Skip header and navigation

Refine By

   MORE

13 records – page 1 of 2.

The acute care nurse practitioner role in Canada.

https://arctichealth.org/en/permalink/ahliterature135437
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:114-39
Publication Type
Article
Date
Dec-2010
Author
Kelley Kilpatrick
Patricia Harbman
Nancy Carter
Ruth Martin-Misener
Denise Bryant-Lukosius
Faith Donald
Sharon Kaasalainen
Ivy Bourgeault
Alba DiCenso
Author Affiliation
Department of Nursing, Université du Québec en Outaouais, CHSRF/CIHR Program in Advanced Practice Nursing, St-Jérôme, QC.
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:114-39
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Acute Disease
Advanced Practice Nursing - education - organization & administration - standards
Canada
Clinical Competence
Curriculum
Delivery of Health Care - organization & administration
Educational Measurement
Educational Status
Focus Groups
Health Policy
Humans
Nurse Practitioners - education - organization & administration - standards
Nurse's Role
Quebec
Abstract
The acute care nurse practitioner (ACNP) role was developed in Canada in the late 1980s to offset rapidly increasing physician workloads in acute care settings and to address the lack of continuity of care for seriously ill patients and increased complexity of care delivery. These challenges provided an opportunity to develop an advanced practice nursing role to care for critically ill patients with the intent of improving continuity of care and patient outcomes. For this paper, we drew on the ACNP-related findings of a scoping review of the literature and key informant interviews conducted for a decision support synthesis on advanced practice nursing. The synthesis revealed that ACNPs are working in a range of clinical settings. While ACNPs are trained at the master's level, there is a gap in specialty education for ACNPs. Important barriers to the full integration of ACNP roles into the Canadian healthcare system include lack of full utilization of role components, limitations to scope of practice, inconsistent team acceptance and funding issues. Facilitators to ACNP role implementation include clear communication about the role, with messages tailored to the specific information needs of various stakeholder groups; supportive leadership of healthcare managers; and stable and predictable funding. The status of ACNP roles continues to evolve across Canada. Ongoing leadership and continuing research are required to enhance the integration of these roles into our healthcare system.
PubMed ID
21478690 View in PubMed
Less detail

Advanced practice nursing in Canada: overview of a decision support synthesis.

https://arctichealth.org/en/permalink/ahliterature135441
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:15-34
Publication Type
Article
Date
Dec-2010
Author
Alba DiCenso
Ruth Martin-Misener
Denise Bryant-Lukosius
Ivy Bourgeault
Kelley Kilpatrick
Faith Donald
Sharon Kaasalainen
Patricia Harbman
Nancy Carter
Sandra Kioke
Julia Abelson
R James McKinlay
Dianna Pasic
Brandi Wasyluk
Julie Vohra
Renee Charbonneau-Smith
Author Affiliation
Ontario Training Centre in Health Services & Policy Research, Nursing and Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, ON.
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:15-34
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Advanced Practice Nursing - classification - methods - organization & administration
Canada
Decision Support Systems, Clinical - classification - organization & administration
Focus Groups
Health Care Surveys
Health Policy
Humans
Leadership
Nurse Clinicians - classification - organization & administration
Nurse Practitioners - classification - organization & administration
Periodicals as Topic - statistics & numerical data
Publishing - statistics & numerical data
Abstract
The objective of this decision support synthesis was to identify and review published and grey literature and to conduct stakeholder interviews to (1) describe the distinguishing characteristics of clinical nurse specialist (CNS) and nurse practitioner (NP) role definitions and competencies relevant to Canadian contexts, (2) identify the key barriers and facilitators for the effective development and utilization of CNS and NP roles and (3) inform the development of evidence-based recommendations for the individual, organizational and system supports required to better integrate CNS and NP roles into the Canadian healthcare system and advance the delivery of nursing and patient care services in Canada. Four types of advanced practice nurses (APNs) were the focus: CNSs, primary healthcare nurse practitioners (PHCNPs), acute care nurse practitioners (ACNPs) and a blended CNS/NP role. We worked with a multidisciplinary, multijurisdictional advisory board that helped identify documents and key informant interviewees, develop interview questions and formulate implications from our findings. We included 468 published and unpublished English- and French-language papers in a scoping review of the literature. We conducted interviews in English and French with 62 Canadian and international key informants (APNs, healthcare administrators, policy makers, nursing regulators, educators, physicians and other team members). We conducted four focus groups with a total of 19 APNs, educators, administrators and policy makers. A multidisciplinary roundtable convened by the Canadian Health Services Research Foundation formulated evidence-informed policy and practice recommendations based on the synthesis findings. This paper forms the foundation for this special issue, which contains 10 papers summarizing different dimensions of our synthesis. Here, we summarize the synthesis methods and the recommendations formulated at the roundtable.
PubMed ID
21478685 View in PubMed
Less detail

