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Relationship Between Nurse Staffing During Labor and Cesarean Birth Rates in US Hospitals
03-01-25
Highlights:
The U.S. cesarean birth rate was 32.4% in 2023 and continues to increase each year.
Avoiding morbidity and mortality risk associated with cesarean birth is critical.
RN staffing during labor and birth is linked to cesarean rates.
RN staffing aligned with national standards...
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Physicians’ Perspectives on Using Direct Observation to Assess Non-English Language Proficiency for Clinical Practice: A Qualitative Study
11-20-24
Communication barriers are known to adversely affect patient safety. Yet few health systems assess and track physician non-English language proficiency for use in clinical settings. Barriers to current assessments (usually simulated clinician oral proficiency interviews) include time constraints...
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Cancer Registrar Workload and Staffing Study: Guidelines for Hospitals Cancer Registry Programs
10-30-24
Cancer registrars are vital to cancer surveillance -- the work includes collecting, coding, reporting, and curating national cancer data that are used to create national statistical data about cancer epidemiology and treatment.
However, cancer registrars are often considered a nonrevenue-producing...
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Systematically Assessing the Quality of Dental Electronic Health Record Data for an Investigation into Oral Health Care Disparities
04-24-24
Objectives: This work describes the process by which the quality of electronic health care data for a public health study was determined. The objectives were to adapt, develop, and implement data quality assessments (DQAs) based on the National Institutes of Health Pragmatic Trials Collaboratory (...
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Patients’ Experiences of Dental Diagnostic Failures: A Qualitative Study Using Social Media
04-15-24
Objective: Despite the many advancements made in patient safety over the past decade, combating diagnostic errors (DEs) remains a crucial, yet understudied initiative toward improvement. This study sought to understand the perception of dental patients who have experienced a dental diagnostic...
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Training Home Care Workers Reduces Emergency Room Service Utilization
03-01-24
Research by Susan A. Chapman and colleagues explored whether enhanced care training provided to trained home care workers would result in better client health outcomes. The researchers studied home-based personal care services provided through California’s IHSS program to compare IHSS consumers...
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Quality Measure Adherence and Oral Health Outcomes in Children
01-30-24
IMPORTANCE: Process-based quality measures are generally intended to promote evidence-based practices that have been proven to improve outcomes. However, due to lack of standardized implementation of diagnostic codes in dentistry, assessing the association between process and oral health outcomes...
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The Association Between Cognitive Ability and Opioid Prescribing in Vulnerable Older Adults with Chronic Pain in Ambulatory Care
11-16-23
Background: Vulnerable older adults living with Alzheimer’s disease or Alzheimer’s disease and related dementia (AD/ADRD) and chronic pain generally receive fewer pain medications than individuals without AD/ADRD, especially in nursing homes. Little is known about pain management in older adults...
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Racial-Ethnic Composition of Primary Care Practices and Comprehensive Primary Care Plus Initiative Participation
03-20-23
It remains unclear whether the racial-ethnic composition or the socioeconomic profiles of eligible primary care practices better explain practice participation in the Centers for Medicare and Medicaid Services’ (CMS) Comprehensive Primary Care Plus (CPC+) program.
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"Long Overdue": Nurse and Resident Physician Perspectives on Implementation of Dual-Handset Interpreter Phones in the Inpatient Setting
02-16-23
Patients with language barriers suffer significant health disparities, including adverse events and poor health outcomes. While remote language services can help improve language access, these modalities remain persistently underused. The objective of this study was to understand clinician...
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Linking Patient Safety Climate With Missed Nursing Care in Labor and Delivery Units: Findings From the LaborRNs Survey
01-13-23
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. We recruited nurse respondents via email distribution of an electronic survey between February 2018 and July 2019. Hospitals with L&D...
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Alzheimer’s Disease Services, Staffing, and Outcomes in Adult Day Health Centers
01-06-23
Increasing rates of Alzheimer disease and related dementia (ADRD) has resulted in greater reliance on adult day health centers (ADHCs) and their skilled workforce. Little is known about staffing in ADHCs that provide ADRD services compared with ADHCs that do not. This study examines whether there...
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Teledentistry Trends in the United States During the COVID-19 Pandemic
10-24-22
This report reviews the use of teledentistry following the COVID-19 pandemic in 4 states—California, Maine, Pennsylvania, and Wisconsin—and the supports needed to enhance dental care in a post-COVID-19 world. States were selected for case studies based on the following parameters: existence of...
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Physician and Nurse Practitioner Teamwork and Job Satisfaction: Gender and Profession
09-08-22
Designing interprofessional primary care teams composed of physicians and nurse practitioners (NPs) is a national priority. We assessed how profession and gender affect teamwork and job satisfaction among primary care physicians and NPs by using survey data from 186 physicians and 398 NPs...
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Policy Considerations for Routine Screening for Adverse Childhood Events (ACEs)
07-01-22
In October of 2021, California mandated commercial insurance coverage of screening for adverse childhood experiences (ACEs) in addition to ACEs screening already covered for the Medi-Cal enrollees. California is the first state to expand ACEs screening coverage, but it is possible other states may...
