The contribution of the charge nurse in integrated healthcare

Abstract

Background: A charge nurse (CN) is defined as a nurse who holds a clinical-administrative management position. The role requires five essential skills: leadership; interpersonal communication; clinical-administrative caring; problem solving; and knowledge and understanding of the work environment. According to Plourde (2012), these skills can be divided into sub-skills that are needed in practice by CNs when upholding appropriate standards of quality of care in healthcare delivery. These skills are also essential for CNs when facilitating the process of integrated care within healthcare facilities. However, the scientific literature describes less-than-ideal work performance by CNs that relates to a lack of specialized and adapted training. Necessary skills are poorly addressed in the education of CNs, and they receive little formal support upon entry to practice. CNs play an essential role in coordinating processes surrounding integrated care in healthcare facilities, however the literature is scarce on this role of the CN. Objective: To demonstrate the extent to which the CN, by fulfilling their role, contributes to integrated care within healthcare facilities. Methods: A scoping review using the Joanna Briggs Institute (2020) framework was performed. Using a prepared search strategy, CINAHL, MEDLINE, Cairn, and grey literature databases were queried for articles written in French or English and published between 2000 and 2022. Articles mentioning at least one of the five CN skills named by Plourde (2012) were selected. Articles were analyzed according to “Leviers et obstacles au développement de l’ISS” by Longpré (2017) (Facilitators and barriers to the development of the integrated care model) which describes essential elements to consider in order to foster integrated healthcare. Results: 150 articles were retained and analyzed. These articles describe CN skills and how they are operationalized in practice. It was found that the skills and sub-skills of the CN are often addressed in articles describing integrated care, including for example the coordination of a patient's care during their hospitalisation. In addition, CNs allow for accessibility, continuity and integration of care. As such, CNs are key player in the implementation and development of better integrated care. Conclusion: This study illuminates the relevance of providing essential CN training that reinforces the CN skill set which in turn improves the quality and safety of integrated care in healthcare facilities.