Robert Janke

Orientation and transition programme component predictors of new graduate workplace integration.

AIM To examine the relationships between selected components of new graduate nurse transition programmes and transition experiences. BACKGROUND Transition support for new graduates is growing increasingly multifaceted; however, an investigation of the effectiveness of the constituent components of the transition process is lacking. METHODS An online survey was disseminated to new graduates working in acute care settings and included questions related to new graduate transition programmes. The Casey Fink Graduate Nurse Experience Survey was used to quantify the transition experience. RESULTS New graduate nurses who participated in a formal new graduate (NG) transition programme had significantly higher total transition scores than non-programme nurses. The orientation length and the average number of hours worked in a two week period were significant predictors of transition; the percentage of preceptored shifts was statistically insignificant. CONCLUSIONS New graduate transition is enhanced with participation in a formal transition programme. Orientation should be at least four weeks in length, and new graduates should work at least 49 hours in a two week period. IMPLICATIONS FOR NURSING MANAGEMENT Nurse managers are in key positions to advocate for new graduate nurse transition programmes with adequate resources to support a four week orientation phase and shift scheduling to ensure an adequate number of hours over two week periods to facilitate transition.

New graduate nurse transition programs: Relationships with bullying and access to support

Abstract New graduate nurses are often targets of bullying and horizontal violence. The support offered by new graduate nurse transition programs may moderate the effects of bullying and limit its negative impact on new graduate nurse transition. This study examined the relationships between access to support, workplace bullying and new graduate nurse transition within the context of new graduate transition programs. As part of a mixed methods study, an online survey was administered to new graduates (N = 245) approximately a year from starting employment. Bullied new graduate nurses were less able to access support when needed and had poorer transition experiences than their non-bullied peers. Participation in a formal transition program improved access to support and transition for bullied new graduate nurses. People supports within transition programs positively influenced the new graduate nurse transition experience. Formal transition programs provide support that attenuates the impact of bullying on new graduate nurses and improves transition.

The academic librarian as co-investigator on an interprofessional primary research team: a case study

OBJECTIVE The objective of this study was to explore the role librarians play on research teams. The experiences of a librarian and a faculty member are situated within the wider literature addressing collaborations between health science librarians and research faculty. METHODS A case study approach is used to outline the involvement of a librarian on a team created to investigate the best practices for integrating nurses into the workplace during their first year of practice. RESULTS Librarians contribute to research teams including expertise in the entire process of knowledge development and dissemination including the ability to navigate issues related to copyright and open access policies of funding agencies. DISCUSSION The librarian reviews the various tasks performed as part of the research team ranging from the grant application, to working on the initial literature review as well as the subsequent manuscripts that emerged from the primary research. The motivations for joining the research team, including authorship and relationship building, are also discussed. Recommendations are also made in terms of how librarians could increase their participation on research teams. CONCLUSION The study shows that librarians can play a key role on interprofessional primary research teams.

Cultural adaptations to augment health and mental health services: a systematic review

BackgroundMembership in diverse racial, ethnic, and cultural groups is often associated with inequitable health and mental health outcomes for diverse populations. Yet, little is known about how cultural adaptations of standard services affect health and mental health outcomes for service recipients. This systematic review identified extant themes in the research regarding cultural adaptations across a broad range of health and mental health services and synthesized the most rigorous experimental research available to isolate and evaluate potential efficacy gains of cultural adaptations to service delivery.MethodsMEDLINE, PsycINFO, CINAHL, EMBASE, and grey literature sources were searched for English-language studies published between January 1955 and January 2015. Cultural adaptations to any aspect of a service delivery were considered. Outcomes of interest included changes in service provider behavior or changes in the behavioral, medical, or self-reported experience of recipients.ResultsThirty-one studies met the inclusion criteria. The most frequently tested adaptation occurred in preventive services and consisted of modifying the content of materials or services delivered. None of the included studies focused on making changes in the provider’s behavior. Many different populations were studied but most research was concerned with the experiences and outcomes of African Americans. Seventeen of the 31 retained studies observed at least one significant effect in favor of a culturally adapted service. However there were also findings that favored the control group or showed no difference. Researchers did not find consistent evidence supporting implementation of any specific type of adaptation nor increased efficacy with any particular cultural group.ConclusionsConceptual frameworks to classify cultural adaptations and their resultant health/mental health outcomes were developed and applied in a variety of ways. This review synthesizes the most rigorous research in the field and identifies implications for policy, practice, and research, including individualization, cost considerations, and patient or client satisfaction, among others.

