Registered Nurses' Association of Ontario

Background: Patients with haematological malignancies frequently experience significant psychological distress due to the complexity and chronic nature of their illness. Despite growing recognition of the mental health burden, an integrative synthesis of effective interventions remains limited. Aim: To identify, categorise and synthesise existing empirical studies on mental health interventions for individuals diagnosed with haematological malignancies. Methods: Following Whittemore and Knafl's integrative review framework, a comprehensive literature search was conducted across databases and academic platforms. A total of 20 studies published between 2000 and 2024 were included based on relevance, methodological quality and language. Study quality was assessed using the Critical Appraisal Skills Programme checklist, and level of evidence was evaluated based on Melnyk and Fineout-Overholt's hierarchy. Results: Three core categories emerged: (1) psychotherapeutic and behavioural therapies (e.g., cognitive behavioral therapy mindfulness); (2) spiritual and supportive care (e.g., religious support, guided presence); and (3) creative and multimodal therapies (e.g., music therapy, digital interventions). Most studies demonstrated moderate to high methodological rigor and reported significant improvements in anxiety, depression, emotional resilience and psychosocial wellbeing. Conclusion: Tailored mental health interventions are crucial in enhancing psychological outcomes and quality of life among patients with haematological cancers, underscoring their integration into oncology and palliative care frameworks.

BackgroundDigital health refers to the field of knowledge and practice associated with the development and use of digital technologies to improve clinical practice and health outcomes. Knowledge of digital health technology is becoming essential for all nurses and health providers.ObjectiveThis study aims to present the results of the systematic reviews that were used to inform the recommendations in a best practice guideline (BPG) following the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach. Reviews focused on digital health education for nurses and health providers, peer champion models, and the use of predictive analytics in digital health environments.MethodsThe BPG team, in collaboration with a panel of 17 experts, conducted 5 systematic reviews to address 5 recommendation questions. Systematic searches looked for relevant studies published in English from January 2017 to July 2022 from 10 databases. The GRADE approach was used to synthesize and evaluate the quality of evidence, ensuring the guideline aligned with international reporting standards.ResultsA total of 18 articles across 4 systematic reviews met the inclusion criteria. From these reviews, 4 corresponding recommendations were drafted for nurses and health providers. The strength of the recommendations was determined through discussion and consensus by the expert panel using the GRADE approach. Among all, 1 systematic review resulted in no recommendation due to insufficient evidence.ConclusionsThe BPG on digital health provides 4 evidence-based recommendations for nurses and health providers on how to incorporate digital health technologies into clinical practice. This BPG is intended to be used across all health care settings.

Nurses face a variety of stressors and research examining nursing employee wellness programs is inconclusive with regard to cost-benefit and outcomes. This study aims to explore the impact of a self-directed short-term (2wk) self-care activity on registered nurses (RNs) self-rated health-related quality of life. This was a prospective nonrandomized interventional pilot study that consented RNs working in a university hospital working day shift and night shift. Demographic data and the RAND-36-item Short Form (RAND-36) scores were obtained at baseline. Each RN then self-selected and committed to engaging in one of 30 self-care activities for a 2-week period. Follow-up RAND-36 scores were obtained after RNs completed the 2-week intervention. The RAND-36 is a tool that was used to collect participant responses. One hundred twenty-one nurses were enrolled in the study. Ninety-five (78.5%) out of the 121 had both baseline and follow-up SF-26 scores available. The nurses were mostly baccalaureate prepared [95 (78.5%)] and worked day shift [87 (71.9%)]. The physical health problems subscale at baseline [21.2 (6.0)] was similar to follow-up [22 (6.0); P=0.386]. There was a statistically significant improvement in RAND-36 subscale scores for: physical functioning (P=0.0096), pain (P=0.003), general health perceptions (P<0.0001), energy and fatigue (P<0.0001), social functioning (P=0.0004), emotional health problems (P=0.0422), and emotional well-being (P=0.0348). This study identified a positive impact on nursing when the nurses self-selected a wellness activity. Positive changes in energy/fatigue, social functioning, and emotional well-being showed potential for healthcare workers and their well-being. Exploring short-term programs that promote autonomous motivation may provide cost-effective wellness programs. Future work should test for sustainability and long-term impact.

