Infection preventionist staffing levels and rates of 10 types of healthcare-associated infections: A 9-year ambidirectional observation

Objective: To quantitatively evaluate relationships between infection preventionists (IPs) staffing levels, nursing hours, and rates of 10 types of healthcare-associated infections (HAIs). Design and setting: An ambidirectional observation in a 528-bed teaching hospital. Patients: All inpatients from July 1, 2012, to February 1, 2021. Methods: Standardized US National Health Safety Network (NHSN) definitions were used for HAIs. Staffing levels were measured in full-time equivalents (FTE) for IPs and total monthly hours worked for nurses. A time-trend analysis using control charts, t tests, Poisson tests, and regression analysis was performed using Minitab and R computing programs on rates and standardized infection ratios (SIRs) of 10 types of HAIs. An additional analysis was performed on 3 stratifications: critically low (2–3 FTE), below recommended IP levels (4–6 FTE), and at recommended IP levels (7–8 FTE). Results: The observation covered 1.6 million patient days of surveillance. IP staffing levels fluctuated from ≤2 IP FTE (critically low) to 7–8 IP FTE (recommended levels). Periods of highest catheter-associated urinary tract infection SIRs, hospital-onset Clostridioides difficile and carbapenem-resistant Enterobacteriaceae infection rates, along with 4 of 5 types of surgical site SIRs coincided with the periods of lowest IP staffing levels and the absence of certified IPs and a healthcare epidemiologist. Central-line–associated bloodstream infections increased amid lower nursing levels despite the increased presence of an IP and a hospital epidemiologist. Conclusions: Of 10 HAIs, 8 had highest incidences during periods of lowest IP staffing and experience. Some HAI rates varied inversely with levels of IP staffing and experience and others appeared to be more influenced by nursing levels or other confounders.

Formalization and employee thriving at work: a moderated mediation model including work engagement and centralization

PurposeUntil recently, scholars have begun to examine the contextual antecedents of employees thriving at work. A recent study has shown that one aspect of organizational structure/context (i.e. formalization) can be an important antecedent of employee thriving at work. However, scholars have urged doing research examining how different aspects of organizational structure can combinedly influence employee work outcomes such as thriving at work. Given that, the present paper proposes a theoretical model to unravel the mechanisms of how two aspects of organizational structure (i.e. formalization and centralization) may operate as the antecedents of employees thriving at work. In particular, the author draws on the Conservation of Resources Theory (COR) to hypothesize that employees' work engagement mediates the relationship between their perception of formalization and thriving at work. The author further hypothesizes that the indirect relationship between formalization and employee thriving at work is moderated by employees' perception of centralization, such that the relationship is stronger in the presence of a lower level of centralization than higher.Design/methodology/approach The author gathered data by employing a time-lagged survey design involving 136 full-time employees from different organizations.FindingsResults show that employee work engagement mediates the relationship between formalization and employee thriving at work. Further, the indirect relationship between formalization and employee thriving at work is stronger when the level of centralization is relatively low.Research limitations/implicationsFormalization is able to enact employees' thriving at work, particularly when organization implements relatively less centralized structure.Originality/valueThis study first introduces work engagement as a mediator in the formalization–employee thriving at work relationship and centralization as a moderator along this mediating process.

Veteran families with complex needs: a qualitative study of the veterans’ support system

Background Families with complex needs face significant challenges accessing and navigating health and social services. For veteran families, these challenges are exacerbated by interactions between military and civilian systems of care, and the density of the veterans’ non-profit sector. This qualitative study was designed to gather rich, detailed information on complex needs in veteran families; and explore service providers’ and families’ experiences of accessing and navigating the veterans’ support system. Methods The study comprised participant background questionnaires (n = 34), focus groups with frontline service providers (n = 18), and one-on-one interviews with veteran families (n = 16) in Australia. The semi-structured focus groups and interviews were designed to gather rich, detailed information on four study topics: (i) health and wellbeing needs in veteran families; (ii) service-access barriers and facilitators; (iii) unmet needs and gaps in service provision; and (iv) practical solutions for improving service delivery. The study recruited participants who could best address the focus on veteran families with complex needs. The questionnaire data was used to describe relevant characteristics of the participant sample. The focus groups and interviews were audio-recorded, transcribed, and a reflexive thematic analysis was conducted to identify patterns of shared meaning in the qualitative data. Results Both service providers and families found the veterans’ support system difficult to access and navigate. System fragmentation was perceived to impede care coordination, and delay access to holistic care for veteran families with complex needs. The medico-legal aspects of compensation and rehabilitation processes were perceived to harm veteran identity, and undermine health and wellbeing outcomes. Recovery-oriented practice was viewed as a way to promote veteran independence and self-management. Participants expressed a strong preference for family-centred care that was informed by an understanding of military lifestyle and culture. Conclusion The health and wellbeing needs of veteran families intensify during the transition from full-time military service to civilian environments, and service- or reintegration-related difficulties may emerge (or persist) for a significant period of time thereafter. Veteran families with complex needs are unduly burdened by care coordination demands. There is a pressing need for high-quality implementation studies that evaluate initiatives for integrating fragmented systems of care.

