Preheal: Forming a Start-up Team Post-COVID-19

The Indian government had been making efforts to foster an innovative business culture by incorporating design thinking and innovation in b-school curricula. Substantial investments had also helped aspiring entrepreneurs pursue their ambitions. One such beneficiary of these initiatives was Preheal Innovations Private Limited, which aimed to build an online platform catering to the healthcare, beauty, and wellness needs of customers throughout India. Mr. Vikrant, founder and CEO of Preheal, had built a robust network of contacts in the healthcare sector after 20 years of experience and this, combined with the company's unique business model catering to customers in both urban (tier-2 and tier-3 cities) and rural areas in India, played a key role in attracting the initial start-up team. However, efforts were interrupted due to COVID-19, which lead to the departure of team members. Post lockdown, Mr. Vikrant had to decide how to relaunch the new venture with either full or partial staffing, in a changed business environment. © 2022 NeilsonJournals Publishing.

Fear of COVID-19 among critical care nurses of public hospitals in Lahore: empirical evidence during third wave

The world has seen a pandemic that dis-rupted life. Till now there are aftershocks of COVID-19 such as Omicron instilling fear among individuals. Healthcare staff is on alert specifically the nurses have suffered a lot mentally due to this issue by developing fatigue. The study was conducted during the deadly 3rd COVID-19 wave. The data were collected by developing the questionnaire of the previously validated measures related to the variables under study from nurses working in the intensive care unit, critical care unit, and floor wards of COVID-19 at Services Hospital, Lahore. A total of 140 questionnaires were used for data analysis. The study used Statistical Package for Social Sciences for frequency and descrip-tive statistics. Whereas the outcomes of fear of COVID-19 were assessed by using the latest Smart Partial Least Squares software which allows to assess the complex research frameworks. The results of the study revealed that the fear of COVID-19 results in poor quality of life among nurses and fatigue. Resilience among nurses can reduce the negative consequences but did not get statistical support.

COVID-19: Adapting to change, general surgery at a district general hospital in the United Kingdom

The Coronavirus pandemic has caused major change across the world and in the National Health Service. In order to cope and help limit contagion, numerous institutions recognised the need to adjust clinical practice quickly yet safely. In this paper, we aim to describe the changes implemented in a general surgery department at a district general hospital in the United Kingdom. Across the surgical specialties, frameworks, protocols and guidelines have been established locally and nationally. The aerosol generating procedures involved in general surgery required us to alter our daily activities. Modifications to patient management were necessary to try and reduce viral spread. Staff wellbeing was heavily promoted in order to help maintain the frontline workforce. A holistic approach was required.

The Association of Bedside Nurse Staffing on Patient Outcomes and Throughput in a Pediatric Cardiac Intensive Care Unit

Health care throughput is the progression of patients from admission to discharge, limited by bed occupancy and hospital capacity. This study examines heart center throughput, cascading effects of limited beds, transfer delays, and nursing staffing on outcomes utilizing elective surgery cancellation during the initial severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic wave. This study was a retrospective single-center study of staffing, adverse events, and transfers. The study period was January 1, 2018 to December 31, 2020 with the SARS-CoV-2 period March to May 2020. There were 2,589 patients, median age 5 months (6 days-4 years), 1,543 (60%) surgical and 1,046 (40%) medical. Mortality was 3.9% ( n = 101), median stay 5 days (3-11 days), median 1:1 nurse staffing 40% (33-48%), median occupancy 54% (43-65%) for step-down unit, and 81% (74-85%) for cardiac intensive care unit. Every 10% increase in step-down unit occupancy had a 0.5-day increase in cardiac intensive care unit stay ( p = 0.044), 2.1% increase in 2-day readmission ( p = 0.023), and 2.6% mortality increase ( p < 0.001). Every 10% increase in cardiac intensive care unit occupancy had 3.4% increase in surgical delay ( p = 0.016), 6.5% increase in transfer delay ( p = 0.020), and a 15% increase in total reported adverse events ( p < 0.01). Elective surgery cancellation is associated with reduced high occupancy days (23-10%, p < 0.001), increased 1:1 nursing (34-55%, p < 0.001), decreased transfer delays (19-4%, p = 0.008), and decreased mortality (3.7-1.5%, p = 0.044). In conclusion, Elective surgery cancellation was associated with increased 1:1 nursing and decreased mortality. Increased cardiac step-down unit occupancy was associated with longer cardiac intensive care unit stay, increased transfer, and surgical delays.

The Changing Landscape of Substitute School Nursing A School Nurse Administrator Roundtable.

School nurse administrators increasingly express concerns over the availability of substitute school nurses with return to in-person learning after the height of the COVID-19 pandemic. While healthcare staffing concerns and shortages are not unique to the school setting, the increasing health acuity of the student population, delegation principles, and staffing models complicate the issue. Traditional methods of covering absences may no longer suffice. In this article, five school nurse administrators share strategies, comparing pre-pandemic to current day facilitation of providing coverage for the absences of their healthcare staff.

