Licensed Practical Nurses A Practical Approach to Quality Care

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2 s A Practical Approach to Quality Care LPNs are professional nurses and work within their own scope of practice, standards of practice and code of ethics. As one of two categories of professional nurses in Newfoundland and Labrador, LPNs are involved in the assessment, planning, implementation and evaluation of nursing care. The Practical Nursing Program in Newfoundland and Labrador is a four (4) semester program that prepares graduates to care for clients across the lifespan in institutional and community based settings within the approved scope of practice. The program prepares its graduates to function as members of the health care team in the provision of independent and interdependent client care. The practical nursing program provides learning experiences to enable graduates to acquire the knowledge and skills necessary to: Provide competent nursing care; Function effectively as a team member; Facilitate client participation in care decisions; Advocate for clients and healthy public policy; and Assume a leadership role in decision making.

3 Table of Contents Introduction Report of the Chairperson and Executive Director/Registrar Financial Highlights Licensure Data Board and Committee Membership Listings Annual General Meeting Date June 26 th, 2014 Time hrs Location CLPNNL, 9 Paton St., St. John s, NL Annual General Meeting Agenda Call to Order Approval of Minutes 2012/13 Annual General Meeting Presentation of the Annual Report 2013/2014 Approval of Auditor s Report for 2013/14 Appointment of Auditor for 2014/2015 Approval of Amendments to the By-laws Presentation of Awards Adjournment 1

4 Introduction The College of s of Newfoundland and Labrador (CLPNNL) is the governing body for s (LPNs) in Newfoundland and Labrador. Its mission is to protect the public through the promotion of efficient, ethical nursing care, regulation of licensed practical nurses practice, the licensure of Practical Nurses and setting the strategic direction for the CLPNNL. Established by statute, but at arm s length from the provincial government, the CLPNNL develops the criteria for eligibility as a (LPN) in Newfoundland and Labrador and sets the Standards of Practice and Code of Ethics that must be met and adhered to in order to maintain that designation. Only those with a valid license from the CLPNNL can practice as a licensed practical nurse in Newfoundland and Labrador and use the titles or Practical Nurse. The CLPNNL has approximately 2300 members and is the second largest group of nurses within the discipline of nursing in Newfoundland and Labrador. Under the s Act and Regulations, the CLPNNL are obligated to: Determine the education requirements and licensing standards that must be met in order to obtain a license to practice as a LPN; Establish the Standards of Practice and Code of Ethics with which LPNs must comply; Evaluate programs for the education of practical nurses in the province to determine whether these programs are operating in compliance with the prescribed standards; Develop and publicize the functions and areas of competence of and standards of practice for LPNs; and Provide a discipline process for people (members of the public) who feel the Standards have not been met. Provincial laws, especially the s Act, provide the legal framework for practical nursing and give the CLPNNL the responsibility for carrying out practical nursing regulations to protect the public interest. 2

5 Introduction About the Practical Nursing Profession LPNs are professional nurses and work within their own competencies, standards of practice, and code of ethics. LPNs are involved in the assessment, planning, implementation, and evaluation of nursing care. LPNs study from the same body of nursing knowledge as registered nurses (RNs) - with a more focused approach in foundational knowledge, critical thinking, and clinical judgment to suit the LPN role of today. LPNs have the knowledge, skill, judgment, and abilities to contribute in all phases of the continuum of care - from prevention to acute treatment and management, to long term and palliative care. LPNs in Newfoundland and Labrador assume full responsibility for their own practice. As trusted and respected professional nurses, LPNs serve individuals, families, and groups, assessing their needs and providing care and treatments as appropriate. LPNs advocate for clients and for the human, physical, and financial resources necessary to provide safe, quality nursing care. Governance of the College of s of Newfoundland and Labrador In accordance with the s Act and Regulations, the CLPNNL as the governing body of the CLPNNL has a Board comprised of six elected LPNs, three Public Representatives appointed by the provincial government, one representative from the Centre for Nursing Studies (parent institution responsible for delivery of Practical Nursing Education), and the Executive Director/Registrar as an ex-officio member. 3

