Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 31.983
Filtrar
1.
J Nurs Adm ; 53(2): 88-95, 2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36692998

RESUMO

ABSTRACT: Innovation is needed to solve nursing workforce issues during times of crisis. A collaborative effort between a hospital system and several universities resulted in the Bridge to Professional Practice Program that was implemented during a period of high patient volume and nursing student downtime. The program provided support for staffing needs and clinical hours to promote readiness for practice for students. The program evaluation outcomes and recommendations for improvement are addressed.


Assuntos
Bacharelado em Enfermagem , Hospitais , Relações Interinstitucionais , Recursos Humanos de Enfermagem no Hospital , Humanos , Bacharelado em Enfermagem/organização & administração , Estudantes de Enfermagem , Mão de Obra em Saúde , Inovação Organizacional , Recursos Humanos de Enfermagem no Hospital/provisão & distribuição , Pesquisa em Avaliação de Enfermagem
5.
J Glob Health ; 13: 04005, 2023 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-36655879

RESUMO

Background: A growing global shortage of health workers is limiting access to health care, especially in resource-limited countries. Family participation in hospital care could enhance care while tackling health worker shortages. With the same resources, it might deliver additional and more personalised care. This review assessed the effect and safety of family participation interventions in the care of hospitalised adults in resource-limited settings and, ultimately, if it is a viable strategy to tackle health worker shortages. Methods: For this systematic review, Medline, Embase, CINAHL and the Global Health Library were searched from inception till April 7, 2022. Clinical studies were included if they described a family participation intervention for hospitalised adults, were performed in a low- or middle-income country and reported on a patient-related outcome. Data were collected on patient, family, staff and health service-related outcomes. Risk of bias was assessed with the ROB2 and ROBINS-I tool. Results: From 4444 studies, six were included for narrative synthesis, with a total of 1794 participants. Four studies were performed in Asia and two in Africa; all were published between 2017 and 2022. In-hospital family participation interventions aimed at medication administration and adherence, delirium prevention, and palliative cancer care were successful in significantly improving patient outcomes. Involving family in post-stroke rehabilitation interventions showed no significant effect on mortality and long-term disability. Few data were reported on participating family members' outcomes or hospital staffing issues. None of the included studies showed harm from family participation. Conclusions: The limited data suggest that family participation can be effective and safe in specific contexts. However, more research is needed to determine the effect of family participation and justify further implementation. Family participation research for enhancing care while tackling health worker shortages should be a collaborative priority of researchers, health care professionals, funding agencies and policymakers. Registration: PROSPERO registration No. CRD42020205878.


Assuntos
Atenção à Saúde , Família , Recursos Humanos em Hospital , Adulto , Humanos , Atenção à Saúde/organização & administração , Hospitais , Países em Desenvolvimento , Recursos Humanos em Hospital/provisão & distribuição
10.
JAMA Netw Open ; 5(12): e2245995, 2022 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-36525275

RESUMO

Importance: Physician headcounts provide useful information about the cancer care delivery workforce; however, efforts to track the oncology workforce would benefit from new measures that capture how essential a physician is for meeting the multidisciplinary cancer care needs of the region. Physicians are considered linchpins when fewer of their peers are connected to other physicians of the same specialty as the focal physician. Because they are locally unique for their specialty, these physicians' networks may be particularly vulnerable to their removal from the network (eg, through relocation or retirement). Objective: To examine a novel network-based physician linchpin score within nationwide cancer patient-sharing networks and explore variation in network vulnerability across hospital referral regions (HRRs). Design, Setting, and Participants: This cross-sectional study analyzed fee-for-service Medicare claims and included Medicare beneficiaries with an incident diagnosis of breast, colorectal, or lung cancer from 2016 to 2018 and their treating physicians. Data were analyzed from March 2022 to October 2022. Exposures: Physician characteristics assessed were specialty, rurality, and Census region. HRR variables assessed include sociodemographic and socioeconomic characteristics and use of cancer services. Main Outcomes and Measures: Oncologist linchpin score, which examined the extent to which a physician's peers were connected to other physicians of the same specialty as the focal physician. Network vulnerability, which distinguished HRRs with more linchpin oncologists than expected based on oncologist density. χ2 and Fisher exact tests were used to examine relationships between oncologist characteristics and linchpin score. Spearman rank correlation coefficient (ρ) was used to measure the strength and direction of relationships between HRR network vulnerability, oncologist density, population sociodemographic and socioeconomic characteristics, and cancer service use. Results: The study cohort comprised 308 714 patients with breast, colorectal, or lung cancer. The study cohort of 308 714 patients included 161 206 (52.2%) patients with breast cancer, 76 604 (24.8%) patients with colorectal cancer, and 70 904 (23.0%) patients with lung cancer. In our sample, 272 425 patients (88%) were White, and 238 603 patients (77%) lived in metropolitan areas. The cancer patient-sharing network included 7221 medical oncologists and 3573 radiation oncologists. HRRs with more vulnerable networks for medical oncology had a higher percentage of beneficiaries eligible for Medicaid (ρ, 0.19; 95% CI, 0.08 to 0.29). HRRs with more vulnerable networks for radiation oncology had a higher percentage of beneficiaries living in poverty (ρ, 0.17; 95% CI, 0.06 to 0.27), and a higher percentage of beneficiaries eligible for Medicaid (ρ, 0.21; 95% CI, 0.09 to 0.31), and lower rates of cohort patients receiving radiation therapy (ρ, -0.18; 95% CI, -0.28 to -0.06; P = .003). The was no association between network vulnerability for medical oncology and percent of cohort patients receiving chemotherapy (ρ, -0.03; 95% CI, -0.15 to 0.08). Conclusions and Relevance: This study found that patient-sharing network vulnerability was associated with poverty and lower rates of radiation therapy. Health policy strategies for addressing network vulnerability may improve access to interdisciplinary care and reduce treatment disparities.


