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1.
AANA J ; 89(2): 133-140, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33832573

RESUMEN

Certified Registered Nurse Anesthetists (CRNAs) are uniquely skilled anesthesia providers with substantial experience managing critically ill patients. During the coronavirus disease 2019 (COVID) pandemic, CRNAs at a large academic medical center in the Mid-Atlantic United States experienced a shift in their daily responsibilities. As the hospital transitioned to the management of patients who tested positive for the virus that causes COVID, the severe acute respiratory syndrome-coronavirus type 2 (SARS-CoV-2), CRNAs were redeployed into the roles of respiratory therapists and intensive care unit registered nurses. Although facing the stress of the global pandemic, this facility's CRNAs proved to be flexible, capable, and necessary members of the care team for patients with COVID-19.


Asunto(s)
/enfermería , Enfermeras Anestesistas/psicología , Rol de la Enfermera/psicología , Admisión y Programación de Personal/estadística & datos numéricos , Rol Profesional , Carga de Trabajo/estadística & datos numéricos , Adulto , Femenino , Humanos , Masculino , Mid-Atlantic Region , Persona de Mediana Edad , Enfermeras Anestesistas/estadística & datos numéricos , Pandemias
2.
Br J Hosp Med (Lond) ; 82(3): 1-10, 2021 Mar 02.
Artículo en Inglés | MEDLINE | ID: mdl-33792379

RESUMEN

Ever-developing changes to the working hours of junior doctors by the European Working Time Directive, the junior doctor contract of 2019 and most recently the COVID-19 pandemic have impacted the professional identity of doctors. There has been little investigation into its influence on the multifaceted aspects of postgraduate medical training, which feeds into how trainees consider themselves professionally and the concept of professional identity or 'being a doctor'. A review of the medical, socio-political and educational literature reveals that the impact on the professional identity development of trainees is influenced by several perspectives from the trainee, trainer and the public. Gross reduction in working hours has no doubt decreased the raw volume of clinical experiences. However, to counteract this, smarter learning processes have evolved, including narrative reflection, supervised learning events, and a greater awareness of coaching and training among trainers.


Asunto(s)
Actitud del Personal de Salud , Competencia Clínica , Educación de Postgrado en Medicina , Cuerpo Médico de Hospitales/educación , Admisión y Programación de Personal , Identificación Social , Continuidad de la Atención al Paciente , Europa (Continente) , Humanos , Internado y Residencia , Medicina Estatal , Reino Unido
3.
Artículo en Inglés | MEDLINE | ID: mdl-33801122

RESUMEN

Work organization practices, including work flexibility, are changing and can affect worker well-being. Common work flexibility types include working at home, taking time off when needed, and changing one's work schedule. Given the changes in and the importance of work flexibility, the study assesses its prevalence and association with worker well-being in the United States. We used 2002-2018 General Social Survey-Quality of Worklife (GSS-QWL) data, descriptive statistics, and regression analyses to assess the reported likelihood of job stress, job satisfaction, healthy days, and days with activity limitations among workers reporting work flexibility. The prevalence of work flexibility remained relatively stable during the period examined. Working at home increased the likelihood of job stress by 22% and job satisfaction by 65%. Taking time off decreased the likelihood of job stress by 56% and days with activity limitations by 24%, and more than doubled the likelihood of job satisfaction. Changing one's schedule decreased the likelihood of job stress by 20% and increased the likelihood of job satisfaction by 62%. This study used all the available data from GSS-QWL and demonstrated the ongoing importance of work flexibility for well-being.


