Jump to content

User:Regued/sandbox

From Wikipedia, the free encyclopedia


Doris Grinspun[edit]

Doris Grinspun RN MSN PhD LLD(hon) Dr(hc) FAAN FCAN OONT (born 29 October 1952) is a nurse leader, author and speaker on health and nursing policy, as well as a policy advocate and public figure in the province of Ontario, Canada. She has served since 1996 as the head of the Registered Nurses' Association of Ontario (RNAO), and has led the growing influence of this professional association both nationally and internationally. An advocate for nursing and health for all, and a proponent of social and environmental determinants of health, she has influenced policy change in Ontario. She founded and has led since 2001 RNAO’s Best Practice Guidelines program, currently implemented in more than 1,000 health organizations in 15 countries. Recently she has played a prominent public role in Ontario's response to the COVID-19 pandemic.[1]

Early and family life[edit]

Grinspun was born as Dorita Rappaport in Santiago, Chile to Jewish parents. Her father, Leib Rappaport, arrived in Chile in 1939 escaping from Czechoslovakia but her grandparents and aunt, last seen at the Terezin concentration camp, perished at the hands of the Nazis. She completed elementary and high school studies at the Hebrew Institute in Santiago. She is the youngest of four sisters.

From childhood she wanted to become a nurse and demonstrated concern for social conditions.[2] After graduating from high school she moved to Israel with a group of classmates and enrolled at the Hadassah School of Nursing in Jerusalem. When she was a second year nursing student the Yom Kippur War broke and Grinspun was asked to open an interim unit for soldiers with minor injuries, later working on a unit with burnt soldiers, which left a lasting impression on her.[2]

In Israel she married her Chilean high school friend, Ricardo Grinspun. They were both active in the Israeli peace movement, moved by the experience of two wars (1973 and 1982).[2] They have two married sons and four grandchildren.

Education and early career[edit]

Grinspun received her Registered Nurse Diploma from the Hadassah School of Nursing in Jerusalem in 1974. She completed a post baccalaureate degree in nursing,[3] magna cum laude, at Tel Aviv University in 1983, while working as a staff nurse in a surgical unit at Meir General Hospital, Kfar Saba, followed by several staff nurse roles at Loewenstein Rehabilitation Hospital,[4] Raanana. Later she became the assistant head nurse of the cranio cerebral injury unit at Loewenstein. In 1983, the family of four moved to Ann Arbor, Michigan for graduate studies, and she completed her third degree in nursing, a master of science in nursing at the University of Michigan.

She also worked as a registered nurse in the rehabilitation department at the University of Michigan Medical Centre and became assistant head nurse. She was impressed both with the quality of health services and highly professional nursing care provided at a top US hospital, but also shocked with the reality that many of these services were rationed by people’s insurance scheme and their ability to pay.[2] After she and her husband completed their graduate studies the family migrated to Canada, attracted by its publicly-funded healthcare system.[2][5]  

In Canada she started work as a clinical nurse specialist in rehabilitation at Queen Elizabeth Hospital in Toronto (now the Toronto Rehabilitation Institute). Soon thereafter she was invited by then vice-president of nursing Judith Shamian to apply as a director of nursing at Mount Sinai Hospital. During the six years (1990-96) she served in that position she led the planning, implementation and evaluation of professional nursing practice across the hospital.

Grinspun completed a PhD degree in sociology at York University in Toronto in 2010. Her dissertation focused on the social construction of nursing caring in a tertiary hospital in Toronto.[6]

Registered Nurses’ Association of Ontario[edit]

The Registered Nurses’ Association of Ontario (RNAO) is the professional association representing registered nurses, nurse practitioners and nursing students in Ontario. Grinspun became the executive director of RNAO in 1996, serving since then as head of the association, with a change of title to chief executive officer in 2011. She has been the longest serving executive leader in RNAO’s history,[7] and has led transformation, growth and impact that have been publicly recognized by nurses,[8][9] universities,[10] politicians[11] and the public.[2] RNAO’s voluntary membership grew from 11,000 when Grinspun took the helm to 45,000 today.[REF] Grinspun envisioned a nursing social movement[REF] with strong grassroots across Ontario utilizing RNAO's network of XX chapters, regions and 31 interest groups.[12] Grinspun's financially robust management of RNAO included the purchase of a home office building in downtown Toronto in 2006, opened in the presence of political leaders.[13]

Grinspun leads the strong media presence of the association. During a one year fiscal period, 2012-2013, there were 863 media hits, 663 RNAO members were quoted in media, and on 93 occasions stories quoted RNAO executive members, most of these featuring Grinspun. Website traffic reached almost 3 million page views during that year. Social media influence continues to grow at a steady pace, as Twitter numbers grow. A search for "Doris Grinspun" in the Toronto Star since 1996 shows 343 results.[REF]

In her role, Grinspun has supervised the publication of RNAO's award winning bimonthly journal[14], Registered Nurse Journal since 1996, and she has used her column to educate, guide and mobilize nurses.

Nursing policy and nursing human resources[edit]

Grinspun has been influential in Ontario health and nursing policy since the late 1990's, working with Ontario governments of different political stripes.

During 1996-1997 there was widespread disruption in the Ontario hospital system as a result of restructuring and layoffs of nurses under Premier Mike Harris. Grinspun's activism[15] soon became evident, as she called in November 1996 for a candlelight vigil at Queen's Park with 600 nurses, other health providers, and politicians in attendance.[16] In an open letter to Ontario citizens, RNAO decried the downsizing of hospitals, firing of nurses, impoverished community health services, the deskilling[15] and de-professionalization of nurses' work, and the promotion of privatized health services.[17]

Grinspun's work with then Minister of Health and Long-Term Care (MOHLTC), Elizabeth Witmer, led to positive engagement with government.[18][19][20] In 1998, the legislature passed Bill 127, Expanded Nursing Services for Patients Act.[21] Bill 127 was proclaimed at the RNAO home office with Minister Witmer in attendance, making Ontario the first Canadian jurisdiction to legally recognize the role of nurse practitioner.[22][23] That same year, following a RNAO report authored by Grinspun,[24] the government established the Ontario Nursing Task Force, with then RNAO president Judith Shamian as a member.[25] The purpose of the Task Force was to enhance the quality of patient care through the effective use of nursing resources. Its 1999 report, Good Nursing, Good Health: An Investment for the 21st Century,[25] focused on helping Ontario retain and attract nurses, improve working conditions for nurses, and ensure nurses have the skills they need. MOHLTC requested a second report from RNAO and the Registered Practical Nurses Association of Ontario.[26] This Grinspun-led report, Ensuring the Care Will Be There,[27] set out a comprehensive nursing recruitment and retention strategy following province-wide consultation.[28][29] The Ontario government based its nursing strategy on these two documents and proceeded to implementation.[30] Grinspun co-chaired the implementation for the ministry's Joint Provincial Nursing Committee (JNPC), and issued two follow-up reports in 2001[31] and 2003.[32] She continued to play a central role in JPNC, which she co-chaired from 2009 till 2012 and again from XX to 2020.

RNAO, under Grinspun's leadership, was central to several milestones in nursing policy in Ontario:

Baccalaureate entry to practice. RNAO advocated for legislation to make the BScN the entry to practice requirement for RN practice in Ontario.[33] On April 2000 the government announced the regulation amending the Nursing Act, 1991,[34] with the requirement becoming effective on January 2005.[33][35] It also announced funding to enable the start-up and expansion of collaborative university-college BScN programs.

