CHNC - National Nurses CHNC - National Nurses

Thursday, June 28th 1:30pm–2:30pm

1:30pm–2:30pm - Network Café

600: Action on Policy: Community Health Nursing and Health Equity

CHNC Research and Health Policy Committee:

Lorraine Telford, R.N., M.N. CCHN(C), Alberta Health Services, Edmonton AB,  Kate McCulloch, MScN, RN, CCHN(C), University of the Fraser Valley, Chilliwack, BC


Participants will apply one of two policy analysis frameworks to one of the following top priorities: a) The Role of the PHN in Public Health, b) Guaranteed Income for Canadians, c) Housing, d) Access to Home Health Nursing, and e) advertising to children through facilitated table discussions. Highlights from each table will be shared with all participants.


Learning Objectives:

  • Participants will be introduced to two practical policy analysis frameworks:  Kingdon's Multiple Streams Theory and Garbage Can of Decision Making.
  • CHNC priorities for advocacy, derived from the recent member survey, will be  shared by the Research and Health Policy Co-chairs.


1:30pm–2:30pm - 60 Minute Oral Presentations

601: Mental Health First Aid Seniors: A New Program to Support Seniors’ Mental Health

Mireille Cyr, Mental Health Commission of Canada, Ottawa, ON

The Mental Health Commission of Canada (MHCC) championed the development of Mental Health First Aid (MHFA) Seniors, a new program intended to increase the capacity of seniors, families (informal caregivers), friends, staff in care settings and communities in Canada to promote mental health in seniors, prevent mental illness and suicide wherever possible in seniors and intervene early when problems first emerge.

The course content and resource materials are based on best available evidence and practice guidelines, and were developed in consultation with Canadian experts in the field of geriatric psychiatry. MHFA Seniors includes two additional sections not found in other MHFA course versions: dementia and delirium.

The MHFA Seniors course was piloted several times in 2016, from which an outcome evaluation was conducted. Like the MHFA Basic course, MHFA Seniors participants report greater recognition of the most common mental health illnesses and problems, increased confidence in providing help to others and a demonstrated increase in help actually provided.

This session will share information about MHFA Seniors and how it addresses the unique needs of Canada’s population of seniors. Participants will gain a better understanding of how MHFA Seniors can contribute to supporting the mental health of seniors.

Learning Objectives:
  • Participants will gain a better understanding of how MHFA Seniors can contribute to supporting the mental health of seniors.
  • Participants will, if interested, learn how to access MHFA Seniors training in their community.
602: Promoting Excellence in Practice & Education Across Canada

CHNC Standards & Competencies Standing Committee:
Genevieve Currie, Marie Dietrich Leurer, Francois Filion, Ruth Schofield

The Community Health Nursing Professional Practice Model & Standards of Practice is a framework that enhances to both practice and education. The model describes the contextual components, including the structure, process and values, necessary for implementation of the Standards of Practice. In this Network Café, various practitioners from across the country will facilitate a discussion surrounding the successes and challenges of fostering excellence in community practice through the implementation of the model and standards.

For a participant (practitioners, researchers, managers, policy makers, and educators), café dialogue will surround questions such as: "What are the attributes of the health care environments in which the model and standards are welcomed? What are the barriers to successful implementation of the model and standards? and How would the Model and Standards apply in a variety of practice experiences? 

The outcome of this café discussion will be networking and learning through the sharing of practice or teaching experiences. This new understanding is hoped to be the catalyst for the successful implementation of the Canadian Community Health Nursing Professional Practice Model and Standards of Practice and facilitating of excellence in community practice consistent with our Blueprint for Action.

608: Food Allergy: The Patient Journey and Implications for Nursing Care

Edmond S. Chan, MD, FRCPC, BC Children’s Hospital, University of British Columbia, Vancouver, BC, Jennifer Gerdts, BComm, Food Allergy Canada, Toronto, ON

Food allergy appears to be increasing, especially in children, and the diagnosis can be overwhelming for patients and families. There are different diet and lifestyle changes to consider whether someone has a food allergy or multiple food allergies. When a young child is newly diagnosed, parents and caregivers take on the primary responsibility of food allergy management, but this shifts over time to the child as they grow and mature.

For many, food allergy is a life-long condition that requires daily management. There is no cure for food allergy, and generally avoiding the allergenic food is required to prevent a reaction. In 2017, new guidelines were released which represented a major shift from previous advice on introducing peanut into a child’s diet. A key part of this session will cover which babies should be introduced to foods early and when a medical evaluation is needed.

