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Cortie CH, Garne D, Parker-Newlyn L, Ivers RG, Mullan J, Mansfield KJ, Bonney A. The Australian health workforce: Disproportionate shortfalls in small rural towns. Aust J Rural Health 2024. [PMID: 38597124 DOI: 10.1111/ajr.13121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 03/21/2024] [Accepted: 03/27/2024] [Indexed: 04/11/2024] Open
Abstract
INTRODUCTION The distribution of health care workers differs greatly across Australia, which is likely to impact health delivery. OBJECTIVE To examine demographic and workplace setting factors of doctors, nurses and midwives, and allied health professionals across Modified Monash Model (MMM) regions and identify factors associated with shortfalls in the health care workforce. DESIGN Descriptive cross-sectional analysis. The study included all health professionals who were registered with the Australian Health Practitioner Regulation Agency in 2021, and who were working in Australia in their registered profession. The study examined number of registrations and full-timed equivalent (FTE) registrations per MMM region classification, adjusted for population. Associated variables included age, gender, origin of qualification, Indigenous status and participation in the private or public (including government, non-government organisation and not-for-profit organisations) sectors. FINDINGS Data were available for 31 221 general practitioners, 77 277 other doctors, 366 696 nurses and midwives, and 195 218 allied health professionals. The lowest FTE per 1000 people was seen in MM5 regions for general practitioners, other doctors, nurses and midwives, and allied health professionals. Demographic factors were mostly consistent across MM regions, although MM5 regions had a higher percentage of nurses and midwives and allied health professionals aged 55 and over. In the private sector, FTE per 1000 people was lowest in MM5-7 regions. In the public sector, FTE per 1000 people was lowest in MM5 regions. DISCUSSION A disproportionate shortfall of health workers was seen in MM5 regions. This shortfall appears to be primarily due to low FTE per capita of private sector workers compared with MM1-4 regions and a low FTE per capita of public sector workers compared with MM6-7 regions. CONCLUSION In Australia, small rural towns have the lowest number of health care workers per capita which is likely to lead to poor health outcomes for those regions.
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Affiliation(s)
- Colin H Cortie
- Graduate School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - David Garne
- Graduate School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - Lyndal Parker-Newlyn
- Graduate School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - Rowena G Ivers
- Graduate School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - Judy Mullan
- Graduate School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - Kylie J Mansfield
- Graduate School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - Andrew Bonney
- Graduate School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
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Robinson T, Govan L, Bradley C, Rossiter R. Transforming health care delivery: The role of primary health care nurses in rural and remote Australia. Aust J Rural Health 2024. [PMID: 38572893 DOI: 10.1111/ajr.13120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 02/29/2024] [Accepted: 03/21/2024] [Indexed: 04/05/2024] Open
Abstract
AIM This paper describes the policy context and approaches taken to improve access to primary health care in Australia by supporting nurses to deliver improved integrated care meeting community needs. CONTEXT In Primary Health Care (PHC), the nursing workforce are predominantly employed in the general practice sector. Despite evidence that nurse-led models of care can bridge traditional treatment silos in the provision of specialised and coordinated care, PHC nurses' scope of practice varies dramatically. Nurse-led models of care are imperative for rural and remote populations that experience workforce shortages and barriers to accessing health care. Existing barriers include policy constraints, limited organisational structures, education and financing models. APPROACH The Australian Primary Health Care Nurses Association (APNA) received funding to implement nurse-led clinics as demonstration projects. The clinics enable PHC nurses to work to their full scope of practice, improve continuity of care and increase access to health care in under serviced locations. We reviewed a range of peer-reviewed literature, policy documents, grey literature and APNA provided sources, particularly those relevant to rural and remote populations. We argue more focus is needed on how to address variations in the scope of practice of the rural and remote PHC nursing workforce. CONCLUSION Despite growing evidence for the effectiveness of nurse-led models of care, significant policy and financial barriers continue to inhibit PHC nurses working to their full scope of practice. If their potential to transform health care and increase access to health services is to be realised these barriers must be addressed.
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Affiliation(s)
- Tracy Robinson
- School of Nursing, Paramedicine and Healthcare Sciences, Charles Sturt University, Orange, New South Wales, Australia
| | - Linda Govan
- Latrobe University, Melbourne, Victoria, Australia
- Australian Primary Health Care Nurses Association (APNA), Melbourne, Victoria, Australia
| | - Cressida Bradley
- Australian Primary Health Care Nurses Association (APNA), Melbourne, Victoria, Australia
| | - Rachel Rossiter
- School of Rural Medicine, Charles Sturt University, Orange, New South Wales, Australia
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Sun R, Pitsika M, Momin S, Sher Z, Macarthur D. Evaluating neurosurgical training: a national survey examining the British trainee experience. Br J Neurosurg 2024:1-13. [PMID: 38533926 DOI: 10.1080/02688697.2024.2332178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 03/12/2024] [Indexed: 03/28/2024]
Abstract
PURPOSE Neurosurgery training in the UK has undergone significant changes over the past few years, including the new competency-based curriculum and a reduction of elective operating due to the pandemic. We conducted a comprehensive survey to assess UK neurosurgical trainees' experiences and perceptions to develop targeted action plans. METHODS An online anonymised survey was developed and distributed amongst the BNTA mailing list. Question types included 10-point Likert scales and free text options. Descriptive statistics, non-parametric testing of Likert scores, and Spearman's rank correlation were used to analyse responses. Pearson's chi-squared test was used for subgroup analysis of categorical data. RESULTS A total of 75 trainees with a National Training Number (NTN) responded. Overall trainees feel they are well trained, well supported, and have caught up with training emerging out of COVID. Funding for training varied between deaneries. There is significant concern amongst trainees regarding the workforce crisis. This, as well as financial concerns are leading to more than a quarter of trainees considering quitting. Half of the trainees are considering going OOP. More than one third of the trainees and more than half of the female trainees are considering working Less Than Full Time (LTFT). Most important supportive mechanisms towards completion of training were social support, along with personal satisfaction from work. An independent mentoring scheme is a preferred additional support mechanism. CONCLUSIONS Overall training experience for neurosurgery trainees in UK and Ireland was positive. There are significant concerns regarding the workforce crisis and costs of training, with a large proportion of neurosurgery trainees considering resigning. OOP and LTFT are popular means of becoming more competitive for consultant posts and to spend time with their families. Deanery experience, senior and peer support does, and will improve trainee experience and protect against attrition.
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Affiliation(s)
- Rosa Sun
- Department of Neurosurgery, University Hospitals North Midlands, Newcastle-under-Lyme, UK
| | - Marina Pitsika
- Department of Neurosurgery, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- Clinical Fellow, General Medical Council, London, UK
| | - Sheikh Momin
- Department of Neurosurgery, University Hospitals North Midlands, Newcastle-under-Lyme, UK
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Zenab Sher
- Department of Neurosurgery, University Hospitals Coventry Warwickshire, Coventry, UK
| | - Donald Macarthur
- Department of Neurosurgery, Nottingham University Hospitals NHS Trust, Nottingham, UK
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Tan J, Korduke O, Smith NL, Eglinton T, Fischer J. What are heads of department looking for in new general surgeons in Aotearoa New Zealand? ANZ J Surg 2024; 94:89-95. [PMID: 37962098 DOI: 10.1111/ans.18769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 10/01/2023] [Accepted: 10/28/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Training pathways vary significantly after completion of the general surgery surgical education and training (SET) program due to increasing sub-specialization. Aotearoa New Zealand requires a diverse range of general surgeons. Appointment of new consultant surgeons can be an opaque process; trainees are often uncertain how to tailor their training to that required by potential employers. Heads of departments (HODs) are influential in new appointments, and their opinions on desirable candidate attributes are valuable. METHODS An online survey was conducted in March 2023. All public hospital general surgery HODs were invited to participate. The survey sought opinions on the importance of attributes, skills and experience when appointing a new consultant general surgeon. RESULTS The response rate was 70% (14/20) including 6 of 7 HODs from tertiary hospitals and 8 of 13 from secondary hospitals. The top three desirable factors were all personal attributes (being a team player, having a strong work ethic, and good interpersonal skills). 10 of 14 respondents disagreed that SET completion alone is sufficient without the need for further training. Most respondents preferred at least 2 years of fellowship training, except for trauma and endocrine surgery, where 1 year was frequently considered sufficient. Only one respondent agreed formal research training is highly valued. CONCLUSION Trainees would be wise to obtain training desired by the majority of HODs while building an individualized profile of attributes, skills and experience tailored to hospitals they may wish to work in. The findings should be considered by organizations responsible for general surgical training and workforce planning.
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Affiliation(s)
- Jeffrey Tan
- Department of General Surgery, Waikato Hospital, Hamilton, New Zealand
| | - Olga Korduke
- Department of General Surgery, Waikato Hospital, Hamilton, New Zealand
| | | | - Tim Eglinton
- Department of General Surgery, Christchurch Hospital, Christchurch, New Zealand
- Department of Surgery, University of Otago Christchurch, Christchurch, New Zealand
| | - Jesse Fischer
- Department of General Surgery, Waikato Hospital, Hamilton, New Zealand
- Department of Surgery, University of Auckland - Waikato Clinical Campus, Hamilton, New Zealand
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Cortie CH, Garne D, Parker-Newlyn L, Ivers RG, Mullan J, Mansfield KJ, Bonney A. An automated protocol for assessing career rurality outcomes of Australian health professionals using retrospective data. Aust J Rural Health 2023; 31:1252-1260. [PMID: 37859332 DOI: 10.1111/ajr.13053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/28/2023] [Accepted: 10/02/2023] [Indexed: 10/21/2023] Open
Abstract
INTRODUCTION Addressing the imbalance of the health workforce between metropolitan and rural areas requires a clear understanding of trends in choices of work location of health care staff. OBJECTIVE Here, we provide an automated and highly reproducible protocol to examine the location of health care workers over multiple years using medical graduates as a case study. DESIGN Data linkage cohort study. The study cohort examined was University of Wollongong Medical graduates from 2010 to 2021 who were registered to practice in Australia. The main outcome measure was graduate location of practice in Modified Monash regsions MM1 or MM2-7 across multiple postgraduate years. This protocol used R Markdown. FINDINGS An automated and reproducible protocol was used to analyse choices of work location for the University of Wollongong's medical graduates. Over 90% of graduates were registered with AHPRA. Around 25%-30% of graduates were found to work in MM2-7 regions across their careers, exceeding the national average. DISCUSSION The protocol presented allows for a fast and reproducible analysis of work location by region for health care workers. This will allow comparisons of outcomes between universities or health professions.
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Affiliation(s)
- Colin H Cortie
- Graduate School of Medicine, University of Wollongong, Australia, Wollongong, New South Wales, Australia
| | - David Garne
- Graduate School of Medicine, University of Wollongong, Australia, Wollongong, New South Wales, Australia
| | - Lyndal Parker-Newlyn
- Graduate School of Medicine, University of Wollongong, Australia, Wollongong, New South Wales, Australia
| | - Rowena G Ivers
- Graduate School of Medicine, University of Wollongong, Australia, Wollongong, New South Wales, Australia
| | - Judy Mullan
- Graduate School of Medicine, University of Wollongong, Australia, Wollongong, New South Wales, Australia
| | - Kylie J Mansfield
- Graduate School of Medicine, University of Wollongong, Australia, Wollongong, New South Wales, Australia
| | - Andrew Bonney
- Graduate School of Medicine, University of Wollongong, Australia, Wollongong, New South Wales, Australia
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Alotaibi T, Alsahafi M, Alariany O, Alqarni AA, Abuzenada M, Almutairi E, Nakshabandi Z, Alyami F, Alsaywid B, Lytras M. The Analysis of Job Satisfaction of Health Practitioners in Saudi Arabia: Determinants and Strategic Recommendations for Health Workforce Planning. Cureus 2023; 15:e50891. [PMID: 38249243 PMCID: PMC10799632 DOI: 10.7759/cureus.50891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Job satisfaction plays an important foundation in the health system to deliver high-quality care services to patients. Job satisfaction describes the inside feeling of workers about their jobs whether they like it or not. Job satisfaction of health practitioners is considered an essential factor that affects their efficiency, well-being, and mental health. AIM This research study is part of an integrated research aiming to understand the determinants of a revised Workforce Planning Strategy in Saudi Arabia, in close relevance to the demand and supply side in Saudi Arabia. RESULTS This study showed that males were significantly more satisfied than females in relation to specialty, organization, and overall global score. There is also evidence for a significant association between age groups and job satisfaction. Older health practitioners had a higher level of satisfaction than younger ones. Regarding nationality, we found that Saudi health practitioners were less satisfied in all aspects, while non-Saudi (Arab) healthcare practitioners were the most satisfied in all aspects except city happiness. CONCLUSION Our study found statistically significant differences that medicine and surgery practitioners are the most satisfied professionals and the least satisfied are dentist practitioners. Health practitioners with more than five years of experience were significantly the most satisfied.
