Measuring the PULSE of Nursing: Development of a Dashboard to Evaluate and Monitor Nursing Care Models.

BACKGROUND: Critical nursing shortages have required many health care organizations to restructure nursing care delivery models. At a tertiary health care center, 150 registered practical nurses were integrated into acute inpatient care settings. PROBLEM: A mechanism to continuously monitor the impact of this staffing change was not available. APPROACH: Leveraging current literature and consultation with external peers, metrics were compiled and categorized according to Donabedian's Structure Process Outcome Framework. Consultation with internal subject matter experts determined the final metrics. OUTCOMES: The Patient care, Utility, Logistics, Systemic Evaluation (PULSE) electronic dashboard was developed, capturing metrics from multiple internal databases and presenting real-time composites of validated indicators. CONCLUSION: The PULSE dashboard is a practical means of enabling nursing leadership to evaluate the impact of change and to make evidence-informed decisions about nursing care delivery at our organization.

Examining Workplace Practices Used to Facilitate Successful Integration of Internationally Educated Nurses Into Acute Care Settings: A Scoping Review.

BACKGROUND: Although the recruitment of internationally educated nurses (IENs) seems to be an effective strategy to sustain a diversified nursing workforce, challenges with transition to practice continue to be documented in the literature. Prelicensure bridging programs purport to facilitate practice readiness; however, IENs who complete these programs also experience difficulties. Little is known about tailored workplace-based bridging programs. This scoping review maps out our current understanding of IEN integration and education strategies implemented within acute care settings and identifies areas for further research. METHOD: Arksey and O'Malley's (2005) five-step scoping review was used to explore current literature and highlight gaps based on the needs of IENs during transition into acute care. RESULTS: Two themes were identified: the need for tailored clinical practice bridging programs within acute care settings and the impact of corporate involvement and social structures on IEN integration. CONCLUSION: Inconsistencies in IEN integration practices point to the significance of implementing tailored, workplace-based bridging programs to ensure safe and full scope of practice. [J Contin Educ Nurs. 2024;55(4):195-201.].

Enhancing Nursing Capacity to Provide Patient Care in a Pandemic.

At the onset of the COVID-19 pandemic, an immediate priority for nurse leaders was to develop a care delivery plan to address anticipated surges in patient volumes and potential staff shortages. This article describes actions taken to enhance patient care capacity. Strategies included reviewing the competencies of nurses and other health professionals, mapping out redeployment pathways, preparing nurses and other health professionals for redeployment as needed and creating a collaborative care team model. This article includes an in-depth focus on the design, implementation and outcomes of an innovative role for fourth-year nursing students in the collaborative care team model.

Transitional care post TAVI: A pilot initiative focused on bridging gaps and improving outcomes.

Interventions focused on ensuring safe transitions for patients from hospital to home can assist in providing continuity of care, preventing readmissions, and reducing duplication of services. Patients undergoing a Transcatheter Aortic Valve Implantation (TAVI) procedure are often frail, elderly, and have multiple co-morbidities. A pilot initiative evaluating transitional care strategies through telephone follow up was implemented in a tertiary centre with the aim to identify gaps and intervene, preventing re-admission and improving patient outcomes. TAVI patients or caregivers were contacted at 3 days and 30 days post discharge by an Advanced Practice Nurse (APN). Telephone follow up centered on best practices for transitional care. Outcomes revealed fluid balance monitoring, medication management, and feelings of anxiety and depression post TAVI were the most frequent areas requiring intervention. Findings from this initiative reinforce the need to establish consistent processes that support elderly patient populations during potentially vulnerable points in the care trajectory.

Development of the Champlain primary care cardiovascular disease prevention and management guideline: tailoring evidence to community practice.

PROBLEM ADDRESSED: A well documented gap remains between evidence and practice for clinical practice guidelines in cardiovascular disease (CVD) care. OBJECTIVE OF PROGRAM: As part of the Champlain CVD Prevention Strategy, practitioners in the Champlain District of Ontario launched a large quality-improvement initiative that focused on increasing the uptake in primary care practice settings of clinical guidelines for heart disease, stroke, diabetes, and CVD risk factors. PROGRAM DESCRIPTION: The Champlain Primary Care CVD Prevention and Management Guideline is a desktop resource for primary care clinicians working in the Champlain District. The guideline was developed by more than 45 local experts to summarize the latest evidence-based strategies for CVD prevention and management, as well as to increase awareness of local community-based programs and services. CONCLUSION: Evidence suggests that tailored strategies are important when implementing specific practice guidelines. This article describes the process of creating an integrated clinical guideline for improvement in the delivery of cardiovascular care.