Search

Background:​ Empathy is a fundamental component of the therapeutic relationship between healthcare providers and patients and has the potential to yield significant benefits, including heightened care satisfaction, enhanced care quality, and improved mental well‐being for patients. As nursing assistants (NAs) are primary direct care providers in long‐term care facilities (LTCFs), it is necessary to understand NAs' views on empathy in their care provision for residents, but a gap exists in the literature regarding NAs' perspectives on empathy in this context. Aim: In this study, we aimed to explore perceptions of empathy among NAs in LTCFs. Research Design: A qualitative approach was applied in this study. Participants and Research Context: Through purposive and snowball sampling, 18 NAs who provided care for residents in six LTCFs in Taiwan were recruited. Face‐to‐face in‐depth interviews were conducted using a semistructured interview guide, and data were analyzed using a content analysis. Ethical Considerations: Ethical approval was obtained from the Institutional Review Board. All participants signed a written informed consent form prior to the interview. Results: Four themes encompassing 11 categories were generated including "being fundamental to caregiving to establish trust and enhance quality care," "practicing altruistic behavior in the pursuit of ethical caregiving," "cycling empathic flow in care," and "facing challenges in delivering empathetic care." Conclusions: NAs in LTCFs viewed empathy as an essential element of the caregiving process. They saw empathy as selfless care, assistance to others, and alleviation of residents' suffering. Understanding residents' emotions, thoughts, and needs, active listening and compassionate engagement were vital to expressing empathy. However, NAs faced challenges in expressing empathy due to demanding tasks, time limitations, and insufficient knowledge and communication skills. In addition, emotional desensitization further complicated the provision of empathic care. The findings of this study can provide information for nurse managers and directors to understand NAs' perspectives on empathy and difficulties when providing empathic care in the long‐term care context. [ABSTRACT FROM AUTHOR]

Background Aims Study design Results Conclusions Relevance to Clinical Practice Family participation in essential care may benefit patients and relatives.To examine the needs, perceptions and preferences of health care providers about family participation in essential care in the adult intensive care unit.A qualitative descriptive study using inductive thematic analysis. Three focus group interviews with a total of 30 intensive care unit health care providers, consisting of 20 critical care nurses, one nursing assistant, five physicians, three physical therapists and one speech therapist working in three Dutch intensive care units.One overarching theme, balancing interests, and four main themes emerged: looking after the patient's interests, taking the relatives' perspective into account, looking after interests of intensive care unit health care providers and conditions for family participation. The first theme, looking after the patient's interests, included three sub‐themes: insecurity about patient's wishes and needs, patient safety concerns and potential benefits for the patient. The second theme, taking the relatives' perspective into account, was also characterized by three sub‐themes: concerns about the relatives' possible burden, potential benefits for the relative and the relationship between patient and relative. The third theme, looking after interests of intensive care unit health care providers, included three sub‐themes: attitude towards family participation in essential care, differing perceptions of essential care and concerns about intensive care unit health care provider's burden. The last theme, conditions for family participation, included two sub‐themes: establishing a relationship and considering family participation in essential care as a process.Health care providers' perceptions and preferences regarding family participation in essential care in the intensive care unit are summarized in the overarching theme balancing interests. This overarching theme also reflects the needs and perceptions of patients and relatives.These findings may support critical care nurses and other health care providers when encouraging family participation in essential care. [ABSTRACT FROM AUTHOR]

This pilot study examines Ohio's licensed nursing home administrators and state tested nursing assistant's perspectives about job satisfaction, future career and employment plans, potential beneficial changes to their organizations, and their thoughts on reducing turnover rates in their field. Ohio Board of Executives of Long-Term Services and Supports provided their contact list of all 1,969 licensed nursing home administrators in Ohio in the fall of 2023. Two surveys were created for licensed nursing home administrators and state tested nursing assistants. Results were analyzed for themes within the open-ended responses; 28 surveys were received from licensed nursing home administrators and 17 surveys were received from state tested nursing assistants. Residents and their families are among the top reasons for job satisfaction, many employees face symptoms of burnout, and wages are a concern among both state tested nursing assistants and licensed nursing home administrators. Future career plans differed between the two professions and had distinct driving factors. A discussion of licensed nursing home administrators' opinions on improving retention and turnover rates should include more accountability, personal responsibility, and adding opportunities for professional growth and development. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion and implications for nursing and health policy Nursing competencies in armed conflict situations are critical for effective response and recovery. This study explores nurses’ perceptions regarding their competencies in armed conflict zones to identify areas of proficiency and those requiring further emphasis in training.This cross‐sectional descriptive study adhered to the STROBE reporting guidelines. It used a validated questionnaire examining 47 different competencies for nursing in armed conflict zones, which were subsequently ranked to identify those that were valued most and least.In total, 102 questionnaires were returned (85% response rate). The highest‐ranked competencies focused on immediate life‐saving interventions and personal safety. In contrast, competencies involving broader disaster management, such as understanding organizational disaster plans, post‐death care, and risk identification, ranked lower. This observation may indicate a tendency to prioritize direct clinical care over strategic planning and long‐term recovery in disaster nursing education.This study highlights the critical need to strengthen emergency care competencies among nurses working in armed conflict zones in Yemen. Its findings underscore the importance of targeted training programs, particularly in complex trauma management and psychological first aid, to address nurses’ self‐identified competency gaps. Policy implications include prioritizing resource allocation for emergency care infrastructure, implementing competency‐based deployment strategies, and ensuring access to mental health support for nurses in working conflict zones. These actions are essential for building a resilient nursing workforce capable of providing quality care amidst the unique challenges of armed conflict. [ABSTRACT FROM AUTHOR]

Background: Research shows that voice--the communication of ideas, concerns, and perspectives by employees to those in positions to instigate changes--is related to job satisfaction, retention, and organizational improvement. Nevertheless, health care professionals often do not exercise voice. Although researchers have explored the barriers registered nurses working in hospitals experience in expressing their voices, there has been a notable lack of attention in research and practice to the voice of certified nursing assistants working in long-term care settings. Purposes: Ensuring that certified nursing assistants can exercise voice is essential for the welfare and well-being of this occupational group and critical for the success of their organizations. Therefore, we explore the barriers certified nursing assistants encounter that hinder them from exercising voice. Methodology: We conducted seven focus groups in which 24 Dutch certified nursing assistants participated. Results: The results show that respondents were not always willing to exercise voice, which stemmed primarily from negative prior experiences with exercising voice. Respondents were further not always able to exercise voice, as the conditions under which they had to do so were unfavorable. Finally, respondents sometimes lacked the necessary skills to convey their ideas, concerns, and perspectives effectively. Practice Implications: Our findings indicate that health care managers must address multiple factors if they wish to enhance the voice of certified nursing assistants. [ABSTRACT FROM AUTHOR]

