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Sample records for healthcare worker hand

  1. Healthcare worker and family caregiver hand hygiene in Bangladeshi healthcare facilities: results from the Bangladesh National Hygiene Baseline Survey.

    Science.gov (United States)

    Horng, L M; Unicomb, L; Alam, M-U; Halder, A K; Shoab, A K; Ghosh, P K; Opel, A; Islam, M K; Luby, S P

    2016-11-01

    Healthcare facility hand hygiene impacts patient care, healthcare worker safety, and infection control, but low-income countries have few data to guide interventions. To conduct a nationally representative survey of hand hygiene infrastructure and behaviour in Bangladeshi healthcare facilities to establish baseline data to aid policy. The 2013 Bangladesh National Hygiene Baseline Survey examined water, sanitation, and hand hygiene across households, schools, restaurants and food vendors, traditional birth attendants, and healthcare facilities. We used probability proportional to size sampling to select 100 rural and urban population clusters, and then surveyed hand hygiene infrastructure in 875 inpatient healthcare facilities, observing behaviour in 100 facilities. More than 96% of facilities had 'improved' water sources, but environmental contamination occurred frequently around water sources. Soap was available at 78-92% of handwashing locations for doctors and nurses, but just 4-30% for patients and family. Only 2% of 4676 hand hygiene opportunities resulted in recommended actions: using alcohol sanitizer or washing both hands with soap, then drying by air or clean cloth. Healthcare workers performed recommended hand hygiene in 9% of 919 opportunities: more after patient contact (26%) than before (11%). Family caregivers frequently washed hands with only water (48% of 2751 opportunities), but with little soap (3%). Healthcare workers had more access to hand hygiene materials and performed better hand hygiene than family, but still had low adherence. Increasing hand hygiene materials and behaviour could improve infection control in Bangladeshi healthcare facilities. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. New technology markedly improves hand-hygiene performance among healthcare workers after restroom visits

    DEFF Research Database (Denmark)

    Møller-Sørensen, H; Korshin, A; Mogensen, T

    2016-01-01

    The risks to patients from pathogens present on healthcare workers' (HCWs') hands are high; however, compliance with hand hygiene among HCWs is low. We devised a prospective intervention trial of a new hand-hygiene dispensing technology to improve HCWs' compliance with hand hygiene. Baseline hand...

  3. Surveillance of nosocomial infections: a preliminary study on hand hygiene compliance of healthcare workers.

    Science.gov (United States)

    Brunetti, L; Santoro, E; De Caro, F; Cavallo, P; Boccia, G; Capunzo, M; Motta, O

    2006-06-01

    The observance of hand hygiene compliance is important to reduce cross-infection by micro-organisms. The aim of this preliminary study was to evaluate the level of hand hygiene in healthcare workers from different departments, with particular emphasis on transient flora. The study was conducted in three departments (Surgery, Intensive Care Unit, Obstetrics and Gynecology) of a hospital in Campania, southern Italy. Over a six-month period, 50 healthcare workers were randomly tested. Imprints of palms and fingertips were taken monthly during the morning shift. The number of colonies per plate was counted and transient pathogens were identified. Risk factors for hand contamination were determined. Total flora was found in the following CFU means per palm and per five fingertips (95% CI): Obstetrics and Gynecology [palms 130 CFUs (95% CI 85-180); fingertips 125 CFUs (95% CI 92-160)]; ICU [palms 80 CFUs (95% CI 58-99); fingertips 62 CFUs (95% CI 45-82)]; Surgery [palms 75 CFUs (95% CI 41-120); fingertips 70 CFUs (95% CI 52-90)] Transient flora was found on 39% of healthcare workers' hands. The only factor associated with hand contamination by transient flora was the absence of gloving during healthcare procedure (P = 0.02).

  4. Self-reported hand hygiene practices, and feasibility and acceptability of alcohol-based hand rubs among village healthcare workers in Inner Mongolia, China.

    Science.gov (United States)

    Li, Y; Wang, Y; Yan, D; Rao, C Y

    2015-08-01

    Good hand hygiene is critical to reduce the risk of healthcare-associated infections. Limited data are available on hand hygiene practices from rural healthcare systems in China. To assess the feasibility and acceptability of sanitizing hands with alcohol-based hand rubs (ABHRs) among Chinese village healthcare workers, and to assess their hand hygiene practice. Five hundred bottles of ABHR were given to village healthcare workers in Inner Mongolia, China. Standardized questionnaires collected information on their work load, availability, and usage of hand hygiene facilities, and knowledge, attitudes, and practices of hand hygiene. In all, 369 (64.2%) participants completed the questionnaire. Although 84.5% of the ABHR recipients believed that receiving the ABHR improved their hand hygiene practice, 78.8% of recipients would pay no more than US$1.5 out of their own pocket (actual cost US$4). The majority (77.2%) who provided medical care at patients' homes never carried hand rubs with them outside their clinics. In general, self-reported hand hygiene compliance was suboptimal, and the lowest compliance was 'before touching a patient'. Reported top three complaints with using ABHR were skin irritation, splashing, and unpleasant residual. Village doctors with less experience practised less hand hygiene. The overall acceptance of ABHR among the village healthcare workers is high as long as it is provided to them for free/low cost, but their overall hand hygiene practice is suboptimal. Hand hygiene education and training is needed in settings outside of traditional healthcare facilities. Published by Elsevier Ltd.

  5. New technology markedly improves hand-hygiene performance among healthcare workers after restroom visits.

    Science.gov (United States)

    Møller-Sørensen, H; Korshin, A; Mogensen, T; Høiby, N

    2016-04-01

    The risks to patients from pathogens present on healthcare workers' (HCWs') hands are high; however, compliance with hand hygiene among HCWs is low. We devised a prospective intervention trial of a new hand-hygiene dispensing technology to improve HCWs' compliance with hand hygiene. Baseline hand-hygiene compliance was observed for three months before and after an intervention consisting of implementation of an electronic device that reminds people to comply with hand hygiene after restroom visits. Compliance in hand-hygiene performance after restroom visits increased among HCWs from 66% to 91% after the intervention. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  6. Hand hygiene in rural Indonesian healthcare workers: barriers beyond sinks, hand rubs and in-service training.

    Science.gov (United States)

    Marjadi, B; McLaws, M-L

    2010-11-01

    Few attempts to increase healthcare workers' hand hygiene compliance have included an in-depth analysis of the social and behavioural context in which hand hygiene is not undertaken. We used a mixed method approach to explore hand hygiene barriers in rural Indonesian healthcare facilities to develop a resource-appropriate adoption of international guidelines. Two hospitals and eight clinics (private and public) in a rural Indonesian district were studied for three months each. Hand hygiene compliance was covertly observed for two shifts each in three adult wards at two hospitals. Qualitative data were collected from direct observation, focus group discussions and semistructured in-depth and informal interviews within healthcare facilities and the community. Major barriers to compliance included longstanding water scarcity, tolerance of dirtiness by the community and the healthcare organisational culture. Hand hygiene compliance was poor (20%; 57/281; 95% CI: 16-25%) and was more likely to be undertaken after patient contact (34% after-patient contact vs 5% before-patient contact, Pperceived to be dirty (49% 'inherent' vs 11% 'elective' opportunities associated with clean contacts, Pcommitment to the provision of supportive working conditions. Copyright © 2010 The Hospital Infection Society. All rights reserved.

  7. Understanding Healthcare Workers Self-Reported Practices, Knowledge and Attitude about Hand Hygiene in a Medical Setting in Rural India.

    Science.gov (United States)

    Diwan, Vishal; Gustafsson, Charlotte; Rosales Klintz, Senia; Joshi, Sudhir Chandra; Joshi, Rita; Sharma, Megha; Shah, Harshada; Pathak, Ashish; Tamhankar, Ashok J; Stålsby Lundborg, Cecilia

    2016-01-01

    To describe self-reported practices and assess knowledge and attitudes regarding hand hygiene among healthcare workers in a rural Indian teaching hospital. A rural teaching hospital and its associated medical and nursing colleges in the district of Ujjain, India. The study population consisted of physicians, nurses, teaching staff, clinical instructors and nursing students. Self-administered questionnaires based on the World Health Organization Guidelines on Hand Hygiene in Healthcare were used. Out of 489 healthcare workers, 259 participated in the study (response rate = 53%). The proportion of healthcare workers that reported to 'always' practice hand hygiene in the selected situations varied from 40-96% amongst categories. Reported barriers to maintaining good hand hygiene were mainly related to high workload, scarcity of resources, lack of scientific information and the perception that priority is not given to hand hygiene, either on an individual or institutional level. Previous training on the topic had a statistically significant association with self-reported practice (p = 0.001). Ninety three per cent of the respondents were willing to attend training on hand hygiene in the near future. Self-reported knowledge and adherence varied between situations, but hand hygiene practices have the potential to improve if the identified constraints could be reduced. Future training should focus on enhancing healthcare workers' knowledge and understanding regarding the importance of persistent practice in all situations.

  8. Skin care education and individual counselling versus treatment as usual in healthcare workers with hand eczema

    DEFF Research Database (Denmark)

    Ibler, K.S.; Jemec, G.B.E.; Thomsen, S.F.

    2012-01-01

    Objective: To evaluate the effect of a secondary prevention programme with education on skin care and individual counselling versus treatment as usual in healthcare workers with hand eczema. Design: Randomised, observer blinded parallel group superiority clinical trial. Setting: Three hospitals...... in Denmark. Participants: 255 healthcare workers with self reported hand eczema within the past year randomised centrally and stratified by profession, severity of eczema, and hospital. 123 were allocated to the intervention group and 132 to the control group. Interventions: Education in skin care...

  9. Improving healthcare worker hand hygiene adherence before patient contact: A multimodal intervention of hand hygiene practice in Three Japanese tertiary care centers.

    Science.gov (United States)

    Sakihama, Tomoko; Honda, Hitoshi; Saint, Sanjay; Fowler, Karen E; Kamiya, Toru; Sato, Yumiko; Iuchi, Ritsuko; Tokuda, Yasuharu

    2016-03-01

    Though hand hygiene is an important method of preventing healthcare-associated infection, we found suboptimal hand hygiene adherence among healthcare workers in 4 diverse Japanese hospitals (adherence rates of 11%-25%). Our goal was to assess multimodal hand hygiene intervention coupled with a contest to improve hand hygiene adherence. A total of 3 to 4 inpatient wards in 3 Japanese hospitals. Pre-post intervention study. The intervention was a multimodal hand hygiene intervention recommended by the World Health Organization that was tailored to each facility. The hospital with the highest adherence after the intervention was given $5000 US dollars and a trophy, provided by an American coinvestigator unaffiliated with any of the Japanese hospitals. We tracked hand hygiene adherence rates before patient contact for each unit and hospital and compared these to pre-intervention adherence rates. We observed 2982 postintervention provider-patient encounters in 10 units across 3 hospitals. Hand hygiene adherence rates were improved overall after the intervention (18% pre- to 33% postintervention; P hand hygiene rates among Japanese healthcare workers. Given the overall low rates, however, further improvement is necessary. © 2015 Society of Hospital Medicine.

  10. Contact Allergy in Danish Healthcare Workers

    DEFF Research Database (Denmark)

    Schwensen, Jakob F; Menné, Torkil; Sommerlund, Mette

    2016-01-01

    Contact dermatitis in healthcare workers is a pan-European problem. We conducted a retrospective observational study of the patch-test results of 1402 healthcare workers and 1402 matched controls with contact dermatitis who were treated at 3 hospitals departments in Denmark between 2007 and 2014....... The primary objective was to determine whether healthcare work was associated with contact allergy to thiuram mix. Unadjusted univariate analyses revealed that healthcare work was significantly associated with occupational contact dermatitis and hand dermatitis. Contact allergy to thiuram mix was more common...... in healthcare workers was significantly associated with having occupational contact dermatitis, hand dermatitis and older age. In conclusion, we report here a potential problem of contact allergy to thiurams in healthcare workers with contact dermatitis. Legislative authorities may in the future focus...

