Burnout among nursing home care aides and the effects on resident outcomes

While burnout among health care workers has been well studied, little is known about the extent to which burnout among health care workers impacts the outcomes of their care recipients. To test this, we used a multi-year (2014-2020) survey of care aides working in approximately 90 nursing homes (NHs); the survey focused on work-life measures, including the Maslach Burnout Inventory (MBI) and work-unit identifier. Resident Assessment Instrument Minimum Data Set (RAI-MDS 2.0) data were obtained on all residents in the sampled NHs during this time and included a unit identifier for each resident. We used multi-level models to test associations between the MBI emotional exhaustion and cynicism sub-scales reported by care aides and the resident outcomes of antipsychotics without indication, depressive symptoms, and responsive behaviors among residents on units. In 2019/2020, our sample included 3,547 care aides and 10,117 residents in 282 units. The mean frequency of emotional exhaustion and cynicism across units was 43% and 50%, respectively. While residents frequently experienced antipsychotics without indication 1,852 (18.3%), depressive symptoms 2,089 (20.7%), and responsive behaviors 3,891 (38.5%), none were found to be associated with either emotional exhaustion or cynicism among care aides.</p

Simultaneous Softening of sigma and rho Mesons associated with Chiral Restoration

Complex poles of the unitarized pi-pi scattering amplitude in nuclear matter are studied. Partial restoration of chiral symmetry is modeled by the decrease of in-medium pion decay constant f*_{pi}. For large chiral restoration (f*_{pi}/f_{pi} << 1), 2nd sheet poles in the scalar (sigma) and the vector (rho) mesons are both dictated by the Lambert W function and show universal softening as f*_{pi} decreases. In-medium pi-pi cross section receives substantial contribution from the soft mode and exhibits a large enhancement in low-energy region. Fate of this universality for small chiral restoration (f*_{pi}/f_{pi} ~ 1) is also discussed.Comment: 5 pages, 4-eps figures, version accepted by Phys. Rev. C (R) with minor modification

30th anniversary commentary on MacGuire J.M. (1990) - Putting nursing research findings into practice: research utilization as an aspect of the management of a change. Journal of Advanced Nursing 15, 614-620

The definitive version is available at www.blackwell-synergy.comAlan Pearso

Contextually appropriate nurse staffing models: a realist review protocol

Introduction: Decisions about nurse staffing models are a concern for health systems globally due to workforce retention and well-being challenges. Nurse staffing models range from all Registered Nurse workforce to a mix of differentially educated nurses and aides (regulated and unregulated), such as Licensed Practical or Vocational Nurses and Health Care Aides. Systematic reviews have examined relationships between specific nurse staffing models and client, staff and health system outcomes (eg, mortality, adverse events, retention, healthcare costs), with inconclusive or contradictory results. No evidence has been synthesised and consolidated on how, why and under what contexts certain staffing models produce different outcomes. We aim to describe how we will (1) conduct a realist review to determine how nurse staffing models produce different client, staff and health system outcomes, in which contexts and through what mechanisms and (2) coproduce recommendations with decision-makers to guide future research and implementation of nurse staffing models. Methods and analysis: Using an integrated knowledge translation approach with researchers and decision-makers as partners, we are conducting a three-phase realist review. In this protocol, we report on the final two phases of this realist review. We will use Citation tracking, tracing Lead authors, identifying Unpublished materials, Google Scholar searching, Theory tracking, ancestry searching for Early examples, and follow-up of Related projects (CLUSTER) searching, specifically designed for realist searches as the review progresses. We will search empirical evidence to test identified programme theories and engage stakeholders to contextualise findings, finalise programme theories document our search processes as per established realist review methods. Ethics and dissemination: Ethical approval for this study was provided by the Health Research Ethics Board of the University of Alberta (Study ID Pro00100425). We will disseminate the findings through peer-reviewed publications, national and international conference presentations, regional briefing sessions, webinars and lay summary