Staff Shortages Research Articles

Examining the perspective of community general support centers and promoting the use of early stage dementia-intensive support teams: Comparing institutions with and without support teams

Objectives Although numerous studies have explored early stage dementia-intensive support teams, focusing on their effectiveness and associated challenges, there is insufficient research on community comprehensive support centers that use support teams. Thus, we focused on community comprehensive support centers from the perspectives of their operators and users, examined the actualities and challenges of support team use, and considered ways to encourage such use.Methods A questionnaire survey was mailed to 2,000 community general support centers selected through evenly-spaced sampling from 5,625 centers in Japan. The survey was conducted from November to December 2022. The survey included basic attributes (institution and presence of a support team), number of times a support team was used, actual number of users, and issues with support team use. For the analysis, we defined centers with and without support teams as "operators" and "users," respectively, and analyzed each group. The participants' demographic details and data related to the frequency of use of support teams were tabulated. Text mining was used to analyze free-field responses.Results A total of 773 responses were received (response rate; 38.8%). Among the respondents, 313 (41.5%) had support teams and 441 (58.4%) did not. The support team use rate was 86.6% for the former and 79.4% for the latter. In 2021, most respondents noted that approximately "1-5 individuals" used support teams, regardless of whether the support center had one.Challenges with support team use identified by centers without support teams were as follows; requirements of support recipients and rules for use under "mechanisms of use," involvement of team doctors and expertise of team members under "support functions," and collaborative support relationship and dissemination of project information under "system for use." Support centers with support teams identified the following challenges; requirements of support recipients and management rules under "management mechanisms," involvement of team doctors and healthcare collaboration under "support functions," and team members role awareness and staff shortage under "management system."Conclusion Many comprehensive centers infrequently used support teams. To promote support team use, the system must be reviewed from the operator and user perspectives to simplify the support team system's rules and ease the requirements for support recipients. Moreover, all dementia supporters must engage in regular and ongoing discussions about the dementia support system, focusing on the municipal responsibility for system operation.

Improving Time to Bleeding Disorder Treatment in the Emergency Department.

Knowledge of the guidelines for treating people with bleeding disorders (PwBD) is vital for emergency department (ED) staff, as PwBD rely on the ED for treatment of acute bleeding episodes or injuries. Unfamiliarity with these guidelines can delay treatment. We aimed to improve the timely treatment of PwBD seeking emergency care by reducing the mean time-to-factor administration in the ED by 20%, from the baseline of 110 to 88minutes. Our quality improvement (QI) initiative (2019-2024) used Plan-Do-Study-Analyze cycles. Weekly electronic health record (EHR) reports tracked PwBD's time of arrival, admission, clotting factor concentrate ordering, and administration. Interventions targeted delays identified in the process. Baseline data showed a 110-mean time-time-to-factor. Our aim of reducing the time-to-factor by 20% from the baseline of 110minutes was reached in May 2020. This improvement was exceeded and sustained throughout the project. At the conclusion, we achieved a 62% reduction in time-to-factor and a mean time-to-factor of 42minutes. By using an EHR tool, we were able to identify when during the ED visit process delays occurred, which helped us better target our interventions. Our educational-based interventions were adapted to reach our intended audiences while working around barriers related to the COVID-19 pandemic, such as high patient volumes and staff shortages. Our results show a decrease in time to factor in the ED and an increase in the PwBD receiving factor within 60minutes of arrival time. This has been a sustainable improvement.

Physiotherapy under pressure: A cross-sectional study on the interplay between perfectionism, moral injury, and burnout.

