2024-04-25 16:24:53
On June 14, Hélène Salette, nurse and Director General of the International Secretariat of Nurses of the Francophone Space (Sidiief) is invited, as a keynote speaker, to the 3rd IPA conference “Integration of evidence into clinical decision-making: from research to reality”. Interview on the challenges of implementing IPAs in France.
Given your experience and your privileged position as an observer of the evolution of French-speaking nursing care how does the implementation of IPAs in France constitute added value for care?
Let us remember that it is above all the population that benefits from the establishment of advanced practice nurses and their expertise. Everywhere in the world, health systems must meet many challenges including that of a sufficient and relevant offer of care. health. On the one hand, the services of advanced practice nurses have proven their effectiveness and on the other hand, their implementation increases accessibility to care, safety and patient satisfaction, prevents breaks in the care pathway and reduces costs (reduction in length of hospitalization and readmission) [1].
In mental health in particular, their role is paramount in meeting the growing needs of the population. Indeed, mental health problems around the world, already very worrying, worsened during the Covid pandemic and subsequently. It is estimated that the global prevalence of depression and anxiety has increased by 25 to 27%. [2]. Mental health APNs therefore have a crucial role to play within multidisciplinary teams. They can implement promotion and prevention initiatives, facilitate access to care and promote therapeutic care oriented towards recovery and reintegration. Furthermore, the development of advanced practice represents a significant lever of attractiveness for nurses who thus have the opportunity to develop their career on a clinical level. Today, the skills and expertise of these qualified nurses are increasingly recognized and valued in health systems.
If, in France, the training of APNs takes place at university, nurses do not have a course in Nursing Sciences. Why is this sector essential in the recognition and structuring of the nursing profession?
It is important to develop the nursing discipline to provide a particular and expert perspective on a healthcare issue, and therefore contribute to the advancement of knowledge, to the development of specific knowledge with benefits for the health of populations. The goal of university training is to develop critical thinking: a critical look at practices, awareness of the sources of knowledge on which practices are based, formulation of questions to facilitate the health experience of patients, etc.
The first university cycle (license) allows you to develop critical thinking and a scientific, professional and social identity of the nurse. This is the level required to integrate research findings into practice. This first cycle therefore makes it possible to develop a solid nursing base, capable of meeting the health needs of the population. It is the foundation on which the discipline is based. The second university cycle (master’s degree) prepares clinicians, advanced practice nurses, teachers and managers to exercise their practice from a disciplinary perspective and to promote it in healthcare environments. This level of training helps refine expertise and train change agents. The third university cycle (doctorate) trains researchers who contribute to the advancement of knowledge and the development of the discipline. It is regarding promoting a systematic and rigorous way of thinking, seeking to understand the experience and lived experience of patients and adjusting care. Nursing research is essential for the evaluation and renewal of practice as well as the development of a body of knowledge that structures the discipline.
While 90% of care is provided by nurses in all health systems, it is essential to support the development of a strong and competent discipline, which contributes to the development of models of care adapted to the needs of patients!
“A discipline is an area of investigation and practice having a unique perspective or distinct way of examining phenomena” Pepin, J. et al (2017) Nursing Thought
In France, the nursing clinic is based more on experience, tradition, intuition, etc. than on the use of conclusive data (evidence base nursing-EMB). How does EMB improve the quality of care while respecting the uniqueness of each patient? ?
I’m surprised that we’re still asking ourselves this question in 2024! We have probably not completely succeeded in developing scientific culture in nursing. Remember that our professional expertise and our clinical credibility are based on our ability to renew our practices, based on the use and integration of evidence. The fact remains that the promotion of research begins, above all, with individual and collective recognition of its scope.
Evidence-based practice aims to maximize the effectiveness and relevance of care interventions. It makes it possible to make clinical decisions informed by best practices and research, to integrate them into care and to adapt them to each patient. Interest in this approach seems to be present among nurses. The challenge is perhaps more on the side of organizations which must give them the means (including in terms of time) to access evidence so that they can integrate it into their practice and also collaborate on research projects. Remember that environments that have developed a culture of excellence in care and that value nursing contribution are a source of attractiveness and loyalty. The introduction of IPAs can therefore be a winning strategy to facilitate this knowledge transfer in practice.
What are currently the major Sidiief issues?
Sidiief’s priority issues include nursing training, quality of care and patient safety and the development of advanced practice. Alerted to the reduction in training requirements (linked to the shortage of nurses in several countries) we took a position in a document entitled Reducing nursing training requirements: a solution damaging to quality and safety.
In terms of quality and safety, Sidiief will organize an online symposium next November on the relevance of care. In the current context of shortage, we are indeed called upon to make choices and prioritize value-added interventions. It is therefore important that these decisions are based on the recommendations.
Furthermore, as part of its latest strategic planning, Sidiief has retained two other priority themes: mental health, due to its global impact and the essential contribution of the profession to improving access to care, and that of digital transformation and the integration of artificial intelligence into healthcare. Our global nursing network, particularly through our expert committees and our congresses, reflects on these different issues and provides informed recommendations. These themes will be addressed during the 9th world congress in Lausanne [Suisse] from June 2 to 5, 2025. The Call for Papers is underway and we hope for many mental health communication projects. I therefore encourage you to come and share your experiences and exchange with nursing colleagues from across the French-speaking world!
[1] International secretariat of nurses in the French-speaking world. (2011). University training of nurses: a response to the challenges of health systems. Montreal; SIDIIEF
[2]
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