المؤلفون: Furuya, Shiro, Liu, Jihua, Sun, Zhongxuan, Lu, Qiongshi, Fletcher, Jason M.

المصدر: Demography, 2023 Dec 01. 60(6), 1631-1648.

الوصول الحر: https://www.jstor.org/stable/48770209Test

المؤلفون: Furuya, Shiro, Liu, Jihua, Sun, Zhongxuan, Lu, Qiongshi, Fletcher, Jason M.

المصدر: Demography, 2023 Dec 01. 60(6), 1649-1664.

الوصول الحر: https://www.jstor.org/stable/48770210Test

المؤلفون: Zhong, Jie, Simpson, Kathleen, Fletcher, Jason, Landstrom, Gay, Lyndon, Audrey, Spetz, Joanne, Gay, Caryl

المصدر: Journal of Patient Safety. 19(3)

مصطلحات موضوعية: Humans, Patient Safety, Nursing Staff, Hospital, Cross-Sectional Studies, Surveys and Questionnaires, Nursing Care

الوصف: OBJECTIVE: This study aimed to explore the association of nurses perceptions of patient safety climate with missed nursing care in labor and delivery (L&D) units. METHODS: We recruited nurse respondents via email distribution of an electronic survey between February 2018 and July 2019. Hospitals with L&D units were recruited from states with projected availability of 2018 state inpatient data in the United States. Measures included the Safety Attitudes Questionnaire Safety Climate Subscale and the Perinatal Missed Care Survey. We estimated the relationship between safety climate and missed care using Kruskal-Wallis tests and mixed-effects linear regression. RESULTS: The analytic sample included 3429 L&D registered nurses from 253 hospitals (response rate, 35%). A majority of respondents (65.7%) reported a perception of good safety climate in their units, with a mean score of 4.12 (±0.73) out of 5. The mean number of aspects of care occasionally, frequently, or always missed on respondents units was 11.04 (±6.99) out of 25. χ2 Tests showed that six mostly commonly missed aspects of care (e.g., timely documentation) and three reasons for missed care (communications, material resources, and labor resources) were associated with safety climate groups ( P < 0.001). The adjusted mixed-effects model identified a significant association between better nurse-perceived safety climate and less missed care ( β = -2.65; 95% confidence interval, -2.97 to -2.34; P < 0.001) after controlling for years of experience and highest nursing education. CONCLUSIONS: Our findings suggest that improving safety climate-for example, through better teamwork and communication-may improve nursing care quality during labor and birth through decreasing missed nursing care. Conversely, it is also possible that strategies to reduce missed care-such as staffing improvements-may improve safety climate.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/6pr3w5b2Test

المؤلفون: Simpson, Kathleen, Fletcher, Jason, Landstrom, Gay, Lyndon, Audrey, Spetz, Joanne, Gay, Caryl

المصدر: Nursing Outlook. 71(3)

مصطلحات موضوعية: High risk, Hospital, Hospitals, Hospitals, Teaching, Inpatients, Nursing staff, Obstetric nursing, Personnel staffing, Pregnancy, Workforce, Infant, Newborn, Humans, Pregnancy, Female, Cross-Sectional Studies, Personnel Staffing and Scheduling, Nursing Staff, Hospital, Hospitals, Workforce

الوصف: BACKGROUND: Evidence is limited on nurse staffing in maternity units. PURPOSE: To estimate the relationship between hospital characteristics and adherence with Association of Womens Health, Obstetric and Neonatal Nurses nurse staffing guidelines. METHODS: We enrolled 3,471 registered nurses in a cross-sectional survey and obtained hospital characteristics from the 2018 American Hospital Association Annual Survey. We used mixed-effects linear regression models to estimate associations between hospital characteristics and staffing guideline adherence. FINDINGS: Overall, nurses reported strong adherence to AWHONN staffing guidelines (rated frequently or always met by ≥80% of respondents) in their hospitals. Higher birth volume, having a neonatal intensive care unit, teaching status, and higher percentage of births paid by Medicaid were all associated with lower mean guideline adherence scores. DISCUSSION AND CONCLUSIONS: Important gaps in staffing were reported more frequently at hospitals serving patients more likely to have medical or obstetric complications, leaving the most vulnerable patients at risk.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/5gr7863dTest

المؤلفون: Fletcher, Jason M., Schwarz, Hans, Engelman, Michal, Johnson, Norman J., Hakes, Jahn, Palloni, Alberto

المصدر: Demography, 2023 Apr 01. 60(2), 351-377.

الوصول الحر: https://www.jstor.org/stable/48720253Test

المؤلفون: Lyndon, Audrey, Simpson, Kathleen Rice, Spetz, Joanne, Zhong, Jie, Gay, Caryl L, Fletcher, Jason, Landstrom, Gay L

المصدر: Nursing Research. 71(6)

مصطلحات موضوعية: Health Services and Systems, Midwifery, Nursing, Health Sciences, Breast Cancer, Cancer, Perinatal Period - Conditions Originating in Perinatal Period, Clinical Research, Preterm, Low Birth Weight and Health of the Newborn, Infant Mortality, Pediatric, 8.1 Organisation and delivery of services, Health and social care services research, Reproductive health and childbirth, Good Health and Well Being, Infant, Newborn, United States, Female, Humans, Pregnancy, Personnel Staffing and Scheduling, Breast Feeding, Milk, Human, Nursing Staff, Hospital, Maternal Health Services, Workforce, childbirth, human milk feeding, missed nursing care, nurse-sensitive patient outcomes, nurse staffing

