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Haswell HE, Taylor MJ. The many costs of condensed medical degrees. BMJ 2024; 386:q1970. [PMID: 39255986 DOI: 10.1136/bmj.q1970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/12/2024]
Affiliation(s)
| | - Matthew J Taylor
- Rotherham, Doncaster, and South Humber NHS Foundation Trust, Rotherham Hospital
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2
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Alkan E, Cushen-Brewster N, Anyanwu P. Organisational factors associated with healthcare workforce development, recruitment, and retention in the United Kingdom: a systematic review. BMC Nurs 2024; 23:604. [PMID: 39217386 PMCID: PMC11366130 DOI: 10.1186/s12912-024-02216-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 08/01/2024] [Indexed: 09/04/2024] Open
Abstract
AIMS To synthesise evidence regarding organisational practice environment factors affecting healthcare workforce development, recruitment, and retention in the UK. METHODS/DATA SOURCES A systematic search of PubMed, Web of Science, EMBASE, and PsycINFO yielded ten relevant studies published between 2018 and 2023 and conducted in the UK (the last search was conducted in March 2023). Adhering to The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, two independent reviewers conducted screening, sifting, and data extraction, applying the quality assessment tool for risk of bias. RESULTS Results highlight key factors associated with staff intention to leave/turnover/retention: workplace challenges, aggression, moral distress, on-the-job embeddedness, leadership involvement, organisational support, and flexible shift patterns. Notably, aggression from colleagues, including clinical staff but not interdisciplinary personnel, has a more detrimental impact on staff intention to leave than aggression from patients. CONCLUSION The complex and context-dependent impacts of these organisational factors on the UK healthcare workforce underscore the need for tailored interventions. The review acknowledges limitations, including bias from excluding qualitative studies, a small pool of included studies, and nurse overrepresentation.
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Affiliation(s)
- Erkan Alkan
- Institute of Health and Well-being, University of Suffolk, Ipswich, UK.
| | | | - Philip Anyanwu
- Institute of Health and Well-being, University of Suffolk, Ipswich, UK
- Applied Health Directorate, Warwick Medical School, University of Warwick, Coventry, UK
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3
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Kearsley SL, Walker L, Johnson MJ, Bravington A. Ancillary hospital workers experience during COVID-19: systematic review and narrative synthesis. BMJ Support Palliat Care 2024:spcare-2024-004855. [PMID: 39084691 DOI: 10.1136/spcare-2024-004855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 07/12/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND COVID-19 overwhelmed healthcare systems worldwide. Its impact on clinical staff is well documented, but little is known about the effects on ancillary staff (cleaners, porters and caterers). AIM To identify the evidence of the impact of COVID-19 on ancillary staff at National Health Service (NHS) hospitals in England. DESIGN Systematic review and narrative synthesis. DATA SOURCES Databases (MEDLINE, CINAHL Ultimate, APA PsycINFO, APA PsycArticles and Academic Search Ultimate). Reference lists were searched. Four independent reviewers screened titles and abstracts against inclusion criteria. Data were extracted from included papers and studies were critically assessed using relevant critical appraisal tools. RESULTS 8/178 studies were included, of which 5 quantitative, 2 qualitative and 1 mixed methods. Ancillary staff had higher rates of past and present COVID-19 infection. Participants felt that the work of ancillary staff had been insufficiently recognised by managers and that they had little voice within the NHS. They also experienced inequity regarding available support and safe working practices due to largely digital modes of communication which they rarely, if ever, used. In an evaluation of a personal protective equipment support 'helper' programme, ancillary workers were more positive about it than nurses, allied health practitioners, and doctors. CONCLUSION Few studies included ancillary staff. As reported, ancillary staff at NHS hospitals had a higher prevalence of COVID-19 infection but felt marginalised and poorly supported. They valued training when offered. Additional research is needed to understand better the impact of COVID-19 on ancillary key workers, and how best to support them in future similar circumstances.
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Affiliation(s)
| | - Liz Walker
- Faculty of Health Sciences, University of Hull, Hull, UK
| | - Miriam J Johnson
- Wolfson Palliative Care Research Centre, University of Hull, Hull, UK
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Atwal A, Sriram V, Brice J. Return to practice for allied health professionals with protected characteristics: a mixed-methods study. BMJ LEADER 2024:leader-2024-000981. [PMID: 38876779 DOI: 10.1136/leader-2024-000981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 05/14/2024] [Indexed: 06/16/2024]
Abstract
INTRODUCTION Return to practice is one mechanism for recruiting and retaining allied health professionals (AHPs) within the health and care workforce in England. It is not known how this affects persons with protected characteristics. AIM To understand experiences of AHPs with protected characteristics of returning to the workforce through a return to practice programme. METHOD A QUAL (semistructured interviews) + qual (focus group interviews) mixed-methods study. 12 online semistructured interviews with return to practice AHPs, followed by 2 online focus groups. RESULTS Our research identifies a new type of returners who have to use the return to practice programme as a vehicle to step into health and social care as they have not been able to find employment. A main driver to return to practice was financial reason. CONCLUSION To date there, is little evidence of leaders understanding the complexities of AHPs in a return to practice programme, the considerable contribution they can make to the workplace and the current inequities that exist.