Nursing workforce allocation in the intensive care units of COVID-19-designated hospitals: A nationwide cross-sectional survey in China.

AIM: To explore the nursing workforce allocation in intensive care units (ICUs) of COVID-19-designated hospitals during the epidemic peak in China. DESIGN: A nationwide cross-sectional online survey. METHODS: A total of 37 head nurses and 262 frontline nurses in 37 ICUs of COVID-19-designated tertiary hospitals located in 22 cities of China were surveyed. The self-reported human resource allocation questionnaire was used to assess the nursing workforce allocation. RESULTS: The average patient-to-nurse ratio was 1.89 ± 1.14, and the median working hours per shift was 5 h. The top four majors of front-line nurses in ICUs were respiratory (31.30%), lemology (27.86%), intensive care (21.76%) and emergency (17.18%). We also found that a smaller average patient-to-nurse ratio (odds ratio [OR]: 0.328, 95% CI: 0.108, 1.000), longer average weekly rest time per person (OR: 0.193, 95% CI: 0.051, 0.729) and larger proportion of 6-9 working years (OR: 0.002, 95% CI: 0.001, 1.121) decreased the occurrence of nursing adverse events.

Clinical Oncology Nursing: Will You Leave or Stay?

Anyone who works in clinical oncology care sees it, experiences it, or feels it on a daily basis: a real or perceived shortage of nurses and, specifically, experienced clinical oncology nurses.

Assessing the impacts of nurse staffing and work schedules on nurse turnover: A systematic review.

AIM: This study aimed to investigate and synthesize the impacts of nurse staffing and work schedules on nurse turnover in acute hospitals. BACKGROUND: The retention of nurses during the COVID-19 pandemic was critical due to the increased demand for nurses. Among the multifaceted factors contributing to nurse turnover, it is worth examining nurse staffing and work schedules while considering policy intervention. METHODS: The findings of this systematic literature review were reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Using eight databases, including CINAHL and PubMed, research articles published from January 2000 until June 2021 were reviewed. The inclusion criteria were original peer-reviewed research, nonexperimental studies published in English or Korean languages, and studies examining the impacts of nurse staffing and work schedules on nurses' actual turnover. RESULTS: Fourteen articles were reviewed. Among them, 12 studies investigated the relationship between nurse staffing and turnover, and four examined the impact of work schedules on nurse turnover. Nurse staffing levels are strongly related to nurse turnover in the expected direction. However, few studies have found that work schedules are significantly related to nurse turnover. CONCLUSION: Inadequate and unsafe nurse staffing leads to increased nurse turnover rates. More studies are needed to investigate the impacts of work schedules on nurse turnover. IMPLICATIONS FOR NURSING, HEALTH, AND SOCIAL POLICY: Several states in the United States have adopted the nurse staffing policy during the COVID-19 pandemic. More hospitals and the government should adopt and implement policies to regulate nurse staffing, reduce nurse turnover, and increase retention. Policy intervention in nurse work schedules should also be considered to prevent nurse turnover.

The Kaiser Permanente Northern California COVID-19 physician redeployment experience: Redeploying physicians to meet the demands of the pandemic

This paper describes a redeployment programme developed by Kaiser Permanente Northern California (KP NCAL) to meet physician staffing needs during five COVID-19 surges in Northern California. By leveraging two existing programmes, creating a flexible system of redeployment levels, and supporting the system with a robust training programme, the physician redeployment programme effectively addressed physician staffing needs, maximised excellent patient care, and supported KP NCAL physicians during the pandemic. The programme delivered care to over 131,000 outpatients with COVID-19 infection and redeployed physicians into more than 800 inpatient shifts. © Henry Stewart Publications, 1749–9216.

Staffing Shortages, Staffing Hours, and Resident Deaths in US Nursing Homes During the COVID-19 Pandemic.