6 Report of the Chairperson and Executive Director/Registrar We are pleased to present the annual report of the College of s of Newfoundland and Labrador (CLPNNL) for the period of April 1, 2013 March 31, This Annual Report highlights the commitment of the CLPNNL towards achieving its mission to regulate and lead the profession in a manner that protects and serves the public through excellence in Practical Nursing. It is the vision of the CLPNNL to foster a professional environment where s (LPNs) are respected and valued as integral members of the nursing team, and provide quality health care services in Newfoundland and Labrador. The fiscal year 2013/14 has marked another milestone in the history of our profession with the development of National Standards of Practice and Code of Ethics for the profession. These Standards of Practice and Code of Ethics were developed by the Canadian Council for Practical Nurse Regulators (CCPNR) and adopted by the Board of the CLPNNL for implementation in this province as of January 1, This report also highlights some of the activities of the past year. The Board of the CLPNNL remains committed to the vision, the mission, the mandate and the values of the organization. It works in collaboration with the government, educational facilities, employers, LPNs and other key stakeholders focusing on initiatives to advance the profession and strive for excellence in the regulation of LPNs in Newfoundland and Labrador. We have been entrusted with an immense responsibility as the profession s self-regulation of 2300 LPNs. The CLPNNL s role for ensuring safe, competent and quality care is supported by the authority established in legislation, by-laws and Board and operational policy. This Annual Report highlights activities in meeting the goals and objectives of the Strategic Plan. The report outlines how the CLPNNL is living its vision and mission, and meeting the strategic direction for 2013/14. 4

7 Report of the Chairperson and Executive Director/Registrar ADVANCING OUR STRATEGIC DIRECTIONS Our current strategic plan that covers the period of , focuses on three strategic directions: Direction 1: Implement an assertive communication strategy designed to secure a strong identity for the profession and pride among members and stakeholders. LPNs are gaining respect throughout the province s health care system and among all stakeholders. This is founded in large part, on the strong partnerships CLPNNL has nurtured over the years. The CLPNNL s identity and communication practices need to be updated and invigorated as a means to instilling even greater respect and pride in the LPN profession within the province. In turn, this will strengthen the profession and the career opportunities open to LPNs. Goals Develop and implement a communications strategy founded on three pillars: a refreshed visual identity, an empowered workplace identity, and a reliance on the use of social media tools. Engage at the national level, on both a Board and an organizational level, to exchange best practices and new partnerships that help position Newfoundland and Labrador s LPNs as being among the most progressive in the country. Create a new staff position or contract professional services to implement the communications strategy. Direction 2: Empower members to become leaders in their profession. The CLPNNL has achieved its goal to increase LPNs scope of professional practice and to promote a strong, positive image of LPNs in the workplace and within the public eye. LPNs must now become leaders in their own careers and in the profession. As self-motivated leaders, they will influence others in recognizing the role of LPNs, create opportunities for their own advancement, and increase their leadership abilities in the workplace. 5

8 Report of the Chairperson and Executive Director/Registrar Goals Widely communicate among LPNs, the definition of leadership in today s evolving health care setting, and identify opportunities to apply leadership in the day-to-day work life of LPNs. Develop (or adopt existing) leadership courses to offer as part of CLPNNL s continuing education curriculum. Begin with a leadership basics workshop and, based on interest, expand to a more in-depth nursing leadership series. Recognize outstanding examples of LPN leadership as a means to model and define leadership among the broad membership. Direction 3: Review and improve the CLPNNL s organizational capacity to ensure continued value to members and the province s health care profession. In recent years, the CLPNNL s work has changed and grown in multiple ways: from developing and overseeing new education standards; to introducing an expanded scope of practice; to enforcing the Code of Ethics and Standards of Practice. In this same period, few changes have been made to the organization s staffing and resource commitments. The CLPNNL must also have the capacity to deliver its full scope of services and to continue advancing the education and competencies of its membership. Goals Update the CLPNNL s staffing structure to reflect the current and emerging priorities and strategic directions, paying specific attention to the areas of communication and discipline. Included in this goal would be the assessment of the CLPNNL s areas of risk to ensure the organization is not at risk of losing key talent, organizational infrastructure, corporate knowledge and/or other capabilities. Revisit the CLPNNL s By-laws to determine if updates are needed to reflect the current governance and operating environment. Lay the groundwork, including a strategy and implementation plan, for a continued competency program for the province s LPNs. 6

