Annual Report 2014 - College of Registered Nurses of Nova Scotia
College of REgistered Nurses of Nova Scotia Annual Report 2014 Annual Report 2014 College of REgistered Nurses of Nova Scotia Annual Report 2014 2 Brooke, RN – Pediatrics College of REgistered Nurses of Nova Scotia Annual Report 2014 Table of Contents Protecting the Public Through Nursing Regulation . . . . . . . . 2 Mission, Vision and Mandate . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2012-2014 Strategic Ends . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Message from President and CEO . . . . . . . . . . . . . . . . . . . . . 5 Year in Review Leadership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Our New Approach to Regulation . . . . . . . . . . . . . . . . . . . 7 Development of New Strategic Plan . . . . . . . . . . . . . . . . . 7 Registration Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 NPs Prescribe Controlled Drugs and Substances . . . . . 8 RN Exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Continuing Competence Program Progress . . . . . . . . . 8 National Nursing Assessment Service . . . . . . . . . . . . . . . 8 Real eNgagement Community Sessions . . . . . . . . . . . . . 9 Nurse Practitioner Exam Approvals . . . . . . . . . . . . . . . . . 10 NP Practice Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Webinar Technology Keeps Education Accessible . . . . 10 Rising Star Award . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 2014 Annual General Meeting . . . . . . . . . . . . . . . . . . . . 11 Resources & Services Registration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Complaint Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Practice Support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Learning & Development . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Publications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Quality Assurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Licence Status Check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Communications & IT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Awards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Where do your fees go? . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Council & Committee Reports Council Members . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Council President Profile . . . . . . . . . . . . . . . . . . . . . . . . . 23 Professional Conduct Statutory Committees • Complaints Committee . . . . . . . . . . . . . . . . . . . . . . . . 24 • Professional Conduct Committee . . . . . . . . . . . . . . . 24 • Fitness to Practice Committee . . . . . . . . . . . . . . . . . . 25 • Reinstatement Committee . . . . . . . . . . . . . . . . . . . . . 25 Statutory Committee Reports • Education Advisory Committee . . . . . . . . . . . . . . . . . 26 • Interdisciplinary Nurse Practitioner Practice Review Committee . . . . . . . . . . . . . . . . . . . . 26 • Nurse Practitioner Committee . . . . . . . . . . . . . . . . . . 26 • Registration Appeal Committee . . . . . . . . . . . . . . . . . 27 Standing Committees: • Awards Committee . . . . . . . . . . . . . . . . . . . . . . . . . . . . • Committee on Appointments . . . . . . . . . . . . . . . . . . . • Nominations Committee . . . . . . . . . . . . . . . . . . . . . . . Financial Statements: • Grant Thornton Auditor’s Report . . . . . . . . . . . . . . . . • Audited Financials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 27 27 28 29 Staff List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . outside back The photos used throughout this report capture images of some of our members who are licensed to practice nursing in Nova Scotia. We would like to acknowledge and thank all of the RNs and NPs who volunteered their time to help us demonstrate the unique contributions and value of the nursing profession. Cover image: Tricia, NP – Pediatrics 1 College of REgistered Nurses of Nova Scotia Annual Report 2014 Protecting the Public through Nursing Regulation The College of Registered Nurses of Nova Scotia (CRNNS) regulates registered nursing practise in Nova Scotia in the best interests of the public. As the regulatory body, we are responsible to: • License registered nurses (RNs) and nurse practitioners (NPs) practising in Nova Scotia; • Set the education requirements for those entering the nursing profession; • Issue annual licences to qualified applicants to practice nursing; • Establish and approve standards, competencies and guidelines for nurses’ practice; • Support the continuing competence of nurses; and • Review and take appropriate action on complaints about nurses’ practice or behavior. We are committed to supporting RNs and NPs, as professionals, to uphold their standards of practice and Code of Ethics in order to provide Nova Scotians with safe and quality nursing care. Nursing has been a self-governing profession in Nova Scotia since 1910. This means that government, through the Registered Nurses Act, has delegated the responsibility to oversee nursing practice to registered nurses themselves. The public trusts that RNs and NPs practice with public interest as their priority and it is the role of CRNNS to ensure that practice in the public interest is maintained. It is a testament to the incredible work of RNs and NPs, and effective oversight on the part of CRNNS, that the legacy of trust and self-regulation has been maintained for over 105 years. Surveys will tell you that nurses are one of the most trusted professionals. Maintaining the trust bestowed on the nursing profession is important to the public, RNs, NPs, other healthcare providers, employers, educators, the unions, the government and CRNNS. The strong history of nursing in Nova Scotia is something that we must all take pride in and cultivate for the generations that follow. We look forward to a stronger future together. 2 Susmy, RN – Geriatric/ Long Term Care Meaghan, RN – Emergency Care College of REgistered Nurses of Nova Scotia Annual Report 2014 Mission Registered nurses regulating their profession to promote excellence in nursing practice. Vision Our vision of success is a future where CRNNS: • Empowers nurses to recognize and realize their contribution to the health of the public and healthcare system and advance their professional development; • Implements innovative regulation that enables the profession to shape the future healthcare system; • Inspires nurses to be leading contributors to public safety; • Enhances nurses’ capacity to meet increased demand and higher expectations of registered nurses and nurse practitioners; • Has a wealth of evidence to influence public policy directions; • Is making connections, building coalitions and influencing change. Mandate CRNNS’ mandate is to regulate the practice of nursing in the public interest. CRNNS’ core regulatory functions are to: • License registered nurses (RNs) and nurse practitioners (NPs) practising in Nova Scotia; • Set the education requirements for those entering the nursing profession; • Issue annual licences to qualified applicants to practice nursing; • Establish and approve standards, competencies and guidelines for nurses’ practice; • Support the continuing competence of nurses; and • Review and take appropriate action on complaints about nurses’ practice or behavior. 3 College of REgistered Nurses of Nova Scotia Annual Report 2014 2012-2014 Strategic Ends Ends (goals) and policies provide direction to the CRNNS’ CEO and staff. They are established by Council in accordance with legislation. Mega End Excellence in RN self-regulation for the health of Nova Scotians. Ends A. Public receives safe, competent, ethical and compassionate care from registered nurses and nurse practitioners. B. Registered nurses and nurse practitioners work to their optimal scope of practice in an evolving healthcare system. B1. Clients receive coordinated care within and across the care continuum. C. Registered nurses and nurse practitioners are competent to practise in intra- and inter-professional collaborative teams. D. Registered nurses and nurse practitioners practise self-regulation. 