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Affiliation(s)
- Talal Alotaibi
- College of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Mohammed Alsahafi
- College of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Osama Alariany
- College of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Ayman A Alqarni
- College of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Maha Abuzenada
- Research and Development, Saudi Commission for Health Specialties, Jeddah, SAU
| | - Eman Almutairi
- Research and Development, Saudi Commission for Health Specialties, Jeddah, SAU
| | - Ziad Nakshabandi
- Research and Development, Saudi Commission for Health Specialties, Jeddah, SAU
| | | | - Basim Alsaywid
- Research and Development, Saudi Commission for Health Specialties, Jeddah, SAU
| | - Miltiades Lytras
- Computer Science, Effat College of Engineering, Effat University, Jeddah, SAU
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Bagstaff K. Developing a model for quantifying staffing requirements in the post-anaesthesia care unit. Nurs Manag (Harrow) 2023; 30:19-25. [PMID: 37401096 DOI: 10.7748/nm.2023.e2096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2022] [Indexed: 07/05/2023]
Abstract
Nurse managers in charge of a post-anaesthesia care unit (PACU) face the task of optimising staffing levels and must be able to justify staffing needs to the wider operational team. The high variability in patient numbers and acuity that characterises the PACU, as well as the broader factors that affect patient flow to and from the PACU, make it challenging to quantify staffing requirements. Staffing models often fail to reflect accurately the needs of patients and therefore the needs of the unit and there is no recommended model for quantifying PACU staffing requirements. In this article, the author describes the challenges of quantifying PACU staffing requirements and the suitability of different types of data. The author also discusses factors to consider when developing model for quantifying PACU staffing requirements.
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Affiliation(s)
- Katie Bagstaff
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, England
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8
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Jessup B, Tran N, Stevens T, Barnett T. Rural origin student representation in health courses at the University of Tasmania: 2011-2020. Aust J Rural Health 2023; 31:944-956. [PMID: 37545396 DOI: 10.1111/ajr.13027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/08/2023] [Accepted: 07/10/2023] [Indexed: 08/08/2023] Open
Abstract
OBJECTIVE To describe longitudinal trends in the admission and completion of domestic Tasmanian rural origin students in health courses at the University of Tasmania (UTAS). METHODS A retrospective audit of records for all domestic Tasmanian students admitted to, or who completed a health course offered by UTAS between 2011 and 2020 was conducted. Data extracted from student records included gender, age, Indigenous background, rural origin (based on residential address outside of Launceston or Hobart at the time of application), health discipline, year of admission and/or completion. Data were analysed in STATA. RESULTS Between 2011 and 2020, 7516 domestic Tasmanian students were admitted to health courses at UTAS, of which 22.6% were rural origin (vs. a rural population of 36.7%). Students admitted were mostly female (77.0%) and studying nursing (51.1%). Rural origin students were more likely to study at the regional campus in Launceston than in Hobart, the capital city (OR, 3.79 [3.4-4.3, p < 0.00]). Over this same period, 5086 students completed a health course. There was little difference in completion rates among regional vs. rural origin students (OR, 1.04 [1.0-1.1, p < 0.00]); however, completion rates decreased with increasing remoteness. Indigenous and male students were less likely to complete than non-Indigenous (OR, 0.73 [0.7-0.8, p < 0.05]) and female students (OR, 0.97 [1.0-1.0, p < 0.05]) respectively. CONCLUSIONS Tasmanian rural origin students are admitted to a range of health courses at UTAS and many complete. However, additional measures are needed to attract a greater number of local rural origin students to study health courses and to support them through to course completion.
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Affiliation(s)
- Belinda Jessup
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Nga Tran
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Terri Stevens
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Tony Barnett
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
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Khoury EG, Nuamek T, Heritage S, Fulton-Ward T, Kucharczak J, Ng C, Kalsi T, Gomes F, Lind MJ, Battisti NML, Cheung KL, Parks R, Pearce J, Baxter MA. Geriatric Oncology as an Unmet Workforce Training Need in the United Kingdom-A Narrative Review by the British Oncology Network for Undergraduate Societies (BONUS) and the International Society of Geriatric Oncology (SIOG) UK Country Group. Cancers (Basel) 2023; 15:4782. [PMID: 37835476 PMCID: PMC10571920 DOI: 10.3390/cancers15194782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/20/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023] Open
Abstract
Cancer is a disease associated with ageing. Managing cancer in older adults may prove challenging owing to pre-existing frailty, comorbidity, and wider holistic needs, as well as the unclear benefits and harms of standard treatment options. With the ongoing advances in oncology and the increasing complexity of treating older adults with cancer, the geriatric oncology field must be a priority for healthcare systems in education, research, and clinical practice. However, geriatric oncology is currently not formally taught in undergraduate education or postgraduate training programmes in the United Kingdom (UK). In this commentary, we outline the landscape of geriatric oncology undergraduate education and postgraduate training for UK doctors. We highlight current challenges and opportunities and provide practical recommendations for better preparing the medical workforce to meet the needs of the growing population of older adults with cancer. This includes key outcomes to be considered for inclusion within undergraduate and postgraduate curricula.
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Affiliation(s)
- Emma G. Khoury
- Academic Cancer Sciences Unit, University of Southampton, Southampton SO16 6YD, UK
| | - Thitikorn Nuamek
- Medical Oncology, The Christie NHS Foundation Trust, Manchester M20 4BX, UK; (T.N.)
| | | | - Taylor Fulton-Ward
- Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Joanna Kucharczak
- School of Clinical Medicine, University of Cambridge, Cambridge CB2 OSP, UK
| | - Cassandra Ng
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester M23 9LT, UK
| | - Tania Kalsi
- Department of Ageing of Health, Guy’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 7EH, UK
- School of Life Course and Population Sciences, King’s College London, London WC2R 2LS, UK
| | - Fabio Gomes
- Medical Oncology, The Christie NHS Foundation Trust, Manchester M20 4BX, UK; (T.N.)
| | - Michael J. Lind
- Queens Centre for Oncology and Haematology, Hull and East Yorkshire NHS Trust, Hull HU16 5JQ, UK
- Cancer Research Group, Hull York Medical School, University of Hull, Hull HU6 7RX, UK
| | - Nicolò M. L. Battisti
- Breast Unit, Department of Medicine, The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK
| | - Kwok-Leung Cheung
- School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
| | - Ruth Parks
- School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
| | - Jessica Pearce
- Leeds Institute of Medical Research at St James’, University of Leeds, Leeds LS2 9JT, UK
| | - Mark A. Baxter
- Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee DD2 1SY, UK
- Tayside Cancer Centre, Ninewells Hospital and Medical School, NHS Tayside, Dundee DD2 1SG, UK
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Hedayioglu J, Yearsley S, Nash G, Waldock K. Staff experiences of the nursing associate role in a community setting. Nurs Stand 2023; 38:28-34. [PMID: 37424191 DOI: 10.7748/ns.2023.e12090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2023] [Indexed: 07/11/2023]
Abstract
The nursing associate role was introduced as a 'bridge' between healthcare assistants and nurses to support patient care. However, the role has involved many challenges in terms of its implementation in established nursing teams. This article details a service evaluation that explored the experiences of the nursing associate role among clinical staff in one community NHS trust using an online questionnaire and in-depth interviews. Three themes were identified from the data: nursing associate training and support; the nursing associate role in development; and nursing associate role recognition and prospects. Overall, the findings showed that trainee nursing associates enjoyed the academic aspects of their training, but support was variable. Additionally, the nursing associate role was viewed as being 'in development' and, while wider recognition of nursing associates is required, the nursing associate role offers a unique career opportunity.
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Affiliation(s)
| | | | - Glynn Nash
- Kent Community Health NHS Foundation Trust, Ashford, England
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11
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Borle K, Kopac N, Dragojlovic N, Llorian ER, Lynd LD. Defining Need Amid Exponential Change: Conceptual Challenges in Workforce Planning for Clinical Genetic Services. Clin Ther 2023; 45:695-701. [PMID: 37516568 DOI: 10.1016/j.clinthera.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 07/10/2023] [Accepted: 07/10/2023] [Indexed: 07/31/2023]
Abstract
Rapid growth in the volume of referrals to clinical genetics services in many countries during the past 15 years makes workforce planning a critical policy tool in ensuring that the capacity of the clinical genetics workforce is large enough to meet current and future needs. This article explores the distinctive challenges of workforce planning in clinical genetics and provides recommendations for addressing these challenges using a needs-based planning approach. Specifically, at least 3 features complicate efforts to estimate the need for clinical genetic services: the difficulty in linking many clinical genetic services to concrete health outcomes; the rapidly changing nature of genetic medicine, which creates intrinsic uncertainty about the appropriate level of service; and the heightened relevance of patient preferences in this context. Our recommendations call for needs-based planning studies to include an explicit definition of necessary care, to be flexible in considering nonhealth benefits, to err on the side of including services currently funded by health systems even when evidence about outcomes is limited, and to use scenario analysis and expert input to explore the impact of uncertainty about patients' preferences and future technologies on estimates of workforce requirements.
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Affiliation(s)
- Kennedy Borle
- Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nicola Kopac
- Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nick Dragojlovic
- Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Elisabet Rodriguez Llorian
- Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Larry D Lynd
- Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada; Centre for Health Evaluation and Outcomes Sciences, Providence Health Research Institute, Vancouver, British Columbia, Canada.
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12
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Dragojlovic N, Borle K, Kopac N, Nisselle A, Nuk J, Jevon M, Friedman JM, Elliott AM, Lynd LD. Workforce Implications of Increased Referrals to Hereditary Cancer Services in Canada: A Scenario-Based Analysis. Curr Oncol 2023; 30:7241-7251. [PMID: 37623006 PMCID: PMC10453026 DOI: 10.3390/curroncol30080525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 07/19/2023] [Accepted: 07/27/2023] [Indexed: 08/26/2023] Open
Abstract
Over the last decade, utilization of clinical genetics services has grown rapidly, putting increasing pressure on the workforce available to deliver genetic healthcare. To highlight the policy challenges facing Canadian health systems, a needs-based workforce requirements model was developed to determine the number of Canadian patients in 2030 for whom an assessment of hereditary cancer risk would be indicated according to current standards and the numbers of genetic counsellors, clinical geneticists and other physicians with expertise in genetics needed to provide care under a diverse set of scenarios. Our model projects that by 2030, a total of 90 specialist physicians and 326 genetic counsellors (1.7-fold and 1.6-fold increases from 2020, respectively) will be required to provide Canadians with indicated hereditary cancer services if current growth trends and care models remain unchanged. However, if the expansion in eligibility for hereditary cancer assessment accelerates, the need for healthcare providers with expertise in genetics would increase dramatically unless alternative care models are widely adopted. Increasing capacity through service delivery innovation, as well as mainstreaming of cancer genetics care, will be critical to Canadian health systems' ability to meet this challenge.
