2018 ANNUAL REPORT | College of Licensed Practical Nurses of Alberta

2018 ANNUAL REPORT

competent committed care

OUR MANDATE

OUR VISION

To regulate and lead the profession in a manner that protects and serves the public through excellence in Practical Nursing.

Influencing a quality person-centred system through regulatory excellence.

OUR MISSION Licensed Practical Nurses (LPNs) are progressive nursing professionals who provide safe, competent and ethical person-centred care in collaboration with clients, families and other providers.

CONTENTS MESSAGE FROM THE COUNCIL PRESIDENT

2

MESSAGE FROM THE CHIEF EXECUTIVE OFFICER

3

OUR YEAR IN NUMBERS 4 GOVERNANCE 6 MESSAGE FROM THE PUBLIC MEMBERS

8

MESSAGE FROM THE ESAC CHAIR

9

CORE FUNCTIONS REGISTRATION 12 CONDUCT 18 COMPETENCE 22 SUPPORTING FUNCTIONS RESEARCH

26

POLICY 28 COMMUNICATION

30

ORGANIZATIONAL CULTURE 32 FINANCIAL HIGHLIGHTS

36

COMPETENT COMMITTED CARE •

1

Message from the

COUNCIL PRESIDENT

T

he Council of the College of Licensed Practical Nurses of Alberta (CLPNA) is responsible to ensure LPNs provide safe, competent and ethical care for Albertans.

Our goal is that every person’s experience with a licensed practical nurse positively impacts their personal health journey. This Annual Report, approved by Council, highlights the activities of the CLPNA in 2018.

Through a policy governance framework, Council ensures continuous movement of the organization toward regulatory excellence. We are equally committed to ensuring evolution within the profession to meet the changing needs of a dynamic healthcare system.

Our annual Think Tank continues to inspire and is an innovation aimed at informing ourselves and influencing a quality healthcare system in Alberta.

It is an honour to serve as President of CLPNA. I commend our dedicated LPNs and public members on Council and value the strategic and visionary leadership of CEO Linda Stanger.

To the 16,657 LPNs who are making a difference in the health journey of Albertans every day...thank you!

Sincerely, Valerie Paice, President

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COLLEGE OF LICENSED PRACTICAL NURSES OF ALBERTA, 2018 ANNUAL REPORT

Message from the

CHIEF EXECUTIVE OFFICER

I

t is a privilege to serve Albertans through my role as CEO of the College of Licensed Practical Nurses of Alberta and to report on the work of the organization as we honour our mandate of public protection.

The CLPNA implemented changes in all areas of responsibility in 2018, in response to evolving regulatory best practice. Collaborations are important to us, and through multiple strong relationships and partnerships, we have contributed, learned, and impacted nursing and health regulation provincially, nationally and internationally. Many of these initiatives have been designed to increase harmonization and best practice across borders.

Early in 2018, a major organizational redesign was implemented. This change is viewed as positive, contributes to increased meaningful productivity, and positions the College well for eventual leadership succession.

The number one challenge facing the CLPNA and the profession is the very dated Health Professions Act LPN Regulation (2003). Work is in progress with government to update this guiding document.

CLPNA is pleased to work with Alberta Health to host the Provincial Health Care Aide directory. We are also working with employers, educators and health care aides (HCAs) on the enrollment process and welcome all of Alberta’s HCAs to join the directory.

Much has been achieved in 2018 in support of our mandate of public protection and goal of regulatory excellence. Thank you to a committed Council, an exceptional team at CLPNA and to our members continually demonstrating excellence in service for Albertans.

With respect and appreciation, Linda Stanger, CEO

COMPETENT COMMITTED CARE •

3

CLPNA 2018 YEAR IN NUMBERS

1047 434 Alberta graduate registrations 2017 - 1390

Out of Province registrations 2017 - 444

IEN registrations 2017 - 411

16,657

5%

212

38

total LPN registrations

complaints received

4 •

259

21 complaint hearings

COLLEGE OF LICENSED PRACTICAL NURSES OF ALBERTA, 2018 ANNUAL REPORT

growth in registration

average age of LPNs

Top Places of Employment

91% H

of Alberta candidates passed CPNRE Exam on 1st write

H

H

Hospital

Continuing Care*

Community Care**

4701

3523

3466

35% 27% 26%

Employment

38% 40% 22% Full-time Part-time Casual 5075

5285

Continuing Competence Program Audit

3165

members selected

2979

10

research projects

Practice Consultations

2401

inquiry responses

9

practical nurse programs

*Continuing Care includes Nursing Home / Long Term Care, and Rehabilitation / Convalescent Centre. **Community Care includes Community Health / Health Centre, Home Care Agency, and Physician’s Office / Family Practice Unit.

COMPETENT COMMITTED CARE •

5

GOVERNANCE

The College of Licensed Practical Nurses of Alberta exists to ensure that Albertans receive safe, competent and ethical care from licensed practical nurses.

Our mandate of protecting and serving the public guides the CLPNA as we regulate and lead the profession.

The CLPNA regulates the profession by: - setting and maintaining rigorous standards in education and registration; - reviewing and approving practical nurse diploma, refresher and specialty programs; - setting and enforcing practice, conduct and professional standards and guidelines; - assuring accountability and proficiency through the continuing competence program; and - managing complaints and discipline.

