[Impact of nurse, nurses' aid staffing and turnover rate on inpatient health outcomes in long term care hospitals]

Physical Therapy Provider Continuity Predicts Functional Improvements in Inpatient Rehabilitation

BACKGROUND AND PURPOSE

Health care continuity has been linked to improved patient outcomes in a variety of professions and settings. Patients in inpatient rehabilitation receive a consistent dosage of physical therapy (PT) treatment; however, the providing physical therapist may vary. Despite the potential influence of PT provider continuity on functional outcomes in the inpatient rehabilitation setting, this association has not yet been studied.

METHODS

An observational retrospective chart review was conducted on 555 discharged inpatient rehabilitation patients. The relationship between the number of PT providers from whom a patient received care and Quality Indicator (QI) Mobility discharge scores was examined with Pearson product-moment correlation coefficients, initially with the entire patient group and secondarily with distinct diagnostic groups. Data from subgroups for whom a significant relationship was established were then included in a hierarchical linear regression analysis accounting for relevant covariates.

RESULTS

The number of PT providers correlated negatively with QI Mobility discharge scores ( r = -0.41, P ≤ 0.001). When controlling for QI Mobility admission scores, the "Stroke" (partial r = -0.17, P = 0.02), "Spinal Cord Injury" (partial r = -0.28, P = 0.002), and "Other Neuromuscular" (partial r = -0.35, P = 0.03) groups demonstrated significant inverse relationships. A hierarchical linear regression incorporating these 3 diagnostic groups revealed that the number of PT providers remained a significant predictor of QI Mobility discharge scores ( B = -1.50, P ≤ 0.001) when accounting for covariates.

DISCUSSION AND CONCLUSIONS

PT provider continuity is related to the functional improvement of neurologically impaired patients in inpatient rehabilitation.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A405 , which discusses the findings of this work in a narrative format).

The effect of the reformed nurse staffing policy on employment of nurses in Korea

Aim

This study aims to analyse the employment effect of reformed nurse staffing policy which is the “Integrated Nursing and Care Service” scheme that was introduced by the Korean government.

Design

Economic evaluation study focusing on employment effect.

Method

An input–output model was used to estimate the employment‐inducing effect of the new staffing policy. The analysed data of 26,381 beds, of 400 hospitals that are participated in the Integrated Nursing and Care Service scheme were retrieved from the Korean National Health Insurance claims database.

Results

The job‐creation effect of the new staffing policy was estimated to be 48.5 persons per USD 1 million expenditure, which means 28,154 persons were employed when USD 580.15 million expenditures was paid to the hospitals by the National Health Insurance Service. In addition, the policy had an employment‐inducing effect which is as high as 3.09~6.07 times higher than that of similar industries and all industries.

Nurses' Clinical Work Experience during Pregnancy

The working environment of nurses contains numerous hazards that can be particularly harmful to pregnant women. In addition, pregnancy-induced changes can themselves cause discomfort. Therefore, it is necessary to analyze pregnant nurses' experiences of clinical work. This qualitative study analyzed data collected through in-depth interviews. From January to June in 2020, 12 shift-work nurses who had experienced pregnancy within three years were interviewed. The main question was "Could you describe your clinical work experience during pregnancy?" Qualitative data from field notes and transcriptions of the interviews were analyzed using Colaizzi's method. Six categories were extracted that described the nurses' clinical work experience during pregnancy, as follows: "enduring alone," "organizational characteristics of nursing," "risky work environment," "strengths that sustain work during pregnancy," "growth as a nurse," and "methods to protect pregnant nurses." Pregnant nurses experienced various difficulties due to physical and mental changes during pregnancy, and the clinical working environment did not provide them with adequate support. The findings of this study will be helpful for developing and implementing practical maternity protection policies and work guidelines.