Boundary work and the introduction of acute care nurse practitioners in healthcare teams.

https://arctichealth.org/en/permalink/ahliterature129343
Source
J Adv Nurs. 2012 Jul;68(7):1504-15
Publication Type
Article
Date
Jul-2012
Author
Kelley Kilpatrick
Mélanie Lavoie-Tremblay
Judith A Ritchie
Lise Lamothe
Diane Doran
Author Affiliation
Université du Québec en Outaouais, St-Jérôme,Québec, Canada. kelley.kilpatrick@uqo.ca
Source
J Adv Nurs. 2012 Jul;68(7):1504-15
Date
Jul-2012
Language
English
Publication Type
Article
Keywords
Acute Disease - nursing
Attitude of Health Personnel
Canada
Cardiology Service, Hospital - organization & administration
Clinical Competence
Cooperative Behavior
Humans
Interprofessional Relations
Licensure, Nursing - legislation & jurisprudence
Nurse practitioners
Nurse's Practice Patterns - organization & administration
Nurse's Role
Organizational Case Studies
Organizational Innovation
Patient Care Team - organization & administration
Qualitative Research
Abstract
This article is a report of a study of boundary work following the introduction of an acute care nurse practitioner role in healthcare teams.
Acute care nurse practitioners enacting their roles in healthcare teams have faced a number of challenges including a mix of positive and negative views of the acute care nurse practitioner role from healthcare team members and acute care nurse practitioner roles crossing the boundaries between the medical and nursing professions. Understanding the process by which the boundaries between professions changed following the introduction of an acute care nurse practitioner role was important since this could affect scope of practice and the team's ability to give patient care.
The study was conducted in two university-affiliated teaching hospitals in Canada. A descriptive multiple case study design was used. Data were collected from March to May 2009.
Participants (N = 59) described boundary work as a process that included: (1) creating space; (2) loss of a valued function; (3) trust; (4) interpersonal dynamics; and (5) time. The development of trust among team members was essential. The co-location of team members working on common projects, and medical and nursing leadership facilitated boundary work.
The micro-level processes of boundary work in healthcare teams have important implications for the development of full scope of practice for acute care nurse practitioners, effective inter-professional teamwork and the integration of new roles in healthcare systems. Future research needs to be undertaken in different contexts, and with patients and families.
Notes
Erratum In: J Adv Nurs. 2012 Jul;68(7):1672
PubMed ID
22117596 View in PubMed
Less detail

The clinical nurse specialist role in Canada.

https://arctichealth.org/en/permalink/ahliterature135436
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:140-66
Publication Type
Article
Date
Dec-2010
Author
Denise Bryant-Lukosius
Nancy Carter
Kelley Kilpatrick
Ruth Martin-Misener
Faith Donald
Sharon Kaasalainen
Patricia Harbman
Ivy Bourgeault
Alba DiCenso
Author Affiliation
School of Nursing and Department of Oncology, McMaster University, CHSRF/CIHR Program in Advanced Practice Nursing, Canadian Centre of Excellence in Oncology Advanced Practice Nursing at the Juravinski Cancer Centre, Hamilton, ON.
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:140-66
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Advanced Practice Nursing - education - organization & administration - standards
Canada
Clinical Competence
Credentialing
Decision Support Techniques
Delivery of Health Care
Educational Measurement
Educational Status
Focus Groups
Humans
Leadership
Nurse Clinicians - education - organization & administration - standards
Nurse's Role
Abstract
The clinical nurse specialist (CNS) provides an important clinical leadership role for the nursing profession and broader healthcare system; yet the prominence and deployment of this role have fluctuated in Canada over the past 40 years. This paper draws on the results of a decision support synthesis examining advanced practice nursing roles in Canada. The synthesis included a scoping review of the Canadian and international literature and in-depth interviews with key informants including CNSs, nurse practitioners, other health providers, educators, healthcare administrators, nursing regulators and government policy makers. Key challenges to the full integration of CNSs in the Canadian healthcare system include the paucity of Canadian research to inform CNS role implementation, absence of a common vision for the CNS role in Canada, lack of a CNS credentialing mechanism and limited access to CNS-specific graduate education. Recommendations for maximizing the potential and long-term sustainability of the CNS role to achieve important patient, provider and health system outcomes in Canada are provided.
PubMed ID
21478691 View in PubMed
Less detail

