Analysis of the main indicators of dental care in Ukraine for 2020

The article presents an analysis of the results of state and sectoral statistical reports of dental healthcare institutions, which were submitted to the State Institution “Center for Medical Statistics of the Ministry of Health of Ukraine” in 2020. As of January 1, 2021, 22,180 general dental practitioners and 766 dentists provided dental care to the population of Ukraine in 6,443 institutions of various forms of ownership. The article pre-sents the structure, staffing level and dentistry personnel density in Ukraine; also, a comparative analysis for the last 5 years was conducted in terms of staffing level of dentists working in healthcare institutions of different forms of ownership. The main indicators of the system of providing dental care in both public and private healthcare facilities are presented. A comparative analysis with the main indicators of dental care for 2019 was carried out. The number of routine examinations of the oral cavity decreases and the number of malignant neoplasms, especially advanced ones, increases.

Do Daytime Activity, Mood at Bedtime and Unit Tumult Predict Nighttime Sleep Quality of Long-Term Care Residents?

Sleep quality declines in old age and is particularly poor for long-term care (LTC) residents with dementia. Compromised sleep quality is associated with severe cognitive and neuropsychiatric symptoms, agitation, aggressiveness, and poor quality of life. Based on the premise that stressors can have a cumulative effect on people with dementia throughout the day that contributes to negative consequences later in the day, we examined if daytime activity, mood, and unit tumult were associated with sleep quality. A convenience sample of 53 LTC residents with dementia participated in this correlational study. Objective sleep quality and activity variables were measured using Actigraphy, and mood was measured by the Observed Emotion Rating Scale. Unit tumult was defined as events in the residents living area that are deviations from the typical day (i.e., census changes, being cared for by a certified nursing assistant from a temporary staffing agency, and lower than usual staffing level). Comorbid illness and level of dementia were control variables. Half of the sample had a sleep efficiency that was less than .85 and were awake for more than 90 minutes at night. Comorbid illness, negative mood at bedtime, and daytime activity level accounted for 26.1% of the variance in total sleep minutes. Census changes and the use of temporary agency staff were associated with poor total sleep time and sleep efficiency. Findings suggest that daytime activity, mood at bedtime, and unit tumult should be considered when designing and testing interventions to improve sleep quality among LTC residents with dementia.

Multiple Perspectives on Disaster Preparedness in Long-Term Care: From Heat to Hospice

Preparedness of residents in long-term care (LTC) exposed to disasters continues to warrant concern. Prior work by our research team highlights explicit evidence of the profound vulnerability of Florida nursing home (NH) residents exposed to Hurricane Irma in 2017. This research adds to our knowledge of the profound effect of disasters on long term care residents. This symposium will utilize mixed methodologies to discuss the varied effects of Hurricane Irma on vulnerable older adults residing in Florida NHs and Assisted Living communities (ALCs). Using a novel methodology for identifying a cohort of ALC residents, the first presentation will present the morbidity and mortality effects of Hurricane Irma on Florida ALC residents and identify high risk groups by health condition. The second presentation will document the effect of Hurricane Irma on NH Residents previously enrolled in Hospice and expound on the effect of the disaster on hospice enrollment after the storm. The third presentation will present qualitative results of interviews with ALC administrators highlighting the effect of the storm on both large and small (<25 beds) facilities. The fourth presentation will address the issue of heat exposure in the days after Hurricane Irma and consider the preventative effect of generators on morbidity and mortality. Finally, a fifth presentation will examine NH staffing level variation in the days leading to the hurricane. To conclude, this symposium offers a multi-faceted view of a disaster’s effects on LTC residents across Florida, including novel data from the NH environment and lesser-examined ALCs.

