The influence of pandemic-related workplace safety practices on frontline service employee wellbeing outcomes.

The COVID-19 pandemic has exposed the vulnerability of frontline employee (FLEs) to infections and other hazards and highlighted the importance of workplace safety practices (WSP) for service organizations. In response to the critical issue of service safety, we developed and empirically tested a model proposing that WSPs negatively influence FLE perceptions of pandemic related threats and positively influence their perceptions of organizational supportiveness (POS). In turn, these perceptions have time-lagged effects on two aspects of FLE wellbeing-reduced emotional exhaustion and increased work engagement. Utilizing data from a two-wave (separated by a month) survey panel consisting of 310 FLEs across the United States, we found evidence for all hypothesized relationships. We discuss the practical and theoretical implications of our findings and provide suggestions for future research on service safety on the organizational frontlines.

Building the case for quality improvement in the health care industry: a focus on goals and training.

Health care organizations are under intense pressure to improve the efficiency and effectiveness of care delivery and, increasingly, they are using quality improvement teams to identify and target projects to improve performance outcomes. This raises the question of what factors actually drive the performance of these projects in a health care environment. Using data from a survey of health care professionals acting as informants for 244 patient care, clinical-administrative, and nonclinical administrative quality improvement project types in 93 health care organizations, we focus on 2 factors--goal setting and quality training--as potential drivers of quality improvement project performance. We find that project-level goals and quality training have positive associations with process quality, while organizational-level goals have no impact. In addition, the relationship between project-level goals and process quality is stronger for patient care projects than for administrative projects. This indicates that the motivational and cognitive effects of goal setting are greater for projects that involve interactions with clinicians than for ones that involve interactions with other staff. Although project-level goal setting is beneficial for improving process quality overall, our findings suggest the importance of being especially attentive to goal setting for projects that impact direct patient care.

The effect of nutritional management on the mood of malnourished patients.

BACKGROUND & AIMS: Starvation and weight loss are common accompaniments of severe illness. The functional consequences of such malnutrition include not only physical changes but also psychological changes such as depression, anxiety, irritability, apathy, poor sleep pattern and loss of concentration. We carried out a pilot observational study in 22 undernourished patients at the time of referral to the nutritional team and after 8 days of nutritional support, using the Profile of Mood States Score (POMS) questionnaire to determine whether measurable and clinically significant changes in mood occurred with treatment. METHODS: Twenty-two undernourished patients with gastrointestinal disease were studied during the first week of treatment by the nutrition team. Psychological assessment was performed using a structured and standardised questionnaire assessing mood states (tension, depression, anger, vigour, fatigue, confusion). The questionnaire was administered to the patients by the same interviewer on days 1 (start of treatment by the nutrition team) and 8. RESULTS: Median (IQR) scores for tension, depression, anger, vigour, fatigue and confusion were 21.5 (11.5), 29.0 (15.8), 15.0 (11.8), 6.0 (7.5), 20.0 (8.5) and 12.0 (7.0) respectively on day 1. Corresponding scores on day 8 were 4.0 (8.8), 3.5 (6.0), 1.0 (1.8), 20.0 (7.5), 10.0 (8.8) and 2.5 (6.8). The improvement in scores seen on day 8 was statistically significant (p<0.01). CONCLUSION: Nutritional status and treatment have important effects on the psychology of patients and formal measurements of psychological function will form an important part of nutritional assessment and monitoring in the future.

Feeding patients after abdominal surgery.

Nutrition in hospital has been the focus of negative attention in recent years. Apart from the issues surrounding older people and nutrition (Odlund-Olin et al 1996), patients undergoing surgery might still be subject to inappropriate nutritional care and practice. Many are still fasted for long periods of time before surgery, and experience inappropriate regimes designed to wean them back onto normal eating and drinking patterns. This can lead to malnourishment and delayed healing. The author examines good practice in perioperative nutritional practice, designed to ensure that the patient recovers as quickly and as well as possible following abdominal surgery.

Prevention of infection: central venous catheters.

This article demonstrates how with set protocols, training and meticulous attention to detail, sepsis can be almost eradicated in central venous catheters.