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Affiliation(s)
- Nick Dragojlovic
- Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC V6T 1Z3, Canada; (N.D.)
| | - Kennedy Borle
- Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC V6T 1Z3, Canada; (N.D.)
| | - Nicola Kopac
- Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC V6T 1Z3, Canada; (N.D.)
| | - Amy Nisselle
- Australian Genomics Health Alliance, Parkville, VIC 3052, Australia
- Murdoch Children’s Research Institute, Department of Pediatrics, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Jennifer Nuk
- Hereditary Cancer Program, BC Cancer, Vancouver, BC V5Z 1J2, Canada
- Department of Medical Genetics, Faculty of Medicine, University of British Columbia, Vancouver, BC V6H 3N1, Canada
| | - Mandy Jevon
- Hereditary Cancer Program, BC Cancer, Vancouver, BC V5Z 1J2, Canada
| | - Jan M. Friedman
- Department of Medical Genetics, Faculty of Medicine, University of British Columbia, Vancouver, BC V6H 3N1, Canada
- BC Children’s Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada
| | - Alison M. Elliott
- Department of Medical Genetics, Faculty of Medicine, University of British Columbia, Vancouver, BC V6H 3N1, Canada
- BC Children’s Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada
- Women’s Health Research Institute, Vancouver, BC V6H 3N1, Canada
| | - Larry D. Lynd
- Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC V6T 1Z3, Canada; (N.D.)
- Centre for Health Evaluation & Outcome Sciences, Providence Health, Vancouver, BC V6Z IY6, Canada
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13
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Ferreira T, Collins AM, Horvath R. Ascertaining the Career Intentions of Medical Students (AIMS) in the United Kingdom Post Graduation: Protocol for a Mixed Methods Study. JMIR Res Protoc 2023; 12:e45992. [PMID: 37335615 PMCID: PMC10337401 DOI: 10.2196/45992] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 05/24/2023] [Accepted: 05/25/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Among doctors in the United Kingdom, there is growing sentiment regarding delaying specialist training, emigrating to practice medicine abroad, or leaving the profession altogether. This trend may have substantial implications for the future of the profession in the United Kingdom. The extent to which this sentiment is also present in the medical student population is not well understood. OBJECTIVE Our primary outcome is to determine current medical students' career intentions after graduation and upon completing the foundation program and to establish the motivations behind these intentions. Secondary outcomes include determining which, if any, demographic factors alter the propensity to pursue different career paths available to a medical graduate, determining which specialties medical students plan on pursuing, and understanding current views on the prospect of working in the National Health Service (NHS). METHODS The Ascertaining the Career Intentions of Medical Students (AIMS) study is a national, multi-institution, and cross-sectional study in which all medical students at all medical schools in the United Kingdom are eligible to participate. It was administered via a novel, mixed methods, and web-based questionnaire and disseminated through a collaborative network of approximately 200 students recruited for this purpose. Both quantitative and thematic analyses will be performed. RESULTS The study was launched nationally on January 16, 2023. Data collection was closed on March 27, 2023, and data analysis has commenced. The results are expected to be available later in the year. CONCLUSIONS Doctors' career satisfaction within the NHS is a well-researched topic; however, there is a shortage of high-powered studies that are able to offer insight into medical students' outlook on their future careers. It is anticipated that the results of this study will bring clarity to this issue. Identified areas of improvement in medical training or within the NHS could be targeted to improve doctors' working conditions and help retain medical graduates. Results may also aid future workforce-planning efforts. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/45992.
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Affiliation(s)
- Tomas Ferreira
- School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Alexander M Collins
- School of Public Health, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Rita Horvath
- School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
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14
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Al-Ghraiybah T, Sim J, Fernandez R, Lago L. Managing missing and erroneous data in nurse staffing surveys. Nurse Res 2023; 31:19-27. [PMID: 36994632 DOI: 10.7748/nr.2023.e1878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2022] [Indexed: 03/31/2023]
Abstract
BACKGROUND Analysis can be problematic in research when data are missing or erroneous. Various methods are available for managing missing and erroneous data, but little is known about which are the best to use when conducting cross-sectional surveys of nurse staffing. AIM To explore how missing and erroneous data were managed in a study that involved a cross-sectional survey of nurse staffing. DISCUSSION The article describes a study that used a cross-sectional survey to estimate the ratio of registered nurses to patients, using self-reported data by nurses. It details the techniques used in the study to manage missing and erroneous data and presents the results of the survey before and after the treatment of missing data. CONCLUSION Managing missing data effectively and reporting procedures transparently reduces the possibility of bias in a study's results and increases its reproducibility. Nurse researchers need to understand the methods available to handle missing and erroneous data. Surveys must contain unambiguous questions, as every participant should have the same understanding of a question's meaning. IMPLICATION FOR PRACTICE Researchers should pilot surveys - even when using validated tools - to ensure participants interpret the questions as intended.
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Affiliation(s)
- Tamer Al-Ghraiybah
- School of Nursing Midwifery and Indigenous Health, University of Wollongong, Wollongong, NSW, Australia
| | - Jenny Sim
- School of Nursing and Midwifery, University of Newcastle, Gosford, NSW, Australia
| | - Ritin Fernandez
- School of Nursing, University of Wollongong, Wollongong, NSW, Australia
| | - Luise Lago
- Centre for Health Research Illawarra Shoalhaven Population, University of Wollongong, Wollongong, NSW, Australia
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15
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Hadler RA, Dexter F. Forecasting Caseload of Critically Ill Patients Who Are Alert and Without Delirium for at Least Two Consecutive Days for the Assessment of Their Psychological Distress. Cureus 2023; 15:e39859. [PMID: 37404410 PMCID: PMC10315008 DOI: 10.7759/cureus.39859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2023] [Indexed: 07/06/2023] Open
Abstract
INTRODUCTION One-quarter of alert, non-delirious patients in critical care units report significant psychological distress. Treatment of this distress depends upon identifying these high-risk patients. Our aim was to characterize how many critical care patients remain alert and without delirium for at least two consecutive days and could thus predictably undergo evaluation for distress. METHODS This retrospective cohort study used data from a large teaching hospital in the United States of America, from October 2014 to March 2022. Patients were included if they were admitted to one of three intensive care units, and for >48 hours all delirium and sedation screenings were negative (Riker sedation-agitation scale four, calm and cooperative, and no delirium based on all Confusion Assessment Method for the Intensive Care Unit scores negative and all Delirium Observation Screening Scale less than three). Means and standard deviations of means for counts and percentages are reported among the most recent six quarters. Means and standard deviations of means for lengths of stay were calculated among all N=30 quarters. The Clopper-Pearson method was used to calculate the lower 99% confidence limit for the percentages of patients who would have had at most one assessment of dignity-related distress before intensive care unit discharge or change in mental status. RESULTS An average of 3.6 (standard deviation 0.2) new patients met the criteria daily. The percentages of all critical care patients (20%, standard deviation 2%) and hours (18%, standard deviation 2%) meeting criteria decreased slightly over the 7.5 years. Patients spent a mean of 3.8 (standard deviation 0.1) days awake in critical care before their condition or site changed. In the context of assessing distress and potentially treating it before the date of change of condition (e.g., transfer), 66% (6818/10314) of patients would have zero or one assessment, lower 99% confidence limit of 65%. CONCLUSIONS Approximately one-fifth of critically ill patients are alert and without delirium and thus could be evaluated for distress during their intensive care unit stay, mostly during a single visit. These estimates can be used to guide workforce planning.
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16
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Jawad S, Thomas M, Hecker K, Kassam A. Exploring the construct of anticipatory stress in finding a job after residency training through cognitive interviewing: Implications for learner well-being and health workforce planning. MedEdPublish (2016) 2023; 13:25. [PMID: 37881509 PMCID: PMC10594048 DOI: 10.12688/mep.19559.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2023] Open
Abstract
Background: Anticipatory stress (AS) is denoted by concern about future events for which there is little control. Most AS research has been physiological studies such as measuring salivary cortisol levels. Medical learners may experience AS regarding employment after residency, however AS a psychological construct across career stages has not previously been studied. The objective of this study is to explore the psychological construct of employment AS in medical students, residents, and former Program Directors (PDs). Methods: Participants were recruited from a large Canadian medical school via purposive sampling. Semi-structured interviews with n=21 participants (six medical students, nine residents, and six PDs) were transcribed verbatim, and coded by two independent reviewers using thematic analysis. Results: Participants agreed that financial, family, and geographical factors exacerbate AS, and it is mitigated by flexibility, social support, and being proactive. External support, job market saturation, and differences between medical specialities also influence AS. Perspectives unique to participant groups included: medical students reflecting on a hidden curriculum and preoccupation with proximal issues over distal concerns of employment; residents experiencing competing residency program demands; former PDs finding that resident competency, yearly hiring fluctuations, and existing stress impact AS. Consequences of AS include physical and psychological manifestations, performance anxiety, and pursuing additional training. Conclusions: Perceptions of AS vary by medical career stage. Individual, program and systems-level changes can help manage and address the underlying cause of AS: an unreliable job market for physicians. Correcting the mismatch between residency positions and job openings may be a proactive, preventative approach.
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Affiliation(s)
- Sana Jawad
- Undergraduate Medical Education, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
| | - Megan Thomas
- Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia, BC V6T 1Z3, Canada
| | - Kent Hecker
- Department of Veterinary Clinical and Diagnostic Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
| | - Aliya Kassam
- Community Health Sciences Cumming School of Medicine, Health Sciences Centre Foothills campus, 3330 Hospital Drive NW, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
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17
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Pandit JJ. More anaesthetists; fewer operations? Difficult questions for the specialty and stark planning implications of the 7th National Audit Project's anaesthetic activity survey. Anaesthesia 2023; 78:677-683. [PMID: 36991476 DOI: 10.1111/anae.16010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2023] [Indexed: 03/31/2023]
Affiliation(s)
- J J Pandit
- Nuffield Department of Anaesthetics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- University of Oxford, UK
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18
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Mackway-Jones A, Hornby R, Mackway-Jones K. Making more nurses, one minute at a time: an efficiency and quality improvement project in emergency triage. Emerg Nurse 2023; 31:e2127. [PMID: 36601815 DOI: 10.7748/en.2023.e2127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2022] [Indexed: 01/06/2023]
Abstract
Emergency triage is a short-duration, high-volume process so small reductions in the time taken to triage one patient can have large repercussions on the total amount of triage time. At the emergency department of a large inner-city hospital, an efficiency and quality improvement project was undertaken to reduce the time taken to safely triage patients and optimise the use of triage nurses' time. The project involved removing processes that did not contribute to the primary aim of triage, supporting individual triage nurses to improve their performance where needed, and optimising the triage process. A 44% reduction in mean triage episode time was seen, equating to 18,000 minutes of triage nurses' time saved every month. This near doubling of triage capacity was associated with an improvement in triage accuracy. The article describes the project, which used lean management principles and statistical process control methods, and discusses its implications for emergency triage.
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Affiliation(s)
- Anna Mackway-Jones
- emergency department, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, England
| | - Rachel Hornby
- Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, England
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19
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Scaife C. Reflecting on the development of a band 5 nurse coordinators' competency pathway in a children's hospital. Nurs Child Young People 2022; 34:16-21. [PMID: 35373540 DOI: 10.7748/ncyp.2022.e1408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2021] [Indexed: 06/14/2023]
Abstract
Taking charge of a clinical shift on a ward or department is daunting for newly qualified nurses. To support band 5 nurses in this development a coordinators' competency pathway was devised at a children's hospital NHS trust in 2012. The pathway consists of a competency-based document, used to guide and assess nurses, and a simulation-based training day. Since it was devised, approximately 200 nurses at the trust have undertaken the pathway. This article reflects on a service evaluation, which used a mixed-methods approach involving quantitative and qualitative data collection undertaken in three data sets over five years, to assess the effectiveness of the pathway and training. It is not possible within the space limitations of this article to present all the results, therefore the main themes from the data analysis are summarised. Overall, respondents felt supported and considered the pathway to be delivered well and the training effective. Most appraised simulation positively as a teaching and learning method. The pathway, which could be replicated anywhere, has been embedded in the trust.
