Registered Nurses' Association of Ontario

About: Registered Nurses' Association of Ontario is a other organization based out in Toronto, Ontario, Canada. It is known for research contribution in the topics: Health care & Best practice. The organization has 51 authors who have published 68 publications receiving 1631 citations. The organization is also known as: RNAO.

A systematic review of the effectiveness of advanced practice nurses in long-term care

Abstract: Aim To report quantitative evidence of the effectiveness of advanced practice nursing roles, clinical nurse specialists and nurse practitioners, in meeting the healthcare needs of older adults living in long-term care residential settings. Background Although studies have examined the effectiveness of advanced practice nurses in this setting, a systematic review of this evidence has not been conducted. Design Quantitative systematic review. Data sources Twelve electronic databases were searched (1966–2010); leaders in the field were contacted; and personal files, reference lists, pertinent journals, and websites were searched for prospective studies with a comparison group. Review methods Studies that met inclusion criteria were reviewed for quality, using a modified version of the Cochrane Effective Practice and Organisation of Care Review Group risk of bias assessment criteria. Results Four prospective studies conducted in the USA and reported in 15 papers were included. Long-term care settings with advanced practice nurses had lower rates of depression, urinary incontinence, pressure ulcers, restraint use, and aggressive behaviours; more residents who experienced improvements in meeting personal goals; and family members who expressed more satisfaction with medical services. Conclusion Advanced practice nurses are associated with improvements in several measures of health status and behaviours of older adults in long-term care settings and in family satisfaction. Further exploration is needed to determine the effect of advanced practice nurses on health services use; resident satisfaction with care and quality of life; and the skills, quality of care, and job satisfaction of healthcare staff.

Comprehensive systematic review of evidence on developing and sustaining nursing leadership that fosters a healthy work environment in healthcare

Abstract: Objectives The objective of this review was to appraise and synthesise the best available evidence on the feasibility, meaningfulness and effectiveness of nursing leadership attributes that contribute to the development and sustainability of nursing leadership to foster a healthy work environment. Inclusion criteria This review considered quantitative and qualitative research papers that addressed the feasibility, meaningfulness and effectiveness of developing and sustaining nursing leadership to foster a healthy work environment in healthcare. Papers of the highest level of evidence ratings were given priority. Participants of interest were leaders and those who were affected by leadership, specifically staff and patients. Interventions of interest including positive leadership attributes, as well as system and policy constructs, that impact on the development and sustainability of nursing leadership within the healthcare environment were considered in the review. Search strategy The search strategy sought to find both published and unpublished studies and papers, limited to the English language. An initial limited search of MEDLINE and CINAHL was undertaken followed by an analysis of the text words contained in the title and abstract, and of the index terms used to describe the paper. A second extensive search was then undertaken using all identified key words and index terms. Methodological quality Each paper was assessed by two independent reviewers for methodological quality prior to inclusion in the review using an appropriate critical appraisal instrument from the System for the Unified Management, Assessment and Review of Information (SUMARI) package. Results A total of 48 papers, experimental, qualitative and textual in nature, were included in the review. The majority of papers were descriptive and examined the relationships between leadership styles and characteristics and particular outcomes, such as satisfaction. Because of the diverse nature of these papers meta-analysis of the results was not possible. For this reason, this section of the review was presented in narrative form. The qualitative and textual papers were analysed using The Joanna Briggs Institute-Qualitative Assessment and Review Instrument and The Joanna Briggs Institute-Narrative, Opinion and Text Assessment and Review Instrument. The process of meta-synthesis embodied in these programs involves the aggregation or synthesis of findings or conclusions. Eight syntheses were derived with key themes related to collaboration, education, emotional intelligence, organisational climate, professional development, positive behaviours and qualities and the need for a supportive environment. Conclusion A combination of leadership styles and characteristics was found to contribute to the development and sustainability of a healthy work environment. The current work conducted in this area provides a solid foundation for future directions in research.

Managing and mitigating conflict in healthcare teams: an integrative review.

Abstract: Aim To review empirical studies examining antecedents (sources, causes, predictors) in the management and mitigation of interpersonal conflict. Background Providing quality care requires positive, collaborative working relationships among healthcare team members. In today's increasingly stress-laden work environments, such relationships can be threatened by interpersonal conflict. Identifying the underlying causes of conflict and choice of conflict management style will help practitioners, leaders and managers build an organizational culture that fosters collegiality and create the best possible environment to engage in effective conflict management. Design Integrative literature review. Data sources CINAHL, MEDLINE, PsycINFO, Proquest ABI/Inform, Cochrane Library and Joanne Briggs Institute Library were searched for empirical studies published between 2002–May 2014. Review methods The review was informed by the approach of Whittemore and Knafl. Findings were extracted, critically examined and grouped into themes. Results Forty-four papers met the inclusion criteria. Several antecedents influence conflict and choice of conflict management style including individual characteristics, contextual factors and interpersonal conditions. Sources most frequently identified include lack of emotional intelligence, certain personality traits, poor work environment, role ambiguity, lack of support and poor communication. Very few published interventions were found. Conclusion By synthesizing the knowledge and identifying antecedents, this review offers evidence to support recommendations on managing and mitigating conflict. As inevitable as conflict is, it is the responsibility of everyone to increase their own awareness, accountability and active participation in understanding conflict and minimizing it. Future research should investigate the testing of interventions to minimize these antecedents and, subsequently, reduce conflict.