Advanced Clinical Practice Fellowships

Creation of a Toolkit to Develop Nurse Champions for Diabetes Care in the Community

Summary

The overall goal of this fellowship was to create a toolkit to develop nurse champions for diabetes care in the community using RNAO's Knowledge to Action Framework (RNAO, 2022). SE Health is a home care agency with 13 regional Service Delivery Centres (SDCs). The focused location of this fellowship was the Central Toronto SDC, where there are several care delivery teams. The nurses selected for this champion program represent the care delivery teams with varied geography, both urban and rural. The identified nurses were provided with the resources and tools necessary to a. increase their knowledge of diabetes care and management and b. support their peers through the sharing of their diabetes knowledge and expertise. This fellowship also aligns with our organizational H.O.P.E. framework. This framework aims to provide holistic care that optimizes health outcomes through practice ownership and empowers clients as partners in their care.

The Knowledge to Action Framework (RNAO, 2022) from the Leading Change Toolkit was used to guide the process of redeveloping core diabetes education for nurses. Using the components of the Knowledge to Action Framework (RNAO, 2022) allowed me to have a clear vision of the work to be done and was an essential tool that contributed to this fellowship’s success. To ensure sustainability and promote application of knowledge, the created diabetes module and toolkit are housed in an accessible online platform for all nurses and leaders within the organization to utilize. 

Through this learning opportunity, I have gained a deeper understanding of the process of developing an educational learning module and toolkit. I have enhanced my knowledge and skills related to diabetes care and management and strengthened my expertise as an educator and leader. The new knowledge I have gained through learning and participating in the Diabetes Canada Conference 2022 was highly beneficial to enhance my own knowledge of diabetes care and gave me a different perspective into the world of diabetes research. 

Outcomes

This fellowship was intended to enhance the care nurses provide to their clients with diabetes in the community, specifically in school settings. Through further engagement of staff and leadership, the need for focused diabetes education for nurses caring for pediatric clients in school settings became evident and thus crystalized the focus of the fellowship. Children with diabetes in school settings are a widely underserved population, often as a result of human resource challenges and the intermittent timing of care. Building capacity within our care teams helps address these needs.

 The creation of a diabetes toolkit allows for the development of diabetes nurse champions who are then able to mentor and provide just-in-time support to their peers. The combination of education and peer support results in a fully optimized nursing team who have the necessary knowledge and tools to provide quality diabetes care for children in school settings. As a result, our nurses can fulfill the requirements of these visits, thereby allowing more children to attend school regardless of the medical complexities they face, such as diabetes. This is evidenced by a decrease in the metric of “missed visits,” unique to home care.  Additionally, a fully optimized workforce also allows parents and caregivers to have the confidence that their child with diabetes will be cared for in a timely, consistent and competent manner. Opportunities for specific population-based metrics, such as satisfaction from clients who receive diabetes care and other specialty programs are being explored.

Staff, Organization, and Stakeholder Outcomes

Through the training and education sessions, the nurse champions participated in diabetes education focused on general diabetes management and a specialized course related to pediatric diabetes management in school settings.  These learning opportunities allowed the nurses to gain a deeper level of knowledge and refresh their existing knowledge. The diabetes education module included pre/post tests for the nurses to assess their competency. The pre/post test results indicated that the nurses’ knowledge of diabetes care and confidence in caring for people with diabetes increased as a result of completing the education module. The nurses participating in the champion program were experienced nurses, however this also indicates the importance of annual refreshers and professional development opportunities.

Our organization’s educational material related to both diabetes in general and to diabetes in school was updated to reflect the most current best practice guidelines. These updates are significant due to the large number of clients SE nurses serve with diabetes in the community. 

During this fellowship, I liaised and collaborated with a network of internal and external stakeholders to broaden my knowledge of diabetes best practice in a community context. Through these meetings I was able to share the homecare context of diabetes care and gain an understanding of the role of diabetes educators working with children in hospitals. Having the opportunity to learn and share knowledge with these stakeholders was key to understanding the external needs related to diabetes in the community, deepening the bigger picture of holistic care.

Overall experience

 This fellowship experience has allowed me to grow my knowledge, collaborate with key stakeholders and truly make an impact on my team by building capacity. 

Firstly, I participated in the Diabetes Canada Conference which enlightened me with a new perspective on holistic care for people with diabetes. I had never participated in a conference of this level before and thoroughly enjoyed the opportunities for networking, learning and seeing the direction diabetes research is heading. I hope to continue to participate in the conference every year. 

I had the opportunity to work with some very talented people in our Learning Solutions department to create the educational modules required for the champion program. I was able to discover how to apply many of the adult learning principles that I have been studying in theory. This was a great experience to see theoretical and pathophysiological content be brought to life in an engaging and informative way. I found the time creating the module was a highlight of the work for me as it allowed for both creativity and knowledge to come together in a meaningful way. 

 Additionally, this fellowship provided me with visibility and exposure to other levels of leadership and further develop my presentation skills. I presented my recommendations to the Professional Practice Leadership Team and to my colleagues across the organization through our Practice Leadership Network. This spurred the interest of others to consider an ACPF. 

While at times, I was challenged to manage my time to ensure I could devote the necessary hours to complete this project, through the guidance of past fellows and my mentors, I was able to use strategies to carve out dedicated time to complete my fellowship. Balancing my role and the requirements of the fellowship helped me grow as a leader as I developed the art of prioritization and delegation. Overall, this ACPF has been a journey of knowledge and leadership transformation for me.