Use and effects of implementation strategies for practice guidelines in nursing: a systematic review.

Background: Practice guidelines can reduce variations in nursing practice and improve patient care. However, implementation of guidelines is complex and inconsistent in practice. It is unclear which strategies are effective at implementing guidelines in nursing.

Initial perceptions of, and intention to use, an online guideline adaptation framework: a descriptive survey.

Aim: The aim of this research was to evaluate CAN-Implement.Pro as a structured and systematic process for planning local evidence implementation, to develop a contextual and demographic profile of potential users and assess their initial perceptions and intention to use CAN-Implement.Pro.

A Canadian Survey of Self-Management Strategies and Satisfaction with Ability to Control Pain: Comparison of Community Dwelling Adults with Neuropathic Pain versus Adults with Non-neuropathic Chronic Pain.

Background: Individuals with chronic pain with neuropathic characteristics (CPNC) describe a different pain experience compared with those with chronic pain without neuropathic characteristics (CP).

Aims: The aim of this study was to describe and compare pain, self-management strategies, and satisfaction with ability to control pain between adults with CPNC versus CP.

Participants: Seven hundred and ten community-dwelling adults with chronic pain participated in a cross-sectional survey.

What Are the Barriers and Facilitators for the Self-Management of Chronic Pain with and without Neuropathic Characteristics?

Chronic pain requires affected individuals to self-manage their health. This study compared barriers and facilitators of self-management in two groups of people with chronic pain: those with and without neuropathic characteristics. A cross-sectional survey study of community-dwelling Canadians was conducted.

Health-related quality of life at healing in individuals with chronic venous or mixed-venous leg ulceration: a longitudinal assessment.

Aims: To identify factors associated with longitudinal changes in health-related quality of life in community-dwelling individuals with venous or mixed-venous leg ulcers.

Background: Most care focuses primarily on healing; this research may additionally lead to strategies to improve quality of life.

Design: Data from four studies (2000-2009) were combined (2012) to examine quality of life in community-dwelling individuals referred for care of chronic leg wounds.

Using the Alberta Continuity of Services Observer-Rated Scale to Measure Continuity of Care in a Psychiatric Population.

Background And Purpose: Continuity of care (CoC) is an important component in the delivery of quality mental health care. Yet, its measurement is inconsistent. We explored the use of the Alberta Continuity of Services Scale for Mental Health (ACSS-MH) observer-rated scale and compared CoC scores in 2 groups (N = 140) of individuals with mental health complaints (5+ and 1 emergency department [ED] visits/year).

The safety at home study: an evidence base for policy and practice change.

This paper explores the policies and practices that are needed to improve the safety of home care in light of the most recent evidence about home care safety in Canada. Four areas for policy and practice change are addressed: 1) the promotion of effective communication processes in home care through cross-sector collaboration, case management and technology innovations; 2) screening for safety risk factors; 3) standardizing care processes, packaging and equipment; and 4) supporting family/caregivers and strengthening clients' ability to engage in therapeutic self-care. Evidence-based strategies for change are presented within the context of the evidence about home care safety issues.

Profiling frequent presenters to the emergency department for mental health complaints: socio-demographic, clinical, and service use characteristics.

Background: A small subset of individuals makes a disproportionate number of ED visits for mental health complaints.

Study Objectives: To explore the population profile and associated socio-demographic, clinical, and service use factors of individuals who make frequent visits (5+ annually) to hospital EDs for mental health complaints.

Methods: Case-control study using electronic health record data.

Symptoms, coping, and quality of life in pediatric brain tumor survivors: a qualitative study.

Purpose/objectives: To explore the symptom experience, coping strategies, and children's descriptions of their quality of life (QOL) after treatment for a brain tumor.

Research Approach: An interpretive descriptive qualitative study.

Setting: A pediatric hospital setting in Ontario, Canada.

Symptom experience and quality of life in pediatric brain tumor survivors: a cross-sectional study.

Context: Little is known about the symptom experience and quality of life of children and youths who have completed treatment for a pediatric brain tumor.

Objectives: This study describes the symptom experience and health-related quality of life of children who have survived a brain tumor.

Methods: This observational cross-sectional study used a convenience sample of 50 children who were being followed in ambulatory care after they had completed brain tumor treatment.

Quality of life and symptoms in pediatric brain tumor survivors: a systematic review.

Little is known about the quality of life of children and youth under the age of 20 who have completed treatment for a pediatric brain tumor. This systematic review was conducted to (a) describe the health-related quality of life (HRQL) outcomes in pediatric brain tumor survivors, (b) identify instruments used to measure HRQL, and (c) determine the relationship between symptoms and HRQL. Using a systematic search and review methodology, databases searched included CINAHL, Medline, Embase, and PsycInfo.

Factors associated with health-related quality of life in chronic leg ulceration.

Background: Individuals with chronic leg ulceration may have significantly impaired health-related quality of life (HRQOL) due to pain, impaired mobility, poor sleep, depression, restricted work capacity, and social isolation. The study purpose was to examine the associations among sociodemographic and clinical factors and HRQOL in a large sample of community-dwelling adults being treated for leg ulcers.

Methods: Data are from the cross-sectional baseline assessment of the Canadian Bandaging Trial, a multi-center, randomized controlled trial conducted to assess time to healing with two forms of high-compression bandaging.

The Role of Preference on Outcomes of People Receiving Evidence-Informed Community Wound Care in Their Home or in a Nurse-Clinic Setting: A Cohort Study (n = 230).