9 Report of the Chairperson and Executive Director/Registrar PROVINCIAL INITIATIVES Canadian Practical Nurse Registration Examination (CPNRE) Jurisdictions in Canada are responsible for ensuring those applying for licensure as a Practical Nurse meet an acceptable level of competence. This level of competence is measured in part by the CPNRE. The CPNRE is the final step in the licensure process and is administered three (3) times a year in January, May and September. The Canadian Practical Nurse Registration Examination is prepared by and purchased from Assessment Strategies Incorporated (ASI). The CLPNNL is an active participant in the development of the examination with representation on the Client Advisory Group, Examination Committee, Blueprint Committee, Competency Review Committee and Standard Setting Committee. Newfoundland and Labrador graduates continue to score among the top in the country, as evidenced through the three writings of the CPNRE of this past year. The following table contains NL statistics as prepared by ASI for the period of April 1, 2013 to March 31, 2014: ASI Statistics for NL: Fiscal Year 2013/14 Number of Candidates in Province First Exam Repeat Exam Number Registered Number Writing Number Not Writing 0 0 Number Passing 75 8 Number Failing 5 6 Percentage Passing 93.75% 75% Practical Nursing Program Centre for Nursing Studies (CNS) The Centre for Nursing Studies in accordance with the s Act has been designated by the CLPNNL as the parent institution for delivery of Practical Nursing Education in the province. Based on a human resource need, identified in collaboration with employers, the CLPNNL grants permission to the CNS to broker the Practical Nursing Program through various sites of the College of the North Atlantic. 7

10 Report of the Chairperson and Executive Director/Registrar There were thirty-eight (38) graduates from the Practical Nursing Program at the CNS in December There are currently forty-one (41) students enrolled in the program at the CNS who are due to complete the program in December The CNS will have another intake of approximately eighty (80) students in September During this past year the CLPNNL contracted with Dr. Alice Collins, Professor, Faculty of Education, Memorial University to complete an evaluation of the Practical Nursing Program. This evaluation was completed for the Centre for Nursing Studies (Parent Institution) and the satellite sites, College of the North Atlantic Corner Brook, Grand Falls-Windsor and Clarenville Campuses. The final evaluation report indicates that the Practical Nursing Program is an excellent preparation for the profession of Practical Nursing. Faculty, students, preceptor and employer satisfaction is very high. The Centre for Nursing Studies, in collaboration with the satellite sites is committed to continual improvement. The Centre for Nursing Studies was granted a five (5) year approval rating which is the highest rating possible in accordance with the policy of the CLPNNL. Practical Nursing Program College of the North Atlantic Corner Brook Campus: There were eleven (11) graduates from the Practical Nursing Program at this site in December There are currently twenty-three (23) students enrolled in the program at this site who are due to graduate in December This site will have another intake of thirty-five (35) students in September Practical Nursing Program College of the North Atlantic Grand Falls-Windsor Campus: There were sixteen (16) graduates from the Practical Nursing Program at this site in December There are currently nineteen (19) students in the program at this site who are due to graduate in December This site will have another intake of approximately thirty-five (35) students in September Practical Nursing Program College of the North Atlantic Clarenville Campus: There were five (5) graduates from the Practical Nursing Program at this site in December There are currently five (5) students in the program at this site who are due to graduate in December This site has been approved to have another intake of approximately sixteen (16) students in September