Introduction: Long-term care assistants are taking on more important roles in the healthcare system. The purpose of this study was to investigate what demographic factors influence the core competencies of nursing assistants, as well as to investigate the levels of organizational support, self-efficacy, and core competencies among nursing assistants in China, to explore the relationship between them. Methods: This is a cross-sectional study with prospective data collection based on a self-report questionnaire. A total of 320 long-term care assistants from two healthcare institutions. We collected socio-demographic characteristics and measured their perceived organizational support, self-efficacy, and core competency levels of the participants. Pearson correlation tests were conducted to examine the relationships among three variables, and a structural equation model was developed to test the interrelationships among these variables. Results: The results indicated that age, employment type, licensing status, monthly income, pre-job training, and training methods were associated with core competency, with nursing knowledge identified as a weak area in core competencies. There were significant associations among each dimension of perceived organizational support, self-efficacy, and core competencies (p < 0.01). The structural equation model demonstrated good fit: X2/df = 2.486, GFI = 0.974, CFI = 0.988, IFI = 0.988, TLI = 0.977, RMSEA = 0.068, SRMR = 0.013. The direct effect of organizational support on core competencies was 0.37, with self-efficacy mediating the relationship between organizational support and core competencies, yielding an indirect effect of 0.122 and a total effect coefficient of 0.492 (all p < 0.001). Conclusion: Training in core competencies should prioritize nursing knowledge. Enhanced perceived organizational support and self-efficacy among nursing assistants were associated with higher core competencies. [ABSTRACT FROM AUTHOR]

Objectives: This scoping review maps the literature on psychosocial distress and coping among nursing assistants (CNAs) in long-term care facilities (LTC) during the COVID-19 pandemic onto the Social Ecological Model (SEM) of Occupational Stress. Methods: Searches yielded 862 unique studies. Inclusion criteria were sample CNAs or equivalent in LTC; includes psychosocial variable; and collect data from February 2020–. A multi-phasic, meta-synthesis was used to synthesize qualitative data. Results: We identified 20 studies (13 quantitative, 7 qualitative) conducted between March 2020 and December 2021 from 14 countries. Prevalence rates were reported for perceived stress (31–33%; n = 1 study), post-traumatic stress (42%; n = 1), anxiety (53%; n = 1), depression (15–59%; n = 2), suicidal thoughts (11–15%; n = 1), and everyday emotional burnout (28%; n = 1). Qualitative studies identified factors contributing to psychosocial distress and coping at each SEM level (i.e. individual, microsystem, organization, and peri-/extra-organizational). Quantitative studies primarily measured factors relating to psychosocial distress and coping at the individual and organizational levels. Conclusions & Clinical Implications: This review identifies specific targets for intervention for psychosocial distress among CNAs in LTC at multiple levels, including job clarity; workload; facility culture; community relations; and policy. These intervention targets remain relevant to the LTC industry beyond the context of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Design Methods Results Conclusion Implications for the Profession Reporting Method Patient or Public Contribution To investigate the association of long‐term care nursing assistants' dual caregiving roles with mental health and to determine whether social support moderates this relationship.A cross‐sectional survey.We surveyed 962 certified long‐term care nursing assistants working in long‐term care and medical facilities across Taiwan from October 2022 to July 2023. ‘Dual caregiving roles’ denote the fulfilment of caregiving duties both at work and within families. Mental health was evaluated using the 5‐item Brief Symptom Rating Scale. Logistic regression analysis was utilized to investigate the association of dual caregiving roles and psychological job demands with poor mental health. Moreover, we explored whether family, colleague, and supervisor support moderated the association between dual caregiving roles and poor mental health.Among long‐term care nursing assistants, 15% had dual caregiving responsibilities. Individuals with both dual caregiving roles and high psychological job demands faced the highest risk of poor mental health compared to those without dual caregiving roles and low psychological job demands. Having dual caregiving roles was associated with poor mental health compared to workers without such roles. Additionally, support from family, colleagues, and supervisors mitigates the association between caregivers' dual caregiving roles and poor mental health.A substantial proportion of long‐term care nursing assistants had dual caregiving roles, leading to an additional mental health burden when combined with high psychological job demands. High social support attenuated this association.Long‐term care nursing assistants with dual caregiving roles had poorer mental health outcomes. Yet, support from family, colleagues, and supervisors mitigated these effects. These results emphasize the importance of enhancing social support to protect the mental well‐being of long‐term care nursing assistants managing both formal and informal caregiving duties.This study adheres to the STROBE guideline of reporting.No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Objective Design Setting Participants Results Conclusion To identify barriers and facilitators contributing to the successful implementation of the allied health assistant role in private disability practice to better meet population needs.A qualitative case study.This study was completed with staff working in private disability practices in a regional context in the Northern Territory.Eight participants were interviewed, including three allied health assistants, three allied health professionals, and two managers with allied health backgrounds.More barriers were reported than facilitators, with four key themes identified. Financial risk was a barrier when employing allied health assistants. This risk was mediated by providing part‐time employment or having allied health assistants in dual roles. Reduced confidence from allied health professionals and assistants to complete delegation work was the second barrier. A facilitator was increasing allied health assistants' task variation, which participants reported increased retention. Finally, a positive working relationship between allied health professionals and assistants facilitates delegation.This research offers private disability providers insight into the realities of employing an allied health assistant. It also suggests that formal training programs for both allied health assistants and professionals require increased focus on delegation in the private disability sector. On a government level, a review of the NDIS price guide for allied health assistant rates is needed if private providers are to better meet the requirements for NDIS participants in regional areas. [ABSTRACT FROM AUTHOR]

Introduction Staff nurse attrition negatively impacts readiness of the warfighter and the health and wellbeing of all beneficiaries of the Military Health System (MHS). To promote the retention of a robust nursing workforce, a complete understanding of nurses' perceptions regarding their intent to leave is necessary. The purpose of this study was to explore the free-text responses of 1,438 nurses working among military medical treatment facilities for factors influencing their intent to leave, as an indicator of potential turnover, or attrition. Materials and Methods This study employed thematic analysis to investigate the qualitative responses from the 2016 and 2018 Military Nursing Practice Environment Surveys. The study was determined to be exempt from Institutional Review Board review through the Womack Army Medical Center's Human Research Protection Program. Results Findings indicate that leadership and management (n  = 647), staffing (n  = 353), career opportunities (n  = 345), staff outcomes (n  = 247), culture (n  = 153), quality of care (n  = 99), patient care barriers (n  = 86), non-patient care activities (n  = 79), lack of formal professional development (n  = 75), and area or care environment (n  = 67) were among the top factors influencing staff nurse intent to leave, respectively. Conclusions Our findings support the evaluation of retention strategies using implementation science for nurses and nurse resource personnel (e.g. nursing assistants, technicians, medics, and corpsman) to ensure a robust nursing work force throughout the MHS. Staff nurses and resource personnel working among military treatment facilities and embedded in units supporting combat and humanitarian missions ensure access to care and health promotion of the warfighter and all MHS beneficiaries. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion In the wake of an increasingly ageing population, Norway has a growing need for healthcare workers, especially in nursing homes. This study explored the employment experiences of migrant nursing assistants working in elderly care in Norway.A qualitative interview‐based study was carried out between March and August 2020. In‐depth, semi‐structured interviews were performed with 13 purposively selected immigrant nursing assistants working in a nursing home within Western Norway. Data were thematically analysed.Migrant nursing assistants working in Norwegian elderly care faced mixed experiences. On the one hand, study participants experienced several barriers in their workplace, resulting from insufficient command of the Norwegian language, heavy workload and mistreatment and discrimination by both patients and colleagues. On the other hand, participants cited the financial compensation from work, the meaningfulness derived from helping others and the flexible day‐off requests as workplace facilitators. Participants also made continuous efforts to learn the Norwegian language and to build good relations with their co‐workers.There is a need to enhance migrant nursing assistants' positive experiences in the Norwegian eldercare sector by making targeted workplace reforms and fostering a supportive and inclusive environment. [ABSTRACT FROM AUTHOR]

