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Staffing ratio

April N Kapu, Carmel A McComiskey, Lacey Buckler, Jennifer Derkazarian, Tammy Goda, Maria A Lofgren, Colleen K McIlvennan, Julie Raaum, Patricia M Selig, Corinna Sicoutris, Barbara Todd, Vicki Turner, Elizabeth Card, Nancy Wells
OBJECTIVE: This study examines data collected from a survey of advanced practice providers' (APPs') perceptions of reasonable versus actual APP-to-patient ratios and other factors that affect workload burden in both inpatient and outpatient clinical settings. BACKGROUND: Advanced practice providers provide accessible, cost-effective, and quality care in a growing number of specialty practices across multiple patient care settings. They are caring for higher volumes of patients and assuming more responsibilities while continuing to navigate highly complex healthcare systems...
October 2016: Journal of Nursing Administration
Kathleen Jr Daly, Luigi Camporota, Nicholas A Barrett
BACKGROUND: The last decade has seen an increase in the number of centres able to provide venovenous extracorporeal membrane oxygenation (VV-ECMO) internationally across different health care systems. To support this growth, a variety of staffing arrangements have been adopted depending on local need and availability of resources, both in terms of manpower and finances to safely meet the complex needs of the patient and circuit management. AIM: The aim of the survey was to describe current staffing arrangements of care provision for adult patients on VV-ECMO, with a focus on understanding the professional roles and responsibilities of staff managing the circuit in order to inform further discussion around different approaches to staffing...
September 21, 2016: Nursing in Critical Care
Barbara A Dennison, Trang Nguyen, Deborah J Gregg, Wei Fan, Changning Xu
BACKGROUND: Breastfeeding provides maternal and infant health benefits. Maternity care practices encompassed in the 10 Steps to Successful Breastfeeding are positively associated with improved breastfeeding outcomes. This study assessed changes in maternity care practices and lactation support. MATERIALS AND METHODS: In 2009, 2011, and 2014, New York (NY) hospitals providing maternity care services were surveyed to assess the implementation of 9 of the 10 Steps to Successful Breastfeeding, professional lactation support, distribution of formula and discharge packs, and patient and hospital barriers to breastfeeding success...
September 19, 2016: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
Katy E French, Alexis B Guzman, Augustin C Rubio, John C Frenzel, Thomas W Feeley
BACKGROUND: With the movement towards bundled payments, stakeholders should know the true cost of the care they deliver. Time-driven activity-based costing (TDABC) can be used to estimate costs for each episode of care. In this analysis, TDABC is used to both estimate the costs of anesthesia care and identify the primary drivers of those costs of 11 common oncologic outpatient surgical procedures. METHODS: Personnel cost were calculated by determining the hourly cost of each provider and the associated process time of the 11 surgical procedures...
September 2016: Healthcare
Ju Young Yoon, Hongsoo Kim, Young-Il Jung, Jung-Hwa Ha
BACKGROUND: This study aimed to describe the levels of social engagement and to examine the relationship between the nursing home scale groups and social engagement in nursing homes in South Korea. METHODS: A total of 314 residents were randomly selected from rosters provided by 10 nursing homes located in three metropolitan areas in South Korea. The outcome variable was social engagement measured by the Revised Index of Social Engagement (RISE), and the key independent variable was the nursing home scale (small, medium, and large)...
September 9, 2016: International Psychogeriatrics
Michael Bracher, Dame Jessica Corner, Richard Wagland
OBJECTIVES: To provide the first systematic analysis of a national (Wales) sample of free-text comments from patients with cancer, to determine emerging themes and insights regarding experiences of cancer care in Wales. DESIGN: Thematic analysis of free-text data from a population-based survey. SETTING AND PARTICIPANTS: Adult patients with a confirmed cancer diagnosis treated within a 3-month period during 2012 in the 7 health boards and 1 trust providing cancer care in Wales...
