December 2002 Newsletter
Healthy Nurses, Healthy Workplaces
CNAC Roundtable
Leaders of national nursing organizations were guests of the Honourable Anne McLellan and Health Canada on Parliament Hill in Ottawa on November 18, 2002. The Minister convened a roundtable to discuss the Canadian Nursing Advisory Committee (CNAC) final report. The stakeholders included the Aboriginal Nurses Association of Canada , Academy of Canadian Executive Nurses , Canadian Association of Schools of Nursing , Canadian Federation of Nurses Unions , Canadian Nurses Association , Canadian Nursing Students Association , and Canadian Practical Nurses Association . The groups enjoyed a rich exchange of ideas with the Minister, Deputy Minister Ian Green, Assistant Deputy Minister Ian Potter (First Nations & Inuit Health Branch), Judith Shamian (Office of Nursing Policy) and other Health Canada officials. The Minister found the meeting valuable, and expressed interest in further consultation with the groups in the future.
UK Healthy Workplaces
The UK Health Development Agency has developed a new, web-based resource giving information on workplace health matters. The website aims to provide directors and senior managers with an overview of the wide range of issues that contribute to workplace health and well-being. There is also an "evidence" site - point your browser to: www.hda-online.org.uk
System Renewal
Health Care Commissioner Romanow's final report - Building on Values: The Future of Health Care in Canada - was released November 28, 2002. The report is available on line at:  Commission on the Future of Health Care in Canada
Senator Kirby's report, The Health of Canadians: The Federal Role , is available on line through the parliamentary web site at: The Health of Canadians – The Federal Role
Nursing Education & Research
Canadian Association of Schools of Nursing 60th Anniversary
The newly created CASN celebrated the 60 th Anniversary of the former organization, the Canadian Association of University Schools of Nursing , during the organization's annual meeting in Ottawa, November 6-10. There were several special events during the week along with business meetings. Congratulations from the ONP! CASN is the national voice for nursing education and nursing research, and represents more than 80 nursing programs in Canada.
Education Roundtable
Given the pivotal role of nursing education in meeting future challenges in health care globally (particularly in addressing solutions and challenges related to healthcare reform), nursing leaders from government, education, research, and healthcare and professional organizations gathered at the Nursing Education Think Tank 2002 to dialogue and determine approaches that will effectively shape the future of nursing education. The Nursing Education Think Tank 2002 was hosted by the Registered Nurses Association of Ontario (RNAO), in partnership with the Office of Nursing Policy, Health Canada and the Nursing Secretariat, Ontario Ministry of Health and Long-Term Care. The Think Tank reflects the shared commitment to support coordinated planning and development of initiatives that will enable nurse educators and other nurse leaders to address the challenges of creating a dynamic system of nursing education as we move into the future. On October 23, 2002, over 30 national and provincial nursing leaders participated in the Think Tank, held at RNAO. The group collectively undertook a status and gap analysis of recommendations and, grouped by theme, prioritized activities, developed action plans, and identified key responsibilities over the next 24 months. A report of the meeting will be issued in December 2002.
Sector Study - Fall 2002 Progress Report
We are pleased to report that the national nursing sector study is underway and that research has begun!
The research team, led by Chair Linda O'Brien-Pallas and Assistant Chair Andrea Baumann from the Nursing Effectiveness, Utilization and Outcomes Research Unit (NRU) , has started to review literature and to identify research gaps. The team is also busy developing nursing occupational group and employer surveys - pivotal research tools that will be used to collect invaluable data from Canada's nurses, employers, and unions. These data will serve to paint an accurate picture of the state of nursing in Canada. Distribution of the surveys is expected in early spring 2003. An interim report of the literature review is expected for January/ February 2003.
The surveys and the research team's detailed work plan were reviewed at the Steering Committee meeting held in November 2002. The Steering Committee - comprised of stakeholders including the three regulated nursing groups, employers, educators, professional associations, regulatory bodies, unions, health researchers, and provincial, territorial, and federal governments - will also discuss and review the report from the Standing Senate Committee on Social Affairs, Science and Technology on the State of the Health Care System in Canada, released at the end of October. In addition, the Steering Committee plans to examine the recommendations from the much-anticipated Romanow Commission on the Future of Health Care in Canada . The next Steering Committee meeting will take place in the spring, 2003.
To develop an integrated strategy for the future of nursing human resources, the Steering Committee recognizes that it must consider any impending policy changes related to health. Undoubtedly, these high profile reports will include research and recommendations related to nursing. After all, nurses represent one-third of all health care professionals in Canada; without them, there wouldn't be a health care system.