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Affiliation(s)
- Clair Scaife
- Sheffield Children's NHS Foundation Trust, Sheffield, England
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20
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Keniston A, Sakumoto M, Astik GJ, Auerbach A, Eid SM, Kangelaris KN, Kulkarni SA, Lee T, Leykum LK, Linker AS, Worster DT, Burden M. Adaptability on Shifting Ground: a Rapid Qualitative Assessment of Multi-institutional Inpatient Surge Planning and Workforce Deployment During the COVID-19 Pandemic. J Gen Intern Med 2022; 37:3956-3964. [PMID: 35319085 PMCID: PMC8939495 DOI: 10.1007/s11606-022-07480-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 03/03/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND During the initial wave of COVID-19 hospitalizations, care delivery and workforce adaptations were rapidly implemented. In response to subsequent surges of patients, institutions have deployed, modified, and/or discontinued their workforce plans. OBJECTIVE Using rapid qualitative methods, we sought to explore hospitalists' experiences with workforce deployment, types of clinicians deployed, and challenges encountered with subsequent iterations of surge planning during the COVID-19 pandemic across a collaborative of hospital medicine groups. APPROACH Using rapid qualitative methods, focus groups were conducted in partnership with the Hospital Medicine Reengineering Network (HOMERuN). We interviewed physicians, advanced practice providers (APP), and physician researchers about (1) ongoing adaptations to the workforce as a result of the COVID-19 pandemic, (2) current struggles with workforce planning, and (3) evolution of workforce planning. KEY RESULTS We conducted five focus groups with 33 individuals from 24 institutions, representing 52% of HOMERuN sites. A variety of adaptations was described by participants, some common across institutions and others specific to the institution's location and context. Adaptations implemented shifted from the first waves of COVID patients to subsequent waves. Three global themes also emerged: (1) adaptability and comfort with dynamic change, (2) the importance of the unique hospitalist skillset for effective surge planning and redeployment, and (3) the lack of universal solutions. CONCLUSIONS Hospital workforce adaptations to the COVID pandemic continued to evolve. While few approaches were universally effective in managing surges of patients, and successful adaptations were highly context dependent, the ability to navigate a complex system, adaptability, and comfort in a chaotic, dynamic environment were themes considered most critical to successful surge management. However, resource constraints and sustained high workload levels raised issues of burnout.
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Affiliation(s)
- Angela Keniston
- Division of Hospital Medicine, University of Colorado School of Medicine, 12401 E. 17th Avenue, Mail Stop F782, Aurora, CO, 80045, USA.
| | - Matthew Sakumoto
- Division of General Internal Medicine, University of California, San Francisco School of Medicine, San Francisco, CA, USA
| | - Gopi J Astik
- Division of Hospital Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Andrew Auerbach
- University of California, San Francisco School of Medicine, San Francisco, CA, USA
| | - Shaker M Eid
- Division of Hospital Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
| | - Kirsten N Kangelaris
- Division of Hospital Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Shradha A Kulkarni
- Division of Hospital Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Tiffany Lee
- University of California, San Francisco School of Medicine, San Francisco, CA, USA
| | - Luci K Leykum
- The University of Texas at Austin, Dell Medical School, South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Anne S Linker
- Division of Hospital Medicine, Mount Sinai Hospital/Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Devin T Worster
- Section of Hospital Medicine, Division of General Internal Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Marisha Burden
- Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, CO, USA
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21
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Muacevic A, Adler JR, Fallon J, Stevenson AJ. Appropriate Medical Staffing Improves Patient Safety, Training and Doctor Wellbeing. Cureus 2022; 14:e32071. [PMID: 36600851 PMCID: PMC9803364 DOI: 10.7759/cureus.32071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2022] [Indexed: 12/03/2022] Open
Abstract
Background Cross-covering of medical and surgical specialities out-of-hours is a problem in many hospitals, leaving trainee doctors responsible out-of-hours for patients they have never met, in specialities where they do not normally work. This has implications for patient safety and doctor wellbeing. In our Trust, a historical decision resulted in trainee doctors in Trauma & Orthopaedics and Ear Nose and Throat Surgery being reallocated out-of-hours to cross-cover medical inpatients. This left one doctor cross-covering all surgical specialities, including General Surgery, Urology, Vascular, Ear, Nose and Throat surgery (ENT), Trauma & Orthopaedics (T&O) and Spinal Surgery. As the out-of-hours workload increased over time, this impacted negatively on patient safety and doctor wellbeing to a point where it became unsustainable. Methods Evidence of safety concerns relating to surgical night shifts was gathered from Exception Reporting data and anecdotally from the Postgraduate Doctor Forum. Once the scale of this problem was accepted by the hospital board, following the successful presentation of two Business Cases, 17 additional doctors were recruited. This recruitment reduced the cross-covering of specialities out-of-hours and enable adequate staffing throughout all departments. Qualitative evidence was gathered by surveying affected doctors before and after the change in order to assess its impact on doctor wellbeing, training and perceived patient safety. Quantitative analysis of Exception Reports and Immediate Safety Concerns was also performed. Results The survey results following the change were overwhelmingly positive, demonstrating a significant improvement in workload, rest breaks and quality of care for patients. Foundation doctors reported higher levels of confidence and enhanced training due to more consistent supervision. Job satisfaction improved, with 81% of surgical senior house officers reporting they would recommend their job, compared with 42% previously. Trends in out-of-hours Exception Reporting and patient safety concerns were analysed to show a moderate improvement following the intervention. Conclusion With the ever-increasing volume and complexity of patients presenting to global healthcare systems, it is key that staffing levels are safe and adequate in order to maintain patient safety and doctor wellbeing. This project has demonstrated how historic short-term fixes such as redeploying trainee doctors out of their home speciality and implementing cross-cover of multiple specialities can have detrimental long-term effects. Our preliminary data revealed multiple issues related to patient safety, junior doctor workload and lack of training opportunities. By using this data, and enlisting the help of multiple valued senior stakeholders, an acceptable Business Plan was approved by the Trust with a view to reversing these issues. The recruitment of additional Trust Grade doctors to create a third tier of the surgical out-of-hours cover has been instrumental in improving conditions within our Trust and has shown that adequate workforce planning is achievable when supported by robust evidence. This project could be used as a guide for other units seeking to make similar improvements.
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22
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Hovenga EJS. Nursing Informatics Integration into Mainstream Health Informatics. Stud Health Technol Inform 2022; 300:149-163. [PMID: 36300408 DOI: 10.3233/shti220947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Nursing Informatics emerged in Australia during the early 1980s and drove the Professional development and acceptance of Health Informatics. Milestones achieved include the development of a national journal, the establishment of the Health Informatics Society of Australia and the Australasian College of Health Informatics (now collectively the Australasian Institute of Digital Health), nursing participation in Health Informatics standards development activities, adoption of the HL7 messaging standard, the delivery of numerous workshops, an annual national health informatics conference since 1993, hosting international conferences, the development and delivery of Health Informatics post graduate programs and establishing a research centre where the first prototype for an archetype repository was developed. This became the openEHR Clinical Knowledge Manager. The most recent milestone was the establishment of a private company that became a Registered Training Organisation. Continuing challenges include workforce capacity building to address the poor understanding of the need for improved data and IT governance at every level, the need to comply with proven scientific and technical principles and a need to transform national and international traditional infrastructures no longer fit for purpose to enable adequately support for global sustainable digital health ecosystems. Desired personal and aggregate data supply chains must be taken seriously and be supported by the best available technologies. Our collective biggest challenge is to improve multidisciplinary and intersectoral collaboration, semantic interoperability and optimum digital support to maintain global public health.
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Affiliation(s)
- Evelyn J S Hovenga
- eHealth Education Pty Ltd and the Global eHealth Collaborative (GeHCo), Melbourne, Australia
- Australian Catholic University, Melbourne, Australia
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23
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Sheiman I. Health workforce policy in the Russian Federation: How to overcome a shortage of physicians? Front Public Health 2022; 10:1023845. [PMID: 36339163 PMCID: PMC9633259 DOI: 10.3389/fpubh.2022.1023845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 09/23/2022] [Indexed: 01/28/2023] Open
Abstract
Russia looks for ways to overcome a shortage of physicians. Health workforce policy is focused on training an additional number of physicians. The current efforts have reduced some areas of the shortage but failed to solve the problem due to many factors that reproduce the deficit. A distorted structure of service delivery with weak primary care generates demand for outpatient specialists and hospital doctors and requires a perpetual increase in their number. The lack of long-term labor planning results in the oversupply of some specialties and the shortage of others. The regulation of post-graduate training is not enough to improve the allocation of physicians across specialties and health system sectors. We argue that an extensive increase in the number of physicians without changing their composition will hardly change the situation. A more active structural policy is required with a focus on strengthening primary care and improving planning and regulation of health workforce structure.
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Luc JGY, Pizano A, Udwadia F, Gupta S, Dairywala M, Joyce C, Robinson E, Rush G, Dunning J, Myers PO, Antonoff MB, Nguyen TC. Early effect of the COVID-19 pandemic on the North American cardiothoracic surgery job market. J Thorac Dis 2022; 14:3304-3313. [PMID: 36245601 PMCID: PMC9562543 DOI: 10.21037/jtd-22-320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 07/28/2022] [Indexed: 11/12/2022]
Abstract
Background The present study aims to report the early effect of the coronavirus disease 2019 (COVID-19) pandemic on the cardiothoracic surgery job market in North America. Methods The Cardiothoracic Surgery Network (CTSNet) job market database was queried, and patterns from January to May for 2019 versus January to May 2020 were compared for trends in job postings and job seekers. Results Our study is comprised of 395 cardiothoracic surgery job postings, of which 98% were positions located in North America and 63% were academic. The negative impact of the pandemic on the cardiothoracic surgery job market was greatest in the cardiothoracic/cardiovascular combined subspecialty, followed by congenital and adult cardiac surgery, whereas general thoracic surgery experienced an increase in proportion of jobs available. Despite an increase in views per job posted in 2020 vs. 2019 (532 vs. 290), employer views of job seeker curriculum vitae declined over the same time period in 2020 (January, 380 views/month to May, 3 views/month) compared to 2019 (January, 100 views/month to May, 54 views/month). Conclusions An analysis of job postings from CTSNet suggests a decline in job availability in the North American cardiothoracic surgical job market following declaration of the pandemic with acknowledgement that there is month to month variability and a supply-demand mismatch. The COVID-19 pandemic has had an unprecedented impact on our field, and the ultimate consequences remain unknown.
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Affiliation(s)
- Jessica G. Y. Luc
- Division of Cardiovascular Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alejandro Pizano
- Department of Cardiothoracic and Vascular Surgery, University of Texas Health Science Center Houston, McGovern Medical School, Houston, TX, USA
| | - Farhad Udwadia
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Saurabh Gupta
- Division of Cardiac Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Mohammed Dairywala
- Department of Cardiothoracic and Vascular Surgery, University of Texas Health Science Center Houston, McGovern Medical School, Houston, TX, USA
| | | | | | - Grahame Rush
- The Cardiothoracic Surgery Network, Chicago, IL, USA
| | - Joel Dunning
- Department of Cardiothoracic Surgery, James Cook University Hospital, Middlesbrough, UK
| | - Patrick O. Myers
- Department of Cardiac Surgery, CHUV-Center Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Mara B. Antonoff
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Tom C. Nguyen
- Division of Cardiothoracic Surgery, Department of Surgery, University of California San Francisco, CA, USA
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25
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Webster B, Archibald D. Self-rostering, work-life balance and job satisfaction in UK nursing: a literature review. Nurs Manag (Harrow) 2022; 29:e2048. [PMID: 35880476 DOI: 10.7748/nm.2022.e2048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2022] [Indexed: 06/15/2023]
Abstract
Nursing vacancies are high across the UK, with some nurses considering leaving the profession. Evidence suggests that employers, including the NHS, need to be more flexible about working times to support employees' work-life balance and job satisfaction. Self-rostering is one approach that has the potential to enhance nurses' work-life balance and job satisfaction, enabling scope for greater autonomy. This could in turn lead to fewer nurses leaving the profession and contribute to making nursing more attractive as a career. This literature review focused on nurses in the NHS and found that self-rostering had a positive effect on their work-life balance and job satisfaction. However, a move to self-rostering can pose challenges and it should be assessed for suitability before implementation. Given the nursing vacancy crisis in the UK and many nurses' intentions to leave the profession, the potential benefits of self-rostering for nurses cannot be overlooked.