4 Christine, RN – Psychiatric/Mental Health College of REgistered Nurses of Nova Scotia Annual Report 2014 Message from President and CEO Jacquelyn Garden-Jayasinghe, MN, NP, RN, President Sue Smith, RN, BN, MAOL CEO & Registrar In many ways, 2014 was a transformative year for CRNNS. Yes, we have been in existence in Nova Scotia for 105 years – that’s no small feat - and we are proud of our history and our contributions to Nova Scotia’s strong and vital nursing profession. Those registered nurses who came before us have demonstrated throughout the years that progress really happens when we are aware of the environments in which we work and adapt, evolve, and change. And we have been listening. The past year was one of preparation, engagement, and change as we worked towards a shared vision of the future of CRNNS. With input from members of the public as the ‘owners’ of CRNNS, Council developed a new strategic plan that sets the direction for the organization over the next three years. Underpinning the plan is the understanding that enabling the provision of safe, competent, ethical and compassionate nursing care to Nova Scotians is at the heart of what we do. We also wanted to have a candid conversation about nursing in Nova Scotia, your relationship with us, and what we can all be doing to contribute to the level of nursing care provided to Nova Scotians. Many of you took the time to share your insight in surveys and focus groups, which has given us valuable information that we will deliver on. This year, CRNNS embraced a relational approach to our work that will allow us to emphasize our commitment to the safety and protection of the public in a more targeted and transparent way. We made decisions that would lay the groundwork leading to enhanced customer service, more opportunity for collaboration and engagement, and improving relationships with our stakeholders. We also made decisions that would see CRNNS focus on applying ‘right-touch’ regulation that will enable us to apply the minimal amount of regulatory force required to achieve appropriate outcomes. Key to our new strategic plan, these are approaches to our work that you will continue to hear more about and they will set a standard for what you can expect from us in the future. The Real eNgagement initiative has continued to create a movement within the nursing community in Nova Scotia and more of you joined us this past year to lend your voice to help shape the future of the nursing profession. In addition to Real eNgagement and our core regulatory work, we undertook a number of key initiatives in 2014 that we are excited to share with you. Please read through this report and learn more about how we spent our year together. While we both have the honour and privilege of sharing with you the accomplishments of CRNNS this past year, we would be remiss if we did not acknowledge the incredible wisdom, leadership and significant contributions of Peter MacDougall as the past Council President (2012-2014) and Donna Denney as the preceding Executive Director of CRNNS (2009 – 2015). It is their commitment to the nursing profession and their vision for the future of CRNNS that continues to play an influential role not only for us but also in the growth and development of CRNNS and the nursing profession in Nova Scotia. This past year was an exciting time of renewal and engagement and we look forward to another successful year of working together with all of our stakeholders towards the ultimate vision of optimum health for all Nova Scotians through excellence in registered nursing practice 5 College of REgistered Nurses of Nova Scotia Annual Report 2014 6 Hilary, RN – Cardiovascular College of REgistered Nurses of Nova Scotia Annual Report 2014 Year in Review Leadership Our New Approach to Regulation Peter MacDougall completed his term as Council President in July 2014 following a successful tenure with member engagement as one of his CRNNS priorities. Peter was replaced by Jacquelyn Garden-Jayasinghe who brings with her a wealth of experience as an NP in Nova Scotia. Please see page 23 to learn more about Jacquelyn and her goals as President. In 2014, Council supported the move to embrace a relational approach to our regulatory work that allows us to emphasize our commitment to the safety and protection of the public. It will also enable us to find new and innovative ways to build positive relationships by being transparent, inclusive and available to our stakeholders. 2014 was also a year in which we prepared for the retirement of Donna Denney, Executive Director & Registrar who retired early in 2015. Council conducted a national search for Donna’s replacement in the fall of 2014 and Sue Smith was appointed CEO & Registrar effective February 2, 2015. Council also approved a title change from Executive Director & Registrar to CEO & Registrar, which is in keeping with comparable leadership positions at our national counterparts. Relational Regulation As the regulatory body, we issue licences to qualified RNs and NPs, set the nursing practice standards, approve nursing education programs, support the continuing competence of nurses, and address complaints received about nursing practice. Our new approach doesn’t change what we do as an organization but it does change how we do it. Right-Touch Regulation As a ‘right-touch’ regulator, we will approach our regulatory oversight by applying the minimal amount of regulatory force needed to achieve appropriate outcomes. This means that we will focus on the risks we’re trying to regulate while regulating that risk and creating the resources needed to promote safe and quality nursing care. Through more engagement with our stakeholders, we will look ahead enabling us to better anticipate changes before they occur so that we can respond to prevent and minimize risks. Development of 2015-2017 Strategic Plan This past year, with input from members of the public as the ‘owners’ of CRNNS, Council developed a strategic plan that sets the direction for the organization over the next three years. Underpinning the 2015-2017 plan is the understanding that enabling the provision of safe, competent, ethical and compassionate nursing care to Nova Scotians is at the heart of what we do. Registration Fee In order to fulfill our obligation to protect the public, we carry out foundational work related to registration and renewal, standards of practice, supporting 7 College of REgistered Nurses of Nova Scotia Annual Report 2014 registrants to meet standards, professional conduct, and governance. Approximately 92% of our operating budget required to support this work comes from annual licensure fees. Last year, Council approved an increase of $25.00 (+ HST) to licensure fees for RNs and NPs for the 2016 licensure year, which opens in July 2015. NPs Prescribe Controlled Drugs and Substances In November 2014, the provincial government announced changes to regulations that authorized nurse practitioners to prescribe controlled drugs and substances (CDS) to patients. CRNNS was instrumental in working with government and other stakeholders throughout this process and implemented measures to ensure that all NPs had access to resources and completed CDS education as a requirement for licensure prior to assuming this authority. This has been a positive move for Nova Scotians as it leads to greater access to timely healthcare within the range of services provided by NPs. 8 RN Exam The Canadian Registered Nurse Exam (CRNE) was written by nursing graduates for the last time in 2014. As of 2015, new graduates who wish to practice in Nova Scotia will write the NCLEX-RN®. CRNNS continued to work towards the transition to the new exam and we published updates and Q&A resources on our website, in our member-publications, and held an Atlantic-wide workshop for educators in 2014. Continuing Competence Program Progress Last year, Council approved revisions to the Continuing Competence Program (CCP) that included the verification of a random sample of learning plans and mandatory education for members when required. In 2014, the CRNNS CCP Working Group continued its work on this project, which included the development of new policies, new and revised program tools and a threeyear implementation plan. The group also began its stakeholder engagement by consulting with the Nova Scotia Nurses Union and the Nova Scotia General Employees Union. Further consultations will occur in 2015 with both members and other key stakeholders. The feedback will be used to refine the CCP prior to finalizing the program in the fall of 2015. National Nursing Assessment Service On August 2014, CRNNS joined with 21 other nursing regulatory bodies across Canada to launch the National Nursing Assessment Service (NNAS). All internationally educated nurses (IEN) applying for a licence in Canada for the first time are now able to apply to the centralized services of NNAS. We worked with NNAS and other regulators to develop a system to assess the IEN’s nursing program against Canadian standards. Not only does the NNAS enhance our ability to determine that the IENs we license are competent to provide safe, ethical care to the public, it also simplifies the application process for IENs wishing to work in Canada. College of REgistered Nurses of Nova Scotia Annual Report 2014 Real eNgagement Community Sessions Real eNgagement hit the road again in 2014 and hosted five sessions across the province in Halifax, Antigonish, New Glasgow, Bridgewater and Yarmouth. Hosted by CRNNS President Jacquelyn Garden-Jayasinghe and/or Executive Director Donney Denney, the sessions had 62 participants and together, they engaged in storytelling through an interactive approach that had participants creating solutions for a preferred nursing future. Gina, NP – Pediatrics 9 College of REgistered Nurses of Nova Scotia Annual Report 2014 Nurse Practitioner Exam Approvals To ensure a standardized approach to NP licensure in Nova Scotia, it was decided that NPs who graduated from an NP program on or after January 1, 2007 and are applying for initial licensure with CRNNS must complete