Marijuana use disorder among adults with functional disabilities-A US population-based cross-sectional study.

BACKGROUND AND OBJECTIVES: Recent studies suggest a growing trend in marijuana use, compared to a stable prevalence of marijuana use disorder among US adults over the first 15 years of the 21st century. This study investigated the recent patterns of marijuana use disorder among people with disabilities (PWD). METHODS: We extracted a nationally representative sample (N = 209,058) from the 2015-2019 National Survey on Drug Use and Health data set and examined associations by functional disability status (any disability, disability by type, and number of disabling limitations) with marijuana use disorder using a series of independent multivariable logistic regression models. We also performed trend analyses during the study period. RESULTS: The prevalence of marijuana use disorder (from 1.7% to 2.3%) increased significantly among PWD between 2015 and 2019 (p-trend < .001). PWD were significantly more likely to report marijuana use disorder (odds ratio [OR], 1.37, 95% confidence interval [CI], 1.24-1.52) than people without disability (PWoD). Those with cognitive limitation only (OR, 1.78, 95% CI, 1.53-2.06) and ≥2 limitations (OR, 1.29, 95% CI, 1.10-1.51) were more likely to report marijuana use disorder than PWoD. DISCUSSION AND CONCLUSIONS: PWD had a consistently higher prevalence of marijuana use disorder than PWoD. Additionally, the level of risk for marijuana use disorder varied by disability type and number of disabling limitations. SCIENTIFIC SIGNIFICANCE: Our study provided new nuance on disparities in marijuana use disorder between PWD and PWoD and further revealed the varied risks for marijuana use disorder across different disability statuses.

All-Cause 30-Day Readmission and Mortality: How the Health of Community Affects Magnet® Performance.

OBJECTIVE: The aim of this study was to determine whether Magnet® and non-Magnet hospitals differ in the occurrence of 30-day readmission and mortality rates among the Medicare population when considering community health factors. BACKGROUND: Magnet hospitals have shown favorable outcomes regarding 30-day readmission and mortality; however, previous research has not evaluated whether the hospital community influences the likelihood of the patient being readmitted to a hospital or how Magnet facilities may mitigate potential mortality risks. METHOD: This study used a cross-sectional study design of 1791 hospitals using a propensity score matching technique to compare Magnet and non-Magnet hospitals with similar hospital and community characteristics. RESULTS: Results reveal no differences in readmission scores between Magnet and non-Magnet hospitals. When considering mortality scores, Magnet hospitals had better performance for pneumonia, congestive heart failure, and chronic obstructive pulmonary disease compared with non-Magnet hospitals. CONCLUSIONS: Our results suggest that there may be universal efforts to improve overall readmission rates taken by hospitals to minimize potential penalties and maximize patient outcomes.

The role of community-level characteristics in comparing United States hospital performance by magnet designation: A propensity score matched study.

AIMS: To assess the impact of community-level characteristics on the role of magnet designation in relation to hospital value-based purchasing quality scores, as health disparities associated with geographical location could confound hospitals' ability to meet outcome metrics. DESIGN: This cross-sectional study was carried out between October 2021 and March 2022 using data from 2016 to 2021. METHODS: Propensity score analysis was used to match hospital and community-level characteristics, implementing nearest neighbour matching to adjust for pre-treatment differences between magnet and non-magnet hospitals to account for multi-level differences. Secondary data were obtained from all operational acute-care facilities in the United States that participated in the Centers for Medicare and Medicaid Services' hospital value-based purchasing (HVBP) program. Dependent variables were the four value-based purchasing domains that comprise the Total Performance Score (TPS; Clinical Care, Person and Community Engagement, Safety, and Efficiency and Cost Reduction). RESULTS: Magnet hospitals had increased odds for better scores in the HVBP domains of Clinical Care and Person and Community Engagement, and decreased odds for having better Safety. However, no statistically significant difference was found for the Efficiency domain or the TPS. CONCLUSION: Measuring performance equitably across organizations of various sizes serving diverse communities remains a key factor in ensuring distributive justice. Analysing the TPS components can identify complex influences of community-level characteristics not evident at the composite level. More research is needed where community and nurse-level factors may indirectly affect patient safety. IMPACT: This study's findings on the role of community contexts can inform policymakers designing value-based care programs and healthcare management administrators deliberating on magnet certification investments across diverse community settings. NO PATIENT OR PUBLIC CONTRIBUTION: For this study of US hospitals' organizational performance, we did not engage members of the patient population nor the general public. However, the multi-disciplinary research team does include diverse perspectives.