Given the escalating challenges for UK-based physiotherapists in workload pressures, budget constraints, staff shortages and patient wait times, the profession (of 65,000 registered physiotherapists) necessitates immediate attention to the health and well-being of the therapists. This pioneering study aims to examine perfectionism, moral injury, and burnout among UK-based physiotherapists across the NHS, private practice, sports, and academia. This cross-sectional study utilised an online survey and implementation of Structure Equation Modelling (SEM) to assess the interplay of perfectionism (Multidimensional Perfectionism Scale-Short Form), moral injury (Moral Injury Symptoms Scale-Healthcare Professionals), and burnout (Shirom-Melamed Burnout Questionnaire). Our sample size calculation represents the UK physiotherapy profession, utilising a 95% confidence interval with a 5% margin of error. Our analysis conducted on (n = 402) UK-based physiotherapists reveals significant burnout levels, with 96% of participants presenting with moderate to high burnout scores. SEM revealed perfectionism and moral injury collectively accounted for a substantial 62% of burnout variability, highlighting their sequential impact on burnout manifestation. With such high levels of burnout, urgent intervention is paramount. Elevated burnout presents challenges for the physiotherapy profession as staff retention, accurate and effective patient care, and overall health are severely impacted due to burnout. Recognising and addressing perfectionism and moral injury, such as through amendment or development of policy, becomes pivotal to mitigate its impact on individual and collective health.

Teledidactic peer-tutored musculoskeletal ultrasound training for medical students-the TELMUS study.

Despite growing interest in musculoskeletal ultrasound (MSUS), training opportunities are often limited due to staff shortages and disbalances of expertise between rural and urban areas. Teledidactic approaches have the potential to expand access to training opportunities. This study aims to compare the effectiveness of teledidactic peer-tutored MSUS training to a conventional approach. A teledidactic course was held by a student tutor following a validated MSUS curriculum. An on-campus MSUS training taught by physician lecturers served as a control. Students were randomly assigned to one of both study groups. Objective structured clinical examinations (OSCE) were conducted before and after the training to objectively measure the learning outcome of the participants. Handheld ultrasound devices (ButterflyIQ®) and iPads (Apple Inc., 8th generation) were provided to the students for the MSUS course. Thirty medical students participated in the study. Prior to the course, baseline OSCE scores were recorded as 13.03/63 (SD ± 4.20) for the on-campus cohort and 13.00/63 (SD ± 6.04) for the teledidactic group. In the post-training OSCE evaluation, the on-campus cohort attained an average score of 56.80/63 (SD ± 4.22), while the TELMUS group averagely achieved 58.53/63 points (SD ± 3.52). While all students' skills increased over time, there was no significant difference between the two cohorts either before or after the course. Peer-tutored, teledidactic MSUS training showed to be non-inferior to the conventional approach and is a promising approach to reduce local and global disparities in educational opportunities regarding MSUS.

Abstract TP139: Coordinating Stroke and Sleep Care with Field Staff and Champions: Difference-Makers in a Quality Improvement Program Addressing Sleep Apnea in Stroke Patients

Background: The Addressing Sleep Apnea Post-Stroke/TIA (ASAP) clinical trial aimed to enhance OSA management at six VA medical centers through a hybrid implementation trial, requiring coordination across hospital medicine, sleep medicine, nursing, and neurology in both inpatient and outpatient settings. This analysis evaluated the trial’s efforts to standardize early OSA screening in stroke/TIA patients. Methods: This mixed-methods evaluation used configurational comparative methods (CCMs) to identify key contextual factors for successful implementation, examining the joint effects of multiple factors. The stepped-wedge trial ran from May 2019 to January 2024 across three implementation waves. The primary outcome was the Group Organization (GO) score, which measured team cohesion in managing sleep apnea among cerebrovascular patients. Data sources included observational data, qualitative interviews, and administrative data across three periods (A, B, C), calibrated into dichotomous or multi-value categories for analysis. Results: Four key difference-makers distinguished more successful sites (GO score ≥6) from others: routines for ordering inpatient OSA tests, patient care coordination during hospitalization, involvement of field staff, and strong local champions. The ability to order and complete sleep studies was crucial for timely OSA diagnosis. Field staff (e.g., respiratory technicians, polysomnographic technologists, research) played a critical role in coordinating care during inpatient stays and post-discharge. Key pathways to success included active field staff engagement and strong champion support, particularly in the final phase. Less successful sites faced barriers like geographic separation and staff shortages. The figure describes the values for each of these factors at the 4 more successful versus 2 less successful sites. Conclusions: The study highlights the importance of flexibility in integrating new practices, particularly in stroke care requiring multi-specialty coordination. Findings provide a roadmap for healthcare systems implementing similar interventions, emphasizing leadership, coordinated care, and robust tracking for program success.

