July 2015
PRACTICAL NURSING
COMMITTED TO EXCELLENCE
AGM and Annual CLPNM Awards Dinner Held in Winnipeg June 1, 2015
2
Practical Nursing | July 2015 | College of Licensed Practical Nurses of Manitoba
PRESIDENT
Cheryl Geisel LPN
BOARD OF DIRECTORS
District I – Elisa Wiebe LPN
District II – Vacant
District III – Rodney Hintz LPN
District IV – Lindsay Maryniuk LPN
District V – Jodi La France LPN
District VI – Patricia Smythe LPN
Public Members – Darlene Barbe
– Tricia Conroy
– Judy Harapiak
– Diwa Marcelino
– Susan Swan
EXECUTIVE DIRECTOR
Jennifer Breton LPN, RN, BN
EXECUTIVE OFFICE
Vicky Bering
Executive Assistant
Barbara Palz, HB Com, CGA
Business Manager
Renata Neufeld, BA (Hons), MPA
Consultant, Policy, Process and
Communications
REGISTRATION DEPARTMENT
Carrie Funk, LPN
Consultant, Regulatory Services
Dina Bering
Administrative Assistant
CREDENTIAL ASSESSMENT
DEPARTMENT
Kathy Halligan, BA (Hons), CTESL, CACE
Consultant, Credential Assessment
PROFESSIONAL CONDUCT
DEPARTMENT
Cristie Perfas, BScN, RN, MN, GNC (C)
Consultant, Conduct
PROFESSIONAL NURSING
PRACTICE DEPARTMENT
Tracy Olson, LPN
Consultant, Practice
EDUCATION AND PROGRAM
EVALUATION DEPARTMENT
Michael Roach, BScN
Consultant, Education and Program
Evaluation
ADVERTISING
To advertise in the Practical Nursing
Journal, please contact:
McCrone Publications Inc.
Email: [email protected]
Toll Free: 1-800-727-0782
Fax: 1-866-413-9328
TABLE OF CONTENTS
President’s Message
3
2016 Registration Renewal
8
2017 Preauthorized Payment Plan
9
2015/2016 Fee Schedule
10
Legal Issues in Nursing: Assessment
12
Ask a Practice Consultant
16
Wanted: CCP Auditors
18
2014 Continuing Competence Program Audit Report
19
Have You Been Accepted into a Practical Nursing
Program in Manitoba?
24
2015 Office Closure Dates
August 3, 2015
October 12, 2015
September 7, 2015
November 11, 2015
Office closed 2:00pm December 23, 2015 and re-opens 9:30am January 4, 2016.
Fragrance-Free Notice
In response to health concerns, CLPNM has a Fragrance-Free Policy and is a scent-free
environment. Please do not use scented products while on the CLPNM premises for
work, education, appointments, or other business.
College of Licensed Practical Nurses of Manitoba
463 St. Anne’s Road
Winnipeg, MB R2M 3C9
Telephone: (204) 663-1212
Toll Free: 1-877-663-1212
Fax: (204) 663-1207
Email: [email protected]
Publications Agreement #40013238
Practical Nursing | July 2015 | College of Licensed Practical Nurses of Manitoba
3
PRESIDENT’S MESSAGE
As the newly-elected President of the College of Licensed
Practical Nurses of Manitoba (CLPNM) I look forward to
upholding the mission, values and duty of the CLPNM in
my new role. My name is Cheryl Geisel, and I was elected
President of the CLPNM Board on June 1, 2015. I am a
licensed practical nurse living and working in Dauphin, MB.
I was previously employed at our local medical clinic, the
Dr. Gendreau PCH in Ste. Rose, MB, and I am currently with
the DRHC, with 13 years of nursing experience in medicine,
surgery, post-partum maternal care, pediatrics, and
geriatrics. I served on the Board of Directors for 2 years
prior to my appointment as its President. It is an honour
and privilege to serve as President, and I thank the Board
for the opportunity.
I would also like to thank our outgoing President, Christy
Froese, for her three years of service, and for her previous
commitment as a member of the Board and various
CLPNM committees. Christy’s presence, dedication and
leadership will be missed. As well, thank you to departing
Board member Yvonne Maguet for her service. We look
forward to having her expertise on the CLPNM Continuing
Competence Committee.
I also wish to congratulate our new LPN graduates as
they venture forth in their new careers. I invite all new
and existing members to consider becoming involved in
the self-regulation of the practical nursing profession.
Self-regulation is a privilege and responsibility granted
to the profession, recognizing that practical nurses are
in the best position to hold one another accountable for
providing safe and effective care that serves the interests
of the public. You can get involved by serving as a CLPNM
Board or committee member, by acting as a continuing
competence program (CCP) or practice auditor, or even just
by attending a CLPNM Quarterly Board Meeting, and/or our
Annual General Meeting to vote on motions and share your
voice as a member of the profession.
It is hard to believe that the 69th Annual General Meeting
and Excellence Awards dinner has come and gone. Here
are some highlights from the event, which was held at the
Viscount Gort Hotel in Winnipeg on June 1, 2015.
69th CLPNM Annual
General Meeting
Highlights
The rules of procedure
were presented
and approved. Vera
Chernecki was the
parliamentarian for the
proceedings.
The Credentials
Report was:
Voting: 11
Non-Voting: 18
Board Members for
the 2016 year were
introduced.
They are:
President – Cheryl Geisel LPN
District I – Elisa Wiebe LPN
District II – Vacant
District III – Rodney Hintz LPN
District IV – Lindsay Maryniuk LPN
District V – Jodi La France LPN
District VI – Patricia Smythe LPN
Cheryl Geisel, LPN
Public Members:
Tricia Conroy
Judy Harapiak
Diwa Marcelino
Darlene Barbe
Susan Swan
Annual Report
Tony Gauthier CA, of Craig and Ross Chartered Accountants,
presented the 2014 audited statements. The 2014 auditor’s
report was adopted as presented.
4
Practical Nursing | July 2015 | College of Licensed Practical Nurses of Manitoba
Previous Wording
Approved June 1, 2015
2.7 Associate Members
The current 2.7 would be deleted and replaced with:
Associate members shall include the following categories; nonpracticing and honorary members, as defined by registration
policies.
2.7 Honorary Members
3.2 Term of Office
3.2 Term of Office
a] Subject to subsection 3.3, the term of office of all Board
members except the President shall be two years.
a] Subject to subsection 3.3, the term of office of all
elected Board members shall be two years; however, the
incumbent may continue to hold office upon completion
of a term until a successor is elected or, if required,
subject to 3.8, appointed by the Board.
b] Appointed Board members, who are not members of the
College and subject to the Act, may serve indefinite two (2)
year terms at the discretion of the Board.
c] The President shall provide written notice of his/her intent
to seek re-election or intent to resign at the spring Board
meeting, 1 year prior to that event.
d] The Vice-President’s term of office will be determined by the
Board upon appointment.
The Board may confer honorary memberships upon any
individual, in accordance with Board policies.
b] The President may serve more than one term but
not more than three consecutive terms; however, the
President may continue to hold office upon completion
of a term until a successor is appointed or elected by
the Board.
c] Before the end of the two year term, the incumbent
President shall provide written notice of his/her intent
to seek re-election or intent to resign.
d] Appointed Board members, who are not members of the
College and subject to the Act, may serve indefinite two
(2) year terms at the discretion of the Board.
e] The Vice-President’s term of office will be determined
by the Board upon appointment.