Psychiatric patient care demands specialized nursing approaches that integrate biological, psychological, and social dimensions of mental health within evidence-based frameworks. This comprehensive literature review examined peer-reviewed articles, clinical guidelines, and evidence-based practices in psychiatric nursing published between 2019-2024 to identify optimal care strategies for mental health patients. The systematic analysis revealed that effective psychiatric nursing care is fundamentally grounded in strong therapeutic relationships, person-centered approaches, and trauma-informed practices that significantly enhance patient outcomes and recovery trajectories. Key findings demonstrate that comprehensive assessment protocols, individualized care planning, crisis intervention strategies, medication management expertise, and collaborative treatment approaches form the core components of quality psychiatric care. The integration of recovery-oriented practices with cultural competency and ethical decision-making frameworks proves essential for addressing the complex needs of diverse psychiatric populations. Furthermore, the implementation of safety protocols, restraint reduction initiatives, and evidence-based de-escalation techniques contributes to therapeutic milieu maintenance while respecting patient autonomy and dignity. The research indicates that successful psychiatric nursing practice requires continuous professional development, adherence to ethical principles, and organizational commitment to quality improvement initiatives that support both patient wellbeing and clinical excellence in mental health care delivery.

Patricia Cox outlines the oral health consequences of dementia. Aim To gain a better understanding of dementia. To gain more knowledge on how to help and support individuals living with dementia. Objectives To gain a better understanding of the most common types of dementia. To understand why oral health may deteriorate in individuals living with dementia. To build knowledge on how best to support individuals living with dementia with oral care and hygiene.

IntroductionPrimary care nurses (PCNs) are the second largest workforce in primary care and play a critical role in facilitating access to coordinated care and reducing health disparities. There is renewed interest in team-based primary care as a solution for health workforce challenges. Some team models enable PCNs (ie, nurse practitioners, registered nurses, licensed/registered practical nurses) to leverage one another’s expertise to work to optimal scope; the extent to which this happens depends on multiple context-dependent factors. We will conduct an umbrella review to synthesise and compare international knowledge syntheses focused on scope of practice enactment (ie., roles and activities) of PCNs in primary care.Methods and analysisWe will conduct the umbrella review according to the Joanna Briggs Institute methodology, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P) guidelines, and using the Nursing Care Organization Framework as guidance. We will search a wide range of scientific electronic databases and grey literature sources, and consider articles published in English and French by the Organization for Economic Cooperation and Development and designated key partner countries for inclusion, with no publication date limits. Two independent reviewers will screen titles, abstracts and full-text articles, and any disagreements will be resolved through discussion or by a third reviewer. We will use the Risk of Bias Assessment Tool for Systematic Reviews to assess the quality and risk of bias in the included systematic and scoping reviews.Ethics and disseminationResults will be presented in a PRISMA Scoping Review flow diagram. We will synthesise data from included studies in a detailed literature review table and develop visual aids to communicate the shared and unique roles and activities of PCN scope of practice. We will disseminate the results of the review through peer-reviewed publications and conferences related to this field. Ethics approval is not required.

