What home health care services can nurses provide?

Nurses play a key role in the health of the population of Quebec, but few people know the scope of their role and the range of services they can provide. In this article, we shed light on the field of practice and the health care services that can be offered at home by registered nurses in Quebec.

The scope of nursing practice covers a vast field of activities, from the preventive aspect to the curative, rehabilitative and palliative aspects. In the document Le champ d’exercice et les activités réservées des infirmières, 3e édition, 2016, it is mentioned that like the medical profession, the scope of practice of the nursing profession is defined very broadly and has the broadest spectrum of interventions among health professionals. It focuses on the assessment of health status and the provision of care and treatment (OPQ, 2005).

There is a wide variety of nursing skills and depending on the qualifications, specializations and expertise, the rights to practice vary and are controlled by the Order of Nurses of Quebec (OIIQ). Also, many may be refundable if covered by your group insurance or applicable as a deduction on your taxes.

Do you know the advantages of nursing practice and which services can be offered at home?

Here are few exemples of possible nursing services offered at home:

• Breastfeeding support

• Contraception

• Covid-19 screening

• STBBI screening (sexually transmitted and blood-borne infections)

• Education and follow-up of hypertension

• Education and follow-up of COPD (chronic obstructive pulmonary disease)

• Education and follow-up of diabetes

• Education and follow-up of mental health diseases

• Drug injections

• Ear lavage

• Blood test

• Removal of stitches or staples

• IUD removal

• Colostomy or ileostomy care

• Foot care

• Wound care

• Preconception care

• Smoking cessation support

• Weight loss support

• Postpartum follow-up (baby and mother)

• PAP test

• Screening test for urinary tract infection

• Streptococcus screening test

• Memory test

• Treatment of plantar warts

• Vaccines (flu, shingles, etc.)

• Travel vaccines

Some of these services require a medical prescription or requisition. Once obtained, the service and its follow-up can be done by the home nurse.

Note: The nurse is required to recommend a medical visit if the care is beyond their skills or scope of practice.

Here is the complete list of activities reserved for nurses of the Order of Nurses of Quebec:

1. Assess the physical and mental condition of a symptomatic person;

2. Exercise clinical supervision of the condition of persons whose state of health presents risks, including monitoring and adjustments of the therapeutic nursing plan;

3. Initiate diagnostic and therapeutic measures, according to a prescription;

4. Initiate diagnostic measures for screening purposes, as part of an activity determining the application of the Public Health Act;

5. Perform invasive diagnostic examinations and tests, as prescribed;

6. Perform and adjust medical treatments, as prescribed;

7. Determine the treatment plan related to wounds and alterations of the skin and integument and provide the care and treatment related thereto;

8. Application of invasive techniques; example, surgical assistance acts;

9. Contribute to pregnancy monitoring, delivery practice and postnatal monitoring;

10. Provide nursing follow-up for people with complex health problems;

11. Administer and adjust medications or other substances, when they are over the counter or subject to a prescription;

12. Carry out vaccinations, as part of an activity resulting from the application of the Public Health Act;

13. Mixing substances to complete the preparation of a medication, according to a prescription;

14. Decide on the use of restraint measures;

15. Decide on the use of isolation measures within the framework of the application of the Act respecting health services and social services and the Act respecting health services and social services for Cree Native persons;

16. Evaluate mental disorders, with the exception of mental retardation, when the nurse has university-level training and clinical experience in psychiatric nursing, determined within the framework of a regulation;

17. Assess a child who is not yet eligible for preschool education and who shows signs of developmental delay, in order to determine rehabilitation and adaptation services that meet his needs.

It is important to remember that the activities that are stated in broad and generic terms include, given their general scope, the activities more precisely defined and reserved for other professionals, in accordance with the description of the scope of nursing practice.

For more information, refer to the following OIIQ document (only French version available): Le champ d’exercice et les activités réservées des infirmières et infirmiers