11 Report of the Chairperson and Executive Director/Registrar Practical Nursing Program College of the North Atlantic Happy Valley-Goose Bay Campus: There will be an intake of approximately sixteen (16) students at this campus for September LPN Workforce Model Working Group Health Workforce Planning, Department of Health and Community Services The CLPNNL continues to advocate for the implementation of the recommendations as outlined in the LPN Workforce Model Report that was completed in January As noted in the final report, there are significant opportunities to improve utilization and well-being of the LPN workforce. Focus on staffing and scheduling practices, utilization of support staff, work processes, illness/injury rates, and other areas could yield significant improvements. Labour Mobility Canadian regulators for practical nursing in Canada have been working with the federal and provincial governments to improve mobility of LPNs within Canada. The CLPNNL supports full mobility of LPNs and is working with other jurisdictional governments to enable labour mobility and to ensure compliance with the agreement without compromising the standards of practice for LPNs. Quality Professional Practice Environment Project (QPPE) Quality Professional Practice Environment is the term used to identify the attributes of a good place to work. The QPPE Project is a joint initiative under the leadership of the Association of Registered Nurses of Newfoundland and Labrador (ARNNL) and the CLPNNL. The program was developed nine (9) years ago in response to nurses concerns about their ability to provide quality client care in challenging practice environments. It is designed to assist nurses and their employers to create and maintain quality workplaces using an action research framework that empowers nurses to develop practical solutions to their unit s unique challenges. This program will come to a close in Approximately seven hundred (700) nurses have used the program to problem solve, influence change and create quality workplaces. The QPPE program at the Bonne Bay Health Centre and Bay St. George Long Term Care Centre, sites added in , continued with an April end date for the active facilitator-led phase. A review of the impact of the full program is underway to evaluate long-term outcomes associated with program participation. 9

12 Report of the Chairperson and Executive Director/Registrar Consolidation of Nursing Education During the past year the CLPNNL continued to support the consolidation of nursing education in the province. We firmly believe that such a model is beneficial for the nursing profession, government and most importantly, the public. At the CPNNL s Annual General Meeting in 2013, a resolution was passed by those members present for the CLPNNL to continue with its efforts to advocate that consolidation of nursing education be a priority action for government. The CLPNNL brought the message of our support for nursing education consolidation to meetings with the Honourable Susan Sullivan, Minister of Health and Community Services and the Honourable Kevin O Brien, Minister of Advanced Education and Skills. Professional Practice Consultations The staff of the CLPNNL continued to provide advice and guidance to support licensed practical nurses in their current and/or emerging roles and competencies. The CLPNNL, in conjunction with the ARNNL, held several education sessions within the Regional Health Authorities on Scope of Practice for LPNs and RNs. In addition, several information sessions were held with LPNs, practical nursing students and other key stakeholders pertaining to the implementation of the new Standards of Practice and Code of Ethics for LPNs. The staff of the CLPNNL regularly collaborates with employers and other organizations to identify common issues and trends in health care which may have an impact on LPN practice and education. New Office Building Project During the fiscal year of 2011/12, the Board made the decision to purchase commercial land to construct new office premises to meet the long term needs of the CLPNNL. In December 2013, construction of the new office premises commenced and the completion date is scheduled for August

13 Report of the Chairperson and Executive Director/Registrar Discipline Review Process The CLPNNL is committed to resolving allegations against LPNs based on the principles of procedural fairness, transparency and due diligence. Each allegation received by the CLPNNL is taken seriously and reviewed thoroughly to determine the appropriate course of action. The s Act and Regulations set out the approaches for addressing unprofessional conduct to protect the public from incompetent or unethical practitioners. Less than one per cent (1%) of the membership are involved in the discipline process each year. The allegations being received by the CLPNNL are becoming more complex, usually involving more than one allegation of unprofessional conduct. There were eight (8) new allegations of professional misconduct or conduct deserving of sanction filed with the CLPNNL against give (5) LPNs during 2013/14. NATIONAL INITIATIVES Canadian Council for Practical Nurse Regulators (CCPNR) The CCPNR is a federation of provincial regulators responsible for the profession of practical nursing in Canada. The CCPNR provides a collective voice on matters affecting practical nurse regulation. The focus of CCPNR is promotion of regulatory excellence and continued harmonization of the LPN profession within member jurisdictions. Paul D. Fisher, Executive Director/Registrar of the CLPNNL is presently the chair of the CCPNR. National Nursing Assessment Service (NNAS): The CCPNR is currently involved in the NNAS. After nearly five (5) years of extensive consultation and active engagement, twenty-three (23) Canadian nursing regulatory bodies (10 Registered Nurses, 9 s and 4 Registered Psychiatric Nurses) supported the creation of a national service to assess the substantial educational equivalence of internationally educated nurses (IENs) applying for licensure in Canada. Human Resources and Skills Development Canada (HRSDC) has been engaged throughout the process as the main funding partner and are prepared to fund the majority of costs associated with the implementation. The value proposition of NNAS has been confirmed by nurse regulators and is focused squarely on addressing the current and anticipated shortage of qualified nurses in Canada. The NNAS official kick off meeting April 12, 2013 in Toronto was, by all accounts, a success feedback has been positive that the event accomplished its objectives. 11