an NP exam in their focus of practice. Council also approved two entry-level NP exams effective in 2014: • American Academy of Nurse Practitioners Certification Program’s (AANPCP) Primary Care Adult-Gerontology NP Exam • Pediatric Nursing Certification Board’s (PNCB) Primary Care Pediatrics NP Exam NP Practice Analysis With the support of CRNNS and other nursing regulators across the country, the Canadian Council of Registered Nurse Regulators (CCRNR) continued its work on the NP Practice Analysis. In 2014, CRNNS supported the NP Practice Analysis by facilitating the project’s national Working Group under the direction of CCRNR. The NP Practice Analysis made great strides in 2014 and some of its accomplishments include: Pro-Exam was chosen as the successful vendor to conduct the analysis, the 10 Patrick, RN – Education Research Advisory Committee and three subject matter expert panels were formed to assist in the analysis and survey development and in the fall 2014, the NP Practice Analysis survey was finalized and distributed to NPs across Canada. The analysis results will be completed in May 2015 and will provide a complete description of entry-level knowledge, skills and abilities that NPs will need to practise in Canada. From that, it will inform a national consensus on NP registration, licensure and exam requirements. Finally, it will also provide a description of the clinical services that NPs are currently providing to clients. Webinar Technology Keeps Education Accessible In partnership with the Canadian Nurses Protective Society, the CRNNS hosted its first webinar in late 2014. The session was a hit and as a result, CRNNS will continue to explore how webinar technology can be used as an adjunct to the Continuing Nursing Education Telehealth Program in 2015. This technology creates more accessibility because it enables CRNNS to engage presenters from outside of the province and enables members to access education from their personal computers rather than having to travel to a Telehealth site. College of REgistered Nurses of Nova Scotia Annual Report 2014 A New Rising Star Award To recognize the achievements of recent nursing graduates, Council approved the addition of a fifth award category called the Rising Star Award. The Rising Star Award recognizes RNs in Nova Scotia who are new to the nursing profession and have exceeded professional expectations, demonstrated excellence in the application of the CRNNS standards for nursing practice, and have shown great potential to become an exceptional member of the nursing profession. Approved in 2014, the inaugural Rising Star Award(s) will be presented to award recipients at the 2015 Awards Banquet. 2014 Annual General Meeting The 2014 Annual General Meeting (AGM) was held on May 13, 2014 at the Holiday Inn Harbourview in Dartmouth. A total of 109 RNs and NPs participated in the meeting, which was an impressive 44% increase from the previous year. There were no motions from the floor on the day of the AGM. The one resolution presented and passed was the date for the 2015 election of councilors set as Friday, April 10, 2015. Susan, RN – Education 11 College of REgistered Nurses of Nova Scotia Annual Report 2014 Resources & Services Registration One of the core services at CRNNS is the registration and licensure of individuals to ensure that those wanting to practise as a registered nurse or nurse practitioner are competent to do so. Each year, we register and licence RNs and NPs of different ages, practice settings, geography and job status to create a diverse and competent nursing workforce in Nova Scotia. Within that, our role is to safeguard the public by registering and licensing only those who meet our criteria set by the Registered Nurses Act, regulation and registration best practice. As the workforce needs evolve, so do we and our goal is to license every single qualified individual in an efficient approach. To become registered and licensed with CRNNS, an individual must complete an approved nursing education program, pass the national nursing registration exam and fulfill all other CRNNS registration requirements. In 2014, the CRNNS issued 529 first-time RN licences and 11 first-time NP licences. Each year, the CRNNS must also review, process and renew the licenses of all current, qualified members who wish to continue practising nursing in Nova Scotia. In 2014, the CRNNS renewed 9625 RN licences and 138 NP licences. 12 Registration 2014 Information % of total % change licensed from 2013 First-Time RN Licences Issued 529 5.1% -1.7% First-Time NP Licences Issued 11 0.1% +10.0% Renewed RN Licences Issued 9,625 93.4% +0.7% Renewed NP Licences Issued 138 1.3% -4.8% Total Active-Practising Licences Issued 10,303 100% +0.5% College of REgistered Nurses of Nova Scotia Annual Report 2014 ComplaintS CRNNS exists to ensure that the public is safe and protected when cared for by registered nurses and nurse practitioners in Nova Scotia. One way we do this is to review - and if required – investigate all complaints we receive about the conduct and competence of RNs and NPs licenced to practice in our province. Some complaints may be resolved informally while others require resolution through a more formal process. In 2014, 55 complaints were received, which involved just .006% of our licenced members. This is a slight increase from 2013 when we received 44 complaints and a decrease from the 73 complaints received in 2012. In 2014, a total of 60 complaints were resolved. 57% (34) were resolved by CRNNS staff without the need for disciplinary actions. The remaining 43% (26) complaints were resolved by one of the four Professional Conduct Statutory Committees involved with the professional conduct process. Four statutory committees are involved in the professional conduct process: the Complaints Committee, the Professional Conduct Committee, the Fitness to Practice Committee, and the Reinstatement Committee. Each of these Committees play a specific role in complaint resolutions, which you can read more about on page 24. Practice Support Two ways in which we support the practice of RNs and NPs is through our practice consultations and workshops. In 2014, CRNNS hosted 57 workshops and responded to 757 practice consultation requests. In 2014, CRNNS Practice Consultants responded to 735 requests for consultation from RNs and NPs. The top consultation themes included professional practice issues, RN and NP scope of practice, policy, patient safety and violence in the workplace. Although the majority of CRNNS consultations were with RNs and NPs, there were approximately 22 consultations in 2014 with non-RN administrators, private agencies, unions, government, academic institutions, community/ home care services and members of the public. The top public consultation themes included professional practice issues, policy, RN scope of practice and patient safety. The most popular workshops last year were: • Collaborative Practice •Documentation •Social Media 13 College of REgistered Nurses of Nova Scotia Annual Report 2014 Learning & Development CRNNS provides RNs and NPs with online learning opportunities to support them in maintaining their continuing competence. In 2014, 1089 RNs and NPs participated in thirteen e-learning modules offered through the CRNNS website. The top three most popular e-learning modules were “Assignment and Delegation Guidelines for RNs and LPNs”, “Documentation Guidelines for RNs” and “Social Media”, with over 33% of e-learning participants accessing them. Continuing Nursing Education via Telehealth was also a popular method of learning and development. Over the course of the year, 881 RNs and NPs attended 57 live on-site sessions delivered through Telehealth. Feedback from RN and NP participants showed that 84% felt the sessions enhanced their learning, 85% thought the sessions helped meet their professional learning objectives and 87% felt the sessions were applicable to their practice. Recorded Telehealth sessions available on the CRNNS website were also frequently accessed, receiving over 20,000 visits in 2014. 