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Affiliation(s)
- Anita Atwal
- Occupational Therapy, London South Bank University, London, UK
| | - Vimal Sriram
- Director of Allied Health Professionals, University Hospitals Bristol and Weston NHS Foundation Trust and Deputy Theme Lead NIHR Applied Research Collaboration Northwest London, Bristol, UK
| | - Jos Brice
- Return to Practice Occupational Therapist, London SouthBank University and NHS England workforce, training and education, London, UK
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Donald N, Lindsay T. Surgical trainee experiences from 2013 to 2023 within the United Kingdom as reported by the General Medical Council National Training Survey. Surgeon 2024; 22:74-79. [PMID: 38081759 DOI: 10.1016/j.surge.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 11/14/2023] [Accepted: 11/18/2023] [Indexed: 03/19/2024]
Abstract
INTRODUCTION The General Medical Council (GMC) issues annual surveys to all doctors within the United Kingdom (UK) in a formal postgraduate training scheme. This facilitates the monitoring of experiences for quality assurance purposes. Low job satisfaction has been associated with heightened levels of burnout and staff turnover, alongside deteriorating clinical care and productivity levels. METHODS We gathered and extracted data from the publicly available online GMC reporting tool. Data ranged from 2013 to 2023 and spanned 12 postgraduate surgical training programmes across all 18 indicators available. In total, 198 individual metrics were recorded, in addition to burnout. We conducted trend analysis and yearly average mean scores for individual metrics, burnout and geographical differences for 141 individual training programmes within the 16 training regions. RESULTS Of the 198 metrics analysed, 83 (42 %) were found to have statistically significant negative trends (P < 0.05), in comparison to 24 (12 %) with positive trends. 5 specialities had over 50 % of metrics showing a significant negative trend. Overall satisfaction was negative in all 12 programmes, with eight reaching significance (P < 0.05). Of 141 individual training programmes, 29 % showed a significantly negative trend in overall satisfaction, with 1 % demonstrating a significant positive trend (P < 0.05). CONCLUSION Our study is the first to explore long-term trends in trainee reported surgical training experiences within the UK. Our data have revealed widespread worsening trainee reported experiences and dissatisfaction across multiple specialities and geographical regions, especially in key areas of overall satisfaction, self-development, and clinical supervision.
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Affiliation(s)
- Neil Donald
- Department of Surgery, Dartford and Gravesham NHS Trust, Darenth Wood Road, Dartford, DA2 8DA, UK.
| | - Tim Lindsay
- Department of Trauma and Orthopaedics, London North West University Hospitals NHS Trust, UK; Imperial College London, UK
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6
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Dixon-Woods M, Summers C, Morgan M, Patel K. The future of the NHS depends on its workforce. BMJ 2024; 384:e079474. [PMID: 38538029 DOI: 10.1136/bmj-2024-079474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Affiliation(s)
| | | | - Matt Morgan
- University Hospital of Wales and Cardiff University, Cardiff, UK
- Curtin University, Australia
- The BMJ
| | - Kiran Patel
- University Hospitals Birmingham and University of Warwick, UK
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7
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Alkan E, Cushen-Brewster N, Anyanwu P. Investigating healthcare workforce recruitment and retention: a mixed-methods study protocol. BMJ Open 2024; 14:e074100. [PMID: 38331865 PMCID: PMC10860040 DOI: 10.1136/bmjopen-2023-074100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 01/22/2024] [Indexed: 02/10/2024] Open
Abstract
INTRODUCTION Although the sustainability of the health workforce has been identified as essential to achieving health and wider development objectives, challenges with securing and retaining the healthcare workforce persist. In the UK, there are notable shortages across a wide range of National Health Service (NHS) staff groups, with a high staff turnover indicating retention issues in the healthcare workforce. In addition, gaps exist in understanding the root cause of individual organisation's workforce deficiencies and how their practice environment factors interact to impact workforce recruitment and retention. METHODS AND ANALYSIS An exploratory mixed-methods approach will be conducted to investigate the impact of organisational practice environment factors on healthcare workforce recruitment and retention in two Integrated Care Systems (ICS) in the East of England. We will conduct an online survey of newly qualified and established nurses and allied health professionals using a questionnaire adapted from two validated instruments. Our calculation suggests a sample size of 373 participants, we will aim to surpass this in our recruitment to strengthen the statistical analyses. Multilevel linear regression models will be fitted to evaluate the association between organisational practice environmental factors and staff recruitment and retention. The qualitative interviews will explore the experiences and perspectives of staff and senior leaders to explain the survey results and any significant associations therein. Also, the interviews will explore how to strengthen the partnership between higher education institutions, Health Education England, health and care service providers, NHS nursing and allied health professional staff to enhance recruiting and retaining staff. An exploratory inductive coding and analysis will follow Braun and Clarke's recommendations to generate key themes from transcribed interview data. ETHICS AND DISSEMINATION Ethical approval has been obtained through the University of Suffolk Research Ethics Committee (approval number: RETH(S)22/051). Findings from our work will be disseminated through publications in peer-reviewed journals; presentations at stakeholders' events, professional and academic conferences; and short reports for stakeholders, including participating ICSs.
