January 2011
January 21, 2011
Primary Care: Vision, Roles and Opportunities

Council approved a new position statement that articulates CARNA's vision for primary care. The document advocates for a deliberate strategy to: attract RNs to roles within primary care, integrate NPs in primary care networks (PCNs) and address barriers which hamper the delivery of primary care. The document reflects the variety of roles and responsibilities of the RNs/NPs who are employed in PCNs and participated in forums and teleconfererences hosted by CARNA. The main barriers identified by members were: lack of funding mechanisms that facilitate inter-professional care or support team development, a lack of understanding of RN and NP scopes of practice within primary care and a lack of dedicated infrastructure to support their role.

To review this document, click here.
Seniors and Healthy Aging: A Position Statement

Council approved a new position statement which provides guidance and support to RNs and NPs for evidence-based decision making, policy development and care planning. It outlines nine CARNA beliefs which form the foundation for evidence-based decision-making, policy development and care planning and will be useful in discussions between CARNA and government officials and other stakeholders. The document references include research evidence indicating the strong relationship between RN staffing levels and positive patient outcomes in both acute and long-term care settings.


Examples of the stated beliefs and associated key points include:

  • Seniors make a significant contribution to the richness of Canadian life and to the economy. Supporting healthy aging is a social responsibility.
    Registered nurses, individually and collectively, recognize the significance of social determinants of health and endeavor as much as possible to advocate for policies and programs that address these determinants (CNA, 2008).
  • Health system reforms are needed in community and continuing care settings.
    Specific requirements for continuing care settings should be developed in regulations under the Alberta Health Act to provide:
    • required programs in areas related to falls prevention and management, skin and wound care, continence and bowel care as well as pain management
    • direction regarding issues of personal care, bathing, oral care, foot and nail care, transferring and positioning techniques, mobility devices and end-of-life care
    • evidence-based staffing plans addressing staff mix, staff scheduling, and continuity of care provider

The document was developed through a process of consultation with members including the Alberta Gerontological Nurses Association (AGNA), a CARNA specialty practice group.

To review this document, click here.
Government Affairs Advisory Committee

Council passed a motion to disband the Government Affairs Advisory Committee (GAAC) and has asked Provincial Executive Committee to develop and present options for political action at the next meeting of council in May. In 2008, council created GAAC as an operational committee to provide strategic advice on issues. The significant changes in council's association role since GAAC was established resulted in the potential for duplication of efforts between councillors and committee members.

Continuing Competence Program Practice Visits

Council approved Competence Committee criteria for registrant selection for a Continuing Competence Program (CCP) practice visit, a competence assessment strategy included in the CCP revision recommendations approved by council in September 2010. Council's approval of the practice visit selection criteria provides direction to the committee for the development of policies and procedures necessary to implement practice visits within the CARNA CCP. Practice visits are authorized under the Health Professions Act and included in the Registered Nurses Profession Regulation. They provide health professional regulatory bodies with a mechanism to fulfill their mandate of public safety while safeguarding the confidentiality of information obtained. After five years of experience implementing and monitoring the CCP, the Competence Committee expects practice visits will be infrequent and only initiated to address practice issues of significant concern that come to their attention. For more information on the recommendations arising from the review of the CCP and approved by council, please refer to the September issue of PC Highlights.

Delegation of Approval of Nursing Refresher Education Programs

Council delegated its authority to approve nursing refresher education programs to the Nursing Education Program Approval Board (NEPAB) effective Jan. 21, 2011 and retracted its previous delegation to the Registration Committee. Nursing refresher programs are designed for former registrants who do not meet the currency of practice requirements (1,125 hours in the past 5 years). NEPAB has developed substantial expertise and experience since council delegated the authority to approve nursing education programs leading to initial entry to practice as a registered nurse (1999) and as a nurse practitioner (2008) to NEPAB. To learn more about NEPAB, click here.


Council also approved the proposed revisions to bylaws for publication to reflect council's decision. Members have 60 days to provide feedback.

To review proposed bylaw changes, Click here.

Standards for Programs Leading to Initial Entry to Practice as an NP

At its January meeting, Provincial Council ratified the NEPAB Standards for Alberta Education Programs Leading to Initial Entry to practice as a Nurse Practitioner, a document submitted to council for review by the Nursing Education Program Approval Board (NEPAB). This document contains the nursing education standards and criteria that represent the requirements for nurse practitioner (NP) education program approval and re-approval and are the basis by which the nursing education programs leading to initial entry to practice as a NP will be reviewed by NEPAB for approval.

