Abstract
Background:
Early during COVID-19, British Columbia coordinated collaboration between academic researchers, public healthcare systems, and private sector partners to focus research resources ...on knowledge gaps in a timely manner, avoid duplication, and identify overlooked aspects. At a collaboration symposium, it became evident that BC’s volunteer search & rescue (SAR) cadre was overlooked.
Objective:
Our exploratory project studied volunteer SAR’s operational readiness; use and perceived value of information sources; consistency in infection prevention measures among volunteer stations, and with their professional counterparts for comparable first aid medical interventions throughout the pandemic.
Methods:
We partnered with the 2 organizations that govern BC’s volunteer SAR stations. Local station leaders completed a short confidential survey. Guidance documents issued by associations governing voluntary and professional first responders were compared.
Results:
Survey responses were received from 33 of 109 local stations, spanning all regions of BC. Most remained operationally ready throughout the entire pandemic (12.1% had to stand down at times). Except for 21% lacking eye protection, all had personal protective equipment commensurate with that of healthcare professionals; however, few used this PPE in a manner consistent with professional counterparts. Usage and perceived usefulness of various information sources differed. There was no communication link between the province’s infection control experts and 2 volunteer SAR organizations.
Conclusions:
Search & rescue capability was maintained despite pandemic impacts. Results reveal strengths and opportunities for improvement in the ways volunteers are informed and protected. Infection control experts providing advice for emergency health services professional responders should remember to include their volunteer counterparts.
Retaining talented and experienced nurses in clinical practice and academia is crucial for maintaining continuity, ensuring high-quality care and education, and fostering a positive work environment. ...Although factors influencing nursing staff retention are well documented, little is known about how workplace factors impact nursing faculty retention outcomes.
A national survey involving 645 nursing faculty across Canada was undertaken. Multivariate regression analysis with interaction effects was conducted to determine the association between work-related factors (i.e., workplace culture and work-life imbalance) and faculty job and career satisfaction, turnover intentions, and professional outlook.
Supportive workplace culture positively influenced faculty job and career satisfaction and professional outlook, while it negatively impacted turnover intentions. Conversely, work-life imbalance decreased faculty job and career satisfaction and professional outlook (i.e., confidence in nursing program, profession), and it increased intentions to leave the job.
Our results offer insights into the work-life experiences of Canadian faculty members and shed light on key factors that impact their job-related outcomes. In the context of competing resources, every effort must be made to improve modifiable workplace factors such as the academic work environment and create targeted interventions and policies to promote faculty retention.
The Single Site Order (SSO)-a policy restricting staff from working at multiple long-term care (LTC) homes-was mandated by the Public Health Agency of Canada to control the spread of COVID-19 in LTC ...homes, where nearly 70% of COVID-19-related deaths in Canada occurred. This mixed methods study assesses the impact of the SSO on LTC residents in British Columbia. Interviews were conducted (residents (n = 6), family members (n = 9), staff (n = 18), and leadership (n = 10) from long-term care homes (n = 4)) and analyzed using thematic analysis. Administrative data were collected between April 2019 and March 2020 and between April 2020 and March 2021 and analyzed using descriptive statistics and data visualization. Qualitative and quantitative data were triangulated and demonstrated that staffing challenges became worse during the implementation of the SSO, resulting in the mental and physical health deterioration of LTC residents. Qualitative data demonstrated decreased time for personalized and proactive care, increased communication challenges, and increased loneliness and isolation. Quantitative data showed a decline in activities of daily living, increased antipsychotic medication use, pressure ulcers, behavioural symptoms, and an increase in falls. Addressing staff workload and staffing shortages during SSO-related policy implementation is essential to avoid resident health deterioration.
Abstract
Aim
While research has demonstrated that nurses' health and working conditions are important predictors of turnover in COVID‐19, the relationship between these factors is not well ...understood. Our study investigated the mechanism through which working conditions and nurses' physical and mental health could impact intent to leave the nursing profession.
Design
Secondary data from a cross‐sectional survey of 3478 nurses in British Columbia administered in May 2021 were analysed using structural equation modelling.
Methods
Two models were assessed utilizing workplace conditions as the predictor, nurses' health as the mediator, and reported turnover intent (Model 1), and anticipated time to turnover (Model 2) as the outcomes.
Results
Nurses' health partially mediated the relationship between working conditions and turnover intent, where poorer workplace conditions were directly and indirectly associated with greater likelihood of leaving the profession. Nurses' health fully mediated the relationship between working conditions and nurses' anticipated time to turnover, after controlling for age. The findings from this study underscore the importance of enhancing working conditions and improving nurses' mental health and safety on the job.
Patient or Public Contribution
The British Columbia Nurses' Union provided the data for this study; survey data from 3478 nurses were utilized in our study.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK, VSZLJ
There are ongoing workforce challenges with the delivery of long-term care (LTC), such as staffing decisions based on arbitrary standards. The Synergy tool, a resident-centered approach to staffing, ...provides objective, real-time acuity and dependency scores (Synergy scores) for residents. The purpose of this study was to implement and evaluate the impact of the Synergy tool on LTC delivery.
A longitudinal mixed methods study took place within two publicly funded LTC homes in British Columbia, Canada. Quantitative data included weekly Synergy scores for residents (24 weeks), monthly aggregated resident falls data (18 months) and a six-month economic evaluation. Qualitative data were gathered from family caregivers and thematically analyzed.