Examining regulatory focus in the acceleration and deceleration of engagement and exhaustion cycles among nurses.

BACKGROUND: Given that emotional exhaustion and nurse engagement have significant implications for nurse well-being and organizational performance, determining how to increase nurse engagement while reducing nurse exhaustion is of value. PURPOSE: Resource loss and gain cycles, as theorized in conservation of resources theory, are examined using the experience of emotional exhaustion to evaluate loss cycles and work engagement to evaluate gain cycles. Furthermore, we integrate conservation of resources theory with regulatory focus theory to examine how the ways in which individuals approach work goals serves as a facilitator to the acceleration and deceleration of both of these cycles. METHODOLOGY/APPROACH: Using data from nurses working in a hospital in the Midwest United States at six time points spanning over 2 years, we demonstrate the accumulation effects of the cycles over time using latent change score modeling. RESULTS: We found that prevention focus was associated with the accelerated accumulation effects of emotional exhaustion and that promotion focus was associated with the accelerated accumulation effects of work engagement. Furthermore, prevention focus attenuated the acceleration of engagement, but promotion did not influence the acceleration of exhaustion. CONCLUSION: Our findings suggest that individual factors such as regulatory focus are key to helping nurses to better control their resource gain and loss cycles. PRACTICE IMPLICATIONS: We provide implications for nurse managers and health care administrators to help encourage promotion focus and suppress prevention focus in the workplace.

Hospital Geographic Location and Unexpected Complications in term Newborns in Florida.

INTRODUCTION: Birth trauma rates in term of neonates is a quality measure used by the Joint Commission. In the United States birth trauma rates occurs at a rate of 37 per 1000 live births and are on the decline. However, this decline has been significantly lower among term neonates born in rural facilities. There is a critical lack of evidence toward the influence geographical risk factors has on birth trauma rates for neonatal patients. We sought to measure rural community and hospital characteristics associated with birth trauma. METHODS: A retrospective longitudinal study design was used to examine inpatient medical discharge data across 103 hospitals of neonates at birth from 2013 to 2018. Discharge data was linked to the American Hospital Association annual survey. We used a multi-level mixed effect model to investigate the relationship between individual and hospital-level attributes associated with increased risk of birth trauma among neonatal patients. RESULTS: We found that rural hospitals were 3.99 times (p < 0.001) more likely to experience higher birth trauma than urban hospitals. Medium sized hospitals were 2.11 times (p < 0.001) more likely to experience higher birth trauma. Hospitals who indicate having a safety culture were more likely (p < 0.05) to have high rates of birth trauma. DISCUSSION: Neonates born at rural hospitals, were more likely to experience a birth-related injury. Policy strategies focusing on improving health care quality in rural areas are critical to mitigating this increased risk of birth trauma. Further research is required to assess how physician characteristics may impact birth trauma rates.

The influence of community health on hospitals attainment of Magnet designation: Implications for policy and practice.

