Developing a tool to measure enactment of complex quality improvement interventions in healthcare.

Quality improvement (QI) projects are common in healthcare settings and often involve interdisciplinary teams working together towards a common goal. Many interventions and programmes have been introduced through research to convey QI skills and knowledge to healthcare workers, however, a few studies have attempted to differentiate between what individuals 'learn' or 'know' versus their capacity to apply their learnings in complex healthcare settings. Understanding and differentiating between delivery, receipt, and enactment of QI skills and knowledge is important because while enactment alone does not guarantee desired QI outcomes, it might be reasonably assumed that 'better enactment' is likely to lead to better outcomes.

Healthcare aide-focused interventions to improve pain management in long-term care homes: A systematic review.

Objectives: Pain is common in long-term care residents. We examined the effectiveness of interventions involving healthcare aides that aim to manage pain for these residents.

Design: A systematic review which follows PRISMA reporting guidelines.

Management of Chronic Pain in Long-Term Care: A Systematic Review and Meta-Analysis.

Objectives: Pain, a complex subjective experience, is common in care home residents. Despite advances in pain management, optimal pain control remains a challenge. In this updated systematic review, we examined effectiveness of interventions for treating chronic pain in care home residents.

Pain Assessment for Nursing Home Residents: A Systematic Review Protocol.

Background: The burden of pain in nursing homes is substantial; however, pain assessment for both acute and chronic conditions remains inadequate, resulting in inappropriate or inadequate treatment. Complexities in assessing resident pain have been attributed to factors (barriers and facilitators) arising at the resident, healthcare provider, and healthcare system levels.

Objectives: In this systematic review protocol, we identify our research approach that will be used to critically appraise and synthesize data in order to assess barriers and facilitators to pain assessment in nursing home residents aged ≥65 years.

Factors Associated With Pain Assessment for Nursing Home Residents: A Systematic Review and Meta-Synthesis.

Objectives: The burden of pain in nursing home residents is substantial; unfortunately, many times it goes undiagnosed and is inadequately treated. To improve identification of pain in this population, we aimed to review and synthesize findings from qualitative studies that report primary barriers and facilitators to pain assessment in nursing home residents.

Design: This is a Cochrane-style systematic review and narrative synthesis of qualitative evidence adhering to PRISMA guidelines.

Nursing Home Length of Stay in 3 Canadian Health Regions: Temporal Trends, Jurisdictional Differences, and Associated Factors.

Objectives: To assess (1) temporal changes (2008-2015) in nursing home (NH) length of stay (LoS) in 3 Canadian health jurisdictions (Edmonton, Calgary, Winnipeg), (2) resident admission characteristics associated with LoS, and (3) temporal changes of admission characteristics in each of the 3 jurisdictions.

Design: Retrospective cohort study using data previously collected in Translating Research in Elder Care (TREC), a longitudinal program of applied health services research in Canadian NHs.

Setting And Participants: 7817 residents admitted between January 2008 and December 2015 to a stable cohort of 18 NHs that have consistently participated in TREC since 2007.

Inhaled magnesium sulfate in the treatment of acute asthma.

Background: Asthma exacerbations can be frequent and range in severity from mild to life-threatening. The use of magnesium sulfate (MgSO₄) is one of numerous treatment options available during acute exacerbations. While the efficacy of intravenous MgSO₄ has been demonstrated, the role of inhaled MgSO₄ is less clear.

Health of health care workers in Canadian nursing homes and pediatric hospitals: a cross-sectional study.

Background: Poor health of health care workers affects quality of care, but research and health data for health care workers are scarce. Our aim was to compare physical/mental health among health care worker groups 1) within nursing homes and pediatric hospitals, 2) between the 2 settings and 3) with the physical/mental health of the Canadian population.

Methods: Using cross-sectional data collected as part of the Translating Research in Elder Care program and the Translating Research on Pain in Children program, we examined the health of health care workers.

Interventions for the Treatment of Pain in Nursing Home Residents: A Systematic Review and Meta-Analysis.