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Alanazi R, Bahari G, Alzahrani ZA, Alhaidary A, Alharbi K, Albagawi BS, Alanazi NH. Exploring the Factors behind Nurses' Decision to Leave Clinical Practice: Revealing Causes for Leaving and Approaches for Enhanced Retention. Healthcare (Basel) 2023; 11:3104. [PMID: 38131992 PMCID: PMC10743077 DOI: 10.3390/healthcare11243104] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/24/2023] [Accepted: 12/02/2023] [Indexed: 12/23/2023] Open
Abstract
Nursing turnover has emerged as an urgent concern with a substantial influence on the financial efficiency and quality of care in healthcare frameworks worldwide. This study determined important factors associated with nurses' intentions to leave and what would bring them back. This was a cross-sectional, multisite study of nurses in three public hospitals. Convenience sampling was used to recruit 205 nurses from the selected hospitals. A questionnaire was used to measure demographic and professional background information, current job satisfaction, and the intention to leave work and return. Bivariate and multivariate analyses were run using SPSS. This study revealed that both job satisfaction (M = 47.26, SD = 11.59, range: 19-76) and intent to leave a current job (M = 14.18, SD = 4.36, range: 4-20) were reported at moderate levels. There were significant differences reported between the scores of nationality and job satisfaction (p < 0.05) and between the means of income level and intention to leave (p < 0.05). There was also a significant, negative association between satisfaction and intention to leave (r = -0.551, p < 0.05). In regression, income level (β = 0.159, p = 0.021), incentives (β = 0.186, p = 0.002), hospital type (β = 0.189, p = 0.005), and intention to leave (β = -0.454, p < 0.001) significantly influenced satisfaction. Gender (β = -0.122, p = 0.037) and nationality (β = -0.210, p = 0.007) were found to influence the intention to leave among participants significantly. In conclusion, this study indicated that job satisfaction and intention to leave are important factors affecting nurses' enthusiasm. Incentives also had a positive impact on increasing nurses' satisfaction levels. Future research studies should investigate what factors might lead to improved monthly salaries and provide more incentives among nurses.
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Affiliation(s)
- Raeed Alanazi
- Nursing Administration and Education Department, College of Nursing, King Saud University, Riyadh 11421, Saudi Arabia; (R.A.); (K.A.)
| | - Ghareeb Bahari
- Nursing Administration and Education Department, College of Nursing, King Saud University, Riyadh 11421, Saudi Arabia; (R.A.); (K.A.)
| | - Zahra Ali Alzahrani
- Nursing Administration, King Faisal Hospital-Makkah, Makkah 24236, Saudi Arabia;
| | - Abdulelah Alhaidary
- Nursing Administration, King Saud University Medical City, Riyadh 11472, Saudi Arabia;
| | - Kholoud Alharbi
- Nursing Administration and Education Department, College of Nursing, King Saud University, Riyadh 11421, Saudi Arabia; (R.A.); (K.A.)
| | - Bander Saad Albagawi
- Medical Surgical Department, College of Nursing, University of Hail, Hail City 2440, Saudi Arabia;
| | - Naif H. Alanazi
- Medical Surgical Department, College of Nursing, King Saud University, Riyadh 11421, Saudi Arabia
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Chang YH, Hsu CH, Tseng YC, Hsiung CA. Country-Level Factors Associated With Nurse Salaries: Empirical Evidence From Organisation for Economic Co-operation and Development Countries and Taiwan. J Nurs Res 2023; 31:e303. [PMID: 37988058 DOI: 10.1097/jnr.0000000000000585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Salary impacts nurse retention rates and thus is a factor affecting the nursing shortage both in Taiwan and around the world. Nurses in Taiwan earn a low salary compared with other health professionals and may be undervalued compared with their international counterparts. PURPOSE This study was designed to analyze the factors associated with nurse salary (NS) in Organisation for Economic Co-operation and Development (OECD) countries and to compare NS in Taiwan with those in OECD member states. METHODS Data were extracted from the OECD statistics database and official statistics for Taiwan. For the 28 OECD member countries considered in this study and Taiwan, 21 indicators characterizing healthcare systems, including demographics, socioeconomic status, health behaviors and risks, healthcare resources, health financing, healthcare utilization, health outcomes, and economic inequality, were examined for the period of 2009-2018. A random-effects model (REM) and a fixed-effects model (FEM) were used to investigate the associations between these indicators and annual NS levels. The expected annual NS for Taiwan was estimated and compared with the actual NS for Taiwan using the REM. RESULTS In the REM, higher NS in OECD countries was shown to be positively associated with gross domestic product per capita (0.49, 95% confidence interval [CI] [0.41, 0.56]), proportion of population aged 65 years and over (2.72, 95% CI [2.17, 3.26]), crude birth rate (1.02, 95% CI [0.56, 1.49]), number of computerized tomography scanners per million population (0.26, 95% CI [0.17, 0.35]), alcohol consumption per person (0.94, 95% CI [0.26, 1.61]), and prevalence of obesity (0.64, 95% CI [0.40, 0.89]) and to be in inversely associated with infant mortality rate (-3.13, 95% CI [-3.94, -2.32]), bed density (-0.99, 95% CI [-1.72, -0.25]), number of hospital discharges (-0.08, 95% CI [-0.11, -0.05]), household out-of-pocket expenditure as a percentage of health expenditure (-0.34, 95% CI [-0.56, -0.11]), and the Gini coefficient (-0.25, 95% CI [-0.50, -0.01]). The FEM results were similar to those of the REM. The predicted annual NS for Taiwan based on the REM rose from 29,390 U.S. dollars (corrected for purchasing power parity; 95% CI [22,532, 36,247]) in 2009 to 49,891 U.S. dollars (95% CI [42,344, 57,438]) in 2018. The actual annual NS in Taiwan in 2018 was approximately 12% lower than the model-predicted value. CONCLUSIONS/IMPLICATIONS FOR PRACTICE Taiwan has a lower NS compared with its OECD counterparts. These findings may help policymakers, healthcare managers, and nurse organizations develop effective strategies to improve the remuneration system for nurses in Taiwan.
