It’s Time – Removing Barriers for NPs
It’s Time
To leverage the unique promise of Nurse Practitioners
Nurse Practitioners have been the fastest growing nursing category across Canada every year since 2015. More and more, the health care system is recognizing the unique promise that Nurse Practitioners present to the quality of care in Ontario. NPs contribute expertise as clinicians, leaders, educators and researchers in inspiring and impactful ways. The unique promise of Nurse Practitioners is rooted in their skills, knowledge, experience and the flexibility they have to contribute in any and all areas, independently or within an interprofessional care team.
Nurse Practitioners (NPs) play a key role in improving health outcomes in diverse populations across the province. And in order to meet the growing needs of patients, there are some long standing barriers to the NP scope of practice that need to be eliminated. Ensuring all patients can receive the same service from their healthcare provider increases equality and efficiencies in the system and avoids delays in treatment and care.
These barriers prevent Nurse Practitioners from being fully utilized to their potential to contribute to a more effective and efficient healthcare system. NPAO calls on the Government of Ontario and Ministry of Health to work with NPAO and its partners to address these barriers to improve equitable and efficient access to healthcare for Ontarians.
Nurse Practitioner Practice Barriers to Address
URGENT – CT/MRI Scope of Practice for Nurse Practitioners
Ontario is the only Province in Canada where ordering CT/MRI procedures is still not within the
Nurse Practitioner scope of practice. The need for this legislation has been going on for years
and the process continues to drag on despite the public input process being completed in
August 2020. It is a significant barrier for NPs to effectively do their jobs. It is a substantial inconvenience to patients and physicians who must take time away from their patients to sign-off on a CT/MRi order for an NP, who is often the most responsible provider. The Government of Ontario needs to amend Regulations 543 and 107/96 to allow Nurse Practitioners to order these tests.
URGENT – Point of Care Testing
Again Ontario lags behind the rest of Canada in adding Point of Care testing to the NP Scope of Practice. The public input process being completed in August 2020. It is a significant barrier for NPs to effectively do their jobs. The Government of Ontario needs to amend Regulations 682 and 683 to allow Nurse Practitioners to order these tests.
Eliminating the above scope of practice limitations should be a high priority for the Government of Ontario and will have an immediate impact on healthcare efficiencies.
Furthermore, there is still a long way to go to enable Registered Nurses in the Extended Class (Nurse Practitioners) to use their education and training more effectively and practice to their full scope of practice as expressed by the government in the 2019 Ontario Economic Outlook and Fiscal Review.
Additional scope of practice barriers for NPs include:
- NPs do not have the authority to complete or sign all Mental Health Forms including, for example, Form 1, 2, or 3.
- NPs do not have the authority to complete a death certificate unless a physician provides a medical diagnosis on the certificate.
- NPs do not have the authority to sign the Employee Health Status Report – Communicable Diseases for EMS employees.
- NPs do not have the authority to sign the ‘Mandatory Blood Testing’ form if working in Community Safety and Correctional Services. Signing authority is currently restricted to the Medical Officer of Health.
- NPs do not have the authority capacity to complete Student Disability Accommodation Form. NPs are not included in the “approved list” of health professionals permitted to complete the required form.
- Inability to defibrillate a patient in the NP office, though the layperson can;
- NPs lack the authority to attend to court matters when managing patients who refuse, withdraw from, or fail to comply with medical treatment.
- NPs do not have the authority to complete Assistive Devices Program (ADP) forms for hearing aids for their adult patients.
Nurse Practitioners’ Association of Ontario
The Nurse Practitioners’ Association of Ontario (NPAO), founded in 1973, is the representative body exclusively dedicated to advancing the Nurse Practitioner profession within an improved healthcare system for all in Ontario. NPAO works collaboratively with many partners and on many fronts to improve the efficiency of the healthcare delivery process and the effectiveness of health outcomes for patients. NPs and NPAO are here to help. For more information about NPAO, visit www.npao.org.
