Canadian Nurse Research Articles

Talking About Strengths-Based Nursing and Healthcare Leadership: What Canadian Nurse Leaders Have to Say.

Nursing leadership is essential to improving nurse retention, their well-being, the quality of nursing care and patient safety. As healthcare leaders become increasingly aware of Strengths-Based Nursing and Healthcare Leadership (SBNH-L), we dialogued with Canadian nurse leaders to understand their views on this leadership approach. Five senior nursing leaders representing practice, academic and health policy contexts were interviewed. Five themes emerged: connections, opportunities for growth, humanism, optimism and hope for the future. Leaders shared that SBNH-L is a valuable, timely leadership approach that will promote system-wide health and healing post-pandemic. A call to action is offered to advance adoption of this essential leadership approach.

Translation and Cross-cultural Validation of the Canadian Nurse Informatics Competency Assessment Scale for French Canadian Nurses.

Translation and Cross-cultural Validation of the Canadian Nurse Informatics Competency Assessment Scale for French Canadian Nurses.

The Psychometric Properties of Version 2 of the Canadian Nurse Informatics Competency Assessment Scale.

In 2020, we conducted a mixed methods study comprised of a cross-sectional survey in which we applied a modified version of the 21-item Canadian Nurse Informatics Competency Assessment Scale and one-on-one interviews to explore self-perceived nursing informatics competency and readiness for future digital health practice. A total of 221 senior-level students in BScN programs in western Canada participated. This article reports on results related to the factor structure and internal consistency reliability of the 26-item (version 2) of the Canadian Nurse Informatics Competency Assessment Scale. Exploratory principal component analysis with the varimax rotation revealed a four-component structure, explaining 55.10% of the variance. All items on the Canadian Nurse Informatics Competency Assessment Scale 2 had good loadings, except item 7, which did not load to any domain but was retained based on an evaluation of the α value and item relevance to nursing practice. A few items shifted to different domains. The overall reliability of the Canadian Nurse Informatics Competency Assessment Scale 2 was (α = .916) and its subscales: information and knowledge management (α = .814), professional and regulatory accountability (α = .741), and use of information and communication technology (α = .895). This study provided preliminary evidence for the factor structure and reliability of the Canadian Nurse Informatics Competency Assessment Scale 2 among nursing students. Further testing is recommended.

Validation and prioritisation of health informatics competencies for Australian nursing and midwifery leaders: A modified Delphi study

BackgroundHealth informatics competency standards for nurses are required to ensure the use and management of health information technologies contributes to the delivery and management of safe, quality care delivery. Historically, these competencies have been identified for nurses as a general group and specifically for undergraduate nursing students but not to the same extent for nurse leaders. AimThe aim of this study was to validate and prioritise health informatics competencies for Australian nurse leaders. MethodThis study utilised a modified Delphi technique to validate and prioritise 26 health informatics competencies for the Australian setting. The competencies were previously developed for Canadian nurses through literature review and consulation with experts. This modified Delphi study included invitations to 20 Australian Chief Nursing Information Officers who were then asked to extend the invitation to nurse leaders in their corresponding organisations. ResultsEleven Chief Nursing Information Officers and seven Nurse Leaders completed the study including 3 rounds of informatics competencies consensus surveys. As a result, 22 revised competency statements were agreed to by the study participants. The top priority competency (Nursing and Midwifery leaders support clinicians to adopt and use information and communication technologies that support safe, quality care delivery) was also the highest ranked in the Canadian team’s initial work. This reflects a common objective of nurses’ need to ensure technology is fit for purpose, not only for nurses and midwives, but for patient safety and quality of care. ConclusionKnowledge is required in the digital health landscape in order for nursing leaders to increase their capability in decision-making in the current and future digital healthcare environments. Differences in the competencies validated and prioritised by Australian nurse leaders and previous work by Canadian nurse leaders support the need to examine context-specific factors for nurse leaders to utilise these competencies.

