Transforming and Supporting Patient Care - Health Professions ...

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244Chapter 10 – Profession of MidwiferyClassSpecific AgentsClass: CNS AgentsSub-class: Anxiolytics, Sedatives,and HypnoticsSub-sub-class: BenzodiazepinesClass: Hormones and Synthetic Substitutes HydrocortisoneSub-class: AdrenalsMupirocin-betamethasonevalerate-miconazoleClass: Local AnestheticsLidocaine HCl with or withoutepinephrine chloroprocaineClass: UterotonicsCarboprostProstaglandins/oxytocicIM ergonovine maleateIM or IV oxytocinErgonovine maleateMisoprostol rectalClass: Serums, Toxoids, and Vaccines Varicella Zoster Immune globulinHepatitis B immune globulinHepatitis B vaccineMMR vaccineClass: Vitamins Phytonadione (vitamin K)Folic acid greater thanone mg/doseClass: Emergency MedicationsOxygenEpinephrine (IV or IM),Antihistamines (IM)SalbutamolASAClass: Local AnestheticsBupivacaineLidocaine hydrochloride (with orwithout epinephrine)Mepivacaine hydrochlorideImplementation ProposalsTo implement HPRAC’s recommendations, the following changes to statutesand regulations are proposed:1. That section 4 of the Midwifery Act, 1991 be repealed and thefollowing substituted:Authorized acts4. In the course of engaging in the practice of midwifery, a memberis authorized, subject to the terms, conditions and limitationsimposed on his or her certificate of registration, to perform thefollowing:1. Communicating a diagnosis of a disease, disorder or dysfunctionthat may be identified through a midwifery assessment.HPRAC Critical Links January 2009
245Chapter 10 – Profession of Midwifery2. Managing labour and conducting spontaneous normal vaginaldeliveries.3. Performing episiotomies and amniotomies and repairingepisiotomies and lacerations, not involving the anus, analsphincter, rectum, urethra and periurethral area.4. Administering, by injection or inhalation, a substance that themember may administer under the regulations.5. Putting an instrument, hand or finger beyond the labia majoraduring pregnancy, labour and the postpartum period.6. Putting an instrument, hand or finger beyond the anal verge forthe purpose of administering suppository drugs that the membermay administer under the regulations.7. Taking blood samples from newborns by skin pricking or fromwomen, fathers or sperm donors from veins or by skin pricking.8. Inserting urinary catheters into women.9. Prescribing a drug that the member may prescribe under theregulations.2. That the Midwifery Act, 1991 be amended by adding the followingsections:Additional requirements for authorized acts4.1 A member shall perform a procedure under the authority ofsection 4 in accordance with any requirements prescribed inthe regulations.Individual scope of practice for midwives4.2 A member is responsible for identifying the limits of his orher educational preparation and competencies, and forresolving situations beyond his or her expertise by consultingwith or referring patients to other health care professionals.3. That sections 11(1) and 11(2) of the Midwifery Act, 1991 be repealedand the following substituted:Regulations11. (1) Subject to the approval of the Lieutenant Governor inCouncil and with prior review by the Minister, the Council maymake regulations,(a) requiring members to keep prescribed records and to provideto the Minister reports containing prescribed informationrespecting the prescribing of drugs; and(b) specifying requirements for the performance of proceduresunder the authority of section 4.4. That the title of Ontario Regulation 884/93 (Designated Drugs) berenamed Drugs and Substances.HPRAC Critical Links January 2009
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Table of ContentsCritical Links:Tra
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5Chapter 1 - An Introductionprofess
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9Chapter 1 - An IntroductionThrough
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14Chapter 1 - An Introductiondate.
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16Chapter 1 - An Introductionprofes
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18Chapter 1 - An Introductionwithin
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20Chapter 2 - Excellence in Health
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56Chapter 3 - A New Drug Approvals
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88Chapter 4 - Critical Links: Propo
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100Chapter 4 - Critical Links: Prop
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102Chapter 5 - Scope of Practice of
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164Chapter 7 - Professions of Chiro
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186Chapter 8 - Profession of Dental
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310Chapter 13 - Profession of Optom
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340Chapter 14 - Profession of Pharm
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366Chapter 15 - Profession of Physi
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378Chapter 16 - Profession of Respi
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394Chapter 17 - Conclusionscontinui
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396Chapter 17 - Conclusionsincluded
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398Chapter 18 - Summary of Proposal
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