AIMS: To determine if there is an association between better County Health Rankings and the increased odds of a hospital gaining Magnet designation in subsequent years (2014-2019) compared with counties with lower rankings. BACKGROUND: The Magnet hospital model is recognized to have a great effect on nurses, patients and organizational outcomes. Although Magnet hospital designation is a well-established structural marker for nursing excellence, the effect of County Health Rankings and subsequent hospital achievement of Magnet status is unknown. DESIGN: A descriptive, cross-sectional quantitative approach was adopted for this study. METHODS: Data were derived from 2010 to 2019 U.S. County Health Rankings, American Hospital Association, and American Nursing Credentialing Center databases. Logistic regression models were utilized to determine associations between county rankings for health behaviours, clinical care, social and economic factors, physical environment and counties with a new Magnet hospital after 2014. RESULTS: Counties with the worst rankings for clinical care and socio-economic status had reduced odds of obtaining a Magnet hospital designation compared with best-ranking counties. While middle-ranking counties for the physical environment ranking had increased odds of having Magnet designation compared with best-ranking counties. Additionally, having an increased percent of government non-federal hospital or a higher percentage of critical access hospitals in the county reduced the odds of having a Magnet-designated facility after 2014. CONCLUSION: The findings underscore the important associations between Magnet-designated facilities' location and the health of its surrounding counties. This study is the first to examine the relationship between County Health Rankings and a hospital's likelihood of obtaining Magnet status and points to the need for future research to explore outcomes of care previously identified as improved in Magnet-designated hospitals. IMPLICATIONS: Recognizing the benefits of Magnet facilities, it is important for health care leaders and policy makers to seek opportunities to promote centres of excellence in higher need communities through policy and financial intervention.

Cancer Risk Perceptions Among People Who Check Their Skin for Skin Cancer: Results from the 2017 U.S. Health Information National Trends Survey (HINTS).

When detected early, melanoma is highly treatable and rarely fatal. Self-skin checks can identify changes in moles that could be an indicator of melanoma. Cancer risk perceptions may influence the uptake of important preventive health behaviors such as self-skin checks. The purpose of this study is to examine cancer risk perception factors associated with those who have checked their skin for signs of skin cancer using the 2017 HINTS data. Retrospective cross-sectional analysis of a nationally representative sample of U.S. adults using the Health Information National Trends Survey (HINTS). Logistic regressions were performed to identify associations between having checked skin for signs of skin cancer, risk perceptions, and demographic variables. White women over the age of 45 with a college degree and annual incomes greater than $75,000 were more likely to check their skin for signs of skin cancer. More than a third reported they would rather not know if they had cancer and more than 60% had some level of worry about having cancer. Those with a personal or family history of cancer were more likely to check. HINTS is a cross-sectional survey which provides only a glimpse of behavioral predictors. Self-skin checks are simple and cost-effective to detect melanoma early and improve outcomes. Fear and worry about cancer were significant factors in the likelihood of checking skin for signs of skin cancer. Population-based strategies could be developed to reduce concerns about early detection.

Association of hospital and community factors on the attainment of Baby-Friendly designation: A breastfeeding health promotion.

The Baby-Friendly Hospital Initiative is a global health promotion intervention that outlines the Ten Steps hospitals should implement to support newborns' breastfeeding. This US-based study aimed to determine which hospital characteristics and community factors are associated with hospitals' attainment of Baby-Friendly designation. We used a cross-sectional design and used 2018 data from the Baby-Friendly, USA Inc. designation program merged with the American Hospital Association annual survey data set. Multilevel logistic regression analysis was used to assess hospital characteristics of interest among the sample consisting of 312 Baby-Friendly hospitals and 1449 non-Baby-Friendly. Our results show that Baby-Friendly hospitals are more likely to be government nonfederal hospitals, in the Midwest or South regions, serve communities with higher birth totals, and reside in competitive markets. Based on the results of this study, hospitals should seek further and examine their community's characteristics and structures to identify opportunities and encourage the attainment of improved breastfeeding initiatives such as Baby-Friendly designation.

Grandparents' Mental Health and Lived Experiences while Raising Their Grandchildren at the Forefront of COVID-19 in Saudi Arabia.

Understanding grandparents' lived experiences and healthy aging is essential to designing efficient, effective, and safe services to support a family structure in which grandparents care for their grandchildren. However, no study to date has explored this concept in an Arab and Muslim country during a pandemic. The purpose of this study was to examine grandparents' experiences raising their grandchildren to provide recommendations for needed mental health interventions during and after COVID-19. We used a phenomenological approach to gain a detailed and in-depth understanding of the lived experiences of 15 grandparents caring for their grandchildren. This study shows the need for support service interventions (support groups, health professional support, and respite care) for grandparents in Saudi Arabia, especially during global crises like COVID-19, that enhance social distance and social isolation. Raising grandchildren affects the physical, mental, and social wellbeing of the grandparents.

