Under the RHPA health profession Acts1 some professions require orders to perform controlled acts as follows:
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Dental Hygienists - require an order from a dentist to perform scaling of teeth, root planning including curetting surrounding tissues and orthodontic and restorative procedures |
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Medical Laboratory Technologists - require an order from a physician, dentist, or prescribed person (e.g. nurse in the extended class) to take blood samples from veins or by skin pricking |
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Medical Radiation Technologists - require an order from a physician to take blood samples from veins, administer substances by injection or inhalation, administer contrast media through or into the rectum or an artificial opening into the body, or tattoo |
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Nurses - require an order from a chiropodist, dentist, midwife, physician or nurse in the extended class to perform a prescribed procedure below the dermis or mucous membrane, administer a substance by injection or inhalation or put an instrument, hand or finger beyond the opening of a body orifice. Under regulation, nurses who meet conditions may initiate certain authorized acts without an order, except where orders are required by other legislation such as the PHA and Nursing Homes Act (NHA) |
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Opticians - require an order from an optometrist or physician to dispense subnormal vision devices, contact lenses or eye glasses |
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Pharmacists - require an order from a dentist, nurse in the extended class, physician or person prescribed by regulation to dispense, sell or compound a drug as it is defined in subsection 117 (1) of the DPRA |
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Respiratory Therapists - require an order from a dentist, midwife, nurse in the extended class or physician to perform a prescribed procedure below the dermis, intubation beyond the point in the nasal passages where they normally narrow or beyond the larynx, and administration of a substance by injection or inhalation
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Under other health legislation that governs practice for particular procedures, settings or sectors, orders are required as follows:
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Public Hospitals Act (PHA). Admissions, outpatient registrations, discharges, treatments and diagnostic procedures must be ordered by a physician, dentist, midwife, or for outpatients only, an nurse in the extended class (PHA Regulation 965). |
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Healing Arts Radiation and Protection Act (HARPA). Ionizing radiation must be ordered by a physician, dentist, chiropractor, chiropodist or nurse in the extended class and may only be applied by a medical radiation technologist, dental hygienist or relevant authorizer. |
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Health Protection and Promotion Act (HPPA). Procedures to promote and protect public health - e.g. procurement and analysis of blood samples, immunizations, physical examinations, personal conduct, isolation, detention, facility closures, food handling - may be ordered by the Medical Officer of Health or designate. |
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Laboratory Specimen and Collection Centre Licensing Act (LSCCLA). The analysis of laboratory specimens must be ordered by a physician, dentist, or as permitted by regulation a midwife or a nurse in the extended class. |
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Drug and Pharmacy Regulation Act (DPRA). The compounding, dispensing and selling of drugs must be ordered (prescribed) by a physician, dentist, person prescribed by regulations, e.g. nurse in the extended class. |
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Controlled Drug and Substances Act and Food and Drug Act (CDSA & FDA) (Canada). The compounding, dispensing and selling of scheduled drugs and substances must be ordered by a physician, dentist or veterinarian. |
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Independent Health Facilities Act (IHFA). Orders are required in accordance with other applicable law and regulation. Failure to comply carries penalties up to revocation of license. |
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Nursing Homes Act (NHA). The application of restraints must be ordered by a physician for a maximum of 12 hours per order or nurse in the extended class with physician affirmation within 12 hours; the administration of medication must be ordered by a physician, dentist or nurse in the extended class and administered by them or a nurse; oxygen must be ordered by an appropriate physician and administered by a physician or nurse; admissions are authorized by a placement coordinator. |
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Patient Restraints Minimization Act (PRMA). The restraint or confinement of a patient in a hospital or facility or the use a monitoring device on such a patient must be ordered by a physician or person prescribed in regulation. |
