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https://www.readbyqxmd.com/read/28608513/out-of-office-hours-elective-surgical-intensive-care-admissions-and-their-associated-complications
#1
David J R Morgan, Kwok Ming Ho, Yang Jian Ong, Marlene L Kolybaba
BACKGROUND: The 'weekend' effect is a controversial theory that links reduced staffing levels, staffing seniority and supportive services at hospitals during 'out-of-office hours' time periods with worsening patient outcomes. It is uncertain whether admitting elective surgery patients to intensive care units (ICU) during 'out-of-office hours' time periods mitigates this affect through higher staffing ratios and seniority. METHODS: Over a 3-year period in Western Australia's largest private hospital, this retrospective nested-cohort study compared all elective surgical patients admitted to the ICU based on whether their admission occurred 'in-office hours' (Monday-Friday 08...
June 12, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28595280/estimating-national-level-exposure-to-antineoplastic-agents-in-the-workplace-carex-canada-findings-and-future-research-needs
#2
Amy L Hall, Paul A Demers, George Astrakianakis, Calvin Ge, Cheryl E Peters
Objectives: Occupational exposure to antineoplastic agents occurs in various environments and is associated with increased cancer risk and adverse reproductive outcomes. National-level information describing the location and extent of occupational exposure to antineoplastic agents is unavailable in Canada and most other countries. CAREX Canada aimed to estimate the prevalence and relative levels of occupational exposures to antineoplastic agents across work setting, occupation, and sex...
June 8, 2017: Annals of Work Exposures and Health
https://www.readbyqxmd.com/read/28592476/factors-influencing-active-family-engagement-in-care-among-critical-care-nurses
#3
Breanna Hetland, Ronald Hickman, Natalie McAndrew, Barbara Daly
Critical care nurses are vital to promoting family engagement in the intensive care unit. However, nurses have varying perceptions about how much family members should be involved. The Questionnaire on Factors That Influence Family Engagement was given to a national sample of 433 critical care nurses. This correlational study explored the impact of nurse and organizational characteristics on barriers and facilitators to family engagement. Study results indicate that (1) nurses were most likely to invite family caregivers to provide simple daily care; (2) age, degree earned, critical care experience, hospital location, unit type, and staffing ratios influenced the scores; and (3) nursing work-flow partially mediated the relationships between the intensive care unit environment and nurses' attitudes and between patient acuity and nurses' attitudes...
2017: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/28576436/cta-in-acute-stroke-short-intensive-training-intervention-is-highly-effective-in-improving-radiologists-performance
#4
E A Cora, G A Ford, D Flynn, P Gonsalves, P White
AIM: To determine whether focussed radiology training in reporting stroke computed tomography angiography (CTA) improved diagnostic performance of general radiology specialty trainees staffing regional on call rotas. MATERIALS AND METHODS: A validated case archive (VCA) consisting of 50 hyperacute stroke CTA cases was developed for a full day course on CTA interpretation. Training days were organised ensuring all local trainees had a chance to attend. The rate of major and minor amendments by neuroradiology consultants were reviewed in 252 on-call radiology trainee reports...
May 30, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28570128/effect-of-a-biopsy-center-on-adequacy-rates-of-thyroid-nodule-fine-needle-aspiration
#5
Vincent A Leung, Anish Kirpalani, Gevork Mnatzakanian, Errol Colak, Paraskevi A Vlachou
OBJECTIVE: The purpose of this study was to investigate the effect of a biopsy center-a dedicated space with a dedicated ultrasound machine and technologist, staffed daily by a radiologist responsible for performing ultrasound-guided procedures only-on the rate of non-diagnostic or unsatisfactory thyroid fine-needle aspiration (FNA). MATERIALS AND METHODS: Three radiologists performed FNA on 1200 nodules in 998 patients between September 2010 and November 2015. We compared rates of nondiagnostic or unsatisfactory FNA before and after implementation of a biopsy center in September 2014 as part of a quality improvement initiative...
June 1, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28546786/the-association-between-higher-nurse-staffing-standards-in-the-fee-schedules-and-the-geographic-distribution-of-hospital-nurses-a-cross-sectional-study-using-nationwide-administrative-data
#6
Noriko Morioka, Jun Tomio, Toshikazu Seto, Yasuki Kobayashi
BACKGROUND: In Japan, the revision of the fee schedules in 2006 introduced a new category of general care ward for more advanced care, with a higher staffing standard, a patient-to-nurse ratio of 7:1. Previous studies have suggested that these changes worsened inequalities in the geographic distribution of nurses, but there have been few quantitative studies evaluating this effect. This study aimed to investigate the association between the distribution of 7:1 beds and the geographic distribution of hospital nursing staffs...
