Staffing Requirements Research Articles

N33 Construction and Application of a Digital Management Platform for the Whole Course of Inflammatory Bowel Disease Patients Based on Action Research

Abstract Background Utilize digital technology to construct a digital platform-based comprehensive management model for Inflammatory Bowel Disease (IBD) patients, and design and develop a digital management platform for IBD patients to achieve efficient, convenient, and intelligent IBD management. Methods From October 2021 to December 2022, under the guidance of action research methodology and based on the chronic disease care model, a digital platform-based management model for the entire course of Inflammatory Bowel Disease (IBD) patients was constructed through a spiral cycle process of "diagnosis, planning, implementation, evaluation, and reflection." Leveraging digital technology and using the online hospital as a vehicle, a comprehensive management platform for IBD patients throughout the entire course of their disease was designed and developed. A total of 83 IBD patients were selected and divided into a control group of 42 cases and an intervention group of 41 cases. The control group received outpatient follow-up plus standard treatment, while the intervention group received outpatient follow-up, standard treatment, and a digital comprehensive course management model. Each group was followed up for 3 and 6 months to observe the patients' fecal calprotectin levels, Inflammatory Bowel Disease Short Health Status (IBDSHS), and patient satisfaction. Results After two rounds of action research, a comprehensive management model for IBD patients throughout the entire course of their disease has been established, comprising three major elements: a digital platform, patients, and a healthcare management team. This platform offers services such as doctor-patient interaction, health consultation, self-management support, health data upload, access to laboratory test reports, and informational support. The intervention group showed lower fecal calprotectin levels at both 3 and 6 months compared to the control group; improvements in all dimensions of the brief health status were significantly greater in the intervention group, and satisfaction was higher in the intervention group than in the control group. Conclusion This study employs action research methods, integrating the practical aspects of IBD clinical diagnosis and care in China, the characteristics of IBD, patient needs, and medical staff requirements, to construct a digital platform-based management model for the entire course of IBD patients. This model not only aligns with the trend of innovative development in China's medical services but also establishes a closed-loop management model centered on IBD patients throughout the entire course of the disease, serving as a tool for the comprehensive management of IBD patients.

Application of the workload indicators of staffing need (WISN) to assess dietetic workforce needs in South African central and tertiary public hospitals

South Africa faces both under- and over-nutrition, highlighting the need for prioritizing nutrition services. Registered dietitians are crucial for delivering appropriate and quality nutrition services. Consequently, this case study employs the World Health Organization evidence-based Workload Indicators of Staffing Need to ascertain the requisite dietetic workforce needed at central and tertiary public hospitals in South Africa. Head dietitians from 21 of 22 central and tertiary public hospitals participated in an online survey to provide data and consensus on workload components and activity standards via Delphi technique. Data were analyzed using the World Health Organisation Workload Indicators of Staffing Need software. Dietetic staffing needs were determined based on the difference between existing and required numbers of dietitians. WISN ratio was used as a metric to gauge dietitians’ workload pressure. Majority (95%) of hospitals experienced dietetic staff shortages and few (14%) had requisite staff to cover basic health services. Majority (76%) exhibited a WISN ratio below 0.5, indicating fullfilment of less than 50% of staff requirements. Based on the Workload Indicators of Staffing Need, dietitians in South African central and tertiary public hospitals experience high workload pressures due to extreme understaffing. The results can guide future profession workforce planning to facilitate enhanced nutrition outcomes in South Africa.

Expectations and Requirements of Surgical Staff for an AI-Supported Clinical Decision Support System for Older Patients: Qualitative Study.

