Predictors of Shift Work Sleep Disorder Among Nurses During the COVID-19 Pandemic: A Multicenter Cross-Sectional Study

Background: Nurses have a high incidence of shift work sleep disorder, which places their health and patient safety in danger. Thus, exploring the factors associated with shift work sleep disorder in nurses is of great significance in improving their sleep health, nursing personnel staffing, and scheduling during the COVID-19 pandemic.Objectives: The purpose of this study was to investigate the incidence of shift work sleep disorder during the COVID-19 pandemic and explore the factors associated with shift work sleep disorder in Chinese nurses.Methods: This was a multicenter cross-sectional study using an online survey. Stratified cluster sampling was used to include 4,275 nurses from 14 hospitals in Shandong, China from December 2020 to June 2021. Stepwise multivariate logistic regression analysis and random forest were used to identify the factors associated with shift work sleep disorder.Results: The prevalence of shift work sleep disorder in the sampled shift nurses was 48.5% during the COVID-19 pandemic. Physical fatigue, psychological stress, shift work more than 6 months per year, busyness during night shift, working more than 40 h per week, working more than four night shifts per month, sleeping more than 8 h before night shift, using sleep medication, irregular meals, and high-intensity physical activity were associated with increased odds of shift work sleep disorder. Good social support, good work-family balance, napping two or three times per week, resting more than one day after shifts, intervals of 8 days or more between shifts, and taking turns to rest during the night shift were associated with decreased odds of shift work sleep disorder.Conclusions: Shift work sleep disorder may be associated with scheduling strategies and personal behavior during the COVID-19 pandemic. To reduce the incidence of shift work sleep disorders in nurses, nursing managers should increase night shift staffing, extend rest days after shift, increase night shift spacing, and reduce overtime, and nurses need to seek more family and social support and control their sleep schedules and diet.

Staff Development as a Component of Management Strategy in the Information Society

Annotation. Introduction. The market economy obtains the features of information economy or knowledge economy, due to the global spread of information, telecommunications systems and technologies, the needs of society that graw in various information services. Thereafter, it highlights the problem of studying the information communications impact on all areas of economic activity. Labor potential is not an exception, the formation and effective use of which in new conditions is the key to ensure the competitiveness of the enterprise. Purpose. The purpose of the article is to study the theoretical foundations and develop practical recommendations for the formation of personnel management strategy, taking into account the requirements of the information economy to the competencies changes. In order to reach this goal the following tasks have been solved: firstly, it has been studied the main features and tasks of the information economy; secondly, the influence of society informatization on the competence of labor personnel has been determined; thirdly, developed proposals for the personnel management strategy formation and enterprise staff according to the needs of the information economy. Results. It is determined the influence of information economy on the labor personnel of the enterprise. Based on the analysis of existing approaches to the information economy, its characteristics are established. The tasks of information economy which require changes in the competencies and skills of labor personnel are considered. It has been developed the algorithm of a sole approach to the management and development of labor personnel, staffing and development of the enterprise in the information economy. It is offered the strategy of personnel development in information economy which includes the purpose, sequence of development, tools of development of workers and methods of their training. Defining the goals of staff development in the information economy has become the basis for highlighting the skills of staff, which allow them to become qualified professionals and achieve career growth. The tendencies of personnel management in the conditions of knowledge economy are established. Conclusions. The use of the proposed personnel development strategy will ensure the formation and implementation of the competencies of workers which are necessary to ensure sustainable competitive advantages of the enterprise in achieving strategic goals. Further research should be aimed at determining the means of staff development to master new competencies, detailing the tools of employee development.

