Abstract
Community health nursing has evolved substantially since the Canadian Community Health Nursing Standards of Practice were last updated in 2019. Increasing health inequities, climate-related health challenges, expanded roles, and greater emphasis on culturally safe, trauma- and violence-informed, anti-racist, and equity-oriented approaches have reshaped how community health nurses support individuals, families, and communities (1–7). The COVID-19 pandemic further accelerated digital and hybrid models of care (8, 9), underscoring the need for updated Standards that reflect current practice realities. This review synthesized recent evidence to guide revisions.
A scoping review was conducted using Arksey and O’Malley’s framework (10) and reported according to PRISMA-ScR (11). Literature from 2019–2024 relevant to public health, home health, and primary care in high-income countries (12) was identified and analyzed. Extracted evidence was charted and mapped to the existing Standards to identify areas requiring revision, clarification, or expansion.
The review revealed marked shifts in community health nursing practice since 2019. Evidence demonstrated increasing integration of equity-oriented, culturally safe, trauma- and violence-informed, and anti-racist approaches, including strengthened responsiveness to Indigenous and racialized communities. Partnership-driven practice, intersectoral collaboration, and community engagement were consistently identified as foundational to effective community health nursing. Digital, virtual, and hybrid care modalities have become routine elements of practice. Notable gaps remained in applying social determinants of health, sustaining policy advocacy, and systematically evaluating community- and population-level impact.
Findings are informing the ongoing revision of the national Community Health Nursing Standards of Practice by identifying emerging expectations, shifts in practice, and areas requiring clearer articulation. The updated Standards are expected to place greater emphasis on equity-oriented practice, collaborative partnerships, system-level engagement, and evidence-informed public health approaches. These anticipated enhancements aim to support community health nurses in delivering responsive, socially accountable, and future-oriented care aligned with the SDGs and the evolving needs of diverse communities.
Notes
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References:
1. Wathen CN, Varcoe, C. M. Trauma- and violence-informed care and provider well-being. EQUIP Healthcare and GTV Incubator; 2023. Available from: https://gtvincubator.uwo.ca/resources/ and https://equiphealthcare.ca/resources/trauma-and-violence-informed-care/
2. Indigenous Services Canada. An update on the socio-economic gaps between Indigenous Peoples and the non-Indigenous population in Canada: Highlights from the 2021 Census [Internet]. Ottawa (ON): Indigenous Services Canada; 2023 [cited 2025 Nov 30]. Available from: https://www.sac-isc.gc.ca/eng/1690909773300/1690909797208
3. Canadian Association of Schools of Nursing. Framework of strategies for nursing education to respond to the Calls to Action of Canada’s Truth and Reconciliation Commission [Internet]. Ottawa (ON): Canadian Association of Schools of Nursing; 2020 [cited 2025 Nov 30]. Available from: https://www.casn.ca/2020/11/framework-of-strategies-for-nursing-education-to-respond-to-the-calls-to-action-of-canadas-truth-and-reconciliation-commission/
4. World Health Organization. World report on social determinants of health equity [Internet]. Geneva: World Health Organization; 2025 [cited 2025 Nov 30]. Available from: https://www.who.int/teams/social-determinants-of-health/equity-and-health/world-report-on-social-determinants-of-health-equity
5. Health Canada. Health of Canadians in a changing climate: advancing our knowledge for action [Internet]. Ottawa (ON): Government of Canada; 2022 [cited 2025 Nov 30]. Available from: https://publications.gc.ca/collections/collection_2022/sc-hc/H129-121-2022-eng.pdf
6. Public Health Agency of Canada. Report on the state of public health in Canada 2022: mobilizing public health action for healthier populations [Internet]. Ottawa (ON): Public Health Agency of Canada; 2022 [cited 2025 Nov 30]. Available from: https://www.canada.ca/en/public-health/corporate/publications/chief-public-health-officer-reports-state-public-health-canada/state-public-health-canada-2022.html
7. Public Health Agency of Canada. Report on the state of public health in Canada 2023: creating the conditions for resilient communities [Internet]. Ottawa (ON): Public Health Agency of Canada; 2023 [cited 2025 Nov 30]. Available from: https://www.canada.ca/en/public-health/corporate/publications/chief-public-health-officer-reports-state-public-health-canada/state-public-health-canada-2023.html
8. Canada Health Infoway. 2020 national survey of Canadian nurses: use of digital health technology in practice [Internet]. Toronto (ON): Canada Health Infoway; 2020 [cited 2025 Nov 30]. Available from: https://www.infoway-inforoute.ca/en/component/edocman/3812-2020-national-survey-of-canadian-nurses-use-of-digital-health-technology-in-practice/view-document?Itemid=0
9. Public Health Agency of Canada. COVID-19 response: lessons learned summary [Internet]. Ottawa (ON): Public Health Agency of Canada; 2023 [cited 2025 Nov 30]. Available from: https://www.canada.ca/en/public-health/corporate/transparency/corporate-management-reporting/evaluation/covid-19-response-lessons-learned-summary.html
10. Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19–32. doi:10.1080/1364557032000119616.