14 Joan, RN – Community Health College of REgistered Nurses of Nova Scotia Annual Report 2014 Publications We support RNs and NPs by producing publications relevant to nursing practice. CRNNS regularly revises publications to maintain their relevance and develops new publications when information through practice consultations, new legislation, environmental scans and/or regulatory best practice is identified that may have an impact on nursing practice. In 2014, CRNNS revised and produced 21 publications. Policy Statements • Nurse Practitioner Scope of Practice Related to Cosmetic Procedures: BOTOX and Dermal Fillers • Nurse Practitioner Standards of Practice Position Statements • Advanced Nursing Practice • Recommended and/or Publicly Funded Vaccines for Immunizations of Staff and Volunteers in Nova Scotia Health Agencies/ Facilities (in partnership with the Nova Scotia Department of Health & Wellness) Professional Practice Guidelines • • • • • Abandonment Guidelines Duty to Provide Care Guidelines A Guide for Self-Employed Registered Nurses Medication Guidelines for Registered Nurses Professional Presence and Registered Nurses in Nova Scotia Practice Guideline • Telenursing Practice Guidelines • Treatment Agreements: Nurse Practitioner Practice Guidelines • When NPs Leave a Practice Temporarily or Permanently Guidelines Reports and Q&As • Fair Registration Practice Act Review Report • Licensure Requirements for Nurse Practitioners Prescribing Controlled Drugs & Substances • Nurse Practitioner Quality Monitoring & Improvement Program First Five Year Cycle Report • Nurse Practitioner Sensitive Outcomes: A 2014 Summary Report • Real eNgagement for Real Action Report • Registered Nurse Sensitive Outcomes: A 2014 Summary Report • Together We Can: College’s Response to Real eNgagement for Real Action Report • Registration Fees for 2016 Licensure Year Q&A • Seasonal Vaccine Q&A 15 College of REgistered Nurses of Nova Scotia Annual Report 2014 Quality Assurance Communication & IT As a nursing profession, we value continuing competence and are dedicated to lifelong learning. As a mechanism to support this, each year all RNs and NPs must participate in the CRNNS Continuing Competence Program (CCP) and NPs must also participate in the CRNNS Nurse Practitioner Quality Monitoring and Improvement Program (NP-QMP™) once every five years. With client care always in mind, the aim of both programs is to provide opportunities for nurses to further develop their professional practice. Emails & Newsletters Licence Status Check The online Licence Status Check showing the registration statuses of all CRNNS members was visited 47,578 times and is the most accessed webpage on crnns.ca. This is a slight increase over the 45,300 visits this verification page had in 2013. 16 Embracing a relational regulator approach to our work means that communications with all of our stakeholders – including our members - is important to us. We are committed to finding more and better opportunities to engage with others and to improve our overall communications. In surveys, members told us that their preferred method of hearing from us is by email. As a result, email continued to be our primary way of communicating targeted information that is timely and specific to the needs of our members. In addition to the variety of emails sent to all CRNNS members, we sent 10 NP Bulletins electronically to notify NPs about matters unique to their practice. Knowing emails are the preferred method of communication for our members, we stopped producing Nursing in Focus, in the spring of 2014, which was printed and mailed to all members twice a year. Instead, we focused our energy on finding new ways of engaging members in two-way communication and enhancing our e-newsletter, On-Line, and increasing the frequency it was sent, from two to four times a year. Stay tuned for our plans to create an even more robust and favourable e-newsletter for stakeholders in 2015. We also introduced our new blog in 2014, which provides another way for us to respond to issues, support nursing practice, and for stakeholders to get to know us better. We have plans to explore this more in 2015 as well. Branding Re-fresh We understand that strengthening the relationships we have with members and other stakeholders starts within. We also believe that enhancing collaboration with others helps us to protect the public through excellence in registered nursing regulation. Creating and bringing the new CRNNS brand alive – both internally and externally – was one of our main focuses in 2014. We conducted surveys and focus groups with a variety of stakeholders and used that feedback to inform the CRNNS brand re-fresh that will launch in May 2015. Amy, RN – Maternal/Newborn Beverly, RN – Critical Care College of REgistered Nurses of Nova Scotia Annual Report 2014 17 College of REgistered Nurses of Nova Scotia Annual Report 2014 Web Visitors Our website had 675,129 visitors last year, which is an increase of over 40% from 2013. The majority of our traffic came from Canada but we had visitors from all over the world who visited crnns.ca for information about practising nursing in Nova Scotia. Our international website traffic: 18 1. United States 2. Philippines 3. India 4. United Kingdom 5. Saudi Arabia 6. United Arab Emirates 7. Australia 8. Nigeria 9. Jamaica Roger, RN – Geriatric/Long Term Care Mariella, RN – Geriatric/Long Term Care College of REgistered Nurses of Nova Scotia Annual Report 2014 How People Access crnns.ca Technology is changing and it’s important for us to know how people are accessing our website so we can work to maximize their user experience. In 2014, the majority (74%) of website visitors still came to our site via desktop computers with 16% accessing the site through mobile devices and 10% via tablet. We will continue to watch for trends in the future and ensure our IT functionality evolves with the use and preferences of our stakeholders. Initial Assessment Portal We are always looking for new ways to provide members with better customer service and more timely results. As of the beginning of 2014, all applicants applying for initial registration with CRNNS have improved access to information about the progression of their application. New applicants can now view the status of their application, submit documentation via email, print receipts, track received and outstanding documents, and quickly access important memos from us about their application. New Website In 2014, we began the foundational work that is required in order to build a responsive new website that addressed the needs and wishes of our stakeholders. Key to the project was the ability for enhanced engagement opportunities with stakeholders, improved functionality through modern technology, and improving the user’s overall experience on our site. Usability testing helped to direct website plans and the new site, set to launch in May 2015, will feature the new look and feel – the brand – of CRNNS. 19 College of REgistered Nurses of Nova Scotia Annual Report 2014 20 Sierra, RN – Psychiatric/Mental Health Sheila, RN - Education College of REgistered Nurses of Nova Scotia Annual Report 2014 Where do your fees go? CRNNS celebrated the success of RNs and NPs at the 2014 Awards Banquet where members were recognized for their contributions to nursing and for being outstanding role models within the nursing profession. Clockwise 9% 10% i i 6% 15% 10 % i i The following individuals were presented with Awards of Excellence: Excellence in Nursing Administration i Awards 7% 2% i i 6% Keith Cockersell, Nurse Practitioner, North End Community Health Centre Barbara Currie, Nurse Practitioner, QEII Health Sciences Centre Eleanore Howard, Enterostomal Therapy Nurse, Annapolis Valley Health Vicky Martin, Charge Nurse, Capital District Health Authority i Excellence in Nursing Clinical Practice % 21 i 14 % Sylvia Wist, Professional Practice Leader in Policy, Capital District Health Authority 9% Managing our registry 15% College oversight 14% Acting to uphold nursing standards 6% Operations 7% Infrastructure 2% Communicating with members and stakeholders 21% Setting and supporting nurses to meet standards 6% CNPS liability coverage for RNs and NPs 10% CNA membership fees paid on behalf of RNs and NPs 10% Meeting our members and stakeholders technology needs i Excellence in Nursing Research Dr. Marsha Campbell-Yeo, Clinician Scientist, Dalhousie University School of Nursing and the IWK Health Centre Health Advocacy Joanne Cumminger, Patient Navigator, Pictou County Health Authority Honorary Life Membership Edith Menzies, retired registered nurse, Annapolis Valley District Health Authority 21 College of REgistered Nurses of Nova Scotia Annual Report 2014 Council Members The CRNNS Council is the governing body represented by registered nurses, nurse practitioners and members of the public who are passionate about the provision of safe and quality nursing care in Nova Scotia. July 1-December 31, 2014 Jacquelyn Garden-Jayasinghe, President – Peter MacDougall, President (Jan. 1-June 30, 2014) Ruth Whelan, President-elect – Jacquelyn Garden-Jayasinghe, President-Elect (Jan. 1-June 30, 2014) Cameron Boys, Councillor at Large – Ruth Whelan, Councillor at Large (Jan. 1-June 30, 2014) Braden Davie, Councillor at Large – Rosalind Benoit, Councillor at Large (Jan. 1-June 30, 2014) Amy MacDearmid, District Councillor-Annapolis – Tim Guest, District Councillor-Annapolis (Jan. 1-June 30, 2014) Marlene Ash, District Councillor-Atlantic Sheri Price, District Councillor-Atlantic – Kelly Ann Lackie, District Councillor-Atlantic (Jan. 1-June 30, 2014) Clare Currie, District Councillor-Cape Breton Cyndee MacPhee, District Councillor-Cape Breton Kathy LeBlanc, District Councillor-Cobequid Marian Mac Lellan, District Councillor-Highland Angela Clifton, District Councillor, Western Anne Bigelow, Public Representative Carolyn Fowler, Public Representative Michael Gillis, Public Representative – John Hudec, Public Representative (Jan. 1-June 30, 2014) Dermot Jardine, Public Representative – Paulette Anderson, Public Representative (Jan. 1-June 30, 2014) Colleen