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PEDIATRICS ◽  
2022 ◽  
Author(s):  
Sarah A. Sobotka ◽  
David E. Hall ◽  
Cary Thurm ◽  
James Gay ◽  
Jay G. Berry

BACKGROUND: Although many children with medical complexity (CMC) use home health care (HHC), little is known about all pediatric HHC utilizers. Our objective was to assess characteristics of pediatric HHC recipients, providers, and payments. METHODS: We conducted a retrospective analysis of 5 209 525 children age 0-to-17 years enrolled Medicaid in the 2016 IBM Watson MarketScan Medicaid Database. HHC utilizers had ≥ 1 HHC claim. Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT) codes were reviewed to codify provider types when possible: registered nurse (RN), licensed practical nurse (LPN), home health aide (HHA), certified nursing assistant (CNA), or companion/personal attendant. Enrollee clinical characteristics, HHC provider type, and payments were assessed. Chronic conditions were evaluated with Agency for Healthcare Research and Quality’s Chronic Condition Indicators and Feudtner’s Complex Chronic Conditions. RESULTS: Of the 0.8% of children who used HHC, 43.8% were age <1 year, 25% had no chronic condition, 38.6% had a noncomplex chronic condition, 21.5% had a complex chronic condition without technology assistance, and 15.5% had technology assistance (eg, tracheostomy). HHC for children with technology assistance accounted for 72.6% of all HHC spending. Forty-five percent of HHC utilizers received RN/LPN-level care, 7.9% companion/personal attendant care, 5.9% HHA/CNA-level care, and 36% received care from an unspecified provider. For children with technology assistance, the majority (77.2%) received RN/LPN care, 17.5% companion/personal assistant care, and 13.8% HHA/CNA care. CONCLUSIONS: Children using HHC are a heterogeneous population who receive it from a variety of providers. Future investigations should explore the role of nonnurse caregivers, particularly with CMC.


PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260827
Author(s):  
Natura Colomer-Pérez ◽  
Sergio A. Useche

The core implication of nursing professionals’ labor is promoting self-care and foster well-being among healthcare service users. The beginning of the healing process starts with the provider, and self-care habits are needed to positively impact on patients’ care outcomes at different spheres. Overall, current literature supports the idea that nurses’ personal self-care should be a necessary skill to be expected in their professional role. In this regard, the Appraisal of Self-care Agency Scale (ASAS) is a worldwide known instrument aimed at assessing the ability to engage in self-care. However, it has never been tested in the Spanish context before, and much less in nursing practitioners or apprentices. The aim of this study was to translate, adapt and validate the ASAS for Spanish nursing apprentices, assessing its dimensionality, psychometric properties and convergent validity by means of the Sense of Coherence (SOC-13) questionnaire. Methods: Data were collected from a random sample of 921 Certificated Nursing Assistant (CNA) Spanish students and was analyzed trough confirmatory factor analyses via structural equation models. The core ASAS construct and its subscales were correlated with the SOC-13 scores. Results: Fair psychometric properties for the questionnaire were set. Also, SEM models endorse the validity and reliability of the four-factor dimensionality of the Spanish adaptation of the ASAS, whose associations to SOC scores were coherent and significant. Conclusion: This study allowed to establish that the Spanish version of the ASAS might be a useful tool for addressing self-care-related issues among nursing apprentices, a key population for promoting both their own and patients’ health and welfare through healthy and care-related behaviors.


2021 ◽  
Vol 12 (10) ◽  
pp. 484-491
Author(s):  
Angela C Young

Background: In 2016 veterinary nursing assistants (VNAs) were introduced as an additional tier to New Zealand veterinary practice. Aim: This study explores the utilisation of VNAs in New Zealand veterinary practices to ascertain the impact of an additional staffing layer to patient outcomes, workload management and staff wellness. Method: Through focus groups and semi-structured interviews with 30 participants, three themes emerged allowing evaluation of the Allied Veterinary Professionals Regulatory Council (AVPRC) Scope of Practice (SP) (AVPRC, 2020) and development of delegation guidelines (DG). Results: Analysis identified weak processes in delegation. The practice-based perspectives of VNA staff utilisation supports the AVPRC SP. Conclusion: Effective communication of the SP and DG for veterinary practice utilisation could contribute to reducing workload pressure. Additionally, individual practice staff discussions regarding own and colleague job expectations, along with review of contractual job descriptions, could further evolution of multi-tiered practices leading to improved patient outcomes, team wellness and business success.


