Experiencing COVID-19 Through the Patient Lens to Promote Empathy: Pilot Testing a Virtual Reality Learning Opportunity.

Understanding the patient's experience with COVID-19 was essential to providing high-quality, person-centered care during the pandemic. Having empathy or being able to understand and respond to the patient's experience may lead to improved outcomes for both patients and clinicians. There is mixed evidence about how best to teach empathy, particularly related to promoting empathy during COVID-19. Literature suggests that virtual reality may be effective in empathy-related education. In collaboration with four patient partners with lived experience, a 360° VR video was developed reflecting their stories and interactions with the healthcare system. The aim of this study was to pilot test the video with interprofessional healthcare providers (HPs) to explore acceptability and utility, while also seeking input on opportunities for improvement. Eleven HPs reviewed the video and participated in one of three focus groups. Focus group data were analyzed using thematic analysis. Data suggest that video content is acceptable and useful in promoting a better understanding of the patient's experience. Building on these encouraging findings, additional iterations of videos to promote empathy will be developed and tested.

Bilinear pooling in video-QA: empirical challenges and motivational drift from neurological parallels.

Bilinear pooling (BLP) refers to a family of operations recently developed for fusing features from different modalities predominantly for visual question answering (VQA) models. Successive BLP techniques have yielded higher performance with lower computational expense, yet at the same time they have drifted further from the original motivational justification of bilinear models, instead becoming empirically motivated by task performance. Furthermore, despite significant success in text-image fusion in VQA, BLP has not yet gained such notoriety in video question answering (video-QA). Though BLP methods have continued to perform well on video tasks when fusing vision and non-textual features, BLP has recently been overshadowed by other vision and textual feature fusion techniques in video-QA. We aim to add a new perspective to the empirical and motivational drift in BLP. We take a step back and discuss the motivational origins of BLP, highlighting the often-overlooked parallels to neurological theories (Dual Coding Theory and The Two-Stream Model of Vision). We seek to carefully and experimentally ascertain the empirical strengths and limitations of BLP as a multimodal text-vision fusion technique in video-QA using two models (TVQA baseline and heterogeneous-memory-enchanced 'HME' model) and four datasets (TVQA, TGif-QA, MSVD-QA, and EgoVQA). We examine the impact of both simply replacing feature concatenation in the existing models with BLP, and a modified version of the TVQA baseline to accommodate BLP that we name the 'dual-stream' model. We find that our relatively simple integration of BLP does not increase, and mostly harms, performance on these video-QA benchmarks. Using our insights on recent work in BLP for video-QA results and recently proposed theoretical multimodal fusion taxonomies, we offer insight into why BLP-driven performance gain for video-QA benchmarks may be more difficult to achieve than in earlier VQA models. We share our perspective on, and suggest solutions for, the key issues we identify with BLP techniques for multimodal fusion in video-QA. We look beyond the empirical justification of BLP techniques and propose both alternatives and improvements to multimodal fusion by drawing neurological inspiration from Dual Coding Theory and the Two-Stream Model of Vision. We qualitatively highlight the potential for neurological inspirations in video-QA by identifying the relative abundance of psycholinguistically 'concrete' words in the vocabularies for each of the text components (e.g., questions and answers) of the four video-QA datasets we experiment with.

Discharge planning in mental healthcare settings: A review and concept analysis.

To ensure a safe transition of mental health patients from hospital to community settings, greater attention is being given to discharge planning. However, assessing the quality of discharge planning has been challenging due to wide variations in its definition. To facilitate evaluation of discharge planning, its meaning in the mental health literature was systematically explored. This concept analysis is part of a larger study to develop an instrument to measure the quality of discharge planning processes in mental health care. Walker and Avant's (2011) concept analysis approach was adopted to provide a comprehensive definition of discharge planning. Electronic databases and grey literature were searched and analysed according to Grant and Booth's (2009) systematic search and review process. Literature published between 1900 and 2018 was reviewed. Forty-nine articles meeting the inclusion criteria were included in the analysis. Discharge planning is a complex, multifaceted concept with six defining attributes: comprehensive needs assessment; collaborative, patient-centered care; resource availability management; care and service coordination; discharge planner role; and a discharge plan. Discharge planning begins with the initial rapid assessment and symptom stabilization of a patient on admission, coincides with treatment planning, and is associated with hospital readmissions and continuity of care. The mental health literature was reviewed to analyse different interpretations of discharge planning. The conceptual definition provided can assist healthcare providers, organizational leaders, and policymakers to design and implement effective discharge planning policies and guidelines. Providing clarity regarding discharge planning also provides a critical foundation for developing an instrument.

