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Accepting the Challenges of Paradigm Shifts in Community and Public Health Nursing Canadian Association of Schools of Nursing May, 2009 J. Underwood, D.

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Presentation on theme: "Accepting the Challenges of Paradigm Shifts in Community and Public Health Nursing Canadian Association of Schools of Nursing May, 2009 J. Underwood, D."— Presentation transcript:

1 Accepting the Challenges of Paradigm Shifts in Community and Public Health Nursing Canadian Association of Schools of Nursing May, 2009 J. Underwood, D. Meagher-Stewart, M. MacDonald, L.L. Stamler, B. Schoenfeld, K. Knibbs

2 Background Adequate community health capacity can mitigate pressures on acute care and long- term care Health Care System shift: from hospital to community to health promotion, disease prevention

3 Purpose of our research To examine: Existing community health nursing (CHN) workforce capacity, including public health nursing Strategies for optimizing utilization of CHN workforce

4 What does this mean for Schools of Nursing? Need curricula to respond to changing paradigms for nursing practice and community health care Support practicing CHNs to respond to paradigms shifts by providing targeted educational opportunities

5 Methods 23 focus groups of public health professionals were held in 6 geographic regions in Canada using Appreciative Inquiry A survey polled 13,775 nurses from all community sub sectors and yielded 7839 responses (57% response rate) Analysis of CHN demographic attributes was conducted using the 2007 CIHI Secondary database

6 Demographic Profile In 2007, 16% (53,404) 327,670 nurses in Canada were CHNs (46,273 RNs; 7,131 LPNs) CHN workforce older LPNs: ~9.5% >60 years old (compared to 7% of all LPNs) RN: ~28% >55 years old (compared to 22% of all RNs) Fewer younger CHNs RNs: ~ 5% <30 years (compared to 10% of all RNs)

7 Survey results: Enablers Selected statements/factors Agreed or strongly agreed (%) RNLPN CHNs feel professional confidence9693 Positive Nurse/Nurse Relationship9288 Positive Nurse/Other Professionals Relationship 8783

8 Survey results: Potential Barriers Selected statements/factors Agreed or strongly agreed (%) RN LPN Positive Physician/ Nurse Relationship6870 Organization uses community-based approach to address social health determinants 4742 CHNs have time/money/access to learning resources 45

9 Focus Group Results: Organizational attributes that support PHN practice

10 Conclusions CHNs~ 16 per cent of the nursing workforce. CHNs thrive in workplaces that collaboratively share vision/goals and support creative, autonomous practice. CHNs work well together, but need time, flexible funding and management support to develop relationships with community/clients, and other professionals. Employers and managers should encourage CHNs to keep up-to-date, provide more access to continuing education, policies, evidence and debriefing sessions, (assure competency & professional confidence)

11 Why is this important for Schools of Nursing? Educational institutions who offer basic and continuing nursing education will: Provide relevant education to student nurses Facilitate educators staying up-to-date Have new funding opportunities consistent with focus on sustainability and entrepreneurial approaches within some universities

12 Implications: undergraduate education Continue to build confidence in nursing abilities relative to community health nursing practice Continue to work on team relationship skills

13 Implications: Undergraduate curricula Preparing for system shift includes: Determinants of health Primary health care Health Promotion Disease Prevention Emergency preparedness Other

14 Implications: Continuing Education Improve access to evidence and continuing education Teach practitioners about knowledge translation and exchange Update knowledge, e.g. social determinants of health

15 Implications: Management Development Effective human resource planning Coordination and planning Creating an ongoing learning culture Creating a supportive work environment Facilitating autonomous practice

16 Implications: Leadership Education Public health leadership Visionary and responsive to community needs Champions for Public Health

17 Conclusions The comprehensive national research program of study about community health nursing (CHN) produced results relevant to Nursing Educators Nursing Education Programs have opportunities to be creative and innovative

18 Opportunity Schools of Nursing Masters of Public Health Programs could partner with: Employers, health organizations and governments

19 The Goals of the Partnership : Ensure undergraduate curricula are relevant to community health nursing practice Improve access to evidence and continuing education Make funding for community and public health leadership and management development available

20 Researchers Jane Underwood (McMaster University) PI, co-lead Dr. Andrea Baumann (McMaster University) Dr. Donna Ciliska (McMaster University) Dr. Donna Meagher-Stewart (Dalhousie University) Dr. Raisa Deber (University of Toronto) Mary MacDonald (University of Saskatchewan) Anne Ehrlich (McMaster University) Bonnie Schoenfeld (University of Saskatchewan) Dr. Melanie Lavoie-Tremblay (McGill University) Dr. Jennifer Blythe (McMaster University) Dr. Audrey LaPorte (University of Toronto) Val Munroe (Vancouver Coastal Health) Kristin Knibbs (University of Saskatchewan) Dr. David Mowat (Peel Public Health), co- lead Dr. David Butler-Jones (Public Health Agency of Canada ) Sandra McDonald Rencz (Office of Nursing Policy, Health Canada) Barbara Oke ( First Nations and Inuit Health Branch ) Valerie St. John ( British Columbia Ministry of Health Services) Dr. Susan Matthews ( Niagara Health System) Carla Troy (Public Health Agency of Canada) Lynn Jobin (Quebec Direction g é n é rale de la sant é publique) Lynnette Leeseberg Stamler (Canadian Ass ’ n Schools of Nursing) Rosemarie Goodyear (Community Health Nurses Association of Canada/ Central Health Region, NFLD) Dr. John Blatherwick ( retired, Vancouver Coastal Health) Dr. Cory Neudorf (Saskatoon Health Region) Paul Fisher (Canadian Council for Practical Nurse Regulators) Dr. Ron Wall (Public Health Agency of Canada) Decision Makers

21 Funders Canadian Health Services Research Foundation Health Canada Public Health Agency for Canada Health Human Resources Strategy Division Office of Nursing Policy Health Canada First Nations & Inuit Health Branch British Columbia Ministry of Health Nursing Directorate Communicable Diseases & Addictions Prevention Branch McMaster Nursing Health Services Research Unit Vancouver Coastal Health Authority

22 Contact Jane Underwood BScN, MBA Consultant/ Co-Investigator, Nursing Health Services Research Unit Phone: (905) 525-9140 x 22380 Email:undrwood@mcmaster.ca

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