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1.
AORN J ; 115(4): 361-363, 2022 04.
Article in English | MEDLINE | ID: covidwho-1772648
2.
PLoS One ; 17(3): e0264921, 2022.
Article in English | MEDLINE | ID: covidwho-1753191

ABSTRACT

PURPOSE: To identify preferred burnout interventions within a resident physician population, utilizing the Nominal Group Technique. The results will be used to design a discrete choice experiment study to inform the development of resident burnout prevention programs. METHODS: Three resident focus groups met (10-14 participants/group) to prioritize a list of 23 factors for burnout prevention programs. The Nominal Group Technique consisted of three steps: an individual, confidential ranking of the 23 factors by importance from 1 to 23, a group discussion of each attribute, including a group review of the rankings, and an opportunity to alter the original ranking across participants. RESULTS: The total number of residents (36) were a representative sample of specialty, year of residency, and sex. There was strong agreement about the most highly rated attributes which grouped naturally into themes of autonomy, meaning, competency and relatedness. There was also disagreement on several of the attributes that is likely due to the differences in residency specialty and subsequently rotation requirements. CONCLUSION: This study identified the need to address multiple organizational factors that may lead to physician burnout. There is a clear need for complex interventions that target systemic and program level factors rather than focus on individual interventions. These results may help residency program directors understand the specific attributes of a burnout prevention program valued by residents. Aligning burnout interventions with resident preferences could improve the efficacy of burnout prevention programs by improving adoption of, and satisfaction with, these programs. Physician burnout is a work-related syndrome characterized by emotional exhaustion, depersonalization, and a sense of reduced personal accomplishment [1]. Burnout is present in epidemic proportions and was estimated to occur in over 50 percent of practicing physicians and in up to 89 percent of resident physicians pre-COVID 19. The burnout epidemic is growing; a recent national survey of US physicians reported an 8.9 percent increase in burnout between 2011 and 2014 [2]. Rates of physician burnout have also increased [3] during the COVID-19 pandemic with a new classification of "pandemic burnout" experienced by over 52 percent of healthcare workers as early as June of 2020 [4]. Physician burnout can lead to depression, suicidal ideation, and relationship problems that may progress to substance abuse, increased interpersonal conflicts, broken relationships, low quality of life, major depression, and suicide [5-7]. The estimated rate of physician suicide is 300-400 annually [8-10].


Subject(s)
Burnout, Professional/prevention & control , Physicians/psychology , Burnout, Professional/epidemiology , Burnout, Professional/psychology , Exercise/psychology , Female , Focus Groups , Humans , Internship and Residency/statistics & numerical data , Male , Mindfulness , Personnel Staffing and Scheduling , Physicians/statistics & numerical data , Risk Factors , Sleep Hygiene , Social Support
3.
Med Biol Eng Comput ; 60(5): 1295-1311, 2022 May.
Article in English | MEDLINE | ID: covidwho-1750816

ABSTRACT

This study presents an efficient solution for the integrated recovery room planning and scheduling problem (IRRPSP). The complexity of the IRRPSP is caused by several sources. The problem combines the assignment of patients to recovery rooms and the scheduling of caregivers over a short-term planning horizon. Moreover, a solution of the IRRPSP should respect a set of hard and soft constraints while solving the main problem such as the maximum capacity of recovery rooms, the maximum daily load of caregivers, the treatment deadlines, etc. Thus, the need for an automated tool to support the decision-makers in handling the planning and scheduling tasks arises. In this paper, we present an exhaustive description of the epidemiological situation within the Kingdom of Saudi Arabia, especially in Jeddah Governorate. We will highlight the importance of implementing a formal and systematic approach in dealing with the scheduling of recovery rooms during extreme emergency periods like the COVID-19 era. To do so, we developed a mathematical programming model to present the IRRPSP in a formal way which will help in analyzing the problem and lately use its solution for comparison and evaluation of our proposed approach. Due to the NP-hard nature of the IRRPSP, we propose a hybrid three-level approach. This study uses real data instances received from the Department of Respiratory and Chest Diseases of the King Abdulaziz Hospital. The computational results show that our solution significantly outperforms the results obtained by CPLEX software with more than 1.33% of satisfied patients on B1 benchmark in much lesser computation time (36.27 to 1546.79 s). Moreover, our proposed approach can properly balance the available nurses and the patient perspectives.


