May 17, 2023

Government approves RPN initiation regs

The Ontario government has approved regulations granting RPNs the authority to initiate, independently, certain controlled acts in certain practice settings without needing an order from an authorized health care professional. The regulations take effect Saturday, July 1, 2023.

The College of Nurses of Ontario (CNO) protects the public through the promotion of safe nursing practice. This includes providing regulatory oversight to ensure changes in nursing scope of practice are implemented safely.  

The Ontario government has approved regulations granting RPNs the authority to initiate, independently, certain controlled acts in certain practice settings without needing an order from an authorized health care professional. The regulations take effect Saturday, July 1, 2023. They are available to view on e-laws, which provides online access to Ontario’s statutes and regulations. 

The authority to perform these controlled acts is not new. RPNs could always do this with an order. The difference is that RPNs who have the relevant competence can now initiate these procedures without an order. These changes are intended to increase access to timely health care services and reduce barriers to care.

“CNO’s role is to protect the public and ensure any changes within nursing scope of practice are implemented safely for all,“ says Carol Timmings, Chief Quality Officer and Deputy Registrar. “Recognizing that many RPNs have the expertise to initiate these controlled acts, helps increase access to health care.”

This change only applies in certain practice settings. For example, RPNs who practice in hospitals always will need an order. This is a requirement under the Public Hospitals Act.

CNO has started to develop resources to support nurses’ ability to apply these changes in practice. These resources include a new practice standard on legislated scope of practice. This practice standard will be brought to CNO council for approval in June 2023.

About CNO

The College of Nurses of Ontario (CNO) is the regulator of the nursing profession in Ontario. It is not a school or a nursing association. CNO acts in the public interest by:

  • assessing qualifications and registering individuals who want to practice nursing in Ontario.
  • setting the practice standards of the profession that nurses in Ontario are expected to meet.
  • promoting nurses' continuing competence through a quality assurance program.
  • holding nurses accountable to those standards by addressing complaints or reports about nursing care.

The College was founded in 1963. By establishing the College, the Ontario government was acknowledging that the nursing profession had the ability to govern itself and put the public's well-being ahead of professional interests.

For the latest information, please see our Nursing Statistics page.

Anyone who wants to use a nursing-related title — Registered Nurse (RN), Registered Practical Nurse (RPN) or Nurse Practitioner (NP) must become a member of CNO.

Frequently Asked Questions

Go to the public Register, Find a Nurse, to conduct a search for the nurse. Contact us if you can't find the person you are looking for.

All public information available about nurses is posted in the public Register, Find a Nurse, which contains profiles of every nurse in Ontario. Publicly available information about nurses include their registration history, business address, and information related to pending disciplinary hearings or past findings.

Unregistered practitioners are people who are seeking employment in nursing or holding themselves out as being able to practice nursing in Ontario, but who are not qualified to do so. They are not registered members of CNO. Only people registered with CNO can use nursing-related titles or perform certain procedures that could cause harm if carried out by a non-registered health professional. CNO takes the issue of unregistered practitioners seriously. See Unregistered Practitioners for more information.

To ensure procedural fairness for both the patient (or client) and the nurse, the Regulated Health Professions Act requires that information gathered during an investigation remain confidential until the matter is referred to the Discipline Committee or Fitness to Practise Committee. CNO will not disclose any information that could identify patients (or clients) or compromise an investigation. See Investigations: A Process Guide for more information.

Information obtained during an investigation will become public if the matter is referred to a disciplinary hearing. If a complaint is not referred to a hearing, no information will be available publicly.

See CNO's hearings schedule, which is updated as hearing dates are confirmed. Hearings at CNO are open to the public and the media. For details on how to attend a hearing, contact the Hearings Administration Team.

A summary of allegations and the disciplinary panel outcomes can be found on the public Register, Find a Nurse. Full decisions and reasons are also available.

Where a disciplinary panel makes a finding of professional misconduct, they have the authority to reprimand a nurse, and suspend or revoke a nurse's registration. Terms, conditions and limitations can also be imposed on a nurse's registration, which restricts their practice for a set period. Nurses can also be required to complete remedial activities, such as reviewing CNO documents and meeting with an expert, before returning to practice.

For detailed information see the Sexual Abuse Prevention section.

Related links