Opportunities and challenges to enhance the value and uptake of Chief Nursing Informatics Officer (CNIO) Roles in Canada: A Qualitative Study.

Clinician informatics leadership has been identified as an essential component of addressing the 'implementation to benefits realization gap' that exists for many digital health technologies. Chief Medical Informatics Officers (CMIOs), and Chief Nursing Informatics Officers (CNIOs) are well-positioned to ensure the success of these initiatives. However, while the CMIO role is fairly well-established in Canada, there is limited uptake of CNIO roles in the country.

Intraoperative Ventilator Management of the Critically Ill Patient.

Strategies for the intraoperative ventilator management of the critically ill patient focus on parameters used for lung protective ventilation with acute respiratory distress syndrome, preventing or limiting the deleterious effects of mechanical ventilation, and optimizing anesthetic and surgical conditions to limit postoperative pulmonary complications for patients at risk. Patient conditions such as obesity, sepsis, the need for laparoscopic surgery, or one-lung ventilation may benefit from intraoperative lung protective ventilation strategies. Anesthesiologists can use risk evaluation and prediction tools, monitor advanced physiologic targets, and incorporate new innovative monitoring techniques to develop an individualized approach for patients.

Supporting the Development of Informatics Competencies Among Senior Nurse Leaders in Canada.

This poster will provide an overview of the various initiatives completed to support the development of informatics competencies among senior nurse leaders in Canada. These initiatives have included a literature review to uncover competencies of relevance to the Canadian context, and a Delphi study to achieve consensus on the competencies for Canada. Current and future plans will be discussed to translate these competencies into practice among senior nurse leaders.

Digital and informatics competencies: Requirements for nursing leaders in Canada.

The use of health information technologies continues to grow, especially with the increase in virtual care in response to COVID-19. As the largest health professional group in Canada, nurses are key stakeholders and their active engagement is essential for the meaningful adoption and use of digital health technologies to support patient care. Nurse leaders in particular are uniquely positioned to inform key technology decisions; therefore, enhancing their informatics capacity is paramount to the success of digital health initiatives and investments.

Academic achievement and gender among adult critical care program directors.

Purpose: Accreditation Council for Graduate Medical Education (ACGME) program director (PD) qualifications includes scholarly activity with demonstrated academic productivity and dissemination. Our hypothesis: academic productivity among adult critical care medicine (CCM) fellowship PDs is affected by gender with women having lower productivity.

Materials And Methods: PDs in 39 institutions with CCM fellowships in anesthesiology, surgery, and pulmonary medicine were analyzed using data from ACGME website, PubMed, and NIH Research Portfolio Online Reporting Tools.

Adapting and validating informatics competencies for senior nurse leaders in the Canadian context: Results of a Delphi study.

Background: Nurse leaders in senior leadership positions in various parts of the world can play an important role in the acquisition, implementation and use of health information technologies. To date, international research related to nurse leader informatics competencies has been carried out in specific healthcare delivery contexts with very specific health information technology environments. In this body of literature, the definition of a 'nurse leader' has not been clearly defined.

End-of-life discussions: Who's doing the talking?

Purpose: To determine, in a tertiary academic medical center, the reported frequency of end-of-life discussions among nurses and the influence of demographic factors on these discussions.

Methods: Survey of nurses on frequency of end-of-life discussions in two urban academic medical centers. Chi-square tests were used to separately assess the relationship between age, gender, specialty, and experience with responses to the question, "Do you regularly talk with your patients about end-of-life wishes?"

Results: Overall, more than one-third of respondents reported rarely or never discussing end-of-life wishes with their patients.

Hyperkalemic Arrest: Developing Team Cognition.

Introduction: Critical events are frequently managed by individuals with different skill sets, funds of knowledge, and experiences who form ad hoc teams on a daily basis without any previous practice together. Such groups' spontaneity of formation puts a premium on individuals' ability to understand team cognition and work together. Team cognition can be thought of as an analogue of individual cognition and is revealed during functional interactions of team members working interdependently on a shared goal.

Managing the Complex Issues of Pediatric Nonaccidental Trauma: A Simulation-Based Case of a Critically Injured Child.

Introduction: Trainees generally have insufficient training in managing critically ill and injured pediatric patients due to limited exposure to such patients. Patient simulation experiences allow trainees to learn management skills needed in such a crisis. Herein, we describe a case regarding a critically injured pediatric patient.

Contextualizing learning to improve care using collaborative communities of practices.

Background: The use of interorganizational, collaborative approaches to build capacity in quality improvement (QI) in health care is showing promise as a useful model for scaling up and accelerating the implementation of interventions that bridge the "know-do" gap to improve clinical care and provider outcomes. Fundamental to a collaborative approach is interorganizational learning whereby organizations acquire, share, and combine knowledge with other organizations and have the opportunity to learn from their respective successes and challenges in improvement areas. This learning approach aims to create the conditions for collaborative, reflective, and innovative experiential systems that enable collective discussions regarding daily practice issues and finding solutions for improvement.

Academic Productivity of Accreditation Council for Graduate Medical Education-Accredited Critical Care Fellowship Program Directors.

