CHNC - National Nurses CHNC - National Nurses

BREAKOUTS 300
Wednesday, June 27th 2:00pm–3:00pm


2:00pm – 3:00pm - 60 Minute Networking Café

300: Getting a Pulse on the Adoption of the Canadian Association of Schools of Nursing (CASN) Entry-to-Practice PHN Competencies in Curriculum and Practice
 
CASN Community Health Nurse Educators Interest Group: 
Ruth Schofield, Francoise FilionSylvane FiliceMarie Dietrich Leurer, Kate McCulloch, Dawn Mercer-Riselli, Donalda Wooten

Entry-to-practice public health nursing competencies help to define the expected knowledge, skills, and attitudes essential for the generalist preparation of registered nurse graduates and new hires in public health. To support the integration of this competency framework in curriculum and practice, an on-line teaching strategies website was created. The question is how well have these tools been adopted in undergraduate nursing education and practice since their release? Survey results from one province prompted a national response to understand the extent of concerns regarding the preparation of new graduates for public health nursing practice. The CASN Community Health Nurse Educators Interest Group conducted a national survey of schools of nursing and public health organizations in Canada. The results will be presented at this network cafe. We are keen to hear your thoughts about the results, to create dialogue about their meaning and implications, and to explore strategies going forward. The intent of the network café is to advance the Blueprint for Action for community health nursing education and workforce development.

Learning Objectives:
  • increase awareness of the adoption of the entry-to-practice PHN competencies in undergraduate nursing education and public health practice
  • become familiar with the use of the complementary on-line teaching strategies
  • discuss the meaning of the survey results, and 4) identify options and possible strategies to address the results.

301: Opportunity and Action: Leadership for Health Equity
Claire Betker, PhD, RN, CCHN(C), Manitoba Health, Winnipeg, MB, Dianne Oickle, MSc, PDt, National Collaborating Center for Determinants of Health, Antigonish, NS

Attention to leadership to address health equity within the nursing profession has grown due to visible commitments, health equity in strategic planning and priority setting, and an increased evidence base to demonstrate the impact of inequities on population health. Leadership competence requires nurturing and support, and embedding equity within formal and informal leadership structures is foundational to organizational capacity for action on health equity. Consistent with the conference theme of "developing leadership”, the focus of this session will be on identifying tools and levers to support leadership action to address health inequities.

In 2016, a scoping review and metasummary on public health leadership for action on health equity was completed as PhD dissertation research (Betker, 2016). Results revealed that values of social justice and solidarity, as well as relationships, are core to public health leadership capacity. The relational aspects of leadership for health equity meant engaging at both political and community levels, and included a unique enabling or bridging role between multiple system levels simultaneously. Contextual and situational knowledge were as important as clinical knowledge, and leadership at individual, organization, and community levels were all important to taking action on health equity. However, public health practitioners in formal and informal leadership positions are not always trained in leadership and have limited opportunity to explore this area of competence.

The National Collaborating Centre for Determinants of Health (NCCDH) collaborated with the author to produce two documents highlighting the relevant findings of this research, to be shared with participants. This interactive and generative session will consider tools and strategies to develop and support leadership competence. Speakers will be drawn from local, regional, and national public and community health sectors. This session will build on outcomes from prior provincial and national evesessionsnts on this topic by the same presenters

Learning Objectives:
  • Identify tools and mechanisms to develop and support public health leadership at multiple levels.
  • Describe factors that impact leadership action for health equity.
  • Consider strategies to empower public and community health nurses as leaders for equity action.
 
302: Exercise Is Medicine: Implementing Nordic Walking Programs within Community Care
Claudia Mariano, MSc, NP-PHC, CDE, West Durham Family Health Team, Pickering, ON, Jessica Lewgood, CEP, MSc , Kin Fit Family Health & Wellness, Estevan, SK, Gabriella De Nino, BaSC, Urban Poling

This interactive session will include both a hands on component during which practical skills will be taught, and research based studies that support program implementation within the community setting.  The remaining thirty minutes will focus on the success of the programs that have already been implemented by Family Health Teams, using the West Durham Family Health Team as a primary example, but will highlight others as well. Relating research to support the findings of study-based cases will be communicated and discussed.

If told to exercise on their own, many patients will not do so. If provided with an opportunity to engage in some form of exercise that is offered by a trusted health care team, patients are more likely to participate and continue their exercise regime beyond the clinic/community health care center through positive engagement.