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Affiliation(s)
- Brian Webster
- intensive care, Ninewells Hospital, Dundee, Scotland
| | - Daryll Archibald
- School of Health Sciences, University of Dundee, Dundee, Scotland
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Brewster L, Lambert M, Shelton C. Who cares where the doctors are? The expectation of mobility and its effect on health outcomes. Sociol Health Illn 2022; 44:1077-1093. [PMID: 35583963 PMCID: PMC9545762 DOI: 10.1111/1467-9566.13480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 04/25/2022] [Indexed: 06/15/2023]
Abstract
Doctors are typically portrayed as active agents in their work lives. However, this paper argues that this construction of agency ignores the effects of the healthcare structures that constrain choice, which in turn affects population health outcomes. Medical training pathways, regional boundaries, and rationalisation all have a long-lasting impact on the provision of healthcare. Using a mobilities lens to examine the movement of doctors, this paper examines how the expectation of movement built into training programmes perpetuates unequal access to healthcare. Long waiting times, poor care quality and lack of preventative care all perpetuate health inequalities; as one of the socio-economic determinants, access to healthcare affects health outcomes.
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Affiliation(s)
- Liz Brewster
- Lancaster Medical School, Health Innovation One, Sir John Fisher Drive, Lancaster UniversityLancasterUK
| | - Michael Lambert
- Department of SociologyLancaster UniversityBowland NorthLancasterUK
| | - Cliff Shelton
- Lancaster Medical School, Health Innovation One, Sir John Fisher Drive, Lancaster UniversityLancasterUK
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Asmoro CP, Hariyati RTS, Ayuningtyas D, Umar J, Tartila DYR. Researching nurses' adherence to patient safety guidelines in emergency departments. Emerg Nurse 2022; 30:e2129. [PMID: 35762099 DOI: 10.7748/en.2022.e2129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND One of the reasons why patient safety may be put at risk during healthcare interventions is a lack of staff adherence to patient safety guidelines. There could be a relationship between staff's adherence to patient safety guidelines and their perceived level of reward for their work and/or motivation. AIM To examine the relationship between reward and adherence to patient safety guidelines, and between motivation and adherence to patient safety guidelines, among nurses working in emergency departments (EDs) in Indonesia. METHOD This was a cross-sectional study of 101 nurses working in the EDs of four hospitals in Indonesia. Self-reported questionnaires were used to collect data on the level of reward participants felt they received for their work, the level of participants' motivation for their work, and participants' adherence to patient safety guidelines. Spearman's rank correlation testing was used to determine the relationships between variables. RESULTS There was a statistically significant negative relationship between reward and adherence (P=0.019, r=-0.233), which meant that those who perceived their reward as low were more likely to adhere to patient safety guidelines than those who felt they were highly rewarded. There was a statistically significant positive relationship between motivation and adherence to patient safety guidelines (P=0.017, r=0.236), which meant that the higher the motivation, the higher participants' level of adherence to patient safety guidelines. CONCLUSION Ensuring ED nurses are motivated for their work by offering rewards - such as a decent salary, a supportive workplace environment and career progression opportunities - is important to enhance their adherence to patient safety guidelines.
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Affiliation(s)
| | | | | | - Jahja Umar
- Universitas Islam Negeri Syarif Hidayatullah Jakarta, South Tangerang, Indonesia
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Nyoni J, Christmals CD, Asamani JA, Illou MMA, Okoroafor S, Nabyonga-Orem J, Ahmat A. The process of developing health workforce strategic plans in Africa: a document analysis. BMJ Glob Health 2022; 7:bmjgh-2021-008418. [PMID: 35618307 PMCID: PMC9150212 DOI: 10.1136/bmjgh-2021-008418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 05/02/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Many countries are faced with a multitude of health workforce-related challenges partly attributed to defective health workforce planning. Earlier efforts to guide the process and harmonise approaches to national health workforce policies and planning in the Africa Region included, among others, the development of the WHO Africa Regional Office (WHO/AFRO) Policies and Plans for Human Resources for Health Guidelines for Countries in the WHO African Region in 2006. Although this guideline has led to uniformity and rigour in developing human resources for health (HRH) policies and strategies in Africa, it has become imperative to synthesise the emerging evidence and best practices in the development of health workforce strategies. METHODS A document analysis was conducted using the READ ( R eadying materials; E xtracting data; A nalysing data and D istilling) approach. RESULTS Fourteen HRH policy/strategic plans were included in the study. The scope of the HRH strategic plans was described in three dimensions: the term of the strategy, sectors covered by the strategy and the health workforce considered in the projections. We found that HRH strategic plan development can be conceptualised as a cyclical, sequential multimethod project, with one phase feeding the subsequent phase with data or instructions. The process is very complex, with different interest groups and sectors that need to be satisfied. The HRH strategic plan development process comprises five main phases linked with external forces and national politics. CONCLUSION There is a need for accurate and comprehensive HRH data collection, astute HRH leadership, and broad base and multisectoral stakeholder consultation with technical support and guidance from experts and major external partners for effective HRH strategic plan development.
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Affiliation(s)
- Jennifer Nyoni
- Health Workforce Unit, Universal Health Coverage - Life Course, World Health Organization Regional Office for Africa, Brazzaville, Brazzaville, Congo
| | - Christmal Dela Christmals
- Centre for Health Professions Education, Faculty of Health Sciences, North-West University - Potchefstroom Campus, Potchefstroom, South Africa
| | - James Avoka Asamani
- Health Workforce Unit, Universal Health Coverage - Life Course, World Health Organization Regional Office for Africa, Brazzaville, Brazzaville, Congo,Centre for Health Professions Education, Faculty of Health Sciences, North-West University - Potchefstroom Campus, Potchefstroom, South Africa
| | - Mourtala Mahaman Abdou Illou
- Health Workforce Unit, Universal Health Coverage - Life Course, World Health Organization Regional Office for Africa, Brazzaville, Brazzaville, Congo
| | - Sunny Okoroafor
- Health Workforce Unit, Universal Health Coverage - Life Course, World Health Organization Regional Office for Africa, Brazzaville, Brazzaville, Congo
| | - Juliet Nabyonga-Orem
- Centre for Health Professions Education, Faculty of Health Sciences, North-West University - Potchefstroom Campus, Potchefstroom, South Africa,Health Financing and Investment, Universal Health Coverage - Life Course Cluster, World Health Organization Regional Office for Africa, Brazzaville, Brazzaville, Congo
| | - Adam Ahmat
- Health Workforce Unit, Universal Health Coverage - Life Course, World Health Organization Regional Office for Africa, Brazzaville, Brazzaville, Congo
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Hejazi MM, Al-Rubaki SS, Bawajeeh OM, Nakshabandi Z, Alsaywid B, Almutairi EM, Lytras MD, Almehdar MH, Abuzenada M, Badawood H. Attitudes and Perceptions of Health Leaders for the Quality Enhancement of Workforce in Saudi Arabia. Healthcare (Basel) 2022; 10:891. [PMID: 35628028 PMCID: PMC9141873 DOI: 10.3390/healthcare10050891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/29/2022] [Accepted: 05/01/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND AND AIM Besides the unique exposure and experience of health leaders in facing challenges and overcoming them, and the relatively fewer articles relating to the perception of health leaders in workforce quality enhancement, health leadership plays a crucial role in redirecting the workforce, increasing job satisfaction, professional development, and burnout prevention. Thus, this study aimed to understand the current healthcare workforce quality and future expectations from the attitudes and perceptions of health leaders. METHODS A qualitative research was carried out using semi-structured interviews consisting of 24 different questions. Participants of the study were healthcare leaders from different backgrounds and governmental institutions. All interviews were recorded, transcribed, and then analyzed using thematic analysis via the N-Vivo program. RESULTS Eleven participants were involved in the study, with one female and ten males. A thematic analysis and N-Vivo program yielded 5 main themes: (1) workforce competency, (2) health transformation, (3) leadership, (4) workforce planning, and (5) healthcare quality, with 22 emerging sub-themes. Moreover, participants responded with different attitudes and perceptions. CONCLUSION Health leaders are satisfied with the current direction of workforce competency and planning, yet fragmentation of the system and poor accessibility may need further enhancement. Furthermore, misutilization of services and the uncertainty of the future and talent pool are potential barriers for capability building. Moreover, with the existing gap in the workforce, health leaders believe that privatization and corporatization may have a positive effect. Aside from that, Saudization with the current plan of having a minimum standard of accepting non-Saudis in certain areas might benefit in maintaining competition and enriching experience. However, catching up with further research in healthcare quality in Saudi Arabia is needed because of the ongoing health transformation.
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Affiliation(s)
- Majid M. Hejazi
- Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia; (M.M.H.); (S.S.A.-R.); (O.M.B.); (Z.N.); (B.A.); (E.M.A.); (M.H.A.); (M.A.); (H.B.)
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 14611, Saudi Arabia
| | - Shayma S. Al-Rubaki
- Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia; (M.M.H.); (S.S.A.-R.); (O.M.B.); (Z.N.); (B.A.); (E.M.A.); (M.H.A.); (M.A.); (H.B.)
- Medicine Program, Batterjee Medical College, Jeddah 21442, Saudi Arabia
| | - Othman M. Bawajeeh
- Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia; (M.M.H.); (S.S.A.-R.); (O.M.B.); (Z.N.); (B.A.); (E.M.A.); (M.H.A.); (M.A.); (H.B.)
- Faculty of Dentistry, King Abdulaziz University, Jeddah 80209, Saudi Arabia
| | - Ziad Nakshabandi
- Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia; (M.M.H.); (S.S.A.-R.); (O.M.B.); (Z.N.); (B.A.); (E.M.A.); (M.H.A.); (M.A.); (H.B.)
- National Center for Health Workforce Planning, Riyadh 11614, Saudi Arabia
| | - Basim Alsaywid
- Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia; (M.M.H.); (S.S.A.-R.); (O.M.B.); (Z.N.); (B.A.); (E.M.A.); (M.H.A.); (M.A.); (H.B.)
- Saudi National Institute of Health Education and Research Skills, Riyadh 12382, Saudi Arabia
| | - Eman M. Almutairi
- Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia; (M.M.H.); (S.S.A.-R.); (O.M.B.); (Z.N.); (B.A.); (E.M.A.); (M.H.A.); (M.A.); (H.B.)
- Health Academy, Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia
| | - Miltiadis D. Lytras
- Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia; (M.M.H.); (S.S.A.-R.); (O.M.B.); (Z.N.); (B.A.); (E.M.A.); (M.H.A.); (M.A.); (H.B.)
- Effat College of Engineering, Effat University, Jeddah 21551, Saudi Arabia
| | - Manal H. Almehdar
- Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia; (M.M.H.); (S.S.A.-R.); (O.M.B.); (Z.N.); (B.A.); (E.M.A.); (M.H.A.); (M.A.); (H.B.)
- Research and Development Center, Saudi Commission for Health Specialties, Jeddah 23343, Saudi Arabia
| | - Maha Abuzenada
- Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia; (M.M.H.); (S.S.A.-R.); (O.M.B.); (Z.N.); (B.A.); (E.M.A.); (M.H.A.); (M.A.); (H.B.)
- Research and Development Center, Saudi Commission for Health Specialties, Jeddah 23343, Saudi Arabia
| | - Halla Badawood
- Saudi Commission for Health Specialties, Riyadh 11614, Saudi Arabia; (M.M.H.); (S.S.A.-R.); (O.M.B.); (Z.N.); (B.A.); (E.M.A.); (M.H.A.); (M.A.); (H.B.)
