Using Twitter to Engage Nurses in Policy Debate to Inform Health Strategy

Purpose:  Health policy can often be designed with little input from frontline nursing or managerial staff, whose clinical and organisational expertise could add value to the development of national health strategies (Gebbie et al, 2000). The Chief Nursing Officer (CNO) for Scotland used social media as part of a communications plan, to help identify areas of practice that need investment and ensure all nurses can contribute to health policy discussion. This study aims to explore the views of those who participated in a Twitter chat and examine the usefulness of social media to engage nurses in policy debate and future health strategy development.

Methods:  The Twitter chat was advertised using email and social media to recruit participants. It was promoted through health boards, higher education institutes, voluntary organisations and other agencies related to nursing and healthcare and run by the CNO and her team in May 2016 under the hashtag #CNOScot. A series of questions were posed throughout the online chat to generate discussion, which lasted one hour. This study adopted a mixed approach as the views of those who participated in the virtual focus group were explored using the the framework approach to produce a thematic analysis of nursing priority areas identified. Descriptive statistics from an analytics platform were also examined to see how useful social media was in reaching and engaging nurses and others in a health policy discussion. No ethical approval was necessary for this study as Twitter is an open public platform. To protect participant privacy identifying information in tweets was anonymised following best practice (Chretien & Kind, 2013; Eysenbach & Till, 2001).

Results:  Sixty-five people took part in the Twitter chat from a range of nursing and other nursing backgrounds. The debate centred around areas of nursing that need investment in particular technology, nursing research and education were identified as vital to developing in the future. “Agree re IT skills - we need to be intentional around development rather than assume”; “It is in pre reg & then not used post reg. The culture is about audit & not research”. Expanding primary care services were also seen as critical to supporting older adults with complex health and social care needs and people suggested successful pilots of innovative practice currently underway that could be scaled up. “currently working with DN colleagues telehealth project & supporting them with their new clinical skills #CNOScot”. Finally, advanced practice and leadership roles in specialist areas such as mental health and palliative care were discussed as being neccessary to address frailty, cognitive decline and other conditions associated with ageing. “#CNOScot I think further development in MH might be a priority and specialist dementia care too?”. 

Conclusion:  Social media was used to gather a diversity of perspectives on how nursing in Scotland needs to develop and was helpful in informing future health policy developments in this area. However, only a small proportion of practising nurses participated and certain groups such as students and those working in the private sector were missing. A multifaceted communications strategy is needed to reach and engage nurses and other key stakeholder groups such as patients and carers to inform future health policy.