Subject(s)
COVID-19 , Recovery Room , Algorithms , Humans , Pandemics , Personnel Staffing and Scheduling
4.
J Appl Psychol ; 107(4): 515-532, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1740404

ABSTRACT

The use of variable work schedules (VWS)-altering the number and timing of employees' work hours on a daily or weekly basis-is an increasingly common human resource (HR) practice designed to increase staffing flexibility. Little research, however, has examined whether and how the use of VWS affects an organization's turnover rates and/or financial performance at the unit level. Despite the common assumption that their use helps firms achieve higher performance by matching the supply of labor to demand fluctuations-especially during a crisis such as coronavirus disease (COVID-19)-this study demonstrates otherwise. I propose that greater use of variable schedules can lead to higher turnover rates and that this effect has been more pronounced during the pandemic. I also argue that managerial reliance on VWS can decrease not only the level of financial performance but also performance recovery during the pandemic-with unit-level turnover as the mediating mechanism. Using data from 1,678 units of a U.S. quick-service restaurant chain across different phases of the COVID-19 pandemic (October 2019-December 2020), I find support for these predictions. Results suggest that scholars and practitioners should reconsider the general assumption that staffing flexibility helps organizations adapt to uncertain environments. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Subject(s)
COVID-19 , Pandemics , Humans , Personnel Staffing and Scheduling , Personnel Turnover , SARS-CoV-2
5.
J Nurs Adm ; 52(2): 91-98, 2022 Feb 01.
Article in English | MEDLINE | ID: covidwho-1621706

ABSTRACT

Nurse staffing is linked to safety, quality, and experience outcomes. In the context of the COVID-19 pandemic, staffing has become more critical as overwhelming demand has met diminishing supply of healthy nurses, capacity for care, and the innovation necessary to deliver optimal quality and experience to patients and the people who care for them. Press Ganey data scientists, along with industry experts, sought to evaluate staffing before the pandemic and its effects on clinical quality, experience, and nurse engagement. Furthermore, interviews with expert nurse researchers and nursing leaders helped to identify the kind of innovation necessary to accommodate the variable demand in patient volumes, acuity, nurse availability, and teamwork. Valuable insights from this work will help healthcare leaders in their quest to optimize nursing care.


Subject(s)
Health Workforce , Models, Statistical , Nursing Staff, Hospital/organization & administration , Personnel Staffing and Scheduling/organization & administration , Databases, Factual , Humans , Outcome Assessment, Health Care , Quality of Health Care
7.
J Cyst Fibros ; 20 Suppl 3: 16-20, 2021 12.
Article in English | MEDLINE | ID: covidwho-1587336

ABSTRACT

BACKGROUND: Chronic care delivery models faced unprecedented financial pressures, with a reduction of in-person visits and adoption of telehealth during the COVID-19 pandemic. We sought to understand the reported financial impact of pandemic-related changes to the cystic fibrosis (CF) care model. METHODS: The U.S. CF Foundation State of Care surveys fielded in Summer 2020 (SoC1) and Spring 2021 (SoC2) included questions for CF programs on the impact of pandemic-related restrictions on overall finances, staffing, licensure, and reimbursement of telehealth services. Descriptive analyses were conducted based on program type. RESULTS: Among the 286 respondents (128 pediatric, 118 adult, 40 affiliate), the majority (62%) reported a detrimental financial impact to their CF care program in SoC1, though fewer (42%) reported detrimental impacts in SoC2. The most common reported impacts in SoC1 were redeployment of clinical staff (68%), furloughs (52%), hiring freezes (51%), decreases in salaries (34%), or layoffs (10%). Reports of lower reimbursement for telehealth increased from 30% to 40% from SoC1 to SoC2. Projecting towards the future, only a minority (17%) of program directors in SoC2 felt that financial support would remain below pre-pandemic levels. CONCLUSIONS: The COVID-19 pandemic resulted in financial strain on the CF care model, including challenges with reimbursement for telehealth services and reductions in staffing due to institutional changes. Planning for the future of CF care model needs to address these short-term impacts, particularly to ensure a lack of interruption in high-quality multi-disciplinary care.


