Nurses' experience of handoffs on four Canadian medical and surgical units: A shared accountability for knowing and safeguarding the patient.

Aims: To explore nurses' experience and describe how they manage various contextual factors affecting the nurse-to-nurse handoff at change of shift.

Design: Qualitative descriptive study.

Methods: A convenience sample of 51 nurses from four medical and surgical care units at a university-affiliated hospital in Montreal, Canada, participated in one of the 19 focus group interviews from November 2017 to January 2018.

Top priorities for the next decade of nursing health services research.

Background: The U.S. health care system faces increasing pressures for reform.

Nursing handoffs and clinical judgments regarding patient risk of deterioration: A mixed-methods study.

Aims And Objectives: To explore how change-of-shift handoffs relate to nurses' clinical judgments regarding patient risk of deterioration.

Background: The transfer of responsibility for patients' care comes with an exchange of information about their condition during change-of-shift handoff. However, it is unclear how this exchange affects nurses' clinical judgments regarding patient risk of deterioration.

Nurses' judgments of patient risk of deterioration at change-of-shift handoff: Agreement between nurses and comparison with early warning scores.

Background: Nurses begin forming judgments regarding patients' clinical stability during change-of-shift handoffs.

Objectives: To examine the agreement between incoming and outgoing nurses' judgments of deterioration risk following handoff and compare these judgments to commonly used early warning scores (MEWS, NEWS, ViEWS).

Methods: Following handoffs on three medical/surgical units, nurses completed the Patient Acuity Rating.

Acceptability and feasibility of recruitment and data collection in a field study of hospital nurses' handoffs using mobile devices.

Background: The portability and multiple functionalities of mobile devices make them well suited for collecting field data for naturalistic research, which is often beset with complexities in recruitment and logistics. This paper describes the implementation of a research protocol using mobile devices to study nurses' exchanges of patient information at change of shift.

Methods: Nurses from three medical and surgical units of an acute care teaching hospital in Montreal, Canada, were invited to participate.

Scope of Nursing Practice in a Tertiary Pediatric Setting: Associations With Nurse and Job Characteristics and Job Satisfaction.

Purpose: While professional nursing, like other health professions, has a recognized educational base and a legal scope of practice that is remarkably consistent across societies, there are important variations even within the same institution or organization in the extent to which professional nurses engage in the full range of activities for which they are qualified. There has been limited study of enacted (actual) scope of nursing practice (ESOP) or of its impacts on nurse job outcomes, such as job satisfaction. The aim of this study is to measure ESOP, as well as its predictors and impact on job satisfaction, in a specialty university-affiliated tertiary referral center in one of the few remaining jurisdictions outside the United States that continue to educate registered nurses at multiple educational levels.

An Integrative Review of the Hands-Free Technique in the OR.

Sharps injury rates are proportionally higher in perioperative areas than in other practice settings. The hands-free technique (HFT) has been shown to decrease the hazards of sharps injuries when passing sharps during surgery. We reviewed and synthesized research studies regarding compliance with the HFT and factors facilitating its use using a key word search of online databases and a secondary search of references.

Variation in Cesarean Birth Rates by Labor and Delivery Nurses.

Objective: To examine variation in the cesarean birth rates of women cared for by labor and delivery nurses.

Design: Retrospective cohort study.

Setting: One high-volume labor and delivery unit at an academic medical center in a major metropolitan area.

Rationing of nursing care interventions and its association with nurse-reported outcomes in the neonatal intensive care unit: a cross-sectional survey.

Background: Evidence internationally suggests that staffing constraints and non-supportive work environments result in the rationing of nursing interventions (that is, limiting or omitting interventions for particular patients), which in turn may influence patient outcomes. In the neonatal intensive care unit (NICU), preliminary studies have found that discharge preparation and infant comfort care are among the most frequently rationed nursing interventions. However, it is unknown if the rationing of discharge preparation is related to lower perceptions of parent and infant readiness for NICU discharge, and if reports of increased rationing of infant comfort care are related to lower levels of perceived neonatal pain control.

Education and Role Title as Predictors of Enacted (Actual) Scope of Practice in Generalist Nurses in a Pediatric Academic Health Sciences Center.

Objective: The aim of this study is to document the enacted (actual) scope of practice (SOP) of nurses in pediatric settings in relation to education level and position.

Background: Baccalaureate-prepared staff nurses routinely carry out only a fraction of the activities essential for quality of care and patient safety they have been educated for. A direct care nurse clinician role exists for nurses with bachelor's degrees in Quebec, Canada.

Optimizing full scope of practice for nurse practitioners in primary care: A proposed conceptual model.

Background: Nurse practitioners (NPs), if utilized to their optimal potential, could play a key role in meeting the growing demand for primary care.

Purpose: The purpose of this study was to propose a comprehensive model for maximizing NP contributions to primary care which includes the factors affecting NP care and patient outcomes and explains their interrelated impact.

Method: We synthesized the results of the published literature to develop a model, which emphasizes NP scope of practice regulations, institutional policies, NP practice environment, and NP workforce outcomes as determinants of NP care and patient outcomes.

Influences on and outcomes of enacted scope of nursing practice: a new model.

Enacted scope of practice is a major issue for nursing administrators, given the potentially negative effect on accessibility, continuity, safety and quality of care, job satisfaction, and organizational costs of nurses working at reduced scope. Optimal deployment of nurses to a fuller enacted scope of nursing practice holds much promise for addressing all of these larger challenges. In this sense, new model of the Enacted Scope of Nursing Practice presented in this article provides a number of directions for interventions that could improve health system functioning.

Patients in the radiology department may be at increased risk of developing critical instability.

The purpose of this study was to calculate the event rate for in-patients in the Radiology Department (RD) developing instability leading to calls for Medical Emergency Team assistance (MET-RD) compared to general ward (MET-W) patients. A retrospective comparison was done of MET-RD and MET-W calls in 2009 in a U.S.

Pain and Anxiety in Rural Acute Coronary Syndrome Patients Awaiting Diagnostic Cardiac Catheterization.

Context: In rural areas of Canada, people with acute coronary syndromes (ACS) can wait up to 32 hours for transfer for diagnostic cardiac catheterization (CATH). While awaiting CATH, it is critical that pain and anxiety management be optimal to preserve myocardial muscle and minimize the risk of further deterioration.

Objectives: The aim of this study was to examine the relationship between clinical management, cardiac pain intensity, and state anxiety for rural ACS patients awaiting diagnostic CATH.