  11. The Hand Eczema Trial (HET): Design of a randomised clinical trial of the effect of classification and individual counselling versus no intervention among health-care workers with hand eczema

    DEFF Research Database (Denmark)

    Ibler, Kristina Sophie; Agner, Tove; Hansen, Jane L.

    2010-01-01

    strategies are needed to reduce occupational hand eczema. METHODS/DESIGN: We describe the design of a randomised clinical trial to investigate the effects of classification of hand eczema plus individual counselling versus no intervention. The trial includes health-care workers with hand eczema identified...... from a self-administered questionnaire delivered to 3181 health-care workers in three Danish hospitals. The questionnaire identifies the prevalence of hand eczema, knowledge of skin-protection, and exposures that can lead to hand eczema. At entry, all participants are assessed regarding: disease...

  12. Intervening with healthcare workers' hand hygiene compliance, knowledge, and perception in a limited-resource hospital in Indonesia: A randomized controlled trial study

    NARCIS (Netherlands)

    D. Santosaningsih (Dewi); Erikawati, D. (Dewi); T. Santoso; Noorhamdani, N. (Noorhamdani); Ratridewi, I. (Irene); Candradikusuma, D. (Didi); Chozin, I.N. (Iin N.); Huwae, T.E.C.J. (Thomas E.C.J.); van der Donk, G. (Gwen); van Boven, E. (Eva); A.F. Voor in 't Holt (Anne); H.A. Verbrugh (Henri); J.A. Severin (Juliëtte)

    2017-01-01

    textabstractBackground: Hand hygiene is recognized as an important measure to prevent healthcare-associated infections. Hand hygiene adherence among healthcare workers is associated with their knowledge and perception. This study aimed to evaluate the effect of three different educational programs

  13. Effectiveness of an electronic hand hygiene monitoring system on healthcare workers' compliance to guidelines.

    Science.gov (United States)

    Al Salman, J M; Hani, S; de Marcellis-Warin, N; Isa, Sister Fatima

    2015-01-01

    Hand hygiene is a growing concern among populations and is a crucial element in ensuring patient safety in a healthcare environment. Numerous management efforts have been conducted in that regard, including education, awareness and observations. To better evaluate the possible impact of technology on a healthcare setting, we observed the impact of a particular niche technology developed as an answer to the growing hand hygiene concerns. A study was conducted at Salmaniya Medical Complex (SMC) in Bahrain on a total of 16 Coronary Care Unit (CCU) beds where the system was installed, and the hand hygiene activity of healthcare workers (HCWs) in this area was monitored for a total period of 28 days. Comments, remarks and suggestions were noted, and improvements were made to the technology during the course of the trial. While resistance to change was significant, overall results were satisfactory. Compliance with hand hygiene techniques went from 38-42% to 60% at the beginning of the trial and then increased to an average of 75% at the end of the 28-day trial. In some cases, compliance peaked at 85% or even at 100%. Our case study demonstrates that technology can be used effectively in promoting and improving hand hygiene compliance in hospitals, which is one way to prevent cross-infections, especially in critical care areas. Copyright © 2014 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  14. Study of bacterial flora associated with mobile phones of healthcare workers and non-healthcare workers.

    Science.gov (United States)

    Morubagal, Raghavendra Rao; Shivappa, Sowmya Govindanahalli; Mahale, Rashmi Padmanabha; Neelambike, Sumana Mhadevaiah

    2017-06-01

    Despite improvements in modern diagnosis and therapies, hospital acquired infections remain a leading problem of global health systems. Healthcare workers mobile phones is a reservoir for potential pathogens. Despite the high possibility of being contaminated, mobile phones are rarely clean and are often touched during or after examination of patients and handling of specimens without proper hand washing. The main objective of the present study was to isolate, identify different types of bacteria and their antibiotic sensitivity from mobile phones of healthcare workers and non-health-care workers. Samples were collected aseptically by rolling over the exposed surfaces of the mobile phones inoculated on the agar plates and incubated aerobically. After incubation, plates were examined for growth. Bacteria were identified and antibiotic sensitivity was tested as per standard microbiological procedures. In this study a total of 175 samples were examined, out of which 125 samples were from healthcare workers (HCWs), 50 samples were from non-healthcare workers (non-HCWs). Among the mobile phones of HCW's from ICUs, Acinetobacter baumannii (36.84%) was the predominant organism isolated followed by methicillin resistant Staphylococcus aureus (MRSA) (21.05%). Predominant organism isolated from HCW's in operation theater theater was MRSA (46.66%). Out of 50 worker's non-HCWs mobile phones samples cultured, 23 (46.00%) samples yielded growth of six different types of bacteria. Our study reveals that there is definite colonization of bacteria on mobile phones of the HCWs. It is not only capable of transferring message but also disease-producing microbes. In order to reduce incidence of nosocomial infections, there should be implementation of hand washing practices and regulations around the use of mobile telephones in hospital settings.

  15. Latex sensitisation in healthcare workers in Singapore.

    Science.gov (United States)

    Tang, M B Y; Leow, Y H; Ng, V; Koh, D; Goh, C L

    2005-06-01

    Epidemiological data on latex sensitisation among Asian healthcare workers is lacking. The aim of the study is to determine the rate of latex sensitisation in our healthcare workers. We recruited 313 healthcare workers, of which 46.6% were operating theatre staff and 53.4% were non-operating theatre staff. Seventy-one administrative staff served as controls. All participants answered a self-administered questionnaire relating to latex exposure and glove-related symptoms. Latex sensitisation was determined by skin prick testing to latex and latex-specific IgE detection. The prevalence of latex sensitisation among healthcare workers was 9.6%, with no difference between operating theatre and nonoperating theatre staff. Glove-related symptoms were reported in 13.7% of all healthcare workers, of which 22.9% were sensitised to latex. Only 26.7% of latex-sensitised healthcare workers had glove-related symptoms while the rest were asymptomatic. The most common symptoms were itch and hand eczema but the most important discriminating symptom was contact urticaria. Personal history of atopy was more common in sensitised healthcare workers (40.0%) compared to non-sensitised workers (31.8%). Only 1 out of 9 (11.2%) symptomatic latex-sensitised subjects had sought previous medical attention for the problem. Latex sensitisation among healthcare workers in Singapore should be considered a significant occupational health risk, as it is in the West. Increased screening and awareness of this problem is essential to identify those at risk.

  16. Hand hygiene in reducing transient flora on the hands of healthcare workers: an educational intervention.

    Science.gov (United States)

    Kapil, R; Bhavsar, H K; Madan, M

    2015-01-01

    Hand hygiene has now been recognised as one of the most effective intervention to control the transmission of infections in a hospital and education is an important tool to ensure its implementation. In order to convince the users and as a part of education, it is important to generate evidence on the role of hand hygiene in reducing the bacterial flora on their hands. The present study was undertaken in a tertiary care hospital to demonstrate the presence of bacterial flora on the hands of healthcare workers (HCW) in different categories, to teach them proper hand hygiene technique using alcohol-based hand rub and determine the outcome for reduction of bacteria. A total sample size of 60 subjects including resident doctors, medical students, nurses and hospital attendants were included in the study after obtaining informed consent. Each person was educated on the technique of hand hygiene with alcohol-based hand rub and hand impressions were cultured before and after hand hygiene. All the subjects were also given a questionnaire to assess their perception on hand hygiene. The WHO posters on proper hand hygiene were displayed in the appropriate areas of the hospital in addition, as an educational tool. Majority (42 out of 60) of the HCWs had bacterial count up to 100 colonies or more on both hands before the application of hand rub while working in the hospital. After use of alcohol hand rub with a proper hand hygiene technique, it was found that the percentage reduction was 95-99% among doctors and nurses, 70% among hospital attendants and 50% among sanitary attendants. Staphylococcus aureus was present on the hands of eight persons of which three were methicillin-resistant Staphylococcus aureus. The study demonstrates that transient bacteria are present on the hands of HCWs but majority could be removed by proper hand hygiene, which needs continuous education to be effective. It also shows that active education by demonstrating the proper hand hygiene technique

  17. Applying psychological frameworks of behaviour change to improve healthcare worker hand hygiene: a systematic review.

    Science.gov (United States)

    Srigley, J A; Corace, K; Hargadon, D P; Yu, D; MacDonald, T; Fabrigar, L; Garber, G

    2015-11-01

    Despite the importance of hand hygiene in preventing transmission of healthcare-associated infections, compliance rates are suboptimal. Hand hygiene is a complex behaviour and psychological frameworks are promising tools to influence healthcare worker (HCW) behaviour. (i) To review the effectiveness of interventions based on psychological theories of behaviour change to improve HCW hand hygiene compliance; (ii) to determine which frameworks have been used to predict HCW hand hygiene compliance. Multiple databases and reference lists of included studies were searched for studies that applied psychological theories to improve and/or predict HCW hand hygiene. All steps in selection, data extraction, and quality assessment were performed independently by two reviewers. The search yielded 918 citations; seven met eligibility criteria. Four studies evaluated hand hygiene interventions based on psychological frameworks. Interventions were informed by goal setting, control theory, operant learning, positive reinforcement, change theory, the theory of planned behaviour, and the transtheoretical model. Three predictive studies employed the theory of planned behaviour, the transtheoretical model, and the theoretical domains framework. Interventions to improve hand hygiene adherence demonstrated efficacy but studies were at moderate to high risk of bias. For many studies, it was unclear how theories of behaviour change were used to inform the interventions. Predictive studies had mixed results. Behaviour change theory is a promising tool for improving hand hygiene; however, these theories have not been extensively examined. Our review reveals a significant gap in the literature and indicates possible avenues for novel research. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  18. The Hand Eczema Trial (HET): Design of a randomised clinical trial of the effect of classification and individual counselling versus no intervention among health-care workers with hand eczema

    DEFF Research Database (Denmark)

    Ibler, Kristina Sophie; Agner, Tove; Hansen, Jane L.

    2010-01-01

    . The experimental group undergoes patch and prick testing; classification of the hand eczema; demonstration of hand washing and appliance of emollients; individual counselling, and a skin-care programme. The control group receives no intervention. All participants are reassessed after six months. The primary...... strategies are needed to reduce occupational hand eczema. METHODS/DESIGN: We describe the design of a randomised clinical trial to investigate the effects of classification of hand eczema plus individual counselling versus no intervention. The trial includes health-care workers with hand eczema identified...

  19. Economic Evaluation of a Multifaceted Implementation Strategy for the Prevention of Hand Eczema Among Healthcare Workers in Comparison with a Control Group: The Hands4U Study.

    NARCIS (Netherlands)

    Van Der Meer, Esther W C; van Dongen, J.M.; Boot, C.R.; van der Gulden, J.W.; Bosmans, J.E.; Anema, J.R.

    2016-01-01

    The aim of this study was to evaluate the cost-effectiveness of a multifaceted implementation strategy for the prevention of hand eczema in comparison with a control group among healthcare workers. A total of 48 departments (n=1,649) were randomly allocated to the implementation strategy or the

  20. Economic Evaluation of a Multifaceted Implementation Strategy for the Prevention of Hand Eczema Among Healthcare Workers in Comparison with a Control Group: The Hands4U Study

    NARCIS (Netherlands)

    Meer, E.W. van der; Dongen, J.M. van; Boot, C.R.; Gulden, J.W.J. van der; Bosmans, J.E.; Anema, J.R.

    2016-01-01

    The aim of this study was to evaluate the cost-effectiveness of a multifaceted implementation strategy for the prevention of hand eczema in comparison with a control group among healthcare workers. A total of 48 departments (n=1,649) were randomly allocated to the implementation strategy or the

  1. Skin care education and individual counselling versus treatment as usual in healthcare workers with hand eczema: randomised clinical trial.

