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This inquiry is about the journal paper "Challenges facing blood transfusion services at a regional blood transfusion center in Western Kenya" written by B.M. Kavuvalu. and others. The purpose of this essay was to provide a succinct summary of the main issues with blood transfusion services in Sub-Africa.
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Staffing concerns, such as shortages and gaps in training, can significantly undermine the effectiveness and efficiency of blood transfusion services. Staffing shortages can lead to increased workload, fatigue, and compromised patient care, which could lead to errors in blood processing, handling, or administration. Additionally, inadequate training can increase the risk of making errors, jeopardizing patient safety and quality of care. These issues can also put pressure on resources and budgets as corrective measures, such as additional training programs or recruitment efforts, become necessary to maintain the integrity of blood transfusion services. Addressing staffing concerns is vital to ensuring the reliability and success of blood transfusion operations, safeguarding both patient outcomes and organizational effectiveness.
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How does Christina Sieloff's theory of group and power to the organization impact nursing safe staffing issues?
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Few ways in which these concepts can impact safe staffing:
1. Decision-Making and Advocacy: Within an organization, the distribution of power and decision-making can influence the allocation of resources, including staffing levels. Nurses and other healthcare professionals must advocate for safe staffing levels based on patient needs and quality of care. Understanding power dynamics and group processes can help nurses navigate the organizational structure and effectively advocate for appropriate staffing.
2. Collaboration and Teamwork: Effective teamwork and collaboration are essential for safe staffing. The theory of group dynamics emphasizes the importance of cohesive and well-functioning teams. In the context of nursing, this means that healthcare professionals need to work together, communicate effectively, and share responsibilities to ensure adequate staffing levels and safe patient care.
3. Staff Engagement and Empowerment: Empowering and engaging staff members is crucial for safe staffing. When nurses feel empowered, they are more likely to voice concerns about staffing inadequacies and work collaboratively to find solutions. Organizations that encourage staff participation in decision-making processes and provide opportunities for professional growth and development can foster a culture of safety and support safe staffing initiatives.
4. Power Imbalances and Advocacy Challenges: Power imbalances within organizations can present challenges in addressing safe staffing issues. Hierarchical structures and decision-making processes may hinder effective communication and limit the ability of frontline nurses to raise concerns. Understanding power dynamics can help nurses navigate these challenges and engage in advocacy efforts to promote safe staffing.
5. Organizational Policies and Support: The theory of group dynamics and power can also inform the development of organizational policies and support systems that prioritize safe staffing. Organizations that recognize the importance of safe staffing and align their policies accordingly can create an environment that values patient safety and supports nurses in providing high-quality care.
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What key criteria/measures could be used to establish the effectiveness of a major university restructure e.g. 3 to 4 years after a restructure.
Some universities seem to restructure every 5 to 7 years as new VCs are appointed. A lot of effort is focused on a university restructure mostly prompted to save cost, become more efficient and innovative. A significant number of staff are made or choose to be made redundant and some corporate knowledge is lost, Yet after the restructure, new staff get re-appointed and generally after 4 or so years staffing numbers are similar to those before the restructure. How effective are restructures and should universities tread carefully before goindg down that track. What key criteria/measures could be used to establish the effectiveness of a major university restructure e.g. 3 to 4 years after a restructure.
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That's great! Restructuring discussions can be crucial for organizations looking to adapt to changing circumstances, improve efficiency, or address specific challenges. Whether it's a small team restructuring or a larger organizational change, having open and effective communication is key. Here are some general tips to consider when navigating restructuring discussions:
Clearly Define Objectives:
Clearly articulate the reasons for the restructuring. Whether it's to improve performance, streamline processes, or respond to market changes, having a well-defined objective provides context for the discussion.
Communication is Key:
Ensure that communication channels are open and transparent. Keeping all stakeholders informed helps manage expectations and reduces uncertainty. Address concerns and questions promptly.
Involve Key Stakeholders:
Involve relevant parties in the discussion. This includes not just top management but also employees who may be directly affected by the restructuring. Their input can be valuable and helps in building a sense of ownership.
