2010 ANNUAL REPORT
CONTENTS REPORTS Introduction ....................................................................................................................................................................... 2 President ............................................................................................................................................................................................... 4 Public Members ............................................................................................................................................................................... 5 Executive Director/Registrar ................................................................................................................................................. 6 Provincial, National, and International Initiatives .................................................................................................. 8 Research Initiatives ....................................................................................................................................................................... 11 Regulatory Services ..................................................................................................................................................................... 12 Conduct .................................................................................................................................................................................................. 15 Education .............................................................................................................................................................................................. 18 Continuing Competency Program .................................................................................................................................... 20 Practice ................................................................................................................................................................................................... 21 Communications ............................................................................................................................................................................. 22
FINANCIAL HIGHLIGHTS College of Licensed Practical Nurses of Alberta ................................................................................................. 25
OUR MISSION To lead and regulate the profession in a manner that protects and serves the public through excellence in Practical Nursing.
OUR VISION Licensed Practical Nurses are a nurse of choice, trusted partner and a valued professional in the healthcare system. The CLPNA embraces change that serves the best interests of the public, the profession and a quality healthcare system.
By 2015, the CLPNA expects to see: • Increased demand for Licensed Practical Nurses, generating continuous growth in the profession • Full utilization of Licensed Practical Nurses throughout the health care system • All Licensed Practical Nurses embrace and fully enact their professional scope of practice • Increased public understanding of the role and contributions of Licensed Practical Nurses • The College initiate and support research relevant to the Licensed Practical Nurse profession and health care system • Enhanced collaborative opportunities provincially, nationally and internationally • The College and Licensed Practical Nurses fully engaged in all decisions affecting the profession
CLPNA - 2010 Annual Report
2010 CLPNA COUNCIL (L-R, back row): Lorraine Strelezki, LPN; Sheana Mahlitz, LPN Jo-Anne Macdonald-Watson, LPN; Peter Bidlock, Public Member; Carla Koyata, LPN; Robert Mitchell, Public Member; Alona Fortier, LPN; Roberta Beaulieu, LPN (L-R, front row): Ralph Westwood, Public Member (2011); Donna Adams, Vice-President; Hugh Pedersen, President; Linda Stanger, Executive Director/Registrar; Allan Buck, Public Member (2011); (Missing: Ted Langford, Public Member)
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INTRODUCTION
ABOUT THE COLLEGE The College of Licensed Practical Nurses of Alberta (CLPNA) is the regulatory organization for Licensed Practical Nurses (LPNs) in Alberta. CLPNA regulates the profession and ensures protection of the public by setting entry-to-practice requirements; approving programs of study; establishing, promoting and enforcing standards for practice and conduct; and enhancing the care provided by members of the profession through the continuing competence program. Under provincial regulation, all health professionals who meet the requirements for LPN registration must be registered with CLPNA to provide LPN services to the public. The organization was founded in 1985 and assumed regulatory responsibility for the profession in 1987 under Alberta’s Health Disciplines Act. CLPNA is currently regulated under the Health Professions Act (1999). The origins of the profession in Alberta can be traced back to the Alberta’s Nurses Aides Act of 1947 and the development of the Certified Nursing Aide. Over the years, the name of the member organization and the title of the occupation changed in compliance with legislation: Alberta Certified Nursing Aide Association (1961) under the Societies Act, Alberta Association of Registered Nursing Assistants (1978) under the Nursing Assistant Registration Act; Professional Council of Registered Nursing Assistants (1987) under the Health Disciplines Act; Professional Council of Licensed Practical Nurses (1990); and, most recently, College of Licensed Practical Nurses of Alberta (1998).
focused approach in foundational knowledge, critical thinking, and clinical judgment to suit the LPN role of today. LPNs have the knowledge, skill, judgment, and ability to contribute in all phases of the continuum of care from prevention to acute treatment and management, to long term and palliative care. LPNs may have independent, interdependent, and often overlapping roles on the health care team. LPNs in Alberta practice autonomously and 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. ORGANIZATIONAL STRUCTURE Minister of Health and Wellness Regulated Committees
Council 9 Elected Council Members 3 Appointed Public Members
ABOUT THE PROFESSION
Executive Director/Registrar (Hearings Director)
LPNs are professional nurses and work within their own scope of practice, standards of practice, and code of ethics. As one of three categories of professional nurses in Alberta, LPNs are frontline nurses involved in the assessment, planning, implementation, and evaluation of nursing care. Operations
LPNs study from the same body of nursing knowledge as registered nurses (RNs) and registered psychiatric nurses (RPNs) with a more
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Education Standards Advisory Committee Council Appeals Committee Hearing Tribunal Complaint Review Committee Registration and Competency Committee
Regulatory Services (Complaints Director)
Professional Practice/ Communications
CLPNA - 2010 Annual Report
GOVERNANCE
COMMITTEES
The role and the responsibilities of the CLPNA are described in the Health Professions Act (HPA). The CLPNA is regulated by Alberta Regulation 2003, Health Professions Act, Licensed Practical Nurses Profession Regulation. The College operates under Bylaws (June, 2008); Code of Ethics and Standards of Practice (June, 2008); and Regulation (May, 2003).
A series of committees mandated by the Health Professions Act assist the CLPNA in their responsibilities under the Act. They are comprised of regulated members appointed by Council, and Public Members drawn from a list appointed by the provincial government.
The governing body of the CLPNA is the Council comprised of eight elected Council Members, three Public Members appointed by provincial government in accordance with the HPA, and the Executive Director/Registrar as an ex-officio member. The Council operates on a policy governance model. In 2010: New national Standards of Practice and Competencies for Perioperative Licensed Practical Nurses were adopted by Council following circulation to the Minister and stakeholders in Alberta. Initial discussion is being held regarding a new Code of Ethics and Standards of Practice for the profession nationally. A revision of the September 2003 DecisionMaking Standards for Nurses in the Supervision of Health Care Aides: Restricted Activities and Activities of Daily Living was completed in 2010. The new document, titled Decision-Making Standards for Nurses in the Supervision of Health Care Aides, was circulated to the Minister and stakeholders in Alberta and adopted by the Councils for CLPNA, the College and Association of Registered Nurses of Alberta (CARNA), and the College of Registered Psychiatric Nurses of Alberta (CRPNA).
CLPNA - 2010 Annual Report
Education Standards Advisory Committee (ESAC) The Education Standards Advisory Committee establishes the Standard for Program Approval for all basic and specialty education programs for practical nurses in Alberta, and approves and monitors programs to ensure compliance with these Standards under the Health Professions Act. Gloria Bauer, Chairperson Linda Stanger, CLPNA Representative Teresa Bateman, CLPNA Representative Pat Fox, LPN Janelle Wallace, LPN Bruce Finkel, Member at Large Pam Mangold, Employer Representative Leona Ferguson, Employer Representative Maureen McQueen, Education Representative Vi Smith, Education Representative Joyce D’Andrea, Education Representative
Council Appeals Committee (CAC) The CAC makes findings and determines disciplinary action arising from an appeal of a Hearing Tribunal Decision under the Health Professions Act. Hugh Pedersen, LPN, Chairperson Jenette Lappenbush, LPN Robert Mitchell, Public Member
Hearing Tribunal (HT) The HT makes findings and determines disciplinary action at professional conduct hearings under the Health Professions Act.
Public Members for Conduct Public Members appointed by the provincial government to sit on the Hearing Tribunal and Complaint Review Committee.
