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Background: Communication between the nurse and the patient is recognized as an important component of care that fosters the creation of therapeutic relationships, yet it is seen as a major shortcoming in intensive care units (ICUs). In this paper the authors explore the diverse factors that affect nursing practices with regard to nurse-patient communication. Purpose: 1) To encourage nurses to reflect on how they communicate with patients in their current practice. 2) To contribute to an ongoing, open discussion regarding nurse-to-patient communication within the critical care setting. 3) To increase awareness and understanding of Gottlieb's (2013) Strengths-Based strategies for nurse-to-patient communication. Methods: Subjective information about nursing perspectives on communication practices were obtained through informal discussions with critical care nurses in Montreal, Canada and were then compared to the existing literature. Results: Data was gathered from nineteen ICU nurses; 63% of the participants stated that they believed nurse-to-patient communication was inadequate on their units. Through analysis of the data, challenges to communication were identified as well as suggestions to overcome these barriers. Factors affecting communication were found to exist in four domains: the system, the team, the nurse and the patient. Conclusion: Communication plays an integral role in nursing care but is often neglected in lieu of more technical and medical care. In response to the findings, strengths-based approaches to communicate vital information to patients are proposed. In response to this paper, further evaluation and implementation 0) communication strategies to improve nurse-to-patient communication within the ICU setting may be practised. [ABSTRACT FROM AUTHOR]

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Background: With QT-prolonging drugs being trialed for the treatment of COVID-19, national health associations allude to the importance of proficient QT interval assessment. However, in Canada there is no policy in place that clearly identifies a single method for routine QT monitoring. Aim: To demonstrate the need for a clear Canadian guideline for the measurement of the QT/QTc interval and to advocate for a standardized approach to education. Methods: This paper uses a medical anthropological approach to scale this practice gap from the individual provider to the institutions that govern practice and education. Nurses and emergency medical personnel from hospitals across Canada were polled with questionnaires on their confidence and knowledge of assessing the QT/QTc interval. We seek to identify causes for the widespread lack of confidence that goes beyond the context of nursing and is interdisciplinary in nature. Findings: Of the 292 participants who were polled, roughly 75% report measuring the QT interval. However, more than 50% of participants are not confident in their measurement. Although critical care nurses report the highest levels of confidence, the rate of correct answers amongst the whole of participants on knowledge-based questions is shockingly low (only nine percent attempted to provide a value for the QTc; 34% of those who were unsure of the normal QTc say they were not taught). Ninety percent of participants report they do not analyze the QTc, with critical care nurses accounting for 34% of participants. Conclusion: The lack of consensus on a QTc formula and the absence of clear guidelines on this well-documented issue exacerbate the continued gap in practice observed in our findings. We urge leading organizations to create a national guideline that supports a standardized approach to QT/QTc measurement that can be taught to and used by not only critical care nurses, but everyone in healthcare who provides cardiac monitoring. [ABSTRACT FROM AUTHOR]

A student's accuracy on drug calculation tests may be influenced by maths anxiety, which can impede one's ability to understand and complete mathematic problems. It is important for healthcare students to overcome this barrier when calculating drug dosages in order to avoid administering the incorrect dose to a patient when in the clinical setting. The aim of this study was to examine the effects of maths anxiety on healthcare students' ability to accurately calculate drug dosages by performing a scoping review of the existing literature. This review utilised a six-stage methodology using the following databases; CINAHL, Embase, Medline, Scopus, PsycINFO, Google Scholar, Trip database ( http://www.tripdatabase.com/ ) and Grey Literature report ( http://www.greylit.org/ ). After an initial title/abstract review of relevant papers, and then full text review of the remaining papers, six articles were selected for inclusion in this study. Of the six articles included, there were three experimental studies, two quantitative studies and one mixed method study. All studies addressed nursing students and the presence of maths anxiety. No relevant studies from other disciplines were identified in the existing literature. Three studies took place in the U.S, the remainder in Canada, Australia and United Kingdom. Upon analysis of these studies, four factors including maths anxiety were identified as having an influence on a student's drug dosage calculation abilities. Ultimately, the results from this review suggest more research is required in nursing and other relevant healthcare disciplines regarding the effects of maths anxiety on drug dosage calculations. This additional knowledge will be important to further inform development of strategies to decrease the potentially serious effects of errors in drug dosage calculation to patient safety. [ABSTRACT FROM AUTHOR]

The Truth and Reconciliation Commission (TRC) of Canada Report: Calls to Action (2015) has proposed that the health of the Indigenous population of Canada has been significantly impacted by colonization. Currently, members of the Indigenous communities often cite experiencing prejudice and systemic racism in the healthcare setting (MacDonald & Steenbeek, 2015). Hospital policies and healthcare professionals' attitudes pose barriers to Indigenous healing practices, which results in a delay in seeking help until critically ill (Stamler, Yiu, & Dosani, 2016). During a voluntary summer clinical project, six undergraduate nursing students developed a semi-structured interview to explore the knowledge of the TRC among 25 nurses in various critical care settings across Canada. Following data collection, the authors determine that due to a lack of cultural competency and safety in such fast-paced units, holistic and personalized care can often be impaired for Indigenous peoples. They further propose that non-Indigenous nurses caring for Indigenous patients have a responsibility to reach a greater understanding of colonial history tofully comprehend power imbalances that are often replicated (Stamler et al, 2016). In this paper, the authors will share the findings from their clinical project and compare them to the application of the TRC's Calls to Action in Canada and internationally. Strategies to improve care to the Indigenous peoples will be explored. The aim is for all nurses to become familiar with how to implement the TRC Calls to Action into practise. [ABSTRACT FROM AUTHOR]