Nurse Educator Certification: Overview and Evaluation of the Canadian Association of Schools of Nursing Program

The Canadian Association of Schools of Nursing (CASN) has spearheaded an education institute and fostered the growth of an accessible cadre of innovative educational programming that were built on identified national nursing educator competencies. The purpose of this article is to outline the development and structure of the CASN Canadian Nurse Educator Certification Program, share an analysis of one aspect of program evaluation data and summarize the program’s current value to nurse educators. The program offers flexible professional development for Canadian nurse educators through three online modules that prepare participants to sit the national certification exam and attain the designation of Canadian Certified Nurse Educator (CCNE). Part of an ongoing program evaluation conducted by CASN in 2021 sought to provide information on the perception of certification of nurse educators in Canada. A review of the process of module delivery that prepares educators to sit the certification exam and how certification is perceived as valuable or not by nurse educators was the focus. The CCNE program participants’ perspectives on the value of module learnings in terms of academic practice were evaluated using the Perceived Value of Certification Tool for the Nurse Educator. Of the 108 respondents to the survey questions, the findings indicate that most CCNE nurse educators perceived that there is value in nurse educator certification. A key survey finding was that educators perceived intrinsic value more so than extrinsic value in obtaining certification. Overall, the respondents believed that certification was not fully recognized by employers, colleagues, or students and that enhancing others’ perceptions of certification was needed. Despite consistent enrolments in the CASN program modules, the program and CCNE designation appear to require further formal recognition from teaching and academic institutions across the country. With the shortage of qualified nursing faculty, the need to strengthen current academic faculty members’ competencies is imperative. The certification and credentialing of academic nurse educators needs to be recognized. Educators should be provided merit for the acquisition of the specialized knowledge, expertise, and competencies required for the role.

Nursing Care Delivery Models and Intraprofessional Collaborative Care: Canadian Nurse Leaders' Perspectives.

IntroductionThere are many different types of nursing care delivery models used to organize and provide care in hospitals. These models are comprised of different organizational structures and staffing skill mixes.ObjectiveThe aim of this study was to explore how nursing care delivery models promote intraprofessional collaborative care in acute care hospitals from the perspectives of nurse leaders.MethodsA qualitative descriptive approach was used for this study. Telephone interviews were conducted between January 2021 and August 2021 using an interview guide comprised of semi-structured and structured questions. Using a purposeful sampling technique, ten leaders from nine hospital systems, representing both urban and rural hospitals in the province of Ontario, Canada, participated in the study. Content analysis was conducted resulting in two overarching themes.ResultsThe first theme, Fluidity of the Model addresses the flexibility of the models and the impact of contextual factors such as changes in nurses’ scope of practice, government funding changes, staffing mix, and organizational policies and rules. The second theme, Tools of the Trade describes the resources that hospitals implement to promote intraprofessional collaboration that indirectly impacts on patient safety.ConclusionNursing care delivery models need to be flexible and adaptable. All nursing care delivery models in this study used various tools to promote intraprofessional collaborative care.

The Tension Between Regulation and the Pursuit of Quality in Canadian Nurse Practitioner Education Programs.

Nurses in advanced practice roles have existed in Canada for over 100 years, yet only in the last two decades, have nurse practitioners (NPs) been recognized as advanced practice nurses (APNs). During this time, NP educational programs have increased and transitioned from post-baccalaureate level to graduate level. Legislation and national NP regulatory approval processes have contributed to existing barriers to NP role implementation and full scope of practice. While regulation is mandatory and focused on public safety, an emphasis towards quality has led to the introduction of a national voluntary NP program accreditation process. The purpose of this paper is to initiate a discussion between Canadian NP regulators and educators related to proposed regulatory approaches and accreditation processes that balance public safety while promoting quality and excellence in NP education. Having two separate and costly processes has led to tension during a time of provincial fiscal restraint on university budgets coupled with the COVID-19 pandemic and its impact on nursing education. An integrated pan-Canadian approach of regulation and accreditation may ensure public safety, continuity, and consistency in quality NP education, enhance mobility of the NP workforce, and systematic planning to guide successful future NP role development and practice.

The Environment as a Patient: A Content Analysis of Canadian Nursing Organizations and Regulatory Bodies Policies on Environmental Health.