Enhanced role of nurses. Premier Dalton McGuinty announced at the 2011 RNAO annual general meeting (AGM): a) changes to the Public Hospitals Act[36] that require chief nurse executives to be a member of a hospital’s board and their quality committees; as well as b) mandating all 37 public health units in the province to appoint a chief nursing officer; and c) that nurse practitioners (NPs) will have their powers extended to admit and discharge patients in hospitals.[37][38] Grinspun has championed an expanded scope of practice[39], for example allowing RNs to prescribe medicines.[40] Premier Kathleen Wynne announced at the 2014 RNAO AGM that the government wants registered nurses to be able to prescribe medications in some circumstances.[41][42]

Expanding scope of practice and utilization of NPs. Grinspun, working with the Nurse Practitioners’ Association of Ontario (NPAO),[43] then an interest group of RNAO, continued to push government to make changes to the nurse practitioner role[44] and open NP-led clinics.[45][46] Since 2012, NPs in Ontario are working autonomously, prescribing without “a list,” and are authorized to admit, treat, transfer and discharge inpatients in hospital.[47] The Primary Care Nurse Task Force, a multi-stakeholder effort co-chaired by Grinspun, called in its 2012 report for full scope utilization of NPs in primary care.[48] The advocacy for increased numbers of NPs continued,[49][50] and government responded,[51][52] bringing them into new sectors.[53] Grinspun argued that expanded scope and larger utilization will provide better health outcomes.[54] Going forward, the RNAO has continued to call for improved compensation, scope of practice and expanded utilization.[55][56] Canada’s first NP-led clinic opened in Sudbury, Ontario, in 2007, following years of advocacy.[57] One year later, the provincial government promised to open 25 clinics in communities across Ontario.[58][59][60][61] These clinics resulted in improved access to primary care for thousands of families.[62] Ontario minister of health Deb Matthews recognized in the Ontario legislature RNAO's role in these advances.[63]

Securing full-time employment and changing work arrangements. Grinspun publicly raised concerns[64] about casualization of the nursing workforce,[65] about fragmentation[66] of nursing care and the increasing use of casual and agency work,[67] part of cost-driven hospital restructuring in Canada during the 1990s.[68] Patient care suffers when employment arrangements undermine the ability to ensure patients have continuity of care and caregiver (the same nurse taking care of the same patient using the same treatment plan as much as possible).[69][70] RN full-time employment helps improve patient outcomes, ensuring system cost-effectiveness, improving recruitment and retention, and ensuring sustainability of the nursing profession.[71] Given a low rate of full-time RN employment in Ontario and in Canada, she advocated for what she coined “the 70% solution” – make sure at least 70% of the nurses in each work setting are permanent full-time.[72][73] RNAO's mobilization was effective and politicians paid attention,[74][75][76] implementing policy changes.[30][77][78]

Recruitment and retention of nurses. Grinspun argued that cost-cutting, restructuring and casualisation backfired and created a nursing shortage,[79][80] with many Canadian nurses seeking jobs in the US. In a RNAO survey of expatriate nurses,[5] most wanted to come back to full-time employment in Ontario.[81]

New graduate employment guarantee. As part of her "70% solution," Grinspun identified that young nursing school graduates had difficulty finding full time employment. She led RNAO to successfully lobby government. In 2007 the Nursing Graduate Guarantee program in Ontario was established, guaranteeing full employment to new graduates as they begin their careers.[82][83][78][84] The program remains in place.[85][86]

RN effectiveness and securing appropriate RN-to-population ratios. Grinspun has made the case that RNs can make a difference in the life of their clients and patients.[6] Armed with evidence about RN effectiveness[87] on patients’ health and clinical outcomes, as well as organizational and system cost-effectiveness, Grinspun has positioned this issue at the forefront of RNAO’s work.[88] Grinspun has been a tenacious advocate for securing an appropriate number of RNs providing direct care to patients, clients and residents; for expanding the RN scope of practice; and addressing the shortfall in Ontario's RN-to-population ratios.[89][90][91][92][93][94]

Healthcare system transformation[edit]

With Grinspun’s arrival at RNAO the organization expanded its focus to embrace a healthcare system-wide perspective and engaged in Canadian public policy discussions:

Enhancing Medicare. Grinspun noticed the limitations of tiered healthcare in her birth country, Chile, and in the United States, and her move to Canada in 1989 was influenced by appreciation of Canadian Medicare.[2] She views Medicare as work in progress and led mobilization to support the Romanow Commission.[95][96][97][98][99] She identified the single focus on hospital services as a weakness, and called during federal-provincial Health Accord discussions for expanding primary care, stopping privatization and expanding Medicare with national programs such as Pharmacare.[100][101][102][103]

Primary care. Grinspun works with RNAO staff to help shape Ontario’s primary care system with influential policy reports that provide evidence to the value of nurses practising to their full scope and contributing to positive clinical and health outcomes as well as system efficiency and cost effectiveness. The report on Primary Solutions for Primary Care (2012)[104] laid out a plan to maximize the role of Ontario’s primary care nurses and to eliminate the care gaps that prevent patients from accessing timely and coordinated care.[105][91]

Grinspun's brainchild, the impactful Enhancing Community Care for Ontarians (ECCO) report calls on the government and health system partners to strengthen community care and anchor the health system in primary care to better meet the health needs of all Ontarians. First published in 2012[106], updated in 2014 as ECCO 2.0[107] and updated in 2020 as ECCO 3.0[108], the latter version aligns with health system transformation that responds to the COVID-19 pandemic. ECCO proposes an accessible, equitable, person-centred integrated and publicly-funded health system, delivered primarily on a not-for-profit basis, realized through a robust community sector anchored in primary care. This influential report has resonated with politicians and been featured in the media.[109][110][111][112][113] Some aspects of the Ontario government plans for health system restructuring announced in February 2019 are consistent with RNAO's ECCO report.[114] The changes introduce local Ontario Health Teams to coordinate and deliver a variety of health services for patients.[115][116][117]

Envisioning healthcare transformation. A long term visioning exercise that Grinspun led with the RNAO board of directors culminated with the 2014 release of Visionary Leadership 2030 – Charting a Course for the Health System and Nursing in Ontario.[118] The report portrays scenarios for transformation in a number of health system areas. It proposes a health system anchored in the communities where people live, work and play, and that helps people stay healthy from birth - physically, emotionally, socially, and cognitively. It does so with health professionals working to their full scope of practice in interprofessional teams.[118][109]

Long-term care. Grinspun has led RNAO's advocacy for changes in the long-term care sector for over two decades, with the goal of enhancing outcomes for residents, families and staff. A number of reports and briefing papers prepared by RNAO alone or in collaboration with other organizations have been released.[119][120][121][122][123][124][88][125][126][127][128][108] Many of RNAO’s recommendations relate to staffing and the funding models required, ensuring safe, evidence-based resident care. They emphasize the need for a skill mix of health providers that reflects the increasing acuity of the residents that currently live in Ontario’s long-term care homes, as well as funding models that address their needs.[129] During the COVID-19 pandemic she led the demand for a Nursing Home Basic Care Guarantee to shore up staffing levels based on these principles.[130] Grinspun was cited dozens of times by the media in reaction to the hundreds of COVID-19 outbreaks in Ontario nursing homes.[131]

Social and environmental determinants of health[edit]

Before Grinspun’s tenure as the head of RNAO, the traditional approach of the professional association was to address matters related to the “profession” (nursing) and the healthcare system. RNAO's policy staff, under Grinspun's leadership, worked to bring a broader definition of health and wellbeing that included the social determinants of health (SDOH) -- such as poverty[132], social exclusion[133], shelter[134], racism[135], nutrition and education --, as well as environmental determinants[136][137] -- such as clean air and water, protection from toxics and climate change.[138][139][140][141][142][143]