MacNeil, Public Representative David Samson, Public Representative Kendra MacCuspic, Nursing Student representative 22 “When I first met Jackie she was a nurse educator with whom I shared an office. I was impressed with her professionalism and caring attitude and I learned a lot about best practice as I witnessed her caring for patients and helping other nurses. Always committed to learning, she went on to become an expert in the care of hypertension sharing her knowledge with patients, colleagues, students and health care professionals around the world. I served on the CRNNS Council with Jackie and am pleased to see her use her diplomacy and passion for the profession as she continues to guide and support registered nurses throughout Nova Scotia.” – Rosalind Benoit, nursing colleague “I was referred to Jackie by my family physician for complicated hypertension. I was immediately impressed by the scope of her knowledge about conditions like mine and her confidence put my mind at ease. She knew exactly what tests needed to be ordered to begin to put the puzzle together. She also tapped into her connections within the healthcare community to help diagnose me. Her care has made all the difference in my life and I consider myself a healthier man today because of her. As President of CRNNS, if she represents the group of nurses who are licensed every year then we’re all in good hands.” – A Patient College of REgistered Nurses of Nova Scotia Annual Report 2014 Jacquelyn Garden-Jayasinghe Council President Profile A graduate from the Dalhousie University School of Nursing with both a Bachelor of Nursing and a Masters of Nursing, Jacquelyn works as a nurse practitioner specializing in the treatment of hypertension in addition to being Council President of CRNNS. “Getting involved with CRNNS has given me a wonderful opportunity to feel connected to my profession and my nursing colleagues in a new way,” says Jacquelyn. “It’s shown me that we all play a role in providing safe and quality nursing care to the public. I’ve seen throughout my career how much more we can accomplish as nurses when we get involved, work together, and are united as one profession.” Jacquelyn Garden-Jayasinghe joined CRNNS as Council President in July 2014 upon being elected into the position by her peers. With a nursing career spanning 29 years, Jacquelyn has made significant contributions not only to the nursing profession in Nova Scotia but to the countless clients she has cared for over the years. A passionate advocate for the important role nurses play in health care, Jacquelyn has always believed that she could use her voice to contribute to sustain and advance the role of registered nurses and nurse practitioners in Nova Scotia. She learned early in her career that selfregulation supports the provision of safe, quality care and that nurses have an opportunity to participate in a self-regulated profession and to help contribute to a strong and vibrant future. “Most of us began our careers because we wanted to help people and I find myself always returning to that sentiment in my role as Council President,” she explains. “The public are at the heart of CRNNS’ work and their mandate is to ensure the public is protected. Their needs and expectations are as essential to CRNNS as they are to nurses and my goal is to strengthen that relationship and connection with Nova Scotians.” As President, Jacquelyn’s goal is to engage with RNs, NPs, and the public at every opportunity. Positive about the future of nursing, Jacquelyn has been instrumental in work that supports re-igniting pride in the profession, engaging nurses in solution-focused approaches, and empowering her colleagues to be decision-makers in health system change. 23 College of REgistered Nurses of Nova Scotia Annual Report 2014 Committee Reports Professional Conduct Statutory Committees Central to regulating registered nursing practice in Nova Scotia with public protection as our top priority, we receive, investigate, and dispose of complaints we receive about the conduct, competence, health or behaviour of an RN or an NP licenced to practice in Nova Scotia. Complaints are received and reviewed by the CEO who forwards the complaint to the Professional Conduct department for appropriate action. Four statutory committees are involved in the professional conduct process and work towards complaint resolution: • Complaints Committee • Professional Conduct Committee • Fitness to Practise Committee • ReInstatement Committee In 2014, 55 complaints were received by CRNNS, which involveded just .006% of our licenced members. This is a slight increase from 2013 when we received 44 complaints and a decrease from the 73 complaints received in 2012. Sources of complaints • Employers/Managers: 33% • CRNNS: 29% • The Public: 24% 24 • Colleague: 9% • Department of Health: 3% • Self-report: 2% Complaints Committee Members: Lorna Khan (Chair), Charlene Murphy (Vice-Chair), Valerie Banfield, Fred Beaton, Garland Brooks, Douglas Bungay, Kimberly Clark, Daphne Connolly, Dannie Currie, Melissa Currie, Valerie Eden, Kim Fleming, Carolyn Fowler, Ethel Gunn, Allison Hodder, Kristine Kempton, Sue Laroche, Bill Lawlor, Deborah Linton, Emerson MacDonald, Ronald MacPherson, Debora Mander, Maria Marshall, Jill Morse, Kate Muir, Ken Nason, James Pritchett, Lora Robers, Suzanne Sheppard-Jackman, Michele Steele, Heather Wood. The role of the Complaints Committee is to review all complaints not resolved by the CEO and dispose of them in accordance with the Regulations. A panel of the Complaints Committee, made up of two nurses and one public representative, acts as a screening committee by resolving less serious complaints and referring serious allegations of professional misconduct, incompetence, incapacity, or conduct unbecoming the profession to a Professional Conduct Committee. In 2014, this Committee met to consider 18 complaints against 16 nurses with the following results: Dismissal1 Non Disciplinary Resolution (counsel, caution, informal resolution) 12 Licensing Sanction (consent reprimand, conditions and/or restrictions) 2 Approval of Request to Voluntarily Resign 1 Referral to a hearing before the PCC 2 Professional Conduct Committee Members: W. Brian Smith (Chair), Sandra MacPherson-Duncan (Vice-Chair), Camilla Benoit, Kenneth Bowes, Barb Campbell, Ramon Cansanay, Glenda Carson, Sharon Chafe, Jacklyn Clark, Jeanette Combes, Barbara Darby, Susan Gouthro, Agnieszka Grabowska-Comeau, Linda (Lyn) Hale, Kara Henman, Christine Hines, William Hodder, Linda Hutchins, Evelyn Kennedy, Sarah Leathley-Britain, James Maclean, Wendy Miles, Deidre Mombourquette, Janet Purvis, Jennifer Riis, Elaine Rivers, Erin Sarrazin, Paula Wadden, Joanne Zevenhuizen. The Professional Conduct Committee conducts formal professional conduct hearings into the allegations referred by the Complaints Committee. A College of REgistered Nurses of Nova Scotia Annual Report 2014 panel of the Professional Conduct Committee hears evidence to determine whether one or more of the allegations against a nurse can be proven true, and if so, whether such proof amounts to a finding of professional misconduct, conduct unbecoming the profession, incompetence and/or incapacity. If one of these findings is determined then the Committee must decide on the appropriate licensing sanction. This committee resolved seven complaints against four nurses, resulting in: Reprimand and 6 month suspension Reprimand and suspension until re-entry program completed Consent revocation of licence and registration The Fitness-to-Practice Committee determines whether a registered nurse is suffering from a medical, physical, mental, or emotional condition, disorder or addiction that is affecting, or could affect, her or his practice. The committee also determines what action may be necessary to protect the public. In 2014, this committee approved one revised Remedial Agreement permitting a nurse to return to practice with conditions and restrictions. Reinstatement Committee 1 2 1 Fitness-to-Practice Committee Members: Cindy Cruikshank (Chair), Michele Steele (Vice-Chair), Carol MacEachern, Lindsay Burke, Heather Spencer-Benoit, Christina Vardy, Fred Beaton, William Hodder. Members: Cyndee MacPhee (Chair), Marian MacLellan, Carolyn Fowler, Kelly Lackie. The Reinstatement Committee hears applications from individuals seeking reinstatement of their registration or lience to practice nursing after having their registration or licence revoked by a Professional Conduct Committee. The Committee did not receive any applications for reinstatement in 2014. 