Medical leave of absences occur due to physical, psychological, and work-related issues. It is imperative for nurse leaders to understand the impact of these situations on a nursing team from organizational and relational perspectives, and to address this issue by understanding the complexity of the transitional work process and improve this process. There may be opportunities to reintegrate nursing staff into areas with staffing challenges, increasing productivity and staff engagement, while ensuring cost avoidance. [ABSTRACT FROM AUTHOR]

Background: Nurses play a crucial role in maintaining the safety of surgical patients. Few nurse staffing studies have looked specifically at surgical patients to examine the impact of exposure to low staffing on patient outcomes. Methods: A longitudinal patient analysis was conducted in four organizations in England using routine data from 213 910 admissions to all surgical specialties. Patients' staffing exposures were modelled as counts of understaffed registered nurse and nurse assistant days in the first 5 inpatient days. Understaffing was identified when staffing per patient-day was below the mean for the ward. Cox models were used to examine mortality within 30 days of admission and readmission within 30 days of discharge. Generalized linear models were used to investigate duration of hospital stay and occurrence of hospital-acquired conditions. Results: Increased exposure to registered nurse understaffing was associated with longer hospital stay and increased risk of deep vein thrombosis, pneumonia, and pressure ulcers. This was also true for nurse assistant understaffing, but the effect sizes tended to be smaller. In the Cox models, there were similarly increased hazards of death for registered nurse understaffing (HR 1.09, 95% c.i. 1.07 to 1.12) and nurse assistant understaffing (HR 1.10, 1.08 to 1.13), whereas the effect size of registered nurse understaffing for readmission (HR 1.02, 1.02 to 1.03) was greater than that seen with nurse assistants (HR 1.01, 1.01 to 1.02). Conclusion: Understaffing by both registered nurses and nursing assistants is associated with increased risks of a range of adverse events, and generally larger effects are seen with registered nurse understaffing. This observational longitudinal study examined nurse staffing levels and their association with a variety of adverse patient outcomes for inpatient admissions to all surgical specialties. The patient-level data came from four disparate National Health Service hospital Trusts in England. The results indicated generally larger adverse effects for registered nurse understaffing compared with understaffing for nurse assistants (healthcare support workers and nurse associates). [ABSTRACT FROM AUTHOR]

The article deals with a legal dispute regarding the calculation of the investment cost deduction for the provision of outpatient services by publicly funded hospitals. It is discussed whether the hospitals were entitled to deduct the deduction from a retroactive payment for outpatient emergency treatments. The Federal Social Court decided that the hospitals were entitled to do so. It also reports on the recalculation of fees and the termination of a nursing assistant due to deception. [Extracted from the article]

AbstractObjectivesMethodResultsConclusionCertified Nursing Assistants (CNAs) are responsible for 80–90% of direct-to-resident care in skilled nursing facilities (SNFs), and may develop close, family-like relationships with their residents. With SNFs becoming a common place of death for older adults, CNAs now find themselves engaging in end-of-life caregiving with limited training and institutional support for emotional outcomes. This study aimed to understand and evaluate the relations between bereavement, death exposure, and compassion fatigue among CNAs, hypothesizing that (a) experiential avoidance moderates the relation between death exposure and negative death attitudes and (b) death attitudes moderate the relation between death exposure and compassion fatigue.One hundred and ten CNAs across all shifts from four skilled nursing facilities in the southeastern United States participated in surveys and, potentially, focus groups.Results failed to find support for death exposure being related either to experiential avoidance or negative death attitudes. However, results supported the relation between negative death attitudes and compassion fatigue.Implications highlight the need to develop interventions focusing on palliative skills-based training and emotional support of CNAs in their role as end-of-life caregivers. By reducing compassion fatigue, it may be possible to decrease job turnover and increase quality-of-care for residents. [ABSTRACT FROM AUTHOR]

Introduction Design Methods Results Conclusion Non‐ventilator hospital‐acquired pneumonia (NV HAP) is a common complication for hospitalized patients. NV HAP develops when patients aspirate oral secretions containing pathogenic bacteria. Appropriate oral hygiene can help mitigate NV HAP development. Hospital staff, including nursing assistants, play an important role in ensuring that these cares are completed.A quasi‐experimental pre–post design was used to evaluate outcomes before and after implementation of a structured oral hygiene education program.A structured oral hygiene program was developed and implemented in a large quaternary hospital. Change in NA knowledge, attitudes, and behaviors before and after implementation of the oral hygiene program was evaluated. Retrospective patient outcomes before and after the intervention were analyzed to detect changes in NV HAP rates.Following the education, nursing assistant knowledge of recommended frequency of oral care for patients who are NPO increased (67.2% vs. 82.1%, p = 0.003). NAs were more likely to report oral hygiene tools including oral suctioning (80.8% vs. 90.2%, p = 0.005) and toothbrushes (89.3% vs. 95.3%, p = 0.031). The unadjusted incidence of NV HAP was significantly lower in the post‐intervention cohort (0.25%) compared to the pre‐intervention cohort (0.74%), p < 0.001. In the adjusted model, non‐invasive positive pressure ventilation increased the odds of NV HAP by nearly sevenfold (AOR = 6.88, 95% CI: 3.99, 11.39).Focused education for NAs is an effective strategy to increase knowledge related to oral hygiene. Implementing a structured oral hygiene program for NAs appears to be a promising practice to decrease NV HAP. [ABSTRACT FROM AUTHOR]

Aim and Objectives Background Design Methods Results Conclusions Relevance to clinical practice Reporting Method Patient of Public Contribution To provide an in‐depth insight into the barriers, facilitators and needs of district nurses and nurse assistants on using patient outcomes in district nursing care.As healthcare demands grow, particularly in district nursing, there is a significant need to understand how to systematically measure and improve patient outcomes in this setting. Further investigation is needed to identify the barriers and facilitators for effective implementation.A multi‐method qualitative study.Open‐ended questions of a survey study (N = 132) were supplemented with in‐depth online focus group interviews involving district nurses and nurse assistants (N = 26) in the Netherlands. Data were analysed using thematic analysis.Different barriers, facilitators and needs were identified and compiled into 16 preconditions for using outcomes in district nursing care. These preconditions were summarised into six overarching themes: follow the steps of a learning healthcare system; provide patient‐centred care; promote the professional's autonomy, attitude, knowledge and skills; enhance shared responsibility and collaborations within and outside organisational boundaries; prioritise and invest in the use of outcomes; and boost the unity and appreciation for district nursing care.The preconditions identified in this study are crucial for nurses, care providers, policymakers and payers in implementing the use of patient outcomes in district nursing practice. Further exploration of appropriate strategies is necessary for a successful implementation.This study represents a significant step towards implementing the use of patient outcomes in district nursing care. While most research has focused on hospitals and general practitioner settings, this study focuses on the needs for district nursing care. By identifying 16 key preconditions across themes such as patient‐centred care, professional autonomy and unity, the findings offer valuable guidance for integrating a learning healthcare system that prioritises the measurement and continuous improvement of patient outcomes in district nursing.Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines.No patient or public contribution. [ABSTRACT FROM AUTHOR]