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Affiliation(s)
| | - Chia Hui Hsu
- MS, Research Assistant, Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Yu-Chun Tseng
- MS, Research Assistant, Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Chao A Hsiung
- PhD, Honorary Investigator, Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
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Weyman A, O'Hara R, Nolan P, Glendinning R, Roy D, Coster J. Determining the relative salience of recognised push variables on health professional decisions to leave the UK National Health Service (NHS) using the method of paired comparisons. BMJ Open 2023; 13:e070016. [PMID: 37699606 PMCID: PMC10514647 DOI: 10.1136/bmjopen-2022-070016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 07/10/2023] [Indexed: 09/14/2023] Open
Abstract
OBJECTIVE The primary and secondary impacts from the COVID-19 pandemic are claimed to have had a detrimental impact on health professional retention within the UK National Health Service (NHS). This study set out to identify priorities for intervention by scaling the relative importance of widely cited push (leave) influences. DESIGN During Summer/Autumn 2021, a UK-wide opportunity sample (n=1958) of NHS health professionals completed an online paired-comparisons exercise to determine the relative salience of work-related stress, workload intensity, time pressure, staffing levels, working hours, work-homelife balance, recognition of effort and pay as reasons why health professionals leave NHS employment. SETTING The study is believed to be the first large-scale systematic assessment of factors driving staff exits from the NHS since the COVID-19 pandemic. RESULTS All professions gave primacy to work-related stress, workload intensity and staffing levels. Pay was typically located around the midpoint of the respective scales; recognition of effort and working hours were ranked lowest. However, differences were apparent in the rank order and relative weighting of push variables between health professions and care delivery functions. Ambulance paramedics present as an outlier, notably with respect to staffing level (F-stat 4.47, p=0.004) and the primacy of work-homelife balance. Relative to staffing level, other push variables exert a stronger influence on paramedics than nurses or doctors (f 4.29, p=0.006). CONCLUSION Findings are relevant to future NHS health professional retention intervention strategy. Excepting paramedics/ambulance services, rankings of leave variables across the different health professional families and organisation types exhibit strong alignment at the ordinal level. However, demographic differences in the weightings and rankings, ascribed to push factors by professional family and organisation type, suggests that, in addition to signposting universal (all-staff) priorities for intervention, bespoke solutions for different professions and functions may be needed.
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Affiliation(s)
- Andrew Weyman
- Department of Psychology, University of Bath, Bath, UK
| | - Rachel O'Hara
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Peter Nolan
- School of Management, University of Leicester, Leicester, UK
| | | | - Deborah Roy
- Department of Psychology, University of Bath, Bath, UK
| | - Joanne Coster
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
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Martin CA, Medisauskaite A, Gogoi M, Teece L, Nazareth J, Pan D, Carr S, Khunti K, Nellums LB, Woolf K, Pareek M. Discrimination, feeling undervalued, and health-care workforce attrition: an analysis from the UK-REACH study. Lancet 2023; 402:845-848. [PMID: 37604176 DOI: 10.1016/s0140-6736(23)01365-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 06/22/2023] [Accepted: 06/28/2023] [Indexed: 08/23/2023]
Affiliation(s)
- Christopher A Martin
- Department of Respiratory Sciences, University of Leicester, Leicester LE1 7RH, UK; Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK; NIHR Leicester Biomedical Research Centre, Leicester, UK
| | | | - Mayuri Gogoi
- Department of Respiratory Sciences, University of Leicester, Leicester LE1 7RH, UK
| | - Lucy Teece
- University College London Medical School, London, UK; Biostatistics Research Group, Department of Health Sciences, University of Leicester, Leicester, UK
| | - Joshua Nazareth
- Department of Respiratory Sciences, University of Leicester, Leicester LE1 7RH, UK; Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK; NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Daniel Pan
- Department of Respiratory Sciences, University of Leicester, Leicester LE1 7RH, UK; Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK; NIHR Leicester Biomedical Research Centre, Leicester, UK; Li Ka Shing Centre for Health Information and Discovery, Oxford Big Data Institute, University of Oxford, Oxford, UK
| | - Sue Carr
- General Medical Council, London, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester LE1 7RH, UK; NIHR Applied Research Collaboration East Midlands, Leicester, UK
| | - Laura B Nellums
- Nottingham Centre for Public Health and Epidemiology, Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK
| | | | - Manish Pareek
- Department of Respiratory Sciences, University of Leicester, Leicester LE1 7RH, UK; Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK; NIHR Leicester Biomedical Research Centre, Leicester, UK; NIHR Applied Research Collaboration East Midlands, Leicester, UK.
