scholarly journals Longitudinal Study of the Variation in Patient Turnover and Patient-to-Nurse Ratio: Descriptive Analysis of a Swiss University Hospital

10.2196/15554 ◽  
2020 ◽  
Vol 22 (4) ◽  
pp. e15554
Author(s):  
Sarah N Musy ◽  
Olga Endrich ◽  
Alexander B Leichtle ◽  
Peter Griffiths ◽  
Christos T Nakas ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Descriptive Analysis ◽  
Nurse Staffing ◽  
Data Sources ◽  
University Hospital ◽  
Nursing Workload ◽  
High Quality ◽  
Discharge Data ◽  
Normal Ranges ◽  
Patient Turnover

Background Variations in patient demand increase the challenge of balancing high-quality nursing skill mixes against budgetary constraints. Developing staffing guidelines that allow high-quality care at minimal cost requires first exploring the dynamic changes in nursing workload over the course of a day. Objective Accordingly, this longitudinal study analyzed nursing care supply and demand in 30-minute increments over a period of 3 years. We assessed 5 care factors: patient count (care demand), nurse count (care supply), the patient-to-nurse ratio for each nurse group, extreme supply-demand mismatches, and patient turnover (ie, number of admissions, discharges, and transfers). Methods Our retrospective analysis of data from the Inselspital University Hospital Bern, Switzerland included all inpatients and nurses working in their units from January 1, 2015 to December 31, 2017. Two data sources were used. The nurse staffing system (tacs) provided information about nurses and all the care they provided to patients, their working time, and admission, discharge, and transfer dates and times. The medical discharge data included patient demographics, further admission and discharge details, and diagnoses. Based on several identifiers, these two data sources were linked. Results Our final dataset included more than 58 million data points for 128,484 patients and 4633 nurses across 70 units. Compared with patient turnover, fluctuations in the number of nurses were less pronounced. The differences mainly coincided with shifts (night, morning, evening). While the percentage of shifts with extreme staffing fluctuations ranged from fewer than 3% (mornings) to 30% (evenings and nights), the percentage within “normal” ranges ranged from fewer than 50% to more than 80%. Patient turnover occurred throughout the measurement period but was lowest at night. Conclusions Based on measurements of patient-to-nurse ratio and patient turnover at 30-minute intervals, our findings indicate that the patient count, which varies considerably throughout the day, is the key driver of changes in the patient-to-nurse ratio. This demand-side variability challenges the supply-side mandate to provide safe and reliable care. Detecting and describing patterns in variability such as these are key to appropriate staffing planning. This descriptive analysis was a first step towards identifying time-related variables to be considered for a predictive nurse staffing model.

scholarly journals Longitudinal Study of the Variation in Patient Turnover and Patient-to-Nurse Ratio: Descriptive Analysis of a Swiss University Hospital (Preprint)

2019 ◽  
Author(s):  
Sarah N Musy ◽  
Olga Endrich ◽  
Alexander B Leichtle ◽  
Peter Griffiths ◽  
Christos T Nakas ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Descriptive Analysis ◽  
Nurse Staffing ◽  
Data Sources ◽  
University Hospital ◽  
Nursing Workload ◽  
High Quality ◽  
Discharge Data ◽  
Normal Ranges ◽  
Patient Turnover

BACKGROUND Variations in patient demand increase the challenge of balancing high-quality nursing skill mixes against budgetary constraints. Developing staffing guidelines that allow high-quality care at minimal cost requires first exploring the dynamic changes in nursing workload over the course of a day. OBJECTIVE Accordingly, this longitudinal study analyzed nursing care supply and demand in 30-minute increments over a period of 3 years. We assessed 5 care factors: patient count (care demand), nurse count (care supply), the patient-to-nurse ratio for each nurse group, extreme supply-demand mismatches, and patient turnover (ie, number of admissions, discharges, and transfers). METHODS Our retrospective analysis of data from the Inselspital University Hospital Bern, Switzerland included all inpatients and nurses working in their units from January 1, 2015 to December 31, 2017. Two data sources were used. The nurse staffing system (tacs) provided information about nurses and all the care they provided to patients, their working time, and admission, discharge, and transfer dates and times. The medical discharge data included patient demographics, further admission and discharge details, and diagnoses. Based on several identifiers, these two data sources were linked. RESULTS Our final dataset included more than 58 million data points for 128,484 patients and 4633 nurses across 70 units. Compared with patient turnover, fluctuations in the number of nurses were less pronounced. The differences mainly coincided with shifts (night, morning, evening). While the percentage of shifts with extreme staffing fluctuations ranged from fewer than 3% (mornings) to 30% (evenings and nights), the percentage within “normal” ranges ranged from fewer than 50% to more than 80%. Patient turnover occurred throughout the measurement period but was lowest at night. CONCLUSIONS Based on measurements of patient-to-nurse ratio and patient turnover at 30-minute intervals, our findings indicate that the patient count, which varies considerably throughout the day, is the key driver of changes in the patient-to-nurse ratio. This demand-side variability challenges the supply-side mandate to provide safe and reliable care. Detecting and describing patterns in variability such as these are key to appropriate staffing planning. This descriptive analysis was a first step towards identifying time-related variables to be considered for a predictive nurse staffing model.