3.3 Eligibility to Hold Office
3.3 Eligibility to Hold Office
a] Registrants on the register of practising licensed practical
nurses who are in good standing shall be eligible for election
or re-election to the Board, with the following exceptions:
a] Registrants on the register of practising licensed practical
nurses who are in good standing shall be eligible for
election or re-election to the Board, with the following
exceptions:
i. employees of the College; or
ii. individuals who hold office on the Board of a nursing
bargaining unit.
b] If an elected registrant ceases to be a practising licensed
practical nurse, they shall cease to be a member of the Board.
c] Board members seeking election to the position of President
shall:
i. Declare in writing their intention to run for office at the
spring Board meeting prior to the annual meeting.
i. Employees of the College; or
ii. Individuals who hold office on the Board of a nursing
bargaining unit.
b] If an elected registrant ceases to be a practising licensed
practical nurse, they shall cease to be a member of the
Board.
c] Board members seeking election to the position of
President shall:
ii. Submit a resume.
i. Declare in writing their intention to run for office at
the spring Board meeting prior to the annual meeting.
iii. Provide evidence their nomination has been supported by
at least three Board members.
ii. Submit a resume.
d] The President shall be eligible for re-election for indefinite
terms at the discretion of the Board.
e] The Vice-President must be a member of the Board to be
eligible for the nominations.
iii. Provide evidence their nomination has been
supported by at least three Board members.
d] The Vice-President must be a member of the Board to be
eligible for the nominations.
Practical Nursing | July 2015 | College of Licensed Practical Nurses of Manitoba
5
Previous Wording
Approved June 1, 2015
3.7 Meetings
3.7 Meetings
d] Written notice of meetings of the Board, stating the business
to be transacted, shall be given to each Director not less than
fifteen (15) calendar days before the meeting. Notice of any
meeting or any irregularity in any meeting notice may be
waived by any Director.
d] Written notice of meetings of the Board, stating the
business to be transacted, shall be given to each
Director not less than fourteen (14) calendar days
before the meeting. Notice of any meeting or any
irregularity in any meeting notice may be waived by any
Director.
3.8 Vacancies
3.8 Vacancies
a] If a Board member resigns, or dies, or is suspended and
is removed from the Board, the Board shall declare the
office vacated and may appoint a successor, in the manner
hereinafter set out, to hold office until the end of the current
term of office.
Add:
b] Vacancies on the Board, so long as a quorum of Board
members remains in office, shall be filled in the manner
hereinafter set out:
i. Vacancies among the officers shall be filled by
appointment by the Board of a then incumbent Board
member.
ii. If an elected Director is elected to the office of President
or Vice-President, the Board shall declare the Director’s
position vacant and shall order that a by-election be held
within the electoral district.
iii. If there is a Vice-President, that person shall fill the
vacancy in the office of President for the remainder of the
predecessors’ term.
iv. A vacancy among the Directors in the first year of the
vacating Director’s term shall be filled by calling a
by-election in the electoral health district from which
the vacancy occurred.
v. A vacancy among the Directors in the second year of the
vacating Director’s term shall be filled by appointment by
the Board.
c] A vacancy that cannot be filled by a member in the electoral
health district from which the vacancy occurs; the Board shall
fill that vacancy by appointment.
d] If vacancies on the Board number such that there is not
a quorum of elected Directors remaining, the remaining
Board Directors shall be forthwith call an election to fill the
vacancies.
e] In the event that the President position becomes
vacant before the end of a term; if there is a VicePresident appointed, they shall assume the role of
President for the remainder of the predecessor’s term.
If there is no Vice-President, the Board shall convene
and appoint a new President subject to Article 3 of the
College By-laws.
Delete 3.8 b(iii)
6
Practical Nursing | July 2015 | College of Licensed Practical Nurses of Manitoba
Previous Wording
Approved June 1, 2015
Article IV – Duties of Officers
Add:
4.1 The President
4.3 Executive Director
a] The President shall preside at all meetings of the Board and
the annual or special meetings, within the term elected. The
President shall see that all orders and resolutions of the
Board are carried into effect.
a] The Executive Director shall be a licensed practical nurse
appointed by and responsible to the Board.
b] The President shall submit a report for the year to the
registrants at the annual meeting, and report to the Board,
matters which in the interest of the College may be required
to be brought to the Board’s attention.
c] An elected Director could fulfill the President’s duties in his/
her absence.
4.2 The Vice-President
b] The Executive Director shall:
i. Be an ex officio, non-voting member of the Board.
ii. Be an ex officio, non-voting member of the College.
iii. Be an ex officio, non-voting member of all
committees of the College with the exception of
the Investigation Committee and the Discipline
Committee.
c] The Executive Director shall act as treasurer of the
College, including:
a] The Vice-President is voted by and from the Board when
required by the Board.
i. Keeping all records of the College, including a record
of all meetings of the College and not the Board.
b] The Vice-President works under the direction of the
President.
ii. Issuing all notices required by statute, by the
By-laws, or by resolution of the Board.
c] The Vice-President performs the duties in the absence or
inability of the President.
iii. Having custody of the seal of the College.
d] The Vice-President performs such duties as may be assigned
by the President or the Board.
e] The Executive Director is authorized to prescribe such
forms, certificates or other documents as may be
required for the purposes of the Act, Regulations, or the
By-laws.
f] In accordance with 6(6) of The Licensed Practical Nurses
Act, the Executive Director may appoint any other
staff necessary to perform the work of the College.
The Executive Director shall set out the duties and
remuneration for these staff in accordance with the
policies and guidelines set by the Board.
CLPNM Excellence Awards
Three LPNs were selected to receive Excellence Awards
from the CLPNM Board of Directors. Congratulations to
the following award recipients: May Schultz, Maureen
Gove and Dianne Kolesar.
Nursing Practice Award
The 2015 recipient was May Schultz. May has been
employed with Actionmarguerite since April of 2011,
where she currently holds an internal float position and
works on all seven units within the facility. May was
nominated by her manager who noted her integrity,
commitment to excellence, respect for cultural diversity,
and strengths in critical thinking and clinical reasoning.
Practical Nursing | July 2015 | College of Licensed Practical Nurses of Manitoba
Nursing Mentor and Preceptor Award
The 2015 recipient was Maureen Grove. Maureen has practiced
as an LPN at Middlechurch Home of Winnipeg since 1996,
and has been the Minimum Data Set (MDS) coordinator at
the facility since February, 2008. Maureen was nominated for
her role in supporting the adoption and success of the MDS
by demonstrating initiative, leadership and a commitment to
ongoing learning.
Educator Award
The 2015 recipient was Dianne Kolesar. Diane is the Nursing
Lab and Theory Instructor at Assiniboine Community College.
She was nominated by her students who value her approach
to teaching, her talent for keeping her students engaged, and
her willingness to support them even outside of dedicated
classroom hours.
7
Licensed Practical Nurses Foundation of Manitoba (LPNFM)
Scholarships
The following first-year Practical Nursing (PN) students were
awarded LPNFM Scholarships in the amount of $500:
• Reesa Atnikov
• Meladie Chaikowsky
• Stephanie Martel
The following second-year PN students were awarded LPNFM
Scholarships in the amount of $1000:
• Reanna Wallcraft
• Susan Haverstock
• Yaroslava Lupanchuk
The 2015 Nursing Mentor/Preceptor award
recipient, Maureen Grove and CLPNM
President Cheryl Geisel.
The 2015 Nursing Practice award recipient,
May Schultz and CLPNM President Cheryl
Geisel.
The 2015 Nursing Educator award recipient,
Dianne Kolesar and CLPNM President Cheryl
Geisel.
Cheryl Geisel President and former CLPNM
President Christy Froese.
Cheryl Geisel President, CLPNM Executive Director Jennifer Breton, and former CLPNM
President Christy Froese.
8
Practical Nursing | July 2015 | College of Licensed Practical Nurses of Manitoba
2016 REGISTRATION RENEWAL
It is time once again for registration renewal with the College of Licensed Practical Nurses of Manitoba
(CLPNM). The 2016 renewal season opens August 15, 2015, and the administrative deadline for renewal
is October 15, 2015.
It is important to note that active practicing registration expires on November 30, 2015.