Geriatric comanagement has been shown to improve outcomes of older surgical inpatients. Furthermore, the choice of discharge location, that is, continuity of care, can have a fundamental impact on convalescence. These challenges and demands have led to the SURGE-Ahead project that aims to develop a clinical decision support system (CDSS) for geriatric comanagement in surgical clinics including a decision support for the best continuity of care option, supported by artificial intelligence (AI) algorithms. This qualitative study aims to explore the current challenges and demands in surgical geriatric patient care. Based on these challenges, the study explores the attitude of interviewees toward the introduction of an AI-supported CDSS (AI-CDSS) in geriatric patient care in surgery, focusing on technical and general wishes about an AI-CDSS, as well as ethical considerations. In this study, 15 personal interviews with physicians, nurses, physiotherapists, and social workers, employed in surgical departments at a university hospital in Southern Germany, were conducted in April 2022. Interviews were conducted in person, transcribed, and coded by 2 researchers (AU, LB) using content and thematic analysis. During the analysis, quotes were sorted into the main categories of geriatric patient care, use of an AI-CDSS, and ethical considerations by 2 authors (AU, LB). The main themes of the interviews were subsequently described in a narrative synthesis, citing key quotes. In total, 399 quotes were extracted and categorized from the interviews. Most quotes could be assigned to the primary code challenges in geriatric patient care (111 quotes), with the most frequent subcode being medical challenges (45 quotes). More quotes were assigned to the primary code chances of an AI-CDSS (37 quotes), with its most frequent subcode being holistic patient overview (16 quotes), then to the primary code limits of an AI-CDSS (26 quotes). Regarding the primary code technical wishes (37 quotes), most quotes could be assigned to the subcode intuitive usability (15 quotes), followed by mobile availability and easy access (11 quotes). Regarding the main category ethical aspects of an AI-CDSS, most quotes could be assigned to the subcode critical position toward trust in an AI-CDSS (9 quotes), followed by the subcodes respecting the patient's will and individual situation (8 quotes) and responsibility remaining in the hands of humans (7 quotes). Support regarding medical geriatric challenges and responsible handling of AI-based recommendations, as well as necessity for a holistic approach focused on usability, were the most important topics of health care professionals in surgery regarding development of an AI-CDSS for geriatric care. These findings, together with the wish to preserve the patient-caregiver relationship, will help set the focus for the ongoing development of AI-supported CDSS.

Interaction between National and Local Governments in Rural Revitalization of China

The article examines the specifics of the interaction of rural working group sent by the Communist Party of China to rural areas with local party bodies and rural self-government; analyzes the selection mechanism and staffing requirements of such groups. Rural working group are an important institutional mechanism by which the party pursues its political line in rural areas. In different historical periods, the content of work in villages and the focus of assistance have changed. Such changes reflected to a certain extent the relationship between the rights of the rural community and the state authorities, as a result of which the village management structure was in a state of constant debugging. After the completion of the formation of a moderately prosperous society in all respects, the criteria for the selection and evaluation of personnel for working group on rural development sent to villages became more stringent. Despite the symbiotic relationship between rural groups and rural "two committees" (the local government committee and the local CPC committee) from the point of view of institutional norms, the specific practice of their interaction has a number of problems, among which are blurring in the distribution of powers and responsibilities, contradictions in the motivations of the activities of workers' working group on rural development and local "two committees". In this regard, rural target groups face a twofold task. First, they must comprehensively and correctly integrate into the daily activities and life of the village in order to build harmonious relations with farmers and rural "two committees". Secondly, such groups should pay more attention to two-way communication with organizations and institutions responsible for the mission of the task force to rural areas; do not hide the difficulties in their work and inform the leadership of the structures that sent the task force to the village about the problems that arise in order to receive all the necessary sufficient assistance.

The Implementation of Integrated Youth Services in Canada: Planning and Costing of a Pan-Canadian Model: La mise en œuvre des services intégrés pour les jeunes au Canada : planification et établissement des coûts d'un modèle pancanadien.

