Browsing by Author "Jackson, Jennifer"
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- ItemOpen AccessA cost benefit analysis of a virtual overdose monitoring service/mobile overdose response service: the national overdose response service(2023-10-04) Rioux, William; Enns, Benjamin; Jackson, Jennifer; Quereshi, Hena; Irvine, Mike; Ghosh, S. M.Abstract Background The overdose crisis continues across Canada which calls for novel harm reduction strategies. Previous research indicates that a majority of eHealth solutions are cost-effective however current literature on the cost-benefit of eHealth for harm reduction is sparse. The National Overdose Response Service (NORS) is a Canada-wide telephone-based harm reduction service. Service users can call the phone number and connect to a peer who can virtually monitor the substance use session and dispatch appropriate interventions in the case of overdose. Objectives of the research/project We aim to assess the cost-benefit of NORS by comparing the estimated cost-savings from prevented overdose mortality to the operating costs of the program, alongside healthcare costs associated with its operation. Methods Data around systems costs and operational costs were gathered for our calculations. Our primary outcome was cost-benefit ratios, derived from estimates and models of mortality rates in current literature and value of life lost. We presented our main results across a range of values for costs and the probability of death following an unwitnessed overdose. These values were utilized to calculate cost-benefit ratios and value per dollar spent on service provision by NORS over the length of the program’s operation (December 2020–2022). Results Over the total funded lifespan of the program, and using a Monte Carlo estimate, the benefit-to-cost ratio of the NORS program was 8.59 (1.53–15.28) per dollar spent, depending on estimated mortality rates following unwitnessed overdose and program operation costs. Further, we conservatively estimate that early community-based naloxone intervention results in healthcare system savings of $4470.82 per overdose response. Conclusions We found the NORS program to have a positive benefit-to-cost ratio when the probability of death following an unwitnessed overdose was greater than 5%. NORS and potentially other virtual overdose monitoring services have the potential to be cost-effective solutions for managing the drug poisoning crisis.
- ItemOpen AccessExploring Hemodialysis Nurses’ Perceptions on Kidney Replacement Therapy Modality Education: A Framework Analysis(2024-03-26) Jaibeeh Barah, Elke Etane; Jackson, Jennifer; Davidson, Sandra; Elliott, MeghanMany people with end-stage kidney disease (ESKD) start and remain on in-centre hemodialysis (ICHD) treatment despite evidence of improved health and system outcomes when they choose a kidney replacement therapy (KRT) modality optimal to their lifestyle such as home dialysis. To make an informed modality decision patients must receive frequent, high quality modality education. This education is inconsistent in the ICHD setting where patients spend the most time with nurses while receiving hemodialysis treatments. The aim of this study was to examine ICHD nurses’ perceptions around KRT modality education for patients receiving ICHD using the COM-B model of behaviour change. To achieve this aim, I utilized the framework analysis (FA) method applying the COM-B model as a theoretical framework to analyze the data. The results demonstrated that ICHD nurses reported some impediments to providing modality education such as knowledge deficits, lack of experience or exposure to other dialysis modalities and lack of resources to support modality education practices. ICHD nurses reported some factors that enhanced modality education, including strong nurse-patient therapeutic relationships and previous experience in other dialysis modalities. I proposed some practice and educational recommendations geared toward targeted education of ICHD nurses, providing structure and appropriate resources to support KRT modality education practice in this setting. Keywords: Modality education, in-center hemodialysis, nurses, kidney replacement therapy
- ItemOpen AccessFactors that Influence Adequacy of Bowel Preparation in Inpatients Undergoing Colonoscopy: A Scoping Review Protocol(2023-07-12) Marchildon, Marianne; Jackson, Jennifer; Hayden, Alix; Rankin, JanetObjective: The objective of this scoping review is to examine the extent and type of research related to the rate of adequate bowel preparation in adult inpatients undergoing colonoscopy. Our intent is to establish an understanding the factors, both modifiable and non-modifiable, that influence the rate of adequate bowel preparation hospitalized patients undergoing colonoscopy. Introduction: Adequate bowel cleansing is necessary to perform successful colonoscopies, detect adenomas, and identify sources of gastrointestinal bleeding. Inpatients, however, experience a higher-than-average rate of inadequate bowel preparation leading to cancelled procedures, increased stress for the patient, increased time in hospital, and increased cost to the healthcare system. Inclusion criteria: This scoping review will consider all studies examining factors that influence the adequacy of bowel preparation in adult inpatients 18 years and older undergoing colonoscopy who have been admitted to hospital as inpatients. Studies published in English between 2000 and 2023 will be included. Methods: An initial search of MEDLINE, CINAHL, SCOPUS, and EMBASE was undertaken to identify seed articles, followed by a systematic search using keywords and subject headings. Study abstracts will be independently screened by two reviewers against inclusion criteria. Discrepancies will be resolved by consensus. Data extraction will be performed in tabular form and include data related to modifiable and non-modifiable factors that influence bowel preparation in adult inpatients.
