Canadian Youth Correctional Officers' Views on Their Work and Relationships With Youth in Their Care.

This study explored the personal perspectives of youth correctional officers within secure and open custody facilities in Ontario. A multi-methods design allowed for quantitative data collection to assess demographics and scores on a relationship scale and qualitative open-ended survey responses to explore areas of interest regarding officer work. Despite a small sample size (N = 26), results indicated trends in officers' views of their work and relationships with youth. Youth officers report various job duties ranging from supervision/security to cleaning and preparing meals. Results indicate differences in endorsement for relationship development with youth for those who see treatment as part of their role in rehabilitation and those who do not. This exploratory study provides a starting point for understanding the unique experiences and duties of youth correctional officers in Ontario, Canada, and their views on relationship development with youth. Future research will include in-person interviews, facilitating more rich data collection.

Exploration of note writing by mental health nurses using a video scenario.

AIMS AND OBJECTIONS: We aimed to explore the content and language of nursing documentation and gain insight into the internal processes of nurses while notetaking. BACKGROUND: Documentation is a core competency of mental health nursing, has clinical and ethical importance and is the integral to the efficient and effective care provided to patients. However, issues related to the content and quality of nursing notes continues to be a concern and there remains gaps in our understanding about the internal processes that nurses engage in when writing notes. DESIGN: We used a mixed method design that included a content analysis with note review and interviews. METHODS: After watching a video, psychiatric nurses (n = 27) wrote a note and then were interviewed about their note taking process. We used the COREQ guidelines for reporting our data. RESULTS: Participants relied on four main themes when determining what to include in their notes-what happened and what the patient said or did, plus anything different than baseline, and safety concerns. Analyses revealed the presence of bias in the notetaking and participants were not familiar with effective strategies to mitigate these during the documentation process. Lastly, we found that notes are typically consistent in using some of the SOAPE format with notes focused on direct observations and the use of 'facts', while assessment and construction of treatment plans are used to a lesser extent. CONCLUSIONS: Our results provide insight into the decision-making process of nursing staff regarding their documentation practices: overall they appear unaware of the importance of their notes, and believe that capturing the facts about their patients is important, while devaluing their own input and interpretations. RELEVANCE TO CLINICAL PRACTICE: Our results provide evidence that mental health nurses may need additional training regarding documentation, more specifically about what to include, word choice and bias.

Investigating the impact of cognitive bias in nursing documentation on decision-making and judgement.

The clinical documentation of patients' mental status, behaviour and functioning is a fundamental aspect of inpatient mental health care. It is an important source of information-sharing with the interprofessional team and used by other clinicians within the circle of care to guide their decision-making process. Given the body of evidence highlighting concerns about the quality of nursing documentation and the growing literature demonstrating the presence of bias in healthcare, it is critically important that we examine the impact of this bias in nursing practice. The primary objective of this study was to determine whether clinical decisions and judgements change when nurses read documentation that is either biased or neutral. Using a quantitative, observational study that used surveys to collect data, participants were exposed to two patient vignettes and six clinical notes associated with each patient (notes were written with either biased or neutral language) and asked to make clinical decisions and judgements. Results from 199 nurse participants from a tertiary mental health hospital revealed a notable relationship between the type of notes read (biased vs. neutral) and clinical practice, namely, participants reading biased notes were less likely to offer health teaching when administering pro re nata (PRN) medication for sleep. We also found differences in decision-making and judgements based on the type of note read depending on years of experience and type of education. The results indicate that biased language in nursing documentation can influence other clinicians' decisions and judgements about patients, thereby indicating a cascade of bias.