The Impact a Nurse Recruiter Has on Nursing Staff Shortages and Nurse Manager Satisfaction in an Acute Psychiatric Facility

Abstract Background: Nursing staff shortages have persisted for the last few decades. Strategies to resolve this enduring challenge continue to drive the creative efforts to attract and retain new staff. These shortages not only affect patient care but can also impact the satisfaction of nurse managers. Little information is available on the effects of a nurse recruiter role on nursing staff shortages as well as nurse manager satisfaction. Purpose: The purpose of this project is to assess how implementing a designated nurse recruiter impacts nursing staff shortages and nurse manager satisfaction in an acute psychiatric facility. This project examines two main objectives to: 1) determine the impact of a nurse recruiter on nursing staff shortages in an acute psychiatric facility and 2) examine nurse managers’ perceived satisfaction with the nurse recruiter and outcomes. Methods: Objective 1 was accomplished through a quasi-experimental study using a descriptive pre- and post- intervention with data collected from May 2022 to May 2023 (6 months prior to implementing a nurse recruiter and 6 months after implementing a nurse recruiter) and included the time to fill position rate, cost per hire, and new hire turnover rate of all nursing staff excluding travelers. Objective 2 was accomplished through a descriptive research design using an online survey provided to the nurse managers of the acute psychiatric facility. Results: For objective 1, implementing a nurse recruiter role showed improvements in reducing new hire turnover rate as well as reductions in cost per hire. There was an increase in the time to fill rate for Registered Nurses (RNs) and no major change for mental health associates (MHAs). For objective 2, 75% of nurse managers agreed that the nurse recruiter allowed them more time on the unit and 100% of the managers believe that the nurse recruiter is an asset to the facility, could be beneficial to other facilities, and has had a positive impact on staffing shortages. Only one nurse manager reported having better job satisfaction since implementing the nurse recruiter and none indicated a better work-life balance. Conclusion: Implementing a nurse recruiter role in an acute psychiatric facility can significantly improve staffing shortages and impact turnover rates while reducing costs. Additional research with a larger sample size is needed to determine how a nurse recruiter can better impact nurse manager satisfaction

Co-Infection Studies on Hepatitis C Virus and Malaria Parasite Liver Stages

Malaria and hepatitis C are infectious diseases that affect millions of people worldwide. These two diseases are caused by two different pathogens, Plasmodium parasite for malaria and hepatitis C virus (HCV) for hepatitis C, that share some similarities in their development within the hepatocytes of the liver. Co-infection of these two pathogens has largely remained unstudied, but due to epidemiological overlap, it is plausible that individuals can be afflicted with both malaria and hepatitis C. To date, it has been shown that Plasmodium parasites and HCV utilize four common host entry factors to gain entry into hepatocytes: Heparan sulfate proteoglycans (HSPGs), scavenger receptor-B1 (SR-B1), cluster of differentiation 81 (CD-81), and apolipoprotein E (apoE). ApoE incorporated into new HCV virions plays a key role in viral infectivity. In its entirety, our hypothesis states that given the increasing prevalence of hepatitis C in parts of the world where malaria is endemic, hepatitis C virus (HCV) and Plasmodium spp. Co-infections are a likely occurrence. In this case, it is plausible that co-infections with these pathogens will affect the replication of either pathogen during their liver stages. Furthermore, it is likely that Plasmodium parasites utilize claudin-1, occludin, and apoE host entry factors, which are important for HCV entry and ability to invade hepatocytes. Using an in vitro model of infection in liver derived HuH7 hepatoma cells, we hope to look at the overall affects theses pathogens have on one another through co-infection studies of P. berghei and HCV both together and individually. Furthermore, we hope to examine other host factors that HCV utilizes for entry into hepatocytes and their affect on Plasmodium entry during the liver stages of infection. This study is significant to public health to improve existing anti-malarial and hepatitis C treatments by intervening at the early stages of each pathogen’s development. By understanding how a pathogen enters, invades, and develops within a host, it is better understood how therapeutic drugs can target and decrease pathogenic development

Engineered GAG-based coatings for mesenchymal stem cells

The therapeutic potency of delivered mesenchymal stem cells (MSCs) in tissue engineering applications may be improved by priming cells toward a differentiated state prior to implantation. Mimicking native extracellular matrix (ECM) interactions, the electrostatic attraction between negatively-charged glycosaminoglycans (GAGs such as heparin and chondroitin sulfate) and positively-charged proteins may act to locally sequester factors present in the culture media (or secreted by nearby cells) to further enhance stem cell response to soluble factors prior to cell transplantation for musculoskeletal disorders. In these experiments, we desulfated the GAG heparin and heparin (Hep) and desulfated (Hep-) heparin were biotinylated via HOBT/EDC chemistry. The dimethyl methylene blue (DMMB) assay indicated full removal of sulfate groups in the desulfated heparin. Human mesenchymal stem cells (MSCs) were then coated as single cells in suspension with sulfo-NHS-biotin, avidin and heparin (Hep) or desulfated heparin (Hep-). Coated cells were then aggregated using a centrifugation method. Results demonstrate that MSC aggregates can be coated without negatively affecting cell viability and anti-inflammatory properties (assayed through a monocyte co-culture study; Hep coating only). Positively-charged proteins bind preferentially to the Hep coated cells and an assay with a reporter cell line suggests that the positively-charged transforming growth factor-β1 (a known chondrogenic factor) remains bioactive after sequestration and release from coated cells. In follow-on studies, cells were cultured in serum-free media either with or without the addition of 10ng/mL fibroblast growth factor-2 (FGF-2) and (media changes every 3 days). DNA quantification revealed that heparin-coated MSC aggregates increased in cell number around ~1.5-fold at day 7, while all other groups either decreased in DNA amount (noncoated and noncoated+FGF) or maintained cell number over time (desulfated heparin-coated+FGF). Previous studies have not demonstrated an increase in DNA content of MSC aggregates over time; thus, this novel finding can represent a new culture platform for MSC aggregates. Since only sulfated heparin-coated samples showed increased DNA amount over time, this suggests that there may be interactions between the negatively-charged sulfate groups on the fully-sulfated heparin with the added growth factor. Taken together, these results suggest that GAG-based coatings may be an exciting means to locally sequester soluble factors and enhance MSC response to soluble factors, and that, through chemical removal of the sulfate groups, the scaffolds’ interactions with growth factors may be tuned to promote optimal MSC response for specific culture conditions

Cases of Irideremia Totalis.

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