Antimicrobial drug use (AMU) in veterinary medicine may contribute to antimicrobial resistant (AMR) infections in both animals and people. Efforts to improve AMU in companion animal medicine are underway and should include all members of the veterinary team, including veterinary support staff. Our objective was to describe knowledge and attitudes regarding AMU, AMR, and antimicrobial stewardship (AMS) in companion animal medicine among veterinary support staff professionals in the United States using an anonymous, online questionnaire. Additionally, we sought to explore veterinary support staff perceptions of their role in the antimicrobial drug (AMD) prescribing process. Veterinary technicians, nurses, assistants, client care representatives, and hospital managers (n = 337) considered AMR a global concern (83.4%), and 40% reported receiving AMR education from their employer. Few (18.3%) were aware of AMS, with only 6.4% indicating that their clinic had an AMS program. Frequent involvement in the AMD prescribing process was reported (43.4%), but only 19.7% perceived involvement with AMS interventions. Approximately one-third of participants (34.9%) said that advice regarding the need for AMDs was routinely provided by staff to pet owners prior to veterinary consultation. Participants estimated that 82.6% of all AMD prescriptions were filled at the clinic as opposed to an outside pharmacy. Given their direct involvement in the AMD prescribing process and frequent interactions with pet owners, AMS should be emphasized to all veterinary staff. Involving support staff in AMS interventions is necessary to improve AMU in companion animal medicine. [ABSTRACT FROM AUTHOR]

Objective: To estimate and contrast the relationships between nurse staffing and health outcomes in nursing homes with low and high dementia census, to understand the association of staffing hours with dementia care quality. Data Sources and Study Setting: A national sample of nursing homes during 2017–2019 (pre‐COVID). Data included the Payroll‐Based Journal, Medicare Claims, Nursing Home Care Compare, and Long‐Term Care Focus. Study Design: Retrospective, regression analyses. We estimated separate linear models predicting six long‐term facility‐level outcomes. Independent variables included staffing hours per resident‐day (HPRD) interacted with the facility percentage of dementia residents, controlling for other resident and facility characteristics. Data Collection/Extraction Methods: Hospital‐based nursing homes, those with fewer than 30% dementia residents, and missing data were excluded. Principal Findings: We found that registered nurses and certified nurse assistants HPRDs were likely to exhibit positive returns in terms of outcomes throughout most of the range of HPRD for both high and low‐census dementia facilities, although, high‐ and low‐dementia facilities differed in most outcome rates at all staffing levels. Average predicted antipsychotics and activities of daily living as functions of HPRD were worse in higher dementia facilities, independent movement, and hospitalizations did not differ significantly, and Emergency Rooms and pressure sores were worse in lower dementia facilities. Average marginal effects were not statistically different [CI included zero] between the high and low dementia facilities for any outcome. Conclusions: These findings suggest that increasing staffing will improve outcomes by similar increments in both low‐ and high‐dementia facilities for all outcomes. However, at any given level of staffing, absolute differences in outcomes between low‐ and high‐dementia facilities remain, suggesting that additional staffing alone will not suffice to close these gaps. Further studies are required to identify opportunities for improvement in performance for both low‐ and high‐dementia census facilities. [ABSTRACT FROM AUTHOR]

The article discusses research which examined the impact of health and well-being self-care interventions on nurses in an adult care medicine unit in an academic health system during the COVID-19 pandemic. The study outlines the Plan Do Check Act Quality Improvement framework and the results of weekly interventions that included exercise, conversations with nursing staff, mindfulness practices, sleep habits, teamwork, and burnout prevention and management.

BACKGROUND: The health of care workers in residential long-term care (LTC) is under pressure. Scholars emphasize the importance of gender-sensitive and intersectional approaches to occupational health. OBJECTIVE: To unravel how the health of nurses and nursing aides is shaped by gender, class, age, sexuality and race. METHODS: A qualitative participatory study. A participatory research team, consisting of academic scholars and nursing aides, conducted semi-structures interviews (N = 20) and one natural group discussion (N = 8 participants) to validate our findings. Thematic data-analysis was guided by gender and intersectionality theory. RESULTS: Empirical findings suggest that gendered norms limit possibilities for self-care for female nurses and nursing aides. Feeling uncared for by society and LTC organizations, paid care workers describe how they take care of each other. These relational health strategies require a feeling of sameness, limiting space for diversity and disability within care teams. Care workers seen as 'cultural other', or those who experienced (chronic) health issues, financial struggles or informal caregiving, risked being excluded from relational care within care teams, which negatively impacted their health. CONCLUSIONS: Care workers' relational health strategies are a gendered and care ethical response to the lack of societal and political care for LTC, but can become mechanisms of exclusion within care teams. This can be understood as a sign of exhaustion, shaped by adverse working conditions and leading to moral stress. The lack of societal appreciation needs to be addressed by occupational health physicians and LTC organizations, to counter mechanisms of exclusion among paid care workers. [ABSTRACT FROM AUTHOR]

Introduction: Since its creation in the 18th century, bedpan has remained more or less the same. Its unique material composition varies from one model to another, but its shape remains relatively similar. The environment is one of the four pillars of the nursing paradigm. It is therefore essential to question this device in the nursing discipline. Aim: To assess perceived patient comfort and ease of bedpan handling by nurses and their assistants. Method: A cross-sectional survey via an online questionnaire was conducted among nurses and nursing assistants, nursing students, and health executives using the bedpan for their patients to assess their feelings and their level of satisfaction. The questionnaire asks professionals about the ease of handling the bedpan and the patient's perceived comfort. Results: 431 responses were obtained out of 3007 persons interviewed (14.3%). 83.0% believe that the cause of poor elimination by the patient is often or very often due to physical discomfort on the bedpan. 62.6% find the installation of the bedpan rather tough or very difficult. 59.2% find the removal of the bedpan rather tough or very difficult. Discussion: Our study confirms our hypothesis and highlights a lack of comfort in the bedpan as perceived by professionals. This analysis is the first step in enabling the nurse researcher to support change in the transformation paradigm. [ABSTRACT FROM AUTHOR]

