The purpose of this project is to assess rates of mental injuries in community health nurses in BC, and to examine relationships between those injuries and psychological hazards in the workplace. Researchers from the BC Nurses’ Union (BCNU) and the University of British Columbia (UBC) collaborated to survey BCNU nurse members (Licensed Practical Nurses, Registered Nurses, and Registered Psychiatric Nurses) in the fall of 2019. The mental injuries assessed in this study are post-traumatic stress disorder (PTSS-14), anxiety (GAD-7), and depression (PHQ-9), and psychological hazards in the workplace are measured using the Guarding Minds at Work questionnaire and additional questions about experiences of violence at work.
The presentation will address how results of the study will be used in advocacy efforts to inform health policy for community nurses in BC. Key learning outcomes for this session include 1) understanding the prevalence of mental injury for community nurses in BC, 2) understanding associations between mental injuries and workplace psychological hazards in the workplace, and 3) understanding how this information can be applied to inform future policy. This presentation falls under theme 8, “Professional Responsibility and Accountability” as it speaks to nursing issues that affect the profession, addresses factors which might hinder the delivery of quality care, and relates to the effective use of community health nursing resources (CHNC, 2019).
Non-verbal, medically-complex children face challenges in timely identification and management of their pain, leading to prolonged suffering. Although standardized pain assessment tools exist, many are designed for neuro-typical children who often present with common sets of behaviors. The purpose of this project was to identify a psychometrically-valid pain assessment tool from evidence-based literature for implementation across nurses working with this population.
Nurses caring for these patients expressed needing support to identify non-verbal pain. The organization implemented both the Individualized Numeric Rating Scale (INRS) to identify behaviors at different pain levels and an accompanying patient-customizable management flowsheet. Parents of medically-complex children co-designed the intervention, as research suggested the value they bring to easily identifying their child’s unique discomfort or deviation from an established baseline. A multi-pronged education plan was created that included an eModule and an interprofessional, caregiver-led case scenario activity. Positive feedback identified the INRS as an opportunity to improve communication regarding pain assessment/management among the interprofessional team.
At any given moment, a child receiving homecare may be visited by multiple nurses and allied-health professionals. The adoption of the INRS and a pain management plan can be a simple way to engage parents as experts while providing nurses with a tangible tool to manage non-verbal pain in this sector.
Key learning outcomes include: (1) introduction to an evidenced-based, paediatric non-verbal pain assessment tool; (2) highlighting benefits of co-designing with patient partners; and (3) strategies to facilitate knowledge translation and uptake of evidenced-based tools in the home care sector.
Community Health Nurses face many challenges delivering care independently to clients with increasing degrees of complexity within a wide range of specialized areas. Providing clinical education and support for safe, quality, evidence-based care in the variety of nursing practice settings within the community is challenging. In response to the need for clinical support for nurses in the community, SE Health created a new clinical support structure: The Clinical Practice Resource Team (CPRT). In 2013, this virtual team was launched to provide just in time support for nurses, coordinators, and leadership team members across Canada by phone or email.
Utilizing this model, CPRT provides accessible support for clinical assessment and decision-making, advisement on policy and procedure, access to resources, intake review for clients with specialized care needs, independent double checks on medication and collaboration with the advanced practice team. Community health nurses receive support in their practice environments that enhances client safety, promotes evidence-based practice and supports collaboration.
Key learning outcomes:
Identify challenges in CHN that impact client safety
Learn about SE Health’s Virtual CPRT and its impact on Community Health Nursing practice
Gain insight into our virtual care model
Discuss how this model may be the future of Community Health Nursing