Clinical nurse specialists and nurse practitioners: title confusion and lack of role clarity.

https://arctichealth.org/en/permalink/ahliterature135434
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:189-201
Publication Type
Article
Date
Dec-2010
Author
Faith Donald
Denise Bryant-Lukosius
Ruth Martin-Misener
Sharon Kaasalainen
Kelley Kilpatrick
Nancy Carter
Patricia Harbman
Ivy Bourgeault
Alba DiCenso
Author Affiliation
Affiliate Faculty, Daphne Cockwell School of Nursing, Ryerson University, CHSRF/CIHR Program in Advanced Practice Nursing, Toronto, ON.
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:189-201
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Advanced Practice Nursing - organization & administration
Attitude of Health Personnel
Awareness
Canada
Curriculum
Focus Groups
Health Policy
Humans
Nurse Clinicians - organization & administration
Nurse Practitioners - organization & administration
Nurse's Role
Social Perception
Abstract
Title confusion and lack of role clarity pose barriers to the integration of advanced practice nursing roles (i.e., clinical nurse specialist [CNS] and nurse practitioner [NP]). Lack of awareness and understanding about NP and CNS roles among the healthcare team and the public contributes to ambiguous role expectations, confusion about NP and CNS scopes of practice and turf protection. This paper draws on the results of a scoping review of the literature and qualitative key informant interviews conducted for a decision support synthesis commissioned by the Canadian Health Services Research Foundation and the Office of Nursing Policy in Health Canada. The goal of this synthesis was to develop a better understanding of advanced practice nursing roles and the factors that influence their effective development and integration in the Canadian healthcare system. Specific recommendations from interview participants and the literature to enhance title and role clarity included the use of consistent titles for NP and CNS roles; the creation of a vision statement to articulate the role of CNSs and NPs across settings; the use of a systematic planning process to guide role development and implementation; the development of a communication strategy to educate healthcare professionals, the public and employers about the roles; attention to inter-professional team dynamics when introducing these new roles; and addressing inter-professionalism in all health professional education program curricula.
PubMed ID
21478694 View in PubMed
Less detail

Development and validation of a time and motion tool to measure cardiology acute care nurse practitioner activities.

https://arctichealth.org/en/permalink/ahliterature128835
Source
Can J Cardiovasc Nurs. 2011;21(4):18-26
Publication Type
Article
Date
2011
Author
Kelley Kilpatrick
Author Affiliation
Université d Québec en Outaouais, Québec, Canada. kelley.kilpatrick@uqo.ca
Source
Can J Cardiovasc Nurs. 2011;21(4):18-26
Date
2011
Language
English
Publication Type
Article
Keywords
Canada
Heart Diseases - nursing
Humans
Nurse practitioners
Observer Variation
Pilot Projects
Reproducibility of Results
Time and Motion Studies
Abstract
Acute care nurse practitioners (ACNPs) provide advanced nursing care to patients and families who are experiencing a complex acute, critical or chronic health condition. A clear understanding of ACNP activities may facilitate the deployment of ACNP roles in health care teams. Time and motion studies represent the gold standard to measure clinician work time.
A time and motion tool to measure cardiology ACNP activities was developed and pilot-tested in two organizations.
The researcher produced a valid and reliable tool. The inter-observer agreement was 0.94 following the pilot study. A training guide and a training schedule were produced to support the use of the time and motion tool. Each activity was defined to facilitate the coding of ACNP activities.
A validated tool can contribute to our knowledge of ACNP activities and role components, and identify the ACNPs' contributions to patient care and the functioning of the health care team.
PubMed ID
22165502 View in PubMed
Less detail

Education of advanced practice nurses in Canada.