Introduction This article reviews process and performance of an innovative effort leveraging virtual health to manage unmet demand for behavioral health and substance use disorder services across a large military region. This effort began in June 2022 and included nearly all of the Defense Health Agency Region—Europe's military behavioral health and substance abuse clinics participating. The two goals of improving access to behavioral health and substance use services for active duty service members and improving utilization of the military clinics were employed. Operational and remote locations with known care gaps could access services as well. Connecting services to the point of need is an established strength of virtual health delivery systems of care. Materials and Methods A team consisting of clinical leaders and Virtual Medical Center—Europe staff developed a centralized screening process and simple business rules. When a clinic was unable to meet its access-to-care standard of 28 days, the patient requesting or referral from a remote location, was offered a virtual video option with a provider from another clinic with availability. Centralized screening was created and staffed by three technicians. The Behavioral Health Integrated Support Network (BHISN) screening clinic assessed appropriateness of virtual care using established exclusion criteria. Once screened, the patient was scheduled for an appointment with one of the 31 therapists in 14 participating clinics in a 3- to 5-day window. The military health system's video connect platform was used. Results Between June 2022 and November 2023, 131 patients who were unable to find routine care in their home clinic were screened, scheduled, and completed a virtual visit with one of the 31 participating therapists from 14 behavioral health and substance use clinics. Seventy-eight (59%) participants were active duty empaneled to military treatment facilities in Europe and 53 (39%) were active duty enrolled in Tricare Prime Remote and deployed to remote locations with limited care. Forty-four percent of patients were recommended for continued virtual therapy or counseling kept their first follow-up demonstrating good follow-up care using a virtual option. The overall no-show rate was low at 7%. Care and consultation were successfully delivered using video visits to location in 18 countries in three geographic Europe, the Middle East and, Africa. Conclusion The Virtual Medical Center—Europe, Army Europe Behavioral Health, and Substance Use leadership work collaboratively to plan and optimize program performance. For BHISN to function as intended requires key dedicated support staff, such as mental health and social services assistants to screen and coordinate virtual care. Scheduling can be performed by a central cell requiring clinics to relinquish some local control in the interest of meeting patient demand in large and diverse area that covers three continents. BHISN shows promising initial success by providing a process of managing demand and connecting requests for behavioral health and substance use care leveraging capacity from all clinics using a virtual video service in a diverse operating environment. [ABSTRACT FROM AUTHOR]

Background: The new competency-based further training regulations (nWBO) for surgical training have been adopted by all German state medical associations. Methods: From May to June 2023 the Young Surgeons' Working Group (CAJC) conducted an anonymous online survey among the 5896 members of the German Society for General and Visceral Surgery (DGAV). Objective: The survey aimed to assess expectations regarding the nWBO and to develop strategies for enhancing surgical training. Results: With 488 participants (response rate 8.3%) the study is representative. The respondents consisted of 107 continuing education assistants (WBA 21.9%), 69 specialist physicians, and 188 senior physicians (specialist physicians 14.1% and senior physicians 38.5%), as well as 107 chief physicians (21.9%). The majority worked in regular care providers (44%), followed by maximum care providers (26.8%) and university clinics (20.1%). Only 22% considered the required operative spectrum of the new medical specialist training regulations (nWBO) to be realistic. Half of the respondents believed that full training in their clinic according to the new catalog will no longer be possible and 54.6% considered achieving the target numbers in 6 years to be impossible or state that they can no longer train the same number of continuing education assistants (WBAs) in the same time frame. Endoscopy (17.1–18.8%), fundoplication (15.4–17.7%) and head and neck procedures (12.1–17.1%) were consistently mentioned as bottlenecks across all levels of care. Rotations for balance were reported to be already established or not necessary in 64.7%. In 48% it was stated that the department had established the partial steps concept. The importance of a structured training concept was considered important by 85% of WBAs, compared to 53.3% of chief physicians (CÄ). If a structured training concept was present in the department, the achievability of the target numbers was significantly assessed more positively in the univariate analysis. In the multivariate analysis, male gender and the status of "habilitated/professor" were independent factors for a more positive assessment of the nWBO. Objective certification of training was considered important by 51.5%. Conclusion: Concerns surround the nWBO and the sentiment is pessimistic. Additional requirements and hospital reforms could exacerbate the situation. Collaboration and rotations are crucial but still insufficiently implemented. Quality-oriented certification could enhance the quality of training. [ABSTRACT FROM AUTHOR]

Purpose: Increasing racial and ethnic diversity in U.S. nursing facilities has necessitated the provision of more culturally competent care. This study explored the cultural challenges in providing palliative care from the perspective of certified nursing assistants (CNAs) and nurses in nursing facilities. Method: A thematic analysis approach was used to examine data from semi-structured interviews with 12 CNAs and 11 nurses from six nursing facilities in a U.S. Midwestern state. Results: Four themes emerged from the data: Cultural Needs Expressed by Residents, Cultural Needs Expressed by Family Members, Accommodating Residents' Cultural Needs, and Organizational Responses to Cultural Competency Challenges. Conclusion: Results highlighted the training variations on diversity and cultural competency issues and the varying cultural competency levels possessed by staff. To support residents' culture-related needs, staff need education and support. Organizations can provide foundational resources for this diversity of cultural expression, including providing more culturally diverse programming facilities. [Journal of Gerontological Nursing, 50(7), 35–41.] [ABSTRACT FROM AUTHOR]

Purpose: To explore the relationship among resilience, stress, and demographic factors in certified nursing assistants (CNAs) who worked in long-term care institutions during the coronavirus disease 2019 pandemic. Method: A cross-sectional correlation-based research design was used. Data were collected using a demographic questionnaire, Connor-Davidson Resilience Scale, and Occupational Stress Scale. CNAs from 21 long-term care institutions in Taiwan were recruited. Results: This study included 118 female and 26 male CNAs (response rate = 80%). Mean age was 46.8 years. A moderately negative correlation was found between workplace resilience and stress. Overall, being a woman and parent were found to be significantly correlated with CNAs' resilience. Furthermore, resilience and shift work were important predictors of stress. Conclusion: We suggest that leadership and management pay more attention to CNAs' basic demographic background information. Furthermore, timely, relevant strategies can be provided to enhance resilience and reduce workplace stress. [Journal of Gerontological Nursing, 50(7), 19–26.] [ABSTRACT FROM AUTHOR]

Background: Hospital patient‐care workers have high occupational injury rates. While physical hazards within hospital work environments are established determinants of injury, social exposures may also contribute. This study examined how reports of unfair treatment at work, a dimension of work‐related experiences of discrimination, were associated with injury among hospital‐based patient‐care workers. Methods: We used data from the Boston Hospital Workers Health Study, a longitudinal cohort of nurses and nursing assistants at two Boston‐area hospitals. In 2018, we conducted a worker survey asking about three types of unfair treatment at work and occupational injuries during the past year. We used mixed‐effects logistic regression models to evaluate associations between specific types, total load, and high‐frequency exposure of unfair treatment with injury, adjusting for age, gender, race and ethnicity, job title, and unit type. Results: Among 1001 respondents, 21% reported being humiliated in front of others at work, 28% reported being watched more closely than other workers, and 47% reported having to work twice as hard as others for the same treatment. For each type of unfair treatment, we observed a monotonic relationship with occupational injury wherein increasing frequency of exposure was associated with increased odds of injury. We also observed monotonic relationships between total load and high‐frequency exposure to unfair treatment and odds of injury. Conclusions: Work‐related unfair treatment is associated with injury among hospital workers. Programs and policies that focus on preventing unfair treatment may lessen injury burden in hospital workers. [ABSTRACT FROM AUTHOR]

