Chantal Viens

How to facilitate the orientation of new nurses into the workplace.

The orientation of new nursing graduates into the workplace is an impressive challenge. A research study was performed to identify the key elements of a program that would address the various issues regarding this orientation. A team of researchers from Laval University and the Centre Hospitalier Universitaire de Quebec (CHUQ) used a descriptive and participative research method and identified five key elements that must be considered in order for this orientation to succeed.

New approaches of organizing care and work: giving way to participation, mobilization, and innovation.

Quebecs health network has undertaken large-scale organizational changes to ensure the continuity, accessibility, and quality of health care and services for the population. This article describes the optimal approach for making changes to the organization of care and work for patients, health care workers, and organizations. This participative action research was carried out by means of interviews and document analysis. One hundred participants were involved, describing a total of 34 projects for significant organizational change. Results include an optimal approach broken down into 4 phases, each of which includes steps, facilitating factors, and potential difficulties. The phases of this approach are: (1) sharing the vision, mission, and values of the organization and identifying the purpose and need underlying the change; (2) building alliances and validating the involvement of the various players; (3) conceptualizing and planning the project; and (4) implementing changes and continuing evaluation. It is possible to rise to the challenge of finding new approaches to organize care and work by giving way to participation, mobilization, and innovation.

[Validity 'and Utilities' clinic of a grid observation (PACSLAC-F) to evaluate the pain in seniors with dementia's living in the Long-Term Care ].

This study presents the validation of the French Canadian version (PACLSAC-F) of the Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC). Unlike the published validation of the English version of the PACSLAC, which was validated retrospectively, the French version was validated prospectively. The PACSLAC-F was completed by nurses working in long-term care facilities after observing 86 seniors, with severe cognitive impairment, in calm, painful or distressing but non-painful situations. The test-retest and inter-observer reliability, the internal consistency, and the discriminent validity were found to be satisfactory. To evaluate the convergent validity with the DOLOPLUS-2 and the clinical relevance of the PACSLAC, it was also completed by nurses during their work shift, with 26 additional patients, for three days per week during a period of four weeks. These results encourage us to test the PACSLAC in a comprehensive program of pain management targeting this population.

Reorganizing care and work: process and productivity gains.

A Montreal-area hospital implemented organizational changes to improve the psychosocial environment for patients and health care workers and enhance organizational efficiency. This article describes a participatory approach to improving the organization of care and work, an approach focused on productivity gains in an organization. Productivity gains were analyzed in 13 units of the Department of Nursing, which had introduced a series of organizational changes. Changes introduced in care and work organization led to productivity gains in all units overseen by the Nursing Directorate. A reorganization of care and work based on the psychosocial work environment and staff participation can have positive outcomes, both for employees and for the wider organization.