Assessing the impact of day programs on individuals living with dementia and their family/friend caregivers (AIDA-DemCare): protocol of a prospective cohort study combined with a qualitative evaluation.

Background: Persons with dementia, their family/friend caregivers, and health systems agree that the preferred place of dementia care is a person's home. Health systems have struggled to provide sufficient community-based dementia care supports, negatively affecting the health and well-being of persons with dementia and their caregivers. Therefore, dementia care and support of dementia caregivers are critical public health priorities.

A Better Way to Care for Long-Term Care Residents in Times of Medical Urgency: An Implementation Intervention Using a Stepped-Wedge Design to Reduce Unnecessary Acute Care Transfers.

Objective: Approximately 25% of long-term care (LTC) residents are transferred to an emergency department (ED) when experiencing an acute change in health status. This can place strain on health care resources and negatively impact residents. Many residents' conditions could be managed within LTC if appropriate supports were provided.

Health System Leadership for Psychological Health and Organizational Resilience During the COVID-19 Pandemic: Protocol for a Multimethod Study.

Background: Since the World Health Organization declared COVID-19 a global pandemic, health systems and health system leaders have faced unprecedented challenges through the various stages of the crisis. Canada and other health systems were largely ill-prepared to handle this crisis. The longevity of the pandemic has profoundly affected health care systems and compounded the rates of negative psychological outcomes in health systems' leaders and staff, rates of emotional exhaustion, and burnout.

Equity, Diversity and Inclusion in Nursing Educational Institutions: A Scoping Review.

Aim: To present the current evidence on the nature and principles of Equity, Diversity and Inclusion (EDI) in Nursing Education Institutions (NEIs).

Method: Five databases (CINAHL, Medline, Scopus, ERIC and Educational Research Complete) and websites of Canadian nursing education institutions were searched for studies and grey literature on EDI. Information was analysed using the Diversio Diversity and Inclusion Survey (DDIS) framework to highlight the nature and principles of EDI in NEIs.

Reimagining the State of Nursing Leadership Science in Canada.

This department column outlines the challenges in the current turbulent Canadian healthcare system and the state of nursing leadership science. The authors tackle strategies for the nursing shortage, highlighting the need for a collective leadership approach, and new ways of working that value nurses in addressing a critical nursing shortage.

Authentic Nursing Leadership and Safety Climate Across Hospital Settings During the COVID-19 Pandemic: A Cross-Sectional Study.

Aim: To analyse the relationship between authentic nursing leadership and safety climates across hospital settings during the COVID-19 pandemic.

Background: Authentic nursing leadership shapes the safety climate by fostering positive perceptions of workplace policies, processes, procedures and practices that influence how safety is prioritised and addressed within an organisation.

Design: A cross-sectional study.

The development and validation of a conceptual definition of avoidable transitions from long-term care to the emergency department: A mixed methods study.

Background/objectives: Transitions to and from Emergency Departments (EDs) can be detrimental to long-term care (LTC) residents and burden the healthcare system. While reducing avoidable transfers is imperative, various terms are used interchangeably including inappropriate, preventable, or unnecessary transitions. Our study objectives were to develop a conceptual definition of avoidable LTC-ED transitions and to verify the level of stakeholder agreement with this definition.

How context links to best practice use in long-term care homes: a mixed methods study.

Background: Context (work environment) plays a crucial role in implementing evidence-based best practices within health care settings. Context is multi-faceted and its complex relationship with best practice use by care aides in long-term care (LTC) homes are understudied. This study used an innovative approach to investigate how context elements interrelate and influence best practice use by LTC care aides.

A nursing perspective on the antecedents and consequences of incivility in higher education: A scoping review.

Background: Understanding antecedents and consequences of incivility across higher education is necessary to create and implement strategies that prevent and slow uncivil behaviors.

Purpose: To identify the nature, extent, and range of research related to antecedents and consequences of incivility in higher education.

Objectives: 1) To identify disciplines and programs sampled in higher education incivility research, and 2) to compare antecedents and consequences examined in nursing education research with other disciplines and programs in higher education.

Factors influencing nurse manager retention, intent to stay or leave and turnover: A systematic review update.

Aims: To understand factors influencing nurse manager retention or intention to leave, develop a preliminary theoretical model and identify strategies and interventions for workforce planning.

Design: Systematic review update of literature with integrated design of mixed research synthesis.

Methods: We included peer-reviewed articles examining factors influencing retention or intention to leave for front-line, middle or patient care nurse managers.

Contextually appropriate nurse staffing models: a realist review protocol.

Introduction: Decisions about nurse staffing models are a concern for health systems globally due to workforce retention and well-being challenges. Nurse staffing models range from all Registered Nurse workforce to a mix of differentially educated nurses and aides (regulated and unregulated), such as Licensed Practical or Vocational Nurses and Health Care Aides. Systematic reviews have examined relationships between specific nurse staffing models and client, staff and health system outcomes (eg, mortality, adverse events, retention, healthcare costs), with inconclusive or contradictory results.

The Association of Nursing Homes' Organizational Context With Care Aide Empowerment: A Cross-Sectional Study.

