The Role of Interpersonal Relations in Healthcare Team Communication and Patient Safety: A Proposed Model of Interpersonal Process in Teamwork.

Patient safety is compromised by medical errors and adverse events related to miscommunications among healthcare providers. Communication among healthcare providers is affected by human factors, such as interpersonal relations. Yet, discussions of interpersonal relations and communication are lacking in healthcare team literature.

Examining the relationship between therapeutic self-care and adverse events for home care clients in Ontario, Canada: a retrospective cohort study.

Background: In an era of a rapidly aging population who requires home care services, clients must possess or develop therapeutic self-care ability in order to manage their health conditions safely in their homes. Therapeutic self-care is the ability to take medications as prescribed and to recognize and manage symptoms that may be experienced, such as pain. The purpose of this research study was to investigate whether therapeutic self-care ability explained variation in the frequency and types of adverse events experienced by home care clients.

Perceived quality of interprofessional interactions between physicians and nurses in oncology outpatient clinics.

Purpose: To evaluate the perceived quality of interactions between nurses and physicians in oncology outpatient clinics.

Methods: A cross-sectional, observational survey involving 250 physicians and nurses was conducted at oncology outpatient clinics at two regional cancer centres in the province of Ontario, Canada. Eligible participants were identified by administrators and invited to complete a one-time survey questionnaire.

Using integrated bio-physiotherapy informatics in home health-care settings: A qualitative analysis of a point-of-care decision support system.

The growing need to gain efficiencies within a home care setting has prompted home care practitioners to focus on health informatics to address the needs of an aging clientele. The remote and heterogeneous nature of the home care environment necessitates the use of non-intrusive client monitoring and a portable, point-of-care graphical user interface. Using a grounded theory approach, this article examines the simulated use of a graphical user interface by practitioners in a home care setting to explore the salient features of monitoring the activity of home care clients.

Identification of serious and reportable events in home care: a Delphi survey to develop consensus.

Objective: To assess which client events should be considered reportable and preventable in home care (HC) settings in the opinion of HC safety experts.

Background: Patient safety in acute care settings has been well documented; however, there are limited data about this issue in HC. While many organizations collect information about 'incidents', there are no standards for reporting and it is challenging to compare incident rates among organizations.

Adverse events among Ontario home care clients associated with emergency room visit or hospitalization: a retrospective cohort study.

Background: Home care (HC) is a critical component of the ongoing restructuring of healthcare in Canada. It impacts three dimensions of healthcare delivery: primary healthcare, chronic disease management, and aging at home strategies. The purpose of our study is to investigate a significant safety dimension of HC, the occurrence of adverse events and their related outcomes.

A formative evaluation of nurses' use of electronic devices in a home care setting.

The purpose of this study was to evaluate the implementation of a clinical information system (CIS) in a community setting. The researchers used a mixed-method design involving interviews, focus groups, and surveys. An independent cross-sectional sample of nurses was surveyed.

Usability evaluation: results from "Evaluation of mobile information technology to improve nurses' access to and use of research evidence".

Usability evaluations are necessary to determine the feasibility of nurses' interactions with computerized clinical decision-support systems. Limitations and challenges of operations that inhibit or facilitate utilization in clinical practice can be identified. This study provided nurses with mobile information terminals, PDAs and tablet PCs, to improve point-of-care access to information.

Examining nursing vital signs documentation workflow: barriers and opportunities in general internal medicine units.

Aims: To characterise the nursing practices of vital signs collection and documentation in a general internal medicine environment to inform strategies for improving workflow design.

Background: Clinical workflow analysis is critical to identify barriers and opportunities in current processes. Analysis can guide the design and development of novel technological solutions to produce greater efficiencies and effectiveness in healthcare delivery.

Recognizing and responding to uncertainty: a grounded theory of nurses' uncertainty.

Background: There has been little research to date exploring nurses' uncertainty in their practice. Understanding nurses' uncertainty is important because it has potential implications for how care is delivered.

Purpose: The purpose of this study is to develop a substantive theory to explain how staff nurses experience and respond to uncertainty in their practice.

Antecedents and consequences of intra-group conflict among nurses.

Aim: To test a theoretical model linking selected antecedent variables to intra-group conflict among nurses, and subsequently conflict management style, job stress and job satisfaction.

Background: A contributing factor to the nursing shortage is job dissatisfaction as a result of conflict among nurses. To develop strategies to reduce conflict, research is needed to understand the causes and outcomes of conflict in nursing work environments.

Hypoxia activates constitutive luciferase reporter constructs.

Hypoxia has been identified as a contributing factor in the pathophysiology of several diseases and oxygen regulation is important during stem cell development, particularly in early embryogenesis. One aspect that has emerged is the role of hypoxia-inducible factors, or HIFs in regulating the effect of hypoxia. Studies in our laboratory sought to examine the hypoxic regulation of HIF activity in placental trophoblast cells, through the use of dual-reporter luciferase assays.

Supportive decision making at the point of care: refinement of a case-based reasoning application for use in nursing practice.

Variations in nursing care have been observed, affecting patient outcomes and quality of care. Case-based reasoners that benchmark for patient indicators can reduce variation through decision support. This study evaluated and validated a case-based reasoning application to establish benchmarks for nursing-sensitive patient outcomes of pain, fatigue, and toilet use, using patient characteristic variables for generating similar cases.

Supporting evidence-based practice for nurses through information technologies.

Purpose: To evaluate the usability of mobile information terminals, such as personal digital assistants (PDAs) or Tablet personal computers, to improve access to information resources for nurses and to explore the relationship between PDA or Tablet-supported information resources and outcomes.

