November 3, 2014


Abstracts
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Abstracts

Resources recommended by Dr. Carole Estabrooks
Joint European Commission – Social Protection Committee: Adequate social protection for long-term care needs in an ageing society
June 2014

This report outlines the need for Member States to move to a proactive policy approach in order to prevent the loss of autonomy for patients, which would in turn reduce care demand. It also seeks to boost efficient, cost-effective care at home and in residential institutions.

Standards for Educational & Psychological Testing (2014 Edition)

The Testing Standards are a product of the American Educational Research Association, the American Psychological Association (APA), and the National Council on Measurement in Education (NCME). Published collaboratively by the three organizations since 1966, it represents the gold standard in guidance on testing in the United States and in many other countries.

CALL FOR PAPERS:
Home Healthcare Nurse is seeking submissions for a column titled “A Day in the Life of…”

The purpose of this column is to introduce readers to the wide variety of roles in home healthcare, and to highlight the typical work day of home care clinicians around the country and world to educate the readers on the work they do, the area in which they work and the people they serve. Manuscripts should be 600-1000 words. Prospective writers should feel free to email me with their ideas at HHNEditor@gmail.com

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Grants & Awards

CAHO: Adopting Research to Improve Care (ARTIC) Program RFP
DEADLINES: LOI 24 November Proposals 2 February

The Adopting Research to Improve Care (ARTIC) Program is a proven model for accelerating and supporting the implementation of research evidence into practice contributing to quality care across Ontario. The ARTIC Program creates the pathway to systematically move research evidence into practice faster. This takes infrastructure, collaboration and the implementation enablers of executive leadership support, education and training, communities of practice and evaluation.

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Publications

KT
Health Care Administration and Organization
Health Care Innovation and Quality Assurance
Research Practice & Methodology
Aging

KT

A critical analysis of workforce development research use in the transformation of children’s services
Non UofA Access
Curran T, Oliver B, Benjamin C.
Journal of Social Work 2014;14(4):360-379.

This article is based on a study commissioned to find out how agencies providing children’s services in England used workforce development research in the transformation of children’s services. Workforce development research is primarily about how new organisational practices are learnt, embedded and developed. Survey and case study methods provided broad and in-depth data that was mapped against a typology developed to capture a diverse range of research activities. Findings Three cross-cutting themes were identified from the analysis: the involvement of children and young people in workforce development research; the development of reflective practice; and the significance of inter-organisational learning cultures. Workforce development research can contribute to a creative culture of inquiry shaping change processes especially where both practitioners and children and young people are involved. In some specialist areas a lack of engagement was attributed to the demands of complex practice and bureaucracy, but in other similar contexts, learning cultures were evident. Application Accounts of learning cultures producing active concepts of childhood link with ‘new’ childhood studies and contrast with accounts of crisis management informed by individualised models of ‘problem families’ highlighted in critiques of neo-liberal forms of government. The study shows that this opposition is not an inevitable consequence of complex practice or service configuration per se, but is contingent on a range of supporting factors such as partnerships with universities. To strengthen the exponential impact of research use illustrated, a participatory approach to organisational research strategy is advanced.

Regional HIV knowledge hubs: a new approach by the health sector to transform knowledge into practice.
Non UofA Access
Mostafavi E, Haghdoost A, Mirzazadeh A, Riedner G, Weis P, Kloss K, et al.
Health promotion international 2014 Mar;29(1):91-97

This study aims to introduce the knowledge hub (KH) as an initiative to facilitate transformation of knowledge into practice and to highlight the activity and limitations with this new policy. The study was conducted through a review of articles; expert views in this field were sought for further information. Regional human immunodeficiency virus (HIV) KHs were developed by the World Health Organization and GTZ. A series of activities including capacity building, development of training models, technical assistance, and application of studies are provided through these hubs. However, financial limitations are the main obstacle in achieving these aims. This piece of work introduces these HIV hubs in order to help countries, particularly developing countries, provide the support needed to fight the progression of HIV.

Assessing the organizational context for EBP implementation: the development and validity testing of the Implementation Climate Scale (ICS).
Non UofA Access
Ehrhart MG, Aarons GA, Farahnak LR.
Implementation science 2014 Oct 23;9(1):157

Although the importance of the organizational environment for implementing evidence-based practices (EBP) has been widely recognized, there are limited options for measuring implementation climate in public sector health settings. The goal of this research was to develop and test a measure of EBP implementation climate that would both capture a broad range of issues important for effective EBP implementation and be of practical use to researchers and managers seeking to understand and improve the implementation of EBPs.MethodsParticipants were 630 clinicians working in 128 work groups in 32 US-based mental health agencies. Items to measure climate for EBP implementation were developed based on past literature on implementation climate and other strategic climates and in consultation with experts on the implementation of EBPs in mental health settings. The sample was randomly split at the work group level of analysis; half of the sample was used for exploratory factor analysis (EFA), and the other half was used for confirmatory factor analysis (CFA). The entire sample was utilized for additional analyses assessing the reliability, support for level of aggregation, and construct-based evidence of validity.ResultsThe EFA resulted in a final factor structure of six dimensions for the Implementation Climate Scale (ICS): 1) focus on EBP, 2) educational support for EBP, 3) recognition for EBP, 4) rewards for EBP, 5) selection for EBP, and 6) selection for openness. This structure was supported in the other half of the sample using CFA. Additional analyses supported the reliability and construct-based evidence of validity for the ICS, as well as the aggregation of the measure to the work group level.ConclusionsThe ICS is a very brief (18 item) and pragmatic measure of a strategic climate for EBP implementation. It captures six dimensions of the organizational context that indicate to employees the extent to which their organization prioritizes and values the successful implementation of EBPs. The ICS can be used by researchers to better understand the role of the organizational context on implementation outcomes and by organizations to evaluate their current climate as they consider how to improve the likelihood of implementation success.

Nova Scotia Health Research Foundation: Gathering Perspectives: A process for generating evidence for informed public sector decision-making
2014

Evidence informed decision-making is a key component of all aspects of the public domain; however, a practical method for generating evidence to inform decisions is not always readily available. The NSHRF presents a four-stage approach to generating evidence, which involves: establishing a work plan and gathering background information; collecting data; synthesizing and summarizing data; and evaluation of the process and its implementation. The approach, which follows traditional social science research methods, has been used by the Nova Scotia Health Research Foundation to inform a variety of initiatives and decisions in Nova Scotia. It has proven to be practical and reliable in public sector decision-making.

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Health Care Administration and Organization

The main cost drivers in dementia: a systematic review.
Non UofA Access
Schaller S, Mauskopf J, Kriza C, Wahlster P, Kolominsky-Rabas PL.
International journal of geriatric psychiatry 2014 Oct 16

Because of the increasing prevalence of dementia worldwide, combined with limited healthcare expenditures, a better understanding of the main cost drivers of dementia in different care settings is needed. METHODS: A systematic review of cost-of-illness (COI) studies in dementia was conducted from 2003 to 2012, searching the following databases: PubMed (Medline), Cochrane Library, ScienceDirect (Embase) and National Health Service Economic Evaluations Database. Costs (per patient) by care setting were analyzed for total, direct, indirect and informal costs and related to the following: (1) cost perspective and (2) disease severity. RESULTS: In total, 27 studies from 14 different healthcare systems were evaluated. In the included studies, total annual costs for dementia of up to $70,911 per patient (mixed setting) were estimated (average estimate of total costs = $30,554). The shares of cost categories in the total costs for dementia indicate significant differences for different care settings. Overall main cost drivers of dementia are informal costs due to home based long term care and nursing home expenditures rather than direct medical costs (inpatient and outpatient services, medication). CONCLUSIONS: The results of this review highlight the significant economic burden of dementia for patients, families and healthcare systems and thus are important for future health policy planning. The significant variation of cost estimates for different care settings underlines the need to understand and address the financial burden of dementia from both perspectives. For health policy planning in dementia, future COI studies should follow a quality standard protocol with clearly defined cost components and separate estimates by care setting and disease severity. Copyright © 2014 John Wiley & Sons, Ltd. Copyright © 2014 John Wiley & Sons, Ltd.