The implementation of Integrated Youth Services (IYS) can help ensure that youth are adequately supported. The objective of this analysis was to provide a model for the planning and costing of IYS throughout Canada over a 15-year period. To estimate resource allocation for IYS, we determined the number of hubs and hub staffing requirements by service level and jurisdiction, backbone support and infrastructure requirements by jurisdiction. A needs-based analytic framework for planning was employed to estimate the number of hubs required. The optimal mix of hub staffing requirements was determined based on prior literature. The costs of running each hub were estimated using publicly available data and internal documents from existing IYS agencies. Finally, the cost of setting up IYS hubs, IYS virtual care and respective backbone support throughout Canada was estimated and projected over 15 years and the cost-savings of IYS were calculated. At maturity, it was estimated that 399 hubs-188 small, 43 medium, 168 large-across Canada would be required to address youth mental health and substance use needs. The cost of implementing IYS initiatives across Canada would vary between $4,349,126 (for less populous jurisdictions) and $248,950,524 (for more populous jurisdictions), for a total annual cost of $676,633,388 (excluding costs of infrastructure). It was estimated that the implementation of IYS hubs would lead to cost-savings of $2.1 billion annually and have the potential to be cost-effective. The implementation of IYS hubs can provide good value for money, in the form of high client satisfaction, earlier supports with improved youth outcomes and decreased health care costs. Future work should address gaps in data availability on mental health and substance use-related needs of youth with neurodevelopmental disorders, youth experiencing homelessness, youth in congregate living and foster care, and Indigenous youth.

Methods and models for assessing the state of the region's human resources potential

Relevance. One of the strategic goals of the development of the regional economy is to improve the socioeconomic condition of the region, which is based on human resources. The Forecast of the long-term socio-economic development of the Russian Federation for the period up to 2030 notes that economic growth will be possible due to certain factors, among which the human resource occupies an important place. Since in the modern arena of the world economy there is a struggle for the ability to introduce innovations, the use of intellectual capital, the knowledge economy needs to take the main place in the socio-economic development of society, given that human resources is one of the fundamental factors in achieving leading positions.The purpose is to conduct a comprehensive study of methods for assessing the human resources potential of the region.Objectives: to identify the features of approaches to the interpretation of the concept of "human potential", to study models for forecasting human potentialMethodology. The following methods were used in the research process: logical and statistical analysis, qualitative and quantitative analysis, as well as an expert approach.Results. Different approaches to the definition of human resources were considered, existing methods of assessing human resources were analyzed, the authors proposed a methodology for assessing human resources and studied the process of its formation.Conclusion. The proposed methodology allows us to determine the choice of preventive measures to build human resources and meet the indicators of the Forecast of social and economic development of the region. Also, this technique can be used to generate staffing requirements and admission control figures.

Staffing situation and basics requirement calculations in the inpatient and outpatient sector in Germany - a representative survey by the Working Group of Senior Gastroenterology Hospital Physicians (ALGK)

In Germany, there are no uniform hospital standards for the transparent calculation of medical staffing requirements in hospitals. This is particularly true for outpatient services.The ALGK conducted a member survey via the link https://de.surveymonkey.com/r/H7TTJYZ from March 21 to May 1, 2024. 400 members with a valid email address were contacted. The 119 extraordinary members who had ended their professional activity were not included. 17 questions were asked in the survey.The response rate was 24%. 37% represented basic and standard, 47% specialized and 16% maximum care providers. Municipal hospitals were represented by 42%, denominational providers by 34% and private providers by 24%. 7% of the hospitals had fewer than 200 beds, 28% 200 to 400 beds, 37% 400 to 600 beds, 15% 600 to 800 beds and 13% more than 800 beds. Up to 1.500 patients were treated annually in 15%, up to 2.500 patients in 15%, each up to 3.000 or 4.000 patient in 22%s, up to 5,000 patientsin 16% and more than 5.000 patients per year in 12%. The average casemix was 2373 ± 999 and the casemix index 0.70 ± 0.11. On average, 17.6 ± 7.6 doctor's posts were available and one consultant treated 14 ± 2.7 patients per day. A transparent personnel calculation was not available in 56% of the departments or clinics, in 82% there was no internal cost allocation or cost recovery calculation, in 54% there was no internal cost allocation. In 54%, there was no feedback on outpatient services from the administration, in 93% there was no transparent calculation of physician positions based on outpatient services, in 97% the training and further training of young colleagues was not taken into account in the calculation of positions, in 75% there was no communicated and recognizable strategic plan by the hospital operator for the senior gastroenterologists with regard to outpatient services. 49% of those surveyed feared that their hospital operator would not be able to cope with the restructuring in the healthcare sector with outpatient services, centralization, minimum volume compliance and would even jeopardize its existence.Transparent job calculation and communication about inpatient and outpatient gastroenterology services and the strategic objectives of the healthcare structural reform are very patchy in German hospitals. This leads to a high degree of uncertainty and existential fears.