scholarly journals Preventing SARS-CoV-2 transmission in the emergency department by implementing a separate pathway for patients with respiratory conditions

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Fulwah Alqahtani ◽  
Marzouqah Alanazi ◽  
Wajdan Alassaf ◽  
Fadilah Sfouq Aleanizy ◽  
Muna Aljahany ◽  
...  
Keyword(s):  
Emergency Department ◽  
Longitudinal Study ◽  
Healthcare Workers ◽  
Respiratory Symptoms ◽  
Control Measures ◽  
University Hospital ◽  
Respiratory Pathway ◽  
Infection Control Measures ◽  
Separate Pathway ◽  
Respiratory Conditions

Abstract Objectives This study aimed to describe the development and implementation of a separated pathway to check and treat patients with a suspected/confirmed coronavirus disease 2019 (COVID-19) in the emergency department (ED) at King Abdullah bin Abdulaziz University Hospital in Riyadh. Methods We conducted a retrospective, descriptive longitudinal study from March to July 2020 by analyzing data of all confirmed cases of COVID-19 among ED visitors and healthcare workers in King Abdullah bin Abdulaziz University Hospital. Results During the study period, a total of 1,182 swab samples were collected for testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), of which 285 (24.1%) tested positive. Of the 285 cases of confirmed SARS-CoV-2 infection, 18 were healthcare workers and 267 were patients. As a result of using the respiratory pathway for COVID-19 patients, the hospital managed to limit transmission of SARS-CoV-2 not only between patients but also between patients and healthcare workers, while also containing the pandemic. There were no cases of nosocomial SARS-CoV-2 infection recorded among the patients who visited the ED or the flu clinic. All confirmed cases were community acquired and patients were cared for under constrained measures. Conclusions Implementing infection control measures and restricting those with respiratory symptoms to the ED pathway prevented nosocomial spread of SARS-CoV-2 infection in the ED.

scholarly journals Prioritising recommendations following analyses of adverse events in healthcare: a systematic review

2020 ◽  
Vol 9 (4) ◽  
pp. e000843
Author(s):  
Kelly Bos ◽  
Maarten J van der Laan ◽  
Dave A Dongelmans
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Data Extraction ◽  
Data Sources ◽  
Cochrane Library ◽  
High Quality ◽  
Data Synthesis ◽  
Study Selection ◽  
Personal Opinion ◽  
User Friendly

PurposeThe purpose of this systematic review was to identify an appropriate method—a user-friendly and validated method—that prioritises recommendations following analyses of adverse events (AEs) based on objective features.Data sourcesThe electronic databases PubMed/MEDLINE, Embase (Ovid), Cochrane Library, PsycINFO (Ovid) and ERIC (Ovid) were searched.Study selectionStudies were considered eligible when reporting on methods to prioritise recommendations.Data extractionTwo teams of reviewers performed the data extraction which was defined prior to this phase.Results of data synthesisEleven methods were identified that are designed to prioritise recommendations. After completing the data extraction, none of the methods met all the predefined criteria. Nine methods were considered user-friendly. One study validated the developed method. Five methods prioritised recommendations based on objective features, not affected by personal opinion or knowledge and expected to be reproducible by different users.ConclusionThere are several methods available to prioritise recommendations following analyses of AEs. All these methods can be used to discuss and select recommendations for implementation. None of the methods is a user-friendly and validated method that prioritises recommendations based on objective features. Although there are possibilities to further improve their features, the ‘Typology of safety functions’ by de Dianous and Fiévez, and the ‘Hierarchy of hazard controls’ by McCaughan have the most potential to select high-quality recommendations as they have only a few clearly defined categories in a well-arranged ordinal sequence.

scholarly journals Presenter: Werner Paulus, University Hospital Muenster, Muenster. Publishing A High-quality, Non-commercial Neuropathology Journal Without a Publisher: The First Nine Months