Magnet Hospitals and 30-Day Readmission and Mortality Rates for Medicare Beneficiaries.

BACKGROUND: US hospitals are penalized for excess 30-day readmissions and mortality for select conditions. Under the Centers for Medicare and Medicaid Services policy, readmission prevention is incentivized to a greater extent than mortality reduction. A strategy to potentially improve hospital performance on either measure is by improving nursing care, as nurses provide the largest amount of direct patient care. However, little is known as to whether achieving nursing excellence, such as Magnet status, is associated with improved hospital performance on readmissions and mortality. OBJECTIVE: The purpose of this study was to examine the relationship between hospitals' Magnet status and performance on readmission and mortality rates for Medicare beneficiaries. RESEARCH DESIGN: This is a cross-sectional analysis of Medicare readmissions and mortality reduction programs from 2013 to 2016. A propensity score-matching approach was used to take into account differences in baseline characteristics when comparing Magnet and non-Magnet hospitals. SUBJECTS: The sample was comprised of 3877 hospitals. MEASURES: The outcome measures were 30-day risk-standardized readmission and mortality rates. RESULTS: Following propensity score matching on hospital characteristics, we found that Magnet hospitals outperformed non-Magnet hospitals in reducing mortality; however, Magnet hospitals performed worse in reducing readmissions for acute myocardial infarction, coronary artery bypass grafting, and stroke. CONCLUSIONS: Magnet hospitals performed better on the Hospital Value-Based Purchasing Mortality Program than the Hospital Readmissions Reduction Program. The results of this study suggest the need for The Magnet Recognition Program to examine the role of nurses in postdischarge activities as a component of its evaluation criteria.

The work engagement of nurses in multiple hospital sectors in Saudi Arabia: a comparative study.

AIM: To examine the differences in work engagement among nurses in Saudi Arabia and its relationship with personal characteristics across different hospital affiliations. BACKGROUND: Quality care requires an adequate supply of engaged nurses who are dedicated, energised and absorbed in their work. In the nursing profession, work engagement is of considerable importance, owing to the shortage of nurses and the continuing reduction in healthcare costs. METHOD: An analytic comparative cross-sectional design was used. Eight hospitals from three provinces and different affiliation types participated in the study. The Utrecht work engagement scale (UWES) was used to measure 980 nurses' work engagement. RESULTS: The findings indicate that nurses' total engagement scores were closer to the higher end of the Likert scale. The findings indicate generally high levels of work engagement, particularly regarding the element of dedication. Furthermore, the study shows significant differences in nurses' engagement among the various work settings and in nurses' age and experience. CONCLUSIONS: A number of nurses' personal characteristics have independent influences on their work engagement. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse leaders should acknowledge that a statement of professional nursing scope of practice is a necessity to encourage and fulfil engagement.

Inpatient Palliative Care and Healthcare Utilization Among Older Patients With Alzheimer's Disease and Related Dementia (ADRD) and High Risk of Mortality in U.S. Hospitals.