BackgroundIndividual, community, and societal health is impacted by the environment, specifically by air, water and soil pollution, and climate change. Poor environmental conditions have been associated with many illness exacerbations. Although global nursing organizations have increased their environmental health focus, evidence is lacking that Canadian nurse leaders and organizations are similarly invested.PurposeThe purpose of this analysis was to explore the policies of Canadian nursing regulatory bodies and associations on nursing practice specific to environmental health.MethodsA content analysis of nursing focused position statements and competency documents was conducted to assess Canadian nursing policies in environmental health. Publicly available position statements and competency documents regarding health and the environment were retrieved from Canadian nursing regulatory colleges and nursing associations, the Canadian Nursing Associations, and the International Council of Nurses. All documents were coded inductively and thematically analyzed.ResultsIn total, 22 documents were retrieved which consisted of 11 policy statements from nursing associations and 11 competency documents from nursing regulators and national associations. Four themes were generated: collaboration, language of engagement, nursing actions, and social justice.ConclusionThere is a gap between nursing policies and competencies directing nursing action related to the health of the environment across Canada. There is an opportunity to improve eco-literacy within the nursing profession, undergraduate education and to produce nursing research on environmental health.

The Expanding Role of the Canadian Nurse Practitioner in Medical Aesthetics.

Advanced practice in nursing is well established and has been active since the 1800s. In most cases, the role was developed because of a specific need or gap in patient care. Advanced practice nurses (APNs) have been experts in medical aesthetic injections for more than 30 years. The APNs' independence became increasingly common as a mechanism of continuity of care for the non-surgical-medical aesthetic patients. The APN role has evolved, and nurse practitioners (NPs) are now collaborating with nurses safely and effectively in nurse-led clinics in medical aesthetics. There are specific education and college regulations that are required to ensure patient safety in this collaborative care model. The role of the NP in a nurse-led medical aesthetic clinic is an accepted and recognized independent practice role that creates an innovative and well-regulated approach to patient care.

Big Data: Why Should Canadian Nurse Leaders Care?

Big data using data science methods (data analytics) has the potential to effectively inform strategies to address complex healthcare challenges. However, this potential can only be realized if healthcare professionals have the requisite depth and breadth of knowledge (i.e., informatics competencies). With the emergence of electronic health records (EHRs - commonly known as clinical information systems [CISs]) in healthcare organizations, data analytics that can "interrogate" CIS big data are now possible. In its digitized form, CIS healthcare data meant to support real-time, evidence-based practice decisions and guide new health policy directions remain more of a conceptual promise than a practice reality. Further, the "data rich information poor" phenomenon existing with today's CISs is often the reality for nurses who document more patient information compared to other healthcare professionals and get negligible results in return. However, data science methods when applied to CIS big data are "uncovering" new evidence currently unavailable through traditional data analytic approaches. Big data science is predicted to provide immense opportunities for nurse leaders by offering robust, electronic tools, which support informed decision-making at corporate tables and "arm" all point-of-care/service clinicians with real-time evidence. In this article, we provide a perspective on how the field of data science can enable informatics-savvy nurse executives to lead clinical transformation in the development of the next generation of evidence-based practice, "practice-based evidence."

The Work of Preparing Canadian Nurses for A Licensure Exam Originating from the USA: A Nurse Educator's Journey into the Institutional Organization of the NCLEX-RN.

The licensing exam for registered nurses in Canada has recently been changed from a Canadian developed, owned and delivered exam to the National Council Licensure Examination for Registered Nurses (NCLEX-RN) which originates from the United States. Rationale for this exam change focused on transitioning to a computer-based exam that has increased writing dates, with increased security, validated psychometrics, increased exam result delivery, and an anticipated decrease in expense to students. Concerns have arisen around the acceptance, implementation and delivery of this exam to Canadian nursing students that reflects the broad Canadian landscape of education and nursing practice. The experience of a Canadian nurse educator in working to facilitate students' transition to this exam is addressed using an institutional ethnographic lens. Finally, we come to conclusions about the importance of countries utilizing licensing exams that reflect their nursing education and practice.

Bibliometric and Textual Analysis of Historical Patterns in Maternal-Infant Health and Nursing Issues in The Canadian NurseJournal, 1905-2015.

Journals are key learning mechanisms for nursing organizations. Analysis of publications provides opportunities to explore influences, priorities, and perspectives of nurses over time. To identify historical trends in maternal-infant health and nursing practice. Historical bibliometric and content analysis of articles in The Canadian Nurse, 1905-2015. Six hundred sixty-eight lead publications in the journal were identified. Data were extracted on authorship, writing style, geographical distribution, and language, and content themes were determined. Five hundred twenty-five publications were written by nurses, and 272 came from the Ontario and Quebec. Nine key content areas were identified, including changing families, women's bodies, prenatal care, birth care, postpartum care, when things go wrong, and keeping babies healthy. The number of maternal-infant publications in this national journal has been decreasing since the emergence of specialty journals. Advances in perinatal nursing practice over the past 115 years in Canada reflect emerging scientific developments and evolving social values. These articles traced the medicalization and reclamation of pregnancy and childbirth, the shifting role of nurses in relation to other health and social care providers, and the impact of determinants of health on the well-being of mothers, infants, and families.

