Nursing Workload Measurement Study

The mandate of The First Nations and Inuit Health Branch (FNIHB) is to ensure First Nations and Inuit communities have access to health services; assist First Nations and Inuit communities in addressing health barriers and disease threats, attain health levels comparable to other Canadians living in similar areas; and build strong partnerships with First Nations and Inuit communities to improve the health system.

FNIHB Health services are led nationally by a Senior Assistant Deputy Minister and Assistant Deputy Minister, Regional Operations. The Senior ADM is responsible for four national directorates- Interprofessional Advisory and Program Support (IPASD), Non-Insured Health Benefits (NIHBD), Internal Client Services and Transitions (ICSTD), Strategic Policy, Planning and Information (SPPID). The ADM Regional Operations shares operational responsibility for the delivery of FN health care services among two national directorates - Health Funding Arrangements (HFAD) and Health Infrastructure Support (HISD) and 8 regional offices. Regional Health services are led by a FNIHB Regional Executive Officers.

Health Canada (HC), through FNIHB, provides a continuum of Primary Health Care (PHC) Services /programs aimed at improving health outcomes for First Nations, including Communicable Diseases Control (CDC), Non-Insured Health Benefits (NIHB), and Public Health (health promotion and disease prevention), as well as Primary Care (PC), including access to emergency services 24 hours a day, seven days a week in 85 remote and isolated First Nation Communities (RIFNC) (south of the 60th parallel) serving a population of 95,000 First Nations (FNs). Primary Health Care services are either directly delivered by Health Canada FNIHB or delivered by First Nations (FN) through contribution agreements

In 49 RIFNCs, FNIHB directly delivers Primary Health Care services including access to 24/7 emergency services serving a population of approximately 62, 000 FNs. Registered nurses, based mostly in nursing stations and a few health centers with treatment component, are predominantly the first point of access to the healthcare system and central to the services delivered in these communities. Registered nurses are the largest group of healthcare providers in these communities. While it is well understood that nurses are the primary interface between the FN client and the health care system in these communities, information about nursing activities is limited. There is no consistent, reliable information available on the work (direct/indirect activities) that nurses do as well as no standard method for collecting this information. The lack of this basic information on nursing activities impacts the ability of nursing management to make evidence informed decisions on appropriate nursing resource requirements and develop strategies to improve them. The lack of reliable data is compounded by the geographic isolation of many communities and the fact that most Nurse Managers are not located on site, thus are not able to routinely observe nursing care delivery. In an effort to better understand nursing activities related to the provision of PHC services in RIFNC, Health Canada is seeking a contractor to conduct a Nursing Workload Measurement (NWLM) study of Health Canada nurses providing PHC services in RIFNCs. The study will be led by the Clinical and Client Care (CCC) Program, Primary Care Division (PCD), Interprofessional Advisory and Support Directorate (IPASD), First Nation and Inuit Health Branch (FNIHB).