Background. Despite the potential of palliative care (PC) to enhance the quality of life for patients with advanced dementia, there is limited knowledge of its inpatient utilization patterns. This study investigated inpatient PC consultation utilization patterns and evaluated its impact on hospital length of stay (LOS) and medical costs among older patients diagnosed with Alzheimer's Disease and Related Dementia who were at a high risk of mortality (ADRD-HRM). Methods. Using the 2016-2019 National Inpatient Sample database, we conducted multivariable logistic regression analyses to identify individual and hospital characteristics influencing PC consultation utilization. We subsequently performed generalized linear models to estimate LOS (using Poisson distribution) and hospital charges (via log-transformation). Results. Our sample encompassed 965,644 hospital discharges (weighted n = 4,828,219) of patients aged 65 years and above with ADRD-HRM. Among them, 14.6% received inpatient PC. There was a notable uptrend in PC consultation utilization from 13.3% in 2016 to 16.3% in 2019 (p trend<.001). Factors positively influencing and associated with PC utilization included patients that are older, non-Hispanic White, with higher income, receiving care from teaching hospitals, and facilitated with greater bed capacity (all P < .05). Although patients who received PC were more likely to have 3.0% longer LOS (P < .001), they had 19.2% lower hospital charges (P < .001). Conclusions. PC substantially reduced hospital expenditures for older patients with ADRD-HRM, but the prevalence remained low at 14.6% in the study period. Future studies should explore the unmet needs of patients with lower sociodemographic status and those in rural hospitals to further increase their PC consultation utilization.

Association of dual COVID-19 and seasonal influenza vaccination with COVID-19 infection and disease severity.

The clinical guideline states that COVID-19 vaccination can be administered concurrently with Influenza (flu) vaccination (dual vaccination). Using data from the 2021 National Health Interview Survey, we conducted descriptive analysis and multivariate logistic regressions to examine the association between dual vaccination status and self-reported COVID-19 infection and severity. Among 21,387 (weighted 185,251,310) U.S. adults, about 22% did not receive either the flu or COVID-19 vaccine, 6.0% received the flu vaccine only, 29.1% received the COVID-19 vaccine only, and 42.5% received both vaccines. In the multivariate analysis, individuals with dual vaccination (OR, 0.65, 95% CI, 0.56-0.75) and COVID-19 vaccine only (OR, 0.71, 95% CI, 0.61-0.82) were significantly less likely to report COVID-19 infection when compared with those unvaccinated. There was no significant difference in self-reported COVID-19 symptom severity by vaccination status. The results suggest that dual vaccination may be an effective strategy to reduce the contagious respiratory disease burden.

Hospital COVID-19 preparedness: Are (were) we ready?

BACKGROUND: Terrorist attacks and natural disasters such as Hurricanes Katrina and Harvey have increased focus on disaster preparedness planning. Despite the attention on planning, many studies have found that hospitals in the United States are underprepared to manage extended disasters appropriately and the surge in patient volume it might bring. AIM: This study aims to profile and examine the availability of hospital capacity specifically related to COVID-19 patients, such as emergency department (ED) beds, intensive care unit (ICU) beds, temporary space setup, and ventilators. METHOD: A cross-sectional retrospective study design was used to examine secondary data from the 2020 American Hospital Association (AHA) Annual Survey. A series of multivariate logistic analyses were conducted to investigate the strength of association between changes in ED beds, ICU beds, staffed beds, and temporary spaces setup, and the 3,655 hospitals' characteristics. RESULTS: Our results highlight that the odds of a change in ED beds are 44 percent lower for government hospitals and 54 percent for for-profit hospitals than not-for-profit hospitals. The odds of ED bed change for nonteaching hospitals were 34 percent lower compared to teaching hospitals. Small and medium hospitals have significantly lower odds (75 and 51 percent, respectively) than large hospitals. For ICU bed change, staffed bed change, and temporary spaces setup, the conclusions were consistently significant regarding the impact of hospital ownership, teaching status, and hospital size. However, temporary spaces setup differs by hospital location. The odds of change is significantly lower (OR = 0.71) in urban hospitals compared with rural hospitals, while for ED beds, the odds of change is considerably higher (OR = 1.57) in urban hospitals compared to rural hospitals. CONCLUSION: There is a need for policymakers to consider not only resource limitations that were created from supply line disruptions during the COVID-19 pandemic but also a more global assessment of the adequacy of funding and support for insurance coverage, hospital finance, and how hospitals meet the needs of the populations they serve.

Mental health initiatives: Providing stress management, wellness, and mindfulness workshops on college campuses.

