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Background Despite older people being the largest demographic accessing health care, nurses often lack knowledge about how to work with them and may hold ageist perceptions towards them. Previous research has identified the gaps in their education program and offered suggestions on what and how to fill those gaps in education related to older people. E-learning activities to fill these gaps were developed. Objective The aim of this study was to determine if nursing students' perceptions about older people could be improved through an e-learning activity focused on communication and understanding older people. Methods A quasi-experimental pre-post design was used to test whether the understanding and communication with older people e-learning activity improved student nurses' perceptions about older people. A feedback survey was also analyzed using descriptive statistics to understand students' perceptions of the learning activity. Results There was a statistically significant decrease in participant's negative perceptions towards older people after completing the e-learning activity. Participants enjoyed the activity and believed that it improved their knowledge of older people, their confidence in working with older people, and their perceptions about older people. Conclusions The strength of the e-learning activity in this study is that the educator need not be an expert in order to use the activity in their course. In this way, knowledge about older people is facilitated despite the dearth of nurse educators with gerontological expertise. More research to test this activity in other universities is needed. Implications for practice Improved understanding and communicating with older people could improve person-centered-care. The flexible delivery of this learning activity could facilitate practicing nurses understanding and communication strategies if offered to them.

Background The increasing numbers of older people (age 65+) make it important to understand how to attract nurses to work with this population. Methods A secondary analysis using qualitative descriptive methods was used to understand how student nurses' perceptions about older people may influence their desire to work with older people. Results Student nurses perceive a generational divide between them and older people, regardless of practice settings. They believe working with older people is heavy work, and not high acuity, and although good to learn skills as a student, not a population they want to work with until they are close to retirement themselves. Conclusions It is important to enhance nursing education so that students understand the older generation, how to communicate with them and the prevalence of older people in healthcare settings, so that they are more likely to choose to work with older people.

AIM To describe ways in which a hospital context, physically and culturally, influences nurses' abilities to promote and engage with environmentally responsible practice. DESIGN A focused ethnographic study. METHODS Data were collected during May and August, 2019. Nurses (n = 22) working in the emergency room and three medicine units within a large Western Canadian hospital were invited to participate. Semi-structured interviews were conducted, and observations were collected. Reporting is in accordance with the consolidated criteria for reporting qualitative research. RESULTS Three themes were identified: patient care not environmental care, organizational role and operational efficiency. Overall, participants indicated patient care was their primary priority, and due to their workload, they were unable to simultaneously consider the environmental impact of their work. Participants stated they had difficulties practicing in environmentally responsible ways because they felt unsupported by their hospital organization. Regardless, there was a desire for the organization to support environmentally responsible practices. CONCLUSION Climate change is a major health concern, and partnership between hospitals and nurses is necessary to ensure environmentally responsible healthcare is delivered. We suggest both a top-down and bottom-up approach to help develop hospital contexts that are relevant and environmentally responsible. IMPACT Nurses have a professional responsibility to address climate change, yet this study identified that nurses found it challenging to practice in environmentally responsible ways within the hospital context. Challenges they faced are related to their workload, their misaligned nursing priorities and, more importantly, because they felt unsupported by their hospital. Findings are important to both the nursing profession as well as other hospital leaders so that a culture of environmentally responsible healthcare can be developed within hospitals.

Aim Health care administrators provided information through semi-structured interviews as to how one faculty of nursing (FoN) was preparing students for practice. Background There is a long-standing disconnect between the nursing education and the clinical arena known as the theory-practice gap. The FoN wanted to redevelop their curriculum to better prepare students for practice and bridge the gap. Method Using developmental evaluation, 36 administrators were interviewed and asked about their expectations of newly graduated nurses, the FoN curriculum, and changes to be made. Results Four themes were identified: entry to programme; curricular content, delivery and structure; clinical recommendations; and stronger relationships. Conclusion Strong academic-practice partnerships are still needed. The current lack of communication and partnership has compromised students' quality of education and their transition into the workforce. Implications for nursing management Leaders in both the education and practice settings can better prepare newly graduated nurses and bridge the theory-practice gap by co-creating a joint committee and creating more touchpoints with one another. A joint committee can develop appropriate entry-to-programme guidelines, discuss relevant trends in practice and shape the curriculum. Clinical experiences for students may also act as extra touchpoints whereby the two groups can discuss clinical mentorship needs and build stronger academic-practice relationships.