Background And Objectives: Organizational context is thought to influence whether care aides feel empowered, but we lack empirical evidence in the nursing home sector. Our objective was to examine the association of features of nursing homes' unit organizational context with care aides' psychological empowerment.

Research Design And Methods: This cross-sectional study analyzed survey data from 3765 care aides in 91 Western Canadian nursing homes.

Organizational Context and Facilitation Interactions on Delirium Risk in Long-Term Care: A Cross-Sectional Study.

Objectives: Organizational context (eg, leadership) and facilitation (eg, coaching behaviors) are thought to interact and influence staff best practices in long-term care (LTC), including the management of delirium. Our objective was to assess if organizational context and facilitation-individually, and their interactions-were associated with delirium in LTC.

Design: Retrospective cross-sectional analysis of secondary data.

Strategies to Improve Emergency Transitions From Long-Term Care Facilities: A Scoping Review.

Background And Objectives: Older adults residing in residential aged care facilities (RACFs) often experience substandard transitions to emergency departments (EDs) through rationed and delayed ED care. We aimed to identify research describing interventions to improve transitions from RACFs to EDs.

Research Design And Methods: In our scoping review, we included English language articles that (a) examined an intervention to improve transitions from RACF to EDs; and (b) focused on older adults (≥65 years).

Factors influencing health-related quality of life among long-term care residents experiencing pain: a systematic review protocol.

Background: Pain is highly burdensome, affecting over 30% of long-term care (LTC) residents. Pain significantly reduces residents' health-related quality of life (HRQoL), limits their ability to perform activities of daily living (ADLs), restricts their social activities, and can lead to hopelessness, depression, and unnecessary healthcare costs. Although pain can generally be prevented or treated, eliminating pain may not always be possible, especially when residents have multiple chronic conditions.

Burnout Among Nursing Home Care Aides and the Effects on Resident Outcomes.

While burnout among health care workers has been well studied, little is known about the extent to which burnout among health care workers impacts the outcomes of their care recipients. To test this, we used a multi-year (2014-2020) survey of care aides working in approximately 90 nursing homes (NHs); the survey focused on work-life measures, including the Maslach Burnout Inventory (MBI) and work-unit identifier. Resident Assessment Instrument Minimum Data Set (RAI-MDS 2.

Incidence of Pressure Injury Among Older Adults Transitioning from Long-term Care to the ED.

Objective: To identify sociodemographic, health condition, and organizational/process factors associated with pressure injury (PI) incidence during older adults' emergency transitions from long-term care (LTC) to the ED.

Methods: Emergency transitions were tracked for older adults within included LTC facilities to participating EDs in two urban centers located in provinces in Canada. Binary logistic regression was used to examine the influence of sociodemographic, service use, and client health and function factors on the incidence of PIs during transitions from LTC facilities to EDs.

Factors influencing emotional support of older adults living in the community: a scoping review protocol.

Background: Emotional support is key to improve older adults' subjective health, and psychological, social and emotional well-being. However, many older adults living in the community lack emotional support, increasing the risk for loneliness, depression, anxiety, potentially avoidable healthcare use and costs, and premature death. Multiple intersecting factors may influence emotional support of older adults in the community, but these are poorly understood.

Organizational Context and Quality Indicators in Nursing Homes: A Microsystem Look.

The association of organizational context with quality of care in nursing homes is not well understood at the clinical microsystem (care unit) level. This cross-sectional study examined the associations of unit-level context with 10 unit-level quality indicators derived from the Minimum Data Set 2.0.

Measuring Potentially Avoidable Acute Care Transfers From Long-Term Care Homes in Quebec: a Cross Sectional Study.

Background: Potentially avoidable emergency department transfers (PAEDTs) and hospitalizations (PAHs) from long-term care (LTC) homes are two key quality improvement metrics. We aimed to: 1) Measure proportions of PAEDTs and PAHs in a Quebec sample; and 2) Compare them with those reported for the rest of Canada.

Methods: We conducted a repeated cross-sectional study of residents who were received at one tertiary hospital between April 2017 and March 2019 from seven LTC homes in Quebec, Canada.

Changes in Health and Well-Being of Care Aides in Nursing Homes From a Pre-Pandemic Baseline in February 2020 to December 2021.

Nursing homes were profoundly affected by the COVID-19 pandemic, influencing work outcomes of care aides who provide the most direct care. We compared care aides' quality of work life by conducting a repeated cross-sectional analysis of data collected in February 2020 and December 2021 from a stratified random sample of urban nursing homes in two Canadian provinces. We used two-level random-intercept repeated-measures regression models, adjusting for demographics and nursing home characteristics.

Nursing assistants' use of best practices and pain in older adults living in nursing homes.

Background: Inadequate pain management persists in nursing homes. Nursing assistants provide the most direct care in nursing homes, and significantly improving the quality of care requires their adoption of best care practices informed by the best available evidence. We assessed the association between nursing assistants' use of best practices and residents' pain levels.

Leadership self-efficacy and nurses' aspiration to leadership: An evolutionary concept analysis.

Background: The complex nature of leadership in nursing and healthcare requires a vast skill set. Leadership self-efficacy (LSE) has emerged as an important concept to support leadership development in the nursing literature. An analysis of LSE can clarify and inform strategies for leadership development among nurses.