GAIL TOMBLIN MURPHY, STEPHEN BIRCH, ADRIAN MACKENZIE, … · 2017-09-05 · [1] HEALTHCARE POLICY...

[1] HEALTHCARE POLICY Vol.13 No.1, 2017

RESEARCH PAPER

An Integrated Needs-Based Approach to Health Service and Health Workforce Planning: Applications for Pandemic Influenza

Démarche axée sur les besoins intégrés pour les services de santé et la planification de la main-d’œuvre en santé : application à une pandémie d’influenza

G A I L TOM BL I N MUR PH Y, S TE PH E N BI RC H , ADR I A N M AC K E N Z I E , JA NE T R IGBY A ND J OA N NE L A N GL EY

Appendix 3. Mapping of professional core competencies and advanced/specialized competencies

Nova ScotiaMapping of professional core (entry-level) and specialized competencies

Legend:1 = core competency of provider group; primary care paramedic2 = skill set obtained in addition to essential competencies (e.g., additional certifications for specific areas); intermediate care paramedic3 = advanced training/education required (e.g., critical care nursing); advanced care paramedic4 = competency requires advanced level of education/specialty (e.g., NP; infectious disease physician, public health); critical care paramedic^ = requires external advice to professional groups to supplement competency of provider group* = these skills will be implemented shortly, pending legislationQ = can assist with components of competency+ = and paramedics above this leveln = see notes

Group with documentation and validated Groups with documentation/not validated to date Groups without documentation

CHR – ChiropractorDDS – DentistDH – Dental HygienistDR – PhysicianDT – DietitianLPN – Licensed Practical NurseMIRTP – Medical Imaging & Radiation Therapy ProfessionalsNP – Nurse PractitionerPHRM – PharmacistRN – Registered NurseRT – Respiratory Therapist

CCA – Continuing Care AssistantOT – Occupational TherapistPMDC – ParamedicPSY – PsychologistPT – Physiotherapist

Adm – Administrative supportEmbalm – EmbalmerLab t. – not as part of MIRTPND – Naturopathic Doctor Oth – External experts/advisors – legal, cultural, spiritual, etc.PHAR A – Pharmacy AssistantSup – Support worker (porters, food services,

housekeeping, etc.)SW – Social Worker (No data available)


Gail Tomblin Murphy et al.

Competency DR NP RN PMDC LPN PHRM RT PT OT DT CCA PSY DDS DH CHR MIRTP Tech SW Sup Adm ND Oth Notes

Infection control and occupational health and safety

1 Implement a site-/area-specific surveillance program for influenza and influenza-like illness (coordinate data collection, summarize outbreak progression, submit report to care site officials and/or Public Health officials)

4 2 – – – 4 – – – – – – 4 – – – – – – – – – PHRM: There are some PHRMs who have advanced pharmacy degrees who may have these skills

2 Advise healthcare providers (in hospital or community settings) regarding appropriate patient placement to minimize/prevent infectious disease transmission (Regulated)

4 1 – 3+ – 4 – – – – – – 4 – – – – – – – PHRM: Same as #1

3 Administer influenza immunization to staff (Regulated)

1 1 1 2+ 1 2 2 2* – – – – 1 2 – 2 – – – – PHRM: Regulations recently passed that authorize PHRM with injection permits to administer drugs via injection, including immunizations. Most PHRMs have these permits.