To provide an overview of the success of integrating reputable Nordic Walking programs into primary and secondary care settings as a means of providing patients access to an affordable and accessible fitness activity through Family Health Teams, Nurse Practitioner Clinics and Community Health Centers. Nordic walking provides a dual combination of much needed resistance and cardiovascular training in an easy to learn work-out. By incorporating these programs in primary and secondary care settings, intervention patients are offered opportunities to learn this safe and low impact form of fitness while being monitored and supported in a conducive social setting.  Beyond the physical benefits, patients will reap the added benefits around positive mood and increased energy levels.

Learning Objectives:
  • Understand the basic steps of Nordic Walking as well as an alternative technique for those patients (or for themselves) who require more support with balance or off-loading.
  • Understand the research which supports this form of physical activity and key nuggets to be able to share with their patients.
  • Gain an understanding of how they can implement such a program into their community practice through examples of other successful programs.
 
2:00pm – 2:25pm -25 Minute Oral Presentations

303A: Marketing and Building a Brand, the Fundamental Tools of the Professional Nursing Student
Logan Tullett, Ryerson University, Toronto, ON

Despite the amount of marketing we as students need to do in order to distinguish ourselves during placement interviews and upcoming job interviews, there is no distinct class or curriculum within nursing school that addresses how students effectively execute this tool. During both my community and my current public health placement, being able to reach out to community partners was essential for my success in getting initiatives off the ground and convincing board members that I was serious about my mission and objectives. Being able to take on this leadership role and work towards partnering with people and organizations that share the same values and goals is what every successful community and public health nurse needs. By directing students on some of the most basic marketing tools that can be applied to the nursing profession, I believe we can create a new calibre of student. Understanding how to write an email in the hopes of networking, how to engage an audience, what answers are best suited for nursing interview questions, and how to use social media to get messages across in nursing, these are all major factors that many students are neglecting. It is my goal to introduce tactics and personal practices that may help them to become more engaged in the world of community and public health nursing so that they may create positive change through building initiatives, addressing public policy, and advocating from a professional standpoint.

Learning Objectives:
  • Building a brand from a professional, ethical and compassionate standpoint.
  • Understanding the importance of communicating and marketing oneself as a nursing student so that potential employers and organizations can better understand your long term value as a nursing staff.
 
304A: Palliative Care Competencies to support Integrated Palliative Care: A Review of the Nova Scotia Journey on Competenciy Framework Devlelopment
Karen Curry, RN MN CCHNc, Victorian Order of Nurses, Halifax, NS

Palliative Care has been receiving national attention in recent years and many reports and frameworks have been developed. In NS the DHW in an effort to promote integrate palliative approach to care developed provincial working groups to work on system change. In 2015 a Working Group was engaged to identify palliative care learning needs across the continuum of care in NS and recommend standardized education. The first step was to identify palliative care competencies for NS health professionals and volunteers. A literature search and environmental scan was completed. The Irish Palliative Care Competence Framework was chosen as the foundation for the NS Palliative Care Competency Framework. Multiple reviews by stakeholders, including health professional colleges, refined the Framework, which outlines both shared and discipline-specific competencies for twenty disciplines and palliative care volunteers. The Framework was then mapped to available educational programs. Pallium’s LEAP(TM) was selected as the primary provincial education program. The framework includes competencies for twenty-one disciplines, six nursing sub-specialties and two physician specialties. The work group invited a public advisor to be part of the working group to ensure work was client centred. This presentation will provide an overview of the process and sharing of the lessons learned from the work and other work on palliative care in NS. CHN working in a variety of settings can draw from the work and share awareness of the framework that can be used to spread the palliative approach to care across care locations. CHN involved in education could also draw from the Framework as a resource when developing resources to support CHN awareness of palliative care in the community

Learning Objectives:
  • Identify the engagement process with stakeholders to develop a comprehensive framework
  • Discuss the value of having a pubic representative involved in the development of a competencies framework.
  • Access resources to support palliative care integration in home and community care

305A: Nunatsiavut: Our Land, Our Air, TB Free Together Campaign 
Sylvia Doody, RN BN MPH CCHN(c), Nunatsiavut Government Department of Health and Social Development, Happy Valley-Goose Bay, NL, Tina Buckle, RN BN CCHN(c) Nunatsiavut Government Department of Health and Social Development, Happy Valley-Goose Bay, NL

In Nunatsiavut, TB has been endemic since the 1950’s and continues to be a major health concern. Since 2009 there have been 3 TB outbreaks which have caused significant community anxiety and fear because of the historical context of TB in the region. The most recent outbreak involved young adults sharing smoking devices. During a community engagement session in Hopedale, it was identified by the community that a TB education campaign was needed to reach out to high risk groups.