The practical nurse profession in Alberta has grown and evolved significantly since its beginning in 1947. The Health Professions Act of 2000 gave the CLPNA the mandate to govern and regulate the LPN profession in the public’s interest. Governance is carried out by a Council of eight licensed practical nurses elected by their peers, and three public members, appointed by the

6 •

COLLEGE OF LICENSED PRACTICAL NURSES OF ALBERTA, 2018 ANNUAL REPORT

provincial government to represent the people of Alberta.

A policy governance model is used to ensure that Council fulfills its obligations outlined in the Health Professions Act (HPA), the Licensed Practical Nurses Profession Regulation (2003), and the CLPNA’s Bylaws (March 2016).

o British Columbia College of Nursing Professionals: proposed Bylaws; and o College and Association of Registered Nurses of Alberta: Infection Prevention and Control

Standards.

In order to anticipate and respond to the health needs of Albertans, the CLPNA values the opportunity to consult with government and stakeholders. Key activities this year included: • a letter, briefing note and draft Standards of Practice requesting urgent amendment to the LPN Profession Regulation to include applying non-ionizing radiation in ultrasound imaging, including any application to a fetus, as an authorized restricted activity for LPNs, submitted to Alberta Health in February 2018 (previously submitted in 2014 and 2016); • amendments to Schedule 10 of the HPA regarding a proposed practice statement and changes to titles (i.e., removing titles no longer used by the profession) submitted to Alberta Health in May 2018; • consultation with members and employers as a requirement of Bill 21: Standards of Practice for Licensed Practical Nurses on Boundary Violations: Protecting Patients from Sexual Abuse and Sexual Misconduct. Feedback was incorporated and submitted to Alberta Health in December 2018; • consultation and feedback with Alberta Health on documents including: o College of Physicians and Surgeons of Alberta: Standards on opioid agonist treatments; o College of Podiatric Physicians of Alberta: proposed amendments to the Standards of Practice to address electronic health records and informed consent; o Alberta Health: proposal to regulate the new profession of counselling therapists, addiction counsellors and child and youth

care counsellors; o Alberta Health: Standards for Medical Device Reprocessing and Single-Use Medical Devices in All Health Care Facilities and Settings;

As healthcare evolves in Alberta, the CLPNA provides ongoing guidance on what LPNs need to know to provide evidence-based care. The following documents were published in 2018: Practice Policies • Professional Responsibility and Accountability; approved January 2018 • Registration Requirements: Actively Engaged; approved March 2018 • Documentation; approved March 2018 • Authorized Restricted Activities for Licensed Practical Nurses; approved December 2018 • Specialized Practice Areas; approved December 2018 Interpretive Documents • Incapacity under the Health Professions Act; approved April 2018 Practice Guidelines • Mobile Devices; approved March 2018 • Medication Management; approved June 2018 Fact Sheets • Naloxone and the Role of the Licensed Practical Nurse in Alberta; revised February 2018 • Bladder Scanning; approved August 2018 • Recreational Cannabis; approved October 2018 • Immunization Regulation; approved December 2018 • FAQ Resource on Aesthetic Nursing, in collaboration with the College and Association of Registered Nurses of Alberta and the College of Registered Psychiatric Nurses of Alberta, September 2018.

COMPETENT COMMITTED CARE •

7

Message from the

PUBLIC MEMBERS

W

e are pleased to represent Albertans as public members on the CLPNA Council. With almost two years’ experience in our roles as public members, we have gained significant knowledge about LPN practice, the regulatory environment and governance processes. This has enabled us to more fully carry out our roles in assuring the College is performing in the public interest, as well as contribute to the overall governance function of the CLPNA Council.

The year included input into the 2018 - 2021 Strategic Plan with specific emphasis on maintaining regulatory excellence and preparing the LPN workforce for the growing needs of an aging population in all areas of the healthcare system, both now and into the future. We contributed to the discussion and development of amendments to LPN Standards of Practice to meet the new requirements of Bill 21: An Act to Protect Patients and support its full implementation effective April 1, 2019.

Another thought-provoking Think Tank was held in October 2018 with many key takeaways for regulated healthcare workers in the everchanging advancements related to genetics, dementia, regenerative medicine, cancer research, artificial intelligence and the ethical implications of these developments.

We are looking forward to another year of growth and opportunities for the CLPNA, and as a Council, strive to continue to be a leader in regulatory excellence and a significant contributor to Alberta’s healthcare system.

Austin Mardon, Lisa Stebbins, John Chapman Public Members

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COLLEGE OF LICENSED PRACTICAL NURSES OF ALBERTA, 2018 ANNUAL REPORT

Message from the

ESAC CHAIR

T

he Education Standards Advisory Committee (ESAC) fulfilled its role of ensuring public safety through standards for education as reflected in the participation of committee members in the review of two diploma programs in 2018. Teams of ESAC committee members assisted the Chair to observe and report to Council on the performance of NorQuest College and Lethbridge College. It is important to note that now all nine of the approved basic diploma practical nurse programs have been assessed based on the Basic Diploma Practical Nurse of Alberta Program Standards approved in 2015.

NorQuest College received Council approval and Lethbridge College is pending Council decision in early 2019.

Once again, the Education Standards Advisory Committee members made an effort to stay current with trends in healthcare and several attended both the CLPNA Think Tank as well as the Annual General Meeting and Conference.

The ESAC members continue to be strong advocates for the preparation of quality nursing graduates. They willingly volunteer their time and expertise and are a pleasure to work with.

Respectfully submitted, D. Jean Valgardson, Chair

The basic practical nurse diploma programs have been fulfilling the requirement of reporting annually to ESAC on their progress implementing recommendations from their approval reports. The programs continue to take their improvement seriously and present their reports in writing and in person or via teleconference at an ESAC meeting.