Development of the Canadian Nurse Informatics Competency Assessment Scale and Evaluation of Alberta's Registered Nurses' Self-perceived Informatics Competencies.

In today's digitally enabled healthcare environment, it is vitally important to assess Canadian nurses' competency in informatics. The researchers developed the Canadian Nurse Informatics Competency Assessment Scale, a 21-item comprehensive measure based on entry-to-practice informatics competencies for registered nurses, to facilitate assessment of informatics competencies and consequent, planning of formal and continuing education in informatics. The Canadian Nurse Informatics Competency Assessment Scale was used in a cross-sectional survey to determine self-perceived informatics competencies for Alberta's practicing nurses. Results from 2844 completed surveys showed that these nurses perceived their overall informatics competency as slightly above the mark of competent. Perceptions of competency were highest on foundational information and communication technology skills, slightly lower on competencies related to professional regulatory accountability and the use of information and communication technologies in the delivery of patient care, and lowest on information and knowledge management competencies. This study shed some light on priority areas for informatics education among practicing nurses in Alberta. Implications for nursing practice and research are discussed.

Psychometric Properties of the Canadian Nurse Informatics Competency Assessment Scale.

Assessment of nursing informatics competencies has gained momentum in the scholarly literature in response to the increased need for resources available to support informatics capacity in nursing. The purpose of this study was to examine the factor structure and internal consistency reliability of the Canadian Nurse Informatics Competency Assessment Scale, a newly developed 21-item measure based on published entry-to-practice informatics competencies for RNs. For this study, 2844 nurses completed the Canadian Nurse Informatics Competency Assessment Scale through a cross-sectional survey. Exploratory principal component analysis with oblique promax rotation revealed a four-component/factor structure for the 21-item Canadian Nurse Informatics Competency Assessment Scale, explaining 61.04% of the variance. Item loading per each component reflected the original Canadian Association of Schools of Nursing grouping of nursing informatics competency indicators, as per three key domains of competency: information and knowledge management (α = .85); professional and regulatory accountability (α = .81); and use of information and communication technology in the delivery of patient care (α = .87) with the exception of one item (Indicator 3), which loaded into the category of foundational information and communication technology skills (α = .81). This study provided preliminary evidence for the construct validity of the entry-to-practice competency domains and the factor structure and reliability of the Canadian Nurse Informatics Competency Assessment Scale among practicing nurses. Further testing among nurses in other settings and among nursing students is recommended.

A National Needs Assessment of Canadian Nurse Practitioners Regarding Cannabis for Therapeutic Purposes.

Introduction: In Canada, the Access to Cannabis for Medical Purposes Regulations (ACMPR) has given nurse practitioners (NPs) the power to authorize cannabis for therapeutic purposes (CTP) to eligible patients. This expansion in NPs' scope of practice underscores the importance of delivering balanced, evidence-based education on cannabis to NPs. The aim of this national study was to assess NPs' knowledge and practice gaps related to CTP to inform the development of future education resources that increase NPs' clinical competence and improve patient care related to medical cannabis.Methods: This is a quantitative, descriptive exploratory design study. A national online survey of NPs was conducted from August 2013 to June 2014. NPs were recruited through email lists held by numerous Canadian nursing organizations. The survey was adapted from a previous national survey that assessed CTP educational needs among Canadian physicians. The survey assessed NPs' knowledge, experience, barriers, and attitudes related to CTP as well as preferred format for future CTP education.Results: The sample consisted of 182 NPs from across Canada. The largest knowledge gap was related to dosing and creating effective treatment plans for patients using CTP. The majority of respondents (76.3%) ranked the need for education on CTP to be either strong or very strong. Over half (57%) reported that they would be comfortable authorizing medical cannabis through the ACMPR; this number increased to 64% if they were to receive appropriate education.Conclusion: Nursing regulatory organizations, in partnership with academic institutions and government agencies, must work toward the development of educational and clinical competencies specific to CTP. Tailored education programs are needed to address the knowledge gaps held by NPs and the clinical barriers they face to including CTP as part of their care.