The goal of this session is to review the prevalence and diagnosis of food allergy, address the guidelines for early peanut introduction in babies and allergy prevention, outline food allergy considerations at different transition points in a patient’s lifecycle, and provide practical recommendations and resources for counselling patients and families on food introduction and allergy management.

Nurses can help support patients in their food allergy journey and reinforce strategies for living confidently and reducing the risk of anaphylaxis, the most serious type of allergic reaction.

Learning Objectives:
  • Understand the prevalence and diagnosis of food allergy
  • Consider the implications of early peanut introduction (prevention) for nursing care
  • Discuss food allergy management at different ages and stages throughout the patient lifecycle

1:30pm-1:55pm - 25 Minute Oral Presentations

603A: Infection Prevention & Control in Community Care: Refreshing the knowledge and Practice in Community Clinic Setting

Karen Curry, RN, MN, CCHNc, Victorian Order of Nurses, Halifax, NS

IP&C audits of nursing treatment clinics were conducted to identify the current state of practices. A number of areas were identified for improvement relating to clinic processes, resources, and a pattern of practices by nurses carried over from the home setting.

IP&C principles and skills are taught in basic nursing programs; however application of these must be learned for the different practice settings. Nurses practicing in client homes implement IP&C practices differently than nurses who practice in facilities, or clinics, as there is lower risk for the spread of infections in client homes.

Home care organizations are increasingly operating nursing treatment clinics as part of funder contracts. Nursing staff are often assigned to both home visits and clinics and may not recognize the differences in risks or the required practices to address the risk for spread of infection in clinics. Nursing practices identified for improvement included: reprocessing equipment, medical supplies, environmental cleaning, and aseptic technique. Clinic procedures and resources identified for improvement include the use of sterile/single use supplies, screening, reprocessing, and environmental cleaning. The Practice Consultant worked with a group of Managers, Educators, and nurses to:
  • Identify evidenced based practices for clinics.
  • Refine an audit tool to support auditing of their clinic processes and resources in order to ensure nurses are supported to provide safe care.
  • Develop a learner/observation tool to support:
  • Nurses in refining their knowledge and skill in correct IP&C practices for clinics  
  • Managers and educators to objectively observe/audit IPC practice in clinics.
  • Review and update Nursing IP&C Education to include the differences in practices from home to clinic.
Learning Objectives:
  • Enhance and refresh awareness of evidenced based Infection Prevention and Control Practices for community ambulatory care clinics.
  • Identify the engagement strategies used to collaborate with front line nurses in the development of tools to support safe IPC Practice in clinic setting.
  • To discuss practical tools that nurses can use to increase awareness of their practice and audit IP& C practices in clinic setting

605A: To Share or Not to Share - Toronto Public Health's Journey to Develop an Informal Breast Milk Sharing Counselling Guidelines

Kathy Jacyniak, RN, BscN, IBCLC, Toronto Pubic Health, ON, Evelyn Vaccari, RD, MHSc, Toronto Public Health, ON

Federal health authorities recommend against informal breast milk sharing. Nonetheless, it is occurring in Toronto and elsewhere. Toronto Public Health (TPH) recognized the need to develop an organizational approach to informal breast milk sharing to respond to a gap identified in our Baby - Friendly Initiative designation self-assessment and to support front-line staff who were requesting guidance on how to counsel clients inquiring about this issue. This presentation will provide an overview of the process that TPH used to tackle a controversial issue with no consensus on the best public health approach. Describe the manner in which the issue was addressed or the innovation or project was developed and implemented or study was conducted:TPH used a collaborative approach which involved child health and development and public health policy considerations. In addition to reviewing the evidence, a legal opinion and an ethical perspective from a bioethicist were sought. Also, consultations with practitioners from various agencies (health care and local milk bank) and other jurisdictions occurred. Ultimately, these inputs led to the development of counselling guidelines for TPH staff on informal breastmilk sharing. Describe the outcomes, implementation strategies, findings, conclusion or solution to the issue or innovation and with an emphasis on how findings can be used in community health nursing (ie. how is it actionable?) in various settings and contexts: Exploring this emerging and somewhat controversial issue from various angles, with a client centered framework, enabled TPH to move forward with staff counselling guidelines and risk reduction messaging to support our clients. The learning from this experience can inform other organizations in their public health practice and policy development.