Present Data and Evidence:
Support your points with data and evidence. This could be financial data, performance metrics, or market trends. Having a solid foundation helps in justifying the need for restructuring.
Address Concerns Empathetically:
Acknowledge and address concerns and fears that may arise during the discussion. Change can be unsettling, and showing empathy can help alleviate anxieties.
Develop a Clear Plan:
Outline a clear plan for the restructuring process. This includes timelines, milestones, and the specific steps that will be taken. Having a roadmap helps everyone understand what to expect.
Offer Support:
Provide support mechanisms for employees who may be directly impacted. This could include training programs, career counseling, or assistance in finding new roles within the organization.
Seek Feedback:
Encourage feedback from employees. They might have valuable insights or suggestions that were not initially considered. Creating a feedback loop promotes a collaborative atmosphere.
Adaptability:
Be open to adapting the restructuring plan based on feedback and changing circumstances. Flexibility is crucial in navigating complex organizational changes.
Celebrate Successes:
Acknowledge and celebrate milestones and successes during and after the restructuring. Recognizing achievements helps boost morale and reinforces a positive organizational culture.
Remember that restructuring can be a challenging process, and the way it is communicated and implemented plays a significant role in its success. Good luck with your discussion!
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Even though community health nursing is recognized as a priority, community health facilities are experiencing some of the worst staffing shortages. However, to guarantee the profession remains fit for purpose and support future recruiting efforts, urgent action is required to keep the community health nurses now employed in their existing positions.
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Before I retired (2012), I was a nurse practitioner for bladder & bowel health on the community. I used to have my own caseload, help others nursing on the community if my expertise was required, and teach.
I seem to remember that people stayed in their jobs and some, I had known for years.
We were all happy to work together and didn't leave work to others.
I would have liked people to have promoted continence a bit more, but tried to lead by a good example.
And people still remember me today! Some are professionals and some were clients. But as there was only one of me in my (large) geographical area but lots of them, I don't always remember who is speaking to me. But nice that they do!
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Hi everyone,
ICU nursing staffing's impact on patient (and other) outcomes is well documented in the literature. Nonetheless, methods (e.g. Nursing activities score) have been criticized during the last decade for not including several aspects of the nurse's work besides bedside duties.
Currently, which would be the most valid approach /tool to objectively estimate nursing staffing?
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The NAS is being referred to in terms of workload in the ICU. Please read the article below
DOI: 10.1016/j.iccn.2018.06.005.
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Any idea related to data/metrics related to Indian Staffing industry will be highly appreciated.Thanks and regards.
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It is obvious to have known that the impact of pandemics is going to be considerably reduced in most of the countries.
Especially in the developing countries that they are really looking for the employees of irrespective of the categories because most of the companies and industries were blocked due to the pandemic period.I mean that the staffing recruitment have been intensified in most of the developing countries in order to tap up the Labor force to generate income as well as the trigger the economic productive activities in general.
It is more important to know the countries GDP could be measured by the number of hands are involving in the economic productive activities are the main matters to measure the Countries National Income.
It is not only in the registered companies or established industries or multi specialty hospitals etc that needs to be clearly identified because the human power resources could only to produce or generate income for the individual, organizations or country.
Anyhow, it is one of the economic indicators to measure the GDP of any countries particularly developing countries are looking for rejuvenate the the economic conditions.
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How can I measure the effect of nurse staffing on quality of care of patients in a hospital? What are the parameters to take into consideration? What are the indicators of the quality of care in relationship with the nurse staffing?