This study followed a cohort of community-dwelling individuals receiving wound-care in a large urban-rural region. During a randomized control trial (RCT) evaluating outcomes of receiving care in a nurse-clinic or at home, many approached were willing to participate if they could choose their location of care. This provided a unique opportunity to enroll them as a "choice" cohort, following them in the same manner as the trial participants but allowing them to select their setting of care.

Frequent emergency department use by individuals seeking mental healthcare: a systematic search and review.

Objective: The aim of this study was to compare research on individuals who frequently use the ED for mental health complaints including parameters used to identify the population, as well as socio-demographic, clinical, and service use factors.

Methods: Systematic search and review of Medline, Cinahl, PsycInfo, and HealthStar (1980 to 2011). Double-data extraction ensured accuracy.

Different context, different results: venous ulcer healing and the use of two high-compression technologies.

Aims And Objectives: To update the evidence for the relative effectiveness of the four-layer and short-stretch compression technologies used for the treatment of venous ulcers.

Background: Compression bandages are the most effective method for venous ulcer healing. Both four-layer and short-stretch compression are effective but the relative benefit of one over the other is not fully understood.

Turning knowledge into action at the point-of-care: the collective experience of nurses facilitating the implementation of evidence-based practice.

Background: Facilitation is considered a way of enabling clinicians to implement evidence into practice by problem solving and providing support. Practice development is a well-established movement in the United Kingdom that incorporates the use of facilitators, but in Canada, the role is more obtuse. Few investigations have observed the process of facilitation as described by individuals experienced in guideline implementation in North America.

Towards a conceptual consensus of continuity in mental healthcare: focused literature search and theory analysis.

Aim: While continuity of care is an important component in the provision of mental health services, a universally accepted definition is missing. There is a need to identify areas of consensus and discrepancy in continuity theory and provide a foundation for advancing measurement capabilities. The purpose of this study was to systematically identify and examine scholarship on continuity in mental healthcare.

Guideline adaptation and implementation planning: a prospective observational study.

Background: Adaptation of high-quality practice guidelines for local use has been advanced as an efficient means to improve acceptability and applicability of evidence-informed care. In a pan-Canadian study, we examined how cancer care groups adapted pre-existing guidelines to their unique context and began implementation planning.

Methods: Using a mixed-methods, case-study design, five cases were purposefully sampled from self-identified groups and followed as they used a structured method and resources for guideline adaptation.

Development and evaluation of evidence-informed clinical nursing protocols for remote assessment, triage and support of cancer treatment-induced symptoms.

The study objective was to develop and evaluate a template for evidence-informed symptom protocols for use by nurses over the telephone for the assessment, triage, and management of patients experiencing cancer treatment-related symptoms. Guided by the CAN-IMPLEMENT© methodology, symptom protocols were developed by, conducting a systematic review of the literature to identify clinical practice guidelines and systematic reviews, appraising their quality, reaching consensus on the protocol template, and evaluating the two symptom protocols for acceptability and usability. After excluding one guideline due to poor overall quality, the symptom protocols were developed using 12 clinical practice guidelines (8 for diarrhea and 4 for fever).

Leg ulcer nursing care in the community: a prospective cohort study of the symptom of pain.

Background: Chronic wounds are managed almost entirely by community nurses. Almost all individuals with leg ulcers report acute pain usually related to dressing change. Little is known about pain after healing.

Priorities, barriers and facilitators for remote support of cancer symptoms: a survey of Canadian oncology nurses.

A survey of 368 Canadian oncology nurses revealed that 54% provided remote support to oncology patients. The most common symptoms identified were fatigue, pain, nausea, constipation, and anxiety. Frequent symptoms which nurses felt low confidence in managing were anxiety, neuropathy, depression, anorexia and skin alterations.

Cost-effectiveness of compression technologies for evidence-informed leg ulcer care: results from the Canadian Bandaging Trial.

Background: Venous leg ulcers, affecting approximately 1% of the population, are costly to manage due to poor healing and high recurrence rates. We evaluated an evidence-informed leg ulcer care protocol with two frequently used high compression systems: 'four-layer bandage' (4LB) and 'short-stretch bandage' (SSB).

Methods: We conducted a cost-effectiveness analysis using individual patient data from the Canadian Bandaging Trial, a publicly funded, pragmatic, randomized trial evaluating high compression therapy with 4LB (n = 215) and SSB (n = 209) for community care of venous leg ulcers.

Pain and psychological characteristics in women waiting for gynaecological surgery.

Objective: Pain is frequently a complaint prior to gynaecological surgery. Psychological factors are also known to influence the experience of pain. The primary objective of this study was to assess the prevalence of pain and the relationship between psychological factors and pain in women awaiting gynaecological surgery.

Roadmap for a participatory research-practice partnership to implement evidence.

Background: Our research team has undertaken implementation of evidence in the form of practice guideline recommendations for populations in hospital, community, and long-term care settings with diverse provider and patient populations (people with chronic wounds, e.g., pressure and leg ulcers, heart failure, stroke, diabetes, palliative care, cancer, and maternity care).

Emergency department visits for symptoms experienced by oncology patients: a systematic review.

Purpose: The aim of this review was to explore the range and prevalence of cancer treatment or disease-related symptoms in the emergency department and their associated outcomes.

Methods: A systematic review examined studies cited in Medline, Embase, PsycINFO, and CINAHL published from 1980 to July 2011. Eligible studies measured emergency department visits for symptom assessment in adult oncology patients.