Registed Nurses' Association of Ontario

How is the North Bay Nurse Practitioner-Led Clinic Implementing the Assessment and Management of Pain Best Practice Guideline?

Terri MacDougall, BScN, NP-PHC
North Bay Nurse Practitioner-Led Clinic

The goal for my fellowship was to learn how the North Bay Nurse Practitioner Led Clinic (NBNPLC) is implementing the Assessment and Management of Pain Best Practice Guideline (BPG).During my fellowship I developed knowledge and skills in data/indicator analysis, and enhanced my knowledge and skill in the language of quality improvement. Adaptive leadership skills were a key development for me, as a Nurse Practitioner-Clinical Director.

The North Bay NPLC is one of twenty five NPLCs in Ontario. NPLCs are a new, innovative model for delivery of comprehensive primary health care. One of the needs of the NBNPLC is the ability to use data to tell our story as a new model, including how we operate according to Best Practices. Utilizing the learning during my fellowship, I can confidently tell the story of how the NBNPLC analyzed and questioned our practices in terms of assessing and managing pain. We put in place improved processes to positively affect patient outcomes in terms of pediatric experience of procedural pain. I will be presenting at the Association of Ontario Health Centres annual conference in June, as well as showing our poster at the Canadian Pain Society’s Conference in May. These presentations will focus on the fellowship period and the improvement project.

As the Clinical Director, I plan to sustain and buildon this learning as we implement additional BPGs. As the Clinical Director of the clinic I feel confident analyzing indicators, and reporting back meaningful data to the clinical team. I am confident in developing clinical policies and putting in place work flow for the clinical team. Engagement of the clinical team is a key strategy that I have learned. Relationships between clinicians are a key ingredient for successful analysis of practice and change management.

Attendance at Health Quality Ontario’s IDEAS Program - Improving & Driving Excellence Across Sectors, was a key strategy for my fellowship. Leadership resilience and team relationship analysis was stressed to participants of IDEAS. Quality improvement involves analysis of practice and engagement of patients to drive improvement. Both of these activities require courage and strength to lead change. During my fellowship, we had staff turnover. I used a new meeting sheet that I devised after attending a Health Achieve workshop. I have reflected on my role and responses in the turnover of staff. Overall, I have positive feelings about how things unfolded.

I am grateful for this Advanced Clinical Practice Fellowship opportunity. It has re-grounded me in the science of nursing. I plan on completing my MScN as a result of being re-energized by nursing best practice. Thank you.