I-8, r. 3 - Regulation respecting certain professional activities which may be engaged in by nursing assistants

Updated to 24 March 2016

This document has official status.

chapter I-8, r. 3

Regulation respecting certain professional activities which may be engaged in by nursing assistants

Nurses Act

(chapter I-8, s. 3).

Professional Code

(chapter C-26, s. 94).

DIVISION I GENERAL

1. The purpose of this Regulation is to determine which of the professional activities that may be performed by nurses may, following the issue of a prescription and in accordance with the other terms and conditions set out herein, be performed by:

(1)  nursing assistants;

(2)  students registered in a program of study leading to a diploma qualifying them for a permit issued by the Ordre des infirmières et infirmiers auxiliaires du Québec;

(3)  persons eligible by equivalence, that is, persons registered in a program of studies or a period of additional training required for purpose of obtaining training equivalence for the issue of a permit by the Ordre des infirmières et infirmiers auxiliaires du Québec;

(4)  candidates for the profession of nursing assistant, that is, persons who have successfully completed a program of studies leading to a diploma giving access to the permit of the Order or to whom the Order have granted a diploma equivalence or a training equivalence for purposes of issuing such a permit.

O.C. 418-2008, s. 1; O.C. 134-2016, s. 1.

DIVISION II MAINTENANCE CARE OF A TRACHEOSTOMY CONNECTED TO A VENTILATOR

2. Nursing assistants may perform the following professional activities:

(1)  provide maintenance care of a tracheostomy connected to a ventilator, when the parameters of the ventilator are regulated;

(2)  open a device incorporated into the ventilation circuit in order to administer a metered-dose inhaler;

(3)  ventilate using a manual, self-inflating resuscitator, whether connected to an oxygen source or not;

(4)  reinstall the tracheal cannula in case of decannulation, in emergency situations, and in the absence of an authorized professional available to perform an immediate intervention.

O.C. 418-2008, s. 2.

3. In order to perform the professional activities set out in section 2, nursing assistants must meet the following conditions:

(1)  they must hold an attestation issued by the Ordre des infirmières et infirmiers auxiliaires du Québec, certifying that:

(a)  they have completed at least 7 hours of theoretical and practical training organized by the Order, in application of subparagraph j of the first paragraph of section 86 of the Professional Code (chapter C-26), and which covers the following aspects:

i.  anatomy of the respiratory system;

ii.  complications and limitations associated with maintenance care of a tracheostomy connected to a ventilator;

iii.  techniques related to maintenance care of a tracheostomy connected to a ventilator;

iv.  the operation of a device incorporated into the ventilation circuit;

(b)  they have successfully performed each of the professional activities set out in paragraphs 1 to 3 of section 2 at least 3 times under the immediate supervision of a nurse or respiratory therapist, and such supervision has been recorded on a form bearing the date, location, as well as the name and signature of the nurse or respiratory therapist who has supervised them;

(2)  they must perform these professional activities in one of the following centres, operated by an institution within the meaning of the Act respecting health services and social services (chapter S-4.2) or the Act respecting health services and social services for Cree Native persons (chapter S-5):

(a)  a residential and long-term care centre;

(b)  a hospital centre, when the patient is in rehabilitation, lodging or long-term care;

(c)  a rehabilitation centre for persons with physical disabilities;

(3)  a nurse must be available on the premises, so that the latter may intervene with the patient quickly;

(4)  the user falls under a therapeutic nursing plan and his state of health is not in a critical or acute phase.

Provided the conditions set out in subparagraphs 2 to 4 of the first paragraph have been met, nursing assistants may, as part of the training set out in subparagraph b of subparagraph 1 of that paragraph, perform the professional activities set out in section 2 under the immediate supervision of a nurse or respiratory therapist.

O.C. 418-2008, s. 3.

DIVISION III ASSISTANCE WITH THE ADMINISTRATION OF INTRAVENOUS THERAPY

4. Nursing assistants may perform the following professional activities:

(1)  install a short peripheral intravenous catheter, measuring less than 7.5 cm;

(2)  administer an intravenous solution without additives using a short peripheral intravenous catheter measuring less than 7.5 cm;

(3)  install and irrigate a short intermittent injection intravenous catheter, measuring less than 7.5 cm, with an isotonic solution.

O.C. 418-2008, s. 4.