News Brief: Alaska nurses fight virtual nurse care model as staff shortage solution.

News Brief: Alaska nurses fight virtual nurse care model as staff shortage solution.

Can a Projected Image Test Replace the Traditional Gross Anatomy Spot Test?

Introduction: Conducting traditional gross anatomy spot (spotter/tag) (3D) in the laboratory is becoming increasingly difficult due to the large number of students and shortage of staff. This study aimed to assess the practicality of conducting projected gross anatomy image test (2D) conducted in a lecture hall for first year medical undergraduates and assessing their performance and attitudes towards this form of testing. Material and Methods: First-year medical undergraduates were subject to two forms of gross anatomy testing in the form of traditional spot test (3D) and projected gross anatomy image test (2D). An online questionnaire was administered to the students to gain information regarding their attitudes regarding the two types of examinations. Descriptive analysis and one-sample T-test was used to compare the results . Results: Sample consisted of 248 students. There were 149 females (60%). Mean age in years was 21.34 (SD=2.3). The mean projected image test scores out of hundred was 70% (SD=3.14). The mean score for the OSPE component of the Y1S1 examination was 63.3% (SD=4.11). The observe difference in the means was statistically significant (p<0.001). Conclusion: While the projected gross anatomy image test (2D) was less time consuming and easy to setup and the students performed better in it they prefer the gross anatomy spot (3D) type of test. Both types have their advantages and disadvantages and maybe used in combination to reduce examination time and invigilator requirements.

Quality Improvement in Nursing Care: A Comprehensive Review of Strategies and Interventions

Nursing care quality plays a pivotal role in ensuring positive patient outcomes and enhancing overall healthcare delivery. This comprehensive review aims to explore and evaluate effective strategies and interventions that contribute to quality improvement in nursing care. By analyzing studies published between 2015 and the present, this review identifies key approaches, including patient-centered care, professional development programs, quality improvement frameworks (e.g., Lean and Six Sigma), technological advancements, and collaborative care models. The findings reveal that implementing evidence-based practices, fostering continuous professional training, and adopting innovative technologies significantly enhance nursing efficiency, reduce medical errors, and improve patient satisfaction. Furthermore, interdisciplinary collaboration and organizational support are crucial in overcoming barriers such as staff shortages and resistance to change. This review highlights the need for integrating these strategies into healthcare systems to promote sustainable improvements in nursing care quality and recommends further research to address existing challenges and gaps. By offering actionable insights and practical recommendations, this review contributes to the advancement of nursing practices and supports the delivery of safe, effective, and patient-centered care.

Experiences of nurses and patients with the implementation of the CCMDD programme

Background: The Central Chronic Medicines Dispensing and Distribution (CCMDD) programme has good benefits for both patients with chronic conditions and nurses if it is effectively implemented. In most of the Sekhukhune Primary Health Care (PHC) facilities, the implementation of the CCMDD programme has been highly challenging but at the same time very beneficial.Aim: The purpose of this study was to describe the experiences of nurses and patients following the implementation of the CCMDD programme in Sekhukhune clinics.Setting: Nine of the Sekhukhune district clinics in Limpopo province, South Africa, were used as study sites.Methods: The qualitative research approach with a descriptive and explorative research design was used in this study. Data were acquired through 45 one-on-one semi-structured interviews, with Sekhukhune PHC nurses managing the CCMDD programme and patients with chronic conditions who are enrolled in the programme, and then analysed thematically.Results: Positive experiences included overcrowding and workload reduction, saving of time and money for transport, improves medication adherence, reduction in incidents of file loss, reduction in patient waiting times, preservation of clinic drug supplies and easy and convenience. However, negative experiences such as shortage of staff, the lack of communication and information on the CCMDD programme hindered the effectiveness of the CCMDD programme.Conclusion: Both nurses and patients of Sekhukhune PHC facilities had positive and negative experiences with regard to the implementation of the CCMDD programme; hence, strategies to improve the programme are needed to be developed.Contribution: The study contributes by providing recommendations for nurse training in the CCMDD programme, in order to improve service delivery processes of the implementation of the CCMDD programme in Sekhukhune PHC facilities.