Subject(s)
COVID-19 , Continuity of Patient Care , Cystic Fibrosis , Health Services Accessibility , Models, Organizational , Telemedicine , Adult , COVID-19/epidemiology , COVID-19/prevention & control , Child , Continuity of Patient Care/organization & administration , Continuity of Patient Care/standards , Costs and Cost Analysis , Cystic Fibrosis/economics , Cystic Fibrosis/epidemiology , Cystic Fibrosis/therapy , Health Services Accessibility/organization & administration , Health Services Accessibility/trends , Health Services Needs and Demand , Humans , Organizational Innovation , Personnel Staffing and Scheduling/organization & administration , Reimbursement Mechanisms/trends , SARS-CoV-2 , Telemedicine/economics , Telemedicine/methods , United States/epidemiology
8.
Policy Polit Nurs Pract ; 23(1): 15-25, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1582584

ABSTRACT

The novel coronavirus disease 2019 (COVID-19) spread rapidly worldwide. Nursing home (NH) residents are the most vulnerable high-risk population to infection. Professional registered nurses' (RNs') infection control is irreplaceable. We used a secondary data analysis method using the government's senior citizen welfare department large data set about all NHs (N = 3,389) across Korea between January 20 and October 20, 2020. Bed size positively associated with the mortality rate (No. of COVID-19 resident deaths / No. of total residents) (p = .048). When the proportion of RNs to total nursing staff was higher, the infection rate was 0.626% lower (p = .049), the mortality rate was 0.088% lower (p = .076), the proportion of confirmed COVID-19 cases per resident out of the total number of NHs was 44.472% lower (p = .041), and the proportion of confirmed COVID-19 deaths per resident out of the total number of NHs was 6.456% lower (p = .055). This study highlighted nurse staffing criteria and suggests that increasing RNs in NHs will reduce infection and mortality rates during the COVID-19 pandemic. We strongly suggest NHs hire at least one RN per day to properly function, and a minimum of four RNs to provide a fully competent RN workforce in long-term care settings in Korean NHs.


Subject(s)
COVID-19 , Humans , Nursing Homes , Pandemics , Personnel Staffing and Scheduling , SARS-CoV-2 , Workforce
9.
J Chin Med Assoc ; 84(10): 951-955, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-1546069

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) spread all over the world in 2020. In the face of the sudden pandemic, workforce mobilization has been of critical concern to medical institutions. During the pandemic, the public's behaviors of seeking medical assistance have also changed. Using the real-world data of a large medical center in Taiwan, this study aimed to analyze the fluctuations of outpatient visits among various departments and divisions in the early phase of the COVID-19 pandemic and to provide suggestions for staff allocation in similar future events. METHODS: Data of outpatient visits at Taipei Veterans General Hospital were obtained for analysis. The weekly fluctuations of outpatient visits among 36 departments or divisions were computed for 8 weeks from February 3 to March 29, 2020, the early phase of the pandemic. The monthly data of outpatient visits by department and division in March 2020 were also extracted for comparison with those in March 2019. A simple regression equation was used to calculate the weekly trends. RESULTS: Average outpatient visits decreased by 26% in 2 months following the outbreak. Among the 36 departments or divisions, ophthalmology, orthopedics, and cardiology underwent marked declines after the outbreak; the slopes of the simple regression equation were -110.8, -100.7, and -99.2, respectively. By contrast, transfusion medicine, toxicology, transplantation surgery, pediatric surgery, chest surgery, technical aid, and oncology were divisions less influenced. In the year-over-year comparison, infection was the only department or division with positive growth (20.5%), whereas all others exhibited negative growth. CONCLUSION: In the future, we can fulfil the additional personnel needs during a pandemic by redeploying physicians from departments experiencing a reduced workload. Hospitals should also establish preparatory employee training programs to ensure that the reassigned personnel are adequately equipped to serve in their new positions.