ESAC is pleased to report that new Advanced Education for Specialty Practice Standards have been developed, approved and scheduled to be implemented in 2019.

These Standards were developed to ensure that the specialty program education meets the competencies approved by Council and direct the educational requirements in the following specialty practice areas: Advanced Orthopedic, Perioperative, Renal Dialysis, Immunization and Advanced Foot Care. All current and future specialty practice programs will be expected to complete a self-study report for ESAC and host an ESAC team visit to their site.

COMPETENT COMMITTED CARE •

9

CLPNA COUNCIL

back row, l-r: Jennifer Peace, LPN; John Chapman, Public Member; Austin Mardon, Public Member; Kurtis Kooiker, LPN; Roop Rani, LPN middle row, l-r: Lisa Stebbins, Public Member; Jean Collins, LPN; Valerie Paice, President, LPN; Tiffany Smith, LPN; Joyce Rossiter, LPN front row, l-r: Linda Stanger, CEO; Richelle Cash, LPN, Vice-President

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COLLEGE OF LICENSED PRACTICAL NURSES OF ALBERTA, 2018 ANNUAL REPORT

CLPNA ORGANIZATIONAL STRUCTURE Minister of Health

Council

8 Elected Licensed Practical Nurses 3 Appointed Members of the Public

Regulated Committees Education Standards Advisory Committee Council Appeals Committee Hearing Tribunal Complaint Review Committee Competence Committee

Chief Executive Officer

Regulatory Affairs

ESAC Chairperson

Executive Officer

Executive Officer

Senior Director Communications

Registration

Finance

Operations

Complaints

Professional Practice

Research

Professional Development

Policy

COMPETENT COMMITTED CARE •

11

Core Function

REGISTRATION

Commits to excellence in registration standards.

The public interest is best served by fair, consistent and transparent registration processes. This is achieved with quality standards that guide the registration process.

In 2018, the CLPNA further enhanced the member database including an update to the member profile and the addition of an online Record of Learning to provide increased functionality for registrants. Further organizational transitions in the database will continue in 2019.

Also new this year, the CLPNA partnered with myBackCheck.com, a Canadian company which performs standardized Criminal Record Checks for registrants of the CLPNA. This service offers a streamlined application process, with the CLPNA directly receiving the results.

12 •

REGISTRATION

The CLPNA continues to utilize the National Nursing Assessment Service (NNAS) which offers a harmonized approach to the initial assessment of internationally educated nurses applying for licensure in Canada. CLPNA serves on the board of NNAS. Another partner in the pursuit of regulatory excellence is the Alberta Federation of Regulated Health Professionals.

The CLPNA participates in subcommittees on registration, continuing competence, legislative and regulatory affairs and complaints.

To ensure LPNs have knowledge of the legislative and regulatory framework for licensed practical nursing in Alberta, applicants to the profession must pass the Jurisprudence Examination. New exams were launched in October, with the redesigned online study guide.

Passing the Canadian Practical Nurse Registration Examination (CPNRE) is the final step required for practical nursing students to obtain full registration with the CLPNA. The Alberta annual average for Canadian first-time writers is 91%, equivalent to the national average. Internationallyeducated nurses who wrote the CPNRE in Alberta had a 90% average, well above the national average of 71%.

Alberta CPNRE Candidates 2018* Alberta Candidates

1st Exam

Registered

1232 118 327 34

1711

Writing

1152 105 316 31

1604

Not Writing

80

Repeat Exam

13

International 1st Exam

11

Total Candidates

International Repeat Exam

3

107

Passing

1046 78 284 23

1431

Failing

106 27 32 8

173

% Passing

91%

89%

74%

90%

74%

* Statistics prepared by Yardstick Assessment Strategies.

COMPETENT COMMITTED CARE •

13

BY THE NUMBERS

MEMBERSHIP

16,657

15860

total LPN registrations

13921

5% growth

12881 11766

15082

+5.0%

2016

2017

16657

+8.4%

+8.0%

+9.5%

+10.7%

10623

8531

9015

+7.0%

+5.7%

2009

2010

2011

+8.6%

14 •

9652

REGISTRATION

+10.0%

2012

2013

2014

2015

2018

Registrations

2017

2018

Alberta Graduates NEW Members

1390

1047

Out of Province NEW Members

444

434

International NEW Members

411

259

Reinstatements*

448 381

Re-Entry Renewals Courtesy Members

0 0 13167 14536 0

TOTAL 15860

0 16657

*Reinstatement = a member whose practice permit has lapsed at least one day.

Registration Applications

2017

2018

Alberta Graduates NEW Applicants

1094

1105

Out of Province NEW Applicants

451

478

International NEW Applicants

416

296

Reinstatements*

430 421

Re-Entry

32 36

Renewals Courtesy Members

14983 16062 0

TOTAL 17406

0 18398

COMPETENT COMMITTED CARE •

15

Age of Active LPNs

38

average age 2017 - 38

Internationally Educated Nurse Registrations 19-25 |

26-30 |

31-35 |

36-40 |

41-45 |

46-50 |

1841 3234 3340 2411 1804 1374

51-55 |

964

56-60 61-65+ | |

870

819

Philippines

177

India

59

Other

10

Nigeria 5 Ghana 2 Australia

Out of Province Registrations

1

Jamaica 1 Kenya 1 Nepal 1

434

UK 1 USA 1

out of province registrations

259

2017 - 444

IEN registrations 2017 - 411

BC |

81

16 •

SK |

19

REGISTRATION

MN |

ON |

15 251

QC |

6

NB |

8

NS |

32

PEI |

3

NL |

15

YT NWT NU | | |

0

3

1

Active LPNs by AHS Area AHS Area

2018

%

Area 0 - Out of Province/Country

1216

7.3%

Area 1 - South Zone (Lethbridge & Medicine Hat)