Factors Associated With Nursing Home Residents’ COVID-19 Infections: A Systematic Review of Literature

Background Nursing homes were impacted disproportionately by the coronavirus because of their resident’s vulnerabilities and settings. Even many previous studies illustrated factors related to nursing home residents’ Covid-19 infections, there’s no such study epitomizing those factors systematically, while some factors were controversial in different studies. The article aims to summarize major types of factors and provide crucially influential implications for nursing homes to prevent and manage their resident infections. Methods All articles published between 01 January 2020 - 15 January 2021 in English version were searched through three electronic databases (PubMed, Web of Science, and Scopus). Two authors screened and evaluated a total of 121 studies independently based on selection and extraction criteria. Results Seventeen identified studies were included in the research, which involved five major types of factors (nursing home’s residence, nursing home, staff, resident, and others). Conclusion nursing home’s county infection rate, size, and staff residence were the strongest significant factors in many studies. Per-capital income, symptom-based screening and testing, and asymptomatic individuals have impacted resident’s infections variously since the beginning of the pandemic. Nursing home’s star rating and a total count of fines became factors when considered its locations. Other factors, including nursing home’s type, historical health deficiencies, staffing level, and staff working different facilities, etc., were also significant factors. The value of factors suggests healthcare systems reflect appropriate measures and allocate more resources to nursing homes in high prevalence counties on the basis of universal allocation.

Optimal Staffing for Vessel Traffic Service Operators: A Case Study of Yeosu VTS

Vessel traffic volume and vessel traffic service (VTS) operator workloads are increasing with the expansion of global maritime trade, contributing to marine accidents by causing difficulties in providing timely services. Therefore, it is essential to have sufficient VTS operators considering the vessel traffic volume and near-miss cases. However, no quantitative method for determining the optimal number of workstations, which is necessary for calculating the VTS operator staffing level, has yet been proposed. This paper proposes a new, microscopic approach for calculating the number of workstations from vessel trajectories and voice recording communication data between VTS operators and navigators. The vessel trajectory data are preprocessed to interpolate different intervals. The proposed method consists of three modules: Information services, navigational assistance services, and traffic organization service. The developed model was applied to the Yeosu VTS in Korea. Another workstation should be added to the current workstation based on the proposed method. The results showed that even without annual statistical data, a reasonable VTS operator staffing level could be calculated. The proposed approach helps prevent vessel accidents by providing timely services even if the vessel traffic is congested if VTS operators are deployed to a sufficient number of workstations.

Planning staffing in the implementation of the national project "Fight against cancer"

Introduction. The leading reason for the growth of oncological morbidity and mortality is the untimely detection and treatment of oncological diseases, restrictions on the availability of specialized oncological medical care formed by the lack of oncologists. For the implementation of the national project to combat oncological diseases, he search for ways to provide medical organizations with personnel is highly relevant. The purpose of the study is to propose ways of providing oncologists to St. Petersburg healthcare institutions at all levels based on an analysis of the staffing level of medical personnel in this profile.Materials and methods. The indicators of provision of all levels of medical organizations in St. Petersburg with oncologists were analyzed using a continuous method of observation over 5 years in the period from 2014 to 2018. The data obtained were statistically processed and used to calculate the need (surplus) in specialists of this profile, as well as to calculate indicators for long-term planning, taking into account the available staffing of medical institutions of city and federal subordination.Results and Discussion. The positive dynamics of staffing of doctors-oncologists, especially individuals, was noted. The growth of the indicator in the analyzed period was 13.6%, which did not allow achieving satisfactory indicators: the staffing rate of oncologists was 88.8%, individuals – 86.1%. Differences in the staffing of medical organizations of various types were noted in 2018: the staffing rate in outpatient medical organizations was 81.7%, and in individuals – 66.7%; in hospitals staffing was 95.6%, and in individuals – 91.6%. Calculations of e deficit (surplus) in the staff of oncologists for medical organizations of all types made it possible to establish that there is no pronounced deficit in specialists, but there is a disproportion in their provision, at a loss for outpatient medical organizations. The calculated prospective need for targeted training of oncologists for medical institutions in St. Petersburg amounted to 18 specialists annually.Conclusion. The actual indicators of staffing of the St. Petersburg oncological service at all levels have been established, approaches have been proposed to meet the needs of medical organizations for oncologists. The implementation of the national project to combat oncological diseases will contribute to the early detection of oncological diseases, increasing the availability of medical care provided for them.