- ItemOpen AccessPerspectives of Acute Care Healthcare Professionals on Harm Reduction Strategies: A Scoping Review Protocol(2023) Boring, Teressa; Lee, Marika; Watkins, Sarah; Jackson, Jennifer; Ens-Giesbrecht, TwylaObjective: The objective of this scoping review is to investigate the perspectives of acute care healthcare professionals on harm reduction strategies. Introduction: Patients with substance use disorders (SUD) are more likely to leave hospitals against medical advice (AMA), which results in untreated health conditions, comorbidities, and increased hospital readmissions. Current research suggests that perceived stigma around addictions may increase the risk of leaving AMA. Harm reduction strategies can enhance patient care and reduce AMA departures; however, implementing these strategies can be challenging if healthcare professionals are opposed to harm reduction. This scoping review will investigate the current literature to understand the perspectives of acute care healthcare professionals on harm reduction strategies. Inclusion criteria: This scoping review will include studies that discuss the perspectives of regulated healthcare professionals working in acute care settings regarding harm reduction strategies. Literature on harm reduction education will be excluded, as well as harm reduction interventions not targeted at patients who use alcohol, illicit drugs, or abuse prescription drugs. Methods: This scoping review protocol follows the Joanna Briggs Institute (JBI) guidelines for developing a protocol (Peters et al., 2022). The searched databases will include MEDLINE(R) (Ovid), APA PsycInfo (Ovid), EMBASE (Ovid), and CINAHL Plus with Full Text (EBSCO). The search will use subject headings and keywords identified during the analysis of seed articles. To make the search more comprehensive, handsearching reference lists and citation tracing will be utilized. Studies will be limited to the English language. Data extraction will use articles from the search that discuss perspectives of harm reduction strategies in acute care. The data extracted will include the author, year of publication, title, setting, study design, participants, aim or questions, methods, and themes or outcomes. The proposed scoping review will follow the JBI methodology for scoping reviews (Peters et al., 2020).
- ItemOpen AccessStrategies for Addressing Needle Debris: Scoping Review Protocol(2022-08) Tung, Megan; Jackson, Jennifer; Ferreira, Carla; Hayden, K. Alix; Ens, TwylaObjective: The objective of this scoping review is to explore the literature about needle debris associated with drug use in a community setting. Introduction: Needle debris in the community poses a public health concern. Needle debris and discarded drug paraphernalia could contribute to perceived social disorder associated with harm reduction services, like supervised consumption sites. Discarded needles represent a public safety risk for both people who use drugs and other community members. Currently, the existing research on this topic is scattered and has yet to be consolidated and reviewed. Addressing needle debris may decrease perceived community impact from harm reduction services, and increase support for these services among area residents, business owners, and others. This scoping review will be undertaken to inform a program of research around needle debris, to review available literature on the topic. Inclusion criteria: Studies that focus on strategies to address needle debris will be included, when referring to discarded needles and drug paraphernalia in the community. Exclusion criteria include strategies for people who use needles, who may generate needle waste inside homes and private property. Needle exchange programs and supervised consumption sites will be excluded when their primary purpose is to provide sterile supplies to prevent HIV/Hepatitis C transmission, and prevent and manage drug poisonings and overdoses, rather than prevent needles being discarded in the community. Methods: This scoping review protocol was established following the Joanna Briggs Institute (JBI) guidelines for developing a protocol (Peters et al., 2022). The databases that will be searched are MEDLINE(R) and Epub Ahead of Print, In-Process, In-Data-Review & Other Non-Indexed Citations and Daily (Ovid), CINAHL Plus with Full Text (EBSCO), APA PsycInfo (Ovid), EMBASE (Ovid), and Social Services Abstracts (ProQuest). The search will be conducted using subject headings and relevant keywords identified from analyzing seed articles. Studies will be limited to the English language. Data extraction will be completed using articles identified from the search that have substantial discussion on needle debris and the concept of disposal, retrieval, collection, prevention, and/or education. For a more comprehensive search, hand searching of reference lists and citation tracing will also be included. The proposed scoping review will be conducted in accordance with the JBI methodology for scoping reviews (Peters et al., 2020).