Learning Objectives:
  • mobilize and engage youth in innovative health promotion initiatives
  • appreciate the importance of a harm reduction approach as it relates to TB health promotion

306A: Participatory Action as a Research Method with Public Health Nurses 
Cheryl Cusack, RN, Phd Manitoba Health, Winnipeg, MB

This session explores and describes participatory action research as a preferred method in addressing nursing practice issues. This is the first study that used participatory action research with public health nurses in Canada to develop a professional practice model.

Participatory action research is a sub-category of action research that incorporates feminist and critical theory with foundations in the field of social psychology. For nurses, critical analysis of long-established beliefs and practices through participatory action research contributes to emancipatory knowledge regarding the impact of traditional hierarchies on their practice.

This study resulted in individual and system change that may not have been possible without the use of participatory action research. The focus was  engagement of participants and recognition of their lived experience, which facilitated public health nurses’ empowerment, leadership, and consciousness-raising.

Learning Objectives:
  • Discuss participatory action as a research method
  • Appreciate the importance of participatory approaches that include nursing staff in decisions pertinent to their practice
  • Describe how participatory action resulted in individual and system change; simultaneously, engaging participants and building on their lived experience to facilitate their empowerment, leadership, and consciousness-raising.
 
2:35pm – 3:00pm -25 Minute Oral Presentations

303B: Transforming Hard Copy Documentation to an Electronic Format… How Hard Can It Be?

MaryJane Herlihey, RN, BScN, CCHN(C), ParaMed Home Health Care, Ottawa, ON,  Pauline Therrien, BScN, RN , ParaMed Home Health Care, Ottawa ON
 
Automation of any type of clinical documentation offers many benefits: legibility, standardization; efficiencies; improved communication, real time point of care reporting, just to name a few. However the transformation process to automation and sustainability is also multifaceted, complex and challenging. In ON, home health care organizations with contracts with the Local Integrated Health Networks (LHIN) (formerly CCAC) are required to submit service provider reports which are completed by front  line clinicians. In 2010, the former ON Association of Community Care Access Centres introduced a standardized automated version of the report for service providers to use. This was a welcoming and exciting change for service providers as it would:  eliminate the inefficient paper process; improve timeliness communication with the LHIN and in addition standardize the form itself.

In 2014 this home health care organization implemented its first of many Automated Provider Reports (APR). Although we felt our automated form was well designed and that we had a solid implementation and sustainability plan in place we were unprepared for some of the unknown road blocks and challenges ahead. In addition we did not have the complete insight into the impact the APR would have on our operations and front line clinicians. We thought it was just a form and that it would be fairly simple and easy to use.

In this presentation we will provide a highlight of our APR journey, sharing the highs, the lows, the lessons learned and the triumphs. In addition we will provide the audience with information on the key factors (external, human, operational processes and technology/systems) that need to be considered when designing, planning or implementing any automated electronic clinical documentation system project, big or small.

Learning Objectives:
  • Gain an understanding of the multifaceted complexities and challenges that can occur with a transformation of clinical documentation from paper to automation.
  • Identify key factors to consider with the design, plan and implementation of any clinical informatics project.
  • Identify key processes and tools to utilize when designing and implementing automated electronic clinical documentation projects.

304B: Developing a Cancer Pain Management Learning Module for Registered Nurses in Palliative Home Care

Gina Fleming, RN BN MN, Saskatchewan Polytechnic, Regina, SK, Creina Twomey BN MN PhD Memorial University of Newfoundland, St John's, NL

There has been a recent shift to provide cancer treatments in outpatient settings, which presents challenges for patients and healthcare providers to achieve optimal pain management. Pain is the most feared symptom of newly diagnosed cancer patients and it is the most common symptom experienced by patients with advanced cancer. Despite extensive advances in treatments and research, cancer patients continue to be under treated for pain. The rational for this project is that improving nurses’ knowledge and understanding will enable them to optimize cancer pain management in the community setting, which leads to better patient outcomes and reflects a client- centered approach to care as registered nurses (RNs) are amongst the most accessible health care providers for palliative patients and families.