    Science.gov (United States)

    Ibler, Kristina Sophie; Jemec, Gregor B E; Diepgen, Thomas L; Gluud, Christian; Lindschou Hansen, Jane; Winkel, Per; Thomsen, Simon Francis; Agner, Tove

    2012-12-12

    To evaluate the effect of a secondary prevention programme with education on skin care and individual counselling versus treatment as usual in healthcare workers with hand eczema. Randomised, observer blinded parallel group superiority clinical trial. Three hospitals in Denmark. 255 healthcare workers with self reported hand eczema within the past year randomised centrally and stratified by profession, severity of eczema, and hospital. 123 were allocated to the intervention group and 132 to the control group. Education in skin care and individual counselling based on patch and prick testing and assessment of work and domestic related exposures. The control was treatment as usual. The primary outcome was clinical severity of disease at five month follow-up measured by scores on the hand eczema severity index. The secondary outcomes were scores on the dermatology life quality index, self evaluated severity of hand eczema, skin protective behaviours, and knowledge of hand eczema from onset to follow-up. Follow-up data were available for 247 of 255 participants (97%). At follow-up, the mean score on the hand eczema severity index was significantly lower (improved) in the intervention group than control group: difference of means, unadjusted -3.56 (95% confidence interval -4.92 to -2.14); adjusted -3.47 (-4.80 to -2.14), both Pgroup at follow-up: difference of means: unadjusted -0.78, non-parametric test P=0.003; adjusted -0.92, -1.48 to -0.37). Self evaluated severity and skin protective behaviour by hand washings and wearing of protective gloves were also statistically significantly better in the intervention group, whereas this was not the case for knowledge of hand eczema. A secondary prevention programme for hand eczema improved severity and quality of life and had a positive effect on self evaluated severity and skin protective behaviour by hand washings and wearing of protective gloves. ClinicalTrials.gov NCT01012453.

  2. The Hand Eczema Trial (HET): Design of a randomised clinical trial of the effect of classification and individual counselling versus no intervention among health-care workers with hand eczema.

    Science.gov (United States)

    Ibler, Kristina Sophie; Agner, Tove; Hansen, Jane Lindschou; Gluud, Christian

    2010-08-31

    Hand eczema is the most frequently recognized occupational disease in Denmark with an incidence of approximately 0.32 per 1000 person-years. Consequences of hand eczema include chronic severe eczema, prolonged sick leave, unemployment, and impaired quality of life. New preventive strategies are needed to reduce occupational hand eczema. We describe the design of a randomised clinical trial to investigate the effects of classification of hand eczema plus individual counselling versus no intervention. The trial includes health-care workers with hand eczema identified from a self-administered questionnaire delivered to 3181 health-care workers in three Danish hospitals. The questionnaire identifies the prevalence of hand eczema, knowledge of skin-protection, and exposures that can lead to hand eczema. At entry, all participants are assessed regarding: disease severity (Hand Eczema Severity Index); self-evaluated disease severity; number of eruptions; quality of life; skin protective behaviour, and knowledge of skin protection. The patients are centrally randomised to intervention versus no intervention 1:1 stratified for hospital, profession, and severity score. The experimental group undergoes patch and prick testing; classification of the hand eczema; demonstration of hand washing and appliance of emollients; individual counselling, and a skin-care programme. The control group receives no intervention. All participants are reassessed after six months. The primary outcome is observer-blinded assessment of disease severity and the secondary outcomes are unblinded assessments of disease severity; number of eruptions; knowledge of skin protection; skin-protective behaviour, and quality of life. The trial is registered in ClinicalTrials.Gov, NCT01012453.

  3. THE KNOWLEDGE OF HEALTH CARE WORKERS AND DOCTORS REGARDING HAND SCRUB

    Directory of Open Access Journals (Sweden)

    Rahul Sanjeev Chaudhary

    2016-08-01

    Full Text Available BACKGROUND Hand hygiene practices of health care workers has been shown to be an effective measure in preventing hospital acquired infections. This concept has been aptly used to improve understanding, training, monitoring, and reporting hand hygiene among healthcare workers. We conducted this study to assess the knowledge of doctors and health care workers regarding hand scrub. METHODS A study was conducted among doctors and health care workers in a tertiary care hospital. Knowledge was evaluated by using self-structured questionnaire based on the guidelines of hand hygiene prescribed by WHO. RESULTS The awareness and knowledge of preoperative surgical hand scrubbing was moderate in doctors, but unfortunately poor in HCWs. CONCLUSION Our study highlights the need for introducing measures in order to increase the knowledge of preoperative hand scrub in teaching hospital which may translate into good practices.

  4. When are the hands of healthcare workers positive for methicillin-resistant Staphylococcus aureus?

    LENUS (Irish Health Repository)

    Creamer, E

    2010-06-01

    Hand hygiene is a key component in reducing infection. There are few reports on the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) on healthcare workers\\' (HCWs\\') hands. The aim of this study was to establish whether HCWs\\' fingertips were contaminated with MRSA in a clinical hospital setting. The study was conducted in an acute tertiary referral hospital on four MRSA wards that were part of a larger research study on MRSA epidemiology and four other wards not included in the study. The fingertips from all categories of 523 HCWs were sampled on 822 occasions by the imprinting of fingertips on MRSA chromogenic agar plates. The type of hand hygiene agent used, if any, and the immediate prior activity of the HCW were recorded. Overall, 38\\/822 (5%) fingertips from 523 HCWs were MRSA-positive; 12\\/194 (6%) after clinical contact, 10\\/138 (10%) after contact with the patient\\'s environment and 15\\/346 (4%) after no specific contact. MRSA was recovered on 2\\/61 (3%) occasions after use of alcohol hand rub, 2\\/35 (6%) after 4% chlorhexidine detergent, 7\\/210 (3%) hand washing with soap and water, and 27\\/493 (5%) when no hand hygiene had been performed. MRSA was recovered from HCWs on seven of the eight wards. MRSA was more frequently present on fingertips on the four non-study wards vs the four MRSA study wards [18\\/250 (7%), 3\\/201 (1%), respectively; Phand hygiene, indicates that more educational programmes are necessary to improve the quality of hand hygiene to prevent transmission of MRSA.

  5. Bacterial contamination of white coats and hands of healthcare ...

    African Journals Online (AJOL)

    Background: Transmission of hospital acquired infections (HAIs) may be associated with contamination of healthcare workers' (HCWs) hands and white coats. Objective: The purpose of this study was to clarify the role of HCWs' white coats in transmitting HAIs and to determine the association between bacterial ...

  6. Hands4U: the effectiveness of a multifaceted implementation strategy on behaviour related to the prevention of hand eczema-a randomised controlled trial among healthcare workers.

    Science.gov (United States)

    van der Meer, Esther W C; Boot, Cécile R L; Twisk, Jos W R; Coenraads, Pieter Jan; Jungbauer, Frank H W; van der Gulden, Joost W J; Anema, Johannes R

    2014-07-01

    To investigate the effects of a multifaceted implementation strategy on behaviour, behavioural determinants, knowledge and awareness of healthcare workers regarding the use of recommendations to prevent hand eczema. The Hands4U study is a randomised controlled trial. A total of 48 departments (n=1649 workers) were randomly allocated to the multifaceted implementation strategy or the control group (minimal implementation strategy). Within the departments designated to the multifaceted implementation strategy, participatory working groups were set up to enhance the implementation of the recommendations for hand eczema. In addition, working group members were trained to become role models, and an education session was given within the department. Outcome measures were awareness, knowledge, receiving information, behaviour and behavioural determinants. Data were collected at baseline, with a 3- and 6-month follow-up. Statistically significant effects were found after 6 months for awareness (OR 6.30; 95% CI 3.41 to 11.63), knowledge (B 0.74; 95% CI 0.54 to 0.95), receiving information (OR 9.81; 95% CI 5.60 to 17.18), washing hands (B -0.40; 95% -0.51 to -0.29), use of moisturiser (B 0.29; 95% CI 0.20 to 0.38), cotton under gloves (OR 3.94; 95% CI 2.04 to 7.60) and the overall compliance measure (B 0.14; 95% CI 0.02 to 0.26), as a result of the multifaceted implementation strategy. No effects were found for behavioural determinants. The multifaceted implementation strategy can be used in healthcare settings to enhance the implementation of recommendations for the prevention of hand eczema. NTR2812. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  7. Development of an observational measure of healthcare worker hand-hygiene behaviour: the hand-hygiene observation tool (HHOT).

    Science.gov (United States)

    McAteer, J; Stone, S; Fuller, C; Charlett, A; Cookson, B; Slade, R; Michie, S

    2008-03-01

    Previous observational measures of healthcare worker (HCW) hand-hygiene behaviour (HHB) fail to provide adequate standard operating procedures (SOPs), accounts of inter-rater agreement testing or evidence of sensitivity to change. This study reports the development of an observational tool in a way that addresses these deficiencies. Observational categories were developed systematically, guided by a clinical guideline, previous measures and pilot hand-hygiene behaviour observations (HHOs). The measure, a simpler version of the Geneva tool, consists of HHOs (before and after low-risk, high-risk or unobserved contact), HHBs (soap, alcohol hand rub, no action, unknown), and type of HCW. Inter-observer agreement for each category was assessed by observation of 298 HHOs and HHBs by two independent observers on acute elderly and intensive care units. Raw agreement (%) and Kappa were 77% and 0.68 for HHB; 83% and 0.77 for HHO; and 90% and 0.77 for HCW. Inter-observer agreement for overall compliance of a group of HCWs was assessed by observation of 1191 HHOs and HHBs by two pairs of independent observers. Overall agreement was good (intraclass correlation coefficient = 0.79). Sensitivity to change was examined by autoregressive time-series modelling of longitudinal observations for 8 months on the intensive therapy unit during an Acinetobacter baumannii outbreak and subsequent strengthening of infection control measures. Sensitivity to change was demonstrated by a rise in compliance from 80 to 98% with an odds ratio of increased compliance of 7.00 (95% confidence interval: 4.02-12.2) P < 0.001.

  8. Relationship between healthcare worker surface contacts, care type and hand hygiene: an observational study in a single-bed hospital ward.

    Science.gov (United States)

    King, M-F; Noakes, C J; Sleigh, P A; Bale, S; Waters, L

    2016-09-01

    This study quantifies the relationship between hand hygiene and the frequency with which healthcare workers (HCWs) touch surfaces in patient rooms. Surface contacts and hand hygiene were recorded in a single-bed UK hospital ward for six care types. Surface contacts often formed non-random patterns, but hygiene before or after patient contact depends significantly on care type (P=0.001). The likelihood of hygiene correlated with the number of surface contacts (95% confidence interval 1.1-5.8, P=0.002), but not with time spent in the room. This highlights that a potential subconscious need for hand hygiene may have developed in HCWs, which may support and help focus future hygiene education programmes. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. Recommended Vaccines for Healthcare Workers

    Science.gov (United States)

    ... Vaccination Resources for Healthcare Professionals Recommended Vaccines for Healthcare Workers Recommend on Facebook Tweet Share Compartir On ... for More Information Resources for Those Vaccinating HCWs Healthcare workers (HCWs) are at risk for exposure to ...

  10. Contact lens use and its compliance for care among healthcare workers in Pakistan

    Directory of Open Access Journals (Sweden)

    Muhammed Hamza Khan

    2013-01-01

    Full Text Available Background: Poor care and hygiene of contact lens (CL results in eye problems and infections. Healthcare workers have an important role in advocating correct lens care. Objectives: To determine the practices of CL care and the adverse consequences of poor CL care among healthcare workers. Setting and Design: A cross-sectional study in one public and three private sector hospitals in Karachi, Pakistan, in 2009-2010. Materials and Methods: We questioned 500 healthcare workers of all ages and both sexes, who wore CL, about compliance with advice on care and any complications due to improper hygiene practices. Ethical approval was obtained. Chi-square tests were used to determine significance and p-value less than 0.05 was considered statistically significant. Results: Of the total CL users, 385 (77% were females. Most (75% respondents wore CL to correct myopia, whereas 54% wore CL only occasionally. Surprisingly, only 24% knew the CL cleaning protocol. Lens solution was changed daily by 33% of users and after more than 2 weeks by 42%. Although 412 (82% participants practised reasonable hand hygiene before inserting CL, 88 (18% did not. Infection and eye dryness were statistically significantly (P < 0.01 associated with sex, hand-washing, and frequency of CL use. Conclusion: Noncompliance with the CL protocol was common among healthcare workers in our society. This behavior calls for targeted health education and awareness programs for healthcare workers.

