Regulation of Nurse Practitioners in British Columbia Canada

Context in British Columbia RN scope of practice is quite broad CNS and NP roles are both advanced practice roles NPs have additional scope of practice

Regulatory Framework for Nurse Practitioners Competencies and Recognition of Educational Programs Initial Registration of Nurse Practitioners Regulatory Oversight of Nurse Practitioners

Forms of NP Practice Partnership with government – agreed on common principles Regulate all forms of nurse practitioner practice Extensive consultation with educators, regulators, nurse practitioners and others

1.The framework must encompass all forms of NP practice USA registers many separate specialities Other jurisdictions were also registering separate specialties

2.The NP role is built on RN strengths NPs are not physician substitutes NP practice should be grounded on a holistic nursing perspective Age-based population groupings

3.A rigorous NP competencies verification system is needed Safety - verification is crucial to the regulatory bodies ability to assure safety Practicality - rigorous verification requires the specialties be limited

4.A broad educational base for practice is important Safe NP practice requires a broad base Reasonableness -Be consistent, where possible, with other jurisdictions -NP is not an entry-level profession -Cost is an issue

5.The professional practice model works well Apply the model used for RN practice Standards require RNs to practise within their own level of competence Standards require RNs to assume primary responsibility to maintain competence and acquire evidence-based knowledge and skills for professional practice

Streams of Nurse Practitioner Practice Nurse practitioner (Family) infants to older adults Nurse practitioner (Adult) adults and older adults Nurse practitioner (Pediatric) infants to adolescents

Focus in Nurse Practitioner Practice Nurse practitioners will develop a number of areas of clinical focus as do registered nurses Each area of focus will build on the broad base of one of the three registration categories

CRNBC will not verify competencies or register nurse practitioners in areas of focus CRNBC will provide regulatory oversight Focus in Nurse Practitioner Practice (cont.)

Implementing B.C.s Approach Core Competencies were applied to the three streams of practice

Schools of nursing were recognized as preparing students to meet the required competencies - so far, family and adult programs Implementing B.C.s Approach (cont.)

Standards, Limits and Conditions (as required under the Regulation) are completed and on the website for the three streams Implementing B.C.s Approach (cont.)

We individually assess those applicants who do not graduate from a B.C. program We have held the first set of examinations - both written and OSCE for the nurse practitioner family

Implementing B.C.s Approach (cont.) In 2006 hold examinations both written and OSCE for the adult and pediatric nurse practitioner Implement the quality assurance processes

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