1210

7.3%

Area 2 - Calgary Zone

5161

31.0%

Area 3 - Central Zone (Red Deer)

1913

11.5%

Area 4 - Edmonton Zone

5687

34.1%

Area 5 - North Zone

1470

8.8%

16657

100%

TOTAL

Active LPNs by Place of Employment & Status Place of Employment

Full-time

Part-time

Casual

2018

%

Association / Government

74

62

35

171

1.3%

Business / Industry / Occupational Health Centre

38

4

11

53

0.4%

Community Health / Health Centre

678

810

394

1882 14.1%

Educational Institution

116

44

68

228

1.7%

Home Care Agency

255

140

253

648

4.9%

Hospital (General/Maternal/Pediatric/Psychiatric)

1513

2216

972

4701

35.2%

65

37

34

136

1.0%

1338

1420

597

3355 25.2%

0

2

1

3

0.0%

Physician’s Office / Family Practice Unit

602

209

125

936

7.0%

Rehabilitation / Convalescent Centre

79

64

25

168

1.3%

Self-Employed

18

10

11

39

0.3%

Other

299

267

453

1019

7.6%

TOTAL

5075 (38%)

Mental Health Centre Nursing Home / Long Term Care Nursing Stations (Outposts or Clinics)

5285 (40%) 2979 (22%)

13339* 100%

*527 are working out of province or out of country.

COMPETENT COMMITTED CARE •

17

Core Function

CONDUCT

Enforce standards of professional practice.

One of the cornerstones of the CLPNA’s commitment to public protection is supporting and enforcing standards of professional practice. This includes working to ensure LPNs are aware of and understand legislation, regulation, professional standards and ethics.

The CLPNA provides clarity to professional conduct through practice consultation and evidence-based documents including practice policies, interpretive documents, practice guidelines, fact sheets and frequently asked questions. This list is noted in the Governance section, pg. 7.

The Alberta government passed Bill 21: An Act to Protect Patients in November 2018, which amends the Health Professions Act to protect

18 •

CONDUCT

patients from sexual abuse and sexual misconduct by regulated health professionals. With new legislation in effect April 1, 2019, the CLPNA developed and consulted with members on new Standards of Practice related to Bill 21. These were approved by Council in December and were sent to the Minister of Health for review.

A reliable source of news about legislation, regulation, professional standards and ethics, CARE magazine

Historical Comparison

reaches LPNs, employers and stakeholders throughout Alberta. Published quarterly, CARE supports high standards of professional practice in print and digitally.

Managing and resolving complaints against practical nurses is another key function of the CLPNA’s legislated mandate. When the conduct or competence of an LPN is called into question, the CLPNA’s Conduct Department follows the process outlined in the Health Professions Act, Part 4, Professional Conduct.

2017

2018

New Complaints Received

161

212

Previous Years’ Complaints in Process

74

82

Source of Complaints

2017

2018

Employer (125)

Employer (154)

Member of Public (12)

Member of Public (24)

Complaints Director (24) Other (0)

Protection for Persons in Care (0)

Complaints Director (26) Other (2)

Protection for Persons in Care (6)

COMPETENT COMMITTED CARE •

19

Complaints Currently In Progress

Type of Complaints Received Abandonment 3

as of December 31, 2018

Investigation – In Progress

77

Breach of Confidentiality/Privacy

9

Investigation Report – Internal Review Bullying 4 Legal Review

32

Clinical Competence – Documentation

4

Undertaking Pending

3

Clinical Competence – Health Assessment

3

Referred to Hearing / Hearing Pending

16

Clinical Competence – Medication Administration

Hearing Complete / Decision Pending

5

36

Monitoring Orders

49

Clinical Competence – Multiple

60

Drug Diversion

3

Council Appeals Committee Complete / Decision Pending

1

Non-Compliance of Orders

1

Complaint Review Committee Pending

1

Non-Nursing Conduct*

3

Patient Abuse – Other

6

Patient Abuse – Physical

3

Patient Abuse – Sexual

1

Patient Abuse – Verbal

3

Complaint Withdrawn

1

Practicing Without a Permit

25

Complaints Dismissed

20

Sexual Harassment

1

Hearings Complete

14

Substance Abuse

3

Handled at the Workplace

13

6

Incapacity* (2014 to 2017: 20 ongoing, 2018: 2 received) 22

Total Complaints in Progress Other** 7

212

*Assessing Incapacity - Section 118 of the HPA relates to assessing incapacity.

During the investigation process, it may be determined the conduct was a direct result of fitness to practice/incapacity. At this time, the complaint file will be managed under section 118.

Disposition of Complaints Closed

Theft 4

Informal Resolution (Agreement & Undertaking) 78

Unethical Conduct

21

Employer Resolution with Sanction

12

Workplace Conflict Non-Practicing

1

Registration Surrendered

1

Unprofessional Communication

11

Resolution with Sanction

8

Sec 55 – Undertaking - Practicing Without A Permit

21

Total Complaints Received in 2018

212

*Non-Nursing Conduct includes behaviour that harms the profession and isn’t directly related to nursing care (i.e., tardiness, inappropriate use of cell phone or social media). **Other includes conduct which meets the definition of “unprofessional conduct”; however, it does not meet the criterion of the above specified conduct.

