Sunday, 15 April 2018

Duty rosters - how far ahead should they be made up?

Roger Watson, Editor-in-Chief

When I was a Charge Nurse, the job I hated most was making up the staff roster. You could never please everyone and, of course, if you were making it up then you certainly could not be seen to be pleasing yourself. Planning ahead was vital, but plan too far ahead and then staff had no flexibility; plan to close to the time when the roster was needed and you had less flexibility as staff requests were too numerous. How far ahead is enough and when is the optimum time to plan rosters, especially as staff may then simply take the time off as sick-time anyway and then you are short of staff or have to employ short-term staff to cover?

This article by from the UK by Drake (2018) titled: 'Does longer roster lead‐time reduce temporary staff usage? A regression analysis of e‐rostering data from 77 hospital units' was based on a study the aim of which was to investigate: 'whether longer roster lead-times reduce temporary staff usage.' Over 9 months nearly 700 rosters were examined from 77 hospitals in England. The effect of late roster approvals may contribute to nearly 40% of the use of temporary staff and longer approval time of 4-6 weeks reduced this to 15%. The complexities of the relationship are explained in the article.

The authors conclude: 'Between 2–4 weeks, roster lead-time is inversely proportional to temporary staff usage and reflects the assumed relationship between these two variables. However, beyond 4 weeks’ lead-time, the relationship enters a “plateau” phase where longer lead-time has negligible effect on staffing. At this stage, other factors, such as sickness, absenteeism, type of unit and patient demand pattern, define the lower limit of temporary staff usage. Consequently, this research implies that the optimum approval lead-time lies between 4–6 weeks.

You can listen to this as a podcast

Reference

Drake, R. G. (2018), Does longer roster lead‐time reduce temporary staff usage? A regression analysis of e‐rostering data from 77 hospital units. J Adv Nurs. doi:10.1111/jan.13578

Saturday, 7 April 2018

Menopause and sexual health

Roger Watson, Editor-in-Chief

Menopause is an inevitable feature of ageing in women who live long enough to experience it. Is is accompanied by age induced hormonal changes in the female reproductive tract which indicate the imminent end of fertility and is accompanied in many women with a period - sometime lasting years - of unpleasant side-effects. The most notable and visible of of these being 'hot flushes'. In any population of women the menopause has an impact on sexuality, this is known from research mainly involving western women. But what do we know about this in a relatively sexually conservative society such as the Cantonese Chinese population?

The study described here by Wong et al. (2108) was conducted in Hong Kong and and article titled: 'The Impact of Menopause on the Sexual Health of Chinese Cantonese Women: A Mixed Methods Study' was published recently in JAN. The study explored 'the impact of menopause on sexual health and marital relationships, the associated factors and the support needed among middle-aged and older women' and involved a sample of over 500 women who completed a questionnaire and 30 of whom were interviewed.

There was a high prevalence of sexual dysfunction and this was associated with depression. The effect on the women's sexual lives was negative and the most commonly reported effects of menopause were low sexual drive and vaginal dryness. As one woman said, more specific information about sex, in addition to the other aspects of menopause, needs to be provided: “I think it (information) should be more focused on sexual life. Because there is a lot of other information already. . . like there are videos about hot flashes, etc.. . . But not much about sex for both partners.”

In conclusion the authors say: 'This study gave a context for healthcare workers to better understand the challenges and needs of middle-aged and menopausal women and to ensure the provision of appropriate management of menopause in both clinical and community settings, targeting the family unit instead of women only. Better knowledge of the menopausal transition will enable healthcare service providers to implement appropriate programmes, education and services for different target populations.

You can listen to this as a podcast

Reference

Wong, E. L., Huang, F. , Cheung, A. W. and Wong, C. K. (2018), The Impact of Menopause on the Sexual Health of Chinese Cantonese Women: A Mixed Methods Study. J Adv Nurs. doi:10.1111/jan.13568