Learning Objectives:
  • Know why informal breast milk sharing is an issue for Toronto Pubic Health (TPH)  and hear about the position statements of various health organizations.
  • Be informed of the literature on informal breast milk sharing practices, evidence about the risks of informal breast milk sharing and harm reduction strategies.
  • Learn more about  legal, ethical and practice considerations related to informal breast milk sharing, as well as the TPH framework and content of the staff counselling guideline.
2:05pm – 2:30pm- 25 Minute Oral Presentations

603B: Falls Prevention: Nurse's Commitment to Client Safety

Karen Curry, RN MN CCHNc, Victorian Order of Nurses, Halifax, NS, Ellen O’Brien, BScN RN CCHNc, Victorian Order of Nuses, Halifax, NS

Falls in older adults often result in moderate to severe injuries (e.g. hip fractures and head injuries with residual deficits). Falls increase the risk for early death and can make it difficult for individuals to live independently. Fall-related injuries result in significant societal economic burden.

In Canada, Safer Healthcare Now! has identified falls prevention as a safety priority. Reducing injuries from falls can increase quality of life for clients and reduce healthcare costs. In  the home care setting nurses do not spend time a long time with clients however embedding falls prevention activities and ensuring documentation and reporting or falls events is embedded in care planning. Our home care organization has had a Falls Strategy in place for some time but recognized we needed to use data to make improvements. We started a project to reivew our documentation and process related to falls prevention activities. A small working group of staff was consulted and provided input to the change in documentation and education development. The learning’s from a serious fall event with a client helped our site ensure that we were following best practices and organizational policy to support falls prevention. Our quality committee shared the story of this risk event with staff  and this helped spread the uptake of the process and documentation. Managers ensured when doing risk event follow up for fall, that the tools, process and collaboration with external supports were documented. Our chart audit data indicates that we continue to report on fall events  and have a high incident on compliance with  the process. Project successes included engaging frontline staff in development of tools, process and sharing of client stories. Our staff now see falls risk assessment as a part of standard assessments and not an " extra” because they have witnessed the benefits to clients.

Learning Objectives:
  • To describe the role of CHN in promoting client safety
  • To understand the barriers and successful interventions that support practice change in home care nursing program to promote falls prevention strategies.
  • To identify the value of using (plan do study act) PDSA in community health programs to support client safety initiatives.
604B: Community Health Nursing Student Projects That Do Make a Difference

Heather Jessup-Falcioni, RN, BScN, BEd, MN, CCHN(c), CCNE(c), Laurentian University, Sudbury, ON

A 30-minute open session audio voice narration PowerPoint format, will provide student placement community clinical examples for participants interested in helping students make experiential connections to community health nursing. Third year nursing students, in the community health courses at Laurentian University, Sudbury, ON, spend 144 community clinical hours over twelve consecutive weeks in the same clinical placement setting. The activities of the placement may involve working directly with clients and client groups or indirectly performing literature reviews and involvement in research, planning and preparing educational resources and policies, or projects that will support the clients the agency/institution is serving. The student is expected to demonstrate, and is evaluated on, the application of the seven Canadian community health nursing standards of practice.

This session uses student audio voice narration PowerPoint format to share several examples of student-initiated projects developed by nursing students in their 12-week community clinical placement. Students demonstrate similar and varying learning outcomes based on the placement setting and contexts of the placement. Student audio narratives share how their community placement experience helped them develop relationships and connection with community partners to develop an appreciation for community health theory and practice. Some of the projects discussed will be: the equity of Infertility within the levels of prevention framework for Northern ON communities; and development of a cell phone google map QR code app for university students new to their community which provides the directions and information necessary for the user to discover how and where to access health care providers and health care and other resources in proximity to the university campus and accessible via public or personal transportation. Through their placement projects students develop a positive attitude toward community health nursing and their partnership experiences.