Resolved 2 Unresolved* 3 Total Complaints Closed

173

*Unresolved complaints consist of complaints where the LPN is unable to participate in the disciplinary proceedings due to health issues and has entered into an agreement with CLPNA.

20 •

CONDUCT

Appeals in 2018

Age of Investigated Member

• Council Appeal Committee – One appeal was heard by this committee regarding restriction placed on a regulated member’s permit. On December 31, the decision from Council was pending.

• Complaints Review Committee – One request for review by a complainant regarding the decision to dismiss the complaint was received in December 2018.

The Complaints Review Committee will meet in January 2019. The final review of the submissions is scheduled in March 2019. The process has followed the framework and deadlines set out in the HPA. • Complaints Review Committee – One request for review by a complainant regarding the decision to dismiss the complaint was received in 2018. The Complaints Review Committee will be scheduled in 2019 for the review process.

20-29

47

30-39

63

40-49

52

50-59

29

60+

21

Hearings

Years of Experience of Investigated Member 1-5 Years

91

6-10 Years

58

11-15 Years

29

16+ Years

34

The CLPNA completed 21 hearings, which handled 23 complaint files (two members had multiple complaints).

At the end of 2018, five written decisions remain pending from the Hearing Tribunal. At the end of 2018, 16 files were referred to hearings planned in 2019.

Hearing Discipline Actions Taken Reprimand/Caution 14 Partial Hearing Costs

14

Education* – Prior to Reinstatement

2

Supervised Practice – After Reinstatement

1

Education** 11 Permit Suspended Until Conditions Met

2

*Education – Prior to Reinstatement: the member does not have an active permit and cannot reinstate until such time as ordered education is completed. **Education: the member holds an active practice permit and must complete ordered education within a time frame.

COMPETENT COMMITTED CARE •

21

Core Function

COMPETENCE

Establish and uphold standards to support competence.

Competence is another core function and education is the first step towards achievement. There are nine practical nurse education programs in Alberta, and several offer programs at multiple sites throughout Alberta.

Programs are required to ensure students meet the competence outcomes within the two year diploma program. A program typically includes 1650 hours of instruction, 750 of which are theoretical and 900 of which are clinical/lab experience. The Education Standards Advisory Committee (ESAC) is responsible for establishing and reviewing standards for these programs. Details on the programs reviewed in 2018 can be found on page 9, in the Message from the ESAC Chair.

Establishing and enforcing standards of competence for practical nurses ensures that Albertans can rely on safe, quality care from LPNs.

22 •

COMPETENCE

The CLPNA’s Continuing Competence Program (CCP) is a formal system for LPNs to assess, monitor and reflect on their nursing practice and ongoing competence needs. By identifying appropriate learning activities and implementing them into practice, LPNs commit to self-directed learning to build and enhance their competence. This ensures patients, colleagues and the healthcare system of the profession’s commitment to safeguarding the public interest.

In June of each year, approximately 25% of LPNs are selected to participate in the Continuing Competence Program Audit process. The Audit process verifies the selected LPNs have met the requirements of the Continuing Competence Program. New supports for members this year included a video tutorial (viewed over 3300 times), a CCP guide, revision of the online Audit form and webpage. There was a 25% decrease in calls and emails asking for assistance.

A new addition to the CCP is the requirement for LPNs to meet a minimum of 1000 practice hours in the previous four registration years. This requirement is being implemented over a three-year transition period from 2019 to 2021, as the CLPNA works with members to ensure understanding of this new requirement.

Review of the Competency Profile for LPNs to align with current LPN scope of practice is underway. The fourth edition of the Competency Profile is expected to be released in 2019.

A collaboration with the Canadian Council for Practical Nurse Regulators is in progress to update the PanCanadian Entry-to-Practice Competencies (ETPC) for LPNs. In order to support a current reflection of competence requirements across Canada for LPNs, national and provincial focus groups are planned for early 2019. The groups will explore the current and future needs for practice, assess areas for competence integration and enhancement as well as develop

Practical Nurse Programs in Alberta • Bow Valley College, Calgary • Columbia College, Calgary

• Keyano College, Fort McMurray

• Lethbridge College, Lethbridge

• Medicine Hat College, Medicine Hat • NorQuest College, Edmonton • Northern Lakes College, Slave Lake/Grande Prairie • Portage College, Lac La Biche/Cold Lake • Red Deer College, Red Deer

Entry-to-Practice Competencies to support safe, quality LPN practice into the future. The CLPNA’s research department will support this initiative with the distribution of a national survey for validation of the competencies as this work continues into 2019.

Facilitating LPN access to resources that support continuing competence is important to the CLPNA. This included offering ten well-attended webinars on multiple topics and two workshops hosted by dementia care professional, Dr. David Sheard, on ‘New Culture Nursing’. The CLPNA also continues to build its Mentorship Program; its goal is to assist in knowledge transfer and build capabilities within the LPN profession.

The CLPNA learning modules are well-subscribed, with 18,812 individuals completing the modules and online exams at www.StudywithCLPNA.com. Nursing Documentation, Infection Prevention and Control and Elder Abuse are the modules with the highest number of completions.

COMPETENT COMMITTED CARE •

23

CCP Audit

3165 members selected 97% compliance 99 members suspended Another tool to enhance competence is the Career Directions© program. It helps prepare nurses for the changing needs of the health system. The Career Directions© webpages were visited over 4000 times, indicating high interest, while there were 90 registrants for two Career Directions© workshops.