Her approach is to devise evidence-based policy, and then working with her team to mobilize nurses and the public calling for action from politicians and governments,[136] utilizing submissions to government, open letters, “action alerts,” presentations, and directly appealing to politicians.[144] For Grinspun, “this is a perfect example of the power of working together to mobilize people towards progressive change.”[145] She devised the “action alert”, now a mainstay of RNAO’s advocacy process, as a way to inform RNAO members of critical nursing, health and social issues, and to mobilize their advocacy efforts,[146] and worked with grassroots organizations to advance common causes (i.e., organizing a community consultation, joining with a group of nurses for an affordable housing rally, or activating members to pen letters to their local media).[145]   

Social determinants. "We believe in the social determinants of health as paramount to the well-being of people," says Grinspun.[147] She identified poverty as the largest preventable source of ill-health in Canada,[148][149][150][151] dedicating a 2005 issue of Registered Nurse Journal to the topic of child poverty.[152] An anti-poverty coalition in which Grinspun played a personal role advocated successfully for the government to announce in 2008 Ontario’s Poverty Reduction Strategy.[153][154][149][8] Grinspun approach was to celebrate the announcement but insist that “actions speak louder than words,” pushing government to demonstrate action through policy and budgets.[145] RNAO has called, working with civil society coalitions, to provide access to healthcare services for refugee claimants, [147] and for an affordable housing strategy.[155][156][157][151]

Environmental determinants of health. Emphasizing evidence linking environmental factors to health, Grinspun prioritized advocacy for a cleaner, greener environment, arguing fewer pollutants and toxics means lower morbidity and mortality (from asthma, lung cancer, cardiovascular disease, allergies, etc.).[158][159] She led the writing of Creating Vibrant Communities,[160] the association’s platform for the 2011 provincial election, outlining recommendations related to greenhouse gas emissions, coal and nuclear power, toxics, pesticides, clean water and public transportation.[143]

Grinspun worked with the RNAO board of directors starting in 2000 to support a campaign to ban the cosmetic use of pesticides in Ontario,[143][161] working with a Partnership for Pesticide Bylaws, a group of 14 community organizations.[162] The association also joined a coalition of health and environmental organizations, led by the Canadian Association of Physicians for the Environment (CAPE), to launch an anti-pesticide ad campaign in 2005.[163] Responding to the pressure, in 2008 the Ontario legislature passed Bill 64: An Act to amend the Pesticides Act to prohibit the use and sale of pesticides that may be used for cosmetic purposes. An editorial in Alternatives Journal says: "Doris Grinspun, CEO of the Registered Nurses' Association of Ontario, played a central role in pressing her province to pass a cosmetic-pesticide ban, the most health-protective legislation of its kind in North America."[164] RNAO also collaborated with CAPE and the Ontario Clean Air Alliance to advocate for the closure of all coal-fired generating units,[165][166][143] a successful campaign leading to complete coal phase-out in 2014.[167]

Best Practice Guidelines program[edit]

An area of vast accomplishment for Grinspun and the team she has assembled at RNAO is in the enhancement of nursing and health evidence-based practice. The RNAO Best Practice Guidelines (BPG) program is the embodiment of that achievement and one that Grinspun considers the most impactful initiative she has been engaged professionally in her career.[8]

Origin of the BPG program[edit]

The 1999 Good Nursing, Good Health: An Investment for the 21st Century report[25] (see above) recommended establishing clinical models in practice environments to allow nurses to gain expertise in clinical areas. Grinspun wrote a proposal to the Ontario Ministry of Health to fund RNAO to create nursing clinical guidelines (dubbed "best practice guidelines", or BPGs) based on the best available evidence, analyzed and rated by nurse experts, and distributed widely to nurses in Ontario. Health minister Elizabeth Witmer allocated in 1999 multiyear funding to RNAO to create a dedicated program for BPG development and implementation.[168] The funding to the BPG program has been extended and increased by successive governments in Ontario, to the present day.

Evolution of the BPG program[edit]

The BPG Program was officially launched in 1999 by RNAO in partnership with the Ontario Ministry of Health and Long-Term Care (MOHLTC) [5]. The purpose of the Program from its inception has been to support Ontario nurses—registered nurses (RNs), nurse practitioners (NPs), and registered practical nurses (RPNs/LPNs)—by providing them with Best Practice Guidelines for client care. It envisioned this would advance nurses’ ability to assert their clinical, health, and relational competence and expertise based on the most relevant evidence. So, for example, the widely used BPG on Preventing Falls and Reducing Injury from Falls, originally published in 2002 and currently in its fourth edition [6], has helped avoid many thousands of injuries from falls in elderly and other at-risk individuals. This emboldened capacity would inspire action at the individual level of each nurse and nursing student, and extend to the collective levels of service and academic organizations, as well as the broad foray of health policy. In doing so, nurses would optimize their contribution to patients, impacting individual patient, organizational and health system outcomes.

Grinspun recognized early on that the traditional tightly planned, and often top-down, approach used by health managers for this type of programs would not produce the type of social engagement needed to deliver substantive and sustained clinical, organizational, and system change through the BPG Program. RNAO’s approach needed to be multifaceted and include dynamic processes that would attract nurses to mobilize their internal commitment and energy to become the drivers for change. In a manner consistent with RNAO’s overall approach to working with its own members, Grinspun envisioned from the outset that the BPG Program should emulate a grassroots movement, one that both creates and delivers the changes proposed by the clinical guidelines. The end goal of this movement led by Grinspun and her team at RNAO has been, by design, consistent and clear: to advance evidence-based practice and improve patient, organization, and health system outcomes. A secondary goal of the Program, and one Grinspun has not shied away from, is to position nursing and nurses as knowledge professionals and robust contributors to health outcomes.

In its infancy, the program focused specifically on health-care issues the government viewed as vital, including elder care, primary health care, mental health, home care and emergency care. The first four Best Practice Guidelines (BPGs) were developed by the end of 2000, pilot tested in 2001, and publicly launched and published in 2002 [4]. In 2003 the government of Premier Dalton McGuinty doubled the program’s annual funding. Since the BPG program began, its growth has been astounding. By 2008 there were 31 clinical guidelines and six healthy workplace BPGs that were in use all over Ontario, across Canada and around the world. Today, there are 54 clinical and healthy work environment BPGs, and thanks to continued support from the provincial government with some added support from the federal government, more are on the way. The association maintains a rigorous guideline review and revision cycle, so that the BPGs remain current and capture the latest evidence.

A number of the earlier BPGs have gone through several editions. Among the most popular BPGs implemented across various sectors are: Preventing Falls and Reducing Injury from Falls (fourth edition) [6]; Person- and Family-Centred Care (2nd edition) [7]; Promoting and Supporting the Initiation, Exclusivity, and Continuation of Breastfeeding for Newborns, Infants and Young Children (3rd edition) [8]; Assessment and Management of Pain (3rd edition) [9]; and Integrating Tobacco Interventions into Daily Practice (3rd edition) [10]. The program is expanding every year and has grown to include top leadership and about 50 expert full time staff as well as thousands of expert nurses and others in health care who have volunteered their time and knowledge to contribute to the development of BPGs. In addition, there are more than 100,000 volunteer champions around the world who, as part of their daily clinical work, support guideline implementation globally, and utilize a data system that is helping track key indicators to evaluate improvements in patient care, organizational and system performance. The guidelines are also integral to nursing education at the undergraduate and graduate levels.