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Dili Koumai Ismael - there are lots of issues underlying your question...
i) How do you measure nurse staffing? Nurse-patient ratio (or equivalent) is a starting point but it rapidly gets more complicated when you consider that not all patients present the same 'demand' (have different needs both qualitatively and quantitatively). Within a unit that might 'average out' but it is unlikely to when comparing between units.
ii) How do you measure quality? There are many many candidate measures but in many respects it depends on the context you are working in and what is likely to be sensitive - anything from patient 'experience' / 'satisfaction' through to hard measures including risk of death are candidates. There is a large evidence on potentially nurse sensitive indicators that you might consult.
iii) THEN you have your study design - many studies in this area are large scale observational studies using cross-sectional data from many wards and many hospitals (see ) and there is a growing body of work using administrative data at a patient level (see ). Studies have also used administrative or survey data to look at care processes for example see https://www.ncbi.nlm.nih.gov/pubmed/31562161) and there are also studies using surveys to explore patient or nurse experiences / perceptions of quality (see for example https://www.ncbi.nlm.nih.gov/pubmed/22434089) Some smaller scale studies using direct observation of care have also explored the issue (see https://www.ncbi.nlm.nih.gov/pubmed/30918050) I'm selecting papers here that my research group have been involved in and there is an awful lot more out there, but I hope it gives you a start.
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I have to summarize model of care for staffing of diagnostic imaging that includes the following modalities: Xray, CT, MRI, interventional radiology, nuclear medicine.
Looking at number of staff required on a shift based on number of inpatients and outpatients
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I have been asked this question at my work quite frequently. I think the general agreement is that it is difficult to overgeneralise - cannot use the answer from one hospital/facility/practice to another. Some places have a very specific type of population/patient and it can be much more tedious than another that reports a lot of "normal" studies - which would be much easier/faster.
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What are the attributes we should select when solving Software Project Staffing Problem using GA Algorithm?
I am currently working on Software Staffing problem. I have ISBSG dataset for implementation. I am trying to solve the staffing problem using GA algorithm. Kindly guide me.
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At the beginning of each shift, how nurses distribute current patients in the unit?
According to my experience, there several factors that are considered such as if the patient is on ECMO, mechanically ventilated, on a particular isolation precaution...
Also, there are nursing to patient ratios as guidelines but their account for the number rather than specific features of the patient.
Any other criteria or methods?
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Distribution of staff in the ICU depends on the availability of workforce or number of staff in the ward and patient status or it's progress. However, 1:2 is good ratio when there is good help and support for the nurse but if not, so 1:1 is relevant.
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Hi,
At the beginning of each shift, how nurses distribute current patients in the unit?
According to my experience, there several factors that are considered such as if the patient is on ECMO, mechanically ventilated, on a particular isolation precaution...
Also, there are nursing to patient ratios as guidelines but their account for the number rather than specific features of the patient.
Any other criteria or methods?
Thanks in advance for your input.
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Dear Dr. Fortunatti,
Heart-centered greetings
When Nurses shortage is critical, many important variables would be secondary!
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Hi All
I need your guidance on how we can combine multiple variables and develop one index.
The goal is to have a index based of which we can plan for staffing. The variables are: daily patient volume,
%admitted,
% severity.
For example if the daily vol is high, also % admitted is high, and % severity is also high then we give more score lets say 3.5 which means we have to plan for more nurses vs if vol is high but severity is low means we might not need more nurse even the vol is high because the severity is low ( low severity = less attention needed)
data lay out:
Date Patient daily vol % admitted %high severity
10/20 250 35% 10%
Any guidance will be highly appreciated.
Thank you
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Thank you David for your valuable suggestions.
I have attached the data layout for your reference.
is there a simplified way to predict/forecast daily some score and looking at the score nurse director will determine the staff?..just thinking :)
I am not sure how we can determine the simplistic way of optimizing the staff resources knowing the composition of patients likely to visit in future dates. If we know what type of patient visits in future dates not only the number of patient, it is optimal way to allocate the staff.
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A library built-in with Smart Library technology will enable us to keep libraries open, extend the opening hours without being staffed. The technology enables remote control of library buildings, including automatic doors, lighting, self-service kiosks and public computers. This allows us to significantly extend library opening hours, so more people can use the library at times that is convenient for them.
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I worry about the privacy implications of 24/7 surveillance. I am also hesitant to do away with human jobs for technology, which is fallible and when it breaks, there are no alternatives.