4 Monitor staff for adverse events (e.g., anaphylaxis) associated with immunization and report

1 1 1 2+ 1 2 1 2* – – – – 1 2 1 1 – – – – PHRM: Same as #3

5 Manage adverse events associated with immunization (Regulated)

1 1 1 2+ 1 2 1 2* – – – – 1 2 1 1 – – – – PHRM: Same as #3

6 Screen staff for illness 1 1 1 1+ – – – – – ^ 2 1 1

7 Screen for eligibility for antiviral treatment/prophylaxis

1 1 1 1+ 3 1 – – – – ^ 2 2 PHRM: Based on protocol; LPNs: This is a Beyond Entry Level Competency (BELC) and the LPN can engage in context

8 Administer antiviral prophylaxis to staff 1 1 1 2+ 1 1 2 2* – – – – 1 2 – 2 – – – – RT: learn but need refresher

9 Monitor staff for adverse events (such as an allergic reaction) associated with prophylaxis and report

1 1 1 2+ 1 1 1 2* – – – – 1 2 – 1 – – – –

10 Manage adverse events associated with prophylaxis 1 1 1 2+ 1 1 1 2* – – – – 1 2 – 1 – – – –

11 Identify staff who, because of illness or burnout, need assistance, rest or other support

1 1 1 1+ 1 1 1 1 1 – – 1 ^ 2 – – – – 1 1 PHRM: requires psych assess which is not within the scope of practice for PHRMs

12 Provide psychosocial support for staff 1 1 1 1+ 1 – 1 1 1 * – 1 ^ – 1 – – – – 1 PHRM: requires psych assess; DT – 1 (basic)

13 Recognize the logistical support needs of staff (e.g., food, family support, pet care) and respond/staff accordingly

1 1 1 – 2 1 1 – 1 1 – ^ – 1 PHRM: Based on expert advice; LPNs: Beyond Entry Level

14 Systematically monitor absenteeism (by various causes) Q

1 1 1 1+ 2 1 1 – 2 – – 1 – 1 LPNs: Beyond Entry Level

15 Identify workplace hazards related to risks from influenza as well as influenza care (e.g., needle sticks) Q

1 1 1 1+ 1 1 1 – 1 – – 1 1 1 1 – 1 – 1 1

16 Provide on-going education and training related to workplace hazards

1 2 1 1+ 2 1 1 – 2 – – ^ 1 1 – PHRM: Based on protocol; LPNs: Beyond Entry Level




17 Rectify identified workplace hazards** 1 1 1 1+ 3 1 1 – – – ^ 1 1 – PHRM: Based on protocol; depends on what the meaning is; LPNs: This is a BELC; however, the LPNs capacity to respond would be context-dependent (meaning some of the interventions may be outside scope), but could certainly do in collaboration with RN

18 Respond to exposure incidents (e.g., needle sticks) 1 1 1 1+ 2 1 1 2 – – ^ 2 2 1 PHRM: Based on protocol; LPNs: Beyond Entry Level

19 Manage fit-testing (booking, supply, records) 2 2 2 2+ 2 2 2 2 – 2 – – – 2 2 1 PHRM: *not sure what this means but probably yes; LPNs: Beyond Entry Level

20 Perform fit-testing 2 2 2 2+ 2 2 2 – – – – – – 2 – – PHRM: *not sure what this means but probably yes; LPNs: Beyond Entry Level

21 Advise healthcare providers, patients and visitors regarding barrier precautions, hand hygiene and other measures to minimize infectious disease transmission

1 1 1 1+ 1 1 1 2 2 – Q 2 ^ 1 1 1

22 Advise on appropriate cleaning, disinfection and sterilization of medical equipment

2 2 – 3 – 1 – 2 – – – ^ 1 – 1 1 1 RT/DT?: Depends on type of equipment; LPNs: In right context with right training can do; however, is context dependent

Public healthcare for well persons

I: Immunization

23 Conduct mass immunization clinics in a community setting (Regulated)

1 1 1 2+ 1 2 2 – – – – – 1 2 – – – – – –– DH: if this means providing; PHRM: with injection permits

24 Screen for eligibility for immunization 1 1 1 1+ 1 1 1 2 – 2 – – 1 1 1 1 – – – – OT: probably be taught but not core

25 Take a medical history relevant to immunization, noting contraindications, allergies, etc. (Regulated)

1 1 1 2+ 1 2 1 2* – – – – 1 1 1 1 – – – – DH: relative to immunization

26 Obtain informed consent for immunization 1 1 1 1+ 1 2 1 1 2 1 1 1 1 1 1 1 – – – – DT: not specifically trained but could be

