Category Archives: Health Care Workers

Nursing Homes in Public Health Emergencies: Special Needs and Potential Roles

Source: Elisabeth D. Root, Jacqueline B. Amoozegar, Shulamit Bernard, Agency for Healthcare Research and Quality, AHRQ Publication No. 07-0029-1, May 2007

From the overview:
To date, most health care preparedness planning efforts have been focused on hospital and first responder preparedness. Nevertheless, the elderly are particularly vulnerable to bioterrorism and other public health emergencies due to their complex physical, medical, and psychological needs. The potential role and question of preparedness on the part of nursing homes has emerged in local and national preparedness discussions. However, little is known about the extent to which nursing homes have planned for and/or been incorporated into regional planning efforts
To address this issue, a series of focus groups was conducted to collect information about disaster- and bioterrorism-related planning activities among nursing homes in five States—North Carolina, Oregon, Pennsylvania, Washington, and Utah—and southern California. The aims of the focus groups were to:
• Determine if nursing home administrators have prepared and trained staff on disaster plans, including bioterrorism response.
• Assess the special needs of the elderly population in nursing home settings during a public health emergency.
• Determine if nursing homes are able to accommodate patient flows from acute care hospitals or provide other resources.
• Assess the impact of State regulations on the ability of nursing homes to offer support and/or surge capacity.
Findings from this report can provide important insight into current nursing home preparedness activities as well as the potential role of nursing homes in larger local or regional preparedness efforts and the special needs of the nursing home population.

See also: Emergency Preparedness Atlas — U.S. Nursing Home and Hospital Facilities
The Agency for Healthcare Research and Quality (AHRQ) sponsored preparation of this atlas to support local/regional planning and response efforts in the event of a bioterrorism or other public health emergency. In the atlas, case studies in six areas illustrate the location of nursing homes relative to population and various emergency preparedness regions. There are also maps of the location of hospitals and nursing homes in all 50 States and the District of Columbia.
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The FLSA Minefields Await the Unwary LTC Employer

Source: John E Lyncheski, Nursing Homes: Long Term Care Management, Vol. 56 no. 7, July 2007

Misunderstood or misapplied provisions of the Department of Labor’s regulations can have explosive consequences. The Department of Labor has long-term care in its sights for nonexempt employee overtime infractions.

The Impact of Medicare’s Payment Rates on the Volume of Services Provided by Skilled Nursing Facilities

Source: Congressional Budget Office Background Paper, Pub. No. 2761, July 2007

Rising costs in Medicare, Medicaid, and other federal health-related programs represent the central long-term fiscal challenge facing the nation. The Congressional Budget Office (CBO) is therefore increasingly focusing on analyzing the causes of those rising costs and potential policy responses.

Medicare’s spending under the fee-for-service portion of the program depends on the rates that Medicare pays to medical providers and the volume of services that medical providers supply to beneficiaries. The Congress has periodically limited growth in Medicare’s payments to providers to reduce spending. The effect on Medicare’s spending of changes in Medicare’s payment rates depends on whether and to what extent the volume of services adjusts in response.

In this background paper, CBO examines changes in the volume of services provided by skilled nursing facilities (SNFs) in response to changes in Medicare’s payment rates for SNFs. As with other CBO background papers, it is designed to make the agency’s analyses more transparent by explaining CBO’s methods and assumptions. In keeping with CBO’s mandate to provide objective, nonpartisan analysis, this paper makes no recommendations.

ANA 2007 Study of Injectable Medication Errors

Source: American Nurses Association and Inviro Medical Devices, 2007

The 2007 Study of Injectable Medication Errors gathered opinions of 1,039 U.S. nurses about errors related to injectable medications and syringe labeling. The independent research, sponsored by the American Nurses Association (ANA) and Inviro Medical Devices, reveals 97% of nurses worry about medication errors, and two-thirds (68%) believe medication errors could be reduced with more consistent syringe labeling.

Community Health Worker National Workforce Study

Source: U.S. Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions, March 2007

During the past decade, private insurers, business enterprises and the Federal government have implemented or proposed changes in health care delivery and financing. These payers were reacting to unprecedented increases in health-related expenditures amid hypercompetitive global markets. Simply, the cost of providing adequate health care to employees and the population at large had become very high.

Some viewed the community health worker (CHW) workforce as a component of cost-effective strategies addressing the health care needs of underserved communities. However, there was little rigorous, comprehensive research about the CHW workforce.

This report describes a comprehensive national study of the community health worker workforce and of the factors that affected its utilization and development.