Sheila Green, LPN, Chairperson Tobi French, LPN Kathryn Kennedy, LPN Larry Leduc, LPN Deborah Reed, LPN Jamie Anderson, LPN Jill Paton, LPN Shelley Blaszkiewicz, LPN Shawn Maxwell, LPN Kunal Sharma, LPN
Grace Brittain Diane Adams Peter Van Bostelen Nancy Brook
Complaint Review Committee (CRC) The CRC reviews and ratifies settlements through alternative complaint resolution and conducts reviews of dismissal of complaint under the Health Professions Act. Anne Lanz, LPN, Chairperson Barry Nesterchuk, LPN Michelle Tavenier, LPN Teresa Stacey, LPN Margaret Devlin, LPN Jane Reif, LPN Brenda Blom, LPN Dawn Gillich, LPN
Registration and Competence Committee (RCC) The RCC determines issues regarding registration and competence matters referred by the Executive Director/ Registrar under the Health Professions Act and the Bylaws. The primary responsibility of the RCC is to guide and support the continuing competency program. Darcy Shenfield, LPN, Chairperson Ashley Holloway, LPN Dorothy Wurst-Thurn, LPN Lorna Diprose, LPN Michelle Rose, LPN Johanne Rousseau-Chicoine, LPN
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PRESIDENT
n my role as a Licensed Practical Nurse, I have the privilege of caring for some of the most promising leaders in our society – Children. Leadership is often demonstrated in a person’s spirit, determination, and perseverance. Through the innocence of children, particularly during times of crisis, leadership points comparable to those in today’s textbooks are readily available, if you listen.
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“I’m free… almost four!” he said in answer to my question. “I fall down off the bench and broke my head, right here… see!” Dried blood was stuck to his eyebrow where a small cut was slowly blanching in response to the topical freezing. The bed looked way oversized for this little chatty boy. His short, dark, curly hair appeared like tightly wound coils of wire on the skin of his head. “So,” I asked, “Do doctors have to go to school for a long time?” “Yup, at least 3 days… sometimes in the afternoon!” he said. “Why 3 days?” I asked. “So they can fix my head!” he answered. “It takes 3 days to learn that!” “My hair is slowly falling out.” I said, “Could the doctor do something about that do you think?”
This young leader highlights the point that preparation is key in avoiding negative outcome. It is possible he underestimates how long it takes! As I look at the health system today, one of the most effective ways we prepare is in building high functioning collaborative teams. The best ones value the contribution of each team member. In more than two decades of self-regulation, CLPNA Council, staff, members of the public, and thousands of LPNs, have demonstrated spirit, determination, and perseverance to positively impact the health system in Alberta. We are a profession that continues to forge ahead with a commitment to excellence in practice and regulation. We have prepared and we are prepared! This annual report reflects the strategic focus of the CLPNA highlighting collaboration, growth, quality education, practice excellence, and our commitment to public protection. On behalf of our profession, I am pleased to present the 2010 Annual Report, as approved by the Council of the College of Licensed Practical Nurses of Alberta. Sincerely, Hugh Pedersen President
“Nope, he would have to go to school for four days to help you!” he said, “But where did it fall out? Did you check the road? Maybe it fell out on the road.” I assured him I would check when I went home. “Are you going to be a doctor, or a policeman or a fireman or maybe a pilot?” I asked. “Yup… I’m going to be a pilot. They have to go to school for free days cause they need to learn to make a corner like this….” He used his tiny hand like an airplane and whooshed past my face in a steep 45 degree bank to the starboard. Then with more sincerity than an astronaut lost in space, he focused his gaze on mine and said with determination, “If someone falls out, you cannot go back and get them!!!!!!!!!!!!”
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CLPNA - 2010 Annual Report
PUBLIC MEMBERS
Peter Bidlock
Ted Langford
Robert Mitchell
s the public members of the CLPNA, we would like to say what a pleasure it is to participate with the Council when there is such respect for each other and the staff; as well as a commitment to ensuring continued growth and enhancement of the profession.
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To all LPNs that put their names forward to serve on the Council or on one of the many committees, we compliment you. Your vision and pro-active approach continues to keep LPNs as trusted, competent partners within the health care system. The College continues to be extremely well-managed and run thanks to Executive Director Linda Stanger and all of the skilled personnel that are assembled in the CLPNA office. We can confirm that the management of the College and its members is done in a manner that serves and protects the public with the intent of providing Albertans with quality health care. To the members and public, it is a pleasure to report that the CLPNA is extremely well-respected, managed and directed. Respectfully submitted, Peter Bidlock Ted Langford Robert Mitchell
CLPNA - 2010 Annual Report
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EXECUTIVE DIRECTOR/REGISTRAR
egulating and leading the profession in a manner that protects and serves the public through excellence in Practical Nursing is the focus of our work at the College of Licensed Practical Nurses of Alberta (CLPNA). Self-regulation is a privilege we take seriously and the following report outlines how CLPNA has delivered on that responsibility in 2010.
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Internally, the CLPNA has worked to stretch our resources and increase convenience for membership. We have increased the frequency and availability of supports through use of webinar, on line material, and video posted on our website. We implemented a new computer data base allowing us to create real time information, track trends, extract a variety of valuable reports and provide online registration for membership. We have increased our focus on meaningful relationships with organizations across the country, and we have moved into the area of research. Cost of self-regulation has increased faster than membership has grown. In response to a projected deficit for 2010, Council approved the implementation of a two-stage registration fee increase – the first in seven years. The new two-stage fee structure for 2011-2012 more closely reflects the cost of meeting the mandate of the college. The CLPNA contributes to and benefits from many collaborative relationships throughout Alberta and Canada. The development of a framework common to all three professional groups for a National Nursing Assessment Service for the IEN and standardizing the English and French language fluency requirements for registration across all three nursing professions are examples. With our LPN partners across Canada, we updated our national exam for implementation in 2012 increasing focus on leadership and critical thinking to support the LPN in meeting the demands of today’s workplace. As well with these regulatory partners, we anticipate approval of a request for Federal funding to complete a Pan Canadian Competency statement for the profession, a document outlining requisite occupational skills and abilities for the profession, and a standardized code of ethics and standards of practice. Work on these initiatives will begin early in 2011. Each of these projects furthers the harmonization process within the LPN profession in Canada, making mobility for the LPN increasingly easy and giving a greater presence to the profession. 6
The CLPNA participates on numerous advisory committees with government, Alberta Health Services, and with the educators providing PN education in Alberta. We have met with the Ministries of Health and Wellness, Employment and Immigration, and Advanced Education. We continue to liaise with CRPNA and CARNA on development of collaborative documents to guide and support Alberta’s nurses in decision making and collaborative practice. During 2010, our admission to the National Council of State Boards of Nursing (NCSBN) in the United States was approved. Recognized worldwide for their excellence in regulatory process, NCSBN provides yet another valuable source of information and support as CLPNA advances regulatory process. In a world increasingly focused on evidence based decision making, CLPNA has enhanced its research activities including educating members, participating on steering committees, and initiating research projects regarding our profession. In all our communication, relationships and initiatives, the CLPNA advances the voice of the LPN with a clear focus on excellence in nursing and patient outcome and making a difference for the system through appropriate utilization of our health human resources. This year, the CLPNA has accomplished much in support of our profession, the health system and the people we serve. It is through the effective leadership of our Council and President, the dedicated work of our staff and volunteers, and the competent committed care by Alberta’s 9000 LPNs that we have a profession to be very proud of. Thanks to each of you for your making a positive difference for Albertans everyday. With respect and appreciation, Linda Stanger Executive Director/Registrar
CLPNA - 2010 Annual Report
As the nurse at the bedside you are well positioned to provide exactly what the public expects competent committed care. Executive Message CARE, Volume 24, 1st Edition, Spring 2010
CLPNA - 2010 Annual Report
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PROVINCIAL INITIATIVES
LPNA welcomed the Government of Alberta’s invitation to respond to the Minister’s Advisory Committee on Health (MACH) A Foundation for Alberta’s Health System regarding the proposed Alberta Health Act. A written response was submitted to MACH in July, and published in the Fall 2010 issue of CARE magazine and on CLPNA’s Blog. A subsequent presentation was made to the committee and representatives of CLPNA attended public consultation sessions on the proposed Act.