2021 ◽  
Vol 48 (s2) ◽  
pp. S11-S11
Author(s):  
Marta Margeta ◽  
Peter Gould ◽  
Lili-Naz Hazrati ◽  
Veronica Hirsch-Reinshagen ◽  
Werner Paulus
Keyword(s):  
Open Access ◽  
Driving Forces ◽  
Scholarly Communication ◽  
University Hospital ◽  
Website Design ◽  
Final Decision ◽  
List Type ◽  
Ethical Challenges ◽  
High Quality ◽  
Commercial Publishing

Scholarly communication faces increasing economical and ethical challenges, including pricing policies and overbearing behavior of commercial publishing houses. Based on the hypothesis that a diamond open access neuropathology journal of a high scientific and technical quality can be run entirely by neuropathologists, we launched Free Neuropathology (FNP; freeneuropathology.org) in January 2020. Classical publisher activities, such as copyediting, layout, website maintenance, and journal promotion, are undertaken by neuropathologists and neuroscientists using free open access software. The journal is free for both readers and authors, and papers are published under a Creative Commons BY SA licence, where copyright remains with the authors. Based on 26 articles published by August 2020, it takes FNP 11.1 days from submission to first, and 19.9 days to final, decision. High-quality copyediting, layout, and online publishing in the final format is accomplished in only 8 days. Absence of a commercial publisher enables prioritization of democratic and scientifically-driven decisions on editorial structure, website design, journal promotion, paper formatting, special article series, and number of accepted papers. This new model of journal publishing, which returns the control of scholarly communication to scientists, will be of interest to neuropathologists and wider scientific community alike.Learning ObjectivesSummarize the current state and driving forces behind commercial and non-commercial scientific publishing in neuropathology.Describe the advantages and challenges of a non-commercial publishing platform for neuropathology.

scholarly journals A dataset on affiliation of venture capitalists in China between 2000 and 2016

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Jin Chen ◽  
Tianyuan Chen ◽  
Yifei Song ◽  
Bin Hao ◽  
Ling Ma
Keyword(s):  
Data Sources ◽  
Venture Capitalists ◽  
High Quality ◽  
Public Agency ◽  
Multiple Data Sources ◽  
Multiple Data ◽  
Multi Stage ◽  
The World ◽  
Prior Literature ◽  
Innovation And Entrepreneurship

AbstractPrior literature emphasizes the distinct roles of differently affiliated venture capitalists (VCs) in nurturing innovation and entrepreneurship. Although China has become the second largest VC market in the world, the unavailability of high-quality datasets on VC affiliation in China’s market hinders such research efforts. To fill up this important gap, we compiled a new panel dataset of VC affiliation in China’s market from multiple data sources. Specifically, we drew on a list of 6,553 VCs that have invested in China between 2000 and 2016 from CVSource database, collected VC’s shareholder information from public sources, and developed a multi-stage procedure to label each VC as the following types: GVC (public agency-affiliated, state-owned enterprise-affiliated), CVC (corporate VC), IVC (independent VC), BVC (bank-affiliated VC), FVC (financial/non-bank-affiliated VC), UVC (university endowment/spin-out unit), and PenVC (pension-affiliated VC). We also denoted whether a VC has foreign background. This dataset helps researchers conduct more nuanced investigations into the investment behaviors of different VCs and their distinct impacts on innovation and entrepreneurship in China’s context.

Analisis Intertekstual Timun Mas dan Buto Ijo pada Iklan Marjan dan Cerita Rakyat Indonesia

2021 ◽  
Vol 9 (1) ◽  
pp. 1-8
Author(s):  
Ade Anggraini Kartika Devi ◽  
Ade Husnul Mawadah
Keyword(s):  
Descriptive Analysis ◽  
Data Sources ◽  
Great Strength ◽  
Happy Ending ◽  
Folk Tales ◽  
Similarities And Differences ◽  
The Difference ◽  
The Relationship

Abstract This study aims to analyze the intertextuality of Timun Mas and Buto Ijo in the Marjan advertisement with Indonesian folklore. The advertisement is considered as a text derived from the previous text because it uses the characters of Buto Ijo and Timun Mas, namely the legendary figures of folklore entitled Timun Mas and Buto Ijo. The data sources are the Timun Mas and Buto Ijo versions of Marjan advertisements and the Timun Mas and Buto Ijo folk tales. Descriptive analysis was carried out using an intertextuality approach to see the relationship between the two texts. The results showed that the character of Buto Ijo in the Marjan advertisement and Indonesian folklore had some similarities and differences. The similarity is Buto Ijo is tall, big, and green. Buto Ijo, as his name implies, is told as a giant green figure who has great strength. The difference lies at the end of the story. In the advertisement, Buto Ijo has a happy ending by joining the Timun Mas family to celebrate Eid. While in folklore, Buto Ijo has a tragic ending. Buto Ijo died from drowning in a sea of ​​shrimp paste that turned into embers in the ocean.