27 Dispense vaccine for administration (Regulated) 1 – – – – 1 – – – – – – – – – 1 – – – – As opposed to delivery; NPs can prescribe but cannot dispense; NP: in emergency situation may be able to

28 Implement measures to ensure vaccine integrity (e.g., maintenance of cold chain)

1 1 1 2+ 1 1 2 2* – – – – 1 2 – 1 – – – – DH: DHs in public health may have more training than others

29 Administer vaccine (Regulated) 1 1 1 2+ 1 2 2 2* – – – – 1 2 – 2 – – – – PHRM: Same as note for #3

30 Document vaccination according to policy and regulations 1 1 1 2+ 1 2 2 2* – – – – 1 2 – 1 – – – – PHRM: Same as note for #3

31 Recognize initial adverse events (e.g., anaphylaxis) occurring in community immunization clinics

1 1 1 2+ 1 2 1 2* – – 2 – 1 2 1 1 – – – – PHRM: Same as note for #3

32 Monitor for adverse events associated with immunization among members of the public (surveillance)

1 1 1 2+ 1 2 1 2* – – 2 – 1 2 1 1 – – – – PHRM: Same as note for #3

33 Manage adverse events associated with immunization among members of the public (Regulated)

1 1 1 2+ 1 2 1 2* – – – – 1 2* 1 1 – – – – PHRM: note re #3; DH: depends on the protocol

34 Provide psychosocial support to the public 1 1 1 – 1 – 1 1 1 1 Q 1 ^ 1 1 – – 1 – – 1 DH: depends on the degree; DT: depends on the degree




35 Provide pastoral/spiritual support/guidance to the public – – – – – – – – – – – – – – – – – – – – 1

II: Prophylaxis

36 Screen members of the public for eligibility for antiviral treatment/prophylaxis

1 1 1 1+ 1 1 1 1 2 – – – 1 1 1 1 – – – –

37 Administer antiviral prophylaxis to members of the public (Regulated)

1 1 1 2+ 1 1 2 2* – – – – 1 2 – 2 – – – –

38 Manage adverse events associated with prophylaxis among members of the public (Regulated)

1 1 1 2+ 1 1 1 2* – – – – 1 2 – 1–2 – – – –

F. Care for patients with influenza

I: Competencies across care settings

39 Conduct a screening history of the chief complaint and relevant aspects of the past medical history (e.g., current medications, co-morbidities)

1 1 1 1+ 1 1 1 – 1 1 – 1 1 1 1 1 – – – – PHRM: linked with 40

40 Triage patients according to acuity of illness and need for care and refer to appropriate care setting (primary and secondary assessment, hospital, emergency dept, non-traditional care site, community) (Regulated)

1 1 1 1+ – 1 2 1 – – – – 4 – 1 – – – – – PHRM: linked with 39

41 Develop care plan with patients/families and other healthcare providers on team

1 1 1 – 1 1 1 1 1 1 – 1 4 – 1 – – – – 1 PHRM: not sure what this means

42 Develop discharge plan with patients/families and other healthcare providers on team

1 1 1 – 1 1 1 – – – – – 4 – – – – PHRM: not sure what this means

43 Take a complete health history (Regulated) 1 1 – – – – – – – – – – 4 – 1 – – – – –

44 Perform a physical exam including a respiratory assessment (heart rate, respiratory rate, inspection, percussion, palpation, auscultation, etc.) (Regulated)

1 1 1 1+ 1 1n 1 1 – – – – 4 – – 2 – – – – PHRM: Can do some but not all

45 Order clinical diagnostic tests (e.g., X-rays or CT scans) (Regulated)

1 1 – – – – – – – – – – 4 – 1 3 – – – –

46 Perform point of care tests for laboratory (e.g., hemoglobin, electrolytes, glucose) (Regulated); NOTE: Physicians, NPs, RNs, PMDCs, LPNs, RTs can draw blood for these tests.

