Canadian Paediatric Nursing
Standards:
Standardizing High Quality Nursing Care
for Children in Canada
2016 CAPHC Nursing L...
Objectives:
• Explore children’s healthcare needs unique to
Canada
• Describe the development process of Canadian
paediatr...
Children VS Elders
3
2016 UNICEF Report: Child Well-being
https://youtu.be/CioMdBRF1RA
4
Key Health Concerns for Canadian Children
• Mental health
• Obesity
• Poverty
• Indigenous Health
• New Immigrant Health
•...
A Call to Action
6
Harnessing our Strengths
• Champion and advocate for children’s health issues
• Care for children and their families as a ...
Why Standards?
• Direction for professional
paediatric nursing education
and practice
• Framework for the
evaluation of th...
The Journey- “Just the beginning”
• Develop a set of outcome oriented standards for
paediatric nursing that will guide pra...
What We Are Building Upon:
• Children’s Rights
– UN “Rights of the Child”
– WHO
• Paediatric Nursing Standards
– US (2008)...
Development of the Canadian
Paediatric Nursing Standards
11
Think Tank: October 2014
• Established interest and need
• Developed core steering committee
• Literature review and statu...
Obtaining perspective: Delphi process
Draft 1 Standards
Developed 5
Paediatric Nursing
Standards to reflect:
- Setting/env...
Summit – September 11-12, 2015
14
Vision
• Paediatric Nurses are a powerful collective force that helps
ensure that all children and families in Canada have...
Outcome Oriented Standards
Exploration
Proficiency /
Competencies
Always
Events
Desired
Outcomes
16
Hybrid Delphi Process
• Initial Round: Expert Consensus Summit
• Round 1 & 2: e-Delphi
Recruitment:
1) Snowball method
2) ...
E-Questionnaire Development
• Approved as a Quality Improvement project
• Use of RedCAP©
• Rated each component with a 4 p...
Data Analysis
• Set limits for agreement
– Greater than 80% for domains
– Greater than 65% for sub-points
• Small sub-grou...
e-Delphi Scoring
• Round 1
– Greater than 80% for domains
– Greater than 70% for sub-points
• Round 2
– Greater than 97.5%...
Revisions
• Terms/key words were stream-lined to ensure
consistency in language
• Repeated concepts were combined or
elimi...
Who responded?
Alberta
British Columbia
Manitoba
New Brunswick
Nfld & Labrador
Northwest Territories
Nova Scotia
Nunavut
O...
Who responded?
Hospital
Staff Development
College/University
Management
Community/Home Care
Clinic/medical office
Rehabili...
Results
Roun
ds
# Agreed to
Participate
# Actual
Participation
# Completed
Questionnaire
in Full
% Completed
1 128 84 78 6...
5 Domains of Paediatric Nursing
Core Standards:
Nursing Process
Safety / Reliability
Quality
Ethics
Research
Education
2. ...
Standard I: Supporting and partnering with
the child and their family
Paediatric Nurses partner with the child and their f...
Standard II: Advocating for Equitable Access
and the Rights of Children and their Family
Paediatric Nurses demonstrate and...
Standard III: Delivering Developmentally
Appropriate Care
Paediatric Nurses perform assessment based on growth
and develop...
Standard IV: Creating a Child & Family
Friendly Environment
Paediatric Nurses play an essential role in creating a child a...
Standard V: Enabling Successful Transitions
Paediatric Nurses support the child and family through healthcare
transitions ...
Small Group Work
In table groups identify opportunities and activities that
integrate the new standards within your assign...
Canadian Assocoation of Paediatric
Nurses (CAPN)
• Official membership with CNA
• Obtained domain name paednurse.ca
• Esta...