Edmonton played host to the CLPNA’s Annual General Meeting and Conference on May 9 to 11. Over 300 practical nurses, students, educators, policy and decision makers learned about relevant issues for the profession.

An initiative aimed at informing care was the sixth annual CLPNA Think Tank, focused on Inspiring Innovation and Creativity. This event featured local and international experts sharing leading practices including significant advances in genetic research, regenerative medicine, artificial intelligence, aging and dementia care. Engaging discussion focused on being innovative with the ethical challenges facing policy makers and healthcare providers from an individual, professional and societal lens.

The CLPNA consults with members, employers and stakeholders across Alberta and within Canada in its efforts to prepare LPNs to meet the changing needs of healthcare. This included presenting education to

24 •

COMPETENCE

nursing students and regulators, and collaborative presentations with allied health partners.

CLPNA – China Guanghua International Nursing Alliance With an ongoing commitment to enhancing nursing education standards, the CLPNA continues its collaboration with China’s Guanghua International Nursing Alliance. A sub-committee of ESAC traveled to China to review eight Chinese nursing programs and share the program review standards and processes currently utilized by ESAC. For three of these Chinese schools, a Chinese Assessment team worked alongside the ESAC sub-committee, learning the review process.

Two additional nursing programs are in the process of review and are to be completed in 2019.

The goal of this project is to transition the program review process to the Chinese Assessment team and to create Chinese Nursing Education Standards that are appropriate to their nursing education system. The CLPNA values this opportunity to introduce standards for nursing education, showcase regulatory excellence and participate in shared learning through this SinoCanadian partnership.

STUDY with CLPNA self-study courses 18,812 completed certificate exams at www.StudywithCLPNA.com

Anaphylaxis

872 1344

Diagnostic Tests & Laboratory Values

1913

Elder Abuse

1678

Health Assessment

2172

Infection Prevention and Control 1050

Intravenous Infusion Therapy Medical Language and Terminology

1017 1265

Medication Administration Medication Drug Calculation

914 4581

Nursing Documentation Pressure Ulcers Relational Practice

764 1242

NOTE: these courses are open to the public and do not represent solely Alberta LPN registrants.

Professional Development Webinars

10 Webinars 2850 Attendees

(44% increase from 2017)

Mentorship Program

126 mentees & 104 mentors oriented to program

45 active matches

COMPETENT COMMITTED CARE •

25

Supporting Function

RESEARCH

Lead and collaborate on research to support regulatory excellence and the creation of knowledge on LPN practice.

26 •

RESEARCH

As the regulatory body for Alberta’s licensed practical nurses, facilitating research is an important part of regulatory excellence. This includes building partnerships and coalitions to create knowledge around LPN practice.

Projects that CLPNA led, collaborated or supported include:

• Perceptions, Attitudes and Motivation: Seeking Insight to Promote Compliance with Professional Standards in Nursing Regulation; partner: Renata Neufeld, Institute of Regulatory Excellence

• Exploring Clinical Leadership for LPNs Within Supportive Living in Alberta; partner: Dr. Lorraine Venturato, University of Calgary

• Optimizing LPN Activity in Home Care: Role, Scope and Opportunities; partner: Dr. Kim Fraser, University of Alberta

• Building Citizen Engagement in the Translating Research in Elder Care Program; partner: Dr. Andrea Gruneir, University of Alberta

• Healthy & Professional Knowledge Workers: Examining the Gendered Nature of Mental Health Issues, Leaves of Absence & Return to Work Experiences; partner: Ivy Lynn Bourgeault, University of Ottawa

• Securing Accessible, Quality Early Learning and

Care for Families Working Non-Standard Hours

in Alberta: A Systematic Scoping Review; partner:

Community University Partnership, University of Alberta

• Translating Research in Elder Care Webinar Series; partner: Faculty of Nursing at University of Alberta

• A Professional Development Strategy to Support Internationally Educated LPNs’ Transition to Employment; internal CLPNA collaboration

• Risk Regulation White Paper; internal CLPNA collaboration • 2018 CLPNA Member Survey The following publications and presentations were completed in 2018:

• Building Capacity for Evidence-Based Practice: Understanding How Licensed Practical Nurses (LPNs) Source Knowledge. World Views on Evidence-Based Nursing, Volume 15, Issue 4, March 2018

• Optimizing LPN Practice in Alberta Health Services (presentations to four AHS partners)

The CLPNA provides funding for exemplary research projects that will enhance knowledge and build lasting collaborative relationships with researchers throughout the province. Recipients of the Fall 2017 Advancing Knowledge in Practical Nursing Research Grant were:

• Education Program Standards of Canadian Practical

Nurse Programs: A Jurisdictional Review and

Proposed Standards Framework. Journal of Nursing

Regulation, Volume 9, Issue 1, April 2018

• Dr. Sienna Caspar, University of Lethbridge.

Project title: LPNs as Change Agents: Building LPN Leadership Capacity to Enable Practice Change in Residential Care Homes, and

• Information Literacy Skills and Training of Licensed

Practical Nurses in Alberta, Canada: Results of a

Survey. Health Information and Libraries Journal,

Volume 35, Issue 2, June 2018

• Dr. Jude Spiers, University of Alberta.

Project title: Enhancing LPNs’ Family Communication Skills to Reduce Potentially Avoidable Transfers of Continuing Care Residents to the Emergency Department: A Mixed Methods Pilot Study.