After this date, registrants cannot practice as an LPN unless their license has been
approved by the CLPNM for the coming year. The privilege of using the title Licensed
Practical Nurse is sanctioned, and as such only those who hold current active practicing
registration are permitted to use the designation or work in that capacity.
RENEW EARLY! All renewal applications must be assessed and processed
by the CLPNM prior to being granted approval. Early renewal will allow the
CLPNM time to contact you should there be an issue with your application.
A complete 2016 registration renewal application includes:
•
an accurate and completed renewal application via the CLPNM’s online
registration system;
•
projected practice hours for the period from December 1, 2014 to
November 30, 2015;
•
a declaration of participation in the Continuing Competence Program
(CCP);
•
full payment of all applicable fees, and
•
full payment of any outstanding amounts owed to the CLPNM.
Please note that the CLPNM may contact you prior to approving your renewal
to request additional information. All follow-up documents must be received
before the administrative deadline of October 15 or late fees will apply.
All registrants applying to renew their registration must comply with the
CCP requirements. Information regarding the CCP is available on the CLPNM
website.
Registrants who are required to submit verification of hours and/or who
have been randomly selected to participate in the CCP audit will not have
their registration renewal approved until the required documents have been
received by the CLPNM. It is the registrant’s responsibility to ensure these
documents, in their entirety, have been received by the CLPNM.
October 16, 2015 – November 30, 2015
If a complete 2016 registration renewal
application, requested documents or
requirements (if applicable), and/or the
associated fees are not received by the
CLPNM by October 15, 2015, late fees
will apply ($105.00). Late fees are in
addition to the registration renewal fee
and are not part of the Preauthorized
Payment Plan (PPP) withdrawals.
Applications will not be processed and
renewals will not be approved until all
fees are paid in full. It is the registrant’s
responsibility to ensure all requirements
have been met.
December 1, 2015 – December 14,
2015
Registrants who have not completed
the renewal process in its entirety
by November 30, 2015, as per LPN
Regulation 22(1), are considered
to be in default and are no longer
authorized to practice as an LPN in
Manitoba. Individuals who practice as
an LPN without current registration are
subject to an unauthorized practice
penalty fee and may be referred to the
CLPNM’s Investigation Committee for
professional misconduct. Registrants
who miss the November 30th deadline
may reactivate their registration between
December 1, 2015 and December
14, 2015. Registrants must submit
the online renewal application form,
provide any outstanding documentation
or requirements, as well as pay the
following fees:
Practical Nursing | July 2015 | College of Licensed Practical Nurses of Manitoba
• 2016 registration renewal fee of
$388.50
• Administrative late fee of $105.00
• Default reactivation fee of $131.25
• Unauthorized practice fee (if
applicable) of $525.00
After December 15, 2015
Registration is cancelled for all registrants
who have not completed the renewal
process in its entirety by December 15,
2015. The registrant is now considered
a former member of CLPNM. If a former
member wishes to regain active practicing
registration after this date, they must
begin the reinstatement process.
Verification of Registration Status
Registrants can verify their registration
status by visiting the CLPNM website and
selecting “Find an LPN” on the homepage.
This link will lead the user to the Public
Register where all LPNs with active
practicing registration can be searched by
entering a name or registration number.
Employers can verify registration status
by accessing the CLPNM’s Employer
Verification System, also located under
the “Find an LPN” link on the website.
9
Resignations
Receipt Information
If you are retiring or resigning from the
profession for the 2016 registration
year, please log into the online renewal
system during renewal time and change
your status to former member. It is
important for the CLPNM to maintain
records of retirements and resignations
for the purposes of health human
resources planning and in the case of a
public health emergency.
You can access your receipt for income
tax purposes by logging into your
profile on the CLPNM website and
clicking on the receipts tab.
Payment Options
Acceptable methods of payment include
Visa, MasterCard, Visa debit, money
order or debit (in person at the CLPNM
office). Cheques and cash are not
accepted.
Registration renewal applications will
not be approved until the required funds
have been received by the CLPNM. Any
dishonored payments will be subject to
an administrative fee.
If you are enrolled in the PPP, are in good
standing and renew your registration
online before October 15, 2015, further
payment will not be required. It is the
registrant’s responsibility to remain
informed of any outstanding payment
requirements.
How to Access the Online
Registration Renewal System
A step-by-step renewal guide
will be available on the CLPNM
website when the registration
year opens August 15, 2015.
To renew your registration, go
to www.clpnm.ca and login
using your User ID (registration
number) and your password,
which remains the same as last
year unless you have changed it.
If you have been selected for the
CCP audit, you will be notified
when you login to the online
registration renewal system.
If you have any questions about
renewing your 2016 registration,
please contact the CLPNM at
(204) 663-1212, toll free at
1-877-663-1212, or by email at
[email protected].
2017 PREAUTHORIZED PAYMENT PLAN
Pay your 2017 fees in advance through the College
of Licensed Practical Nurses of Manitoba’s (CLPNM’s)
Preauthorized Payment Plan (PPP). This option is available
to active practising registrants who wish to pay for
upcoming registration fees through automatic bank debit.
If you wish to join, a PPP application must be completed
and submitted to the CLPNM office in person, by mail to
463 St. Anne’s Road, Winnipeg, MB R2M 3C9 or by fax
(204) 663-1207. The completed application may also be
emailed to [email protected].
Automatic withdrawals for 2017 fees will be ten equal
payments of $38.85 based on the current annual fee.
The payments will begin November 15, 2015 and are
withdrawn monthly up to and including August 15, 2016.
Application forms are available on the Fee Schedule page
of the College website at www.clpnm.ca.
If you are already enrolled in the plan and wish to
continue there is nothing you need to do.
If you have any questions regarding the PPP, please
contact Barbara Palz, Business Manager at bpalz@clpnm.
ca or (204) 663-1212.
10
Practical Nursing | July 2015 | College of Licensed Practical Nurses of Manitoba
2015/2016 FEE SCHEDULE
Amount
Active Practicing Registration Renewal Fee (by Oct 15)
GST
Total
$370.00
$18.50
$388.50
Oct 16 - Nov 30 (add late filing administration fee 100.00)
$470.00
$23.50
$493.50
Dec 1 - Dec 15 (add default re-activation fee 125.00)
$595.00
$29.75
$624.75
After December 15 cancelled (add re-instatement fee 150.00)
$745 .00
$37.25
$782.25
$470.00
$23.50
$493.50
Graduate Registration Fee
$100.00
$5.00
$105.00
Graduate Registration Renewal Fee
$100.00
$5.00
$105.00
Student Registration Fee
$50.00
$2.50
$52.50
Student Registration Renewal Fee (2nd year)
$50.00
$2.50
$52.50
$50.00
$2.50
$52.50
$400.00
$20.00
$420.00
Late Filing Administrative Fee - Exam
$50.00
$2.50
$52.50
DNW - Did Not Write
$75.00
$3.75
$78.75
Re-scoring Exam Fee
$75.00
$3.75
$78.75
IEN Credential Assessment
$420.00
$21.00
$441.00
Re-assessment fee
$150.00
$7.50
$157.50
File extension fee
$150.00
$7.50
$157.50
Endorsement (currently registered in another province)
$300.00
$15.00
$315.00
Educational Session (required by order of Investigation/Discipline)
$300.00
$15.00
$315.00
Unauthorized Practice Penalty
$500.00
$25.00
$525.00
Non-Negotiable Transaction Fee
$50.00
$0.00
$50.00
Processing Fee
$75.00
$3.75
$78.75
Verifications
$75.00
$3.75
$78.75
Appeal of Registration decision
$200.00
$10.00
$210.00
Application for Enrolment, Active Practising Registration
Includes Practising fee of 370.00 and Initial Enrolment of 100.0
Late filing administrative fee - Grad and student
Exam Fee (CPNRE)
Credential Assessment
Administrative Fees
Payment options: Visa, MasterCard, Debit, Money Order
Pre-authorized Payment Plan (PPP) 10 payments of $38.85 on the 15th of each month from Nov/15 - Aug/16
Practical Nursing | July 2015 | College of Licensed Practical Nurses of Manitoba
11
12
Practical Nursing | July 2015 | College of Licensed Practical Nurses of Manitoba
LEGAL ISSUES IN NURSING:
ASSESSMENT
This article was originally published in CARE Magazine, Fall 2014 issue, by the College of Licensed Practical Nurses of Alberta (www.clpna.com).