- Occupational Therapy Department, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Jeddah 14611, Saudi Arabia
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Pit S, Ramsden R, Tan AJ, Payne K, Barr J, Eames B, Edwards M, Colbran R. Persuasive Design Techniques and App Design Recommendations to Improve Health Workforce Capability in Rural Health Professionals: What Do Users Want and How Does an App Help? JMIR Hum Factors 2022; 9:e35094. [PMID: 35499866 PMCID: PMC9112088 DOI: 10.2196/35094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 12/11/2021] [Accepted: 12/28/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Health professionals' perceptions of persuasive design techniques for use in technological solutions to improve health workforce capability have not been previously explored. OBJECTIVE This study aims to explore rural health professionals' perceptions of health workforce capability and persuasive design techniques; and translate these into recommendations for designing a health workforce capability app to increase their impact and usefulness. METHODS Qualitative interviews with 13 rural health professionals were conducted. Subsequently, 32 persuasive techniques were used as a framework to deductively analyze the data. Persuasive design technique domains were Primary Task Support, Dialog Support, System Credibility Support, Social Support, and Cialdini's Principles of Persuasion. RESULTS Persuasive design techniques can be applied across the factors that influence health workforce capability including health and personal qualities; competencies and skills; values, attitudes, and motivation; and factors that operate outside of work and at the team, organizational, and labor market levels. The majority of the 32 persuasive design techniques were reflected in the data from the interviews and led to recommendations as to how these could be translated into practice, with the exception of scarcity. Many suggestions and persuasive design techniques link back to the need for tailored and localized solutions such as the need for country-specific-based evidence, the wish for localized communities of practice, learning from other rural health professionals, and referral pathways to other clinicians. Participants identified how persuasive design techniques can optimize the user experience to help meet rural health professionals needs for more efficient systems to improve patient access to care, quality care, and to enable working in interprofessional team-based care. Social inclusion plays a vital role for health professionals, indicating the importance of the Social Support domain of persuasive techniques. Overall, health professionals were open to self-monitoring of their work performance and some professionals used wearables to monitor their health. CONCLUSIONS Rural health professionals' perceptions of health workforce capability informed which persuasive design techniques can be used to optimize the user experience of an app. These were translated into recommendations for designing a health workforce capability app to increase likelihood of adoption. This study has also contributed to the further validation of the Persuasive Systems Design model through empirically aligning elements of the model to increase persuasive system content and functionality with real-world applied data, in this case the health workforce capability of rural health professionals. Our findings confirm that these techniques can be used to develop a future prototype of an app that may assist health professionals in improving or maintaining their health workforce capability which in turn may increase recruitment and retention in rural areas. Health professionals need to be central during the design phase. Interventions are needed to provide a supportive environment to rural and remote health professionals to increase their rural health workforce capability.
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Affiliation(s)
- Sabrina Pit
- New South Wales Rural Doctors Network, Hamilton, Australia
- School of Medicine, Western Sydney University, Campbelltown, Australia
- University Centre for Rural Health, Faculty of Medicine and Health Sciences, University of Sydney, Lismore, Australia
| | - Robyn Ramsden
- New South Wales Rural Doctors Network, Hamilton, Australia
| | - Aaron Jh Tan
- New South Wales Rural Doctors Network, Hamilton, Australia
| | - Kristy Payne
- New South Wales Rural Doctors Network, Hamilton, Australia
| | - James Barr
- New South Wales Rural Doctors Network, Hamilton, Australia
| | - Benjamin Eames
- New South Wales Rural Doctors Network, Hamilton, Australia
| | - Mike Edwards
- New South Wales Rural Doctors Network, Hamilton, Australia
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Dexter F, Epstein RH. Managing capacity for urgent surgery: staffing, staff scheduling in-house or on-call from home, and work assignments. Br J Anaesth 2021; 128:399-402. [PMID: 34924177 DOI: 10.1016/j.bja.2021.11.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/15/2021] [Accepted: 11/22/2021] [Indexed: 11/16/2022] Open
Abstract
Parmar and colleagues developed and validated a graphical method for choosing the number of operating theatres to set aside for urgent surgical cases. We address appropriate usage of their new method for calculating anaesthesia staffing, including comparison with previously published techniques. Parmar and colleagues' method is based on all staff scheduled in-house, rather than some on-call from home. We review that this is not nearly as large a limitation as it may seem because of behavioural factors of staff assignment.
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Affiliation(s)
- Franklin Dexter
- Department of Anesthesia, University of Iowa, Iowa City, IA, USA.
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Quinn BG, O'Donnell S, Thompson D. Gender diversity in nursing: time to think again. Nurs Manag (Harrow) 2021; 29:20-24. [PMID: 34747161 DOI: 10.7748/nm.2021.e2010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 08/19/2021] [Indexed: 11/09/2022]
Abstract
Despite recent discussions and campaigns to widen nursing's appeal to people of diverse gender identities, it continues to be perceived as a largely female profession. In the context of an ageing workforce, and alongside recruitment and retention challenges, efforts should be directed at developing a more inclusive profession rather than focusing on why people other than women do not become nurses. To attract more men, transgender people and those who identify as nonbinary, as well as women, the approach to nursing recruitment needs to change. The profession must develop a more inclusive culture and examine and promote the advantages that gender diversity can bring to nursing. This article explores the lack of gender diversity in contemporary nursing, briefly examines the history of gender in nursing, and considers how the profession might evolve into a more gender-diverse and inclusive workforce.
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Affiliation(s)
| | - Shane O'Donnell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland
| | - David Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland
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Linker AS, Kulkarni SA, Astik GJ, Keniston A, Sakumoto M, Eid SM, Burden M, Leykum LK; HOMERuN COVID-19 Collaborative Working Group. Bracing for the Wave: a Multi-Institutional Survey Analysis of Inpatient Workforce Adaptations in the First Phase of COVID-19. J Gen Intern Med 2021; 36:3456-61. [PMID: 34047919 DOI: 10.1007/s11606-021-06697-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 03/03/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Medical centers across the country have had to rapidly adapt clinician staffing strategies to accommodate large influxes of patients with the coronavirus disease 2019 (COVID-19). OBJECTIVE We sought to understand the adaptations and staffing strategies that US academic medical centers employed in the inpatient setting early in the spread of COVID-19, and to assess whether those changes were sustained during the first phase of the pandemic. DESIGN Cross-sectional survey assessing organization-level, team-level, and clinician-level inpatient workforce adaptations. PARTICIPANTS Hospital medicine leadership at 27 academic medical centers in the USA. KEY RESULTS Twenty-seven of 36 centers responded to the survey (75%). Widespread practices included frequent staffing reassessment, organization-level changes such as geographic cohorting and redeployment of non-hospitalists, and exempting high-risk healthcare workers from direct care of patients with COVID-19. Several practices were implemented but discontinued, such as reduction of non-essential services, indicating that they were less sustainable for large centers. CONCLUSION These findings provide guidance for inpatient leaders seeking to identify sustainable practices for COVID-19 inpatient workforce planning.
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den Boer JCL, van den Bosch LJ, van Dam BAFM, Bruers JJM. Work situation and prospects of recently graduated dentists in the Netherlands. Eur J Dent Educ 2021; 25:837-845. [PMID: 33474782 PMCID: PMC8596787 DOI: 10.1111/eje.12663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/22/2020] [Accepted: 01/07/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Dentists who have graduated recently from a Dutch dental school work mainly in the Netherlands, where collaboration and differentiation are relevant factors. Furthermore, the Netherlands face regional undersupplies of dentists. The objective of this study was to describe choices and aims of recently graduated dentists for the near future. MATERIALS AND METHODS An invitation for the web questionnaire was sent by e-mail to 945 dentists who had graduated from a Dutch dental school between 2013 and 2017, of whom 230 (24.3%) participated in the survey. RESULTS Approximately three quarters (77%) of the recently graduated dentists worked as a general dentist in a practice of some else, primarily in urban areas. The choice for a practice was affected by location, earnings, and the opportunity to gain experience. Furthermore, the career choices were affected most by the desired length of the working week and financial security. The narrow majority (53%) of the recently graduated dentists believed that in 5 years they will be practice owner; 49% expected to be a differentiated dentist. Furthermore, 41% believed they will work in a smaller municipality. DISCUSSION Although recently graduated dentists seem receptive to work in smaller municipalities, the peripheral regions are conceivably less appealing. Practice ownership conceivably is an option for the near future for a narrow majority of the recently graduated dentists. CONCLUSION Recently graduated dentists have different preferences regarding their work situation in 5 years.
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Affiliation(s)
- Joost C. L. den Boer
- Department of Research & InformationRoyal Dutch Dental Association (KNMT)UtrechtThe Netherlands
- Department of Social DentistryAcademic Centre for Dentistry Amsterdam (ACTA)University of Amsterdam and Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Luuk J. van den Bosch
- Tandheelkundig Centrum Stad van de ZonHeerhugowaardThe Netherlands
- Tandheelkundig Centrum ObdamObdamThe Netherlands
| | | | - Josef J. M. Bruers
- Department of Research & InformationRoyal Dutch Dental Association (KNMT)UtrechtThe Netherlands
- Department of Social DentistryAcademic Centre for Dentistry Amsterdam (ACTA)University of Amsterdam and Vrije Universiteit AmsterdamAmsterdamThe Netherlands
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Leider JP, Sellers K, Bogaert K, Liss-Levinson R, Castrucci BC. Voluntary Separations and Workforce Planning: How Intent to Leave Public Health Agencies Manifests in Actual Departure in the United States. J Public Health Manag Pract 2021; 27:38-45. [PMID: 32769420 PMCID: PMC7690638 DOI: 10.1097/phh.0000000000001172] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To ascertain levels of turnover in public health staff between 2014 and 2017 due to retirement or quitting and to project levels of turnover for the whole of the state and local governmental public health in the United States nationally. DESIGN Turnover outcomes were analyzed for 15 128 staff from public health agencies between 2014 and 2017. Determinants of turnover were assessed using a logit model, associated with actually leaving one's organization. A microsimulation model was used to project expected turnover onto the broader workforce. RESULTS Between 2014 and 2017, 33% of staff left their agency. Half of the staff who indicated they were considering leaving in 2014 had done so by 2017, as did a quarter of the staff who had said they were not considering leaving. Staff younger than 30 years constituted 6% of the workforce but 13% of those who left (P < .001). CONCLUSIONS Public health agencies are expected to experience turnover in 60 000 of 200 000 staff positions between 2017 and 2020. IMPLICATIONS As much as one-third of the US public health workforce is expected to leave in the coming years. Retention efforts, especially around younger staff, must be a priority. Succession planning for those retiring is also a significant concern.
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Affiliation(s)
- Jonathon P. Leider
- School of Public Health, University of Minnesota, Minneapolis, Minnesota (Dr Leider); Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Dr Leider); de Beaumont Foundation, Bethesda, Maryland (Drs Sellers and Castrucci); Association of State and Territorial Health Officials, Arlington, Virginia (Ms Bogaert); and Center for State and Local Government Excellence, Washington, District of Columbia (Dr Liss-Levinson)
| | - Katie Sellers
- School of Public Health, University of Minnesota, Minneapolis, Minnesota (Dr Leider); Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Dr Leider); de Beaumont Foundation, Bethesda, Maryland (Drs Sellers and Castrucci); Association of State and Territorial Health Officials, Arlington, Virginia (Ms Bogaert); and Center for State and Local Government Excellence, Washington, District of Columbia (Dr Liss-Levinson)
| | - Kyle Bogaert
- School of Public Health, University of Minnesota, Minneapolis, Minnesota (Dr Leider); Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Dr Leider); de Beaumont Foundation, Bethesda, Maryland (Drs Sellers and Castrucci); Association of State and Territorial Health Officials, Arlington, Virginia (Ms Bogaert); and Center for State and Local Government Excellence, Washington, District of Columbia (Dr Liss-Levinson)
| | - Rivka Liss-Levinson
- School of Public Health, University of Minnesota, Minneapolis, Minnesota (Dr Leider); Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Dr Leider); de Beaumont Foundation, Bethesda, Maryland (Drs Sellers and Castrucci); Association of State and Territorial Health Officials, Arlington, Virginia (Ms Bogaert); and Center for State and Local Government Excellence, Washington, District of Columbia (Dr Liss-Levinson)
| | - Brian C. Castrucci
- School of Public Health, University of Minnesota, Minneapolis, Minnesota (Dr Leider); Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Dr Leider); de Beaumont Foundation, Bethesda, Maryland (Drs Sellers and Castrucci); Association of State and Territorial Health Officials, Arlington, Virginia (Ms Bogaert); and Center for State and Local Government Excellence, Washington, District of Columbia (Dr Liss-Levinson)
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Duru DC, Hammoud MS. Identifying effective retention strategies for front-line nurses. Nurs Manag (Harrow) 2021; 29:17-24. [PMID: 34490763 DOI: 10.7748/nm.2021.e1971] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 05/25/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Nurse retention is a significant issue worldwide, with many nurses planning to leave the profession. Therefore, it is crucial that healthcare organisations and senior leaders identify effective strategies for retaining their employees, who are their most valuable assets. AIM To explore strategies to reduce the voluntary turnover of front-line nurses from the perspective of senior healthcare leaders. METHOD This study used a case study design and a qualitative approach. Semi-structured interviews were conducted with six senior leaders in one US hospital and documents from the organisation's website were reviewed to gain information on the retention strategies used. FINDINGS Three themes were identified from the data: job satisfaction, financial compensation and effective communication. Retention strategies used by the senior leaders included a points competition to support recognition of nurses' work, a stoplight strategy and reports, sign-on bonuses, preceptor incentives, tuition reimbursements, staff shout-out boards and stay interviews. CONCLUSION Effective communication, respect, competitive financial compensation, benefits and proper recognition are among the main strategies that senior leaders can use to retain nurses. Shared governance is also important in empowering nurses and subsequently improving retention.