Subject(s)
Ambulatory Care/statistics & numerical data , COVID-19/epidemiology , SARS-CoV-2 , Emergency Service, Hospital , Humans , Personnel Staffing and Scheduling , Taiwan/epidemiology
11.
J Adv Nurs ; 78(4): 1075-1088, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1522730

ABSTRACT

AIMS: To understand how COVID-19 affected nurse staffing in intensive care units (ICUs) in England, and to identify factors that influenced, and were influenced by, pandemic staffing models. DESIGN: Exploratory qualitative study. METHODS: Semi-structured, online interviews conducted July-September 2020 with regional critical care leaders including policy leads (n = 4) and directors/lead nurses (n = 10) across critical care networks in England. FINDINGS: The six themes emerging from the framework analysis illustrate how the pre-pandemic ICU culture influenced ICU staffing models during the pandemic. Changes in staffing impacted on the workforce and the care delivered, whilst it was necessary to learn from, and adjust to, a rapidly changing situation. Variation across and between networks necessitated variation in responses. The overwhelming outcome was that the pandemic has challenged the central tenets of ICU nurse staffing. CONCLUSIONS: Pandemic nurse staffing models resulted in changes to ICU skill-mix and staffing numbers. Factors such as the impact of nurse staffing on care practices and on the workforce need to be taken into account when developing and testing future nurse staffing models for ICU. The extent to which ICUs will return to former staffing models is not yet known but there seems to be an appetite for change. IMPACT: In common with many countries, nurse staffing in English ICUs was adapted to address surge requirements during the COVID-19 pandemic. Findings highlight the challenge COVID-19 presented to pre-pandemic ICU nurse staffing guidelines, the impact on patient and staff well-being and the potential legacy for future staffing models. Study findings have implications for ICU nurse managers, researchers and policy makers: nurse staffing models need to be adaptable to the local context of care and future research should investigate the impact of different models on patients, staff and health service outcomes.


Subject(s)
COVID-19 , Nursing Staff, Hospital , COVID-19/epidemiology , Critical Care , Humans , Intensive Care Units , Pandemics , Personnel Staffing and Scheduling , SARS-CoV-2 , Workforce
12.
J Nurses Prof Dev ; 37(6): E20-E26, 2021.
Article in English | MEDLINE | ID: covidwho-1522396

ABSTRACT

Cross-training of nurses is an approach used by hospitals to mitigate anticipated nurse staffing shortages. This article provides professional practice nurse educators guidance on how to plan, implement, and evaluate expedited cross-training that integrate the principles of just-in-time training. Sixty-one nurses in a postacute care hospital setting were cross-trained over the course of 8 weeks using a six-step method.


Subject(s)
Nurses , Nursing Staff, Hospital , Humans , Interprofessional Education , Personnel Staffing and Scheduling , Workforce
13.
J Nurs Adm ; 51(12): 600-605, 2021 Dec 01.
Article in English | MEDLINE | ID: covidwho-1522395

ABSTRACT

OBJECTIVE: The aim of this study was to explore the occupational stress perception of nurses and how they manage it during the COVID-19 pandemic. BACKGROUND: The management of occupational stress is a key factor in promoting nurses' well-being. METHODS: A descriptive cross-sectional study was conducted. RESULTS: The top occupational stressors from the nurses' perspectives (N = 236) as measured by using an updated version of the Nursing Stress Scale (NSS) included wearing a face mask at all times in the hospital, unpredictable staffing and scheduling, not enough staff to adequately cover the unit, feeling helpless in the case a patient fails to improve, and being assigned to a COVID-19 patient. The mean stress score was 31.87. The updated NSS Cronbach's α was 0.92, and the interclass interclass correlation coefficient was 0.914. CONCLUSION: Nurse administrators are in a strategic position to develop interventions (eg, open door policy, meetings, and employee assistance programs) to assist nurses in effectively managing stress.


