Search

Attempting to support student mental health, many Canadian universities have implemented a fall break with the assumption it would be helpful in alleviating students' stress and anxiety. However, there is no baseline data regarding stress level or mental illness burden of students to understand its effectiveness. Using case study methodology with mixed methods, this research sought to appraise, given a lack of baseline data, the impact of a fall break on student mental health. While the surveys revealed that students overwhelmingly liked the break and perceived it to reduce their school related stress, the focus groups revealed key insights into understanding stress and coping among university students about how students like to de-stress that have practical implications for any policy aimed at promoting students' mental wellness. This research offers practical policy suggestions to help post-secondary institutions determine whether a fall break week can be effective in addressing students' stress and anxiety.

Work-integrated learning (WIL) is an expanding practice in Canadian non-clinical health-related undergraduate programs. WIL participants frequently encounter failure experiences, yet there is limited literature exploring how students overcome failure and how instructors can support this process. This study aimed to understand how students overcome and learn from failure experiences in a non-clinical undergraduate health-related WIL program. Using a constructivist grounded theory approach, in-depth interviews were conducted with 10 previous students from an established WIL program. Iterative cycles of data analysis and constant comparison generated a theoretical explanation highlighting how students overcome failure by renegotiating their expectations through 1) experiencing and managing the wave of emotion, 2) modifying expectations of self and others, 3) redefining success and moving forward, and 4) building flexibility of expectations. This research presents failure as a tool for learning and a steppingstone toward success. Findings inform a pedagogical framework to optimize student learning from failure.

The mental wellness of university students can be critical for their success. In an attempt to minimize stress for students, many universities have implemented a policy for a fall break with limited evidence to support its intended outcomes. This case study offers a critical appraisal of the formation of the fall break policy at one medium sized comprehensive university using qualitative and quantitative forms of evidence triangulated from (1) University Student Union survey, (2) document analysis and; (3) informant interview. The lack of uniformity on how the fall break is labelled, the timing of the break and its evaluation emerged as design flaws in the creation stage that perhaps, could have been mitigated if faculty and student voices were included in policy creation decisions.

Public health responses to the COVID‐19 pandemic, such as business restrictions, social distancing and lockdowns, had social and economic impacts on individuals and communities. Caremongering Facebook groups spread across Canada to support vulnerable individuals by providing a forum for sharing information and offering assistance. We sought to understand the specific impacts of Caremongering groups on individuals 1 year after the pandemic began. We used a convergent parallel mixed‐methods approach that included semi‐structured interviews with group moderators from 16 Caremongering groups and survey data from 165 group members. We used a constant comparative approach for thematic analysis of interview transcripts and open‐ended text responses to the survey. We used source theme tables as joint displays to integrate interview and survey findings. Our results revealed five major themes: providing food, sharing information, supporting health and wellness, acquiring goods and services (non‐food), and connecting communities. Respondents of our survey tended to be 35–65 years of age range, but reported helping adults of all ages. Our findings illustrate the potential of using a social media platform to connect with others and provide and access support. The Caremongering initiative demonstrates a community‐driven, social media solution to issues such as isolation, loneliness and community health promotion. [ABSTRACT FROM AUTHOR]

Work-integrated learning (WIL) is an expanding practice in Canadian non-clinical health-related undergraduate programs. WIL participants frequently encounter failure experiences, yet there is limited literature exploring how students overcome failure and how instructors can support this process. This study aimed to understand how students overcome and learn from failure experiences in a non-clinical undergraduate health-related WIL program. Using a constructivist grounded theory approach, in-depth interviews were conducted with 10 previous students from an established WIL program. Iterative cycles of data analysis and constant comparison generated a theoretical explanation highlighting how students overcome failure by renegotiating their expectations through 1) experiencing and managing the wave of emotion, 2) modifying expectations of self and others, 3) redefining success and moving forward, and 4) building flexibility of expectations. This research presents failure as a tool for learning and a steppingstone toward success. Findings inform a pedagogical framework to optimize student learning from failure. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Antimicrobial stewardship programs (ASPs) have predominately involved infectious diseases physicians and pharmacists with little attention to the nurses. To achieve optimal success of ASPs, engagement of nurses to actively participate in initiatives, strategies, and solutions to combat antibiotic resistance across the health care spectrum is required. In this context, the experiences of local ASP teams engaging nurses in appropriate antimicrobial use were explored to inform future strategies to enhance their involvement in ASPs. [ABSTRACT FROM AUTHOR]