https://arctichealth.org/en/permalink/ahliterature135439
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:61-84
Publication Type
Article
Date
Dec-2010
Author
Ruth Martin-Misener
Denise Bryant-Lukosius
Patricia Harbman
Faith Donald
Sharon Kaasalainen
Nancy Carter
Kelley Kilpatrick
Alba DiCenso
Author Affiliation
Graduate Programs, School of Nursing, Dalhousie University, Halifax, NS.
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:61-84
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Advanced Practice Nursing - education - trends
Canada
Clinical Competence
Curriculum
Decision Support Techniques
Education, Nursing, Continuing
Educational Measurement
Educational Status
Focus Groups
Humans
Interdisciplinary Communication
Nurse Clinicians - organization & administration
Nurse Practitioners - organization & administration
Abstract
In Canada, education programs for the clinical nurse specialist (CNS) and nurse practitioner (NP) roles began 40 years ago. NP programs are offered in almost all provinces. Education for the CNS role has occurred through graduate nursing programs generically defined as providing preparation for advanced nursing practice. For this paper, we drew on pertinent sections of a scoping review of the literature and key informant interviews conducted for a decision support synthesis on advanced practice nursing to describe the following: (1) history of advanced practice nursing education in Canada, (2) current status of advanced practice nursing education in Canada, (3) curriculum issues, (4) interprofessional education, (5) resources for education and (6) continuing education. Although national frameworks defining advanced nursing practice and NP competencies provide some direction for education programs, Canada does not have countrywide standards of education for either the NP or CNS role. Inconsistency in the educational requirements for primary healthcare NPs continues to cause significant problems and interferes with inter-jurisdictional licensing portability. For both CNSs and NPs, there can be a mismatch between a generalized education and specialized practice. The value of interprofessional education in facilitating effective teamwork is emphasized. Recommendations for future directions for advanced practice nursing education are offered.
Notes
Comment In: Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:85-721478688
PubMed ID
21478687 View in PubMed
Less detail

Factors enabling advanced practice nursing role integration in Canada.

https://arctichealth.org/en/permalink/ahliterature135433
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:211-38
Publication Type
Article
Date
Dec-2010
Author
Alba DiCenso
Denise Bryant-Lukosius
Ruth Martin-Misener
Faith Donald
Julia Abelson
Ivy Bourgeault
Kelley Kilpatrick
Nancy Carter
Sharon Kaasalainen
Patricia Harbman
Author Affiliation
CHSRF/CIHR in Advanced Practice Nursing, Ontario Training Centre in Health Services & Policy Research, McMaster University, Hamilton, ON.
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:211-38
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Advanced Practice Nursing - manpower - organization & administration
Awareness
Canada
Curriculum
Decision Support Systems, Clinical
Delivery of Health Care - manpower - organization & administration
Education, Nursing, Continuing
Focus Groups
Great Britain
Health Care Surveys
Health Policy
Humans
Interprofessional Relations
Leadership
Nurse Clinicians - organization & administration - supply & distribution
Nurse Practitioners - organization & administration - supply & distribution
Personnel Turnover
Primary Health Care - organization & administration
United States
Abstract
Although advanced practice nurses (APNs) have existed in Canada for over 40 years and there is abundant evidence of their safety and effectiveness, their full integration into our healthcare system has not been fully realized. For this paper, we drew on pertinent sections of a scoping review of the Canadian literature from 1990 onward and interviews or focus groups with 81 key informants conducted for a decision support synthesis on advanced practice nursing to identify the factors that enable role development and implementation across the three types of APNs: clinical nurse specialists, primary healthcare nurse practitioners and acute care nurse practitioners. For development of advanced practice nursing roles, many of the enabling factors occur at the federal/provincial/territorial (F/P/T) level. They include utilization of a pan-Canadian approach, provision of high-quality education, and development of appropriate legislative and regulatory mechanisms. Systematic planning to guide role development is needed at both the F/P/T and organizational levels. For implementation of advanced practice nursing roles, some of the enabling factors require action at the F/P/T level. They include recruitment and retention, role funding, intra-professional relations between clinical nurse specialists and nurse practitioners, public awareness, national leadership support and role evaluation. Factors requiring action at the level of the organization include role clarity, healthcare setting support, implementation of all role components and continuing education. Finally, inter-professional relations require action at both the F/P/T and organizational levels. A multidisciplinary roundtable formulated policy and practice recommendations based on the synthesis findings, and these are summarized in this paper.
PubMed ID
21478695 View in PubMed
Less detail

A historical overview of the development of advanced practice nursing roles in Canada.