1 2 2 3+ 2–3 2 2 – – 1 – – 4 – 1 2 – – – – DT: do glucose only; NP: not all NPs are able to do point of care testing – depends on the environment; LPN: can be trained to perform a number of plan of care (POC) testing; however, cannot broadly interpret results (meaning make changes to POC based on the findings without the benefit of a care directive or MD orders). Can respond to unanticipated results with consultation

47 Measure temperature 1 1 1 1+ 1 1 1 1 2 1 1 – 1 1 1 1 – – – –

48 Take pulse 1 1 1 1+ 1 1 1 1 2 2 1 – 1 1 1 1 – – – –




49 Take blood pressure 1 1 1 1+ 1 1 1 1 2 2 1 – 1 1 1 1 – – – –

50 Take venous blood samples (Regulated) 1 1 1 1+ 1 – 2 – – – – – 4 – – 1 Lab t. – – –

51 Obtain nasal samples 1 1 1 – 1 1 1 – – – – – – 2 1 – Lab t. – – – PHRM: when standards of practice for testing are completed and adopted.

52 Perform nasopharyngeal wash to obtain sample (Regulated) 1 1 1 – 1 – 1 – – – – – – 1 1 – Lab t.

53 Obtain throat swabs (with tip touching posterior pharynx) (Regulated)

1 1 1 – 1 1 1 – – – – – 1 2 1 – Lab t. – – – PHRM: when standards of practice for testing are completed and adopted.

54 Obtain clinical specimens for other cultured diagnostic laboratory tests (e.g., urine, stool, wound) (Regulated)

1 1 1 – 1 – 1 – – – – – 4 – 1 – Lab t. – – –

55 Interpret the results of history, physical exam, chest X-ray and lab tests, leading to a diagnosis (Regulated)

1 1 – – – – – – – – – – 4 – 1 1 – – – – NP: cannot look at X-ray and diagnose but would read report

56 Obtain consent for medications (e.g., antiviral treatment/prophylaxis)

1 1 1 1+ 1 1 1 – – – – – 1 2 1 1 – – – – CHR: trained but generally do not focus on meds

57 Prescribe medication (including antivirals for treatment/prevention of influenza) (Regulated)

1 1 – – – 1 – – – – – – 1* – – – – – – – – DDS: *Some restrictions apply

58 Monitor for adverse events associated with treatment/prophylaxis

1 1 1 2+ 1 1 1 1 2 2 – – 1 1 1 1 – – –

59 Manage adverse events associated with treatment/prophylaxis (Regulated)

1 1 1 2+ 1 1 1 1 – – – – 1 * 1 1 – – – –

60 Admit a patient or discharge a patient to home or to another care setting (Regulated); Q: can assist with admittance

1 Q Q – – – 1 Q Q – – – 1 – – – – – – – Depends on level – actual admitting and discharge are done by doctors. However, others provide the relative info for decision; NP: depends on where they are – cannot admit/discharge patients from hospital but can from private practice

61 Recommend supports in the home for personal care/ADLs as required

1 1 1 – 1 – 1 1 1 2 – 1 1 – 1 – – – – – NP: depends on the type

62 Recommend/assist to arrange any self-care or mobility equipment required post discharge from hospital

1 1 1 – 1 – 1 1 1 2 Q – 4 – 1 – – – – RT: Patients under respiratory care – RTs do work with mobility after care-specific