Objective: College students experience stressors that can increase the risk for mental health concerns and negatively impact retention rates. It is crucial for practitioners working on college campuses to find creative ways to meet the needs of their students and cultivate a campus culture that is dedicated to bolstering mental health. The purpose of this study was to explore if implementing 1-h mental health workshops covering stress management, wellness, mindfulness, and SMART goals was feasible and advantageous for students. Participants: Researchers hosted 1-h workshops in 13 classrooms. Participants included 257 students who completed the pretest and 151 students who completed the post-test. Methods: A quasi-experimental 1-group pre- and post-test design was utilized. Results: Means and standard deviations were utilized to examine knowledge, attitudes, and intentions in each domain. Results indicated statistically significant improvements in each. Conclusion: Implications and interventions are provided for mental health practitioner working on college campuses.

Effects of post-discharge telemonitoring on 30-day chronic obstructive pulmonary disease readmissions and mortality.

INTRODUCTION: Much attention has been focused on decreasing chronic obstructive pulmonary disease (COPD) hospital readmissions. The US health system has struggled to meet this goal. The objective of this study was to assess the efficacy of telehealth services on the reduction of hospital readmission and mortality rates for COPD. METHODS: We used a cross-sectional design to examine the association between hospital risk-adjusted readmission and mortality rates for COPD and hospital use of post-discharge telemonitoring (TM). Data for 777 hospitals were sourced from the Centers for Medicare & Medicaid Services and the American Hospital Association annual surveys. Propensity score matching using the kennel weights method was applied to calculate the weighted probability of being a hospital that offers post-discharge TM services. RESULTS: Hospitals with post-discharge TM had about 34% significantly higher odds (adjusted odds ratio (AOR) = 1.34; 95% confidence interval (CI) 1.06-1.70) of 30-day COPD readmission and 33% significantly lower odds (AOR = 0.67; 95% CI 0.50-0.90) of 30-day COPD mortality compared to hospitals without post-discharge TM services. DISCUSSION: Overall, hospitals that offer post-discharge TM services have seen an improvement in 30-day COPD mortality rates. However, those same hospitals have also experienced a significant increase in 30-day COPD readmissions. TM can potentially decrease mortality in patients recently admitted for acute exacerbation of COPD. The results provide further evidence that readmissions present a problematic assessment of health-care quality, as the need for readmission may or may not be directly related to the quality of care received while in hospital.

Improving Health and Addressing Social Determinants of Health Through Hospital Partnerships.

Hospitals and health systems are forming partnerships to develop an integrated social network of services that better address the needs of their surrounding communities and their social determinants of health (SDOH). There is little research on the association of these partnered services with hospital outcomes. This study examined the association between hospital social need partnerships and activities to improve hospital and community outcomes. A secondary cross-sectional design to analyze 2021 census data of nonfederal short-term acute care hospitals in the United States was utilized. Data were obtained from the American Hospital Association. Four multilevel logistic regression models were used to analyze data from 1005 hospitals. The authors found that hospital partnership type differed in association to social need outcomes. They found that hospitals with a partnership with health insurance providers were more likely to have better health outcomes. Hospitals partnered with health insurance providers, local organizations addressing housing insecurity, local businesses, or chambers of commerce were more likely to have decreased health care costs. Hospitals partnered with health care providers, health insurance providers, local organizations providing legal assistance, or law enforcement/safety forces were more likely to have decreased utilization of hospital services. However, hospitals partnered with other local or state government or social service organizations were less likely to indicate decreased utilization of services. Many hospitals and health systems across the United States are screening for SDOH and are advancing health care delivery and improving the community's overall health and well-being by identifying unmet social needs and partnering with the community to address them.

Hospital-Acquired Conditions Reduction Program, Racial and Ethnic Diversity, and Magnet Designation in the United States.