  11. Quantification of Staphylococcus aureus and Staphylococcus epidermidis on the hands of health-care workers using a real-time polymerase chain reaction method

    DEFF Research Database (Denmark)

    Horn, P; Schouenborg, P Øland; Brandslund, I

    2007-01-01

    OBJECTIVE: The objective of this study was to test a polymerase chain reaction (PCR) assay intended as a tool for monitoring hand hygiene in hospital wards. METHODS: The hands of 20 health-care workers were sampled for 10 days using real-time PCR for quantification of Staphylococcus aureus and S....... epidermidis. Reference intervals (CI) and biological variation were evaluated using index of individuality (II) and critical difference (CD). RESULTS: 45% of the participants were positive for S. aureus on all 10 days. Intra-individual biological variation (CVI) was 129% for S. aureus and 62% for S...

  12. Economic Evaluation of a Multifaceted Implementation Strategy for the Prevention of Hand Eczema Among Healthcare Workers in Comparison with a Control Group: The Hands4U Study.

    Science.gov (United States)

    van der Meer, Esther W C; van Dongen, Johanna M; Boot, Cécile R L; van der Gulden, Joost W J; Bosmans, Judith E; Anema, Johannes R

    2016-05-01

    The aim of this study was to evaluate the cost-effectiveness of a multifaceted implementation strategy for the prevention of hand eczema in comparison with a control group among healthcare workers. A total of 48 departments (n=1,649) were randomly allocated to the implementation strategy or the control group. Data on hand eczema and costs were collected at baseline and every 3 months. Cost-effectiveness analyses were performed using linear multilevel analyses. The probability of the implementation strategy being cost-effective gradually increased with an increasing willingness-to-pay, to 0.84 at a ceiling ratio of €590,000 per person with hand eczema prevented (societal perspective). The implementation strategy appeared to be not cost-effective in comparison with the control group (societal perspective), nor was it cost-beneficial to the employer. However, this study had some methodological problems which should be taken into account when interpreting the results.

  13. Assessment of Fidelity in Interventions to Improve Hand Hygiene of Healthcare Workers: A Systematic Review

    Science.gov (United States)

    Musuuza, Jackson S.; Barker, Anna; Ngam, Caitlyn; Vellardita, Lia; Safdar, Nasia

    2016-01-01

    OBJECTIVE Compliance with hand hygiene in healthcare workers is fundamental to infection prevention yet remains a challenge to sustain. We examined fidelity reporting in interventions to improve hand hygiene compliance, and we assessed 5 measures of intervention fidelity: (1) adherence, (2) exposure or dose, (3) quality of intervention delivery, (4) participant responsiveness, and (5) program differentiation. DESIGN Systematic review METHODS A librarian performed searches of the literature in PubMed, Cumulative Index to Nursing and Allied Health (CINAHL), Cochrane Library, and Web of Science of material published prior to June 19, 2015. The review protocol was registered in PROSPERO International Prospective Register of Systematic Reviews, and assessment of study quality was conducted for each study reviewed. RESULTS A total of 100 studies met the inclusion criteria. Only 8 of these 100 studies reported all 5 measures of intervention fidelity. In addition, 39 of 100 (39%) failed to include at least 3 fidelity measures; 20 of 100 (20%) failed to include 4 measures; 17 of 100 (17%) failed to include 2 measures, while 16 of 100 (16%) of the studies failed to include at least 1 measure of fidelity. Participant responsiveness and adherence to the intervention were the most frequently unreported fidelity measures, while quality of the delivery was the most frequently reported measure. CONCLUSIONS Almost all hand hygiene intervention studies failed to report at least 1 fidelity measurement. To facilitate replication and effective implementation, reporting fidelity should be standard practice when describing results of complex behavioral interventions such as hand hygiene. PMID:26861117

  14. Occupational Stress Among Home Healthcare Workers: Integrating Worker and Agency-Level Factors.

    Science.gov (United States)

    Zoeckler, Jeanette M

    2018-02-01

    Home healthcare work is physically and emotionally exhausting. In addition, home healthcare workers frequently work under precarious work arrangements for low wages and in poor work conditions. Little is known about how sources of job strain for home healthcare workers might be reduced. This research examines the occupational stressors among paid home care workers by analyzing home healthcare agency characteristics and individual home healthcare workers' experiences in upstate New York agencies (n = 9). The study augments existing theoretical models and describes new sources of stress arising from the nature of agency-based caregiving. Results feature the analysis of both agency executives' (n = 20) and home healthcare workers' narratives (n = 25) to make the agency's inner workings more transparent. Agency structures and culture are implicated in the lack of progress to address home care workers' health problems. Policy change should focus on compensation, healthier work conditions, and training requirements.

  15. Hand hygiene and healthcare system change within multi-modal promotion: a narrative review.

    Science.gov (United States)

    Allegranzi, B; Sax, H; Pittet, D

    2013-02-01

    Many factors may influence the level of compliance with hand hygiene recommendations by healthcare workers. Lack of products and facilities as well as their inappropriate and non-ergonomic location represent important barriers. Targeted actions aimed at making hand hygiene practices feasible during healthcare delivery by ensuring that the necessary infrastructure is in place, defined as 'system change', are essential to improve hand hygiene in healthcare. In particular, access to alcohol-based hand rubs (AHRs) enables appropriate and timely hand hygiene performance at the point of care. The feasibility and impact of system change within multi-modal strategies have been demonstrated both at institutional level and on a large scale. The introduction of AHRs overcomes some important barriers to best hand hygiene practices and is associated with higher compliance, especially when integrated within multi-modal strategies. Several studies demonstrated the association between AHR consumption and reduction in healthcare-associated infection, in particular, meticillin-resistant Staphylococcus aureus bacteraemia. Recent reports demonstrate the feasibility and success of system change implementation on a large scale. The World Health Organization and other investigators have reported the challenges and encouraging results of implementing hand hygiene improvement strategies, including AHR introduction, in settings with limited resources. This review summarizes the available evidence demonstrating the need for system change and its importance within multi-modal hand hygiene improvement strategies. This topic is also discussed in a global perspective and highlights some controversial issues. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  16. Frequent Multidrug-Resistant Acinetobacter baumannii Contamination of Gloves, Gowns, and Hands of Healthcare Workers

    Science.gov (United States)

    Morgan, Daniel J.; Liang, Stephen Y.; Smith, Catherine L.; Johnson, J. Kristie; Harris, Anthony D.; Furuno, Jon P.; Thom, Kerri A.; Snyder, Graham M.; Day, Hannah R.; Perencevich, Eli N.

    2010-01-01

    BACKGROUND Multidrug-resistant (MDR) gram-negative bacilli are important nosocomial pathogens. OBJECTIVE To determine the incidence of transmission of MDR Acinetobacter baumannii and Pseudomonas aeruginosa from patients to healthcare workers (HCWs) during routine patient care. DESIGN Prospective cohort study. SETTING Medical and surgical intensive care units. METHODS We observed HCWs who entered the rooms of patients colonized with MDR A. baumannii or colonized with both MDR A. baumannii and MDR P. aeruginosa. We examined their hands before room entry, their disposable gloves and/or gowns upon completion of patient care, and their hands after removal of gloves and/or gowns and before hand hygiene. RESULTS Sixty-five interactions occurred with patients colonized with MDR A. baumannii and 134 with patients colonized with both MDR A. baumannii and MDR P. aeruginosa. Of 199 interactions between HCWs and patients colonized with MDR A. baumannii, 77 (38.7% [95% confidence interval {CI}, 31.9%–45.5%]) resulted in HCW contamination of gloves and/or gowns, and 9 (4.5% [95% CI, 1.6%–7.4%]) resulted in contamination of HCW hands after glove removal before hand hygiene. Of 134 interactions with patients colonized with MDR P. aeruginosa, 11 (8.2% [95% CI, 3.6%–12.9%]) resulted in HCW contamination of gloves and/or gowns, and 1 resulted in HCW contamination of hands. Independent risk factors for contamination with MDR A. baumannii were manipulation of wound dressing (adjusted odds ratio [aOR], 25.9 [95% CI, 3.1–208.8]), manipulation of artificial airway (aOR, 2.1 [95% CI, 1.1–4.0]), time in room longer than 5 minutes (aOR, 4.3 [95% CI, 2.0–9.1]), being a physician or nurse practitioner (aOR, 7.4 [95% CI, 1.6–35.2]), and being a nurse (aOR, 2.3 [95% CI, 1.1–4.8]). CONCLUSIONS Gowns, gloves, and unwashed hands of HCWs were frequently contaminated with MDR A. baumannii. MDR A. baumannii appears to be more easily transmitted than MDR P. aeruginosa and perhaps more

  17. The 'My five moments for hand hygiene' concept for the overcrowded setting in resource-limited healthcare systems.

    Science.gov (United States)

    Salmon, S; Pittet, D; Sax, H; McLaws, M L

    2015-10-01

    Hand hygiene is a core activity of patient safety for the prevention of healthcare-associated infections (HCAIs). To standardize hand hygiene practices globally the World Health Organization (WHO) released Guidelines on Hand Hygiene in Health Care and introduced the 'My five moments for hand hygiene' concept to define indications for hand hygiene rooted in an evidence-based model for transmission of micro-organisms by healthcare workers' (HCWs) hands. Central to the concept is the division of the healthcare environment into two geographical care zones, the patient zone and the healthcare zone, that requires the HCW to comply with specific hand hygiene moments. In resource-limited, overcrowded healthcare settings inadequate or no spatial separation between beds occurs frequently. These conditions challenge the HCW's ability to visualize and delineate patient zones. The 'My five moments for hand hygiene' concept has been adapted for these conditions with the aim of assisting hand hygiene educators, auditors, and HCWs to minimize ambiguity regarding shared patient zones and achieve the ultimate goal set by the WHO Guidelines--the reduction of infectious risks. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  18. Real-time feedback for improving compliance to hand sanitization among healthcare workers in an open layout ICU using radiofrequency identification.

    Science.gov (United States)

    Radhakrishna, Kedar; Waghmare, Abijeet; Ekstrand, Maria; Raj, Tony; Selvam, Sumithra; Sreerama, Sai Madhukar; Sampath, Sriram

    2015-06-01

    The aim of this study is to increase hand sanitizer usage among healthcare workers by developing and implementing a low-cost intervention using RFID and wireless mesh networks to provide real-time alarms for increasing hand hygiene compliance during opportune moments in an open layout Intensive Care Unit (ICU). A wireless, RFID based system was developed and implemented in the ICU. The ICU beds were divded into an intervention arm (n = 10) and a control arm (n = 14). Passive RFID tags were issued to the doctors, nurses and support staff of the ICU. Long range RFID readers were positioned strategically. Sensors were placed beneath the hand sanitizers to record sanitizer usage. The system would alert the HCWs by flashing a light if an opportune moment for hand sanitization was detected. A significant increase in hand sanitizer use was noted in the intervention arm. Usage was highest during the early part of the workday and decreased as the day progressed. Hand wash events per person hour was highest among the ancilliary staff followed by the doctors and nurses. Real-time feedback has potential to increase hand hygiene compliance among HCWs. The system demonstrates the possibility of automating compliance monitoring in an ICU with an open layout.