Learning Objectives:
  • Identify the importance of student partnerships in development of clinical projects
  • Describe several community health projects developed by nursing students
  • Facilitate engagement of nursing students in clinical project development
605B: Strengthening Community Ties: Supporting LGBTQ2 Client Centred Care for Older Adults

Janet Leung, BASc, BScN 2nd Entry Nursing Student, York University, Toronto, ON,  Jennifer Kong, BSc, BScN 2nd Entry Nursing Student, York University, Toronto, ON, Anna Mathew, BSc, BScN 2nd Entry Nursing Student, York University, Toronto, ON

Many LGBTQ2 individuals, especially adults aged 65 years and beyond, often experience fear, anxiety, and vulnerability due to stigmatization, discrimination, and violence. By understanding the unique needs of LGBTQ2 clients and the communities in which they live, community health nurses can provide appropriately client centred care and participate in developing positive environments, promoting health and wellness while respecting freedom and choice. As part of a community health nursing student practicum at a long-term care facility, a proposal was developed to improve LGBTQ2 client centred care through strengthening the capacities of a non-profit long-term care organization in Toronto, Ontario. Community neighborhood and site assessments were conducted by examining quantitative and qualitative data from windshield surveys, demographics, organizational policies and procedures, and seven formal interviews with staff and LGBTQ2 clients. Organizational policies were evaluated in relations to their alignment with the continuum of access and equity discourses (Daley & MacDonnell, 2011). A strengths, weaknesses, opportunities, and threats (SWOT) analysis was conducted, which identified the lack of policies, procedures, and service options to protect and support LGBTQ2 clients and staff. Comprehensive recommendations of policies, strategies, initiatives, and programs to establish diverse and inclusive physical and social environments were developed with the application of LGBTQ2 care best practice guidelines (Toronto Long-Term Care Homes & Services, 2008; 2017).

Learning Objectives:
  • Learn about the importance and role of nurses in supporting LGBTQ2 client centred care.
  • Understand LGBTQ2 client centred care best practices and strategies to develop a positive LGBTQ2 environment to support freedom and choice of clients.
  • Apply best practices and lessons learned to create space for dialogue fostering diverse and inclusive physical and social environments supporting LGBTQ2 client centred care.
606B: Effectiveness of Web Based Knowledge Translation Strategies to Increase Use and Awareness of Cancer Prevention Evidence in Practice
Emily Belita, RN, PhD Student, McMaster University, Hamilton, ON, Jennifer Yost, PhD, Villanova University, Villanova, PA,  Maureen Dobbins, PhD, RN, McMaster University/National Collaborating Centre for Methods and Tools, Hamilton, ON,  Anthony Levinson, PhD, McMaster University, Hamilton, ON,  Noori Akhtar-Danesh, PhD, McMaster University, Hamilton, ON, Cory Neudorf, PhD, University of Saskatchewan, Regina, SK,  Olivia Marquez, MSc, Health Evidence, Hamilton, ON

Background: Based on the pervasiveness and costliness of cancer, it is critical to implement effective prevention strategies informed by the best available research evidence. Despite increased expectations for evidence-informed decision making in public health, challenges to achieving this exist. The objectives of this study were to enhance awareness and use of high quality cancer prevention evidence among Canadian public health professionals by implementing three knowledge translation (KT) strategies.

Methods: This 18-month prospective cohort study used 3 KT strategies (tailored email messages (TMs), webinars, and Twitter) to disseminate evidence to health professionals in Canada who make decisions or provide services related to cancer prevention. Data was collected via an electronic survey at baseline (2015) and follow-up (2017) on awareness and use of research evidence, and satisfaction with KT strategies.

Results: Final data analysis is pending and preliminary results are presented. At baseline, 313 participants enrolled in the study and 134 participants (42.9%) completed follow-up. Higher satisfaction scores were reported for TMs (M = 31.6, SD = 8.1) and webinars (M = 31.4, SD = 7.7), compared to Twitter (M = 24.9, SD = 8.2). Greater satisfaction was reported for increasing awareness of high quality research evidence, as compared to promoting its use in practice. A marginally significant difference was found between pre- (M = 4.6, SD = 1.4) and post-scores (M = 4.4, SD = 1.4) in awareness of high quality research (p = 0.096).

Conclusions: There is modest satisfaction among public health professionals regarding use of online KT strategies in cancer prevention, with greater satisfaction for increasing awareness of high quality research evidence rather than promoting its use in practice. This study provides insight on best practice methods to transform how research evidence is disseminated to professionals and applied in public health practice in Canada.

Learning Objectives:
  • Describe the Knowledge to Action Cancer Prevention (CIHR) study: background, description of knowledge translation strategies, recruitment, and methods.
  • Present findings on the awareness, use and uptake of cancer prevention knowledge in practice from Twitter, webinars, and tailored email messaging.
  • Learn how KT strategies from this study can increase the uptake and use of cancer prevention knowledge in practice in Canada.