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How do I make up a 0.01M Na2HP04/NaH2P04 buffer solution, pH adjusted to 7? Both chemicals that I have on hand are anhydrous. The molecular weight of Na2HP04 is 141.96 g/mol and the molecular weight of NaH2P04 is 119.98 g/mol. Do I just dissolve 1.4196 g of Na2HP04 and 1.1998 g of NaH2P04 into 950 ml distilled water, then adjust the pH to 7 and make up to 1000 ml in a volumetric flask? Most of the methods I find use Na2HP04.2H2O and NaH2P04.2H2O. Thanks! (Please note that chemistry is not my field but I am helping out in the chemistry lab because we are short staffed currently)
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Need carbon stock/sequestration value in above-ground-biomass of mangrove at different mangrove site of Gujarat,Orissa,Maharashtra.
Gujarat : Pandey, C. N., and R. Pandey. "Carbon sequestration in mangroves of Gujarat, India." International Journal of Botany and Research 3.2 (2013): 57-70.
Maharashtra: Patil, Vikrant, et al. "Estimation of carbon stocks in Avicennia marina stand using allometry, CHN analysis, and GIS methods." Wetlands 34.2 (2014): 379-391.
Pachpande, Sheetal Chaudhari, and Madhuri Pejaver. "Natural carbon sequestration by dominant mangrove species Avicennia marina var. Accutissima ex Staf and Moldenke ex Moldenke found across Thane Creek, Maharashtra, India." International Journal od Scientific and Engineering Research 6 (2015): 1162-1165.
Kindly refer articles.
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Thank you to all of you for your kind reply.
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Hi all,
I’m working on a project for developing models for disease progression in plants, early diagnostics, and treatment recommendations using sensor arrays and AI. Additionally we’re looking at phenotyping and making adjustments during the grow cycle. We’re in early stage budgeting and project planning. I’m budgeting for the wet lab and need to establish the best equipment and costs. We’ll need to be able to culture various plant pathogens and develop inoculums. We need to monitor the incoming plant genetics, work with tissue cultures, and monitor the progression of the pathogen on infected hosts. We’ll need to monitor the outcome of various treatments. We’ve determined the sensor equipment, grow chambers, and other configurations. I’ve attached an excel sheet on some very preliminary thoughts on lab equipment.
Any advice on equipment and costs for the lab would be extremely helpful! Any other insights would also be useful. We’re looking to begin staffing the project in three months and will have several positions available for plant biologists. If you think you can help with the budgeting for equipment send a message and we can compensate you for your time.
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Along with lab, it is important to arrange similar field conditions for validation
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What are the Challenges around organisational structure and staffing?
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I'm wondering whether your research is targeted towards traditional or new organizational forms and structures? You may well find differences and familiar categories like job security apply differentially in different industries, or are valued differently by different demographic groups, or are not applicable in the same way in network organizations. And what about organizations where the employment status of the employee has had to be determined by the courts (for example Uber)? How does organizational politics affect organizational structure (eg through territorial resistance and empire building, aggressive change management) or employee perception (eg conflict resolution, group dynamics, resource allocation). So what specific research interest do you have, in what kinds of organization?
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Utilizing the correct mix of physicians and non physcisions can asssit in assuring there is 24 hour coverage based on the strategic mission, patient outcomes, and catchement area.
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YES!!!  Hope for the best..... and TRAIN TOGETHER FOR THE WORST!!!!
Google "Meredith Addison emergency nurse" and let's NETWORK!!!
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If you have no previous recruiting or staffing experience and you want to break into the arena, I suggest you to follow a state-of-the-art training program that will put you ahead of the curve as a certified Search and Hiring Job Market recruiter.
Personally I just followed a three-stage training program designed to learn the best practices of recruiting at each stage of the recruitment life cycle.
After that i suggest you to have access to workbooks, live training webinars, articles, videos, and other resources to help you along the way.