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12
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Woolf K, Papineni P, Lagrata S, Pareek M. Retention of ethnic minority staff is critical to resolving the NHS workforce crisis. BMJ 2023; 380:541. [PMID: 36898716 DOI: 10.1136/bmj.p541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Affiliation(s)
| | | | | | - Manish Pareek
- University of Leicester and NIHR Leicester Biomedical Research Centre, Leicester, UK
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13
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Islam MI, Bagnulo S, Wang Y, Ramsden R, Wrightson T, Masset A, Colbran R, Edwards M, Martiniuk A. Job Satisfaction of Health Practitioners Providing Outreach Health Services during COVID-19 in Rural New South Wales (NSW) and the Australian Capital Territory (ACT), Australia. Healthcare (Basel) 2022; 11:3. [PMID: 36611463 PMCID: PMC9819187 DOI: 10.3390/healthcare11010003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 12/16/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Background: Outreach health practitioners play a key role in enhancing access to healthcare for remote, rural, regional, and Aboriginal and Torres Strait Islander communities in Australia. Outreach health practitioners are those providing ongoing and integrated health services in communities that would otherwise have limited access. In the context of the COVID-19 pandemic, it is important to understand the job satisfaction of health workers as it correlates with long-term retention of the workforce, as well as effectiveness in the role and clinical outcomes for patients. Method: The study analysed data from 258 outreach health practitioners who responded to two cross-sectional surveys conducted by the NSW Rural Doctors Network during the COVID-19 pandemic in 2020/21 and 2021/22 in NSW and the ACT, Australia. Both bivariate and multivariate analyses were employed to assess the associations between the outcome variable (outreach health practitioners' job satisfaction) and independent variables (sociodemographic factors, motivation, self-confidence, communication, capability). Results: Overall, the study showed that 92.2% of health practitioners were satisfied in their role providing outreach health services during the COVID-19 pandemic. In the multivariable model, factors significantly associated with higher satisfaction included good communication with other local health practitioners, using telehealth along with in-person care, and having high self-rated capability compared to those health practitioners who said they had lower job satisfaction. Conclusions: Outreach health practitioners' job satisfaction is important because poor satisfaction may lead to suboptimal healthcare delivery, poor clinical outcomes, and poor retention of staff in rural settings. These findings should be taken into consideration when developing future strategies to improve job satisfaction among rural outreach health practitioners and to enhance attraction, recruitment and retention and may be applicable to the broader health workforce.
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Affiliation(s)
- Md Irteja Islam
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, Sydney, NSW 2006, Australia
- Centre for Health Research and Faculty of Health, Engineering and Sciences, The University of Southern Queensland, West Street, Darling Heights, Toowoomba, QLD 4350, Australia
| | - Sharif Bagnulo
- NSW Rural Doctors Network, Suite 1, 53 Cleary Street, Hamilton, Sydney, NSW 2303, Australia
- Australasian College of Health Service Management, 11/41-43 Higginbotham Rd., Gladesville, Sydney, NSW 2111, Australia
| | - Yiwen Wang
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, Sydney, NSW 2006, Australia
| | - Robyn Ramsden
- NSW Rural Doctors Network, Suite 1, 53 Cleary Street, Hamilton, Sydney, NSW 2303, Australia
- School of Health and Social Development, Deakin University, 1 Gheringhap Street, Geelong, Melbourne, VIC 3220, Australia
| | - Trent Wrightson
- NSW Rural Doctors Network, Suite 1, 53 Cleary Street, Hamilton, Sydney, NSW 2303, Australia
| | - Amanda Masset
- NSW Rural Doctors Network, Suite 1, 53 Cleary Street, Hamilton, Sydney, NSW 2303, Australia
| | - Richard Colbran
- NSW Rural Doctors Network, Suite 1, 53 Cleary Street, Hamilton, Sydney, NSW 2303, Australia
| | - Mike Edwards
- NSW Rural Doctors Network, Suite 1, 53 Cleary Street, Hamilton, Sydney, NSW 2303, Australia
| | - Alexandra Martiniuk
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, Sydney, NSW 2006, Australia
- Office of the Chief Scientist, The George Institute for Global Health, Level 5/1 King Street, Newtown, Sydney, NSW 2042, Australia
- Dalla Lana School of Public Health, The University of Toronto, 155 College Street Room 500, Toronto, ON M5T 3M7, Canada
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14
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Overqualification and underemployment for nursing graduates in Australia: A retrospective observational study. Int J Nurs Stud 2022; 136:104376. [DOI: 10.1016/j.ijnurstu.2022.104376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 11/09/2022]
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Anderson JE. Theorising Health System Resilience and the Role of Government Policy- Challenges and Future Directions Comment on "Government Actions and Their Relation to Resilience in Healthcare During the COVID-19 Pandemic in New South Wales, Australia and Ontario, Canada". Int J Health Policy Manag 2022; 11:1960-1963. [PMID: 35942969 PMCID: PMC9808210 DOI: 10.34172/ijhpm.2022.7364] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 06/15/2022] [Indexed: 01/12/2023] Open
Abstract
Resilient healthcare (RHC) emphasises the importance of adaptive capacity to respond to unanticipated crises such as the global coronavirus disease 2019 (COVID-19) pandemic but there are few examples of RHC research focusing on the decisions taken by macro level policy makers. The Smaggus et al paper analyses the actions of two governments in Canada and Australia as described in media releases from a resilience perspective. The paper clearly articulates the need for conceptual clarity when analysing system resilience, and integrates three theoretical perspectives to understand the types of government responses and how they were related to resilience. The paper makes a valuable contribution to the developing RHC evidence base, but challenges remain in identifying conceptual frameworks, researching macro level resilience, including identifying and accessing reliable macro level data sources, analysing interactions between macro, meso and micro system levels, and understanding how resilience manifests at different temporal and spatial scales.