Background/Objectives: Transitions to and from Emergency Departments (EDs) can be detrimental to long‐term care (LTC) residents and burden the healthcare system. While reducing avoidable transfers is imperative, various terms are used interchangeably including inappropriate, preventable, or unnecessary transitions. Our study objectives were to develop a conceptual definition of avoidable LTC‐ED transitions and to verify the level of stakeholder agreement with this definition. Methods: The EXamining Aged Care Transitions study adopted an exploratory sequential mixed‐method design. The study was conducted in 2015–2016 in 16 LTC facilities, 1 ED, and 1 Emergency Medical Service (EMS) in a major urban center in western Canada. Phase 1 included 80 participants, (healthcare aides, licensed practical nurses, registered nurses, LTC managers, family members of residents, and EMS staff). We conducted semistructured interviews (n = 25) and focus groups (n = 19). In Phase 2, 327 ED staff, EMS staff, LTC staff, and medical directors responded to a survey based on the qualitative findings. Results: Avoidable transitions were attributed to limited resources in LTC, insufficient preventive care, and resident or family wishes. The definition generated was: A transition of an LTC resident to the ED is considered avoidable if: (a) Diagnostic testing, medical assessment, and treatment can be accessed in a timely manner by other means; (b) the reasons for a transfer are unclear and the transition would increase the disorientation, pain, or discomfort of a resident, outweighing a clear benefit of a transfer; and (c) the transition is against the wishes expressed by the resident over time, including through informal and undocumented conversations. There was a high level of agreement with the definition across the four participant groups. Conclusions and Implications: To effectively reduce LTC resident avoidable transitions, stakeholders must share a common definition. Our conceptual definition may significantly contribute to improved care for LTC residents. Key points: Important dimensions in assessing transition avoidability include timely diagnostic testing availability, in‐facility assessment and treatment options, clear transfer purpose, risk/benefit analysis for resident well‐being, and recognition of advanced care goals and informal care preferences.Our findings highlighted essential differences between perceptions of unnecessary and avoidable transitions.Avoidable transitions were attributed to limited resources in long‐term care, insufficient preventive care, and resident or family wishes. [ABSTRACT FROM AUTHOR]

Copyright of Revista Nutrición Clínica y Dietética Hospitalaria is the property of Sociedad Espanola de Dietetica y Ciencias de la Alimentacion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: To investigate the correlation between job values, job stress, and job satisfaction among nursing assistants in a hospital setting. Design: A cross‐sectional study. Methods: Data were collected from nursing assistants working in a regional hospital and a medical center in Northern Taiwan. A self‐rated structured questionnaire was used to collect data on participants' demographic characteristics, job values, job stress, and job satisfaction. Descriptive statistics, t test, one‐way analysis of variance, Pearson's correlation coefficient, and stepwise regression were used for data analysis. Results: A total of 135 questionnaires were distributed; of them, 132 were returned, resulting in a response rate of 97.8%. The average age of the participants was 57.08 ± 5.86 years, with the majority being female, high school educated, and married. Most participants (70%) had >5 years of experience in working as nursing assistants. The average job satisfaction score of was 63.63, indicating a moderate level of job satisfaction. Job satisfaction exhibited a significantly positive correlation with job values but a significantly negative correlation with job stress. Job value was negatively correlated with job stress. Stepwise regression revealed that job values significantly explained the variance in job satisfaction among hospital nursing assistants. Conclusions: Nursing assistants are integral to clinical practice. To enhance their job satisfaction and professional development, health‐care institutions and policymakers should implement strategies such as providing continual training, offering recognition and rewards to enhance sense of accomplishment. Patient or Public Contribution: This study involves no patient or public contribution. [ABSTRACT FROM AUTHOR]

Background: There is a knowledge-to-practice gap regarding parent-delivered pain management, and few studies have investigated parents' and nurses' participation in and acceptance of combined parent-delivered pain-alleviating interventions such as skin-to-skin contact (SSC), breastfeeding, and parental musical presence. This study investigated parents' and nurses' perceptions of and reflections on experiencing combined parent-delivered pain management. Methods: This qualitative study applies a collaborative participatory action research design using ethnographic data collection methods such as focus groups, video observations, and video-stimulated recall interviews with parents and nurses. Results: The results concern three main categories, i.e., preparation, participation, and closeness, as well as various sub-categories. Preparations were central to enabling combined parent-delivered pain management. Participation was facilitated by parental musical presence, in which parents shifted their attention toward their infant. Closeness and presence during neonatal care helped parents become active during their infant's painful procedures. Parental lullaby singing created a calm and trusting atmosphere and after the procedure, both parents and nurses felt that they had successfully supported the infant through a potentially painful procedure. Conclusions: Mental and practical preparation is central to implementing combined parent-delivered pain management. When parents and nurses explored the interventions, they found the methods feasible, promoting self-efficacy and confidence in both parents and nurses. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Context (work environment) plays a crucial role in implementing evidence-based best practices within health care settings. Context is multi-faceted and its complex relationship with best practice use by care aides in long-term care (LTC) homes are understudied. This study used an innovative approach to investigate how context elements interrelate and influence best practice use by LTC care aides. Methods: In this secondary analysis study, we combined coincidence analysis (a configurational comparative method) and qualitative analysis to examine data collected through the Translating Research in Elder Care (TREC) program. Coincidence analysis of clinical microsystem (care unit)-level data aggregated from a survey of 1,506 care aides across 36 Canadian LTC homes identified configurations (paths) of context elements linked consistently to care aides' best practices use, measured with a scale of conceptual research use (CRU). Qualitative analysis of ethnographic case study data from 3 LTC homes (co-occurring with the survey) further informed interpretation of the configurations. Results: Three paths led to very high CRU at the care unit level: very high leadership; frequent use of educational materials; or a combination of very high social capital (teamwork) and frequent communication between care aides and clinical educators or specialists. Conversely, 2 paths led to very low CRU, consisting of 3 context elements related to unfavorable conditions in relationships, resources, and formal learning opportunities. Our qualitative analysis provided insights into how specific context elements served as facilitators or barriers for best practices. This qualitative exploration was especially helpful in understanding 2 of the paths, illustrating the pivotal role of leadership and the function of teamwork in mitigating the negative impact of time constraints. Conclusions: Our study deepens understanding of the complex interrelationships between context elements and their impact on the implementation of best practices in LTC homes. The findings underscore that there is no singular, universal bundle of context-related elements that enhance or hinder best practice use in LTC homes. [ABSTRACT FROM AUTHOR]

Care aides in long-term care (LTC) institutions care for older disabled residents at high risk for COVID-19. However, they experienced many stressors during the COVID-19 pandemic. This study aims to explore the working experiences of care aides in LTC institutions following the relaxation of COVID-19 regulations in Taiwan. This qualitative descriptive study included 20 care aides who had cared for residents with COVID-19. Data were obtained via semi-structured interviews. Caring for residents with COVID-19 and the difficulties, resources and teamwork, and impact of care aides' work on their lives were discussed. Consequently, four themes were identified. First, difficulties in care, which included physical limitations by protection, workload, and impact of work schedule on the lives of the care aides. Second, psychological impact, such as worry, social isolation, and burnout. Third, interpersonal relationships with supervisors, colleagues, residents, and their families. Fourth, infection control policy from the institution and government. When infection control policies were relaxed, care aides had difficulties in caring for residents; furthermore, their family and social lives were also affected. They were required to learn knowledge of and skills for COVID-19 management. Institutions were required to provide support in materials, care processes, environment, and management. [ABSTRACT FROM AUTHOR]