Assuntos
Acesso aos Serviços de Saúde , Mão de Obra em Saúde , Oncologistas , Idoso , Humanos , Neoplasias Colorretais/terapia , Estudos Transversais , Neoplasias Pulmonares/terapia , Medicare , Estados Unidos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Oncologistas/provisão & distribuição , Feminino , Neoplasias da Mama/terapia , Mão de Obra em Saúde/estatística & dados numéricos
12.
JAMA ; 328(19): 1974-1977, 2022 11 15.
Artigo em Inglês | MEDLINE | ID: mdl-36378215

RESUMO

This study evaluates and compares US trends between 2010 and 2019 in per-capita primary care physician supply by county-level racial and ethnic minority concentration, poverty, rurality, and region.


Assuntos
Médicos de Atenção Primária , Serviços de Saúde Rural , Humanos , Médicos de Atenção Primária/provisão & distribuição , Características de Residência , Estados Unidos
18.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 57(11): 1156-1162, 2022 Nov 09.
Artigo em Chinês | MEDLINE | ID: mdl-36379895

RESUMO

Objective: To study the quantity, structure and allocation equity of stomatologists, in order to provide bases and advices for improving the allocation of stomatologists in China. Methods: On the basis of data from China Health Statistics Yearbooks and Brief Book of Administrative Divisions of the People's Republic of China, the general situation of stomatologists was analyzed by descriptive analysis. Gini coefficient was used to evaluate the allocation equity in 2010 and 2020. Results: The total number of stomatologists reached 2 780 hundred in 2020, which increased by 150.5% compared with that in 2010. The overall quality structure of stomatologists had improved. The gender proportion was balanced and the age distribution was reasonable. The team was mainly composed by the young people, in which the numbers under 44 years old accounted for 71.6% (1 991 hundred/2 780 hundred). The proportion of personnel with senior professional titles decreased to 7.9% (220 hundred/2 780 hundred) while the total number increased to 220 thousand. The distribution of stomatologists by population was fair. Gini coefficients of the whole country as well as the eastern, central and western regions were less than 0.3. Conclusions: The quantity, quality and allocation equity of stomatologists were still insufficient in China. It is necessary to optimize the human resources allocation for stomatologists. It is suggested to increase the talents supply through supply-side reform, medicine-education collaboration and multi-agent participation. And it is suggested to optimize criterions to improve the quality of stomatologists.


Assuntos
Alocação de Recursos , Adolescente , Adulto , Humanos , China , Medicina Bucal , Odontólogos/provisão & distribuição
19.
Addict Sci Clin Pract ; 17(1): 63, 2022 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-36401298

RESUMO

BACKGROUND: Despite the proven efficacy of medications for opioid use disorder (MOUD) and recent reduction in barriers to prescribers, numerous obstacles exist for patients seeking MOUD. Prior studies have used telephone surveys to investigate pharmacy-related barriers to MOUD. We applied this methodology to evaluate inpatient and outpatient pharmacy barriers to MOUD in South Florida. METHODS: Randomly selected pharmacies in South Florida (Miami-Dade, Broward, and Palm Beach Counties) were called using a standardized script with a "secret shopper" approach until 200 successful surveys had been completed. The primary outcome was the availability of any buprenorphine products. Second, a list of all 48 acute care hospitals within the aforementioned counties was compiled, and hospitals were contacted by telephone using a second structured script. RESULTS: A total of 1374 outpatient pharmacies and 48 inpatient pharmacies were identified. 378 randomly selected outpatient pharmacies were contacted to accrue 200 successful calls (53% success rate). All 48 inpatient pharmacies were contacted to successfully complete 25 inpatient surveys (52%). Of the 200 outpatient pharmacies contacted, 38% had any buprenorphine available. There was a significant difference in buprenorphine availability by county, with Miami-Dade having the least availability and Palm Beach having the most availability (27% vs. 47%, respectively; p = 0.04). Of the 38% with buprenorphine available, 82% had a sufficient supply for a two-week prescription of buprenorphine 8 mg twice daily. Of the pharmacies that did not have buprenorphine, 55% would be willing to order with a median estimated time to receive an order of 2 days (IQR 1.25-3 days). Of the 25 surveyed inpatient pharmacies, 88% reported having buprenorphine on inpatient formulary, and 55% of hospitals had at least one restriction on ordering of buprenorphine beyond federal regulations. CONCLUSIONS: The results of this study highlight significant pharmacy-related barriers to comprehensive OUD treatment across the healthcare system including both acute care hospital pharmacies and outpatient community pharmacies. Despite efforts to increase the number of MOUD providers, there still remain downstream obstacles to MOUD access.


Assuntos
Buprenorfina , Transtornos Relacionados ao Uso de Opioides , Farmácias , Humanos , Buprenorfina/provisão & distribuição , Florida , Pacientes Internados , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Pacientes Ambulatoriais
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...