63 Assist to mobilize/progress activity to recover strength and exercise tolerance

3 – – – 1 – 1 1 1 – 1 – 4 – 1 – – – – – RT: Same as 62

64 Assess the need for pressure relief equipment/ positioning as required

1 1 1 – 1 – – 1 1 – Q – 4 – 1 – – – – –

65 Order therapeutic diets (Regulated) 1 1 – – – – – – 1 – – 4 – – – – – – – DT: under new act

66 Adjust therapeutic diets (Regulated) 1 1 – – – – – – 1 – – 4 – – – – – – – DT: under new act

67 Provide pharmacy services (i.e., check prescriptions for conflicts, dispense them) (Regulated)

– – – – – 1 – – – – – – – – – – – – – – NP*: checking prescriptions for conflicts is something they do but cannot dispense

68 Prepare total parenteral nutrition (Regulated) – – – – – 1 – – – – – – – – – – PHAR A – – –




69 Identify need for palliative/end-of-life care (including withdrawal of treatment) (Regulated)

1 1 – – – – – – – – – 4 – – – – – – –

70 Pronounce cessation of life 1 2 1Q 1Q 1 – Q1 Q– – – – – – – – – – – – – Others can identify cessation of life; formal pronouncement done by Physicians, NPs, others?

71 Identify cause of death for death certificate (Regulated) 4 2 – – – – – – – – – – – – – – – – – –

72 Sign death certificate (Regulated) 4 2 – – – – – – – – – – – – – – – – – – NP: if delegated by the Chief Medical Examiner

73 Provide post-mortem care (Regulated if requires embalming)

– 1 1 1+ 1 – – – – – – – – – – – Embalm – – – Regulated if embalming is required

74 Store and manage bodies (Regulated) – – – – – – – – – – – – – – – – – 1 – 1

75 Dispose of bodies (Regulated) – – – – – – – – – – – – – – – – 1 1 – 1

II: Supportive care across settings

76 Assess nutritional and hydration needs of patient (Regulated) 1 1 1 1+ 1 – 1* – – 1 – – – – 1 – – – – – RT: specific to monitoring hydration – they monitor fluid levels

77 Perform oral feeding of patients 1 1 1 1+ 1 – – 1 1 1 1 – – – 1 – – – – –

78 Assess swallowing ability (Regulated) 1 2–3 1 1+ 1 – – – 1 1 – – ^ – 1 – – – – 1 SLPs do formal assessments; again, this depends on whether mean assessment or screening; OTs – general assessments, although some may have additional training to do fluoroscopes, barium swallowing

79 Initiate and maintain enteral feeding (Regulated) 1 1 1 – 2 – – – – * – – – – – – – – – – DT: under new act, can order but do not actually do it; LPN: Beyond EL

80 Initiate and maintain parenteral feeding (Regulated) 1 1 1 – 2 – – – – * – – – – – – – – – – DT: under new act, can order but do not actually do it; LPN: Beyond EL

81 Manage potential influenza cases identified in the community (refer for formal assessment, triage)

1 1 1 1+ – 1 1 1 – – – – ^ – 1 – – – – –

82 Educate the patient and family re: hand hygiene routine/use of PPE (e.g., masks)

1 1 1 1+ 1 1 1 1 1 1 1 – 1 1 1 1 1 – – –

83 Perform hand hygiene according to provincial policy 1 1 1 1+ 1 1 1 1 1 1 1 – 1 1 1 1 1 1 – –

84 Don and remove appropriate PPE according to provincial policy

1 1 1 1+ 1 1 1 1 1 1 1 – 1 1 1 1 1 1 – – PHRM: depends on the type of equipment

85 Keep patient area, equipment, etc., clean and disinfected 1 1 1 – 1 – 1 – – – 1 – 1 1 1 1 1 1 – –

86 Clean the patient room upon discharge of the patient according to level of sanitization required during a pandemic

– – – – – – – – – – 1 – – 2 – 1 – – 1 –

87 Provide assistance with ADLs (including personal care such as bathing and toileting) to patients

– 1 1 – 1 – – – 1 – 1 – – – – 1 – – – 1

88 Provide psychosocial support to ill patients and families 1 1 1 1+ 1 1 1 1 1 1 1 1 1 2 1 – 1 – – 1 DH: depends on degree

89 Provide pastoral/spiritual support/guidance to ill patients and families

– – – – – – – – – – – – – – – – – – – 1




90 Provide support to patients in their homes (e.g., delivery of meals, groceries, medication, care for dependents, etc.)

