Nursing care for persons with developmental disabilities: Review of literature on barriers and facilitators faced by nurses to provide care.

AIMS: To identify barriers and facilitators to nursing care of individuals with developmental disabilities (DDs). BACKGROUND: Individuals with DDs experience health disparities. Nurses, although well positioned to provide optimal care to this population, face challenges. DESIGN: Narrative review of extant published peer-reviewed literature. DATA SOURCES: Electronic databases, ProQuest and EBSCO, were searched for studies published in English between 2000 and 2019. REVIEW METHODS: Three reviewers reviewed abstracts and completed data extraction. Knowledge synthesis was completed by evaluating the 17 selected studies. RESULTS: Emerging themes were: (1) barriers and challenges to nursing interventions; (2) facilitators to nursing care; and (3) recommendations for nursing education, policy and practice. CONCLUSION: Nursing has the potential to be a key partner in supporting the health of people with DDs. IMPACT: There is a need for specific education and training, so nurses are better equipped to provide care for people with DDs.

Implementation of the National Nursing Quality Report Initiative in Canada: Insights From Pilot Participants.

A qualitative study was undertaken to explore the perceptions and experiences of nurse leaders associated with their participation in the pilot testing of a national nursing database. Interviews with 18 participants were conducted and analyzed using a direct content analysis approach. Three themes emerged including selecting, accessing, and uploading indicators; using indicators and monitoring tools for improvement; and perceiving involvement as a catalyst. Study findings may inform quality improvement efforts in health care organizations.

Measuring outcomes of nursing care, improving the health of Canadians: NNQR (C), C-HOBIC and NQuiRE.

The purpose of this paper is to inform the nursing community of the extraordinary progress that the Canadian National Nursing Quality Report (NNQR(C)), the Canadian Health Outcomes for Better Information and Care (C-HOBIC) and the Nursing Quality Indicators for Reporting and Evaluation (NQuiRE) have made to date, and to share our commitment to continue working together to build a strong nursing profession that, armed with evidence, will contribute to healthier Canadians.

Development and evaluation of an RN/RPN utilization toolkit.

PURPOSE: To develop and evaluate a toolkit for Registered Nurse/Registered Practical Nurse (RN/RPN) staff mix decision-making based on the College of Nurses of Ontario's practice standard for utilization of RNs and RPNs. METHODS: Descriptive exploratory. The toolkit was tested in a sample of 2,069 inpatients on 36 medical/surgical units in five academic and two community acute care hospitals in southern Ontario. Survey and focus group data were used to evaluate the toolkit's psychometric properties, feasibility of use and utility. RESULTS: Results support the validity and reliability of the Patient Care Needs Assessment (PCNA) tool and the consensus-based process for conducting patient care reviews. Review participants valued the consensus approach. There was limited evidence for the validity and utility of the Unit Environmental Profile (UEP) tool. Nursing unit leaders reported confidence in planning unit staff mix ratios based on information generated through application of the toolkit, specifically the PCNA, although they were less clear about how to incorporate environmental data into staff mix decisions. CONCLUSIONS: Results confirm that the toolkit consistently measured the constructs that it was intended to measure and was useful in informing RN/RPN staff mix decision-making. Further refinement and testing of the UEP is required. Future research is needed to evaluate the quality of decisions resulting from the application of the toolkit, illuminate processes for integrating data into decisions and adapt the toolkit for application in other sectors.

Evidence-based research in nursing administration: the time is now.

The paper "Working in Canada or the United States: Perceptions of Canadian Nurses Living in a Border Community" by Cameron, Armstrong-Stassen, Rajacich and Freeman sheds new light on the recruitment and retention factors that influence the reasons nurses select certain work environments. In a border city where Canadian nurses have a choice between working in the United States or Canada, the researchers found that full-time employment was the most important factor attracting nurses to specific institutions, followed by educational opportunities, relationships with physicians and supervisors, and scheduling that is compatible with the nurse's lifestyle. While these employment factors have been identified in the past, the research reminds us of the importance of focusing on the elements that attract nurses to specific healthcare institutions and encourage them to remain, as well as the relative importance of these factors.

Interview with Susan VanDeVelde-Coke.

Susan VanDeVelde-Coke, RN, MA, MBA, PhD, is Executive Vice President, Programs/Chief, Health Professions and Nursing Executive, Sunnybrook Health Sciences Centre, Toronto; former Vice President, Operations, of the Victorian Order of Nurses (VON), Ottawa; and Adjunct Professor at the University of Toronto. In this interview, Dr. Coke reflects on the state of nursing today from the perspective of a senior nurse administrator.

Long-term psychological and occupational effects of providing hospital healthcare during SARS outbreak.

Healthcare workers (HCWs) found the 2003 outbreak of severe acute respiratory syndrome (SARS) to be stressful, but the long-term impact is not known. From 13 to 26 months after the SARS outbreak, 769 HCWs at 9 Toronto hospitals that treated SARS patients and 4 Hamilton hospitals that did not treat SARS patients completed a survey of several adverse outcomes. Toronto HCWs reported significantly higher levels of burnout (p = 0.019), psychological distress (p<0.001), and posttraumatic stress (p<0.001). Toronto workers were more likely to have reduced patient contact and work hours and to report behavioral consequences of stress. Variance in adverse outcomes was explained by a protective effect of the perceived adequacy of training and support and by a provocative effect of maladaptive coping style and other individual factors. The results reinforce the value of effective staff support and training in preparation for future outbreaks.