Background: More than one-half of nursing home residents experience a complex mix of pain. Despite this, assessment and treatment of pain remain inadequate.

Methods: Using techniques of the Cochrane Collaboration and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we assessed efficacy of interventions aimed at reducing chronic pain in nursing home residents >65 years of age.

Making Research Results Relevant and Useable: Presenting Complex Organizational Context Data to Nonresearch Stakeholders in the Nursing Home Setting.

Background: The success of evidence-based practice depends on clearly and effectively communicating often complex data to stakeholders. In our program of research, Translating Research in Elder Care (TREC), we focus on improving the quality and safety of care delivered to nursing home residents in western Canada. More specifically, we investigate associations among organizational context, the use of best practices and resident outcomes.

Impact of Symptoms and Care Practices on Nursing Home Residents at the End of Life: A Rating by Front-line Care Providers.

Objectives: Burdensome symptoms and potentially inappropriate care practices are common at the end of life for nursing home residents. Appropriately managing symptoms and limiting aggressive care practices is key to high-quality end-of-life care. Little research is available, however, on the opinions of nursing home care providers about the impact of symptoms and practices for both residents and care facilities.

Factors associated with rushed and missed resident care in western Canadian nursing homes: a cross-sectional survey of health care aides.

Aims And Objectives: To describe the nature, frequency and factors associated with care that was rushed or missed by health care aides in western Canadian nursing homes.

Background: The growing number of nursing home residents with dementia has created job strain for frontline health care providers, the majority of whom are health care aides. Due to the associated complexity of care, health care aides are challenged to complete more care tasks in less time.

Physical trauma and risk of multiple sclerosis: a systematic review and meta-analysis of observational studies.

Background: We aimed to examine physical trauma as a risk factor for the subsequent diagnosis of MS.

Methods: We searched for observational studies that evaluated the risk for developing MS after physical trauma that occurred in childhood (≤20 years) or "premorbid" (>20 years). We performed a meta-analysis using a random effects model.

Practice sensitive quality indicators in RAI-MDS 2.0 nursing home data.

Background: In recent years, improving the quality of care for nursing home residents has generated a considerable amount of attention. In response, quality indicators (QIs), based on available evidence and expert consensus, have been identified within the Resident Assessment Instrument-Minimum Data Set 2.0 (RAI-MDS 2.

Dementia diagnosis and osteoporosis treatment propensity: a population-based nested case-control study.

Aim: Increasing age and a diagnosis of dementia both dramatically increase the risk of serious osteoporosis-related sequela. We sought to examine the factors associated with osteoporosis treatment, in relation to dementia diagnosis, in older adults with osteoporosis.

Methods: This was a population-based, retrospective, nested, case-control study utilizing administrative healthcare data from British Columbia, Canada.

Surgery and risk for multiple sclerosis: a systematic review and meta-analysis of case-control studies.

Background: Although the precise etiology of multiple sclerosis is largely unknown, there is some speculation that a prior history of surgery may be associated with the subsequent risk for developing the disease. Therefore, we aimed to examine surgery as a risk factor for the diagnosis of multiple sclerosis.

Methods: We searched for observational studies that evaluated the risk for developing multiple sclerosis after surgery that occurred in childhood (≤ 20 years of age) or "premorbid" (> 20 years of age).

The association between serious upper gastrointestinal bleeding and incident bisphosphonate use: a population-based nested cohort study.

Background: Oral bisphosphonates are commonly used to prevent / treat osteoporosis. However, bisphosphonate treatment is not without risk and serious adverse effects, including upper gastrointestinal bleeding (UGIB) have been described. We sought to determine if new users of bisphosphonate drugs were more likely to suffer a serious UGIB within 120 days of drug initiation.

Inhaled magnesium sulfate in the treatment of acute asthma.

Background: Asthma exacerbations can be frequent and range in severity from relatively mild to status asthmaticus. The use of magnesium sulfate (MgSO(4)) is one of numerous treatment options available during acute exacerbations. While the efficacy of intravenous MgSO(4) has been demonstrated, little is known of the role of inhaled MgSO(4).