– 1 1 – 1 meds 1 – 1 1 1 – – – 1 1 – – – 1 RT: monitors when someone is having advanced respiratory care in the home; monitors environment and contacts appropriate people; DT: some support Re: diabetes

91 Educate patient re: self-care to promote recovery and to regain previous activity levels

1 1 1 – 1 1 1 1 1 1 1 1 1 2 1 – – – – – DH: in general sense, yes; PHRM: specific to meds

92 Educate the patient/family re: community resources available post discharge from hospital (e.g., grocery delivery services)

1 1 1 – 1 1 – 1 1 1 1 1 1 2 – – – – – 1 DH: could do depending on what is required; DH in public health would do; RT: in narrower context of respiratory care; PHRM: with respect to meds

III: Competencies within healthcare facilities

93 Provide a clinical laboratory testing service (hematology, chemistry, etc.) (Regulated)

– – – – – – – – – – – – – – – – 1 – – – – –

94 Provide diagnostic imaging services (Regulated) – – – – – – – – – – – – – – – 1 1 – – – –

95 Measure oxygen saturation (Regulated) 1 1 1 1+ 1 – 1 1 – – – – ^ – – – – – – – – –

96 Order ECG (Regulated) 1 1 2 3+ – – – – – – – – – – – – – – – – – –

97 Perform ECG (Regulated) 1 1 2 3+ 2 – 2 – – – – – – – – 1 – – – – – – LPN: Beyond EL

98 Interpret ECG (Regulated) 1 1 2 3+ – – – – – – – – – – – 2 – – – – – – NP: depending on where you work as an NP, could interpret – depends on specialty, may not go solely on one’s own interpretation

99 Perform intramuscular injections (Regulated) 1 1 1 2+ 1 2 2 – – – – – ^ – – 2 – – – – – – PHRM: Note item 3

100 Perform subcutaneous injections (Regulated) 1 1 1 1+ 1 2 1 – – – – – 1 1 – 2 – – – – – – PHRM: Note item 3

101 Start intravenous lines (Regulated) 1 1 1 2+ 1 – 1 – – – – – 4 – – 1 – – – – – – LPN: is an ELC for grads after 2012 and BELC for grads before 2012

102 Maintain intravenous lines (site/tubing) (Regulated) 1 1 1 2+ 1 – 1 – – – – – 4 – – 1 – – – – – –

103 Set up and administer oxygen via nasal prongs and mask

1 1 1 1+ 1 2n 1 1 1 – – 1 1 1 – 1 – – – – – – PHRM: could probably via protocol but not currently trained; OT: at high level (depends on what set up means); LPN: Very limited and specific contexts

104 Set up and administer oxygen via non-rebreather mask (Regulated)

1 1 1 3+ 1 – 1 – 1 – – – 1 1 – – – – – – – – OT: at high level (depends on what set up means)

105 Check oxygen administration set-ups to ensure integrity

1 1 1 1+ 1 2n 1 1 1 – – – 1 2 – 1 – – – – – – PHRM: could probably via protocol but not currently trained

106 Administer medication by inhalation (Regulated) 1 1 1 3+ 1 1 1 – – – – – 4 – – 1 – – – – – –

107 Administer medication orally (Regulated) 1 1 1 – 1 1 1 – – – – – 4 – – 1 – – – – – –

108 Manage sedation of influenza patients requiring critical care/ICU care (Regulated)

1 1* – – – – 1 – – – – – – – – – – – – – – – RN/LPN: Depends on the type – IM, regulated so put in “–”, even though there may be some instances

