Advancing Excellence in Community Health Nursing Through Evidence-Based National Standards of Practice.

BACKGROUND: Current standards of practice are necessary to ensure safe nursing practice in Canada and across the world. This article aimed to describe and present findings from the rigorous review process undertaken to update the 2011 Canadian Community Health Nursing Standards of Practice. METHOD: A revision process included a scoping review of the literature, focus groups, and a modified Delphi method. RESULTS: Through the inclusive consultation process, 495 community health nurses enhanced the content of the standards with respect to cultural safety, cultural humility, Indigenous health and ways of knowing, health equity, and evidence-informed practice. CONCLUSION: This comprehensive revision process can guide other nursing specialty groups developing or revising specialized practice standards in Canada and across the world. [J Contin Educ Nurs. 2021;52(4):168-175.].

The impact of alcohol use disorders and alcohol consumption on treatment-seeking individuals with social anxiety disorder.

Comorbid social anxiety and alcohol use disorders (SAD-AUD) in the community and the complex interactions that occur between these disorders have emerged as a significant clinical, public health, and research issue. The authors examined (a) the rates of comorbid SAD-AUD, (b) the impact of comorbid SAD-AUD on outcomes targeting social anxiety disorder, and (c) the effect of pretreatment alcohol consumption and alcohol use before, during, and after social situations on a composite measure of social anxiety in 172 adults presenting with social anxiety disorder. There was low incidence of AUD in this sample of individuals with SAD. Results indicated that alcohol consumption did not lead to worse social anxiety symptoms; however, alcohol use before and during social situations was associated with more severe social anxiety symptoms. These findings suggest that the function of alcohol use may be more important than the overall level of alcohol use and has implications for treatment.

'What do we lose when we can't go to the anatomy lab?'

Correspondence: What do we lose when we can't go into the anatomy lab?

Trends in cannabis use over time among Canadian youth: 2004-2014.

Cannabis is the most commonly used illicit substance among Canadian youth. The current study examined national trends in cannabis use among Canadian youth from 2004/05 to 2014/15 using nationally representative data from the Canadian Student Tobacco, Alcohol and Drugs Survey (CSTADS). Data were collected from students in Grades 7 to 12 as part of the Canadian Student Tobacco, Alcohol and Drugs Survey (formerly the Youth Smoking Survey) using a repeat-cross sectional survey across 6 biennial survey waves between 2004 and 2014 (N = 243,057). Regression models examined factors associated with cannabis use in the past 12 months, perceived ease of access, and a multilinear regression examined age of initiation across survey cycles. The findings indicate that use of cannabis in the past 12-months significantly decreased among Canadian youth. Past-year use peaked in 2008/09 at 27.3%; compared to 16.5%, in 2014/15. Mean age of initiation did not vary over time, while youth in recent cycles reported that cannabis was more difficult to access: in 2006/07, 77.1% reported that it would be easy to access cannabis compared to 49.0% in 2014/15. Overall, cannabis use among Canadian youth appears to have peaked around 2008/09, with substantial declines over the past decade. It will be critically important to examine any changes in patterns of use following legalization of non-medical cannabis in Canada.

Priority setting and policy advocacy by nursing associations: a scoping review and implications using a socio-ecological whole systems lens.

OBJECTIVE: We undertook an interpretative scoping review to examine organizational priority setting and policy advocacy and the factors that influence nursing associations' cross-sector public policy choices and actions. METHOD: Evidence was drawn from research, narrative, and theoretical sources that described priority setting and policy advocacy undertaken by non-governmental, non-profit, and nursing associations. Text was extracted from selected papers, imported into NVivo 8, coded, and analyzed using a descriptive-analytical narrative method. RESULTS: Many internal and external factors are shown to shape organizations' policy choices and actions including governance and governance structures, membership arrangements, legislative, professional, and jurisdictional mandates, perceived credibility, and external system disruptions. CONCLUSIONS: Internal and external factors are identified in the literature as critical to how organizations succeed or fail to set achievable priorities and advance their advocacy goals. Case comparisons and longitudinal research are needed to understand nursing associations' policy choices and actions for cross-sector public policy given their complex organizational structures and dynamic professional-legal-social-economic-political-ecological environments. A socio-ecological systems perspective can inform the development of theoretical frameworks and research to understand leverage points and blockages to guide nursing associations' public policy choices and actions at varying points in time.

Understanding the role of communities of practice in evidence-informed decision making in public health.

