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1.
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
2.
Worldviews Evid Based Nurs ; 18(4): 251-260, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1346021

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, providing care for critically ill patients has been challenging due to the limited number of skilled nurses, rapid transmission of the virus, and increased patient acuity in relation to the virus. These factors have led to the implementation of team nursing as a model of nursing care out of necessity for resource allocation. Nurses can use prior evidence to inform the model of nursing care and reimagine patient care responsibilities during a crisis. PURPOSE: To review the evidence for team nursing as a model of patient care and delegation and determine how it affects patient, nurse, and organizational outcomes. METHODS: We conducted an integrative review of team nursing and delegation using Whittemore and Knafl's (2005) methodology. RESULTS: We identified 22 team nursing articles, 21 delegation articles, and two papers about U.S. nursing laws and scopes of practice for delegation. Overall, team nursing had varied effects on patient, nursing, and organizational outcomes compared with other nursing care models. Education regarding delegation is critical for team nursing, and evidence indicates that it improves nurses' delegation knowledge, decision-making, and competency. LINKING EVIDENCE TO ACTION: Team nursing had both positive and negative outcomes for patients, nurses, and the organization. Delegation education improved team nursing care.


Subject(s)
COVID-19/nursing , Delegation, Professional/methods , Nursing, Team/standards , Personnel Staffing and Scheduling/standards , COVID-19/transmission , Delegation, Professional/standards , Health Workforce , Humans , Nursing, Team/methods
4.
Am J Health Syst Pharm ; 77(19): 1598-1605, 2020 09 18.
Article in English | MEDLINE | ID: covidwho-1317904

ABSTRACT

PURPOSE: To describe our medical center's pharmacy services preparedness process and offer guidance to assist other institutions in preparing for surges of critically ill patients such as those experienced during the coronavirus disease 2019 (COVID-19) pandemic. SUMMARY: The leadership of a department of pharmacy at an urban medical center in the US epicenter of the COVID-19 pandemic proactively created a pharmacy action plan in anticipation of a surge in admissions of critically ill patients with COVID-19. It was essential to create guidance documents outlining workflow, provide comprehensive staff education, and repurpose non-intensive care unit (ICU)-trained clinical pharmacotherapy specialists to work in ICUs. Teamwork was crucial to ensure staff safety, develop complete scheduling, maintain adequate drug inventory and sterile compounding, optimize the electronic health record and automated dispensing cabinets to help ensure appropriate prescribing and effective management of medication supplies, and streamline the pharmacy workflow to ensure that all patients received pharmacotherapeutic regimens in a timely fashion. CONCLUSION: Each hospital should view the COVID-19 crisis as an opportunity to internally review and enhance workflow processes, initiatives that can continue even after the resolution of the COVID-19 pandemic.


Subject(s)
COVID-19/drug therapy , Medication Therapy Management/organization & administration , Pharmacy Service, Hospital/organization & administration , Practice Guidelines as Topic , Academic Medical Centers/organization & administration , Academic Medical Centers/standards , COVID-19/epidemiology , Hospitals, Urban/organization & administration , Hospitals, Urban/standards , Humans , Leadership , New York/epidemiology , Pandemics/prevention & control , Personnel Staffing and Scheduling/organization & administration , Personnel Staffing and Scheduling/standards , Pharmacists/organization & administration , Pharmacy Service, Hospital/standards , Tertiary Care Centers/organization & administration , Tertiary Care Centers/standards , Workflow , Workforce/organization & administration , Workforce/standards
5.
J Aging Health ; 33(7-8): 607-617, 2021.
Article in English | MEDLINE | ID: covidwho-1166845

ABSTRACT

The COVID-19 pandemic has exerted a disproportionate effect on older European populations living in nursing homes. This article discusses the 'fatal underfunding hypothesis', and reports an exploratory empirical analysis of the regional variation in nursing home fatalities during the first wave of the COVID-19 pandemic in Spain, one of the European countries with the highest number of nursing home fatalities. We draw on descriptive and multivariate regression analysis to examine the association between fatalities and measures of nursing home organisation, capacity and coordination plans alongside other characteristics. We document a correlation between regional nursing home fatalities (as a share of excess deaths) and a number of proxies for underfunding including nursing home size, occupancy rate and lower staff to a resident ratio (proxying understaffing). Our preliminary estimates reveal a 0.44 percentual point reduction in the share of nursing home fatalities for each additional staff per place in a nursing home consistent with a fatal underfunding hypothesis.


Subject(s)
COVID-19/mortality , Capacity Building , Capital Financing , Nursing Homes , Aged , Female , Health Services Needs and Demand , Humans , Long-Term Care/economics , Male , Mortality , Nursing Homes/organization & administration , Nursing Homes/standards , Nursing Homes/statistics & numerical data , Personnel Staffing and Scheduling/standards , SARS-CoV-2 , Spain/epidemiology
6.
Best Pract Res Clin Anaesthesiol ; 35(3): 425-435, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1023482

ABSTRACT

The novel SARS-CoV-2 pandemic starting in 2019 profoundly changed the world, and thousands of residents of New York City were affected, leading to one of the most acute surges in regional hospital capacity. As the largest academic medical center in the Bronx, Montefiore Medical Center was immediately impacted, and the entire hospital was mobilized to address the needs of its community. In this article, we describe our experiences as a large academic anesthesiology department during this pandemic. Our goals were to maximize our staff's expertise, maintain our commitment to wellness and safety, and preserve the quality of patient care. Lessons learned include the importance of critical care training presence and leadership, the challenges of converting an ambulatory surgery center to an intensive care unit (ICU), and the management of effective communication. Lastly, we provide suggestions for institutions facing an acute surge, or subsequent waves of COVID-19, based on a single center's experiences.


Subject(s)
Academic Medical Centers/trends , Anesthesiology/trends , COVID-19/epidemiology , Critical Care/trends , Hospital Restructuring/trends , Personnel Staffing and Scheduling/trends , Academic Medical Centers/standards , Anesthesiology/standards , COVID-19/therapy , Critical Care/standards , Health Personnel/standards , Health Personnel/trends , Hospital Restructuring/standards , Humans , New York City , Pandemics , Personnel Staffing and Scheduling/standards
12.
Infect Control Hosp Epidemiol ; 41(12): 1443-1445, 2020 12.
Article in English | MEDLINE | ID: covidwho-656539

ABSTRACT

Reducing severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infections among healthcare workers is critical. We ran Monte Carlo simulations modeling the spread of SARS-CoV-2 in non-COVID-19 wards, and we found that longer nursing shifts and scheduling designs in which teams of nurses and doctors co-rotate no more frequently than every 3 days can lead to fewer infections.


Subject(s)
COVID-19 , Health Workforce/organization & administration , Infection Control/methods , Medical Staff, Hospital , Personnel Staffing and Scheduling , Safety Management/standards , COVID-19/epidemiology , COVID-19/prevention & control , Connecticut/epidemiology , Humans , Medical Staff, Hospital/organization & administration , Medical Staff, Hospital/statistics & numerical data , Occupational Exposure/prevention & control , Organizational Innovation , Personnel Staffing and Scheduling/organization & administration , Personnel Staffing and Scheduling/standards , Personnel Staffing and Scheduling/trends , SARS-CoV-2 , Safety Management/organization & administration
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