Home and Community Care Support Services

Care transitions are the movement of patients between different levels or locations of care, such as from a hospital to a patient’s home in the community. Care transitions are a high-risk time for older adults given their complex health and social care needs, with nearly 1 in 5 experiencing

> More than 10 years ago my family and I landed in Canada to start a new life. My parents hoped to provide my brother and I with a better environment in which to learn English and thrive as citizens of a modern and multicultural society. Upon exiting the airport in Vancouver, BC, Canada’s

IntroductionUrgent, tailored and equitable action is needed to address the alarming rise in syphilis rates in Canada. In the last decade, the rates of infectious syphilis have increased by 345% in Ontario, Canada. Underserved populations—people who use drugs, un(der)housed individuals and those living in rural and remote areas—face unique social and healthcare challenges that increase their vulnerability to syphilis infections and hinder their access to timely diagnosis and treatment. This study assesses the real-world implementation and effectiveness of using a recently approved syphilis point-of-care test in conjunction with public health outreach to break barriers and bring services to the population at the highest risk.Methods and analysisThe Syphilis Rapid Point-of-Care Testing and Immediate Treatment Evaluation (SPRITE) study includes eight public health units in Ontario, Canada. Implementation and evaluation of this rapid ‘test and treat’ outreach model of care will be assessed using the Practical, Robust Implementation and Sustainability Model (PRISM)/Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) Framework, following a community-based participatory approach. Network models will be used to estimate the population-level impact of implementing this model of care to curb transmission. Knowledge mobilisation will be assessed using the Reciprocity, Externalities, Access, and Partnership (REAP) Self-Assessment Model.Ethics and disseminationThe SPRITE study was approved by the Queen’s University Research Ethics Board (REB) and is to be conducted in accordance with the Canadian Tri-Council Policy Statement V.2 and the latest Seoul revision of the Declaration of Helsinki. Knowledge generated from this study will be mobilised through community-based organisations and the broader public health community.

Background Nurses are the primary healthcare providers in correctional facilities. A solid knowledge and expertise that includes the use of research evidence in clinical decision making is needed to optimize nursing practice and promote positive health outcomes within these settings. The institutional emphasis on custodial care within a heavily secured, regulated, and punitive environment presents unique contextual challenges for nursing practice. Subsequently, correctional nurses are not always able to obtain training or ongoing education that is required for broad scopes of practice. The purpose of the proposed study is to develop an educational intervention for correctional nurses to support the provision of evidence-informed care. Methods A two-phase mixed methods research design will be used. The setting will be three provincial correctional facilities. Phase one will focus on identifying nurses’ scope of practice and practice needs, describing work environment characteristics that support evidence-informed practice and developing the intervention. Semi-structured interviews will be completed with nurses and nurse managers. To facilitate priorities for the intervention, a Delphi process will be used to rank the learning needs identified by participants. Based on findings, an online intervention will be developed. Phase two will involve evaluating the acceptability and feasibility of the intervention to inform a future experimental design. Discussion The context of provincial correctional facilities presents unique challenges for nurses’ provision of care. This study will generate information to address practice and learning needs specific to correctional nurses. Interventions tailored to barriers and supports within specific contexts are important to enable nurses to provide evidence-informed care.

Background Nurses are the primary healthcare providers in correctional facilities. A solid knowledge and expertise that includes the use of research evidence in clinical decision making is needed to optimize nursing practice and promote positive health outcomes within these settings. The institutional emphasis on custodial care within a heavily secured, regulated, and punitive environment presents unique contextual challenges for nursing practice. Subsequently, correctional nurses are not always able to obtain training or ongoing education that is required for broad scopes of practice. The purpose of the proposed study is to develop an educational intervention for correctional nurses to support the provision of evidence-informed care. Methods A two-phase mixed methods research design will be used. The setting will be three provincial correctional facilities. Phase one will focus on identifying nurses’ scope of practice and practice needs, describing work environment characteristics that support evidence-informed practice and developing the intervention. Semi-structured interviews will be completed with nurses and nurse managers. To facilitate priorities for the intervention, a Delphi process will be used to rank the learning needs identified by participants. Based on findings, an online intervention will be developed. Phase two will involve evaluating the acceptability and feasibility of the intervention to inform a future experimental design. Discussion The context of provincial correctional facilities presents unique challenges for nurses’ provision of care. This study will generate information to address practice and learning needs specific to correctional nurses. Interventions tailored to barriers and supports within specific contexts are important to enable nurses to provide evidence-informed care.