Sigma Membership
Alpha Beta Sigma at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Public and Community Health, Primary Care, Policy and Advocacy, Community Health Nursing, Nursing Practice, Practice Guidelines, Practice Guidelines--Canada
Recommended Citation
MacNevin, Shannan; Schofield, Ruth; Fseifes, Manal; and Etowa, Josephine B., "Strengthening Community Health Nursing: A Scoping Review to Update National Practice Standards" (2026). International Nursing Research Congress (INRC). 262.
https://www.sigmarepository.org/inrc/2026/presentations_2026/262
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-08-31
Strengthening Community Health Nursing: A Scoping Review to Update National Practice Standards
Toronto, Ontario, Canada
Community health nursing has evolved substantially since the Canadian Community Health Nursing Standards of Practice were last updated in 2019. Increasing health inequities, climate-related health challenges, expanded roles, and greater emphasis on culturally safe, trauma- and violence-informed, anti-racist, and equity-oriented approaches have reshaped how community health nurses support individuals, families, and communities (1–7). The COVID-19 pandemic further accelerated digital and hybrid models of care (8, 9), underscoring the need for updated Standards that reflect current practice realities. This review synthesized recent evidence to guide revisions.
A scoping review was conducted using Arksey and O’Malley’s framework (10) and reported according to PRISMA-ScR (11). Literature from 2019–2024 relevant to public health, home health, and primary care in high-income countries (12) was identified and analyzed. Extracted evidence was charted and mapped to the existing Standards to identify areas requiring revision, clarification, or expansion.
The review revealed marked shifts in community health nursing practice since 2019. Evidence demonstrated increasing integration of equity-oriented, culturally safe, trauma- and violence-informed, and anti-racist approaches, including strengthened responsiveness to Indigenous and racialized communities. Partnership-driven practice, intersectoral collaboration, and community engagement were consistently identified as foundational to effective community health nursing. Digital, virtual, and hybrid care modalities have become routine elements of practice. Notable gaps remained in applying social determinants of health, sustaining policy advocacy, and systematically evaluating community- and population-level impact.
Findings are informing the ongoing revision of the national Community Health Nursing Standards of Practice by identifying emerging expectations, shifts in practice, and areas requiring clearer articulation. The updated Standards are expected to place greater emphasis on equity-oriented practice, collaborative partnerships, system-level engagement, and evidence-informed public health approaches. These anticipated enhancements aim to support community health nurses in delivering responsive, socially accountable, and future-oriented care aligned with the SDGs and the evolving needs of diverse communities.
Description
This scoping review synthesized evidence from 2019 to 2024 to guide updates to the Canadian Community Health Nursing Standards of Practice. Participants will gain insight into emerging equity-focused, culturally safe, trauma- and violence-informed, anti-racist, and digital approaches reshaping community health nursing, and learn how updating the Standards can strengthen leadership, policy influence, and socially accountable practice.