Subject(s)
COVID-19 , Nursing Staff, Hospital/psychology , Occupational Stress/psychology , Personnel Staffing and Scheduling/standards , Cross-Sectional Studies , Humans , Nursing Staff, Hospital/organization & administration , Personal Protective Equipment
15.
Clin Nurse Spec ; 35(6): 279-280, 2021.
Article in English | MEDLINE | ID: covidwho-1467450
16.
Int J Environ Res Public Health ; 17(22)2020 11 19.
Article in English | MEDLINE | ID: covidwho-1456323

ABSTRACT

Skill mix refers to the number and educational experience of nurses working in clinical settings. Authors have used several measures to determine the skill mix, which includes nurse-to-patient ratio and the proportion of baccalaureate-prepared nurses. Observational studies have tested the association between nursing skill mix and patient outcomes (mortality). To date, this body of research has not been subject to systematic review or meta-analysis. The aim of this study is to systematically review and meta-analyse observational and experimental research that tests the association between nursing skill mix and patient mortality in medical and surgical settings. We will search four key electronic databases-MEDLINE [OVID], EMBASE [OVID], CINAHL [EBSCOhost], and ProQuest Central (five databases)-from inception. Title, abstract, and full-text screening will be undertaken independently by at least two researchers using COVIDENCE review management software. We will include studies where the authors report an association between nursing skill mix and outcomes in adult medical and surgical inpatients. Extracted data from included studies will consist measures of nursing skill mix and inpatient mortality outcomes. A meta-analysis will be undertaken if there are at least two studies with similar designs, exposures, and outcomes. The findings will inform future research and workforce planning in health systems internationally.


Subject(s)
Nursing Staff, Hospital , Patients , Adult , Databases, Factual , General Surgery/statistics & numerical data , Humans , Nursing Staff, Hospital/standards , Nursing Staff, Hospital/statistics & numerical data , Patients/statistics & numerical data , Personnel Staffing and Scheduling/statistics & numerical data , Workforce/statistics & numerical data
17.
Gerontologist ; 60(3): e200-e217, 2020 04 02.
Article in English | MEDLINE | ID: covidwho-1455299

ABSTRACT

BACKGROUND AND OBJECTIVES: In long-term care (LTC) facilities, nursing staff are important contributors to resident care and well-being. Despite this, the relationships between nursing staff coverage, care hours, and quality of resident care in LTC facilities are not well understood and have implications for policy-makers. This systematic review summarizes current evidence on the relationship between nursing staff coverage, care hours, and quality of resident care in LTC facilities. RESEARCH DESIGN AND METHODS: A structured literature search was conducted using four bibliographic databases and gray literature sources. Abstracts were screened by two independent reviewers using Covidence software. Data from the included studies were summarized using a pretested extraction form. The studies were critically appraised, and their results were synthesized narratively. RESULTS: The systematic searched yielded 15,842 citations, of which 54 studies (all observational) were included for synthesis. Most studies (n = 53, 98%) investigated the effect of nursing staff time on resident care. Eleven studies addressed minimum care hours and quality of care. One study examined the association between different nursing staff coverage models and resident outcomes. Overall, the quality of the included studies was poor. DISCUSSION AND IMPLICATIONS: Because the evidence was inconsistent and of low quality, there is uncertainty about the direction and magnitude of the association between nursing staff time and type of coverage on quality of care. More rigorously designed studies are needed to test the effects of different cutoffs of care hours and different nursing coverage models on the quality of resident care in LTC facilities.


