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Complete a Declaration of Registration Controlled acts authorized to NPs
Requirements
NPs have the authority to perform the following
controlled acts:
Title protection communicating to a client, or a clients representative,
Many titles used by nurses are protected under the a diagnosis made by the NP identifying as the cause of
Nursing Act. This means that, in Ontario, only members the clients symptoms, a disease or disorder.
of the College can use the titles of nurse, Registered performing a procedure below the dermis or a
Nurse, Registered Practical Nurse, or any variation, mucous membrane.
abbreviation or equivalent in another language. Only putting an instrument, hand or finger:
nurses in the Extended Class can use the title Nurse i. beyond the external ear canal
Practitioner. Individuals who refer to themselves as nurses ii. beyond the point in the nasal passages where
or attempt to obtain employment as nurses in Ontario they normally narrow
without being registered with the College are illegal iii. beyond the larynx
practitioners and can be prosecuted under the Nursing iv. beyond the opening of the urethra
Act and RHPA. v. beyond the labia majora
vi. beyond the anal verge, or
Controlled acts authorized to nursing vii. into an artificial opening of the body.
The RHPA lists 13 controlled acts that are considered applying or ordering the application of a prescribed
potentially harmful if performed by unqualified form of energy.
persons. The Nursing Act authorizes nurses to perform setting or casting a fracture of a bone or dislocation
these controlled acts when ordered or permitted by the of a joint.
regulations pertaining to initiation: administering a substance, by injection or inhalation,
performing a prescribed procedure below the dermis in accordance with the regulation, or when it has been
or mucous membrane; ordered by another health care professional who is
administering a substance by injection or inhalation; authorized to order the procedure.
putting an instrument, hand or finger: prescribing, dispensing, selling or compounding a
i. beyond the external ear canal drug in accordance with the regulation.
ii. beyond the point in the nasal passages
where they normally narrow Quality Assurance
iii. beyond the larynx The RHPA requires that the College establish and
iv. beyond the opening of the urethra operate a Quality Assurance (QA) Program that assists
v. beyond the labia majora nurses to maintain competence and continually
vi. beyond the anal verge or evaluate their practice.
vii. into an artificial opening in the body.
dispensing a drug. Professional misconduct regulations
Regulation under the Nursing Act defines professional
Initiation of controlled acts by nurses misconduct for nurses as an act or omission that
The Nursing Act gives RNs and RPNs who meet breaches accepted ethical and professional standards of
certain conditions the authority to initiate specific conduct. For a complete list of acts that are considered
controlled acts. This means that these RNs and RPNs professional misconduct, refer to the Colleges
may independently decide that a specific procedure is Professional Misconduct document.
required and initiate the procedure without a specific
order or directive from a physician. Regulations under For a copy of the Nursing Act, 1991, contact Service
the Nursing Act outline how RNs and RPNs can safely Ontario Publications at www.serviceontario.ca/
initiate such procedures. In some cases, the authority publications.
of RNs and RPNs to initiate may be limited by other
legislation or employer policies. For further information,
refer to the Colleges Decisions About Procedures and
Authority, practice document.
JUNE 2014
41064
Copyright College of Nurses of Ontario, 2014. 2013-126