Basic Education in Canada and Its Implications for Education in China

This paper explores the advantages, characteristics, and implications of basic education in Canada over education in China. By analyzing the successful experience of the Canadian education system, we can provide reference for the reform of basic education in China and promote the sustainable development of China’s education industry. Canada’s basic education covers all stages and focuses on the comprehensive development of students and the cultivation of innovative spirit. Its educational management model is characterized by common management, implementing a 12-year compulsory education system, diversifying the education system, emphasizing the cultivation of students’ self-learning ability in educational methods, and having strict requirements for the teaching staff. There are problems in China’s basic education, such as uneven distribution of educational resources, prevalence of exam-oriented education, and the need to improve the educational and teaching abilities of some teachers. The inspiration of Canadian education for China includes strengthening cooperation between governments and schools at all levels, emphasizing quality education, improving teachers’ professional quality, and optimizing the allocation of educational resources. China should learn from Canada’s experience and adopt comprehensive measures to improve the quality of basic education in China, including building a diversified education system, strengthening students’ self-learning ability, emphasizing students’ comprehensive development, and enhancing teacher training.

Abstract 272: Essential Requirements to Develop Stroke Thrombectomy Program in Limited Resource Settings: A Modified Delphi Survey

Introduction Mechanical thrombectomy (MT) has revolutionized care for patients with ischemic strokes from large vessel occlusion (LVO) leading to adoption as the standard of care. However, the Mechanical Thrombectomy Global Access For Stroke (MT‐GLASS) study, demonstrated that global access to mechanical thrombectomy is <3% of the demand. One possible reason for these shortcomings are the significant resources required to develop a sustainable MT service. Our aim is to understand what infrastructure, equipment and staff are essential to perform safe and effective MT for LVO‐stroke in resource limited settings. Methods Using a modified Delphi method iterative rounds of surveys were administered to an international panel of stroke leaders. Initial survey questions covered optimal and minimal requirements for diagnosis, imaging, equipment, and staff to perform MT. Results from the initial survey underwent qualitative analysis to create statements identifying essential requirements for a stroke thrombectomy program in resource‐limited setting. These statements were distributed in follow up surveys with participants rating their level of agreement with each statement using a 5‐point Likert scale. Consensus was defined as 70‐100% of respondents agreeing (Likert scale levels strongly agree and agree) or disagreeing (Likert scale levels disagree and strongly disagree) with the statement. Results A total of 27 experts answered the initial 40‐question survey. Experts from various specialties including neurosurgery, neurointervention, and vascular neurology, with majority (63%) from an academic center (63%) across 18 countries participated. Experts uniformly agreed that it is possible to develop a stroke thrombectomy program in a resource‐limited setting though barriers would include cost, public awareness of stroke symptoms, and developing an emergency triage protocol to efficiently identify and image potential MT candidates. 86% of respondents agreed that interventionalists are the appropriate provider to identify candidates for MT. There was disagreement on minimum necessary imaging required to identify a candidate for MT with the most common answer of CT head and CTA (54%) not meeting consensus definition. Essential equipment to perform MT that achieved consensus included (% agreement) access sheath (92%), guide catheter (100%), glidewire (100%), aspiration catheter (100%), aspiration syringe (92%), microcatheter and microwire (85%). Other listed equipment did not achieve consensus as essential equipment including ultrasound for access (8%), diagnostic catheter (69%), aspiration pump (23%), stent retriever (69%), extracranial stent (69%), intracranial stent (54%), and coils (54%). Experts agreed that access to common femoral artery can be safely obtained through palpation alone (76% agree) and that closure devices are not necessary as manual pressure will suffice (76% agree). Example of area lacking consensus is the necessity of invasive blood pressure monitoring follow MT (54% agree it is necessary, 30% disagree, 16% indifferent). Conclusions We have demonstrated that a strong consensus exists among experts that it is possible to create a MT program in a limited resource setting. While country specific barriers need to be addressed, the essential requirements for development of these programs were identified. We believe that these results can serve as a blueprint for development of national stroke programs which include MT.