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The Health Human Resources Forecasting and Simulation Model – Nursing Project, a project sponsored by Alberta Health & Wellness and Alberta Health Services, began in May with the goal of developing a model to assist in forecasting nurse staffing requirements. CLPNA is a member of the External Advisory Committee. CLPNA participated in Alberta Health Services (AHS) Summit on Health Human Resource (HHR) planning in November. AHS acknowledges underemployment of LPNs within their system. Underemployment, plus reported underutilization of the LPN, points to two areas where significant expansion is possible as partial solution to the nursing shortage in Alberta. The College response to the AHS discussion paper: Forecasting to Planning: Modeling Options for the Alberta Nursing and Health Care Aide Workforce, focused on the critical importance of utilizing the full knowledge skill and ability of all health care providers, increasing employment and utilization of the LPN within AHS, and the positive effect an immediate expansion in PN education seats would have on increasing the total number of regulated nurses in the province. The Alberta College Admission and Transfer Task Group established by the Minister of Advanced Education submitted their final report to the Minister in the first quarter of 2010. The group, which included CLPNA representation, made recommendations regarding developing and
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enhancing transferability among nursing programs, including Licensed Practical Nurse diploma programs to Registered Nurse degree programs, and between institutions instructing RN degree programs. The main recommendation focused on ensuring student awareness of available transfer options. CLPNA participated on the Alberta Continuing Care Expert Advisory Committee with Alberta Health and Wellness, reviewing guidelines for Continuing Care Living Options. Recommendations with a strong focus on safety were advanced to the Deputy Minister of Health. CLPNA participates in the Alberta Federation of Regulated Health Professionals and subcommittees related to complaints process, continuing competence, and legislative review. CLPNA, along with other members of the Complaint Process Working Group, submitted a proposal for funding in the third quarter of 2010 to develop an educational program for conduct committees designated under the HPA. Approval is pending. The Successful Transition of the Entry Level NurseProvincial Steering Committee supports entry level nurses in the Alberta workforce through identifying and addressing issues related to the integration of the entry level nurse for the three nursing professions in Alberta. Members of the committee include educators, regulators of the three nursing professions, Alberta Health Services and Alberta Health and Wellness. The group forwarded an application for funding to develop a Toolkit “supporting adoption of promising practices that have been shown to enhance retention and satisfaction of new graduates and to support effective integration of new graduates in the health care workforce”.
2010 focused on three initiatives to serve the needs of internationally educated nurses (IENs) including: • an IEN Self-Assessment Tool designed to aid the IEN in determining their readiness for the LPN role in Alberta prior to applying for registration; • an IEN Orientation to the Canadian Healthcare Education Module, a self-study module to prepare an IEN with information to ease the transition to the Alberta workplace; and • a Resource Guide designed to assist with successful integration of IENs into Alberta workplaces, nursing profession, and community. CLPNA, with over 120 invited participants, attended an Open Space Forum on Primary Care in Alberta sponsored by Alberta Health Services. The focus question was “What are the key steps to expanding/evolving/enhancing primary care in Alberta and how do we overcome the obstacles to doing this?” Much of the group discussions related to physician, nurse practitioner, registered nurse interaction and concern. CLPNA has seen increased opportunity for LPNs in primary care and anticipates future growth in this area. Work continues with the other nursing regulatory bodies in Alberta. Council approved Decision Making Standards for Supervision of Health Care Aides (2010), a collaborative document from CLPNA, CRPNA and CARNA, and an update to the Collaborative Nursing Practice in Alberta (2003) document is in progress following consultation with members of each nursing profession. CLPNA shared in the 60-year celebration of the Registered Psychiatric Nurse profession in Alberta, and attended CARNA’s Annual General Meeting. The CLPNA provided keynote presentations on leadership at two provincial gerontology nursing events.
A proposal submitted to the Alberta Government Foreign Qualification Recognition (FQR) Innovation Fund late in
CLPNA - 2010 Annual Report
NATIONAL INITIATIVES
Canadian Council for Practical Nurse Regulators (CCPNR) The CCPNR is a federation of regulators responsible for the profession of practical nursing in Canada and 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.
informs the Framework; develop policy/educational documents based on current literature and expert opinion; and communicate and disseminate the new 2011 Framework to nursing and health care communities. This project is on hold pending additional literature review and input by experts.
New Standards of Practice and Competencies for Perioperative Licensed Practical Nurses (2010) were developed, adopted by provincial regulators, and circulated to employers. CCPNR has worked on National projects with the Canadian Nurses Association, College of Nurses of Ontario, and had an initial meeting with the National Council of State Boards of Nursing (USA) to discuss issues related to labour mobility for the LPN between our countries. Funding approval is pending on a proposal to Human Resources and Skills Development Canada (HRSDC) for development of a competency statement for the profession; a description of the requisite skills and abilities for the profession; and a common code of ethics and standards of practice. Approval is anticipated early in 2011.
It has been important to have the national Licensed Practical Nurse voice heard related to the LPN scope of practice, role and responsibilities. The absolute lack of LPN specific research is a barrier and limits evidence on which to effectively base staff mix decisions.
CLPNA Executive Director completed a two-year term of office as chair of CCPNR on Dec. 31, 2010.
National Nursing Assessment Service CLPNA participated in phase two of a national project to harmonize the registration requirements and the process by which the IEN must demonstrate these requirements are met, including all forms used for registration purposes. Over 750 required elements have been standardized and work continues toward establishing a centralized assessment service across the three nursing professions (LPN, RN, RPN) in Canada. CLPNA participated in both phases of this initiative.
Evidence-Informed Nursing Care Delivery Models across the Continuum of Care National Working Group - Language Proficiency This project initiated by the Canadian Nurses Association involved two committees, a Task Force and a Working Group, with CLPNA representatives involved on behalf of CCPNR. The goal of the Task Force was to accelerate the transfer of knowledge relevant to staff mix models for Licensed Practical Nurses, Registered Nurses, and Registered Psychiatric Nurses into the hands of healthcare administrators and providers. This initiative included a round table discussion with invited experts from practice, research, regulatory, and associations. Participants presented research evidence and examples of how nursing practice leaders are making changes. The ensuing dialogue generated next steps: Develop guiding principles for nursing care delivery models; support the completion and publication of a revised staff mix framework; and publish the staff mix literature review that was created as part of the framework revision.
The National Working Group on Language Proficiency Tests completed a benchmarking exercise and formulated recommendations to standardize the language testing tools to Canadian English Language Benchmark Assessment for Nurses (CELBAN) and International English Language Testing System (IELTS) and established acceptable minimum scores to be used by all categories of nursing within Canada. CLPNA participated in the standard setting exercise with regulators, and educators from other nursing professions throughout Canada.
The goals of the Working Group were to update the Evaluation Framework to Determine the Impact of Nursing Staff Mix Decisions (2005); update the 2004 literature review that
CLPNA - 2010 Annual Report
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INTERNATIONAL INITIATIVES
ixty-four students in Jamaica successfully completed a pilot program initiated between Jamaica’s Pre-University practical nurse program, NorQuest College, and the Government of Jamaica, with regulatory input from CLPNA. Graduates were assessed by NorQuest College and required to establish equivalency with the beginning Alberta practical nurse. Graduates have employment offers with private continuing care operators in Alberta and are applying for temporary foreign worker status. They are expected to arrive in Alberta in early 2011.
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CLPNA was welcomed as an Associate Member of the National Council of State Boards of Nursing (NCSBN) at their Annual Meeting on August 11-13, 2010. NCSBN Associate Members gain access to information, education, and networking opportunities regarding issues common to the international nursing community. NCSBN is a U.S. national organization “through which boards of nursing act and counsel together on matters of common interest and concern”. All 60 U.S. nursing regulatory boards are members of the NCSBN, and several Canadian nursing regulatory boards belong as Associate Members.
