ESPCN Policies & Procedures
What Are Restricted Activities?
Restricted Activities are defined as high-risk activities that are part of providing a health service that require specific competencies and skills to be carried out safely and are listed in the Health Professions Act (2000) and the Health Professions Restricted Activity Regulation (Alta Red 22/2023, s60). Restricted activities are not linked to any particular health profession, and a number of regulated health practitioners may perform them. (College of Registered Nurses of Alberta [CRNA], 2022a).
The College of Registered Nurses of Alberta sets the standards for the performance of restricted activities for Registered Nurses (RN) and Nurse Practitioners (NP) (CRNA, 2022a; CRNA 2022b). RN/NPs should consider incorporating a restricted activity into their practice based on the needs of their clients, the need to support continuity of care, and the support of their employer, not on the desire for the convenience of any health care professional (CRNA, 2022b, p. 5). A Decision-Making Framework is available to nurses to guide the incorporation of a restricted activity into their practice (CRNA, 2022b, p. 9).
When nurses perform restricted activities, they are responsible and accountable for their own practice. RNs will still require orders for any aspect of care that is out of scope of their practice. For example, if an RN is providing an injection, the ESPCN policy and procedure will guide the performance of an injection; however, the RN would need an order for the medication being administered (prescribing it is not within the scope of the RN). If an NP is providing an injection, the NP can prescribe the medication being administered and use the ESPCN policy and procedure to guide the performance of the procedure.
ESPCN RNs and NPs are required to complete a competency pathway, including policy/procedure review, readings, and written and/or practical tests for each restricted activity they perform in practice. Clinic teams are encouraged to have discussions about roles and responsibilities related to restrictive activities. Collaboration with the Most Responsible Provider is indicated in policies and procedures. This may include the need for a patient-specific order for a medication, a medical diagnosis, responsibility for follow-up on abnormal results, or referral to the physician/NP for the completion of the activity, as the patient is outside the conditions set within the policy and procedure.
References:
- CRNA. (2022a). Restricted Activities Standards. Author: Alberta. Retrieved from restricted-activities-standards-2022.pdf
- CRNA. (2022b). Incorporating a Restricted Activity into Practice Guidelines. Author. Retrieved from 29-incorporating-a-restricted-activity-into-practice-guidelines-2022.pdf
- Province of Alberta. (2023). Health Professions Act: Health Professions Restricted Activity Regulation. Alberta Kings Printer.