Since Spring 2021, WeRPN has been implementing a strategy to accelerate and scale its research initiatives. Through facilitating collaboration with RPNs, researchers, academics, and employers provincially, nationally, and internationally WeRPN is creating a pathway for research-related activities that will elevate the profile of RPNs in Ontario – and advance career prospects.
To build research capacity for RPNs and inspire a research culture, WeRPN introduced the 2021-22 RPN Research Fellowships. In August 2021, a Call for RPN Research Fellowship Proposals valued at $12,500 each was made to four principal investigators whose studies were previously approved by the WeRPN Research Advisory Council. The two successful research teams embedded an RPN into the research project as trainees.
Barriers and Facilitators to the practice of RPN role in academic acute care hospitals. Lyra Nartia, RPN Research Fellow
Nartia is an RPN from Unity Health, Toronto, Ontario, collaborating with Principal Investigator Sonya Canzian of Unity Health on this research project.
This study aims to examine the lived experiences of RPNs being re-integrated into a Dialysis unit in an academic acute care hospital and identify current and potential strategies to support a seamless transition.
Because of increased acute care demands due to staff shortages and fiscal constraints, nursing teams are overwhelmed, and new nursing care delivery models have been developed and implemented across Ontario. RPNs are now being introduced into interprofessional teams not previously seen within acute care settings. Ongoing changes in educational requirements for RPNs to meet evolving standards of practice have enabled an increase in healthcare competencies and clinical skills training. Furthermore, an expansion in scope of practice accredits RPNs to deliver high-level care to patients with complex acute care needs. But as RPNs are reintroduced into these settings, it is essential that they feel supported and equipped to be successful.
There is a wealth of knowledge to support nursing teams within acute care settings. But much of it focuses on RNs. Nartia’s research study aims to evaluate how RPNs adjust to working within an acute care setting, examine the suitability of the professional environment for role fulfillment and completion, and understand what strategies affect confidence and readiness to care for various patient assignments across differing units.
A validated survey tool focusing on role clarity, team functioning, and communication (The Assessment for Collaborative Environments – ACE-15) is being administered to participants in tandem with in-depth, semi-structured interviews, guided by Jonathan Smith’s Interpretative Phenomenological Analysis (IPA) methodology.
This research study directly aligns with WeRPNs’ strategic plan. It will contribute to the growing body of evidence showing that better-staffed hospitals have improved patient outcomes, reduced mortality, and lower readmissions, resulting in cost-saving measures for the Ontario healthcare system. Nartia is scheduled approximately two days every week to build applied research knowledge and capacity using a stepwise approach to conduct a qualitative study using an Interpretative Phenomenological Analysis (IPA) lens. She works closely with the project’s principal investigator, the research coordinator and the study team members through all stages of the project to learn how to complete a background literature search, conduct in-depth semi-structured interviews, code interview data using NVivo software, conduct a thematic analysis in preparation for manuscript writing, and manuscript development. Her hands-on experience in advancing this research highlights the value and impact of RPNs in providing optimal care within the health system context.
Nartia is also receiving research mentorship through Unity Health Toronto’s Interprofessional Practice Based Research (IPBR) program. The IPBR team assists nurses and health disciplines professionals in engaging in the identification, implementation, and evaluation of best practices through research. To stimulate a culture of innovation, the research results will be shared in highly accessible ways, including a website to allow for multidirectional knowledge exchange and through open-access academic journals and presentations at academic conferences. Results will also be shared through various forums and networks within the clinical and academic community.
Finally, audio-visual material will be developed by Unity Health Toronto’s media department that will include excerpts from the RPNs’ narratives that will describe their experience and work in acute care settings within multidisciplinary teams. This will give RPNs a voice to advocate for the profession, influence positive changes in nursing practice and, ultimately, advance patient care. “At first, I didn’t have much confidence in my capabilities, but working with such a supportive team has boosted my self-esteem,” says Nartia. “This work is key to ensuring RPNs’ voices are heard.”
The use of evidence to inform practice is necessary for practice competency. Learning these skills requires nurturing and support. By having time to devote to research, Khan and Nartia will develop a robust skillset in conducting research through theoretical and practical training. The established resources, infrastructure, and programming at these sponsoring agencies will enhance research capacity and capability.
Building capacity in Rehabilitation services: mapping Rehabilitation nursing care practices in Geriatric and Stroke Rehabilitation Units. Christina Khan, RPN Research Fellow
Kahn works in Stroke/Neurological rehabilitation at the Parkwood Institute in London, Ontario and is participating in this project with Principal nvestigator, Dr. Denise Connelly of Western University.
“When I was asked to participate in this amazing research project, I immediately felt enthusiastic and excited,” says Khan. “I feel honoured to be invited into this amazing research team because it will allow me to advance my nursing career through knowledge and understanding of what research means in nursing practice.”
Khan’s research project aims to explore and examine the perceptions of RPNs’ roles in rehabilitation units and map the RPNs’ rehabilitation practices to those outlined in existing frameworks. RPNs are well-positioned to assist rehabilitation patients with achieving their goals by supporting daily activities and promoting continuous and coordinated care. But despite these contributions, the rehabilitation practices of RPNs are undervalued, underutilized, and poorly described in Canadian literature.
Compared to rehabilitation nursing competencies and standards of practice in the United States, United Kingdom, and Australasia, little is known about the roles and perceptions of RPNs working in inpatient geriatric and stroke rehabilitation units in Canada.
Gaining a better understanding of the rehabilitation practices of RPNs could improve the rehabilitation of older adults in stroke and geriatric rehabilitation units and provide better insight into the contributions of RPNs to rehabilitation in Canada. Khan’s fellowship focuses on engaging all aspects of the research process to provide exposure and training in conducting research and applying theoretical research methods related to RPN practice.
For instance, Khan is a member of an interdisciplinary and international research team. This includes academics, clinicians, research trainees, and research support staff from three sites in Ontario, Canada, and international members from the United Kingdom, Australia and the United States of America.
Khan’s clinical practice in a rehabilitation unit and as an RPN health care professional means she can contribute to conversations about all aspects of implementing the selected research theory and methods in her clinical setting (i.e., stroke and geriatric care units at Parkwood Institute).
Khan will collect observational data within the hospital inpatient clinical settings. Following each interview, she will contribute her insight and expertise in interpreting and analyzing observational data, provide input into creating research deliverables, and disseminate findings. She will be included as an author and engaged in writing/ contributing to published materials from the research project providing feedback and revisions to presentations, abstracts, manuscripts, and other deliverables.
“I feel that together as a research team coming from different medical backgrounds and expertise, we will be able to successfully collaborate to capture rehabilitation that nurses perform on our patient population,” says Kahn.