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Enrollees' global rating process of health care with the national CAHPS Benchmarking Database.

The CAHPS survey, a national-level data set, was used to determine how enrollees rate their health care with an emerging new noncompensatory model. The test results show the "People's experiences with how well their doctors communicate" attribute has the largest impact on the global rating of health care. We discuss the implications of this study for health care managers who work hard to improve how patients perceive their health care services.

Adolescent↗

Benchmarking the endodontic literature on MEDLINE.

The purpose of this study was to identify and quantify the endodontic literature available for clinical decision making. A search strategy based on Medical Subject Headings for endodontics was developed to examine MEDLINE. The identified articles were limited to human subjects and English. Sensitive and specific methodological search filters identified four categories of information: etiology, diagnosis, therapy, and prognosis. The results were then subdivided by year to identify trends. Between 1990 and 1998 MEDLINE identified 3,152 articles published in English on endodontics in humans. The number of articles per year (mean +/- SD) for sensitive and specific searches was etiology (28+/-10, 1+/-2), diagnosis (38+/-11, 1+/-1), therapy (59+/-15, 3+/-3), and prognosis (40+/-13, 10+/-5), respectively. The number of articles in each category increased by 1 to 3% each year. There were 150 articles/yr in endodontics in at least 120 journals cited on MEDLINE on which to base clinical decisions.

Analysis of Variance↗

Nursing workforce management: using benchmarking for planning and outcomes monitoring.

The goal of maintaining the balance between demand for nursing care and the supply of nurses is the basis for state and regional planning to meet future nursing workforce needs. Projecting nursing supply needs solely on the basis of historical registered nurse to population ratios does not specifically consider the healthcare needs of the population. The authors present a model in which state population data and nursing resource data are compared with national data to assist state planning groups in developing an effective workforce management plan. Integrating population demographic data, healthcare needs of citizens, and nurse resource factors at the state level can improve the accuracy of projection statistics.

Adult↗

Take benchmarking to the next level.

Reposition and revitalize your organization by teaching staff members to use data for identifying, setting, and directing performance goals.

Benchmarking↗

Moral turpitude: a benchmark toward eligibility for registered nurse licensure?

The purpose of this descriptive study was to explore the concept of moral turpitude and related terms as they are used in the process of licensing professional nurses. The researchers reviewed applications for licensure and nurse practice acts or rules and regulations for nursing for the 50 states and Washington, DC. Terms such as moral turpitude, moral character, and morality are used by approximately half of the states and, when used, are not usually defined. Agreement among states on uniform definitions and standards of nursing practice can be a step toward aligning practice acts, bringing consistency to disciplinary actions, and informing the public about the profession's standards for practice.

Benchmarking↗

Assessing quality of care in a trauma referral center: benchmarking performance by TRISS-based statistics or by analysis of stratified ISS data?

BACKGROUND: Using prospectively collected data from Ulleval University Hospital in Norway, standard TRISS-based methods with case mix correction were compared with analysis based on ISS stratified data. METHODS: Reference data were The Major Trauma Outcome Study (MTOS) controlled sites, used for calculation of AIS 90 based TRISS coefficients. Present TRISS convention requires RTS scoring on hospital admission, excluding many severely injured patients intubated before arrival. Therefore, all Ulleval patients were RTS scored using prehospital data if needed. RESULTS: There was 6.6% of MTOS controlled sites patients (mortality rate 26.7%) that had been excluded before estimation of TRISS coefficients because of lack of data for Ps calculation. Analyses based on ISS stratified data included these patients and indicated significant better performance at Ulleval for blunt, but not for penetrating trauma. No TRISS-based analysis detected this difference. CONCLUSIONS: The RTS convention should be changed to reduce patient exclusion. Presently, stratified ISS based data should also be analyzed.

Adult↗

Benchmarking DNA extraction protocols across use cases for culture-independent Nanopore metagenomics.