Background: Quality Improvement (QI) approaches are used extensively in healthcare settings and increasingly in public health. However, the proliferation of QI in Canadian public health settings is unknown. Purpose: The purpose of this study was to (a) assess the QI maturity in Ontario local public health units in Canada, and (b) to determine the relevance of the QI Maturity Tool in a Canadian setting Methods: The QI Maturity Tool (Version 5) was used to conduct a cross-sectional assessment of the QI maturity of 36 local public health units in Ontario, Canada. After tool items were reviewed for relevance, individuals most responsible for QI at each health unit were surveyed. Descriptive statistics were used to analyze the data. Results: Thirty-one individuals responded (response rate: 86%). Respondents reported strong leadership support for QI, but limited training and resources available to advance this area. Approximately half of public health units were found to be at the 'beginner' stage of QI maturity; 19% and 26% were in the 'emerging' and 'progressive' stages, respectively. Only 3% were in the 'achieving' stage and none are in the 'excelling' stage. Implications: The QI Maturity Tool is valuable for determining the maturity of QI in Ontario public health settings. There appears to be strong support for advancing QI across local public health in Ontario, but limited infrastructure to enable associated QI activities. [ABSTRACT FROM AUTHOR]

Objective The goal was to explore the perspectives of health care professionals on factors that influence change to policies, protocols and practices in the Neonatal Intensive Care Unit (NICU) with regard to nosocomial infection and chronic lung disease. Study design An exploratory descriptive design using semi-structured individual and focus group interviews was used. Individual interviews ( n = 76) and focus group sessions ( n = 14 with a total of 78 participants) were conducted for a total of 154 health professional participants. Methods Mayring’s qualitative content analysis approach was used to analyse the data. All interviews were audio-taped, transcribed and analysed using inductive reasoning. The data were then organized into categories that reflected emerging themes. Results Seven categories that influenced practice change were derived from the data including staffing issues, consistency in practice, the approval process, a multidisciplinary approach to care, frequency and consistency of communication, rationale for change and the feedback process. These categories were further delineated into three emerging themes related to human resources, organizational structure and communications. Pettigrew’s conceptual framework provided a lens to view the results in relation to the process of change. Conclusions This study has helped to further our understanding of individual and organizational factors that facilitate and hinder changes in clinical practice in the NICU. These factors will be used as a starting point for organizational change to enhance infant outcomes in the NICU. [ABSTRACT FROM AUTHOR]