Effect of nursing home ownership on hospitalization of long-stay residents: an instrumental variables approach.
Non UofA Access
Hirth RA, Grabowski DC, Feng Z, Rahman M, Mor V.
International journal of health care finance and economics 2014 Mar;14(1):1-18

Hospitalizations among nursing home residents are frequent, expensive, and often associated with further deterioration of resident condition. The literature indicates that a substantial fraction of admissions is potentially preventable and that nonprofit nursing homes are less likely to hospitalize their residents. However, the correlation between ownership and hospitalization might reflect unobserved resident differences rather than a causal relationship. Using national minimum data set assessments linked with Medicare claims, we use a national cohort of long-stay residents who were newly admitted to nursing homes within an 18-month period spanning January 1, 2004 and June 30, 2005. After instrumenting for ownership status, we found that IV estimates of the effect of nonprofit ownership on hospitalization are at least as large as the non-instrumented effects, indicating that selection bias does not explain the observed relationship. We also found evidence suggesting the lower rate of hospitalizations among nonprofits was due to a different threshold for transfer.

Are nursing home survey deficiencies higher in facilities with greater staff turnover.
Non UofA Access
Lerner NB, Johantgen M, Trinkoff AM, Storr CL, Han K.
Journal of the American Medical Directors Association 2014 Feb;15(2):102-107

To examine CNA and licensed nurse (RN+LPN/LVN) turnover in relation to numbers of deficiencies in nursing homes. DESIGN: A secondary data analysis of information from the National Nursing Home Survey (NNHS) and contemporaneous data from the Online Survey, Certification and Reporting (OSCAR) database. Data were linked by facility as the unit of analysis to determine the relationship of CNA and licensed nurse turnover on nursing home deficiencies. SETTING: The 2004 NNHS used a multistage sampling strategy to generate a final sample of 1174 nursing homes, which represent 16,100 NHs in the United States. PARTICIPANTS: This study focused on the 1151 NNHS facilities with complete deficiency data. MEASUREMENTS: Turnover was defined as the total CNAs/licensed nurse full-time equivalents (FTEs) who left during the preceding 3 months (full- and part-time) divided by the total FTE. NHs with high turnover were defined as those with rates above the 75th percentile (25.3% for CNA turnover and 17.9% for licensed nurse turnover) versus all other facilities. This study used selected OSCAR deficiencies from the Quality of Care, Quality of Life, and Resident Behavior categories, which are considered to be more closely related to nursing care. We defined NHs with high deficiencies as those with numbers of deficiencies above the 75th percentile versus all others. Using SUDAAN PROC RLOGIST, we included NNHS sampling design effects and examined associations of CNA/licensed nurse turnover with NH deficiencies, adjusting for staffing, skill mix, bed size, and ownership in binomial logistic regression models. RESULTS: High CNA turnover was associated with high numbers of Quality of Care (OR 1.53, 95% CI 1.10-2.13), Resident Behavior (OR 1.42, 95% CI 1.03-1.97) and total selected deficiencies (OR 1.54, 95% CI 1.12-2.12). Licensed nurse turnover was significantly related to Quality of Care deficiencies (OR 2.06, 95% CI 1.50-2.82) and total selected deficiencies (OR 1.71, 95% CI 1.25-2.33). When both CNA turnover and licensed nurse turnover were included in the same model, high licensed nurse turnover was significantly associated with Quality of Care and total deficiencies, whereas CNA turnover was not associated with that category of deficiencies. CONCLUSION: Turnover in nursing homes for both licensed nurses and CNAs is associated with quality problems as measured by deficiencies. Copyright © 2014 American Medical Directors Association, Inc.

Volunteers supporting older people in formal care settings in England: personal and local factors influencing prevalence and type of participation.
Non UofA Access
Hussein S, Manthorpe J.
Journal of applied gerontology 2014 Dec;33(8):923-941

In the UK context of financial austerity and the promotion of the social responsibility through the concept of the “Big Society,” volunteers are becoming a more important part of the labor workforce. This is particularly so in the long-term care (LTC) sector, where both shortages of staff and demands for support are particularly high. This article investigate the levels and profile of contribution of volunteers in the LTC sector using a large national data set, National Minimum Data Set for Social Care, linked to local area levels of rurality and socio-economic status. The analysis shows that volunteer activity in formal care services varies between sectors and service types, with no strong relationship between local area deprivation, unemployment levels, and levels of volunteering. However, some significant association was found with level of rurality. The contribution of volunteers is most evident in provision of counseling, support, advocacy, and advice. © The Author(s) 2012.

Nursing Care Market: Global Industry Analysis and Forecast to 2020
Persistence Market Research
2014

In recent time there is increased demand of nursing care due to rising aging population. Rising concern for better healthcare and increasing prevalence of various diseases such as diabetes and cancer are some of the key factors driving the growth of the global nursing care market. In addition, increasing healthcare awareness and long term care system is also fuelling the growth of the global nursing care market. However, lack of reimbursements for nursing care and high cost of healthcare is restraining the growth of the global nursing care market. In addition, lack of skilled professionals is also restraining the global nursing care market.
The report covers geographic segmentation:
-North America
-Europe
-Asia
The report provides:
-The market size and forecast for the different segments and geographies for the period of 2010 to 2020;
-Company profiles of some of the leading companies operating in the market; and,
-Porters five forces analysis of the market.

Current and emerging occupational safety and health (OSH) issues in the healthcare sector, including home and community care (EU)
European Agency for Safety and Health at Work
October 2014

This report gives an overview of the current and emerging OSH issues for health- and social care workers and how these affect their safety and health at work and influence the quality of care they provide. It combines a literature review and the responses received to a questionnaire sent to OSH experts in all Member States, therefore allowing the findings from the literature to be compared with those from the ‘front line’. The report highlights the challenges facing the sector, including shortages of skilled and experienced professionals, an ageing workforce, increased use of technology requiring new skills and the introduction of new care pathways to tackle multiple chronic conditions. The fact that people are living longer and increasingly needing long-term care shifts the emphasis from the controlled setting of acute hospital care to care in the community and people’s homes. The home care setting presents a particularly difficult work environment owing to small work spaces, lack of training, lone working, little or no supervision and having to face the same hazards as those encountered in, for example, hospitals but with insufficient measures in place to control the risks.

NHS: Five Year Forward View (UK)
October 2014

This document sets out a vision for the future of the NHS. It has been developed by the partner organisations that deliver and oversee health and care services including NHS England, Public Health England, Monitor, Health Education England, the Care Quality Commission and the NHS Trust Development Authority. The purpose of the Five Year Forward View is to articulate why change is needed, what that change might look like and how we can achieve it. It describes various models of care which could be provided in the future, defining the actions required at local and national level to support delivery.

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Health Care Innovation and Quality Assurance

Analysing organisational context: case studies on the contribution of absorptive capacity theory to understanding inter-organisational variation in performance improvement.
Non UofA Access
Harvey G, Jas P, Walshe K.
BMJ quality & safety 2014 Oct 21

Organisational context is frequently cited as an important consideration when implementing and evaluating quality improvement interventions in healthcare, but limited guidance is available on which aspects of context are most influential or modifiable. This paper examines how internal and external contextual factors mediate organisational-level performance improvement through applying the knowledge-based theory of absorptive capacity (AC). METHODS: Three healthcare case studies are presented. Each case is a UK National Health Service organisation that had been identified as having performance problems. Qualitative data were collected through semi-structured interviews with general and clinical managers within the organisation and members of external teams supporting or overseeing performance improvement (n=22). Interview data were analysed using an existing AC framework from the literature. RESULTS: The organisation with the highest AC showed the quickest and most comprehensive performance improvement. Internal characteristics including strategic priorities, processes for managing information, communication and orientation to learning and development impacted on the organisation’s ability to engage successfully with external stakeholders and make use of available knowledge. This enabled the organisation to thrive despite the challenging external environment. Lower levels of AC appeared to delay or limit the improvement trajectory. CONCLUSIONS: Developing a more detailed and nuanced understanding of how context influences improvement is an important step towards achieving more effective and sustainable quality improvement programmes in healthcare. AC, with its focus on knowledge and organisational learning, provides a useful way to explore the relationship between context and quality improvement and represents a potentially valuable area for future research and development. Published by the BMJ Publishing Group Limited.

