The Development of an Intradisciplinary Staff Training Intervention on the Optimal Management of Behavioural and Psychological Symptoms of Dementia: A Qualitative Study.

Introduction: Behavioural and psychological symptoms of dementia (BPSDs) are a group of highly prevalent symptoms in residents with a neurocognitive disorder, including agitation and depressive symptoms. Caregiving staff often mention knowledge and skills deficits regarding optimal BPSD management. While several staff training on BPSDs management exist internationally, their transferability to other clinical contexts is limited, owing to methodological challenges.

The External Validation of the Nursing Homes Short Depression Inventory in Older Adults with Major Neurocognitive Disorders in Long-Term Care Centers.

Introduction: Depression is often difficult to detect in long-term care (LTC) patients with major neurocognitive disorders (MNCD), and an observer-rated screening scale could facilitate assessments. This study aimed to establish the external validity and reliability of the Nursing Homes Short Depression Inventory (NH-SDI) in LTC patients with MNCD and to compare its estimates to the Cornell Scale for Depression in Dementia (CSDD), the most used scale for depression in MNCD.

Methods: A focus discussion group of experts assessed the content validity of the NH-SDI.

Development and Validation Process of the Intensive Care Unit Omitted Nursing Care (ICU-ONC) Instrument Among French Canadian Nurses.

The purpose of this article is to document the development and validation process of an instrument adapted for French-speaking nurses and to measure the occurrence of omitted nursing care (ONC) in the intensive care unit (ICU). An electronic Delphi panel, involving ICU nursing experts from the province of Quebec (Canada), was used to develop the intensive care unit omitted nursing care (ICU-ONC) instrument. For the validation process, an electronic cross-sectional survey was conducted.

Staff Training Interventions to Prevent or Reduce Behavioural and Psychological Symptoms of Dementia in Nursing Home Residents: A Mixed Methods Systematic Review.

Introduction: Nursing home (NH) staff mention knowledge deficits regarding the management of behavioural and psychological symptoms of dementia (BPSDs) in residents with neurocognitive disorders (NCDs). Staff training therefore appears to be necessary. However, existing evidence on best training practices and their outcomes remains scattered.

Accuracy of Observer-Rated Measurement Scales for Depression Assessment in Patients with Major Neurocognitive Disorders Residing in Long-Term Care Centers: A Systematic Review.

Introduction: Depression is often under-detected in long-term care (LTC) patients with major neurocognitive disorders (MNCD) and is associated with important morbidity, mortality, and costs. Observer-rated outcome measures (ObsROMs) could help resolve this problematic; however, evidence on their accuracy is scattered in the literature. This systematic review aimed at summarizing this evidence.

Adapting the Healthy Work Environment Assessment Tool for French-Canadian Intensive Care Nurses.

Background: Self-administered instruments are used to measure components of work environments that cannot be measured directly. The Healthy Work Environment Assessment Tool (HWEAT) of the American Association of Critical-Care Nurses is a promising instrument. However, it is available only in English and Japanese, precluding its use in other populations and cross-national comparisons.

The characteristics and factors associated with omitted nursing care in the intensive care unit: A cross-sectional study.

Introduction: Prior research showed that work environment features in acute care settings influence nurses' capacity to provide care and impacts patient outcomes (e.g., falls).

Nurse Staffing Practices and Postoperative Atrial Fibrillation Among Cardiac Surgery Patients: A Multisite Cohort Study.

Background: Postoperative atrial fibrillation (POAF) is a frequent complication of cardiac surgery that is associated with increased morbidity, mortality, and costs. Recent studies suggest that nurse staffing practices are associated with adverse postoperative events, but whether these practices are also related to POAF occurrence is unknown.

Methods: To fill this knowledge gap, a cohort of 6401 cardiac surgery patients admitted to 2 Canadian university health centres (UHC A and UHC B) between 2014 and 2018 was studied.

Effects of Telerehabilitation on Patient Adherence to a Rehabilitation Plan: Protocol for a Mixed Methods Trial.

Background: Strong evidence supports beginning stroke rehabilitation as soon as the patient's medical status has stabilized and continuing following discharge from acute care. However, adherence to rehabilitation treatments over the rehabilitation phase has been shown to be suboptimal.