Pictured left to right: Linda Stanger, Chair CCPNR (2008-2010); Myrna Broadway, President NCSBN; and Teresa Bateman, past Chair National Practice Consultants Group (2009-2010).
Representatives from the Canadian Council for Practical Nurse Regulators (CCPNR) attended the December NCSBN Board Meeting in Chicago on December 8, 2010 by invitation from Myra Broadway, President of the National Council of State Boards of Nursing (NCSBN). Discussion centered on the competencies and the role and scope of the Canadian Licensed Practical Nurse to increase understanding as a first step in facilitating ease of mobility for LPNs between Canada and the US. In addition, common issues facing the nursing regulatory environment were part of a general discussion.
To help ease the nursing shortage, CLPNA worked with Alberta Health Services and NorQuest College during 2008 and 2009 on a pilot project to recruit and register Philippine nurses in Alberta. The registration process was contingent on the IEN’s employment with Alberta Health Services. During that time, CLPNA licensed 432 Philippine nurses as LPNs. In 2010, a remaining 400 nurses who were qualified for registration, but had not yet immigrated to Alberta, were notified that due to the termination by Alberta Health Services of any off shore recruitment initiative, the applications for registration would not be processed.
Licensed Practical Nurses are increasingly assuming roles as “a nurse of choice”, as greater numbers of employers, other healthcare professionals, and the public recognize the contributions LPNs can bring to the health care team. Executive Message CARE, Volume 24, 3rd Edition, Winter 2010
The LPN has the opportunity at the bed-side to be most effective and efficient in minute-by-minute skilled, knowledgeable, and compassionate care giving. Ken Chapman, Cambridge Strategies Inc. CARE, Volume 24, 1st Edition, Spring 2010
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CLPNA - 2010 Annual Report
RESEARCH INITIATIVES
Knowledge and Education Project (KEP) A final report released in late 2009 by the Steering Committee of the Knowledge and Education Project (KEP), compared the knowledge of the entry-level practical nurse, registered nurse, and psychiatric nurse just prior to graduation with the goal of helping managers with staffing decisions. Dissemination of the KEP report occurred in 2010. The study concluded that all categories of nurse in Alberta are educated to provide safe competent care within their scope of practice. This study is an important start in understanding the uniqueness and similarity between the categories of professional nurse. CLPNA’s response to the study was published in the Spring 2010 issue of CARE magazine and on CLPNA’s Blog. CLPNA participated on the Steering Committee of this project funded by Alberta Health and Wellness. Conjoint Survey by Cambridge Strategies A Conjoint Survey of 900 members of the public and 1491 CLPNA members was conducted in Spring 2010 and determined LPNs are 99% aligned with the public in their values and beliefs about quality care. In practical terms, what the consumer wants is what the LPN values and believes they deliver. The consumer values nurses who are skilled, knowledgeable, caring/compassionate, thorough, and ethical. 88% of public respondent’s ranked one of these five values as #1, so if nurses deliver on all five values they effectively meet the expectation of 88% of the population. Cambridge Strategies was engaged to facilitate this study to increase the profile of the LPN profession in Alberta. A subsequent social media initiative was launched by CLPNA to promote word of mouth advertisement. “Talk the Walk” encouraged LPNs to engage in conversation with patients helping them understand more about the profession. This social media initiative has been maintained as a key communication tool for CLPNA and will continue into the future. Research Project: Understanding LPNs Full Scope of Practice Alberta Health and Wellness funded a research project designed to evaluate the impact on quality of care and patient outcomes when LPNs work to scope. The study Understanding LPNs Full Scope of Practice also explores the supports and barriers in place, impacting LPNs ability to work to the full extent of their knowledge, skill, and ability. The research team, led by Dr. Rena Shimoni at Bow Valley College includes leading researchers in evaluation research (Dr. Gail Barrington); the sociology of occupations (Dr. Milosh Raykov); and nursing (Dr. Sean Clarke). Included on the Steering Committee is representation from Alberta Health Services including Research and Administration, Alberta Health And Wellness, University of Alberta Faculty of Nursing, Bow Valley College, NorQuest College, Covenant Health, Alberta
CLPNA - 2010 Annual Report
Continuing Care Association, College of Registered Psychiatric Nurses of Alberta, College and Association of Registered Nurses of Alberta, CLPNA, and members of the LPN profession. CLPNA is the fund holder for the project. The study concludes March 31, 2012. LPN Research Network Development Day On March 19, 2010, CLPNA hosted 23 LPNs for the first LPN Research Network Development Day. Participants learned about research study design, methodology, and the value of developing a base of LPN research provincially, nationally, and internationally. Dr. Rena Shimoni, Dean of Applied Research & Innovation at Bow Valley College, led the session which generated enthusiasm and several initial ideas for research questions for the profession. Provincial Nursing Survey CLPNA participated on the planning committee of a provincial Multi-Stakeholder Nursing Survey (March-May 2010) initiated by Alberta Health and Wellness Workforce Policy and Planning branch. It was unique because it specifically examined the work patterns of the entire Alberta nurse workforce at one point in time, and includes all of the key stakeholders for the purpose of understanding why nurses work the way they do. Survey results are intended to support evidence-based planning and decision-making within the Workforce Planning and Policy Branch of Alberta Health and Wellness and beyond. Quality Work Environment Study (QWEST) CLPNA participated on the Steering committee of the Quality Work Environment Study (QWEST) project, a three-year (2007-2010) research study funded by the Social Sciences and Health Research Council and led by Dr. Greta Cummings, University of Alberta. The purpose of QWEST was to look at the relationships between nurse manager leadership, features of the nursing work environment, patient safety and nursing work life across three different contexts in the Capital Health region (teaching hospitals, general hospitals and longterm care). The study used qualitative and quantitative methods in their examination of these three contextual settings. Results of the study were shared with participants in a one-day symposium, and strategies were identified to address results. More information is available at www.clear.ualberta.ca.
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REGULATORY SERVICES
LPN registration in 2010 increased 5.7% over the previous year to 9015 members. LPNs comprise the second largest group of professional nurses in Alberta and in Canada. Registration Fee Increased The Council approved a graduated increase to the annual Registration Renewal fee for an Active Practice Permit from $250 per year to $300 effective for the 2011 registration year and $350 for the 2012 registration year. This is the first fee increase in seven years as costs have increased in all areas of the College at a rate not sustainable within the current fee structure and membership growth rate.
website. Fifty-eight percent of members completed their 2011 Registration Renewal online, with the remainder completing a paper form. Members reported they found the online Registration Renewal quicker, easier, and clearer than completing the paper version. Also appreciated was the immediate confirmation of registration status, instead of waiting days or weeks for manual paperwork processing and delivery.
New Database Launched CLPNA implemented a new database on June 8, 2010. Content from the existing database was converted to the new Alinity software format through a very smooth and uneventful transition. The Public Registry was maintained without interruption during the conversion. CLPNA and Alinity have developed several database modules designed to ease complex administrative processes. For the Continuing Competency Program Validation (CCPV), the database can randomly select members for the validation process and track participation. The Conduct module now tracks each step in the very detailed conduct process including monitoring of orders. Previously, these processes were completed manually. The system is very user-friendly and further modules will be developed to meet identified business need.
Online Registration Introduced The new database installed in June 2010 was followed by the creation of an online Registration Renewal system which went live for the 2011 registration year on October 1 on a secured members/applicants only
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Online registration extends CLPNA’s capacity for environmental stewardship by reducing the quantity of paper generated during the Registration Renewal process. The quantity of incomplete paper Registration Renewal forms returned to the member reduced by 90%. This resulted in efficiencies from reduced postage and processing time. Membership data is now instant rather than waiting for manual dataentry. In addition to eliminating some data-entry time, potential for dataentry errors was significantly reduced. Members and applicants are now able to update their CLPNA profile online, including mailing address, email, phone numbers, employment information, and learning plans.