Transfer of residents to hospital prior to cardiac death: the influence of nursing home quality and ownership type.
Non UofA Access
Anic GM, Pathak EB, Tanner JP, Casper ML, Branch LG.
Open heart 2014 Aug 12;1(1):e000041-2014-000041. eCollection 2014

We hypothesised that among nursing home decedents, nursing home for-profit status and poor quality-of-care ratings, as well as patient characteristics, would lower the likelihood of transfer to hospital prior to heart disease death. METHODS: Using death certificates from a large metropolitan area (Tampa Florida Metropolitan Statistical Area) for 1998-2002, we geocoded residential street addresses of heart disease decedents to identify 2172 persons who resided in nursing homes (n=131) at the time of death. We analysed decedent place of death as an indicator of transfer prior to death. Multilevel logistic regression modelling was used for analysis. Cause of death and decedent characteristics were obtained from death certificates. Nursing home characteristics, including state inspector ratings for multiple time points, were obtained from Florida’s Agency for Healthcare Administration. RESULTS: Nursing home for-profit status, level of nursing care and quality-of-care ratings were not associated with the likelihood of transfer to hospital prior to heart disease death. Nursing homes >5 miles from a hospital were more likely to transfer decedents, compared with facilities located close to a hospital. Significant predictors of no transfer for nursing home residents were being white, female, older, less educated and widowed/unmarried. CONCLUSIONS: In this study population, contrary to our hypotheses, sociodemographic characteristics of nursing home decedents were more important predictors of no transfer prior to cardiac death than quality rankings or for-profit status of nursing homes.

Implementation of a self-management support approach (WISE) across a health system: a process evaluation explaining what did and did not work for organisations, clinicians and patients.
Non UofA Access
Kennedy A, Rogers A, Chew-Graham C, Blakeman T, Bowen R, Gardner C, et al.
Implementation science 2014 Oct 21;9(1):129

Implementation of long-term condition management interventions rests on the notion of whole systems re-design, where incorporating wider elements of health care systems are integral to embedding effective and integrated solutions. However, most self-management support (SMS) evaluations still focus on particular elements or outcomes of a sub-system. A randomised controlled trial of a SMS intervention (WISE Whole System Informing Self-management Engagement) implemented in primary care showed no effect on patient-level outcomes. This paper reports on a parallel process evaluation to ascertain influences affecting WISE implementation at patient, clinical and organisational levels. Normalisation Process Theory (NPT) provided a sensitising background and analytical framework.MethodsA multi-method approach using surveys and interviews with organisational stakeholders, practice staff and trial participants about impact of training and use of tools developed for WISE. Analysis was sensitised by NPT (coherence, cognitive participation, collective action and reflective monitoring). The aim was to identify what worked and what did not work for who and in what context.ResultsInterviews with organisation stakeholders emphasised top-down initiation of WISE by managers who supported innovation in self-management. Staff from 31 practices indicated engagement with training but patchy adoption of WISE tools; SMS was neither prioritised by practices nor fitted with a biomedically focussed ethos, so little effort was invested in WISE techniques. Interviews with 24 patients indicated no awareness of any changes following the training of practice staff; furthermore, they did not view primary care as an appropriate place for SMS.ConclusionThe results contribute to understanding why SMS is not routinely adopted and implemented in primary care. WISE was not embedded because of the perceived lack of relevance and fit to the ethos and existing work. Enacting SMS within primary care practice was not viewed as a legitimate activity or a professional priority. There was failure to, in principle, engage with and identify patients¿ support needs. Policy presumptions concerning SMS appear to be misplaced. Implementation of SMS within the health service does not currently account for patient circumstances. Primary care priorities and support for SMS could be enhanced if they link to patients¿ broader systems of implementation networks and resources.

Association between skilled nursing facility quality indicators and hospital readmissions.
Non UofA Access
Neuman MD, Wirtalla C, Werner RM.
JAMA 2014 Oct 15;312(15):1542-1551

Hospital readmissions are common, costly, and potentially preventable. Little is known about the association between available skilled nursing facility (SNF) performance measures and the risk of hospital readmission. OBJECTIVE: To measure the association between SNF performance measures and hospital readmissions among Medicare beneficiaries receiving postacute care at SNFs in the United States. DESIGN AND PARTICIPANTS: Using national Medicare data on fee-for-service Medicare beneficiaries discharged to a SNF after an acute care hospitalization between September 1, 2009, and August 31, 2010, we examined the association between SNF performance on publicly available metrics (SNF staffing intensity, health deficiencies identified through site inspections, and the percentages of SNF patients with delirium, moderate to severe pain, and new or worsening pressure ulcers) and the risk of readmission or death 30 days after discharge to a SNF. Adjusted analyses controlled for patient case mix, SNF facility factors, and the discharging hospital. MAIN OUTCOMES AND MEASURES: Readmission to an acute care hospital or death within 30 days of the index hospital discharge. RESULTS: Of 1,530,824 patients discharged, 357,752 (23.3%; 99% CI, 23.3%-23.5%) were readmitted or died within 30 days; 72,472 died within 30 days (4.7%; 99% CI, 4.7%-4.8%), and 321,709 were readmitted (21.0%; 99% CI, 20.9%-21.1%). The unadjusted risk of readmission or death was lower at SNFs with better staffing ratings. SNFs ranked lowest (19.2% of all SNFs) had a 30-day risk of readmission or death of 25.5% (99% CI, 25.3%-25.8%) vs 19.8% (99% CI, 19.5%-20.1%) among those ranked highest. SNFs with better facility inspection ratings also had a lower risk of readmission or death. SNFs ranked lowest (20.1% of all SNFs) had a risk of 24.9% (99% CI, 24.7%-25.1%) vs 21.5% (99% CI, 21.2%-21.7%) among those ranked highest . Adjustment for patient factors, SNF facility factors, and the discharging hospital attenuated these associations; we observed small differences in the adjusted risk of readmission or death according to SNF facility inspection ratings (lowest vs highest rating: 23.7%; 99% CI: 23.7%, 23.7%; vs 23.0%; 99% CI: 23.0%, 23.1%). Other measures did not predict clinically meaningful differences in the adjusted risk of readmission or death. CONCLUSIONS AND RELEVANCE: Among fee-for-service Medicare beneficiaries discharged to a SNF after an acute care hospitalization, available performance measures were not consistently associated with differences in the adjusted risk of readmission or death.

Quality of prescribing in Belgian nursing homes: an electronic assessment of the medication chart.
Non UofA Access
Elseviers MM, Vander Stichele RR, Van Bortel L.
International journal for quality in health care 2014 Feb;26(1):93-99

To develop a computerized assessment tool for monitoring the quality of prescribing in Belgian nursing homes. DESIGN: In a observational cross-sectional study of the medication charts of nursing home residents, potentially inappropriate medication (PIM) was investigated using three scoring systems for the elderly (Beers, ACOVE, BEDNURS) complemented with a list of drug-drug interactions. SETTING: A representative stratified sample of Belgian nursing homes (n = 76). PARTICIPANTS: A random sample of nursing home residents with a complete data set (n = 1730) excluding palliative care patients. MAIN OUTCOME MEASURE: A combination of PIM scores to assess inappropriate, under- and overprescribing. RESULTS: Included residents had a mean age of 85, 78% were female. They used a mean of 7.1 chronic medications. Most PIMs were detected by the application of the ACOVE criteria for underprescribing with 58% of patients having at least one PIM. Using the BEDNURS and the Beers criteria, at least one PIM was noticed in 56 and 27% of patients, respectively. Patients’ characteristics showing a positive relationship with the PIM score were age, female gender, amount of clinical and nursing care problems, number of prescriptions and the use of psychotropic drugs (multiple regression analysis R(2) = 0.332). CONCLUSIONS: In Belgian nursing homes, the observed high level of drug utilization was associated with potentially inappropriate prescribing. The development of a combined assessment tool and the implementation of a computerized monitoring system of PIMs is highly recommended to improve the quality of prescribing.

