jswizzle3737/ontario_laws_and_regs huggingface dataset:
17. (1) A member who is a registered nurse in the extended class may only prescribe a drug if all of the following conditions are met: 1.  The member must have a nurse-patient relationship with the patient for whom the drug is prescribed. 2.  The member must prescribe the drug for therapeutic purposes only. 3.  The member must ensure that the following information is recorded on the prescription: i.  the name and address of the person for whom the drug is prescribed, ii.  the name, strength (where applicable) and quantity of the drug that is prescribed, iii.  the directions for use, iv.  the member’s name, address, telephone number, title and registration number issued by the College, v.  the member’s signature, vi.  the date on which the drug is prescribed, and vii.  the number of refills, if applicable. 4.  The member must retain a copy of the information recorded on the prescription required under paragraph 3 as part of the patient’s health record.  O. Reg. 387/11, s. 1; O. Reg. 336/23, s. 3 (1). (2) A member who is a registered nurse in the extended class and who meets the conditions set out in subsection (1) of this section is authorized to prescribe a controlled substance if the member satisfies the Executive Director that the member has, within any time period set by Council, successfully completed education approved by Council that was specifically designed to educate registered nurses in the extended class to safely, effectively and ethically prescribe controlled substances. O. Reg. 111/17, s. 2; O. Reg. 336/23, s. 3 (2). (3) The education mentioned in subsection (2) may be education that is either independent of or part of the education and training required to become a registered nurse in the extended class. O. Reg. 111/17, s. 2. Dispensing
18. (1) A member who is a registered nurse in the extended class may only dispense a drug if all of the conditions set out in subsection (5) are met. O. Reg. 336/23, s. 4. (2) A member who is a registered nurse in the General class may only dispense a drug described in Schedule 2 that the member prescribed if all of the conditions set out in subsection (5) are met. O. Reg. 336/23, s. 4. (3) A member who is a registered nurse or a registered practical nurse may dispense a drug prescribed under section 16.1 if the dispensing is ordered by the member who prescribed the drug under that section and all of the conditions set out in subsection (5) are met. O. Reg. 336/23, s. 4. (4) When dispensing a drug under clause 5 (1) (b) of the Act, a member who is a registered nurse or a registered practical nurse shall only dispense the drug if all of the conditions set out in subsection (5) are met. O. Reg. 336/23, s. 4. (5) For the purposes of subsections (1) to (4), the following conditions must be met: 1.  The member must have a nurse-patient relationship with the patient for whom the drug is dispensed. 2.  The member must provide the drug directly to the patient or the patient’s representative. 3.  The member must dispense the drug for therapeutic purposes only. 4.  The member must have reasonable grounds to believe that the drug has been obtained and stored in accordance with any applicable legislation. 5.  The member must be satisfied that the drug has not expired and will not expire before the date on which the patient is expected to take the last of the drug. 6.  The member must ensure that the container in which the drug is dispensed is marked with, i.  an identification number, if applicable, ii.  the member’s name and title along with the name and title of the prescriber if the member is not the prescriber, iii.  the name, address and telephone number of the place from which the drug is dispensed, iv.  the identification of the drug as to its name, its strength (where applicable) and, if available, its manufacturer, v.  the quantity of the drug dispensed, vi.  the date the drug is dispensed, vii.  the expiry date of the drug, if applicable, viii.  the name of the patient for whom the drug is dispensed, and ix.  the directions for use. 7.  The member must retain a copy of the information set out under paragraph 6 on the container in which the drug was dispensed in the patient’s health record. O. Reg. 336/23, s. 4. Compounding
19. For the purposes of paragraph 8 of subsection 5.1 (1) of the Act, a member may only compound a drug if all of the following conditions are met: 1.  The member must only compound two or more non-sterile creams or ointments to produce a compounded cream or ointment. 2.  The member must ensure that the compounded cream or ointment is for topical use only and for therapeutic purposes. 3.  The member must have a nurse-patient relationship with the patient for whom the cream or ointment is compounded. 4.  The member must dispense the compounded cream or ointment to the patient or his or her representative or apply it directly to the patient. 5.  The member must have made reasonable inquiries and be satisfied that, i.  the patient does not have reasonable or timely access to a pharmacy, ii.  the patient would not otherwise receive the compounded cream or ointment, or iii.  the patient does not have the financial resources to obtain the compounded cream or ointment if it is not compounded by the member. 6.  The member must have reasonable grounds to believe that the creams or ointments used in the compounding have been obtained and stored in accordance with any applicable legislation. 