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Staffing ratio

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The Oncology Nursing Society (ONS) has conducted several member surveys that included questions about staffing but has not established nurse-patient ratios, given the number and complexity of variables that must be considered. The 2016 ONS member survey showed that staffing was the most frequently cited challenge in the practice setting. With the implementation of ONS Communities in 2017, members have the opportunity to network and connect about issues. Staffing in chemotherapy infusion centers has been a frequent topic...
April 1, 2018: Clinical Journal of Oncology Nursing
Frances M Wu, Lisa V Rubenstein, Jean Yoon
BACKGROUND: New models of patient-centered primary care such as the patient-centered medical home (PCMH) depend on high levels of interdisciplinary primary care team functioning to achieve improved outcomes. A few studies have qualitatively assessed barriers and facilitators to optimal team functioning; however, we know of no prior study that assesses PCMH team functioning in relationship to patient health outcomes. PURPOSE: The aim of the study was to assess the relationships between primary care team functioning, patients' use of acute care, and mortality...
March 12, 2018: Health Care Management Review
Matthew Cox, Catherine O'Connor, Katie Biggs, Daniel Hind, Oscar Bortolami, Matthew Franklin, Barbara Collins, Stephen Walters, Allan Wailoo, Julie Channell, Paul Albert, Ursula Freeman, Stephen Bourke, Michael Steiner, Jon Miles, Tom O'Brien, David McWilliams, Terry Schofield, John O'Reilly, Rodney Hughes
BACKGROUND: Chronic obstructive pulmonary disease (COPD) affects > 3 million people in the UK. Acute exacerbations of COPD (AECOPD) are the second most common reason for emergency hospital admission in the UK. Pulmonary rehabilitation is usual care for stable COPD but there is little evidence for early pulmonary rehabilitation (EPR) following AECOPD, either in hospital or immediately post discharge. OBJECTIVE: To assess the feasibility of recruiting patients, collecting data and delivering EPR to patients with AECOPD to evaluate EPR compared with usual care...
March 2018: Health Technology Assessment: HTA
Christopher S Parshuram, Karen Dryden-Palmer, Catherine Farrell, Ronald Gottesman, Martin Gray, James S Hutchison, Mark Helfaer, Elizabeth A Hunt, Ari R Joffe, Jacques Lacroix, Michael Alice Moga, Vinay Nadkarni, Nelly Ninis, Patricia C Parkin, David Wensley, Andrew R Willan, George A Tomlinson
Importance: There is limited evidence that the use of severity of illness scores in pediatric patients can facilitate timely admission to the intensive care unit or improve patient outcomes. Objective: To determine the effect of the Bedside Paediatric Early Warning System (BedsidePEWS) on all-cause hospital mortality and late admission to the intensive care unit (ICU), cardiac arrest, and ICU resource use. Design, Setting, and Participants: A multicenter cluster randomized trial of 21 hospitals located in 7 countries (Belgium, Canada, England, Ireland, Italy, New Zealand, and the Netherlands) that provided inpatient pediatric care for infants (gestational age ≥37 weeks) to teenagers (aged ≤18 years)...
February 27, 2018: JAMA: the Journal of the American Medical Association
Samuel I Watson, Yen-Fu Chen, Julian F Bion, Cassie P Aldridge, Alan Girling, Richard J Lilford
INTRODUCTION: This protocol concerns the evaluation of increased specialist staffing at weekends in hospitals in England. Seven-day health services are a key policy for the UK government and other health systems trying to improve use of infrastructure and resources. A particular motivation for the 7-day policy has been the observed increase in the risk of death associated with weekend admission, which has been attributed to fewer hospital specialists being available at weekends. However, the causes of the weekend effect have not been adequately characterised; many of the excess deaths associated with the 'weekend effect' may not be preventable, and the presumed benefits of improved specialist cover might be offset by the cost of implementation...
February 23, 2018: BMJ Open
Chul-Gyu Kim, Kyun-Seop Bae
BACKGROUND: Nurse staffing level is an important factor on nursing sensitive outcome. The relationships of nurse staffing level with nursing sensitive outcomes such as mortality, upper gastrointestinal bleeding and pressure ulcer have been explored in the United States, Canada, Australia, and New Zealand. Lower level of hospital nurse staffing seems associated with more adverse outcomes, especially mortality. However, there is insufficient evidence of the nurse staffing level-outcome relationship in other indicators...
