[Jen]

Part 1: Develop a research question using PICO that focused on a clinical problem you have experienced. Post your research question in the discussion area below and share why you chose this research question (Maximum 250 words)

Part 2: Comment on one of your peer’s research questions. (Maximum 250 words) • Ask a clarifying question • Offer a different perspective • Share your reflections or your experience related to the research question.

[Ashley]

Idea #1 – How does school nursing support impact the child’s school experience?

Children who require these supports often struggle to acquire staffing, wait-lists and high turnover. They are required to miss school when these supports are not in place for them leading to lower levels of attendance, more caregiver burden for parents, etc.

However it would be naive to assume that with staffing in place there is no impact on the experience as my little friend and I are asked questions all the time about why her care occurs (confidentiality/privacy issues), reality of differences between students who require traditional schooling vs those needing support and the interruptions to her day to support her feeding schedule also play a role.

P: students requiring nursing support at school
I: nursing visits
C: non-supported classmates/peers
O: – struggling to make it quantifiable, could track attendance but only measures one factor…

Idea #2 – How do nurses working in home and community care access mentors and professional support?

P: Home & Community Care (HCC) Nurses
I: Team-building/mentor opportunities
C: Unsupported HCC nurses
O: Increased confidence in skills, staff engagement, increased retention and job satisfaction

Idea 1 or 2? Thanks for helping me narrow it down team!

[Megan]

Hi Ashley,
I thought that both questions were very well thought out and crafted. However, the first question surrounding the need for skilled nursing care in schools stood out as question that when researched and answered could solve some very real issues for children and families in today’s schools. So many times I see job advertisements for either private homes or agencies that require 1 to 1 nursing care for a child to attend school. It would seem as though is up to the parents to provide this extra support for their child to attend school safely. What if it were a requirement for public schools to provide licensed nursing staff for the children whom attend? I think that even tracking attendance is a great beginning. Perhaps there are other factors to consider such a grades and hitting other academic milestones. Nonetheless, I thought your first idea for a research question was very well thought out.
Megan S.

[Jen]

Hi Ashely,

Well done!
You may want to consider narrowing down if there is a particular school experience that you are interested in (e.g., interactions with peers, emotional development, overall adjustment to the school environment etc) . For your second question – defining the meaning of ‘unsupported’ would be helpful in your literature search to keep it focused to your area of research inquiry.

Sidenote: I have not come across any research about RPNs working in school-based settings yet. I am interested to see what emerges from your research. Identifying gaps in research is just as (if not more) important than advancing upon what is currently known. For your second question, there are some HCC literature emerging within the past few years that may be of interest to you. The articles and webinars can be viewed in the library.

Jen

[Megan]

Hello Everyone,
I worked for a brief time in long-term care and crafted this research question based on my experience.
Thank you,
Megan S.

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[Brandon]

Hello Megan,

This is a really great research question, especially with how much staffing impacts resident care in long-term care. I come from an acute care background, and see the same with patient ratio, and lack of a sustainable number.

One question I have is whether you’re focusing just on licensed staff (RNs/RPNs) or also including PSWs, since the legislation mostly talks about direct care hours.

Another could be looking at how other provinces or countries that have set ratios compare in terms of outcomes if available.

From my own experience, when staffing is short, residents/patients do wait longer for care, safety risks go up, and quality of life I find can drop. Staff get burned out, which circles back and affects residents too. This is definitely a topic I see first hand almost every shift.

[Marissa]

Hi Megan,
I think you’ve chosen a really important and timely topic for your PICO question. The lack of legislation around safe nurse-to-patient ratios is a critical issue across many healthcare settings. While your focus on Long Term Care (LTC) is incredibly relevant, especially given the chronic staffing challenges in those environments, I agree it’s essential to recognize that this concern extends to all areas of nursing. Inpatient care nurses, for example, often find themselves managing upwards of 12 patients on their own in an acute setting, which can compromise both patient safety and nurse well-being. Highlighting this issue across the broader spectrum of nursing could strengthen your research and emphasize the urgency for systemic change.

[Jen]

Hello Megan,

Very good question! There is some interest work coming out of the province of British Columbia on this topic.