2021 ◽  
Vol 72 (1) ◽  
pp. 6-11
Author(s):  
Mihaela Stoia

Abstract This study aims to estimate the occupational etiology of COVID-19 in the healthcare sector and obtain a risk matrix for the burden of disease across occupations and specific activities. The study population included 4515 cases and 133077 controls. We have used an epidemiological model that included data collected over one year from employed persons with confirmed SARS-CoV-2 infection, age group 20-64, and residing in Sibiu County. We measured the incidence rate (IR), relative risk (RR), and risk of COVID-19 attributable to the occupational exposure (AR), respectively, statistical analysis based on frequency distribution and the portion of cases to compute the risk levels in social- and healthcare workers. According to this model, approximately 70.5% of COVID-19 risk could be attributable to occupational exposure. The workplace is a strong predictor of infection risk (RR 3.4), particularly in residential long-term care facilities, hospitals, and ambulance services. The highest-risk job functions are nurse, nursing assistant, ambulance worker, and dentist. In conclusion, we believe in having demonstrated that epidemiological modeling may be helpful for risk management and notification of COVID-19 as an occupational disease in frontline staff and essential healthcare personnel.


2021 ◽  
Author(s):  
Maria de Fatima Pessoa Militao de Albuquerque ◽  
Wayner Vieira de Souza ◽  
Ulisses Ramos Montarroyos ◽  
Cresio Romeu Pereira ◽  
Cynthia Braga ◽  
...  

Introduction: The disparities in the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among frontline health care workers (HCWs) and the unique work circumstances are poorly documented for low-and middle-income countries. Methods: We assessed the frequency of SARS-CoV-2 infection, personal protective equipment (PPE) shortages, PPE use, and accidents involving biological material among HCWs in the Recife metropolitan area, Northeast Brazil. Using respondent driven sampling, we included HCWs attending suspected or confirmed COVID-19 patients from May 2020 to February 2021. Results: We analyzed 1,525 HCWs (527 physicians, 471 registered nurses, 263 nursing assistants/technicians, and 264 physical therapists). Women predominated in all categories (81.1%). Nurses were older and had more comorbidities (hypertension and overweight/obesity) than the other HCWs. The overall prevalence of SARS-CoV-2 infection was 61.8% after adjustment for the cluster random effect, weighted by network, and reference population size. The independent risk factors for a positive RT-PCR test were being a nursing assistant (OR adjusted: 2.56), not always using all recommended PPE in routine practice (ORadj: 2.15), and reporting a splash of biological fluid/respiratory secretion in the eyes (ORadj: 3.37). Conclusions: The high risk of infection among HCWs reflects PPE shortages and younger, possibly less experienced, frontline HCWs. There were disparities in the risk of SARS-CoV-2 infection among HCWs, with nursing assistants being the most vulnerable, possibly due to their longer and frequent contact with COVID-19 patients.


2021 ◽  
Author(s):  
Amanda Souza Pereira Sales ◽  
Cecília Souza França ◽  
Larissa Miranda dos Santos ◽  
Poliana G. V. Oliveira dos Santos ◽  
Murialdo Gasparet ◽  
...  

