CHNC - National Nurses CHNC - National Nurses

Thursday, June 28th 9:30am–10:30am

9:00am – 12:00pm – 3 hour Leadership Workshop 

400: Developing Leadership Competencies for Advancing PHN Practice

CHNC Standards & Competencies Standing Committee and CHN Leadership Institute Subcommittee: 

Ruth Schofield, Genevieve Currie, Francoise Filion, May Tao, Fay Michayluk, Andrea Baumann

Leadership plays a pivotal role in the lives of all public health nurses. It is an essential element for quality professional practice and practice environments. Leadership is a shared responsibility – public health nurses in all domains of practice and at all levels must maximize their leadership potential. Changing practice environments over the past few years have made acquiring leadership skills and influencing change with these skills more challenging.

Public Health Nurses use leadership competencies to build capacity in organizations, communities and with individuals. Public health nurses face population health and system level issues on a daily basis. Leadership competencies are required to address these issues on the front line and in nursing management. In an interactive workshop, leadership competencies will be shared and linked to key strategies and tools addressing public health nursing practice issues. Strategies and tools will be introduced to assist participants to build on their leadership capacity and skills to advance frontline nursing practice, education and administration. The LEADS framework for leadership development and learning needs as well as the Organizational Readiness to Change Assessment tool will be discussed

Learning Objectives:
  • Become aware of leadership development needs for PHNs
  • Reflect on personal learning needs for leadership development
  • Learn about the LEADS framework within leadership development
  • Identify how to use the ORCA tool to support practice change

9:30am – 10:30am- 60 Minute Oral Presentations

401: Introduction to a Client Centered and Culturally Safe Assessment Tool for Community Health Nurses (The BC First Nations Health Authority Roadmap to Wellness Tool and Daily Organizer)

Susan Stoneson RNc, BSN, MN, ANP, First Nations Health Authority, Vancouver, BC

In this presentation nurses will be introduced to the BC First Nations Health Authority Roadmap to Wellness Tool and Daily Organizer. These tools can be used by Community Health Nurses to work with individuals and groups to identify gaps in wellness and support them to make SMARTER goals as they create their own wellness plan. The tool is based on the First Nations perspective of wellness and uses the wellness wheel to emphasize that wellness belongs to every individual. Throughout these tools wellness is looked at through a holistic lens and broken down into the categories of Spiritual (Culture and Tradition and Nurturing the Spirit); Physical (Fun and Recreation and Physical Health); Mental (Stress Management and Career Satisfaction) and Emotional (Family and Friends and Significant Other). The option of using Brief Action Planning and Motivational interviewing strategies to break down the smarter goals into an individual realistic plan is also an option. The accompanying Daily Organizer mirrors the Roadmap tool and provides a resource for journaling, goal setting and acts as a food diary to support weekly goals and lifelong wellness. These resources provide community health nurses with wellness plan assessment tools that model client centered and culturally safe practice.

Learning Objectives:
  • After this session participants will be able to be introduced to the BC First Nations Health Authority Roadmap to Wellness Tool and Daily Organizer
  • After this session participants will be able to identify the BC First Nations philosophy of wellness  wheel
  • After this session participants will be able to understand how to use an assement tool that demonstrates client centered and culturally safe practice
9:30am – 9:55am- 25 Minute Oral Presentations

402A: Preparing to Parent in British Columbia:  A Profile of BC Healthy Connections Project Participants (Nurse-Family Partnership)

Nicole Catherine, MSc, PhD, Children's Health Policy Centre, Vancouver, BC,  Charlotte Waddell, MSc, MD, CCFP, FRCPC, Simon Fraser University, Vancouver, BC,  Rosemary Lever, B.Sc., M.A., Simon Fraser University, Vancouver, BC,  Donna Jepsen, RN CCHN(C), BSN, IBCLC, MSc, CCNE, BSN, IBCLC, MSc, CCNE, Ministry of Health, Vancouver, BC

The BCHCP involves a randomized controlled trial (RCT) investigating the effectiveness of the Nurse Family Partnership (NFP) program compared to existing BC services in improving child and maternal health (2012-2021). NFP is an evidence-based, intensive public health nurse-home visitation program for young pregnant women experiencing socioeconomic disadvantage that begins early in pregnancy and continues until children are two years old. The BCHCP involves a unique policy-practice-research collaboration with 3 Ministries (Health; Mental Health and Addictions; and Children and Family Development), all regional health authorities, and a team of international investigators.

Baseline descriptive data are now available on participants when they first entered the trial early in pregnancy, prior to randomization (to existing services or NFP). These data show that unacceptable pockets of concentrated disadvantage exist in this population of pregnant girls and young women.

These findings confirm that public health is reaching the population that NFP is intended to support. Beyond NFP, these data support renewed efforts and new public health initiatives to better address the inequities in the social determinants of health starting early in life – a finding with important implications for community health nurses across domains.