2017: BMC Nursing
https://www.readbyqxmd.com/read/28534543/-evolution-of-patient-safety-culture-in-a-medium-stay-hospital-monitoring-indicators
#7
M J Merino-Plaza, F J Carrera-Hueso, M Castillo-Blasco, A Martínez-Asensi, R Martínez-Capella, N Fikri-Benbrahim
BACKGROUND: Patient safety is a challenge for health care. The aim of this study is to identify the dimensions with the greatest impact on patient safety culture of healthcare staff in a medium-stay hospital; to asses its evolution over time and to check the sensitivity of monitoring indicators. METHODS: Two cross-sectional studies (2013 to 2015) were conducted. The safety culture assessment tool used was the Spanish version of the "Hospital Survey on Patient Safety" (AHRQ)...
April 30, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/28515601/quality-indicators-compliance-survey-in-indian-intensive-care-units
#8
Munta Kartik, Palepu B N Gopal, Rahul Amte
CONTEXT: The quality of health care and outcomes of Intensive Care Unit (ICU) have been a major subject of discussion in the past decade. Quality indicators in ICUs maintain an order of uniformity and standard care of delivery across ICUs. AIMS: In this study, we tried to analyze the percentage compliance of quality indicators in ICU across our country. METHODS: Four hundred complete questionnaire forms were collected in two stages by means of conducting a survey and through email responses to the survey questionnaire...
April 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28492412/patients-in-prehospital-transport-to-the-emergency-department-a-cohort-study-of-risk-factors-for-7-day-mortality
#9
Camilla L Noergaard Bech, Mikkel Brabrand, Søren Mikkelsen, Annmarie Lassen
BACKGROUND: Ambulance transfer is the first contact with the healthcare system for many patients in emergency conditions.We aimed to identify prognostic risk factors accessible in the prehospital phase that indicate an increased risk of 7-day mortality. PATIENTS AND METHODS: We included patients aged 18 years or older, transferred by ambulance to the emergency department at Odense University Hospital, from 1 April 2012 to 30 September 2014. We carried out multivariate logistic regressions, adjusted for age and sex, to describe the relationship between vital sign values recorded in the prehospital setting and 7-day mortality...
May 10, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28485906/-complexity-of-care-and-organizational-effectiveness-a-survey-among-medical-care-units-in-nine-lombardy-region-hospitals
#10
Sara Pasquali, Enrica Capitoni, Giuseppina Tiraboschi, Adriana Alborghetti, Giuseppe De Luca, Stefania Di Mauro
AIM: Eleven medical care units of nine Lombardy Region hospitals organized by levels of care model or by the traditional departmental model have been analyzed, in order to evaluate if methods for complexity of patient-care evaluation represent an index factor of nursing organizational effectiveness. METHOD: Survey with nine Nurses in managerial position was conducted between Nov. 2013-Jan. 2014. The following factors have been described: context and nursing care model, staffing, complexity evaluation, patient satisfaction, staff well-being...
January 2017: Professioni Infermieristiche
https://www.readbyqxmd.com/read/28481826/the-impact-of-nurse-staffing-on-in-hospital-mortality-of-stroke-patients-in-korea
#11
Wankyo Chung, Min Sohn
BACKGROUND: Stroke is one of the leading causes of death in Korea, and a well-qualified, adequate nursing force achieves better patient outcomes. STUDY PURPOSES: This study examined the association between nurse staffing and in-hospital mortality among stroke patients in a nationally representative sample. METHODS: This cross-sectional retrospective study was conducted using 2009 National Health Insurance claims data of stroke patients admitted to variously sized Korean hospitals...
May 5, 2017: Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28471925/improving-staffing-and-nurse-engagement-in-a-neuroscience-intermediate-unit
#12
Charles Nadolski, Pheraby Britt, Leah C Ramos
The neuroscience intermediate unit is a 23-bed unit that was initially staffed with a nurse-to-patient ratio of 1:4 to 1:5. In time, the unit's capacity to care for the exceeding number of progressively acute patients fell short of the desired goals in the staff affecting the nurse satisfaction. The clinical nurses desired a lower nurse-patient ratio. The purpose of this project was to justify a staffing increase through a return on investment and increased quality metrics. METHODS: This initiative used mixed methodology to determine the ideal staffing for a neuroscience intermediate unit...
June 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28466462/are-high-nurse-workload-staffing-ratios-associated-with-decreased-survival-in-critically-ill-patients-a-cohort-study
#13
Anna Lee, Yip Sing Leo Cheung, Gavin Matthew Joynt, Czarina Chi Hung Leung, Wai-Tat Wong, Charles David Gomersall
BACKGROUND: Despite the central role of nurses in intensive care, a relationship between intensive care nurse workload/staffing ratios and survival has not been clearly established. We determined whether there is a threshold workload/staffing ratio above which the probability of hospital survival is reduced and then modeled the relationship between exposure to inadequate staffing at any stage of a patient's ICU stay and risk-adjusted hospital survival. METHODS: Retrospective analysis of prospectively collected data from a cohort of adult patients admitted to two multi-disciplinary Intensive Care Units was performed...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28466290/-evaluation-of-care-conditions-in-intensive-care-units-results-of-an-online-questionnaire-of-critical-care-nurses
#14
REVIEW
M Isfort
In the following article, selected results of a descriptive study on personnel staffing and patients' care in intensive care units in Germany are presented and discussed. The main focus is laid on comparing features of personnel staffing with indicators of job satisfaction and patients' care. The study is based on an online questionnaire of critical care nurses run in 2017. The article represents the data of 2233 included German critical care nurses. The main results are the following: a low nurse patient ratio (≥1:3) in intensive care units has the tendency to cause higher risks in patients' care and shows lower job satisfaction than nurses with higher nurse-patient ratio (≤1:2)...