Annotated Bibliography

Web Sites Start Reporting Hospital Mortality Data

Source: Paula Rasich, Hospitals & Health Networks, Vol. 81 no. 6, June 2007

The next evolution in quality reporting is here as outcomes data goes public.

As the number of public Web sites on hospital performance have flourished during the past couple of years, mortality data has been noticeably absent. That’s all changing. The question is: Are hospitals ready?

This month, the federal government’s Hospital Compare Web site, which posts data on how well hospitals meet performance measures, will for the first time publish 30-day mortality rates for heart attack and heart failure. Pneumonia will be added soon. Using Medicare claims data, the site will show whether a hospital’s death rate is better or worse than what is expected for a hospital’s patient population.

NURSES: Satisfaction Not Guaranteed

Source: Lee Ann Runy, Hospitals & Health Networks, Vol. 81 no. 6, June 2007

A recent study predicts that the nursing shortage in the United States will grow to 340,000 by 2020. And, as a story on page 60 of this issue shows, it’s not just baby boomer nurses who are leaving the workforce; first-year nursing school graduates quit at an exceptionally high rate. One way to ease the exodus is to improve work conditions. If nurse statisfaction data from Press Ganey and others is an indicator, there’s plenty of room for improvement. In a survey of more than 33,000 registered nurses in 2005, Press Ganey found that nurses’ satisfaction with work conditions and senior leadership was lower than their satisfaction with co-workers and job security. Not surprisingly, increased staffing level was cited as the top area in need of attention.

Medical Surveillance for Health Care Workers Exposed to Hazardous Drugs Recommended in New NIOSH Report

Source: National Institute For Occupational Safety And Health, NIOSH Publication No. 2007-117, April 2007

A new report from the National Institute for Occupational Safety and Health (NIOSH) recommends that employers institute medical surveillance programs for health-care workers who are occupationally exposed to hazardous drugs, and suggests practical strategies and components for such programs.

The document, Workplace Solutions: Medical Surveillance for Health Care Workers Exposed to Hazardous Drugs, supplements previous NIOSH resources that highlighted potential health risks for health-care employees who are exposed to hazardous drugs.

The U.S. health care industry is one of the fastest growing sectors, with over 16.6 million workers in 2005. It is estimated that 5.5 million of these health care workers are potentially exposed to hazardous drugs or drug waste, including pharmacists, nurses, physicians, maintenance workers, operating room personnel, and others who may come into contact with these drugs while performing their job.

Hazardous drugs are those that have been determined through research studies to have a potential for causing harm to healthy individuals, including potential risks of cancer, skin rashes, birth defects, and reproductive toxicity. These same drugs also play a critical role in treatment of patients with serious illnesses like cancer and HIV infection. Although the potential therapeutic benefits of hazardous drugs outweigh the risks of side effects for ill patients, exposed health care workers risk these same side effects with no therapeutic benefit.

Pandemic Influenza Preparedness and Response Guidance for Healthcare Workers and Healthcare Employers

Source: Occupational Safety and Health Administration U.S. Department of Labor, OSHA 3328-05, 2007

A comprehensive resource for healthcare planners and practitioners, the new guidance offers information and tools to assist the industry in preparing for and responding to an influenza pandemic. It includes technical information on infection control and industrial hygiene practices to reduce the risk of infection in healthcare settings; workplace preparations and planning issues; and OSHA standards that have special importance to pandemic preparedness planners and responders in the industry.

Commentary: Supervisors Of The World Unite! The NLRB Tells Nurses And Professional Workers Which Side They Are On

Source: Harris Freeman, WorkingUSA: The Journal of Labor and Society, Vol. 10 no. 1, March 2007
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The National Labor Relations Board (NLRB) has finally issued the long-awaited Oakwood Healthcare, Inc. decision, holding that registered nurses who nominally coordinate and guide the work of other nurses or health care workers are supervisory personnel who fall outside the coverage of the National Labor Relations Act. Oakwood Healthcare is a seminal NLRB decision, articulating a remarkably expansive rule for determining whether or not an employee is a supervisor. By radically redefining who is a worker and who is a boss, Oakwood Healthcare has the potential to do what no other single case in the history of the NLRB has ever done—deprive more than eight million professionals and skilled workers of their right to join a labor union. If Oakwood Healthcare is not reversed by the federal courts or undermined by statutory labor law reform, as many as eight million professional employees and skilled workers will join the 32 million members of the U.S. workforce—one out of four workers—who, according to the General Accounting Office, do not have the legal right to join unions. As dissenting Board member Wilma Liebman ominously noted, Oakwood Healthcare creates a class of workers existing in a legal limbo “hav[ing] neither the genuine prerogatives of management, nor the statutory rights of ordinary employees.”