Learning Objectives:
  • Recognize the innovative aspects of the BCHCP, in particular how formal policy, academic, provider, and community collaboration was built into this provincial initiative
  • Explore how unacceptable pockets of deep socioeconomic disadvantage exist for BC girls and young women who are preparing to parent for the first time
  • Identify the rigorous scientific methodology of a BC-wide public health intervention involving a randomized controlled trial design
403A: Investigation of Anemia Levels in the Pre and Postnatal Population on Southern Saskatchewan First Nation Communities

Catherine Miller, RN, BSN, MN, Department of Indigenous Services Canada, Fort Qu Appelle, SK
A First Nation Inuit Health Branch, South Service Center nursing Maternal and Child Health report indicated there is a high proportion of postpartum women residing on Southern First Nation Communities, demonstrating low hemoglobin levels or anemia. The data utilized for this report was incomplete and was only obtained from one tertiary care center, therefore it was decided more data was required to understand the extent of the anemia within this population. A descriptive design study was developed to assess anemia within the pre and post natal population residing on twenty five southern Saskatchewan First Nation Communities. Hemoglobin testing was initiated to be incorporated within the community health nursing pre and post natal program January 2017. The Community health nurses were trained and provided with Hemocue hemoglobin meters, as well as additional resources. Data is to be collected for one year to January 2018 . Preliminary data analysis for January-October 2017 was preformed and found;  Sixteen communities participated in the data collection, Two hundred and three pre or post natal clients were identified. Eighty percent of the prenatal clients were tested with thirty -six percent demonstrating mild or moderate anemia. Ninety-two percent of the postnatal clients were tested and fifty percent demonstrated anemia. Analysis of the complete year data collection is to occur in the near future. In addition, future activities will include investigation regarding the cause(s) of anemia, interventions to prevent or treat anemia and to incorporate hemoglobin testing into the Community Health Nurses regular practice.

Learning Objectives:
  • Understand  the extent of anemia in the on reserve pre and post natal First Nation population in southern Saskatchewan.
  • Understand the importance to  incorporate hemoglobin testing into Community Health Nursing Practice
  • Identify a need for enhanced interventions for anemia
405A: Filling the Void: Development of a Home Health Education Program

Lisa Bower, RN, MN, Vancouver Coastal Health, Vancouver, BC, Ipsita Banerjee, RN, BSN, Vancouver Coastal Health, Vancouver, BC,  Linda Chau, RN, BSN, Vancouver Coastal Health, Vancouver, BC,  Nubia Martens, RN, BScN, BEd, Vancouver Coastal Health, Vancouver, BC

The Regional Home Health Education Program (RHHEP) was designed in response to changes in the collective agreement with the union and lack of qualified applicants applying for home care nurse positions. The job description required two years of community care experience. The purpose of the program is to qualify registered nurses to go into home care nurses positions by providing eight weeks of paid education across three communities of care. The development of the program involved multiple subject matter experts and stakeholders in addition to educators. On-line prerequisites are required prior to the start of the eight week program. The first six weeks consist of classroom days, followed by practice days that involve being partnered with a preceptor to apply and consolidate knowledge. Topics covered in the classroom include: introduction to home health practice, electronic documentation, care of the older adult, self-management support, wound care, ostomy care, medication management, working with unregulated care providers and palliative care. The last two weeks require the learners to carry modified caseloads doing independent home visits. Reflection is expected as well as homework assignments. A competency evaluation tool is used to determine if the learners have been successful in completing the requirements. Some of the challenges have included upskilling facilitation skills of educators, discomfort with evaluating learners, lack of classroom space and limited suitable applicants applying to the program. The program has been run twice and resulted in a total of 34 new home care nurses ready to support clients and feeling supported due to the cohort model. The program also resulted in education of current staff to become preceptors and support the learners. In conclusion, a regional home health education program can be implemented across several areas to make new nurses more job ready in this unique area of nursing practice.

Learning Objectives:
  • Describe the components of the Regional Home Health Education program (RHHEP)
  • Summarize lessons learned and unintentional learning outcomes as a result of the program
  • Examine if a similar program could be applied in your region
10:05am – 10:30am- 25 Minute Oral Presentations

402B: Leading Nursing Innovation in Public Health Practice
Katie Dilworth, MHSc, BScN, RN, CHNC(C), Toronto Public Health, Toronto, ON

Getting the right nurse in a role is one of the most pressing and important roles for organizations. A strong health system, in fact, is founded upon clear professional nursing roles that reflect the full range of community health nursing competencies. Public Health Nursing (PHN) in this large urban health unit demands a broad range of competencies along with a very strong foundation in social determinants of health and health equity. Evaluation of the organization's recruitment process demonstrated challenges in filling PHN positions. The process was arduous, time consuming, and some PHNs hired into specific roles had limited competencies for the breadth of nursing opportunities public health nursing. The status quo was no longer an option in the face of current and anticipated changes in the healthcare system.

A Strategic PHN recruitment process was designed and implemented that integrated the CHNC Standards of Practice and PHN Competencies. The goal was to ensure nurses have a consistent broad range of skills and are ready for suitability interviews for vacant positions. The initiative involved recruiting nurses into a pool which managers could access for suitability interviews as vacancies arose.

