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Nursing Leadership

Kristen Callaghan, Ruth Martin-Misener, Colleen O'Connell, Frederick Burge, Emily Gard Marshall
The addition of nurse practitioners (NPs) in primary healthcare (PHC) is intended to improve accessibility. This study compared access to NP services in consultative, dyad and multiprofessional team structures in Nova Scotia. Accessibility indicators included NP appointment wait times, after-hours coverage and acceptance of new patients. Secondary analysis of province-wide survey data from PHC providers showed multiprofessional structures had shorter median NP appointment wait times: 0.5 days for urgent appointments versus 6...
2017: Nursing Leadership
Christina Hurlock-Chorostecki, Michelle Acorn
Hospitals require identification of the most responsible provider (MRP) for care of admitted patients. Traditionally, the MRP has been a physician. However, legislation changes within Ontario authorize the nurse practitioner (NP) to admit and provide care for hospital in-patients. There is little evidence illustrating adoption of the NP-as-MRP model in Ontario. Reasons for a delayed adoption of this innovative model of care are unclear and warrant investigation. One hospital implemented the NP-as-MRP as an appropriate and beneficial model to maximize access to care for senior patients...
2017: Nursing Leadership
Shannon Spenceley, Sienna Caspar, Em Pijl
In 2012, the World Health Organization estimated that the number of people living with dementia worldwide was approximately 35.6 million; they projected a doubling of this number by 2030, and tripling by 2050. Although the majority of people living with a dementia live in the community, residential facility care by nursing providers is a common part of the dementia journey in most countries. Previously published research confirms that caring for people living with dementia in such facilities often creates moral distress for nursing care providers...
2017: Nursing Leadership
M Suzanne Cole
Presently only about 9% of seniors over the age of 75 live in residential care facilities but the anticipated exponential growth of the senior population will put increasing pressure on the need for supportive, continuing care services in the years ahead (CIHI 2017a). They are on average 86 years of age with a diagnosis of dementia (67%) and some cognitive and/or functional impairment (98%) (CIHI 2017b). These compromised seniors are also more likely to use hospital services than others, and in many jurisdictions occupy acute care beds for extended periods because ongoing management of their complex conditions is often not possible within long-term care (LTC) homes...
2017: Nursing Leadership
Maria Mathews, Dana Ryan, Melissa Power
Using a cross-sectional survey of managers, we examined the role of nurse practitioners (NPs) in long-term care (LTC) facilities in Newfoundland and Labrador. We compared facilities with no regular primary care provider, with only family physicians (FPs) and with both FPs and NPs. A total of 91 of 127 (71.0%) facilities completed the survey; 19 (21.3%) facilities had no primary care provider, 42 (47.2%) had FPs only and 28 (31.5%) had both FPs and NPs. NPs and FPs provide a similar range of services in LTC...
2017: Nursing Leadership
Carrie A McAiney, Jenny Ploeg, Abigail Wickson-Griffiths, Sharon Kaasalainen, Ruth Martin-Misener, Noori Akhtar-Danesh, Faith Donald, Nancy Carter, Esther Sangster-Gormley, Kevin Brazil, Alan Taniguchi, Lori Schindel Martin
Nurse practitioners (NPs) can play an important role in providing primary care to residents in long-term care (LTC) homes. However, relatively little is known about the day-to-day collaboration between NPs and physicians (MDs) in LTC, or factors that may influence this collaboration. Survey data from NPs in Canadian LTC homes were used to explore these issues. Thirty-seven of the 45 (82%) identified LTC NPs across Canada completed the survey. NPs worked with an average of 3.4 MDs, ranging from 1-26 MDs. The most common reasons for collaborating included managing acute and chronic conditions, and updating MDs on resident status changes...
2017: Nursing Leadership
Lynn Stevenson, David Byres
The recently released book Public Policy and Canadian Nursing: Lessons from the Field, by Michael J. Villeneuve, has been described as a "must read" by Gail Donner, professor emerita, Faculty of Nursing, University of Toronto, and by Kathleen Macmillan, professor and director of the School of Nursing at Dalhousie University. That is an excellent recommendation from two well-respected Canadian nurse leaders.
2017: Nursing Leadership
Lynn M Nagle
Discussions of seniors with complex co-morbid conditions "clogging up" or "blocking" acute care beds have been persistent over the last two decades. In reality, many of these hospital admissions are likely avoidable with the allocation of appropriate resources to manage their care in the community. While promises of enhanced community-based care and support have been touted for years, the solutions have been inadequate, and continue to fall short of the mark. Notwithstanding the likely need for more long-term residential care beds in the face of Canada's aging demographic, it is clear that much more could be done to maintain seniors in their own homes or within residential care facilities - that is to say, out of the hospital!...
2017: Nursing Leadership
Karima Velji, Callum Tyrrell, Mark Rice, Andrea Marshall, Sanaz Riahi
Patient partnership has become a central element of healthcare delivery in many countries. The concept has specific relevance in mental health, as it is a critical enabler of recovery and healing (Bailey and Williams 2014). Patient partnership implies active engagement of patients in shaping decisions at the direct care, organizational and system level (Health Quality Ontario 2017). This article will outline the concept of patient partnership, and highlight the journey of one mental health.