ESTABLISHING A SHARED –USER COMMUNITY KITCHEN IN LILIW LAGUNA KITCHEN UTILITY PROJECT FOR ALL

The study aims to analyze the financial feasibility of establishing a shared-use community/ commercial kitchen as an economic development tool. The study was intended to reveal other potential opportunities that could exist with a viable community kitchen concept to enhance workforce training in the food service industry, culinary arts and help the local food manufacturers who do not have their kitchen facility. A 700 square meter, including areas for processing, storage, shipping, warehousing, etc and areas for culinary training, shared user community kitchen facility is needed in Liliw Laguna according to the fifty (50) respondent’s. The volume of responses and their consistent support of the shared – use concept of community kitchen facility provide sufficient basis for a positive feasibility determination. The strength of the anecdotal information drawn from in – depth interviews simply verifies the survey and provides a high degree of confidence in the study result. The needed facility design and equipment should match ethnic foods, local delicacies/snack foods, meat products and catered meals production. Freelance cooks wanted to use the facility regularly. Ninety-eight percent of the facility schedule could be absorbed by the potential users. The number of caterers without a kitchen in Liliw Laguna area seems to provide a sufficient base to provide a steady revenue stream, for the facility. Specialty food producers accounted for majority of all intended users (60% of respondents) with caterers the second most likely users (23% of respondents). Survey results indicated that there is a potential “hour lease” estimated at 166/168 revenue hours per week. Both groups would utilize the proposed facility. Liliw Senior High School – TVL strand within the vicinity desire to utilize the kitchen as a training facility. The capital budget needed is Php 9, 401, 981. The internal rate of return of the project is 23% at 20% cost money hurdle cost. The Return – on – Investment is 43% using DuPont’s Model and has positive net present value Php 1, 597, 649 assuming project life of eight years. The project can generate sufficient revenue to achieve breakeven point at 3, 173 rental services of Php 850 per hour. Has the ability to pay for itself within three and half (3.5) years with two employees – a facility General Manager on full time employment basis and a Facility General Manager on full time employment basis and a Facility General Affairs Assistant as soon as the revenue permits. The survey result indicated that the facility site is preferred at Mh. Del Pilar Bgry Pagasa Liliw Laguna. Many catering institutions need to be located in close proximity to their catering sites and clientele. A variety of collaborations is possible in developing the project and operating the facility. Potential structures include choices as Liliw Laguna as sole sponsor, owner, operator and administrator of the project transforming the kitchen as Government Owned and Controlled Corporation. KEYWORDS: Shared-User, Community Kitchen, Kusina ng Bayan, Kitchen Utility for All

General practitioners’ experiences with, views of, and attitudes towards, general practice-based pharmacists: a cross-sectional survey

Background There is limited United Kingdom (UK) literature on general practice-based pharmacists’ (PBPs’) role evolution and few studies have explored general practitioners’ (GPs’) experiences on pharmacist integration into general practice. Therefore, this study aimed to investigate GPs’ experiences with, views of, and attitudes towards PBPs in Northern Ireland (NI). Methods A paper-based self-administered questionnaire comprising four sections was mailed in 2019 to 329 general practices across NI and was completed by one GP in every practice who had most contact with the PBP. Descriptive analyses were used and responses to open-ended questions were analysed thematically. Results The response rate was 61.7% (203/329). There was at least one PBP per general practice. All GPs had face-to-face meetings with PBPs, with three-quarters (78.7%, n = 159) meeting with the PBP more than once a week. Approximately two-thirds of GPs (62.4%, n = 126) reported that PBPs were qualified as independent prescribers, and 76.2% of these (n = 96/126) indicated that prescribers were currently prescribing for patients. The majority of GPs reported that PBPs always/very often had the required clinical skills (83.6%, n = 162) and knowledge (87.0%, n = 167) to provide safe and effective care for patients. However, 31.1% (n = 61) stated that PBPs only sometimes had the confidence to make clinical decisions. The majority of GPs (> 85%) displayed largely positive attitudes towards collaboration with PBPs. Most GPs agreed/strongly agreed that PBPs will have a positive impact on patient outcomes (95.0%, n = 192) and can provide a better link between general practices and community pharmacists (96.1%, n = 194). However, 24.8% of GPs (n = 50) were unclear if the PBP role moved community pharmacists to the periphery of the primary care team. An evaluation of the free-text comments indicated that GPs were in favour of more PBP sessions and full-time posts. Conclusion Most GPs had positive views of, and attitudes towards, PBPs. The findings may have implications for future developments in order to extend integration of PBPs within general practice, including the enhancement of training in clinical skills and decision-making. Exploring PBPs’, community pharmacists’ and patients’ views of this role in general practice is required to corroborate study findings.