5. In order to perform the professional activities set out in section 4, nursing assistants must meet the following conditions:

(1)  they must hold an attestation issued by the Ordre des infirmières et infirmiers auxiliaires du Québec, certifying that:

(a)  they have successfully completed at least 21 h of theoretical and practical training organized by the Order, in application of subparagraph j of the first paragraph of section 86 of the Professional Code (chapter C-26), covering the following aspects:

i.  anatomy of the vascular system;

ii.  short peripheral intravenous catheter installation techniques;

iii.  administration of an intravenous solution without additives;

iv.  installation and irrigation of a short intermittent injection peripheral intravenous catheter;

v.  complications and limitations associated with the installation and irrigation of a short peripheral intravenous catheter;

vi.  complications and limitations associated with the administration of an intravenous solution without additives;

vii.  preventing infections related to the use of a short peripheral intravenous catheter;

(b)  they must have successfully performed each of these professional activities at least 3 times under the immediate supervision of a nurse, and such supervision must have been recorded on a form bearing the date, location, as well as the name and signature of the nurse who has supervised them;

(2)  these professional activities have been performed in a centre operated by an institution within the meaning of the Act respecting health services and social services (chapter S-4.2) or the Act respecting health services and social services for Cree Native persons (chapter S-5), except for the fields of pediatrics and neonatology;

(3)  the patient falls under a therapeutic nursing plan.

Provided that the conditions set out in subparagraphs 2 and 3 of the first paragraph have been met, nursing assistants may, as part of the training set out in subparagraph b of subparagraph 1 of that paragraph, perform the professional activities set out in section 4.

Subparagraph 1 of the first paragraph does not apply to nursing assistants:

(1)  who have completed the training set out therein as part of a program of study leading to a diploma qualifying them for a permit issued by the Ordre des infirmières et infirmiers auxiliaires du Québec;

(2)  who have been granted diploma or training equivalence by the Ordre des infirmières et infirmiers auxiliaires du Québec after the training set out in subparagraph 1 of the first paragraph has been incorporated into the program of study leading to a diploma qualifying them for a permit issued by the Order.

O.C. 418-2008, s. 5.

6. Nursing assistants may also perform the following professional activities:

(1)  check intravenous infusions and maintain the flow rate;

(2)  remove intravenous infusions if administered with a peripheral intravenous catheter measuring less than 7.5 cm;

(3)  remove a peripheral intravenous catheter measuring less than 7.5 cm.

In order to perform these professional activities, nursing assistants must meet the following conditions:

(1)  these professional activities are performed in a pediatric unit in a centre operated by an institution within the meaning of the Act respecting health services and social services (chapter S-4.2) or the Act respecting health services and social services for Cree Native persons (chapter S-5);

(2)  the patient falls under a therapeutic nursing plan.

O.C. 418-2008, s. 6.

7. Students registered in a program of study leading to a diploma qualifying them for a permit issued by the Ordre des infirmières et infirmiers auxiliaires du Québec may perform the professional activities set out in section 4 if they meet the conditions set out in subparagraphs 2 and 3 of the first paragraph of section 5, and to the extent that the performance of such activities is required in order for them to complete this program.

These students may also perform the professional activities set out in section 6 if they meet the conditions set out therein and to the extent that the performance of such activities is required in order for them to complete their programs.

O.C. 418-2008, s. 7.

8. Persons eligible by equivalence may perform the professional activities set out in section 4 if they meet the conditions set out in subparagraphs 2 and 3 of the first paragraph of section 5, and to the extent that the performance of such activities is required in order to obtain training equivalence.

Such persons may also perform the professional activities set out in section 6 if they meet the conditions set out therein and to the extent that the performance of such activities is required in order to obtain training equivalence.

O.C. 418-2008, s. 8.

8.1. Candidates for the profession of nursing assistant may perform the professional activities listed in section 4 if they meet the following conditions:

(1)  these professional activities are performed in a centre operated by a public or private institution under agreement within the meaning of the Act respecting health services and social services (chapter S-4.2) or the Act respecting health services and social services for Cree Native persons (chapter S-5), except in pediatrics or neonatology;

(2)  they perform these professionals activities under the supervision of a nurse or of a nursing assistant authorized to perform these activities who is present in the care unit concerned;

(3)  when the supervision is performed by a nursing assistant, a nurse is present in the care unit or in the building in the case of a long term care unit, in order to intervene with the patient rapidly or to respond rapidly to the candidate’s request;

(4)  the patient falls under a therapeutic nursing plan.

O.C. 134-2016, s. 2.

9. Nursing assistants who performed the professional activities set out in the first paragraph of section 6 before 29 May 2008 may continue to do so provided the following conditions have been met:

(1)  these professional activities are performed in a centre operated by an institution within the meaning of the Act respecting health services and social services (chapter S-4.2) or the Act respecting health services and social services for Cree Native persons (chapter S-5);

(2)  the patient falls under a therapeutic nursing plan.

This section will cease to be in effect on 29 May 2016.

O.C. 418-2008, s. 9; O.C. 266-2011, s. 1; O.C. 436-2013, s. 1.

DIVISION IV FINAL

10. This Regulation replaces the Regulation respecting certain professional activities which may be engaged in by nursing assistants (O.C. 630-2007, 07-08-07).

O.C. 418-2008, s. 10.

11. (Omitted).

O.C. 418-2008, s. 11.

REFERENCES

O.C. 418-2008, 2008 G.O. 2, 1318

O.C. 66-2011, 2011 G.O. 2, 893

O.C. 436-2013, 2013 G.O. 2, 1102

O.C. 134-2016, 2016 G. O. 2, 1281