Culturally safe dementia care: Building nursing capacity to work with First Nations elders with memory loss

This community-based research project will build capacity amongst nurses to care for First Nations Elders with memory loss in a culturally safe way. The objectives are:

  1. To translate First Nations perspectives on dementia  research findings into a knowledge translation intervention for front-line nursing staff based on traditional storytelling with Elders;
  2. To determine the knowledge, skills and values of nursing staff with respect to cultural safety and dementia care before and after the traditional storytelling intervention; and
  3. To assess the effectiveness of the KT intervention in terms of changing nursing practice and improving care for First Nations Elders with memory loss.

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Fostering cultural safety in nursing practice with people experiencing problematic substance use

The purpose of this project is to generate new knowledge that will foster understanding of what constitutes safe nursing care in acute care settings for people who are experiencing problematic substance use and social disadvantage. The target audience will be practicing nurses who provide care to people experiencing substance use, as well as health care administrators, nursing leaders and policy makers. The key research question is: What is culturally safe care from the perspective of patients and nurses in acute care settings and what supports the delivery of culturally safe care?

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Impacts of a Palliative Approach for Nursing (IPAN)

This practice-relevant nursing health services research initiative will address the questions:

  1. How and in which contexts can a palliative approach better meet the needs of patients with a life-limiting illness and their family members?
  2. How can a palliative approach guide the development of innovations in health care delivery systems to better support nursing practice and the health system in British Columbia?

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The Utilization and Impact of Nurse Pracitioners and Physician Assistants: A Research Synthesis

The objective of this 12-month project is to use a research synthesis approach to develop the knowledge required to inform decision makers charged with the implementation of nurse practitioner and physician assistant roles.

Some areas to be addressed through this synthesis are:

  • What are the varying scopes of practice and practice autonomy for both roles?
  • What population health needs are best served by which role?
  • Are there barriers to implementing both roles simultaneously?
  • Can both roles effectively support the BC health care system and, if so, how?

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Best Practices: Integration of New Graduate Nurses in the Workplace

The overall objective of this 18-month project is to explore the use of best practices to facilitate the successful integration and retention of new graduate Registered Nurses (RNs) and Registered Psychiatric Nurses (RPNs). This project will evaluate the current application of health human resources best practice knowledge/strategies in BC to support the beginning practice of new nursing graduates, and to identify best practice knowledge/strategies likely to succeed in various health care settings.

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Evaluation of Care Delivery Model Redesign

In 2007, the Vancouver Island Health Authority (VIHA) began developing a data-driven process to redesign how care is delivered to patients: Care Delivery Model Redesign (CDMR). The overarching goals of CDMR are to achieve care delivery that is responsive to the care needs and experiences of patients, embodies inter-professional practice, and is based on data and evidence. This evaluation will aim to answer three questions about the model:

  • To what extent have the activities of CDMR contributed to delivering care that meets or exceeds a recognized standard?
  • To what extent have the activities of CDMR contributed to optimized staff utilization, based on patient care needs?
  • What are the factors that enable the development of a high-functioning inpatient unit? While questions 1 and 2 focus on patient care quality and optimizing staff, question 3 is intended to capture the interplay of factors between these two domains and others, such as leadership and culture.

Evaluation of the Enhanced Seniors Team Initiative

Primary Investigators: Katy Mukai and Dr. Ann Holyrood

The Enhanced Seniors Team (EST) is an initiative under the Care Continuum Transformation Project (CCT) that the Vancouver Island Health Authority (VIHA) launched at Nanaimo Regional General Hospital. The EST focuses on improving care for frail, at-risk older adults being seen in the Emergency Department (ED). The aim of the EST is to initiate early, goal-directed care planning and evidence-based interventions to prevent cognitive and functional losses associated with acute illness among hospitalized older patients. The team collaborates with the medical and surgical unit teams to achieve patient goals, decrease hospital length of stay and improve transition to home. The interdisciplinary EST includes a case manager who helps reduce unnecessary hospital admissions by providing referrals that increase access to community-based services and resources.

The health authority wishes to evaluate the impact of the EST in Nanaimo in order to inform implementation of the model in other VIHA hospitals.

Evaluation of the Integration of Nurse Practitioners into the BC Healthcare System

The nurse practitioner (NP) role is new to BC and its impact has yet to be evaluated. The proposed multi-year study will evaluate a practice innovation – the integration of NPs into the BC healthcare system, and will establish a framework for sustainable ongoing evaluation of the impact of NP practice on those they serve and the health care system. The study process will be divided into three parts addressing the following broad questions:

  1. What changes result for patients, and what are the implications for the health care system when NPs become part of the care process?
  2. What is the impact of adding a NP to the functioning of collaborative health care teams?
  3. What are the practice settings and scope of practice of NPs working in BC?

The final work of the project team will be to use the study findings to develop an ongoing evaluation method for future data collection and evaluation of NPs’ practice and impact.

Evaluation of the Residential Program Care Delivery Model

CDM was launched in Fraser Health in July 2010, with plans to implement the model across all residential care beds in the Health Authority. The model consists of three inter-related aspects: staff mix, funding methodology and direct care hours. CDM sets a goal of reaching 3.36 direct care hours per resident per day across Fraser Health by targeting residents, their families and staff in residential care programs in FH-operated facilities. The evaluation project will examine Phase 1 of the implementation of CDM (July 2010 to January 2011) and will include monitoring funding indicators as well as quality of care indicators.

Evaluation of Collaborative Practice Project

The focus of this evaluation program will be the impact of Collaborative Practice on three residential facilities: Banfield Pavilion, Evergreen House and Minoru Residence. Collaborative Practice Program has two key characteristics: 1) it is an approach to matching staff to patient needs through participation of nurses, unions, professional practice and clinical and operational leaders; 2) it promotes a team-oriented model of nursing care. The purpose of the evaluation will be to assess and compare the impact of the program at these three sites on health human resources and patient outcomes.

The evaluation of Collaborative Practice will include six main areas of focus:

  •     impact on clinical outcomes
  •     impact on health human resources
  •     nursing staff engagement
  •     consistent collaborative approach to care
  •     impact on clinician roles
  •     productivity