25 College of REgistered Nurses of Nova Scotia Annual Report 2014 Committee Reports Statutory Committees Education Advisory Committee Members: Jo-Anne MacDonald (Chair), Courtney Breen, Garland Brooks, Duana d’Entremont, Anita Ferguson, John McNeil , Willena Nemeth, Ruth Martin-Misener, Kimberly Newton, Mary van Soeren, Ruth Whelan, Audrey Watson. The Education Advisory Committee (EAC) advises and makes recommendations to Council on establishing the standards for nursing education programs; and approves, conditionally approves or denies approval of baccalaureate, nurse practitioner and nursing re-entry programs. In 2014, Council approved the EAC recommendation to approve the Cape Breton University Bachelor of Science of Nursing BScN, 4-year Program for five years until September 30, 2019 with recommendations to be addressed in their annual progress reports. EAC also reviewed the 2014 Annual Progress Reports from three Nova Scotia baccalaureate, one nurse practitioner, and two nursing re-entry programs. Approval of university nursing education programs supports the CRNNS mandate of public protection 26 by assuring that graduates of Nova Scotia nursing education programs have the competencies to practice nursing at an entry level. Interdisciplinary Nurse Practitioner Practice Review Committee Members: Keith Cockersell (Chair), Paulette Anderson, Cindy Planetta, Sheila Higgins-McGray, Lena MacDonald, Barbara Currie, Sandra Duke, Darla MacPherson, Kim Hebert, Nancy Edgecombe, Dermot Jardine, Douglas (Gus) Grant, Shelagh Campbell-Palmer, Marsha Campbell-Yeo, Connie Venedam Marchand. The Interdisciplinary Nurse Practitioner Practice Review Committee (IDPRC) reviews the practice of NPs through a quality monitoring and improvement program (NP-QMP). This program supports NPs to improve their practice by providing them with performance feedback from health provider colleagues and clients. In 2014, the IDPRC undertook a comprehensive review of the first five year cycle of the NP–QMP, including the program’s strengths and opportunities. Based on survey and focus group feedback from NP participants, program improvements were made to the survey tools, methods and survey reports. The past year, a new five year cycle of the program began with 17 NP participants. The results of the 2014 NPQMP™ continued to demonstrate that 99.4% of the NPs’ performance indicators were rated as meeting or exceeding expectations. The IDPRC supports the CRNNS mandate of regulating NP practice in the public interest by providing NPs with the information they need to reflect on ways to improve their delivery of client care. Nurse Practitioner Committee Members: Ruth Martin-Misener (Chair), Marsha Campbell-Yeo, Dawn Chubbs, Nancy Edgecombe, Geralynn Hirsch, Debbie Roach. The Nurse Practitioner Committee is established by legislative authority to conduct competence assessments for nurse practitioners when a nurse practitioner has changed practice settings, or is working with a different client population, or a competence assessment is otherwise required by the Act or Regulations. College of REgistered Nurses of Nova Scotia Annual Report 2014 Standing Committees In the 2014, NP Committee members conducted competence assessments of seven nurse practitioners who were changing their patient populations and/or practice settings. The results of these assessments are as follows: • Three NPs met the required competencies without having to complete a clinical practicum or case studies; • Four NPs successfully completed a competence assessment review by assessors. Registration Appeal Committee Members: Loretta Manning (Chair), Elizabeth Cooper, Agnieszka Grabowska-Comeau, Daphne Connolly, Trudy Campbell, Amy MacDearmid, Rosalind Benoit, W. Brian Smith. Committee Reports Awards Selections Committee Members: Marian Mac Lellan (Chair), Kathy LeBlanc, Clare Currie, Angela Clifton & Colleen MacNeil, Ruth Whalen, Kelly Lackie, Rebecca Dorey Committee on Appointments Members: David Samson (Chair), Ruth Whelan, Cameron Boys, Tim Guest Nominations Committee Members: Peter MacDougall (Chair), Carolyn Power, Judy Bailey Braden Davie The Registration Appeal Committee, appointed by Council, meets to consider requests from applicants that request a review of CRNNS’ decision to deny registration or licensure as a registered nurse or nurse practitioner in Nova Scotia. There were no registration appeals heard by the Committee in 2014. 27 College of REgistered Nurses of Nova Scotia Annual Report 2014 Independent Auditor’s Report Grant Thornton LLP Suite 1100, 2000 Barrington Street Halifax, NS B3J 3K1 T (902) 421-1734 F (902) 420-102648 www.GrantThornton.ca To the members of the College of Registered Nurses of Nova Scotia We have audited the accompanying financial statements of the College of Registered Nurses of Nova Scotia, which comprise the statement of financial position as at December 31, 2014 and the statements of operations, changes in net assets and cash flows for the year then ended, and a summary of significant accounting policies and other explanatory information. Management’s responsibility for the financial statements Management is responsible for the preparation and fair presentation of these financial statements in accordance with Canadian accounting standards for not-for-profit organizations, and for such internal control as management determines is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error. Auditor’s responsibility Our responsibility is to express an opinion on these financial statements based on our audit. We conducted our audit in accordance with Canadian generally accepted auditing standards. Those standards require that we comply with ethical requirements and plan and perform the audit to obtain reasonable assurance about whether the financial statements are free from material misstatement. An audit involves performing procedures to obtain audit evidence about the amounts and disclosures in the financial statements. The procedures selected depend on the auditor’s judgment, including the assessment of the risks of material misstatement of the financial statements, whether due to fraud or error. 28 In making those risk assessments, the auditor considers internal control relevant to the entity’s preparation and fair presentation of the financial statements in order to design audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of the entity’s internal control. An audit also includes evaluating the appropriateness of accounting policies used and the reasonableness of accounting estimates made by management, as well as evaluating the overall presentation of the financial statements. We believe that the audit evidence we have obtained in our audits is sufficient and appropriate to provide a basis for our audit opinion. Opinion In our opinion, the financial statements present fairly, in all material respects, the financial position of the College of Registered Nurses of Nova Scotia as at December 31, 2014, and the results of its operations and its cash flows for the year then ended in accordance with Canadian accounting standards for not-forprofit organizations. Halifax, Canada Chartered Accountants April 14, 2015 College of REgistered Nurses of Nova Scotia Annual Report 2014 Statement of Financial Position Statement of Operations College of Registered Nurses of Nova Scotia College of Registered Nurses of Nova Scotia Year ended December 31 2014 2013 Revenue Membership $5,156,550 $4,258,681 Investment income 133,128 131,233 Other 293,814276,024 5,583,4924,665,938 Expenses Administrative 276,148220,009 Interagency 547,965543,234 Legislated services 2,201,8312,212,223 Member services 2,084,7181,713,629 Premises 364,664353,380 Amortization of property and equipment 64,169 68,130 Loss on disposal of property and equipment 4,795 5,544,2905,110,605 Excess of revenues over expenditures (expenditures over revenues) $39,202 $(444,667) December 31 2014 2013 Assets Current Cash and cash equivalents $130,922$ 502,645 Short term investments (note 4) 4,914,1826,223,591 Receivables 100,726 110,103 Prepaids 24,397 30,801 5,170,2276,867,140 Long term investments (note 4) Property and equipment (note 5) 3,368,5451,602,579 177,076 194,449 $8,715,848$ 8,664,168 Liabilities Current Payables and accruals (note 6) $646,163$ 618,796 Deferred revenue 4,069,9434,086,856 4,716,1064,705,652 Deferred lease incentive Retirement benefits (note 7) 11,860 14,706 305,234300,364 5,033,2005,020,722 Net assets Net investment in property and equipment 177,076 194,449 Net investment in liquidity reserve 1,065,7721,019,859 Unrestricted 2,439,8002,429,138 3,682,6483,643,446 $8,715,848$ 8,664,168 Commitments (note 9) On behalf of the Council See accompanying notes to the financial statements. 29 Statement of Changes in Net Assets College of Registered Nurses of Nova Scotia Year ended December 31 Investment inInvestment property and in liquidity 2014 2013 equipment reserveUnrestrictedTotalTotal Net assets, beginning of year 30 $ 194,449 $ Excess of revenues over expenditures (expenditures over revenues) Purchase of property and equipment, net of disposals Transfers (from) to liquidity reserve Net assets, end of year $ See accompanying notes to the financial statements. $ 2,429,138 $ (64,169) - 46,796 - - 1,019,859 45,913 $ 4,088,113 103,371 39,202 (444,667) (46,796) - - (45,913) - - 3,643,446 177,076$ 1,065,772 $ 2,439,800$ 3,682,648 $ 3,643,446 College of REgistered Nurses of Nova Scotia Annual Report 2014 Statement of cash flows Notes to the financial statements College of Registered Nurses of Nova Scotia Year ended December 31 College of Registered Nurses of Nova Scotia December 31 2014 2013 Increase (decrease) in cash and cash equivalents Operating Net income (loss) $39,202$(444,667) Amortization 64,169 68,130 Amortization of deferred lease incentive (2,846) (2,846) Loss on disposal of property and equipment 4,795 Increase (decrease) in retirement benefits liability 4,870(64,940) Change in non-cash operating working capital (note 8) 110,190(444,323) 136,425449,534 26,235 893,857 Investing Purchase of investments, net (456,557) (53,155) Purchase of property and equipment (51,591) (37,733) 1. Nature of Operations The College of Registered Nurses of Nova Scotia (the “College”) is the professional regulatory body for registered nurses and nurse practitioners licensed to practice in Nova Scotia. The College is a non-profit organization exempt from tax under paragraph 149(1)(L) of the Income Tax Act and, therefore, is not required to pay income taxes. 