Description
Using an advance care planning project as an example, this infographic details the pathway from issue identification in the clinical practice setting, to nursing-led research to better understand the issue, to knowledge mobilization to inform a provincial practice change. Advance care planning (ACP) is the process of thinking about and sharing your values, beliefs, and preferences towards care with your loved ones and health-care team. The goal of advance care planning is to ensure that the health and personal care a patient receives is in line with what they want, even in the event that they’re unable to speak for themselves. While working in systemic therapy at BC Cancer Vancouver, a registered nurse identified an opportunity to improve nursing practices related to advance care planning, launching a provincial research project to understand how to better support oncology nurses. Foundational research in the practice setting revealed that while nurses recognized the value ACP brings to both nursing care and patient outcomes, they reported limited engagement in ACP in their workplace due to structural factors alongside uncertainties related to role clarity and organizational approach. To bridge this knowledge-to-practice gap, a knowledge mobilization (KMb) project was initiated to mobilize the research findings into practice through a province-wide nursing practice change. This infographic illustrates the visual timeline of the project, mapping the sequential progression from issue identification and local embedded research to knowledge mobilization, evaluation, and sustainability. It highlights key collaborative milestones driven by an ACP Nursing Working Group, including co-creating a new approach to ACP, conducting feedback sessions with more than 200 nurses across all six regional cancer centres, developing new educational resources for nurses and patients, and pilot testing, scaling, and spreading the clinical practice change. Survey results collected before and after KMb demonstrated (1) improvements in reported ACP confidence, knowledge, and access to resources, and (2) increases in ACP initiation and follow-up. To ensure long-term sustainability of this provincial practice change, the project successfully integrated ACP education and sustainment into the professional practice nursing portfolio, embedded the new ACP practice and resources into nursing orientation, and established nursing champions to lead ongoing ACP clinical change. Through close collaboration with nurses, nursing leaders, and patients, project team successfully translated local research to practice through a province-wide practice change that better supports oncology nurses with ACP. This pathway may act as a guide for future knowledge mobilization projects. This work was supported by a Michael Smith Health Research BC Reach Award (#RA-2023-3456) co-funded by the BC Nurses’ Union and is titled: Embedded Knowledge Mobilization: Strengthening Oncology Nurses’ Capacity for Effective Advance Care Planning Conversations. Heather Kilgour (Clinical Nurse Specialist, BC Cancer Vancouver) is co-leading this work with Dr. Leah Lambert (Senior Scientist, Clinical Research Department, BC Cancer Research Institute) and Ruby Gidda (Executive Director of Professional Practice Nursing and Executive Director of Abbotsford). We acknowledge the valuable contributions of the broader study team through the foundational research that informed the development of this work. doi:http://dx.doi.org/10.14288/1.0452611