Objective: The aim of this study is to assess the impact of a telerehabilitation platform on stroke patients' adherence to a rehabilitation plan and on their level of reintegration into normal social activities, in comparison with usual care.

Nurse staffing practices and adverse events in acute care hospitals: The research protocol of a multisite patient-level longitudinal study.

Aims: We describe an innovative research protocol to: (a) examine patient-level longitudinal associations between nurse staffing practices and the risk of adverse events in acute care hospitals and; (b) determine possible thresholds for safe nurse staffing.

Design: A dynamic cohort of adult medical, surgical and intensive care unit patients admitted to 16 hospitals in Quebec (Canada) between January 2015-December 2019.

Methods: Patients in the cohort will be followed from admission until 30-day postdischarge to assess exposure to selected nurse staffing practices in relation to the subsequent occurrence of adverse events.

Interventions to prevent or reduce rationing or missed nursing care: A scoping review.

Aims: To collate and synthesize published research on interventions developed and tested to prevent or reduce the rates of rationed or missed nursing care in healthcare institutions.

Background: Rationed and missed nursing care has been widely studied, including its predictors and associations with patient and nurse outcomes.

Design: Scoping review.

Associations of 4 Nurse Staffing Practices With Hospital Mortality.

Background: Cross-sectional studies of hospital-level administrative data have suggested that 4 nurse staffing practices-using adequate staffing levels, higher proportions of registered nurses (RNs) (skill mix), and more educated and experienced RNs-are each associated with reduced hospital mortality. To increase the validity of this evidence, patient-level longitudinal studies assessing the simultaneous associations of these staffing practices with mortality are required.

Methods: A dynamic cohort of 146,349 adult medical, surgical, and intensive care patients admitted to a Canadian University Health Center was followed for 7 years (2010-2017).

Validation of an algorithm based on administrative data to detect new onset of atrial fibrillation after cardiac surgery.

Introduction: Postoperative atrial fibrillation (POAF) is a frequent complication of cardiac surgery associated with important morbidity, mortality, and costs. To assess the effectiveness of preventive interventions, an important prerequisite is to have access to accurate measures of POAF incidence. The aim of this study was to develop and validate such a measure.

Conceptual and methodological challenges of studies examining the determinants and outcomes of omitted nursing care: A narrative review of the literature.

Background: Over the past two decades, several studies have examined the determinants and outcomes of omitted nursing care in hospitals and other settings. These studies have raised several challenges associated with the definition and measurement of this phenomenon which must be addressed to move the field forward. However, these challenges remain scattered throughout the literature.

Are hospital nurse staffing practices associated with postoperative cardiac events and death? A systematic review.

Introduction: Postoperative cardiac events are frequent complications of surgery, and their occurrence could be associated with suboptimal nurse staffing practices, but the existing evidence remains scattered. We systematically reviewed studies linking nurse staffing practices to postoperative cardiac events and two related outcomes, all-cause mortality and failure-to-rescue.

Methods: A systematic search of the English/French literature was undertaken in the CINAHL, PsychInfo, and Medline databases.

Development of a New Comorbidity Assessment Tool for Specific Prediction of Perioperative Mortality in Contemporary Patients Treated with Radical Cystectomy.

Purpose: The Deyo adaptation of the Charlson comorbidity index (DaCCI), which relies on 17 comorbid condition groupings defined with 200 ICD-9-CM diagnostic codes, lacks specificity in the context of radical cystectomy (RC) for bladder cancer (BCa). We attempted to develop a new comorbidity assessment tool based on individual comorbid conditions and/or BCa manifestations for specific prediction of perioperative mortality after RC.

Methods: We relied on 7076 T1-T4 nonmetastatic BCa patients treated with RC between 2000 and 2009 in the SEER-Medicare linked database.

Discursive practice - lean thinking, nurses' responsibilities and the cost to care.

Purpose: The purpose of this paper is to explore the literature regarding work intensification that is being experienced by nurses, to examine the effects this is having on their capacity to complete care. The authors contend that nurses' inability to provide all the care patients require, has negative implications on their professional responsibility.

