Transforming nursing through knowledge

Professional Accountability: Practice

Practice - reflects the work a nurse executive performs together with staff related to the provision of direct care or services.
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    The Ontario Public Health Standards are published as the guidelines for the provision of mandatory health programs and services by the 
    Minister of Health and Long-Term Care, pursuant to Section 7 of the Health Protection and Promotion Act, R.S.O. 1990, c. H.7.
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    The Nursing Act, 1991, in conjunction with the Regulated Health Professions Act, 1991 (RHPA), came into effect in 1993. These two pieces of legislation determine how the nursing profession is regulated in Ontario. The RHPA contains a procedural code applicable to all of Ontario’s self-regulated health professions. The Nursing Act establishes the mandate of the College of Nurses of Ontario and defines a scope of practice for the nursing profession. Regulations are made under the Nursing Act about registration (e.g., classes of registration, entry-to-practice requirements, title protection), controlled acts (including initiation), quality assurance and professional misconduct. 
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    The scope of practice model is set out in the Regulated Health Professions Act, 1991 (RHPA) and consists of two elements: a scope of practice statement and a series of authorized or controlled acts. 
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    Presentation provided at the National Health Leadership Conference, Niagara Falls, ON, 10-11 June 2013.

    Objective: Seek ways to increase efficiency and cost-effectiveness while safeguarding residents, staff and the organization

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    Nurses play an integral role in the delivery of quality care in the home. Home nursing care is the promotion of health, assessment, provision of care and treatment of health conditions by supportive, preventive, therapeutic, palliative and rehabilitative means in order to attain or maintain optimal function (Havens 2003). Home health nurses are committed to the provision of accessible, responsive and timely care which allows people to stay in their homes with safety and dignity (Community Health Nurses of Canada 2010). 
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    The Ontario Public Health Organizational Standards (Organizational Standards) establish the management and governance requirements for all boards of health and public health units. Similar to the Ontario Public Health Standards (OPHS) 2008, which outline the expectations for providing public health programs and services, the Organizational Standards outline the expectations for the effective governance of boards of health and effective management of public health units. Organizational Standards help promote organizational excellence, establish the foundation for effective and efficient program and service delivery and contribute to a public health sector with a greater focus on performance, accountability and sustainability.
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    A review of the literature provided evidence of the vast array of diverse competencies required for the unique and complex practice of home health nursing (Mildon & Underwood, 2010). The review also identified over a dozen organizing frameworks for home health nursing competencies. The existence of so many frameworks speaks to the challenge of organizing competencies in a way that is practical, comprehensive and meaningful.
    As recommended at the conclusion of the literature review, the Canadian Community Health Nursing Standards of Practice (Community Health Nurses Association of Canada, 2008) have been used as the organizing framework for the home health nursing competencies contained in this document. The competencies are broad in scope, thereby lending themselves to application in multiple settings and for 
    further detailing into more specific elements of practice for position descriptions or performance appraisal tools. 
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    Describes public health/community health nursing practice in Canada. It focuses on these essential functions:
    • public health,
    • health promotion,
    • disease and injury prevention,
    • health protection,
    • health surveillance,
    • population health assessment, and
    • emergency preparedness and response.
    It is intended to reflect the practice of public health/community health nursing which occurs in diverse settings and can be defined in terms of roles, activities, qualifications, standards, and competencies.


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    Designed to support community health nursing practice, this document
    • summarizes the development and purpose of community health nursing standards
    • describes community health nursing and its mission, values and beliefs, and practice focus areas of home health and public health nursing 
    • provides a framework for community health nursing practice in the Canadian Community Health Nursing Practice Model 
    • presents the five standards of practice and indicators showing how community health nurses apply these standards
    • lists definitions and sources
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    Professional Standards, Revised 2002 (Professional Standards) provides an overall framework for the practice of nursing and a link with other standards, guidelines and competencies developed by the College of Nurses of Ontario (CNO). It describes in broad terms the professional expectations of nurses and applies to all nurses, in every area of practice.