Public Registry Members and employers requiring verification of LPN registration status may access the online Public Registry available on the CLPNA’s website. This information is available in real time, and complies with requirements of the Health Professions Act (HPA) and the Personal Information Protection Act (PIPA). Information available includes the member’s name, registration number, Practice Permit type, Practice Permit expiry date, specialties and restrictions.
CLPNA - 2010 Annual Report
We strongly encourage the support of research regarding Alberta LPNs. This will ensure increased evidence for decisions in important policy areas such as staff mix, safety, and utilization. Executive Message
CANADIAN PRACTICAL NURSE REGISTRATION EXAMINATION (CPNRE) Jurisdictions in Canada are responsible for ensuring those applying for registration as a practical nurse meet an acceptable level of competence to practice. This level of competence is measured, in part, by the Canadian Practical Nurse Registration Examination (CPNRE) administered by the Provincial and Territorial Regulatory Authorities, such as CLPNA. The CPNRE is the final step in the registration process and is administered three times a year in January, May, and September. The CPNRE is prepared by Assessment Strategies Incorporated (ASI) working in collaboration with representation from practical nurses, educators, and employers of practical nurses from across Canada. These individuals serve as the content experts in developing and validating the CPNRE on behalf of the regulatory authorities. CLPNA is an active participant in the development of the CPNRE with representation on the Client Advisory Group, Examination Committee, Blueprint Committee, Competency Review Committee. CLPNA also hosts an annual Jurisdictional Review of draft exam questions.
New CPNRE Blueprint Approved In 2010, a new Canadian Practical Nurse Registration Examination Blueprint (2012-2016) was approved by the CPNRE Client Advisory Group (CAG), comprised of representatives from each of the Canadian practical nursing regulatory authorities that administer the CPNRE, including the CLPNA.
CLPNA - 2010 Annual Report
CARE, Volume 24, 2nd Edition, Fall 2010
The CPNRE Blueprint informs changes to the Canadian Practical Nurse Registration Examination (CPNRE). These changes are effective January 2012. The blueprint contains guidelines and specifications for developing the exam, and serves as a framework and guide for subsequent activities in the exam development process. The CPNRE Blueprint is available at www.cpnre.ca.
Different levels of nursing bring different contributions, and we heard how much that matters to you. Everybody brings a contribution and we have to work together. Dr. Judith Shamian, CNA President CNA Biennial Convention
Alberta CPNRE Candidates 2010*
CARE, Volume 24, 2nd Edition, Fall 2010
IEN’s
IEN’s Repeat Exam
Total Candidates
98
23
16
868
721
98
22
16
857
Not Writing
10
0
1
0
11
Passing
632
51
16
10
709
Failing
89
47
6
6
148
88%
52%
73%
63%
83%
1st Exam
Repeat Exam
Registered
731
Writing
Number of Candidates
% Passing
*Statistics prepared by Assessment Strategies Incorporated (ASI). IEN: Internationally Educated Nurse
The CLPNA believes in a health care system in which each profession should do what it does best, where overlap is minimized, and where each professional is expected to work to the full extent of their skill and ability. CARE, Volume 24, 2nd Edition, Fall 2010
13
26-30
31-35
36-40
41-45
46-50
51-55
56-60
61-65+
2010 MEMBERSHIP STATISTICS
Registrations
Out of Province & International Registrations
LPN Registration Trends 2009 661
2010
5
4
Other Canadian LPNs
277
264
Non Canadian LPNs Renewals
136 7452
34 7992
Alberta Initial Graduates Re-Entry LPNs
TOTAL
2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986
721
8531
9015
LPN Gender Distribution
94%
6%
Number of LPNs
Percentage of Loss/Increase
9015
5.7%
8531 7859 7264 6863 6533 6037 5575 5172 4848 4431 4342 4606 4723 4963 5562 6196 6378 6545 6651 6736 6956 7225 7894 8643
8.6% 8.1% 5.8% 5.0% 8.2% 8.3% 7.8% 6.7% 9.4% 2.0% -5.7% -2.5% -4.8% -10.8% -10.0% -2.9% -2.6% -1.6% -1.3% -3.2% -3.7% -8.5% -8.7%
601
413 298 247
205 53 1998
34
41
1999
2000
74
90
80
81
2001
2002
2003
2004
124
2005
2006
2007
2008
2009
2010
YEAR
In Migration Breakdown
BC |
SK |
MN |
ON |
QC |
NB |
NS |
PEI |
NL |
NT |
YK |
NU |
102
6
5
121
1
3
15
1
10
0
0
0
26-30
31-35
36-40
41-45
46-50
51-55
56-60
USA OTHER* | |
31
3
61-65+
*Philippines
TOTAL - 298
R9 1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
Y
Age of Active LPNs
Distribution of LPNs by Region (former) 18.3% 1646
Average Age: 2008 - 41.2
13.0% 11.8% 10.5% 10.6% 1171 8.8% 1063 9.7% 952 8.7% 870 946 782 797
8.7% 788
2010 - 41.4 19-25
26-30
31-35
36-40
41-45
46-50
AGE GROUPS
14
2009
2010
R1 Chinook Regional Health Authority R2 Palliser Health Region
476 293
513 320
R3 Calgary Health Region
1995
2146
R4 David Thompson Regional Health Authority
863
882
26-30 31-35 36-40 41-45 R5 East Central Health
2009 - 40.7
51-55
56-60
61-65+
R8
46-50
51-55
56-60
61-65+
407
427
R6 Capital Health
2987
3094
R7 Aspen Regional Health Authority R8 Peace Country Health
455 383
478 401
R9 Northern Lights Health Region
133
148
Other Canadian
539
606
TOTAL
8531
9015
R7
R6
R5
R4 R3
R2 R1
CLPNA - 2010 Annual Report
CONDUCT
he CLPNA is committed to resolving complaints against LPNs based on the principles of procedural fairness, transparency and due diligence. Each complaint is taken seriously and reviewed thoroughly to determine appropriate course of action. The Health Professions Act sets out the approaches for addressing unprofessional conduct to protect the public from incompetent or unethical practitioners. Fewer than 1% of membership is involved in the conduct process every year.
T
Several trends in conduct are noted for 2010: There was an increase in complaints from employers as they become increasingly aware of their legal obligation to inform the CLPNA when a LPN is terminated, suspended, or the LPN has resigned for reasons of unprofessional conduct. In addressing these matters, the College relates to the employer as the complainant. Complaints are becoming increasing complex, usually involving more than one allegation of unprofessional conduct. The most significant complaint types involve clinical incompetence, substance abuse, and practicing without a permit (failure to renew registration on time).
CLPNA - 2010 Annual Report
2006
2007
2008
2009
2010
Complaints in Process From Previous Year
14
21
20
16
30
New Complaints Received
30
20
19
38
81*
Total Complaints in Process
44
41
39
54
111
Historical Comparison
*In 2010, the Complaints Director lodged 30 complaints against LPNs found to be practicing without a Practice Permit. Previously, these issues were resolved through registration processes and were not counted as formal complaints of unprofessional conduct.
