Advisory council calls for national pharmacare plan
A report, released on June 12 by the Advisory Council on the Implementation of National Pharmacare, is being celebrated for its call to implement a universal, single-payer, national pharmacare plan. “(RNAO has) been pushing for this for a long time,” says RNAO CEO Doris Grinspun. “You cannot have healthy people if they don’t have universal access to medications.” In 2018, Canadians spent $34 billion on prescription medication through a patchwork of provincial and private drug plans. The report warns that by 2027, in the absence of a pharmacare plan, those costs could rise to $55.8 billion. “It costs us a lot more not to have (a plan). Both from a financial perspective and access to health care perspective, this is essential, necessary and urgent,” says Grinspun. Former Ontario health minister Eric Hoskins, who headed up the advisory council, predicts Canadians could save roughly $5 billion a year once the recommended plan is fully implemented by 2027. He is calling for a phase-in, with essential drugs covered by 2022, and additional medications added by 2027. (The Craig Needles Show, Global News Radio, June 13)
A glimpse of care in a rural setting
To better understand what it means to practise in rural communities, medical students from Western University spent four days working alongside health-care professionals in Leamington in May. Yvonne Bauer, a staff nurse at Erie Shores Hospital, says the experience is important because health care is different in rural areas. “In the city, for an MRI, you have to go down two floors. In rural settings, you have to go 45 minutes for an MRI,” she says. During the visit, students shadowed Bauer and other health-care providers to learn about the nuances of rural care, such as the close bond between patients and practitioners. The experience was part of a placement called the 21st Discovery Week, which takes place at the end of the first year for all undergraduate students in Western’s school of medicine and dentistry. According to the Canadian Institute for Health Information, six million Canadians live in rural and remote communities, making up almost 20 per cent of the population. (Kingsville Reporter, May 28)
Hospital adopts senior friendly strategy
Sault Area Hospital is improving care for seniors through an Ontario Senior Friendly Hospital Strategy. “You can have a 65-year-old who is athletic and living a great life, and a 65-year-old who has a lot of morbidities and is fairly handicapped in their life,” says Liz Ferguson, the hospital’s VP of clinical operations and chief nursing officer. Using the strategy – which launched in 2011 to improve the experiences and outcomes of hospitalized seniors by preventing physical and mental decline – the hospital is creating a geriatric rehab unit and increasing staff education on falls. As a result, the number of falls is decreasing, and falls not previously detected are now being spotted. “We know seniors fall,” Ferguson says. “Our goal is to make sure they fall safely.” (Sault Star, April 25)
Public health funding at risk
RNAO CEO Doris Grinspun joined a number of health-care professionals at a media event May 13 to call for a stop to planned cuts to public health that were part of the provincial government’s first budget, released in April. By the end of May, Premier Doug Ford announced the cuts would not apply to the current fiscal year. For full details on changes to public health, and RNAO’s advocacy on this issue, see Policy at Work. (City News, May 13)
Leadership award for former RNAO president
In June, Vanessa Burkoski received a 2019 Nursing Leadership Award from the Canadian College of Health Leaders. The RNAO past-president, who is chief nurse executive for Humber River Hospital (HRH), as well as chief for its People Strategy, was recognized for her vision and leadership in the execution of several HRH initiatives, including: a patient safety plan; the creation of patient care councils that allow teams of patient and family advisors to collaborate with care providers on quality improvement initiatives; and the launch of an annual scholarly practice day to recognize innovation among staff. The award acknowledges Burkoski for her ongoing commitment to excellence in patient-centred care, innovation and leadership.
Recognizing work with Indigenous communities
In May, RNAO member Barathi Vengadasamy received an Indigenous Services Canada Award of Excellence in Nursing. The honour recognizes the dedication and initiative of nurses “…to improving the health of First Nations and Inuit,” Seamus O’Regan, minister of Indigenous Services, said in a media release. Former RNAO member Janet McKenzie, a First Nations Cree nurse practising in her home community, was also recognized. The work of this year’s winners is “…an inspiration, and improves the quality of life in the communities you serve,” O’Regan said. Vengadasamy and McKenzie were nominated by their peers.