2017: Nursing Leadership
Geoffrey Maina, Brenda Mishak, Anthony de Padua, Gillian Strudwick, Angelica Docabo, Hira Tahir
Prince Albert, Saskatchewan, is experiencing a substance use and addiction crisis with devastating consequences. To engage local stakeholders on substance use and addiction issues, nurse researchers at the University of Saskatchewan, Prince Albert Campus, planned and organized a one-day community engagement and knowledge exchange forum. The forum provided the opportunity for interested community groups, members and individuals to share their experiences and to explore novel ways to prevent and respond to the substance abuse and addiction challenges in the region...
2017: Nursing Leadership
Leigh Chapman
The current overdose epidemic we are facing in Canada and internationally calls on nursing leaders to prioritize holistic and compassionate care for people who use drugs (PWUD) and their families. Nurses are well positioned to provide person-centred care and advocate with and for this population. To do so requires an examination of one's personal values and beliefs surrounding drugs and the people who use them. As a nurse leader, I was forced to confront my views about illicit drug use following the untimely death of my brother Brad from overdose...
2017: Nursing Leadership
Mary Lou Ackerman, Tazim Virani, Barry Billings
Barriers such as stigma and access issues prevent 60% of Canadians with mental health issues from seeking help. Saint Elizabeth Health Care's IntelligentCareâ„¢ Platform supports a range of digital health solutions for holistic health including three specific innovations: a secure social networking tool, an artificial intelligence-driven assistant that uses conversational cognitive behaviour therapy techniques, and a mobile mindfulness meditation application that generates personalized meditation suggestions...
2017: Nursing Leadership
Kim Ritchie, Andra Duff-Woskosky, Sarah Kipping
Transitions between hospital and community are particularly challenging for vulnerable adults experiencing behavioural and psychological symptoms (BPSD) of dementia. Too often, miscommunication results in triggering a recurrence of disruptive behaviours leading to frustration of staff and families. As part of the implementation of Health Quality Ontario (HQO) Quality Standards, this project involved improving transitions using an electronic-based care plan on a 23-bed geriatric dementia unit in a mental health hospital...
2017: Nursing Leadership
Lenora Marcellus, Sana Z Shahram
The promotion, protection and restoration of mental health are foundational to healthy communities. However, most mental health services in Canada, already underfunded in comparison to hospital-based medical-surgical programs, continue to be focused on providing reactive acute care. Mental health problems in later life often have their roots in the prenatal, infancy and early childhood life periods, and considerable evidence has accumulated about the effectiveness of interventions during this period of time...
2017: Nursing Leadership
Margaret Gehrs, Gillian Strudwick, Sara Ling, Emilene Reisdorfer, Kristin Cleverley
Mental health and addictions services are integral to Canada's healthcare system, and yet it is difficult to recruit experienced nurse leaders with advanced practice, management or clinical informatics expertise in this field. Master's-level graduates, aspiring to be mental health nurse leaders, often lack the confidence and experience required to lead quality improvement, advancements in clinical care, service design and technology innovations for improved patient care. This paper describes an initiative that develops nursing leaders through a unique scholarship, internship and mentorship model, which aims to foster confidence, critical thinking and leadership competency development in the mental health and addictions context...
2017: Nursing Leadership
Barbara Mildon, Kristin Cleverly, Gillian Strudwick, Rani Srivastava, Karima Velji
Five nurse leaders in mental health offer their perspectives on key issues facing the sector and reflect on how nurses can make a difference in the following critical areas: nursing practice, transitions of care, innovative technologies, challenging stigma and creating patient partnerships.
2017: Nursing Leadership
Lynn M Nagle
Over the course of the last two decades, much progress has been made in the approaches to the care of people with mental health and addiction challenges. Yet there is still more work to do in terms of advocacy and the provision of meaningful and effective support for these individuals.
2017: Nursing Leadership
Richard Booth, Josephine McMurray, Sandra Regan, Anita Kothari, Lorie Donelle, Susan McBride, Annette Sobel, Jodi Hall, Robert Fraser, Lyndsay Foisey
In the province of Ontario, many of the public health units (PHUs) now possess and use social media as part of their daily health promotion and communication operations. To explore this topic, a planning meeting was held to generate deeper insights toward the use of these forms of technology for preventative services delivery. The planning meeting was held with 50 participants, comprising representatives from 20 of the 36 PHUs in Ontario, interested academics, students and government representatives. A nominal group technique (NGT) was used to build consensus related to future research needs, as related to public health and social media...
2017: Nursing Leadership
Sharon Kaasalainen
The Special Focus on Advanced Practice Nursing in Canada, published in the Canadian Journal of Nursing Leadership (, highlights the unique contributions that advanced practice nurses (APNs) have added to meet the demands of the evolving Canadian healthcare system. Drs. Martin-Misener and Bryant-Lukosius should be commended for their vision as editors of this Special Issue of CJNL, and profiling some excellent work that has occurred across the country in this field of research...
2017: Nursing Leadership
Cynthia J Bergeron, Gina Barton, Wendy Gamache-Holmes, Mary Ellen Barry, Barbara Butler, Lisa Dunnett, William Koval, Kristen Augustin, Natalie Russell, Monica Tominey
As a prime example of the value of an interprofessional approach to care advocated by Orchard and colleagues earlier in this issue (Orchard 2017a, 2017b), the following case study profiles one highly effective interprofessional New Brunswick-based team which cares for clients and families in their homes; a model which has been functional and extremely successful for more than three decades and remains unparalleled in Canada.
2017: Nursing Leadership
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