	February 2020 \| Volume 19 Number 1
www.cno.org \| français	Print

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What are my accountabilities as a nurse manager during the novel coronavirus outbreak?

Proper planning is key to determining how well a facility and its nursing staff will manage coronavirus. Employers are responsible for establishing a working environment that supports safe and effective patient care. This includes arranging appropriate staffing coverage and Personal Protective Equipment (PPE) for all nurses who require it. Your practice setting must also provide proper PPE training and fitting.

CNO’s Professional Standards, Revised 2002 specifies that nursing managers need to access and share up-to-date, evidence-based information and guidelines with staff. Nurse managers must also provide staff with clear policies on screening and managing the outbreak.

All nurses are accountable to take action when patient care may be compromised. This includes identifying strategies to prepare for, reduce and resolve situations that may leave patients without the nursing services they need. This accountability is found in CNO’s practice guideline, Refusing Assignments and Discontinuing Nursing Service.

To ensure a safe practice environment, nurse managers should consider:

Are there strategies in place for prioritizing patient care needs?
Have you explored concerns with your staff and clearly communicated your organization’s plan to address these concerns?
Have you included front line staff in the creation and implementation of these strategies?
Is there a readily available system for replacement staff?
Are strategies in place to facilitate the reorganization of workload, if needed?
Are there clear policies and lines of communication for nurses to follow when staffing is short?

Nurse managers can show leadership by working through dilemmas that nurses may have regarding assignments by following the decision-making process found on page 6 of the Refusing Assignments and Discontinuing Nursing Services practice guideline.

Resources for nurses

To help nurses find the information they need to provide safe patient care, we’ve created a resource page that contains coronavirus-related FAQs, info about accountabilities, and current infection prevention and control guidelines.

We will continue to closely monitor the situation. As more information becomes available, we will update our Novel Coronavirus webpage. You can also follow us on social media to stay up to date.

CNO’s role

CNO’s mandate is to protect the public—but patient safety is a responsibility we all share. Our role during the novel coronavirus outbreak is to support nurses’ ability to provide safe and competent care and understand their accountabilities.

If nurses have questions about their accountabilities when caring for patients affected with the new coronavirus, they can contact us. One of our Advanced Practice Consultants can help identify the appropriate practice standards and guidelines to guide their decision-making and help them understand their accountabilities.

New Reporting Guide and updated Reporting form

We have published a new Reporting Guide and updated the Reporting form. The goal is to help employers, nurses and anyone who works with a nurse clearly understand what, when and how to report a concern they have about a nurse’s practice to CNO.

The guide replaces Mandatory Reporting: A process guide for employers, facility operators and nurses. We have also updated the Reporting form to make it easier to complete and submit to CNO.

CNO’s mandate is to protect the public. We achieve this by partnering with those who work with nurses. Patient safety is a collective responsibility—we need you to send us a report when you believe a nurse poses a serious risk of harm to patients.

The Reporting Guide is now an easy-to-navigate online document. It includes:

a table that easily explains what you should report to CNO
a section on a nurse’s professional accountability to act in the best interest of their patients and to protect them from harm
a section on your legal obligations to report certain conduct and concerns

We have also updated the Reporting form based on feedback. It now includes:

instructions on how to complete the form
a second contact person section, since more than one person might have information about the concern
more areas to list incidents, since the person submitting the form might have multiple concerns about the nurse’s practice
the ability to submit the form electronically on cno.org

We will be adding additional supporting resources to the File a Report section throughout 2020. We will inform you when we launch a new resource. And, we want to hear from you: Please email us your feedback about the new reporting information.

Our response to the Long-Term Care Homes Public Inquiry recommendations

On July 31, 2019, Commissioner Eileen Gillese released her Long-Term Care Homes Public Inquiry Report. The report made 10 recommendations specifically for CNO.

At the inquiry, CNO provided information to help improve the system and protect residents and patients from harm. We also made a commitment to publicly report on our response to each of the 10 recommendations.

We have listed all the actions and improvements we have made to meet the report’s recommendations in our new fact sheet, Our Response to the Long-Term Care Homes Public Inquiry Recommendations. All our actions have the core purpose of protecting residents from harm.

Actions include adding a new decision-making tool to our investigation process to help investigators assess the risk a nurse poses to patients, and developing a new Reporting Guide, so employers, nurses and those who work with a nurse know what, when and how to report a concern to us

We will continue to find opportunities to strengthen and enhance our processes, as we have always done. You can read our full response to the recommendations here.