Asunto(s)
Satisfacción en el Trabajo , Estrés Laboral , Humanos , Estudios Longitudinales , Estrés Laboral/epidemiología , Admisión y Programación de Personal , Análisis de Regresión , Encuestas y Cuestionarios , Estados Unidos
4.
J Nurs Adm ; 51(5): 249-256, 2021 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-33882552

RESUMEN

OBJECTIVE: The aim of this study was to determine whether there are modifiable characteristics of nurses and hospitals associated with nurse specialty certification. BACKGROUND: Hospitals, nurses, and patients benefit from nurse specialty certification, but little actionable evidence guides administrators seeking higher hospital certification rates. METHODS: This is a cross-sectional, secondary data analysis of 20 454 nurses in 471 hospitals across 4 states. RESULTS: Rates of certified nurses varied significantly across hospitals. Higher odds of certification were associated with Magnet® recognition and better hospital work environments at the facility level, and with BSN education, unit type (most notably, oncology), older age, more years of experience, and full-time employment at the individual nurse level. CONCLUSION: Two strategies that hold promise for increasing nurse specialty certification are improving hospital work environments and preferentially hiring BSN nurses.


Asunto(s)
Certificación/estadística & datos numéricos , Habilitación Profesional/normas , Personal de Enfermería en Hospital/educación , Especialidades de Enfermería/normas , Adulto , Competencia Clínica/normas , Estudios Transversales , Femenino , Humanos , Liderazgo , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Admisión y Programación de Personal/organización & administración , Estados Unidos
5.
J Nurs Adm ; 51(4): 177-178, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33734174

RESUMEN

The COVID-19 pandemic exhausted the nursing workforce, casting doubt that future supply will meet demand. To preserve their workforces, nursing leaders are offering emotional support to the frontline. Although these efforts are essential, leaders are overlooking an untapped opportunity to safeguard staffing levels: creating a more flexible nursing workforce. In this article, the authors discuss flexible nurse staffing and suggest 4 key opportunities for improvement.


Asunto(s)
/enfermería , Personal de Enfermería/provisión & distribución , Admisión y Programación de Personal/organización & administración , Fuerza Laboral en Salud/organización & administración , Humanos
8.
Inquiry ; 58: 46958021997223, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33682512

RESUMEN

In order to explore the rational use of nursing resources in the epidemic situation of COVID-19, we optimized the shift arrangement in COVID-19 isolation area and constructed a reasonable nursing schedule under the condition of limited human resources. Seventy-eight nurses were arranged in COVID-19 isolation area to work for 1 week according to 3 different shifts: 4 + 4 h, 6 h and 6 h (overlapping by 1 h). Through the form of questionnaire, the comprehensive job satisfaction of 3 different models were compared, and the nursing quality and the consumption of protective equipment under 3 different modes were analyzed. The results showed that the comprehensive job satisfaction and nursing quality of nurses in 6 h (overlapping by 1 h) shift mode were better than those in other shift modes, and the consumption of protective equipment was lower.


Asunto(s)
/enfermería , Personal de Enfermería en Hospital/psicología , Admisión y Programación de Personal/estadística & datos numéricos , Tolerancia al Trabajo Programado/psicología , Adulto , Estudios Transversales , Femenino , Humanos , Satisfacción en el Trabajo , Masculino , Factores de Tiempo , Lugar de Trabajo/psicología
9.
J Occup Health ; 63(1): e12211, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33683773

RESUMEN

OBJECTIVES: To address ongoing problems concerning population aging and labor shortages in Japan, employers have sought to improve work efficiency and labor productivity. However, it is unclear how presenteeism is affected by working styles in line with current corporate initiatives, such as reduced working hours, varied employment status, and flexible work arrangements. The purpose of this article was to investigate the association between work style and presenteeism. METHODS: This cross-sectional study extracted data from employee profiles, employee attendance records, and a questionnaire in a large service sector company. Multiple linear regression was conducted to estimate the contributions of work style variables to the Work Limitations Questionnaire (WLQ) index score. RESULTS: In total, 21 500 participants were eligible for analysis. The WLQ index was lower for those working < 35 h/week (adjusted regression coefficient [ARC]:-0.35%; 95% CI: -0.48 to - 0.21) and higher for those working 40-44 h/week or ≥ 45 h/week, compared with those working 35-39 h/week. The position of team manager was positively associated with the WLQ index, whereas senior manager (ARC: -1.44%; 95% CI: -1.71 to - 1.17) and part-time staff (ARC: -1.75%; 95% CI: -1.98 to - 1.52) positions were negatively associated with the WLQ index, compared with non-managers. Those who worked remotely had significantly lower WLQ index scores (ARC: -0.61%; 95% CI: -0.95 to - 0.27). CONCLUSIONS: Reduced working hours and flexible work arrangements were associated with lower work limitations, which imply presenteeism, although additional research is necessary to verify these results.


