O. Reg. 63/03: GENERAL

 

ONTARIO regulation 63/03

made under the

charitable institutions act

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

Amending Reg. 69 of R.R.O. 1990

(General)

1. The definition of “registered nursing assistant” in subsection 1 (1) of Regulation 69 of the Revised Regulations of Ontario, 1990 is revoked and the following substituted:

“registered nurse in the extended class” means a member of the College of Nurses of Ontario who is a registered nurse and who holds an extended certificate of registration under the Nursing Act, 1991;

“registered nursing staff” means those members of the nursing staff who are registered nurses including registered nurses in the extended class or registered practical nurses;

“registered practical nurse” means a member of the College of Nurses of Ontario who holds a certificate of registration as a registered practical nurse under the Nursing Act, 1991;

2. Section 14 of the Regulation is amended by adding the following subsections:

(6) An approved corporation maintaining and operating a charitable institution may appoint one or more registered nurses in the extended class for the institution, and, if the approved corporation does so, the approved corporation shall obtain a written statement signed by each of those registered nurses in the extended class stating that he or she will advise the administrator on care matters in the institution that are within the competence of a registered nurse in the extended class.

(7) The registered nurse in the extended class appointed under subsection (6) shall comply with the “Standards for Consultation with Physicians by RN(EC)s” including “Collaboration” set out in the publication of the College of Nurses of Ontario entitled “Standards of Practice for Registered Nurses who hold an extended class certificate of registration” as amended from time to time.

(8) An approved corporation maintaining and operating a charitable institution shall notify the Director in writing of the name, address, telephone number and date of appointment of each registered nurse in the extended class appointed under subsection (6) and, wherever there is a change in any of that information, the approved corporation shall notify the Director in writing of the change.

3. (1) Subsection 15 (2) of the Regulation is revoked and the following substituted:

(2) The physician appointed under subsection 14 (1) is responsible for the medical care provided for or administered to the residents of the charitable institution.

(2.1) All medications and drugs provided for or used in the charitable institution are subject to the approval of the physician appointed under subsection 14 (1) or a registered nurse in the extended class appointed under subsection 14 (6).

(2.2) A registered nurse in the extended class appointed under subsection 14 (6) is responsible for the care provided to or administered to the residents of the charitable institution that is within the competence of a registered nurse in the extended class.

(2) Subsection 15 (4) of the Regulation is amended by striking out “The physician for the institution” in the portion before clause (a) and substituting “The physician for the institution, a registered nurse in the extended class or the attending physician retained under subsection (4.2)”.

(3) Section 15 of the Regulation is amended by adding the following subsections:

(4.2) A resident, or the person who is lawfully authorized to make a decision on behalf of the resident concerning the resident’s personal care, may retain an attending physician to attend the resident and provide the resident with medical care.

(4.3) A resident, or the person who is lawfully authorized to make a decision on behalf of the resident concerning the resident’s personal care, may retain a registered nurse in the extended class to attend the resident and provide the resident with care.

(4.4) The registered nurse in the extended class retained under subsection (4.3) shall comply with the “Standards for Consultation with Physicians by RN(EC)s” including “Collaboration” set out in the publication of the College of Nurses of Ontario entitled “Standards of Practice for Registered Nurses who hold an extended class certificate of registration” as amended from time to time.

(4) Section 15 of the Regulation is amended by adding the following subsection:

(5.1) Any registered nurse in the extended class appointed under subsection 14 (6) shall attend and prescribe medication or treatment for any resident who requests his or her services.

(5) Subsections 15 (6), (7) and (8) of the Regulation are revoked and the following substituted:

(6) At least once a year, each resident of the institution shall be given a complete physical examination by the physician for the institution, the attending physician or a registered nurse in the extended class.

(7) One of the persons mentioned in subsection (6) shall make a detailed written report of the results of each physical examination of a resident and any recommendations pertaining to the examination, and the report shall be retained along with other records of the resident for at least 20 years after the last entry in the records with respect to the resident or, where the resident dies, for at least five years after the death of the resident.

(8) A resident shall be given any special diet that may be directed by the physician for the institution, the attending physician or a registered nurse in the extended class.

5. (1) The definition of “pharmacist” in subsection 19 (1) of the Regulation is revoked and the following substituted:

“pharmacist” means a member of the Ontario College of Pharmacists;

(2) The definition of “prescription drug” in subsection 19 (1) of the Regulation is revoked and the following substituted:

“prescription drug” means,

(a) a controlled drug mentioned in Schedule G to the Food and Drugs Act (Canada),

(b) a controlled substance as defined in the Controlled Drugs and Substances Act (Canada).

(3) Subsection 19 (2) of the Regulation is amended by striking out “all nursing staff” at the end and substituting “all registered nursing staff”.

(4) Subsection 19 (3) of the Regulation is revoked and the following substituted:

(3) Every drug cabinet or storeroom shall be kept locked and the keys shall be under the control of a registered nurse who is on duty or a registered practical nurse on duty or the administrator in the absence of a registered nurse and registered practical nurse.

(5) Subsection 19 (4) of the Regulation is amended by striking out “physician or a pharmacist” at the end and substituting “physician, pharmacist or registered nurse”.

(6) Subsection 19 (7) of the Regulation is amended by striking out “physician, or” and substituting “physician, registered nurse in the extended class or”.

(7) Subsection 19 (8) of the Regulation is revoked and the following substituted:

(8) A prescription drug shall be administered to a resident only by a physician, a member of the Royal College of Dental Surgeons of Ontario, a registered nurse or a registered practical nurse.

6. Clause 20.1 (2) (a) of the Regulation is amended by adding “or a registered nurse in the extended class attending the resident” after “resident’s physician”.

7. (1) Clause 49 (2) (a) of the Regulation is amended by adding “or registered nurse in the extended class” after “a physician”.

(2) Clause 49 (3) (a) of the Regulation is amended by adding “or registered nurse in the extended class” after “a physician”.

8. Subsection 58 (1) of the Regulation is revoked and the following substituted:

(1) An approved corporation maintaining and operating an approved charitable home for the aged shall ensure that each resident’s plan of care is reviewed at least quarterly by at least the following members of the interdisciplinary team providing the resident’s care:

1. The physician providing the resident’s care.

2. The registered nurse in the extended class, if any, providing the resident’s care.

3. The nursing staff providing the resident’s care.

4. The food services supervisor or dietitian responsible for the resident’s meals.