Utility of a Clinical Scoring System for Point of Care Triaging in COVID-19 Pneumonia

BackgroundSurges in COVID-19 disease cases can rapidly overwhelm healthcare resources; triaging to appropriate levels of care can assist in resource planning. At the beginning of the pandemic, we developed a simple triage tool, the Temple COVID-19 Pneumonia Triage Tool (TemCOV) based on a combination of clinical and radiographic features that are readily available on presentation to categorize and predict illness severity.MethodsWe prospectively examined 579 sequential cases admitted to Temple University Hospital who were assigned severity categories on admission. Our primary outcome was to compare the performance of TemCOV in predicting patients who have the highest likely of admission to the ICU at 24 and at 72 hours to other standard triage tools: the National Early Warning System (NEWS), the Modified Early Warning System (MEWS) and the CURB65 score. Additional endpoints included need for invasive mechanical ventilation (IMV) within 72 hours, total hospital admission charges, and mortality.Results26% of patients fell within our highest risk Category 4 and were more likely to require ICU admission at 24 hours (OR 11.51) and 72 hours (OR 8.6). Additionally they had the highest likelihood of needing IMV (OR 29.47) and in-hospital mortality (OR 2.37)., TemCOV performed similar to MEWS in predicting ICU admission at 24 hours (receive operator characteristic (ROC) curve area under the curve (AUC) 0.77 vs. 0.74, p=0.21) but better than NEWS2 and CURB65 (ROC AUC 0.77 vs. 0.69 and 0.77 vs. 0.64, respectively, p<0.01). While all severity scores had a weak correlation to hospital charges, the TemCOV performed the best among all severity scores measured (r=0.18); median hospital charges for Category 4 patients was $170,468 ($96,972-$487,556).ConclusionTemCOV is a simple triage score that can be used upon hospitalization in patients with COVID-19 that predicts the need for hospital resources such as ICU bed capacity, invasive mechanical ventilation and personnel staffing.

Personnel: Staffing the Asylums and Serving the Colours

A vast staff served the asylums: doctors, nurses, attendants, artisans, clergy, kitchen and laundry workers, and other who maintained buildings, farm, gardens and cemetery. Ward work was particularly demanding, with long hours, and poor conditions of employment. A regimented and punitive culture and distrust between management and lower ranks of staff, contributed to “a general feeling of insecurity” among them. They had high rates of sickness and a high turnover, sometimes over 75 per cent annually, resulting in an inexperienced workforce. The asylum leadership contributed to creating a dysfunctional system in which the patients, whom the asylum was meant to serve, were far from central to it.

Protocols for Personal Protective Equipment in a COVID-19 Medical Shelter

The coronavirus disease 2019 (COVID-19) has greatly impacted health-care systems worldwide, leading to an unprecedented rise in demand for health-care resources. In anticipation of an acute strain on established medical facilities in Dallas, Texas, federal officials worked in conjunction with local medical personnel to convert a convention center into a Federal Medical Station capable of caring for patients affected by COVID-19. A 200,000 square foot event space was designated as a direct patient care area, with surrounding spaces repurposed to house ancillary services. Given the highly transmissible nature of the novel coronavirus, the donning and doffing of personal protective equipment (PPE) was of particular importance for personnel staffing the facility. Furthermore, nationwide shortages in the availability of PPE necessitated the reuse of certain protective materials. This article seeks to delineate the procedures implemented regarding PPE in the setting of a COVID-19 disaster response shelter, including workspace flow, donning and doffing procedures, PPE conservation, and exposure event protocols.

Validation of an Instrument to guide Nursing Staffing in Obstetric Rooming in

ABSTRACT Objectives: to construct and validate an instrument for the classification of mother-baby binomials that subsidizes personnel Staffing in in-rooming units. Method: methodological study. The construction was based on theoretical and legal references. Content validity was performed by experts through the content validity index measurement. Then, the instrument was applied to a sample of 122 binomials, and exploratory factor analysis was performed using the principal components analysis. Results: the instrument consisted of seven care indicators: Birth route; Maternal morbidity; Neonatal morbidity; Breastfeeding; Social aggravating factors; Care guidance; and interaction and bonding. All with content validity index of 1. The construct was composed of 3 domains, with Cronbach’s alpha of 0.62, 0.85 and 0.89. Conclusions: the classification instrument of mother-baby binomials allows the classification of mother-baby binomials and may support personnel Staffing in in-rooming units.

