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From Sudbury to Sogog: Stories from a Canadian Student\u27s Health Promotion Without Borders Excursion to Mongolia
No full textAs the popularity of International Service-Learning (ISL) excursions continues to grow, there is an increasing need for research that explores these types of experiences. This manuscript focuses on the experiences of the lead author (S.L.D.) while participating in an ISL excursion offered by the Health Promotion Without Borders (HPWB) Program as part of their graduate research. The HPWB Program has facilitated ISL excursions for students in the School of Kinesiology and Health Sciences (SKHS) at Laurentian University (LU) in Canada for over two decades. However, there is limited formal research about the experiences of HPWB participants while completing their ISL excursions. This research addresses this need by using an autoethnographic approach to explore the lead author\u27s HPWB experience. During the lead author\u27s excursion, they confronted many moments of cultural dissonance, which challenged their usual way of thinking. Through critical reflection after their excursion, the lead author realized the defining role those moments of cultural dissonance had on the nature of their ISL experience. The lead author wrote six stories to share their understanding of those cultural dissonance encounters and provide a snapshot of their excursion for the reader to make sense of in their own way. Overall, this research may benefit future ISL participants and coordinators and adds to the sparse literature available on the nature of ISL experiences from the participant perspective using an autoethnographic method
Substance Use Disorder Presentations and Referral Patterns for an Emergency Department in a Northern Ontario City
No full textObjectives: Substance use, both alcohol and opioids, is higher in Sudbury, Ontario than in the remainder of the province and the numbers increased during COVID-19. In response to increased use during the pandemic, the hospital developed the Addictions Medicine Consult Service (AMCS) to complement the existing addiction services. After a full year of operation, a program evaluation was completed to determine the effectiveness and gaps of the AMCS, to enact changes for service improvement.
Methods: A retrospective chart review was conducted. Analysis of the characteristics and frequency of people presenting with substance use to the emergency department, along with referrals to addiction services, was undertaken.
Results: Fewer than seven percent of patients presenting with substance use in the emergency department were referred to the AMCS. The majority used alcohol and were housed, followed by those who used fentanyl who were unlikely to be housed. Many patients were referred to Crisis, the multidisciplinary mental health team in the hospital, which is available 24/7 but which does not include addictions expertise.
Conclusions: Changes to service delivery to increase the use of the AMCS were implemented to improve service accessibility and delivery of care. These included nursing daily rounds in the emergency department and adding more direct links with resources in the community.
A Descriptive Analysis of the Previous Care Experiences of Patients Being Rostered in British Columbia’s New Nurse-Practitioner Primary Care Clinics
No full textAim: This article analyzes the previous care experiences and socio-demographic characteristics of patients being rostered in British Columbia’s new Nurse-Practitioner Primary Care Clinics (NP-PCCs)
Background: Nurse Practitioner (NP)-led clinics leverage the NPs’ extended scope of practice to increase accessibility to Primary Care. In 2020, British Columbia announced the opening of four Nurse-Practitioner Primary Care Clinics.
Methods: This study provides a descriptive analysis of the demographics and previous care experiences of 424 patients newly rostered to one of BC’s new clinics.
Findings: The patients rostered to BC’s NP-PCCs are generally representative of the population from the clinics’ catchment areas. On average, rostered patients reported poor levels of accessibility to primary care services before joining one of the clinics.
Conclusion: The NP-PCC model has been effectively reaching out to the patient populations for which it has been designed
Evaluating the implementation of the Nurse Practitioner role within Canada’s National Ballet School
No full textAim: To evaluate the implementation of a nurse practitioner role within Canada’s National Ballet School (NBS) and evaluate the comfort level of student access care.
Background: NBS is an internationally recognized professional ballet and academic program, with approximately 60% of their students living in residence. Until Fall 2020 there was no onsite regular primary care services. A family physician visited weekly to see residence students only. NBS recognized the need to provide more comprehensive primary care services to the students, as elite dancers may experience additional healthcare issues such as dance related injuries, nutritional issues and body dissatisfaction. The role of a nurse practitioner was implemented in Fall 2020.
