Establishing a Regulatory Framework for Certified Practices in British Columbia

In British Columbia, limitations on the scope of practice for registered nurses (RNs) have led to the development of mechanisms that expand the activities of RNs without clarifying who is responsible and accountable for these activities. In the 1990s, the provincial government of British Columbia decided to move to a new restricted activities framework, requiring a review of the scopes of practice of all health professions. This article describes the concerns identified with the mechanisms of delegation and indirect orders and the development of a new regulatory approach. This new approach, called Certified Practice, was developed for activities that are usually outside the scope of practice for RNs and require registration as a nurse practitioner. This article may help other jurisdictions exploring an expansion of the scope of practice for RNs.