NERVOUS-PSYCHIC STABILITY AS A PREREQUISITE OF MILITARY PERSONNEL’S READINESS TO SPECIAL PHYSICAL-COMBAT TRAINING

The article presents the results of the author’s empirical study of nervous-psychological stability as a prerequisite for the military personnel’s readiness for special physical-combat training. Military personnel’s personal factors that determine the formation of their nervous-psychological stability and psychological readiness for service-combat and service-training activities are described. The study included a psychological diagnostic study of military personnel in the course of their special physical-combat training. We determined that the increase in the overall level of service members adaptability, their emotional stability and self-control, insistence and determination within the normative behaviour limits, and courage and willingness to accept a justified risk is in line with the growth of their nervous-psychic stability, as a prerequisite of readiness to special physical-combat training. As for interpersonal interaction, extraversion, trust, easiness, high self-control, practicality, certain conformity and willingness to adhere to discipline and subordination become really important, which indicate the improved professional communicative skills with experience and development of mental and physical stability and professional adaptability, in general. In addition, the system of attitudes towards oneself is harmonized in a general and confidence in one's own potential becomes deeper. Thus, nervous-psychic stability, as one of the leading professionally significant qualities in the structure of a service member’s personality, influence directly psychological readiness for both service-combat and service-training activities, which is realized in the process of special physical-combat training. This help improve the tools of professional and psychological selection and can become the basis for military personnel staffing with people having necessary potential for the effective performance of their duties and professional growth.

Pandemic influenza and major disease outbreak preparedness in US emergency departments: A selected survey of emergency health professionals

Objective: To assess the level of pandemic preparedness at emergency departments (EDs) around the country and to better understand current barriers to preparedness in the United States represented by health professionals in the American College of Emergency Physician (ACEP) Disaster Medicine Section (DMS).Methods, design, and setting: A cross-sectional survey of ACEP DMS members was performed. A total of 300 members were surveyed both via e-mail and with paper surveys during the 2009 ACEP Scientific Assembly DMS Meeting. An optional comments section was included for section members’ perspectives on barriers to preparedness. A 15-item pandemic preparedness score was calculated for each respondent based on key preparedness indicators as defined by the authors. Results were analyzed with descriptive statistics, χ2 analysis, Cochran-Armitage trend test, and analysis of variance. Free text comments were coded and subjected to frequency-based analysis.Results: A total of 92 DMS members completed the survey with a response rate of 31 percent. Although 85 percent of those surveyed indicated that their hospital had a plan for pandemic influenza response and other infectious disease threats, only 68 percent indicated that their ED had a plan, and 52 percent indicated that their hospital or ED had conducted disaster preparedness drills. Only 57 percent indicated that there was a plan to augment ED staff in the event of a staffing shortage, and 63 percent indicated that there were adequate supplies of personal protective equipment. While 63 percent of respondents indicated that their ED had a plan for distribution of vaccines and antivirals, only 32 percent of EDs had a plan for allocation of ventilators. A total of 42 percent of respondents felt that their ED was prepared in the event of a pandemic influenza or other disease outbreak, and only 35 percent felt that their hospital was prepared. The average pandemic preparedness score among respondents was 8.30 of a total of 15. Larger EDs were more likely to have a higher preparedness score (p = 0.03) and more likely to have a pandemic preparedness plan (p = 0.037). Some major barriers to preparedness cited by section members included lack of local administration support, challenges in funding, need for dedicated disaster preparedness personnel, staffing shortages, and a lack of communication among disaster response agencies, particularly at the federal level.Conclusions: There appear to be significant gaps in pandemic influenza and other infectious disease outbreak planning among the hospitals where ACEP DMS members work. This may reflect a broader underlying inadequacy of preparedness measures.