Reprinted with permission.
Article written by: Chris Rokosh, RN, PNC(C), Legal Nurse Consultant and president of CanLNC Incorporated; he is a popular speaker on legal
issues in nursing across Canada and in the US.
The first article in this series (CLPNM
PN Journal, April 2015) included
a case study about a medical
malpractice lawsuit involving a lack of
communication. You may recall 17-yearold Will Johnston whose right tibia was
fractured when he was hit by a car. The
tibia was successfully repaired, but
post-operatively Will developed severe
pain in his leg and became confused
and irritable. The nurses caring for
him documented signs of weakness
and changes to the colour, warmth,
sensation and movement in his right
foot, but they failed to communicate
this information to the doctor. Will was
ultimately diagnosed with compartment
syndrome, had a below-the-knee
amputation, and filed a multimillion
dollar lawsuit, suing both the nurses
and doctors for the loss of his leg. When
the nursing care was examined, it was
determined that the nurses had failed
to meet the standard of care in two key
areas: by not communicating important
clinical information to the doctor and
by not assessing Will’s leg according to
hospital policy. This article will focus
on the issue of nursing assessments;
more specifically, medical malpractice
lawsuits claiming that the nurse
performed inadequate assessments.
All nurses are tasked with the
responsibility of providing safe,
ethical and competent care. We are
also responsible and accountable to
ensure that our practice meets both
professional standards and legal
requirements. This requires that patient
assessments are done according to
doctors’ orders, current standards of
care, best practice guidelines, facility
policy, and most importantly according
to each patient’s individual condition.
The court’s view is that nurses have
a specialized body of knowledge and
that they are expected to use critical
thinking to respond appropriately to
information obtained through their
assessments. In some situations, nurses
are required to assess patients without
the assistance of subjective information,
such as during periods of sleep, recovery
from anesthesia, in pediatric care or
when working with unconscious or
mentally compromised patients. But
in all situations, the expectation is
that if the patient’s condition changes,
so will the detail and frequency of
nursing assessments. This means that
you may need to assess patients more
frequently if they become unstable or
develop complications. Seems pretty
straightforward, doesn’t it?
Many medical malpractice lawsuits
include allegations that the nurse did
not assess the patient often enough
or that they didn’t assess them at all.
You may be familiar with the saying
‘nothing written, nothing done.’ Many
nurses are. This saying comes from a
1974 Supreme Court of Canada case
called Kolesar vs. Jeffries. Although it
is often used in reference to a lack of
nursing documentation, it’s really based
on a lack of nursing assessment. The
case involved a young man who had a
spinal fusion and was returned to the
surgical unit in satisfactory condition.
The next morning he was found dead.
There were no written entries in the
medical record between 10 p.m. and 5
a.m. on the morning when his death
was discovered. The nurse testified in
court that she had measured pulse and
respiration rates every half hour over
night, and that they were always normal.
She just hadn’t written anything down.
But the absence of documentation led
the judge to believe that nothing was
charted because nothing was done.
This highlights both the importance of
performing assessments according to
the standards of care, and the necessity
of documenting that you have done
so. Let’s learn more about this issue by
examining a case study involving the
assessment of a patient on a medical
unit.
CASE STUDY
At 2:30 p.m., a 47-year-old woman
named Margaret arrived in the
emergency department complaining
of a sudden onset of upper abdominal
pain, nausea and vomiting. She came
to the hospital directly from the airport
after spending two weeks at an allinclusive resort in Mexico. Her medical
history was significant for hypertension
and chronic back pain. She was a
smoker and admitted to occasional
heavy alcohol use, especially in the past
two weeks. Surgical history included
a tonsillectomy many years ago, a
hysterectomy 6 years ago and dental
surgery. Current medications included
vitamins, hormone replacement therapy,
Tylenol #3 (for back pain), and Labetalol
(to control blood pressure). Her vital
signs on admission were temperature
37.8 degrees, BP 176/88 mmHg, pulse
90 beats per minute and respirations
Practical Nursing | July 2015 | College of Licensed Practical Nurses of Manitoba
24 breaths per minute. Laboratory tests
revealed an elevated white blood cell
count and an elevated serum amylase.
Her abdomen was tender and slightly
rigid. Margaret was diagnosed with
acute pancreatitis and admitted to
the medical unit. The doctor provided
orders for IV fluids, antibiotics,
additional lab and diagnostic testing,
and consultation with an internist.
Margaret was to remain NPO overnight
and provided with medication orders
to control pain and nausea. Vital signs
were ordered as per protocol.
At 8:45 p.m., Margaret arrived on the
medical unit and was assigned to LPN
Amy who was working a 12 hour night
shift. Nurse Amy performed an initial
physical assessment and completed the
admission paperwork. Margaret denied
having any pain or nausea. Temperature
remained at 37.8 degrees. BP was
168/90 mmHg, pulse was 84 beats
per minute and respirations were 22
breaths per minute. Nurse Amy oriented
Margaret to her room, reminded her
that she was NPO and showed her
how to use the call bell. She also gave
Margaret a warm blanket, settled her
into bed and encouraged her to get
some sleep.
At 10:20 p.m., Nurse Amy returned to
Margaret’s room to change her IV bag
and check her vital signs. Temperature
was now 37.0 degrees, BP was 102/58
mmHg and pulse was 116 beats
per minute. Respirations were not
measured. Margaret again denied
having pain or nausea, but complained
of feeling cold. Nurse Amy gave her
another warm blanket and encouraged
Margaret to use her call bell if she
needed anything during the night.
Between 11:00 p.m. and 6:00 a.m.,
Nurse Amy documented that she
performed Q1H rounds and that
Margaret appeared to be sleeping with
quiet, easy respirations. She also noted
that the IV was infusing as ordered.
Margaret did not ring her call bell or get
up to use the bathroom overnight.
At 6:15 a.m., Nurse Amy entered
Margaret’s room to check her vital
signs. When Nurse Amy touched
Margaret’s arm, she noted that her
skin felt cool to the touch. Although
Margaret opened her eyes when she
was spoken to, she did not respond
to the questions Nurse Amy asked
her. Nurse Amy was unable to obtain
a blood pressure or temperature and
the pulse felt weak. Respirations were
shallow and Margaret was breathing at
a rate of 6 breaths per minute. Nurse
Amy left the room to get another
blood pressure monitor, thinking
that the one she had wasn’t working
right. But she wasn’t able to obtain a
reading on the second machine either.
She then rang the call bell and asked
the charge nurse to come to the room.
By the time the charge nurse arrived,
Margaret had lost consciousness and
stopped breathing.
At 6:27 a.m., a Code Blue was
called. Margaret was resuscitated,
intubated and taken to the ICU. Her
remaining hospital stay was long and
complicated, and included a diagnosis
of sepsis, three laparotomies to
remove sections of ischemic bowel,
pneumonia and a brain injury due to
prolonged hypoxia. Fifteen months
after her hospitalization, she was
still unable to return to work as
an accountant and had developed
insulin-dependent diabetes. It was
uncertain that she would ever be able
to return to full-time employment.
Margaret filed a lawsuit against
the hospital claiming, among other
things, that Nurse Amy had failed
to assess her vital signs properly
during the first night of her admission.
Margaret claimed that Nurse Amy was
expected to know that a decrease in
BP accompanied by a rise in the pulse
rate can indicate the onset of shock
in a patient with pancreatitis. She also
claimed that Nurse Amy was required
to communicate the 10:20 p.m. vital
signs to the charge nurse or the
doctor, alleging that earlier medical
intervention could have prevented, or
lessened, her injuries.