Quantitative findings from Synergy scores revealed considerable variability for resident acuity/dependency needs within and across units; and falls decreased during implementation. The six-month economic evaluation demonstrated some cost savings by comparing Synergy tool training and implementation costs with savings from resident fall rate reductions. Qualitative analyses yielded three positive impact themes (
,
, and
), and two negative structural themes (
and
).
The Synergy tool provides useful data for enhancing a 'fit' between resident needs and available staff.
Nurses experience an alarming rate of violence in the workplace. While previous work has indicated that working conditions play an important role in workplace violence outcomes, these studies have ...not used comprehensive and systematically operationalized variables.
Through cross-sectional survey responses from 4066 British Columbian nurses, we identified which of the 13 psychosocial factors, as outlined in the National Standard of Psychological Workplace Health and Safety, are most predictive of workplace violence perpetrated against nurses by patients and their visitors (Type II violence) and organizational employees (Type III violence).
Eighty-seven percent of respondents indicated that they had experienced Type II violence, whereas 48% indicated they had experienced Type III violence over the last year. Lack of physical safety, workload management, and psychological protection were the top three psychosocial factors in the workplace predictive of Type II violence, whereas lack of civility and respect, organizational culture, and psychological support were the top three factors associated with Type III violence.
The findings in this study shed light on the distinct psychosocial factors in the workplace in need of investment and intervention to address Type II and III violence.
Nursing students, particularly at the time of entering clinical education, experience a great deal of stress and emotion typically related to their educational and clinical competence. Emotional ...intelligence is known to be one of the required skills to effectively cope with such feelings. The aim of this study was to investigate the effect of training on first-year nursing students’ levels of emotional intelligence. This was a quasi-experiment study in which 69 first-year nursing students affiliated with Tehran University of Medical Sciences were assigned to either the control or the experimental groups. The study intervention included of an emotional intelligence educational program offered in eight two-hour sessions for eight subsequent weeks. In total, 66 students completed the study. The study groups did not differ significantly in terms of emotional intelligence scores before and after educational program. Although the educational program did not have an effect on students’ emotional intelligence scores, this study finding can be explained. Limited time for exercising the acquired knowledge and skills may explain the non-significant findings. Moreover, our participants were exclusively first-year students who had no clinical experience and hence, might have felt no real need to learn emotional intelligence skills.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Context: To slow the spread of COVID-19 within the Canadian long-term residential care (LTRC) sector, a series of pandemic management strategies were introduced, including restricted visitation and ...single site employment. These strategies were enacted to prevent and control infection, resulting in unknown impact on direct care staff and staff capacity to deliver quality care or service.Objective: To explore staff reports of outcomes associated with LTRC pandemic management strategies, particularly their impact on LTRC staff mental health, work behaviours and quality of care or service provision.Method: This was a case study using mixed methods including a longitudinal survey and interviews with staff from one LTRC site in British Columbia. Survey data from 68 staff who participated in both survey times were analyzed using regressions with relative weight analysis. Semi-structured interviews were conducted with 26 LTRC staff and analyzed using content analysis.Findings: Survey data demonstrated that staff perceived the sick time policy and staffing levels as the most inadequate pandemic management strategies. Survey data also showed the visitation policy, the sick time policy and the single site employment policy were most significantly associated with negative outcomes to staff mental health, work behaviours and quality of care or service delivery. Qualitative data suggested connections between these policies and inadequate staffing levels and heavy workloads.Limitations: The study design along with the low response rate and the small sample size limits the generalizability of the findings to other settings.Implications: The development and implementation of pandemic management strategies must be informed by and give consideration to working conditions of LTRC staff including long standing systemic issues such as staffing shortages and heavy workloads.
The patient health questionnaire 9 item (PHQ-9) is a widely used self-reported measure for screening depressive symptoms. This study aims to examine measurement invariance and psychometric properties ...of the PHQ-9 for screening depressive symptoms in nurses across different nursing roles, gender, and workplace sector.
The study is a secondary analysis of pre-COVID and COVID-19 survey data from 4,176 nurses and 3,238 nurses in British Columbia. Data from the PHQ-9 tested the assumption of unidimensionality, reliability, and presence of differential item functioning (DIF).
The PHQ-9 showed excellent internal consistency (
= .9) and a unidimensional factor structure. PHQ-9 items were free of DIF across nursing roles, gender, and workplace sector.
This study supported the valid use of the PHQ-9 as a screening tool for depressive symptoms among nurses.
Workplace violence is a prevalent phenomenon in healthcare and nurses are particularly at risk from workplace violence due to the nature of their work or inadequacies within their work environments. ...Although workplace violence is known to have serious negative implications for nurses, patients and the larger healthcare system, the mechanism through which it functions is less clear.
The purpose of this study is to examine whether work environment conditions moderate the mediating effect that burnout has on the relationship between workplace violence and three health outcomes.
A secondary analysis of cross-sectional correlational survey data was conducted.
The study took place in British Columbia, Canada.
537 medical-surgical nurses were included in the study.
Survey data were analyzed using moderated mediation regressions with the PROCESS macro on SPSS.
Burnout mediated the relationship between workplace violence and health outcomes including musculoskeletal injuries, anxiety disorders and sleep disturbances. Work environment conditions moderated the direct relationship between workplace violence and burnout; and the indirect relationship between workplace violence and the three health outcomes. In healthier work environments, workplace violence was more strongly related to increased reports of burnout, musculoskeletal injuries, anxiety disorders and sleep disturbances compared to less healthy work environments.
Nurses in healthier work environments may not expect workplace violence, and they may be at more burnout risk than nurses in less healthy environments who have normalized unsafe work conditions. Violence may be the new ‘reality shock’ for nurses.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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