OBJECTIVES: Staffing shortages at nursing homes during the COVID-19 pandemic may have impacted care providers' staffing hours and affected residents' care and outcomes. This study examines the association of staffing shortages with staffing hours and resident deaths in nursing homes during the COVID-19 pandemic. DESIGN: This study measured staffing hours per resident using payroll data and measured weekly resident deaths and staffing shortages using the Centers for Disease Control and Prevention's National Healthcare Safety Network data. Multivariate linear regressions with facility and county-week fixed effects were used to investigate the association of staffing shortages with staffing hours and resident deaths. SETTING AND PARTICIPANTS: 15,212 nursing homes. MEASURES: The primary outcomes included staffing hours per resident of registered nurses (RNs), licensed practical nurses (LPNs), and certified nursing assistants (CNAs) and weekly total deaths per 100 residents. RESULTS: Between May 31, 2020, and May 15, 2022, 18.4% to 33.3% of nursing homes reported staffing shortages during any week. Staffing shortages were associated with lower staffing hours per resident with a 0.009 decrease in RN hours per resident (95% CI 0.005-0.014), a 0.014 decrease in LPN hours per resident (95% CI 0.010-0.018), and a 0.050 decrease in CNA hours per resident (95% CI 0.043-0.057). These are equivalent to a 1.8%, 1.7%, and 2.4% decline, respectively. There was a positive association between staffing shortages and resident deaths with 0.068 (95% CI 0.048-0.088) total deaths per 100 residents. This was equivalent to an increase of 10.5%. CONCLUSION AND IMPLICATIONS: Our results showed that self-reported staffing shortages were associated with a statistically significant decrease in staffing hours and with a statistically significant increase in resident deaths. These results suggest that addressing staffing shortages in nursing homes can save lives.

E-nursing homes: transforming access to nurses in nursing homes in response to the staffing crisis.

The UK is facing a nationwide staffing crisis within adult social care, due to difficulties in recruiting and retaining registered nurses. Current interpretation of legislation means nursing homes must always have the physical presence of a registered nurse on duty within the home. With the shortage of registered nurses increasing, reliance on agency workers is commonplace, a practice impacting service cost and continuity of care. Lack of innovation to tackle this issue means the question of how to transform service delivery to combat staffing shortages is open for debate. The potential for technology to augment the provision of care was highlighted during the COVID-19 pandemic. In this article the authors present one possible solution focused on the provision of digital nursing care within nursing homes. Anticipated benefits include enhanced accessibility of nursing roles, reduced risk of viral spread and opportunities for upskilling staff. However, challenges include the current interpretation of legislation.

Perspectives of nursing home administrators across the United States during the COVID-19 pandemic.

OBJECTIVE: To characterize the experiences of nursing home administrators as they manage facilities across the United States during the COVID-19 pandemic. DATA SOURCES AND STUDY SETTING: We conducted 156 interviews, consisting of four repeated interviews with administrators from 40 nursing homes in eight health care markets across the country from July 2020 through December 2021. STUDY DESIGN: We subjected the interview transcripts to a rigorous qualitative analysis to identify overarching themes using a modified grounded theory approach to applied thematic analysis. DATA COLLECTION METHODS: In-depth, semi-structured qualitative interviews were conducted virtually or by phone, and audio-recorded, with participants' consent. Audio recordings were transcribed. PRINCIPAL FINDINGS: Interviews with nursing home administrators revealed a number of important cross-cutting themes. In interviewing each facility's administrator four times over the course of the pandemic, we heard perspectives regarding the stages of the pandemic, and how they varied by the facility and changed over time. We also heard how policies implemented by federal, state, and local governments to respond to COVID-19 were frequently changing, confusing, and conflicting. Administrators described the effect of COVID-19 and efforts to mitigate it on residents, including how restrictions on activities, communal dining, and visitation resulted in cognitive decline, depression, and weight loss. Administrators also discussed the impact of COVID-19 on staff and staffing levels, reporting widespread challenges in keeping facilities staffed as well as strategies used to hire and retain staff. Administrators described concerns for the sustainability of the nursing home industry resulting from the substantial costs and pressures associated with responding to COVID-19, the reductions in revenue, and the negative impact of how nursing homes appeared in the media. CONCLUSIONS: Findings from our research reflect nursing home administrator perspectives regarding challenges operating during COVID-19 and have substantial implications for policy and practice.

'I have enough pressure as it is, without the worry of doing something wrong because of ignorance': The impact of Covid-19 on people who employ social care personal assistants

People with care and support needs were often badly affected by Covid-19, although the impact on people employing Personal Assistants (PAs) has not been addressed. We aimed to explore the experiences of people employing PAs during the pandemic to inform care systems and social work practice. Remote qualitative interviews were conducted with seventy PA employers across England in 2021–2022. Data were analysed thematically to explore salient themes. The Covid-19 pandemic elucidated role tensions of PA employers: Navigating care arrangements during a time of unprecedented uncertainty reinforced participants' role as an employer, but exposed some aspects of employment responsibilities and legal obligations that participants felt ill-equipped to manage. Reports of contact with or by social workers were few and not perceived as helpful. The often-informal nature of PA arrangements and its blurred relational boundaries affected participants' expectations of their PAs. PA employers would welcome support from social workers in their employment role and flexibility with care plans, albeit with greater autonomy over their Direct Payment (DP) budget to enhance the potential of this arrangement. In the context of declining DP uptake in England, our study offers some potential explanations for this, with suggestions for systemic change and social work practice.

Community diagnostic centres: what, where and why?

The British Journal of Healthcare Management's editor discusses the potential benefits of community diagnostic centres for patients and the wider NHS, along with key considerations to drive this model forward.

