Initial testing of the use of the Safer Nursing Care Tool in a Canadian acute care context.

AIM: Initial testing of England's Safer Nursing Care Tool for adult in-patient acute care wards in a university-affiliated Canadian hospital. BACKGROUND: Safe-nursing staffing decisions have significant impacts on patients' safety and quality of care. The Safer Nursing Care Tool was developed in England to provide managers with a validated formula for making appropriate nursing staffing decisions. The tool has been widely used and studied in the UK but has yet to be tested in a Canadian context. METHOD: Ten high service quality acute care wards from a university-affiliated Canadian hospital tested the use of the Safer Nursing Care Tool. Service quality, patients' dependency/acuity and staff activity data were benchmarked against information collected in 726 comparable UK wards. RESULTS: Higher bed occupancy and patient dependency/acuity mix were found in the 10 Canadian wards compared to their UK counterparts. Overall staff activity was comparable between UK and Canadian wards. CONCLUSION: The Safer Nursing Care Tool can be applied in this Canadian hospital, and further testing in other hospitals and specialties is required. IMPLICATION FOR NURSING MANAGEMENT: The Safer Nursing Care Tool is a valid staffing tool to use that, when combined with professional judgement, can help managers to properly establish nursing staff in acute care wards.

Development and implementation of the specialized nurse practitioner role: use of the PEPPA framework to achieve success.

In 2003, amendments to the Nurses' Act in Quebec, Canada, allowed for an expanded nursing role. Specialized nurse practitioners were introduced to the health-care system in 2005. By merging medical knowledge with advanced practice nursing, the specialized nurse practitioner is gaining in popularity and acceptance with staff members and patients. To guide our team through the process, we used the PEPPA (participatory, evidence-based, patient-focused process for guiding the development, implementation, and evaluation of advanced practice nursing) framework. By using a framework specifically designed for the development, implementation, and evaluation of an advanced practice nursing role, we were better prepared for the path that lay ahead. Ultimately, the goal of the implementation of the specialized nurse practitioner role is to improve the quality of care to a specific population of patients, whether it is through individualized clinical follow-up, evidence-based practice, patient teaching, or promoting continuous education for the nurses.

A pre-post evaluation of the Adler/Sheiner Programme (ASP): a nursing informational programme to support families and nurses in an intensive care unit (ICU).

BACKGROUND: ICU nurses often report that timely informational and supportive resources would ease distress for clients and providers alike. OBJECTIVES: This pilot study was aimed to explore the role of a comprehensive information and support programme in enhancing the work environment, task performance and reducing emotional distress amongst ICU nurses. RESEARCH METHODOLOGY/DESIGN: Through a mixed quantitative and qualitative design, nurses were invited to complete self-report questionnaires (n=25) and to participate in focus groups (n=7) prior to (T1) and 6 weeks after the implementation of the supportive programme (T2). RESULTS: Measures of physical and mental effort were found to be significantly lower (t=2.45, p=0.02) at post test (T2). Statistical trends towards significance were observed for higher performance satisfaction (t=1.70, p=0.10) and lower emotional distress (t=2.00, p=0.06) at T2. Focus group data revealed that nurses felt more supported in their work, had more satisfaction with work tasks accomplished and felt more emotionally supported with the programme being in place. CONCLUSIONS: Preliminary data from this pilot study suggest that a comprehensive information and support programme designed to support nurses in the ICU can enhance well being and workplace related factors. Work is currently underway to document the program's impact on family members in the ICU. Future studies should document further how and when similar programme contribute to enhance the workplace for other ICU staff.

Bridging the gap: interprofessional collaboration between nurse practitioner and clinical nurse specialist.

PURPOSE/OBJECTIVES: The purpose of this article was to describe the collaborative model established between the specialized nurse practitioner (SNP) and the clinical nurse specialist (CNS), within the cardiac surgery population. BACKGROUND/RATIONALE: The literature has shown a trend that SNPs and CNSs work in parallel or even in competition. Little has been written about a collaborative model and the advantages to working together toward a mutual goal. It was felt that a collaborative model between advance practice nurses could demonstrate the advantages of using their unique perspectives to achieve improvement in the quality of care given to the patients. DESCRIPTION OF THE PROJECT/INNOVATION: The Structuration Model of Interprofessional Collaboration was used as a guide to our interventions and elaboration of our project. The team set out to establish, promote, and nurture a collaborative approach to care for the cardiac surgery population from admission to 3 months after discharge. OUTCOMES: A collaborative relationship was achieved between the SNP and the CNS, to the benefit of the patient population. INTERPRETATION/CONCLUSION: Collaboration between these 2 advanced practice nurses is realistic and attainable. The advantages to this relationship outweigh the negative feelings harbored toward each professional title. By working in collaboration instead of in parallel, resources are pooled together to achieve greater services and care for the patients. IMPLICATIONS: A change in attitude between professionals has a positive impact on working relationships, partnerships, and communication. Ultimately, it is an advantage for the advanced practice nurse, the multidisciplinary team, and the patient.

Supporting families in the ICU: a descriptive correlational study of informational support, anxiety, and satisfaction with care.

BACKGROUND: Informational support to family members of ICU patients has significant potential for reducing their psychological distress, enabling them to better cope and support the patient. OBJECTIVES: To describe family member perception of informational support, anxiety, satisfaction with care, and their interrelationships, to guide further refinement of a local informational support initiative and its eventual evaluation. METHODOLOGY/DESIGN: This cross-sectional descriptive correlational pilot study collected data from a convenience sample of 29 family members using self-report questionnaires. SETTING: 22-bed medical-surgical intensive care unit of a 659-bed university affiliated teaching hospital in Montreal, Quebec, Canada. RESULTS: Mean informational support, assessed with a modified version of the CCFNI (Molter and Leske, 1983), was 55.41(SD=13.28; theoretical range of 20-80). Mean anxiety, assessed with the State Anxiety Scale (Spielberger et al., 1983) was 45.41 (SD=15.27; theoretical range of 20-80). Mean satisfaction with care, assessed using Androfact (Version 4.0, 2001), was 83.09 (SD=15.49; theoretical range of 24-96). A significant positive correlation was found between informational support and satisfaction with care (r=0.741, p<.001). No significant relationships were noted between informational support and anxiety nor between satisfaction with care and anxiety. CONCLUSION: Findings are related to the ultimate objectives of refining a local informational support initiative and its eventual evaluation, and in so doing, are of more widespread interest to others striving to make evidence based improvements to the care of similar populations.