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Affiliation(s)
- Janet E. Anderson
- Department of Anaesthesiology and Perioperative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
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Liu C, Zhou H, Jin Y, Chuang YC, Chien CW, Tung TH. Application of a Hybrid Multi-Criterion Decision-Making Model for Evaluation and Improvement of Nurses' Job Satisfaction. Front Public Health 2022; 10:896061. [PMID: 35942263 PMCID: PMC9356381 DOI: 10.3389/fpubh.2022.896061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Abstract
Background The global shortage and turnover of nurses is a current challenge. Past studies have shown that nurse job satisfaction may ameliorate nurse shortage. Although there are many studies on the criteria influencing nurses' job satisfaction, few have examined the causal relationships and weight of each criterion from a systematic perspective. Objective Identify the key criteria and causal relationships that affect nurses' job satisfaction, and help nurse leaders identify high-weight, high-impact dimensions and contextualize them for improvement. Methods The study developed a hybrid multi-criterion decision-making model, which incorporated the McCloskey/Mueller satisfaction 13-item scale (MMSS-13), and the Decision-Making Trial and Evaluation Laboratory and the Importance-Performance Analysis methods the model was used to analyze key factors of nurse satisfaction and their interrelationships based on the experience of 15 clinical nurse specialists. Results In MMSS-13's dimension level, “satisfaction with work conditions and supervisor support” (C5) had the highest impact, and “satisfaction with salary and benefits” (C1) had the highest weight. In criteria level, “salary” (C11), “flexibility in scheduling time off” (C24), “maternity leave time” (C31), “opportunities for social contact after work” (C41), and “your head nurse or facility manager” (C51) had high influence under their corresponding dimensions. The “benefits package” (C13) was the top criterion with the highest impact on MMSS-13. Conclusions This study assessed nurses' job satisfaction from a multidimensional perspective and revealed the causal relationships between the dimensions. It refined the assessment of nurse job satisfaction to help nurse leaders better assess nurse job satisfaction and make strategic improvements. The study found that compensation and benefits had the highest weight in nurses' job satisfaction. Meanwhile, support for family responsibilities and working conditions, and support from supervisors were the cause dimensions of job satisfaction. Among the more detailed criteria, salary, benefits package, maternity leave time, and leadership had a greater impact on nurses' job satisfaction. Nurse leaders should start with these dimensions to achieve efficient improvement of nurses' job satisfaction.
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Affiliation(s)
- Chao Liu
- Institute for Hospital Management, Tsinghua University, Shenzhen, China
| | - Huili Zhou
- Taizhou Hospital of Zhejiang Province Affiliated With Wenzhou Medical University, Taizhou, China
| | - Yanjun Jin
- Taizhou Hospital of Zhejiang Province Affiliated With Wenzhou Medical University, Taizhou, China
| | - Yen-Ching Chuang
- Institute of Public Health and Emergency Management, Taizhou University, Taizhou, China
- Business College, Taizhou University, Taizhou, China
| | - Ching-Wen Chien
- Institute for Hospital Management, Tsinghua University, Shenzhen, China
- *Correspondence: Ching-Wen Chien
| | - Tao-Hsin Tung
- Taizhou Hospital of Zhejiang Province Affiliated With Wenzhou Medical University, Taizhou, China
- Evidence-Based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
- Tao-Hsin Tung
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Chu S. Elizabeth Casson Memorial Lecture 2022: Optimising performance, clinical and economic outcomes in occupational therapy service delivery. Br J Occup Ther 2022. [DOI: 10.1177/03080226221103140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The rise in health and social care costs has prompted a critical look at the way health and social care services are managed and delivered. There has been a significant change in assessing the performance and evaluating the outcomes of services. Where once only performance outcome data related to service efficiency were required, now evidence of clinical effectiveness and cost-effectiveness is demanded. When evaluating the outcomes of service delivery, it is important to measure performance outcomes (related to service efficiency), clinical outcomes (related to service effectiveness) and economic outcomes (related to cost-effectiveness). This lecture examines the interdependent relationship between performance, clinical and economic outcomes in service delivery which is underpinned by strong leadership, the application of various service improvement strategies and collaborative research between managers, clinicians, researchers and health economists, with patient and public involvement. Service improvement strategies based on practice-based and research-based evidence will be suggested to optimise performance, clinical and economic outcomes. My lecture concludes that occupational therapists should adopt these service improvement strategies and conduct clinical researches and economic evaluations to develop an efficient, effective and cost-effective service which can meet the client’s needs by using allocated resources and is value for money from a commissioning perspective.
