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Nurse staffing ratios

Herlinde Wynendaele, Ruben Willems, Jeroen Trybou
AIMS: To evaluate and summarise current evidence on the relationship between the patient-nurse ratio staffing method and nurse employee outcomes. BACKGROUND: Evidence-based decision-making linking nurse staffing with staff-related outcomes is a much needed research area. Although multiple studies have investigated this phenomenon, the evidence is mixed and fragmented. EVALUATION: A systematic literature search was conducted using Pubmed, Embase, Web of Science, Cinahl, Cochrane Library and the ERIC databases...
February 23, 2019: Journal of Nursing Management
Yuejen Zhao, Deborah Jane Russell, Steven Guthridge, Mark Ramjan, Michael P Jones, John S Humphreys, John Wakerman
OBJECTIVES: To compare the costs and effects of higher turnover of resident nurses and Aboriginal health practitioners and higher use of agency-employed nurses in remote primary care (PC) services and quantify associations between staffing patterns and health outcomes in remote PC clinics in the Northern Territory (NT) of Australia. DESIGN: Observational cohort study, using hospital admission, financial and payroll data for the period 2013-2015. SETTING: 53 NT Government run PC clinics in remote communities...
February 20, 2019: BMJ Open
Johannes Gräske, Annika Schmidt, Karin Wolf-Ostermann
BACKGROUND: Shared-housing arrangements (SHAs) in Germany are an alternative care arrangement for people with dementia. They are disconnected from traditional nursing homes and are often situated in ordinary apartment buildings. Community health care providers serve persons with dementia in SHAs, and there is no official regulation regarding the staff-resident ratio. The association between the staff-resident ratio and the quality of life (QoL) of persons with dementia has not yet been investigated in SHAs...
February 20, 2019: Israel Journal of Health Policy Research
Stephen M Pastores, Vladimir Kvetan, Craig M Coopersmith, J Christopher Farmer, Curtis Sessler, John W Christman, Rhonda D'Agostino, Jose Diaz-Gomez, Sara R Gregg, Roozehra A Khan, April N Kapu, Henry Masur, Gargi Mehta, Jason Moore, John M Oropello, Kristen Price
OBJECTIVES: To assess-by literature review and expert consensus-workforce, workload, and burnout considerations among intensivists and advanced practice providers. DESIGN: Data were synthesized from monthly expert consensus and literature review. SETTING: Workforce and Workload section workgroup of the Academic Leaders in Critical Care Medicine Task Force. MEASUREMENTS AND MAIN RESULTS: Multidisciplinary care teams led by intensivists are an essential component of critical care delivery...
January 24, 2019: Critical Care Medicine
Craig DeWolfe, Sarah Birch, Anne Callen Washofsky, Catherine Gardner, Robert McCarter, Neha H Shah
OBJECTIVES: Hospitals are employing more nurse practitioners and physician assistants on inpatient pediatric units. With this study, we compared patient outcomes in high-volume inpatient diagnoses on pediatric hospital medicine services staffed by attending physician hospitalists and residents (hospitalist and resident service [HRS]) with 1 staffed by attending physician hospitalists and advanced practice providers (HAPPS). METHODS: A historical cohort study was implemented by using administrative data for patients admitted to HRS and HAPPS from 2007 to 2011 with asthma, bronchiolitis, cellulitis, and pneumonia with severity levels 1 and 2 for all-patient refined diagnosis-related groups...
February 2019: Hospital Pediatrics
Daniel J Snyder, Thomas R Kroshus, Aakash Keswani, Evan B Garden, Karl M Koenig, Kevin J Bozic, David S Jevsevar, Jashvant Poeran, Calin S Moucha
BACKGROUND: Nursing Home Compare (NHC) ratings, created and maintained by Medicare, are used by both hospitals and consumers to aid in the skilled nursing facility (SNF) selection process. To date, no studies have linked NHC ratings to actual episode-based outcomes. The purpose of this study was to evaluate whether NHC ratings are valid predictors of 90-day complications, readmission, and bundle costs for patients discharged to an SNF after primary total joint arthroplasty (TJA). METHODS: All SNF-discharged primary TJA cases in 2017 at a multihospital academic health system were queried...
