Extra Nursing Shifts Endanger Care; UK Policy Could Worsen Antibiotic Resistance; and Trials Begin for New Cancer Drugs

Patrick Lee

November 22, 2022




Extra Nursing Shifts Endanger Care

Nurses pick up extra shifts for the pay or incentives — but 50-plus-hour weeks may affect their health and patient care. Evidence suggests that long hours may hurt a nurse's physical and mental health, diminish the quality of care, and lead to patient errors.

More than half of RNs and LPNs don't think they get paid enough, and many are dissatisfied with their earnings, according to Medscape's RN/LPN Compensation Report 2022.

Errors and risks: Extended shifts led to more medication errors, nurses falling asleep during work hours, decreased productivity in the last 4 shift hours of a 12-hour shift, increased risk of mistakes and near-errors associated with decreased vigilance, critical thinking impairment, and more needlestick injuries, a study published by the American Association of Occupational Health Nurses finds.

Physical and mental fatigue: A work shift that lasts more than 8 hours can disrupt the body's sleep-wake cycle and lead to physical and mental fatigue, resulting in errors, injuries, and accidents, the US Occupational Safety and Health Administration says.




UK Policy Could Worsen Antibiotic Resistance

A recent British policy that allows pharmacists to prescribe drugs for minor ailments could worsen bacterial resistance to antibiotics ― a growing global health problem ― one critic says. The policy may result in the overprescription of antibiotics for conditions that don't warrant them, writes Salvador Macip, MD, associate professor in the Department of Molecular and Cellular Biology at the University of Leicester in Great Britain and professor and researcher in the Department of Health Sciences at the Universitat Oberta de Catalunya in Barcelona, Spain.

Doctors need to avoid prescribing antibiotics if there is no clear need, and patients need to complete their courses of treatment, says Macip. In addition, they should not pressure their doctors to give them antibiotics and they should avoid self-prescribing them.

Little incentive: Markets offer pharma companies little incentive to invest millions of dollars to develop new antibiotics that would be useful only for a limited amount of time.

Potential solutions: Governments should invest more in developing new antibiotics or offer incentives to companies to do so.




Trials Begin for New Cancer Drugs

Six new clinical trials for promising new drugs and treatments for breast cancer have started in recent months. The US National Library of Medicine of the National Institutes of Health posted information on the trials online at clinicaltrials.gov.

"We have been waiting (and hoping) for a vaccine to reduce recurrence for decades," commented Medscape columnist Kathy Miller, MD, professor of oncology and medicine at the Indiana University School of Medicine, Indianapolis. "Fingers crossed."

New immunotherapy: Researchers will begin a randomized phase 3 study to test an investigational immunotherapy called GLSI-100, developed by Greenwich LifeSciences. The trial will test the treatment in patients with HER2/neu-positive breast cancer with a high risk of recurrence following neoadjuvant and postoperative adjuvant standard of care.

New drugs: Researchers will conduct a randomized phase 3 open-label study of giredestrant in combination with standard treatments in patients with ER-positive, HER2-negative locally advanced/metastatic breast cancer who have previously received cyclin-dependent kinase 4/6 inhibitors plus endocrine therapy.

Another study is underway on an open-label randomized phase 3 trial of gedatolisib in patients with ER-positive, HER2-negative locally advanced/metastatic breast cancer for whom therapy with CDK 4/6 and aromatase inhibitors has failed.

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