When a professional fighter allegedly went haywire in a Nevada hospital and attacked nurses, it briefly brought some national attention to a long-standing problem: violence against healthcare workers. Of course, it’s not just famous people or athletes who can cause trouble, which makes the challenge of protecting hospital employees daunting.
A series of PHI issue briefs describes the direct-care workforces in several states.
Indeed, the direct-care industry is positioned to grow significantly over the next several years, creating tens of thousands of new jobs in the six states highlighted. Illinois alone will add more than 42,000 direct-care positions by 2016, an increase of 40 percent.
From the Council 4 summary:
Millions of Americans contribute blood and money to the Red Cross with the belief that the organization is well run and the blood supply is protected. But a new Jobs with Justice report raises serious concerns about donor safety and the security of the nation’s blood supply.
The Missouri Jobs with Justice Workers’ Rights Board released the report, “Labor Relations at the American Red Cross and Its Impact on Employee and Donor Safety,” after hearing from front-line Red Cross workers across the country. The investigative report outlines practices that jeopardize blood donors’ safety and the integrity of the blood supply, including long work hours that lead to fatigue and mistakes; sharp pay cuts that cause dramatic increases in employee turnover and hiring non-qualified workers instead of certified nurses.
Source: Denise Danna, Marirose Bernard, John Jones, Pamela Mathews, Journal of Nursing Administration, Volume 39 Issue 10, October 2009
From the abstract:
Since Hurricane Katrina, there have been numerous lessons learned and improvements in disaster planning and nursing management. The subsequent Hurricane Gustav allowed nurses and disaster planners to “test the system” and identify improvements that worked and did not. The authors outline those improvements and give direction for change and further improvements.
From the summary:
This guide from Department of Health & Human Services’ (HHS) Agency for Healthcare Research and Quality (AHRQ) can help community planners prepare for public health emergencies, such as pandemic flu, when demand for medical resources outweighs supply. The guide includes information on ethical and legal issues, and on the provision of services to address pre-hospital, acute hospital care, alternative care sites, and palliative care during a public health emergency.
To illustrate how to apply these basic principles, the guide includes a special section on influenza pandemic preparedness. This new guide is an abbreviated version of Mass Medical Care with Scarce Resources, published by AHRQ in 2007.
A recent study shows the number of methicillin resistant Staphylococcus aureus (MRSA) infections found in patients located at 13 New Mexico hospitals and three state clinics was cut almost in half after the facilities agreed to self report cases.
Last year, the facilities reported 44 cases of MRSA, but after agreeing to self report the cases, the MRSA infections dropped to 27 cases. This reduction was a result of simple medical measures, such as handwashing, nasal swab tests, and segregating the infected.
New Mexico MRSA Collaborative
From the summary:
The health care community will play an important role in the eventual implementation of health care reform legislation, but will also have a unique ability to explain to patients how health reform will impact their lives, the health of their communities, and the delivery of their health care. The public has very high confidence in health professionals to recommend the right thing. One recent survey found that 79 percent of responders had at least a fair amount of confidence in nurses’ groups, and 70 percent in doctors’ groups.
From the abstract:
School closure is an important component of U.S. pandemic flu mitigation strategy. The benefit is a reduction in epidemic severity through reduction in school-age contacts. However, school closure involves two types of cost. First is the direct economic impact of the worker absenteeism generated by school closures. Second, many of the relevant absentees will be health care workers themselves, which will adversely affect the delivery of vaccine and other emergency services. Neither of these costs has been estimated in detail for the United States. We offer detailed estimates, and improve on the methodologies thus far employed in the non-U.S. literature. We give estimates of both the direct economic and health care impacts for school closure durations of 2, 4, 8, and 12 weeks under a range of assumptions. We find that closing all schools in the U.S. for four weeks could cost between $10 and $47 billion dollars (0.1-0.3% of GDP) and lead to a reduction of 6% to 19% in key health care personnel. These should be considered conservative (i.e., low) economic estimates in that earnings rather than total compensation are used to calculate costs. We also provide per student costs, so regionally heterogeneous policies can be evaluated. These estimates permit the epidemiological benefits of school closure to be compared to the costs at multiple scales and over many durations.
Source: Barbara A. Mark, Lisa Lindley, Cheryl B. Jones, Policy, Politics, & Nursing Practice, Vol. 10, No. 2, May 2009
From the abstract:
The authors examined the relationship between nurse working conditions and nursing unit costs in 210 general medical, general surgical, and general medical surgical units in 112 randomly selected U.S. hospitals. Data were collected from registered nurses (N = 3,747 and 2,878), patients (N = 2,100), study coordinators, and secondary data sources. After controlling for relevant hospital, nursing unit, and patient characteristics, the authors found that good working conditions did not increase nursing unit costs. Teaching status was associated with higher costs, whereas larger unit size was associated with lower costs. Higher proportions of registered nurses and licensed practical nurse staffing were also associated with higher costs. Patient variables were not significantly related to costs. We suggest a variety of strategies that managers may use to improve working conditions.
From the abstract:
Public schools provide many services in addition to academic instruction and childcare for which they receive little credit. School nursing services is one such area, and provides important benefits to individual students and the general citizenry. However, the extent to which these services are delivered to students are seldom clearly described, and the costs of delivering them are buried deep in administrative budgets. Thus, what taxpayers are getting for their money is unknown. As a results, nursing and many other school services are easily targeted for downsizing and budget cutbacks. This is not good educational policy, and it is poor management.
The three-year study presented here was a programmatic R&D effort to help a large, urban school district develop and implement the Nursing Accomplishment Information System (NAIS), an information management system that allowed the district to (a) clearly define its nursing services, (b) track the extent to which these services were actually delivered, and (c) calculate the costs of these services. As a result, the district found, and was able to communicate its constituencies, that it was delivering an impressive array of nursing services to students in a very cost-effective manner. Thus, the study yielded an operational prototype that can be used to determine and manage the costs and benefits of any service provided by a public school district.