Background: The authors evaluated an initiative of the Nursing Secretariat, Ontario Ministry of Health and Long-Term Care, which provided nurses with PDAs and Tablet PCs, to enable Internet access to information resources. Nurses had access to drug and medical reference information, best practice guidelines (BPGs), and to abstracts of recent research studies.

Identification of safety outcomes for Canadian home care clients: evidence from the resident assessment instrument--home care reporting system concerning emergency room visits.

Problems of patient safety have been well documented in hospitals. However, we have very limited data about patient safety problems among home care clients. The purpose of this study was to assess the burden of safety problems among Canadian home care clients using data collected through the Resident Assessment Instrument - Home Care (RAI HC), and to explore the role of age and patient safety risk factors in explaining variations in adverse outcomes, with a particular focus on emergency room visits.

The nature of safety problems among Canadian homecare clients: evidence from the RAI-HC reporting system.

Aim(s): The purpose of this study was to identify the nature of patient safety problems among Canadian homecare (HC) clients, using data collected through the RAI-HC((c)) assessment instrument.

Background: Problems of patient safety have been well documented in hospitals. However, we have very limited data about patient safety problems among HC clients.

Nurses' uncertainty in decision-making: a literature review.

Aim: This paper is a report of the results of a review of the literature conducted with the goal of determining how nurses' clinical uncertainty has been conceptualized in the nursing literature.

Background: Although existing research has advanced the body of knowledge regarding the concept of uncertainty in decision-making, this has been largely from physicians' viewpoints and from patients' perspectives (patients' uncertainty). Understanding how nurses' experience and act on uncertainty remains relatively unreported.

Evidence in the palm of your hand: development of an outcomes-focused knowledge translation intervention.

Aim: The aim of the project was to develop an electronic information gathering and dissemination system to support both nursing-sensitive outcomes data collection and evidence-based decision-making at the point-of-patient care.

Background: With the current explosion of health-related knowledge, it is a challenge for nurses to regularly access information that is most current. The Internet provides timely access to health information, however, nurses do not readily use the Internet to access practice information because of being task-driven and coping with heavy workloads.

Outcomes-focused knowledge translation: a framework for knowledge translation and patient outcomes improvement.

Background: Regularly accessing information that is current and reliable continues to be a challenge for front-line staff nurses. Reconceptualizing how nurses access information and designing appropriate decision support systems to facilitate timely access to information may be important for increasing research utilization.

Description Of Strategy: An outcomes-focused knowledge translation framework was developed to guide the continuous improvement of patient care through the uptake of research evidence and feedback data about patient outcomes.

Impact of hospital nursing care on 30-day mortality for acute medical patients.

Aim: This paper reports on structures and processes of hospital care influencing 30-day mortality for acute medical patients.

Background: Wide variation in risk-adjusted 30-day hospital mortality rates for acute medical patients indicates that hospital structures and processes of care affect patient death. Because nurses provide the majority of care to hospitalized patients, we propose that structures and processes of nursing care have an impact on patient death or survival.

Nursing-sensitive outcomes data collection in acute care and long-term-care settings.

Background: Most administrative databases do not contain good information about nursing-sensitive outcomes.

Objectives: To determine (a) the reliability of the instruments measuring nursing-sensitive outcomes, (b) whether the outcome measures are sensitive to changes in patients' health, and (c) whether the outcome measures are associated with nursing interventions.

Methods: The sample consisted of 890 patients from acute care hospitals and long-term-care facilities.

Measurement of nurse job satisfaction using the McCloskey/Mueller Satisfaction Scale.

Background: Originally developed to rank rewards that nurses value and that encourage them to remain in their jobs, the McCloskey/Mueller Satisfaction Scale (MMSS) is being used extensively in research and practice to measure nurse job satisfaction. Since its original development in 1990, limited evidence of psychometric properties of the MMSS has been reported.

Objective: To investigate and report the psychometric properties of the MMSS when used in 2003 to measure hospital nurse job satisfaction.

A theory-driven approach to evaluating quality of nursing care.

Purpose: To review the propositions of a theory-driven approach and to discuss its application to evaluating the quality of nursing care.

Organizing Framework: The focus in the theory-driven approach to evaluation is on identifying patient, professional, and setting characteristics that affect the processes of care at micro and meso levels, which in turn contribute to outcome achievement. Implications for examining the interrelationships among characteristics, processes, and outcomes are discussed and illustrated with examples from published research.

Nurses' integration of outcomes assessment data into practice.

The purpose of this article is to provide initial insight from rational and phenomenologic theoretical perspectives into how nurses integrate baseline and follow-up outcomes assessment data into practice to inform their clinical decision-making. Preliminary findings from 29 nurse interviews indicate that some nurses use outcomes assessment data for evaluating their interventions and for decisions concerning initial and/or discharge planning. Nurses' perceived usefulness of outcomes data was based on task complexity and nurses' level of expertise.

Western lowland gorilla diet and resource availability: new evidence, cross-site comparisons, and reflections on indirect sampling methods.

We describe the resource availability and diet of western lowland gorillas (Gorilla gorilla gorilla) from a new study site in the Central African Republic and Republic of Congo based on 3 years of study. The results, based on 715 fecal samples and 617 days of feeding trails, were similar to those reported from three other sites, in spite of differences in herb and fruit availability. Staple foods (consumed year-round) included high-quality herbs (Haumania), swamp herbs (when present), and a minimal diversity of fruit.