الوصف: BackgroundNursing care is essential to overall quality of healthcare experienced by patients and families-especially during childbearing. However, evidence regarding quality of nursing care during labor and birth is lacking, and established nurse-sensitive outcome indicators have limited applicability to maternity care. Nurse-sensitive outcomes need to be established for maternity care, and prior research suggests that the initiation of human milk feeding during childbirth hospitalization is a potentially nurse-sensitive outcome.ObjectiveThe aim of this study was to determine the relationship between nurse-reported staffing, missed nursing care during labor and birth, and exclusive breast milk feeding during childbirth hospitalization as a nurse-sensitive outcome.Methods2018 Joint Commission PC-05 Exclusive Breast Milk Feeding rates were linked to survey data from labor nurses who worked in a selected sample of hospitals with both PC-05 data and valid 2018 American Hospital Association Annual Survey data. Nurse-reported staffing was measured as the perceived compliance with Association of Women's Health, Obstetric and Neonatal Nurses staffing guidelines by the labor and delivery unit. Data from the nurse survey were aggregated to the hospital level. Bivariate linear regression was used to determine associations between nurse and hospital characteristics and exclusive breast milk feeding rates. Generalized structural equation modeling was used to model relationships between nurse-reported staffing, nurse-reported missed care, and exclusive breast milk feeding at the hospital level.ResultsThe sample included 184 hospitals in 29 states and 2,691 labor nurses who worked day, night, or evening shifts. Bivariate analyses demonstrated a positive association between nurse-reported staffing and exclusive breast milk feeding and a negative association between missed nursing care and exclusive breast milk feeding. In structural equation models controlling for covariates, missed skin-to-skin mother-baby care and missed breastfeeding within 1 hour of birth mediated the relationship between nurse-reported staffing and exclusive breast milk feeding rates.DiscussionThis study provides evidence that hospitals' nurse-reported compliance with Association of Women's Health, Obstetric and Neonatal Nurses staffing guidelines predicts hospital-exclusive breast milk feeding rates and that the rates are a nurse-sensitive outcome.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/1xm98806Test

المؤلفون: Fletcher, Jason, Wu, Yuchang, Li, Tianchang, Lu, Qiongshi

المساهمون: Wang, Heming, National Institute on Aging

المصدر: PLOS ONE ; volume 19, issue 2, page e0282212 ; ISSN 1932-6203

الوصف: Researchers often claim that sibling analysis can be used to separate causal genetic effects from the assortment of biases that contaminate most downstream genetic studies (e.g. polygenic score predictors). Indeed, typical results from sibling analysis show large (>50%) attenuations in the associations between polygenic scores and phenotypes compared to non-sibling analysis, consistent with researchers’ expectations about bias reduction. This paper explores these expectations by using family (quad) data and simulations that include indirect genetic effect processes and evaluates the ability of sibling analysis to uncover direct genetic effects of polygenic scores. We find that sibling analysis, in general, fail to uncover direct genetic effects; indeed, these models have both upward and downward biases that are difficult to sign in typical data. When genetic nurture effects exist, sibling analysis creates “measurement error” that attenuates associations between polygenic scores and phenotypes. As the correlation between direct and indirect effect changes, this bias can increase or decrease. Our findings suggest that interpreting results from sibling analysis aimed at uncovering direct genetic effects should be treated with caution.

الإتاحة: https://doi.org/10.1371/journal.pone.0282212Test

المؤلفون: Topping, Michael, Fletcher, Jason

المساهمون: University of Wisconsin-Madison, NIA

المصدر: Social Science & Medicine ; volume 346, page 116692 ; ISSN 0277-9536

مصطلحات موضوعية: History and Philosophy of Science, Health (social science)

الإتاحة: https://doi.org/10.1016/j.socscimed.2024.116692Test
https://api.elsevier.com/content/article/PII:S0277953624001369?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S0277953624001369?httpAccept=text/plainTest

المؤلفون: Dunn Navarra, Ann-Margaret, Gormley, Maurade, Liang, Eva, Loughran, Claire, Vorderstrasse, Allison, Garcia, David R., Rosenberg, Michael G., Fletcher, Jason, Goldsamt, Lloyd A.

المساهمون: National Institute of Nursing Research, National Institutes of Health

المصدر: PEC Innovation ; volume 4, page 100263 ; ISSN 2772-6282

الإتاحة: https://doi.org/10.1016/j.pecinn.2024.100263Test
https://api.elsevier.com/content/article/PII:S2772628224000116?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S2772628224000116?httpAccept=text/plainTest

المؤلفون: Fletcher, Jason, Noghanibehambari, Hamid

المساهمون: National Institute on Aging

المصدر: Journal of Environmental Economics and Management ; volume 123, page 102903 ; ISSN 0095-0696

مصطلحات موضوعية: Management, Monitoring, Policy and Law, Economics and Econometrics

الإتاحة: https://doi.org/10.1016/j.jeem.2023.102903Test
https://api.elsevier.com/content/article/PII:S0095069623001213?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S0095069623001213?httpAccept=text/plainTest