Changing English Local Authority Duties by the Adoption of Easements in the COVID-19 Pandemic, Findings from an Interview-Based Study

This article reports findings from a study on the effect of the adjustments or 'easements' that were made to the 2014 Care Act when measures to manage the impact of COVID-19 were introduced in England in 2020. Only eight local authorities (LAs) implemented the changes permitted. The experiences of five are explored in this article. Data were collected in 2021 through interviews with Directors of Adult Social Services and other senior managers in these LAs and analysed using a thematic approach. Participants referred to the challenges under which they were working pre-pandemic, including resource pressures and problems recruiting and retaining staff. Despite the conditions attached to adopting easements these LAs had done so because of the uncertainties they were facing. All ceased to use them within a short time because they could manage without them. They had been shocked by the concerted opposition to easements and the time necessitated in responding to this. They contrasted their experiences with the apparent ease with which NHS colleagues had been able to change their practices. The experiences of these LAs may contribute to planning for the continuity of social care in any future emergency.

Human Resources for Pediatric Health Care of Ukraine.

Introduction. The quality and availability of medical care for children of country depends on the quantity of pediatricians and the quality of their training. This is especially important in the context of the COVID-19 pandemic. Purpose. To assess the state of staffing and training of pediatricians in healthcare institutions of Ukraine in comparison with same world and European indicators and determine the necessary measures for improvement. Materials and methods. For this research we have used methods of the system approach and epidemiological analysis of data from GU "Center of medical statistics of the Ministry of Health of Ukraine" for eleven years (2009-2020). Results. According to the level of training of doctors, including pediatricians, Ukraine has reached total rank of 38th in the European region. Such dynamics of changes in the availability of human resources for healthcare is accompanied by reductions in the volume of training of pediatricians since 2017. According to the Center for Medical Statistics from 31.12.2020 the Ministry of Health of Ukraine provided medical care in pediatric health care institutions of all forms of ownership with the help of 8812 pediatricians, of whom 7925 (90%) were worked in primary health care centers, clinics and hospitals of the Ministry of Health of Ukraine. This numbers are significantly lower than in 2009, when there were 12 450 practicing pediatricians. As we see, the number of pediatricians has decreased by 15.4% for the last 7 years. Conclusion. Importance of the problems with personnel in pediatric healthcare had shown us a necessity of radical government management decisions for improvement of the situation with the training of pediatricians and preventing of risks of limitations of access to pediatric medical assistance and deterioration of quality of medical care for children in the country. This might be possible with rational planning of the state necessity in the training of pediatricians and significant improvement of their social protection and working conditions. Possible steps should include increasing pediatrics necessity state order up to 1000 pediatricians in state medical universities annually by targeted regional medical personnel necessity order, taking into account the needs of the regions and reviewing their training programs in accordance with the modern requirements.Copyright © 2022, Professionalnye Izdaniya. All rights reserved.

Human Resources for Pediatric Health Care of Ukraine.

Introduction. The quality and availability of medical care for children of country depends on the quantity of pediatricians and the quality of their training. This is especially important in the context of the COVID-19 pandemic. Purpose. To assess the state of staffing and training of pediatricians in healthcare institutions of Ukraine in comparison with same world and European indicators and determine the necessary measures for improvement. Materials and methods. For this research we have used methods of the system approach and epidemiological analysis of data from GU "Center of medical statistics of the Ministry of Health of Ukraine" for eleven years (2009-2020). Results. According to the level of training of doctors, including pediatricians, Ukraine has reached total rank of 38th in the European region. Such dynamics of changes in the availability of human resources for healthcare is accompanied by reductions in the volume of training of pediatricians since 2017. According to the Center for Medical Statistics from 31.12.2020 the Ministry of Health of Ukraine provided medical care in pediatric health care institutions of all forms of ownership with the help of 8812 pediatricians, of whom 7925 (90%) were worked in primary health care centers, clinics and hospitals of the Ministry of Health of Ukraine. This numbers are significantly lower than in 2009, when there were 12 450 practicing pediatricians. As we see, the number of pediatricians has decreased by 15.4% for the last 7 years. Conclusion. Importance of the problems with personnel in pediatric healthcare had shown us a necessity of radical government management decisions for improvement of the situation with the training of pediatricians and preventing of risks of limitations of access to pediatric medical assistance and deterioration of quality of medical care for children in the country. This might be possible with rational planning of the state necessity in the training of pediatricians and significant improvement of their social protection and working conditions. Possible steps should include increasing pediatrics necessity state order up to 1000 pediatricians in state medical universities annually by targeted regional medical personnel necessity order, taking into account the needs of the regions and reviewing their training programs in accordance with the modern requirements.Copyright © 2022, Professionalnye Izdaniya. All rights reserved.