  19. Improving hand hygiene compliance in healthcare settings using behavior change theories: reflections.

    Science.gov (United States)

    Al-Tawfiq, Jaffar A; Pittet, Didier

    2013-01-01

    Although hand hygiene is the most effective method for preventing healthcare-associated infections, hand hygiene practice falls short in many healthcare facilities. The compliance rate is mostly linked to system design and easily accessible hand hygiene products. System change, healthcare worker motivation, and complex behavioral considerations seem to play a significant role. This article discusses the application of behavioral theories in hand hygiene promotion in a theoretical manner. The program relies on the transtheoretical model (TTM) of health behavior change, John Keller's (ARCS) Model of Motivational Design, and the theory of planned behavior (TPB). Thus, the program links attitudes and behavior to hand hygiene promotion. The TTM of health behavior change helps to tailor interventions to predict and motivate individual movement across the pathway to change. A program could be based on this theory with multiple intercalations with John Keller's ARCS and the TPB. Such a program could be strengthened by linking attitudes and behavior to promote hand hygiene. The program could utilize different strategies such as organization cultural change that may increase the attention as well as fostering the movement in the ARCS stages. In addition, modeling TPB by creating peer pressure, ability to overcome obstacles, and increasing knowledge of the role of hand hygiene may lead to the desired outcome. The understanding and application of behavior change theories may result in an effective program to improve awareness and raise intention and thus may increase the potential for success of hand hygiene promotion programs.

  20. Hand eczema

    DEFF Research Database (Denmark)

    Ibler, K.S.; Jemec, G.B.E.; Flyvholm, M.-A.

    2012-01-01

    Background. Healthcare workers are at increased risk of developing hand eczema. Objectives. To investigate the prevalence and severity of self-reported hand eczema, and to relate the findings to demographic data, occupation, medical speciality, wards, shifts, and working hours. Patients/materials......Background. Healthcare workers are at increased risk of developing hand eczema. Objectives. To investigate the prevalence and severity of self-reported hand eczema, and to relate the findings to demographic data, occupation, medical speciality, wards, shifts, and working hours. Patients...... dermatitis, younger age, male sex (male doctors), and working hours. Eighty nine per cent of subjects reported mild/moderate lesions. Atopic dermatitis was the only factor significantly related to severity. Sick leave was reported by 8% of subjects, and notification to the authorities by 12%. Conclusions...... or severity, but cultural differences between professions with respect to coping with the eczema were significant. Atopic dermatitis was related to increased prevalence and severity, and preventive efforts should be made for healthcare workers with atopic dermatitis....

  1. Stakeholders' Perceptions on Shortage of Healthcare Workers in Primary Healthcare in Botswana: Focus Group Discussions.

    Directory of Open Access Journals (Sweden)

    Oathokwa Nkomazana

    Full Text Available An adequate health workforce force is central to universal health coverage and positive public health outcomes. However many African countries have critical shortages of healthcare workers, which are worse in primary healthcare. The aim of this study was to explore the perceptions of healthcare workers, policy makers and the community on the shortage of healthcare workers in Botswana.Fifteen focus group discussions were conducted with three groups of policy makers, six groups of healthcare workers and six groups of community members in rural, urban and remote rural health districts of Botswana. All the participants were 18 years and older. Recruitment was purposive and the framework method was used to inductively analyse the data.There was a perceived shortage of healthcare workers in primary healthcare, which was believed to result from an increased need for health services, inequitable distribution of healthcare workers, migration and too few such workers being trained. Migration was mainly the result of unfavourable personal and family factors, weak and ineffective healthcare and human resources management, low salaries and inadequate incentives for rural and remote area service.Botswana has a perceived shortage of healthcare workers, which is worse in primary healthcare and rural areas, as a result of multiple complex factors. To address the scarcity the country should train adequate numbers of healthcare workers and distribute them equitably to sufficiently resourced healthcare facilities. They should be competently managed and adequately remunerated and the living conditions and rural infrastructure should also be improved.

  2. Hand hygiene strategies

    OpenAIRE

    Yazaji, Eskandar Alex

    2011-01-01

    Hand hygiene is one of the major players in preventing healthcare associated infections. However, healthcare workers compliance with hand hygiene continues to be a challenge. This article will address strategies to help improving hand hygiene compliance. Keywords: hand hygiene; healthcare associated infections; multidisciplinary program; system change; accountability; education; feedback(Published: 18 July 2011)Citation: Journal of Community Hospital Internal Medicine Perspectives 2011, 1: 72...

  3. Tuberculosis in healthcare workers and infection control measures at primary healthcare facilities in South Africa.

    Science.gov (United States)

    Claassens, Mareli M; van Schalkwyk, Cari; du Toit, Elizabeth; Roest, Eline; Lombard, Carl J; Enarson, Donald A; Beyers, Nulda; Borgdorff, Martien W

    2013-01-01

    Challenges exist regarding TB infection control and TB in hospital-based healthcare workers in South Africa. However, few studies report on TB in non-hospital based healthcare workers such as primary or community healthcare workers. Our objectives were to investigate the implementation of TB infection control measures at primary healthcare facilities, the smear positive TB incidence rate amongst primary healthcare workers and the association between TB infection control measures and all types of TB in healthcare workers. One hundred and thirty three primary healthcare facilities were visited in five provinces of South Africa in 2009. At each facility, a TB infection control audit and facility questionnaire were completed. The number of healthcare workers who had had TB during the past three years was obtained. The standardised incidence ratio of smear positive TB in primary healthcare workers indicated an incidence rate of more than double that of the general population. In a univariable logistic regression, the infection control audit score was significantly associated with reported cases of TB in healthcare workers (OR=1.04, 95%CI 1.01-1.08, p=0.02) as was the number of staff (OR=3.78, 95%CI 1.77-8.08). In the multivariable analysis, the number of staff remained significantly associated with TB in healthcare workers (OR=3.33, 95%CI 1.37-8.08). The high rate of TB in healthcare workers suggests a substantial nosocomial transmission risk, but the infection control audit tool which was used did not perform adequately as a measure of this risk. Infection control measures should be monitored by validated tools developed and tested locally. Different strategies, such as routine surveillance systems, could be used to evaluate the burden of TB in healthcare workers in order to calculate TB incidence, monitor trends and implement interventions to decrease occupational TB.

  4. Tuberculosis in Healthcare Workers and Infection Control Measures at Primary Healthcare Facilities in South Africa

    Science.gov (United States)

    Claassens, Mareli M.; van Schalkwyk, Cari; du Toit, Elizabeth; Roest, Eline; Lombard, Carl J.; Enarson, Donald A.; Beyers, Nulda; Borgdorff, Martien W.

    2013-01-01

    Background Challenges exist regarding TB infection control and TB in hospital-based healthcare workers in South Africa. However, few studies report on TB in non-hospital based healthcare workers such as primary or community healthcare workers. Our objectives were to investigate the implementation of TB infection control measures at primary healthcare facilities, the smear positive TB incidence rate amongst primary healthcare workers and the association between TB infection control measures and all types of TB in healthcare workers. Methods One hundred and thirty three primary healthcare facilities were visited in five provinces of South Africa in 2009. At each facility, a TB infection control audit and facility questionnaire were completed. The number of healthcare workers who had had TB during the past three years was obtained. Results The standardised incidence ratio of smear positive TB in primary healthcare workers indicated an incidence rate of more than double that of the general population. In a univariable logistic regression, the infection control audit score was significantly associated with reported cases of TB in healthcare workers (OR=1.04, 95%CI 1.01-1.08, p=0.02) as was the number of staff (OR=3.78, 95%CI 1.77-8.08). In the multivariable analysis, the number of staff remained significantly associated with TB in healthcare workers (OR=3.33, 95%CI 1.37-8.08). Conclusion The high rate of TB in healthcare workers suggests a substantial nosocomial transmission risk, but the infection control audit tool which was used did not perform adequately as a measure of this risk. Infection control measures should be monitored by validated tools developed and tested locally. Different strategies, such as routine surveillance systems, could be used to evaluate the burden of TB in healthcare workers in order to calculate TB incidence, monitor trends and implement interventions to decrease occupational TB. PMID:24098461

  5. Impact of a hospital-wide hand hygiene promotion strategy on healthcare-associated infections.

    Science.gov (United States)

    Ling, Moi Lin; How, Kue Bien

    2012-03-23

    During the Severe Acute Respiratory Syndrome (SARS) outbreak, high compliance in healthcare workers to hand hygiene was primarily driven by fear. However, the post-SARS period confirmed that this practice was not sustainable. At the Singapore General Hospital, a 1,600-bedded acute tertiary care hospital, the hand hygiene program was revised in early 2007 following Singapore's signing of the pledge to the World Health Organization (WHO) "Clean Care is Safer Care" program. A multi-prong approach was used in designing the hand hygiene program. This included system change; training and education; evaluation and feedback; reminders in the workplace; and institutional safety climate. Hand hygiene compliance rate improved from 20% (in January 2007) to 61% (2010). Improvement was also seen annually in the compliance to each of the 5 moments as well as in all staff categories. Healthcare-associated MRSA infections were reduced from 0.6 (2007) to 0.3 (2010) per 1000 patient-days. Leadership's support of the program evidenced through visible leadership presence, messaging and release of resources is the key factor in helping to make the program a true success. The hospital was recognised as a Global Hand Hygiene Expert Centre in January 2011. The WHO multi-prong interventions work in improving compliance and reducing healthcare associated infections.

  6. Healthcare Workers and Workplace Violence

    Directory of Open Access Journals (Sweden)

    Tevfik Pinar

    2013-06-01

    Full Text Available Workplace violence is a threatening worldwide public health problem. Healthcare workers have under particular risk of workplace violence, and they are being exposed to violence 4-16 times more than other service workers. The frequency of violence in the health sector in the world has indicated in different range of results since there is no consistent definition of workplace violence and differences in research methodology (any type of violence: 22,0% - 60,0%; physical violence: 2,6% - 57,0%; verbal violence: 24,3% - 82,0%; sexual harassment: %1,9 - 10,5%. All healthcare workers have right to work in a safe working place. The safety of healthcare workers should deserve the same priority as patient safety. Various risk factors including social, cultural, environmental, organizational and personal elements play a role in the formation of workplace violence that is very important for our country. Considering all those factors, the workplace violence in health sector should be seriously handled and the strategies and policies must be developed for prevention. [TAF Prev Med Bull 2013; 12(3.000: 315-326

  7. Why healthcare workers give prelacteal feeds.

    Science.gov (United States)

    Akuse, R M; Obinya, E A

    2002-08-01

    Because prelacteal feeds can adversely affect breastfeeding, UNICEF/WHO discourage their use unless medically indicated. The study was carried out to determine the proportion of healthcare workers who routinely give prelacteal feeds, and their reasons for doing so; further, to determine whether any differences exist between medically and non-medically trained healthcare workers in their administration of prelacteal feeds. Survey. Primary, secondary and tertiary health facilities in Kaduna township Nigeria. Of 1100 healthcare workers sampled, 747 (68%) responded. Of these 80% had received medical training, 20% had not. Use of a pretested validated questionnaire. Large proportions of both medical and non-medically trained healthcare workers stated they routinely give prelacteal feeds (doctors, 68.2%; nurses, 70.2%; and non-medical, 73.6%). However their reasons for doing so differed significantly (P=0.00001). Nurses gave mainly for perceived breast milk insufficiency, doctors for prevention of dehydration, hypoglycaemia and neonatal jaundice and non-medical staff to prepare the gastrointestinal tract for digestion and to quench thirst. Most healthcare workers (medical and non-medical) routinely and unnecessarily give prelacteal feeds. Therefore training and retraining programmes in lactation management are necessary and must include non-medical staff. These programmes, while emphasizing the danger of giving prelacteal feeds, must deal with the misconceptions of each group. Deliberate efforts have to be made to incorporate clinical training in breastfeeding in curricula of Schools of Medicine and Nursing.

  8. [Hand hygiene technique assessment using electronic equipment in 26 Hungarian healthcare institutions].

    Science.gov (United States)

    Lehotsky, Ákos; Morvai, Júlia; Szilágyi, László; Bánsághi, Száva; Benkó, Alíz; Haidegger, Tamás

    2017-07-01

    Hand hygiene is probably the most effective tool of nosocomial infection prevention, however, proper feedback and control is needed to develop the individual hand hygiene practice. Assessing the efficiency of modern education tools, and digital demonstration and verification equipment during their wide-range deployment. 1269 healthcare workers took part in a training organized by our team. The training included the assessment of the participants' hand hygiene technique to identify the most often missed areas. The hand hygiene technique was examined by a digital device. 33% of the participants disinfected their hands incorrectly. The most often missed sites are the fingertips (33% on the left hand, 37% on the right hand) and the thumbs (42% on the left hand, 32% on the right hand). The feedback has a fundamental role in the development of the hand hygiene technique. With the usage of electronic devices feedback can be provided efficiently and simply. Orv Hetil. 2017; 158(29): 1143-1148.