Thank you to our supporters
• Think Tank & Summit participants
• Delphi responders
• Financial supporters:
33
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Oct 25 CAPHC Breakfast Symposium - Sponsored by the Nursing Network

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CAPHC Breakfast Symposium
Canadian Paediatric Nursing Standards: Standardizing High Quality Nursing Care for Children in Canada

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Oct 25 CAPHC Breakfast Symposium - Sponsored by the Nursing Network

  1. 1. Canadian Paediatric Nursing Standards: Standardizing High Quality Nursing Care for Children in Canada 2016 CAPHC Nursing Leadership Breakfast Session B. Fleming-Carroll, L. Rudden, F. So, K. Breen-Reid, M. McAllister, P. Hubley, M. Ballantyne
  2. 2. Objectives: • Explore children’s healthcare needs unique to Canada • Describe the development process of Canadian paediatric nursing standards • Share the Paediatric Nursing Standards • Building next steps for knowledge translation 2
  3. 3. Children VS Elders 3
  4. 4. 2016 UNICEF Report: Child Well-being https://youtu.be/CioMdBRF1RA 4
  5. 5. Key Health Concerns for Canadian Children • Mental health • Obesity • Poverty • Indigenous Health • New Immigrant Health • Childhood Disability & Complex Care • Chronic Health Conditions 5
  6. 6. A Call to Action 6
  7. 7. Harnessing our Strengths • Champion and advocate for children’s health issues • Care for children and their families as a unit • Focus on health promotion, illness prevention, curative & rehab. of the child • Working in many different settings • Many contacts with child & family members over time • Strength-based approach to care • Delivery of developmentally appropriate care • Focus on optimal functioning • Integrate scientific theory related to child health • Understanding of ethical, moral and legal problems unique to children • Breadth of knowledge related growth and development • Integration of Anticipatory guidance & health coaching • Frontline to vulnerable populations • Navigator/coordinator-understands the system • Collaborator with teams/sectors to provide best care 7
  8. 8. Why Standards? • Direction for professional paediatric nursing education and practice • Framework for the evaluation of this specialized practice. • Measurable standards define the nursing profession’s accountability to the public and the practice outcomes for which they are responsible. (Adapted from American Nursing Association [ANA]) “There will always be some interest more immediate than protecting the well-being of children. There will never be one more important.” - UNICEF REPORT CARD 2010 8
  9. 9. The Journey- “Just the beginning” • Develop a set of outcome oriented standards for paediatric nursing that will guide practice across the country and enable children and families to receive a consistent level of high quality care no matter where they are in Canada • To grow the value of specialty training for nurses who practice in paediatric settings • To grow the value paediatric nursing as a viable specialty area 9
  10. 10. What We Are Building Upon: • Children’s Rights – UN “Rights of the Child” – WHO • Paediatric Nursing Standards – US (2008) – UK (2013) – Australia (2006) • Canada • Canadian Nurses Association (CNA) • Canadian Association of Paediatric Nurses (CAPN) • Paediatric Intensive Care Nursing (CNA) • Provincial/Territorial standards 10
  11. 11. Development of the Canadian Paediatric Nursing Standards 11
  12. 12. Think Tank: October 2014 • Established interest and need • Developed core steering committee • Literature review and status report • Process map 12
  13. 13. Obtaining perspective: Delphi process Draft 1 Standards Developed 5 Paediatric Nursing Standards to reflect: - Setting/environment - Focus of nursing - Patient populations - Understanding of terms - Glossary E-Delphi Survey Round 1 Engaged >100 Canadian Nurses - Refinement - Understanding - Context - Refine Glossary E-Delphi Survey Round 2 Engaged >80 Nurses from all provinces/territories - Further refinement - Feedback concerning application, communication Review, Steering Committee Ratification Ensure agreement across standards Consistent language Reliability Validity 13
  14. 14. Summit – September 11-12, 2015 14
  15. 15. Vision • Paediatric Nurses are a powerful collective force that helps ensure that all children and families in Canada have equitable access to highest quality pediatric care regardless of their circumstances. • Paediatric Nursing Standards are leveraged to prepare the best paediatric nurses in the world and they are integrated into the practice of any nurse who works with children, youth and families in all settings and through key transitions. • Children, youth and families are healthier, safer and more able to reach their full potential as a result of our leadership in evidence based: policy development, advocacy, health promotion, early detection and family centred care. 15
  16. 16. Outcome Oriented Standards Exploration Proficiency / Competencies Always Events Desired Outcomes 16
  17. 17. Hybrid Delphi Process • Initial Round: Expert Consensus Summit • Round 1 & 2: e-Delphi Recruitment: 1) Snowball method 2) Direct contact 17
  18. 18. E-Questionnaire Development • Approved as a Quality Improvement project • Use of RedCAP© • Rated each component with a 4 point scale (5 domains, Always events, competencies) • Qualitative field to ask for clarifications & additions • Instruction package and glossary of terms 18
  19. 19. Data Analysis • Set limits for agreement – Greater than 80% for domains – Greater than 65% for sub-points • Small sub-group from steering committee reviewed the feedback and scoring 19
  20. 20. e-Delphi Scoring • Round 1 – Greater than 80% for domains – Greater than 70% for sub-points • Round 2 – Greater than 97.5% agreement for domains – Greater than 92% agreement for sub-points 20
  21. 21. Revisions • Terms/key words were stream-lined to ensure consistency in language • Repeated concepts were combined or eliminated • Additional sub-points were accepted based on participant consensus • Revisions & additions to glossary to ensure clarification 21