2. Change in Accounting Policies In fiscal 2014, the College adopted the provisions of the CPA Handbook, Part III – Accounting Standards for Not-for-profit organizations, Section 3463 Reporting employee future benefits by not-for-profit organizations. The adoption of this section did not result in any adjustments to the previously reported assets, liabilities, net assets, or revenues over expenditures of the College. The transition did not result in any adjustments to the statement of cash flows. (508,148)(90,888) Net (decrease) increase in cash and cash equivalents (371,723) 358,646 Beginning of year 502,645 143,999 Cash and cash equivalents End of year See accompanying notes to the financial statements. 3. Summary of Significant Accounting Policies These financial statements have been prepared in accordance with Canadian accounting standards for not-for-profit organizations (“ASNPO”). The significant accounting policies are detailed as follows: $130,922$ 502,645 31 Notes to the Financial Statements College of Registered Nurses of Nova Scotia December 31 Fund accounting The accounts are maintained in accordance with the principles of fund accounting. This method ensures observance of restrictions, if any, on the use of the resources by maintaining separate accounts for each fund. Funds that have limitations placed on their use by internal or external parties are classified as restricted. The following provides a brief description of each fund group: • The unrestricted fund is for general operating funds. • The net investment in liquidity reserve represents an estimate of three months of operating expenditures net of non-cash and externally funded expenditures allocated to fund a future wind-down or contingencies. • The net investment in property and equipment is the balance in capital assets less associated amortization. Financial instruments Initial measurement The College’s financial instruments are measured at fair value when issued or acquired. For financial instruments subsequently measured at cost or amortized cost, fair value is adjusted by the amount of the related financing fees and transaction costs. Transaction costs and financing fees relating to financial instruments that are measured subsequently at fair value are recognized in operations in the year in which they are incurred. Financial instruments consist of cash and cash equivalents, receivables, short term and long term investments, payables and accruals and deferred revenue. Subsequent measurement At each reporting date, the College measures its financial assets and liabilities at cost or amortized cost (less impairment in the case of financial assets), except for investments held, which are measured at fair value. The financial instruments measured at amortized cost are cash and cash equivalents, receivables, payables and accruals and deferred revenue. 32 For financial assets measured at cost or amortized cost, the College regularly assesses whether there are any indications of impairment. If there is an indication of impairment, and the College determines that there is a significant adverse change in the expected timing or amount of future cash flows from the financial asset, it recognizes an impairment loss in the statement of operations. Any reversals of previously recognized impairment losses are recognized in operations in the year the reversal occurs. The College’s main financial instrument risk exposure is detailed as follows: Credit risk Credit risk on financial instruments is the risk of financial loss occurring as a result of default or insolvency of a counterparty on its obligations to the College. The College’s credit risk is primarily attributable to receivables. Receivables are managed by closely monitoring delinquent contributors and ensuring that any late payments or deviations are investigated. Liquidity risk Liquidity risk is the risk that the College will not be able to pay financial instrument liabilities as they come due. The College’s liquidity risk from financial instruments is its need to meet operating requirements for payables and accruals. The majority of assets held by the College are invested in securities that can be readily disposed of as liquidity needs arise. Market risk Market risk is the risk that the fair value or future cash flows of a financial instrument will fluctuate because of changes in market prices. For purposes of this disclosure, the College segregates market risk into three categories: interest rate risk, currency risk and other price risk. The College is not exposed to significant currency or other price risk. College of REgistered Nurses of Nova Scotia Annual Report 2014 Notes to the financial statements College of Registered Nurses of Nova Scotia December 31 Interest rate risk • The College is exposed to interest rate risk through the cash and interest bearing investments held. The College manages its portfolio investments based on its cash flow needs and with a view to optimizing its interest income. The investments held as of December 31, 2014 are invested in guaranteed investment certificates, treasury bills, and mutual funds with fixed interest rates ranging from 1.75% - 4.4% with maturity dates between February 2015 to October 2018. Sensitivity to a plus or minus 1% change in rates would not have a significant effect on the College’s operations. Cash and cash equivalents Cash and cash equivalents include cash on hand and balances with banks. Investments Investments are carried at quoted market value. Gains or losses on sales of investments are recognized as investment income in the year of disposal. Property and equipment Property and equipment is recorded at its original cost and subsequently measured at cost less accumulated depreciation. Property and equipment is depreciated over its estimated useful life. Management reviews estimates of the useful lives of property and equipment and adjusts the estimates as required. Management regularly reviews assets for impairment and adjusts as necessary. Property and equipment is depreciated over the estimated useful life of the asset using the methods and rates as follows: Computer software and hardware Office equipment 40% declining balance 20% declining balance Leasehold improvements are being amortized using the straight-line method to the end of the lease term. Deferred revenue All fees collected or receivable as at year end, which relate to future fiscal years, are recorded as deferred revenue. Deferred lease incentive The deferred lease incentive is amortized on a straight-line basis over the term of the lease. Employee future benefits The College has a number of defined benefit plans that provide benefits to its employees. These include: the Post-retirement health subsidy benefit, Retirement allowance and participation in Nova Scotia Health Employees’ Pension Plan. The College accounts for the Post-retirement health subsidy benefit and the Retirement allowance using the immediate recognition approach. These plans are unfunded. The cost of pension benefits earned by employees are actuarially determined using the projected benefit method. The College accounts for participation in the multiemployer Nova Scotia Health Employees’ Pension Plan as a defined contribution plan. The College is not obligated for any unfunded liability, nor does the College have entitlement to any surplus that may arise in the plan. Contributions to this plan are required by both employees and the College. Total contributions made by the College during the year were $225,697 (2013–$209,991) and are recognized as an expense in the period. 