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Saturday, January 23, 2021
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Talking points

Covid-19   Influenza   Vaccines   Staffing Grids

Today’s Read: 3 minutes

We hope that you were able to find moments of rest this weekend. Today’s newsletter focuses on the conversations you may find yourself in, especially the ones around Covid-19 disinformation regarding how it compares to the flu and how to convince others to take the vaccine. In addition, we look at how patient-to-nurse ratios affect sepsis outcomes and the effect of NPs on the bottom line.

MORNING BRIEF

4 ways to encourage Covid-19 vaccines

Even though we’re still making our way through Phase 1a vaccination group, it isn’t too soon to think about how to encourage others to get vaccinated, especially since the CDC announced their recommendations for who should be included in the Phase 1b group last night.

At last tally about 70% of the public said they would get the Covid-19 vaccine if it was safe and free. While this is the majority of Americans, communication is still key. Becker Healthcare complied some talking points from televised news reports around the county that you can use when talking to patients or using social media:

  • Acknowledge that there are risks with the vaccines just like anything else in medicine and life. This is a more effective message than saying that vaccines don’t cause harm because it is less likely to alienate people who are vaccine hesitant.
  • Explain that the symptoms people might feel after inoculation are not Covid-19, but a normal response by their immune system.
  • Stress to others that you shouldn’t let these symptoms deter you from the second dose; especially because no one knows whether one dose provides any protection.
  • Consider post-vaccination swag. A ‘I got the vaccine’ sticker could go a long way in increasing public confidence, as well as open up conversations with patients about the vaccine.

Staffing for sepsis

Implementing patient-to-nurse ratios could greatly reduce sepsis deaths, suggests a study published in American Journal of Infection Control.

Researchers from the Center for Health Outcomes and Policy Research (CHOPR) at the University of Pennsylvania School of Nursing looked at 116 New York state hospitals and more than 52,000 hospitalized patients with a diagnosis of sepsis. On average, nurses cared for 6.3 patients each. In addition, staffing varied substantially by hospital from 4.3 patients-per-nurse in the best staffed hospitals to 10.5 patients-per-nurse in the worst staffed hospitals.

The study found that these ratios affected mortality from sepsis. Specifically, for each additional patient added to a nurse’s workload there was a:

  • 12% higher in-hospital mortality from sepsis;
  • 7% higher odds of 60-day mortality; 
  • 7% higher odds of 60-day readmission, and longer lengths of stay; and
  • Only a 5% improvement in mortality associated with improved adherence to mandated care bundles.

Additionally, the study showed that improved nurse staffing reduced length of stay by two times more than adherence to the care bundles irrespective of nurse-to-patient ratio. Read more about the study and legislation it hopes to influence here.

Head-to-head: Influenza vs. Covid-19

You already know that Covid-19 is worse than influenza, now there are head-to-head numbers to help make the point when speaking to those who don’t believe it.

A recent study in The Lancet Respiratory Medicine evaluated data from 89,530 patients hospitalized with Covid-19 between March 1 and April 30, 2020 and 45,819 patients hospitalized with seasonal influenza between December 1, 2018 and February 28, 2019 in France. Here’s how the two compared:

  • Death rate among hospitalized Covid-19 patients was three times higher than seasonal influenza, 16.9% vs 5.8% respectively.
  • Intensive care was required for 16.3% of Covid-19 patients compared to 10.8% of influenza patients, and the average stay in the ICU with Covid-19 was nearly twice as long—15 days vs 8 days.
  • Fewer children aged under 18 years were hospitalized with Covid-19 compared with seasonal influenza, 1.4% vs 19.5% respectively.

We should note the limitations to this retrospective study. First, Covid-19 testing is more standardized than the testing practices for influenza, which may account for the increased number of patients hospitalized for Covid-19 compared with seasonal flu. Second, it isn’t possible to say whether the 2018/2019 flu season is representative of all seasonal influenzas, although the authors note that it was the most severe season in the past 5 years in France.

ONE BIG NUMBER

$3.2M

The amount of cost savings realized as a result of reduced adverse events after nurse practitioner care was introduced to six sites in Canada, according to a report in Nurse Outlook. Once introduced, NPs managed patients’ medications and adverse events including falls, pressure ulcers, and short-term transfers to the hospital. Canada lags behind the U.S. in the use and autonomy of NPs, and laws supporting their increased role in care are being revised.

DAILY DIVERSION

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