14 Report of the Chairperson and Executive Director/Registrar Effective August 12, 2014, in order to apply to be a nurse in Canada, all internationally educated nurses will require their documents and credentials to be submitted to and verified by the National Nursing Assessment Service (NNAS), before completing the application process with the province where they wish to work. Once all documents are received and an assessment of international credentials is complete, applicants will be notified by the NNAS. They may then apply to the regulatory body in the province where they wish to work to complete the assessment for eligibility to practice as nurse. Inter-Jurisdictional LPN Project: In 2013, upon completion of HRSDC funding CCPNR in collaboration with member regulatory bodies announced the successful completion of four new documents, namely: Requisite Skills and Abilities for LPNs; Harmonized Entry to Practice Competencies for LPNs; National Code of Ethics and Standards of Practice for LPNs. These documents were the product of a huge collaborative effort on behalf of all members of CCPNR. Staff Mix Decision-making Framework for Quality Nursing Care: This document was released in 2012 and during this past year CCPNR had representation on a steering committee that was charged with the responsibility of developing an accompanying Position Statement. This position statement has been approved by CCPNR, the Canadian Nurses Association (CNA), and the Registered Psychiatric Nurses of Canada (RPNC). The Position Statement is now available at This project was funded by HRSDC and led by CNA. CLPNNL S INVOLVEMENT WITH KEY STAKEHOLDERS The CLPNNL works extensively with stakeholders to protect the public through the promotion and delivery of efficient and ethical nursing care. We enjoy productive and collaborative relationships with our partners. Our partners include: Centre for Nursing Studies Advisory Committee Practical Nursing Program Assessment Strategies Inc. Review Committee of the Practical Nurses Registration Examination, Client Advisory Committee and the CPNRE Competency & Blueprint Development Committee Canadian Council for Practical Nurse Regulators ARNNL Advisory Committee on Nursing Administration Canadian Institute for Health Information LPN Database Development Project Canadian Network of National Association of Regulators 12

15 Report of the Chairperson and Executive Director/Registrar ARNNL Quality Professional Practice Environment Advisory Committee Centre for Nursing Studies Recruitment Committee for the Practical Nursing Program Health Professions Regulatory Network of NL National Nursing Assessment Service Internationally Educated Nurses Atlantic Collaborative Forum Elder Abuse Committee of NL Chancellor Park Partnerships Advisory Council CONCLUDING COMMENTS The CLPNNL is accountable for and has a duty to carry out its activities in a manner that serves and protects the public interest. The work of the staff, board and committee members in 2013/14 focused on continuing the implementation and execution of the Strategic Plan. It is with much gratitude and appreciation that we acknowledge the contributions of the CLPNNL Board and Committee members. We are grateful to the CLPNNL staff for their hard work and dedication to the organization. We also acknowledge the valued positive collaborative working relationships with LPNs, the Department of Health and Community Services, the Centre for Nursing Studies, the College of the North Atlantic, the Association of Registered Nurses of Newfoundland and Labrador and employers. Without the commitment of these stakeholders, we could not meet the expectations and obligations of a self-regulating profession. The CLPNNL looks forward to building on the accomplishments of the past year. We have made significant progress on many fronts this year and there is still a great deal to accomplish related to the utilization of LPNs in many practice settings throughout the province. The CLPNNL will continue to advance the profession in the coming year. Jane Helleur MBA, CMC Chairperson Public Representative Paul D. Fisher LPN, CI, BAHSA Executive Director/Registrar 13

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26 Licensure Data Licensure Statistics for 2013/2014 # of LPNs / /03 Prac cing LPNs for Newfoundland and Labrador / / / / / /09 Licensure Year / / / / /14 Percentage Distribu on of LPNs by Age Group 2013/ / / / / / / / / / / /03 0% 20% 40% 60% 80% 100% <

