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Impact of the single site order in LTC: exacerbation of an overburdened system.

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Title: Impact of the single site order in LTC: exacerbation of an overburdened system.
Authors: Havaei, Farinaz1 (AUTHOR) farinaz.havaei@ubc.ca, Sims-Gould, Joanie2 (AUTHOR), Staempfli, Sabina1 (AUTHOR), Franke, Thea2 (AUTHOR), Park, Minjeong3 (AUTHOR), Ma, Andy1 (AUTHOR), Kaulius, Megan1 (AUTHOR)
Source: BMC Health Services Research. 6/20/2023, Vol. 23 Issue 1, p1-13. 13p. 2 Charts, 5 Graphs.
Subject Terms: *PRACTICAL nurses, *JOB vacancies, *NURSING home employees, *SICK leave, *PRACTICAL nursing, *DISEASE exacerbation
Geographic Terms: BRITISH Columbia, CANADA
Abstract: Background: The long-term care (LTC) sector has been at the epicentre of COVID-19 in Canada. This study aimed to understand the impact that the Single Site Order (SSO) had on staff and leadership in four LTC homes in the Lower Mainland of British Columbia, Canada. Methods: A mixed method study was conducted by analyzing administrative staffing data. Overtime, turnover, and job vacancy data were extracted and analyzed from four quarters before (April 2019 – March 2020) and four quarters during the pandemic (April 2020 – March 2021) using scatterplots and two-part linear trendlines across total direct care nursing staff and by designation (i.e., registered nurses (RNs), licenced practical nurses (LPNs) and care aids (CAs)). Virtual interviews were conducted with a purposive sample of leadership (10) and staff (18) from each of the four partner care homes (n = 28). Transcripts were analyzed in NVivo 12 using thematic analysis. Results: Quantitative data indicated that the total overtime rate increased from before to during the pandemic, with RNs demonstrating the steepest rate increase. Additionally, while rates of voluntary turnover showed an upward trend before the pandemic for all direct care nursing staff, the rate for LPNs and, most drastically, for RNs was higher during the pandemic, while this rate decreased for CAs. Qualitative analysis identified two main themes and sub-themes: (1) overtime (loss of staff, mental health, and sick leave) and (2) staff turnover (the need to train new staff, and gender/race) as the most notable impacts associated with the SSO. Conclusions: The results of this study indicate that the outcomes due to COVID-19 and the SSO are not equal across nursing designations, with the RN shortage in the LTC sector highly evident. Quantitative and qualitative data underscore the substantial impact the pandemic and associated policies have on the LTC sector, namely, that staff are over-worked and care homes are understaffed. [ABSTRACT FROM AUTHOR]
Copyright of BMC Health Services Research is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Impact of the single site order in LTC: exacerbation of an overburdened system.
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  Data: <searchLink fieldCode="JN" term="%22BMC+Health+Services+Research%22">BMC Health Services Research</searchLink>. 6/20/2023, Vol. 23 Issue 1, p1-13. 13p. 2 Charts, 5 Graphs.
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  Data: *<searchLink fieldCode="DE" term="%22PRACTICAL+nurses%22">PRACTICAL nurses</searchLink><br />*<searchLink fieldCode="DE" term="%22JOB+vacancies%22">JOB vacancies</searchLink><br />*<searchLink fieldCode="DE" term="%22NURSING+home+employees%22">NURSING home employees</searchLink><br />*<searchLink fieldCode="DE" term="%22SICK+leave%22">SICK leave</searchLink><br />*<searchLink fieldCode="DE" term="%22PRACTICAL+nursing%22">PRACTICAL nursing</searchLink><br />*<searchLink fieldCode="DE" term="%22DISEASE+exacerbation%22">DISEASE exacerbation</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22BRITISH+Columbia%22">BRITISH Columbia</searchLink><br /><searchLink fieldCode="DE" term="%22CANADA%22">CANADA</searchLink>
– Name: Abstract
  Label: Abstract
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  Data: Background: The long-term care (LTC) sector has been at the epicentre of COVID-19 in Canada. This study aimed to understand the impact that the Single Site Order (SSO) had on staff and leadership in four LTC homes in the Lower Mainland of British Columbia, Canada. Methods: A mixed method study was conducted by analyzing administrative staffing data. Overtime, turnover, and job vacancy data were extracted and analyzed from four quarters before (April 2019 – March 2020) and four quarters during the pandemic (April 2020 – March 2021) using scatterplots and two-part linear trendlines across total direct care nursing staff and by designation (i.e., registered nurses (RNs), licenced practical nurses (LPNs) and care aids (CAs)). Virtual interviews were conducted with a purposive sample of leadership (10) and staff (18) from each of the four partner care homes (n = 28). Transcripts were analyzed in NVivo 12 using thematic analysis. Results: Quantitative data indicated that the total overtime rate increased from before to during the pandemic, with RNs demonstrating the steepest rate increase. Additionally, while rates of voluntary turnover showed an upward trend before the pandemic for all direct care nursing staff, the rate for LPNs and, most drastically, for RNs was higher during the pandemic, while this rate decreased for CAs. Qualitative analysis identified two main themes and sub-themes: (1) overtime (loss of staff, mental health, and sick leave) and (2) staff turnover (the need to train new staff, and gender/race) as the most notable impacts associated with the SSO. Conclusions: The results of this study indicate that the outcomes due to COVID-19 and the SSO are not equal across nursing designations, with the RN shortage in the LTC sector highly evident. Quantitative and qualitative data underscore the substantial impact the pandemic and associated policies have on the LTC sector, namely, that staff are over-worked and care homes are understaffed. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of BMC Health Services Research is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1186/s12913-023-09670-7
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        Text: English
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      – SubjectFull: BRITISH Columbia
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      – SubjectFull: PRACTICAL nurses
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