As the research question is written, the population is licensed nurses. The intervention is legislative nurse to resident ratios. The comparison is number of legislative direct care hours. The outcome is safety and quality of life for residents living in LTC. You will be using this question to help guide subsequent learning activities during this course. It may be helpful to narrow the question down to help keep your literature search focused. – It is easy to get trapped in a ‘rabbit hole’ during a literature search. Especially for topics that we feel passionate about. I’ve offered some suggestions below for your consideration.

What is the impact of nurse to resident ratios on the safety and quality of life for residents living in long-term care homes?
P – Licensed nurses in Ontario (RN, RPN)
I – Nurse to resident ratios
C- Legislated direct care hours in LTC
O- Resident safety and quality of life

Sidenote: Did you read the latest WeRPN State of Nursing Report? Legislated safe staff and workload standards are an area of advocacy by the association. If you are interested to read the report, let me know and I can share the link. I am very interested to learn more about your research inquiry and outcome as we move forward in this course.

Jen

[Megan]

Hi Jen,
Thank you for the feedback. I will definitely follow your advice regarding narrowing the focus. I am interested to read about WeRPNs advocacy efforts
surrounding legislated safe staffing workloads; please send the link.
Thank you!
Megan S

[Brandon]

P : Practical Nursing (PN) students and educators in Ontario

I : Integration of formal nursing research education into PN curricula

C : Limited or no structured research education within PN curricula

O : Improved preparedness of Registered Practical Nurses (RPNs) to apply evidence-informed practice in clinical settings

Research Question:
In PN students and educators in Ontario, does integrating formal research education into PN curricula, compared to limited or no structured research education, improve RPNs’ preparedness to apply evidence-informed practice in clinical settings?

Rationale:
My research is focused on exploring gaps in nursing research education at the PN level and how this impacts RPNs’ readiness to engage in evidence-based practice once they enter the workforce. Many RPNs report limited training in research during their schooling, which may hinder their confidence and ability to use evidence effectively in practice. By investigating the impact of including structured research education in PN programs, this project aims to identify strategies to better prepare RPNs for evidence-informed decision-making, ultimately improving patient care outcomes and professional growth.

[Ashley]

100% yes!!! I’m so happy to see you tackling this topic Brandon. As a relatively new grad I feel like this was hardly spoken of while in school. When I transitioned to community work I definitely missed having peer contacts and have had to try and recreate the wheel/teach myself what options are available out there for mentorship and ongoing opportunities to ensure my practice is evidenced based. I quickly became our staffs go-to for questions and often felt that this area of nursing really struggles with retention and I believe the confidence piece is a huge part of it.

[Helena]

Great question Brandon! This is a relevant and well scoped research question focusing on a practical issue in nursing education. I don’t remember talking about research much in school when I was a student. Just more about the fundamentals of nursing and the skills required to complete our tasks. I do feel like if this topic was covered more in our curricula we would be able to understand evidence based research in our practice and also the process of how this information is collected. We hear these terms in our practice but not fully understand how to use this information.

[Mary Shannon]

Hello Brandon, I think your question is brilliant.
I applaud the enhancement of PN education. Our practice is based on evidence and in order to be seen as a credible shareholders, we need to be part of the research. I am a Certificate RPN and have watched our profession expand so much over the years.

[Jen]

Hi Brandon,

Overall great job!

For the purpose of this course, you may want to narrow your research question and focus your Population of interest on either PN students OR educators. Example: What are the strengths and opportunities in research education for Ontario practical nursing students? Or how is research education integrated into practical nursing programs in Ontario?

For the outcome – will your research inquiry improve preparedness of RPNs to apply evidence … or maybe it is to better understand PN research education upon entry-to-practice?

Sidenote: Did you know that WeRPN’s research program was established in response to the under representation of RPNs in research and in the research driven literature?
It will be great to learn more about your research inquiry and findings as we move forward in this course. Such an important topic to support RPNs and inform education and leadership.

Jen

[Marissa]

Clinical Topic: Addressing work-related trauma and burnout in frontline healthcare professionals.

P (Population): Frontline healthcare workers (nurses, paramedics, physicians, etc.) exposed to traumatic events during clinical practice

I (Intervention): Structured peer support and debriefing programs

C (Comparison): No formal support or debriefing intervention

O (Outcome): Reduction in symptoms of post-traumatic stress and burnout

Research Question:

In frontline healthcare workers exposed to traumatic clinical events, do structured peer support and debriefing programs reduce symptoms of PTSD and burnout compared to no formal support?