Educational management in personnel training of hydrometeorological services: world experience

Introduction. The relevance of the presented study is determined by the fact that the acceleration of climate change on the planet has a significant impact on almost all spheres of economic and social life of mankind, which imposes new requirements both on the information provided by hydrometeorological services and on the personnel of managers and specialists providing it.Purpose setting. The purpose of the presented studies is to summarize the world experience in the development of promising requirements for the skills and competence of managers and specialists of national meteorological services in the interests of forming a system of requirements for staffing and training of managers and specialists of hydrometeorological services of the Roshydromet system.Methodology and methods of the study. The methodological base of the research consists of well-known scientific works devoted to the promising requirements for the skills and competencies of managers and specialists of the hydrometeorological service. Results. The novelty of the obtained results lies in the fact that, based on the generalization of world experience in the development of promising requirements for the skills and competence of managers and specialists of national hydrometeorological services, it was found that when forming personnel management strategies, on the one hand, requirements are put forward for a wide range of competencies of personnel who own both traditional technologies and innovative technologies for processing and interpreting information based on IT. On the other hand, hydrometeorological services impose increased demands on themselves, which is manifested in strategic aspirations to form a holistic motivation system for their employees, covering all levels of human needs, according to substantive theories of motivation – from economic competitiveness to opportunities for training, development and self-expression.Conclusion. The practical significance of the obtained results lies in the possibility of using world experience in developing promising requirements for the skills and competence of managers and specialists of national meteorological services when forming strategies for personnel management of hydrometeorological structures of the Roshydromet system.

Telemedicine and outcome in patient care: Review

Telemedicine is a term given to the use of electronic and telecommunication methods in patient’s healthcare. Presently it is being used for diagnostic, treatment and research purposes. Since the recent pandemic telemedicine has become more transformative and has enhanced patient’s access to different medical settings across the globe, this review will evaluate the role of telemedicine in improving patient outcomes. The management of chronic diseases in areas of the world where specialty medical services are not easily accessible has been evaluated along with the patient's involvement and use of modern and state-of-the-art technologies. The overall findings indicate that telemedicine has improved the patient's ability to actively participate in their health management, with more compliance toward the management of the medical problem and fewer OPD visits. On the other hand, it encourages fewer doctor and paramedical staff requirements for a particular population size and the limited role of physical examination of the patient.

Improving efficiency in the emergency department Monte Carlo simulation for determining the optimal number of staff

This paper examines the application of Monte Carlo simulation to determine optimal staffing levels at reception desks in the Emergency Department. The study utilizes data collected from a hospital in Bogotá, with all data anonymized to maintain the confidentiality of both the institution and its patients. By leveraging programming tools, the study randomizes the data and models various scenarios to assess the staffing requirements accurately. The primary goal is to enhance the efficiency and quality of service by aligning staffing levels with patient demand. The use of historical data, combined with the simulation of hypothetical scenarios, provides a robust basis for predicting future needs and making informed staffing decisions. The study's findings offer valuable insights into human resources management, enabling the Emergency Department to strategically allocate personnel, minimize wait times, and improve overall patient care. This approach demonstrates the potential for simulation-based models to optimize resource allocation in critical healthcare environments.