In 2003, after seeing that uptake of the clinical guidelines was facilitated by key elements in the work environment, Grinspun and her team envisioned that in addition to evidence-based guidelines that advance the clinical practice of nurses, there was also an urgent need for evidence-based guidelines to enrich work environments. The Healthy Work Environments (HWE) BPGs were born, designed to support health care organizations in creating and sustaining positive work environments. This program was initiated with funding from the Ontario Ministry of Health and Long-Term Care and support from Health Canada, Office of Nursing Policy. The initial goal of the program was the development of six guidelines and systematic literature reviews related to healthy work environments. The six areas included leadership, collaborative practice, workload and staffing, professionalism, embracing diversity and workplace health, safety, and well-being. For the project, a healthy work environment was defined as “a practice setting that maximizes the health and well-being of nurses, quality patient outcomes and organizational and system performance”[11]. This leading edge work attracted much attention and interest across the health system, as these new guidelines were developed and published. For instance, the development panel for the Developing and Sustaining Interprofessional Health Care: Optimizing Patients / Clients, Organizational, and System Outcomes BPG [12] was co-chaired by Dr. Stewart Kennedy, then President of the Ontario Medical Association.

RNAO has also engaged in developing health system guidelines. That is the case with the Care Transitions BPG [13] to assist nurses and other health care professionals become more comfortable, confident and competent when caring for clients undergoing care transitions within and between healthcare sectors. This BPG is playing an important role, at the current time, in Premier Doug Ford’s plans to create Ontario Health Teams (OHTs) across the province of Ontario. At the current time, four of the proposed OHTs, each one composed of more than a dozen organizations, have adopted BPG implementation as part of their proposed plan of action, and several others have indicated interest. For example, all 13 organizations composing the North Western Toronto Ontario Health Team are training together to drive evidence-based practice, enhance health outcomes for patients and promote staff engagement [14].   

RNAO’s plans from the outset included broad dissemination of the evidence-based guidelines and active support for their implementation. Today, RNAO leads what is likely the most robust and expansive implementation program for evidence-based practice for nurses anywhere in the world, and is amongst the strongest in any healthcare field [5]. Grinspun envisioned from the outset that social entrepreneurship would be the driving force expanding the program. This would work in three ways: 1) by scaling up, or expanding coverage; 2) scaling out, or altering the policies, laws, and standards; and 3) scaling deep, or changing the norms [15]. In the BPG Program, scaling up happens when BPGs are disseminated widely within an organization; scaling out, when they are disseminated to other organizations or to the health system; and scaling deep, when uptake and sustainability have occurred and an evidence-based culture has been achieved. Scaling deep can occur within an organization or across the health system, especially through policy impact and cultural change.

The focus of scaling up is on wide dissemination and uptake of BPGs within an organization. The first broad dissemination initiative was the development of ‘champions’ in the organizations adopting the BPGs. It began in 2002 by training individual nurses as champions who are passionate about BPGs to facilitate BPG uptake in their workplaces. By 2003 there were 278 champions in all sectors of Ontario’s healthcare system (JPNC Implementation Monitoring Subcommittee, 2003). At first, all the champions were direct care RNs; over the years the role has evolved to include all nurses and other health professionals in all roles. These are individuals selected by their organizations (and in many organizations, selected by their peers) and/or who volunteer for this role. Such a bottom-up approach helps ensure role sustainability. Champions are committed to evidence-informed practice and improving people’s care and health. They raise awareness of BPGs, support understanding, and influence their uptake among workplace peers. In 2002, with already hundreds of Champions trained, RNAO launched the Champions Network to foster active engagement and knowledge exchange among champions and between them and RNAO. Through this program, over 100,000 volunteer champions worldwide access tools and strategies such as in-person workshops, teleconferences, webinars, institutes and online modules.


"When I looked at the RNAO best practice guidelines, which have been adopted not only elsewhere in Canada but across the world, I realized that nurses do instinctively what I aspire to do across the health care system: build a system that is of the highest quality, that is evidence-based, that is cost-effective and that puts the patient at the centre." Specify from whom the quote is.[63]


Add here other materials

Snippets[edit]

"It's a great debate about the future of health care in our province. I want to say that it's a debate made more pleasant by the opportunity to have it in front of someone whom I consider a health care hero. That's Doris Grinspun from the Registered Nurses Association of Ontario."[169]

References[edit]

