Nursing Innovation
At the frontlines of health care, nurses have a unique vantage point to observe patterns in patient care, identify emerging needs and gather insights for developing new medical interventions. Academic studies on the impacts of nurse-led research show how critical their perspectives are in shaping health care to improve patient outcomes. According to a study by nursing researchers Dr. Marcela Campoli and Tanya Mulvey, nurse-led research has the potential to enhance evidence-based practice for the entire profession and craft the future of health care. In turn, taking part in research gives nurses a special – and often untapped – potential for professional growth, enabling them to shape and strengthen their areas of practice.
But too often, nurses face obstacles that limit their participation in evidence-based research. Heavy workloads, lack of mentorship, and staffing shortages can confine nurses to an observational role when it comes to advances in health care. When health care research ignores nurses’ voices, it risks losing the nuances of patient care, weakening the impact of research and slowing down patient-focused and evidence-based improvements to medicine.
Recognizing these obstacles, Providence Health Care (PHC) Director of Research Aggie Black developed the Practice-Based Research Challenge. This annual program encourages frontline nurses to develop and lead their own research projects in their worksites. BCNU has supported this nurse-led research program since its inception in 2011 and has committed to funding one nurse-led team every year.
"Our partnership with BCNU has had many benefits: through the BCNU’s funding, PHC can support another team of nurses to conduct meaningful research, and by supporting the Research Challenge, the union is offering additional educational opportunities for point-of-care nurses”
The program supports point-of-care nurses who may lack research experience but are eager to explore questions arising from their work. The initiative offers research training, mentorship and funding opportunities to help participants develop projects based on their clinical observations. This partnership bridges the gap between research and practice, fostering a collaborative approach with other health-care professionals. More importantly, it helps participants to integrate their findings into clinical environments, leaving an immediate and lasting impact on the patients they see every day.
As the 15th cohort of the Research Challenge prepares to begin their studies in January 2025, Black reflects on the meaningful impact of this partnership in advancing nursing research.
“Our partnership with BCNU has had many benefits: through the BCNU’s funding, PHC can support another team of nurses to conduct meaningful research, and by supporting the Research Challenge, the union is offering additional educational opportunities for point-of-care nurses,” says Black. “The Research Challenge projects lift the nursing voice in research, and the project findings aim to improve patient care.”
To date, the PHC Research Challenge has supported 143 teams, leaving a legacy of critical evidence-based findings. Participant evaluations of the program have been overwhelmingly positive, with those taking part reporting that they increased their knowledge of research, added to their skills and built their confidence. More than two-thirds of participants reported that what they discovered during the Research Challenge led to practice changes at their worksite. A further 26 percent were inspired by the program to enroll in graduate school.
One exemplary project on patient experience showcases the program’s impact. BCNU member Josie Mackey observed that post-transplant patients at the St. Paul’s Hospital Heart Centre often became informal mentors to those awaiting transplants. The post-transplant patients offered firsthand insights and reassurances that eased pre-transplant patients’ worries and helped them prepare for surgery.
In 2022, Mackey led a team that conducted a study to formalize this heart transplant mentorship program at St Paul’s. Her team interviewed heart transplant patients about what they would like to see included in the program.
Based on the strength of the preliminary research conducted during the Research Challenge, the team recently won additional funding from a Vancouver Coastal Health Research Institute/Providence Research Team Grant. Not stopping at St. Paul’s, this new funding will enable the team to expand their heart transplant mentorship program across BC, benefiting patients throughout the province.
“Working alongside patients in the St. Paul’s Heart Transplant clinic outside a clinical aspect was special. I was able to appreciate patients’ perspectives on what is important to them and see how they act as peers to other patients,” says Mackey. She emphasizes the importance of BCNU’s support, saying the union’s backing was instrumental in making opportunities possible for nurses.
While the Research Challenge has led to improvements in health-care practice, past participants have also used the study to improve nurses’ health and safety on the job.
Zoe Esseiva and Avery Rossi, both new nurses and BCNU members, frequently encountered aggressive patients and abusive language while working in inpatient medicine units. They knew that Behaviour Support Plans (BSPs) were in place to help care teams manage these patients, but many staff lacked training. Esseiva and Rossi realized that no one had formally evaluated the effectiveness of these tools and sought opportunities to improve them.
In 2022, using funding provided through the PHC Research Challenge, Esseiva and Rossi launched a project to assess how well BSPs were working, review staff training on using BSPs and identify potential improvements in the approach. Participating in the Research Challenge allowed them to lead a study on staff experiences with behaviourally complex patients that aimed to enhance staff preparedness and improve patient care through better utilization of BSPs.
“While working on a medical unit, Zoe and I recognized the issues in treating patients who had challenging behaviours and were put on a “behaviour care plan,” Rossi says. “By being a part of the Research Challenge, we were empowered to lead changes to the behaviour care planning process by examining interdisciplinary staff’s experiences working with patients who were behaviourally complex.”
One of the Research Challenge’s strengths lies in its ability to cultivate a research-positive culture within nursing. Even participants whose teams do not receive funding benefit from the program’s workshops and training, emphasizing the critical role research plays in informing clinical decisions and patient outcomes. By connecting bedside practice with evidence-based research, the program shows how data can drive practical change in the health-care environment.
BCNU continues to play a role in sustaining and growing the programs created through the Research Challenge, and the partnership with PHC stands as a model for how collaboration between unions and health-care organizations can foster innovation, empower clinicians and improve care across the province. The program shows that nurse-led research is not just achievable but essential for advancing health-care practices and supporting teams of clinicians new to research, guiding them in conducting practice-relevant studies.
“As nursing is an evidence-based profession, it is rewarding and empowering to have the opportunity to be at the forefront of generating evidence for clinical practice,” says Esseiva, who found the program so worthwhile that she is pursuing a Master of Science in Nursing at UBC this fall. “I recommend the Research Challenge to any nurse looking to explore the research world and gain graduate-ready research skills,” she adds. •
BCNU members at Providence-run health-care facilities who are interested in participating in the Providence Research Challenge can reach out to Aggie Black at ablack@providencehealth.bc.ca
UPDATE (Winter 2024)