Aims and objectives The purpose of this study was to explore Canadian nurses' perspectives on climate change, health, nursing practice and the relationships between these concepts. Background Climate change negatively impacts human health. With a mandate to promote health, nurses have a professional and ethical responsibility to address climate change. Little is known about Canadian nurses' perspectives on climate change or how they perceive of their professional responsibility towards addressing it. Methods A focused ethnography was conducted in three medicine units and the emergency room at a Canadian hospital. Nurses (n = 22) participated in semi-structured interviews, and observations were collected. Data were analysed via thematic analysis. Reporting is in accordance with the COREQ guideline. Results Three themes were identified: muddled terminology, climate change and health, and nursing's relationship to climate change. Conclusion Participants had varying levels of knowledge about climate change and its relationship to health or practice. Climate change was a personal concern, and nursing's role in addressing it was not understood. Relevance to practice This study highlighted that practising nurses did not readily recognise their role in addressing climate change. More work is needed to clarify this role and bring it into the consciousness of every-day nursing practice. Furthermore, more work is needed to examine how healthcare organisations can better support environmentally responsible nursing practice.

Background Negative perceptions about working with older people within nursing contribute to the deficit of educators with expertise to teach student nurses, and nurses graduating ill‐equipped to work with the ageing population. The perceptions of nurses who have recently graduated from a nursing programme can provide insights into what they wished they knew about working with older people before they graduated. Methods A qualitative descriptive study design examined recently graduated registered nurses’ reflections on their education preparation to work with older people. Content and thematic analysis was used to develop the themes of first impressions and preparation to work with older people. Results Key findings were that nurses did not recognise the importance of learning about older people until they had graduated. Only then did they realise that the ageing population was so complex and prevalent. They perceived a lack of education particularly related to working with older people with dementia and their behaviours, as well as learning how to communicate to an older population. Participants perceived that as students, it was up to them to fit in learning about working with older people without the support of faculty. Conclusions Faculty need to be supported in learning how to best incorporate content about older people into their curriculum. This could include the development of learning activities that dispel negative stereotypes about ageing and facilitates interest in older people, as this is the population, students are most likely to work with when they graduate. Implications for practice Nurses in practice may require education on working with people with dementia as it is a deficit in nursing programmes.

Objectives To examine nursing staffs' geriatric knowledge, perceptions about interprofessional collaboration and patient-centred care, and perceived learning needs related to working with hospitalised older people. Method A triangulation mixed methods design was used. A survey was administered to nursing staff that contained the Knowledge About Older Patients Quiz, the patient-centered Care measure and the Modified Index of Interdisciplinary Collaboration measure. Interviews were conducted to understand nursing staffs' learning needs. Survey data were analysed using descriptive statistics. Interview data were analysed using content analysis. Survey and interview data were then compared and contrasted. Results Twenty-two nursing staff (response rate 26%) completed surveys and 14 participated in interviews. The mean knowledge about older patients score was 22.95, indicating moderately high gerontological knowledge. The mean scores on the patient-centered Care measure and Modified Index of Interdisciplinary Collaboration were moderately high at 3.75 and 3.86, respectively. Themes developed from analysis of the interview data were as follows: complex vulnerable population, clinical care concerns and working as a team. In spite of scores on knowledge surveys, nursing staff identified learning needs related to managing the responsive behaviours of older patients with cognitive impairment, chemical and physical restraints, mobility and continence. Conclusions There was an incongruence between survey and interview data as nursing staff reported gaps in their knowledge despite moderately high scores on the Knowledge about Older People Quiz. Further research is needed to understand additional factors that influence nurses' educational needs.

BACKGROUND Nurses often lack the knowledge and expertise to work with older people with cognitive impairment, which includes dementia, delirium and depression. This is due in part to deficits in their basic nursing education related to older people and managing the care needs of people with cognitive impairment. We developed an e-learning activity to facilitate student nurses' knowledge of cognitive impairment. OBJECTIVES To test if the e-learning activity could improve student nurses' knowledge of cognitive impairment and whether they would find the style of learning beneficial. DESIGN A quasi-experimental pre-post-test design was used to test if the cognitive impairment e-learning activity could improve student nurses' knowledge about assessing and managing the needs of older people who are experiencing cognitive impairment. A 12-item true/false quiz was completed by participants. SETTINGS One large Western Canadian university. PARTICIPANTS Second year nursing students in the four-year baccalaureate degree program, second year nursing students in the bilingual four-year baccalaureate degree program, and first year nursing students in the two-year after-degree nursing program were invited to participate. Data from 166 students were included in the analysis (n = 166). RESULTS Based on the results of a paired t-test (p

Interprofessional collaboration is understood to improve efficiencies and quality of care but is associated with challenges such as professionals’ differing routines, knowledge, and identities, as well as professional hierarchies and time constraints. Given these challenges, there is limited understanding of how professionals collaborate effectively in providing patient-centred care. This study, with a convergence triangulation mixed-methods study design, explored interprofessional staffs’ perceptions of interprofessional collaboration and patient-centred care when working with hospitalized older adults. Thirty-six staff responded to a survey which included the Patient-Centred Care measure and the Modified Index of Interdisciplinary Collaboration; we also interviewed 14 nursing staff. Although all scores suggested a high value was placed on interprofessional collaboration, scores were low related to activities that facilitated team processes. We identified three themes from the data: knowing the patient/family, functional needs, and communication processes. Staff identified daily rounds with interprofessional teams as supportive of interprofessional collaboration and patient-centred-care.

