Changing Trends in Job Satisfaction and Burnout for Care Aides in Long-Term Care Homes: The Role of Work Environment.

Objectives: This study examined the association between care unit work environments in long-term care (LTC) homes and trends in care aides' job satisfaction and burnout (exhaustion, cynicism, reduced professional efficacy) from 2014 to early 2020.

Design: This was a retrospective longitudinal study using data from care aide surveys collected by the Translating Research in Elder Care research program over 3 periods: September 2014-May 2015 (T), May 2017-December 2017 (T), and September 2019-March 2020 (T).

Settings And Participants: The study included 631 care aides from a stratified random sample of 84 LTC homes in 3 Canadian provinces, who participated in data collection at all 3 time points.

EXploring Patterns of Use and Effects of Adult Day Programs to Improve Trajectories of Continuing Care (EXPEDITE): Protocol for a Retrospective Cohort Study.

Background: Adult day programs provide critical supports to older adults and their family or friend caregivers. High-quality care in the community for as long as possible and minimizing facility-based continuing care are key priorities of older adults, their caregivers, and health care systems. While most older adults in need of care live in the community, about 10% of newly admitted care home residents have relatively low care needs that could be met in the community with the right supports.

Barriers to healthy transitions between nursing homes and emergency departments.

This study identifies barriers to healthy transitions between nursing homes and emergency departments by exploring current practices in both primary care (out-of-hours primary care and nursing homes) and specialist healthcare (ambulance services and emergency departments) organizations from the perspectives of healthcare professionals. The objective is to highlight areas where improvements to these transitions are most needed. NH residents frequently use acute healthcare services.

Gastroenterologist and surgeon perceptions of recommendations for optimal endoscopic localization of colorectal neoplasms.

National consensus recommendations have recently been developed to standardize colorectal tumour localization and documentation during colonoscopy. In this qualitative semi-structured interview study, we identified and contrast the perceived barriers and facilitators to using these new recommendations according to gastroenterologists and surgeons in a large central Canadian city. Interviews were analyzed according to the Consolidated Framework for Implementation Research (CFIR) through directed content analysis.

Strategies to Improve Emergency Transitions From Long-Term Care Facilities: A Scoping Review.

Background And Objectives: Older adults residing in residential aged care facilities (RACFs) often experience substandard transitions to emergency departments (EDs) through rationed and delayed ED care. We aimed to identify research describing interventions to improve transitions from RACFs to EDs.

Research Design And Methods: In our scoping review, we included English language articles that (a) examined an intervention to improve transitions from RACF to EDs; and (b) focused on older adults (≥65 years).

Counting what counts: assessing quality of life and its social determinants among nursing home residents with dementia.

Background: Maximizing quality of life (QoL) is a major goal of care for people with dementia in nursing homes (NHs). Social determinants are critical for residents' QoL. However, similar to the United States and other countries, most Canadian NHs routinely monitor and publicly report quality of care, but not resident QoL and its social determinants.

Database quality assessment in research in paramedicine: a scoping review.

Background: Research in paramedicine faces challenges in developing research capacity, including access to high-quality data. A variety of unique factors in the paramedic work environment influence data quality. In other fields of healthcare, data quality assessment (DQA) frameworks provide common methods of quality assessment as well as standards of transparent reporting.

Development and validation of the Overall Fidelity Enactment Scale for Complex Interventions (OFES-CI).

Background: In many quality improvement (QI) and other complex interventions, assessing the fidelity with which participants 'enact' intervention activities (ie, implement them as intended) is underexplored. Adapting the evaluative approach used in objective structured clinical examinations, we aimed to develop and validate a practical approach to assessing fidelity enactment-the Overall Fidelity Enactment Scale for Complex Interventions (OFES-CI).

Methods: We developed the OFES-CI to evaluate enactment of the SCOPE QI intervention, which teaches nursing home teams to use plan-do-study-act (PDSA) cycles.

Changes in Health and Well-Being of Care Aides in Nursing Homes From a Pre-Pandemic Baseline in February 2020 to December 2021.

Nursing homes were profoundly affected by the COVID-19 pandemic, influencing work outcomes of care aides who provide the most direct care. We compared care aides' quality of work life by conducting a repeated cross-sectional analysis of data collected in February 2020 and December 2021 from a stratified random sample of urban nursing homes in two Canadian provinces. We used two-level random-intercept repeated-measures regression models, adjusting for demographics and nursing home characteristics.