A literature review was conducted to identify content for the learning module. Interviews were conducted with the Medical Director and Clinical Nurse Specialist (CNS) and a focus group was facilitated with four RNs to identify content and explore barriers related to cancer pain management. Ethical approval was obtained from the Regina Qu’Appelle Health Region (RQHR) Research Ethic Board (REB) prior to the colleague consultation process.

A learning module was developed based on findings from the literature and colleague consultations. Key learning outcomes include: identifying aspects of comprehensive pain assessment, describing principles of opioid management for cancer pain, identifying adjuvant medications and non-pharmacological interventions for cancer pain management, and describing how to complete an independent double check when pre-loading high alert medications in a community setting. The learning module has been developed for Palliative Home Care to serve as an educational resource for RNs new to the Palliative Home Care practice environment.

Learning Objectives:
  • Participants identify aspects of a comprehensive pain assessment.
  • Participants will describe principles of opioid management for cancer pain.
  • Participants will describe how to complete an independent double check when preloading medications in a community setting.
  
305B: Student-Based Interprofessional Initiative to Enhance Trauma Informed Care Pedagogy

Aja Toste, BSc (hons), BScN (candidate), University of Toronto, Toronto, ON,  Rachelle Marek, BA (hons), BScN (candidate), University of Toronto, Toronto, ON,  Daniela Graziano, MSc, BScN (candidate), University of Toronto, Toronto, ON,  Sarah Kanji, BSc, MSc,  MD student, University of Toronto, Toronto, ON,  Sarah Freeman, BHSc, MD student, University of Toronto, Toronto, ON,  Julia Pasquale, BMSc, MSc, MD student, University of Toronto, Toronto, ON,  Athena Hau, BSc (hons), BScN student, University of Toronto, Toronto, ON

An interdisciplinary team of nursing and medical students from the University of Toronto collaborated to offer a seven-hour long TIC workshop. The total number of participants consisted of 75 nursing and medical students representing three different ON universities. The event included the following: presentation of a narrative project on adverse health experiences; an introduction to TIC; small-group workshops focused on interviewing, physical assessment, and moving forward from disclosure of trauma (topics included safety planning, self-care, and addressing vicarious trauma); and an interdisciplinary panel discussing healthcare providers’ experiences in working within a TIC framework. To evaluate the success of this model, each participant was asked to complete a workshop feedback form, as well as pre- and post-surveys to assess changes in knowledge, skills, and confidence in integrating trauma informed care into their future practice.

Learning Objectives:
  • To describe effective strategies to integrating comprehensive trauma informed care into nursing and medicine curricula.
  • To describe the outcomes of a one-day trauma informed care event on participants’ confidence in and application of trauma informed care practices.
  • To expand and replicate workshops in other universities and across healthcare settings.

306B: Ready to Roll? Examining the Readiness and Role of Canadian Nurses in the Legalization of Cannabis

Karey Shuhendler, RN, CCHN(C), MN , Canadian Nurses Association,  Josette Roussel, RN, MSc, MEd, Canadian Nurses Association,  Ashley Chisholm, MSc., Canadian Nurses Association,  Chantelle Bailey, PGDip, MSc, PhD, Canadian Nurses Association

CNA is developing educational resources to meet the needs of nurses in Canada, and will undertake an evaluation of the effectiveness of these tools used by nurses to educate people in Canada on the risks, harms and harm reduction strategies for non-medical cannabis use.

Community health nurses have a unique opportunity to provide leadership as it pertains to informing development of cannabis education, and implementing into practice. As Canada moves forward with legalization of recreational cannabis, there is consensus from health organizations that a robust public education campaign is necessary to prepare the public for this new policy direction. While CNA has advocated for such a public education approach, we maintain that adequately preparing Canada’s nurses is an essential component of such an approach. As the largest group of healthcare providers, and often a person’s first point of contact with the health care system, nurses have a responsibility to provide support, education, and referral as necessary for cannabis users regardless of whether they are using legally or illegally.

In 2017, to inform the Canadian Nurses Association (CNA) policy work on the legalization of non-medical cannabis, CNA engaged with nurses using a national survey to assess their knowledge on non-medical cannabis use. This assessment has been a key element to develop CNA’s response to the federal legislation on non-medical cannabis and advance policy to meet the needs of nurses in Canada.

Learning Objectives:
  • Learn about the leadership role of the nursing association in the legalization of non-medical cannabis
  • Identify nurses self-reported knowledge gaps related to harms of non-medical cannabis use
  • Identify next steps for nurses and nursing organizations as key participants in health education and harm reduction, as legalization of non-medical cannabis moves forward