  1. ^ "COVID-19 Press Room". rnao.ca. Retrieved 2020-05-16.
  2. ^ a b c d e f g Grinspun, Doris (2005). "Turning Challenges into Opportunities". PACEsetterS. 2 (4): 6–11. doi:10.1097/01.jbi.0000396163.58995.c1. ISSN 1449-7700.
  3. ^ "Post-Diploma Baccalaureate Nursing Program". University of Northern British Columbia. Retrieved 2020-05-16.
  4. ^ "Loewenstein - Israel's largest and leading rehabilitation hospital". Loewenstein Hospital. Retrieved 2020-05-16.
  5. ^ a b RNAO. "Most Canadian nurses abroad would like to come home, survey suggests." Canadian Press NewsWire; Toronto, 22 Dec 2000
  6. ^ a b Grinspun, Doris. 2010. “The Social Construction of Caring in Nursing.” Doctoral Dissertation, Graduate Program in Sociology, York University. http://search.proquest.com/docview/1018368268/.
  7. ^ "90 Years of Leadership - Past Executive Directors / Chief Executive Officers". Registered Nurses' Association of Ontario. Retrieved 2020-05-16.{{cite web}}: CS1 maint: url-status (link)
  8. ^ a b c Grinspun D (2010). "A passion for improving health care: an interview with Doris Grinspun. Interview by Deborah Gardner". Nurs Econ. 28 (2): 126–9. PMID 20446386.
  9. ^ Muzio, L. (2003). Doris grinspun: RNAO's dynamic outspoken RN leader. SRNA Newsbulletin, 5(3), 24. Retrieved through ProQuest.
  10. ^ "Dr. Doris Grinspun, Doctor of Laws, honoris causa". ontariotechu.ca. Retrieved 2020-05-17.{{cite web}}: CS1 maint: url-status (link)
  11. ^ Smitherman, George. (2019). Unconventional Candour : the Life and Times of George Smitherman. Dundurn. pp. 83–84, 91–92. ISBN 978-1-4597-4466-0. OCLC 1112424774.
  12. ^ Doris Grinspun. (2000). Building our house - strengthening our home: RNAO's executive network structure. Dialogue with your Executive Director. Registered Nurse Journal, Nov-Dec, p. 14.
  13. ^ Kersey, Kimberley (2006). "Home sweet home - RNAO officially opens its doors and welcomes visitors to 158 Pearl Street, our new home in Toronto" (PDF). Registered Nurses Journal. March-April 2006: 24–25.
  14. ^ National Magazine Awards (2018-06-20). "2018 National Magazine Award Winners". National Magazine Awards.{{cite web}}: CS1 maint: url-status (link)
  15. ^ a b Bailey, S. (1997, Jan 29). Health care: Depletion of skilled nurses called threat to health care: [FINAL edition]. The Windsor Star Retrieved from https://search-proquest-com.ezproxy.library.yorku.ca/docview/254244001?accountid=15182
  16. ^ RNAO (January–February 1997). "RNAO's candlelight vigil". Registered Nurse Journal. January-February 1997: 22.{{cite journal}}: CS1 maint: date format (link)
  17. ^ RNAO (January–February 1997). "Open letter to Ontario citizens from the Registered Nurses Association of Ontario". Registered Nurse Journal. January-February 1997: 6–7.{{cite journal}}: CS1 maint: date format (link)
  18. ^ Chamberlain, Art (3 April 1998). "Ontario to pay for more nurses but skepticism greets vague announcement". Toronto Star.{{cite news}}: CS1 maint: url-status (link)
  19. ^ Chamberlain, Art (5 April 1998). "Will nurses come home? Ontario faces a critical shortage of nurses. Hospitals are trying to lure some back from the U.S., but it will take more than ads". Toronto Star.{{cite news}}: CS1 maint: url-status (link)
  20. ^ Hudson, K. (1998, Oct 12). Digging in: A day with Elizabeth Witmer: [1 edition]. Toronto Star
  21. ^ "Expanded Nursing Services for Patients Act, 1997". Legislative Assembly of Ontario. Retrieved 2020-05-18.
  22. ^ Rita Daly, T. S. (1996, Dec 03). New `super nurses' get province's nod they'll allow doctors to focus on the more serious ailments: [final edition]. Toronto Star Retrieved from https://search-proquest-com.ezproxy.library.yorku.ca/docview/437600643?accountid=15182
  23. ^ RNAO (March–April 1998). "Ontario Nurses Welcome Proclamation of the Nurse Practitioner Leglslation". Registered Nurse Journal. March-April 1998: 20.{{cite journal}}: CS1 maint: date format (link)
  24. ^ Registered Nurses’ Association of Ontario. (1998). Putting Out the Health Care Fire: A Proposal to Re-invest in Nursing Care in Ontario. A report submitted to Premier Michael D. Harris, March.
  25. ^ a b c Nursing Task Force. (1998). Good Nursing, Good Health: An Investment for the 21st Century, Legislative Assembly of Ontario,, http://www.ontla.on.ca/library/Repository/mon/8000/206177.pdf or http://www.health.gov.on.ca/en/common/ministry/publications/reports/nurserep99/nurse_rep.aspx
  26. ^ "Registered Practical Nurses Association of Ontario". Retrieved 2020-05-18.{{cite web}}: CS1 maint: url-status (link)
  27. ^ RNAO & RPNAO. (2000). Ensuring The Care Will Be There - Report on Nursing Recruitment and Retention in Ontario. Toronto: Registered Nurses Association of Ontario in collaboration with the Registered Practical Nurses Association of Ontario. https://rnao.ca/sites/rnao-ca/files/storage/related/719_R&R_Full_Report050100.pdf
  28. ^ RNAO. "Aggressive Policy Initiatives and Immediate Recruitment and Retention Campaign Needed to Avoid Devastating Nursing Shortage" Canada NewsWire; Ottawa 27 Apr 2000: 1.
  29. ^ Daly, Rita."90,000 Nurses needed 'in next 12 years' ; Only half of Ontario nurses work full-time" Toronto Star; Toronto, Ont. 28 Apr 2000: 1.
  30. ^ a b WALLACE IMMEN. "Ontario to announce funds to hire nurses: Health-care critics hope expected boost of $375-million will address severe shortages" The Globe and Mail (1936-2016); Toronto, Ont. 15 Mar 1999: A7.
  31. ^ "Progress Report on the Nursing Task Force Strategy in Ontario" (PDF). Joint Provincial Nursing Committee, Government of Ontario. 2001.{{cite web}}: CS1 maint: url-status (link)
  32. ^ "Good Nursing, Good Health - The Return on Our Investment. Progress Report, JPNC Implementation Monitoring Subcommittee" (PDF). Joint Provincial Nursing Committee, Government of Ontario. 2003.{{cite web}}: CS1 maint: url-status (link)
  33. ^ a b Daly, R. (2000, Apr 13). University degrees for nurses becoming mandatory in ontario ; bachelor of science will be a must in 2005: [1 edition]. Toronto Star
  34. ^ "Nursing Act, 1991". www.ontario.ca. Retrieved 2020-05-18.{{cite web}}: CS1 maint: url-status (link)
  35. ^ "New provincial rules will require nurses to obtain degrees" Canadian Press NewsWire; Toronto 12 Apr 2000
  36. ^ "Public Hospitals Act, 1990". Ontario.ca. 2014-07-24. Retrieved 2020-05-19.{{cite web}}: CS1 maint: url-status (link)
  37. ^ "Government announces new powers for nurses to advance quality care". rnao.ca. Retrieved 2020-05-19.
  38. ^ Leslie, K. (2011, Apr 08). Ontario gives nurse practitioners power to admit, discharge hospital patients: Nurse practitioners get more powers. The Canadian Press
  39. ^ Peter Krivel. Should we let nurses deliver anesthetics? (2006, May 06), p. R5. Toronto Star
  40. ^ Using RNs to their full scope + evidence = better health care for less money. (2012, Mar 01). Canada NewsWire
  41. ^ Benzie, R. (2013, Apr 13). Wynne wants to let registered nurses prescribe some medications. Toronto Star
  42. ^ Premier, minister of health say province is moving forward on RN prescribing. (2015, Feb 27). Canada NewsWire
  43. ^ "Nurse Practitioners' Association of Ontario".{{cite web}}: CS1 maint: url-status (link)
  44. ^ RNAO (2009). "Proposed changes to scope of practice for Nurse Practitioners insufficient to increase timely access to health services: Nurses say". rnao.ca. Retrieved 2020-05-18.{{cite web}}: CS1 maint: url-status (link)
  45. ^ Government of Ontario, Ministry of Health and Long-Term Care. "Nurse Practitioner-Led Clinics - Public Information - MOHLTC". www.health.gov.on.ca. Retrieved 2020-06-04.