January 2, 2018: International Journal of Nursing Studies
Albert Brühl, Katarina Planer, Anja Hagel
A validity test was conducted to determine how care level-based nurse-to-resident ratios compare with actual daily care times per resident in Germany. Stability across different long-term care facilities was tested. Care level-based nurse-to-resident ratios were compared with the standard minimum nurse-to-resident ratios. Levels of care are determined by classification authorities in long-term care insurance programs and are used to distribute resources. Care levels are a powerful tool for classifying authorities in long-term care insurance...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
Shuai Yuan, Xinyu Zhou, Yuqing Zhang, Hanpin Zhang, Juncai Pu, Lining Yang, Lanxiang Liu, Xiaofeng Jiang, Peng Xie
Background: Depression and anxiety are the most common mental disorders in children and adolescents. Bibliotherapy is a treatment using written materials for mental health problems. Its main advantages are ease of use, low cost, low staffing demands, and greater privacy. Yet few meta-analyses have focused on the effect of bibliotherapy on depression and anxiety disorders in children and adolescents. Methods: We included randomized controlled trials comparing bibliotherapy with control conditions for depression and anxiety in children and adolescents (aged ≤18 years)...
2018: Neuropsychiatric Disease and Treatment
Ivy Razmus
PURPOSE: The purpose of this study was to identify associations among pediatric patient characteristics (age and gender), hospital characteristics, inpatient unit characteristics (unit type, pressure injury prevention practices, and nurse staffing measures), and hospital-acquired pressure injuries (HAPIs) in a group of pediatric patients and in those determined to be at risk for pressure injury. DESIGN: A descriptive, correlational analysis of data from a large dataset...
January 25, 2018: Journal of Wound, Ostomy, and Continence Nursing
Fernando G Zampieri, Thiago C Lisboa, Thiago D Correa, Fernando A Bozza, Marcus Ferez, Haggeas S Fernandes, André M Japiassú, Juan Carlos R Verdeal, Ana Cláudia P Carvalho, Marcos F Knibel, Bruno F Mazza, Fernando Colombari, José Mauro Vieira, William N Viana, Roberto Costa, Michele M Godoy, Marcelo O Maia, Eliana B Caser, Jorge I F Salluh, Marcio Soares
INTRODUCTION: Higher mortality for patients admitted to intensive care units (ICUs) during the weekends has been occasionally reported with conflicting results that could be related to organisational factors. We investigated the effects of ICU organisational and staffing patterns on the potential association between weekend admission and outcomes in critically ill patients. METHODS: We included 59 614 patients admitted to 78 ICUs participating during 2013. We defined 'weekend admission' as any ICU admission from Friday 19:00 until Monday 07:00...
January 24, 2018: BMJ Open
Nicholas Leigh-Hunt, Duncan Cooper, Andrew Furber, Gwyn Bevan, Muir Gray
Background: The Socio-Technical Allocation of Resources (STAR) has been developed for value for money analysis of health services through stakeholder workshops. This article reports on its application for prioritization of interventions within public health programmes. Methods: The STAR tool was used by identifying costs and service activity for interventions within commissioned public health programmes, with benefits estimated from the literature on economic evaluations in terms of costs per Quality-Adjusted Life Years (QALYs); consensus on how these QALY values applied to local services was obtained with local commissioners...
January 23, 2018: Journal of Public Health
Stephanie Q Ko, Jordan B Strom, Changyu Shen, Robert W Yeh
BACKGROUND: Apparent increase in mortality associated with being admitted to hospital on a weekend compared to weekdays has led to controversial policy changes to weekend staffing in the United Kingdom. Studies in the United States have been inconclusive and diagnosis specific, and whether to implement such changes is subject to ongoing debate. OBJECTIVE: To compare mortality, length of stay, and cost between patients admitted on weekdays and weekends. DESIGN: Retrospective cohort study...
January 25, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Heather A Cooke
AIMS AND OBJECTIVES: This article aims to examine RCAs' own experiences of personhood in dementia care settings. BACKGROUND: Conceptually, person-centred care entails fostering the personhood of residents and the residential care aides (RCAs) who provide much of their hands-on care. To date, however, staff personhood has been overlooked in the empirical literature. DESIGN: The study was part of a larger focused ethnographic project exploring how the organisational care environment impedes or facilitates the provision of quality dementia care...
January 24, 2018: International Journal of Older People Nursing
Yunmi Kim, Sunju You, Jinhyun Kim
PURPOSE: This study aimed to analyze the impact of increasing the supply of newly licensed nurses on improving the hospital nurse staffing grades for the period of 2009~2014. METHODS: Using public administrative data, we analyzed the effect of newly licensed nurses on staffing in 1,594 hospitals using Generalized Estimating Equation (GEE) ordered logistic regression, and of supply variation on improving staffing grades in 1,042 hospitals using GEE logistic regression...