Development Strategy Management Model for Tennis Club in Guangzhou City, the People’s Republic of China

Background and Aim: More tennis players in Guangzhou offer a larger platform for the sport's growth. The Guangzhou Tennis Club has grown quickly in the last few years. However, as the tennis club has grown, several issues have emerged, including management, staffing, and club operations. Materials and Methods: This study used a questionnaire to look into 286 club members, 143 club coaches, and 53 club administrators from 50 tennis clubs in Guangzhou. The data is analyzed using the descriptive statistics method, and the resultant conclusion serves as a foundation for guidance for the Guangzhou Tennis Club's strategic management model. The instrument; (1) Survey data questionnaire for research purposes. (2) Evaluation form for focus groups. (3) Expert interview guide. (4) Questionnaire for expert assessment. Analyzing Data: (1) The average and percentage must be used in the questionnaire. (2) Content analysis will be used to analyze the data from focus groups and interviews. Results: (1) Able to fully mobilize resources to support development; good at forging cooperative relationships with pertinent institutions. (2) There are organizations to support the growth of the tennis club, and the staff management structure is well-defined. (3) There are standards and design requirements for both members and staff to meet to enter the club. Issues and challenges: (1) Absence of strategies to encourage tennis club growth in conjunction with pertinent institutional or national policies. (2) Professional staff is absent from tennis club management and instruction, and the clubs' development trajectory is unidirectional. (3) Absence of a system for tracking tennis club performance and lack of authority over the maximum number of members. And (4) abusing the tennis club welfare allowance, pressuring staff members. Conclusion: (1) Guangzhou Tennis Club should be taken into consideration when creating the phased development plan, and national and government policies should be used to promote development. The organizing section's management development strategy can be summed up as follows: using the organization's current resources to support the club's quick development. The leading development strategy should be summed up in the leadership section as follows: suitable systems should be developed to standardize each employee's daily work and have requirements for employees. The following succinctly describes the controlling development strategy in the control section: planning employee development and effectively ensuring employee welfare, as well as collaboratively advancing the growth of Guangzhou Tennis Club. (2) Fifteen experts have given the Guangzhou Tennis Club's development strategy management mode, which was created for this study, high marks. The Guangzhou Tennis Club's development strategic management mode received an average score of 4.65 from 15 participants, indicating that the experts are satisfied with the mode's practical application and overall impact.

Cleaning time and motion: an observational study on the time required to clean shared medical equipment in hospitals effectively

Despite the important role that cleaning plays in reducing the risk of healthcare-associated infections, no research has been undertaken to quantify the time required for effective cleaning and disinfection of different pieces of shared medical equipment commonly used in hospitals. This short report presents the results from a study that aimed to quantify the time required to clean common pieces of shared medical equipment effectively. An observational time and motion study was conducted in a nursing simulation laboratory to determine the time required for effective cleaning and disinfection of 12 pieces of shared medical equipment commonly used in hospital. After training, the participants cleaned and disinfected equipment, with the time taken to clean recorded. Cleaning was deemed to be effective if ≥80% of ultraviolet fluorescent dots were removed during the cleaning process. The time to clean equipment effectively ranged from 50s [blood glucose testing kit; 95% confidence interval (CI) 0:40-1:00 (min:s)] to 3min 53s [medication trolley; 95% CI 3:36-4:11 (min:s)]. The intravenous stand was cleaned most effectively, with 100% of dots removed (N= 100 dots). In contrast, the bladder scanner was the most difficult to clean, with 12 attempts required to meet the 80% threshold for effective cleaning. This study will inform staffing and training requirements to plan the cleaning and disinfection of shared medical equipment effectively. The findings can also be used for business cases, and in future cost-effectiveness evaluations of cleaning interventions that include shared medical equipment.

Hospital Nurse Staffing Legislation: Mixed Approaches In Some States, While Others Have No Requirements.