Exploring the lived experiences of diagnostic radiographers after transitioning to non-emergency imaging settings.

The demand for diagnostic imaging in emergency clinical settings has increased in recent years, placing pressure on the available workforce. However, challenges including staff shortages and inflexible shift patterns may prompt radiographers to leave emergency settings. This study explores the lived experiences of radiographers who have transitioned to non-emergency settings and factors that might influence their decision to return. A descriptive phenomenological approach was used. Semi-structured interviews were conducted with 12 diagnostic radiographers working in the UK, who had transitioned to non-emergency settings within the last one to five years. Participants provided insight into (1) the past: reasons for transitioning, (2) the present: current thoughts on wellbeing and professional development, and (3) the future: possibility of returning to the emergency setting. Occupational pressures including excessive workloads, physical exhaustion, and time constraints leading to moral distress, were commonly cited reasons for transitioning to non-emergency setting. Since transitioning, participants reported improvement in their physical and mental well-being, renewed job satisfaction, and enhanced work-life balance. Career advancement opportunities, a better work environment, competitive salaries, and improved mental health support, could encourage a return to the emergency setting. This study highlights the valuable learning experiences that emergency settings offer diagnostic radiographers, greatly enhancing their skills and overall competence. However, challenging work conditions can lead to job dissatisfaction and burn out. Instead of leaving the profession altogether, some radiographers found renewed satisfaction by transitioning to non-emergency settings. The majority of participants would consider returning to emergency imaging under the right conditions. Flexibility regarding work arrangements, career advancement opportunities, competitive salary offers, and improved mental health support through interventions such as debriefing, could help retain radiographers in emergency settings.

Rethinking housekeeping job quality: insights from hotel housekeepers and managers

ABSTRACT This study explored how hotel housekeepers perceived their job quality. A mixed-method approach was employed to gather insights from 645 Taiwanese hotel housekeepers. Follow-up interviews were conducted with sixteen senior human resources managers and executive housekeepers. The content analysis revealed twelve common factors influencing hotel housekeepers’ positive or negative perceptions of their jobs. The housekeeping job quality paradigm developed from this study indicates that, despite being perceived as undesirable, housekeepers can maintain a positive view of their work when their physiological and psychological needs are met. Managers believe that the role of hotel housekeeping will become increasingly important in the future. It is expected that the housekeeping staffing shortage will worsen. They suggested that addressing the needs of housekeepers, raising their salaries, and adopting management practices that respect employees are essential to maintaining a sustainable workforce.

Responding to daily volume surges in real time in an academic setting: the "Ad Hoc" shift.

Staffing shortages and increased radiology study volumes have led to higher workloads and increased rates of burnout among pediatric radiologists. These conditions are exacerbated by daily fluctuations in study volumes which can occur due to a plethora of reasons and can often be unpredictable. Current solutions involve increasing staffing numbers and offsetting certain specialized studies to other subspecialties. However, these solutions can be costly and impractical. Therefore, we devised a dynamic, flexible two-hour shift called the Ad Hoc shift in which a designated pediatric radiologist dubbed as the "maestro" assesses the body division workflow in real-time and decides whether to recruit additional radiologists during high study volumes. In this paper, we discuss the protocol of the proposed Ad Hoc shift, along with preliminary results from our institution after a year of implementation. Additionally, we discuss its advantages and address some considerations that may arise during the implementation process.

Механизмы стимулирования деятельности малого и среднего бизнеса в странах БРИКС

Small and medium-sized businesses in all countries contribute to the creation of an optimal competitive envi-ronment, provide conditions for increasing employment, and have a significant incentive for innovation. The study of mechanisms to stimulate the activities of small and medium-sized businesses in the BRICS countries allows us to identify the problems of development of this segment of the economy. The paper analyzes in de-tail the areas of financial, property, information, and consulting support for SME companies in the BRICS coun-tries, including in the field of employee training and innovation. The results showed that in each BRICS country, measures are being carried out and implemented in various areas of SME support, which has a positive effect on the level of contribution of small and medium-sized businesses to the country’s GDP. In order to receive appropriate support, small and medium-sized businesses must carefully determine their size and characteris-tics in order to meet the established criteria for this type of company. It is recommended to create clusters of SMEs as a basis for the formation of value chains and obtaining a synergistic effect. The transition to digital technologies will allow SMEs to solve the issues of staff shortages and ensure access to many resources.