2016: BMJ Open
Jed D Gonzalo, Judy Himes, Brian McGillen, Vicki Shifflet, Erik Lehman
BACKGROUND: Interprofessional collaboration improves the quality of medical care, but integration into inpatient workflow has been limited. Identification of systems-based factors promoting or diminishing bedside interprofessional rounds (BIR), one method of interprofessional collaboration, is critical for potential improvements in collaboration in hospital settings. The objective of this study was to determine whether the percentage of bedside interprofessional rounds in 18 hospital-based clinical units is attributable to spatial, staffing, patient, or nursing perception characteristics...
2016: BMC Health Services Research
Sophie Witter, Patrick G Ilboudo, Nadia Cunden, Chakib Boukhalfa, Patrick Makoutode, Zoumana Daou
Many countries, especially in Africa, have in recent years introduced fee exemptions or subsidies targeting deliveries and emergency obstetric care. A number of aspects of these policies have been studied but there are few studies which look at how staff have been affected and how they have responded. This article focuses on this question, comparing data from Benin, Burkina Faso, Mali and Morocco. It is nested in wider evaluation of the policies. The article analyses responses to a health worker survey, carried out in 2012 on 683 health staff (doctors, nurses, midwives and others such as auxiliaries) across the four countries...
August 30, 2016: Health Policy and Planning
Clara Berridge, Denise A Tyler, Susan C Miller
This article examines whether staff empowerment practices common to nursing home culture change are associated with certified nursing assistant (CNA) retention. Data from 2,034 nursing home administrators from a 2009/2010 national nursing home survey and ordered logistic regression were used. After adjustment for covariates, a greater staff empowerment practice score was positively associated with greater retention. Compared with the low empowerment category, nursing homes with scores in the medium category had a 44% greater likelihood of having higher CNA retention (odds ratio [OR] = 1...
August 25, 2016: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
Tina W F Yen, Jianing Li, Rodney A Sparapani, Purushuttom W Laud, Ann B Nattinger
BACKGROUND: Several surgeon characteristics are associated with the use of sentinel lymph node biopsy (SLNB) for breast cancer. No studies have systematically examined the relative contribution of both surgeon and hospital factors on receipt of SLNB. OBJECTIVE: To evaluate the relationship between surgeon and hospital characteristics, including a novel claims-based classification of hospital commitment to cancer care (HC), and receipt of SLNB for breast cancer, a marker of quality care...
August 2016: Medicine (Baltimore)
Steven A Farmer, Joel Shalowitz, Meaghan George, Frank McStay, Kavita Patel, James Perrin, Ali Moghtaderi, Mark McClellan
BACKGROUND AND OBJECTIVES: Payers are implementing alternative payment models that attempt to align payment with high-value care. This study calculates the breakeven capitated payment rate for a midsize pediatric practice and explores how several different staffing scenarios affect the rate. METHODS: We supplemented a literature review and data from >200 practices with interviews of practice administrators, physicians, and payers to construct an income statement for a hypothetical, independent, midsize pediatric practice in fee-for-service...
August 2016: Pediatrics
Hannah Ruth Barker, Peter Griffiths, Ines Mesa-Eguiagaray, Ruth Pickering, Lisa Gould, Jackie Bridges
BACKGROUND: The quality of staff-patient interactions underpins the overall quality of patient experience and can affect other important outcomes. However no studies have been identified that comprehensively explore both the quality and quantity of interactions in general hospital settings. AIMS & OBJECTIVES: To quantify and characterise the quality of staff-patient interactions and to identify factors associated with negative interaction ratings. SETTING: Data were gathered at two acute English NHS hospitals between March and April 2015...
October 2016: International Journal of Nursing Studies
Jenny Kay
NHS Improvement chief executive Jim Mackey says: 'I've met with providers who even went above the 1:8 ratio.' He talks as if one nurse to eight patients is a ceiling when in fact it is the level at which harm to patients starts.