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Affiliation(s)
- Desmond Chuma Duru
- College of Management and Technology, Walden University, Minneapolis, MN, US
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Madden K, Maher D, Montero-Odasso M, Lam RE. Unmet Needs for Geriatric Medicine and Care of the Elderly Physicians Work Force in Canada. Can Geriatr J 2021; 24:162-163. [PMID: 34484497 PMCID: PMC8390321 DOI: 10.5770/cgj.24.555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Although the current low workforce availability of care of the elderly (COE) physicians, geriatric medicine specialists, and geriatric psychiatrists is undeniable, the ongoing demographic shift means this situation will only worsen. This evolving crisis is outlined clearly in the article "Updated Inventory and Projected Requirements for Specialist Physicians in Geriatrics" by Basu et al. found in this issue of the Canadian Geriatrics Journal.
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Affiliation(s)
- Kenneth Madden
- Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Deviani Maher
- Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | | | - Robert E. Lam
- Division of Geriatric Medicine, University of Toronto, Toronto, ON
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Phillips LA, de Los Santos N, Jackson J. Licenced practical nurses' perceptions of their work environments and their intention to stay: A cross-sectional study of four practice settings. Nurs Open 2021; 8:3299-3305. [PMID: 34432374 PMCID: PMC8510757 DOI: 10.1002/nop2.1046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 06/26/2021] [Accepted: 08/04/2021] [Indexed: 11/06/2022] Open
Abstract
Aims and objectives This study aimed to understand how licenced practical nurses perceive their work environments across different work settings and to analyse the association between these nurses’ perceptions of their work environments and their intentions to stay employed at their current nursing unit. Design A cross‐sectional descriptive survey was conducted with Licensed Practical Nurses in Alberta, Canada. Methods The study population consisted of 598 licenced practical nurses. Survey measures included demographic information, the Perceived Work Environment‐Nursing Work Index, and an intention to stay scale. Descriptive statistics were calculated and mean scores for perceptions about the work environment were compared by work setting. The associations between perceived work environment and intention to stay were analysed using linear regression. Results Overall, licenced practical nurses rated their work environment as mixed, with statistically significantly lower scores in acute care settings. Nurse manager ability and adequate staffing and resources were the highest contributing variables.
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Rocha J, Castillo-Lavergne CM, Byrd MJ, Carnethon MR, Miller R, Lin M, Marsh EE, Jackson JK, Yancy CW. Reimagining educational equity through strategic alliance partnerships in response to the USA STEM-M diversity gap. Health Promot Int 2021; 37:6356832. [PMID: 34427310 DOI: 10.1093/heapro/daab094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Addressing the USA diversity gap in science, technology, engineering, mathematics and medicine (STEM-M) through strategic alliance partnerships (SAPs) is an innovative solution toward combating the educational inequalities presented in K-12 education for marginalized youth interested in STEM-M professions. We present a model that unites multiple stakeholder s committed to diversifying the workforce in STEM-M, through the implementation of a multi-year high school pipeline program designed to better achieve STEM-M equity, access and opportunity at the secondary school level. We developed a unique model based on an SAP in a large metropolitan area in the Midwest that joins an Academic Medical Center and a local Public High School. Our results involving 46 students over 8 years demonstrate 100% high school graduation rates; 97% college attendance with full or partial scholarship support, and early evidence of post-graduation aspirations in STEM-M careers. Our early progress calls for more rigorous study against standard educational practices. If our program is proven to be more effective, then potentially more strategic public-private partnerships to foster K-12 pipeline programs to better achieve equity through educational access, opportunities and resources should be developed and targeted for those marginalized youth that have been historically denied STEM-M opportunities. After 10 years of dedicated effort, we see evidence of potential benefits of this SAP to develop K-12 pipeline programs with similar aims of STEM-M diversification, particularly by way of more-equitable provision of educational opportunities to students belonging to minority racial and ethnic groups.
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Affiliation(s)
- Janet Rocha
- Department of Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Marcus J Byrd
- Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Mercedes R Carnethon
- Department of Preventive Medicine (Epidemiology), Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Maria Lin
- Northwestern Medicine Scholars, Northwestern Memorial Healthcare, Chicago, IL, USA
| | - Erica E Marsh
- Department of Obstetrics and Gynecology (Reproductive Endocrinology), University of Michigan School of Medicine, Ann Arbor, MI, USA
| | | | - Clyde W Yancy
- Department of Medicine (Cardiology) and Medical Social Sciences, Diversity and Inclusion, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Northwood K, Cabral S, Cutbush J, Stedman T, Parker S. Understanding the drivers of bottlenecks in RANZCP training: modelling and a calculator to determining sustainable trainee intake. Australas Psychiatry 2021; 29:459-464. [PMID: 33347779 DOI: 10.1177/1039856220975281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Demand for places in postgraduate psychiatry training programmes has increased over recent years. All systems have capacity limits, and concerns have been raised regarding the sustainability of the current intake. This paper presents a modelling exercise to exploring the presence and strategies to resolve bottleneck in the Queensland training programme. METHODS Mathematical modelling based on the RANZCP training regulations and the characteristics of the accredited training programme. RESULTS A training bottleneck was identified which has been impacted by increased training intake, demand for Advanced Training certificates, and location factors. CONCLUSIONS This investigation raises important questions regarding the future management of postgraduate training in psychiatry in Queensland that may be applicable more widely across Australia and New Zealand. In particular, it highlights the large impact that can result from even small incremental increases in trainees across varying levels of the postgraduate programme and the importance of limiting trainee intake in a manner proportional to the availability of mandatory terms.
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Affiliation(s)
- Korinne Northwood
- Metro South Addiction and Mental Health Services (MSAMHS), Australia.,University of Queensland, Faculty of Medicine, Australia
| | - Sidney Cabral
- Metro South Addiction and Mental Health Services (MSAMHS), Australia
| | - Jimsie Cutbush
- Metro South Addiction and Mental Health Services (MSAMHS), Australia
| | | | - Stephen Parker
- Metro South Addiction and Mental Health Services (MSAMHS), Australia.,University of Queensland, Faculty of Medicine, Australia
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41
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Bakeer HM, Nassar RA, Sweelam RKM. Investigating organisational justice and job satisfaction as perceived by nurses, and its relationship to organizational citizenship behaviour. Nurs Manag (Harrow) 2021; 28:19-25. [PMID: 34227376 DOI: 10.7748/nm.2021.e1973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 03/30/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Organisational justice refers to the extent to which employees perceive workplace procedures, interactions, and outcomes to be fair in nature. Previous research has found that organisational justice has been associated with an employee's commitment to their organisation, job satisfaction, and intention to leave their role. Organisational justice has also been linked to organisational citizenship behaviours, and the likelihood of these behaviours being demonstrated by employees. AIM To investigate staff nurses' perceptions of organisational justice and job satisfaction and its relationship to their levels of organisational citizenship behaviour. METHOD Perceived levels of organisational justice, job satisfaction, and levels of organisational citizenship behaviour were evaluated among 175 nurses working in two hospitals in Egypt. Analysis was undertaken to ascertain whether a correlation existed between organisational justice or job satisfaction and levels of organisational citizenship behaviour. RESULTS The majority of nurses in this study were found to perceive moderate levels of organisational justice. Organisational justice was positively correlated with levels of organisational citizenship behaviour, as was job satisfaction. CONCLUSION This study found that nurses in two hospitals in Egypt perceived moderate levels of organisational justice in their place of work. Nurse managers should pay extra attention to strategies that promote organisational justice among nurses.
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Affiliation(s)
- Huda Mohammed Bakeer
- Nursing Administration Department, Faculty of Nursing, Menoufia University, Menoufia, Egypt
| | - Rehab AbdAllah Nassar
- Nursing Administration Department, Faculty of Nursing, Menoufia University, Menoufia, Egypt
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Lee P, Margaret N. Nursing organisation during COVID-19: experiences of an unaided, not-for-profit quaternary care teaching hospital in India. Nurs Manag (Harrow) 2021; 28:26-31. [PMID: 34155872 DOI: 10.7748/nm.2021.e1978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 03/28/2021] [Indexed: 11/09/2022]
Abstract
India reported its index case of coronavirus disease 2019 (COVID-19) in January 2020 and since then there has been an alarming rise in cases. In response to the worsening pandemic and the challenge presented by COVID-19 for hospitals in the public sector, the Government of India asked the country's private hospitals to reserve a percentage of their beds for COVID-19 patients. This article describes how nursing services at the Christian Medical College, Vellore - an unaided, not-for-profit quaternary care teaching hospital in Tamil Nadu, India - addressed various challenges to ensure a sustained, high-quality nursing care response to increased patient load. The main challenges included changing COVID-19 policies, ensuring the hospital was prepared to care for COVID-19 patients, and ensuring the availability of nurses. The article demonstrates how proactive planning, empowered involvement of nursing leaders and collaborative efforts resulted in deployment and training of 1,400 nurses, and ensured coordinated care for more than 10,000 patients with COVID-19.
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Affiliation(s)
- Premila Lee
- College of Nursing, Christian Medical College, Vellore, Tamil Nadu, India
| | - Nirmala Margaret
- College of Nursing, Christian Medical College, Vellore, Tamil Nadu, India
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43
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Jacob N, Burton C, Hale R, Jones A, Lloyd A, Rafferty AM, Allen D. Pro-judge study: Nurses' professional judgement in nurse staffing systems. J Adv Nurs 2021; 77:4226-4233. [PMID: 34138491 DOI: 10.1111/jan.14921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/20/2021] [Accepted: 05/24/2021] [Indexed: 11/24/2022]
Abstract
AIMS Aim of this study is to better understand the role of nurses' professional judgment in nurse staffing systems. DESIGN Qualitative comparative case study design of nurse staffing systems in England and Wales. METHODS Data will be collected through a variety of sources: individual interviews, observations of relevant meetings and analysis of key documents. Ethical approval for the study was granted in August 2020 from The Healthcare Research Ethics Committee (SREC reference: REC741). Data generation will be informed by science and technology studies and practice theories. DISCUSSION Ensuring adequate numbers of nurses are available to care for patients in response to shifting demand is an international policy priority. Emerging evidence on the use of formal workforce planning methodologies across the developed world highlights both the centrality of nurses' professional judgement in nurse staffing methodologies and the urgent need for theoretically informed research to better understand and conceptualise its contribution to decision-making. This study is designed to address this gap in understanding. It takes advantage of nurses' experiences of managing the service and staffing impacts of the Covid-19 pandemic and differences in strategic approaches to nurse staffing systems between England and Wales. IMPACT The research will: make visible the knowledge and skills that underpin professional judgement in nurse staffing decisions and provide a conceptual language with which to articulate this; lay the foundations for evidence-based programmes of nurse education and continuing professional development; furnish the evidence to inform the development of nurse-led decision support tools to augment professional judgement; and generate wider insights into the effectiveness of nurse staffing systems in practice.