Objectives: Academic productivity is an expectation for program directors of Accreditation Council for Graduate Medical Education-accredited subspecialty programs in critical care medicine. Within the adult critical care Accreditation Council for Graduate Medical Education-accredited programs, we hypothesized that program director length of time from subspecialty critical care certification would correlate positively with academic productivity, and primary field would impact academic productivity.

Design: This study received Institutional Review Board exemption from the University of Florida.

The Case for Standardized Data in Nursing.

With the increased focus on quality and safety within the healthcare system, the collection, reporting and use of standardized data are essential to understanding the impact of clinicians practice on patient care. This article examines how the Canadian Health Outcomes for Better Information and Care (C-HOBIC) dataset can support clinical decision-making and facilitate improved sharing of information as patients transition between sectors of the healthcare system. If the benefits of electronic health records are to be fully realized, it is vital that information is collected in a standardized format to support point-of-care clinicians in decision-making, as well as for health system use.

Long-Term Outcomes for Different Forms of Stress Cardiomyopathy After Surgical Treatment for Subarachnoid Hemorrhage.

Background: Stress-induced cardiomyopathy (SCM) after subarachnoid hemorrhage (SAH) includes predominant apical or basal regional left ventricular dysfunction (RLVD) with concomitant changes in electrocardiogram or increase in cardiac enzymes. We hypothesized that difference in outcome is associated with the type of RLVD after SAH.

Methods: We studied a single-center retrospective cohort of SAH patients hospitalized between 2000 and 2010 with follow-up until 2013.

Nutrition and metabolic support for critically ill patients.

Purpose Of Review: Acute critical illness increases the risk of malnutrition, are more obese, and have multiple comorbidities and frequent pre-existing nutritional deficits. There is a vast amount of research and literature being written on nutritional practices in the critically ill. We review and discuss herein the important nutrition literature over the past 12 months.

Leveraging data to transform nursing care: insights from nurse leaders.

A study was undertaken to gain insight into how nurse leaders are influencing the use of performance data to improve nursing care in hospitals. Two themes emerged: getting relevant, reliable, and timely data into the hands of nurses, and the leaders' ability to "connect the dots" in working with different stakeholders. Study findings may inform nurse leaders in their efforts to leverage data to transform nursing care.

The relationship among evidence-based practice and client dyspnea, pain, falls, and pressure ulcer outcomes in the community setting.

Background: There are gaps in knowledge about the extent to which home care nurses' practice is based on best evidence and whether evidence-based practice impacts patient outcomes.

Aim: The purpose of this study was to investigate the relationship between evidence-based practice and client pain, dyspnea, falls, and pressure ulcer outcomes in the home care setting. Evidence-based practice was defined as nursing interventions based on best practice guidelines.

Evaluating nurses' use of HOBIC in home care.

Health Outcomes for Better Information and Care (HOBIC), a program funded by the Ontario Ministry of Health and Long-Term Care, introduces a collection of evidence-based clinical outcome measures reflective of nursing care. The authors report on an evaluation of the experiences of nurse early adopters of HOBIC in home care. The findings reveal challenges and nuances associated with the introduction of HOBIC and the use of supporting technologies in the delivery of home nursing care.

Measuring outcomes of nursing care, improving the health of Canadians: NNQR (C), C-HOBIC and NQuiRE.

The purpose of this paper is to inform the nursing community of the extraordinary progress that the Canadian National Nursing Quality Report (NNQR(C)), the Canadian Health Outcomes for Better Information and Care (C-HOBIC) and the Nursing Quality Indicators for Reporting and Evaluation (NQuiRE) have made to date, and to share our commitment to continue working together to build a strong nursing profession that, armed with evidence, will contribute to healthier Canadians.

"The potential is unlimited!" Nurse leader perspectives on the integration of HOBIC in Ontario.

Nurse leaders from a sample of acute care and long-term care sites participating in the Health Outcomes for Better Information and Care program in Ontario provided information on their experiences with HOBIC implementation. In addition, they described strategies to enhance successful implementation of the program. Finally, they discussed the potential future uses they envisioned for healthcare settings from the HOBIC data.

Exploring nurses' perceptions of collecting and using HOBIC measures to guide clinical practice and improve care.

Ontario's Health Outcomes for Better Information and Care (HOBIC) is designed to help organizations and nurses plan and evaluate care by comparing patient outcomes with historical data on similar cases. Yet, fewer than 15% of patients in a 2010 study were found to have complete admission and discharge data sets. This low utilization rate of HOBIC measures prompted the current qualitative study, in which nurses from three clinical settings in an academic teaching hospital were interviewed to gain their perceptions related to collecting and using HOBIC measures in practice.

C-HOBIC - Standardized Information to Support Clinical Practice and Quality Patient Care across Canada.

Canadian Health Outcomes for Better Information and Care (C-HOBIC) is leading the collection of standardized clinical outcomes reflective of nursing practice. C-HOBIC introduces a systematic structured language for patient assessments across the health care system enabling abstraction of information into jurisdictional EHRs Thus the information is available to clinicians across the health care system. This paper provides the background to C-HOBIC with an overview of the evidence supporting the clinical outcomes; the methodology for the electronic collection and abstraction of outcomes including the implications of including nursing information on databases; and describes the approach to coding information for interoperability and comparability of clinical information across the health care system.