13
Do you think Nurse Amy met the
standard of care?
Pancreatitis is an inflammation of
the pancreas, the large gland behind
the stomach that is responsible for
the release of digestive enzymes
into the small intestine and the
release of insulin or glucagon into the
bloodstream. Pancreatic inflammation
happens when the digestive enzymes
are activated before they are released
into the intestine and begin attacking
the pancreas itself. The most common
causes are gall stones and chronic
alcohol use. There are two forms of
pancreatitis: acute and chronic. Acute
pancreatitis affects approximately one
per cent of the population (Lam and
Lombard, 1999) and about 70 per cent
of attacks are mild. However, of those
individuals who develop severe forms
of the disease, one in four will die
(Forrest et al, 1995).
The main symptom of pancreatitis is a
sudden onset of abdominal pain in the
epigastric region that may radiate to
the back and be associated with nausea
and vomiting (Alexander et al, 2000). A
serum amylase more than four times the
upper limit is diagnostic of pancreatitis.
Physically, the patient may appear
acutely unwell with signs of shock,
abdominal tenderness and guarding or
rigidity (Henry and Thompson, 2001).
The nursing plan of care includes the
administration of analgesia, antibiotics
and anti-nausea medications, IV fluids,
accurate measurement of intake and
output, and regular observation of
vital signs. In the acute stage, it may
be necessary to take the patient’s
blood pressure, pulse, temperature and
respirations every hour and respond
to the results accordingly. Signs and
symptoms of septic or hypovolemic
shock, such as falling BP, rising pulse,
lack of urinary output and decreased
temperature must be reported
immediately due to the risk of injury to
the patient.
The lawyer representing Margaret
in the lawsuit retained a nursing
14
Practical Nursing | July 2015 | College of Licensed Practical Nurses of Manitoba
expert to review the medical records and
determine whether or not Nurse Amy had
met the standard of care. The reviewing
nurse discovered that at 10:20 p.m., Nurse
Amy had drawn a small downward arrow
next to the blood pressure and a small
upward arrow beside the pulse. This
indicated that Nurse Amy recognized that
the blood pressure had fallen and that
the pulse had risen, yet she had failed
to reassess the vital signs until nearly 8
hours later. When Nurse Amy was asked
why she didn’t reassess Margaret’s vital
signs, she referred to the doctor’s orders
which said to monitor vital signs as per
protocol and the unit policy, which said
to assess vital signs QID. She said that
Margaret had looked tired and unwell at
10:20 p.m. and said that it was important
for her to get some rest. She also said that
she had never looked after a patient with
pancreatitis.
The nurse expert responded that hospital
policies provide minimum guidelines for
assessment, and that a doctor’s orders
can only be altered if the doctor is
made aware of a change in the patient’s
condition. She also said that regardless
of Nurse Amy’s inexperience with
pancreatitis, it is the expected knowledge
of all nurses that unstable vital signs in an
acutely-ill patient can indicate impending
decompensation. The nurse expert stated
that patients can present as stable, but
very quickly become unstable, and that
there are no hospital policies or doctors’
orders that can adequately cover all of
the emergency situations that develop
on medical units. For that reason, nurses
are required to use critical thinking in
situations involving the risk of injury,
and to assess patients more frequently
based on their clinical condition. She
confirmed that a nurse does not need a
doctor’s order or change in hospital policy
to assess vital signs more frequently
than ordered. Her opinion was that
Nurse Amy failed to meet the standard
of care by not revising the plan of care
to include reassessment of Margaret’s
vital signs within 15 to 30 minutes and
urgent communication with the charge
nurse or the doctor no later than 10:30
p.m. This case settled out of court for an
undisclosed amount of money.
Start a Conversation
Use this case study to spark a
conversation on nursing assessment
with your colleagues. Note any
similarities between this case and
the Kolesar vs. Jeffries judgement,
which sparked the ‘nothing written,
nothing done’ saying that we are
all so familiar with. Were you
able to identify issues with both
communication and assessment?
How would you rate the level
of nursing assessments in your
workplace? Have you ever witnessed,
or been part of a situation, where
a lack of assessment caused a
problem? Did the patient suffer
as a result? What currently guides
your patient assessments? Is it
doctors’ orders, hospital policy,
what the charge nurse says, the
‘culture’ on your unit or the patient’s
clinical condition? What will you do
differently now that you know the
outcome of this case? Want to learn
more? Watch for more articles in
future CLPNM PN Journals!
WORKSHOPS COMING TO MANITOBA
THIS FALL/WINTER
WALKING THROUGH GRIEF–Helping Others Deal with Loss
Winnipeg: October 14, 2015
TRAUMA–Strategies for Resolving the Impact of Post-Traumatic Stress
Winnipeg: October 15-16, 2015
GENDER & SEXUAL IDENTITY IN YOUTH
–Equipping Caregivers to Support Healthy Development
Winnipeg: November 4-6, 2015
SELF-INJURY BEHAVIOUR IN YOUTH–Issues and Strategies
Winnipeg: November 16-17, 2015
WEBINARS
No matter where you live, you can easily access
some of CTRI’s workshops right from your desk.
Our one hour webinars offer you the opportunity
to hear, view and engage with our trainers. To
purchase a pre-recorded webinar or to register
for one of our live webinars, please visit our
website.
ADDICTIONS AND YOUTH–Creating Opportunities for Change
Winnipeg: November 18, 2015
DE-ESCALATING POTENTIALLY VIOLENT SITUATIONS™
Winnipeg: November 26, 2015
AUTISM–Strategies for Self-Regulation, Learning and Challenging Behaviours
Winnipeg: December 8-9, 2015
ANXIETY–Practical Intervention Strategies
Winnipeg: December 10, 2015
Each month, CTRI offers a
FREE webinar.
Please visit our website for more information.
ADDICTIONS AND MENTAL ILLNESS–Working with Co-occurring Disorders
Winnipeg: February 18, 2016
DEPRESSION–Practical Intervention Strategies
Winnipeg: February 19, 2016
TO REGISTER OR FOR MORE INFORMATION:
204.452.9199
www.ctrinstitute.com
Visit our website for
more workshops coming
to Manitoba in 2016
[email protected]
Practical Nursing | July 2015 | College of Licensed Practical Nurses of Manitoba
15
16
Practical Nursing | July 2015 | College of Licensed Practical Nurses of Manitoba
ASK A PRACTICE CONSULTANT
Question: I belong to a nursing association that relates to my domain of practice. My association
has developed guidelines for practice and education. Am I obligated to follow these guidelines?
What are my obligations if the guidelines are inconsistent with the professional practice obligations
established by the College of Licensed Practical Nurses of Manitoba?
Answer:
While both organizations may share
the goal of quality patient care, there
is a fundamental difference between
the role of a regulatory body and that
of a professional association. LPNs
must understand the differences in
these roles in order to identify when a
guideline is optional, and when it sets
out professional practice obligations.
A regulatory body is mandated to
govern its members in a manner
that protects the public interest.
The College of Licensed Practical
Nurses of Manitoba (CLPNM) is
the only regulatory body with the
authority to regulate practical nursing
in Manitoba. The CLPNM Board of
Directors is comprised of active
Licensed Practical Nurses (LPNs) and
public representatives who are tasked
with overseeing this authority. This
authority is derived from The Licensed
Practical Nurses Act (the Act).
The CLPNM is accountable to the
public. It is responsible for ensuring
that practical nurses provide safe,
competent and ethical nursing care
to Manitobans. It establishes entryto-practice criteria; grants registration
to qualified applicants; establishes
and monitors standards of education,
practice, and ethics; ensures
continuing competence; and oversees
the conduct of practical nurses. The
right to practice as a practical nurse in
Manitoba requires membership in, and
compliance with the directives of, the
CLPNM.
