It is well-established that Two-Spirit, lesbian, gay, bisexual, trans, queer, intersex, and asexual (2SLGBTQIA+) people are subject to discrimination within healthcare settings, leading to poor health outcomes. In fact, these instances of discrimination are growing in context of rising hate toward the 2SLGBTQIA+ community. In response, the Island Health Authority has recently launched a revolutionary role: the 2SLGBTQIA+ Liaison Nurse. This Liaison Nurse works directly with 2SLGBTQIA+ patients in the healthcare system to support: navigating the system, advocating for services, ensuring a safe and respectful healthcare encounter, and accessing gender-affirming care. Our larger project will involve scaling up and implementing this role across additional healthcare sites in BC, and evaluating the role to ensure safe, quality, and equitable care for 2SLGBTQIA+ people across the province. Funding through a C2 grant will support bringing together health authority, community, and researcher representatives to develop a comprehensive research plan for implementing and evaluating this role. In particular, funds will support a 2-Day Intensive in Vancouver to support necessary conversations in support of the project’s next steps.
Award Partner: BC Nurses' Union
Creating a roadmap for critical care nursing retention
Nurses specializing in critical care handle the most severe cases in hospitals. Typically, they undergo additional training beyond their initial four-year nursing education to work in intensive care units (ICUs). During the COVID-19 pandemic, shortage of ICU-trained nurses led to non-ICU-trained nurses having to care for these patients. Anecdotal evidence suggests following the pandemic, many ICU-nurses have resigned because they experienced significant moral distress due to feeling unprepared to provide safe and ethical care. This has worsened the shortage of ICU-trained nurses particularly at Abbotsford Regional Hospital.
The federal Chief Nursing Officer released a toolkit on nursing retention, but its recommendations are broad, thus tailoring to suit specific practice environments is needed. We propose this convening and collaborating grant to bring together ICU-trained nurses and managers to brainstorm strategies tailored to retain ICU-trained nurses. We will develop an evidence-informed, nurse centred implementation research roadmap to support the recruitment and retention of ICU-trained nurses within Fraser Health, with a specific focus on Abbotsford Hospital due to its rural location and unique challenges.
Building a practice-based research learning community in British Columbia to strengthen learning health systems and health human resources
Ongoing challenges exist for attracting and keeping healthcare professionals in BC and across Canada due to low job satisfaction and working conditions. Professional development opportunities such as practice-based research (PBR) programs offer a solution to these challenges, as they have been shown to increase job satisfaction and retention of clinicians who work at point-of-care and see opportunities for practice and health system improvement. PBR programs provide training, mentorship, and funding to enable healthcare professionals to conduct small research projects that can lead to better patient experience and outcomes. However, more research is needed on the impact of PBR programs as they are not offered in all BC health authorities and there are continued threats (e.g., fiscal constraints, capacity limits) to sustaining existing PBR programs. Our convening and collaborating activities will bring together leaders, clinicians and people with lived experience in the healthcare system, creating a network that will formulate plans for evaluating, spreading and sustaining PBR programs, for the benefit of patients, clinicians and the healthcare system.
Co-Creating Collaborative Pathways: Advancing Indigenous Clinical Nurse Specialist Roles
Health organizations in BC are creating Clinical Nurse Specialist, Indigenous Health and Cultural Safety (CNS IH;ICS) roles. This collaborative partnership intends to convene expert knowledge holders to ensure the CNS IH;ICS leaders are leading an impactful, nurtured, and sustainable workforce. The BC Indigenous Health Nursing Research Chair has generated knowledge into the practice of Indigenous health nursing and the Providence Health Care and BC Cancer research team conducted a study examining the CNS roles. Our research activities include hosting a two-day Symposium to bridge these two parallel pathways of knowledge to generate share and mobilize research findings that will inform, nurture, and sustain the CNS IH;ICS roles in BC. Formalizing this partnership and collaboration will address the health human resources crisis by identifying pathways for a collaborative research inquiry to increase structural frameworks that inform Indigenous health policy and program development. Indigenous health systems require a distinct approach that recognizes the authentic voices and experiences of Indigenous nurses in health leadership and provides opportunities for intergenerational research mentorship and training.