33 Notes to the financial statements College of Registered Nurses of Nova Scotia December 31 Revenue Membership fees Revenue from membership fees are recognized on an accrual basis as the related services are provided. Investment income Investment income consists of interest income and realized and unrealized gains on investments. Interest income is recognized on an accrual basis. Realized gains or losses on sale of investments are the difference between the proceeds received and the cost of investments sold. Unrealized gains or losses on investments represent the difference between the carrying value at the year end and the carrying value at the previous year end or purchase value during the year, less the reversal of previously recognized unrealized gains and losses in respect of disposals during the year. Other income Income related to projects and professional development are recognized as the related services are provided. Use of estimates The preparation of the financial statements in conformity with ASNPO requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. By their nature, these estimates are subject to measurement uncertainty and the effect on the financial statements of changes in such estimates in future periods could be significant. Items subject to significant management estimates include useful lives of capital assets. 34 Allocation of expenses The College allocates its general IT, finance and human resources support expenses across administrative, legislative and member services. These allocations are determined annually based on the estimated amount of time the individuals within these support areas are working in each functional area. The amount allocated to each functional area is listed in note 11. 4. Investments 20142013 Total investments Less: Investments maturing within the next year $ 8,282,727 Long term investments $ 3,368,545 $ 7,826,170 (4,914,182)(6,223,591) $ 1,602,579 Total interest income earned during the year is $89,371 (2013 - $145,077). 5. Property and Equipment 20142013 AccumulatedNet bookNet book Costdepreciation value value Furniture and fixtures $ 424,985 Leasehold improvements 75,457 Computer equipment 189,952 Computer software 21,130 $ 337,069 35,384 146,677 15,318 $ 534,448 $ 177,076 $ 194,449 $ 711,524 $ 87,916 40,073 43,275 5,812 $ 98,722 42,313 45,810 7,604 College of REgistered Nurses of Nova Scotia Annual Report 2014 Notes to the financial statements College of Registered Nurses of Nova Scotia December 31 6. Payables and Accruals 20142013 employed, the retiring allowance will be paid to the employee’s beneficiary or estate. No allowance is paid to a member who terminates employment prior to eligibility for benefits. The most recent actuarial valuation of this plan was as of December 31, 2013. The next valuation will occur on December 31, 2015. Trade $ 250,003 $ 117,638 Information pertaining to the College’s defined benefit plans are as follows: Miscellaneous 104,569156,104 Government remittances 291,591345,054 Defined benefit obligation 20142013 $ 646,163 $ 618,796 7. Retirement Benefits Post-retirement health subsidy benefit Employees are eligible for a post-retirement health subsidy program if the employee retires directly from active status after age 60, has been employed by the College for a minimum of ten continuous years and is enrolled in the Health Association of Nova Scotia Health Plan. The benefit is equal to 65% of the monthly premium of either single, couple or family coverage as charged by the Health Association of Nova Scotia Retirement Health Plan. This subsidy ceases upon the retiree reaching age 65. The most recent actuarial valuation of this plan was as of December 31, 2013. The next valuation will occur on December 31, 2015. Retirement allowance Employees retiring after the age of 60 and who have been employed by the College for a minimum of ten continuous years are eligible to receive a retirement allowance. The allowance is equal to one weeks’ pay for each year of full-time service, to a maximum of 30 weeks. If an eligible employee dies while actively $ 58,282 $ 65,469 246,952234,895 $ 305,234 $ 300,364 Post-retirement health subsidy benefit Retirement Allowance Total The defined benefit costs recognized during the year are as follows: Employer current service cost Finance cost Defined benefit cost Retirement AllowancePost Retirement 2014 201320142013 $ 27,125 9,371 $ 18,791 9,612 $ 5,548 $ 2,170 4,832 2,523 $ 36,496 $ 28,403 $ 7,718 $ 7,355 Remeasurements and other items $ 20,994 $ 1,386 $ 4,613 $ (17,540) 35 Notes to the financial statements College of Registered Nurses of Nova Scotia December 31 Actuarial assumptions used in measuring the benefit cost and accrued benefit obligations include the following: Discount rate for benefit expense Rate of compensation increase for benefit expense Retirement AllowancePost Retirement 2014 201320142013 3.5% 3.5% 3.9% 3.5% 3.6% 3.5% Change in non-cash operating working capital Receivables Prepaids Payables and accruals Deferred revenue 3.5% 20142013 $ 9,377 $ (42,499) 6,404(3,130) 27,36734,913 (16,913)904,573 $ 26,235 $ 893,857 9. Commitments The College has entered into various lease agreements for premises and equipment. Minimum payments required over the next five years for the base rent of the premises lease and equipment leases are as follows: 36 2015 $ 385,941 2016392,834 2017391,475 2018399,762 201965,923 4.1% 8. Supplemental cash flow information 10. Government Contributions During the year, the College received government contributions as follows: Nova Scotia Department of Health - Nursing School Transcripts Nova Scotia Department of Health - Nova Scotia Telehealth Nova Scotia Department of Health Controlled Drugs & Substances NP Education Deferred contributions, beginning of year Deferred contributions, end of year Government contributions earned during the year 20142013 $ 14,400 $ 14,400 72,00072,000 28,000114,40086,400 93,60093,600 93,60093,600 $ 114,400 $ 86,400 Of the total government contributions earned during the year, $86,400 (2013 $86,400) is recognized in membership revenue while the remainder of $28,000 (2013 - $Nil) is recognized in other revenue. College of REgistered Nurses of Nova Scotia Annual Report 2014 Notes to the financial statements College of Registered Nurses of Nova Scotia December 31 11. Allocation of administrative expenditures MemberLegislatedTotalTotal services servicesAdministration 2014 2013 Finance and human resources Information technology $ 108,608 173,214 $ 108,608 173,214 $ 108,608 173,214 $ 325,824 519,642 $ 313,995 373,634 $ 281,822 $ 281,822 $ 281,822 $ 845,466 $ 687,629 12. Comparative figures The financial statements have been reclassified to conform with the financial statement presentation adopted for the current year. 37 CRNNS Staff exeCuTiVe offiCe Sue Smith, CEO & Registrar . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ssmith@crnns.ca Shelley Farouse, executive assistant . . . . . . . . . . . . . . . . . . . . . . . sfarouse@crnns.ca hillary maceachern, communications consultant. . . . . . . . . hmaceachern@crnns.ca Jane Wilson, communications consultant. . . . . . . . . . . . . . . . . . . . . . jwilson@crnns.ca Corporate Services Colleen Arnold, Director . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . carnold@crnns.ca Sheri MacLellan, Corporate Services Assistant . . . . . . . . . . . . . . . smaclellan@crnns.ca Karen Mahoney, Multimedia Designer . . . . . . . . . . . . . . . . . . . . . kmahoney@crnns.ca Susan Crowe, Finance Officer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . scrowe@crnns.ca Song Peng, Technology Applications Specialist . . . . . . . . . . . . . . . . . . . speng@crnns.ca Lee Whynot, Technology & Information Systems Officer . . . . . . . . lwhynot@crnns.ca Lidia Zykova, Records Management Analyst . . . . . . . . . . . . . . . . . . . . lzykova@crnns.ca Policy, Practice & Legislative Services Teri Crawford, Director . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . tcrawford@crnns.ca Jennifer Best, Practice Consultant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . jbest@crnns.ca Clare Brown, Practice Consultant . . . . . . . . . . . . . . . . . . . . . . . . . . . . cbrown@crnns.ca Darlene Martin, Administrative Assistant . . . . . . . . . . . . . . . . . . . . . dmartin@crnns.ca Lynn Miller, Policy Consultant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . lmiller@crnns.ca Crystal Morgan, Administrative Assistant . . . . . . . . . . . . . . . . . . . . cmorgan@crnns.ca Elizabeth Parenteau, Policy Consultant . . . . . . . . . . . . . . . . . . . . eparenteau@crnns.ca Paula Prendergast, Policy Consultant . . . . . . . . . . . . . . . . . . . . pprendergast@crnns.ca Professional Conduct & Registration Services Heather Totton, Director . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . htotton@crnns.ca Karen Boutilier, Administrative Assistant . . . . . . . . . . . . . . . . . . . . kboutilier@crnns.ca Ann Marie Cameron, Registration Officer . . . . . . . . . . . . . . . . . amcameron@crnns.ca Matthew Lafond, Professional Conduct Consultant . . . . . . . . . . . . mlafond@crnns.ca Krista Mosher, Registration Services Assistant . . . . . . . . . . . . . . . . kmosher@crnns.ca Darlene Mott, Professional Conduct Consultant . . . . . . . . . . . . . . . . . dmott@crnns.ca Elizabeth Parenteau, Professional Conduct Consultant . . . . . . eparenteau@crnns.ca Cathy Rose, Policy Consultant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . crose@crnns.ca Shelly Spears, Registration Services Assistant . . . . . . . . . . . . . . . . . . sspears@crnns.ca Haley Young, Administrative Assistant . . . . . . . . . . . . . . . . . . . . . . . hyoung@crnns.ca www.crnns.ca
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