7.  The member must be satisfied that the creams or ointments used in the compounding  have not expired and will not expire before the date on which the patient is expected to apply the last of the compounded cream or ointment. 8.  The member must ensure that the container holding the compounded cream or ointment is marked with, i.  an identification number, if applicable, ii.  the name and title of the member, iii.  the name, address and telephone number of the place in which the compounded cream or ointment was compounded, iv.  the identification of the substances used in the compounded cream and ointment, their names, strength and manufacturer, v.  the percentage of each of the creams or ointments used to make the compounded cream or ointment and the quantity placed in the container, vi.  the date the compounded cream or ointment was compounded and the date the compounded cream or ointment was dispensed, if different from the former date, vii.  the expiry date of the compounded cream or ointment, viii.  the name of the patient for whom the cream or ointment was compounded, and ix.  the directions for use. 9.  The member must retain a copy of the information set out under paragraph 8 in the patient’s health record, along with the information provided by the patient in response to the inquiries under paragraph 5.  O. Reg. 387/11, s. 1. Selling
19.1 (1) For the purposes of paragraph 8 of subsection 5.1 (1) of the Act, a member may only sell a drug if all of the following conditions are met: 1.  The member must have a nurse-patient relationship with the patient to whom the drug is sold. 2.  The member must sell the drug for therapeutic purposes only and only if he or she dispenses the drug directly to the patient or the patient’s representative or the drug is administered to the patient. 3.  The member must have made reasonable inquiries and be satisfied that, i.  the patient does not have reasonable or timely access to a pharmacy, ii.  the patient would not otherwise buy the drug, iii.  the patient does not have the financial resources to obtain the drug if it is not sold by the member, or iv.  the drug is sold in conjunction with a health promotion initiative. 4.  The member must have reasonable grounds to believe that the drug has been obtained and stored in accordance with any applicable federal or provincial legislation. 5.  The member must be satisfied that the drug has not expired and will not expire before the date on which the patient is expected to take the last of the drug. 6.  The member must not sell a drug if the selling provides a profit to him or her or a direct or indirect personal or financial benefit, other than the actual cost of the drug. 7.  The member must retain in the patient’s health record a record that the drug was sold to the patient, the price charged and the information provided by the patient in response to the inquiries under paragraph 3.  O. Reg. 387/11, s. 1. (2) A registered nurse in the extended class shall not describe himself or herself orally or in writing as a person who is authorized to sell a drug unless he or she sets out in writing or orally the inquiries that must be made by the member before selling a drug to a patient under paragraph 3 of subsection (1).  O. Reg. 387/11, s. 1. Administration of a Substance by Injection or Inhalation
20. (1) A member who is a registered nurse in the extended class may only administer a substance by injection or inhalation if all of the conditions set out in subsection (5) are met. O. Reg. 336/23, s. 5. (2) A member who is a registered nurse in the General class may only administer by injection or inhalation a substance described in Schedule 2 that the member prescribed, where that substance may be administered by injection or inhalation, if all of the conditions set out in subsection (5) are met. O. Reg. 336/23, s. 5. (3) A member who is a registered nurse or a registered practical nurse may administer by injection or inhalation a substance prescribed under section 16.1, where that substance may be administered by injection or inhalation, if the administering is ordered by the member who prescribed the substance and all of the conditions set out in subsection (5) are met. O. Reg. 336/23, s. 5. (4) It is a standard of practice of the profession that, when administering a substance by injection or inhalation under clause 5 (1) (b) of the Act, a member who is a registered nurse or a registered practical nurse shall only administer the substance if all of the conditions set out in subsection (5) are met. O. Reg. 336/23, s. 5. (5) For the purposes of subsections (1) to (4), the following conditions must be met: (a)  the member has a nurse-patient relationship with the patient for whom the administration of a substance by injection or inhalation is performed; and (b)  the procedure is performed only for therapeutic purposes. O. Reg. 336/23, s. 5. Part IV   Quality Assurance General
21. (1) In this Part, “assessor” means an assessor appointed under section 81 of the Health Professions Procedural Code; (“évaluateur”) “Committee” means the Quality Assurance Committee of the College. (“comité”)  O. Reg. 311/10, s. 1. (2) Unless otherwise specified, this Part only applies to members holding a general or extended class certificate of registration.  O. Reg. 311/10, s. 1; O. Reg. 174/12, s. 11.