Background: Clinical guidelines suggest that routine assessment, treatment, and prevention of pain, agitation, and delirium (PAD) is essential to improving patient outcomes as delirium is associated with increased mortality and morbidity. Despite the well-established improvements on patient outcomes, adherence to PAD guidelines is poor in community intensive care units (ICU). This quality improvement (QI) project aims to evaluate the impact of a multifaceted and multidisciplinary intervention on PAD management in a Canadian community ICU and to describe the experience of a Canadian community hospital in conducting a QI project., Methods: A ten-member PAD advisory committee was formed to develop and implement the intervention. The intervention consisted of a multidisciplinary rounds script, poster, interviews, visual reminders, educational modules, pamphlet and video. The 4-week intervention targeted nurses, family members, physicians, and the multidisciplinary team. An uncontrolled, before-and-after study methodology was used. Adherence to PAD assessment guidelines by nurses was measured over a 6-week pre-intervention and over a 6-week post-intervention periods., Results: Data on 430 and 406 patient-days (PD) were available for analysis during the pre- and post- intervention periods, respectively. The intervention did not improve the proportion of PD with guideline compliance to the assessment of pain (23.4% vs. 22.4%, p=0.80), agitation (42.9% vs. 38.9%, p=0.28), nor delirium (35.2% vs. 29.6%, p=0.10) by nurses., Discussion: The implementation of a multifaceted and multidisciplinary intervention on PAD assessment did not result in significant improvements in guideline adherence in a community ICU. Barriers to knowledge translation are apparent at multiple levels including the personal level (low completion rates on educational modules), interventional level (under-collection of data), and organisational level (coinciding with hospital accreditation education). Our next steps include reintroduction of education modules using organisation approved platforms, updating existing ICU policy, updating admission order sets, and conducting audit and feedback., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectives: The purpose of this study was to explore the experiences, beliefs and perceptions of intensive care unit (ICU) nurses on the management of pain, agitation and delirium (PAD) in critically ill patients., Design: A qualitative descriptive study., Setting: This study took place in a community hospital ICU located in a medium size Canadian city., Participants: Purposeful sampling was conducted. Participants included full-time nurses working in the ICU. Forty-six ICU nurses participated., Methods: A total of five focus group sessions were held to collect data. There were one to three separate groups in each focus group session, with no more than seven participants in each group. There were 10 separate groups in total. A semistructured question guide was used. Thematic analysis method was adopted to analyse the data, and to search for emergent themes and patterns., Results: Three main themes emerged: (1) the professional perspectives on patient wakefulness state, (2) the professional perspectives on PAD management of critically ill patients and (3) the factors impacting PAD management. Nurses have different opinions on the optimal level of patient sedation and felt that many factors, including environmental, healthcare teams, patients and family members, can influence PAD management. This potentially leads to inconsistent PAD management in critically ill patients. The nurses also believed that PAD management requires a multidisciplinary approach including healthcare teams and patients' families., Conclusions: Many external and internal factors contribute to the complexity of PAD management including the attitudes of nursing staff towards PAD. The themes emerged from this study suggested the need of a multifaceted and multidisciplinary quality improvement programme to optimise the management of PAD in the ICU., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: No standardised set of quality measures associated with transitioning complex-care patients across the various healthcare settings and home exists. In this context, a structured panel process was used to define quality measures for care transitions involving complex-care patients across healthcare settings., Methods: A modified Delphi consensus technique based on the RAND method was used to develop measures of quality care transitions across the continuum of care. Specific stages included a literature review, individual rating of each measure by each of the panelists (n=11), a face-to-face consensus meeting, and final ranking by the panelists., Results: The literature review produced an initial set of 119 measures. To advance to rounds 1 and 2, an aggregate rating of >75% of the measure was required. This analysis yielded 30/119 measures in round 1 and 11/30 measures in round 2. The final round of scoring yielded the following top five measures: (1) readmission rates within 30 days, (2) primary care visit within 7 days postdischarge for high-risk patients, (3) medication reconciliation completed at admission and prior to discharge, (4) readmission rates within 72 h and (5) time from discharge to homecare nursing visit for high-risk patients., Conclusions: The five measures identified through this research may be useful as indicators of overall care quality related to care transitions involving complex-care patients across different healthcare settings. Further research efforts are called for to explore the applicability and feasibility of using the quality measures to drive quality improvement across the healthcare system.

The Manchester Patient Safety Culture Assessment Tool (MaPSCAT) was used to examine the levels of safety culture maturity in four programs across one large healthcare organization. The MaPSCAT is based on a theoretical framework that was developed in the United Kingdom through extensive literature reviews and expert input. It provides a view of safety culture on 10 dimensions (continuous improvement, priority given to safety, system errors and individual responsibility, recording incidents, evaluating incidents, learning and effecting change, communication, personnel management, staff education and teamwork) at five progressive levels of safety maturity. These levels are pathological ("Why waste our time on safety?"), reactive ("We do something when we have an incident"), bureaucratic ("We have systems in place to manage safety"), proactive ("We are always on alert for risks") and generative ("Risk management is an integral part of everything we do"). This article highlights the use of a new tool, the results of a study completed with this tool and how the results can be used to advance safety culture.

Patient safety has emerged as an important issue in Canadian health care, as reflected in the Canadian Council on Health Services Accreditation's patient/client safety goals. Achieving these goals calls for concerted efforts within health-care organizations. To assist nurse leaders in their efforts in developing a culture of safety that is receptive to reporting and learning from adverse events and near misses, the authors explore the challenges and provide four recommendations for action. By enacting these recommendations, nurse leaders can support the analysis and actions necessary to identify improvements that will create safer health-care environments.