Nurse Practitioner Admitting and Discharging to Acute Care

NPs are accountable to practice in accordance with their practice standards, code of ethics and employer policies to ensure they are providing safe, competent, compassionate and ethical nursing services at all times and in all roles. Additionally, they must obtain and possess the necessary knowledge, skill and judgement to competently admit and discharge clients from hospitals.

This resource is for NPs to help them understand:

• Legislative authority in relation to admission and discharge of clients from acute care settings.
• Professional accountability in relation to client admission and discharge, including professional scope of practice, individual competence and scope of employment. 

Legislative Authority

Legislative authority is provided by the following:

• The Registered Nurses Act, 1988 (the Act). The Act provides the legislative authority for RN and NP practice in Saskatchewan. It is the foundation upon which entry-level competencies (ELCs) and practice standards for NPs are developed.
• The Attending Health Professionals Regulations. This set of regulations provide the authority for NPs to admit and discharge to Saskatchewan hospitals.

The changes to the Attending Health Professionals Regulations are enabling rather than mandatory, meaning that not all NPs will immediately be enabled to admit/discharge to all Saskatchewan hospitals. Implementation decisions will be made by the Saskatchewan Health Authority.

Professional Accountability

Professional Scope of Practice

• The professional scope of practice represents the broadest category and is informed by The Registered Nurses Act, 1988; NP Practice Standards; NP Entry-Level Competencies and other related provincial and federal legislation.
• Admitting clients to and discharging clients from hospitals is within the professional scope of practice of the NP who has the required knowledge, skills and judgement.
• NPs are accountable to provide safe, competent, compassionate and ethical care within their professional scope of practice.

Individual Competence

• Individual competence represents an NPs practice based on their entry-to-practice education, practice experience, practice context and any beyond entry-level competencies acquired through additional education (formal and informal) over the course of a career.
• NPs are accountable to provide safe, competent, compassionate and ethical care within their educational preparation and individual competence.
  • NPs must work collaboratively with their employer to attain the necessary education and competencies to safely admit or discharge clients from hospital.
  • NPs are required to collaborate, consult and refer clients to the most appropriate health care professional when the client’s needs are beyond their competence, individual and/or professional scope of practice.

Scope of Employment

• The scope of employment is defined by the employer through the job description, policies, guidelines and context specific education.
• NPs are accountable to practice in accordance with employer specific policies, processes, practices and/or guidelines related to the client admission and discharge process.

NPs are expected to demonstrate leadership in the development of policies to optimize their individual scope of practice within their employment setting.

Liability Considerations

All NPs licensed with CRNS have professional liability protection from the Canadian Nurses Protective Society (CNPS).

If you have questions regarding your liability coverage related to your responsibilities for client admission and discharge, please contact CNPS.

For further information, please contact a CRNS Practice & Education Advisor at practiceadvice@crns.ca