Public Policy and Canadian Nursing: Lessons from the Field By Michael J. Villeneuve.

The recently released book Public Policy and Canadian Nursing: Lessons from the Field, by Michael J. Villeneuve, has been described as a "must read" by Gail Donner, professor emerita, Faculty of Nursing, University of Toronto, and by Kathleen Macmillan, professor and director of the School of Nursing at Dalhousie University. That is an excellent recommendation from two well-respected Canadian nurse leaders.

Imagining Gerontological Nursing: Canadian Nurses and Eldercare, 1905–70

This article explores how Canadian nurses understood care for the elderly in the decades before geriatric/gerontological nursing emerged as a distinct subspeciality. Using articles, editorials, and advertisements published in the Canadian national nursing journal Canadian Nurse, this paper argues that from 1905 until the 1940s, Canadian nurses imagined care for the elderly as part of a wider paradigm of chronic and rehabilitative care, which integrated personal, domestic, scientific, and therapeutic practices. As the population of seniors grew after the Second World War, Canadian nurses joined other health professionals in defining old age as a distinct life phase best understood through the tools of scientific medicine. Embracing geriatric science held some advantages but also made it more difficult for nurses to sustain the integration of personal and scientific care. This article traces the historical shifts in how Canadian nurses approached care for the elderly and, in doing so, contributes to the larger project of making nurses’ work and knowledge visible.

Canadian Nurse Practitioner Core Competencies Identified: An Opportunity to Build Mental Health and Illness Skills and Knowledge

In 2015, the Canadian Counsel of Registered Nurse Regulators released a report that identified entry-to-practice core competencies for adult, family/all ages, and pediatric nurse practitioners (NPs) across Canada. The report is expected to guide future decisions about NP entry-to-practice examinations and allow for Canadian Counsel of Registered Nurse Regulators member organizations to develop pan-Canadian requirements for licensure. Optimistically, it could set the stage for a national approach to NP education. This is an opportune time to highlight various stakeholders' call for increased mental health education for NPs and identify challenges and promising strategies for reaching that goal.

Canadian Nurse Graduates considering Migrating Abroad for Work: Are Their Expectations Being Met in Canada?

An RN credential has been called "a ticket to the world." Canadian RNs have been active participants in migration, especially to the United States. In an increasingly globally oriented world, Canadian nurse graduates have many employment options. The purpose of this study was to explore the job values and expectations of baccalaureate nursing students who indicated they were considering migrating for work abroad for their first job and to explore their confidence in having these values met in Canada compared to another country. This was a quantitative study guided by the Value-Expectancy Framework. Data were collected through a Web-based self-report survey and analyzed using descriptive statistics for sample characteristics and t tests for comparison. Nonprobability convenience sampling of graduating baccalaureate nursing students from a Canadian border region was used. Of 130 respondents, 92 (70.8%) indicated that they were considering migrating from Canada for work. Respondents believed that working abroad would provide more adventure, full-time work, professional development, appropriate staffing, flexible scheduling, and freedom to choose their preferred job sector/specialty. The authors conclude that there is a need to study nursing graduates' labour mobility both within and outside of Canada and the factors that influence their decision-making and to address the factors that encourage them to leave Canada. Human resource planning will become increasingly important given the predicted nursing shortage and changes to nurse licensure in Canada with the potential to influence migration.

Canadian Nurse Graduates considering Migrating Abroad for Work: Are Their Expectations Being Met in Canada?

Knowledge about the beneficial effects of social support has not been used to systematically develop and evaluate interventions to help refugee new parents cope. The purpose of this study was to design and evaluate a social support intervention for refugee new parents. A multi-method research design was used and participatory research strategies were employed. Qualitative and quantitative measures were used to understand experiences of participants and to assess the perceived psychosocial and health-related outcomes of the intervention. Mentored support groups, matched by gender and ethnicity, met biweekly over 7 months. The participants were 48 Sudanese and 37 Zimbabwean refugee parents in 2 Canadian provinces. Increases were found in informational support, spousal support, community engagement, coping, and support-seeking. Decreases were found in parenting stress, loneliness, and isolation. The authors conclude that there is a need for culturally appropriate nursing practices and programs for refugee new parents from diverse cultures.