Protocol for developing a set of performance measures to monitor and evaluate delirium care quality for older adults in the emergency department using a modified e-Delphi process.

Introduction: Older adults are at high risk of developing delirium in the emergency department (ED). Delirium associated with an ED visit is independently linked to poorer outcomes such as increased length of hospital stay and mortality. Performance measures (PMs) are needed to identify variations in the quality of delirium care to help focus improvement efforts where they are most needed.

A critical appraisal and recommendation synthesis of delirium clinical practice guidelines relevant to the care of older adults in the emergency department: An umbrella review.

Rationale: Older adults are at high risk of developing delirium in the emergency department (ED); however, it is often missed or undertreated. Improving ED delirium care is challenging in part due to a lack of standards to guide best practice. Clinical practice guidelines (CPGs) translate evidence into recommendations to improve practice.

The experiences and needs of unpaid family caregivers for persons living with dementia in rural settings: A qualitative systematic review.

Purpose: Unpaid family caregivers provide extensive support for community-dwelling persons living with dementia, impacting family caregivers' health and wellbeing. Further, unpaid family caregiving in rural settings has additional challenges because of lower access to services. This systematic review examines qualitative evidence to summarize the experiences and needs of rural unpaid family caregivers of persons living with dementia.

Building a Program Theory of Implementation Using Process Evaluation of a Complex Quality Improvement Trial in Nursing Homes.

Background And Objectives: Significant quality problems exist in long-term care (LTC). Interventions to improve care are complex and often have limited success. Implementation remains a black box.

Factors Associated With the Quality of Life of Nursing Home Residents During the COVID-19 Pandemic: A Cross-Sectional Study.

Objectives: Quality of life (QoL) of nursing home (NH) residents is critical, yet understudied, particularly during the COVID-19 pandemic. Our objective was to examine whether COVID-19 outbreaks, lack of access to geriatric professionals, and care aide burnout were associated with NH residents' QoL.

Design: Cross-sectional study (July to December 2021).

Research on Abuse in Home Care: A Scoping Review.

Home care is the preferred care option for most people who need support; yet abuse exists in these settings toward both home care workers and clients. There are no existing reviews that assess the scope of current research on abuse in home care, and tangentially related reviews are dated. For these reasons, a scoping review is warranted to map the current state of research on abuse in home care and examine current interventions in this field.

Safer Care for Older Persons in (residential) Environments (SCOPE): a pragmatic controlled trial of a care aide-led quality improvement intervention.

Background: The increased complexity of residents and increased needs for care in long-term care (LTC) have not been met with increased staffing. There remains a need to improve the quality of care for residents. Care aides, providers of the bulk of direct care, are well placed to contribute to quality improvement efforts but are often excluded from so doing.

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.

Changes in Health and Well-Being of Nursing Home Managers from a Prepandemic Baseline in February 2020 to December 2021.

Objective: To evaluate changes in mental health and well-being (eg, quality of work life, health, intention to leave) among nursing home managers from a February 2020 prepandemic baseline to December 2021 in Alberta, Canada.

Design: Repeated cross-sectional survey.

Setting And Participants: A random sample of nursing homes (n = 35) in urban areas of Alberta was selected on 3 strata (region, size, ownership).

A critical appraisal of delirium clinical practice guidelines relevant to the care of older adults in the emergency department with a synthesis of recommendations: an umbrella review protocol.

Background: Up to 35% of older adults present to the emergency department (ED) with delirium or develop the condition during their ED stay. Delirium associated with an ED visit is independently linked to poorer outcomes such as loss of independence, increased length of hospital stay, and mortality. Improving the quality of delirium care for older ED patients is hindered by a lack of knowledge and standards to guide best practice.

Reporting unit context data to stakeholders in long-term care: a practical approach.

Background: The importance of reporting research evidence to stakeholders in ways that balance complexity and usability is well-documented. However, guidance for how to accomplish this is less clear. We describe a method of developing and visualising dimension-specific scores for organisational context (context rank method).

Database quality assessment in research in paramedicine: a scoping review protocol.

Introduction: The paramedic practice environment presents unique challenges to data documentation and access, as well as linkage to other parts of the healthcare system. Variable or unknown data quality can influence the validity of research in paramedicine. A number of database quality assessment (DQA) frameworks have been developed and used to evaluate data quality in other areas of healthcare.