Asunto(s)
Empleo , Admisión y Programación de Personal , Presentismo , Personal Administrativo , Adulto , Estudios Transversales , Femenino , Humanos , Japón , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Factores de Tiempo , Adulto Joven
12.
South Med J ; 114(4): 207-212, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33787932

RESUMEN

OBJECTIVES: This pilot study explores how healthcare leaders understand spiritual care and how that understanding informs staffing and resource decisions. METHODS: This study is based on interviews with 11 healthcare leaders, representing 18 hospitals in 9 systems, conducted between August 2019 and February 2020. RESULTS: Leaders see the value of chaplains in terms of their work supporting staff in tragic situations and during organizational change. They aim to continue to maintain chaplaincy efforts in the midst of challenging economic realities. CONCLUSIONS: Chaplains' interactions with staff alongside patient outcomes are a contributing factor in how resources decisions are made about spiritual care.


Asunto(s)
Actitud del Personal de Salud , Servicio de Capellanía en Hospital/organización & administración , Toma de Decisiones , Liderazgo , Cuidado Pastoral/organización & administración , Rol Profesional , Espiritualidad , Adulto , Anciano , Clero , Femenino , Humanos , Relaciones Interprofesionales , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Servicios de Salud del Trabajador/organización & administración , Selección de Personal/organización & administración , Admisión y Programación de Personal/organización & administración , Proyectos Piloto , Estados Unidos
14.
J Perioper Pract ; 31(3): 102-107, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33550921

RESUMEN

This literature review aims to provide an account of the changes to orthopaedics in the era of COVID-19. Herein, the authors explored the use of telemedicine in orthopaedics as well as changes in surgical protocols, screening methods, work priorities and orthopaedic education. There was increased utilisation of telemedicine in orthopaedic training and outpatient cases as a means to provide continuity in education and care. The need to implement social distancing measures, coupled with the reduced availability of staff, has dictated that the practice of orthopaedics shifts to focus on acute care whilst redistributing resources to front-line specialities. This was facilitated by the cancellation of electives and the reduction of outpatient clinics. Thus, it is demonstrated that major changes have been implemented in many aspects of orthopaedic practice in order to address the challenges of the COVID-19 pandemic.


Asunto(s)
/epidemiología , Procedimientos Ortopédicos/tendencias , Ortopedia/tendencias , Telemedicina/tendencias , Procedimientos Quirúrgicos Electivos/tendencias , Humanos , Pandemias/prevención & control , Admisión y Programación de Personal/tendencias
15.
J Am Board Fam Med ; 34(Suppl): S217-S221, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33622841

RESUMEN

The University of Colorado family medicine residency watched along with the rest of the nation as the first cases of COVID-19 were being reported in the United States in March 2020. Concern grew as epidemiological models began to predict alarming hospital bed shortages for the state. Massive scheduling adjustments were needed as faculty and residents found themselves in groups at high risk for severe COVID-19 and residents found themselves dismissed from nonessential learning experiences in an effort to conserve personal protective equipment and limit exposures. A dedicated surge team was formed to tackle these issues while continuing to support our goals of maximizing patient safety, resident education, and physician wellness. The surge team created a plan that was implemented in 2 main phases. Phase 1 assumed business as usual with increased layers of backup for both residents and faculty. Phase 2 redistributed unassigned residents and inpatient faculty to increase capacity for adult medicine and COVID-19 patients on our essential services. Lessons learned from these surge efforts may help inform similar decisions being made by other residency programs presently and in the future.