Abstract TP374: Data Linkage is Effective for Improving the Available Data for Stroke: An Example from the Australian Stroke Clinical Registry.

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Monique F Kilkenny ◽  
Helen M Dewey ◽  
Natasha A Lannin ◽  
Vijaya Sundararajan ◽  
Joyce Lim ◽  
...  
Keyword(s):  
Hospital Discharge ◽  
Hospital Discharge Data ◽  
Hospital Data ◽  
High Quality ◽  
Clinical Registry ◽  
Large Hospital ◽  
Common Data Elements ◽  
Discharge Data ◽  
Data Elements ◽  
Data Collections

Introduction: Multiple data collections can be a burden for clinicians. In 2009, the Australian Stroke Clinical Registry (AuSCR) was established by non-government and research organizations to provide quality of care data unavailable for acute stroke admissions. We show here the reliability of linking complimentary registry data with routinely collected hospital discharge data submitted to governmental bodies. Hypothesis: A high quality linkage with a > 90% rate is possible, but requires multiple personal identifiers common to each dataset. Methods: AuSCR identifying variables included date of birth (DoB), Medicare number, first name, surname, postcode, gender, hospital record number, hospital name and admission date. The Victorian Department of Health emergency department (ED) and hospital discharge linked dataset has most of these, with first name truncated to the first 3 digits, but no surname. Common data elements of AuSCR patients registered at a large hospital in Melbourne, Victoria (Australia) between 15 June 2009 and 31 December 2010 were submitted to undergo stepwise deterministic linkage. Results: The Victorian AuSCR sample had 818 records from 788 individuals. Three steps with 1) Medicare number, postcode, gender and DoB (80% matched); 2) hospital number/admit date; and 3) ED number/visit date were required to link AuSCR data with the ED and hospital discharge data. These led to an overall high quality linkage of >99% (782/788) of AuSCR patients, including 731/788 for ED records and 736/788 for hospital records. Conclusion: Multiple personal identifiers from registries are required to achieve reliable linkage to routinely collected hospital data. Benefits of these linked data include the ability to investigate a broader range of research questions than with a single dataset. Characters with spaces= 1941 (limit is 1950)

scholarly journals Knowledge and attitudes towards dementia in a sample of medical residents from a university-hospital in São Paulo, Brazil

2016 ◽  
Vol 10 (1) ◽  
pp. 37-41 ◽  
Author(s):  
Alessandro Ferrari Jacinto ◽  
Paulo José Fortes Villas Boas ◽  
Vânia Ferreira de Sá Mayoral ◽  
Vanessa de Albuquerque Citero
Keyword(s):  
Descriptive Analysis ◽  
Sao Paulo ◽  
University Hospital ◽  
Medical Residents ◽  
Good Knowledge ◽  
Public Healthcare ◽  
São Paulo ◽  
Medical Specialties ◽  
Dementia Prevalence ◽  
Knowledge And Attitudes

An estimated 61% of the 24.3 million people diagnosed with dementia worldwide live in underdeveloped countries, including Brazil, where a public healthcare system covers the majority of the population. This care is usually provided by General Practitioners (GP) and in Brazil many doctors recently graduated from medical school and residents of different medical specialties practice as GPs. Objective : The aim of this study was to describe the knowledge and attitudes about dementia in a sample of Brazilian medical residents from a university-hospital in São Paulo, Brazil. Methods : A total of 152 Brazilian medical residents participated in the study. Participants answered a "Knowledge Quiz" (KQ) and "Attitude Quiz" (AQ) about dementia issues, transculturally adapted for use in Brazilian physicians. A descriptive analysis of the correct answers on knowledge and of the attitude aspects was performed. Results : The medical residents showed poor knowledge (<50%) about dementia prevalence and incidence and a good knowledge on disease management and diagnosis. Participants tended to be optimistic about caring for demented patients. Conclusion : In this study, it is likely that the physicians' good knowledge about dementia issues is the reason for their optimism dealing with demented patients.

scholarly journals Nursing workload, nurse staffing methodologies and tools: A systematic scoping review and discussion