  9. Tuberculosis in healthcare workers and infection control measures at primary healthcare facilities in South Africa

    NARCIS (Netherlands)

    Claassens, Mareli M.; van Schalkwyk, Cari; du Toit, Elizabeth; Roest, Eline; Lombard, Carl J.; Enarson, Donald A.; Beyers, Nulda; Borgdorff, Martien W.

    2013-01-01

    Challenges exist regarding TB infection control and TB in hospital-based healthcare workers in South Africa. However, few studies report on TB in non-hospital based healthcare workers such as primary or community healthcare workers. Our objectives were to investigate the implementation of TB

  10. Hands4U: the effects of a multifaceted implementation strategy on hand eczema prevalence in a healthcare setting. Results of a randomized controlled trial.

    Science.gov (United States)

    van der Meer, Esther W C; Boot, Cécile R L; van der Gulden, Joost W J; Knol, Dirk L; Jungbauer, Frank H W; Coenraads, Pieter Jan; Anema, Johannes R

    2015-05-01

    Healthcare workers have an increased risk of developing hand eczema. A multifaceted implementation strategy was developed to implement a guideline to prevent hand eczema among healthcare workers. To investigate the effects of the implementation strategy on self-reported hand eczema and preventive behaviour. A randomized controlled trial was performed. A total of 48 departments (n = 1649) were randomly allocated to the multifaceted implementation strategy or the control group. The strategy consisted of education, participatory working groups, and role models. Outcome measures were self-reported hand eczema and preventive behaviour. Data were collected at baseline, and 3, 6, 9 and 12 months of follow-up. Participants in the intervention group were significantly more likely to report hand eczema [odds ratio (OR) 1.45; 95% confidence interval (CI) 1.03-2.04], and they reported significantly less hand washing (B, - 0.38; 95%CI: - 0.48 to - 0.27), reported significantly more frequent use of a moisturizer (B, 0.30; 95%CI: 0.22-0.39) and were more likely to report wearing cotton undergloves (OR 6.33; 95%CI: 3.23-12.41) than participants in the control group 12 months after baseline. The strategy implemented can be used in practice, as it showed positive effects on preventive behaviour. More research is needed to investigate the unexpected effects on hand eczema. © 2014 The Authors. Contact Dermatitis published by John Wiley & Sons Ltd.

  11. Impact of a hospital-wide hand hygiene promotion strategy on healthcare-associated infections

    Directory of Open Access Journals (Sweden)

    Ling Moi Lin

    2012-03-01

    Full Text Available Abstract Background During the Severe Acute Respiratory Syndrome (SARS outbreak, high compliance in healthcare workers to hand hygiene was primarily driven by fear. However, the post-SARS period confirmed that this practice was not sustainable. At the Singapore General Hospital, a 1,600-bedded acute tertiary care hospital, the hand hygiene program was revised in early 2007 following Singapore's signing of the pledge to the World Health Organization (WHO "Clean Care is Safer Care" program. Findings A multi-prong approach was used in designing the hand hygiene program. This included system change; training and education; evaluation and feedback; reminders in the workplace; and institutional safety climate. Hand hygiene compliance rate improved from 20% (in January 2007 to 61% (2010. Improvement was also seen annually in the compliance to each of the 5 moments as well as in all staff categories. Healthcare-associated MRSA infections were reduced from 0.6 (2007 to 0.3 (2010 per 1000 patient-days. Conclusions Leadership's support of the program evidenced through visible leadership presence, messaging and release of resources is the key factor in helping to make the program a true success. The hospital was recognised as a Global Hand Hygiene Expert Centre in January 2011. The WHO multi-prong interventions work in improving compliance and reducing healthcare associated infections.

  12. Introduction to ergonomics for healthcare workers.

    Science.gov (United States)

    Waters, Thomas R

    2010-01-01

    Healthcare workers who handle and move patients as part of their jobs suffer a disproportionately high number of work-related musculoskeletal disorders (MSDs). The majority of reported work-related MSDs are back pain cases that result in significant numbers of lost work days. It is likely that these lost workdays have a substantial impact on the quality and cost of health care. Patient care ergonomics can reduce the risk of work-related MSDs by helping safety experts design the work so it can be safely performed by most workers. This article provides a general overview of ergonomics--what it is, how it can be used to help design safe work, and why all healthcare workers and administrators should know and understand how excessive work demands can lead to increased risk of work-related MSDs. The article will also explain technological solutions that can be implemented to reduce the risk of work-related MSDs for healthcare workers.

  13. Tuberculosis and latent tuberculosis infection among healthcare workers in Kisumu, Kenya.

    Science.gov (United States)

    Agaya, Janet; Nnadi, Chimeremma D; Odhiambo, Joseph; Obonyo, Charles; Obiero, Vincent; Lipke, Virginia; Okeyo, Elisha; Cain, Kevin; Oeltmann, John E

    2015-12-01

    To assess prevalence and occupational risk factors of latent TB infection and history of TB disease ascribed to work in a healthcare setting in western Kenya. We conducted a cross-sectional survey among healthcare workers in western Kenya in 2013. They were recruited from dispensaries, health centres and hospitals that offer both TB and HIV services. School workers from the health facilities' catchment communities were randomly selected to serve as the community comparison group. Latent TB infection was diagnosed by tuberculin skin testing. HIV status of participants was assessed. Using a logistic regression model, we determined the adjusted odds of latent TB infection among healthcare workers compared to school workers; and among healthcare workers only, we assessed work-related risk factors for latent TB infection. We enrolled 1005 healthcare workers and 411 school workers. Approximately 60% of both groups were female. A total of 22% of 958 healthcare workers and 12% of 392 school workers tested HIV positive. Prevalence of self-reported history of TB disease was 7.4% among healthcare workers and 3.6% among school workers. Prevalence of latent TB infection was 60% among healthcare workers and 48% among school workers. Adjusted odds of latent TB infection were 1.5 times higher among healthcare workers than school workers (95% confidence interval 1.2-2.0). Healthcare workers at all three facility types had similar prevalence of latent TB infection (P = 0.72), but increasing years of employment was associated with increased odds of LTBI (P Kenya which offer TB and HIV services are at increased risk of latent TB infection, and the risk is similar across facility types. Implementation of WHO-recommended TB infection control measures are urgently needed in health facilities to protect healthcare workers. © 2015 John Wiley & Sons Ltd.

  14. Smoking and Depression among Healthcare Workers

    Directory of Open Access Journals (Sweden)

    Madhusudhan Ghimire

    2014-06-01

    Full Text Available Introduction: Healthcare workers are a special public icon for the community because people would like to adopt and implement their knowledge, skill, attitude and behaviour for improving quality of health. People respect them for their knowledge and health behavior. It is believed that the level of health status of health workers as well as community should go ahead parallel but many researchers have noted that high risk behaviours (smoking, tobacco use, alcoholism, irregular diet intake, lack of exercise etc. are prevalent among health workers. The result of this will be physical, psychological, familial and social disturbance, which might have an impact on health care delivery system of the country. The study was concerned to assess health status (body mass index, smoking and depression of healthcare workers and its impact on social adjustment in Banke district of Nepal. Methods: A cross sectional study design was applied to conduct the research. One hundred and eight respondents were selected through random sampling from the purposive group. Data wa collected through interview by using interview schedule. SPSS-16 windows process was used to analyze data. Results: Most of the respondent (81.40% were under the age group less than 30 years (M = 27.35, SD = 9.24 years. More than 57.40% of respondents were female. Most of them (68.50% were unmarried. Maximum (82.20% responders had normal Body Mass Index (18.5-24.99. Near about forty percent (38.9% healthcare worker had faced social problems in their working area. Conclusion: Age (above 20 years and male healthcare workers were more likely to smoke cigarettes. Depressed health workers were more likely to smoke cigarette. Depression could be observed as a determinant for social adjustment.

  15. Influence of Handprint Culture Training on Compliance of Healthcare Workers with Hand Hygiene

    Directory of Open Access Journals (Sweden)

    Hala Fouad

    2018-01-01

    Full Text Available Objective. We aimed to study the effect of visual observation of bacterial growth from handprints on healthcare workers’ (HCWs compliance with hand hygiene (HH. Settings. Medical and postoperative cardiac surgery units. Design. Prospective cohort study. Subject. The study included 40 HCWs. Intervention. Each HCW was interviewed on 3 separate occasions. The 1st interview was held to obtain a handprint culture before and after a session demonstrating the 7 steps of HH using alcohol-based hand rub, allowing comparison of results before and after HH. A 2nd interview was held 6 weeks later to obtain handprint culture after HH. A 3rd interview was held to obtain a handprint culture before HH. One month before implementation of handprint cultures and during the 12-week study period, monitoring of HCWs for compliance with HH was observed by 2 independent observers. Main Results. There was a significant improvement in HH compliance following handprint culture interview (p<0.001. The frequency of positive cultures, obtained from patients with suspected healthcare-associated infections, significantly declined (blood cultures: p=0.001; wound cultures: p = 0,003; sputum cultures: p=0.005. Conclusion. The visual message of handprint bacterial growth before and after HH seems an effective method to improve HH compliance.

  16. Healthcare worker contact networks and the prevention of hospital-acquired infections.

    Directory of Open Access Journals (Sweden)

    Donald E Curtis

    Full Text Available We present a comprehensive approach to using electronic medical records (EMR for constructing contact networks of healthcare workers in a hospital. This approach is applied at the University of Iowa Hospitals and Clinics (UIHC--a 3.2 million square foot facility with 700 beds and about 8,000 healthcare workers--by obtaining 19.8 million EMR data points, spread over more than 21 months. We use these data to construct 9,000 different healthcare worker contact networks, which serve as proxies for patterns of actual healthcare worker contacts. Unlike earlier approaches, our methods are based on large-scale data and do not make any a priori assumptions about edges (contacts between healthcare workers, degree distributions of healthcare workers, their assignment to wards, etc. Preliminary validation using data gathered from a 10-day long deployment of a wireless sensor network in the Medical Intensive Care Unit suggests that EMR logins can serve as realistic proxies for hospital-wide healthcare worker movement and contact patterns. Despite spatial and job-related constraints on healthcare worker movement and interactions, analysis reveals a strong structural similarity between the healthcare worker contact networks we generate and social networks that arise in other (e.g., online settings. Furthermore, our analysis shows that disease can spread much more rapidly within the constructed contact networks as compared to random networks of similar size and density. Using the generated contact networks, we evaluate several alternate vaccination policies and conclude that a simple policy that vaccinates the most mobile healthcare workers first, is robust and quite effective relative to a random vaccination policy.

  17. Difficulties facing healthcare workers in the era of AIDS treatment in Lesotho.

    Science.gov (United States)

    Koto, Masebeo Veronica; Maharaj, Pranitha

    2016-01-01

    Sub-Saharan Africa is most affected by the AIDS pandemic and Lesotho is no exception. In many countries, healthcare workers are at the forefront of the fight against AIDS. This study explores the difficulties facing healthcare workers in Lesotho using a combination of qualitative methods--focus group discussions and in-depth interviews. The findings suggest that healthcare workers are afraid of contracting HIV from their patients and this affects their delivery of services. In addition, the results revealed that poor infrastructure and shortage of supplies at the facilities hinder healthcare workers from performing their duties effectively. The other concern was the heavy workload and severe time constraints which puts enormous stress on healthcare workers. Stigma and discrimination emerged as major problems for healthcare workers. Addressing the challenges facing healthcare workers is essential in effectively managing the AIDS pandemic facing the continent.