  22. 22. Who responded? Alberta British Columbia Manitoba New Brunswick Nfld & Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Total 90 nurses 22
  23. 23. Who responded? Hospital Staff Development College/University Management Community/Home Care Clinic/medical office Rehabilitation Other Public Health Outpost Research Government 23
  24. 24. Results Roun ds # Agreed to Participate # Actual Participation # Completed Questionnaire in Full % Completed 1 128 84 78 61 2 135 85 77 57 STANDARDS • Over 97.5% endorsement ALWAYS EVENTS • Over 92% endorsement COMPETENCIES • Over 92% endorsement 24
  25. 25. 5 Domains of Paediatric Nursing Core Standards: Nursing Process Safety / Reliability Quality Ethics Research Education 2. Advocating for Equitable Access and the Rights of Children and their Family 1. Supporting and partnering with the child and their family 3. Delivering Developmentally Appropriate Care 4. Facilitating a child and family friendly environment 5. Enabling Successful Transitions 25
  26. 26. Standard I: Supporting and partnering with the child and their family Paediatric Nurses partner with the child and their family to achieve their optimal level of health and well-being leading to resilient families and healthy communities. The Paediatric Nurse ALWAYS: • Establishes an intentional therapeutic relationship with the child and family • Respects the child and family in goal setting and decision making • Collects and uses information from the child and family context to inform care • Communicates with child and family as partners in care • Advocates for optimal use of resources to support the child and family • Recognizes and fosters the parenting role to support child well-being 26
  27. 27. Standard II: Advocating for Equitable Access and the Rights of Children and their Family Paediatric Nurses demonstrate and mobilize their understanding of the social determinants and other systemic factors that impact child health. The Paediatric Nurse ALWAYS: • Completes a comprehensive assessment (beyond physical assessment) through an advocacy lens considering Social Determinants of Health and child well-being • Facilitates an appropriate environment to perform assessment and intervention considering privacy and confidentiality • Build capacity in the child and their family to self-advocate • Engages in a community of practice or network that focuses on paediatric nursing practice and knowledge and resources for children and families • Supports the child and family to navigate the health care system 27
  28. 28. Standard III: Delivering Developmentally Appropriate Care Paediatric Nurses perform assessment based on growth and development and deliver paediatric-specific care. The Paediatric Nurse ALWAYS: • Demonstrates knowledge of typical development and variation from typical • Demonstrates knowledge of safety risks relevant to developmental stage • Provides anticipatory guidance and coaching on typical development and safety related to the developmental stage of the child and family • Performs safety assessment at point of care to minimize risk and harm with developmental stage • Incorporates developmentally appropriate play and/or recreational activities into care • Performs age and developmentally appropriate bio-psychosocial assessment • Uses developmentally appropriate strategies when preparing for and performing interventions • Considers development that is influenced by ethnicity, spirituality and culture 28
  29. 29. Standard IV: Creating a Child & Family Friendly Environment Paediatric Nurses play an essential role in creating a child and family friendly environment that welcomes families and promotes hope and healing. It is understood that the environment changes as the child grows and is influenced by multiple factors including but not exclusive to psychological, spiritual, and social. The Paediatric Nurse ALWAYS: • Completes a child and family assessment • Demonstrates cultural competency and humility in all child and family interactions • Engages the child and family in all care decisions and plan of care in a respectful non- judgmental, culturally safe manner • Shares information relevant to plan of care and collaborates with and amongst circle of care providers • Recognizes and fosters family strengths and supports • Uses strategies to support and foster resiliency • Demonstrates caring and compassion to both child and family 29
  30. 30. Standard V: Enabling Successful Transitions Paediatric Nurses support the child and family through healthcare transitions to maximize their well-being. This may include, but is not limited to, hand-off between healthcare providers, admission and discharge, and facility transfer (such a from paediatric to adult care institutions) The Paediatric Nurse ALWAYS: • Uses effective communication strategies at all transitions in care • Engages in planning of health education and coaching at all transitions • Provides health education and information to optimize transition of the child and family • Assesses readiness and supports safe transition • Anticipates resources to support transitions in care • Plays an active role in facilitating effective transition 30
  31. 31. Small Group Work In table groups identify opportunities and activities that integrate the new standards within your assigned sector. 1. Paediatric Tertiary/Quaternary Hospitals 2. Community Hospitals 3. Community & Public Health Organizations 4. University & College nursing Programs 5. Research 6. Government & Professional Associations 31
  32. 32. Canadian Assocoation of Paediatric Nurses (CAPN) • Official membership with CNA • Obtained domain name paednurse.ca • Establish an Interim Executive for CAPN • First Executive meeting to be organized Nov. 2016 • Establish Roadmap including website development & membership, toolkits for standards implementation 32
  33. 33. Thank you to our supporters • Think Tank & Summit participants • Delphi responders • Financial supporters: 33

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