Changes in Nurse Staffing Grades of Korean Hospitals during COVID-19 Pandemic

The global COVID-19 pandemic is creating challenges to manage staff ratios in clinical units. Nurse staffing level is an important indicator of the quality of care. This study aimed to identify any changes in the nurse staffing levels in the general wards of hospitals in Korea during the COVID-19 pandemic. The unit of analysis was the hospitals. This longitudinal study observed the quarterly change of the nurse staffing grades in 969 hospitals in 2020. The nurse staffing grades ranged from 1 to 7 according to the nurse–patient ratio measured by the number of patients (or beds) per nurse. The major dependent and independent variables were the change of nurse staffing grades and three quarterly observation points being compared with those during the 1st quarter (1Q) of 2020, respectively. A generalized linear model was used. Unexpectedly, the nurse staffing grades significantly improved (2Q: RR, 27.2%; 95% confidence interval (CI), 15.1–27.6; p < 0.001; 3Q: RR, 95% CI, 20.2%; 16.9–21.6; p < 0.001; 4Q: RR, 26.6%; 95% CI, 17.8–39.6; p < 0.001) quarterly, indicating that the nurse staffing levels increased. In the comparison of grades at 2Q, 3Q, and 4Q with those at 1Q, most figures improved in tertiary, general, and small hospitals (p < 0.05), except at 3Q and 4Q of general hospitals. In conclusion, the nurse staffing levels did not decrease, but nursing shortage might occur.

Staffing the unit with nurses: the role of nurse managers

PurposeTo explore the staffing practices of nurse managers at the unit.Design/methodology/approachIntroduction: Ensuring that units are staffed with adequate nurses to render quality nursing care to clients has become increasingly challenging for most hospitals. There is growing evidence linking best patient outcomes and fewer adverse events to the presence of nurses at the bedside. Hospitals require to attract and retain nurses in the units to address the issues of quality, staff and patient safety. Methods: The study used a descriptive phenomenological design to purposively select 15 nurse managers (NMs) and 47 nurses for in-depth interviews and focus group discussions respectively.FindingsThe study found that the demand for nurses to work in the unit was not scientific. Nurses affirmed their frustration of inadequate numbers of staff in the unit especially, at the periphery hospitals. Time can be used as a source of motivation for nurses and nurses should be involved in the development of the duty roster to enable effective compliance. Compensation for additional duties is relevant in nursing.Research limitations/implicationsThe research was carried only in one region in Ghana, and the findings may not be the same in the other regions.Practical implicationsInadequate staffing level has serious implications on patient safety, quality of care and staff outcomes. This situation necessitates the implementation of health sector staffing norms to ensure the right calibre of mix staff are recruited and retained.Originality/valueThis study is the first in Ghana that we aware of that explore staffing practices at the unit that identifies factors that impact staff schedules for effective care.

The impact of leadership on the nursing workforce during the COVID-19 pandemic

Aims: To determine how the learning about protective factors from previous pandemics were implemented and the impact of this on nurses experience. Background: The COVID-19 pandemic led to systemic change within healthcare settings and demands placed on frontline nurses has been overwhelming. Lessons learned from previous pandemics indicate that clear communication and strong visible leadership can mitigate the impact stressful events may have on nurses. Conversely, a lack of clear leadership and regulatory protocols in times of crisis can lead to an increase in psychological distress for nurses. Design: Secondary analysis of semi-structured interview transcripts. Methods: Secondary data analysis was conducted on data collected during a hospital-wide evaluation of barriers and facilitators to changes implemented to support the surge of COVID-19 related admissions in wave one of the pandemic. Participants represented three-levels of leadership: whole trust (n=17), division (n=7), ward/department-level (n=8), and individual nurses (n=16). Data were collected through semi-structured video interviews between May and July 2020. Interviews were analysed using Framework analysis. Results: Key changes that were implemented in wave one reported at whole trust level included: a new acute staffing level, redeploying nurses, increasing the visibility of nursing leadership, new staff wellbeing initiatives, new roles created to support families and various training initiatives. Two main themes emerged from the interviews at division, ward/department and individual nurse level: impact of leadership, and impact on the delivery of nursing care. Conclusions: Leadership through a crisis is essential for the protective effect of nurses emotional wellbeing. While nursing leadership was made more visible during wave one of the pandemic and processes were in place to increase communication, system-level challenges resulting in negative experiences existed. By identifying these challenges, it has been possible to overcome them during wave two by employing different leadership styles, to support nurse wellbeing.