Hospital-acquired infections (HAIs) remain a major cause of patient morbidity, mortality, and increased healthcare costs, with critical care units and surgical wards particularly vulnerable due to invasive procedures, compromised immunity, and prolonged hospital stays. Evidence-based nursing bundles structured, standardized sets of clinical interventions have consistently demonstrated effectiveness in reducing HAI incidence when applied systematically. This study examines the integration of such bundles with Internet of Things (IoT) devices to enhance compliance monitoring, improve real-time decision-making, and strengthen infection prevention strategies in high-risk hospital environments. The proposed framework incorporates standardized nursing bundles for central line-associated bloodstream infection (CLABSI) prevention, ventilator-associated pneumonia (VAP) protocols, and surgical site infection (SSI) reduction, combined with IoT-enabled sensors, wearable devices, and environmental monitoring systems. Real-time data from hand hygiene dispensers, patient vitals, and cleanliness audits are captured, securely transmitted to cloud-based platforms, and analyzed using machine learning algorithms to identify deviations from established care protocols. Embedding these IoT data streams into nursing workflow dashboards enables clinical teams to receive actionable alerts, track bundle compliance, and initiate timely interventions. Simulated pilot testing suggests that such integration can significantly reduce HAI rates, enable faster detection of protocol breaches, and optimize resource allocation for infection control efforts. This fusion of IoT capabilities with evidence-based nursing bundles not only enhances clinical accountability and supports precision nursing but also provides a foundation for data-driven quality improvement initiatives. Future research should address interoperability standards, cost-effectiveness analysis, and robust privacy safeguards to ensure scalable, sustainable adoption of IoT-assisted infection prevention systems across diverse healthcare settings.

Objective: This study evaluates the efficacy of a multilayered xeomin injection technique compared to a conventional deep injection approach in managing bruxism.Methods: Forty patients diagnosed with bruxism were divided into two groups: the control group received deep injections at four points in the masseter, while the study group received both deep and superficial injections, with internal redirection to four sites. Treatment outcomes were assessed using electromyography (EMG) to measure muscle activity, bite force measurement, Visual Analog Scale (VAS) for pain, and patient satisfaction scores, these outcomes were evaluated during different follow up intervals (Baseline, 1 month, 3 months and 6 months). Statistical analysis was conducted using SPSS, with significance set at p < 0.05.Results: The study group exhibited significantly greater reductions in EMG activity and bite force compared to the control group (p < 0.05). Additionally, VAS scores demonstrated lower pain levels post-treatment in the study group, and patient satisfaction scores were significantly higher. The previously mentioned parameters were assessed at baseline, 1 month, 3 months, and 6 months post-treatment, with improvements starting from the 1-month follow-up and continuing through the subsequent intervals.Conclusion: Multilayered xeomin injection into the masseter muscle provides superior therapeutic benefits for bruxism management, resulting in improved muscle relaxation, reduced bite force, and higher patient satisfaction compared to conventional deep injections. This technique may serve as a refined protocol for clinicians treating bruxism.

Background: Minimum dietary diversity for children (MDD-C) is a benchmark developed by the World Health Organization (WHO) to assess diet diversity in infants and young children worldwide. The lack of such diet diversity among growing children, which often leads to malnutrition, has been considered a significant public health concern in Nepal. This study is to assess the dietary diversity and associated factors among children aged 6-59 months in wards 2 and 3 of Madhyapur Thimi Municipality. Methods: A cross-sectional descriptive study was carried out by measuring the research variables in 2023 among the residents of wards number 2 (Jatigaal) and 3 (Kaushaltar) of Madhyapur Thimi Municipality. The survey was created and administered by the researchers themselves. The sample size of the study was 385. The survey includes a structured questionnaire to assess dietary diversity and associated factors among children aged 6-59 months. The association between the factors was measured by using Fisher’s Exact test. Results: 73.5% of the study population fulfilled the minimum requirement of dietary diversity. Factors such as the mother’s educational status (p=0.002), mother’s ethnicity (p=0.015), monthly expenditure on food (p=0.001), awareness of communicable diseases (p=0.001), feeding times a day (p=0.001), personal hygiene practices status (p=0.004), and awareness of junk foods (p=0.001) showed a significant association with MDD-C. Conclusion: Increasing mothers’ awareness about junk food, communicable diseases, and the importance of their hygiene practices via formal or informal education campaigns is necessary to increase the proportion of children meeting the MDD-C benchmark and prevent malnutrition.

Although culturally appropriate care is vital to quality of care, many barriers exist to implementing culturally appropriate care in practice. Nurse leaders are in a position where they can act toward addressing some of the barriers and engage nursing staff in strategies to promote the implementation of culturally appropriate care practices on a unit. This article is an opinion piece wherein the authors illustrate leadership strategies that advocate for and nurture a practice where nursing staff are supported to apply their culturally appropriate skills in practice.