  18. Enhanced performance feedback and patient participation to improve hand hygiene compliance of health-care workers in the setting of established multimodal promotion: a single-centre, cluster randomised controlled trial.

    Science.gov (United States)

    Stewardson, Andrew James; Sax, Hugo; Gayet-Ageron, Angèle; Touveneau, Sylvie; Longtin, Yves; Zingg, Walter; Pittet, Didier

    2016-12-01

    Hand hygiene compliance of health-care workers remains suboptimal despite standard multimodal promotion, and evidence for the effectiveness of novel interventions is urgently needed. We aimed to assess the effect of enhanced performance feedback and patient participation on hand hygiene compliance in the setting of multimodal promotion. We did a single-centre, cluster randomised controlled trial at University of Geneva Hospitals (Geneva, Switzerland). All wards hosting adult, lucid patients, and all health-care workers and patients in these wards, were eligible. After a 15-month baseline period, eligible wards were assigned by computer-generated block randomisation (1:1:1), stratified by the type of ward, to one of three groups: control, enhanced performance feedback, or enhanced performance feedback plus patient participation. Standard multimodal hand hygiene promotion was done hospital-wide throughout the study. The primary outcome was hand hygiene compliance of health-care workers (according to the WHO Five Moments of Hand Hygiene) at the opportunity level, measured by direct observation (20-min sessions) by 12 validated infection control nurses, with each ward audited at least once every 3 months. This trial is registered with ISRCTN, number ISRCTN43599478. We randomly assigned 67 wards to the control group (n=21), enhanced performance feedback (n=24), or enhanced performance feedback plus patient participation (n=22) on May 19, 2010. One ward in the control group became a high-dependency unit and was excluded from analysis. During 1367 observation sessions, 12 579 hand hygiene opportunities were recorded. Between the baseline period (April 1, 2009, to June 30, 2010) and the intervention period (July 1, 2010, to June 30, 2012), mean hand hygiene compliance increased from 66% (95% CI 62-70) to 73% (70-77) in the control group (odds ratio [OR] 1·41, 95% CI 1·21-1·63), from 65% (62-69) to 75% (72-77) in the enhanced performance feedback group (1·61, 1·41-1

  19. Vaccines for preventing hepatitis B in health-care workers

    DEFF Research Database (Denmark)

    Chen, Weikeng; Gluud, C

    2005-01-01

    Hepatitis B virus (HBV) causes acute and chronic liver diseases. Hepatitis B vaccination is recommended for health-care workers.......Hepatitis B virus (HBV) causes acute and chronic liver diseases. Hepatitis B vaccination is recommended for health-care workers....

  20. Changes in healthcare-associated Staphylococcus aureus bloodstream infections after the introduction of a national hand hygiene initiative.

    Science.gov (United States)

    Barnett, Adrian G; Page, Katie; Campbell, Megan; Brain, David; Martin, Elizabeth; Rashleigh-Rolls, Rebecca; Halton, Kate; Hall, Lisa; Jimmieson, Nerina; White, Katherine; Paterson, David; Graves, Nicholas

    2014-08-01

    Interventions that prevent healthcare-associated infection should lead to fewer deaths and shorter hospital stays. Cleaning hands (with soap or alcohol) is an effective way to prevent the transmission of organisms, but rates of compliance with hand hygiene are sometimes disappointingly low. The National Hand Hygiene Initiative in Australia aimed to improve hand hygiene compliance among healthcare workers, with the goal of reducing rates of healthcare-associated infection. We examined whether the introduction of the National Hand Hygiene Initiative was associated with a change in infection rates. Monthly infection rates for healthcare-associated Staphylococcus aureus bloodstream infections were examined in 38 Australian hospitals across 6 states. We used Poisson regression and examined 12 possible patterns of change, with the best fitting pattern chosen using the Akaike information criterion. Monthly bed-days were included to control for increased hospital use over time. The National Hand Hygiene Initiative was associated with a reduction in infection rates in 4 of the 6 states studied. Two states showed an immediate reduction in rates of 17% and 28%, 2 states showed a linear decrease in rates of 8% and 11% per year, and 2 showed no change in infection rates. The intervention was associated with reduced infection rates in most states. The failure in 2 states may have been because those states already had effective initiatives before the national initiative's introduction or because infection rates were already low and could not be further reduced.

  1. Risk of bloodborne pathogen exposure among Zambian healthcare workers

    Directory of Open Access Journals (Sweden)

    Elayne Kornblatt Phillips

    2012-06-01

    Full Text Available Purpose: Understanding the risks of bloodborne pathogen transmission is fundamental to prioritizing interventions when resources are limited. This study investigated the risks to healthcare workers in Zambia. Design: A survey was completed anonymously by a convenience sample of workers in three hospitals and two clinics in Zambia. Respondents provided information regarding job category, injuries with contaminated sharps, hepatitis B vaccination status and the availability of HIV post-exposure prophylaxis (PEP. Results: Nurses reported the largest number of injuries. The average annual sharps injury rate was 1.3 injuries per worker, and service workers (housekeepers, laundry, ward assistants had the highest rate of these injuries, 1.9 per year. Injuries were often related to inadequate disposal methods. Syringe needles accounted for the largest proportion of injuries (60%, and 15% of these injuries were related to procedures with a higher-than-average risk for infection. Most workers (88% reported the availability of PEP, and only 8% were fully vaccinated against hepatitis B. Conclusions: The injury risks identified among Zambian workers are serious and are exacerbated by the high prevalence of bloodborne pathogens in the population. This suggests that there is a high risk of occupationally acquired bloodborne pathogen infection. The findings also highlight the need for a hepatitis B vaccination program focused on healthcare workers. The risks associated with bloodborne pathogens threaten to further diminish an already scarce resource in Zambia – trained healthcare workers. To decrease these risks, we suggest the use of low-cost disposal alternatives, the implementation of cost-sensitive protective strategies and the re-allocation of some treatment resources to primary prevention. Keywords: Healthcare worker safety, Zambian healthcare workers, Bloodborne pathogen transmission, Sharps injury prevention, Infectious diseases

  2. Prevalence of needle stick injuries among healthcare workers

    African Journals Online (AJOL)

    Abe Olugbenga

    stick injury among healthcare workers at the Federal Medical Centre (FMC), Owerri. Materials and ... health workers when exposed to work .... factors and prevention of Health care workers at .... software called Statistical Package for Social.

  3. Workplace Bullying among Healthcare Workers

    Science.gov (United States)

    Ariza-Montes, Antonio; Muniz, Noel M.; Montero-Simó, María José; Araque-Padilla, Rafael Angel

    2013-01-01

    This paper aims to assess consistent predictors through the use of a sample that includes different actors from the healthcare work force to identify certain key elements in a set of job-related organizational contexts. The utilized data were obtained from the 5th European Working Conditions Survey, conducted in 2010 by the European Foundation for the Improvement of Living and Working Conditions. In light of these objectives, we collected a subsample of 284 health professionals, some of them from the International Standard Classification of Occupations—subgroup 22—(ISCO-08). The results indicated that the chance of a healthcare worker referring to him/herself as bullied increases among those who work on a shift schedule, perform monotonous and rotating tasks, suffer from work stress, enjoy little satisfaction from their working conditions, and do not perceive opportunities for promotions in their organizations. The present work summarizes an array of outcomes and proposes within the usual course of events that workplace bullying could be reduced if job demands were limited and job resources were increased. The implications of these findings could assist human resource managers in facilitating, to some extent, good social relationships among healthcare workers. PMID:23887621

  4. Workplace Bullying among Healthcare Workers

    Directory of Open Access Journals (Sweden)

    María José Montero-Simó

    2013-07-01

    Full Text Available This paper aims to assess consistent predictors through the use of a sample that includes different actors from the healthcare work force to identify certain key elements in a set of job-related organizational contexts. The utilized data were obtained from the 5th European Working Conditions Survey, conducted in 2010 by the European Foundation for the Improvement of Living and Working Conditions. In light of these objectives, we collected a subsample of 284 health professionals, some of them from the International Standard Classification of Occupations—subgroup 22—(ISCO-08. The results indicated that the chance of a healthcare worker referring to him/herself as bullied increases among those who work on a shift schedule, perform monotonous and rotating tasks, suffer from work stress, enjoy little satisfaction from their working conditions, and do not perceive opportunities for promotions in their organizations. The present work summarizes an array of outcomes and proposes within the usual course of events that workplace bullying could be reduced if job demands were limited and job resources were increased. The implications of these findings could assist human resource managers in facilitating, to some extent, good social relationships among healthcare workers.

  5. Hand hygiene practices among community Health Officers in Rivers ...

    African Journals Online (AJOL)

    EB

    Hand washing with soap and water or alcohol-based hand rub has long been considered one of the most important infection control measures to prevent healthcare-associated infections. However, compliance by healthcare workers with recommended hand hygiene procedures is unacceptably low, with compliance rates ...

  6. Knowledge, opinions and practices of healthcare workers related to infant feeding in the context of HIV

    Directory of Open Access Journals (Sweden)

    Liska Janse van Rensburg

    2016-10-01

    Objective: To determine the knowledge, opinions and practices of healthcare workers in maternity wards in a regional hospital in Bloemfontein, Free State Province, South Africa, regarding infant feeding in the context of HIV. Methods: For this descriptive cross-sectional study, all the healthcare workers in the maternity wards of Pelonomi Regional Hospital who voluntarily gave their consent during the scheduled meetings (n = 64, were enrolled and handed over the self-administered questionnaires. Results: Only 14% of the respondents considered themselves to be experts in HIV and infant feeding. Approximately 97% felt that breastfeeding was an excellent feeding choice provided proper guidelines were followed. However, 10% indicated that formula feeding is the safest feeding option. 45% stated that heat-treated breast milk is a good infant feeding option; however, 29% considered it a good infant feeding option but it requires too much work. Only 6% could comprehensively explain the term “exclusive breastfeeding” as per World Health Organisation (WHO definition. Confusion existed regarding the period for which an infant could be breastfed according to the newest WHO guidelines, with only 26% providing the correct answer. Twenty per cent reported that no risk exists for HIV transmission via breastfeeding if all the necessary guidelines are followed. Conclusion: Healthcare workers' knowledge did not conform favourably with the current WHO guidelines. These healthcare workers were actively involved in the care of patients in the maternity wards where HIV-infected mothers regularly seek counselling on infant feeding matters.

  7. New working conditions and consequences on activity of home healthcare workers.

    Science.gov (United States)

    Van De Weerdt, Corinne; Baratta, René

    2012-01-01

    Home healthcare is steadily growing in Europe. There are a number of reasons for this development: aging population, rising hospital costs, preference to stay in one's own home. Nevertheless, it has been known that home healthcare workers are frequently exposed to a variety of potentially serious occupational hazards. Furthermore, emotional labor is frequently high in this profession. This paper describes an ergonomic study conducted at a home healthcare service. The research focuses on analyzing working conditions of home healthcare aides and nurses, as well as the impacts of their work in terms of job satisfaction, well-being, emotions at work, relationships with the others and occupational stress. The study show that employee strategies are specifically centered around preserving the relationship between patients and workers and coping with the job demands. This paper also shows that home healthcare workers express emotions and conceal them from others. Finally, recommendations discussed with the manager and workers to improve working conditions in this sector led to practical proposals: for example, implementing certain equipment items better suited to difficult care, encouraging assistance between healthcare workers when operations require this through adequate organizational measures, extending work emotion-focused discussion groups with management involvement.

  8. Healthcare workers satisfaction and patient satisfaction – where is the linkage?

    OpenAIRE

    Janicijevic, I; Seke, K; Djokovic, A; Filipovic, T

    2013-01-01

    Background: This study aims to assess at what level healthcare worker satisfaction affects patient satisfaction, as well as which elements of healthcare worker satisfaction affect health service quality and patient satisfaction.