All LPNs in Manitoba are expected
to understand and adhere to the
professional obligations set out in the
Act, and in the CLPNM’s Standards
of Practice, Code of Ethics and
Regulatory Bulletins. These documents
collectively establish the professional
standards for the practical nursing
profession. Any LPN who does not
practice consistently with these
requirements may be investigated and
sanctioned by the CLPNM.
Professional associations play a
different role. Often, they exist to
support the goals and interests of their
members. An association may provide
networking opportunities, publish
information of relevance to an area
of practice, and arrange professional
development opportunities. An
association might also advocate on
behalf of its members and advance
awareness of the contribution the
profession can make in pursuit of
improved health care and policy
planning.
While membership in a professional
association is not mandatory, it may
offer a wealth of information and
professional connections, as well as
a venue for sharing perspectives,
experiences and practice resources.
Membership in an association
demonstrates a desire to learn and a
dedication to professional growth.
While associations can play an
important role in supporting quality
practice, LPNs must be aware that
no professional association has
any regulatory authority over the
profession of practical nursing
in Manitoba. An LPN may choose
to adopt a guideline issued by a
professional association; however,
if that guideline is in conflict with
a professional or legal obligation,
the CLPNM will hold the nurse
accountable for complying with the
professional or legal obligation.
Any LPN who has questions on this
topic is encouraged to contact the
Practice Consultant with the
CLPNM at 204-663-1212 or
1-877-663-1212 toll free.
To review the Standards of Practice,
Code of Ethics and Regulatory Bulletins,
please visit www.clpnm.ca.
Practical Nursing | July 2015 | College of Licensed Practical Nurses of Manitoba
17
18
Practical Nursing | July 2015 | College of Licensed Practical Nurses of Manitoba
WANTED: CCP AUDITORS
The annual Continuing Competence Program (CCP) audit is dependent upon active practicing
licensed practical nurses’ (LPN) participation.
Auditors are active practicing LPNs who are responsible for assessing submitted CCP materials.
Appointed auditors are provided support and clear guidelines regarding their duties with the peer
auditing process.
As a self-regulating professional, contributing to the work of the College of Licensed Practical
Nurses of Manitoba (CLPNM) offers opportunities for LPNs to continue to meet their practice
standards in addition to offering a resume-building opportunity.
The CCP audit occurs in three phases every year from January to April. Auditors spend 1 to 3 days
auditing during each phase. CCP auditors are compensated for time spent auditing.
If you are interested in serving as a CCP auditor, please submit your resume to:
The College of Licensed Practical Nurses of Manitoba
463 St. Anne’s Road
Winnipeg, MB R2M 3C9
Or by email at [email protected]
For further information, please contact the CLPNM at (204) 663-1212.
Practical Nursing | July 2015 | College of Licensed Practical Nurses of Manitoba
19
2014 CONTINUING COMPETENCE
PROGRAM AUDIT REPORT
The mission of the College of Licensed Practical Nurses of Manitoba (CLPNM) is to
protect and serve Manitobans through effective, transparent, objective, and supportive
nursing regulation. As professionalism is a core value of the CLPNM, providing nursing
regulation that supports individual nurses to continuously improve their skills,
knowledge, and expertise is of upmost importance, so that licensed practical nurses
(LPNs) may offer the highest quality and exemplary professional service to Manitobans.
In accordance with The Licensed Practical Nurses Act (The Act), ongoing participation in
the Continuing Competence Program (CCP) for all LPNs is a mandatory expectation of
active practicing registration. Licensed practical nurses understand that comprehensive
and active participation in the CCP by all LPNs contributes directly to the CLPNM’s
mandate of public protection and to the delivery of safe, competent and ethical care to
their clients.
The CLPNM’s materials to be utilized
for CCP participation may be found on
the CLPNM website at www.clpnm.ca.
To learn the specific documentation
that is to be submitted when selected
to participate in the CCP audit, please
see the CCP Instruction Guide and/
or attend a CCP Information Session
offered at the CLPNM in-person or via
teleconference. Information regarding
these resources may be found on the
CLPNM website.
CCP Audit
The CCP consists of five (5) components that form a system of assessing the
ongoing knowledge, skills and judgment of a professional practitioner. These
components consist of:
1. Practice hours: LPNs must meet a minimum requirement of hours practised
in a four-year period.
2. Self-assessment: LPNs must formally assess their knowledge, skills and
judgment, and learn to identify gaps and possible areas for further learning.
3. Learning plan: LPNs must create a formal learning plan every year, which
outlines their learning goals, the relevance of those goals to their current or
expected area(s) of practice, the means they have undertaken (or will take,
for the current year) to meet those goals, and the impact of that learning on
their practice.
4. Profession portfolio: LPNs must possess, maintain, and update a portfolio
with professional education materials gathered in the course of educational
goals; this portfolio is to serve as an easy place to refer back to as a
refresher, or as a compilation of materials for current study, and serves as
evidence of education acquired.
5. Audit: LPNs must work with the CLPNM from time to time to ensure
compliance with the practice of the CCP in an effective, relevant, and useful
way that directly contributes to public protection.
One of the five (5) components that
form the CCP is the annual CCP audit.
Each year the CLPNM is required to
conduct an audit of CCP practice on
randomly-selected active practicing
registrants in order to verify
compliance and the quality of CCP
practice. Licensed practical nurses
in Manitoba are well aware that
the first four (4) components of the
CCP are continuous and mandatory
components of CCP practice. The
fifth component, the CCP audit, is a
mandatory component for the LPN to
participate in only when selected to
do so by the CLPNM.
In accordance with CLPNM policy,
registrants selected for the CCP audit
who have met all other requirements
for registration renewal shall be
subject to a conditional license.
The audited individual’s ability to
practice fully as an LPN will not be
hampered by the condition. Upon
successful completion of the audit,
the condition is then removed. As
20
Practical Nursing | July 2015 | College of Licensed Practical Nurses of Manitoba
ongoing compliance with the CCP is
a requirement of active practicing
registration, once verified by way of
the audit, the CLPNM can ascertain
that the LPN has met all registration
requirements. Further, the condition
is an indicator to employers that they
are participating in the CCP audit.
During the auditing process, the
LPN CCP auditing team will assess
submitted CCP documentation to
see if it complies with the expected
standards. The auditors may direct
registrants to submit further
documentation and/or to attend
specific CCP education prior to being
able to determine that the registrant
has successfully met the requirements
of the CCP.
When it can be determined through
the audit process that the registrant
has successfully met the requirements
of the CCP, the conditional registration
status may be removed, and the
CLPNM notifies the registrant.
Verification of Hours
Stated in Regulation 26 (1), to satisfy
the requirement of continuing
competence and for ongoing
registration, registrants must have
practiced a minimum of one thousand
(1000) hours in the four (4) years
immediately preceding the year for
which renewal is sought.
Out of the randomly selected
registrants chosen for the 2014
audit, fifteen percent (15%) of those
registrants (also randomly selected)
were required to submit a verification
of hours. The registrant forwarded a
CLPNM verification of hours form to all
of their previous and current nursing
employers from the past four (4) years
to verify that they had practiced a
minimum of one thousand (1000)
hours over that period of time.
Verification of hours for CCP audit
2014
Total number selected to participate
47
Number resigned
2
Cancelled on Dec. 15, 2014 for non-renewal
4
Total number required to participate
41
Total number submitted
*41
*The CLPNM has determined that all verifications met the minimum practice hour
requirement for active practicing registration, and were submitted within the registration
renewal deadline.
The CCP Audit Process
The CCP Committee appointed twelve
(12) active practicing LPNs in good
standing, and from various practice
areas, as CCP auditors to conduct the
2014 CCP audit. Eight (8) LPNs were
appointed to conduct the audit while
four (4) were appointed as alternates.
Auditors worked in groups of two
(2) ensuring that each audit was
independently evaluated by two (2)
separate individuals.