22. (1) The Committee shall administer the quality assurance program of the College.  O. Reg. 311/10, s. 1. (2) Any of the powers of the Committee under this Part may be exercised by a panel of the Committee appointed under this section.  O. Reg. 311/10, s. 1. (3) The chair of the Committee may select a panel of at least three members from the members of the Committee.  O. Reg. 311/10, s. 1. (4) A panel shall include, (a)  at least one member who is both a member of the Council and a member of the College; and (b)  at least one person who is a member of the Council appointed to the Council by the Lieutenant Governor in Council.  O. Reg. 311/10, s. 1. (5) Three members of a panel shall constitute a quorum.  O. Reg. 311/10, s. 1.
23. The quality assurance program shall include the following components: 1.  Member assessment. 2.  Practice assessment. 3.  Remediation.  O. Reg. 311/10, s. 1. Member Assessment
24. (1) The purpose of the member assessment shall be to assist each member to promote continuing competence and continuing quality improvement of the member’s practice by assisting the member in, (a)  identifying the extent to which his or her practice meets current standards of practice of the profession; (b)  identifying changes in entry to practice competencies, practice environments and technology and the relevance of those changes to the member’s practice; and (c)  identifying actions which the member should take to maintain continuing competence and to continue quality improvement of the member’s practice.  O. Reg. 311/10, s. 1. (2) Each member to whom this Part applies shall participate in a member assessment in accordance with a program approved by Council.  O. Reg. 311/10, s. 1. (3) A member assessment shall include, (a)  a self assessment; (b)  a written learning plan; and (c)  if requested by the Committee or an assessor, the completion of, (i)  one or more written questionnaires, and (ii)  any other materials that, in the opinion of the Committee or an assessor, are relevant to the assessment.  O. Reg. 311/10, s. 1. (4) In order to promote continuing competence and continuing quality improvement of the member’s practice, each member shall prepare and update his or her learning plan at least once every 12 months and shall include in the learning plan a record of, (a)  the specific programs or activities that the member plans to undertake; and (b)  the specific programs or activities in which the member has participated.  O. Reg. 311/10, s. 1.
25. (1) The member shall retain the learning plan as well as any written materials required to be completed as part of the member assessment for at least two years.  O. Reg. 311/10, s. 1. (2) The member shall, upon written request of the Committee, submit the learning plan and any written materials required to be completed as part of the member assessment within 30 days of receipt of that request.  O. Reg. 311/10, s. 1. (3) Each member shall at the time of payment of his or her annual fee, if requested, confirm whether or not he or she has completed the member assessment and prepared a learning plan in accordance with this Part in the previous 12 months.  O. Reg. 311/10, s. 1.
26. (1) The Committee may require a member who fails to comply with subsection 24 (2), (3) or (4) or section 25, to undergo a practice assessment within the time specified by the Committee.  O. Reg. 311/10, s. 1. (2) The Committee shall give notice to the member described in subsection (1) that he or she may be required to participate in a practice assessment.  O. Reg. 311/10, s. 1. (3) If the Committee determines that the member should undergo a practice assessment, it will give notice of its determination to the member and the member shall be allowed at least 14 days to make submissions to the Committee.  O. Reg. 311/10, s. 1. (4) The Committee shall consider all information that is relevant, including the member’s submissions, and determine whether or not the member shall be required to undergo a practice assessment.  O. Reg. 311/10, s. 1. Practice Assessment and Remediation
27. The purpose of the practice assessment is to assess the knowledge, skill and judgment of the member and shall include peer assessment.  O. Reg. 311/10, s. 1.
28. (1) The practice assessment shall include one or more of the following activities: 1.  Requiring the member to complete one or more questionnaires. 2.  Assessing the records required to be maintained by the member relating to the member assessment. 3.  Requiring the member to answer questions relating to the standards of practice of the profession. 4.  Requiring the member to demonstrate the application of standards of practice in clinical simulations. 5.  Inspecting the member’s records, including without limitation, records relating to the care of patients. 6.  Inspecting the member’s clinical practice in accordance with section 82 of the Health Professions Procedural Code. 7.  Inspecting the premises where the member practises. 8.  Requiring the member to participate in any other reasonable activity approved by the Committee to assess whether the member has satisfactory knowledge, skill and judgment.  O. Reg. 311/10, s. 1. (2) The Committee may require a member to undertake the same or different practice assessment activities as another member holding the same class of certificate of registration.  O. Reg. 311/10, s. 1. (3) The Committee may require a member to undertake one or more additional practice assessment activities if, in the opinion of the Committee, additional information is required to determine whether the member’s knowledge, skill and judgment are satisfactory.  O. Reg. 311/10, s. 1.
