Abuse in Canadian long-term care homes: a mixed methods study.

Objective: To examine reported cases of abuse in long-term care (LTC) homes in the province of Ontario, Canada, to determine the extent and nature of abuse experienced by residents between 2019 and 2022.

Design: A qualitative mixed methods study was conducted using document analysis and descriptive statistics. Three data sources were analysed: LTC legislation, inspection reports from a publicly available provincial government administrative database and articles published by major Canadian newspapers.

Work precarity, employment characteristics and health among Canada's long-term care and seniors' home workers during the COVID-19 pandemic.

Background: The COVID-19 pandemic has highlighted several issues among health care workers in Canada's long-term care and seniors' (LTCS) homes, including labour shortages, staff retention difficulties, overcrowding, and precarious working conditions. There is currently a lack of information on the health, well-being and working conditions of health care workers in LTCS homes - many of them immigrants - and a limited understanding of the relationship between them. This paper examines differences between immigrant and non-immigrant workers' health outcomes and precarious working conditions during the pandemic.

Innovative nursing employment initiatives to strengthen and sustain the health workforce in Canada.

Health systems worldwide are at a critical juncture due to an increasing demand for health services and a diminishing pool of health human resources. While COVID-19 exacerbated nursing deficits, the need to strengthen and sustain the health workforce in Canada was evident decades prior and supported by numerous studies that warned of significant shortages. Post pandemic, building health system capacity has become paramount.

Factors associated with pressure ulcer and dehydration in long-term care settings in Ontario, Canada.

Pressure ulcers and dehydration are common conditions among residents of long-term care facilities that result in negative health effects. They have been associated with signs of neglect and increased 30-day mortality among LTC residents. However, they are both preventable and with proper care can be effectively managed and treated.

The changing profile of the internationally educated nurse workforce: Post-pandemic implications for health human resource planning.

As part of its post COVID-19 recovery plan, the Canadian government is increasing the number of skilled immigrants, including Internationally Educated Nurses (IENs). However, pre-pandemic data show that IENs are underutilized and underemployed despite their education and experience. Focusing on the province of Ontario, this article explores trends in the IEN workforce and policies to address the nursing shortage.

The Crisis in the Nursing Labour Market: Canadian Policy Perspectives.

The labour market for care professionals has experienced significant changes, resulting in critical shortages globally. Nurses represent the largest share of health workers worldwide; nonetheless, an estimated 13 million more nurses will be needed over the next 10 years. Prior to the pandemic, the domestic supply of nurses in Canada had not kept pace with the ever-increasing demand for services.

Rights versus Risks: The Impact of Isolation on Residents and Families in Long-Term Care.

Early in the COVID-19 pandemic, the Ontario government created directives for long-term care (LTC) homes. As a result, residents were isolated in their rooms and visitors were banned. This commentary examines these practices and their impact on LTC residents and their families.

Inspection Reports: The Canary in the Coal Mine.

Neglect in the Ontario long-term care (LTC) sector is defined under section 5 of O. Reg. 79/10 of the Long-Term Care Homes Act, 2007.

COVID-19 Issues in Long-Term Care in Ontario: A Document Analysis.

The COVID-19 crisis in long-term care in Canada has been characterized as a crisis upon a crisis. This study examines recent documents on the crisis in long-term care in Ontario, using document and thematic analysis to synthesize issues and recommendations from the perspectives of different groups and organizations. Thirty-three documents from 20 organizations were analysed and six thematic areas were identified: resident care; human resources; governance, leadership and management; financing; physical infrastructure and supplies; and training and preparation.

Exemplars in Long-Term Care during COVID-19: The Importance of Leadership.

Early in the pandemic, many long-term care (LTC) homes struggled to manage resources and care for vulnerable residents. Using an appreciative inquiry approach, we analyzed exemplar homes in Ontario that remained free of COVID-19 in wave one and interviewed executive directors, directors of care and staff. Findings demonstrate the importance of leadership styles; clear, consistent communication; focusing on staff and resident safety; using a team-based approach; and adapting staff roles to meet care needs.

Perspectives from the Netherlands: Responses from, Strategies of and Challenges for Long-Term Care Health Personnel.

The outbreak of the COVID-19 crisis severely afflicted the Dutch long-term care sector. To protect vulnerable residents of nursing homes the government took several measures, of which the complete nationwide visitors' ban was the most restrictive. These measures had not only a large impact on residents but they also greatly impacted nursing home personnel.

