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Government reviews regulations to expand RPN scope of practice

The College of Nurse of Ontario (CNO) protects the public by promoting safe nursing practice. This includes implementing changes to nursing legislation to protect the public through the regulation of nursing practice.

The Ontario government is reviewing proposed changes under the Nursing Act, 1991 to expand the scope of practice for RPNs. You can see the changes on the Regulatory Registry, a government website that shares information on new, amended or approved regulations.

If government approves the regulation, RPNs who have the relevant competence will be able to independently initiate specific controlled acts without an order in certain practice settings. These changes are intended to increase patient access to timely health care services and reduce barriers to patient care.

“Using the training and expertise of RPNs more efficiently makes health care more accessible to patients and may help lessen some of the pressures in the health care system,” says Anne Marie Shin, Director of Professional Practice. 

In 2017, CNO started work to expand RPN scope of practice at the Minister of Health’s request. CNO led policy work and a robust public consultation, and reviewed stakeholder feedback to inform the regulation changes. CNO’s Council (or board) approved the proposed regulation, which we submitted to government for review in September 2020.  

Supporting safe practice

If government approves the regulation, CNO will begin developing resources to support RPNs to implement this scope of practice change.   

“Nurses in Ontario are world-class. Recognizing that RPNs have the knowledge, skill and judgement to further address needs in the health care system will hopefully expand access to safe care for Ontarians,” says Carol Timmings, Deputy Registrar and Chief Quality Officer.

While the changes may give RPNs access to initiate controlled acts, they will not apply to certain practice settings because of other legislation or facility policies. For example, RPNs who practice in hospitals will always need an order. This is a requirement under the Public Hospitals Act.

If the regulation is approved, we will also engage with nurses and other partners in the health care system to support implementation. We will keep you informed with updates on www.cno.org and social media, and in The Standard.




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Page last reviewed December 19, 2022