OBJECTIVE: A key quality indicator in any health system is its ability to reduce morbidity and mortality. In recent years, healthcare organizations in the United States have been held to stricter measures of accountability to provide safe, quality care. This study aimed to explore the contextual factors driving racial disparities in hospital-acquired conditions incident rates among Medicare recipients in Magnet and non-Magnet hospitals. METHODS: A cross-sectional observational study was performed using data from Hospital-Acquired Condition Reduction Program. Performance from 1823 hospitals were used to examine the association between Magnet recognition and community's racial and ethnic differences in hospital performance on the Hospital-Acquired Condition Reduction Program. The unit of analysis was the hospital level. A propensity score matching approach was used to take into account differences in baseline characteristics when comparing Magnet and non-Magnet hospitals. The outcome measures were risk-standardized hospital performance on the Hospital-Acquired Condition Reduction Program domains and overall performance. RESULTS: Study findings show that Magnet hospitals had decreased methicillin-resistant Staphylococcus aureus (MRSA) rate (ß = -0.22; 95% confidence interval, -0.36 to -0.08) compared with non-Magnet hospitals. No other statistical difference was identified. CONCLUSIONS: Results from this study show community's racial and ethnic differences in hospital-acquired conditions occurrence differ between Magnet and non-Magnet hospitals for MRSA, indicating its association with nursing practice. However, because this improvement is limited to only MRSA, there are likely opportunities for Magnet hospitals to continue process improvements focused on additional Hospital-Acquired Condition Reduction Program measures.

Single-Vendor Electronic Health Record Use Is Associated With Greater Opportunities for Organizational and Clinical Care Improvements.

Objective: To compare how hospitals that use single-vendor vs best-of-breed electronic health record (EHR) vendors utilize clinical and organizational evaluation capabilities. Methods: Data from the 2018 (June 1, 2016, to December 31, 2017) American Hospital Association Information Technology Supplement Survey and Medicare Final Rule Standardizing File were used. Multinomial logistic regression analysis of hospitals (n=1902) was conducted to identify hospital characteristics associated with the use of EHRs for (1) clinical care evaluation capabilities and (2) organizational evaluation capabilities. Results: Single-vendor EHR hospitals were more likely (relative risk ratio, 3.37; 95% confidence interval, 1.97-5.76) to use EHRs for clinical care and organizational evaluation capabilities. Not-for-profit hospitals were more likely to use EHRs for all organizational evaluation capabilities than government nonfederal hospitals. For-profit hospitals were less likely to use EHRs for organizational or clinical evaluation capabilities than government nonfederal hospitals. Conclusion: Hospitals using the single-vendor EHR system were more likely to engage in clinical care and organizational evaluation than hospitals using best-of-breed EHR systems.

Striking a Balance between Work and Play: The Effects of Work-Life Interference and Burnout on Faculty Turnover Intentions and Career Satisfaction.

BACKGROUND: The interactions between work and personal life are important for ensuring well-being, especially during COVID-19 where the lines between work and home are blurred. Work-life interference/imbalance can result in work-related burnout, which has been shown to have negative effects on faculty members' physical and psychological health. Although our understanding of burnout has advanced considerably in recent years, little is known about the effects of burnout on nursing faculty turnover intentions and career satisfaction. OBJECTIVE: To test a hypothesized model examining the effects of work-life interference on nursing faculty burnout (emotional exhaustion and cynicism), turnover intentions and, ultimately, career satisfaction. DESIGN: A predictive cross-sectional design was used. SETTINGS: An online national survey of nursing faculty members was administered throughout Canada in summer 2021. PARTICIPANTS: Nursing faculty who held full-time or part-time positions in Canadian academic settings were invited via email to participate in the study. METHODS: Data were collected from an anonymous survey housed on Qualtrics. Descriptive statistics and reliability estimates were computed. The hypothesized model was tested using structural equation modeling. RESULTS: Data suggest that work-life interference significantly increases burnout which contributes to both higher turnover intentions and lower career satisfaction. Turnover intentions, in turn, decrease career satisfaction. CONCLUSIONS: The findings add to the growing body of literature linking burnout to turnover and dissatisfaction, highlighting key antecedents and/or drivers of burnout among nurse academics. These results provide suggestions for suitable areas for the development of interventions and policies within the organizational structure to reduce the risk of burnout during and post-COVID-19 and improve faculty retention.