During the audit, the auditors looked
for all of the required components
and reviewed the learning plans
for completeness, evidence of
interventions, and for evidence of
knowledge gained. Through audit
processes, the auditors had the
ability to provide registrants with
peer feedback in relation to their CCP
content.
In order to provide LPNs with multiple
opportunities to succeed in the audit,
the annual CCP audit took place over
three (3) phases. CCP audit phase
one (1) took place in January 2015,
phase two (2) took place in February
2015 and phase three (3) took place
at the end of April 2015. After each
of the audit phases were completed,
registrants were notified. Those
registrants who successfully passed
through any one (1) phase of the audit
had the audit condition removed from
their registration. This was immediately
reflected via the CLPNM public register
and the employer verification system,
both available on the CLPNM website at
www.clpnm.ca.
To ensure consistency and objectivity,
the auditors were provided an
evaluation tool to use in order to
independently review each registrant’s
CCP materials. The tool was applied
as a guideline in which to assess
whether each learning plan contained
the mandatory components of the
CCP. Once an audit was evaluated, the
auditors then determined the results
of each individual audit. If it was
determined that the registrant had not
successfully met the requirements of
the CCP, the auditors completed an
audit direction form, which outlined
what follow-up actions were required
before the auditors could consider the
registrant to have met the requirements.
Any registrant who completed the entire
audit process, and whose CCP did not
meet audit requirements were deemed
to no longer meet the requirements
for registration as an active practicing
LPN in Manitoba. This resulted in the
involvement of the CLPNM Executive
Director, who provided the registrant
with further direction.
21
Practical Nursing | July 2015 | College of Licensed Practical Nurses of Manitoba
The 2014 CCP Audit
There were 328 active practicing LPNs
randomly selected to participate in
the 2014 CCP audit. Out of the 328
selected, *21 resigned their active
practicing registration, and 9 were
cancelled on December 15, 2014 for
non-renewal as per Regulation. **As
determined by the Executive director,
1 met the criteria for exemption
from participating in the 2014 audit.
The remaining 1 had voluntarily
surrendered their registration in
September 2014. This left a total of
296 active practicing registrants who
were required to participate in Phase
One (1) of the 2014 audit; of which 20
were independent practicing. Phase
one occurred in January 2015.
CCP Audit
2014
Total number selected to participate
328
Resigned
*21
Cancelled on Dec. 15, 2014 for non-renewal
Exempted
Voluntary surrender
Total number required to participate in the audit
9
**1
1
296
*21 resigned their active practicing registration during the 2015 registration renewal
period and up to the commencement of audit Phase One (1) on January 20, 2015.
2014 CCP Audit Phase One (1):
The 2014 CCP Audit Phase One (1) results
were divided into two (2) categories:
1. Successfully met CCP requirements –
These registrants received a letter from
the Practice Department via email and
regular mail, per their address on file at
the CLPNM, conveying the successful
completion of their audit.
2. Have not met CCP requirements –
These registrants received a letter from
the Executive Director via registered
mail, per their contact information on file
at the CLPNM. Along with the letter, the
registrant received a photocopy of the
auditor’s evaluation tools that outlined
their findings, and a copy of an auditor
direction form that outlined what followup information was required before the
auditors could consider the registrant
to have met the requirements. This
correspondence also informed registrants
of the timeframe in which to submit this
follow-up information, and reminded
registrants that the CCP was a mandatory
component of ongoing licensure and as
such required their participation. The
CLPNM also sent email notification, per
their address on file at the CLPNM, of the
incoming time sensitive registered mail.
Audit Phase 1 (January 20 – 22, 2015)
Total number required to participate in the audit
Number of independent practice (IP) audits
2014
296
20
Total number who met requirements
128 (43%)
Number of IP who met requirements
10
Total number who did not meet requirements
168 (57%)
Number of IP who did not meet requirements
10
Audit Phase One (1) was completed by 8 LPN auditors.
22
Practical Nursing | July 2015 | College of Licensed Practical Nurses of Manitoba
2014 CCP Audit Phase Two (2):
The 2014 CCP Audit Phase Two (2) results
were divided into two (2) categories:
1. Successfully met CCP requirements –
These registrants received a letter from
the Practice Department via email and
regular mail, per their address on file at
the CLPNM, conveying the successful
completion of their audit.
2. Have not met CCP requirements – These
registrants were notified in the same
manner with the same content as after
the first audit phase, but were also
informed of a mandatory CCP education
requirement. Prior to the CLPNM
accepting the follow-up information as
directed by the auditors, registrants were
informed of the timeframe in which to
attend a CCP information session and then
submit their additional documentation.
Audit Phase 2 (February 24 – 25, 2015)
2014
Total number required to participate in phase 2
168
Total number audited
*162
Number of IP audits
10
Total number who met requirements
133 (82%)
Number of IP who met requirements
7
Total number who did not meet requirements
29 (18%)
Number of IP who did not meet requirements
3
*1 registrant resigned, 1 was a former member, 2 were exempt, and 2 were cancelled for
non-compliance.
Audit Phase Two (2) was completed by 6 LPN auditors.
2014 CCP Audit Phase Three (3):
The 2014 CCP Audit Phase Three (3) results
were divided into two (2) categories:
1. Successfully met CCP requirements –
These registrants received a letter from
the Practice Department via email and
regular mail, per their address on file at
the CLPNM, conveying the successful
completion of their audit.
2. Have not met CCP requirements – These
registrants were notified in the same
manner with the same content as after
the first audit phase, but were also
informed of the requirement to contact
the CLPNM Practice Department in order
to schedule a mandatory one-on-one
consultation with a practice consultant.
Prior to the CLPNM accepting the
follow-up information as directed by the
auditors, registrants were informed of
the timeframe in which to contact the
Practice Department in order to schedule
a mutually agreeable time for the
consultation, which would subsequently
require the registrant to submit their
follow-up information and/or meet other
actions per the direction of the CLPNM.
Audit Phase 3 (April 22, 2015)
2014
Total number required to participate in phase 3
29
Total number audited
*26
Number of IP audits
Total number who met requirements
Total number of IP who met requirements
3
25 (96%)
2
Total number who did not meet requirements
1 (4%)
Number of IP who did not meet requirements
1
*1 registrant resigned, and 2 were cancelled due to CCP non-compliance.
Audit Phase Three (3) was completed by 2 LPN auditors.
Practical Nursing | July 2015 | College of Licensed Practical Nurses of Manitoba
23
2014 CCP Audit Final Outcome:
Conclusion
The final results, after completion of the third and final audit phase for the 2014
Continuing Competence Program audit concludes:
Continuing one’s professional
development contributes
to safeguarding the public,
the employer, the profession
and themselves. Engaging
in professional growth and
development can deliver a greater
appreciation of the implications
and impacts of a nurse’s practice.
Registrant compliance with the
CCP can lead to increased public
confidence in the individual LPN
providing their care, and to the
profession as a whole.
2014 CCP Audit
January to April 2015
Total number required to participate in the audit
296
Number of independent practice (IP) audits
20
Total number who met requirements
295 (99.6%)
Number of IP who met requirements
19
Total number who did not meet requirements
1 (0.4%)
Number of IP who did not meet requirements
1
2013 and 2014 CCP Audit Outcome Comparison
The table below outlines a summarized comparison of the 2014 CCP audit outcomes
with the 2013 CCP audit outcomes.