Methods: Utilizing a descriptive quantitative, multiple group design, a survey was distributed to participants. Participants included full-time students, parents and student-facing staff at the school. The study took place between July and August 2022.
Findings: Participants included students (n=27), parents (n=22) and staff (n=20). Participants noted the positive impacts of having a nurse practitioner at the school, however students also noted some barriers. Four themes emerged regarding the role of the NP and comfort of students accessing care, including (1) Access to care; (2) Confidentiality and trust; (3) Increased support; and (4) Primary care.
Conclusion: The role of the nurse practitioner was successfully implemented within the NBS. The evaluation demonstrated the nurse practitioner provided improved access to services and increased support. While most staff and parents understood the scope of practice of the nurse practitioner, not all students did
Nursing and Dental Students Working Together: A Descriptive Study
No full textAim
This study was designed to answer the question: what are the student and faculty perceptions of an interprofessional clinical experience (IPE) involving advanced practice nursing (APRN) and dental medicine (DM) students?
Background
Students and faculty participating in an innovative IPE experience pairing APRN students with DM students in a university-run dental clinic were polled about their perceptions of the experience.
Method
Using directed content analysis, semi-structured interviews with faculty members and responses to evaluation questions from students were analyzed for themes.
Findings
Six themes emerged: 1) Interprofessionalism is generally positive. 2) Communication is essential. 3) Faculty preceptors need to adapt their pedagogical styles to promote the IPE experience 4) Specific strategies are employed to equalize roles of each of the professions 5) Complementarity in roles and mutuality in functions fosters comprehensive, holistic care 6) Tension exists between the need to model professional behavior, interact between professions, and respect the patient’s time.
Conclusions
Instituting an IPE experience into a clinical setting requires excellent communication, flexibility, and adjustments to ensure equity of roles
Liens entre compromis social et vieillissement en santé. Quelques leçons d’une innovation sociale québécoise.
No full textLe vieillissement de la population canadienne appelle à une évolution du système de santé en raison des multiples enjeux qu’il soulève. En 2008, l’Institut national de santé publique du Québec adopte une nouvelle approche visant la prise en charge du vieillissement dans une perspective de responsabilité populationnelle. Cet article analyse l’espace d’innovation ouvert dans la mise en œuvre par les primo adoptants de cette approche. Cette analyse permet de suggérer que le compromis social est un incontournable à la fois pour la réussite de cette innovation et, in fine, au vieillissement en santé. De plus, l’innovation ne suffit pas à atteindre cet objectif ultime. Sa mise en œuvre requiert de laisser aux acteurs la latitude de sélectionner, à partir d’une démarche d’élaboration de compromis sociaux, les solutions conformes à une éthique du bien-être collectif adaptées aux conditions locales de mise en œuvre de l’approche.Résumé
Le vieillissement de la population canadienne appelle à une évolution du système de santé en raison des multiples enjeux qu’il soulève. En 2008, l’Institut national de santé publique du Québec adopte une nouvelle approche visant la prise en charge du vieillissement dans une perspective de responsabilité populationnelle. Cet article analyse l’espace d’innovation ouvert dans la mise en œuvre par les primo adoptants de cette approche. Cette analyse permet de suggérer que le compromis social est un incontournable à la fois pour la réussite de cette innovation et, in fine, au vieillissement en santé. De plus, l’innovation ne suffit pas à atteindre cet objectif ultime. Sa mise en œuvre requiert de laisser aux acteurs la latitude de sélectionner, à partir d’une démarche d’élaboration de compromis sociaux, les solutions conformes à une éthique du bien-être collectif adaptées aux conditions locales de mise en œuvre de l’approche
Utilisation de la simulation pour améliorer la formation des infirmières praticiennes concernant la prescription d\u27opioïdes et l\u27aide médicale à mourir : un projet d\u27amélioration de la qualité
No full textAim: A Quality Improvement Project, guided by the Service-Learning framework, was undertaken to determine if introducing simulation into graduate nurse practitioner (NP) education would improve students’ knowledge, self-reported competency, and confidence regarding opioid prescribing and participation in Medical Assistance in Dying (MAiD).