109 Administer medication by intravenous route (Regulated) 1 1 1 3+ 1–2 – 1 – – – – – 4 – – 1 – – – – – – LPN: is an ELC for grads after 2012 and BELC for grads before 2012




110 Administer medication by intravenous push (Regulated) 1 1 1 2+ 3* – 3 – – – – – 4 – – 1 – – – – – –

111 Perform oral suction for patients who are not intubated or trached (Regulated)

1 1 1 1+ 1 – 1 1 – – – – 4 1 – – – – – – – –

112 Perform deep suction for patients who are not intubated or trached (Regulated)

1 2 3 1+ 1* – 1 1 – – – – 4 – – – – – – – – – *if trained for ICU

113 Insert and maintain Foley catheters (Regulated) 1 1 1 4 1 – – – – – Q – 4 – – 2 – – – – – –

114 Insert an oral or nasal airway, etc., as part of basic life support techniques (Regulated)

1 1 3 1+ – – 1 – – – – – 4 – – – – – – – – –

115 Perform intubation (Regulated) 1 3 3 3+ – – 1 – – – – – 4 – – – – – – – – – NP: Depends on where you work

116 Set up ventilation, including establishment of ventilation parameters (Regulated)

1 3–4 3 3+ – – 1 – – – – – 4 – – – – – – – – –

117 Monitor ventilation (Regulated) 1 3–4 3 3+ 2–3 – 1 – – – – – 4 – – – – – – – – – LPN: Beyond EL

118 Insert a central line (Regulated) 1 3–4 – – – – – – – – – – 4 – – – – – – – – – NP: *with specific training

119 Maintain a central line (Regulated) 1 1 1 4 2 – 1 – – – – – 4 – – – – – – – – – LPN: Beyond EL

120 Insert an arterial line (Regulated) 1 3–4 – 4 – – 1 – – – – – 4 – – – – – – – – –

121 Maintain an arterial line (Regulated) 1 2–3 2–3 4 – – 1 – – – – – 4 – – – – – – – – –

122 Administer medication by continuous infusion (Regulated) 1 1 1 3+ 1–2 – 2 – – – – – 4 – – 1 – – – – – – LPN: is an ELC for grads after 2012 and BELC for grads before 2012

123 Suction intubated/ventilated patients (Regulated) 1 2* 1 2–3 2–3 – 1 1 – – – – 4 – – – – – – – – – *with specific training; LPN: Beyond EL, maybe a 3

124 Undertake advanced cardiac life support interventions (Regulated)

1 2 2 1 – – 1 – – – – – 4 – – – – – – – – – NP: Depending on where you work

125 Manage inotropes and vasopressors (Regulated) 1 2 2–3 4 – – 3 – – – – – 4 – – – – – – – – –

126 Manage insulin infusions (Regulated) 1 2 2–3 4 – – – – – – – –

127 Recommend insulin adjustments (Regulated) 1 1 Q – – 1 – – – 1 – – 4 – – – – – – – – – DT: under new act will be able to recommend (and order) – cannot order initial prescription; LPN: would be accountable to consult with appropriate healthcare provider when there are indications that current treatment plan is not working; however, they would not be responsible to recommend alternative actions

128 Perform peritoneal dialysis (Regulated) 1 2–3 2 – 2–3 – – – – – – – 4 – – – – – – – – –

129 Perform hemodialysis (Regulated) 1 2–3 2–3 – 3 – – – – – – – 4 – – – – – – – – –

130 Manage dialysis (Regulated) 1 2–3 2 – 2–3 – – – – – – – 4 – – – – – – – – –

131 Perform basic life support techniques (CPR) 1 1 1 1+ 1 1 1 1 2 2 2 2 1 1 1 1

132 Use automated external defibrillator 1 1 1 1+ 1 1 1 1 2 2 2 2 1 1 1 1

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GAIL TOMBLIN MURPHY, STEPHEN BIRCH, ADRIAN MACKENZIE, … · 2017-09-05 · [1] HEALTHCARE POLICY...

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