Factors that influence the decision-making of an interdisciplinary rehabilitation team when choosing a discharge destination for stroke survivors.

This study explored the culture of one interdisciplinary rehabilitation team in British Columbia (BC), Canada, to identify the specific client, clinical, and family factors considered by team members when determining post-hospital discharge placement. The study took the form of an ethnography of a health care team on a stroke unit of a Canadian hospital using observations of the interdisciplinary rehabilitation team meetings and follow-up interviews with team members. The findings from the study indicate post-hospital discharge destination decisions were influenced by specific social, economic, and policy factors; specific types of interactions among members of the team; and the condition of stroke survivors, and the ability and willingness of the patient's family to contribute to home care.

Organizational impact of nurse supply and workload on nurses continuing professional development opportunities: an integrative review.

AIM: To identify the best evidence on the impact of healthcare organizations' supply of nurses and nursing workload on the continuing professional development opportunities of Registered Nurses in the acute care hospital. BACKGROUND: To maintain registration and professional competence nurses are expected to participate in continuing professional development. One challenge of recruitment and retention is the Registered Nurse's ability to participate in continuing professional development opportunities. DESIGN: The integrative review method was used to present Registered Nurses perspectives on this area of professional concern. DATA SOURCES: The review was conducted for the period of 2001-February 2015. Keywords were: nurs*, continuing professional development, continuing education, professional development, supply, shortage, staffing, workload, nurse: patient ratio, barrier and deterrent. REVIEW METHODS: The integrative review used a structured approach for literature search and data evaluation, analysis and presentation. Eleven international studies met the inclusion criteria. RESULTS: Nurses are reluctant or prevented from leaving clinical settings to attend continuing professional development due to lack of relief cover, obtaining paid or unpaid study leave, use of personal time to undertake mandatory training and organizational culture and leadership issues constraining the implementation of learning to benefit patients. CONCLUSION: Culture, leadership and workload issues impact nurses' ability to attend continuing professional development. The consequences affect competence to practice, the provision of safe, quality patient care, maintenance of professional registration, job satisfaction, recruitment and retention. Organizational leadership plays an important role in supporting attendance at continuing professional development as an investment for the future.