1. May 24, 2009 Discipline & Regulation Aug 29, 2007 CNO Press Release –CNO will regulate 4 NP specialties…NP(A) Scope of Practice, RN(EC) –3 controlled acts within RN scope + 4 additional controlled acts –Self-regulating –Authorizing mechanisms (directives) PHA (reg 965) – NPs in ambulatory to full scope….does not apply to in-patients

2. May 24, 2009 CNPI Core Competency Framework Canadian Nurse Practitioners (Jan 2005) Health Assessment & Diagnosis Health-Care Management & therapeutic Intervention Health Promotion & Prevention of Illness, Injury & Complications Professional Role & Responsibilities

3. May 24, 2009 APN National Framework (CNA ’08) Minimum education = graduate degree in nursing Roles focus on clinical practice Competencies –Clinical, research, leadership –Consultation & collaboration

4. May 24, 2009 Clinical Activities… Start with patient & program needs –Patient flow, patient safety, QI Identify gaps –Patient satisfaction, best practices Build on strengths of teams –Maximize expertise & experience –Accept overlap and distinct focus Identify evaluation measures

5. May 24, 2009 Collaborative Practice Dynamic process & outcome Shared interest Involves synthesis of different perspectives to understand complexity Develops integrative solutions More that the sum of the parts

6. May 24, 2009 10 Lessons in Collaboration Know thyself Manage diversity Conflict resolution Win-win solutions Master interpersonal & process skills It’s a journey Shared decision making Structure & spontaneous Balance autonomy & unity Not for all decisions (D. Gardner, 2009)

7. May 24, 2009 Innovation = Our future 1988 – 1NNP….2009 74NPs “not sure where this will land exactly…but…we’re willing and possibilities will emerge” “we have to work together…new systems…new models…new ways”

8. May 24, 2009 Progress Regulations exist Commitment to teams and new models Advisory Group, Courses launched, Students engaged Preceptors poised Organizations willing 1 st graduates December ’09 Next cohort….

9. May 24, 2009 Nurses in Anesthesia Care Around the World 106 Countries Role varies Title varies Regulations vary

10. May 24, 2009

11. NPs on the Anesthesia Care Team FIRST IN CANADA May 24, 2009