In this article we report on qualitative findings that describe public health practitioners' practice-based definitions of evidence-informed decision making (EIDM) and communities of practice (CoP), and how CoP could be a mechanism to enhance their capacity to practice EIDM. Our findings emerged from a qualitative descriptive analysis of group discussions and participant concept maps from two consensus-building workshops that were conducted with public health practitioners (N = 90) in two provinces in eastern Canada. Participants recognized the importance of EIDM and the significance of integrating explicit and tacit evidence in the EIDM process, which was enhanced by CoP. Tacit knowledge, particularly from peers and personal experience, was the preferred source of knowledge, with informal peer interactions being the favored form of CoP to support EIDM. CoP helped practitioners build relationships and community capacity, share and create knowledge, and build professional confidence and critical inquiry. Participants described individual and organizational attributes that were needed to enable CoP and EIDM.

Include them and they will tell you: learnings from a participatory process with youth.

Encouraging youth voice, visibility, and active participation in adolescent-related research is strongly advocated in the literature. In this article, we describe how participatory approaches informed by arts-based methods (e.g., reflective writing, dramatization) were used with adolescents to enhance the research process in an exploratory study designed to develop and evaluate prevention resources for sexual risk-taking behaviors.Youth aged 15 to 17 years participated in iterative focus groups conducted over a 1-year period in school settings in Prince Edward Island, Canada. Descriptions of our experiences, strategies, and insights provide evidence for guiding practice to optimize adolescent participation in research.

Mapping a research agenda for home care safety: perspectives from researchers, providers, and decision makers.

The purpose of this qualitative interpretive design was to explore the perspectives of researchers, health care providers, policy makers, and decision makers on key risks, concerns, and emerging issues related to home care safety that would inform a line of research inquiry. Defining safety specifically in this home care context has yet to be described; consequently, gaining insight from various stakeholders about safety issues relevant to the home care sector is necessary in order to inform strategic directions for future research. To begin to map a research agenda, a three-part environmental scan was conducted: (a) a pilot study with home care recipients and providers; (b) key informant interviews with researchers, health care providers, policy makers, and decision makers; and (c) a review of literature in three topic areas. Only the results of the key informant interviews are reported here.

Building nurses' capacity in community health services.

This paper describes core processes, components, and insights gained from a research internship offered through the University of Ottawa, Canada. The growing demand for high quality nursing research requires the development and implementation of strategies for enhanced research capacity. A three-month intensive internship was developed as a main feature of a nursing chair held by the first author. The internship was deliberately structured around core processes of providing individual and group mentoring, creating opportunities for experiential education, and strengthening networks with researchers and decision-makers in health services and policy research. Building and sustaining individual research capacity was supported with strategies to address system challenges. If nurses are going to make their voices heard and increase their contributions to novel health service delivery approaches, building research capacity will be a core element. The internship may be a useful prototype for the development of initiatives to build research capacity in other settings.

A remediation process for nursing students at risk for clinical failure.

The authors propose a remediation process for nursing students at risk for clinical failure. The process is embedded within the context of clinical evaluation and includes the use of a learning contract as an integral component. The strengths and limits of the process and suggestions for further development are included.

Advanced practice nursing: unification through a common identity.

Despite the wide variety of advanced practice roles in nursing and the well-documented differences among them [Hamric, A. (2000). A definition of advanced nursing practice. In A. Hamric, J. Spross, & C. Hanson (Eds.), Advanced nursing practice: An integrative approach (pp. 53-73). Philadelphia, PA: W. B. Saunders], the authors suggest that nurses in these roles should adopt a common identity, that of an "advanced practice nurse" (APN). The authors outline the development of advanced practice nursing in Canada and the United States, tracking historical influences and highlighting current issues facing APNs. The authors explore elements that constitute the definable and describable core of advanced practice nursing-knowledge, education, scope of practice, regulatory issues, and outcomes. They conclude that adoption of a common identity for all advanced practice nursing roles may clarify role confusion (which is currently experienced within and outside the profession), reinforce links between knowledge development and nursing practice, and ensure that advanced nursing practice is responsive to the needs of society.

The Joint Venture Model of Knowledge Utilization: a guide for change in nursing.

Knowledge utilization (KU) is an essential component of today's nursing practice and healthcare system. Despite advances in knowledge generation, the gap in knowledge transfer from research to practice continues. KU models have moved beyond factors affecting the individual nurse to a broader perspective that includes the practice environment and the socio-political context. This paper proposes one such theoretical model the Joint Venture Model of Knowledge Utilization (JVMKU). Key components of the JVMKU that emerged from an extensive multidisciplinary review of the literature include leadership, emotional intelligence, person, message, empowered workplace and the socio-political environment. The model has a broad and practical application and is not specific to one type of KU or one population. This paper provides a description of the JVMKU, its development and suggested uses at both local and organizational levels. Nurses in both leadership and point-of-care positions will recognize the concepts identified and will be able to apply this model for KU in their own workplace for assessment of areas requiring strengthening and support.