- ItemOpen AccessSupervised consumption site enables cost savings by avoiding emergency services: a cost analysis study(2022-03-28) Khair, Shahreen; Eastwood, Cathy A.; Lu, Mingshan; Jackson, JenniferAbstract Background and aims We report on a cost analysis study, using population level data to determine the emergency service costs avoided from emergency overdose management at supervised consumption services (SCS). Design We completed a cost analysis from a payer’s perspective. In this setting, there is a single-payer model of service delivery. Setting In Calgary, Canada, ‘Safeworks Harm Reduction Program’ was established in late 2017 and offers 24/7 access to SCS. The facility is a nurse-led service, available for client drop-in. We conducted a cost analysis for the entire duration of the program from November 2017 to January 2020, a period of 2 years and 3 months. Methods We assessed costs using the following factors from government health databases: monthly operational costs of providing services for drug consumption, cost of providing ambulance pre-hospital care for clients with overdoses who could not be revived at the facility, cost of initial treatment in an emergency department, and benefit of costs averted from overdoses that were successfully managed at the SCS. Results The proportion of clients who have overdosed at the SCS has decreased steadily for the duration of the program. The number of overdoses that can be managed on site at the SCS has trended upward, currently 98%. Each overdose that is managed at the SCS produces approximately $1600 CAD in cost savings, with a savings of over $2.3 million for the lifetime of the program. Conclusion Overdose management at an SCS creates cost savings by offsetting costs required for managing overdoses using emergency department and pre-hospital ambulance services.
- ItemOpen AccessThe impact of the work environment on the health-related quality of life of Licensed Practical Nurses: a cross-sectional survey in four work environments(2022-03-19) Phillips, Leah A.; de Los Santos, Nyla; Ntanda, Henry; Jackson, JenniferAbstract Background Nurses are known to have negative health outcomes related to their work. While it is acknowledged that nursing work is associated with things like back injuries and burnout, there is limited evidence as to what factors in the work environment contribute to these issues. Purpose The aims of this study were to assess how Licensed Practical Nurses (LPNs) report their Health-related quality of life (HRQoL), and how nurses’ health is impacted by their work environment. Methods These data used for analysis comes from a cross-sectional survey administered online to all LPNs in Alberta (2018). The survey collected data on the following variables: participant’s demographics, the SF-36 HRQoL, Practice Environment Scale of the Nursing Work Index (PES-NW) and the CD-RISC measure of resilience. The beta distribution was used to model HRQoL outcomes. In instances where optimal health (score of ‘1’) was observed then an extended version of beta distribution (called one—inflated beta) was applied. Results 4,425 LPNs responded to the survey. LPNs (mean age: 40) report lower scores on each SF-36 subscale than the general Canadian population aged 35–44. LPNs who work ‘causal’ had better physical health, (OR 1.21, CI 1.11–1.32, p = 0.000), and mental health (OR 1.22, CI 1.12–1.30, p = 0.000) than LPNs who work full time, even after controlling for resilience. LPNs’ views on the adequacy of staffing and resources in their workplaces have an influence across all dimensions of health. Conclusion This study suggests that improvements in the work environment could positively impact health outcomes and that adequate resourcing could support the nursing workforce.