#successful #professional #recruiter #previous #staffing #experience #break #suggest #follow #training #program #ahead #curve #certified #Personally #followed #designed #recruitment #cycle #workbooks #articles #videos #help #successivo #precedente #esperienza #programma #articolo #Randieri #Intellisystem #IntellisystemTechnologies
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In order to recruit the right people in the company you need at least to know the psychology of the person. For example, what about you, you know your own worth, that is why you are ambitious, you can be entrusted  critical tasks, you will fulfill them. You are quite a persistent and persevering person. You define yourgoal and try to reach it. It is good for you to work individually, you are a creative person. But you can  also work in a team. You are impressionable, so you can be manipulated. Your career started during the studies and will continue until 45 years, then you will use the earned experience.
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In general across Australia regional campuses are in retreat. From having been viewed at one stage as a dynamic component of universities' participation and expansion agenda they can sometimes be framed as out-of-touch with a vision of world class universities in the neo-liberal competitive world of university league tables. Faced with the challenges of a shift towards on-line learning and the centrality of competitive world class research agendas, regional campuses - from once being viewed as success stories - are now sometimes viewed as a drag upon performance and an economic drain upon resources. They are often staffed by more junior and casualised faculty members.
I work at a regional campus of a university currently reflecting upon how central 'place' and place-based pedagogies are to its future vision. How do others view this question from their national settings?
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I agree. The presence of higher education in small communities should be treated as a kind of 'mission'. In Poland, we are now on the eve of introducing the new Higher Education Act. There are different opinion about the way it will treat small communities. We will see it within the next few months.
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Obviously we have the smoking ban in place but are finding it hard to cope with on the ward. Patients have e-cigarettes a their disposal and use these well. There is no issue with patients that have unescorted leave as they are able to go for a cigarette whenever they want. However, patients with escorted leave need staff to take them out for a cigarette. As a team we are aware that we should no longer be escorting out for cigarettes but due to the majority of incidents revolving around patient inability to smoke, we do escort out and have put in place set times when we will do this that the patients are aware of. The issue with this is that we are often short staffed and are unable to escort out at the set times which increases incidents. This also brings up the issue of leave for sectioned vs informal patients. Obviously it is easier to not escort a sectioned patient for a cigarette then an informal patient.
I'm trying to find an easier way to deal with this that suits both staff and patients (as much as possible), so anything that can be offered in terms of experience or research would be very helpful.
Thanks in advance.
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There is great value in holistic wellness and approach to treatment. There is an inpatient addiction treatment program in Idaho called The Walker Center that has some success with implementing a no-smoking policy. They provide smoking cessation medications, patches, and lozenges. They do not allow gum, you may reach out to them for specifics.
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In this model the INPUT OF CAPACITY MODEL
Six types of input data are required to run the model:
1. Yard geometry, 2. Yard operations, 3. Crew staffing, 4. Arriving trains, 5. Classification-yard assignment, and 6 . Departing trains.
I found this from the paper done by W. A. STOCK, M. SAKASITA, M.A. HACKWORTH, P. J. WONG, D. B. KORETZ, AND V. V. MUDHOLKAR
published in Transportation Research Record 802
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Thanks for the question and in my case thanks for bringing the CAPACITY paper to my attention. I think that you can see from the paper the large amount of careful and very detailed modeling that they did for a specific case study. It is unlikely that you can get an "off the shelf" version of this for your use, but I think the work done on the paper would provide a good guide for your efforts. Also the parameterization is specific to their case study, but if your case is similar (track geometry etc) you could replace their data with numbers from your case. Note too that they were a large team and this is a task, if you are starting from scratch, that would be a very big challenge for one person.
You could find one of the authors and see if they can offer any follow up?
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In Ireland the Taskforce on nurse staffing and skill mix is using "trendcare" to assist in identifying missed care, we also use an EWS to identify escalation in deterioration for the patient. I wonder if you have experience of these being used in the UK and what are the benefits if any of there use in care.
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Thanks for that Peter there is a project under way in the Office of the Nursing and Midwifery services directorate in Ireland specifically for EWS, you may know about it.