  46. ^ RNAO. Announcement paves the way for nurse practitioner-led clinic to open doors in sault ste. marie. (2008, Apr 18). Canada NewsWire Retrieved from hhttps://search-proquest-com.ezproxy.library.yorku.ca/docview/455344455?accountid=15182
  47. ^ Mulligan, C. (2011, Aug 30). Nurse practitioners to gain new powers ; HEALTH: New regulations in effect oct. 1. Sudbury Star Retrieved from https://search-proquest-com.ezproxy.library.yorku.ca/docview/2215495808?accountid=15182
  48. ^ RNAO. (2012). Primary solutions for primary care: Maximizing and expanding the role of the primary care nurse in Ontario. Primary care nurse task force report. Retrieved from: https://rnao.ca/sites/rnao-ca/files/Primary__Care_Report_2012_0.pdf
  49. ^ RNAO. "Provincial Report Again Demonstrates Cost-Effectiveness Of Expanding Use of Nurse Practitioners in Primary Health Care" Canada NewsWire; Ottawa 19 July 2000: 1.
  50. ^ Kennedy, Gordon. "Nurses without jobs" Sudbury Star; Sudbury, Ont. 13 Aug 2000: A1 / FRONT.
  51. ^ Boyle, T. (2002, Sep 25). 369 jobs for nurse practitioners ; move designed to ease shortage of MDs in province, premier says: [ontario edition]. Toronto Star Retrieved from https://search-proquest-com.ezproxy.library.yorku.ca/docview/438501752?accountid=15182
  52. ^ Government's commitment to double number of nurse practitioners good news for public and profession: Registered Nurses Association of Ontario. (2002, May 10). Canada NewsWire
  53. ^ RNAO. Media release: Seniors in long-term care homes to benefit from the expertise of nurse practitioners. (2014, Mar 03). Canada NewsWire Retrieved from https://search-proquest-com.ezproxy.library.yorku.ca/docview/1503653000?accountid=15182
  54. ^ RNAO. Patients the big winners of McGuinty government's policy to expand nurse practitioners' role and scope. (2011, Aug 29). Canada NewsWire Retrieved from https://search-proquest-com.ezproxy.library.yorku.ca/docview/885579191?accountid=15182
  55. ^ "Ontario Pre-Budget Submission 2018: Improving Ontarians' health and healthcare Submission to Standing Committee on Finance and Economic Affairs". rnao.ca. Retrieved 2020-06-04.
  56. ^ RNAO. Ontario Pre-Budget Submission 2019: Improving Ontarians' health and health care. Submission to Standing Committee on Finance and Economic Affairs. (January 29, 2019). Retrieved from https://rnao.ca/sites/rnao-ca/files/RNAO_Pre-Budget_Submission_Final-1.pdf
  57. ^ RNAO. First nurse practitioner-led clinic opens doors in sudbury. (2007, Aug 30). Canada NewsWire Retrieved from https://search-proquest-com.ezproxy.library.yorku.ca/docview/454846138?accountid=15182
  58. ^ RNAO. Announcement paves the way for nurse practitioner-led clinic to open doors in sault ste. marie. (2008, Apr 18). Canada NewsWire Retrieved from https://search-proquest-com.ezproxy.library.yorku.ca/docview/455344455?accountid=15182
  59. ^ Dalby, P. (2008, May 10). Nurse-led clinics win small-town hearts; successful pilot project in sudbury convinces province to fund clinics for 25 towns and cities. Toronto Star Retrieved from https://search-proquest-com.ezproxy.library.yorku.ca/docview/439434337?accountid=15182
  60. ^ Benady, S. (2010). Number of NP-led clinics to rise five fold in ontario next year. Medical Post, 46(20), 53. Retrieved from https://search-proquest-com.ezproxy.library.yorku.ca/docview/817452808?accountid=15182
  61. ^ Robertson, K. (2012, May 05). Doors open to a new model of care: Nurse practitioner-led clinics, sprouting across ontario to meet physician shortages, offer an alternative to primary care. Toronto Star
  62. ^ "Nurse practitioner-led clinics - How to get ongoing health care, education and illness prevention services from a nurse". www.ontario.ca. Retrieved 2020-06-05.{{cite web}}: CS1 maint: url-status (link)
  63. ^ a b Ontario Legislature. May 10, 2011. 39th Parliament, 2nd Session. Intervention by Hon. Deborah Matthews, Minister of Health and Long-Term Care, at 1510-1520. Available at: https://www.ola.org/en/legislative-business/house-documents/parliament-39/session-2/2011-05-10/hansard
  64. ^ Patient care too fragmented, head of nurses' group says: Changing face of hospitals, assembly-line medicine have human, financial cost: [Final Edition] Egan, Kelly.The Ottawa Citizen; Ottawa, Ont. 04 June 1998: A6.
  65. ^ Grinspun, Doris (2002-12-15). "A Flexible Nursing Workforce: Realities and Fallouts". Healthcare Quarterly. 6 (1): 79–84. doi:10.12927/hcq..16664. ISSN 1929-6347.
  66. ^ "Fragmentation of the labour force". Eurofound. Retrieved 2020-05-20.
  67. ^ Galt, V. (2002, Jan 23). Health workers stressed out, study says. The Globe and Mail Retrieved from https://search-proquest-com.ezproxy.library.yorku.ca/docview/384223938?accountid=15182
  68. ^ Barer, Morris L.; Evans, Steven G. Morgan and Robert G. (2003-11-15). "Strangulation or Rationalization? Costs and Access in Canadian Hospitals". Healthcare Quarterly. doi:10.12927/hcq.2003.17241. Retrieved 2020-06-05.{{cite web}}: CS1 maint: url-status (link)
  69. ^ Grinspun, Doris (2007-01-15). "Healthy Workplaces: The Case for Shared Clinical Decision Making and Increased Full-Time Employment". HealthcarePapers. 7 (sp): 85–91. doi:10.12927/hcpap..18684. ISSN 1929-6339.
  70. ^ Grinspun, D. (2003). Part-time and casual nursing work: The perils of healthcare restructuring. The International Journal of Sociology and Social Policy, 23(8), 54-80. doi:http://dx.doi.org.ezproxy.library.yorku.ca/10.1108/01443330310790642
  71. ^ RNAO (2006). "Backgrounder: Ontario's Commitment to RN Employment". Retrieved 2020-05-20.{{cite web}}: CS1 maint: url-status (link)
  72. ^ RNAO (2003). "Survey of Casual and Part-Time Registered Nurses in Ontario". rnao.ca. Retrieved 2020-05-20.{{cite web}}: CS1 maint: url-status (link)
  73. ^ RNAO (2005). "The 70 Per Cent Solution: A progress report on increasing full-time employment for Ontario RNs". rnao.ca. Retrieved 2020-05-20.{{cite web}}: CS1 maint: url-status (link)
  74. ^ Hawaleshka, Danylo. "A staffing crunch". Maclean's, Toronto Vol. 111, Iss. 24,  (Jun 15, 1998): 20
  75. ^ Goddu, Jean."Nurses predict continued labour unrest." The Globe and Mail; Toronto, Ont. 24 July 1998: A.9.
  76. ^ McCann, Wendy. "Hospitals warn cash-flow problem could endanger patients" Canadian Press NewsWire; Toronto. 09 Oct 1998
  77. ^ Boyle, Theresa. "Ontario commits $375 million to nurses ; Will mean 10,000 full- and part-time caregivers added" Toronto Star; Toronto, Ont. [Toronto, Ont]14 Mar 1999: 1.
  78. ^ a b Funston, M. (2007, May 05). Graduates face better prospects; after a steady decline due to budget cuts and layoffs, advocates believe nursing is now 'on the road to recovery': [ONT edition]. Toronto Star Retrieved from https://search-proquest-com.ezproxy.library.yorku.ca/docview/439219489?accountid=15182
  79. ^ Boyle, T. (1999, Feb 14). Bringing nurses home ; Ontario has started to recruit nurses who found work in the united states. Toronto Star: 1
  80. ^ Picard, A. (2001, Feb 24). Poor conditions stressing out nurses. The Globe and Mail: A6.
  81. ^ Boyle, T. (2000, Dec 02). Battle on to bring Ontario's nurses back; good salaries and training are a must if hiring needs to be met, professional association says. Toronto Star : A28.
  82. ^ Greenberg, L. (2006, May 09). Ontario guarantees jobs for nursing graduates: 4,000 expected to graduate in 2007: [all but toronto edition]. National Post Retrieved from https://search-proquest-com.ezproxy.library.yorku.ca/docview/330613086?accountid=15182
