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BACKGROUND: Despite widespread recognition of the undeniable impact of nurses on patient safety, important barriers relating to the organization of health systems still hinder the full expansion of the role of these professionals. In Quebec (Canada), nurses work overload and increased adverse events are preoccupying and point to a possible lack of contemporary tools for continuous professional development. Innovative training tools should stimulate reflective practice focused on a holistic view of the patient in order to support a full scope of nursing practice and ensure continuous improvement in the quality of care. Such tools would make it possible to better understand their practice, according to their own perception, as well as its applicability in the emergence of a professional conscience essential to lasting safety competencies. This study\'s overarching goal was to propose a model and a portfolio prototype to support nurses’ training. METHOD: Based on a humanistic and reflective perspective on patient care and safety competencies, a design approach was used to develop a portfolio prototype. A qualitative approach was used to collect and analyse data using shadowing observations of 10 nurse/patient dyads, followed by individual interviews about their care experience. The research was conducted in acute and long-term care settings of the Quebec City area. The iteration process resulted in a first version of the prototype that was then presented to various stakeholders during a co-design workshop aimed at better understanding the clinical applicability of this prototype and improve it. FINDINGS: The INSÉPArable project, which closely links nurse, safety and patient, is illustrated in two interrelated steps. An iceberg as a metaphor for nursing practice where the essence of care where the « art of nursing » is hidden and a spherical model that depicts how the portfolio tools aim at consciously directing learners towards optimal conditions that support the full emergence of nursing practice in an inductive perception of sustainable patient safety promotion. DISCUSSION: More than an individual reflective perspective, INSÉPArable highlights the need for a collective awareness among nurse managers regarding underlying the optimal conditions for the application of this tool. As well, this implies a renewed mode of governance and the implementation of more humanistic processes in optimization mechanisms that redefine the contemporary professionalism of nurses, which are closely linked to patient safety.
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10.1016/j.ijnsa.2020.100011
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document_parses/pdf_json/5aabdad12067d49a4f0e0c8d8ea616e31fa6739f.json
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document_parses/pmc_json/PMC7577252.xml.json
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The INSÉPArable portfolio tool: the art of bringing out the invisible for a full scope of nursing practice and sustainable patient safety
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