Stay tuned to these quarterly updates and to Building the Future for news on Building the Future and to find out how you can have your voice heard.
Research Highlight
Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction . Linda H. Aiken, PhD, RN; Sean P. Clarke, PhD, RN; Douglas M. Sloane, PhD; Julie Sochalski, PhD, RN; Jeffrey H. Silber, MD, PhD. JAMA . 2002;288:1987-1993. Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction
Context - The worsening hospital nurse shortage and recent California legislation mandating minimum hospital patient-to-nurse ratios demand an understanding of how nurse staffing levels affect patient outcomes and nurse retention in hospital practice.
Objective - To determine the association between the patient-to-nurse ratio and patient mortality, failure-to-rescue (deaths following complications) among surgical patients, and factors related to nurse retention.
Design, Setting, and Participants - Cross-sectional analyses of linked data from 10 184 staff nurses surveyed, 232 342 general, orthopedic, and vascular surgery patients discharged from the hospital between April 1, 1998, and November 30, 1999, and administrative data from 168 nonfederal adult general hospitals in Pennsylvania.
Main Outcome Measures - Risk-adjusted patient mortality and failure-to-rescue within 30 days of admission, and nurse-reported job dissatisfaction and job-related burnout.
Results - After adjusting for patient and hospital characteristics (size, teaching status, and technology), each additional patient per nurse was associated with a 7% (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.03-1.12) increase in the likelihood of dying within 30 days of admission and a 7% (OR, 1.07; 95% CI, 1.02-1.11) increase in the odds of failure-to-rescue. After adjusting for nurse and hospital characteristics, each additional patient per nurse was associated with a 23% (OR, 1.23; 95% CI, 1.13-1.34) increase in the odds of burnout and a 15% (OR, 1.15; 95% CI, 1.07-1.25) increase in the odds of job dissatisfaction.
Conclusions - In hospitals with high patient-to-nurse ratios, surgical patients experience higher risk-adjusted 30-day mortality and failure-to-rescue rates, and nurses are more likely to experience burnout and job dissatisfaction.
Science & Technology Funding
The new S&T site was just launched by our Canadian Mission to the European Union in advance of the launch of the EU's 6th Framework Program for Research and Development. This multi-year funding program features health as a key theme over the next six years. Canadians cannot participate directly but with Canadian funding can partner with Europeans to submit joint proposals. Note, for example, that Healthy Workplaces for Nurses could be an area of interest in Europe because of a new initiative on health workplaces. Web site is at: International Trade Canada
Click on the icon Canada-EU partnerships for more information.
Health System Renewal
For further perspectives on the Romanow, Kirby and other reform reports, we suggest consulting the web pages of your provincial/ territorial government, professional association, union and education sites. Some of the sites are:
FYI
CHSRF - Recruiting
The Canadian Health Services Research Foundation (CHSRF) is recruiting for the position of Assistant Director, Research Programs. Refer to the link below to view the job posting and the job description.
Canadian Health Services Research Foundation
Recent Presentations
The Future of Nursing Leadership at the Joan Gilchrist Nursing Explorations Series, Montreal, Quebec on October18, 2002.
Nursing and Health Policy: Double Helix , the Marion Woodward Lecture of 2002, at the University of British Columbia School of Nursing in Vancouver, B.C. on October 24, 2002.
Registered Nurses Association of Ontario Healthy Workplaces in Action 2nd International Conference , Toronto ON, November 21-22. Judith Shamian delivered the keynote address, Healthy Nurses = Healthy Patients: Let's make it a Reality . Mike Villeneuve participated in a panel session discussing healthy workplaces and the CCHSA project to develop quality of worklife indicators. Linda MacLeod presented concepts behind the healthy workplace guidelines project and discussed the model being developed.
Upcoming Conferences
The 2003 Nursing Leadership Conference
February 10-11, 2003,
Crowne Plaza,
Ottawa Ontario
Canadian Nurses Association
Canadian Association of Schools of Nursing (CASN)
The Future Is Now: Educating For New Dimensions In Nursing Practice
April 24-26, 2003
Sheraton Halifax Hotel,
Halifax Nova Scotia
Canadian Association of Schools of Nursing
Canadian Federation of Nurses Unions (CFNU) Biennial Convention
June 3-6, 2003
St. John's Newfoundland
The Canadian Federation of Nurses Unions
International Council of Nurses
Building Excellence Through Evidence
June 27-29, 2003
Marrakesh Morocco
International Council of Nurses
Sigma Theta Tau International Honor Society of Nursing
37 th Biennial Convention
November 1-5, 2003,
Toronto, Ontario
Honor Society of Nursing
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