Effect of oral healthcare education on knowledge, attitude and skills of care home nurses: a systematic literature review.
Non UofA Access
de Lugt-Lustig KH, Vanobbergen JN, van der Putten GJ, De Visschere LM, Schols JM, de Baat C.
Community dentistry and oral epidemiology 2014 Feb;42(1):88-96

To systematically review the literature on the effect of providing oral healthcare education to care home nurses on their oral healthcare knowledge and attitude and their oral hygiene care skills. METHODS: A literature search was obtained for relevant articles on oral healthcare education of nurses in care homes, using five electronic retrieval systems and databases. The search was limited to human studies, articles published in English and articles published during the period January 1990 to December 2011. The methodological quality of an article was assessed on the basis of criteria published by the Cochrane Collaboration. For articles not meeting all methodological quality criteria, relevance criteria were used to determine how much scientific evidence could be assigned to the study findings. RESULTS: In accordance with the methodological quality criteria, two randomized controlled trials were included. Additionally, four studies were included after determining the scientific evidence of the study findings. The studies included revealed some scientific evidence and indications that an oral healthcare education programme for care home nurses may improve the nurses’ oral healthcare knowledge and attitude. Any effect of oral healthcare education to care home nurses’ oral hygiene care skills could not be determined. CONCLUSIONS: Oral healthcare education may have a positive effect on care home nurses’ oral healthcare knowledge and attitude and on care home residents’ oral hygiene, whereas any effect on care home nurses’ oral hygiene care skills could not be found. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The relationship between patients’ perceptions of care quality and three factors: nursing staff job satisfaction, organizational characteristics and patient age.
Non UofA Access
Kvist T, Voutilainen A, Mantynen R, Vehvilainen-Julkunen K.
BMC health services research 2014 Oct 18;14(1):466-6963-14-466

The relationship between nurses’ job satisfaction and their perceptions of quality of care has been examined in previous studies. There is little evidence, however, about relationships between the job satisfaction of nursing staff and quality of care perceived by the patients. The aim of this study was to analyze, how the job satisfaction of nursing staff, organizational characteristics (hospital and unit type), and patients’ age relate to patients’ perceptions of the quality of care. METHODS: The study was cross-sectional and descriptive, based on a secondary analysis of survey data acquired during the At Safe study in Finland. The study included 98 units at four acute care hospitals between autumn 2008 and spring 2009. The participants were 1909 patients and 929 nursing staff. Patients’ perceptions of quality of care were measured using the 42-item RHCS questionnaire. Job satisfaction of nursing staff was measured with the 37-item KUHJSS scale. Statistical analyses included descriptive statistics, principal component analysis, t-tests, analysis of variance, linear regression, and multivariate analysis of variance. RESULTS: Patients’ perceptions of overall quality of care were positively related to general job satisfaction of nursing staff. Adequate numbers of staff appeared to be the clearest aspect affecting quality of care. Older patients were more satisfied with staff number than younger patients. Patients cared for in outpatient departments felt more respected than patients in wards, whereas patients in wards reported better care of basic needs (e.g., hygiene, food) than outpatients. CONCLUSIONS: The evaluation of resources by nursing staff is related to patients’ perceptions of the adequacy of nursing staff levels in the unit. The results emphasize the importance of considering patients’ perceptions of the quality of care and assessments by nurses of their job satisfaction at the hospital unit level when evaluating quality of care.

The Oral Health Self-Care Behavior and Dental Attitudes among Nursing Home Personnel.
Non UofA Access
Wiener RC, Meckstroth R.
Journal of studies in social sciences 2014 Mar 1;6(2):1-12

The need for nursing home care will increase for the next several decades. Rural areas will be impacted in particular, as many older adults live in rural areas. Daily oral infection control changes when a person moves from independent living to institutional living. Oral care to dependent individuals is influenced by many factors. The purpose of this study is to determine the association of oral health self-care behavior with dental attitudes in nursing home personnel in a rural state. A survey was provided to attendees at an oral health conference. Questions were asked to determine dental knowledge, oral health self-care behavior, and dental care attitudes. Of 128 long term care health care facilities’ personnel invited, there were 31 attendees, and 21 of the attendees participated (67.7%). Nursing home personnel had a high level of dental knowledge. Oral health self-care behavior was independently influenced by dental knowledge (β=0.17; p=0.0444) and dental attitudes (β=0.55; p=.0081). Further investigation is needed to determine if oral health self-care attitudes and oral self-care behavior of nursing home personnel are factors in the provision of quality daily oral infection control for dependent nursing home residents living in rural areas.

The Namaste Care programme can reduce behavioural symptoms in care home residents with advanced dementia.
Non UofA Access
Stacpoole M, Hockley J, Thompsell A, Simard J, Volicer L.
International journal of geriatric psychiatry 2014 Oct 22

The objective of the study was to evaluate the effects of the Namaste Care programme on the behavioural symptoms of residents with advanced dementia in care homes and their pain management. METHODS: Six dementia care homes collaborated in an action research study-one withdrew. Inclusion criteria were a dementia diagnosis and a Bedford Alzheimer’s Nursing Severity Scale score of >16. Primary research measures were the Neuropsychiatric Inventory-Nursing Homes (NPI-NH) and Doloplus-2 behavioural pain assessment scale for the elderly. Measures were recorded at baseline and at three 1-2 monthly intervals after Namaste Care started. RESULTS: Management disruption occurred across all care homes. The severity of behavioural symptoms, pain and occupational disruptiveness (NPI-NH) decreased in four care homes. Increased severity of behavioural symptoms in one care home was probably related to poor pain management, reflected in increased pain scores, and disrupted leadership. Comparison of NPI-NH scores showed that severity of behavioural symptoms and occupational disruptiveness were significantly lower after initiation of Namaste Care (n = 34, p < 0.001) and after the second interval (n = 32, p < 0.001 and p = 0.003). However, comparison of these measures in the second and third intervals revealed that both were slightly increased in the third interval (n = 24, p < 0.001 and p = 0.001). CONCLUSIONS: Where there are strong leadership, adequate staffing, and good nursing and medical care, the Namaste Care programme can improve quality of life for people with advanced dementia in care homes by decreasing behavioural symptoms. Namaste is not a substitute for good clinical care Copyright © 2014 John Wiley & Sons, Ltd.

Health Foundation: Person-centred care: from ideas to action
Bringing together the evidence on shared decision making and self-management support (UK)

October 2014

This report seeks to bring together the evidence on shared decision making and self-management support, with the aim of providing greater coherence and clarity in debates about person-centred care.

Joseph Rowntree Foundation: John Kennedy’s Care Home Inquiry (UK)
October 2014

The final report of a personal inquiry into the crisis in UK care homes for older people. Between May 2013 and May 2014, John Kennedy, the Joseph Rowntree Housing Trust’s Director of Care Services, carried out an inquiry to discover how to address the crisis in the UK’s care homes, and to find out what makes a good care home. During John’s inquiry, which built on existing JRF research, he spoke to a range of people involved in the care sector, and used social media to broaden the range of views.

Care Quality Commission: State of Care 2013/14 (UK)
2014

In 2013/14 we began to introduce a new, tougher approach to inspecting care services. Our more rigorous, expert-led inspections are starting to give us a deeper understanding of the quality of health and social care than ever before. We’ve found many examples of good and outstanding care. But we’ve also found wide variation in quality. There are big differences in the quality of care that people experience from different providers, in different places and sometimes at different times of the day or day of the week.

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Research Practice & Methodology

Benchmarks for detecting ‘breakthroughs’ in clinical trials: empirical assessment of the probability of large treatment effects using kernel density estimation.
Non UofA Access
Miladinovic B, Kumar A, Mhaskar R, Djulbegovic B.
BMJ open 2014 Oct 21;4(10):e005249-2014-005249

To understand how often ‘breakthroughs,’ that is, treatments that significantly improve health outcomes, can be developed. DESIGN: We applied weighted adaptive kernel density estimation to construct the probability density function for observed treatment effects from five publicly funded cohorts and one privately funded group. DATA SOURCES: 820 trials involving 1064 comparisons and enrolling 331 004 patients were conducted by five publicly funded cooperative groups. 40 cancer trials involving 50 comparisons and enrolling a total of 19 889 patients were conducted by GlaxoSmithKline. RESULTS: We calculated that the probability of detecting treatment with large effects is 10% (5-25%), and that the probability of detecting treatment with very large treatment effects is 2% (0.3-10%). Researchers themselves judged that they discovered a new, breakthrough intervention in 16% of trials. CONCLUSIONS: We propose these figures as the benchmarks against which future development of ‘breakthrough’ treatments should be measured. Published by the BMJ Publishing Group Limited