29. (1) A member shall undergo a practice assessment, (a)  if required to do so by the Committee under section 26; or (b)  if the member’s name is selected in accordance with a process approved by Council.  O. Reg. 311/10, s. 1. (2) The Council may approve different processes for selection under clause (1) (b) for members holding different classes of certificate of registration.  O. Reg. 311/10, s. 1.
31. The provisions of sections 28 and 30 apply with necessary modifications to a practice reassessment provided that the Committee shall not require the member to undergo more than two practice reassessments without the member’s written consent.  O. Reg. 311/10, s. 1. Part v   Delegation
32. In this Part, “controlled act” means a controlled act set out in subsection 27 (2) of the Regulated Health Professions Act, 1991; (“acte autorisé”) “delegatee” means a person to whom a controlled act is delegated; (“délégataire”) “delegator” means a person who delegates a controlled act. (“délégant”) O. Reg. 268/13, s. 1.
33. A member shall not, except in accordance with this Regulation, delegate a controlled act or perform a controlled act that was delegated to him or her. O. Reg. 268/13, s. 1.
34. (1) A member who delegates a controlled act is responsible for the decision to delegate the controlled act. O. Reg. 268/13, s. 1. (2) A member who performs a controlled act that is delegated to him or her is responsible for the decision to carry out the controlled act and for its performance. O. Reg. 268/13, s. 1.
35. (1) Subject to this Part, and to the terms, conditions and limitations placed on their certificate of registration, a registered nurse in the General class or a registered practical nurse in the General class who is authorized to perform a controlled act set out in section 4 or 4.1 of the Act may delegate that controlled act. O. Reg. 291/23, s. 12; O. Reg. 336/23, s. 6 (1). (2) Despite subsection (1), a member mentioned in that subsection may not delegate the controlled act of treating, by means of psychotherapy technique delivered through a therapeutic relationship, an individual’s serious disorder of thought, cognition, mood, emotional regulation, perception or memory that may seriously impair the individual’s judgment, insight, behaviour, communication or social functioning. O. Reg. 268/13, s. 2 (1). (3) Despite subsection (1), a member mentioned in that subsection may not delegate the controlled act of dispensing a drug. O. Reg. 268/13, s. 2 (2). (4) Despite subsection (1), a member who is a registered nurse in the General class may not delegate the controlled acts of prescribing a drug or communicating to a patient or to their representative a diagnosis made by the member where the purpose of that communication is for prescribing a drug as authorized under paragraph 5 of section 4.1 of the Act. O. Reg. 336/23, s. 6 (2).
36. (1) Subject to this Part, and to the terms, conditions and limitations placed on his or her certificate of registration, a registered nurse in the extended class who is authorized to perform a controlled act set out in section 5.1 of the Act may delegate that controlled act. O. Reg. 268/13, s. 1. (2) Despite subsection (1), a member mentioned in that subsection may not delegate the controlled acts of prescribing, dispensing, compounding or selling a drug. O. Reg. 268/13, s. 1. (3) Despite subsection (1), a member mentioned in that subsection may not delegate the controlled act of ordering the application of a form of energy prescribed by the regulations under the Regulated Health Professions Act, 1991. O. Reg. 268/13, s. 1. (4) Despite subsection (1), a member mentioned in that subsection may not delegate the controlled act of setting a fracture of a bone or dislocation of a joint. O. Reg. 268/13, s. 1. (5) Despite subsection (1), a member mentioned in that subsection may not delegate the controlled act of treating, by means of psychotherapy technique delivered through a therapeutic relationship, an individual’s serious disorder of thought, cognition, mood, emotional regulation, perception or memory that may seriously impair the individual’s judgment, insight, behaviour, communication or social functioning. O. Reg. 268/13, s. 3.
