ADVANCE

MEETING THE NEED

We regulate and lead the growing number of LPNs. By setting and maintaining high standards for entry into the profession and advancing regulatory best practice we safeguard the public interest. When complaints arise, we respond with fairness and transparency.

%

growth in registration
with 11766 members

NEW
Practical Nurse Graduates

%

increase in out-of-province
and international registrations

REGULATORY SERVICES

CLPNA registration climbed in 2013. The number of CLPNA registrants grew by a record 10.7%, while new registrations from outside Alberta and from Internationally Educated Nurses leapt 31% from the previous year, exceeding all previous highs. Practical nurse graduates in Alberta reached a historic high of 979. Meanwhile, the average age of Alberta’s LPNs continued to decline to an average 39.1 years, making the province one of the youngest jurisdictions in Canada.

Jurisprudence Exam

On January 1, 2013, successful completion of the CLPNA’s Jurisprudence Examination became a registration requirement for Internationally Educated Nurse (IEN) Applicants. The Exam ensures LPNs have the “necessary knowledge to practice nursing safely within the legislative framework that exists in Alberta and Canada, and understand their professional role and responsibilities”. It tests understanding of key regulatory concepts including Code of Ethics, Standards of Practice, regulation and legislation, and practice knowledge.

In 2015, the Jurisprudence Examination will be a registration requirement for graduates from a practical nurse program in Alberta and practical nurse applicants from other jurisdictions in Canada.

Exam topics are broad and designed to be relevant to all nurses, regardless of experience or educational background. Regulatory information includes the role of the federal and provincial governments in the Canadian health care system; and understanding key legislation needed to inform nursing practice in Alberta.

Practice information includes planning for success and communicating effectively in the healthcare workplace; collaboration among healthcare providers; ethical dilemmas; and expectations surrounding professionalism and lifelong learning. Key information is also given regarding patient-centered care; and patient safety issues and the LPN role.

Development of the Exam and accompanying Study Guide was made possible by a grant from the Alberta Enterprise and Advanced Education (formerly Alberta Employment and Immigration) Foreign Qualification Recognition (FQR) Innovation Fund. CLPNA is the second nursing regulatory body in Canada to implement a Jurisprudence examination.

This is an exciting time for Licensed Practical Nurses. Growth in the profession is evident across the country.
Jo-Anne Macdonald-Watson, President and Linda Stanger, Executive Director, CLPNA
(From Executive Message,CARE, Volume 27, 4th Edition, Winter 2013)
Employer Verification of LPNs

Employers now have a better way to verify the status of their LPN employees. The CLPNA’s online Employer Verification of LPNs service authorizes employers to view a complete list of all LPN employees by facility. Names of all Licensed Practical Nurses at the facility, CLPNA registration numbers, current & future Practice Permit expiry dates, LPN specialties, and registration or discipline conditions are all listed. Employers can verify LPN registrations each year after the annual registration renewal deadline of December 1.

The Employer Verification of LPNs service complies with the Health Professions Act (HPA) and privacy guidelines of the Personal Information Protection Act (PIPA).

Online Practice Permits

With online registration in October 2013, most LPNs were able to immediately see and print their 2014 Practice Permit and income tax receipt from their computer, rather than waiting for one to be mailed from CLPNA. CLPNA will no longer be printing and mailing over 11,000 Practice Permits every year, and it means savings for LPNs, since those who need to reprint a permit or tax receipt can now do so at no cost at www.CLPNA.com.

Online Practice Permits are now considered a best practice in regulation, as any terms, conditions or limitations added or removed as a result of the registration process or a disciplinary hearing are immediately apparent on a member’s permit. There is also significant reduction in the risk of fraudulent copying of Practice Permits, with employers directed to the online verification system to verify the current registration status for LPNs on staff or those applying for positions.

Canadian Practical Nurse Registration Examination (CPNRE)

Jurisdictions in Canada are responsible for ensuring that those applying for registration as a practical nurse meet an acceptable level of competence to practice. This level of competence is measured, in part, by the Canadian Practical Nurse Registration Examination (CPNRE) administered by all provincial and territorial LPN regulatory authorities except Quebec. The CPNRE is the final step in the registration process and is administered three times a year in January, May, and September. Candidates have a maximum of three attempts at successfully completing the exam.

The CPNRE is prepared by Assessment Strategies Incorporated (ASI) working in collaboration with representation from practical nurses, educators, and employers of practical nurses from across Canada. These individuals serve as the content experts in developing and validating the CPNRE on behalf of the regulatory authorities. CLPNA is an active participant in the development of the CPNRE with representation on the Client Advisory Group, Examination Committee, Blueprint Committee, and Competency Review Committee.

Alberta CPNRE Candidates 2013*

Number of Candidates 1st Exam Repeat Exam IENs IENs Repeat Exam Total IENs Candidates
Registered 1041 159 97 7 1304
Writing 1034 159 86 7 1286
Not Writing 7 0 11 0 18
Passing 912 107 71 4 1094
Failing 122 52 15 3 192
% Passing 88% 67% 83% 43% 85%

* Statistics prepared by Assessment Strategies Incorporated (ASI).
IEN: Internationally Educated Nurse

MEMBERSHIP STATISTICS



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*Reinstatement (Less than 4 Years) = a member whose practice permit has lapsed at least one day.