Asunto(s)
/terapia , Creación de Capacidad , Medicina Familiar y Comunitaria/educación , Internado y Residencia/organización & administración , /epidemiología , Colorado/epidemiología , Humanos , Comunicación Interdisciplinaria , Pandemias , Admisión y Programación de Personal/organización & administración
16.
JAMA Netw Open ; 4(2): e2036469, 2021 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-33538823

RESUMEN

Importance: Clinician burnout is a major risk to the health of the US. Nurses make up most of the health care workforce, and estimating nursing burnout and associated factors is vital for addressing the causes of burnout. Objective: To measure rates of nurse burnout and examine factors associated with leaving or considering leaving employment owing to burnout. Design, Setting, and Participants: This secondary analysis used cross-sectional survey data collected from April 30 to October 12, 2018, in the National Sample Survey of Registered Nurses in the US. All nurses who responded were included (N = 3 957 661). Data were analyzed from June 5 to October 1, 2020. Exposures: Age, sex, race and ethnicity categorized by self-reported survey question, household income, and geographic region. Data were stratified by workplace setting, hours worked, and dominant function (direct patient care, other function, no dominant function) at work. Main Outcomes and Measures: The primary outcomes were the likelihood of leaving employment in the last year owing to burnout or considering leaving employment owing to burnout. Results: The 3 957 661 responding nurses were predominantly female (90.4%) and White (80.7%); the mean (weighted SD) age was 48.7 (0.04) years. Among nurses who reported leaving their job in 2017 (n = 418 769), 31.5% reported burnout as a reason, with lower proportions of nurses reporting burnout in the West (16.6%) and higher proportions in the Southeast (30.0%). Compared with working less than 20 h/wk, nurses who worked more than 40 h/wk had a higher likelihood identifying burnout as a reason they left their job (odds ratio, 3.28; 95% CI, 1.61-6.67). Respondents who reported leaving or considering leaving their job owing to burnout reported a stressful work environment (68.6% and 59.5%, respectively) and inadequate staffing (63.0% and 60.9%, respectively). Conclusions and Relevance: These findings suggest that burnout is a significant problem among US nurses who leave their job or consider leaving their job. Health systems should focus on implementing known strategies to alleviate burnout, including adequate nurse staffing and limiting the number of hours worked per shift.


Asunto(s)
Agotamiento Profesional/epidemiología , Enfermeras y Enfermeros/estadística & datos numéricos , Admisión y Programación de Personal , Carga de Trabajo , Adulto , Femenino , Hospitales , Humanos , Masculino , Persona de Mediana Edad , Enfermeras y Enfermeros/psicología , Prevalencia , Factores de Riesgo , Estados Unidos/epidemiología
17.
Artículo en Inglés | MEDLINE | ID: mdl-33562866

RESUMEN

Although a necessity in a modern society, irregular work schedule can lead to sleep problems. We investigated the effect of work schedule irregularity on sleep disturbance of 17,846 Korean service workers using the fifth Korean Working Conditions Survey. The odds ratio (OR) and 95% confidence interval (CI) for sleep disturbance occurrence were calculated through a multiple logistic regression model. The adjusted ORs for moderate and severe sleep disturbances for those with irregular work hours were 2.11 (95% CI 1.90-2.33) and 3.10 (95% CI 2.62-3.66), respectively. Work schedule irregularity and emotion suppression at work showed synergistic effect on both moderate and severe sleep disturbances. Sleep disturbances can lead to brain function deterioration and work-related injuries; therefore, appropriate measures should be addressed for the vulnerable population.


Asunto(s)
Trastornos del Sueño-Vigilia , Emociones , Humanos , Admisión y Programación de Personal , República de Corea/epidemiología , Sueño , Trastornos del Sueño-Vigilia/epidemiología , Tolerancia al Trabajo Programado
18.
J Contin Educ Nurs ; 52(3): 109-111, 2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-33631018

RESUMEN

This article describes how a health care organization optimized staffing during the COVID-19 crisis by capitalizing on the expertise of nursing professional development practitioners to create a rapid deployment onboarding plan. The rapid onboarding training plan provided Riley Hospital for Children at Indiana University Health with a sense of stability in an uncertain time. Designing a plan that easily could be modified allowed the organization to be prepared during the pandemic and at a point where staffing needs must meet surge capacity. [J Contin Educ Nurs. 2021;52(3):109-111.].


