Evaluation of the process of harmonization
clinical practices and optimizing
the scope of practice of nurses

at the CIUSSS du 
Saguenay-Lac-Saint-Jean

principal investigators

Marie-Eve Poitras,

Chantale Simard, Maud-Christine Chouinard, Véronique Roberge, Sylvie Massé, Line Marois, Caroline Savard, Annick Bergeron, Manon Fouquet, Kim Larocque, Clémence Dallaire and

J ohanne Déry

Funding

$ 80,000

Quebec Nursing Intervention Research Network

study setting

CIUSSS of Saguenay-Lac-Saint-Jean

themes

Nursing practice, optimization, harmonization

In recent years, a major reorganization of the health and social services network in Quebec has taken place, leading, among other things, to the creation of Integrated Health and Social Services Centers (CISSS) and Integrated University Health and Services Centers Social (CIUSSS). This has led to major changes  in the structure of services, bringing together professionals, particularly nurses, from various backgrounds with diversified practices. Through this major reorganization, the Nursing Department (DSI) of each CIUSSS became responsible for nursing professional development and the quality of services in all the establishments thus merged. 

infirmière Sourire

Faced with this challenge, the DSI of the CIUSSS du Saguenay-Lac-Saint-Jean (SLSJ) recently began implementing a vast approach to ensure that the practice of nurses is more uniform across the facilities. The approach also aims to optimize their practice so that they perform all the tasks for which they have been trained. 

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What results have we had?

The project had to be put on hold due to the COVID-19 pandemic but is still ongoing.

What are our goals?

1) Describe how practice harmonization and optimization activities are carried out in the facilities

2) Understand what can facilitate or make difficult the process of harmonizing practices and optimizing 

3) Determine how nurses, clinical support teams and managers perceive the impacts of the process (quality of care, well-being and quality of life at work)

4) Measure the impact of the approach using indicators

How?

Our project is based on the single case study, mobilizing a mixed approach (from qualitative and quantitative data) and based on an evolutionary evaluation approach. We also use the Quadruple Aim model.

In order to carry out the project, we used:

1) Individual interviews with managers 

2) Group interviews with nurses,

executive advisors

3) Sociodemographic data questionnaires 

4) Span of practice questionnaires

5) Logbooks

6) Field Notes

7) Participant observation

We then proceeded to analyze the data by

grouping the data according to the identified themes.

  Thus, we can highlight the findings

by the different groups of participants.

We also compared data from

questionnaires before and after the implementation of the

approach to assess its effect.​

Publications

Poitras, ME Marois, L Simard, C Savard, C Roberge, V Déry, J Dallaire, C Dassylva, A Chouinard, MC. (2020). Harmonization and optimization of nurses' clinical practices: towards an updated care management. Update on health and social services. 15(4): 8-10.

 

Simard C, Marois L, Massé S, Savard C, Poitras ME, Roberge V, Déry J, Dallaire C, Chouinard MC. (2020). Approach to harmonizing clinical practices and optimizing the scope of practice of nurses. Nursing Perspectives.