Knowledge to Action (KTA) Virtual Podium Archived Recordings
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This collection provides links to all InspireNet members' webinar recordings offered through our KT initiative, the Virtual Podium (details: http://www.inspirenet.ca/KT-Invitation-Virtual-Podium)
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Item Can people who misuse drugs and alcohol consent for health care?(InspireNet, 2015-01-29) Taylor, DarleneAll individuals over the age of 18 have the legal right to consent/refuse health care provided they have the capacity to do so. Nurses who deliver care to clients who misuse substances often find assessing capacity to consent challenging especially if their clients have been using drugs or alcohol prior to a clinical encounter. The Capacity Assessment Instrument for People who misuse Substances (CAIPS) has been developed to facility nurses’ decision-making process related to assessing capacity to consent in this vulnerable population. This webinar will introduce nurses to the CAIPS instrument, explaining how it works and under which circumstances it can be used.Item Clinical nursing instructors' experiences teaching students deemed at risk of failure(InspireNet, 2015) MacLeod, StephanieItem Implementation of national guidelines for dementia care in a Swedish nursing home: Presentation of an action research project(InspireNet, 2013-12-03) Boström, Anne-MarieCanada and Sweden face many similarities when it comes to an aging population and the opportunities and challenges for families and society. In Sweden, municipalities are responsible for providing social and health care for older persons in their homes and in special housing for older people. In 2010, the Swedish National Board of Health and Welfare launched guidelines for care of persons with dementia. The guidelines are based on evidence and best available knowledge on the provision of care for persons with dementia. In our research project, the overall aim was to study the effect and outcomes following implementation of the dementia guidelines from three perspectives: older persons’ with dementia living in a nursing home; family members’; and staff’s perspective working in the same nursing home where older people reside. The implementation project was conducted in a nursing home where 200 residents are living in 24 small-scale units and 200 staff are employed consisting of 170 nurse aides, 25 health professionals and 5 managers. Participatory action research methodology was used to implement the guidelines. Regularly meetings were held with the managers. Unit-based seminars for staff were facilitated by faculty members from Karolinska Institute every second week. These activities have been complemented with lectures and poster presentations in all units to share accomplished changes. Information meetings for family members were scheduled every six months. The conclusions from the project so far are that managers and staff have increased awareness of the dementia guidelines and identified areas for practice changes. The next step is to sustain the model with unit-based seminars using nursing-home staff instead of faculty members as facilitators.Item Nursing Practice in Rural and Remote Canada: Spotlight on Licensed/Registered Practical Nurses(InspireNet, 2014-10-17) Maynart, WilliamsTransformations in the healthcare system, particularly in primary healthcare (PHC) are impacting the regulated nursing workforce in Canada. This is especially the case in rural/remote communities where nurses are on the front line, facing many demands, often with sparse resources, and sometimes in communities where the population demographics are in flux. Licensed practical nurses are also known as registered practical nurses (RPNs) in Ontario. LPNs and RPNs work within healthcare teams, assessing clients and participating in duties related to health promotion and illness prevention. They may work in a range of settings, including hospitals, long term care facilities, and community health centres. Information and publications about the LPN workforce, particularly in rural areas, are scarce. This paper reports findings of an analysis of Canadian Institute for Health Information (CIHI) Nursing Database (NDB) administrative data. Data on LPNs working in rural/remote areas for 2003 and 2010 and in all provinces and territories were examined. The purpose of this paper is to identify key characteristics and geographical distribution of the LPN workforce in rural/remote Canada, and changes in this workforce over the last decade. We also identify the potential LPN workforce engaged in primary healthcare in rural/remote Canada, and discuss implications for staff mix. The characteristics and geographical distribution of Canada’s LPNs were analyzed based on workforce numbers, demographics, employment, education, and migration. Findings indicate that the overall supply of LPNs increased between 2003 and 2010. The overall proportion of LPNs working in rural areas, however, decreased during this time. The average age of LPNs decreased while the proportion of male LPNs increased. More rural LPNs reported full-time employment status in 2010 compared to 2003. A similar trend was found for multiple