July 27, 2016: Nursing Standard
Kojiro Morita, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga
OBJECTIVE: To determine if sufficient nurse staffing reduced in-hospital fractures in acute care hospitals. DATA SOURCES/STUDY SETTING: The Japanese Diagnosis Procedure Combination inpatient (DPC) database from July 2010 to March 2014 linked with the Surveys for Medical Institutions. STUDY DESIGN: We conducted a retrospective cohort study to examine the association of inpatient nurse-to-occupied bed ratio (NBR) with in-hospital fractures. Multivariable logistic regression with generalized estimating equations was performed, adjusting for patient characteristics and hospital characteristics...
July 24, 2016: Health Services Research
Ashley Hodgson, Dorothy Morgan, Ryan Peterson
Identifying anxiety and depression in hospital patients has important implications for the quality of care, including reducing hospital admissions, promoting patient-centered care, and improving long-term patient outcomes. Hospital admissions are important opportunities for uncovering mental illness; whether hospitals actually take advantage of these important opportunities may depend on staffing. Nurse staffing is central to achieving the goals outlined by patient-centered care initiatives. The results of this study suggest an effect of nursing ratios on the detection of secondary mental health conditions via a quasi-experiment surrounding California's minimum nursing ratio law...
May 2016: Nursing Economic$
Marcio Soares, Fernando A Bozza, Luciano C P Azevedo, Ulysses V A Silva, Thiago D Corrêa, Fernando Colombari, André P Torelly, Pedro Varaschin, William N Viana, Marcos F Knibel, Moyzés Damasceno, Rodolfo Espinoza, Marcus Ferez, Juliana G Silveira, Suzana A Lobo, Ana Paula P Moraes, Ricardo A Lima, Alexandre G R de Carvalho, Pedro E A A do Brasil, Jeremy M Kahn, Derek C Angus, Jorge I F Salluh
PURPOSE: To investigate the impact of organizational characteristics and processes of care on hospital mortality and resource use in patients with cancer admitted to intensive care units (ICUs). PATIENTS AND METHODS: We performed a retrospective cohort study of 9,946 patients with cancer (solid, n = 8,956; hematologic, n = 990) admitted to 70 ICUs (51 located in general hospitals and 19 in cancer centers) during 2013. We retrieved patients' clinical and outcome data from an electronic ICU quality registry...
September 20, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Seiko Mizuno, Susumu Kunisawa, Noriko Sasaki, Kiyohide Fushimi, Yuichi Imanaka
BACKGROUND: Many hospitals experience a reduction in the number of available physicians on days when national scientific meetings are conducted. This study investigates the relationship between in-hospital mortality in acute myocardial infarction (AMI) patients and admission during national cardiology meeting dates. METHODS: Using an administrative database, we analyzed patients with AMI admitted to acute care hospitals in Japan from 2011 to 2013. There were 3 major national cardiology meetings held each year...
October 1, 2016: International Journal of Cardiology
(no author information available yet)
Safe staffing decisions should be made locally and not be governed by ratios.
July 13, 2016: Nursing Standard
Julia Lukewich, Dana S Edge, Elizabeth VanDenKerkhof, Tyler Williamson, Joan Tranmer
BACKGROUND: As the organization of primary care continues to evolve toward more interdisciplinary team structures, demonstrating effectiveness of care delivery is becoming important, particularly for nonphysician providers. Nurses are the most common nonphysician provider within primary care. The purpose of this study was to examine the relation between primary care delivery models that incorporate registered nurses and clinical outcomes of patients with type 2 diabetes. METHODS: Patient data from the Canadian Primary Care Sentinel Surveillance Network were matched with survey data from 15 Family Health Team practices in southeastern Ontario...
April 2016: CMAJ Open
Yunmi Kim, Seon-Ha Kim, Young Ko
In this study, we examined the effect of variations in nurse staffing levels on the length of stay and medical expenses of patients who underwent hip or knee surgeries. A cross-sectional study was conducted using the National Health Insurance database and hospital surveys from 2010. Patient length of stay and medical expenses by nurse staffing level and skill mix were compared after adjusting for hospital and patient characteristics. Nurse staffing was measured based on staffing grade, the bed-to-registered nurse/nurse aid ratio, the bed-to-nursing personnel ratio, and the RN proportion...
July 11, 2016: Nursing & Health Sciences
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