Chronic Pain and Women’s Health: Developing and Scaling Out Sex and Gender Informed Resources to Nursing Students and Educators in BC
In 2021, the Canadian Pain Task Force released the Action Plan for Pain in Canada, which included six recommendations to advance action on pain in Canada, including the need to increase awareness, education, and specialized training in pain. The Task Force also identified that women are among the populations disproportionately affected by chronic pain, and that health care professionals require additional knowledge and skills to effectively treat and manage pain. This project will respond to the recommendation and subsequent recommendations for action identified by CEWH researchers.
The purpose of this project is to create a research and educational agenda that improves how women’s health, and important sex and gender related considerations related to the experience of chronic pain and opioid use for pain management, are integrated into the BC nursing curricula. The project will: gather nursing students, nurse educators, chronic pain researchers, and people with lived and living experience of chronic pain in a hybrid learning event; prepare a research and educational agenda that identifies opportunities and priorities for women’s chronic pain in the nursing field; and create training resources for nursing students and educators.
Developing a research agenda to support northern internationally educated nurses return to the healthcare workforce
The nursing workforce is in crisis. The BC government’s commitment to health workforce strategy highlights that a systemic approach supporting nurses with international education (IENs) living in British Columbia returning to the workforce needs to be updated and strengthened. The proposed activities are based on this need and call for a learning system approach to workforce planning, including building capacity for IEN networking, education, recruitment, and retention. Applying learning systems principles to co-create a nimble northern post-secondary-health authority partnership will require effective teamwork to develop a research agenda on IEN access to education to support workforce sustainability. To use evidence to guide IEN programming in northern BC, we intend to invite provincial partners and stakeholders and facilitate a face-to-face meeting, followed by four online group meetings. Participatory techniques will be used in these sessions to explore the practicality of original and creative solutions for IEN nurse assessment, education, and employment in the north. Finally, we will focus on determining ways to improve IEN systems in practice, research, and policy across BC.
STARS — STARting off Right: Best Supports for New Graduate Nurses
Reflecting the global nursing workforce shortage, the province of British Columbia is facing a nursing staffing crisis: in addition to high numbers of experienced nurses choosing to retire, many new graduate nurses are leaving the profession within a few years of graduation (British Columbia Nurses Union, 2022). To address this crisis, we will host a co-design workshop that will bring together research users and researchers focused on better supporting new graduate nurses as they transition to clinical practice. During the workshop, we will share best practice research, innovative solutions, co-design scaling solutions, prioritize research gaps, and determine how best to share information. Specifically, the workshop will include examination on support for groups of nurses with high barriers when transitioning to practice, including Indigenous, Black, and internationally educated nurses. Our intended outcomes centre on co-designing a research agenda with priority areas for future research and co-design best practice KT products. Finally, we will increase the capacity of knowledge translation for researchers and research users through co-development and exposure to consultant design experts in visual knowledge translation.
Embedded Knowledge Mobilization: Strengthening Oncology Nurses’ Capacity for Effective Advanced Care Planning Conversations
Advance care planning (ACP) is a process that supports patients to reflect on their personal values and preferences towards care, and share these preferences with their healthcare team. ACP supports patient- and family-centered care, ensuring the care a patient receives aligns with their goals and preferences. Recent research conducted at BC Cancer aimed to learn how to better support oncology nurses in conducting ACP across the cancer journey. Study findings provide important insight into (1) local barriers and facilitators for oncology nurses to conduct ACP and (2) changes needed to support nursing-led ACP at BC Cancer.
To translate these findings into clinical practice, we will assemble direct care nurses, nursing leaders, patient and family partners, and relevant knowledge users to inform a nursing practice change that enhances oncology nurses’ ability to conduct ACP. Our approach will involve key activities, including the establishment of a provincial ACP working group to oversee all activities, engagement sessions with direct care nurses to identify barriers and facilitators to the proposed practice change, and targeted implementation strategies such as educational sessions to promote awareness and build ACP proficiency.