The article deals with the legal aspects of recruiting and employing nursing professionals from third countries in Austria. It is pointed out that both employers and employees have to go through complex and time-consuming procedures. The article provides an overview of the necessary procedural steps and legal foundations. It also discusses the legal situation in Germany to demonstrate a simplification of the overall process. The article emphasizes the importance of recruiting foreign professionals to fill open positions in the nursing sector quickly and with qualified individuals. It is also noted that a team with employees from different cultural backgrounds can benefit from different experiences and ways of thinking. The article also mentions the complex legal framework for recruiting international professionals in Austria and the various laws that regulate this. It is noted that the process of recruiting, hiring, and integrating international professionals is a major challenge and requires enormous administrative effort. It is also pointed out that an accelerated skilled worker procedure, as already practiced in Germany, can increase efficiency and speed up the recruitment and hiring process. The text describes the requirements and procedures for applying for a Red-White-Red Card for foreign professionals in Austria. The required documents include proof of adequate accommodation, health insurance, livelihood, and German language skills. Individuals who have completed training in a nursing assistant profession or in advanced health and nursing care are exempt from the Foreign Employment Act. Applications are submitted to the locally competent provincial government and reviewed by the regional branch of the Public Employment Service. It is discussed whether this review could be waived for nursing professions, as they are in demand. The article describes the process of nostrification of foreign educational qualifications in the field of health and nursing care in Austria. It is explained that the completed education is extensively and detailedly examined and that the required language skills must be proven. Age plays a subordinate role. It also discusses the professional regulations of the Health and Nursing Care Act (GuKG) that regulate the activities of qualified nursing professionals. It is emphasized that nostrification should only be carried out in exceptional cases for further training purposes without having to go through a complex nostrification procedure. The required documents for the nostrification procedure are also listed. The certification of documents is required depending on the country of origin. Specific certification and translation guidelines apply to nursing staff from Tunisia recruited for the LKH-University Hospital Graz. All documents issued in the country of origin must have full diplomatic certification to be recognized in Austria. Certification can be done by the Austrian representation authority in the country of origin. The documents must be submitted in German or English translation, which must be made by an officially registered and sworn interpreter. The translations must be certified by the interpreter. The entire process [Extracted from the article]

• Exercise programs are effective in reducing low back pain for both nursing staff: nurses and nursing assistants. • Focusing on back and trunk exercises provide evidence based for low back pain relief for nurses and nursing assistants. • Exercise program for nurses and nursing assistants are more successful in those under 40 years old engaging in shorter exercise (20 sessions). Introduction : Nurses have a high prevalence of low back pain due to ergonomic hazards in healthcare workplaces. While exercise programs have been suggested as an intervention strategy, the effectiveness of low back pain programs has been inconsistent in the research literature. The purpose of study is to determine the effect of exercise programs to reduce low back pain among nursing staff. Methods : A systematic review and meta-analysis was conducted with five databases and systematically searched. Following the PRISMA guidelines, included studies evaluated low back pain relief among nurses or nursing assistants and described the exercise program. Two reviewers independently appraised, extracted, and synthesized all available studies. The study protocol was registered in PROSPERO (CRD42022359511). Results : A total of 296 articles with 1,355 nursing staff from nine countries were obtained. Nine randomized controlled trials with a moderate to low risk of bias quality were included. Exercise programs had a small but significant effect on low back pain of nursing staff (SMD = -0.48; 95% CI = -0.76 to −0.19; p = 0.03, I2 = 62%, p = 0.001). A subgroup analysis of nurses and nursing assistants showed moderate and small effects, respectively (I2 = 0% p < 0.0001, SMD −0.73 CI 95% [-0.97 to –0.48], p = 0.76, and I2 = 0% p = 0.002, SMD −0.23 CI 95% [-0.38 to −0.08], p < 0.88). Exercise for back and trunk exhibited a moderate effect on low back pain (SMD −0.56 CI 95% [-0.86 to −0.25], p = 0.01, I2 = 66%, p < 0.0004). A subgroup analysis comparing age, under 40 years old revealed a moderate effect size (SMD = -0.59; 95% CI = -0.83to −0.35; p = 0.06; I2 = 64%, p < 0.0001). Conclusions : Exercise programs are an effective treatment to reduce low back pain in nurses and nursing assistants, especially among younger staff. Practical application : Back and trunk exercise programs should be recommended for nursing staff with low back pain. [ABSTRACT FROM AUTHOR]

Aims: To investigate the experience of nursing assistants being delegated nursing tasks by registered nurses. Design: Mixed method explanatory sequential design. Methods: A total of 79 nursing assistants working in an acute hospital in Australia completed surveys that aimed to identify their experience of working with nurses and the activities they were delegated. The survey data were analysed using descriptive statistics. Interviews with 11 nursing assistants were conducted and analysed using Braun and Clarke's thematic analysis. Results were triangulated to provide a richer understanding of the phenomena. Results: Most nursing assistants felt supported completing delegated care activities. However, there was confusion around their scope of practice, some felt overworked and believed that they did not have the right to refuse a delegation. Factors impacting the nursing assistant's decision to accept a delegation included the attitude of the nurses, wanting to be part of the team and the culture of the ward. Nursing assistants who were studying to be nurses felt more supported than those who were not. Conclusions: Delegation is a two‐way relationship and both parties need to be cognisant of their roles and responsibilities to ensure safe and effective nursing care is provided. Incorrectly accepting or refusing delegated activities may impact patient safety. Implications for the profession and/or patient care: Highlights the need for implementing strategies to support safe delegation practices between the registered and unregulated workforce to promote patient safety. Impact: Describes the experiences of nursing assistants working in the acute care environment when accepting delegated care from nurses.Reports a range of factors that inhibit or facilitate effective delegation practices between nurses and nursing assistants.Provides evidence to support the need for stronger education and policy development regarding delegation practices between nurses and unregulated staff. Reporting method: Complied with the APA Style JARS‐MIXED reporting criteria for mixed method research. Patient or public contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

While burnout among health care workers has been well studied, little is known about the extent to which burnout among health care workers impacts the outcomes of their care recipients. To test this, we used a multi-year (2014–2020) survey of care aides working in approximately 90 nursing homes (NHs); the survey focused on work–life measures, including the Maslach Burnout Inventory (MBI) and work-unit identifier. Resident Assessment Instrument Minimum Data Set (RAI-MDS 2.0) data were obtained on all residents in the sampled NHs during this time and included a unit identifier for each resident. We used multi-level models to test associations between the MBI emotional exhaustion and cynicism sub-scales reported by care aides and the resident outcomes of antipsychotics without indication, depressive symptoms, and responsive behaviors among residents on units. In 2019/2020, our sample included 3,547 care aides and 10,117 residents in 282 units. The mean frequency of emotional exhaustion and cynicism across units was 43% and 50%, respectively. While residents frequently experienced antipsychotics without indication 1,852 (18.3%), depressive symptoms 2,089 (20.7%), and responsive behaviors 3,891 (38.5%), none were found to be associated with either emotional exhaustion or cynicism among care aides. [ABSTRACT FROM AUTHOR]