December 8, 2018: Journal of Arthroplasty
Robert James Lucero, David S Lindberg, Elizabeth A Fehlberg, Ragnhildur I Bjarnadottir, Yin Li, Jeannie P Cimiotti, Marsha Crane, Mattia Prosperi
BACKGROUND AND PURPOSE: Electronic health record (EHR) data provides opportunities for new approaches to identify risk factors associated with iatrogenic conditions, such as hospital-acquired falls. There is a critical need to validate and translate prediction models that support fall prevention clinical decision-making in hospitals. The purpose of this study was to explore a combined data-driven and practice-based approach to identify risk factors associated with falls. PROCEDURES: We conducted an observational case-control study of EHR data from January 1, 2013 to October 31, 2013 from 14 medical-surgical units of a tertiary referral teaching hospital...
February 2019: International Journal of Medical Informatics
Amanda Hoerst, Adnan Bakar, Steven C Cassidy, Martha Clabby, Erica Del Grippo, Margaret Graupe, Ashraf S Harahsheh, Anthony M Hlavacek, Stephen A Hart, Alaina K Kipps, Nicolas L Madsen, Dora D O'Neil, Sonali S Patel, Courtney M Strohacker, Ronn E Tanel
BACKGROUND: The Pediatric Acute Care Cardiology Collaborative (PAC3 ) was established in 2014 to improve the quality, value, and experience of hospital-based cardiac acute care outside of the intensive care unit. An initial PAC3 project was a comprehensive survey to understand unit structure, practices, and resource utilization across the collaborative. This report aims to describe the previously unknown degree of practice variation across member institutions. METHODS: A 126-stem question survey was developed with a total of 412 possible response fields across nine domains including demographics, staffing, available resources and therapies, and standard care practices...
January 3, 2019: Congenital Heart Disease
Nazar Mohamed, Ahmed Al-Qasmi, Said Al-Lamki, Mohamed Bayoumi, Ali Al-Hinai
Background: Oman is a high-income country having a relatively small population scattered over large sparsely populated areas. This presents challenges to the provision of health services. It is important to ensure that all health facilities at all levels of care have the right number and skills mix of health workers to deliver quality health care. Aims: The main aim was to develop national staffing norms to ensure adequate numbers, appropriate skills mix and equitable distribution of health professionals in primary health care (PHC) using the workload indicators of staffing needs (WISN) method...
December 9, 2018: Eastern Mediterranean Health Journal
Bora Plaku-Alakbarova, Laura Punnett, Rebecca J Gore
Background: Nursing home resident care is an ongoing topic of public discussion, and there is great interest in improving the quality of resident care. This study investigated the association between nursing home employees' job satisfaction and residents' satisfaction with care and medical outcomes. Methods: Employee and resident satisfaction were measured by questionnaire in 175 skilled nursing facilities in the eastern United States from 2005 to 2009. Facility-level data on residents' pressure ulcers, medically unexplained weight loss, and falls were obtained from the Centers for Medicare and Medicaid Services Long-Term Care Minimum Data Set...
December 2018: Safety and Health At Work
Miia M Jansson, Hannu P Syrjälä, Tero I Ala-Kokko
BACKGROUND: Nurse understaffing and increased nursing workload have been associated with increased risk of adverse patient outcomes and even mortality. AIM: To determine whether nurse staffing and nursing workload are associated with ventilator-associated pneumonia and mortality. METHODS: This prospective, observational cohort study was conducted in a single tertiary-level teaching hospital in Finland during 2014-2015. The association between nurse staffing, nursing workload and prognosis was determined using daily nurse-to-patient ratios, Therapeutic Intervention Scoring System and Intensive Care Nursing Scoring System scores, and Intensive Care Nursing Scoring System indices...
March 2019: Journal of Hospital Infection
Sylvia H Hsu, Peiyin Hung, Shi-Yi Wang
BACKGROUND: To enhance the quality of hospice care and to facilitate consumers' choices, the Centers for Medicare and Medicaid Services (CMS) began the Hospice Quality Reporting Program, in which CMS posted the quality measures of participating hospices on its reporting website, Hospice Compare. Little is known about the participation rate and the types of nonparticipating hospices. OBJECTIVE: To examine the factors associated with hospices' nonparticipation in Hospice Compare...
