nursing staff;

10. Subsections 24 (1) and (2) of the Regulation are revoked and the following substituted:

(1) Every order for treatment or for a diagnostic procedure of a patient shall, except as provided in subsection (2), be in writing and shall be dated and authenticated by the physician, dentist, midwife or registered nurse in the extended class giving the order.

(2) A physician, dentist, midwife or registered nurse in the extended class may dictate an order for treatment or for a diagnostic procedure by telephone to a person designated by the administrator to take such orders.

Tony Clement

Minister of Health and Long-Term Care

Dated on February 12, 2003.