2014 CCP Audit
2014
2013
Total number selected to participate
328
308
Resigned
24
20
Cancelled on December 15 for non-renewal
9
6
Exempt
3
3
Voluntary surrender
1
0
Cancelled for CCP non-compliance
4
1
Number of independent practice (IP) audits completed
20
22
296
282
Audit Phase 1 MET
128 (43%)
158 (56%)
Audit Phase 1 NOT MET
168 (57%)
124 (44%)
162
122
133 (82%)
93 (76%)
29 (18%)
29 (24%)
26
27
25 (96%)
26 (96%)
1 (4%)
1 (4%)
Total number audited in Phase 1
Total number audited in Phase 2
Audit Phase 2 MET
Audit Phase 2 NOT MET
Total number audited in Phase 3
Audit Phase 3 MET
Audit Phase 3 NOT MET
Out of the 296 licensed practical
nurses who participated in the
2014 CCP audit, 295 met the
requirements and have had the
CCP audit condition removed
from their 2015 active practicing
registration. As evidenced by
the 2014 CCP audit, the CLPNM
and its registrants embrace
the importance of ongoing
professional growth and
development for the maintenance
of safe and competent nursing
practice.
24
Practical Nursing | July 2015 | College of Licensed Practical Nurses of Manitoba
HAVE YOU BEEN ACCEPTED INTO A
PRACTICAL NURSING PROGRAM IN
MANITOBA?
Have you or someone you know
recently been accepted into a practical
nursing program in Manitoba?
Congratulations on taking your first
steps into the wonderful world of
nursing! Did you know that students
who are enrolled either full-time
or part-time in a practical nursing
program in Manitoba are required to
register with the College of Licensed
Practical Nurses of Manitoba (CLPNM)?
Programs that you may have registered
in, which require you to have a student
registration with the CLPNM include:
• The Diploma in Practical Nursing (DPN)
Program
• The Practical Nursing Qualification
Recognition (PNQR) Pilot Program
• The Practical Nursing Refresher (PNR)
Program
How do I apply to the student practical
nurse register?
A CLPNM representative may attend
your school’s orientation session and
provide a presentation about the
CLPNM; at this time, you will receive a
student register application form. If you
are not at the session, you can contact
CLPNM for the information.
From your first day of classes you have
four (4) weeks to apply to the student
register. In order for your application to
be considered complete, you will need
to submit the following documents (and
fee) with your application form:
• A Criminal Record Check (CRC) for
Vulnerable Sector Search
• A Child Abuse Registry Check (CARC)
• An Adult Abuse Registry Check (AARC)
• Payment of $52.50 by Visa,
MasterCard, Debit or Money Order
(cash and cheques are not accepted)
The CLPNM will accept original copies or
notarized copies of the above required
documents. (All notarized copies
must be notarized by a Notary Public.)
Once the CLPNM has received these
documents you will not need to submit
them to the CLPNM again unless you are
otherwise notified.
Please be aware that even if you have
submitted these documents to your
school, it does not mean that they
have automatically been forwarded to
the CLPNM. It is your responsibility to
ensure that we have received these
documents by the deadline.
How long does my student practical
nurse registration last?
Your student registration is valid for
a maximum of twelve (12) months. If
the nursing program you are taking is
longer than twelve (12) months (i.e. the
DPN program), you must remember to
renew your student registration. To see
if you are currently registered, you can
search the CLPNM website at https://
clpnm.alinityapp.com/WebClient/
registrantdirectory.aspx.
What happens to my student
registration if I withdraw from my
nursing program?
If you withdraw from your nursing
program voluntarily, or if you are
unsuccessful, you change cohorts, or
you transfer schools (including changing
campuses within the same school), your
student registration is automatically
cancelled. Please note: if you decide to
re-join a program, you must re-apply for
student registration even if it is within
the same twelve (12) month period.
What is important to know about my
student registration?
According to The Licensed Practical
Nurses Act (The ACT), 2001, all students
taking a practical nursing program in
Manitoba are required to have their
name on the student register. Whether
you are currently taking courses in class
or out on clinical practice, you must be
on CLPNM’s student register.
CLPNM requires the following
information for you to be listed on the
student register:
• Name
• Address
• Email address
• School you are attending
• Student number
• If you are a full time or part time
student
Practical Nursing | July 2015 | College of Licensed Practical Nurses of Manitoba
As the CLPNM regularly communicates
with students through email (i.e.
sending renewal reminders), it is
your responsibility to update CLPNM
with changes to any of the above
information.
How do I know if I am on the student
register?
Once all of your documents and
payment have been submitted and
approved by the CLPNM, you will
be sent a confirmation email. The
email will also contain information
on how to access your online receipt,
and how to view your registration
on the CLPNM website. CLPNM no
longer hands out paper registrations/
registration cards. Confirmation of
registration is now on our public
register at: https://clpnm.alinityapp.
com/WebClient/registrantdirectory.
aspx.
What happens if I apply late?
You are considered late if the
following documents (and fee) have
not been received and approved by
the CLPNM within four (4) weeks of
the start of your program:
• A completed application form
• A Criminal Record Check (CRC) for
Vulnerable Sector Search
• A Child Abuse Registry Check (CARC)
• An Adult Abuse Registry Check
(AARC)
• The fee of $52.50
If you are late in applying to the
student register you must pay a late
fee of $52.50 in addition to your
student application fee of $52.50 for
a total of $105.00.
Depending on how late your
application is, you may also have to
undergo a registration assessment
by CLPNM’s Executive Director. (This
assessment also includes a fee of
$78.75, which must be paid prior to
the registration assessment.)
If you have failed to register as a student
prior to participating in your clinical
practicum, you are not able to sign SPN
after your name when you are charting.
Only those who are on the student
register are able to sign a chart with the
SPN designation.
What happens if I do not apply at all?
Ultimately, if you do not apply to the
student register, your ability to apply
for graduate practical nurse (GPN)
registration will be impacted. You
will be expected to apply and pay for
all registration fees for your student
registration, including late fees, and
you will have to undergo a registration
assessment by the CLPNM’s Executive
Director (at your own cost) prior to being
eligible to apply for GPN registration.
As you must have your GPN registration
before you begin working in Manitoba,
this will impact how quickly you can
begin working after you finish your
practical nursing program. Also, you are
required to have your GPN registration
in order to write the Canadian Practical
Nurse Registration Exam (CPNRE);
therefore, your ability to write the exam
on time may be impacted.
Are you or someone you know getting
ready to start the second year of a
practical nursing program in Manitoba?
Congratulations! You have made it
through your first year as a practical
nursing student. I am sure that your
head must be spinning by now with all
of the new nursing knowledge you have
acquired; therefore, as a courtesy from
the CLPNM, students who are enrolled
either full-time or part-time in a practical
nursing program in Manitoba will receive
an email reminder to renew their student
registration.
How do I know if I have to renew?
Student registrations are only valid for
a total of twelve (12) months. If you are
starting your second year of the DPN
program, or if you are continuing your
PNR program beyond twelve (12) months,
you are required to renew your student
registration.
25
Approximately two (2) months
before your student license expires
you will receive an email from the
CLPNM with instructions on how to
renew your student registration. It is
important that you keep your email
address up-to-date with us to ensure
you receive your notification.
How do I renew?
Student renewals are now completed
online on the CLPNM’s website: www.
clpnm.ca; you will not receive a paper
copy of the renewal form. You must
complete your registration renewal
before your student registration
expires, which includes paying the
renewal fee of $52.50.
If you have already submitted your
Criminal Record Check (CRC) for
Vulnerable Sector Search, Child
Abuse Registry Check (CARC) and
Adult Abuse Registry Check (AARC)
you do not need to resubmit these
documents unless you have been
advised to do so by the CLPNM.
Once you have submitted all of the
requirements for student registration
renewal, you will receive an email
from the CLPNM approving your
registration.
What happens if I am late or do not
renew?
Registering late (after your first year
student registration expires) means
that you are in school without a
student license. You will need to
complete your application form
online and pay a late fee of $52.50
(for a total of $105.00).
You may also be subject to an
assessment by the CLPNM’s Executive
Director, which includes payment
of an assessment fee of $78.75.
If you do not renew your license,
your ability to apply for your GPN
registration may be impacted, as well
as beginning to work and to write the
CPNRE.
26
Practical Nursing | July 2015 | College of Licensed Practical Nurses of Manitoba