Asunto(s)
/enfermería , Capacitación en Servicio , Personal de Enfermería en Hospital/organización & administración , Enfermería Pediátrica , Admisión y Programación de Personal , Algoritmos , Competencia Clínica , Hospitales Pediátricos , Humanos , Indiana/epidemiología , Personal de Enfermería en Hospital/educación , Pandemias , Enfermería Pediátrica/educación , Capacidad de Reacción
19.
Ann R Coll Surg Engl ; 103(2): 88-95, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33559552

RESUMEN

INTRODUCTION: COVID-19 remains a threat for a fear of a second pandemic. Emergency orthopaedic operations are still among the most commonly performed procedures with increased risk of transmission of SARS CoV-2 to the patients and the healthcare workers. The aim of this study was to present the evidence available into best practices limiting the spread of COVID-19 in healthcare setting during current and future pandemics. METHODS: A review of the literature was performed in multiple databases (PubMed, the Cochrane Library, Google Scholar, World Health Organization and Centers for Disease Control), using 'COVID-19' with other relevant keywords in different combinations. Owing to the limited and heterogenous evidence available, data were presented in a narrative manner. FINDINGS: From the evidence gathered it was noted that a multimodal approach to minimising pathogen transmission is required. This primarily comprises the wider engineering and administrative controls to reduce the concentration of the pathogen and to separate staff and patients from it. Theatre isolation and traffic control bundling, theatre flow and logistics, ventilation and waste management form a pivotal role in the environmental/engineering controls. Administrative measures include policies for both patients and staff. For patients, isolation and preoperative screening are of utmost value. For staff, testing for COVID-19, risk assessment, redeployment and provision of persona; protective equipment, together with the necessary training are important administrative controls. CONCLUSION: We believe these measures are likely to improve the sustainability of resources and can be carried to elective settings in order to return to some form of normality and help to mitigate the effects of future pandemics.


Asunto(s)
/prevención & control , Servicio de Limpieza en Hospital , Control de Infecciones/métodos , Quirófanos , Equipo de Protección Personal , Ventilación , Administración de Residuos , Flujo de Trabajo , Filtros de Aire , Humanos , Capacitación en Servicio , Admisión y Programación de Personal , Medición de Riesgo , Medicina Estatal , Reino Unido
20.
Ann R Coll Surg Engl ; 103(2): 110-113, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33559551

RESUMEN

INTRODUCTION: The weekend effect has been defined as a real or perceived decline in patient care provided on weekends and that provided on weekdays. The primary aim of this study was to investigate the association between day of surgery and length of stay for patients receiving elective lower limb joint arthroplasty in a large NHS teaching hospital. MATERIALS AND METHODS: Data were obtained from a prospectively collected database of consecutive patients undergoing elective primary total knee and hip arthroplasty. Patient and clinical variables were collected alongside length of hospital stay. Data were anonymised and analysed using a multiple linear regression model. RESULTS: A total of 3,544 knee and 3,277 hip replacements were included. No association was found between length of stay and day of surgery for either procedure. A significant association was noted between longer length of stay and increasing age, higher American Society of Anesthesiologists grade and male compared with female gender. DISCUSSION: No evidence of a weekend effect was identified. Certain patient factors predicted longer hospital stay and focussing additional resources on these patient groups may prove a useful strategy in reducing overall length of stay. CONCLUSIONS: Length of stay reduced across the time period included in this review while maintaining equality between the days of the week, which represents the successful management of weekend services.


Asunto(s)
Artroplastia de Reemplazo de Cadera/estadística & datos numéricos , Artroplastia de Reemplazo de Rodilla/estadística & datos numéricos , Procedimientos Quirúrgicos Electivos/estadística & datos numéricos , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Artroplastia de Reemplazo de Cadera/efectos adversos , Artroplastia de Reemplazo de Rodilla/efectos adversos , Procedimientos Quirúrgicos Electivos/efectos adversos , Femenino , Humanos , Tiempo de Internación/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Admisión y Programación de Personal , Estudios Prospectivos , Factores de Riesgo , Factores de Tiempo , Adulto Joven
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