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I am seeking the community's help on this: Do you have any experience with validated, non-proprietary scores which facilitate physician and nursing staffing ratios. Is SOFA score an appropriate tool for this?  What is your opinion about other scores such as the TISS scores, CMI scores, etc.?   Any substantiated input will be appreciated. 
Thank you,
Markos
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I recommend reading:
Nursing Activitie Score. Crit Care Med 2007; 31:374
Monitoring cost in the ICU: a search for a pertinent methodology. Acta Anaesthesiol Scandinavica 2012; 56:1104 
Critical care medicine in the hospital: lessons from the EURICUS-studies. Med Intensiva 2007; 31(4):194
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I know it has been successful before at UF & Shands & UPMC in Pittsburgh
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Choice of staffing model is as important as its implementation.
The following paper examines what management style is best for a team-based organization.
Hope this helps,
Thanks
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Critical Review to evaluate the strengths and weakness
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Hello Alina
You may have seen some of these papers - and some may not be as relevant as others, but here is my list of suggestions:
This paper is available from Deane Waldman’s publication pages on ResearchGate:
Waldman, J. D., Kelly, F., Arora, S., & Smith, H. L. (2004). The shocking cost of turnover in health care. Health Care Management Review, (35), 206-11.
This is also available from ResearchGate:
Hayes, L. J., O’Brien-Pallas, L., Duffield, C., Shamian, J., Buchan, J., Hughes, F., ... & Stone, P. W. (2006). Nurse turnover: a literature review. International Journal of Nursing Studies, 43(2), 237-263.
Kash, B. A., Castle, N. G., Naufal, G. S., & Hawes, C. (2006). Effect of staff turnover on staffing: A closer look at registered nurses, licensed vocational nurses, and certified nursing assistants. The Gerontologist, 46(5), 609-619.
This is available from Prof. Timothy Ives ResearchGate publication page and has some relevance:
Sloane, P. D., Zimmerman, S., Brown, L. C., Ives, T. J., & Walsh, J. F. (2002). Inappropriate medication prescribing in residential care/assisted living facilities. Journal of the American Geriatrics Society, 50(6), 1001-1011.
Cho, S. H., Ketefian, S., Barkauskas, V. H., & Smith, D. G. (2003). The effects of nurse staffing on adverse events, morbidity, mortality, and medical costs. Nursing Research, 52(2), 71-79.
Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J. A., Busse, R., Clarke, H., ... & Shamian, J. (2001). Nurses’ reports on hospital care in five countries. Health affairs, 20(3), 43-53.
Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J., & Silber, J. H. (2002). Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. Jama, 288(16), 1987-1993.
Larrabee, J. H., Janney, M. A., Ostrow, C. L., Withrow, M. L., Hobbs, G. R., & Burant, C. (2003). Predicting registered nurse job satisfaction and intent to leave. Journal of Nursing Administration, 33(5), 271-283.
Poghosyan, L., Clarke, S. P., Finlayson, M., & Aiken, L. H. (2010). Nurse burnout and quality of care: Cross‐national investigation in six countries. Research in Nursing & Health, 33(4), 288-298.
Castle, N. G., & Engberg, J. (2005). Staff Turnover and Quality of Care in Nursing Homes. Medical Care, 43(6), 616-626.
The following papers may be relevant but are quite old now:
Peter J. Gergen’s publication page on ResearchGate, although it is now quite old (1998):
Kovner, C., & Gergen, P. J. (1998). Nurse staffing levels and adverse events following surgery in US hospitals. Image: The Journal of Nursing Scholarship, 30(4), 315-321.
Davidson, H., Folcarelli, P. H., Crawford, S., Duprat, L. J., & Clifford, J. C. (1997). The effects of health care reforms on job satisfaction and voluntary turnover among hospital-based nurses. Medical Care, 35(6), 634-645.
Lake, E. T. (1998). Advances in understanding and predicting nurse turnover. Research in the Sociology of Health Care, 147-172.