Oxford Nanopore Technologies (ONT) sequencing offers several advantages for metagenomics, including long reads, rapid turnaround, low upfront cost, scalability and portability. However, for ONT metagenomics, DNA yield, quality and integrity are important considerations when selecting an extraction method. Many metagenomic extraction methods use harsh lysis conditions to extract a wide range of species and provide an accurate community composition, but these conditions can compromise DNA fragment length. Therefore, extraction methods for ONT metagenomics must balance DNA shearing and recovery with representative community lysis. We systematically evaluated DNA extraction methods for ONT metagenomic sequencing using a use case-oriented framework. Among nearly 50 extraction methods screened, 7 were selected for detailed comparison based on suitability for metagenomics, variation in methodology, availability, cost and processing time: Norgen BioTek Corp's Stool DNA Isolation (NG), Zymo Research's ZymoBIOMICS Quick-DNA HMW MagBead (ZMG), Qiagen's DNeasy Blood and Tissue (QBT), Macherey-Nagel's NucleoMag DNA Microbiome (MN), Zymo Research's ZymoBIOMICS DNA Mini Prep (ZMI), Qiagen's DNeasy PowerSoil/QIAamp PowerFecal Pro (PS) and Qiagen's QIAamp Fast DNA Stool Mini (QIA). Methods were tested using Zymo Research's ZymoBIOMICS Microbial Community Standard (MCS), a matrix-free mock community with known composition. DNA extracts were sequenced on an ONT PromethION using the Rapid Barcoding Kit, except QIA due to insufficient DNA yield. Metrics for the method, DNA extracts, sequencing and genomes were evaluated, revealing trade-offs between methods. The two magnetic bead methods, MN and ZMG, produced the highest mean read length N50 values (13.9 and 16.5 kb, respectively) but showed apparent community compositions skewed towards Gram-negative bacteria. In contrast, ZMI and PS maintained a community composition close to expected, with reduced mean read length N50 values (4.5 vs. 7.5 kb). Performance across various metrics is presented in the context of the following use cases: maximizing genome coverage and assembly completeness, preserving composition accuracy, targeting specific species and limiting required resources (equipment, time or budget). The metrics and use case considerations presented offer practical guidance for informed selection of DNA extraction methods for ONT metagenomics. For accurate community composition, ZMI or PS are recommended, while PS and ZMG perform best at maximizing genome coverage and assembly completeness. NG and QBT may be the most economical options, though performance trade-offs were observed. Finally, PS may be the preferred method for time-sensitive diagnostic or field applications.

Metagenomics↗

Benchmarking the current dispensing rate of Welsh hospital pharmacies.

BACKGROUND: There is a need to develop capacity measures for pharmacy services for strategic purposes, to provide guidance on safe working limits and to contribute to the target 40% reduction in serious medication errors by 2005. Attempts have been made to quantify workloads in the form of items/person/hour (i/p/h). However, much of these data are anecdotal, small scale or associated with vague methodology. OBJECTIVE: We estimate national average dispensing rates by collecting accurate data from secondary care dispensaries across Wales. METHOD: Seventeen sites collected hourly data relating to staff time and items dispensed over a 3-day period. The result showed a Welsh national average for non-specialist hospital pharmacy dispensing rates of 9.9 items/person/h (95% CI = 0.9, n = 17). There was a significant positive association between hospital size and telephone interruptions (r(s) = 0.83, P < 0.001) but no correlation between hospital size and dispensing rates (r(s) = 0.06, P = 0.822).

Benchmarking↗

Benchmarking occupational stressors and strain levels for rural nurses and other health sector workers.

This study was conducted with 1097 employees (866 females, 217 males, 14 did not indicate gender) in a regional Health Service District who completed the Queensland Public Agency Staff Survey in 2002. Nurses' results on measures of organizational climate and psychological outcomes were compared with those of other employees in the Health Service District. Nurses reported less favourable outcomes on all but one of the organizational climate scales, and also were found to have more distress (strain), and lower levels of morale, Job Satisfaction and Quality of Worklife than others. Results were generally less favourable for nurses working in the large regional hospital and in mental health than for nurses in other facilities. The study has implications for recruiting and retaining nurses at a time when shortages within the profession are chronic.

Adaptation, Psychological↗