AIM As part of a larger primary study on evidence-informed practice with hospitalised older people, we aimed to (a) examine nursing staffs' perceptions of the interactive geriatric educational intervention and to explore how perceptions of their work context may influence their ability to enact the evidence-informed assessment and care approaches discussed during the educational sessions and (b) compare differences in perceptions of context between RNs, LPNs and HCAs. METHOD A survey-based evaluation that used both closed and open-ended questions was conducted as part of an interactive educational intervention on cognitive impairment and managing responsive behaviours. Data were gathered on participants' perceptions of the education intervention and organisational context. RESULTS Findings from this study suggest when education is tailored to nurses' articulated educational needs, it is well received; however, barriers to implementation exist. Assessment of the context by using a standardised survey tool to get the nursing staffs' perceptions of organisational context revealed strengths in leadership support and day-to-day interactions with other nurses and healthcare professionals, but potential barriers related to lack of facilitation to transfer new knowledge into practice existed. CONCLUSION Providing evidence-based education related to care of older patients and evaluating nursing staffs' perceptions of the education and their context has laid the groundwork for a long-term relationship with the managers and nursing staff on the participating medical units. Further investigation about how best to incorporate the facilitator role into the medical units to support evidence-based practices with older patients is warranted. IMPLICATIONS FOR PRACTICE: While nurses are receptive to new knowledge, the unpredictable workload of acute care creates challenges to implementing this new knowledge. Assessment of contextual factors that influence evidence-informed practice facilitates planning for implementation of new knowledge and support practice change.

Background and objectives: First year students experience a significant transition when entering nursing school. The purpose of this research was to explore first year nursing students’ experiences to enhance and innovate the undergraduate nursing program at a large public Canadian university.Methods: The Faculty of Nursing approached their curriculum redesign process utilizing a Developmental Evaluation (DE) framework. Nineteen first year students participated in semi structured interviews and focus groups where they discussed their personal experiences as well as the perceived strengths and weaknesses of the program. After thematic analysis of the data, recommendations were provided to the faculty administration to guide changes made to the new curriculum.Results: Students appreciated opportunities where they could apply their knowledge to real-world situations. Students also expressed many sources of stress, such as inconsistency within and between courses, differing expectations, content, instruction style, and evaluation. They also voiced that there was a lack of communication and support from the Faculty and identified issues with grading systems.Conclusions: The findings from this study highlighted the need to revise the nursing curriculum to provide more student support and foster a positive student-faculty relationship. The current structure of nursing programs has created competition among students, causing a greater focus on obtaining higher grades than on meaningful learning. Integrated learning with authentic experiences was best received by first year students and provided for a collaborative environment. Finally, the findings from this study highlight the opportunities created by utilizing a DE approach to evaluate and innovate nursing curricula.

Background Despite efforts to incorporate information about older people in pre-licensure nursing programs, there are inconsistent results from studies examining student nurses' perceptions towards the aging population. There is research suggesting that healthcare settings and nursing practice is perpetuating negative perspectives towards older people. Objective To gain an understanding of how social contexts are influencing student nurses' experiences when learning to work with older people. Design Descriptive case study guided by the theoretical framework of social learning theory. Setting A university in Western Canada that offers a pre-licensure nursing program. Participants 28 student nurses and 13 faculty in the nursing program. Methods Participant interviews and focus groups were conducted with nursing faculty and students. Results Key findings from this study are that students' previous experiences with older people, through family or work experiences, and their first clinical experience in long- term care negatively influenced their perceptions about working with older people. Clinical nurses and faculty influenced students' perceptions about nursing practice with older people, sometimes in subtle ways, underscoring that students are learning from what they see and hear in practice. Students were ill-prepared for the complexity of the aging population, particularly those with cognitive impairment. Conclusions Learning activities that engage students in active learning, such as simulation, providing students with a positive lexicon of how to describe older patients, and more overt attention to the perspectives students and faculty bring to the learning environment need to be carefully explored. Meaningful learning experiences with older people in multiple contexts are needed to thoughtfully plan how to disrupt negative perceptions that might emerge through the nursing education program.