Workplace violence BPG launches
The second edition of RNAO’s best practice guideline (BPG) on violence, harassment and bullying against health workers is now available online. This edition combines two previous guidelines: Preventing and Managing Violence in the Workplace (2009) and Workplace Health, Safety and Well-being of the Nurse (2008). It also delves into bullying more directly than the previous BPGs, and addresses the serious health issues bullying can cause. Issues of violence and harassment in the workplace continue to put health-care workers and quality care at risk, and developing prevention strategies is vital to reducing negative incidents, says Henrietta Van hulle, one of the two expert panel co-chairs. “There are a variety of prevention efforts that can improve potential negative outcomes related to workplace violence,” she says. “It is my hope this BPG will ensure caregivers are cared for, so they can provide the kind of exceptional care that led them to a health-care career.”
This BPG marks RNAO’s full transition to the GRADE methodology, placing the association at the forefront of international standards. Visit RNAO.ca/BPG for your free download.
NP represents Canada on international board
NP and former RNAO policy analyst Valerie Rzepka (far right) has joined the board of directors of the World Association for Disaster and Emergency Medicine (WADEM) Nursing Special Interest Group. In the role, she will collaborate with an international team of nursing experts to improve practice and knowledge around disaster nursing. Rzepka first got involved in disaster nursing in 2004. She co-founded and is now executive director for the Canadian Medical Assistance Teams, a grassroots humanitarian relief organization. Rzepka applied for the position with WADEM because she finds there is too much focus on the medical model in disaster response: “I feel there needs to be a lot more of a nursing presence because nurses are the ones delivering most of the care during a disaster.” The special interest group includes representatives from Botswana, Canada, Israel, Japan, Tanzania and the U.S.
Newest BPSO cohort
In April, RNAO honoured its newest cohort of BPSOs in long-term care representing 18 nursing homes, and one organization in Jamaica.
The Ontario organizations are: Grove Park Home; Tilbury Manor; The Perley and Rideau Veterans’ Health Centre; William A. George Extended Care Facility; the Regional Municipality of Halton and its homes: Allendale, Post Inn Village, and Creek Way Village; Woodingford Lodge and its homes: Ingersoll, Woodstock, and Tillsonburg; and the Regional Municipality of Niagara and its homes: Linhaven, Gilmore Lodge, Northland Pointe, Deer Park Villa, Upper Canada Lodge, Woodlands of Sunset, Meadows of Dorchester, and Douglas H. Rapelje Lodge.
The international BPSO is: University Hospital of the West Indies in Jamaica. The south Australian branch of the Australian Nursing and Midwifery Federation renewed its commitment as a BPSO.
Ostomy guideline marks milestone
In April, RNAO released Supporting Adults Who Anticipate or Live with an Ostomy, the next edition of the 2009 best practice guideline (BPG), Ostomy Care and Management. This edition provides nurses and other members of the interprofessional team with evidence-based recommendations to support patients, enhance access to care, promote positive outcomes, and enable patients to better manage their condition.
The guideline’s expert panel recommends that people who have or expect to have an ostomy consult with nurses who specialize in wound, ostomy and continence as members of an interprofessional team. This means that, before surgery, these specialized nurses educate and counsel patients.
The panel also recommends health service organizations standardize care for ostomy so interprofessional teams counsel patients on how to care for themselves, adapt new approaches to daily living, and deal with potential complications. The interprofessional team should also plan discharge based on the readiness of patients, then schedule home visits and telephone calls within four weeks of discharge.
The BPG includes strategies to prevent one of the the most common complications of ostomy: when one or more loops of the intestine protrude through the abdominal wall, creating a bulge around the peristomal skin, something called parastomal hernias.
The panel recommends providers assess the quality of life in persons who have or expect to have an ostomy and focus on areas such as self-identity, sexuality and psychological well-being.
This latest guideline marks a milestone for RNAO’s BPG program, which is improving and streamlining how it formulates questions and researches recommendations so BPGs prove even more useful. Using a proven methodology called GRADE from this BPG onwards – including all next editions and new ones – each BPG panel will harness the expertise of its members to craft pointed practice recommendations for the most salient issues they want to tackle. RNAO’s guideline development methodologists then turn those into the research questions for systematic review. Expert panels tether recommendations more closely to evidence and report the strengths and limitations of each recommendation. The new approach results in fewer and sharper recommendations. In the case of this new ostomy BPG it has six rated recommendations, instead of the 26 included in the 2009 version.
For a free download, visit RNAO.ca/BPG/guidelines/ostomy.