COMPETENT COMMITTED CARE •

27

Supporting Function

POLICY

Create evidence informed policy to support regulatory processes.

Developing policy and support documents is a key function of a self-regulating profession. The CLPNA’s focus on evidence-informed policy supports regulatory processes and assists LPNs in the provision of safe, competent, ethical care.

The CLPNA published an array of policies in 2018, all of which can be seen on page 7 under Governance, and can also be accessed by members of the public, LPNs and stakeholders at www.CLPNA.com under Governance.

28 •

POLICY

New Evidence-Based Policy

5 Practice Policies

1 Interpretive Document 2 Practice Guidelines 5 Fact Sheets

COMPETENT COMMITTED CARE •

29

Supporting Function

COMMUNICATION

Facilitate responsive and relevant communication with the public, LPNs and stakeholders.

The CLPNA shares clear, relevant information with the public, licensed practical nurses and stakeholders.

Responsiveness and reliability in the promotion of safe practice are the goal, whether communicating on the CLPNA’s websites, on one of many social media platforms, in CARE magazine, or in person at the Annual General Meeting, Conference or Think Tank.

Public awareness of LPN competence and professionalism was shared throughout the province through radio, television, digital billboards and online advertising. Television advertising also reminded the public of the CLPNA’s role in managing complaints about LPN practice.

30 •

COMMUNICATION

460,000 visitors to CLPNA.com

In 2018, the CLPNA offered members the ability to receive CARE magazine either as a printed edition or an online-only edition. 47% of members chose the online edition.

Information on CLPNA.com is current and frequently accessed this year with 460,000 visits. In 2018, 47 news stories were shared and were read 121,000 times, an increase of 85% from 2017. Considering the CLPNA website hosts important information for the public, LPNs, employers and stakeholders, this increased traffic can be an indicator of interest and engagement.

47 news posts on CLPNA.com were viewed 121,000 times.

Digital Billboard - December 2018

COMPETENT COMMITTED CARE •

31

Supporting Function

ORGANIZATIONAL CULTURE

Create a productive environment built on trust, respect, safety, collaboration and a commitment to continuous improvement and fiscal responsibility.

As an organization built around serving the public interest, the CLPNA strives to be a workplace that exemplifies respect and responsibility.

As a team, we commit to the operating principles of culture, collaboration and communication. These principles guide the co-creation of a healthy workplace where we hold ourselves accountable for our resources, timeliness, quality and service.

In 2018, this was reinforced by the CLPNA’s ongoing commitment to supporting our team charter, which affirms our accountability for psychological health and safety in the workplace. Implementation of new Occupational Health and Safety (OH&S) regulation to protect

32 •

ORGANIZATIONAL CULTURE

the team is also a priority, with an internal OH&S Committee in place to guide workplace health and safety initiatives.

The CLPNA supports life-long learning and professional development in staff and volunteers, including students we support through the Summer Temporary Employment Program (STEP).

In 2018, three STEP students engaged in work related to achieving the CLPNA’s mandate.

The CLPNA completed an expansion and renovation in 2018 which resulted in modernizing the existing 7000 square foot facility and adding an additional 3000 square feet to accommodate continued growth. This innovative work integrated evidence-informed design principles including ‘right to light’, allowing natural light to flow through glass walls and into all work spaces in the office. Additionally, various meeting spaces were added throughout the office to ensure sufficient areas for private consultations. The design has aligned with our organization’s operating principles, in that it has provided for a collaborative and healthy work space.

COMPETENT COMMITTED CARE •

33

We believe in Alberta’s Licensed Practical Nurses.

Whether we’re authorizing grants for continuing education, selecting the best LPNs for an award, or fundraising, the Fredrickson-McGregor Education Foundation for Licensed Practical Nurses provides financial support for LPNs completing post-basic education to enhance their competence as an LPN. The Foundation administers the proceeds of a $3 million endowment fund to enhance LPN nursing knowledge, skills and ability.

Top Grant-Approved Education Courses for 2018: Immunization 129 CLPNA AGM & Conference

80

In 2018, the Foundation Education Grant Program approved 647 applicants for a total of $311,740.97, with 481 applicants receiving $222,375.74 in grant disbursement upon completion of education. There was also $12,000.00 disbursed to 80 LPNs requesting the $150.00 allocation for the 2018 CLPNA AGM and Conference.

Foot Care

59

Infectious Diseases Update

29

Intramuscular and Intradermal Injections

22

Intravenous Initiation, Infusion and Medication Administration

20

Diabetes Update

18

Since the Education Grant Program began in September 2006, the foundation has approved 6128 applications for a total of $2,686,674.12 in grants, and distributed 68.5% of the approved funds.

Phlebotomy 16

2018 APPROVED EDUCATION The Grant Administrator is currently approving education that enhances the LPN’s current role, or that will allow

34 •

them to advance into another LPN role. Education related to immunization and foot care are the top two grants requested, as well as one-day seminars such as Infectious Diseases Update, Diabetes Update and Geriatric Gems.

COLLEGE OF LICENSED PRACTICAL NURSES OF ALBERTA, 2018 ANNUAL REPORT

Perioperative Specialty Applications (contains 4 courses) 13 Orthopedic Specialty Applications (contains 4 courses) 12 Geriatric Gems

11

The Alberta Health Care Aide (HCA) Directory is a project funded by Alberta Health and developed by CLPNA with a Steering Committee comprised of representatives from Alberta Health, Alberta Health Services, Covenant Health and CLPNA. The goal of this initiative is to provide a centralized source of information regarding the HCA workforce in Alberta supporting effective Human Health Resource planning in the province of Alberta.

