The findings from this pilot study provide preliminary empirical evidence that could inform educational programs for and performance evaluation of, health care aides providing end-of-life care in personal care home environments.

This study investigated the effects of non-disruptive nighttime care for residents in a personal care setting. The sample consisted of 18 personal care home residents in an urban, 388bed, long-term care facility located in Winnipeg, Manitoba, Canada. The study used a quasiexperimental, single-arm design, exposing all residents to both intervention and control conditions. Independent variables were the current nighttime routine of regular rounds to turn and change residents, and a non-disruptive plan of care in which residents were checked hourly by staff and necessary care was provided when they were awake. Outcome variables included total sleep from evening bedtime to morning awakening, longest period of uninterrupted sleep at night, amount of time spent sleeping during the day, self-reported restfulness of cognitively intact residents, and skin condition. Findings suggested that the non-disruptive nighttime care routine increased total sleep by an average of 30 minutes a night for each resident. The amount of uninterrupted sleep increased by approximately 45 minutes with the new routine. No significant differences were noted in the amount of time spent sleeping during the day. There was no evidence of skin breakdown during any phase of the study. Clinical implications of this study demonstrate a need for gerontological nurses to re-evaluate nighttime care routines in personal care settings.

Despite growing awareness of the benefits of interprofessional education and interprofessional collaboration (IPC), understanding how teams successfully transition to IPC is limited. Student exposure to interprofessional teams fosters the learners' integration and application of classroom-based interprofessional theory to practice. A further benefit might be reinforcing the value of IPC to members of the mentoring team and strengthening their IPC. The research question for this study was: Does training in IPC and clinical team facilitation and mentorship of pre-licensure learners during interprofessional clinical placements improve the mentoring teams' collaborative working relationships compared to control teams? Statistical analyses included repeated time analysis multivariate analysis of variance (MANOVA). Teams on four clinical units participated in the project. Impact on intervention teams pre- versus post-interprofessional clinical placement was modest with only the Cost of Team score of the Attitudes Towards Healthcare Team Scale improving relative to controls (p = 0.059) although reflective evaluations by intervention team members noted many perceived benefits of interprofessional clinical placements. The significantly higher group scores for control teams (geriatric and palliative care) on three of four subscales of the Assessment of Interprofessional Team Collaboration Scale underscore our need to better understand the unique features within geriatric and palliative care settings that foster superior IPC and to recognise that the transition to IPC likely requires a more diverse intervention than the interprofessional clinical placement experience implemented in this study. More recently, it is encouraging to see the development of innovative tools that use an evidence-based, multi-dimensional approach to support teams in their transition to IPC.

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BackgroundNursing home (NH) administrators need tools to measure the effectiveness of care delivered at the end of life so that they have objective data on which to evaluate current practices, and identify areas of resident care in need of improvement.MethodsA three-phase mixed methods study was used to develop and test an empirically derived chart audit tool aimed at assessing the care delivered along the entire dying trajectory.ResultsThe Auditing Care at the End of Life (ACE) instrument contains 27 questions captured across 6 domains, which are indicative of quality end-of-life care for nursing home residents.ConclusionsBy developing a brief chart audit tool that captures best practices derived from expert consensus and the research literature, NH facilities will be equipped with one means for monitoring and assessing the care delivered to dying residents.