The role of SAI in the context of war: evidence from Ukraine

PurposeThe purpose of this article is to enrich the knowledge of international practitioners and academics on the role of the Supreme Audit Institution (SAI) under substantial crisis conditions. For this, we analyse the case of the Ukrainian SAI affected by the war.Design/methodology/approachThis is a viewpoint of Ukrainian practitioners and academics that is built on official documentation and reports, as well as experiences of practitioners directly engaged in the activities of the SAI.FindingsThis study shows the role of the Ukrainian SAI before the war and discusses how it has changed during the war and what have been the main challenges. The multi-faceted challenges faced by the Ukrainian SAI (staff shortages, disrupted operations, limited access to documents, and increased focus on defence and humanitarian audits) caused a shift towards risk-based approaches, accelerated adoption of the International Standards of Supreme Audit Institutions (ISSAI) and strengthened international collaboration. We forecast that the role of the SAI will become even more prominent in the future reconstruction phase.Practical implicationsUsing Ukrainian experience as a case, the paper exemplifies actions required to maintain public accountability and governance, even amidst significant disruption and uncertainty.Originality/valueTo our knowledge, this is the first practitioners’ paper written about the experience of SAIs operating under war conditions.

Vital signs-based healthcare kiosks for screening chronic and infectious diseases: a systematic review

BackgroundIncreasing demands, such as the COVID-19 pandemic, have presented substantial challenges to global healthcare systems, resulting in staff shortages and overcrowded emergency rooms. Health kiosks have emerged as a promising solution to improve overall efficiency and healthcare accessibility. However, although kiosks are commonly used worldwide for access to information and financial services, the health kiosk industry, valued at $800 million, accounts for just 1.9% of the $42 billion global kiosk market. This review aims to bridge the research-to-practice gap by examining the development of health kiosk technology from 2013 to 2023.MethodsWe conducted a systematic search across PubMed, IEEE Xplore, and Google Scholar databases, identifying 5,537 articles, with 36 studies meeting inclusion criteria for detailed analysis. We evaluated each study based on kiosk purpose, targeted diseases, measured vital signs, and user demographics, along with an assessment of limitations in participant selection and data reporting.ResultsThe findings reveal that blood pressure is the most frequently measured vital sign, utilized in 34% of the studies. Furthermore, cardiovascular disease detection emerges as the primary motivation in 56% of the included studies. The United States, India, and the United Kingdom are notable contributors, accounting for 43% of the reviewed articles. Our assessment reveals considerable limitations in participant selection and data reporting in many studies. Additionally, several research gaps remain, including a lack of performance testing, user experience evaluation, clinical intervention, development standardization, and inadequate sanitization protocols.ConclusionsThis review highlights health kiosks’ potential to ease the burden on healthcare system and expand accessibility. However, widespread adoption is hindered by technical, regulatory, and financial challenges. Addressing these barriers could enable health kiosks to play a greater role in early disease detection and healthcare delivery.

Pandemic-Era School Staff Shortages: Evidence from Unfilled Position Data in Illinois

Abstract Concerns about school staff shortages are longstanding. However, data on shortages are limited, dated, and rare for non-teaching staff. I use administrative data on unfilled certificated positions in Illinois public schools from the fall of 2022 to paint a detailed picture of shortages across teaching, administrative, and other roles, between districts, and between schools. Teacher and administrator shortage rates are low on average, but shortages of other staff - mostly paraprofessionals - are more severe. However, staff-to-student ratios have increased recently for all staff types. Shortages vary substantially between schools within districts and across urbanicity, grade level, and student characteristics, often in ways that likely exacerbate inequities.

