Nursing leadership (Toronto, Ont.)最新文献

Background: There is a growing interest in quality improvement collaboratives (QICs), even though less remains known about contextual factors that impact collective and local project implementation. A study was undertaken that used the Consolidated Framework for Implementation Research (CFIR) to explore the contextual factors impacting the use of this nationwide QIC in Canada.

Methods: A deductive or direct qualitative content analysis using CFIR was employed to explore the contextual factors impacting the implementation of a nationwide QIC and participating organizations. Data were used from document analysis and semi-structured interviews with participants from 30 participating healthcare organizations across Canada.

Results: A variety of contextual factors emerged, which influenced the uptake of the QICs across different settings, including intervention characteristics, outer setting, inner setting, and process factors. This study illustrates how organizations can consider a multi-pronged, theory-driven approach to guide the evaluation of safety and quality improvement efforts.

Conclusions: This study provides insights into contextual factors that impact the implementation of local safety projects involved in a larger QIC, which may serve as a template or blueprint for healthcare leaders in their efforts to guide the co-design, implementation and evaluation of safety and quality improvement efforts.

Health inequity among Indigenous populations continues to widen despite advances in Indigenous health research. Under Canada's esteemed universal healthcare system, Indigenous populations continue to experience much poorer health outcomes due to the intersectional legacies of colonialism and racism. In this commentary, we reflect on structural, systemic and service delivery racism at all levels of care, which are deeply embedded in historical, political, institutional and socioeconomic policies and practices that continue to perpetuate harm and genocide of Indigenous Peoples. We call for immediate action to re-establishing epistemic justice and reframing Indigenous knowledge systems in nursing practices, policies, research and education as the starting point in counteracting systemic racism.

As the number of people with dementia admitted to hospitals is expected to grow, now is the time to identify methods to improve nursing care of this population. We conducted an environmental scan to identify and describe interventions in Canadian hospitals to improve the nursing care of people with dementia, how they are being evaluated and what issues influence the success of interventions. Methods included a search of published and unpublished literature and key stakeholder interviews. Interventions are described under three categories: (1) interventions to improve nurses' knowledge, attitudes and skills; (2) interventions to address responsive behaviours; and (3) interventions to help nurses individualize care. The evaluation of interventions rarely included an evaluation of effectiveness and more often included a qualitative evaluation of nurses' experiences with interventions. We summarize the factors affecting the implementation of interventions following the Consolidated Framework for Implementation Research (Damschroder et al. 2009) and suggest strategies for supporting the success of interventions to improve patient care and the experiences of nurses working with people with dementia.

As summer slowly gives way to autumn, I find myself reflecting on the activities of the summer. One memory that stands out is attendance at the 29th International Congress of Nurses held in Montreal in July 2023. Cohosted by the International Council of Nurses and the Canadian Nurses Association, it was an amazing opportunity to meet and learn with nurses from all over the world. It was wonderful to be able to get together in person and feel the palpable energy created by more than 6,000 delegates from 123 countries gathered together for a common purpose. Check out the videos at the following link to see what I mean: https://icncongress2023.org/.

Taking Care, published by HarperCollins Publishers in 2023, is a rich and beautifully written story of nursing that moves beyond the narrow confines of professional nursing. This book is about the work that is nursing and the stories of inspiring nurse leaders and the challenges that they have and continue to overcome. The book is divided into ten chapters named in a way that is reminiscent of a nursing textbook - "Chapter 1: Origins," "Chapter 4: Community," "Chapter 7: Environment" and so on. The introduction is a powerful "chapter" in itself. It sets us up for a deeper understanding of the rest of the book. In this chapter, the author explains her own experiences with nurses. We learn of her harrowing experiences as the mother of a premature baby and as a caretaker for her parents.

It is easy to get lost in a sea of negativity about everything that is going wrong with healthcare and nursing today. Nurses' Voices (https://nursesvoices.ca/) was launched to amplify the voices of Canadian nurses in challenging times. We listened to amazing stories of nurses making a difference in our healthcare system despite the difficult situations they faced. Our guests talked about their experiences, their aspirations, their challenges, what brings them joy in tough situations and their determination to deliver the best care possible to Canadians despite everything. Talking with these nurses reaffirmed for us that if we want to grow and thrive as a profession in an ever-changing healthcare system, where the new normal is uncertainty, then we need to listen and learn from each other. This is what we heard, and this is what we learned.

Organizational support for nurse managers (NMs) is not a new phenomenon. However, generally speaking, NMs are not well supported in their roles. This lack of support is burdensome to NMs' role functioning and has impacts on NM recruitment and retention; NM job satisfaction; and outcomes for front-line nurses and patients. There is a gap in the nursing literature as to what supports are currently in place to effectively support NMs. A scoping review (n = 24) focusing on North American healthcare organizations was conducted to examine what organizational supports are currently in place to support NMs and highlight gaps. Arksey and O'Malley's (2005) scoping review framework was used for this review. NM supports are currently lacking; however, they do include orientation to the NM role; competency and professional development; ancillary and clinical support; and support from upper management. The implications for nursing leadership related to organizational supports and gaps in supports for NMs are presented. Healthcare organizations have work to do in order to better support NMs and ensure quality work environments that facilitate the successful functioning of NMs at all stages of their career.

To increase retention of nurses and ease the nursing shortage, innovative mentorship strategies must be implemented. Our rapid review shows that mentorship programs in hospitals for early-, mid- and late-career nurses is an effective way to improve nurse retention. The unique needs of internationally educated nurses must also be considered in these programs to bolster the Canadian nursing workforce supply. We highlight five tools that are critical to the successful implementation of nurse mentorship programs in hospitals: (1) establish reciprocal relationships between mentors, mentees, hospital administrators and leaders ; (2) facilitate administrative structures, resources and support for mentors and mentees ; (3) enable effective features of mentorship programs ; (4) ensure that mentorship promotes professional and personal development ; and (5) support internationally educated nurses through mentorship.

The Public Health Leadership program administered by the Public Health Branch at the Regional Municipality of York, ON, focused on enhancing people-centred competencies of managers to effectively support staff during the pandemic. The program aimed to boost participative management competencies and resiliency skills of managers by providing them with peer mentorship, ready-to-use resiliency tools, debriefing supports and actionable strategies in the form of e-blasts. Program participants provided feedback collected through two program evaluation surveys. This article describes the results of the qualitative evaluation by highlighting the key strategies and approaches that managers found most useful for enhancing their leadership practice. Key themes emerging from the evaluation indicate that the mentorship component had the most impact on the participants' leadership skills and confidence as a leader.