Design/methodology/approach: The authors used institutional ethnography to review the discourse in the literature.

Associations between nurse education and experience and the risk of mortality and adverse events in acute care hospitals: A systematic review of observational studies.

Objectives: To provide knowledge from the summarization of the evidence on the: a) associations between nurse education and experience and the occurrence of mortality and adverse events in acute care hospitals, and; b) benefits to patients and organizations of the recent Institute of Medicine's recommendation that 80% of registered nurses should be educated at the baccalaureate degree by 2020.

Data Sources: A systematic search of English and French literature was conducted in six electronic databases: 1) Medline, 2) PubMed, 3) CINAHL, 4) Scopus, 5) Campbell, and 6) Cochrane databases. Additional studies were identified by searching bibliographies, prior reviews, and by contacting authors.

Hospital readmissions and the day of the week.

Objectives Patients discharged from hospitals on a Friday (Friday discharges) are readmitted sooner (a shorter time-to-emergency-readmission) than those discharged on any other day of the week. To evaluate the cost-effectiveness of increasing weekend capacity, the effect estimate of Friday discharge on time-to-emergency-readmission needs to be precise. However, precise effect estimation is complicated by the confounding effect of differing healthcare-seeking behaviour and admission practices, and therefore different admission probability, by day of the week.

Accuracy and generalizability of using automated methods for identifying adverse events from electronic health record data: a validation study protocol.

Background: Adverse events (AEs) in acute care hospitals are frequent and associated with significant morbidity, mortality, and costs. Measuring AEs is necessary for quality improvement and benchmarking purposes, but current detection methods lack in accuracy, efficiency, and generalizability. The growing availability of electronic health records (EHR) and the development of natural language processing techniques for encoding narrative data offer an opportunity to develop potentially better methods.

Rationing of nursing care interventions and its association with nurse-reported outcomes in the neonatal intensive care unit: a cross-sectional survey.

Background: Evidence internationally suggests that staffing constraints and non-supportive work environments result in the rationing of nursing interventions (that is, limiting or omitting interventions for particular patients), which in turn may influence patient outcomes. In the neonatal intensive care unit (NICU), preliminary studies have found that discharge preparation and infant comfort care are among the most frequently rationed nursing interventions. However, it is unknown if the rationing of discharge preparation is related to lower perceptions of parent and infant readiness for NICU discharge, and if reports of increased rationing of infant comfort care are related to lower levels of perceived neonatal pain control.

Improving patient safety by optimizing the use of nursing human resources.

Background: Recent ecological studies have suggested that inadequate nurse staffing may contribute to the incidence of adverse events in acute care hospitals. However, longitudinal studies are needed to further examine these associations and to identify the staffing patterns that are of greatest risk. The aims of this study are to determine if (a) nurse staffing levels are associated with an increased risk of adverse events, (b) the risk of adverse events in relationship to nurse staffing levels is modified by the complexity of patient requirements, and (c) optimal nurse staffing levels can be established.

Automated Extraction of VTE Events From Narrative Radiology Reports in Electronic Health Records: A Validation Study.

Background: Surveillance of venous thromboembolisms (VTEs) is necessary for improving patient safety in acute care hospitals, but current detection methods are inaccurate and inefficient. With the growing availability of clinical narratives in an electronic format, automated surveillance using natural language processing (NLP) techniques may represent a better method.

Objective: We assessed the accuracy of using symbolic NLP for identifying the 2 clinical manifestations of VTE, deep vein thrombosis (DVT) and pulmonary embolism (PE), from narrative radiology reports.

Challenges to the implementation of a nationwide electronic prescribing network in primary care: a qualitative study of users' perceptions.

Background And Objective: The objective of this study was to identify physicians' and pharmacists' perceptions of the challenges and benefits to implementing a nationwide electronic prescribing network linking medical clinics and community pharmacies in Quebec, Canada.

Methods: Forty-nine people (12 general practitioners, 2 managers, 33 community pharmacists, and 2 pharmacy staff members) from 40 points of care (10 primary care clinics (42% of all the connected sites) and 30 community pharmacies (44%)) were interviewed in 2013. Verbatim transcripts were analyzed using thematic analysis.