Introduction Research in palliative care (PC) is often regarded as challenging due to the vulnerability of the population and other peculiarities. We aim to systematically identify barriers to research in PC in the literature. Methods The electronic databases CINAHL, MEDLINE were searched for papers published in the last 25 years. Citations and then abstracts were screened for inclusion. Original papers were included on first-level analysis. On a second level reviews, reports, and position papers were analyzed. Papers containing a direct patient report were specifically analyzed. Barriers were categorized (ethical considerations, financial and time expenses, study design and methodology, human resources and politics) and results quantified. Results Twenty-one original papers and 65 other papers were included. Five studies involved patients directly, five were systematic reviews, three were study experiences, and seven were surveys or workshop reports. Most papers originated from UK, USA, or Norwegian Universities. Ethics and methods were the most often mentioned categories on both levels. Accrual, attrition, and gatekeeping were frequently named barriers. Complex invasive studies or possible side effects hinder patients' participation, as patients are often willing to participate for altruistic motivations. Discussion Barriers to PC research are ethical concerns and methodological challenges. Possible strategies to overcome methodological barriers include international collaborative efforts to include more patients and improve study designs. Ethical barriers indicate the need for patient involvement in the research development process and tailoring research specifically to the PC population. [ABSTRACT FROM AUTHOR]

Abstract Clinical nursing leadership is critical for quality care. All nurses including students should receive clinical nursing leadership education. Research pertaining to educational strategies on clinical leadership for nursing students remains sparse. The aim of this paper is to report the qualitative evaluation of a co-constructed educational intervention on clinical nursing leadership, developed for 1st year preregistration nursing students. The research question was "what are the components of an educational intervention that support the development of clinical nursing leadership in 1st year nursing students?". The intervention included videos, brainstorming, journal entries on students' clinical leadership paired with the observation of a nurse's clinical leadership. A research and development model guided the study. Focus groups and individual interviews were conducted with 23 students and 6 educators who tested the intervention. Thematic analysis revealed three intervention components that supported learning: visual examples at the student's level, observation of role models and animated discussions in small groups. Visual examples and observation of role models supported learning by expanding student's initial views of nursing beyond a technical role to one that is embedded with clinical nursing leadership. Animated discussions in small groups helped students learn to speak up and be open to other's opinions. Highlights • Clinical nursing leadership is critical for improving care and patient safety. • An early educational intervention on clinical nursing leadership is evaluated. • The strategies used were videos, role models, journal entries, and brainstorming. • Videos helped students expand their perception of nursing and clinical leadership. • Journal entries and brainstorming need additional evaluation. [ABSTRACT FROM AUTHOR]

This paper explores the ways that Aboriginal people living with HIV and AIDS experience feelings of depression. Seventy-two individuals participated in an in-depth semi-structured interview. Many participants described their depression in terms of their relationships, including isolation or a disconnection from people, communities, and culture. Depression was closely linked to their individual experiences with racism, a history of fostering and adoption, childhood abuse, disconnection from family and community, and substance abuse. The paper ends with a discussion of how our findings compare to those from research on non-Aboriginal populations and with a consideration of their service-related implications. [ABSTRACT FROM AUTHOR]

This special edition of the Review includes four papers that deal with health care reform in Canada in the 1990-2003 period. The papers are a small sample of some 30 case studies that have been prepared from an ongoing research project entitled Cross-Provincial Comparison of Health Care Reform in Canada (hereafter referred to as either the Cross-Provincial Project or the Project). Among other things, the 30 studies examine the nature and extent of health care reform that occurred during that period and the factors that help to explain why reform did, or did not, occur. The purpose of this introductory paper is three-fold: to provide the rationale and context for the Project; to describe the research methodology used; and to outline some preliminary results. In so doing, it is intended to provide some framework for the remainder of this special edition. [ABSTRACT FROM AUTHOR]

The paucity of literature in the field of visitor attractions, combined with the virtual vacuum of literature on international comparative research methodologies in tourism generally, and more specifically within the visitor attractions sector, together serve as the catalytic focus for this paper. Where studies have been completed on visitor attractions in the international arena, they have often been practitioner-led and lack the depth of analysis and rigour required for academic scrutiny. This paper will begin to fill this gap, by evaluating the methodological options available to academics when researching visitor attractions in different countries. Reference will be made throughout the paper to an international comparative Study undertaken by the authors at visitor attractions in Scotland, Canada, Australia and New Zealand. The paper concludes with a synthesis of those methodological issues deemed to be of benefit to future researchers wishing to advance their understanding of the management of-visitor attractions in different countries around the world. [ABSTRACT FROM AUTHOR]

This paper explores the role of nonprofit organizations in the immigrant settlement and integration sector in the public policy process in three Canadian provinces. Drawing on thirty one (31) semi-structured interviews with nonprofit and mid-level policy officials (working for a provincial government) in three provinces (Ontario, British Columbia and Saskatchewan), the place of nonprofit agencies in providing input and voice to policy issues in the area of settlement and integration services is presented. Issues regarding the willingness to use advocacy/voice with government funders, the usefulness of government consultations, strategies used in approaching government, the role of research in making evidence-based cases regarding policy and program change, among other considerations are examined. The assessments provided by key nonprofit actors and government policy officials are used to bring better understanding of the perceived roles of nonprofit organizations in the daily work of policy. [ABSTRACT FROM AUTHOR]