Human–robot interactions and experiences of staff and service robots in aged care

The rise of robotics in aged care is transforming how older adults are cared for, addressing staff shortages and workload. Daily interactions with staff and residents highlight an urgent need to better understand and improve human–robot interactions. This study investigates how 34 staff interacted with 10 service robots in a regional Australian aged care facility over 5 years, focusing primarily on their experience with service robots that transported meals and laundry. Guided by the Almere model, the research employs a qualitative case study approach, drawing on observations, focus groups, and interviews with management, industry leaders, and frontline staff. Findings are categorised into Emotional Reactions, Human–Robot Interaction and Collaboration, Social License and Environmental Dynamics. Results indicate conditional acceptance of service robots with scepticism about the service robots’ reliability and practical utility. Our study highlights the importance of a supportive environment, robust infrastructure and adequate training for successful robotic adoption. It also argues for engaging diverse multi-tiered stakeholders in investigating, designing, and implementing robotics in aged care, emphasising the role of social behaviours and interactions for what we propose as functional social service robots.

Enhancing Real-Time Patient Monitoring in Intensive Care Units with Deep Learning and the Internet of Things.

The demand for intensive care units (ICUs) is steadily increasing, yet there is a relative shortage of medical staff to meet this need. Intensive care work is inherently heavy and stressful, highlighting the importance of optimizing these units' working conditions and processes. Such optimization is crucial for enhancing work efficiency and elevating the level of diagnosis and treatment provided in ICUs. The intelligent ICU concept represents a novel ward management model that has emerged through advancements in modern science and technology. This includes communication technology, the Internet of Things (IoT), artificial intelligence (AI), robotics, and big data analytics. By leveraging these technologies, the intelligent ICU aims to significantly reduce potential risks associated with human error and improve patient monitoring and treatment outcomes. Deep learning (DL) and IoT technologies have huge potential to revolutionize the surveillance of patients in the ICUs due to the critical and complex nature of their conditions. This article provides an overview of the most recent research and applications of linical data for critically ill patients, with a focus on the execution of AI. In the ICU, seamless and continuous monitoring is critical, as even little delays in patient care decision-making can result in irreparable repercussions or death. This article looks at how modern technologies like DL and the IoT can improve patient monitoring, clinical results, and ICU processes. Furthermore, it investigates the function of wearable and advanced health sensors coupled with IoT networking systems, which enable the secure connection and analysis of various forms of patient data for predictive and remote analysis by medical professionals. By assessing existing patient monitoring systems, outlining the roles of DL and IoT, and analyzing the benefits and limitations of their integration, this study hopes to shed light on the future of ICU patient care and identify opportunities for further research.

“If You’re Being Forced, You’re Being Forced”: A Qualitative Examination of How Overtime Affects Correctional Officers

Canadian correctional institutions operate with insufficient staffing levels, leading to occupational stress that negatively affects prisons’ overall functioning as well as staff and incarcerated people’s wellness. The literature suggests a direct correlation between staffing levels and correctional officer (CO) wellness, but little is known about the nuances of the effects of forced overtime on COs’ well-being. Drawing on the job demand–control–support (JDCS) model, our qualitative study examines, through semi-structured interviews with federally employed COs in Canada ( n = 93), how overtime affects the health and wellness of COs in concrete and discursive ways. Findings focus on the relationship between staff shortages, overtime, mental health, and a perceived lack of agency in accordance with the JDCS model. Practical implications and potential strategies to mediate the effects of forced overtime in correctional spaces are discussed.

Identifying the Added Value and Requirements of Telerehabilitation in Home-based Geriatric Rehabilitation: An Exploratory Qualitative Study

Geriatric rehabilitation (GR) facilities are turning to innovative tools such as telerehabilitation to support home-based treatment due to challenges with population ageing, staff shortages, and mounting budgetary pressures. This study identified the potential added value as well as the requirements of using telerehabilitation in home-based GR, according to stakeholders and potential end-users. This exploratory qualitative study design conducted semi-structured interviews among nineteen care professionals, three patients and one informal caregiver. The qualitative data from these interviews were transcribed verbatim and analysed with inductive content analysis. Interviewees indicated multiple added values and requirements for telerehabilitation in home-based GR. Overall, there was great emphasis on blended care implementation,in which telerehabilitation is used in conjunction with in-person care. It is recommended to use the present findings towards developing and implementing a telerehabilitation intervention in home-based GR and assess its feasibility and usability.