Type of Complaints Received Abandonment
1
Abuse - Physical
1
Abuse - Verbal
3
Boundary Issues
1
Clinical Competence - Documentation
1
Clinical Competence - Medication Administration
13
Clinical Competence - Multiple
15
Criminal Charge
1
Misrepresentation
1
Other
1
Practicing Without A Permit
30
Substance Abuse
6
Theft
1
Unethical Conduct
6
Total Complaints Received
81
15
CONDUCT
Areas of Responsibility of Investigated Members
Disposition of Complaints Processed
Ambulatory Care
1
Complaints in Investigation Stage
Community Health
1
Complaint’s Pending Hearing
7
Emergency Care
3
Hearings Completed
19
Geriatrics
28
Council Appeals Committee Appeal Hearings Completed
0
Home Care
5
Complaint Review Committee Review of Dismissal of Complaint
2
46
Maternal / Child
2
Alternative Complaint Resolution Decisions Ratified
0
Medical
9
Alternative Complaint Reviews in Progress
0
Mental Health
3
Appeals to Court
0
Nursing In Several Clinical Areas
10
Incapacity Assessments
0
Occupational Health
1
Complaints Dismissed
3
Operating Room
2
Resolved by Complaints Director (Consent Resolution)
4
Other Client Care
1
Surrendered Registrations
0
Pediatrics
2
Member’s Location Unknown - File Suspended
1
Physicians / Clinic Office Nursing
3
Undertakings Completed
29
Rehabilitation
3
Member Deceased - File Closed
0
Sub Acute
1
Total Discipline Events
Surgical
3
111
Teaching - Employees
1
Request to Vary an Order (post-Hearing)
1
Unknown
2
Monitoring of Orders
21
Total Complaints Received
81
Hearings Summary Upon review of the Investigation Report, the Complaints Director may refer complaints to the Hearing Tribunal for a formal Hearing. Based on the evidence, the Tribunal determines if the investigated member has met the Standards of Practice of the profession. If the member is found guilty of unprofessional conduct, the Tribunal decides what measures are necessary to protect the public from unsafe practice and determines the appropriate steps required to remediate and rehabilitate the individual nurse.
16
CLPNA - 2010 Annual Report
Hearings Summary Overview File No.
Complaint Type
Finding
Outcome (Sanctioned Orders)
C-09-03
Breach of Confidentiality
Unprofessional conduct on all allegations
Reprimand Remedial Education
C-09-04
Substance Abuse Sleeping During Shift
Unprofessional conduct on all allegations
Reprimand Counseling Physician Monitoring
C-09-06
Unethical Conduct
Unprofessional conduct on all allegations
Reprimand Remedial Education
C-09-07
Abuse - Verbal
Unprofessional conduct on all allegations
Caution Remedial Education
C-09-08
Abuse - Verbal
Unprofessional conduct on all allegations
Reprimand Remedial Education
C-09-10
Clinical Incompetence – Multiple Areas
Unprofessional conduct on all allegations
Reprimand Remedial Education
C-09-14
Clinical Incompetence – Multiple Areas
Unprofessional conduct on all allegations
Reprimand Remedial Education
C-09-15
Boundary Issues
Unprofessional conduct on all allegations
Reprimand Remedial Education
C-09-17
Clinical Incompetence Medication Administration
Unprofessional conduct on all allegations
Reprimand Remedial Education Practice Conditions Counseling
C-09-19
Boundary Issues
Unprofessional conduct on all allegations with one exception
Written decision pending at time of this report
C-09-20
Clinical Incompetence – Multiple Areas
Unprofessional conduct on all allegations
Caution Remedial Education Counseling Employer Progress Report
C-09-23
Unethical Conduct Clinical Incompetence Medication Administration
Unprofessional conduct on all allegations
Caution Remedial Education
C-09-25
Substance Abuse Theft
Unprofessional conduct on all allegations
Suspension Reinstatement with Conditions Physician Monitoring Counseling Referral to Attorney General
CLPNA - 2010 Annual Report
Outcome (Sanctioned Orders)
File No.
Complaint Type
Finding
C-09-27
Substance Abuse Theft
Unprofessional conduct on all allegations
Suspension Reinstatement with Conditions Physician Monitoring Counseling Referral to Attorney General
C-10-02
Substance Abuse Clinical Incompetence – Multiple Areas Theft
Unprofessional conduct on all allegations
Suspension Reinstatement with Conditions Remedial Education Physician Monitoring Counseling Employer Progress Reports Referral to Attorney General
C-10-07
Clinical Incompetence – Multiple Areas Practicing Without a Permit
Unprofessional conduct on all allegations
Caution Fine Hearing Costs Remedial Education
C-10-12
Substance Abuse
Unprofessional conduct on all allegations
Caution Physician Monitoring Counseling
C-10-23
Substance Abuse Clinical Incompetence – Multiple Areas Theft
Unprofessional conduct on all allegations
Suspension Reinstatement with Conditions Remedial Education Physician Monitoring Counseling Employer Progress Reports Referral to Attorney General
17
EDUCATION
ewly graduating LPNs in Alberta complete a two-year diploma in practical nursing offered at the college level. The program provides a minimum of 1650 instructional hours including 750 hours of theoretical instruction and 900 hours of clinical / lab experience. After program completion, LPNs must pass the Canadian Practical Nurse Registration Exam (CPNRE).
N
The following colleges are approved to provide practical nurse education in Alberta: • Bow Valley College, Calgary (with multiple brokered sites) • NorQuest College, Edmonton (with multiple brokered sites) • Columbia College, Calgary • Lethbridge College • Northern Lakes College, Grouard/Slave Lake/Grande Prairie • Medicine Hat College • Portage College, Lac La Biche/Cold Lake • Red Deer College • Sprott-Shaw College, Red Deer
There are numerous post-basic learning opportunities for LPNs. Further education is available for specialization in immunization, operating room, advanced orthopedics, and renal dialysis. Certificate programs include mental health, chronic disease management, leadership, gerontology, wound care, palliative care, and foot care. REFRESHER BURSARY PROGRAM The Refresher Bursary Program is funded through a grant from Alberta Health and Wellness. The purpose of this Program is to offset tuition costs for individuals wanting to re-enter the Licensed Practical Nurse profession, after eligibility for registration has lapsed. Experience has shown those achieving greatest success in this type of refresher education have been out of the profession less than 10 years. Reimbursement payments totaling $49,458 were disbursed to 20 individuals. To date eight individuals have completed the refresher program and have returned to practice.
EDUCATION STANDARDS ADVISORY COMMITTEE The College of Licensed Practical Nurses is responsible for approving all basic and specialty education programs for practical nurses offered in Alberta. The Education Standards Advisory Committee (ESAC) is a Standing Committee of the Council of the College of Licensed Practical Nurses of Alberta. ESAC is responsible for establishing the Standards for Program Approval and for reviewing and monitoring basic and specialty practice programs to ensure compliance with these Standards. This year much of ESAC’s attention was turned inward. ESAC revised the Standards for Program Approval for both basic and specialty programs as well as refining the processes used for monitoring and approving these programs. One of the major outcomes from this exercise was the establishment of criteria that clearly articulate the role and responsibilities of a credentialing institution when its program is brokered to and offered by another educational institution. These criteria are intended to ensure that the brokering institution maintains the educational standards that are in place for all our approved programs sites. In 2009, Sprott-Shaw College received conditional approval to implement a PN program in Red Deer. Their first student intake, originally scheduled for fall 2010, has been delayed indefinitely. Medicine Hat College received approval to offer a standalone PN Program beginning in September 2010. They had previously offered the PN Program through a brokering arrangement with Bow Valley College dating back to 2002. The Red Deer College PN Program, implemented in 2007, was reviewed and a three year approval is pending. ESAC continues to work with service providers in the Calgary area who have expressed interest in developing a post-diploma Perioperative Program for LPNs who wish to work in the Operating Room. ESAC commends the nurse educators in the PN Programs for their commitment to providing sound educational programs for students. Graduates are the future of the profession and ESAC is proud of the excellent work of Alberta’s nurse educators. Gloria Bauer, Chair, ESAC
18
CLPNA - 2010 Annual Report
FREDRICKSON-MCGREGOR EDUCATION FOUNDATION FOR LPNS The Fredrickson-McGregor Education Foundation for LPNs (the ‘Foundation’) is a non-profit organization that raises, manages and distributes educational grants, awards and bursaries to CLPNA members to enhance their nursing knowledge, skill, and ability, and honor their achievements. The Foundation administers a $3 million Endowment Fund and a $100,000 Operating Room Grant for the CLPNA.