Why I Chose This Question:

Healthcare workers frequently encounter emotionally intense and traumatic situations, particularly during crises such as pandemics, mass casualty events, and high-stakes critical care scenarios. These experiences can lead to cumulative psychological stress, yet many professionals suffer in silence due to stigma, lack of support, or overwhelming workloads. Over time, this unaddressed trauma contributes to burnout, compassion fatigue, and even post-traumatic stress disorder (PTSD). Investigating the effectiveness of structured peer support and debriefing programs offers a promising avenue for fostering emotional resilience, enhancing workplace culture, and improving both staff retention and mental health outcomes. By prioritizing trauma-informed care for caregivers themselves, healthcare institutions can build more sustainable and compassionate systems.

[Jen]

Hi Marissa,

Great work!

Your research question is very well structured. Due to the limited time in this course, it may be helpful to narrow down your question to focus on one specific population – either nurses (RPN &/OR RNs &/OR PNs) OR paramedics OR physicians.

I also to suggest limiting your inquiry to one or two geographical locations (e.g., Ontario and British Columbia or Canada etc.). This will help you to focus your search strategies when exploring what is already known with the literature.

So your research question may look something like – How do structured peer support and debriefing programs affect symptoms of trauma (or burnout) in nurses working in Ontario?

Sidenote: WeRPN is currently working with a team to explore psychological safety in LTC – Dr. Yoon and Attila, RPN presented at a WeResearch Webinar. The recording is available. If you are interested, I am happy to share the link with you.

Jen

[Helena]

Clinical topic: How does access to limited community recourses impact patients discharge and readmission rates.

P (population): Geriatric Patients 65 and older

I (intervention): Integration of formal research into community based programs on how resources are granted and qualifications needed to have support at home.

C (comparison) Limited or no community supports available for geriatric patients

O (outcome)

Research Question
How do access to community support and post hospital care resources influence the rate of successful geriatric patient discharge and subsequent readmissions rates?

Why I chose this question

I have worked in a lot of areas of nursing and this impacts the patient and families tremendously, this is often a barrier to discharge.

Limited access to community resources negatively impacts geriatric discharge by causing longer hospital stays, increasing the risk of readmission and functional decline, creating increase stress and burden for both patients and care givers. Patients face challenges in managing health conditions, requiring more support for daily living, may experience poorer health outcomes without necessary services like home care, transportation and coordinated follow-up care

[April]

Hello Helena

I am glad to see you brought this topic of “limited community resources and its impact on patients discharge and readmission rates.” With my many years of nursing practice in hospitals and primary care I have seen a lot of patients return to clinic or hospital just because the community resources are limited especially in the rural areas. I have worked most of my nursing career in the rural area and we are very limited in community resources. Many times, I have had to send patients to a larger city clinic or hospital as we did not have the resources that this patient needed. I am now retired (non-practicing) from nursing, but I sit on a rural local Health Care Services Advisory Committee for our local municipality and just this committee alone has challenges from finding space for a new physician, if we are lucky enough to get one. To advocating for a local lab so our patients don’t have to travel 30 to 45 minutes away for service. Then there is the lack of community care services, so health care worker can support patients in their home. We have a large amount to older adults and people with illnesses. It is all a challenge for all involved! Thank you for making this topic a priority. WE NEED MORE COMMUNITY SERVICES FOR ALL
April

[Jen]

Hi Helena,

Very important topic area and great start to a research question!

Thinking ahead to subsequent activities within this course, this question opens up many possible avenues for inquiry. To support my understanding of your inquiry, could you please clarify if you would like to explore access to nursing? resources – or if you would like to examine patient hospital discharge and readmissions?

Here are a couple of suggestions that may be helpful. Please disregard any suggestions that are not a good fit.

P- Ontario Nurses (RPNs, RNs)
I – community resources
C – community resources and supports (with and without)
O – reduced hospital admissions of older adults over the age of 65 years
RQ: What resources support community nurses in Ontario to reduce hospital admissions for older adults over the age of 65 years.

Or

P: Geriatric patients (age 60+ years)
I: Community nursing care
C: No community nursing care
O: Decreased hospital admissions and readmissions
RQ: What is known about hospital discharges for older adults in Ontario who do and do not receive community nursing care and supports?