Evaluation demonstrated nurses interested in working in public health gained a better understanding of public health nursing and were more prepared for the evaluation process. Successful candidates had a broad range of skills that enabled participation in a variety of nursing opportunities. Managers identified efficiencies and improvements in the recruitment process. Professional expectations represented in the Canadian Community Health Nursing Standards of Practice are a vision for excellence in nursing practice and ensure our clients and community's health. This innovative strategy demonstrates their value to public health organizations.

Learning Objectives:
  • Community Health Nurses will increase their understanding of how the CHNC standards and competencies are foundational to Public Health Nursing.
  • Nursing leaders will learn about an innovative strategy that enables strategic recruitment of nurses.
  • Participants will learn about the outcomes of the evaluation of the strategy.
403B: Nunatsiavut Sexual Health & Wellness Program

Tina Buckle, RN BN CCHN(c), Nunatsiavut Government Department of Health and Social Development, Happy Valley-Goose Bay, NL,  Sylvia Doody, RN BN MPH CCHN(c), Nunatsiavut Government Department of Health and Social Development, Happy Valley-Goose Bay, NL

In Nunatsiavut, sexual health and wellness education was not standardized. Education was delivered by various professionals with varying levels of sexual health promotion training and comfort delivering program content. Sexual health and wellness materials were often outdated, lacked cultural sensitivity and consistent messaging.

The development of the Nunatsiavut sexual health & wellness program included an environmental scan of current sexual health and wellness programming, youth engagement sessions along with a survey, and resource development based on feedback from the youth engagement sessions and surveys. There was also a poster and slogan development contest to brand the program. Program materials and promotional items bearing the new logo were developed to accompany the new resource to be used during the roll out. An advisory group made up of collaborative partners lead this process.

This public health program demonstrates innovation because youth were integral in informing the development of a sexual health and wellness program from program inception to completion. Youth were engaged and chose the selected topics, validated program content, developed the program logo and slogan and informed the selection of promotional materials

Learning Objectives:
  • mobilize and engage youth in sexual health promotion
  • appreciate an innovative approach to youth sexual health promotion
405B: Critical Essay on Caring in Nursing Education

Pamela Scheveck, MEd, RN, Assiniboine Community College, Winnipeg, MB, Lorri McLeod, MA (Ed.), Assiniboine Community College, Winnipeg, MB

The purpose of this article is to advance nursing education by critically examining our teaching practice to ensure we are teaching the caring values of nursing. I propose outcome based learning as restrictive to the values of caring in nursing. Using Dr. Jean Watson’s Theory of Human Caring and six of Jean Watson’s 10 Caritas Processes, I provide suggestions on how caring can be infused into the nursing curriculum.

Learning Objectives:
  • explain why caring is central to nursing.
  • identify how outcome based learning can impede caring in education.
  • understand how mindful compassionate teaching can provide a therapeutic envirornment for students and teachers to grow their competecies.

406B: The Path Towards Transformative Incident Management in a Community Based Setting

Kim Daly, RN BN MN, First Nations & Inuit Health Branch, Ottawa, ON,  Leila Gillis, RN, BSN, MN, First Nations & Inuit Health Branch, Ottawa, ON,  Joan Reiter, RN, BSN, MBA, First Nations & Inuit Health Branch, Ottawa, ON

You just gave the wrong immunization. What happens now? Incidents occur in every health care system and in most cases, are due to organizational systemic factors. Effectively preventing and managing incidents leads to improved care and reduced client and staff harm. As part of continuous quality improvement, the First Nations and Inuit Health Branch (FNIHB) is improving its primary care incident management process. Working with stakeholders, FNIHB developed an evidence-based, client-centered incident management process which is being piloted in several remote First Nations communities.

Improving incident management has focused on:
  • Clients at the focal point:  there is a person, who is part of family, a community at the end of the needle
  • Systemic issues versus individual blame: maybe the vaccine label had a similar colour to another vaccine
  • Translating lessons learned into safer care:  sharing lessons learned so this type of incident can be prevented or managed better.

FNIHB embarked on this transformation through a number of methods. A review of the evidence and gap analysis identified the start of a path to transformation. Stakeholder engagement included a ‘voice of the customer’ exercise, a LEAN process to ‘trial’ draft processes, partnering with organizations and ensuring an end-user working group to guide the process. Draft tools and resources have been developed to support practice and implementation.

Process is as important as outcomes. While FNIHB has developed tools to help support incident management, the process has started to influence an organizational culture shift. Knowledge translation across jurisdictions, critical analysis of current practices, a greater appreciation of the importance of both client and staff safety, and an enhanced focus on client involvement in incident management have all begun to surface.

Learning Objectives:
  • Understand how a complex health organization developed an incident management management process.
  • Understand the lessons learned during the development and implementation of pilot sites.
  • Understand the next steps for full implementation of the process.