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Affiliation(s)
- Sidney Chu
- Honorary Fellow, Brunel University London, London, UK
- Fellow, Royal College of Occupational Therapists, London, UK
- Retired Director and Consultant Therapist, Kid Power Therapy and Training Co. Ltd., Borehamwood, UK
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Fernandes A, Santinha G, Forte T. Public Service Motivation and Determining Factors to Attract and Retain Health Professionals in the Public Sector: A Systematic Review. Behav Sci (Basel) 2022; 12:95. [PMID: 35447667 PMCID: PMC9028512 DOI: 10.3390/bs12040095] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/23/2022] [Accepted: 03/25/2022] [Indexed: 02/07/2023] Open
Abstract
(1) Background: The motivational determinants of health professionals to choose and remain in the public sector have been increasingly addressed, including the customized approach of Public Service Motivation (PSM). However, to date, no systematic research overview has been performed in this domain, leaving the body of literature unstructured. This article fills this gap by assessing the motivational factors of choice for the public sector in the health field, and the conceptual and methodological trends of this research stream. (2) Methods: This study follows the PRISMA protocol to ascertain patterns in past research and inform researchers, practitioners, and policymakers. Eighty-nine documents published between 1998 and 2021 were retained after selecting them according to their theme and outlined goals. (3) Results: Common motivational determinants are remuneration, available resources, work conditions, and frequency of contact and interaction with patients. The PSM construct and scale are often employed as main frameworks, but there is also a concern in assessing motivation drawing on psychological constructs that reflect the challenging line of work and environment that is health care, such as presenteeism, stress, and perception of hindrances. (4) Conclusions: By focusing on health professionals' motivation, this study contributes to a timely systematization in challenging times for health institutions and their human resources.
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Affiliation(s)
- Alexandre Fernandes
- Governance, Competitiveness and Public Policies (GOVCOPP), Department of Social, Political and Territorial Sciences, University of Aveiro, 3810-193 Aveiro, Portugal; (G.S.); (T.F.)
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Tomblin Murphy G, Sampalli T, Bourque Bearskin L, Cashen N, Cummings G, Elliott Rose A, Etowa J, Grinspun D, Jones EW, Lavoie-Tremblay M, MacMillan K, MacQuarrie C, Martin-Misener R, Oulton J, Ricciardelli R, Silas L, Thorne S, Villeneuve M. Investing in Canada’s nursing workforce post-pandemic: A call to action. Facets (Ott) 2022. [DOI: 10.1139/facets-2022-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Nurses represent the highest proportion of healthcare workers globally and have played a vital role during the COVID-19 pandemic. The pandemic has shed light on multiple vulnerabilities that have impacted the nursing workforce including critical levels of staffing shortages in Canada. A review sponsored by the Royal Society of Canada investigated the impact of the pandemic on the nursing workforce in Canada to inform planning and implementation of sustainable nursing workforce strategies. The review methods included a trend analysis of peer-reviewed articles, a jurisdictional scan of policies and strategies, analyses of published surveys and interviews of nurses in Canada, and a targeted case study from Nova Scotia and Saskatchewan. Findings from the review have identified longstanding and COVID-specific impacts, gaps, and opportunities to strengthen the nursing workforce. These findings were integrated with expert perspectives from national nursing leaders involved in guiding the review to arrive at recommendations and actions that are presented in this policy brief. The findings and recommendations from this policy brief are meant to inform a national and sustained focus on retention and recruitment efforts in Canada.
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Affiliation(s)
- Gail Tomblin Murphy
- VP Research, Innovation and Discovery and Chief Nurse Executive, Nova Scotia Health, Halifax, NS B3H 1V7, Canada
| | - Tara Sampalli
- Senior Scientific Director, Research, Innovation and Discovery, Nova Scotia Health, Halifax, NS B3S 1B8, Canada
| | - Lisa Bourque Bearskin
- Associate Professor, and Researcher, Thompson Rivers University, School of Nursing, Kamloops, BC V2C 0C8, Canada
| | - Nancy Cashen
- Interim Director, Nursing and Professional Practice, IWK Health, Halifax, NS B3K 6R8, Canada
| | - Greta Cummings
- College of Health Sciences, and Professor, Faculty of Nursing, University of Alberta, Edmonton, AB T6G 1C9, Canada
| | - Annette Elliott Rose
- VP Clinical Care and Chief Nurse Executive, IWK Health, Halifax, NS B3K 6R8, Canada
| | - Josephine Etowa
- Professor at the University of Ottawa’s Faculty of Health Sciences, School of Nursing, Ottawa, ON K1H 8M5, Canada
| | - Doris Grinspun
- Chief Executive Officer of the Registered Nurses’ Association of Ontario, Toronto, ON M2P 2A9, Canada
| | - Esyllt W. Jones
- Professor of History, University of Manitoba, Winnipeg, MB R3T 2M5, Canada
| | - Mélanie Lavoie-Tremblay
- Associate Professor and Vice-Dean research, innovation and entrepreneuriat, Faculty of Nursing, University of Montréal, Montréal, QC H3T 1A8, Canada
| | - Kathleen MacMillan
- Adjunct (retired) Dalhousie University, School of Nursing; Adjunct, University of Prince Edward Island, Faculty of Nursing, Charlottetown, PE C1A 4P3, Canada
| | - Cindy MacQuarrie
- Senior Director, Interprofessional Practice and Learning, IWK Health, Halifax, NS B3H 2Y9, Canada
| | - Ruth Martin-Misener
- Professor and the Director of the School of Nursing and Assistant Dean, Research, at the Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Judith Oulton