  83. ^ RNAO. Ontario RNs applaud investment in nursing's future. (2007, Feb 27). Canada NewsWire Retrieved from https://search-proquest-com.ezproxy.library.yorku.ca/docview/455525327?accountid=15182
  84. ^ RNAO (6 March 2008). "Ontario nurses applaud the success and expansion of full-time employment guarantee". rnao.ca (in French). Retrieved 2020-06-05.{{cite web}}: CS1 maint: url-status (link)
  85. ^ "RNAO and CARE Centre Applaud the Ontario Government's Expansion of the Nursing Graduate Guarantee Program". rnao.ca. 2013.{{cite web}}: CS1 maint: url-status (link)
  86. ^ Government of Ontario, Ministry of Health and Long-Term Care. "Nursing Graduate Guarantee Initiative". www.health.gov.on.ca. Retrieved 2020-06-05.{{cite web}}: CS1 maint: url-status (link)
  87. ^ Lulat, Z., Blain‐McLeod, J., Grinspun, D., Penney, T., Harripaul‐Yhap, A., & Rey, M. (2018). Seventy years of RN effectiveness: A database development project to inform best practice. Worldviews on Evidence-Based Nursing, 15(4), 281-289. doi:http://dx.doi.org.ezproxy.library.yorku.ca/10.1111/wvn.12283
  88. ^ a b RNAO. 2016. Mind the Safety Gap in Health System Transformation: Reclaiming the Role of the RN. Toronto: Registered Nurses' Association of Ontario. Available at: https://rnao.ca/mind-the-gap
  89. ^ Bailey, S. (1997, Jan 29). Health care: Depletion of skilled nurses called threat to health care: [FINAL edition]. The Windsor Star
  90. ^ Funston, M. (2008, May 10). The 'dark age' of nursing is over; now, with government money, the push is on to recruit new nurses. Toronto Star
  91. ^ a b van de Geyn, L. (2012, May 05). Nurses lobby for more responsibility: Doctor shortages and increasing waiting times lead to calls for an expansion of RNs' duties. Toronto Star
  92. ^ Scarrow, J. (2015, May 09). Nurses take step toward prescribing authority: Talks to get underway for a framework allowing RNs to order medicines, tests. Toronto Star
  93. ^ "RNAO & ONA – Ontarians Need More RNs: Backgrounder – May 2018". rnao.ca. Retrieved 2020-07-29.
  94. ^ Health care fix means hiring more nurses; Ontario has worst ratio of RNs-to-population. (2018, Jul 24). The Ottawa Citizen
  95. ^ Doris Grinspun. (2003). Vigilance needed to secure Medicare's second generation. Registered Nurse Journal. Jan-Feb, p. 7
  96. ^ Doris Grinspun. (2010). Standing up for Medicare. Registered Nurse Journal. May-June, p. 6.
  97. ^ Premiers and PM take note: Canadians - 23,902 and counting - show support for romanow report by signing on to national on-line petition www.petitiononline.com/romanow. (2003, Jan 15). Canada NewsWire
  98. ^ Greenaway, N. (2002, Nov 27). Romanow reforms expected to push one-stop health care: [final edition]. Times - Colonist
  99. ^ Greenaway, N. (2002, Nov 27). Chretien says more cash possible for health care: Provinces must agree to plan: [final edition]. Calgary Herald
  100. ^ Doris Grinspun. (2003). Vigilance needed to secure Medicare's second generation. Executive Director's Dispatch. Registered Nurse Journal, Jan-Feb, p. 7.
  101. ^ Health accord historic moment for canadians - but pyrrhic victory if queue jumping, for-profit health care not curtailed provincially: Registered nurses association of ontario. (2003, Feb 05). Canada NewsWire
  102. ^ RNAO applauds premiers and territorial leaders for placing evidence at the forefront of patient care, urges prime minister harper to get back to the table and discuss a 2014 health accord. (2012, Jul 25). Canada NewsWire
  103. ^ Nurses urge health ministers to build medicare's next phase. (2016, Oct 14). Canada NewsWire
  104. ^ RNAO. Primary Solutions for Primary Care - Primary Care Nurse Task Force Report. (Registered Nurses Association of Ontario, 2012).
  105. ^ Doris Grinspun. Registered nurses shape whole-system change. Registered Nurse Journal. 24, 6 (2012).
  106. ^ RNAO (2012). "RNAO's ECCO Report: Enhancing Community Care for Ontarians – A Three Year Plan". rnao.ca.{{cite web}}: CS1 maint: url-status (link)
  107. ^ RNAO (2014). "A Three Year Plan - ECCO 2.0 Report: Enhancing Community Care for Ontarians". rnao.ca.
  108. ^ a b "ECCO 3.0: Enhancing Community Care for Ontarians". RNAO.ca. Retrieved 2020-07-29.
  109. ^ a b Dal, P. (2014, May 10). Nurses have vision for future of health care: RNAO study looks at ways to improve ability to look after the needs of patients. Toronto Star
  110. ^ Mulligan, C. (2012, Oct 06). Nurses' tough medicine: Eliminate bureaucracy, association says. Sudbury Star
  111. ^ Hansard - Standing Committee on the Legislative Assembly (23 Nov 2016). "Committee Transcript 2016-Nov-23 | Legislative Assembly of Ontario". www.ola.org. Retrieved 2020-07-30.{{cite web}}: CS1 maint: url-status (link)
  112. ^ RNAO applauds health minister's plans to reform the health system, calling them the biggest changes in 20 years. (2016, Jun 02). Canada NewsWire
  113. ^ McQuigge, M. (2020, May 12). Ontario's nurses say COVID-19 pandemic highlights need for sweeping reforms. The Canadian Press
  114. ^ Nurses welcome health system reform and urge the government to ensure RNs and NPs play key role. (2019, Feb 26). Canada NewsWire
  115. ^ "Building a Connected Public Health Care System for the Patient". news.ontario.ca. Retrieved 2020-07-30.
  116. ^ Rob Ferguson. (2019). Health reforms to make for 'seamless' care. Toronto Star, Feb 27, p. A1.
  117. ^ Shawn Jeffords and, A. J. (2019, Feb 26). New ontario health super agency and co-ordinated health teams announced. The Canadian Press.
  118. ^ a b RNAO. Visionary Leadership 2030 – Charting a Course for the Health System and Nursing in Ontario. (Registered Nurses Association of Ontario, 2014).
  119. ^ Registered Nurses’ Association of Ontario. (2007). Staffing and Care Standards for Long-Term Care Homes - Submission to the Ministry of Health and Long-Term Care. Available at: https://rnao.ca/sites/rnao-ca/files/storage/related/3163_RNAO_submission_to_MOHLTC_--_Staffing_and_Care_Standards_in_LTC_-_Dec_21_20071.pdf
  120. ^ Registered Nurses’ Association of Ontario (2009). Response to the Minister of Health and Long-Term Care on: Part 2 of the Draft Regulation under the Long-Term Care Homes Act, 2007. Available at: https://rnao.ca/sites/rnao-ca/files/storage/related/5625_RNAO_response_to_2nd_LTCHA_draft_regulation_Oct_15_2009_-_FINAL.pdf
  121. ^ Registered Nurses’ Association of Ontario (2010). Position Statement: Strengthening Client Centred Care in Long-Term Care. Available at: https://rnao.ca/sites/rnao-ca/files/Position_Statement_LTC_client_centred_care.pdf
  122. ^ Registered Nurses' Association of Ontario (2011). Response to the Ontario Seniors’ Secretariat on: Initial Draft Regulations under the Retirement Homes Act, 2010. Available at: https://rnao.ca/sites/rnao-ca/files/response_to_Initial_Draft_Regulations_under_Retirement_Homes_Act_Final_110408.pdf
  123. ^ Registered Nurses' Association of Ontario (2012). Submission to the Government of Ontario’s Seniors Care Strategy. Available at: https://rnao.ca/sites/rnao-ca/files/RNAOs_Submission_to_the_Government_of_Ontarios_Seniors_Care_Strategy_-_Sept._6.pdf
  124. ^ Long-Term Care Task Force On Resident Care and Safety (2013). Progress Report - Delivering on the Action Plan to Address Abuse and Neglect in Long-Term Care Homes. Available at: https://neltoolkit.rnao.ca/sites/default/files/Long-Term%20Care%20Task%20Force%20on%20Resident%20Care%20and%20Safety_Progress%20Report_2013.pdf
  125. ^ Registered Nurses’ Association of Ontario. Transforming long-term care to keep residents healthy and safe. 2018 Provincial elections backgrounder. Available at: https://rnao.ca/sites/rnao-ca/files/Transforming_long-term_care_backgrounder.pdf