Sidenote: While there has been a gradual increase in RPN research in home and community care, I have not come across any particular RPN focused studies examining hospital admission/discharge. It will be very interesting to see what information emerges from the lens of an RPN in research!

Jen

[Mary Shannon]

P- Healthcare workers- RN/RPN/PSW
I- regulating and/or redefining scopes of practice
C- look to like global health systems
O- decrease shortages with increased scopes

Research Question: How could redefining healthcare providers scopes of practice help fill in the gaps in staffing across the healthcare system?

Inspiration: Last week’s perioperative webinar sparked a brainstorm for me on what a reassessed skill mix within the setting I work in would look like. Staffing quotas could be met by utilizing the RPNs within their scopes. This lead to considering healthcare as a whole and finding creative solutions while lifting up each other.

[Jen]

Hi Mary Shannon,

Great topic! Your PICO is well defined. Due to the limited time we have together in this course, it may be helpful to narrow your search to either a provincial or national focus and to concentrate on one population (either PSWs or Nurses). It also might be helpful to be more specific as to what is meant by ‘redefining’.

Here are some suggestions if you find them helpful.
RQ – How do healthcare organizations in Ontario make decisions for optimizing their nursing workforce and scope-of-practice?
P – Ontario Nurses (RPN,RN,NP)
I -role optimization
C-scope of practice
O- Organizational knowledge of nursing roles

Or

RQ – What is known in existing literature about the RPN-RN staff mix in Ontario acute care hospitals
P – Ontario Nurses (RPN, RN)
I – Staff mix
C- literature
O- role clarity

Sidenote: Wonderful to learn that you were inspired by the WeResearch Webinar. You may also be interested to learn that WeRPN has funded multiple research studies in 2024 and 2025 that are examining RPN-RN roles. RPNs are engaged on each of these research teams in various role. Once the findings are available, the researchers will share them with us at WeRPN.

You may also be interested to explore the other available publications and reports on nursing role clarity that are available through the WeRPN library.

I look forward to learning more about your research inquiry as we progress through the course.

Jen

[April]

Population Intervention Comparison Outcome Research Question
P – Young child immunizations in Ontario

I -Apply numbing cream ac injections, lidocaine
Administering the most painful vaccine last minimizes the priming effect of the first injection on subsequent injections, thus reducing overall pain
Use of CARD system

C – Look to global health care systems to compare

O – Improved care by nurse giving injections. Child & parent feel comforted with use of these interventions

RQ – In Ontario when it is time for young children to have their 12- months immunizations it will require three injections at the same clinical visit. Is there any evidence-informed clinical practice that demonstrates that these interventions reduce painful immunization injections?

Research Question:

In Ontario when it is time for young children to have their 12-months immunizations it will require three injections at the same clinical visit.
Is there any evidence-informed clinical practice that demonstrates that these interventions reduce painful immunization injections? Interventions, CARD program, numbing cream and administering the most painful immunization injection first. Is there any evidence that two nurses giving the last two injections at same time as parent cuddles and/or breast feeds child reduces pain at injection site?

Rationale:

My research is focused on less painful immunization injections. This subject came to light as I have spent a lot of my nursing career working in primary care where the clinic I worked at had a Ontario Well-Babies Program. The immunization schedule for Ontario required young children have to more than one injection at some clinical visits. The child’s 12-month visit usually required three injections at one visit or the parent and child would have to return to clinic for additional injections, putting a burden on the whole family. For a child to have more than one injection at a time can be an issue for all involved. This is where the CARD program can be used to support the child and parent, as well as the use of numbing cream, giving most painful injection first.

[Jen]

Hi April,

Great topic! There are a number of very strong research questions proposed. Here are some thoughts to help you narrow down your research question for subsequent learning activities in this course.

P – Babies (Age 1 year)
I – nurse administration of mandatory vaccines
C- Pain management
O- Reduce pain response
RQ: What nursing interventions effectively reduce pain responses when administering the 12-month immunizations to babies?

Or

P- Ontario Nurses (RPNs) in public health
I – Administration of 3 immunization injections in babies at 1 year of age
C- Pain management interventions
O- Reduce pain response

How can nurses reduce pain during childhood immunizations in children at 1 year of age during public health clinics?

I hope this helps. It will be great to see what emerges from RPN inquiries in this area.

I look forward to following your research and outcomes throughout this course.

Jen

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