Abstract
Background: Workforce stabilization is critical to sustainability and expansion of home and community care, given rising demand for care outside facility-based settings. Continuous knowledge and skill-building, rooted in up-to-date and evidence-based competencies and resources, is central to ensuring home health nurses are equipped to deliver care in dynamic community care contexts that include: increasing use of digital health tools, rising complexity of client needs, and evolving models of integrated care. This presentation will feature two examples of applied health research projects focused on identifying and optimizing knowledge and skills needed by the nursing workforce to support delivery of integrated home and community care including: () updating Canadian Home Health Nursing (HHN) competencies, and (2) developing evidence-based tools to build key integrated care competencies among home health nurses working in transitional care programs.
Approach: To update the HHN competencies, a modified e-Delphi study was completed with a diverse expert panel of home health nurses (n=43) across Canada working in point-of-care, leadership, and education roles. Additional feedback was obtained during consultations with an advisory working group of home health nursing leaders (n=28), home health nurses (n=4), and interdisciplinary home care team members (n=2). To develop practical tools and resources to support continuous knowledge and skill-building in the nursing workforce related to integrated care competencies, nurses working in community-based transitional care models will be interviewed about their experiences, challenges and opportunities related to the use of standardized assessment data to support evidence-informed, person-centred and goal-oriented care planning with clients, families and interdisciplinary teams.
Results: A total of 93 competencies were recommended for inclusion in the updated HHN competencies based on feedback from home health nurses, including Registered Nurses and Registered / Licensed Practical Nurses from 0 provinces and territories in Canada. Key competencies which may be of particular importance to integrated care settings focus on data-informed decision making (e.g., using assessment tools to inform care planning, use of technology to facilitate data collection), and communication and information sharing among interdisciplinary home care team members. Interviews with transitional care nurses are anticipated to provide important context to understanding current practices related to operationalization of data generated from standardized assessments to support capacity-building practice initiatives among the nursing workforce in integrated home and community transitional care settings. Preliminary interview results will be presented at the conference.
Implications: Engaging in the collaborative development of HHN competencies with point-of-care providers, operational leaders, funders, and policy makers is critical to creating a purpose-built nursing workforce for integrated care, as competencies serve as the foundation for workforce training and development initiatives. Developed competencies can be used to support skill-building and knowledge uptake, including informing pre-service education curriculum as well as professional development opportunities available to home health nurses. Intentional inclusion of competencies which support integrated care ensures the home health nursing workforce will be equipped with the skills necessary for effective integrated care delivery. Next steps in this work includes the co-design of practical tools and resources with experts-by-experience to support nursing workforce capacity building based on competencies related to data-informed and goal-oriented care.