To review a practical and scientifically sound application of the wound bed preparation model for communities without ideal resources. This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and registered nurses with an interest in skin and wound care. After participating in this educational activity, the participant will:1. Summarize issues related to wound assessment.2. Identify a class of drugs for the treatment of type II diabetes mellitus that has been shown to improve glycemia, nephroprotection, and cardiovascular outcomes.3. Synthesize strategies for wound management, including treatment in resource-limited settings.4. Specify the target time for edge advancement in chronic, healable wounds.

ABSTRACT Purpose Strategies for preventing and ending homelessness are frequently measured by their effectiveness on indices of tenancy sustainment. To shift this narrative, we conducted research to identify what is needed to “thrive” following homelessness from the perspectives of persons with lived experience in Ontario, Canada. Methods Conducted in the context of a community-based participatory research study aimed at informing the development of intervention strategies, we interviewed 46 persons living with mental illness and/or substance use disorder [n = 25 (54.3%) unhoused; n = 21 (45.7%) housed following homelessness] using qualitative interviews. A subsample of 14 participants agreed to engage in photovoice interviews. We analysed these data abductively using thematic analysis informed by health equity and social justice. Results Participants described experiences of “living in a state of lack” following homelessness. This essence was expressed through four themes: 1) housing as part one of the journey to home; 2) finding and keeping “my people”; 3) meaningful activity as critical for thriving following homelessness; and 4) struggling to access mental health supports in the context of challenging circumstances. Conclusions Individuals struggle to thrive following homelessness in the context of insufficient resources. There is a need to build on existing interventions to address outcomes beyond tenancy sustainment.

To provide an overview and synthesis of the current evidence on healthcare aides' involvement in team decision-making in long-term care. Healthcare aides provide the most direct care to residents in long-term care homes and are uniquely positioned to influence the quality of care. Yet, they are not typically included in team decisions for improving resident care. As demand for long-term care increases, it is essential that we have a comprehensive understanding of ways to support healthcare aides' role on the interprofessional team for decision-making about resident care. Narrative review. Five electronic databases were searched for articles published in English between 2008 and 2020. Thematic analysis was conducted to synthesise findings using an organising framework. Reporting followed the PRISMA-ScR. Twelve studies were included. Results indicate that work environment factors that influenced (supported or hindered) healthcare aides' involvement in decision-making included information access/availability, hierarchical staffing structures and supervisor support/shared governance. Relational processes that influenced team decision-making included team communication and collaboration, information sharing and exchange, and the quality of work relationships among team members. Strategies are discussed that could address the identified barriers and support healthcare aides' active involvement in team decisions regarding resident care. This review highlights the pervasive underutilization of healthcare aides, who have the most knowledge of residents to support person-centred care. There remains a paucity of research on healthcare aides' involvement in team decision-making. Research is needed to examine the effectiveness of interventions to support healthcare aides' participation in decision-making and the impact on staff and resident outcomes. It is crucial that healthcare aides are afforded opportunities to be part of the interprofessional team for information sharing and decision-making for resident care. Managers play a key role in supporting healthcare aides' inclusion in decision-making.

Background: Due to the COVID-19 pandemic, many community palliative healthcare providers shifted from providing care in a patient’s home to providing almost exclusively virtual palliative care, or a combination of in-person and virtual care. Research on virtual palliative care is thus needed to provide evidence-based recommendations aiming to enhance the delivery of palliative care during and beyond the pandemic. Aim: To explore the experiences and perceptions of community palliative care providers, patients and caregivers who delivered or received virtual palliative care as a component of home-based palliative care during the COVID-19 pandemic. Design: Qualitative study using phone and video-based semi-structured interviews. Data were analyzed using thematic analysis. Setting/participants: A total of 37 participants, including community palliative care patients/caregivers (n = 19) and healthcare providers (n = 18) recruited from sites in Ottawa and Toronto, Ontario, Canada. Results: Overall, participants preferred in-person palliative care compared to virtual care, but suggested virtual care could be a useful supplement to in-person care. The findings are presented in three main themes: (1) Impact of COVID-19 pandemic on community palliative care services; (2) Factors influencing transition from exclusively virtual model of care back to a blended model of care; and (3) Recommended uses and implementation of virtual palliative care Conclusions: Incorporating virtual palliative care into healthcare provider practice models (blended care models) may be the ideal model of care and standard practice moving forward beyond the COVID-19 pandemic, which has important implications toward organization and delivery of community palliative care services and funding of healthcare providers.

The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 5.120 (2020 JCR, received in June 2021)The IJIC 20th Anniversary Issue was published in 2021.