Background and Objectives Organizational context is thought to influence whether care aides feel empowered, but we lack empirical evidence in the nursing home sector. Our objective was to examine the association of features of nursing homes' unit organizational context with care aides' psychological empowerment. Research Design and Methods This cross-sectional study analyzed survey data from 3765 care aides in 91 Western Canadian nursing homes. Random-intercept mixed-effects regressions were used to examine the associations between nursing home unit organizational context and care aides' psychological empowerment, controlling for care aide, care unit, and nursing home covariates. Results Organizational (IVs) culture, social capital, and care aides' perceptions of sufficient time to do their work were positively associated with all four components of psychological empowerment (DVs): competence (0.17 [0.13, 0.21] for culture, 0.18 [0.14, 0.21] for social capital, 0.03 [0.01, 0.05] for time), meaning (0.21 [0.18, 0.25] for culture, 0.19 [0.16, 0.23] for social capital, 0.03 [0.01, 0.05 for time), self-determination (0.38 [0.33, 0.44] for culture, 0.17 [0.12, 0.21] for social capital, 0.08 [0.05, 0.11] for time), and impact (0.26 [0.21, 0.31] for culture, 0.23 [0.19, 0.28] for social capital, 0.04 [0.01, 0.07] for time). Discussion and Implications In this study, modifiable elements of organizational context (i.e. culture, social capital, and time) were positively associated with care aides' psychological empowerment. Future interventions might usefully target these modifiable elements of unit level context in the interest of assessing their effects on staff work attitudes and outcomes, including the quality of resident care. [ABSTRACT FROM AUTHOR]

Aim(s): To conceptualise and identify characteristics of clinical leadership in the nursing home setting. Design: A qualitative study using semi‐structured focus group interviews and a thematic analysis. Methods: Five semi‐structured focus group interviews were conducted with 41 healthcare professionals from nursing and other healthcare disciplines working in nursing homes (such as nurse assistants, licensed practical nurses, registered nurses (RNs), occupational therapists, recreational therapists, psychologists and gerontologists). Qualitative thematic content analysis of the gathered data was done. Results: Clinical leaders in nursing homes can be defined as passionate healthcare professionals providing person‐centred care with strong communication skills. They are clinical experts in their field and motivated to engage in lifelong learning. They are team players with informal leadership skills. They are visionary, committed, resilient and responsive. Awareness of the definition and the main characteristics of clinical leadership is necessary to facilitate the identification, support and development of healthcare professionals. Focussing on the development of competencies, training courses and monitoring and assessment methods is necessary to improve the evidence of clinical leadership in nursing homes. [ABSTRACT FROM AUTHOR]

To evaluate the moral distress (MD)in health professionals of pediatric and adult units to show how the complexity of care in the pediatric field causes the professionals who carry out their activity in these units to present a higher level of moral distress and a worse climate ethical. Design: Observational study with health professionals who currently work in Spanish Hospitals. Methods: A 58-item questionnaire was electronically distributed which included sociodemographic and employment characteristics, the Spanish version of the Measure of Moral Unrest for Healthcare Professionals (MMD-HP-SPA) and the Hospital Ethical Climate Survey (HECS). Results: A total of 169 health professionals completed the questionnaire. The moral distress was significantly higher among nurses than among physicians and nursing assistant care technicians. Focusing on the type of unit, moral distress it was only significantly higher for those physicians treating adult patients compared to those treating pediatric patients. Regarding the total score of the HECS survey, the medical group shows higher scores compared to the nursing group. Conclusion: Statistically significant differences have been found only in the medical group that treats adult patients, presenting a higher level of moral unrests than the pediatrician group. The MMD-HP-SPA questionnaire is a valid and useful instrument to detect MD in our hospital units in order to be able to implement strategies/interventions that improve the ethical climate and other factors that can mitigate and prevent this MD. [ABSTRACT FROM AUTHOR]

The article discusses the need for a new model of primary healthcare that focuses on preventative care rather than reactive treatment. It highlights the Osana experiment, a value-based primary care model that was piloted in Sydney, Australia, and demonstrated superior health outcomes and a positive return on investment. The model emphasizes proactive health assessments, patient activation, and the use of data science and gamification. Preliminary results from the experiment showed significant reductions in hospital admissions and improvements in various health outcomes. While the model had higher costs compared to traditional care, it delivered a positive return on investment due to reduced healthcare utilization. The article concludes that models like Osana may offer a viable solution to address the growing epidemic of chronic diseases and ensure the future sustainability of healthcare systems. [Extracted from the article]

The article "GesR: Health Law" provides a compilation of essays and case law in the field of health law. Various topics are addressed, including hospital reform, the selection of an expert witness, the assessment of suicidality in psychiatric treatment, and the permissibility of a "digital marketplace infrastructure" for pharmacies. Other topics include the statute of limitations for breach of duty to inform, the liability for damages in "Corona" vaccinations, and the termination of a nursing assistant after deception regarding a "vaccination obstacle". The text also includes judgments on topics such as the treatment of premature infants, discharge management, and the prescription surcharge. In addition, information is provided on various organizations and associations in the healthcare sector, such as the National Association of Statutory Health Insurance Funds, the German Hospital Federation (DKG), the Joint Federal Committee (G-BA), the National Association of Statutory Health Insurance Physicians (KBV), the Association of Research-Based Pharmaceutical Companies (Vfa), and the Medical Service of the National Association of Statutory Health Insurance Funds (MD-Bund). Legal literature and online databases are also recommended. [Extracted from the article]

The article is about the termination of employment of a nursing assistant who deceived about a "vaccination obstacle". The Federal Labour Court has ruled that the extraordinary immediate termination is effective. The plaintiff had submitted a forged certificate certifying temporary inability to be vaccinated. The court confirmed that the termination was justified as the employee had violated ancillary contractual obligations. Due to the seriousness of the breach of duty, a warning was not necessary. [Extracted from the article]

While mechanical vibration lessens discomfort associated with injection site pain (ISP), many local anesthetic injectors (LAIs) do not use vibratory anesthetic devices (VADs). Injector preference of vibration device is influenced by functional concerns, but qualitatively there is an element of adoption that is driven by visual feedback. We sought to capture operator preferences of vibration device design elements to further understand why injectors do not use these devices. We conducted a survey of image preferences among nurses and medical assistants employed at 8 dermatological clinics to investigate barriers to VAD use. Images were electronically modified with features distinct from the original device (a VAD commonly used in clinical practice). Participants rated their likelihood and comfort of use of each VAD represented in the images. Two-sample t-tests were used to compare the rating of the unmodified VAD to each modified VAD within participants. A response rate of 100% was achieved with 35 participants (average age, 38.5 years; 6 (17.1%) male, 29 (82.9%) female). Despite 28 (80%) participants knowing that mechanical vibration reduces ISP, only 16 (45.7%) endorsed ever using mechanical vibration as topical anesthetic. Images modified by pattern, color, and sterility covering were rated significantly lower than the original, unmodified VAD image (plain white VAD), confirming that visual feedback does impact adoption. Through independent comment categorization, aesthetics were found to be important to LAIs. Aesthetic preferences opposing functional concerns may factor into the lack of VAD use. Defining these visual preference barriers to adoption may help promote VAD use during dermatologic procedures. [ABSTRACT FROM AUTHOR]