Networks of trainees: examining the effects of attending an interdisciplinary research training camp on the careers of new obesity scholars. Canada-flat-icon
Non UofA Access
Godley J, Glenn NM, Sharma AM, Spence JC.
Journal of multidisciplinary healthcare 2014 Oct 9;7:459-470

Students training in obesity research, prevention, and management face the challenge of developing expertise in their chosen academic field while at the same time recognizing that obesity is a complex issue that requires a multidisciplinary and multisectoral approach. In appreciation of this challenge, the Canadian Obesity Network (CON) has run an interdisciplinary summer training camp for graduate students, new career researchers, and clinicians for the past 8 years. This paper evaluates the effects of attending this training camp on trainees’ early careers. We use social network analysis to examine the professional connections developed among trainee Canadian obesity researchers who attended this camp over its first 5 years of operation (2006-2010). We examine four relationships (knowing, contacting, and meeting each other, and working together) among previous trainees. We assess the presence and diversity of these relationships among trainees across different years and disciplines and find that interdisciplinary contact and working relationships established at the training camp have been maintained over time. In addition, we evaluate the qualitative data on trainees’ career trajectories and their assessments of the impact that the camp had on their careers. Many trainees report that camp attendance had a positive impact on their career development, particularly in terms of establishing contacts and professional relationships. Both the quantitative and the qualitative results demonstrate the importance of interdisciplinary training and relationships for career development in the health sciences.

Reporting discrepancies between the ClinicalTrials.gov results database and peer-reviewed publications.
Non UofA Access
Hartung DM, Zarin DA, Guise JM, McDonagh M, Paynter R, Helfand M.
Annals of Internal Medicine 2014 Apr 1;160(7):477-483

ClinicalTrials.gov requires reporting of result summaries for many drug and device trials. PURPOSE: To evaluate the consistency of reporting of trials that are registered in the ClinicalTrials.gov results database and published in the literature. DATA SOURCES: ClinicalTrials.gov results database and matched publications identified through ClinicalTrials.gov and a manual search of 2 electronic databases. STUDY SELECTION: 10% random sample of phase 3 or 4 trials with results in the ClinicalTrials.gov results database, completed before 1 January 2009, with 2 or more groups. DATA EXTRACTION: One reviewer extracted data about trial design and results from the results database and matching publications. A subsample was independently verified. DATA SYNTHESIS: Of 110 trials with results, most were industry-sponsored, parallel-design drug studies. The most common inconsistency was the number of secondary outcome measures reported (80%). Sixteen trials (15%) reported the primary outcome description inconsistently, and 22 (20%) reported the primary outcome value inconsistently. Thirty-eight trials inconsistently reported the number of individuals with a serious adverse event (SAE); of these, 33 (87%) reported more SAEs in ClinicalTrials.gov. Among the 84 trials that reported SAEs in ClinicalTrials.gov, 11 publications did not mention SAEs, 5 reported them as zero or not occurring, and 21 reported a different number of SAEs. Among 29 trials that reported deaths in ClinicalTrials.gov, 28% differed from the matched publication. LIMITATION: Small sample that included earliest results posted to the database. CONCLUSION: Reporting discrepancies between the ClinicalTrials.gov results database and matching publications are common. Which source contains the more accurate account of results is unclear, although ClinicalTrials.gov may provide a more comprehensive description of adverse events than the publication.

Mapping social processes at work in nursing knowledge development.
Non UofA Access
Hamilton P, Willis E, Henderson J, Harvey C, Toffoli L, Abery E, et al.
Nursing & health sciences 2014 Sep;16(3):395-402

In this paper, we suggest a blueprint for combining bibliometrics and critical analysis as a way to review published scientific works in nursing. This new approach is neither a systematic review nor meta-analysis. Instead, it is a way for researchers and clinicians to understand how and why current nursing knowledge developed as it did. Our approach will enable consumers and producers of nursing knowledge to recognize and take into account the social processes involved in the development, evaluation, and utilization of new nursing knowledge. We offer a rationale and a strategy for examining the socially-sanctioned actions by which nurse scientists signal to readers the boundaries of their thinking about a problem, the roots of their ideas, and the significance of their work. These actions – based on social processes of authority, credibility, and prestige – have bearing on the careers of nurse scientists and on the ways the knowledge they create enters into the everyday world of nurse clinicians and determines their actions at the bedside, as well as their opportunities for advancement.© 2014 Wiley Publishing Asia Pty Ltd.

How to make more published research true.
Non UofA Access
Ioannidis JP.
PLoS medicine 2014 Oct 21;11(10):e1001747

In a 2005 paper that has been accessed more than a million times, John Ioannidis explained why most published research findings were false. Here he revisits the topic, this time to address how to improve matters. Please see later in the article for the Editors’ Summary.

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Aging

Urban and rural differences in risk of admission to a care home: A census-based follow-up study.
Non UofA Access
McCann M, Grundy E, O’Reilly D.
Health & place 2014 Oct 6;30C:171-176

Research on admissions to care homes for older people has paid more attention to individual and social characteristics than to geographical factors. This paper considers rural-urban differences in household composition and admission rates. Cohort: 51,619 people aged 65 years or older at the time of the 2001 Census and not living in a care home, drawn from a data linkage study based on c.28% of the Northern Ireland population. Living alone was less common in rural areas; 25% of older people in rural areas lived with children compared to 18% in urban areas. Care home admission was more common in urban (4.7%) and intermediate (4.3%) areas than in rural areas (3.2%). Even after adjusting for age, sex, health and living arrangements, the rate of care home admission in rural areas was still only 75% of that in urban areas. People in rural areas experience better family support by living as part of two or three generation households. Even after accounting for this difference, older rural dwellers are less likely to enter care homes; suggesting that neighbours and relatives in rural areas provide more informal care; or that there may be differential deployment of formal home care services. Copyright © 2014 Elsevier Ltd. All rights reserved.

Best practice guidelines for the management of frailty: a British Geriatrics Society, Age UK and Royal College of General Practitioners report.
Non UofA Access
Turner G, Clegg A.
Age and Ageing 2014 Nov;43(6):744-747

Older people are majority users of health and social care services in the UK and internationally. Many older people who access these services have frailty, which is a state of vulnerability to adverse outcomes. The existing health care response to frailty is mainly secondary care-based and reactive to the acute health crises of falls, delirium and immobility. A more proactive, integrated, person-centred and community-based response to frailty is required. The British Geriatrics Society Fit for Frailty guideline is consensus best practice guidance for the management of frailty in community and outpatient settings. RECOGNITION OF FRAILTY: The BGS recommends that all encounters between health and social care staff and older people in community and outpatient settings should include an assessment for frailty. A gait speed 10s; and a score of ≥3 on the PRISMA 7 questionnaire can indicate frailty. The common clinical presentations of frailty (falls, delirium, sudden immobility) can also be used to indicate the possible presence of frailty. MANAGEMENT OF FRAILTY: The BGS recommends an holistic medical review based on the principles of comprehensive geriatric assessment (CGA) for all older people identified with frailty. This will: diagnose medical illnesses to optimise treatment; apply evidence-based medication review checklists (e.g. STOPP/START criteria); include discussion with older people and carers to define the impact of illness; work with the older person to create an individualised care and support plan. SCREENING FOR FRAILTY: The BGS does not recommend population screening for frailty using currently available instruments. © The Author 2014.

2014 Report on the Milestones for the US National Plan to Address Alzheimer’s Disease.
Non UofA Access
Alzheimer’s Association National Plan Milestone Workgroup, Fargo KN, Aisen P, Albert M, Au R, Corrada MM, et al.
Alzheimer’s & dementia 2014 Oct;10(5 Suppl):S430-52

With increasing numbers of people with Alzheimer’s and other dementias across the globe, many countries have developed national plans to deal with the resulting challenges. In the United States, the National Alzheimer’s Project Act, signed into law in 2011, required the creation of such a plan with annual updates thereafter. Pursuant to this, the US Department of Health and Human Services (HHS) released the National Plan to Address Alzheimer’s Disease in 2012, including an ambitious research goal of preventing and effectively treating Alzheimer’s disease by 2025. To guide investments, activities, and the measurement of progress toward achieving this 2025 goal, in its first annual plan update (2013) HHS also incorporated into the plan a set of short, medium and long-term milestones. HHS further committed to updating these milestones on an ongoing basis to account for progress and setbacks, and emerging opportunities and obstacles. To assist HHS as it updates these milestones, the Alzheimer’s Association convened a National Plan Milestone Workgroup consisting of scientific experts representing all areas of Alzheimer’s and dementia research. The workgroup evaluated each milestone and made recommendations to ensure that they collectively constitute an adequate work plan for reaching the goal of preventing and effectively treating Alzheimer’s by 2025. This report presents these Workgroup recommendations. Copyright © 2014 The Alzheimer’s Association.