The role of unregulated care providers in home care: A scoping review.

AIM AND BACKGROUND: Health care needs of individuals living in the community are increasing. To meet the rising need, unregulated care providers are providing more complex patient care. The aim of this review is to articulate the unregulated care provider role by identifying patient care activities offered by unregulated care providers in home care. METHODS: A scoping review was conducted. One thousand and eleven published manuscripts were identified in CINAHL, Ageline and MEDLINE. Eleven additional manuscripts were identified through hand searching. Manuscripts were screened for relevancy and data were abstracted to address the research question. RESULTS: Twenty-eight studies originating from Canada, Sweden, Belgium, UK, USA and New Zealand were included. Three categories of patient care activities provided by unregulated care providers were found: (1) personal care and core skills; (2) delegated tasks and added skills; and (3) specialty roles. CONCLUSION: Unregulated care providers predominantly provide assistance with personal care and activities of daily living. However, unregulated care providers also provide care outside their training, including care once provided by nurses. IMPLICATIONS FOR NURSING MANAGEMENT: Guidelines clearly articulating responsibilities of nurses transferring care activities to unregulated care providers should be developed. Processes and policies regarding evaluation and supervision of unregulated care providers providing added skills should be developed to ensure appropriate monitoring and support.

Nursing Process Health Care Indicators: A Scoping Review of Development Methods.

Identifying how nursing care directly affects patients is essential to improving care quality, reducing costs, and determining nursing's contribution to overall organizational performance. This scoping review examined methods used for developing nursing process health care indicators. Key concepts and sources of evidence were identified to lay a foundation for future development and identification of valid and reliable nursing process health care indicators.

A Drosophila LexA Enhancer-Trap Resource for Developmental Biology and Neuroendocrine Research.

Novel binary gene expression tools like the LexA-LexAop system could powerfully enhance studies of metabolism, development, and neurobiology in Drosophila However, specific LexA drivers for neuroendocrine cells and many other developmentally relevant systems remain limited. In a unique high school biology course, we generated a LexA-based enhancer trap collection by transposon mobilization. The initial collection provides a source of novel LexA-based elements that permit targeted gene expression in the corpora cardiaca, cells central for metabolic homeostasis, and other neuroendocrine cell types. The collection further contains specific LexA drivers for stem cells and other enteric cells in the gut, and other developmentally relevant tissue types. We provide detailed analysis of nearly 100 new LexA lines, including molecular mapping of insertions, description of enhancer-driven reporter expression in larval tissues, and adult neuroendocrine cells, comparison with established enhancer trap collections and tissue specific RNAseq. Generation of this open-resource LexA collection facilitates neuroendocrine and developmental biology investigations, and shows how empowering secondary school science can achieve research and educational goals.

Systematic Review: Bridging the Gap in RPN-to-RN Transitions.

PURPOSE: To review the evidence examining the influences of successful education and professional role transition for registered practical nurses (RPNs) pursuing a baccalaureate degree in nursing (BScN) and registered nurse (RN) licensure through RPN-to-RN bridging programs. DESIGN: Systematic review of papers published between 1995 and 2014 that evaluated students' education and professional role transitions from RPN to RN. METHODS: Thirty-nine papers were selected that observed or studied the change or transition in designation from RPN to RN, or its equivalent, through bridging programs and analyzed thematically according to Meleis, Sawyer, Im, Hilfinger Messias, and Schumacher's transition model. FINDINGS: Personal, community, and social conditions related to preparation for entry, program enrolment, and postgraduate clinical integration influence successful education and professional role transitions for RPN-to-RN bridging students. CONCLUSIONS: Providing key transition supports may enhance the potential for successful student transition into and throughout a bridging program, but further research is necessary to enhance this understanding and to recommend best practices for optimizing students' success. CLINICAL RELEVANCE: The evidence from this review identifies facilitators and barriers to successful education and professional role transition for RPN-to-RN bridging students, and identifies important considerations for future research.