Legislative agendas aimed at regulating nurse staffing in US hospitals have intensified after acute workforce disruptions triggered by COVID-19. Emerging evidence consistently demonstrates the benefits of higher nurse staffing levels, although uncertainty remains regarding whether and which legislative approaches can achieve this outcome. The purpose of this study was to provide a comprehensive updated review of hospital nurse staffing requirements across all fifty states. As of January 2024, seven states had laws pertaining to staffing ratios for at least one hospital unit, including California and Oregon, which had ratios pertaining to multiple units. Eight states required nurse staffing committees, of which six specified a percentage of committee members who must be registered nurses. Eleven states required nurse staffing plans. Five states had pending legislation, and one state, Idaho, had passed legislation banning minimum nurse staffing requirements. The variety of state regulations provides an opportunity for comparative evaluations of efficacy and feasibility to inform new legislation on the horizon.

ANALYSING THE ROLE OF HR ANALYTICS IN STRATEGIC DECISION MAKING

Analytics for human resources (HR) have become a vital tool for contemporary organizational management, allowing for data-driven choices that are in line with strategic goals. The incorporation of HR analytics into strategic decision-making procedures is examined in this abstract, with a focus on how it might significantly improve organizational performance. The study looks at how insights into workforce dynamics, talent management, employee engagement, and productivity from HR analytics help make well-informed decisions. HR specialists may enhance resource allocation, reduce risks, and identify trends by utilizing predictive analytics, which will provide their company a competitive edge. The abstract also addresses the difficulties in implementing HR analytics, such as the requirement for qualified staff, data privacy issues, and integrating analytics with current HR systems. The study presents real-world examples of how businesses effectively applied HR analytics to achieve strategic goals, highlighting the practical advantages of data-driven HR procedures. The results emphasize how crucial it is for HR departments to develop a data-centric culture in order to properly utilize HR analytics in strategic decision-making. These abstract lays the groundwork for an in-depth examination of how HR analytics is changing the strategic environment and provides a road map for businesses looking to improve their decision-making processes with cutting-edge data.

Social workers’ educational level and attitudes toward child participation in cases regarding children’s contact with birth parents – the case of Norway

ABSTRACT Previous international research indicates that social workers may lack the competence to comfortably involve children in child protection processes. Implementation of stricter competence requirements for child welfare staff has been discussed to address shortcomings in child welfare practice. In Norway, this implementation is scheduled for 2031, and subject to ongoing discussion. Through multivariate robust linear regression analysis of data collected in five Norwegian urban settlements (n = 135), this study explored the association between social workers educational level and attitudes toward child participation in cases concerning contact between children in out-of-home care and their birth parents. The results indicate a significant difference in attitudes toward children’s involvement in cases concerning contact with birth parents when comparing social workers with master’s degrees to those with bachelor’s degrees, whereas social workers with master’s degrees exhibit more positive attitudes. Social workers are generally found to have positive attitudes toward participation; however, the findings indicate concerns regarding participation in cases related to contact, particularly due to potential loyalty conflicts that might cause stress to the child.

Staffing and Workload in Primary Care Facilities of Selected Geographically Isolated and Disadvantaged Communities in the Philippines.

Staffing shortages and health inequities are persistent barriers in the Philippines toward achieving universal health care. To ensure an adequate and responsive health workforce, there is a need to evaluate the Human Resources for Health (HRH) status across health facilities, particularly those in underserved communities. Hence, this study aims to determine the staffing requirements and workload pressure among primary care facilities in selected geographically isolated and disadvantaged areas (GIDAs) in the Philippines. The study utilized the workload indicators of staffing need (WISN) methodology from the World Health Organization to determine the staffing and workload situation among three health worker cadres (physicians, nurses, and midwives) in the study sites. Particularly, six primary care facilities (four rural health units and two community hospitals) located in Surigao del Norte were involved in the study. WISN-related data (health service statistics, available working time, and health professionals' workload components) were collected through records review, focus group discussions, and key informant interviews. The WISN software was used to analyze the staffing levels and workload pressure in the selected facilities. A total of 40 health workers, including physicians (n = 5, 13%), nurses (n = 21, 52%), and midwives (n = 14, 35%) participated in the study. The findings noted varying levels of staffing and workload pressures among the three cadres in selected primary care facilities, which were influenced by several factors. Particularly, health facilities with additional human resources obtained from deployment programs indicated adequate staffing and low to normal workload pressures. However, further analysis revealed potential HRH maldistribution and reliance on the temporary nature of the staff augmentation program in delivering primary care services, which need to be addressed to optimize health workforce planning. Service workload may also have been impacted by the temporary closure of health facilities due to disasters. Among the few cadres that reported staffing shortage and high workload pressure, these were due to higher service demands, increased task delegation, and inadequate service coordination. Hence, context-specific challenges and situational factors in GIDAs need to be considered when determining the staffing and workload requirements. There is a need to improve the capacities of health facilities and local government units (LGUs) to engage in evidence-based HRH planning through the WISN methodology. Doing so could improve staffing and workload distribution among health care facilities in the country. Moreover, interorganizational collaboration (DOH, LGUs, and health facilities) should be strengthened to improve delineation and prevent duplication/omission of health services, rationalize HRH distribution and augmentation, and streamline the priority health services based on the local contextual factors.