Subject(s)
Homes for the Aged/standards , Nursing Homes/standards , Nursing Staff/statistics & numerical data , Personnel Staffing and Scheduling/statistics & numerical data , Quality of Health Care , Aged , Delivery of Health Care/standards , Humans , Long-Term Care , Workforce
19.
Health Serv Res ; 57(2): 322-332, 2022 04.
Article in English | MEDLINE | ID: covidwho-1396636

ABSTRACT

OBJECTIVE: To describe the association between nursing home staff turnover and the presence and scope of infection control citations. DATA SOURCES: Secondary data for all US nursing homes between March 31, 2017, through December 31, 2019 were obtained from Payroll-Based Journal (PBJ), Nursing Home Compare, and Long-Term Care: Facts on Care in the US (LTC Focus). STUDY DESIGN: We estimated the association between nurse turnover and the probability of an infection control citation and the scope of the citation while controlling for nursing home fixed effects. Our turnover measure is the percent of the facility's nursing staff hours that were provided by new staff (less than 60 days of experience in the last 180 days) during the 2 weeks prior to the health inspection. We calculated turnover for all staff together and separately for registered nurses, licensed practical nurses (LPNs), and certified nursing assistants. DATA COLLECTION/EXTRACTION METHODS: We linked nursing homes standard inspection surveys to 650 million shifts from the PBJ data. We excluded any nursing home with incomplete or missing staffing data. Our final analytic sample included 12,550 nursing homes with 30,536 surveys. PRINCIPAL FINDINGS: Staff turnover was associated with an increased likelihood of an infection control citation (average marginal effect [AME] = 0.12 percentage points [pp]; 95% confidence interval [CI]: 0.05, 0.18). LPN (AME = 0.06 pp; 95% CI: 0.01, 0.11) turnover was conditionally associated with an infection control citation. Conditional on having at least an isolated citation for infection control, staff turnover was positively associated with receiving a citation coded as a "pattern" (AME = 0.21 pp; 95% CI: 0.10, 0.32). Conditional of having at least a pattern citation, staff turnover was positively associated with receiving a widespread citation (AME = 0.21 pp; 95% CI: 0.10, 0.32). CONCLUSIONS: Turnover was positively associated with the probability of an infection control citation. Staff turnover should be considered an important factor related to the spread of infections within nursing homes.


Subject(s)
Nursing Homes , Nursing Staff , Humans , Infection Control , Long-Term Care , Personnel Staffing and Scheduling , Personnel Turnover
20.
Psychosomatics ; 61(6): 662-671, 2020.
Article in English | MEDLINE | ID: covidwho-1386490

ABSTRACT

BACKGROUND: Patients with psychiatric illnesses are particularly vulnerable to highly contagious, droplet-spread organisms such as SARS-CoV-2. Patients with mental illnesses may not be able to consistently follow up behavioral prescriptions to avoid contagion, and they are frequently found in settings with close contact and inadequate infection control, such as group homes, homeless shelters, residential rehabilitation centers, and correctional facilities. Furthermore, inpatient psychiatry settings are generally designed as communal spaces, with heavy emphasis on group and milieu therapies. As such, inpatient psychiatry services are vulnerable to rampant spread of contagion. OBJECTIVE: With this in mind, the authors outline the decision process and ultimate design and implementation of a regional inpatient psychiatry unit for patients infected with asymptomatic SARS-CoV-2 and share key points for consideration in implementing future units elsewhere. CONCLUSION: A major takeaway point of the analysis is the particular expertise of trained experts in psychosomatic medicine for treating patients infected with SARS-CoV-2.


Subject(s)
Asymptomatic Infections , Coronavirus Infections/complications , Hospital Design and Construction/methods , Hospital Units , Hospitalization , Infection Control/methods , Mental Disorders/therapy , Personnel Staffing and Scheduling/organization & administration , Pneumonia, Viral/complications , Betacoronavirus , COVID-19 , Humans , Involuntary Commitment , Mental Disorders/complications , Pandemics , Personal Protective Equipment , Psychiatric Department, Hospital , Psychotherapy, Group/methods , Recreation , SARS-CoV-2 , Ventilation/methods , Visitors to Patients
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