  126. ^ Registered Nurses' Association of Ontario (2019). Ontario Pre-Budget Submission 2019: Improving Ontarians' health and health care. Submission to Standing Committee on Finance and Economic Affairs, January 29. Available at https://rnao.ca/sites/rnao-ca/files/RNAO_Pre-Budget_Submission_Final-1.pdf
  127. ^ Registered Nurses' Association of Ontario (2019). A better approach to long-term care in Ontario. Queen's Park on the Road briefing. https://qpor.rnao.ca/sites/default/files/A%20better%20approach%20to%20long-term%20care%20bulletin%202019.pdf
  128. ^ Registered Nurses' Association of Ontario (2020). Ontario Pre-Budget Submission 2020: Investing in Health. Available at: https://rnao.ca/policy/%5Bpolicytype%5D/ontario-pre-budget-submission-2020-investing-health
  129. ^ Registered Nurses' Association of Ontario. (2020). Long-Term Care Systemic Failings: Two Decades of Staffing and Funding Recommendations, June 5. Available at: https://rnao.ca/news/media-releases/2020/06/05/rnao-releases-list-35-reports-and-recommendations-dating-back-20-year
  130. ^ Registered Nurses' Association of Ontario. (2020). Nursing Home Basic Care Guarantee - RNAO Submission to the Long-Term Care Staffing Study Advisory Group, June 9. Available at: https://rnao.ca/policy/nursing-home-basic-care-guarantee
  131. ^ "COVID-19 Press room". RNAO.ca. Retrieved 2020-07-30.
  132. ^ Registered Nurses' Association of Ontario (2008). "Briefing Note: Moving Forward with a Comprehensive Poverty Reduction Strategy for Ontario". rnao.ca.{{cite web}}: CS1 maint: url-status (link)
  133. ^ Registered Nurses' Association of Ontario (2006). "Briefing Note on Social Exclusion". rnao.ca.{{cite web}}: CS1 maint: url-status (link)
  134. ^ Registered Nurses' Association of Ontario (2004). "Position Statement: Homelessness". rnao.ca.{{cite web}}: CS1 maint: url-status (link)
  135. ^ Registered Nurses' Association of Ontario (2002). "Policy Statement: Racism". rnao.ca.{{cite web}}: CS1 maint: url-status (link)
  136. ^ a b Registered Nurses' Association of Ontario (2008). "Position Statement: Environmental Carcinogens & Health". rnao.ca.{{cite web}}: CS1 maint: url-status (link)
  137. ^ Registered Nurses' Association of Ontario (2008). "Briefing Note: The Environment and Human Health". rnao.ca.{{cite web}}: CS1 maint: url-status (link)
  138. ^ Registered Nurses' Association of Ontario (2011). "Position Statement: Healthy Energy Solutions for Ontario". rnao.ca.{{cite web}}: CS1 maint: url-status (link)
  139. ^ Registered Nurses' Association of Ontario. RNs urge ontarians to remember that their vote on oct. 10 can help create a healthier society. (2007, Oct 01). Canada NewsWire
  140. ^ Registered Nurses' Association of Ontario. RNs kick-start 2011 provincial election with release of comprehensive policy recommendations for creating vibrant communities. (2010, Jan 28). Canada NewsWire
  141. ^ Registered Nurses' Association of Ontario. (2012). Creating Vibrant Communities: RNAO's challenge to Ontario's political parties. Available at: https://rnao.ca/policy/reports/creating-vibrant-communities
  142. ^ Mulligan, C. (2011, Sep 20). Nurses press candidates for answers and vision. Sudbury Star
  143. ^ a b c d Gerstel, J. (2010, May 08). Bedside view drives lobbying efforts MPP's visit 'good for me, good for the nurses' nurses' association calls for action on issues such as poverty, jobs and climate change. Toronto Star
  144. ^ Cordileone, E. (2007, May 05). Eyeing the corridors of power; nurses used to bow and keep silent, but now they seek to make changes as legislators: Toronto Star
  145. ^ a b c Doris Grinspun. (2014). Pushing for $$$ in Ontario’s budget. CEO Dispatch. Registered Nurse Journal, Jan-Feb, p. 6.
  146. ^ "Action Alerts". rnao.ca. Retrieved 2020-12-15.
  147. ^ a b Newman, A. (2016, May 07). New arrivals provide new perspective: Primary health care is a key issue for refugees, nurse practitioner stresses. Toronto Star.
  148. ^ Registered Nurses' Association of Ontario (2008). "Poverty as a Key Determinant of Health: Moving Toward an Ontario Where All May Live in Dignity". rnao.ca.{{cite web}}: CS1 maint: url-status (link)
  149. ^ a b Defining poverty; what does it mean to be poor in ontario today? as the province grapples with that question, the star asked dozens of local experts. here are their answers. (2008, Apr 19). Toronto Star
  150. ^ Registered Nurses' Association of Ontario (2009). "What Else Can I Do About Poverty?". rnao.ca.{{cite web}}: CS1 maint: url-status (link)
  151. ^ a b Laurel Rothman and Doris Grinspun. (2004, Jul 27). Don't forget plight of poor children: Toronto Star
  152. ^ Kearsey, K. Growing pains - One million Canadian children struggle through childhood. Registered Nurse Journal 2 17, 12–16 (2005).
  153. ^ John Campey, U. S., & Grinspun, D. (2007, Nov 25). Walking the walk on poverty; thursday's throne speech provides an early test of McGuinty's commitment to helping ontario's poor: [ONT edition]. Toronto Star
  154. ^ Government of Ontario. Community leaders support McGuinty liberal poverty reduction strategy. (2008, Dec 04). Canada NewsWire
  155. ^ "Opportunities to Influence Ontario's Affordable Housing Strategy June 2009". rnao.ca. Retrieved 2020-12-15.
  156. ^ "A Recovery for All Includes Housing for All". rnao.ca. Retrieved 2020-12-15.
  157. ^ "Input on Long-Term Affordable Housing Strategy Update". rnao.ca. Retrieved 2020-12-15.
  158. ^ "Environmental Determinants of Health". rnao.ca. Retrieved 2020-12-22.
  159. ^ Gideon Forman. (2015). Healers on the Front Lines: Five healthcare professionals share the secrets of their successful environmental campaigns. Alternatives Journal, April. Available at: https://www.alternativesjournal.ca/people-and-profiles/healers-front-lines
  160. ^ RNAO. (2010). Creating Vibrant Communities. Registered Nurses' Association of Ontario. https://rnao.ca/policy/reports/creating-vibrant-communities
  161. ^ "Position Statement: Environmental Carcinogens & Health". rnao.ca. 2008.{{cite web}}: CS1 maint: url-status (link)
  162. ^ April 08, TEA Staff 5sc on; 2009. "Toronto Pesticide By-law". Toronto Environmental Alliance. Retrieved 2020-12-22. {{cite web}}: |last2= has numeric name (help)CS1 maint: numeric names: authors list (link)
  163. ^ Leslie, K. (2008, Jan 15). Health, environmental groups urge Ontarians to quickly ban pesticides from lawns. The Canadian Press
  164. ^ Forman, G. (2015). The ultimate health issue. Alternatives Journal, 41(2), 5-6.
  165. ^ "Let's beat the heat — and the smog | Ontario Clean Air Alliance". 2010.{{cite web}}: CS1 maint: url-status (link)
  166. ^ Registered Nurses' Association of Ontario. Ontario nurses say shut down of coal-fired power units will save lives. (2010, Oct 01). Canada NewsWire
  167. ^ Government of Ontario. "The end of coal - Learn how Ontario became the first North American government to eliminate coal-fired electricity generation, paving the way for a cleaner, greener electricity system". www.ontario.ca. Retrieved 2020-12-22.{{cite web}}: CS1 maint: url-status (link)
  168. ^ J. Scarrow, “Revolutionizing nursing practice,” Regist. Nurse J., no. March/April, pp. 12–17, 2008.
  169. ^ Ontario Legislature. March 23, 2004. 38th Parliament, 1st Session. Intervention by Hon George Smitherman (Minister of Health and Long-Term Care): at 1620. Available at: https://www.ola.org/en/legislative-business/house-documents/parliament-38/session-1/2004-03-23/hansard
Retrieved from "https://en.wikipedia.org/w/index.php?title=User:Regued/sandbox&oldid=1091912983"