Evaluating diabetes care in primary healthcare centers in Abuja, Nigeria: a cross-sectional formative assessment

IntroductionNoncommunicable diseases (NCDs) are associated with high and rising burden of morbidity and mortality in sub-Saharan Africa, including Nigeria. Diabetes mellitus (DM) is among the leading causes of NCD-related deaths worldwide and is a foremost public health problem in Nigeria. As part of National policy, Nigeria has committed to implement the World Health Organization (WHO) Package of Essential Non-communicable Disease interventions for primary care. Implementing the intervention requires the availability of essential elements, including guidelines, trained staff, health management information systems (HMIS), equipment, and medications, in primary healthcare centers (PHCs). This study assessed the availability of the DM component of the WHO package, and the readiness of the health workers in these PHCs to implement a DM screening, evaluation, and management program to inform future adoption and implementation.MethodsThis cross-sectional formative assessment adapted the WHO Service Availability and Readiness Assessment (SARA) tool to survey 30 PHCs selected by multistage sampling for readiness to deliver DM diagnosis and care in Abuja, Nigeria, between August and October 2021. The SARA tool was adapted to focus on DM services and the availability and readiness indicator scores were calculated based on the proportion of PHCs with available DM care services, minimum staff requirement, diagnostic tests, equipment, medications, and national guidelines/protocols for DM care within the defined SARA domain.ResultsAll 30 PHCs reported the availability of at least two full-time staff (median [interquartile range] = 5 [4–9]), which were mostly community health extension workers (median [interquartile range]) = 3 [1–4]. At least one staff member was recently trained in DM care in 11 PHCs (36%). The study also reported high availability of paper-based HMIS (100%), and DM screening services using a glucometer (87%), but low availability of DM job aids (27%), treatment (23%), and national guidelines/protocols (0%).ConclusionThis formative assessment of PHCs’ readiness to implement a DM screening, evaluation, and management program in Abuja demonstrated readiness to integrate DM care into PHCs regarding equipment, paper-based HMIS, and nonphysician health workers' availability. However, strategies are needed to promote DM health workforce training, provide DM management guidelines, and supply essential DM medications.

Resource Requirements in a Burn Mass Casualty Event.

Burn mass casualty event occurrences are rare but will place significant burdens on any burn unit or healthcare system. Effective disaster preparedness plays a significant role in mitigating the aftermath of a burn mass casualty. The aim of this study was to assess the resource requirements during the initial two weeks of a burn mass casualty event. Eight patients in a burn mass casualty event were simulated using the Emergo Train System®. These simulated patients were matched with real historical patients treated in our burn centre, and their resource requirements were analysed. An average of eight staff is required to care for a patient per day along with almost 75 h of operating time (excluding anaesthesia and turnover time). A substantial quantity of consumables was used in the first two weeks. This study has demonstrated the substantial material consumption and staff requirements in the first two weeks of management in a burn mass casualty event. Such findings will offer valuable insight for disaster preparedness planning and resource management strategies.