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[Marian Knock] RN, BSN, MHA is the Executive Director of the Canadian Nurse Practitioner Initiative (CNPI), which is funded by Health Canada and administered by the Canadian Nurses Association. In this article, Marian provides a better understanding of this exciting new initiative and its impact on primary health care in Canada.
The CNPI is funded by Health Canada, which provided $8.9 million as part of its commitment to provide better access to primary health care for all Canadians. This initiative is part of the overall Primary Health Care Transition Fund (PHCTF) established by the Government of Canada, which made a total investment of $800 million. The funding for CNPI and other initiatives under the PHCTF will end in March 2006.
To learn more about the CNPI's work, visit and bookmark <www.cnpi.ca>. The site will have regular updates, as well as copies of reports and communications materials for use by nursing groups, other professional associations, employers and governments. You can also subscribe online to automatically receive the CNPI e-newsletter. The website will also profile some NPs across Canada so that people can better understand what NPs do in their various practice settings.
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Marian Knock meets with Marg Tansey, Chief of Nursing Practice at the Royal Ottawa Hospital, and her client Glen Parslow. Ms. Tansey is a nurse practitioner who works in both primary health care and tertiary care settings.Marian Knock RN, BSN, MHA is the Executive Director of the Canadian Nurse Practitioner Initiative (CNPI), which is funded by Health Canada and administered by the Canadian Nurses Association. In this article, Marian provides a better understanding of this exciting new initiative and its impact on primary health care in Canada.Marian Knock, Executive Director, Canadian Nurse Practitioner Initiative
What is the Canadian Nurse Practitioner Initiative (CNPI)?
The CNPI came about through the efforts of the Nurse Practitioner Planning Network (NPPN), a Canada-wide group representing nursing stakeholders, including regulatory bodies, professional associations and governments. The NPPN was responsible for designing the proposal that was submitted to (and later accepted by) Health Canada's Primary Health Care Transition Fund.
The CNPI was established to develop a national framework to further the implementation, integration and sustainability of the role of the nurse practitioner (NP) in primary health-care settings across Canada.
To do this, we created a governance structure that includes the CNPI Advisory Committee and five working groups, called task forces, representing the varied stakeholders from the nursing community (including regulators, educators, associations and NPs), government, employers and health-care professionals such as physicians and pharmacists.
The initiative is being managed by CNA, whose Executive Director Lucille Auffrey chairs the CNPI Advisory Committee. Together, it is our hope that we'll develop recommendations for mechanisms and processes to support the integration and sustainability of the NP role in Canada's health system.
How is it funded?
The CNPI is funded by Health Canada, which provided $8.9 million as part of its commitment to provide better access to primary health care for all Canadians. This initiative is part of the overall Primary Health Care Transition Fund (PHCTF) established by the Government of Canada, which made a total investment of $800 million. The funding for CNPI and other initiatives under the PHCTF will end in March 2006.
Is it a daunting challenge to get consensus on the approach to the role of the nurse practitioner in primary health care?
Yes, without a doubt, but we are finding as we work through our consultation process and start to receive input that the collective will to achieve this is far greater than the challenge. I think everyone sees this as an excellent opportunity for nurses to demonstrate to governments, stakeholders and the public-at-large, that they have tremendous capacity to make a significant contribution to primary health-care renewal and high-quality primary health-care services.
What do you see as your biggest challenge?
I think for all of us working on the CNPI, our biggest challenge is the lack of consistency in provincial and territorial approaches and understanding of NPs and the role that they can play. Our plan is to address this head-on by developing the foundation for a shared national understanding of the NP role in primary health care.
How will you achieve a national approach to the role of the nurse practitioner?
Our focus is on five different strategic areas. The first is Practice and Evaluation, which will describe consistent practice guidelines that can be used by all jurisdictions to integrate NPs into their primary health-care settings. As part of its work, this task force will seek a definition of NPs.
The second activity is focused on the development of mechanisms to promote consistency in the approach to the Legislation and Regulation of NPs across Canada. This includes the development of core competencies, a licensure/ registration examination, and a mechanism to accommodate the licensing/ registration of NPs when moving between Canadian provinces and territories.
Our third focus is on education and agreements around core curriculum for NP education. The Education task force will also make recommendations on delivery methods, prior learning assessment, continuing education, re-entry and strategies to award credits through a prior learning assessment process.
But isn't it true that there aren't nearly enough nurses, let alone nurse practitioners available in Canada to meet the demand?
I agree, but the role of an NP offers another career path for RNs and may serve as a retention strategy for those RNs who want to take on a new role. As well, through our Health Human Resources Planning task force, our fourth strategic focus, we are counting on the CNPI to develop models that provinces and territories need to help plan expectations for future NP requirements in a renewed primary health-care system.
Part of this task force's work will be to develop a national database of educational programs for NPs and enhancements to the national registered nurses database to include data on NPs. This task force will also develop recommendations for increasing the supply of NPs as a national primary healthcare resource.
It seems that nurse practitioners have been talked about for years but there still isn't consensus across the country or among jurisdictions on the role of this important resource. How will the CNPI be different?
You have identified a major challenge for this initiative, and one that the CNPI will address through its task force focused on Change Management, Social Marketing and Strategic Communications.
This part of the initiative, and the fifth strategic focus, will support each of the other areas so that during the course of the project we will foster a collaborative environment in which governments, health professionals, employers and academics work together to integrate NPs into the primary health-care system. You will see much more public awareness and acceptance of the NP as an integral part of the primary health-care team as work in this area continues until March 2006.
For more information about the CNPI:
To learn more about the CNPI's work, visit and bookmark
CNPI Advisory Committee Members
Lucille Auffrey, Chair, Advisory Committee
Canadian Nurses Association
Marian Knock, Executive Director
Canadian Nurse Practitioner Initiative
Theresa Agnew
East End Community Health Centre
Diane Bewick
Canadian Public Health Association
Michel Brazeau
Royal College of Physicians & Surgeons of Canada
Dawn Bruyere
Aboriginal Nurses Association of Canada
Brenda Canitz
Office of Nursing Services, First Nations and Inuit Health Branch
CJ Côté
Canadian Forces Health Services Group Headquarters
Fran Gillingham
Eastern Kings Memorial Community Health Centre
Rosemary Graham
Vancouver Coastal Health Authority
Louise Hagan
Faculté des Sciences infirmières, Université Laval
Donna Hutton
Alberta Association of Registered Nurses
Kathleen MacMillan
Humber Institute of Technology & Advanced Learning
John Maxted
The College of Family Physicians of Canada
Dale Quest
College of Nursing, University of Saskatchewan
Ann Sutherland-Boal
British Columbia Ministry of Health Services, Nursing Directorate
Copyright Canadian Nurses Association Mar 2005