https://arctichealth.org/en/permalink/ahliterature135440
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:35-60
Publication Type
Article
Date
Dec-2010
Author
Sharon Kaasalainen
Ruth Martin-Misener
Kelley Kilpatrick
Patricia Harbman
Denise Bryant-Lukosius
Faith Donald
Nancy Carter
Alba DiCenso
Author Affiliation
Affiliate Faculty, School of Nursing, McMaster University, Career Scientist, Ontario Ministry of Health and Long-Term Care, Hamilton, ON.
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:35-60
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Advanced Practice Nursing - history - manpower - methods
Canada
Delivery of Health Care - history - organization & administration
Health Policy - history - trends
Health services needs and demand
History of Nursing
History, 20th Century
Humans
Nurse Clinicians
Nurse's Role - history
Qualitative Research
Abstract
Advanced practice nursing has evolved over the years to become recognized today as an important and growing trend among healthcare systems worldwide. To understand the development and current status of advanced practice nursing within a Canadian context, it is important to explore its historical roots and influences. The purpose of this paper is to provide a historical overview of the major influences on the development of advanced practice nursing roles that exist in Canada today, those roles being the nurse practitioner and the clinical nurse specialist. Using a scoping review and qualitative interviews, data were summarized according to three distinct time periods related to the development of advanced practice nursing. They are the early beginnings; the first formal wave, between the mid 1960s and mid 1980s; and the second wave, beginning in the late 1980s and continuing to the present. This paper highlights how advanced practice nursing roles have evolved over the years to meet emerging needs within the Canadian healthcare system. A number of influential factors have both facilitated and hindered the development of the roles, despite strong evidence to support their effectiveness. Given the progress over the past few decades, the future of advanced practice nursing within the Canadian healthcare system is promising.
PubMed ID
21478686 View in PubMed
Less detail

Practice patterns and perceived impact of clinical nurse specialist roles in Canada: results of a national survey.

https://arctichealth.org/en/permalink/ahliterature115062
Source
Int J Nurs Stud. 2013 Nov;50(11):1524-36
Publication Type
Article
Date
Nov-2013
Author
Kelley Kilpatrick
Alba DiCenso
Denise Bryant-Lukosius
Judith A Ritchie
Ruth Martin-Misener
Nancy Carter
Author Affiliation
Canadian Centre for Advanced Practice Nursing Research, Faculty of Nursing, Université de Montréal, Centre de recherche de l'Hôpital Maisonneuve-Rosemont, Hôpital Maisonneuve-Rosemont, CSA - RC - Aile bleue - Bureau F121, 5415 boul. l'Assomption, Montréal, QC, Canada H1T 2M4. Electronic address: kelley.kilpatrick@umontreal.ca.
Source
Int J Nurs Stud. 2013 Nov;50(11):1524-36
Date
Nov-2013
Language
English
Publication Type
Article
Keywords
Adult
Canada
Cross-Sectional Studies
Data Collection
Female
Humans
Male
Middle Aged
Nurse Clinicians
Nurse's Role
Specialties, Nursing
Abstract
Clinical nurse specialists are recognized internationally for providing an advanced level of practice. They positively impact the delivery of healthcare services by using specialty-specific expert knowledge and skills, and integrating competencies as clinicians, educators, researchers, consultants and leaders. Graduate-level education is recommended for the role but many countries do not have formal credentialing mechanisms for clinical nurse specialists. Previous studies have found that clinical nurse specialist roles are poorly understood by stakeholders. Few national studies have examined the utilization of clinical nurse specialists.
To identify the practice patterns of clinical nurse specialists in Canada.
A descriptive cross-sectional survey.
Self-identified clinical nurse specialists in Canada.
A 50-item self-report questionnaire was developed, pilot-tested in English and French, and administered to self-identified clinical nurse specialists from April 2011 to August 2011. Data were analyzed using descriptive and inferential statistics and content analysis.
The actual number of clinical nurse specialists in Canada remains unknown. The response rate using the number of registry-identified clinical nurse specialists was 33% (804/2431). Of this number, 608 reported working as a clinical nurse specialist. The response rate for graduate-prepared clinical nurse specialists was 60% (471/782). The practice patterns of clinical nurse specialists varied across clinical specialties. Graduate-level education influenced their practice patterns. Few administrative structures and resources were in place to support clinical nurse specialist role development. The lack of title protection resulted in confusion around who identifies themselves as a clinical nurse specialist and consequently made it difficult to determine the number of clinical nurse specialists in Canada.
This is the first national survey of clinical nurse specialists in Canada. A clearer understanding of these roles provides stakeholders with much needed information about clinical nurse specialist practice patterns. Such information can inform decisions about policies, education and organizational supports to effectively utilize this role in healthcare systems. This study emphasizes the need to develop standardized educational requirements, consistent role titles and credentialing mechanisms to facilitate the identification and comparison of clinical nurse specialist roles and role outcomes internationally.
PubMed ID
23548169 View in PubMed
Less detail

13 records – page 1 of 2.