Background: Canadian government regulations authorize NPs to prescribe opioids and participate in MAiD. Simulation-based learning provides an opportunity for NP students to improve knowledge and critical-thinking skills regarding MAiD protocols and opioid prescribing in a safe, non-judgmental environment.
Methods: A four-hour simulation-based workshop on opioid prescribing and MAiD was provided to NP students in their final course before graduation. NP students rotated through three 60-minute simulation-based scenario stations; two opioid scenarios using standardized patients and a MAiD scenario with a high-fidelity manikin. Students were expected to apply knowledge obtained during their NP program to conduct a thorough assessment, determine diagnostic tests/tools, formulate diagnoses, and develop a collaborative treatment plan. Outcomes measures included completing a pre/post-simulation knowledge-based quiz, self-assessment on each scenario, and debriefing.
Findings: Scores on the pre-simulation quiz score ranged from 3–9 (M = 6.19); post-simulation quiz scores ranged from 6-12 (M = 9.88). Paired-Samples T-Test indicated a statistically significant increase between pre and post-mean scores. In all scenarios, there was an increase in the percentage of NP students who self-reported themselves as “competent” between their pre/post-simulation assessments.
Conclusions: This educational innovation created an engaging environment that facilitated learning. Given that opioid prescribing and MAiD are authorized acts for NPs, it is essential that graduates feel supported and prepared for these situations.
Objectif : Un PAQ, guidé par le cadre d\u27apprentissage par le service, a été entrepris pour déterminer si l\u27introduction de la simulation dans la formation des infirmières praticiennes diplômées (IP) améliorerait les connaissances, les compétences autodéclarées et la confiance des étudiants concernant la prescription d\u27opioïdes et la participation à l\u27assistance médicale dans Mourant (AMM).
Contexte : Les règlements du gouvernement canadien autorisent les IP à prescrire des opioïdes et à participer à l\u27AMM. L\u27apprentissage basé sur la simulation offre aux étudiants IP l\u27occasion d\u27améliorer leurs connaissances et leurs capacités de réflexion critique concernant les protocoles d\u27AMM et la prescription d\u27opioïdes dans un environnement sûr et sans jugement.
Méthodes : Un atelier de simulation de quatre heures sur la prescription d\u27opioïdes et l\u27AMM a été offert aux étudiants IP dans leur cours final avant l\u27obtention du diplôme. Les étudiants NP ont effectué une rotation dans trois stations de scénarios de simulation de 60 minutes; deux scénarios d\u27opioïdes utilisant des patients standardisés et un scénario d\u27AMM avec un mannequin haute fidélité. Les étudiants devaient appliquer les connaissances acquises au cours de leur programme d\u27IP pour effectuer une évaluation approfondie, déterminer les tests/outils de diagnostic, formuler des diagnostics et élaborer un plan de traitement collaboratif. Les mesures des résultats comprenaient la réalisation d\u27un quiz basé sur les connaissances avant/après la simulation, l\u27auto-évaluation de chaque scénario et un débriefing.
Constatations : Les scores au questionnaire de pré-simulation variaient de 3 à 9 (M = 6,19) ; les scores du quiz post-simulation variaient de 6 à 12 (M = 9,88). Le test T pour échantillons appariés a indiqué une augmentation statistiquement significative entre les scores moyens avant et après M = 3,69, IC à 95 % [4,77, 2,61], t (15) = 7,29, p < 0,005, d = 1,82. Dans tous les scénarios, il y a eu une augmentation du pourcentage d\u27étudiants IP qui se sont déclarés « compétents » entre leurs évaluations avant et après la simulation.