May 2, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28455091/differences-in-test-ordering-between-nurse-practitioners-and-attending-emergency-physicians-when-acting-as-provider-in-triage
#15
Tomer Begaz, David Elashoff, Tristan R Grogan, David Talan, Breena R Taira
STUDY OBJECTIVES: To compare diagnostic test ordering practices of NPs with those of physicians in the role of Provider in Triage (PIT). METHODS: This was a secondary analysis of data from a prospective RCT of waiting room diagnostic testing, where 770 patients had diagnostic studies ordered from the waiting room. The primary outcome was the number of test categories ordered by provider type. Other outcomes included total tests ordered by the end of ED stay, and time in an ED bed...
April 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28398697/effects-of-targeting-lower-versus-higher-arterial-oxygen-saturations-on-death-or-disability-in-preterm-infants
#16
REVIEW
Lisa M Askie, Brian A Darlow, Peter G Davis, Neil Finer, Ben Stenson, Maximo Vento, Robin Whyte
BACKGROUND: The use of supplemental oxygen in the care of extremely preterm infants has been common practice since the 1940s. Despite this, there is little agreement regarding which oxygen saturation (SpO₂) ranges to target to maximise short- or long-term growth and development, while minimising harms. There are two opposing concerns. Lower oxygen levels (targeting SpO₂ at 90% or less) may impair neurodevelopment or result in death. Higher oxygen levels (targeting SpO₂ greater than 90%) may increase severe retinopathy of prematurity or chronic lung disease...
April 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28388827/relationships-between-nurse-staffing-and-patients-experiences-and-the-mediating-effects-of-missed-nursing-care
#17
Sung-Hyun Cho, Barbara A Mark, George Knafl, Hyoung Eun Chang, Hyo-Jeong Yoon
PURPOSE: The aims of this study were to examine the relationships between nurse staffing and patients' experiences, and to determine the mediating effects of patient-reported missed care on the relationship between nurse staffing and patients' experiences. DESIGN: The study included 362 nurses and 208 patients from 23 nursing units of six hospitals in South Korea. METHODS: Nurse staffing was measured by patient-to-nurse ratios and by nurse- and patient-perceived staffing adequacy...
May 2017: Journal of Nursing Scholarship
https://www.readbyqxmd.com/read/28380716/dietary-service-staffing-impact-nutritional-quality-in-nursing-homes
#18
Kelly M Smith, Kali S Thomas, Shanthi Johnson, Hongdao Meng, Kathryn Hyer
OBJECTIVE: To examine the relationship between dietary service staff and dietary deficiency citations in nursing homes (NHs). METHOD: 2007-2011 Online Survey and Certification and Reporting data for 14,881 freestanding NHs were used to examine the relationship between dietary service staff and the probability of receiving a dietary service-related deficiency citation. An unconditional logit model with random effects was employed. RESULTS: Findings suggest that higher staffing levels for dietitians (odds ratio [OR] = ...
January 1, 2017: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
https://www.readbyqxmd.com/read/28376546/association-of-nursing-overtime-nurse-staffing-and-unit-occupancy-with-health-care-associated-infections-in-the-nicu
#19
Marc Beltempo, Régis Blais, Guy Lacroix, Michèle Cabot, Bruno Piedboeuf
Objective This study aims to assess the association of nursing overtime, nurse staffing, and unit occupancy with health care-associated infections (HCAIs) in the neonatal intensive care unit (NICU). Study Design A 2-year retrospective cohort study was conducted for 2,236 infants admitted in a Canadian tertiary care, 51-bed NICU. Daily administrative data were obtained from the database "Logibec" and combined to the patient outcomes database. Median values for the nursing overtime hours/total hours worked ratio, the available to recommended nurse staffing ratio, and the unit occupancy rate over 3-day periods before HCAI were compared with days that did not precede infections...
April 4, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28375852/postoperative-complications-and-outcomes-associated-with-a-transition-to-24-7-intensivist-management-of-cardiac-surgery-patients
#20
Marc A Benoit, Sean M Bagshaw, Colleen M Norris, Mohamad Zibdawi, Wu Dat Chin, David B Ross, Sean van Diepen
OBJECTIVES: Nighttime intensivist staffing does not improve patient outcomes in general ICUs. Few studies have examined the association between dedicated in-house 24/7 intensivist coverage on outcomes in specialized cardiac surgical ICUs. We sought to evaluate the association between 24/7 in-house intensivist-only management of cardiac surgical patients on postoperative complications and health resource utilization. DESIGN: Before-and-after propensity matched cohort study...
April 3, 2017: Critical Care Medicine
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