- Former Executive Director, Canadian Nurses Association, Ottawa, ON K1Z 7M4, Canada
| | - Rosemary Ricciardelli
- Professor, Sociology, Memorial University of Newfoundland, St. John’s, NL A1C 5S7, Canada
| | - Linda Silas
- President of Canadian Federation of Nurses Unions, Ottawa, ON K1V 8X7, Canada
| | - Sally Thorne
- Professor, School of Nursing and Associate Dean, Faculty of Applied Science, University of British Columbia, Vancouver, BC V6T 2B5, Canada
| | - Michael Villeneuve
- Chief Executive Officer, Canadian Nurses Association, Ottawa, ON K1Z 7M4, Canada
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Jesus TS, Castellini G, Gianola S. Global health workforce research: Comparative analyses of the scientific publication trends in PubMed. Int J Health Plann Manage 2021; 37:1351-1365. [PMID: 34897803 DOI: 10.1002/hpm.3401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 10/21/2021] [Accepted: 11/30/2021] [Indexed: 12/24/2022] Open
Abstract
AIM To analyse the amount of Human Resources for Health (HRH) research publication trends [1990-2019], compared to the broader health policy, systems, and services research (HPSSR). METHODS PubMed and its indexation system with Medical Subject Headings (MeSH) are used for this time-trend study. Searches combine MeSH terms for research publications and HPSSR or HRH subjects, except education. Sub-group searches are conducted on: funding support, and high- versus low- and middle-income countries (HICs vs. LMICs). Linear regressions are used for the analysis. RESULTS HRH research publications rose exponentially (r2 = 0.94; p < 0.001) from 129 yearly publications in 1990, to 867 in 2018. Yet, HRH research publications had a logarithmic decrease (p < 0.001) in percentage of broader HPSSR publications, from 2.5% to 1.5% [1990-2018]. Funding support increased significantly and linearly (p < 0.001 r2 = 0.88), up to 44% in 2018. The percentage of HRH research publications addressing LMICs grew linearly (p < 0.001; r2 = 0.75), up to 23% in 2018. CONCLUSION HRH research publications in the PubMed database increased especially in the more recent years but did not outpace (in earlier times was outpaced) by the growth of HPSSR publications overall. Yearly, HICs still accounted for more than three-quarters of HRH research. These findings can inform global and health research policies.
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Affiliation(s)
- Tiago S Jesus
- Global Health and Tropical Medicine, Institute of Hygiene and Tropical Medicine - NOVA University of Lisbon, Lisbon, Portugal.,Department of Occupational Therapy, College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, Massachusetts, USA
| | - Greta Castellini
- IRCCS Istituto Ortopedico Galeazzi, Unit of Clinical Epidemiology, Milan, Italy
| | - Silvia Gianola
- IRCCS Istituto Ortopedico Galeazzi, Unit of Clinical Epidemiology, Milan, Italy
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Hewko SJ, Clow S, Oyesegun A, Vanleeuwen C. High Turnover in Clinical Dietetics: A Descriptive Analysis. CAN J DIET PRACT RES 2021; 83:46-48. [PMID: 34582259 DOI: 10.3148/cjdpr-2021-023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Purpose: To identify key attributes of Canadian clinical registered dietitian (RD) jobs associated with high rates of turnover.Methods: Managers of clinical RDs in Canada were eligible to complete a survey on the topic of turnover in clinical RD positions. Specifically, key details were sought regarding positions with the highest and lowest turnover in each manager's portfolio.Results: High turnover (HT) positions turned over an average of 4.0 times in a 5-year period in contrast to 0.3 times in low turnover (LT) positions. Resignation was the top reason for turnover in both HT and LT positions. HT and LT positions were of analogous full-time equivalent, had comparable caseloads, and served clients/patients with similar diagnoses including diabetes and neurological conditions.Conclusions: There is significant variation in the frequency of turnover across positions in clinical dietetics in Canada. What differentiates HT positions from LT positions remains unclear. More research is required to guide managers seeking to balance turnover and preclude uneven nutrition care quality across units and programs.
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Affiliation(s)
- Sarah J Hewko
- University of Prince Edward Island, Charlottetown, PE
| | - Samantha Clow
- Dietetic Intern, University of Prince Edward Island, Charlottetown, PE
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22
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Rattanasirivilai P, Shirodkar AL. A study of the role and educational needs of ophthalmic specialist nurses. ACTA ACUST UNITED AC 2021; 30:858-864. [PMID: 34288742 DOI: 10.12968/bjon.2021.30.14.858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AIMS To explore the current roles, responsibilities and educational needs of ophthalmic specialist nurses (OSNs) in the UK. METHOD A survey of 73 OSNs ranging from band 4 to band 8 was undertaken in May 2018. FINDINGS 73% of OSNs undertake more than one active role, with 59% involved in nurse-led clinics; 63% felt formal learning resources were limited, with 63% reporting training opportunities and 21% reporting time as major barriers to further training. More than 38% emphasised hands-on clinic-based teaching had a greater impact on their educational needs. Some 64% were assessed on their skills annually and 59% felt confident with their skill set. CONCLUSION The Ophthalmic Common Clinical Competency Framework provides a curriculum and assessment tools for OSNs to use as a structure to maintain clinical skills and knowledge. Eye departments should use this as guidance to target learning needs and improve standards of care to meet the changing needs of society.
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Affiliation(s)
| | - Amy-Lee Shirodkar
- Consultant Ophthalmologist, Arrowe Park Hospital, Wirral University Teaching Hospital Trust, Wirral
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