ABSTRACT
AIM: To present the process used by professional staff from 10 Canadian jurisdictional regulatory bodies to develop entry-level competencies for registered nurse practice. BACKGROUND: Canada is composed of provinces and territories, commonly referred to as jurisdictions with the governmental legal authority to administer the affairs of the area. Each jurisdiction establishes regulatory bodies with the mandate to protect the public. The Executive Directors of the jurisdictional regulatory bodies initiated this collaborative project to develop entry-level competencies for registered nurses. The purpose of the project was to enhance the consistency of entry-level registered nurse competencies, thereby supporting reciprocity of registration and workforce mobility, within Canada. This was the first time that Canadian nursing regulatory bodies have collaborated in a jurisdictional-driven project of this magnitude for registered nurses exclusively. This initiative has demonstrated how nursing regulatory bodies, working together, can achieve a common goal. PROCESS: The project participants worked from 2004 to 2006, developing and refining the competencies. Multiple methods were used to accomplish the task, including monthly teleconferences, frequent E-mail communications, small group work and face-to-face meetings. At various stages in the project, consultation with registered nurses within several participating jurisdictions occurred, depending on where each jurisdiction was in their jurisdictional competency review. This project spanned a 2-year period and resulted in a comprehensive document that captured the views of the participants and enhanced the resulting document. CONCLUSION: The result is a document stating the core competencies for entry-level registered nurses in the 10 participating jurisdictions and includes several components that establish the context in which entry-level competencies are developed and applied. The 119 competency statements are organized in a standard-based framework of five categories: professional responsibility and accountability; knowledge-based practice; ethical practice; service to the public; and self-regulation. The project team plans to follow up on implementation as each jurisdiction decides how to use the competencies within their particular jurisdiction.
Subject(s)
Clinical Competence/standards , Education, Nursing/organization & administration , Health Policy , Nursing/standards , Canada , Cooperative Behavior , Humans , Policy MakingABSTRACT
Health care network should promote better quality, equity and care efficacy. On the subject of breast cancer, literature has shown inequality in care depending on geographical areas and health centres locations. This article illustrates a method of analysis of female non in situ non metastatic breast cancer patients hospital care pathway, from the 2002 and 2003 Poitou-Charentes' county Diagnosis Related Groups (DRG's) data bases. The treatments several phases are described along with their combination. The number of chemotherapy and radiotherapy sessions per patient are each analysed for comparison between Health Centres, Health Centres Status, and in view of the referentials recommendations. Several health pathways options are quantified: Mono/pluri Health Centres sites, inside/outside a geographical department, inside/outside Poitou-Charentes county. Nine hundred and nine patients hospital care pathways are described. Surgery was more often partial (66%), with Health Centres variation between 17 and 68%. Among the 308 patients who had chemotherapy, 78% received between 4 and 6 sessions, with variation per Health Centre between 65 and 90%. Radiotherapy is difficult to trace because of the Health Centres non systematic radiotherapy sessions linkage, and private Health Centres lack of information (no DRG's). 91% of identified radiotherapy benefiting patients had 25 to 35 sessions, in conformation with recommendations depending on the surgery performed with Health Centres variation ratio between 76 and 96%. Hospital care pathways options between two type of treatments were identified. 90% of the hospital care pathways took place in the same geographical department, and 30% took place in public Health Centres alone. Despite radiotherapy tractability limits, proper DRG's data collection allows the description of health pathways between Health Centres and allows health practice disparity identification. Using this tool, in accordance with the Cancer Plan, can therefore help health networks in evaluating care pathway in cancer and many other fields.
Subject(s)
Breast Neoplasms/therapy , Carcinoma, Ductal, Breast/therapy , Critical Pathways , Adult , Aged , Aged, 80 and over , Combined Modality Therapy , Diagnosis-Related Groups , Female , France , Humans , Middle AgedABSTRACT
This paper profiles Alena Jean MacMaster, an extraordinary nurse leader, activist, visionary and humanitarian from New Brunswick. Her determination and drive were instrumental in fostering the development and progression of health care, nursing education and nursing services at the local, provincial, federal and international levels. "First, loyalty to the institution in which you serve. The patient is the most important person in the entire institution," was Miss MacMaster's guiding principle throughout her career.