Assessing the Sustainability Index of Part-Time and Full-time Hazelnut Farms in Giresun and Ordu Province, Turkey

The study's primary purposes were to assess the sustainability index of hazelnut farms and explore the effects of part-time and full-time farming types on sustainability index in hazelnut production in the Giresun and Ordu Province of Turkey. One hundred fifty-two hazelnut farms were selected using the stratified sampling method, and data were collected. Several steps were taken, including using factor analysis after standardizing the variables to determine their weights to calculate the composite hazelnut farms sustainability index. The research findings showed that overall hazelnut sustainability scores of farms varied from 0.28 to 0.59, and the average score was 0.44 at sampled farms. The composite hazelnut sustainability index was at an unsatisfactory level. The social and economic sustainability index value of farms was equal, and they were higher than the environmental index value. The values were 0.50 and 0.30, respectively. While the economic sustainability index score of full-time farms was higher than that of part-time farms, and part-time farms had higher environmental sustainability index scores than that of full-time farms. Social sustainability scores were not different in terms of farm type. It was recommended that when designing and regulation support policies, policy-makers should differentiate part-time and full-time hazelnut farming. Training and extension programs must be planned to increase the level of knowledge of every willing farmer. In addition, training and certification programs must be implemented to enhance the quality of the foreign labor force.

Assessing International Sport Federations' Sustainability Practices: Toward Integrating Sustainability in Their Main Sports Events

Research Question: Sustainability has become a pressing issue for a wide range of organizations, including sports' world governing bodies. This paper examines (1) how sustainability can be defined in the context of international sport federations and (2) how international federations implement social and environmental sustainability practices. We used an eight-dimensional analytical framework to analyze multiple case studies and drew on neo-institutional theory to interpret the recent changes international federations have made with regard to sustainability.Research Methods: Our methodology combined a multiple case study with analyses of official documents and in-depth semi-structured interviews.Results and Findings: Our six case studies revealed five approaches to sustainability: (a) implementing sustainability pilot events; (b) partnering with NGOs; (c) partnering with sustainability consultancies; (d) creating a sustainability committee; and (e) launching a comprehensive sustainability strategy with at least a full-time sustainability manager.Implications: In terms of theory, examining our data through the lens of neo-institutional theory provides insights into international federations' recent sustainability behaviors. Our findings enabled us to draw up a “sustainability ladder” of sport federations' responsibilities, which can be used to assess the degree to which they have embraced sustainability. In practical terms, our findings should encourage more sport federations to take concrete steps to improve their sustainability by implementing the five approaches.

Research Note: Gender Differences in Employment During the COVID-19 Epidemic

We investigate the impact of the COVID-19 epidemic on gender disparities in three employment outcomes: labor force participation, full-time employment, and unemployment. Using data from the monthly Current Population Survey, in this research note we test individual fixed-effects models to examine the employment status of women relative to that of men in the nine months following the onset of the epidemic in March of 2020. We also test separate models to examine differences between women and men based on the presence of young children. Because the economic effects of the epidemic coincided with the summer months, when women's employment often declines, we account for seasonality in women's employment status. After doing so, we find that women's full-time employment did not decline significantly relative to that of men during the months following the beginning of the epidemic. Gender gaps in unemployment and labor force participation did increase, however, in the early and later months of the year, respectively. Our findings regarding women's labor force participation and employment have implications for our understanding of the long-term effects of the health crisis on other demographic outcomes.

Assessing the Effect of Instructor’s Emotional Intelligence (EI) on the Students’ Satisfaction Index (SSI): Meta-Analysis of University Students

The present study aims to examine the relationship of instructors’ emotional intelligence (EI) with the satisfaction index of their corresponding students. For this purpose, data were collected from 650 full-time students and 6 male instructors from a major Middle Eastern University. Emotional intelligence of the instructors was measured with the help of average of students’ responses with the weightage of each assessing parameter, i.e., self-awareness, self-management, social awareness, and relationship management which also reflected the students’ satisfaction index (SSI). Moreover, authenticity of the data was confirmed with the help of Cronbach’s alpha, and the analysis of data was carried out using descriptive statistics, correlation, and box plots. The students’ satisfaction index is calculated by correlating various parameters such as comfort, skill, learning, and motivation in order to identify the most critical parameter. For identifying the most critical parameter, box plots are used. Final results reveal a strong correlation of instructor’s EI with student satisfaction index (r = 0.951, p < 0.005 , F >> Fcritical). Findings of the study can be beneficial to highlight the importance of students’ satisfaction index (SSI) which is correlated with instructor’s EI.

Impact of work-study conflict on workplace outcomes: supervisor support for juggling many balls

Purpose Drawing on conservation of resource theory, this study aims to examine the impact of work-study conflict (WSC) on workplace outcomes (job performance, job satisfaction, burnout and turnover intention). The study also investigated whether these relationships were contingent on the level of supervisor support at the workplace. Design/methodology/approach Survey data were collected in two-time lags from 752 studying professionals (non-traditional students) through a convenient sampling technique. Findings Results showed that WSC enhances burnout and turnover intention but has no significant direct relationship with job performance and job satisfaction. It was also found that the relationships between WSC and workplace outcomes, i.e. job performance, job satisfaction and burnout were conditional on the level of supervisor support. Originality/value The research contributes to WSC literature by being the first to empirically investigate the direct and interactive effects of WSC and supervisor support on important workplace outcomes of those adults who were primarily working and then decided to study further for career development rather than on full-time students.