Nursing Publications and Research

The development of an online instrument for prior learning assessment and recognition of internationally educated nurses: A pilot study

Elaine Elizabeth Santa Mina et al. — Mon, 07 Feb 2011 06:51:07 PST

A fully online prior learning assessment and recognition (PLAR) tool for internationally educated nurses (IENs) was developed and tested by an inter-professional team at Ryerson University. The tool consisted of two stages: a self-assessment component followed by a multiple-choice examination and narrative (vignette) evaluation. The purposes of the study were to describe the demographic profile of the IEN registered nurse (RN), to develop the benchmark responses that demonstrate competency at the entry-to-practice level of the typical IEN RN, and to describe the experience of completing an online PLAR tool. A mixed-method approach was used. Findings demonstrated that IEN RNs who immigrate to Ontario, Canada, are of various ages and come from a wide spectrum of countries. The PLAR process holds promise for an objective assessment of IEN’s eligibility to write the Canadian Registered Nurses Examination (CRNE) and to meet a global need. Further testing of the tool across a broader sample is required.

Context and Cardiovascular Risk Modification in Two Regions of Ontario, Canada: A Photo Elicitation Study

Jan E. Angus et al. — Fri, 05 Nov 2010 06:55:27 PDT

Cardiovascular diseases, which include coronary heart diseases (CHD), remain the leading cause of death in Canada and other industrialized countries. This qualitative study used photo-elicitation, focus groups and in-depth interviews to understand health behaviour change from the perspectives of 38 people who were aware of their high risk for CHD and had received information about cardiovascular risk modification while participating in a larger intervention study. Participants were drawn from two selected regions: Sudbury and District (northern Ontario) and the Greater Toronto Area (southern Ontario). Analysis drew on concepts of place and space to capture the complex interplay between geographic location, sociodemographic position, and people’s efforts to understand and modify their risk for CHD. Three major sites of difference and ambiguity emerged: 1) place and access to health resources; 2) time and food culture; and 3) itineraries or travels through multiple locations. All participants reported difficulties in learning and adhering to new lifestyle patterns, but access to supportive health resources was different in the two regions. Even within regions, subgroups experienced different patterns of constraint and advantage. In each region, “fast” food and traditional foods were entrenched within different temporal and social meanings. Finally, different and shifting strategies for risk modification were required at various points during daily and seasonal travels through neighbourhoods, to workplaces, or on vacation. Thus health education for CHD risk modification should be place-specific and tailored to the needs and resources of specific communities.

The trainees' perspective on developing an end-of-grant knowledge translation plan

Brenda MY Leung et al. — Thu, 28 Oct 2010 08:11:54 PDT

BACKGROUND: Knowledge translation (KT) is a rapidly growing field that is becoming an integral part of research protocols.

METHODS: This meeting report describes one group's experience at the 2009 KT Canada Summer Institute in developing an end-of-grant KT plan for a randomized control trial proposal.

RESULTS: Included is a discussion of the process, challenges and recommendations from the trainee's perspective in developing an end-of-grant KT plan.

CONCLUSION: New researchers should consider developing an end-of-grant KT plan with strategies that move beyond passive dissemination to incorporate innovative means of collaboration with the end user to craft the message, package the information and share the research findings with end users.

Supported housing programs for persons with serious mental illness in rural northern communities: A mixed method evaluation

Phyllis Montgomery et al. — Thu, 28 Oct 2010 08:11:54 PDT

Background: During the past two decades, consumers, providers and policy makers have recognized the role of supported housing intervention for persons diagnosed with serious mental illness (SMI) to be able to live independently in the community. Much of supported housing research to date, however, has been conducted in large urban centers rather than northern and rural communities. Northern conditional and contextual issues such as rural poverty, lack of accessible mental health services, small or non-existing housing markets, lack of a continuum of support or housing services, and in some communities, a poor quality of housing challenge the viability of effective supported housing services. The current research proposal aims to describe and evaluate the processes and outcomes of supported housing programs for persons living with SMI in northern and rural communities from the perspective of clients, their families, and community providers.

Methods: This research will use a mixed method design guided by participatory action research. The study will be conducted over two years, in four stages. Stage I will involve setting up the research in each of the four northern sites. In Stage II a descriptive cross-sectional survey will be used to obtain information about the three client outcomes: housing history, quality of life and housing preference. In Stage III two participatory action strategies, focus groups and photo-voice, will be used to explore perceptions of supported housing services. In the last stage findings from the study will be re-presented to the participants, as well as other key community individuals in order to translate them into policy.

Conclusion: Supported housing intervention is a core feature of mental health care, and it requires evaluation. The lack of research in northern and rural SMI populations heightens the relevance of research findings for health service planning. The inclusion of multiple stakeholder groups, using a variety of data collection approaches, contributes to a comprehensive, systems-level examination of supported housing in smaller communities. It is anticipated that the study's findings will not only have utility across Ontario, but also Canada.

Timing of surgical antibiotic prophylaxis administration: Complexities of analysis

Carrie Cartmill et al. — Thu, 28 Oct 2010 08:11:52 PDT

Background The timing of prophylactic antibiotic administration is a patient safety outcome that is recurrently tracked and reported. The interpretation of these data has important implications for patient safety practices. However, diverse data collection methods and approaches to analysis impede knowledge building in this field. This paper makes explicit several challenges to quantifying the timing of prophylactic antibiotics that we encountered during a recent study and offers a suggested protocol for resolving these challenges.

Challenges Two clear challenges manifested during the data extraction process: the actual classification of antibiotic timing, and the additional complication of multiple antibiotic regimens with different timing classifications in a single case. A formalized protocol was developed for dealing with incomplete, ambiguous and unclear documentation. A hierarchical coding system was implemented for managing cases with multiple antibiotic regimens.

Interpretation Researchers who are tracking prophylactic antibiotic timing as an outcome measure should be aware that documentation of antibiotic timing in the patient chart is frequently incomplete and unclear, and these inconsistencies should be accounted for in analyses. We have developed a systematic method for dealing with specific problematic patterns encountered in the data. We propose that the general adoption of a systematic approach to analysis of this type of data will allow for cross-study comparisons and ensure that interpretation of results is on the basis of timing practices rather than documentation practices.