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Affiliation(s)
- Nina Jacob
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Chris Burton
- School of Allied and Public Health Professions, Canterbury Christ Church University, Canterbury, UK
| | - Rachel Hale
- School of Psychology, Cardiff University, Cardiff, UK
| | - Aled Jones
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Amy Lloyd
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Anne Marie Rafferty
- Florence Nightingale School of Nursing and Midwifery, King's College London, London, UK
| | - Davina Allen
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
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44
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Hainey CL. Implementation of a ward staff self-rostering system: improving morale and retention. Nurs Manag (Harrow) 2021; 28:22-27. [PMID: 33876592 DOI: 10.7748/nm.2021.e1987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2021] [Indexed: 11/09/2022]
Abstract
Staff morale is an important factor in maintaining and improving nurse recruitment and retention. Evidence suggests more flexible working patterns can improve nurses' work-life balance and subsequently their workplace satisfaction. This article describes a ward-based quality improvement project that introduced a self-rostering system that enabled nurses to select their own shifts for a given four-week roster period. The aim was to increase staff satisfaction and subsequently improve retention and recruitment. The article describes the project and discusses the positive outcomes.
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45
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Dowers H. Can a clinical skills facilitator improve staff retention in a children's hospital? Nurs Child Young People 2021; 33:12-17. [PMID: 33870662 DOI: 10.7748/ncyp.2021.e1358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2020] [Indexed: 11/09/2022]
Abstract
Clinical skills facilitators are experienced nurses responsible for staff education and support in a clinical area, where they are employed supernumerary to the team. This article discusses the implementation and evaluation of a pilot clinical skills facilitator role on a medical ward in a children's hospital in an NHS trust in England, aimed at improving the retention of nursing staff. A baseline survey was conducted at the start of the pilot and a follow-up survey was conducted at the end, nine months later. The surveys contained ten statements about three factors important for staff retention: clinical skills, job satisfaction and well-being at work. Improvements were seen in all ten statements and a review of staff retention data showed that no member of staff had left the ward in the year of pilot implementation, compared with four the year before. The development of clinical skills facilitator roles on children's wards is therefore of potential benefit for staff retention.
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Affiliation(s)
- Holly Dowers
- University Hospitals of Leicester NHS Trust, Leicester, England
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46
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Charalambous L. Managing volunteers who support patients with dementia or cognitive impairment on acute hospital wards: the NURTURe model. Nurs Manag (Harrow) 2021; 28:34-40. [PMID: 33590732 DOI: 10.7748/nm.2021.e1981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2020] [Indexed: 11/09/2022]
Abstract
Volunteers are widely used to support patients with dementia or cognitive impairment on acute hospital wards. However, it appears that traditional volunteer management models do not fully address the challenges posed by managing volunteers in that setting. In a study of the use of volunteers in the care of people with dementia and cognitive impairment on acute hospital wards, interviews with a range of stakeholders revealed challenges regarding the environment, role and image of volunteers. Based on the study findings, an alternative model for managing volunteers on acute hospital wards was developed. This article describes the study and discusses the development of this alternative approach, the NURTURe model.
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47
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Lucas G, Brook J, Thomas T, Daniel D, Ahmet L, Salmon D. Healthcare professionals' views of a new second-level nursing associate role: A qualitative study exploring early implementation in an acute setting. J Clin Nurs 2021; 30:1312-1324. [PMID: 33497521 DOI: 10.1111/jocn.15675] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 12/14/2020] [Accepted: 01/07/2021] [Indexed: 11/28/2022]
Abstract
AIM The study aimed to establish the views of a range of stakeholders about their experiences of the newly implemented nursing associate role in England and its potential to contribute to patient care. BACKGROUND Second-level nursing roles are increasingly used internationally within the healthcare workforce. In response to registered nurse workforce deficits, a new nursing associate role has been introduced in England to augment care provided by registered nurses and enable career progression of support workers. DESIGN Qualitative descriptive design. METHODS Semi-structured interviews and a focus group were conducted with a range of healthcare professionals in a large inner city acute secondary care healthcare organisation in England. Interviews were guided by the Consolidated Framework for Implementation Research and analysed using Framework Analysis. The study was reported according to COREQ guidelines. RESULTS 33 healthcare professionals were interviewed-directors of nursing, ward managers, nursing associates and multidisciplinary team members. Participants perceived the role was broadly adaptable to different healthcare settings and provided a positive professional development mechanism for healthcare support workers. Managers felt training commitments made implementing the role complex and costly. Participants argued the role had limitations, particularly with intravenous medicine management. Implementation was impeded by rapid pace and consequent lack of clear communication and planning. CONCLUSIONS The nursing associate role was perceived as an inclusive pathway into nursing but with limitations when working with high-acuity patients. Further evaluation is needed to investigate how the role has embedded over time. RELEVANCE TO CLINICAL PRACTICE The role should be seen as both a stepping stone into registered nursing positions and valued as part of the nursing workforce. Consideration must be given to how the role can be safely implemented in different settings. Findings have relevance to healthcare leaders internationally, who continue to work in a climate of economic pressure and staffing shortages.
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Affiliation(s)
| | | | - Tamara Thomas
- Barts Health NHS Trust, The Royal London Hospital, London, UK
| | - Dionne Daniel
- Barts Health NHS Trust, The Royal London Hospital, London, UK
| | - Leyla Ahmet
- City, University of London, London, UK.,Barts Health NHS Trust, The Royal London Hospital, London, UK
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48
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Fan EMP, Nguyen NHL, Ang SY, Aloweni F, Goh HQI, Quek LT, Ayre TC, Pourghaderi AR, Lam SW, Ong EHM. Impact of COVID-19 on acute isolation bed capacity and nursing workforce requirements: A retrospective review. J Nurs Manag 2021; 29:1220-1227. [PMID: 33480121 PMCID: PMC8013355 DOI: 10.1111/jonm.13260] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 01/07/2021] [Accepted: 01/15/2021] [Indexed: 11/30/2022]
Abstract
Aim To understand the impact of COVID‐19 on isolation bed capacity requirements, nursing workforce requirements and nurse:patient ratios. Background COVID‐19 created an increased demand for isolation beds and nursing workforce globally. Methods This was a retrospective review of bed capacity, bed occupancy and nursing workforce data from the isolation units of a tertiary hospital in Singapore from 23 January 2020 to 31 May 2020. R v4.0.1 and Tidyverse 1.3.0 library were used for data cleaning and plotly 4.9.2.1 library for data visualization. Results In January to March 2020, isolation bed capacity was low (=<203 beds). A sharp increase in bed capacity was seen from 195 to 487 beds during 25 March to 29 April 2020, after which it plateaued. Bed occupancy remained lower than bed capacity throughout January to May 2020. After 16 April 2020, we experienced a shortage of 1.1 to 70.2 nurses in isolation wards. Due to low occupancy rates, nurse:patient ratio remained acceptable (minimum nurse:patient ratio = 0.26). Conclusion COVID‐19 caused drastic changes in isolation bed capacity and nursing workforce requirements. Implications for Nursing Management Building a model to predict nursing workforce requirements during pandemic surges may be helpful for planning and adequate staffing.
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Affiliation(s)
| | | | - Shin Yuh Ang
- Nursing Division, Singapore General Hospital, Singapore, Singapore
| | - Fazila Aloweni
- Nursing Division, Singapore General Hospital, Singapore, Singapore
| | - Hui Qi Ivy Goh
- Nursing Division, Singapore General Hospital, Singapore, Singapore
| | - Li Ting Quek
- Nursing Division, Singapore General Hospital, Singapore, Singapore
| | - Tracy Carol Ayre
- Nursing Division, Singapore General Hospital, Singapore, Singapore
| | | | - Shao Wei Lam
- Health Services Research Centre, SingHealth, Singapore, Singapore
| | - Eng Hock Marcus Ong
- Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore.,Health Services and Systems Research, Duke-NUS Graduate Medical School, Singapore, Singapore
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Henshall C, Kozlowska O, Walthall H, Heinen A, Smith R, Carding P. Interventions and strategies aimed at clinical academic pathway development for nurses in the United Kingdom: A systematised review of the literature. J Clin Nurs 2021; 30:1502-1518. [PMID: 33434295 DOI: 10.1111/jocn.15657] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 12/13/2020] [Accepted: 12/31/2020] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES To review interventions and strategies designed to progress UK clinical academic career pathways in nursing and identify barriers and facilitators to aid wider implementation. BACKGROUND For over a decade, the UK political agenda has promoted the entry of nurses into clinical academic roles. Partnerships between the National Health Service and academia are known to increase nursing recruitment, retention and quality of care. However, there remains a lack of nurses working in these partnership roles. DESIGN A systematised review was conducted. An electronic database search was carried out in PubMed, CINAHL, the British Nursing Database and PsychInfo for articles published between September 2006 to June 2020. A narrative approach to data synthesis was used, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. RESULTS Ten papers were included in the review. The authors reported a range of programmes, pathways and toolkits. Pathway outcome measures included numbers of nurses recruited onto clinical academic programmes, clinical academic programmes completed, nursing research outputs, impact on clinical practice and impact on nursing recruitment. Barriers and facilitators to pathway development included funding, clinical and research time constraints, infrastructure, strong and strategic clinical academic leadership and effective partnership working. The quality of the included studies was mixed; more high-quality, evidence-based programmes need to be developed and rigorously evaluated. CONCLUSIONS The findings can inform nursing clinical academic research pathway development internationally, by identifying key drivers for success. Sustained and cohesive implementation of clinical academic research pathways is lacking across the UK. RELEVANCE TO CLINICAL PRACTICE Strong, strategic leadership is required to enable progression of clinical academic nursing research pathway opportunities. Clinical nursing practitioners need to collaborate with external partners to enable development of clinical academic pathways within the nursing profession; this can lead to improvements in patient care and high-quality clinical outcomes.
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Affiliation(s)
| | | | - Helen Walthall
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Anna Heinen
- Oxford Health NHS Foundation Trust, Oxford, UK
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50
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Alsharari AF, Abuadas FH, Hakami MN, Darraj AA, Hakami MW. Impact of night shift rotations on nursing performance and patient safety: A cross-sectional study. Nurs Open 2021; 8:1479-1488. [PMID: 33449446 PMCID: PMC8046148 DOI: 10.1002/nop2.766] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/26/2020] [Accepted: 12/15/2020] [Indexed: 01/16/2023] Open
Abstract
Aim Hospitals operate on a 24‐hr basis, with shiftwork being unavoidable for most nurses. This study aims to explore the impact of night shiftwork rotations on nurses' physiological status, work performance and patient safety concerns among nurses in public hospitals. Design A descriptive predictive correlational design using a self‐administered questionnaire. Methods Electronic and printable survey questionnaires were distrusted among nurses working in public hospitals in multiple regions of Saudi Arabia. The study recruited 1,256 nurses from different nationalities, hospital work units and work experience. Results A large proportion of nurses on night shiftwork encountered patient safety issues (85.7%) and physiological consequences (93.6%). Counselling sessions and programmes to support at‐risk nurses are recommended.
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Affiliation(s)
- Abdalkarem F Alsharari
- Nursing Department, College of Applied Medical Sciences, Jouf University, Sakakah, Saudi Arabia
| | - Fuad H Abuadas
- Nursing Department, College of Applied Medical Sciences, Jouf University, Sakakah, Saudi Arabia
| | - Mohammed N Hakami
- College of Nursing, King Saud University, Riyadh, Saudi Arabia.,Ministry of Health, Riyadh, Saudi Arabia
| | - Adel A Darraj
- Ministry of Health, Riyadh, Saudi Arabia.,Sydney Nursing School, University of Sydney, Sydney, NSW, Australia
| | - Magbool W Hakami
- College of Nursing, King Saud University, Riyadh, Saudi Arabia.,Ministry of Health, Riyadh, Saudi Arabia
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