Which factors are associated with mortality in institutionalized older adults with dementia?
Non UofA Access
Navarro-Gil P, Gonzalez-Velez AE, Ayala A, Martin-Garcia S, Martinez-Martin P, Forjaz MJ, et al.
Archives of Gerontology and Geriatrics 2014 Jul 14

Residential facilities are increasingly used as a resource for dependent older adults and a high percentage of patients with dementia die there. Information about the leading medical causes and exposures to risk factors of mortality in institutionalized older patients with dementia could guide the development of clinical management interventions. The data of 387 institutionalized adults aged over 60, diagnosed with dementia, was analyzed retrospectively. Information about sociodemographic, comorbidities, quality of life and leisure and free time variables was collected in a survey answered by caregivers; after 19 months, information was collected on the result variable (living vs. deceased). A multivariate logistic regression model was created to determine the factors associated with mortality, which were: age (odds ratio (OR)=1.986; 95% confidence interval (CI): 1.229-3.209); diabetes (OR=2.322; 1.350-3.996); hypertension (OR=1.695; 1.044-2.752); diseases of the genitourinary system (OR=2.455;1.419-4.248), worsening of health over last twelve months (OR=1.653; 1.018-2.685) and not performing passive (OR=1.616; 0.968-2.700) or social (OR=2.242; 1.170-4.299) leisure activities. Besides age, the number of comorbid illnesses and the inability to perform leisure activities predicted mortality in institutionalized adults with dementia. These predictors might be useful clinical markers for identifying patients at increased risk for mortality. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Prevalence of urinary incontinence and associated factors in nursing home residents.
Non UofA Access
Jerez-Roig J, Santos MM, Souza DL, Amaral FL, Lima KC.
Neurourology and urodynamics 2014 Oct 12

To determine the prevalence of urinary incontinence (UI) and associated factors in the institutionalized elderly. METHODS: A cross-sectional study is presented herein, conducted between October and December 2013, in 10 nursing homes in the city of Natal (Northeast Brazil). Individuals over the age of 60, who reside in institutions, were included. Hospitalized individuals and those at end of life were excluded. Data collection included sociodemographic information, UI characterization, as well as variables related to the institution itself and to health conditions (comorbidities, medication, pelvic floor surgery, Barthel Index for functional capacity, and Pfeiffer test for cognitive status). UI was verified through the Minimum Data Set (MDS) version 3.0, which was also used to assess urinary devices and UI toileting programs. The Chi-square test (or Fisher’s exact test), the linear Chi-square test, and logistic regression were utilized to model associations. RESULTS: The final sample consisted of 321 elderly, mostly females, with a mean age of 81.5 years. The prevalence of UI was 58.88% (CI 95%: 53.42-64.13) and the final model revealed a statistically significant association between UI and white race, physical inactivity, stroke, mobility impairment, and cognitive decline. The most frequent UI type was functional UI and toileting programs (prompted voiding) were only applied to approximately 8% of residents. CONCLUSIONS: It is concluded that UI is a health issue that affects more than half of the institutionalized elderly, and is associated with white race, physical inactivity, stroke, and other geriatric syndromes such as immobility and cognitive disability. Neurourol. Urodynam. © 2014 Wiley Periodicals, Inc. © 2014 Wiley Periodicals, Inc.

Networks of Informal Caring: A Mixed-Methods Approach.
Non UofA Access
Rutherford A, Bowes A.
Canadian journal on aging = La revue canadienne du vieillissement 2014 Oct 29:1-15

Care for older people is a complex phenomenon, and is an area of pressing policy concern. Bringing together literature on care from social gerontology and economics, we report the findings of a mixed-methods project exploring networks of informal caring. Using quantitative data from the British Household Panel Survey (official survey of British households), together with qualitative interviews with older people and informal carers, we describe differences in formal care networks, and the factors and decision-making processes that have contributed to the formation of the networks. A network approach to care permits both quantitative and qualitative study, and the approach can be used to explore many important questions.

UK Department of Health: Carers strategy: actions for 2014 to 2016
October 2014

The document identifies the main actions for the next 2 years around supporting carers. There is an overview of evidence gathered over the last few years. It also explains the main achievements in recognising and supporting carers during that time. This builds on the national Carers Strategy of 2008 and the next steps update of 2010.

McMaster Health Forum: Meeting the Future Home and Community Care Canada-flat-icon
Michael G. Wilson; Francois-Pierre Gauvin; John N Lavis.
August 20, 2014. Citizen Brief. Panel Summary.

On August 20, 2014, the McMaster Health Forum convened a citizen panel on meeting the future home and community care needs of older adults in Ontario. The input from the citizen panel will guide the efforts of policymakers, managers and professional leaders who make decisions about our health system. It will also be used by the Ontario Association of Community Care Access Centres (OACCAC) in their continued efforts to provide optimal home and community care to older adults in Ontario. This summary highlights the views and experiences of panel participants about:
-the underlying problem;  three possible options to address the problem; and
-potential barriers and facilitators to implement these options.
The citizen panel did not aim for consensus. However, the summary describes areas of common ground and differences of opinions among participants and (where possible) identifies the values underlying different positions.

ILC-UK: New perspectives and approaches to understanding dementia and stigma (UK)
2014

This new compendium of essays examines the social stigma which surrounds dementia, highlighting that stigma is impending early diagnosis, care and research into the disease. The report, New perspectives and approaches to understanding dementia and stigma, published by the International Longevity Centre UK (ILC-UK) in collaboration with the MRC, Alzheimer’s Research UK, Alzheimer’s Society and supported by the drug company Pfizer, shines a light on the impact the fear around dementia has on those living with the condition, their families and carers, which prevents the research community capturing a full picture of the disease.

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Events

UofA

Brown Bag: RSO Reorganization and the New Grant Application Process
Thursday 6 Nov 12:00-13:00 Location TBA

This session will introduce the changes taking place in RSO and what that means to you. If you plan to apply for funding, you won’t want to miss this session.

NAHLA Research Exposition – Reviewing the Evidence
Wednesday 26 November 17:00-18:30 ECHA 1-490

Learn about methods for reviewing health evidence from the experts. Please join us for an summary of methods for reviewing health evidence, the work of the Cochrane Collaboration, and a presentation on methods for producing umbrella reviews (overviews of systematic reviews). Come and enjoy the presentations, ask questions, and eat cookies!
Lisa Hartling, Director of the Alberta Research Centre for Health Evidence (ARCHE) and the University of Alberta Evidence-based Practice Center – Lisa will discuss different review methods, such as systematic, scoping, rapid, and umbrella reviews (overviews of systematic reviews).
Denise Thomson, Co-Director, Cochrane Child Health Field; Board of Directors, Cochrane Innovations; Fields representative, Cochrane Collaboration Steering Group – Denise will introduce the Cochrane Collaboration and describe how this international group organizes the production of reviews. Denise will also talk about her work promoting child health evidence.
Michelle Foisy, PhD Student & Project Coordinator, Alberta Research Centre for Health Evidence (ARCHE) – Michelle will introduce a specific review method for analyzing Cochrane systematic reviews. Umbrella reviews (overviews of systematic reviews) are an emerging method for analyzing pre-synthesized evidence.

Online

KT Canada Webinar: The RE-AIM Framework: History, Recent Applications, and Future Directions
Presenter: Dr. Russell E. Glasgow
Thursday 13 November 10 am UofA folks this will be shown in ECHA 5-001

Learning Objectives:
Describe the rationale for development of and the main dimensions of the RE-AIM framework
Discuss how the RE-AIM framework has been applied to address health disparities
Describe common challenges to use of and future directions for RE-AIM

Webinar: How to support what is often “the worst day of their lives”: The move from home to care
Wednesday 12 November 10:00-11:00

Families caring for people with dementia often must move the person from their care to the care of others via a long-term care home. This decision is seldom an easy one; the day itself is often described by care partners as the worst day of their lives. This session will examine what is in the “invisible suitcase” brought on move day by the person, their caregiver and family members. With the “invisible suitcase” in mind, we will explore how staff can provide support, with the goal of making the experience better for everyone.

