Canadian Nurses Association

As the Canadian healthcare system faces rising complexity, workforce shortages and growing demands for quality and efficiency, the role of nurses has become increasingly critical. Historically trained as generalists, today's nurses are often thrust into highly specialized roles without the formal training or recognition to match the complexity of their practice. The prevailing perception - "a nurse is a nurse" - undermines recognition of the diverse roles and competencies within the profession. Specialty nursing certification, while proven to improve outcomes, remains underutilized and undervalued in Canada. For the healthcare system to thrive, nurse executives across all sectors must become vocal champions of specialty nursing certification. Doing so is not only a professional imperative but also a strategic necessity for optimizing patient outcomes, ensuring workforce sustainability and achieving better value.

When I read Nagle and White's (2025) challenge to the nursing profession, "it really is now or never," I had to reflect on my previous interactions with the authors and how I came to know the Health Outcomes for Better Information and Care (HOBIC) initiative in the early 2000s and why we must respond to their call for action. In 1999, the HOBIC initiative was launched by leaders, Lynn Nagle, Peggy White and Dorothy Pringle, to address gaps in health information representing nursing's contributions to patient care and the need for the inclusion of standardized clinical data in electronic health records (funded by the Ontario Ministry of Health and Long-Term Care) and HOBIC expanded nationally. On behalf of the Canadian Nurses Association, we applaud the authors for their unrelenting advocacy, thought leadership, research contributions and strategic foresight, especially now with technological advancements and artificial intelligence (AI) integration occurring at breakneck speed. As knowledge workers, we need to ensure that our intelligence and impact are represented in the data, and we need every nurse across Canada to embrace this imperative. The risks associated with not doing this are too serious for the people we serve and the health of Canadians.

Hospitalized patients often experience sleep disruption that fragments their sleep and disturbs their circadian rhythms, putting them at risk for sleep deprivation. The risk increases with greater severity of illness and is especially high in intensive care unit patients. Sleep deprivation can prolong the intensive care unit stay, contribute to emotional and physiological distress, and even increase the patient's risk of death. Critical care nurses in a 28-bed medical intensive care unit reported that patients often complained of sleep disruption or exhibited emotional and physical distress resulting from sleep deprivation. An analysis of the gap between recommended evidence-based best practice and current practices in the unit revealed numerous opportunities to improve patients' sleep. The aim of this evidence-based quality improvement project was to increase interprofessional adherence to an existing sleep-promoting schedule to reduce avoidable interruptions and improve patient sleep quality. To promote sleep, staff member interactions with patients between midnight and 4 am were minimized, if appropriate. Documented patient encounters and call bell initiation were evaluated as process measures. Patients' self-perceived sleep quality, an outcome measure, was evaluated using the Richards-Campbell Sleep Questionnaire. Adherence to a sleep-promoting schedule reduced patient sleep interruptions between midnight and 4 am by as much as two-thirds while increasing patients' overall self-perceived sleep quality by 6.7 percentage points. An interprofessional effort to minimize patient interruptions at night in an intensive care unit setting led to improved patient sleep quality and sustainable practice changes.

To review a practical and scientifically sound application of the wound bed preparation model for communities without ideal resources. This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and registered nurses with an interest in skin and wound care. After participating in this educational activity, the participant will:1. Summarize issues related to wound assessment.2. Identify a class of drugs for the treatment of type II diabetes mellitus that has been shown to improve glycemia, nephroprotection, and cardiovascular outcomes.3. Synthesize strategies for wound management, including treatment in resource-limited settings.4. Specify the target time for edge advancement in chronic, healable wounds.

Aims and ObjectivesTo describe characteristics of service utilization by advanced practice nurses (APNs) employing an electronic consultation (eConsult) service in their care for older adults.BackgroundCanada's aging population is projected to place unprecedented demands on the healthcare system. APNs, which include clinical nurse specialists (CNSs) and nurse practitioners (NPs), are nurses with advanced knowledge who can independently provide age‐appropriate care. eConsult is a secure web‐based platform enabling asynchronous, provider‐to‐provider communication. APNs can send and receive eConsults to address patient‐specific concerns.MethodsThis is a retrospective analysis of eConsult utilization and user survey data for cases completed in 2019, reported in line with the STROBE guidelines. Eligible eConsults included those that had APN involvement (as a referrer or responder) and were concerning an older patient (≥65 years). Descriptive statistics were used to analyse service utilization and survey response data.ResultsOf 430 eligible eConsults, 421 (97.9%) were initiated by NPs and the rest by physicians. 23 (5.3%) were received by a CNS, of which 14 (3.3%) involved an NP‐to‐CNS exchange. Median specialist response interval was 0.9 days. 53% of eConsults was for dermatology, haematology, cardiology, gastroenterology and endocrinology. 73% of eConsults avoided a face‐to‐face referral after the consultation. In 90% of eConsults, APNs rated the service as helpful and/or educational.ConclusionsThrough eConsult, APNs can collaborate with each other and physicians to access and provide a breadth of advice facilitating timely specialist‐informed care for older patients, thus helping to alleviate some of the demands placed on the healthcare system.Relevance to Clinical PracticeThere is an opportunity for APNs to further adopt eConsult into their clinical practice, and this can, in turn, support the integration of the APN role in the health workforce.Patient or Public ContributionCurrent APN eConsult users were involved in the study design and interpretation of results.

Video Abstract Video 1 Equitable healthcare for Indigenous peoples: Development of the “Sharing Circle” Web site to provide a culturally safe method to communicate wound, ostomy, and continence information and resources. {"href":"Single Video Player","role":"media-player-id","content-type":"play-in-place","position":"float","orientation":"portrait","label":"Video 1.","caption":"The “Sharing Circle”: A step toward equitable healthcare for Indigenous people in Canada.","object-id":[{"pub-id-type":"doi","id":""},{"pub-id-type":"other","content-type":"media-stream-id","id":"1_dqqp7ye0"},{"pub-id-type":"other","content-type":"media-source","id":"Kaltura"}]}

Contexte et objectifs : Bien qu’il existe des soins de santé et des services communautaires aux survivants, ceux-ci sont sous-utilisés par les jeunes adultes atteints du cancer (c’est-à-dire âgés de 18 à 39 ans). Un atelier a été organisé à Montréal (Canada) visant à cerner les besoins des JAC signalés par cette population au cours de la transition post-thérapeutique et à examiner les services qui leur sont offerts actuellement. Méthodologie : Dix-sept intervenants (n = 17) ont été recrutés, dont 7 jeunes adultes ayant eu le cancer (JAC), et nous leur avons demandé de prendre part à un atelier d’une journée visant à examiner les meilleures approches et pratiques qui permettraient de combler les besoins des JAC après le traitement. Toutes les discussions ont été transcrites, puis une analyse qualitative des thèmes a été effectuée. Résultats : Deux grands constats ressortent : les différences et les similitudes entre les parties prenantes concernant les perceptions des besoins post-traitement ; et des suggestions pour répondre aux besoins des JAC, après le traitement. Conclusions : Les résultats montrent l’importance de la collaboration entre les différents intervenants, y compris les JAC, lorsqu’il s’agit de concevoir des services destinés aux JAC. Les résultats comprennent des suggestions visant à améliorer la qualité des services offerts dans la collectivité et les établissements de soins de santé. Mots clés : participation du patient, participation de la collectivité, survie, jeune adulte, cancer, services de soins de santé