COVID-19 and Long-Term Care: What Have We Learned?

The COVID-19 pandemic has led to thousands of deaths; of these, a disproportionate number has occurred in long-term care settings. The papers presented here deal with a number of issues highlighted by this crisis in several jurisdictions, including Ontario, Quebec and the Netherlands. Analyzing these may give us some insight into what is necessary to prevent this disaster from happening again.

COVID-19 excess mortality among long-term care residents in Ontario, Canada.

The coronavirus disease 2019 (COVID-19) has had devastating consequences worldwide, including a spike in global mortality. Residents of long-term care homes have been disproportionately affected. We conducted a retrospective cohort study to determine the scale of pandemic-related deaths of long-term care residents in the province of Ontario, Canada, and to estimate excess mortality due to a positive COVID-19 test adjusted for demographics and regional variations.

Diversifying the health workforce: a mixed methods analysis of an employment integration strategy.

Background: Historically, immigration has been a significant population driver in Canada. In October 2020, immigration targets were raised to an unprecedented level to support economic recovery in response to COVID-19. In addition to the economic impact on Canada, the pandemic has created extraordinary challenges for the health sector and heightened the demand for healthcare professionals.

Work readiness, transition, and integration: The challenge of specialty practice.

Aim: To determine how extended orientation enhances the work readiness of new graduate nurses as they transitioned to their professional role in a specialty care hospital.

Background: Given increased complexity of care and high-patient acuity, there is concern about the work readiness of new graduate nurses in specialty areas.

Design: Qualitative exploratory study using an inductive approach.

Policy to practice: Investment in transitioning new graduate nurses to the workplace.

Aim: To analyse nurses' perceptions of the impact of an extended transition programme on key dimensions of care delivery 1-6 years after graduation. The dimensions included decision-making, communication, care management, system integration and commitment.

Background: Health care employers in Ontario, Canada, can apply for government funding to support an extended transition programme for new graduate nurses that includes orientation and mentorship.

A government policy on full-time nursing employment in Ontario, Canada: An evaluation.

Purpose: To evaluate the impact of a government full-time employment policy targeting new graduate nurses in the province of Ontario, Canada, by comparing participants with non-participants.

Methods: The Policy Impact on Nurse Employment (PINEP) survey was administered in 2014 to nurses who graduated between 2007 and 2012. Backward multiple logistic regression analysis was conducted to determine the effect of participation in the policy on key outcomes: full-time employment, retention and perceptions of clinical proficiency.

Strategic Workforce Planning for Health Human Resources: A Nursing Case Analysis.

Background Health-care organizations provide services in a challenging environment, making the introduction of health human resources initiatives especially critical for safe patient care. Purpose To demonstrate how one specialty hospital in Ontario, Canada, leveraged an employment policy to stabilize its nursing workforce over a six-year period (2007 to 2012). Methods An observational cross-sectional study was conducted in which administrative data were analyzed to compare full-time status and retention of new nurses prepolicy and during the policy.

Interpreting angina: symptoms along a gender continuum.

Background: 'Typical' angina is often used to describe symptoms common among men, while 'atypical' angina is used to describe symptoms common among women, despite a higher prevalence of angina among women. This discrepancy is a source of controversy in cardiac care among women.

Objectives: To redefine angina by (1) qualitatively comparing angina symptoms and experiences in women and men and (2) to propose a more meaningful construct of angina that integrates a more gender-centred approach.

The road to providing quality care: orientation and mentorship for new graduate nurses.

Clinical work demands can overwhelm new graduate nurses (NGNs) and cause significant stress as they begin practice in their first place of employment. The authors examine the impact of a government-supported extended orientation and mentorship program intended to facilitate the transition of NGNs to professional practice. A longitudinal trend study was conducted over 3 years of the program (2008, 2009, and 2010).

Full-time work for nurses: employers' perspectives.

Aim: To examine an employer response to a government employment policy, the Nursing Graduate Guarantee (NGG), over a 2-year period (2008-2009 and 2009-2010).

Background: Healthcare organizations rely on a stable supply of nurses to meet their staffing needs. However, employment trends have indicated a propensity for part-time employment.

Workforce integration of new graduate nurses: evaluation of a health human resources employment policy.

Historically, economic changes have negatively affected the nursing workforce in Ontario. The trend towards part-time and casual employment emerged from healthcare restructuring in the 1990s. The severe acute respiratory syndrome (SARS) outbreak in 2003 alerted the Ontario government to the issue of part-time and casual nursing.