O. Reg. 216/11: Hospital Management


Published: 2011-06-03

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ontario regulation 216/11

made under the

Public Hospitals act

Made: May 19, 2011
Approved: June 1, 2011
Filed: June 3, 2011
Published on e-Laws: June 7, 2011
Printed in The Ontario Gazette: June 18, 2011


Amending Reg. 965 of R.R.O. 1990

(Hospital Management)

1. (1) The definition of “attending registered nurse in the extended class” in subsection 1 (1) of Regulation 965 of the Revised Regulations of Ontario, 1990 is revoked and the following substituted:

“attending registered nurse in the extended class” means a registered nurse in the extended class who attends a patient in the hospital; (“infirmière autorisée traitante de la catégorie supérieure, infirmier autorisé traitant”)

(2) The definition of “extended class nursing staff” in subsection 1 (1) of the Regulation is amended by striking out “out-patients” wherever it appears in clauses (a) and (b) and substituting in each case “patients”.

2. Subsection 7 (2.1) of the Regulation is amended by striking out “out-patients” and substituting “patients”.

3. (1) Subsection 11 (1) of the Regulation is amended by adding the following clause:

(a.1) on the order or under the authority of a registered nurse in the extended class who is a member of the extended class nursing staff;

(2) Subsection 11 (2) of the Regulation is revoked and the following substituted:

(2) No physician, registered nurse in the extended class, dentist or midwife shall order the admission of a person to a hospital unless, in the opinion of the physician, registered nurse in the extended class, dentist or midwife, it is clinically necessary that the person be admitted.

4. (1) Subsection 14 (1) of the Regulation is revoked and the following substituted:

(1) A physician, a registered nurse in the extended class, an oral and maxillofacial surgeon or a midwife who knows or suspects that a person being admitted to the hospital on the physician’s, registered nurse in the extended class’s, oral and maxillofacial surgeon’s or midwife’s order is or may become dangerous to himself or herself or to other persons, shall forthwith notify the administrator concerning the patient.

(2) The French version of subsection 14 (2) of the Regulation is amended by striking out “de la catégorie supérieure” after “l'infirmière autorisée traitante”.

5. Paragraphs 1 and 2 of subsection 16 (1) of the Regulation are revoked and the following substituted:

1. The attending physician, registered nurse in the extended class or midwife or, if the attending dentist is an oral and maxillofacial surgeon, the attending dentist.

2. A member of the medical, extended class nursing, dental or midwifery staff designated by a person referred to in paragraph 1.

6. Section 17 of the Regulation is revoked and the following substituted:

17. (1) When a patient dies in a hospital, the attending physician or registered nurse in the extended class shall cause a copy of the medical certificate of death required under the Vital Statistics Act to be filed in the medical record pertaining to the patient. 

(2) Where the Vital Statistics Act requires a coroner to complete the medical certificate of death and the coroner does not provide the attending physician or registered nurse in the extended class with a copy of the medical certificate of death, the attending physician or registered nurse in the extended class shall complete a report in Form 1 and cause a copy of the report to be filed in the medical record pertaining to the patient.

7. (1) Clause 19 (4) (a) of the Regulation is revoked and the following substituted:

(a) the names of the attending physicians, registered nurses in the extended class, dentists and midwives of the patient;

(2) Subsection 19 (4) of the Regulation is amended by adding the following clauses:

(c.1) records of all examinations carried out on the patient in the hospital by a registered nurse in the extended class;

.  .  .  .  .

(h.1) records of all treatment carried out on the patient in the hospital by a registered nurse in the extended class;

(3) Clause 19 (4) (k) of the Regulation is amended by striking out “dentist” in the portion before subclause (i) and substituting “registered nurse in the extended class, dentist”.

(4) The French version of clause 19 (5) (a) of the Regulation is amended by striking out “de la catégorie supérieure” after “infirmières autorisées traitantes”.

8. (1) Clause 25 (1) (b) of the Regulation is revoked and the following substituted:

(b) is authenticated by a member of the medical staff, a member of the extended class nursing staff, a member of the midwifery staff or a member of the dental staff who is an oral and maxillofacial surgeon,

(2) Subsection 25 (2) of the Regulation is amended by striking out “clause (3) (d) or (3.1) (d)” and substituting “clause (3) (d), (3.1) (d) or (3.2) (d)”.

(3) Section 25 of the Regulation is amended by adding the following subsection:

(3.2) Every board shall ensure that procedures are established in a hospital that provide, within 72 hours after a patient is admitted to the hospital by a registered nurse in the extended class, that a registered nurse in the extended class,

(a) takes a history of the patient;

(b) gives the patient a physical examination;

(c) makes a provisional diagnosis of the patient’s condition; and

(d) records, dates and authenticates the history and a report of the findings of the physical examination and the provisional diagnosis of the patient.

(4) Subsection 25 (4) of the Regulation is amended by striking out “Subsections (3) and (3.1)” at the beginning and substituting “Subsections (3), (3.1) and (3.2)”.

(5) Subsection 25 (5) of the Regulation is amended by striking out “Subsections (1), (3) and (3.1)” at the beginning and substituting “Subsections (1), (3), (3.1) and (3.2)”.

9. Form 1 of the Regulation is revoked and the following substituted:

Form 1
CERTIFICATE OF DEATH

Public Hospitals Act

 


 


CAUSE OF DEATH




 




 




Name of Patient ………………………………………………………………………………………………………………




 




 




Date and Hour of Death ………………………………………………………………………………………………………




 




 


Approximate Interval Between Onset and Death




 


I


 


 




IMMEDIATE CAUSE—State the disease, injury or complication that caused death, not the mode of dying, such as heart failure, asphyxia, asthenia, etc.


 


 




 


 




 


 




(a)


…………………………………………


………………




 


 


due to


 




 


 




MORBID CONDITIONS, if any, giving rise to immediate cause (state in order backwards from immediate cause).


 


 




 


 




(b)


…………………………………………


………………




 


due to


 




 


 




 


(c)


…………………………………………


………………




 


 


…………………………………………


………………




 


II


 


 




OTHER MORBID CONDITIONS (if important) contributing to death but not causally related to immediate cause.


 


 


 




 


 




…………………………………………


……………….




 




 




 


……………………………………………….……...




 


Signature of Attending Physician /




 


Registered Nurse in the Extended Class




 




 


…………………………………………….………...




 


Date Signed












Commencement

10. (1) Subject to subsection (2), this Regulation comes into force on July 1, 2011.

(2) Sections 3, 4 and 8 come into force on July 1, 2012.

Made by:
Pris par :

La ministre de la Santé et des Soins de longue durée,

Deborah Drake Matthews

Minister of Health and Long-Term Care

Date made: May 19, 2011.
Pris le : 19 mai 2011.

 

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