Nurse Practitioner - Neurology/Neuromuscular Clinic

Medical Directive ID: 
Lead Contact Person: 
Wilma Koopman, RN, NP
Physician/Nurse Lead: 
Dr. Michael Nicolle, Chief, Division of Neurology
Clinical Neurological Sciences
Approval By: 
Medical Advisory Committee
Original Effective Date: 
Wednesday, June 8, 2011
Revised Date: 
Wednesday, July 18, 2018
To Be Reviewed Date: 
Sunday, July 18, 2021
This Medical Directive Applies to the following sites: 
Thames Valley Children's Centre
This Medical Directive Applies to the following patient population: 


**This directive is a renewal and replaces directive # CNS-2010-001 & CNS-2014-002** Nurse Practitioner (NP) Diagnostic and Prescriptive Authority: NPs in Ontario are authorized to order the following diagnostic tests:

•X-rays of the chest, ribs, arm (includes shoulder and elbow), wrist, hand, leg (includes hip andknee), ankle and foot, as well as mammography –– includes specific views (e.g. coned)

•Diagnostic ultrasound of the abdomen, pelvis and breast –– includes specific views (e.g. of aspecific organ), techniques (e.g. transvaginal) or indications (e.g. pregnancy) within theseanatomical regions

•Electrocardiograms in non-urgent, non-acute circumstances


Due to advanced specialty scope of practice, NP’s in Adult Neurology/Neuromuscular Clinic (NMC) at London Health Sciences Centre- Victoria Hospital (LHSC-VH), University Hospital (LHSC-UH) and Thames Valley Children’s Centre (TVCC) require medical directives only for additional diagnostic and prescriptive authority which falls outside this jurisdiction, to provide timely and appropriate care as outlined in Appendix 1.

Click the link to view the entire medical directive in detail: 


SurnameKnown ByDate Signed
DohertyTimothySep 4 2018 04:17:17:310PM
Florendo-CumbermackAnitaAug 26 2018 12:18:39:187PM
NicolleMichaelSep 13 2018 02:44:32:750PM
ShoesmithChristenAug 28 2018 11:59:28:630AM
VenanceShannonAug 29 2018 04:08:00:890PM