Utilizing RNs with Additional Authorized Practice [RN(AAP)]

I am a manager of a facility and have had a staff member approach me about changing the care model to include the RN(AAP) role. What is an RN(AAP), and what do I need to consider before incorporating them into an existing care model?

An RN(AAP) is a Registered Nurse (RN) in good standing in the general practice category who is authorized to treat limited common medical disorders according to specific clinical decision tools (CDT) (1)

It is the responsibility of all RNs in Saskatchewan to understand the standards of practice, code of conduct, and entry-level competencies and be accountable to apply these to their nursing practice in every nursing role and practice setting.

• In addition to the indicators contained in the five Practice Standards for general RN practice, RN(AAP) have additional responsibilities for professional accountability, professional responsibility, and knowledge-based practice (2).

Scope of practice for RN(AAP) practice is defined by Clinical Decision Tools (CDT) and is not restricted to a geographic area or location. Although AAP practice was initiated in remote northern communities, there is no restriction geographically, and therefore, no barriers to implementation in the setting you manage, providing there are practice supports available, including policy and consultation resources (3).

CDTs have been developed based on limited common medical conditions, are specific to RN(AAP) practice and must be used by the RN(AAP) in conjunction with their clinical knowledge and judgment to ensure appropriate client care is provided (4).

RN(AAP) practice is restricted to the:

• setting they are hired to practice as an RN(AAP);
• description of their roles and responsibilities;
• directives of the CDTs and the health needs of the client; and
• the activities they are competent to perform (5).

To safely implement this care model, the following requirements must be applicable (6):

• There is current evidence that the client need is proportional to the available providers.
• There exists an ability to seek consultation with, and guidance from, a physician and/or NP, to ensure the client’s needs are met in a timely manner, when:
  • addressing the needs of the client in emergency situations beyond RN(AAP) practice contained in the CDTs;
  • the client’s condition deteriorates, or symptoms persist despite treatment;
  • the care exceeds what an RN(AAP) can perform for a limited common medical disorder as described in the CDT.
  • there are no other employer-approved means to provide the necessary care (i.e., RN Specialty Practice Clinical Protocol).
• The ordering and dispensing of medication comply with all federal and provincial legislation.
• That within the context of care, the RN(AAP) are refraining from diagnosing, treating, or prescribing for oneself, friends, co-workers, or family members who are not under their authority to treat and when other RN(AAP)s, physicians or NPs are available.
• Access to specific diagnostics and screening tests listed within the CDTs are available for use in determining a differential diagnosis.
• That the care model is sustainable, consistent, and agile enough that the public has a reasonable expectation to receive the same care day to day. This may be achieved through adopting a model that combines RN(AAP) practice as well as RN optimization with Clinical Protocols using the RNSP model.

It is important that any model of care change is developed strategically in collaboration with all team members at all levels of the organization to ensure the safety of the public. A care model change should not be implemented to accommodate an individual request, recognizing that health teams are dynamic and interdependent. Evaluating the goals and ensuring the client remains at the center of care should be completed at scheduled intervals or when opportunities for improvement are identified.

CRNS Resources

Bylaws

Registered Nurse Practice Standards (2026)

Code of Conduct (2026)

RN with Additional Authorized Practice [RN(AAP)] Practice Standards (2026)

Clinical Decision Tools (CDTs)