CFHI: ‘Highly Adoptable Improvement’: Minimizing Workload Burnout, While Maximizing Capacity and Value
Monday 3 November 10:00-11:00

Change initiatives that do not create additional workload and have high perceived value are more likely to be adopted, cause less workplace burden, and achieve the intended outcomes. That’s the hypothesis behind ‘highly adoptable improvement’, which Dr. Chris Hayes, Medical Director of Quality and Performance at St. Michael’s Hospital in Toronto and Canadian Harkness Fellow in Health Care Policy and Practice will introduce on this session of On Call.

TVN: Frailty in the elderly
Wednesday 5 November 10:00-11:00 MT

Join us online with Dr. Melissa K. Andrew for a discussion of what frailty is and why it matters for the health and health care of older adults. In this presentation, we will first consider what frailty is, what it means to be frail, and how frailty is distinct from chronological age. We will discuss different ways we can think about frailty and consider how frailty impacts older peoples’ health and health care. We will examine different approaches to the measurement of frailty in research and clinical settings, and also consider how social factors are relevant to frailty and its clinical management.

TVN: Knowledge translation: moving evidence and practice into policy
Wednesday 3 December 10:00-11:00 MT

Join us online for an overview of knowledge translation (KT), including comparing end-of-grant KT with integrated KT. Potential frameworks for conducting integrated KT in different settings (i.e. clinical vs. policy) will be discussed. A strategy for determining and addressing barriers to the translation of knowledge will be explored, along with an approach to consider when developing implementation strategies.

Looking for an easy-to-use template to help you communicate to decision makers?
Tuesday 18 November 11:00-12:30 MT

What is a briefing note?
A briefing note informs decision makers about an issue by succinctly describing the issue and background information, and describing key considerations, options to address the issue and recommended actions.
How can the Briefing Note: Decisions, Rationale and Key Findings Summary help you?
Developed by Health EvidenceTM, the Briefing Note: Decisions, Rationale and Key Findings Summary helps you to identify and document what is known about an issue and what actions are recommended for your public health organization. The fillable template records such critical elements as:
• a description of the issue(s) (i.e., change in practice, program, or policy)
• the types and nature of the evidence
• the options considered and the rationale for these options
• the recommendations made and the rationale for these recommendations

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Courses

IWH: Fall 2014 Systematic Review Workshop
1-5 December Toronto ON $2750 Student discount is available

The systematic review workshops offered by the Institute for Work & Health are designed to teach participants how to plan, conduct and communicate the results of a systematic review.

IHI: Getting Results at Scale
19​-20 February Orlando FL ​US$1975

Are you struggling with how to implement and sustain improvements across your hospital or health system? The Institute for Healthcare Improvement (IHI), a leader in how to effectively take improvement results to full scale based on more than a decade of experience in the field, has refined its approach to include a more cohesive and balanced set of steps for achieving, and sustaining, system-wide change. During this two-day seminar, learn a new approach that informs a sequence of activities needed to achieve full-scale implementation, including strategies to enhance adoption of the improvements and the infrastructure needed to support them.

Online

Participative Research and Policy: research use, relevance and impact
EPPI-Centre, Institute of Education, University of London
This course runs for 15 weeks from 14 January 2015
Deadline for applications is 8 December 2014 £670

This course will enable you to involve policy makers, practitioners and service users in doing and using research. You will work with other students and the course leader, to critically engage with the latest theories and debates about the relevance and application of research findings for policy, practice and personal decisions. The course is designed for people seeking a critical understanding of research impact and public engagement and for people in public or voluntary sector organisations that are, or aspire to become, research informed. On successful completion of this course you will be able to plan how to conduct and use research collaboratively.

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News

National Quality Forum to Craft HCBS Quality Measurement Framework (US)

The National Quality Forum is embarking on a new two-year project to create a framework for quality measurement for residents living in a community who are supported by home and community-based services, or HCBS.

Alberta Government’s vow on increased continuing care beds creates doubts Canada-flat-icon

Doubts and question marks surround the Prentice government’s pledge this week to open hundreds of new continuing-care beds across Alberta over the next year in an urgent move to reduce hospital overcrowding and ER delays.

Newfoundland & Labrador government creates new Department of Seniors, Wellness and Social Development Canada-flat-icon

The new department combines functions from a number of government departments into new branches focused on seniors, aging and social development as well as health promotion, wellness and sport. On seniors’ issues specifically, the mandate will also cross departments and government agencies – from health care to housing.

Long-term care, supportive living and home care – how do they differ in Alberta? Canada-flat-icon

The levels of care offered to Alberta seniors can be confusing, especially as the government announces measures to move people out of hospital beds into more appropriate settings.

Prentice government advances plan to boost seniors care spaces across Alberta Canada-flat-icon

As the next step in ensuring seniors have accommodation options that fit their needs, a targeted 1,500 continuing care living spaces will be constructed in both rural and urban areas.

NHS ‘to grind to halt’ with dementia warns professor (UK)

The NHS will “grind to a halt” unless more is done to help care for dementia patients in the community, Wales’ only professor of geriatrics has warned.

Old and Stale? — Aging Researchers, Funding Trends, and the Doughnut Effect (US)

As more grants go to older scientists while younger scientists go without, many younger researchers are leaving academic research in pursuit of other interests and jobs that pay more.

Dementias Platform UK (DPUK) has been launched by the Medical Research Council (UK)

Dementias Platform UK will look at the causes of dementia across a range of neurodegenerative conditions, including Alzheimer’s, Parkinson’s and Motor Neurone Disease following millions of pounds of investment from the government for new technologies.

BC Care aides struggle to support seniors – poll Canada-flat-icon

Nearly three-quarters (73.3 per cent) of B.C.’s care aides say they are forced to rush through basic care for the elderly and disabled, according to a Viewpoints Research survey commissioned by the Hospital Employees’ Union.

Alberta care homes fight to prevent release of financial reports Canada-flat-icon

A continuing care operator is fighting a recent ruling by Alberta’s information czar that would reveal how hundreds of millions in taxpayer dollars are spent each year at the province’s nursing homes and supportive living facilities.

Nursing Home Style

Are there mean girls in nursing homes who shun you if you wear the wrong outfit?

A plan to double the number of Canadian academics winning international awards Canada-flat-icon

This concerted effort is being spearheaded by Governor General David Johnston and Howard Alper, chair of the Science, Technology and Innovation Council.

Navigating caregiving, chronic conditions a strain on Canadians, according to new survey Canada-flat-icon

For many Canadians, finding their way through the healthcare system is a daunting task. In fact, 81 per cent of Canadians find the system too complicated, and 78 per cent agree that navigating it is a challenge, according to a recent survey commissioned by CARP and the Sheridan Centre for Elder Research, and made possible by Amgen Canada.

Final Care Act guidance published (UK)

The Care Act regulations and guidance for local authorities have been strengthened as a result of consultation.

Alzheimer’s Society responds to the new national criteria for social care eligibility (UK)

In response to the Care Act (see above), the Alzheimer’s Society responds that in setting the eligibility criteria for council-funded social care so high thousands of people with dementia will be cut off from the vital support they need and deserve.

Edmonton’s best dementia facility only ‘half’ of what it should be: U.K. expert Canada-flat-icon

According to the Alzheimer Society, McConnell Place is one of the best places for dementia care in Edmonton. With just 12 residents in each of its three wings, the facility is small but offers patients a yard and plenty of activities. Still, Dr. David Sheard believes that it’s only “halfway there.”

Australia establishes National Institute for Dementia Research

Health Minister Mr. Peter Dutton said the NHMRC National Institute for Dementia Research was a cornerstone of the Australian Government’s $200 million commitment to boosting research into dementia.

NHS England: General Practitioners to be given £55 for every diagnosis of dementia

This move is part of NHS England’s ongoing push to identify and diagnose two-thirds of people with dementia by April 2015.

Ottawa to cap number of foreign caregivers in Canada Canada-flat-icon

Starting in December, Ottawa will replace the live-in caregiver program with two new labour streams, and restrict the number of foreign nannies it accepts.