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A Toolkit to Advance Racial Health Equity in Primary Care Improvement
04-21-22
The California Improvement Network (CIN) is focused on effectively integrating equity into health care improvement projects. Informed by its Racial Health Equity Workgroup and developed in partnership with HealthBegins, this practical toolkit is designed to help health care organizations —...
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Prescribing Patterns in Nursing Home Residents Living with Dementia by Specialty and Provider Type
04-04-22
Objective/Issue
Little is known about the contributions of different provider specialties in prescribing medications for nursing home residents living with dementia. In this study, we examine prescribing patterns for common psychiatric medications and for opioid and non-opioid analgesics in long-...
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Geriatric Medicine: Restraints and Immobility (Chapter 118)
02-22-22
Pathy’s Principles and Practice of Geriatric Medicine, Sixth Edition delivers a comprehensive overview of the subject, offering up-to-date, evidence-based, information about the many, and varied, problems suffered by ageing patients. In this latest edition, the authors take a refreshed approach to...
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A Longitudinal Cohort Study of Opioid Prescriptions Associated with Nonsurgical Dental Visits Among Oregon and New York State Medicaid Beneficiaries, 2014-2016
02-10-22
Studies estimate that approximately one-third of all opioid prescriptions (Rxs) from dentists are associated with nonsurgical dental procedures, which suggests unwarranted opioid use. The authors conducted a retrospective longitudinal cohort study of adult Medicaid beneficiaries using...
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Psychometric Properties of the Perinatal Missed Care Survey and Missed Care During Labor and Birth
02-01-22
Kalisch and colleagues developed one of the reliable and valid measures of missed nursing care, the MISSCARE survey, which has been used extensively in medical surgical care and has been adapted to pediatric and neonatal intensive care. Our team previously adapted the MISSCARE Survey for the labor...
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CIN Connections, Winter 2022 — Centering Equity in Health Care Improvement
01-11-22
The California Improvement Network (CIN) is a community of health care professionals committed to identifying and spreading ideas for better primary care delivery. This issue of CIN Connections offers ways to implement quality improvement efforts that intentionally advance health equity in primary...
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Resource Brokering: Efforts to Assist Patients With Housing, Transportation, and Economic Needs in Primary Care Settings
11-01-21
Clinicians and policy makers are exploring the role of primary care in improving patients’ social conditions, yet little research examines strategies used in clinical settings to assist patients with social needs. This study used interviews focused on how organizations develop and implement case...
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Dental Therapists in the United States: Health Equity, Advancing
10-01-21
Dental therapists (DTs) are primary care dental providers, used globally, and were introduced in the United States (US) in 2005. DTs have now been adopted in 13 states and several Tribal nations. This study aimed to qualitatively examine the drivers and outcomes of the US dental therapy movement...
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Recommendations to Deliver Person-Centered Long-Term Care for Persons Living With Dementia
07-02-21
Person-centered care (PCC) is the standard for the delivery of long-term services and supports (LTSS). In this article, we summarize the state of the science on meaningful outcomes and workforce development and discuss what is needed to ensure that person-centered LTSS becomes a universal reality....
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A Systematic Review of the Roles and Contributions of Peer Providers in the Behavioral Health Workforce
06-24-21
Approximately 1 in 5 U.S. adults experienced a mental illness in the past year, a number that is expected to rise amid a shortage of mental health and substance use disorder (SUD) providers. One way to address this growing need for behavioral health services is through the use of peer providers, or...
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Time to Ensure Sufficient Nursing Home Staffing and Eliminate Inequities in Care
05-26-21
The overwhelming nursing home resident infection and death rates from the COVID-19 pandemic has led to the question: What policies can best protect nursing home residents now and in the future? In this article we present data that inadequate nurse staffing levels and high staff turnover rates are...
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Adolescents' Substance Use and Physical Activity Before and During the COVID-19 Pandemic
05-03-21
Stay-at-home policies related to the COVID-19 pandemic could disrupt adolescents’ substance use and physical activity. This study aimed to compare adolescents’ substance use and physical activity behaviors before and after stay-at-home restrictions. In this cohort, a reduction in e-cigarette use...
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Implementing Care Coordination in a Large Dental Care Organization in the United States by Upskilling Front Office Personnel
04-07-21
Care coordination is a key strategy used to improve health outcomes and efficiency, yet there are limited examples in dentistry. A large dental accountable care organization piloted care coordination by retraining existing administrative staff to coordinate the care of high-risk patients. Following...
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The Association Between Scope of Practice Regulations and Nurse Practitioner Prescribing of Buprenorphine After the 2016 Opioid Bill
04-01-21
This article examines the relationship between federal regulations, state scope-of-practice regulations on nurse practitioners (NPs), and buprenorphine prescribing patterns using pharmacy claims data from Optum’s deidentified Clinformatics Data Mart between January 2015 and September 2018. The...
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Health, Quality of Life, and Economic Impacts of Home Care Vouchers for Middle-Income Adults With Disabilities
12-16-20
The Support at Home pilot program provided financial support for the purchase of home care services by middle-income adults with disabilities in San Francisco to support aging in place. The mixed-methods evaluation of the program incorporated administrative records, surveys of clients and...