Practical Nursing is a profession as opposed to a job, complete with accountabilities and professional guidelines. It’s pretty exciting times now, exciting and challenging. Our students have to deliver. Mary Anne Fish, Director, Practical Nurse Program, Bow Valley College CARE, Volume 24, 3rd Edition, Winter 2010
Education Grant Program
Operating Room Grant Program In 2008, the CLPNA received a $100,000 grant from the Alberta Government to fund post-basic perioperative nursing education for Licensed Practical Nurses. From July 30, 2008 to October 31, 2010, 37 applications were approved for a total of $82,833 and $44,991 (62%) of approved funds were distributed.
Education Grant Funds 2010 Requested Funds
Approved Funds
Distributed Funds
$33,552
$22,813
Jason Dunne, Dean, Faculty of Health Sciences, NorQuest College
$20,623
CARE, Volume 24, 2nd Edition, Fall 2010
$17,176 $14,138
LPN and RN staff members complement each other. They come with different perspectives and experiences. Together they create the best possible learning experience for the student practical nurse.
$15,879
$13,368 $10,085 $6,877
$6,966
$1,488 Jan 31/10
April 30/10
July 30/10
$309 Oct 30/10
Since the Education Grant Program began in September 2006, the Foundation has approved 1457 applications for a total of $600,645 in grants and distributed $399,436 (65%) of the approved funds. In 2010, the Foundation approved 227 applications for a total of $51,724 (47% of requested funds) in grants. The top three courses for which grant funding is applied are immunization, orthopedics, and foot care. The Foundation currently approves the following courses for grant funds: foot care, gerontology, immunization, IM/ID injections, infusion therapy, leadership, mental health, orthopedics and operating room.
CLPNA - 2010 Annual Report
19
CONTINUING COMPETENCY PROGRAM
he Continuing Competence Program (CCP) is a formal system of assessing the ongoing knowledge, skills, attitudes, and judgment of a professional practitioner. CCP promotes safe, ethical, and competent practice, and identifies opportunities to pursue and achieve professional growth throughout a professional’s career. LPNs authorized to practice participate in the CCP during annual Registration Renewal.
T
Annual Participation LPNs assess, maintain, and/or enhance competence on an ongoing basis using the tools of the CCP, which include the Competency Profile, Standards of Practice, and Self-Assessment Tool. Members self-reflect on their professional practice and develop learning goals for the next year through a self-directed, job-specific process. Annual submission of a Learning Plan with at least two mandatory learning objectives is necessary for Registration Renewal. This process has been in place since 2003. A new online Registration Renewal process for 2011, which began in Fall 2010, required members to submit more specific Learning Plans. Throughout the year, members can access their Learning Plans on a secure website to review and update as necessary. During annual Registration Renewal members identify whether they completed their Learning Plans from the previous year, and if they did not they give reasons why. Validation 2009
2010
5% member participation
10% member participation
(400 LPNs)
(850 LPNs)
Complete
95.0%
96.0%
Incomplete
1.0%
0.0%
Non-Complient
2.0%
2.5%
Exemption
1.0%
1.0%
Planned Retirement
1.0%
0.5%
20
The Continuing Competency Program Validation (CCPV) process confirms member learning occurred and how the learning changed thinking and behaviors in practice. Each year, members are randomly selected and required to provide documentation that confirms completion of learning for the previous two years. The first year of required CCPV participation was 2009. CCPV has two streams of participation. In 2010, 5% of practicing membership were required to complete a Basic Validation consisting of a survey questionnaire. Another 5% were required to complete the Full Validation consisting of the same survey questionnaire with verification of completion of learning objectives and learning activities including employer education, formal certifications and research reading (10% of total membership, or 850 LPNs, participated in the 2010 CCPV process). This more than doubles the participation in the 2009 CCPV involving 5% of total membership or 400 LPNs. In 2010, enhanced support and assistance was available for membership for both annual CCP and those randomly chosen for CCPV. Total practice calls and emails related to CCP during 2010 was 1297, or 40% of total inquires. CCPV webinars offered assistance in completing the process, and self-help videos were developed and posted on the CLPNA website. In the first 60 days of the 2010 CCPV, 50% successfully completed the process and 50% were non-compliant, incomplete, or had no response. As of December 31, 2010, 27 members did not successfully complete the 2010 CCPV. As per Section 39 of the Health Professions Act (HPA), 25 members had not applied for Registration Renewal of a 2011 Practice Permit and the members’ Practice Permits were suspended on January 4, 2011.The two remaining members applied for Registration Renewal prior to December 31, 2010 and their registration application was processed, but due to unsuccessful completion of CCPV, their 2011 Practice Permits were suspended as per Section 40(2) (C) of the HPA.
One thing you don’t get in the classroom is learning how to communicate with the different types of people you’ll encounter as a nurse. In the practicum’s, you have to learn how to be flexible and innovative on the spot. Angela Nethercott, LPN CARE, Volume 24, 3rd Edition, Winter 2010
The scope of practice keeps changing and growing. We have a living curriculum that responds to the changing health care environment. Donna Adams, Clinical Placement Facilitator, Bow Valley College CARE, Volume 24, 3rd Edition, Winter 2010
This year’s Continuing Competency Program and CCP Validation clearly indicated that LPNs are engaged in life-long learning resulting in professional development and positive influence on their nursing practice. CLPNA - 2010 Annual Report
PRACTICE
he CLPNA provides practice consultation and information to members, students, employers, government, the public, and other stakeholders. Information is available on the CLPNA’s website and through email, telephone, and in-person consultation.
administration, IV initiation, direct IV push, central line care, and leadership.
T
CLPNA launched web conferencing in 2010 to provide professional practice sessions across the province in a timelier, more cost-effective manner. Requests for information on registration, leadership, documentation, accountability, responsibility, and continuing competence are the main themes addressed. Requests have increased due to the ease of this new delivery method and further improvements are planned for 2011.
LPN practice roles and nursing opportunities continue to expand in mental health, maternity, home care, community health, primary care, emergency, dermatology, rehabilitation and educator roles. The Practice department answered 3321 inquiries by phone and email in 2010, an increase of 7% over 2009. Professional practice issues comprised the majority of calls at 70%, and relate to continuing competence, scope of practice, and professionalism. An interest in post-basic education in the Immunization Specialty has increased this year to 4% of total practice calls; a 6% increase in immunization inquiries from last year.
Temporary Registration Practice Statement In Fall 2010, Council approved the newly updated Temporary Registration Practice Statement. A Temporary Practice Permit is the registration type designated to a new graduate that authorizes practice before the novice nurse successfully completes the Canadian Practical Nurse Registration Exam (CPNRE). The revised Practice Statement articulates parameters for the novice nurse and employer, including restrictions around supervision of a temporary Practice Permit holder.