I hope there is something here of help to you
Best wishes
Mary
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Recruitment ans Staffing Process
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Hello Pritisha
It is quite easier... You need to define what you what to improve... For example as a Six Sigma Champion in GE, I have mentored one of my HRM's project on improving the 'Time for Bubble Assignment", the moment request for sending our techies comes from our guys to the time our techies reached our site, it was a very wider span... We had a great work on this project to reduce the span and maintained it... Let me know if any further help
Kind Regards
Ramanan
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Companies are increasingly checking online representation and social network activities of candidates for suitability. This also applies to academic institutions, I would assume. What are the pitfalls to avoid and good practices to follow from the candidates' point of view regarding social network activities (such as here on RG)?
Coaching from HRM practitioners is highly encouraged, which might be well appreciated by younger colleagues.
Disclosure: I am not involved in hiring academics, and I do not seek new employment.
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Interesting question Michael, altough I don't think that I am an expert in HRM I' ll try to share some thoughts:
1)In our 'search engine era' there is nothing that you have written and can be hidden, so keep in your mind that everything is recorded.
2)When you apply to somewhere you have to be at least polite, so avoid net fights, since this is an indicator of an aggressive behavior
3)You have to clearly demonstrate your qualifications: if you hide them, nobody will try to reveal them, there exist not time for this
4)Fear is not a good advisor: remember the extreme relativity of our beliefs, especially when different cultures are interacting
5)Good luck!
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The relationship between nurse staffing ratios and quality
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To add to Joanne's answer above - this is an area with a massive literature. The positive association has been demonstrated against a range of quality and safety measures - primarily safety. Linda Aiken is not the only researcher in the area but possibly the best known.
Try : Kane, R.L., Shamliyan, T.A., Mueller, C., Duval, S., Wilt, T.J., 2007. The Association of Registered Nurse Staffing Levels and Patient Outcomes: Systematic Review and Meta-Analysis. Medical Care 45 (12), 1195-1204 1110.1097/MLR.1190b1013e3181468ca3181463.
...for a comprehensive if slightly dated overview of the safety literature.
Recent reports from the RN4CAST study show associations with other outcomes e.g.:
Ball, J.E., Murrells, T., Rafferty, A.M., Morrow, E., Griffiths, P., 2013. ‘Care left undone’ during nursing shifts: associations with workload and perceived quality of care. BMJ Quality & Safety.
Aiken, L.H., Sermeus, W., Van den Heede, K., Sloane, D.M., Busse, R., McKee, M., Bruyneel, L., Rafferty, A.M., Griffiths, P., Moreno-Casbas, M.T., Tishelman, C., Scott, A., Brzostek, T., Kinnunen, J., Schwendimann, R., Heinen, M., Zikos, D., Sjetne, I.S., Smith, H.L., Kutney-Lee, A., 2012. Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. British Medical Journal 344.
Aiken, L.H., Sloane, D.M., Bruyneel, L., Van den Heede, K., Sermeus, W., 2013. Nurses’ reports of working conditions and hospital quality of care in 12 countries in Europe. International Journal of Nursing Studies 50 (2), 143-153.
...although limited as they are all self report.
The translation of this to specific ratios is difficult - largely for the reasons highlighted above and the evidence on that policy is less clear cut. Try
McHugh, M.D., Brooks Carthon, M., Sloane, D.M., Wu, E., Kelly, L., Aiken, L.H., 2012. Impact of Nurse Staffing Mandates on Safety-Net Hospitals: Lessons from California. Milbank Quarterly 90 (1), 160-186.
For a favourable gloss.
Some of the limitations are covered in:
Griffiths, P., 2009. RN+RN=better care? What do we know about the association between the number of nurses and patient outcomes? International Journal of Nursing Studies 46 (10), 1289-1290.
...one issue that is very germane for many health sectors is the absence of medical staffing from this literature. See
Griffiths, P., Jones, S., Bottle, A., 2013. Is “failure to rescue” derived from administrative data in England a nurse sensitive patient safety indicator for surgical care? Observational study. International Journal of Nursing Studies 50 (2), 292.
I hope that helps to give you a start - apologies for the bias toward my own work but i am of course more familiar!
Peter