Measuring the quality of evidence-based nursing care: NQuIRE - nursing quality indicators for reporting and evaluation data-system / Midiendo la calidad del cuidado de enfermería basado en la evidencia: NQuIRE: sistema de indicadores de calidad en enfermería para reportar y evaluar / Avaliando a qualidade dos cuidados de enfermagem baseada em evidências: NQuIRE: sistema de indicadores de qualidade na enfermagem para referenciar e avaliar

Nursing Quality Indicators for Reporting and Evaluation (NQuIRE) is an international quality improvement initiative to develop and sustain a data-system of nursing-sensitive quality indicators derived from recommendations within the Registered Nurses’ Association of Ontario’s evidence-based best practice guidelines. Objective: The purpose of this article is to provide an overview of the indicator database within the context of the Registered Nurses’ Association of Ontario’s best practice guideline program and Best Practice Spotlight Organization® Designation. Future directions for technical enhancements, quality indicator development and research within the database will also be discussed. Topic: Nursing Quality Indicators for Reporting and Evaluation consists of a database, a data dictionary, including a set of organization-level structural indicators, as well as a set of process and outcome indicators for each best practice guideline, and data collection and reporting processes. Conclusions: The data-system collects, analyzes and reports quality indicator data submitted by health-care service and academic organizations participating in the Registered Nurses’ Association of Ontario’s Best Practice Spotlight Organization® Designation.

El sistema de indicadores de calidad en enfermería para reportar y evaluar (NQuIRE) es una iniciativa internacional de mejoramiento de la calidad para desarrollar y sostener un sistema de datos de indicadores de calidad de enfermería derivados de las recomendaciones de guías de buenas prácticas basadas en la evidencia de la Asociación de Enfermeras Profesionales de Ontario. Objetivo: El propósito de este artículo es ofrecer un panorama de la base de datos de indicadores dentro del contexto del programa de guías de buenas prácticas de enfermería de la Asociación de Enfermeras Profesionales de Ontario y el programa de centros comprometidos con la Excelencia en Cuidados. Futuras directrices para el mejoramiento técnico, desarrollo e investigación de los indicadores de calidad en la base de datos también serán discutidos. Desarrollo del tema: El Sistema de Indicadores de Calidad en Enfermería para Reportar y Evaluar consta de una base de datos, un diccionario de datos que incluye un conjunto de indicadores estructurales a nivel de la organización, además de un conjunto de indicadores de procesos y resultados para cada guía de mejores prácticas, y procesos de recopilación y reporte de datos. Conclusiones: El sistema de datos recopila, analiza e informa los datos sobre indicadores de calidad presentados por las organizaciones académicas y de servicio de atención médica que participan en el programa de designación como Centro Comprometido con la Excelencia en Cuidados de la Organización de Enfermeras Profesionales de Ontario.

O Sistema de Indicadores da Avaliação de Qualidade na Enfermagem é uma iniciativa internacional de melhoria na qualidade para promover e manter um sistema de dados de indicadores de qualidade na enfermagem decorrentes das recomendações de diretrizes de melhores práticas baseadas em evidências da Associação das Enfermeiras Profissionais de Ontario, no Canadá*. Objetivo: O objetivo deste artigo é fornecer uma visão geral do banco de dados de indicadores no contexto do Programa das Guias* de Boas Práticas na Enfermagem da Associação de Enfermeiras Profissionais de Ontario e o Programa dos Centros Comprometidos com a Excelência nos Cuidados. Orientações futuras para o aprimoramento técnico, pesquisa e desenvolvimento de indicadores de qualidade no banco de dados, também serão discutidos. Temas: O sistema de indicadores de Qualidade na Enfermagem para o Relatório e Avaliação conta com um banco de dados, um dicionário de dados que inclui um conjunto de indicadores estruturais próprio da organização, juntamente com um conjunto de indicadores de processos e resultados para cada guia de melhores práticas, e processos recopilados e dados relatados. Conclusões: O sistema de dados recolhe, analisa e informa os indicadores de qualidade apresentados pelas organizações acadêmicas e os serviços médicos escolhidos como Centros Comprometidos com a Excelência nos Cuidados da Organização de Enfermeiras Profissionais de Ontario.