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The public, and particularly investors, are demanding greater accountability from entities, specifically regarding the impact they may have on environmental, social, and governance issues. By publishing its first two standards related to sustainability, accounting standard-setting bodies are evidently aiming to become leaders in this emerging field, at least concerning the financial aspect attached to it. While the adoption of these new standards represents a promising headway, much work remains to be done, and the involvement of the accounting profession must be carried out with careful consideration of the risk to its reputation. The information published largely relies on highly specialized data, many of which lack objectivity, remain relatively vague, and some may even be tinged with a high degree of speculation.

Keywords: Governance, Gouvernance, informations financières, financial information, sustainability, durabilité, standards, normes, accounting profession, profession comptable

Background: The rise in mental health- and addiction (MHA)-related emergency department (ED) visits has been recognized as a contributing factor to ED crises and increasing healthcare costs. While prior research has centred largely on patients’ perspectives, limited attention has been given to healthcare providers’ (HCPs’) insights. This study specifically explores HCPs’ perceptions of why patients with MHA issues frequently present to EDs.Methods: In this qualitative research, data collection involved semi-structured individual interviews. Thematic analysis approach was utilized in data analysis.Results: Six HCPs from diverse disciplines participated in this qualitative study. Four major themes emerged from the data analysis: (a) social determinants of mental health (a housing crisis and financial problems); (b) structural barriers (overstimulation and not a priority in ED, inadequate knowledge and training among HCPs, lack of withdrawal management facilities, stigma from HCPs, shortages of HCPs); (c) suggestions for prevention (more funding/ resources and early childhood education); and (d) HCPs’ response to working with patients (making a difference and rewarding).Conclusions: The study found that HCPs perceived low socioeconomic status and the limited availability of community mental health services and resources as key factors that contribute to frequent MHA-related ED visits. To understand the complex needs of individuals with MHA disorders better, all levels of government, community organizations, and HCPs, especially nurses, should collaborate to develop and implement effective interventions aimed at reducing frequent ED visits or returns related to MHA issues.

Keywords: Emergency department, Service des urgences, mental health and addiction, santé mentale et toxicomanie, visites fréquentes, frequent visits, prestataires de soins de santé, healthcare providers

Introduction: Health systems across Canada are facing high numbers of patients who use drugs (PWUD), have a diagnosed substance use disorder, or are experiencing a toxic drug poisoning event, necessitating innovative approaches to care. With high instances of toxic drug poisoning events, emergency department staff are facing increasing burnout and moral distress (Van Hout & O’Reilly, 2020). A quality improvement pilot-project was conducted with the aim of incorporating individuals with lived experience using unregulated drugs (i.e., peers) into emergency department teams to improve patient outcomes and enhance staff supports, in response to the significant impact of the toxic drug crisis on health-care systems.Methods: The project used an overarching Plan-Do-Study-Act (PDSA) quality improvement framework, and a mixed-methods, utilization-focused evaluation to assess the impacts of embedding peers into the emergency department. A mixed methods design was used to collect data from intake forms, patient/staff experience surveys, and a semi-structured focus group of peer support staff.Results: The most common reasons for peer encounters (N = 764) were emotional support, harm reduction, referrals, witnessed consumption, and requests for basic necessities. The patient survey (N = 51) results demonstrated how the peers helped the majority of patients feel safe and more supported while accessing emergency care. ED staff (N = 22) shared positive experiences in the survey about the new peer program, highlighting improvements in patient support, increased access to harm reduction services, and the development of a more trusting healthcare system. During focus groups, peers (N = 2) outlined the importance of having this role embedded into emergency departments to ensure patients are receiving the care they need in a high-stress environment that, historically, has had the potential to cause significant harm through stigma and biases to PWUD.Conclusion: Integrating peers in the ED during the toxic drug crisis improved support for both patients and staff. This approach also has the potential to boost staff morale, reduce workload stress, decrease stigma toward PWUD, and enhance patient care. Overall, the hope is that integrating peers optimizes resources and strengthens both patient and provider experiences.

Keywords: emergency department, service des urgences, drug use, consommation de drogues, crise des drogues illégales toxiques, toxic drug crisis, peer support workers, soutien par les pairs, lived experience, expérience vécue

Residential and long-term care centers are living environments that provide support not only for residents, but also for their loved ones, throughout the resident’s stay. This support should continue in the post-death period, as the family grieves. Bereavement can have a significant impact on families’ quality of life, such as the development of complex persistent grief, which requires healthcare professionals, including nurses, to support families through this important transition. Current bereavement follow-up practices in long-term care centers are rather limited, consisting mainly of commemorative gestures. The aim of this study is to explore the state of knowledge related to nursing practices in grief support for families in long-term care centers. A literature review was conducted according to the principles of a structured narrative review. A total of 21 articles were selected according to the established selection criteria. A thematic analysis of the articles identified three main themes: bereavement care, the nurse’s role and bereavement care nursing interventions. Bereavement follow-up comprises five components: 1) acknowledgement of death, 2) transmission of bereavement information, 3) assessment of bereavement, 4) intervention in bereavement and 5) refer to specialized resources as needed. The nurse is described as a professional with a central role in bereavement follow-up, because of the privileged relationship she develops with families and the interpersonal and communication skills she possesses. The literature does, however, recognize a need for training nurses in bereavement. Nursing interventions for bereavement follow-up could be grouped into four types: 1) an interdisciplinary bereavement follow-up meeting, 2) a strength-oriented therapeutic family conversation, 3) a written bereavement adjustment tool and 4) an individual bereavement follow-up meeting. This study provides an in-depth understanding of bereavement follow-up, as well as interventions that can be adapted to the residential context. These could help guide nurses’ practice in this care setting.

Keywords: Infirmière, Nursing, grief support, Suivi de deuil, Famille, families, CHSLD, long-term care, Revue narrative structurée, narrative review