37. (1) A member shall ensure, before delegating any controlled act, that he or she, (a)  has the authority under the Act and its regulations to perform the controlled act himself or herself; (b)  has the knowledge, skill and judgment to perform the controlled act safely and ethically; (c)  has a nurse-patient relationship with the patient for whom the controlled act will be performed; (d)  has considered whether delegation of the controlled act is appropriate, bearing in mind the best interests and needs of the patient; (e)  after taking reasonable steps, is satisfied that sufficient safeguards and resources are available to the delegatee so that the controlled act may be performed safely and ethically; (f)  has considered whether delegation of the controlled act should be subject to any conditions to ensure that it is performed safely and ethically and has made the delegation subject to conditions, if applicable; (g)  after taking reasonable steps, is satisfied that the delegatee is a person who is permitted to accept the delegation; (h)  after taking reasonable steps, is satisfied that the delegatee is, (i)  a member of the College who has a nurse-patient relationship with the patient, (ii)  a health care provider who has a professional relationship with the patient, (iii)   a person in the patient’s household, or (iv)  a person who routinely provides assistance or treatment for the patient; and (i)  after taking reasonable steps, is satisfied, (i)  that the delegatee has the knowledge, skill and judgment to perform the controlled act safely and ethically, where the delegatee is a member of the College or member of a health profession other than the profession of nursing, or (ii)  that the delegation is appropriate for the patient and that the delegatee has the knowledge, skill and judgment to perform the controlled act safely and ethically, where the delegatee is not a member of the College or a member of another health profession. O. Reg. 268/13, s. 1. (2) A member shall not delegate a controlled act that was delegated to him or her to perform. O. Reg. 268/13, s. 1. (3) A member who delegated a controlled act but has reasonable grounds to believe that the delegatee no longer has the ability to perform the controlled act safely and ethically shall immediately cease to delegate the controlled act to that delegatee. O. Reg. 268/13, s. 1.
38. The delegation of a controlled act may be made orally or in writing. O. Reg. 268/13, s. 1.
39. A member who delegates a controlled act shall, (a)  ensure that a written record of the particulars of the delegation is available in the place where the controlled act is to be performed before it is performed; (b)  ensure that a written record of the particulars of the delegation, or a copy of the record, is placed in the patient record at the time the delegation takes place or within a reasonable period of time afterwards; or (c)  record particulars of the delegation in the patient record either at the time the delegation takes place or within a reasonable period of time afterwards. O. Reg. 268/13, s. 1.
40. Subject to this Part, and to the terms, conditions and limitations placed on their certificate of registration, the following members may, in the course of engaging in the practice of nursing, perform controlled acts that are delegated to them: 1.  A registered nurse in the General class or registered practical nurse in the General class. 2.  A registered nurse in the extended class. 3.  A registered nurse in the Special Assignment class or a registered practical nurse in the Special Assignment class. O. Reg. 268/13, s. 1; O. Reg. 291/23, s. 13.
41. (1) A member shall not accept the delegation of a controlled act unless the person delegating the controlled act was, at the time of the delegation, a member of the College or a member of another College authorized to perform that controlled act by a health profession Act governing his or her profession. O. Reg. 268/13, s. 1. (2) A member shall not perform a controlled act that was delegated to him or her by a person to whom the controlled act was delegated. O. Reg. 268/13, s. 1. (3) A member shall only perform a controlled act delegated to him or her if, before performing the controlled act, the member ensures that he or she, (a)  has the knowledge, skill and judgment to perform the controlled act safely and ethically; (b)  has a nurse-patient relationship with the patient for whom the controlled act is to be performed; (c)  has considered whether performing the controlled act is appropriate, bearing in mind the best interests and needs of the patient; (d)  after taking reasonable steps, is satisfied that there are sufficient safeguards and resources available to ensure that the controlled act can be performed safely and ethically; (e)  has no reason to believe that the delegator is not permitted to delegate that controlled act; and (f)  if the delegation is subject to any conditions, has ensured that any conditions have been met. O. Reg. 268/13, s. 1. (4) A member who performs a controlled act that was delegated to him or her shall record particulars of the delegation in the patient record, unless, (a)  a written record of the particulars of the delegation is available in the place where the controlled act is to be performed; (b)  a written record of the particulars of the delegation, or a copy of the record, is present in the patient record; or (c)  the particulars of the delegation have already been recorded in the patient record. O. Reg. 268/13, s. 1.