employer status. The vast majority of rural LPNs reported a diploma as their entry-to-practice education and was involved in direct care. We conclude by discussing the implications of increasing proportions of LPNs in community health agency locations for workforce mix in rural settings. This analysis will assist in planning for staffing in rural and remote Canada.Item Putting the Pieces Back Together; Un-fracturing Sleep for the Critically Ill(InspireNet, 2014-11-26) Bains, VininderNatural restorative sleep has a specific architecture; it consists of 6 to 8 hours of nocturnal consecutive sleep. A person cycles from light sleep, to deep and rapid eye movement (REM) sleep every 90 to 120 minutes, with 20% to 25% of the night spent in REM sleep. This architecture is achieved by the co-ordination of 2 separate processes; the circadian rhythm and Process S, also known as the homeostatic process (Patel, Chipman, Carlin, & Shade, 2008). Circadian rhythm is controlled by the cyclic interplay of a several neurotransmitters such as dopamine, serotonin, norepinephrine, melatonin acetylcholine and histamine (Patel et al., 2008). Process S is influenced by how long you have been awake; it affects the duration and depth of sleep (Patel et al., 2008). If you are awake for long periods, process S will allow you to sleep longer, and more deeply than usual to recover. Sleep also has a purpose; it allows us to recover and restore normal function. Sleep deprivation has been known to impair immune function, alter cognition, reduce pain tolerance, contribute to delirium, slow wound healing, glucose intolerance, cause hypertension and hemodynamic instability (Tembo & Parker, 2009). The most crucial need for efficient sleep is during an illness, and yet this is the time when a person is least likely to achieve it. Instead sleep, for any hospital patient, is very disrupted. Sleep disruption is worst for the critically ill patient. In the ICU, it consisting of many 3 to 15 minute micro-naps, 50% of sleep occurs during the day, and because of the fragmented pattern of sleep, patients spend as little as 0-8% of their sleep in the REM state (Elliott, McKinley, Cistulli, & Fien, 2013). The effects of prolonged sleep deprivation have long term affects, contributing to sleep disturbances, which persists many months after discharge. There are also many environmental factors that we as health care workers can impact to promote or prevent sleep. One study reported in only 9 out of 147 nights, did ICU patients receive a 2-3 hour block of undisturbed time at night to sleep (Tamburri, DiBrienza, Zozula, & Redeker, 2004). Other research indicate average noise levels in ICU is 53dB to 65dB (Patel et al., 2008) which far exceed the recommendation of less than 35dB to promote sleep. (Agency, 1974) Today sleep in the Intensive Care Unit (ICU) is as woefully inadequate and highly fractured today as it was when it was first researched 40 years ago (Elliott et al., 2013) Will we make a difference?Item Some Don’t Like it Hot. Temperature Management in Brain Injury(InspireNet, 2013-09-26) Bains, VininderIn hypoxic brain injury such as post cardiac arrest, induction of therapeutic hypothermia has been repeatedly shown to improve the chances of neurological recovery, especially when it is applied as early. This has inspired a resurgence of interest in applying hypothermia to other types of brain injury despite the fact research conducted before 2003 had found therapeutic hypothermia ineffective in improving outcomes in traumatic brain injury. Proponents of therapeutic hypothermia suggest how we apply the therapy is as important as if we do. The potential benefits of hypothermia can be negated if poorly applied. Complications such as hypotension, shivering, VAP and infection may undo any benefits of cooling on brain injury. New tools to induce and maintain hypothermia as well as advances in critical care may allow us to apply therapeutic hypothermia better than we could before allowing many to re-investigate this not so novel therapy. To date however the controversy of how to manage temperature in traumatic brain injury remains. Current studies have conflicting results. We will explore the current state of the science, and highlight upcoming research.Item Some like it Hot. Revelations in Managing Fever in the ICU.(InspireNet, 2013-08-30) Bains, VininderMany animal studies have been conducted over the decades that indicate that fever is an important and sometimes lifesaving immune response. Until very recently, there was little solid human clinical research to help guide the decision of when and how to treat fever. As a result, most professionals held either the opinion that fever suppression was necessary to reduce oxygen demand in critical illness, or that routine fever suppression was relatively harmless. New research is challenging these long held beliefs. We will be exploring a number of recent discoveries in our understanding of basic thermoregulation, the physiology of the febrile response and the benefits of fever. Recently published clinical trials can better help guide our decision of when and how to treat fever. Temperature and how it is managed appears to have a greater impact on patient outcomes than previously thought.