2020 ◽  
Vol 103 ◽  
pp. 103487 ◽  
Author(s):  
Peter Griffiths ◽  
Christina Saville ◽  
Jane Ball ◽  
Jeremy Jones ◽  
Natalie Pattison ◽  
...  
Keyword(s):  
Scoping Review ◽  
Nurse Staffing ◽  
Nursing Workload

scholarly journals Konsep Khilafah Menurut Sayyid Quthb dan Taqiyuddin Al-Nabhani dalam Perspektif Syiasyah Syar’iyyah

PALAPA ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 244-284
Author(s):  
Nurhadi Nurhadi ◽  
Mawardi Dalimunthe
Keyword(s):  
Islamic Law ◽  
Descriptive Analysis ◽  
Data Sources ◽  
Primary Data ◽  
Legal Basis ◽  
Islamic World ◽  
The People ◽  
Qualitative Descriptive ◽  
The One ◽  
The Right

The purpose of this study is to find out the concept of khilafah according to Sayyid Quthub and Taqiyuddin al-Nabhani, differences and legal basis. This study is a library model, with primary data sources, the Zhilalal-Qur'anic Tafseer and Nizham Al-Hukmi Fi Al-Islam and qualitative descriptive analysis methods. The result is the thought of the concept of khilafah according to sayyid Quthub: 1). The concept of the ruler / caliph, that who becomes the ruler of the choice of the Muslims, acts in absolute freedom, but that person gets the authority because he constantly applies the law of Allah Almighty. 2). The Islamic government system, the Supra Nasional government (the unity of the entire Islamic world). 3). The pillars of his Islamic government: a). Justice of the ruler; b). People's obedience; c). Consultation between the people and the authorities. Thought of the concept of the Caliphate according to Taqiyuddin Al-Nabhani: 1). The concept of the ruler / caliph is a person who represents the Ummah in government affairs and power and in applying syara 'laws. 2). The system of government is khilafah. 3). The pillars of his Islamic government: a). Sovereignty in the hands of syara '; b). Power of the people; c). To appoint a legal Caliph fardlu for all Muslims; d). Only Khailfah has the right to carry out tabanni (adoption) against syara 'laws; e) The Caliph has the right to make constitutions and all other laws. The differences in the concept of khilafah are both: 1). According to Sayyid Quthub, if the ruler fails, then the ruler can be dismissed if the Muslims are no longer satisfied with him. This statement gives a signal that the people get rid of the rulers who no longer fulfill their functions (zhalim rulers). It is different from the opinion of Taqiyuddin al-Nabhani. An Amir al-mu'minin (Khalifah), even though he is responsible before the people and his representatives, but the people and their representatives are not entitled to dismiss him. Nor will the Caliph be dismissed, except when deviating from Shara law. The one who determined the dismissal was only the Mazhalim court. 2). The system of Islamic government according to Sayyid Quthub does not question any system of government in accordance with the system of conditions of society, but this government is characterized by respect for the supremacy of Islamic law (shari'ah). Whereas According to Taqiyuddin Al-Nabhani that the system of Islamic government is khilafah. 3). The pillars of Islamic government according to Sayyid Quthub and Taqiyyuddin al-Nabhani, points three parts a and b at the above conclusions are: 1). Sayyid Quthub: a). Justice of the ruler; b). People's obedience; c). Consultation between the people and the authorities. 2). Taqiyyuddin al-Nabhani: a). Sovereignty in the hands of syara; b). Power of the people; c). To appoint a legal Caliph fardlu for all Muslims; d). Only Khailfah has the right to do tabanni (adoption) against the laws of shara; e). The Caliph has the right to make constitutions and all other laws. The legal bases for determining the Caliphate according to both: 1). The legal basis for the establishment of the Caliphate according to Sayyid Quthub: 1). Ruler, Qur'an Surah (2) al-Baqarah verse 30; 2). Islamic Government System, Qur'an Surah (24) an-Nur verse 55; 3). Pillars of Islamic Government, Qur'an Surah (4) an-Nisa 'verse 58. 2). The legal basis for the establishment of the Caliphate according to Taqiyyuddin al-Nabhani: 1). Ruler, hadith of Muslim history from Abu Said Al khudri, Hadith no. 1853 and Muslims from Abdullah Bin Amru Bin Ash, Hadith no. 1844; 2). Islamic Government System, Al-Qur'an surah an-Nisa '(4) verse 59, an-Nisa' (4) verse 65. Muslim, saheeh Muslim, volumes, 3 pp., 1459 and 1480; 3). Islamic Pillars of Government al-Qur'an surah An-Nisa (3) verse 65, and Surah An-Nisa (3) verses': 5.

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