The Medical Orders for Scope of Treatment (MOST) form completion: a retrospective study.

BACKGROUND: Advance care planning (ACP) involves discussions about patient and families' wishes and preferences for future healthcare respecting autonomy, improving quality of care, and reducing overtreatment. The Medical Orders for Scope of Treatment (MOST) form records person preferred level and types of treatment and intervention. PURPOSE: To examine the MOST form use in inpatient units within a British Columbia (Canada) hospital, estimate and compare its completion rate, and inform health policies for continuous, quality and individualized patient care. METHODS: About 5,000 patients admitted to the participating tertiary acute care hospital during October 2020. Data from 780 eligible participants in medical, surgical, or psychiatry unit were analyzed with descriptive statistics, the chi-square test for group comparisons, and logistic regression to assess predictors of the MOST form completion. RESULTS: Participants' (54% men) age ranged from 20-97 years (mean = 59.53, SD = 19.54). Mainly physicians (99.1%) completed the MOST form for about 60% of them. A statistically significant difference of MOST completion found among the units [Pearson χ2 (df=2, n=780) = 79.53, p < .001, φ = .319]. Multivariate logistic regression analysis demonstrated that age (OR = 1.05, 95% CI 1.04 to 1.06) and unit admission (OR = .60, 95% CI 0.36 to 0.99 in psychiatry; and OR = .21, 95% CI 0.14 to 0.31 in surgery) were independently associated with the MOST form completion. CONCLUSION: Our findings demonstrate a need for consistent and broad completion of the MOST form across all jurisdictions using, desirably, advanced electronic systems. Healthcare providers need to raise awareness of the MOST completion benefits and be prepared to discuss topics relevant to end-of-life. Further research is required on the MOST form completion.

Stories Are Like Water: An Academic Writing Workshop for Nurses.

Traditionally, there is very little formal instruction in academic writing for nurses in graduate programs. We, the writing scholar and a nurse educator and PhD student at a major Canadian university, describe how we collaborated on developing and delivering a 1-day academic writing workshop for incoming master of nursing students. By sharing this description, we hope to motivate nursing faculty to offer similar workshops to address the dearth of writing instruction for graduate students in nursing and to improve scholarship outcomes.

Feeling Pulled in Different Directions: A Parsesciencing Inquiry.

The Parsesciencing mode of inquiry was used to advance understanding of a universal humanuniverse living experience of feeling pulled in different directions. Ten people engaged in dialogue to address the question, "What is your experience of feeling pulled in different directions?" The discerning extant moment of this inquiry was that feeling pulled in different directions is constrained vigor surfacing in wavering with cherished potentials.

Stories are like water: an academic writing workshop for nurses.

Traditionally, there is very little formal instruction in academic writing for nurses in graduate programs. We, the writing scholar and a nurse educator and PhD student at a major Canadian university, describe how we collaborated on developing and delivering a 1-day academic writing workshop for incoming master of nursing students. By sharing this description, we hope to motivate nursing faculty to offer similar workshops to address the dearth of writing instruction for graduate students in nursing and to improve scholarship outcomes.

Concept Inventing: Feeling Pulled in Different Directions.

People refer to feeling pulled in different directions as laboring with everyday living of life challenges and opportunities. Guided by concept inventing within a humanbecoming worldview, a now-truth of this phenomenon is that feeling pulled in different directions is visualizing surfaces with spirited longing in a riveting uncertitude of diversions. The ingenuous proclamation was expressed in the language of humanbecoming as imaging the powering valuing of languaging originating and illuminated within the artform Scorned as Timber, Beloved of the Sky by Emily Carr. This exploration contributes to nursing knowledge within the humanbecoming paradigm and offers foci for future inquiry.

More Than Words? Embracing a Practice-Care Distinction for Nursing Practice Education.

In this paper, authors draw on distinctions between nursing practice and nursing care to inform abstraction and assignment of pre-licensure practice experience hours. Authors discuss an imperative to develop understandings of practice education and practice experience hours that reflect nursing as a basic human science, with implications for the enrichment of student scholarship and flourishing.

An interdisciplinary team communication framework and its application to healthcare 'e-teams' systems design.

BACKGROUND: There are few studies that examine the processes that interdisciplinary teams engage in and how we can design health information systems (HIS) to support those team processes. This was an exploratory study with two purposes: (1) To develop a framework for interdisciplinary team communication based on structures, processes and outcomes that were identified as having occurred during weekly team meetings. (2) To use the framework to guide 'e-teams' HIS design to support interdisciplinary team meeting communication. METHODS: An ethnographic approach was used to collect data on two interdisciplinary teams. Qualitative content analysis was used to analyze the data according to structures, processes and outcomes. RESULTS: We present details for team meta-concepts of structures, processes and outcomes and the concepts and sub concepts within each meta-concept. We also provide an exploratory framework for interdisciplinary team communication and describe how the framework can guide HIS design to support 'e-teams'. CONCLUSION: The structures, processes and outcomes that describe interdisciplinary teams are complex and often occur in a non-linear fashion. Electronic data support, process facilitation and team video conferencing are three HIS tools that can enhance team function.

Evaluating an Initiative to Promote Entry-Level Competence in Palliative and End-of-Life Care for Registered Nurses in Canada.

Numerous competency statements have been developed for the purpose of guiding nurse educators and clinicians. Rarely, though, are there evaluations of the use of these competency statements in practice. In this cross-sectional descriptive study, nurse educators were surveyed to determine how the Canadian Association of Schools of Nursing (CASN) Palliative and End-of-Life Care Entry-to-Practice Competencies and Indicators are used in schools of nursing in Canada. Twenty-four respondents consented to participating in this study. Findings supported that some version of palliative and end-of-life care (PEOLC) education was offered at each school of nursing in Canada, and it was most commonly threaded throughout existing undergraduate courses. Data also suggested that if nurse educators were interested in PEOLC and had existing knowledge or expertise in PEOLC, the CASN Palliative and End-of-Life Care competency document was used to integrate content into curricula. This study provides some initial insights into the use of the CASN Palliative and End-of-Life Care competency document in Canadian schools of nursing. Implications for additional research, policy, education, and practice are discussed.

Nursing: whose discipline is it anyway?

Nursing is variously described as a profession, a discipline, an occupation. The meanings we assign to such words and the expectations, demands, and responsibilities that each reveals to and/or exacts from those of us privileged to call ourselves registered nurse provides a splendid arena for viewing the struggle of nursing as an intellectual endeavor embedded in its own distinctive knowledge base, experiences, purposes, and values. Currently, pressure exerted within and without nursing to adopt the self-limiting potential and subordinated position that a professional discipline orientation and applied degree education confer on nursing is mounting. This article examines the relationships among historical events, contemporary influences, and confounding definitions that are integral to how we choose to guide and shape the evolution of nursing scholarship, practice, and education. The authors contend that the full significance of these relationships must be appreciated if nursing is to advance as a scholarly academic discipline and practice profession.