Nurse Practitioner Competencies Approved

Council approved the updated CARNA NP Competencies that includes revisions based on the Canadian Nurse Practitioner Core Competency Framework (2010) and feedback from Alberta members.

Notable changes to the previous document dated 2005 include:

  • the addition of assumptions used in the development of the core competencies
  • the addition of professional requirements for practicing in Alberta as an NP
  • revised competencies
  • a revised glossary of terms
  • updated references

For CARNA Continuing Competence Program requirements, NPs will continue to use the 2005 CARNA Nurse Practitioner Competencies for the remainder of the current (2011) practice year. At renewal for the 2012 practice year, NPs will select their continuing competence NP indicators using the 2011 CARNA Nurse Practitioner Competencies.

Please note however, that for the purposes of NP practice, NPs are accountable for the 2011 CARNA Nurse Practitioner Competencies.


To review this document click here.

Complementary and/or Alternative Therapy and Natural Health Products: Standards for Registered Nurses

Council approved the updated Alternative and/or Complementary Therapy: Standards for Registered Nurses which includes revisions based on a literature review and member and stakeholder feedback. Respondents noted that the use by clients of complementary and alternative therapy medicine (CAM) has increased and members indicated a need for standards that provide direction for practice.

Notable changes to the previous document dated 2006 include:

  • updates reflecting the most recent information from Health Canada
  • clarification of regulated versus unregulated providers CAM therapies
  • increased emphasis on the fact that the nursing practice standards still apply to all nurses and identification of the standards unique to CAM therapy
  • addition of a standard which requires that, prior to implementing and administering CAM, RNs are required to perform and document a patient assessment, formulate a nursing diagnosis and discuss the risks and benefits of treatment with the client
  • a focus on the need for appropriate training in CAM therapy, continuing education and the need to consult with other health-care professionals when appropriate
To review this document, click here.

Open Forum

Open Forum is an opportunity for discussion and for voicing of ideas, questions or issues by members attending the meeting as observers.

A member commended CARNA on the introduction of a flexible payment option for the payment of registration fees. For more information on the new option, click here.

A member asked about the $2,500 fee required when filing a request for review (or appeal) of a decision of the registrar, Registration Committee or Competence Committee. Such reviews are conducted by the Registration Review Committee. The registrar indicated that the cost to CARNA for conducting a registration review ranges from $10,000 - $44,000. There is potential for the fee to be refunded to the member if the appeal is successful. To learn more about the responsibilities of the Registration Review Committee and other regulatory committees, click here.


A member suggested that CARNA amend its 2010/11 budget to provide for a donation of $1 per member to the Canadian Nurse Foundation Nursing 4.0 campaign for undergraduate scholarships for Alberta nursing students. Council has referred this item to Provincial Executive Committee for review. CARNA currently contributes a portion of each registrant's fee to the Alberta Registered Nurse Educational Trust.

Bylaw Changes re Appointment to Regulatory Committees/ Boards

Council considered the proposed changes to bylaws submitted at the September meeting of council and the feedback submitted by members related to appointments to regulatory committees. Council decided that applications for appointments to regulatory committees will be reviewed by a committee of council, and recommendations forwarded to council for action.


Council appointed Donna Clare and Marianna Marangoni-Zuege to the Competence Committee for a term ending Sept. 30, 2014 and reappointed Diane Denham to serve on the Registration Committee for a two-year term ending Sept. 30, 2012.

Council also appointed Claire Mills to the Canadian Nurses Protective Society (CNPS) Board of Directors for a term ending Jan. 31, 2012.

Invited Guests

The meeting of Provincial Council included an informal dialogue with Fred Horne, parliamentary assistant to the minister of health and wellness and a briefing by John Cowell, CEO of the Health Quality Council of Alberta on the findings of the survey of Albertans to measure satisfaction and experience with health care.

Upcoming Meetings

Thursday, May 19, 2011 1300 - 1700h Open Forum 1600 - 1700h

Friday, May 20, 2011 0900 - 1600h

To confirm your attendance, please contact: Giselle Allard, 780.453.0510 or gallard@nurses.ab.ca

The agenda will be posted on the CARNA website two weeks prior to the meeting.


2011 CARNA Annual General Meeting

Thursday, June 9, 2011 at the Calgary Hyatt
Lunch at 1130h, with Dr. Ann Tourangeau presenting : Choices and Tradeoffs: Nurse Staffing and Hospital Mortality Rates

Meeting starts at 1315h

Please pre-register at www.carnaconference.ca

CARNA Documents

All CARNA publications including standards, guidelines and position statements approved by council are posted on the CARNA website under Resources.