Evaluation of the process for harmonizing 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 significant changes in the structure of services, bringing together professionals, especially nurses, from various backgrounds with diverse practices. Through this major reorganization, the Nursing Department (DSI) of each of the CIUSSS has become responsible for professional nursing development and the quality of services of all the establishments thus merged.

infirmière Sourire

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

What are our goals?

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1) Describe how the harmonization of practices 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 process using indicators

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How? 'Or' What?

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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.

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In order to carry out the project, we used:

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1) Individual interviews with managers

2) Group interviews with nurses,

executive advisers

3) Sociodemographic data questionnaires

4) Scope of practice questionnaires

5) Logbooks

6) Field notes

7) Participant observation

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We then proceeded to analyze the data by

grouping the data according to the identified themes.

Thus, we can bring out the findings

main by the different groups of participants.

We also compared data from

questionnaires before and after the implementation of the

process in order to assess its effect.

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What results have we had?

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

Publications

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Poitras, ME Marois, L Simard, C Savard, C Roberge, V Déry, J Dallaire, C Dassylva, A Chouinard, MC. (2020). Harmonization and optimization of clinical practices of nurses: towards updated care management. Le Point en santé et services sociaux. 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 harmonize clinical practices and optimize the scope of practice of nurses. Nursing perspectives.

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