December 2017: Journal of Korean Academy of Nursing
Linda H Aiken, Douglas M Sloane, Jane Ball, Luk Bruyneel, Anne Marie Rafferty, Peter Griffiths
OBJECTIVES: To inform healthcare workforce policy decisions by showing how patient perceptions of hospital care are associated with confidence in nurses and doctors, nurse staffing levels and hospital work environments. DESIGN: Cross-sectional surveys of 66 348 hospital patients and 2963 inpatient nurses. SETTING: Patients surveyed were discharged in 2010 from 161 National Health Service (NHS) trusts in England. Inpatient nurses were surveyed in 2010 in a sample of 46 hospitals in 31 of the same 161 trusts...
January 11, 2018: BMJ Open
M Joannidis, S J Klein, P Metnitz, A Valentin
In Austria, the reimbursement of intensive care services is based on a Diagnosis-Related Groups (DRG) system which has been adapted to the Austrian framework conditions. Compared to Germany where economic considerations had led to personnel cuts, mandatory targets outlined in both the LKF ("Leistungsorientierte Krankenanstaltenfinanzierung", Performance-oriented Hospital Financing) and ÖSG ("Österreichischer Strukturplan Gesundheit", Austrian Health Care Structure Plan) plans ensure a high level of medical and intensive care...
January 9, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Mona Al-Amin, Melody K Schiaffino, Sinyoung Park, Jeffrey Harman
This study examines hospital characteristics associated with sustained superior performance on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) measures. We classified hospitals as sustainers if they remained in the top 25th percentile of overall patient ratings of inpatient experience from 2009 through 2013. We classified hospital characteristics as modifiable or unmodifiable. Modifiable characteristics are operational measures that hospitals can change to improve performance; these characteristics include registered nurse (RN) staffing levels, presence of hospitalists, and level of physician integration...
January 2018: Journal of Healthcare Management / American College of Healthcare Executives
Amir Vahedian-Azimi, Mohammadreza Hajiesmaeili, Mari Kangasniemi, Joana Fornés-Vives, Rita L Hunsucker, Farshid Rahimibashar, Mohammad A Pourhoseingholi, Leily Farrokhvar, Andrew C Miller
BACKGROUND: Health care is a demanding field, with a high level of responsibility and exposure to emotional and physical danger. High levels of stress may result in depression, anxiety, burnout syndrome, and in extreme cases, post-traumatic stress disorder. The aim of this study was to determine which personal, professional, and organizational variables are associated with greater perceived stress among critical care nurses for purposes of developing integrative solutions to decrease stress in the future...
January 1, 2017: Journal of Intensive Care Medicine
Julian Bion, Cassie P Aldridge, Alan Girling, Gavin Rudge, Chris Beet, Tim Evans, R Mark Temple, Chris Roseveare, Mike Clancy, Amunpreet Boyal, Carolyn Tarrant, Elizabeth Sutton, Jianxia Sun, Peter Rees, Russell Mannion, Yen-Fu Chen, Samuel Ian Watson, Richard Lilford
INTRODUCTION: The mortality associated with weekend admission to hospital (the 'weekend effect') has for many years been attributed to deficiencies in quality of hospital care, often assumed to be due to suboptimal senior medical staffing at weekends. This protocol describes a case note review to determine whether there are differences in care quality for emergency admissions (EAs) to hospital at weekends compared with weekdays, and whether the difference has reduced over time as health policies have changed to promote 7-day services...
December 22, 2017: BMJ Open
Thomas W Cheng, Alik Farber, Jeffrey A Kalish, Douglas W Jones, Myriam Castagne, Denis Rybin, Stephen J Raulli, Jeffrey J Siracuse
OBJECTIVE: Length of stay (LOS) is commonly used to gauge hospital resource utilization and can affect hospital profit margin. Other fields of surgery have showed that operations performed close to the weekend have longer LOS and higher patient morbidity. Our goal was to investigate whether asymptomatic patients undergoing elective carotid endarterectomy (CEA) earlier in the week had a shorter LOS and improved clinical outcomes compared to those treated before the weekend. METHODS: The Vascular Quality Initiative database was queried for elective weekday CEAs performed for asymptomatic carotid stenosis from 2005 to 2017...
December 5, 2017: Annals of Vascular Surgery
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