2010 saw an increase in LPN job postings in the CARE magazine and on the CLPNA website. Based on practice consultation, utilization is increasing in multiple areas including infusion therapy, medication Practice Inquiries - 2010 Jan
Feb
Mar
Apr
May
June
July
Aug
Sept
Oct
Nov
Dec
Total
204
182
210
370
567
396
357
179
212
166
287
191
3321
Inquiries by Origin
8%
Inquiries by Competency Category
8%
9% 22% 15%
68%
LPNs
Professional Practice
Managers/Administrators
Clinical Practice
Educators
70%
LPN Specialties
Gov’t/Public/Others
CLPNA - 2010 Annual Report
21
COMMUNICATIONS
Magazine, Website, and Social Media Growth The CLPNA’s full-colour magazine, CARE, published feature stories on dialysis nursing, and a two-part series examining basic LPN education from both the classroom and the clinical perspective. Circulation averaged over 10,000 copies per issue distributed to LPNs, LPN employers, and stakeholders. CLPNA social media websites launched at the 2010 Spring Conference in April with the “Talk the Walk” initiative. A Facebook Page (www.facebook.com/clpna), Twitter account (www.twitter.com/clpna) and Blog (www.blog. clpna.com) keeps members, employers, and stakeholders informed about the work of the college. Participation on the social media sites increased steadily over the year resulting in 514 followers on Facebook and 119 on Twitter. While Facebook followers are primarily LPNs or practical nurse students, Twitter followers include Alberta media, politicians, unions, and healthrelated organizations.
The CLPNA’s 2009 marketing campaign “It Says a Lot About You” won a local Award of Excellence in the category of “Communications & Marketing Programs and Campaigns” from the International Association of Business Communicators (IABC). The campaign encourages young Albertans to choose a career as a Licensed Practical Nurse, and was funded by a marketing grant through Alberta Employment and Immigration. IABC is a global network of communication professionals with approximately 400 members in Edmonton. CLPNA maintains additional websites for Spring Conference (www.clpnaconference.com), the “It Says a Lot About You” media campaign (www.saysalotaboutyou.com), and for the Fredrickson-McGregor Education Foundation for LPNs (www.foundation.clpna.com).
Traffic to CLPNA’s primary website, www.clpna.com, has more than doubled since statistics began in September 2008 to 156,000 visits per year and 410,000 pageviews. Information and interactive videos have been added to the website to support practice, continuing competence, and public awareness. National Nursing Week posed opportunity for LPNs to discuss their role as professional nurses with a new professional pin and poster shared via the CARE magazine.
22
CLPNA - 2010 Annual Report
2010 Spring Conference Energy and spirit distinguished the proceedings of the 2010 CLPNA Spring Conference on April 8-9, 2010 at the Edmonton Marriott at River Cree Resort. The two-day professional development forum brought over 400 LPNs and colleagues from across Alberta to celebrate the nursing profession. The “People-Focused, Patient-Centered” theme was introduced by keynote speaker Warren McDonald. Warren reflected on the importance of caring health professionals after losing his legs in a tragic hiking accident. Brenda Robinson challenged delegates to embrace generational change in the workplace in her unique comedic style. Lawyer/blogger Ken Chapman encouraged LPNs to promote the profession through social media, and naturist Brian Keating shared leadership lessons through videos from around the world. Session topics included dealing with professional errors; occupational health and safety; working with families of children with disabilities; understanding communication styles; leadership in remote locations; and understanding Alzheimer’s disease.
CLPNA - 2010 Annual Report
I loved the energy and spirit. Gathering new information, rejuvenating myself, and seeing old friends is always a plus. Speakers were all fabulous. Learning to embrace change with new skills! I enjoyed the sessions relevant to my changing role.
23
We’re going out there very well trained. We can do everything the system requires us to do. If they want me to work full scope, I can. Angela Nethercott, LPN CARE, Volume 24, 3rd Edition, Winter 2010
24
CLPNA - 2010 Annual Report
FINANCIAL HIGHLIGHTS COLLEGE OF LICENSED PRACTICAL NURSES OF ALBERTA
The complete audited financial statements are available by contacting CLPNA at 780.484.8886.
CLPNA - 2010 Annual Report
25
STATEMENT OF FINANCIAL POSITION 2010
As at December 31, 2010
ASSETS CURRENT Cash Short-term investments Accounts receivable Prepaid expenses
$
NET ASSETS Unrestricted Restricted net assets Endowment Fund Refresher Bursary Fund Capital Fund Operating Room Nursing Specialty Education Fund Alberta Provider Fund
366,050 3,835,490 8,378 67,202 4,277,120
3,022,795 649,547
2,966,729 617,058
$ 8,217,803
$ 7,860,907
$
LEASE INDUCEMENT
$
4,545,461 INVESTMENTS RESTRICTED FOR ENDOWMENT FUND CAPITAL ASSETS
LIABILITIES CURRENT Accounts payable and accrued liabilities Prepaid registration fees
608,511 3,863,336 17,273 56,341
2009
185,919 2,486,825
$
201,687 2,008,488
2,672,744
2,210,175
174,120
197,336
2,846,864
2,407,511
536,231
671,684
3,022,553 1,107,514 649,547 43,094 12,000
2,919,147 1,161,696 617,058 83,811 -
5,370,939
5,453,396
$ 8,217,803
$ 7,860,907
Approved by the Council: Council member
Council member
26
CLPNA - 2010 Annual Report
STATEMENT OF OPERATIONS - GENERAL FUND AND CAPITAL FUND 2010
Year Ended December 31, 2010
REVENUES Registration Fees Active Out of province assessment Initial Late Reinstatement Fines Associate License verification Document fees National examinations Grants Annual general meeting Grant administration fees Marketing contributions Continuing competency profile Program fees Advertising Interest income Miscellaneous
EXPENSES Administration Marketing Rent and occupancy costs Office and computer Amortization of capital assets Bank charges and interest Postage Professional fees Telephone and utilities Consulting fees Printing Loss on disposition of capital assets Travel Personnel Costs Cost of Services
EXCESS OF REVENUES OVER (UNDER) EXPENSES
CLPNA - 2010 Annual Report
$
2009
$ 2,215,370 48,551 26,600 20,310 15,575 16,500 10,620 9,890 880 259,170 14,208 143,603 26,000 35,775 32,465 15,043 13,172 2,941
$ 2,098,790 79,975 33,050 18,340 15,900 13,060 8,895 8,576 1,938 342,165 221,941 182,096 34,000 50,000 44,951 31,339 15,950 9,938 3,321
2,906,673
3,214,225
178,824 61,904 179,417 49,469 64,693 44,993 24,069 31,743 6,764 21,695 52,166 1,064,090 1,229,810
236,840 167,403 103,319 87,362 47,159 46,259 42,678 25,588 10,850 15,354 77,973 985,284 1,315,971
3,009,637
3,162,040
(102,964)
$
52,185
27
STATEMENT OF CHANGES IN NET ASSETS Year Ended December 31, 2010
NET ASSETS AT BEGINNING OF YEAR
Unrestricted
$
671,684
Capital Fund
Excess of revenue over (under) expenses
$
98,148
Investment in capital assets
$
(233,601)
NET ASSETS AT END OF YEAR
$
536,231
617,058
(201,112)
233,601
649,547
83,811
(40,717)
-
43,094
Endowment Fund
2,919,147
103,406
-
3,022,553
Refresher Bursary Fund
1,161,696
(54,182)
-
1,107,514
-
12,000
-
12,000
Operating Room Nursing Specialty Education Fund
Alberta Provider Fund $
5,453,396
$
(82,457)
$
-
$
5,370,939
STATEMENT OF OPERATIONS - ENDOWMENT FUND 2010
Year Ended December 31, 2010
REVENUES Investment income Unrealized gain on held-for-trading portfolio investments
$
EXPENSES Brokerage fee Loss on disposal of long-term portfolio investments Donation to Fredrickson McGregor Education Foundation
EXCESS OF REVENUES OVER EXPENSES
28
$
99,885 171,905
2009
$
99,858 304,630
271,790
404,488
18,901 66,715 82,768
16,620 104,042 -
168,384
120,662
103,406
$
283,826
CLPNA - 2010 Annual Report
2010 Poster
St. Albert Trail Place 13163 -146 Street Edmonton, AB T5L 4S8 Phone 780.484.8886 Toll Free 1.800.661.5877 Fax 780.484.9069
www.clpna.com