Conclusions : Cette innovation pédagogique a créé un environnement engageant qui a facilité l\u27apprentissage. Étant donné que la prescription d\u27opioïdes et l\u27AMM sont des actes autorisés pour les IP, il est essentiel que les diplômées se sentent soutenues et préparées à ces situations
Nurse Practitioners in LTC can Mitigate the Harmful Effects of Social Isolation
No full textAbstract
Aim: The aim of this narrative literature review is to summarize the current literature surrounding social isolation in long term care (LTC) during the COVID-19 pandemic, and to highlight the role of nurse practitioners in addressing social isolation.
Background: LTC homes in Ontario struggled with protecting their residents from the COVID-19 virus and enforcing lockdowns which including restricting outside visitors. Many LTC homes have nurse practitioners (NPs) available to support implementation of public health policies, while also providing medical oversight to the home. Despite having funding policies in Ontario for NPs in LTC, many homes do not have one as part of their health care team.
Methods: 15 peer-reviewed articles from 2019-2022 are included in this review, focusing on articles to assist in exploring the research question ‘What was the role of nurse practitioners in addressing factors associated with social isolation in LTC during the COVID-19 pandemic’?
Findings: Social isolation was identified as being a concern pre-pandemic, and was intensified during the pandemic due to lockdown measures and visitor restrictions. Nurse practitioners are well positioned to identify risk for isolation, and create plans to mitigate the effects for LTC residents.
Conclusion: Future outbreaks and/or pandemics will hold the same requirement for lockdown, but an assessment tool to predict exposure risk to the home and to individuals would allow for purposeful implementation of appropriate levels of isolation. Having nurse practitioners in all LTC homes would be an effective and appropriate way to monitor and implement such protocols, and to mitigate potentially harmful outcomes of social isolation.
 
A Concept Analysis: Changes to Homeostasis and the Risk of Falling
No full textAnnually, more than 30% of older adults experience a fall and most falls occur in the population aged 65 years and older. Research supports that factors leading to increased fall risk include the number of years institutionalized, performance of activities of daily living (ADLs), history of falls, age, diseases/conditions, cognitive impairment, sensory deficits, medication use, aggressive behaviours and environment. These factors destabilize older adults in long-term care (LTC) facilities and lead to falls. The term homeostasis is not present in nursing literature in relation to falls. The aim of this concept analysis was to operationalize the concept of homeostasis in relation to falls and examine how changes to this state can increase fall risk for older adults. Case scenarios and a concept map were used to illustrate the relationship between homeostasis and the risk of falling, in relation to falls in older adults
Meeting Together in a Good Way: A Discussion on the Educational Mapping Activity of Indigenous Content in a Nurse Practitioner Program
No full textA Primary Health Care Nurse Practitioner program carried out a unique curriculum mapping activity related to Indigenous content which resulted in the creation of a report entitled Maawanji\u27idiwag: Meeting Together in a Good Way. The activity was carried out by a working group which consisted of Indigenous knowledge keepers, Elders, faculty, and a student. The curriculum mapping activity prioritized the health-related Calls to Action from the Final Report of the Truth and Reconciliation of Canada (TRC), the Calls to Justice from Reclaiming Power and Place: The Final Report of the National Inquiry into Missing and Murdered Indigenous Women and Girls and the articles from the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP) as ‘Action Calls’ within a Nurse Practitioner Program. The mapping process was also guided by Bartlett’s decolonizing research framework The associated literature with the intersecting concepts of decolonization, Indigenization, reconciliation, cultural safety, and humility were linked to these national reports and the curriculum mapping activity and subsequent report. The goal of this paper is to share the many insights and learning from the curriculum mapping report to promote further deep dialogues, involvement and meaningful change within nursing education and health care