Caregivers Nova Scotia offers relief for families taking care of loved ones Canada-flat-icon

A provincial organization dedicated to helping unpaid caregivers says there’s an urgent need for its services, but many people still don’t know it exists. Caregivers Nova Scotia, which is funded by the Department of Health and Wellness, provides support for those looking after loved ones.

Institute of Medicine Honors Penn’s Linda Aiken (US)

Linda Aiken, the Claire M. Fagin Leadership Professor of Nursing and the director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania in Philadelphia, was presented with the Gustav O. Lienhard Award from the Institute of Medicine.

VA hospital at Anschutz in Aurora lands geriatric research center (US)

Once it’s up and running, the new Veteran’s Affairs building at the Anschutz Medical Campus in Aurora will include a research and treatment center entirely devoted to the care of aging veterans.

Meeting the Future Home and Community Care Needs of Older Adults in Ontario Canada-flat-icon

The McMaster Health Forum convened a citizen panel on the subject of meeting the future home and community care needs of older adults in Ontario.

Cost of Informal Caregiving for U.S. Elderly Is $522 Billion Annually

The price tag for informal caregiving of elderly people by friends and relatives in the United States comes to $522 billion a year, according to a new RAND Corporation study.

A Farewell to His Fans and Himself: Glen Campbell, on the Road With Alzheimer’s in ‘I’ll Be Me’

From the very first scene, “I’ll Be Me” signals that it is not going to be a conventional documentary about a celebrity, in this case the country-pop singer and guitarist Glen Campbell. As Mr. Campbell sits in a darkened room watching home movies of his younger self, he asks his wife, Kim, “Who is that?”

Province commits $70M for fire safety upgrades in older Alberta seniors’ care facilities Canada-flat-icon

Alberta Premier Jim Prentice says the province is committing $70 million to put more sprinklers and other fire safety devices in seniors facilities as soon as possible. Prentice said Wednesday it’s part of a broader strategy to equip the 24,000 government owned and supported seniors care units in Alberta.

Dementia leading cause of death for women in Britain

The prevalence of dementia in Britain is revealed in official figures showing that the number of deaths in which it was the underlying cause jumped by seven per cent in a single year. Dementia and Alzheimer’s disease are the biggest cause of death among women and ranked third after heart disease and cancer for men.

Radical rest homes: Old people should live everywhere Canada-flat-icon

Aren’t seniors’ residences boring places for bingo, movie afternoons and white bread sandwiches with the crusts cut off? Or worse, prisons for the incarcerated elderly? Not in Janet Torge’s world. For 30 years she has been imagining and re-imagining a different way of growing old.

Government’s announcement of program to renovate and rebuild long-term care homes will mean better care and safety for residents Canada-flat-icon

The Ontario government will soon begin a capital redevelopment program for approximately 300 long-term care homes that do not meet current design standards (1998).

Better care plans to help elderly and reduce hospital visits (UK)

The plans, which will also provide more dignity for older people and reduce the length of stay in hospital, are funded by the government’s £5.3 billion Better Care Fund. It was originally set at £3.8 billion but has increased significantly following additional local investment.

Survey on Living with Chronic Diseases in Canada, 2014 Data now Available from StatsCan Canada-flat-icon

Data from the 2014 Survey on Living with Chronic Diseases in Canada are now available upon request. The objective of the survey (sponsored by the Public Health Agency of Canada) was to assess the impact of mood and anxiety disorders on quality of life and to provide more information on how Canadians manage their chronic condition. Data were collected from October 2013 until March 2014. Approximately 3,400 individuals aged 18 years and older residing in households in the 10 provinces were interviewed.

Huge reorg of Nova Scotia’s health system Canada-flat-icon

Nova Scotia is cutting the number of district health authorities in the province from ten to two, with the aim of reducing administration and saving $5 million annually in senior management salaries. The new Health Authorities Act passed through the legislature in just five days.

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Resources

Frailsafe Safety Tool

The FRAILSafe Project has identified the most common and highest impact issues that can result in harm to frail older patients in the first few days of arrival in acute care: Confusion; Equipment Related; Reduced Mobility; Falls; Pressure Ulcers; Poor Advanced Care Planning and Adverse Drug Medication. Based on these harms, FRAILSafe has created a safety checklist that improves communication and team working, and intends to provide a ‘check and challenge’ list triggering an interaction between the senior physician and another member of staff. The draft of the safety checklist is available on the website, in addition to information on its implementation and examples of other case studies.

TheKing’sFund: Is your care home dementia friendly?

To support clinical and care staff, managers and estates colleagues, The King’s Fund has produced a range of resources to enable hospitals, care homes, primary care premises and specialist housing providers to become more dementia friendly.

Tactics for proof-reading

Here are some great tips and tricks for making proof reading easier and better.

Alive Inside: A Story of Music & Memory
Documentary available to NetFlix subscribers

This moving documentary follows social worker Dan Cohen as he uses music to unlock memory in nursing-home patients afflicted with Alzheimer’s disease.

How Do You Say, ‘Read Me?’ Or Choosing Keywords to Retrieve Information

So you’ve written a snappy and yet accurate and informative title for your journal article, and so after your victory lap you spend just a few seconds thinking about the keywords. That’s probably a mistake, argues the just-retired editor of an important political science journal.

Don’t Let A Snob Story Become a Sob Story

There are a number of species of snobbery that show up on campus and it’s useful to develop skills for counting or even reversing its malign influence. Step one: learn to laugh.

The Confidence Gap in Academic Writing

Are you signaling doubt in your writing? Tips and tricks on being a self-assured academic writer.

Let’s Talk About Dementia Blog

The Let’s Talk about Dementia blog is hosted and supported by Alzheimer Scotland and led by its Allied Health Professionals. The blog shares the work and practice of the allied health professionals working with individuals with dementia and their families. It offers advice to families, ranging in topics from diet to physical activities to information on prolonging stays in the community. It also offers practical help to health care professionals.

Predatory Publishing: What Editors Need to Know
INANE Predatory Publishing Practices Collaborative. (2014).
Nurse Author & Editor, 24(3), 1.
Free registration required to view

This article provides some great guidelines on how to determine whether an open access journal is predatory or not.

WHO Info App
Free

The official World Health Organization info app. Keep the latest health information at your fingertips with this app from the World Health Organization.

To quote, or not to quote: making the most of qualitative data

This is a guide on using quotes as qualitative data and the different ways you might use quotes and, in particular, the different purposes for using them. We also put together some things that are worth considering for how you use quotes in your next evaluation report.

Health Foundation: A quick guide to person-centred care

-Despite a growing recognition of the need for care to be more person-centred, there remains a gap between the commitment to a person-centred approach and the reality on the ground.
-Person-centred care is hard to define. Instead, we have identified a framework that outlines its four main principles.
-There is a strong argument for adopting more person-centred approaches, including improved clinical and health outcomes, better value for money and happier patients and health care staff.

NICE: Tailored resource for carers and care providers on supporting people to live well with dementia

The resource is intended for care givers as well as care providers. It outlines 10 quality statements, their key messages and key resources for a greater understanding of quality of care. The quality statements include:
Discussing concerns about possible dementia
Choice and control in decisions
Reviewing needs and preferences
Leisure activities of interest and choice
Maintaining and developing relationships
Physical and mental health and wellbeing
Design and adaptation of housing
Planning and evaluating services
Independent advocacy
Involvement and contribution to the community


Eating Well for People with Dementia – a guide for carer’s

This is a pamphlet developed by the Northern Health and Social Care Trust. At 24 pages, it’s a comprehensive booklet that explains to caregiver’s some of the ways dementia can impact food intake and the importance of nutrition to people with dementia. It includes information on good nutrition, appropriate amounts of fluid and fibre intake, dealing with difficulties of eating, and advice on some common problems related to eating.

The Sexuality Assessment Tool (SEXat)

The Sexuality Assessment Tool (SEXat) for residential care facilities has been developed to help long-term care facilities support the expression of sexuality of residents, both with and without dementia. There are many challenges long-term care staff must consider in regards to a residents sexual expression, including privacy (or lack thereof), staff attitudes and lack of staff education. This assessment will inform facilities as to how they’re doing when it comes to supporting sexual expression of residents.

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