Indicators and Measurement Tools for Health Systems Integration: A Knowledge Synthesis

Background: Despite far reaching support for integrated care, conceptualizing and measuring integrated care remains challenging. This knowledge synthesis aimed to identify indicator domains and tools to measure progress towards integrated care. Methods: We used an established framework and a Delphi survey with integration experts to identify relevant measurement domains. For each domain, we searched and reviewed the literature for relevant tools. Findings: From 7,133 abstracts, we retrieved 114 unique tools. We found many quality tools to measure care coordination, patient engagement and team effectiveness/performance. In contrast, there were few tools in the domains of performance measurement and information systems, alignment of organizational goals and resource allocation. The search yielded 12 tools that measure overall integration or three or more indicator domains. Discussion: Our findings highlight a continued gap in tools to measure foundational components that support integrated care. In the absence of such targeted tools, “overall integration” tools may be useful for a broad assessment of the overall state of a system. Conclusions: Continued progress towards integrated care depends on our ability to evaluate the success of strategies across different levels and context. This study has identified 114 tools that measure integrated care across 16 domains, supporting efforts towards a unified measurement framework.

Effects of Mentioning the Incentive Prize in the Email Subject Line on Survey Response

Objective – This study examined the effects that mentioning the survey incentive prize in the subject line of a reminder email had on the response rate and data quality. To date, manipulation of the subject line, specifically in terms of mentioning the incentive prize, has received limited attention in the survey design literature. Methods – The delivery of the survey invitation is discussed in terms of the timing of the launch and reminder emails. Particular emphasis is given to the design of the email subject line and justification of the format. Weekly response rates from four LibQUAL+TM surveys were compared. In addition, weekly responses for one year were analyzed using SPSS to investigate if there were any between means differences in terms of three elements of data quality. The three elements were: length of time it took to complete the survey, the number of core questions with an N/A response, and the number of illogical responses where minimum scores were higher than desired. Results – The response rates for the second week were grouped together based on the presence or absence of the subject line manipulation. There was a significant difference between these means (4.75%, p 0.033). There was no statistical difference in regards to the measures of data quality as determined by a one-way ANOVA test. Conclusions – Reminding survey participants with an email that mentions the incentive prize in the subject line appears to increase response rates with no deleterious effects on data quality. The results of this investigation are encouraging, and those running the LibQUAL+TM survey in their universities should consider implementing this method to increase response rates. Further research to replicate these findings in other contexts and using an experimental design would be beneficial.

The Helpfulness and Timing of Transition Program Education

The purpose of this study was to examine relationships between transition program education and new graduate nurse transition. Although new graduates preferred hands-on learning, the helpfulness of workshops was associated with better transition. New graduates, many of whom were from the Millennial Generation, liked a variety of educational modalities. Access to support was better for nurse graduates who received education delivered throughout the first year of transition.

The efficacy of telehealth delivered educational approaches for patients with chronic diseases: A systematic review

OBJECTIVE The virtual delivery of patient education and other forms of telehealth have been proposed as alternatives to providing needed care for patients with chronic diseases. The purpose of this systematic review was to compare the efficacy of virtual education delivery on patient outcomes compared with usual care. METHODS The review examined citations from 3 databases, MEDLINE, CINAHL, and EMBASE using the search words telehealth, chronic disease, patient education, and related concepts. From 2447 records published between 2006 and 2017, 16 high to moderate quality studies were selected for review. Eligible papers compared virtual education to usual care using designs allowing for assessment of causality. RESULTS Telehealth modalities included the web, telephone, videoconference, and television delivered to patients with diabetes, chronic obstructive pulmonary disease, irritable bowel syndrome and heart failure. In 11 of 16 studies, virtually delivered interventions significantly improved outcomes compared to control conditions. In the remaining 5 studies, virtual education showed comparable outcomes to the control conditions. CONCLUSIONS Findings demonstrated that virtual education delivered to patients with chronic diseases was comparable, or more effective, than usual care. RESEARCH IMPLICATIONS Despite its benefits, there is potential for further research into the individual components which improve effectiveness of virtually delivered interventions.

Health Sciences cultural safety education in Australia, Canada, New Zealand, and the United States: a literature review

Objectives To review the research literature on cultural safety education within post-secondary health science programs. Methods We conducted health and social science database searches from 1996-2016, using combined keywords: cultural competence or safety; teaching or curriculum; universities, polytechnics or professional programs; and Aboriginal or Indigenous. In dyads, authors selected, and reviewed studies independently followed by discussion and consensus to identify thematic linkages of major findings. Results A total of 1583 abstracts and 122 full-text articles were reviewed with 40 selected for final inclusion. Publications from Australia, Canada, New Zealand and the United States described curriculum development and delivery. A variety of evaluation approaches were used including anecdotal reports, focus groups, interviews, course evaluations, reflective journals, pre-post surveys, critical reflective papers, and exam questions. Duration and depth of curricular exposure ranged from one day to integration across a six-year program. Changes in student knowledge, attitude, self-confidence, and behaviour when working with Indigenous populations were reported. Cultural safety education and application to practice were shown to be linked to improved relationships, healthier outcomes, and increased number of Indigenous people entering health education programs and graduates interested in working in diverse communities. Conclusions This review provides a summary of multidisciplinary didactic and experiential instructional approaches to cultural safety education and the impact on students, educators and Indigenous people. Institutional support, strategic planning and cultural safety curriculum policy within post-secondary settings and community engagement are imperative for positive student experiences, advocacy, and actions toward health equity and improved health for Indigenous people and communities.