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

Background: The use of the Internet to administer questionnaires has many potential advantages over the use of pen-and-paper administration. Yet it is important to validate Internet administration, as most questionnaires were initially developed and validated for pen-and-paper delivery. While some have been validated for use over the Internet, these questionnaires have predominately been used amongst the healthy general population. To date, information is lacking on the validity of questionnaires administered over the Internet in patients with chronic diseases such as heart failure. Objectives: To determine the validity of three heart failure questionnaires administered over the Internet compared to pen-and-paper administration in patients with heart failure. Methods: We conducted a prospective randomized study using test-retest design comparing administration via the Internet to pen-and-paper administration for three heart failure questionnaires provided to patients recruited from a heart failure clinic in Toronto, Ontario, Canada: the Kansas City Cardiomyopathy Questionnaire (KCCQ), the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and the Self-Care Heart Failure Index (SCHFI). Results: Of the 58 subjects enrolled, 34 completed all three questionnaires. The mean difference and confidence intervals for the summary scores of the KCCQ, MLHFQ, and SCHFI were 1.2 (CI -1.5 to 4.0, scale from 0 to 100), 4.0 (CI -1.98 to 10.04, scale from 0 to 105), and 10.1 (CI 1.18 to 19.07, scale from 66.7 to 300), respectively. Conclusions: Internet administration of the KCCQ appears to be equivalent to pen-and-paper administration. For the MLHFQ and SCHFI, we were unable to demonstrate equivalence. Further research is necessary to determine if the administration methods are equivalent for these instruments. [ABSTRACT FROM AUTHOR]

Background: The increasing prevalence of heart failure and its unpredictable trajectory highlight the need for patients to make their end-of-life care wishes known using advanced care directives (ACDs). The paucity of literature addressing heart failure patients' decision-making processes and knowledge of ACDs underscores the need for investigation. The purposes of this study were to (1) determine patients' awareness, comprehension, and utilization of ACDs and (2) determine their knowledge of the process of cardiopulmonary resuscitation and their current resuscitation preference., Methods: A prospective, single-centre study was designed to collect quantitative data addressing patients' understanding of ACDs and cardiopulmonary resuscitation as well as their current resuscitation preference. Patients who consented were interviewed using a semistructured questionnaire. Data were analyzed using descriptive statistics., Results: Of the 41 participants, 76% did not know what ACDs were and fewer recalled discussing them with their physician. Nearly 80% of the 37 queried participants would have preferred to discuss ACDs. More than 75% of participants wanted full resuscitation if they were to require it at this time. Most participants had not documented their resuscitation preference, and only slightly over half said their substitute decision maker was aware of their preference. Among the 19 with an implantable cardioverter-defibrillator, nearly half would want it deactivated should their condition worsen. Only 2 participants recalled having discussed this option with their physician., Conclusions: There remains a lack of knowledge and utilization of ACDs among this heart failure population. Participants' preferences highlight the importance of discussing ACDs and exploring resuscitation preferences early and often in heart failure., (Copyright © 2011 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)

Objective: The study's objective was to evaluate patients attending a cardiac secondary prevention clinic on their accessibility to the Internet and to investigate their perceptions on using the Internet to obtain educational information for secondary prevention., Design: This was a prospective, descriptive, cross-sectional project., Setting: The study took place at a tertiary care hospital in Southern Ontario, Canada., Subjects: The subjects were 50 individuals attending a cardiac secondary prevention clinic. They were primarily male (80%) with an average age of 60 years., Measures: A self-administered questionnaire was used that identified demographics, current Internet access, experience with using the Internet for health care information, and perceptions of the utility of Internet information., Results: Sixty-six percent had Internet access at home, and 51% said they used the Internet daily. A significant number of participants indicated they would access an Internet site for continued educational support after discharge from a secondary prevention cardiac clinic., Conclusion: The results from this project evaluation suggest that Internet-based education would be a valuable adjunct to current secondary prevention care delivery models.

Background: The global paradigm shift resulting from radical transformations in knowledge and technology is significantly changing the context of healthcare delivery. In this changing environment, the contributions of health professions are vital in ensuring that the healthcare system adapts to meet the needs of today's patient. Advanced practice nurses (APNs) are clinical scholars and leaders in creating innovative approaches to patient care and organizational and professional leadership., Aims: To develop a comprehensive conceptual framework for advanced nursing practice at University Health Network that will enhance role clarity by describing the complexity of these nursing roles and the significant contributions they make to patients and the healthcare system., Methods: A critical review of the literature and a consultative process were undertaken to build consensus and develop a comprehensive framework for advanced nursing practice., Results: The development of the University Health Network Framework for Advanced Nursing Practice (UHN-FANP), which clearly articulates all dimensions of advanced nursing practice roles., Conclusion: As clinical leadership roles in nursing continue to evolve, utilization of a conceptual framework facilitates role clarity, role implementation and role evaluation.