The Directory was established in 2017 and continued enroling HCAs throughout 2018. Enrolment on the Directory was voluntary until the end of 2018, when through a government directive, enrolment became a requirement for HCAs employed in publicly-funded institutions.

COMPETENT COMMITTED CARE •

35

FINANCIAL HIGHLIGHTS

36 •

COLLEGE OF LICENSED PRACTICAL NURSES OF ALBERTA, 2018 ANNUAL REPORT

Statement of Financial Position 2018

December 31, 2018

2017 (Restated)

ASSETS CURRENT

Cash

Cash held for restricted funds

Investments

Accounts receivable

Prepaid expenses

$

11,287,230 11,644,672 303,175 2,977,605 3,324,211 1,356,703 792,590

INVESTMENTS INVESTMENTS RESTRICTED FOR ENDOWMENT FUND CAPITAL ASSETS

LIABILITIES CURRENT

Accounts payable and accrued liabilities

Goods and services tax payable

Deferred grant revenue

Prepaid registration fees

3,985,580 $ 4,073,610 161,996 267,794 6,638,722 6,922,087 143,872 7,643 357,060 373,538

$ 15,924,713 $

$ 15,761,473

830,334 $ 676,046 3,209 1,848 229,327 394,566 5,381,845 5,237,495

LEASE INDUCEMENT

6,444,715 6,309,955 399,844 281,196 6,844,559 6,591,151

NET ASSETS

Unrestricted

Internally restricted for Seniors Care Education

Restricted net assets

4,195,846 4,503,521 550,000 550,000

Capital Fund

1,356,703 792,590

Endowment Fund

2,977,605 3,324,211

9,080,154 9,170,322

$ 15,924,713

Approved by the Council

$ 15,761,473

President Vice President

COMPETENT COMMITTED CARE •

37

General Fund and Capital Fund - Statement of Operations Year Ended December 31, 2018

2018

2017 (Restated)

REVENUE Registration fees Active Out of province assessment Late Reinstatement Fines Associate License verification Consulting services HCA Directory Program development National examinations Annual general meeting Alberta Directory grant Foreign Qualifications Recognition Innovation grant Jurisprudence examination Continuing competency profile Program fees Advertising Interest income Miscellaneous

38 •

COLLEGE OF LICENSED PRACTICAL NURSES OF ALBERTA, 2018 ANNUAL REPORT

$ 5,698,527 254,452 112,900 3,650 14,250 32,977 28,171

$ 5,428,805 256,875 96,200 18,900 12,000 36,440 25,899

40,036 34,000 485,963 520,590 159,970 167,805 165,239 160,160 27,127 98,153 54,084 64,055 800 51,850 10,095 10,000 9,990 20,581 153,629 127,174 1,327 1,891 $ 7,287,187

7,097,378

General Fund and Capital Fund - Statement of Operations 2018

Year Ended December 31, 2018

2017 (Restated)

EXPENSES Administration Public information Rent and occupancy costs Office and computer Amortization of capital assets Bank charges and interest Postage Professional fees Telephone and utilities Consulting fees Printing Travel Jurisprudence project Alberta Directory project Foreign Qualifications Recognition Innovation project Schedule of Personnel Costs Schedule of Cost of Services

116,735 141,247 406,529 281,554 397,583 378,550 209,705 191,645 140,228 130,878 23,194 19,894 286,278 129,254 35,287 31,530 44,105 28,292 4,340 6,282 93,585 89,857 44,888 43,470 194,305 160,160 - 126,196 3,108,028 2,712,504 1,818,442 1,876,360

6,923,232

6,347,673

363,955

749,705

(107,517)

42,782

INCOME FROM OPERATIONS Unrealized gain (loss) on investments EXCESS OF REVENUE OVER EXPENSES

$

256,438

$

792,487

COMPETENT COMMITTED CARE •

39

Endowment Fund - Statement of Operations 2018

Year Ended December 31, 2018

REVENUE

Investment income

Unrealized gain (loss) on portfolio investments

Gain on disposal of long-term portfolio investments

$

2017

64,160 (253,913) 36,688

$

91,109 154,866 27,644

(153,065)

273,619

EXPENSES

Brokerage fee

Donation to Fredrickson McGregor Education Foundation

23,541 170,000

26,497 170,000

193,541

196,497

EXCESS OF REVENUE OVER (UNDER) EXPENSES

$

(346,606)

$

77,122

Statement of Changes in Net Assets Year Ended December 31, 2018

Unrestricted

Internally Restricted for Seniors Care Education

NET ASSETS AT BEGINNING OF YEAR AS PREVIOUSLY REPORTED

$ 4,713,261

$

Restated for prior period error

(209,740)

As restated

$

$ 9,380,062

$ 3,324,211

-

-

-

(209,740)

4,503,521

550,000

792,590

3,324,211

9,170,322

Excess of revenue over (under) expenses

466,143

-

(209,705)

(346,606)

(90,168)

Investment in capital assets

(773,818)

-

773,818

-

-

NET ASSETS AT END OF YEAR

$ 4,195,846

550,000

$ 1,356,703

$ 2,977,605

$ 9,080,154

The complete audited financial statements are available by contacting the CLPNA at 780.484.8886

40 •

2018 Total

792,590

$

550,000

Endowment Fund

Capital Fund

COLLEGE OF LICENSED PRACTICAL NURSES OF ALBERTA, 2018 ANNUAL REPORT

competent committed care

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