Using staffing ratios for workforce planning: evidence on nine allied health professions.

BACKGROUND: Modern healthcare managers are faced with pressure to deliver effective, efficient services within the context of fixed budget constraints. Managers are required to make decisions regarding the skill mix of the workforce particularly when staffing new services. One measure used to identify numbers and mix of staff in healthcare settings is workforce ratio. The aim of this study was to identify workforce ratios in nine allied health professions and to identify whether these measures are useful for planning allied health workforce requirements. METHODS: A systematic literature search using relevant MeSH headings of business, medical and allied health databases and relevant grey literature for the period 2000-2008 was undertaken. RESULTS: Twelve articles were identified which described the use of workforce ratios in allied health services. Only one of these was a staffing ratio linked to clinical outcomes. The most comprehensive measures were identified in rehabilitation medicine. CONCLUSION: The evidence for use of staffing ratios for allied health practitioners is scarce and lags behind the fields of nursing and medicine.

How do allied health professionals evaluate new models of care? What are we measuring and why?

The aim of this study was to identify what outcome measures or quality indicators are being used to evaluate advanced and new roles in nine allied health professions and whether the measures are evaluating outcomes of interest to the patient, the clinician, or the healthcare provider. A systematic search strategy was used. Medical and allied health databases were searched and relevant articles extracted. Relevant studies with at least 1 outcome measure were evaluated. A total of 106 articles were identified that described advanced roles, however, only 23 of these described an outcome measure in sufficient detail to be included for review. The majority of the reported measures fit into the economic and process categories. The most reported outcome related to patients was satisfaction surveys. Measures of patient health outcomes were infrequently reported. It is unclear from the studies evaluated whether new models of allied healthcare can be shown to be as safe and effective as traditional care for a given procedure. Outcome measures chosen to evaluate these services often reflect organizational need and not patient outcomes. Organizations need to ensure that high-quality performance measures are chosen to evaluate the success of new health service innovations. There needs to be a move away from in-house type surveys that add little or no valid evidence as to the effect of a new innovation. More importance needs to be placed on patient outcomes as a measure of the quality of allied health interventions.

Prevalence and correlates of low back pain among occupational therapy students in Northern Queensland.

BACKGROUND: Although low back pain (LBP) is an important issue for the health profession, few studies have examined LBP among occupational therapy students. PURPOSE: To investigate the prevalence and distribution of LBP, its adverse sequelae; and to identify potential risk factors. METHODS: In 2005, a self-reported questionnaire was administered to occupational therapy students in Northern Queensland. FINDINGS: The 72-month period-prevalence of LBP was 64.6%. Nearly half (46.9%) had experienced pain for over 2 days, 38.8% suffered LBP that affected their daily lives, and 24.5% had sought medical treatment. The prevalence of LBP ranged from 45.5 to 77.1% (p = 0.004), while the prevalence of LBP symptoms persisting longer than two days was 34.1 to 62.5% (p = 0.020). Logistic regression analysis indicated that year of study and weekly computer usage were statistically-significant LBP risk factors. IMPLICATIONS: The occupational therapy profession will need to further investigate the high prevalence of student LBP identified in this study.

Nonfatal heroin overdoses in Queensland, Australia: an analysis of ambulance data.

In the past decade, the utilization of ambulance data to inform the prevalence of nonfatal heroin overdose has increased. These data can assist public health policymakers, law enforcement agencies, and health providers in planning and allocating resources. This study examined the 672 ambulance attendances at nonfatal heroin overdoses in Queensland, Australia, in 2000. Gender distribution showed a typical 70/30 male-to-female ratio. An equal number of persons with nonfatal heroin overdose were between 15 and 24 years of age and 25 and 34 years of age. Police were present in only 1 of 6 cases, and 28.1% of patients reported using drugs alone. Ambulance data are proving to be a valuable population-based resource for describing the incidence and characteristics of nonfatal heroin overdose episodes. Future studies could focus on the differences between nonfatal heroin overdose and fatal heroin overdose samples.

CPR training in households of patients with chest pain.

The objectives of this study are to (1). quantify prior cardiopulmonary resuscitation (CPR) training in households of patients presenting to the Emergency Department (ED) with or without chest pain or ischaemic heart disease (IHD); (2). evaluate the willingness of household members to undertake CPR training; and (3). identify potential barriers to the learning and provision of bystander CPR. A cross-sectional study was conducted by surveying patients presenting to the ED of a metropolitan teaching hospital over a 6-month period. Two in five households of patients presenting with chest pain or IHD had prior training in CPR. This was no higher than for households of patients presenting without chest pain or IHD. Just under two in three households of patients presenting with chest pain or IHD were willing to participate in future CPR classes. Potential barriers to learning CPR included lack of information on CPR classes, perceived lack of intellectual and/or physical capability to learn CPR and concern about causing anxiety in the person at risk of cardiac arrest. Potential barriers to CPR provision included an unknown cardiac arrest victim and fear of infection. The ED provides an opportunity for increasing family and community capacity for bystander intervention through referral to appropriate training.

Factors influencing Queenslanders' willingness to perform bystander cardiopulmonary resuscitation.

STUDY OBJECTIVE: The chances of surviving an out-of-hospital cardiac arrest (OHCA) are greatly increased if a bystander provides cardiopulmonary resuscitation (CPR) while awaiting the arrival of the emergency medical services. Over 50% of adult Queenslanders have been trained in CPR at some time in the past, however, little is known about the factors that affect their willingness to perform CPR. METHOD: A random survey of 4480 Queensland residents was conducted to address this question. RESULTS: The survey indicated that the most common barriers to performing CPR were a fear of disease, visible blood and perceived danger. In contrast, respondents indicated that they were more likely to administer CPR if the respondent knew the victim, the victim would die if CPR was not administered, and respondents believed that they possessed the necessary skills to perform CPR. A majority (84%) of respondents indicated that they were at least likely to administer CPR. A logistic regression analysis revealed that the respondents most likely to perform CPR were males, those who were married or in a de facto relationship, those in paid employment, smokers, those recently trained in CPR, prospective organ donors, those who cited no barriers to CPR and those who cited one or more factors that would facilitate CPR. CONCLUSIONS: This study indicates that there is considerable variation in Queenslanders' willingness to perform bystander CPR. Public health education campaigns aimed at correcting inaccurate perceptions of risk and addressing other barriers to bystander CPR would promote its use in response to OHCA.

Knowledge of the national emergency telephone number and prevalence and characteristics of those trained in CPR in Queensland: baseline information for targeted training interventions.

Members of the community contribute to survival from out-of-hospital cardiac arrest by contacting emergency medical services and performing cardiopulmonary resuscitation (CPR) prior to the arrival of an ambulance. In Australia there is a paucity of information of the extent that community members know the emergency telephone number and are trained in CPR. A survey of Queensland adults (n=4490) was conducted to ascertain current knowledge and training levels and to target CPR training. Although most respondents (88.3%) could state the Australian emergency telephone number correctly, significant age differences were apparent (P<0.001). One in five respondents aged 60 years and older could not state the emergency number correctly. While just over half the respondents (53.9%) had completed some form of CPR training, only 12.1% had recent training. Older people were more likely to have never had CPR training than young adults. Additional demographic and socio-economic differences were found between those never trained in CPR and those who were. The results emphasise the need to increase CPR training in those aged 40 and over, particularly females, and to increase the awareness of the emergency telephone number amongst older people.