scholarly journals Targeted Minimal Staff-to-Patient Ratios Are Unachievable – A Nationwide Survey in German ICUs During the COVID-19 Pandemic

Cureus ◽  
2021 ◽  
Author(s):  
Clemens Grimm ◽  
Steffen Dickel ◽  
Alexandra Sachkova ◽  
Maria Popp ◽  
Martin Golinksi ◽  
...  
2021 ◽  
Author(s):  
Clemens Grimm ◽  
Steffen Dickel ◽  
Alexandra Sachkova ◽  
Maria Popp ◽  
Martin Golinski ◽  
...  

Abstract Background: The surge in patients during the COVID-19 pandemic has exacerbated the looming problem of staff shortage in German ICUs possibly leading to worse outcomes for patients. Methods: Within the German Evidence Ecosystem CEOsys network, we conducted an online national mixed-methods survey assessing the standard of care in German ICUs treating patients with COVID-19. Results: A total of 171 German ICUs reported a median ideal number of patients per intensivist of 8 (interquartile range, IQR = 3rd quartile - 1st quartile = 4.0) and per nurse of 2.0 (IQR = 1.0). For COVID-19 patients, the median target was a maximum of 6.0 (IQR = 2.0) patients per intensivist or 2.0 (IQR = 0.0) patients per nurse. Targets for intensivists were rarely met by 15.2% and never met by 3.5% of responding institutions. Targets for nursing staffing could rarely be met in 32.2% and never in 5.3% of responding institutions.Conclusions: Shortages of staffing in the critical care setting are eminent during the COVID-19 pandemic and might not only negatively affect patient outcomes, but also staff wellbeing and healthcare costs. A joint effort that scrutinizes the demands and structures of our health care system seems fundamental to be prepared for the future.


Author(s):  
Richard Titus ◽  
Fred Heinzelmann ◽  
John M. Boyle
Keyword(s):  

2015 ◽  
pp. 89-108 ◽  
Author(s):  
A. Kazun

The article analyzes social and economic factors that provide Russian attorneys an opportunity to compensate the institutional weakness of their profession, to protect the independency and effectively defend the interests of the clients. As an indicator of dependent position of attorney we use the proportion of cases with plea bargaining. Using the date of representative nationwide survey of 3317 attorneys in Russia we conclude that the independence of attorney is associated with‘resources for confrontation’: previous experience, client’s demand for legal services, communication with colleagues and membership in professional associations.


Author(s):  
Francesco Claps ◽  
Daniele Amparore ◽  
Francesco Esperto ◽  
Giovanni Cacciamani ◽  
Cristian Fiori ◽  
...  

Author(s):  
Todd A. Eisenstadt ◽  
Karleen Jones West

Parting from conventional social science arguments that people speak for the ethnic groups they represent or for social or class-based groups, this study argues that attitudes of Ecuador’s Amazon citizens are shaped by environmental vulnerability, and specifically exposure to environmental degradation. Using results of a nationwide survey to demonstrate that vulnerability matters in determining environmental attitudes of respondents, the authors argue that groups might have more success mobilizing on behalf of the environment through geographically based “polycentric rights,” rather than through more traditional and ethnically bound multicultural rights. This book offers among the first methodological bridges between scholarship considering social movements, and predominantly ethnic groups, as primary agents of environmental change in Latin America and those emphasizing the agency of individuals. The authors conduct a nationwide survey to glean respondent positions on a range of environmental issues, then contextualize these findings through scores of in-depth interviews with indigenous, environmental, government, academic, and civil society leaders throughout Ecuador between 2014 and 2017. They find that some abstract issues—like indigenous worldviews—affect peoples’ attitudes, but that concrete experiences—such as that of living in areas of environmental degradation due to oil drilling—is a more important conditioner of environmental attitudes. The authors qualify post-materialism, an early theory of environmentalism, which argues that material well-being makes citizens more protective of the environment. The book concludes that post-materialism must be tempered by individual vulnerability, and that group activism is more successful where people have not yet been adversely impacted by environmental degradation such as oil spills and forest destruction.


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