November 26, 2018: Medical Care
Qinyu Chen, Griffin Olsen, Fabio Bagante, Katiuscha Merath, Jay J Idrees, Ozgur Akgul, Jordan Cloyd, Mary Dillhoff, Susan White, Timothy M Pawlik
BACKGROUND: The effect of various hospital characteristics on failure to rescue (FTR) after liver surgery has not been well examined. We sought to examine the relationship between hospital characteristics and FTR after liver surgery. METHODS: The 2013-2015 Medicare-Provider Analysis and Review (MEDPAR) database was used to identify Medicare beneficiaries who underwent liver surgery. The effect of various hospital characteristics on FTR was compared among the highest mortality hospitals (HMH) and the lowest mortality hospitals (LMH)...
November 21, 2018: World Journal of Surgery
Joanna Wang, Christina Kortsalioudaki, Paul T Heath, Jim Buttery, Paul Clarke, Despoina Gkentzi, Mark Anthony, Kenneth Tan
OBJECTIVE: To investigate the epidemiology and healthcare factors associated with late-onset neonatal enterococcal infections. DESIGN: Multicentre, multinational retrospective cohort study using prospectively collected infection data from a neonatal infection surveillance network between 2004 and 2016; this was supplemented with healthcare data from a questionnaire distributed to participating neonatal units. SETTING: Sixty neonatal units across Europe (UK, Greece, Estonia) and Australia...
November 13, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
Heather L Tubbs-Cooley, Constance A Mara, Adam C Carle, Barbara A Mark, Rita H Pickler
Importance: Quality improvement initiatives demonstrate the contribution of reliable nursing care to gains in clinical and safety outcomes in neonatal intensive care units (NICUs); when core care is missed, outcomes can worsen. Objective: To evaluate the association of NICU nurse workload with missed nursing care. Design, Setting, and Participants: A prospective design was used to evaluate associations between shift-level workload of individual nurses and missed care for assigned infants from March 1, 2013, through January 31, 2014, at a 52-bed level IV NICU in a Midwestern academic medical center...
November 12, 2018: JAMA Pediatrics
Yunmi Kim, Jiyun Kim, Soon Ae Shin
BACKGROUND: Nurses play crucial roles in cardiopulmonary resuscitation after perioperative cardiac arrest (PCA), and the level of nurse staffing is thought to influence the survival rate for cardiac arrest. However, no previous study has investigated the survival rate after PCA in Korea. In addition, nurse staffing levels in Korea are relatively low and their legal standard is not widely followed. OBJECTIVES: This study investigated the relationships between nurse staffing level and survival after PCA in Korean hospitals using inpatient National Health Insurance (NHI) claim data...
January 2019: International Journal of Nursing Studies
Jae-Hyun Kim
After the implementation of a policy differentiating inpatient nursing fees, no study is found in the nursing literature for intensive care unit (ICU) patients admitted with cardiovascular (CV) disease exclusively in Korea. This study investigates the relationship between ICU nurse staffing and 30-day mortality using large representative claim database.National Health Insurance Service-Senior (NHIS-Senior) claim database from 2002 to 2013, which was released by the Korean National Health Insurance Service (KNHIS), was used in this study...
October 2018: Medicine (Baltimore)
Helena Temkin-Greener, Tiffany Lee, Thomas Caprio, Shubing Cai
OBJECTIVE: Ultrahigh therapy use has increased in SNFs without concomitant increases in residents' characteristics. It has been suggested that this trend may also have influenced the provision of high-intensity rehabilitation therapies to residents who are at the end of life (EOL). Motivated by lack of evidence, we examined therapy use and intensity among long-stay EOL residents. DESIGN: An observational study covering a time period 2012-2016. SETTING AND PARTICIPANTS: New York State nursing homes (N = 647) and their long-stay decedent residents (N = 55,691)...
September 24, 2018: Journal of the American Medical Directors Association
Anica C Law, Jennifer P Stevens, Samuel Hohmann, Allan J Walkey
OBJECTIVES: To assess whether Massachusetts legislation directed at ICU nurse staffing was associated with improvements in patient outcomes. DESIGN: Retrospective cohort study; difference-in-difference design to compare outcomes in Massachusetts with outcomes of other states (before and after the March 31, 2016, compliance deadline). SETTING: Administrative claims data collected from medical centers across the United States (Vizient). PATIENTS: Adults between 18 and 99 years old who were admitted to ICUs for greater than or equal to 1 day...
October 2018: Critical Care Medicine
Michael Rie
No abstract text is available yet for this article.
October 2018: Critical Care Medicine
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