Newly Acquired Burnout During the Coronavirus Disease 2019 (COVID-19) Pandemic: A Retrospective Cohort Study on the Experiences of New York State Primary Care Clinicians.

The well-being of primary care clinicians represents an area of increasing interest amid concerns that the COVID-19 pandemic may have exacerbated already high prevalence rates of clinician burnout. This retrospective cohort study was designed to identify demographic, clinical, and work-specific factors that may have contributed to newly acquired burnout after the onset of the COVID-19 pandemic. An anonymous web-based questionnaire distributed in August 2020 to New York State (NYS) primary care clinicians, via email outreach and newsletters, produced 1,499 NYS primary care clinician survey respondents. Burnout assessment was measured pre-pandemic and early in the pandemic using a validated single-item question with a 5-point scale ranging from (1) enjoy work to (5) completely burned out. Demographic and work factors were assessed via the self-reporting questionnaire. Thirty percent of 1,499 survey respondents reported newly acquired burnout during the early pandemic period. This was more often reported by clinicians who were women, were younger than 56 years old, had adult dependents, practiced in New York City, had dual roles (patient care and administration), and were employees. Lack of control in the workplace prior to the pandemic was predictive of burnout early in the pandemic, while work control changes experienced following the pandemic were associated with newly acquired burnout. Low response rate and potential recall bias represent limitations. These findings demonstrate that reporting of burnout increased among primary care clinicians during the pandemic, partially due to varied and numerous work environment and systemic factors.

A longitudinal cohort study of opioid prescriptions associated with nonsurgical dental visits among Oregon and New York state Medicaid beneficiaries, 2014-2016.

BACKGROUND: Studies estimate that approximately one-third of all opioid prescriptions (Rxs) from dentists are associated with nonsurgical dental procedures, which suggests unwarranted opioid use. METHODS: The authors conducted a retrospective longitudinal cohort study of adult Medicaid beneficiaries using administrative claims data from New York (NY) and Oregon (OR) (2014-2016) to examine opioid Rxs associated with nonsurgical dental visits. The primary outcomes were the number of all opioid Rxs from dentists compared with nondentists, number of opioid Rxs associated with surgical and nonsurgical dental visits, time to subsequent dental visits and visit type, and total dental morphine milligram equivalents (MMEs) received during the 90 days after an opioid-related, nonsurgical dental visit. RESULTS: Dentists prescribed 6.9% (NY) and 11.9% (OR) of all opioid Rxs during the 3-year study period. One-third of all opioid-related dental visits were nonsurgical and one-half of the subsequent dental visits were either nonsurgical or did not occur within 90 days. Mean time to a subsequent dental visit was 3 weeks. Beneficiaries with a surgical dental follow-up visit received significantly higher total MMEs (NY: 1.19 MMEs; OR: 1.21 MMEs; P < .001) for each additional day before the follow-up visit compared with nonsurgical dental follow-up visits. CONCLUSIONS: Medicaid beneficiaries might be exposed to unnecessary opioid Rxs in situations in which they may not be indicated or effective and without a plan for more definitive treatment. PRACTICAL IMPLICATIONS: Dentists need to avoid delays in scheduling definitive treatment and take appropriate steps to monitor prescribed opioid use to reduce the well-known risks associated with undue or prolonged opioid exposure.

Toward a methodology for substate projections of registered nurse supply and demand in New York.

Even as concerns about nursing shortages continue nationwide and for individual states in the United States, there is little information on the impact of nursing shortages at substate levels, such as counties or groups of small counties. National and state level assessments can mask wide geographic variation in the distribution of registered nurses (RNs). The Center for Health Workforce Studies at the School of Public Health, University at Albany, developed a practical approach to projecting RN supply and demand at substate levels. The experimental model used in this research was adapted from a methodology utilized for the RN National Supply Model and National Demand Model developed by the Health Resources and Services Administration in the department of Health and Human Services to make RN supply and demand projections at the broader national and state levels. The Center's research highlighted the value of substate analyses in the identification of RN supply and demand gaps and found that supply and demand gaps vary greatly by region and within regions. This study also provided an in-depth understanding of the dynamics that drive substate labor markets for RNs as well as the need for substate analyses to help policymakers better allocate scarce resources to address nursing shortages.

Privacy in the pharmacy environment: analysis of observations from inside the pharmacy.

OBJECTIVE: To measure the extent to which pharmacist-patient conversations are private. DESIGN: Cross sectional. SETTING: New York State, April to June 2007. PARTICIPANTS: No individual participants were enrolled; the study consisted of observations of the pharmacy environment and pharmacy patient-staff interactions. INTERVENTION: Measurement of privacy-related distances in the pharmacy. MAIN OUTCOME MEASURES: Distance between patients at the pharmacy counter and staff behind the counter, distance between patient waiting area and pharmacy counter, and distance that a pharmacy counter conversation was audible. RESULTS: Observational data were recorded from 597 pharmacy staff-patient interactions in 282 pharmacies across New York State. Of the 597 interactions, 167 occurred while a second patient was within 6 ft. Of the 282 pharmacies, pharmacy staff-patient conversations were audible to observers more than 6 ft away in 229 pharmacies; 142 could be heard more than 15 ft away. CONCLUSION: Most staff-patient conversations in the pharmacy setting are not private and, as a result, have a high potential for incidental protected health information disclosures.

Understanding the supply and distribution of registered nurses: where are the data and what can they tell us?

Health workforce researchers routinely conduct studies to determine whether a profession is currently in short supply and whether future shortages are likely. This is particularly important for registered nursing since the profession has experienced periodic shortages over the past three decades. Registered nurse (RN) forecast studies can be valuable in quantifying supply and demand gaps and identifying the most appropriate strategies to avert future shortages. In order to quantify RN supply/demand gaps, it is important to have accurate data on RNs, including the number of active RNs as well as their demographic, education, and practice characteristics, and work location(s). A lack of relevant and timely data on the nursing workforce is a significant barrier to identifying where nursing shortages exist, where they are most severe, and determining the factors that contribute to them. This lack of understanding impedes the development of effective health workforce programs and policies to mitigate shortages and the ability to evaluate these programs and policies for effectiveness. This study describes the national data sources available to nursing researchers to study the supply and distribution of the RN workforce and assesses the sources' strengths and limitations. This study also explores the potential for using state-level data for nursing workforce research.