27 Licensure Data Percentage Distribu on of LPNs by Trends in Employment Types Percentage (%) / / / / / / / / / / / /14 Licensure Year PFT PPT TFT TPT Not Employed in Nursing 60 Percentage Distribu on of LPNs by Employer Types 45 Percentage (%) / / / / / / / / / / / /14 Licensure Year Hospitals Nursing Homes Other 25

28 Licensure Data Age distribu on of LPNs currently licensed in Newfoundland and Labrador for 2013/ Number of LPNs under 39 yrs of age Number of LPNs age between 40 and 49 Number of LPNs age between 50 and 54 Number of LPNs age between 55 and 59 Number of LPNs 60 yrs of age and older Age distribu on of LPNs currently employed with Eastern Health for 2013/ Number of LPNs under 39 yrs of age Number of LPNs age between 40 and 49 Number of LPNs age between 50 and 54 Number of LPNs age between 55 and 59 Number of LPNs 60 yrs of age and older Age distribu on of LPNs currently employed with Central Health for 2013/ Number of LPNs under 39 yrs of age Number of LPNs age between 40 and 49 Number of LPNs age between 50 and 54 Number of LPNs age between 55 and 59 Number of LPNs 60 yrs of age and older 26

29 Licensure Data Age distribu on of LPNs currently employed with Western Health for 2013/ Number of LPNs under 39 yrs of age Number of LPNs age between 40 and 49 Number of LPNs age between 50 and 54 Number of LPNs age between 55 and 59 Number of LPNs 60 yrs of age and older Age distribu on of LPNs currently employed with Labrador Grenfell Health for 2013/ Number of LPNs under 39 yrs of age Number of LPNs age between 40 and 49 Number of LPNs age between 50 and 54 Number of LPNs age between 55 and 59 Number of LPNs 60 yrs of age and older Age distribu on of LPNs currently employed with Private and Other Health for 2013/ Number of LPNs under 39 yrs of age Number of LPNs age between 40 and 49 Number of LPNs age between 50 and 54 Number of LPNs age between 55 and 59 Number of LPNs 60 yrs of age and older 27

30 Canadian Prac cal Nurses Registra on Exam Results / # of candidates wri ng st Exam Repeat Exam Registered Wri ng Not Wri ng Passing Failing 100% Percentage Passing CPNRE /14 99% 90% 80% 70% 71% 60% 50% 40% 30% 29% 20% 10% 0% 1st Exam 1% Passing Failing Repeat Exam 28

31 Board and Committee Membership Listings College of s of Newfoundland and Labrador Board Members Jane Helleur Public Representative, Chairperson Elizabeth Crawford Public Representative Joseph Duggan Public Representative Wanda Wadman Centre for Nursing Studies Connie Winter - Zone 1 Judy MacKay Pike - Zone 1 Christopher Matthews - Zone 2 Pearl Blake - Zone 3 Mimajoan Saunders - Zone 4 Scott Carroll - Zone 5 Paul D. Fisher Executive Director/Registrar (non-voting member) Committees Complaints Authorization Committee Elizabeth Crawford Wanda Wadman Pearl Blake Connie Winter Discipline Panel Oonagh O Dea Peggy Spurrell Mary Lannon Ivy Strong Rita Butler Gerald Parrott Madeline Tilley Jacqueline Sharpe Harvey Applin Cynthia Whiteway Education Committee Mimajoan Saunders Nina Thompson Connie Winter Karen Rowsell Fran Abbott Kathy Watkins Annette Morgan Janice O Neill Paul D. Fisher Finance Committee Joseph Duggan Mimajoan Saunders Connie Winter Rod Hayward Chris Beer Nadine Hedderson-Burton Paul D. Fisher Public Representative, Chairperson Centre for Nursing Studies, Vice Chairperson Public Representative, Chairperson Public Representative Public Representative PN Program, Centre for Nursing Studies Continuing Education, Centre for Nursing Studies Employer Representative Practice Consultant Executive Director/Registrar Board Member, Public Representative Executive Director/Registrar 29

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