Transforming and Supporting Patient Care - Health Professions ...

More documents

Recommendations

Info

236Chapter 10 – Profession of Midwiferycarbotosin and oxygen. Midwives do not carry nitroglycerine for homebirths, since the need is extremely rare. However, a midwife couldadminister nitroglyerine in a hospital where a standing order has beenissued. 27Request 2The CMO and AMO are requesting that the regulatory approvals mechanismfor clinical regulations be revised. 28Proponents’ RationaleThe proponents said that currently, approval of and modifications toregulations occur within the Ministry. Revising the regulatory mechanismfor regulations related to clinical practice will enable the CMO, and byextension midwives, to respond to ongoing changes in the standard ofpractice in maternity care in a timely way. 29Request 3The CMO and AMO are requesting the authority to prescribe and/oradminister any substance on the order of a physician. 30Proponents’ RationaleIn comparison to other health professions that administer drugs, themidwifery profession is the only one that has a specific list of drugs itsmembers can administer under the order of a physician. For registerednurses, the Nursing Act, 1991 states that a member shall not perform acontrolled act unless the procedure is ordered by a person who isauthorized to do the procedure such as chiropodists, dentists, physiciansand midwives. 31 Respiratory therapists have a similar provision in itsprofession specific regulation 32 as do medical radiation technologists. 33What HPRAC FoundEpidemiological TrendsChanges in the population of childbearing women are having an impact onthe type of care that women require. The submission notes that the increasein the average maternal age, as well as increases in rates of obesity and theassociated risk of increased blood pressure, genetic abnormalities, andoverall greater morbidity have resulted in the need for more tests and fordifferent treatment protocols.27HPRAC meeting with AOM, December 11 200828Ibid: 7.29Ibid: 10.30Ibid: 7.31Nursing Act, 1991, S.O. 1991, c. 32, s.5. (1).32Respiratory Therapy Act, 1991, S.O. 1991, c.39, s.5. (1).33Medical Radiation Technology Act, 1991, S.O. 1991, c.29, s.5. (1).HPRAC Critical Links January 2009
237Chapter 10 – Profession of MidwiferyHPRAC agrees that midwives need access to appropriate tools to strengthentheir role as primary low-risk maternity care providers.Health Human Resources, Access to Care and Coordination of CareHPRAC’s scope of practice review discussed in detail the growing maternitycrisis in Canada. Over the past 15 to 20 years, demographic and other socialtrends have had a significant effect on the provision of maternity care.These trends include a shortage of maternity care providers and regionaldisparities in the provision of maternity care. There are fewer familyphysicians attending births. The number of family physicians attendingbirths has decreased by 43 percent from 1992 to 1999. By 2003-2004, only6.9 percent of family physicians billed OHIP for more than one birth. 34Obstetricians now attend over 80 percent of births. Obstetricians are seeingmore patients and are spending more time on call to address the shortageof family physicians delivering babies. There are indications that theshortage of obstetricians will become more severe in the near future. Atleast 34 percent of obstetricians are planning to retire within the nextfive years.A report released recently by the Society of Obstetricians and Gynaecologistsof Canada confirms that there is a serious crisis looming in Canada becauseof a critical shortage of obstetricians. This report was extensively coveredin the media.The problems facing obstetricians are part of a larger, more complexhuman resources struggle occurring throughout Canada's health-relatedprofessions. Cross-country shortages of family doctors, midwives,nurses and nurse practitioners have resulted in an increasing number ofobstetricians taking on bigger workloads and responsibilities thatnormally don't fall to a specialist.According to the executive director of the Canadian Women's HealthNetwork, Madeline Boscoe, “(The) problem…not only leaves obstetriciansoverworked, but also underutilizes their expertise…[and] it may preventwomen with serious health issues that require a specialist from gettingsufficient care.” 35As noted in its scope of practice review, HPRAC views midwives as playingan important role in addressing the health human resources shortage byproviding primary maternal care for low-risk births in Ontario.HPRAC’s ObservationsClasses versus Individual DrugsHPRAC is recommending a revised process for drug approvals in Ontariothat will be based on the approval of classes of drugs in regulations underhealth profession Acts. A new and expedited process for the approval ofindividual drugs within classes is also being proposed. The implementation34HPRAC. Review of the Scope of Practice of Midwifery. 80-81.35The Globe and Mail. December 5, 2008.HPRAC Critical Links January 2009