LPN GENDER DISTRIBUTION



OUT OF PROVINCE REGISTRATIONS



INTERNATIONALLY
EDUCATED NURSE
REGISTRATIONS


ACTIVE MEMBERS BY PLACE OF EMPLOYMENT & STATUS

1

%

of membership involved
in complaint process

COMPLAINTS

The CLPNA is mandated to respond to complaints and allegations of unprofessional conduct, incompetence and incapacity of our members to ensure the profession’s Code of Ethics and Standards of Practice are upheld. The complaints process is designed to protect the public and improve the LPN’s nursing practice.

The Complaints Process

The CLPNA receives, investigates and resolves complaints about the practice of Licensed Practical Nurses in accordance with processes identified in the Health Professions Act (HPA). The CLPNA is committed to resolving complaints against LPNs based on the principles of procedural fairness, transparency and due diligence. Each complaint is taken seriously and reviewed thoroughly to determine appropriate course of action. The Health Professions Act sets out the approaches for addressing unprofessional conduct to protect the public from incompetent or unethical practitioners. Approximately 1% of the membership is involved in the complaints process every year.

The CLPNA attempts to resolve complaints through informal resolution processes where possible, rather than refer to disciplinary hearings. This year, 92 minor complaints were successfully resolved using an informal resolution process. Serious complaints are investigated and referred to disciplinary hearing according to the determination of the Complaints Director. Alternatively, when evidence does not exist or is deemed to be insufficient, a complaint may be dismissed.

In accordance with the HPA, employers have a legal obligation to inform the CLPNA when an LPN is terminated, suspended, or the LPN has resigned for reasons of unprofessional conduct.

Disposition of Complaints Processed in 2013

  • Complaints in Investigation Stage 66
  • Complaints Pending Hearing 15
  • Hearings Completed 21
  • Appeal Hearings Completed 0
  • Review of Dismissal of Complaint 1
  • Alternative Complaint Resolution Decisions Ratified 0
  • Alternative Complaint Reviews in Progress 0
  • Appeals to Alberta Court of Queen’s Bench 0
  • Section 118 – Incapacity Assessments 1
  • Complaints Dismissed 9
  • Informal Resolution 92
  • Members Location Unknown - File Suspended 0
  • Member Deceased - File Closed 0
  • Complaint Withdrawn 3
  • Total Discipline Events 208
  • Interim Suspensions and/or Conditions of Practice Permit 7
  • Surrender of Practice Permit by Agreement and Undertaking 2
  • Monitoring of Orders 33
  • Files Closed 115

Disciplinary Hearings Summary

A complaint is referred to a hearing when informal methods of resolution are unsuccessful, or when a complaint investigation reveals a serious breach of a practice standard or ethical conduct of an LPN. The Complaints Director may refer complaints to the Hearing tribunal for a formal hearing. Based on the evidence, the Tribunal determines if the investigated member has met the Standards of Practice and Code of Ethics of the profession. If the member is found to be guilty of unprofessional conduct, the Tribunal decides what measures are necessary to protect the public from unsafe practice and determines the appropriate steps required to remediate and rehabilitate the individual nurse.

There were 21 hearings held and concluded in 2013. All hearings were open to the public.


Hearing Findings

Hearing Tribunals receive evidence, listen to testimonies and consider the facts of the complaint in order to makea well-reasoned decision. The Hearing Tribunal includes members of the profession and the public to support an objective review of the matter.

  • Guilty of Unprofessional Conduct 21
  • Not Guilty of Unprofessional Conduct 0
Historical Comparison 2011 2012 2013
Complaints in Process - Previous Years 53 78 85
New Complaints Received 89 108 122
Total Complaints in Process 142 186 201
Source of Complaints 2011 2012 2013
Employer 51 61 70
Complaints Director 30 30 39
Member of Public 8 13 7
Other 0 0 0
Protection for Persons in Care 0 4 6

Type of Complaints Received

  • Abandonment 6
  • Abuse – physical, verbal, sexual 3
  • Boundary Issues 1
  • Breach of Confidentiality 2
  • Clinical Competence – Health Assessment 1
  • Clinical Competence – Medication Administration 14
  • Clinical Competence – Multiple 27
  • Criminal Charges/Conviction 1
  • Failure to Provide Supervision 4
  • Health – Mental 1
  • Inappropriate Business Practices 3
  • Other 4
  • Practicing Without A Permit 40
  • Substance Abuse 4
  • Theft 7
  • Unethical Conduct 2
  • Workplace Conflict Non-Practice 2
  • Total Complaints Received 122
The Health Professions Act sets out the approaches for addressing unprofessional conduct to protect the public from incompetent or unethical practitioners.
Hearing Discipline Actions Taken

Where possible the Hearing Tribunal strives to take a remedial approach when determining orders, to provide the LPN an opportunity to improve their nursing practice. Suspensions and cancellations are orders reserved for very serious offenses.

  • Caution 6
  • Reprimand 15
  • Fines 12
  • Partial Hearing Costs 16
  • Education 19
  • Publication 0
  • Practice Restriction 0
  • Supervised Practice 2
  • Drug Screening 2
  • Fitness to Practice Certification 2
  • Suspension of Practice Permit 2
  • Cancellation of Practice Permit 1
  • Referral to Attorney General
    *review of matters that may be criminal in nature
    2