The current literature has pointed out the existence of positive influences of spiritual and religious beliefs in cancer treatment. The study, promoted by the Centre for Multidisciplinary Research in Culture, Faith and Reason (NUCFER), sought to understand the conception of cancer patients and health professionals about the inclusion of spirituality in the treatment of people with cancer. Thus, the general objective of this project was to understand the meaning of spirituality for cancer patients during their treatment and how this experience can contribute to support human care and relationships between patients and the healthcare team. The research was qualitative, using the semi-structured interview technique. 06 (six) health professionals were interviewed, one Nursing Assistant, three Registered Nurses and two Doctors; and 05 (five) people who have already gone through cancer treatment or are going through it. In a total of eleven people interviewed, all stated that it is important to take into account the spirituality of patients undergoing cancer treatment, as it significantly contributes to the treatment and coping with the difficulties arising from this painful process, in addition to valuing the human person byseeing them beyond their disease. Thus, the research revealed that the spirituality of patients undergoing cancer treatment must be taken into account, respected and encouraged when they wish. Subsequently, ithelps to maintain the emotional health of these individuals in high suffering, to recognize themselves in their integrity as humans, to respect all their expressions of living beings in the world. This representsa humanized treatment and promotes dignity of the human person


2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Amy Richmond Campbell ◽  
Susan Kennerly ◽  
Melvin Swanson ◽  
Thompson Forbes ◽  
Teresa Anderson ◽  
...  

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
David Morrison ◽  
Jerome Carson

Purpose The purpose of this paper is to provide a profile of Dave Morrison. Design/methodology/approach In this case study, Dave provides a short biography of his background and is then interviewed by Jerome. Findings Dave has had two careers. The first as a scaffolder. The second as a nursing assistant in mental health services. He has ended up bruised and battered in both. Research limitations/implications Every case study tells a different story. The effects of stress can be cumulative. Practical implications There are many accounts of how hospitalisation has traumatised service users. Yet, working in these services can also be traumatic for the care staff. Social implications Professor Tony Butterworth used to say “Happy nurse equals happy patient”. If you look after staff needs, they will provide better care. Have we ever really looked after the needs of mental health-care staff? Originality/value Dave’s story is unique. As Nicola Adams says, “Fall down eight times, get up nine”. Dave has fallen down many more times than this. Eventually, it gets harder to get back up.


2021 ◽  
pp. 073346482110356
Author(s):  
Katherine A. Kennedy ◽  
Katherine M. Abbott ◽  
John R. Bowblis

Objectives: The objective of this study was to examine the relationship between high wages and empowerment practices on certified nursing assistant (CNA) retention, necessary for providing high-quality care for nursing home (NH) residents. Methods: Measures of provider-level CNA empowerment and wages from the 2015 Ohio Biennial Survey were used to estimate two regression models on retention ( n = 719), one without and one with an interaction term of high wages and high empowerment. Results: Only in the context of the interacted model were NHs that provided both high wages and high empowerment associated with a 7.09 percentage-point improvement in the CNA retention rate ( p = .0003). Individually, high wages and a high empowerment score were not statistically significant in either regression model. Discussion: Retaining CNAs in NH communities requires a combination of empowerment practices (e.g., involving CNAs in decision-making about hiring other staff) and high hourly wages.


2021 ◽  
Vol 1 (2) ◽  
Author(s):  
Nasrin Sarabi

Background: Using different skill levels for patient care not only helps better and more fully meet patients' needs but also reduces the need for expert nurses. Objectives: This study was conducted to determine the perceptions of nurses and nursing assistants about the nursing assistant role. Methods: This study was conducted based on a conventional content analysis approach. The data was collected at the Ganjavian hospital in Dezful, Iran. Ten nurses and eleven nursing assistants were selected by purposeful sampling, and data were collected using unstructured interviews. The recorded interviews were eventually transcribed verbatim, and meaning units were then identified. Coding was then performed by compressing the meaning units and converting them into codes. The codes were summarized and classified to form categories. At last, the categories formed themes based on their similarities and differences. Results: Displeasure of the position was the main category of the study, which consisted of the two main subcategories of “having a small role in assisting nurses” and “reluctance to work”. Conclusions: The results of the study showed that nursing assistants have problems performing their roles, which need to be addressed by nursing managers.


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