Page 4:
Table of ContentsCritical Links:Tra
Page 9 and 10:
5Chapter 1 - An Introductionprofess
Page 11 and 12:
7Chapter 1 - An IntroductionThese r
Page 13 and 14:
9Chapter 1 - An IntroductionThrough
Page 16 and 17:
12Chapter 1 - An Introductionreport
Page 18 and 19:
14Chapter 1 - An Introductiondate.
Page 20 and 21:
16Chapter 1 - An Introductionprofes
Page 22 and 23:
18Chapter 1 - An Introductionwithin
Page 24 and 25:
20Chapter 2 - Excellence in Health
Page 26 and 27:
Page 28 and 29:
Page 30 and 31:
Page 32 and 33:
Page 34 and 35:
Page 36 and 37:
Page 38 and 39:
Page 40 and 41:
Page 42 and 43:
Page 44 and 45:
Page 46 and 47:
Page 48 and 49:
Page 50 and 51:
Page 52 and 53:
Page 54 and 55:
Page 56 and 57:
Page 58 and 59:
Page 60 and 61:
56Chapter 3 - A New Drug Approvals
Page 62 and 63:
Page 64 and 65:
Page 66 and 67:
Page 68 and 69:
Page 70 and 71:
Page 72 and 73:
Page 74 and 75:
Page 76 and 77:
Page 78 and 79:
Page 80 and 81:
Page 82 and 83:
Page 84 and 85:
Page 86 and 87:
Page 88 and 89:
Page 90 and 91:
Page 92 and 93:
88Chapter 4 - Critical Links: Propo
Page 94 and 95:
Page 96 and 97:
Page 98 and 99:
Page 100 and 101:
Page 102 and 103:
Page 104 and 105:
100Chapter 4 - Critical Links: Prop
Page 106 and 107:
102Chapter 5 - Scope of Practice of
Page 108 and 109:
Page 110 and 111:
Page 112 and 113:
Page 114 and 115:
Page 116 and 117:
Page 118 and 119:
Page 120 and 121:
Page 122 and 123:
Page 124 and 125:
Page 126 and 127:
Page 128 and 129:
Page 130 and 131:
Page 132 and 133:
Page 134 and 135:
Page 136 and 137:
Page 138 and 139:
Page 140 and 141:
Page 142 and 143:
Page 144 and 145:
Page 146 and 147:
Page 148 and 149:
Page 150 and 151:
Page 152 and 153:
Page 154 and 155:
Page 156 and 157:
Page 158 and 159:
Page 160 and 161:
Page 162 and 163:
Page 164 and 165:
Page 166 and 167:
Page 168 and 169:
164Chapter 7 - Professions of Chiro
Page 170 and 171:
Page 172 and 173:
Page 174 and 175:
Page 176 and 177:
Page 178 and 179:
Page 180 and 181:
Page 182 and 183:
Page 184 and 185:
Page 186 and 187:
Page 188 and 189:
Page 190 and 191: 186Chapter 8 - Profession of Dental
Page 218 and 219: 214Chapter 9 - Profession of Dentis
Page 228 and 229: 224Chapter 10 - Profession of Midwi
Page 254 and 255: 250Chapter 11 - Profession of Natur
Page 278 and 279: 274Chapter 12 - Profession of Nursi
Page 290 and 291:
286Chapter 12 - Profession of Nursi
Page 292 and 293:
Page 294 and 295:
Page 296 and 297:
Page 298 and 299:
Page 300 and 301:
Page 302 and 303:
Page 304 and 305:
Page 306 and 307:
Page 308 and 309:
Page 310 and 311:
Page 312 and 313:
Page 314 and 315:
310Chapter 13 - Profession of Optom
Page 316 and 317:
Page 318 and 319:
Page 320 and 321:
Page 322 and 323:
Page 324 and 325:
Page 326 and 327:
Page 328 and 329:
Page 330 and 331:
Page 332 and 333:
Page 334 and 335:
Page 336 and 337:
Page 338 and 339:
Page 340 and 341:
Page 342 and 343:
Page 344 and 345:
340Chapter 14 - Profession of Pharm
Page 346 and 347:
Page 348 and 349:
Page 350 and 351:
Page 352 and 353:
Page 354 and 355:
Page 356 and 357:
Page 358 and 359:
Page 360 and 361:
Page 362 and 363:
Page 364 and 365:
Page 366 and 367:
Page 368 and 369:
Page 370 and 371:
366Chapter 15 - Profession of Physi
Page 372 and 373:
Page 374 and 375:
Page 376 and 377:
Page 378 and 379:
Page 380 and 381:
Page 382 and 383:
378Chapter 16 - Profession of Respi
Page 384 and 385:
Page 386 and 387:
Page 388 and 389:
Page 390 and 391:
Page 392 and 393:
Page 394 and 395:
Page 396 and 397:
Page 398 and 399:
394Chapter 17 - Conclusionscontinui
Page 400 and 401:
396Chapter 17 - Conclusionsincluded
Page 402 and 403:
398Chapter 18 - Summary of Proposal
Page 404 and 405:
Page 406 and 407:
Page 408 and 409:
Page 410 and 411:
Page 412 and 413:
Page 414 and 415:
Page 416 and 417:
Page 418 and 419:
Page 420 and 421:
Page 422 and 423:
Page 424 and 425:
Page 426 and 427:
Page 428 and 429:
Page 430 and 431:
Page 432 and 433:
Page 434 and 435:
Page 436 and 437:
Page 438 and 439:
Page 440 and 441:
Page 442 and 443:
Page 444 and 445:
Page 446 and 447:
Page 448 and 449:
Page 450 and 451:
Page 452 and 453:
Page 454 and 455:
Page 456 and 457:
Page 458 and 459:
Page 460 and 461:
Page 462 and 463:
show all

Transforming and Supporting Patient Care - Health Professions ...

Create successful ePaper yourself

Delete template?

Save as template?