  9. Risk of tuberculosis transmission among healthcare workers.

    Science.gov (United States)

    Diel, Roland; Niemann, Stefan; Nienhaus, Albert

    2018-04-01

    Data from a prospective molecular-epidemiological study (1997-2015) of patients with culture-confirmed tuberculosis in Hamburg, Germany, were evaluated to assess the occupational risk of Mycobacterium tuberculosis complex transmission in a low-incidence setting. Isolates of M. tuberculosis complex were genotyped using IS6110 restriction fragment length polymorphism analysis. Results of structured questionnaires, geographical mapping and additional patient interviews were used for confirming epidemiological links. Out of the 2393 cases, 918 (38.4%) were classified into 224 clusters comprising 2-70 patients per cluster. Among the 918 cluster members, epidemiological links could be confirmed in 340 (37.0%) patients. In total, 55 (2.3%) patients were healthcare workers; 26 healthcare workers remained unclustered, but 29 healthcare workers belonged to cluster groups. Conventional contact tracing performed before genotyping to identify sources of the reported index cases detected only 73 (3.1%) patients. Logistic regression analysis confirmed work in the healthcare sector as strongest predictor for clustering of patients with verified epidemiological links (odds ratio (OR) 3.1, 95% CI 1.6-5.9), followed by alcoholism (OR 2.3, 95% CI 1.7-3.2) and sputum smear positivity (OR 1.8, 95% CI 1.4-2.3). Immigrants were more likely to be cluster nonmembers (OR 0.3, 95% CI 0.3-0.5). Recent transmission in Hamburg within the 19-year study period was found to be strongly associated with working in a healthcare facility. Although clusters also include many "imported" strains from abroad or regional highly prevalent M. tuberculosis strains with no evident epidemiological connection, routine molecular-epidemiological survey is indispensable to optimising and controlling the effectiveness of TB control strategies in German healthcare settings.

  10. A Review of Electronic Hand Hygiene Monitoring: Considerations for Hospital Management in Data Collection, Healthcare Worker Supervision, and Patient Perception.

    Science.gov (United States)

    McGuckin, Maryanne; Govednik, John

    2015-01-01

    Healthcare-associated infections (HAIs) in U.S. acute care hospitals lead to a burden of $96-$147 billion annually on the U.S. health system and affect 1 in 20 hospital patients (Marchetti & Rossiter, 2013). Hospital managers are charged with reducing and eliminating HAIs to cut costs and improve patient outcomes. Healthcare worker (HCW) hand hygiene (HH) practice is the most effective means of preventing the spread of HAIs, but compliance is at or below 50% (McGuckin, Waterman, & Govednik, 2009). For managers to increase the frequency of HCW HH occurrences and improve the quality of HH performance, companies have introduced electronic technologies to assist managers in training, supervising, and gathering data in the patient care setting. Although these technologies offer valuable feedback regarding compliance, little is known in terms of capabilities in the clinical setting. Less is known about HCW or patient attitudes if the system allows feedback to be shared. Early-adopting managers have begun to examine their experiences with HH technologies and publish their findings. We review peer-reviewed research on infection prevention that focused on the capabilities of these electronic systems, as well as the related research on HCW and patient interactions with electronic HH systems. Research suggests that these systems are capable of collecting data, but the results are mixed regarding their impact on HH compliance, reducing HAIs, or both and their costs. Research also indicates that HCWs and patients may not regard the technology as positively as industry or healthcare managers may have intended. When considering the adoption of electronic HH monitoring systems, hospital administrators should proceed with caution.

  11. Home Healthcare Workers: How to Prevent Latex Allergies

    Science.gov (United States)

    ... can help prevent allergic reactions for both home healthcare workers and their clients. LATEX EXPOSURE REACTIONS Three ... being used). • Inform your employer and your personal healthcare professionals that you have latex allergy. • Wear a ...

  12. Human health risk assessment of chloroxylenol in liquid hand soap and dishwashing soap used by consumers and health-care professionals.

    Science.gov (United States)

    Yost, Lisa J; Rodricks, Joseph D; Turnbull, Duncan; DeLeo, Paul C; Nash, J Frank; Quiñones-Rivera, Antonio; Carlson, Pete A

    2016-10-01

    A quantitative human risk assessment of chloroxylenol was conducted for liquid hand and dishwashing soap products used by consumers and health-care workers. The toxicological data for chloroxylenol indicate lack of genotoxicity, no evidence of carcinogenicity, and minimal systemic toxicity. No observed adverse effect levels (NOAEL) were established from chronic toxicity studies, specifically a carcinogenicity study that found no cancer excess (18 mg/kg-day) and studies of developmental and reproductive toxicity (100 mg/kg-day). Exposure to chloroxylenol for adults and children was estimated for two types of rinse-off cleaning products, one liquid hand soap, and two dishwashing products. The identified NOAELs were used together with exposure estimates to derive margin of exposure (MOE) estimates for chloroxylenol (i.e., estimates of exposure over NOAELs). These estimates were designed with conservative assumptions and likely overestimate exposure and risk (i.e., highest frequency, 100% dermal penetration). The resulting MOEs ranged from 178 to over 100, 000, 000 indicating negligibly small potential for harm related to consumer or health-care worker exposure to chloroxylenol in liquid soaps used in dish washing and hand washing. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Frequency and pattern of violence towards healthcare workers in a ...

    African Journals Online (AJOL)

    Background: Workplace violence is a well-recognized concern for healthcare workers and can broadly be divided into physical and psychological types. Objective: The purpose of this study was to investigate the frequency and pattern of violence towards healthcare workers in a mental health facility in Maiduguri, North-East ...

  14. Hand Hygiene in Healthcare Settings 2 PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    This 30 second PSA encourages people to wash their hands often while in the hospital or visiting someone in the hospital. It also encourages them to remind their healthcare providers to wash their hands, too.

  15. Hand Hygiene in Healthcare Settings 1 PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    This 30 second PSA encourages people to wash their hands often while in the hospital or visiting someone in the hospital. It also encourages them to remind their healthcare providers to wash their hands, too.

  16. Patient safety--worker safety: building a culture of safety to improve healthcare worker and patient well-being.

    Science.gov (United States)

    Yassi, Annalee; Hancock, Tina

    2005-01-01

    Patient safety within the Canadian healthcare system is currently a high national priority, which merits a comprehensive understanding of the underlying causes of adverse events. Not least among these is worker health and safety, which is linked to patient outcomes. Healthcare workers have a high risk of workplace injuries and more mental health problems than most other occupational groups. Many healthcare professionals feel fatigued, stressed, in pain, or at risk of illness or injury-factors they feel impede their ability to provide consistent quality care. With this background, the Occupational Health and Safety Agency for Healthcare (OHSAH) in British Columbia, jointly governed by healthcare unions and healthcare employers, launched several major initiatives to improve the healthcare workplace. These included the promotion of safe patient handling, adaptive clothing, scheduled toileting, stroke management training, measures to improve management of aggressive behaviour and, of course, infection control-all intended to improve the safety of workers, but also to improve patient safety and quality of care. Other projects also explicitly promoting physical and mental health at work, as well as patient safety are also underway. Results of the projects are at various stages of completion, but ample evidence has already been obtained to indicate that looking after the well-being of healthcare workers results in safer and better quality patient care. While more research is needed, our work to date suggests that a comprehensive systems approach to promoting a climate of safety, which includes taking into account workplace organizational factors and physical and psychological hazards for workers, is the best way to improve the healthcare workplace and thereby patient safety.

  17. Clean Hands Count

    Medline Plus

    Full Text Available ... 03. R Mayer 371,490 views 4:03 The psychological trick behind getting people to say yes - Duration: 8:06. PBS NewsHour 606,671 views 8:06 Should You Really Wash Your Hands? - Duration: 4:51. Gross Science 57,828 views 4:51 Healthcare Worker Hand ...

  18. Etiological explanation, treatability and preventability of childhood autism: a survey of Nigerian healthcare workers' opinion

    Directory of Open Access Journals (Sweden)

    Okonkwo Kevin O

    2009-02-01

    Full Text Available Abstract Background Because of their peculiar sociocultural background, healthcare workers in sub-Saharan African subcultures may have various conceptions on different aspects of autism spectrum disorders (ASD, such as etiology, treatment and issues of prognosis. These various conceptions, if different from current knowledge in literature about ASD, may negatively influence help-seeking behavior of parents of children with ASD who seek advice and information from the healthcare workers. This study assessed the opinions of healthcare workers in Nigeria on aspects of etiology, treatability and preventability of childhood autism, and relates their opinions to the sociodemographic variables. Methods Healthcare workers working in four tertiary healthcare facilities located in the south-east and south-south regions of Nigeria were interviewed with a sociodemographic questionnaire, personal opinion on etiology, treatability and preventability of childhood autism (POETPCA questionnaire and knowledge about childhood autism among health workers (KCAHW questionnaire to assess their knowledge and opinions on various aspects of childhood autism. Results A total of 134 healthcare workers participated in the study. In all, 78 (58.2%, 19 (14.2% and 36 (26.9% of the healthcare workers were of the opinion that the etiology of childhood autism can be explained by natural, preternatural and supernatural causes, respectively. One (0.7% of the healthcare workers was unsure of the explanation of the etiology. Knowledge about childhood autism as measured by scores on the KCAHW questionnaire was the only factor significantly associated with the opinions of the healthcare workers on etiology of childhood autism. In all, 73 (54.5% and 43 (32.1%, of the healthcare workers subscribed to the opinion that childhood autism is treatable and preventable respectively. Previous involvement with managing children with ASD significantly influenced the opinion of the healthcare

  19. Patient empowerment and hand hygiene, 1997-2012.

    Science.gov (United States)

    McGuckin, M; Govednik, J

    2013-07-01

    Multi-modal hand hygiene programmes that include patient empowerment are promoted as a necessary component of hand hygiene compliance. However, the question still remains, do we have enough information to determine if, and under what conditions, patients will be able to play an immediate role in healthcare workers' hand hygiene behaviour? To review the current literature on patient willingness to be empowered, barriers to empowerment, and hand hygiene programmes that include patient empowerment and hand hygiene improvement. A Medline (Ovid) search of all English-language papers for 1997-2007 and 2008-2012 was conducted using the following keywords alone and in various combinations: 'patient participation', 'involvement', 'empowerment', 'education', 'decision-making', 'professional-patient relations', 'behavioural change', 'culture of safety', 'social marketing', 'consumer awareness', 'leadership', 'institutional climate', 'hand hygiene' and 'patient reminders'. The 1997-2007 review was conducted as part of the World Health Organization's Guidelines on Hand Hygiene in Health Care, and updated with the 2008-2012 review. Several studies show that, in principle, patients are willing to be empowered. However, there is variation in the actual number of patients that practice empowerment for hand hygiene, ranging from 5% to 80%. The actual performance of patient empowerment can be increased when a patient is given explicit permission by a healthcare worker. There is ongoing support from patients that they are willing to be empowered. There is a need to develop programmes that empower both healthcare workers and patients so that they become more comfortable in their roles. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  20. Compassion, Mindfulness, and the Happiness of Healthcare Workers.

    Science.gov (United States)

    Benzo, Roberto P; Kirsch, Janae L; Nelson, Carlie

    Decreased well-being of healthcare workers expressed as stress and decreased job satisfaction influences patient safety, patient satisfaction, and cost containment. Self-compassion has garnered recent attention due to its positive association with well-being and happiness. Discovering novel pathways to increase the well-being of healthcare workers is essential. This study sought to explore the influence of self-compassion on employee happiness in healthcare professionals. A total of 400 participants (mean age = 45 ± 14, 65% female) healthcare workers at a large teaching hospital were randomly asked to complete questionnaires assessing their levels of happiness and self-compassion, life conditions, and habits. Participants completed the Happiness Scale and Self-Compassion Scales, the Five Facet Mindfulness Questionnaire as well as variables associated with well-being: relationship status, the number of hours spent exercising a week, attendance at a wellness facility, and engagement in a regular spiritual practice. Self-compassion was significantly and independently associated with perceived happiness explaining 39% of its variance after adjusting for age, marital status, gender, time spent exercising, and attendance to an exercise facility. Two specific subdomains of self-compassion from the instrument used, coping with isolation and mindfulness, accounted for 95% of the self-compassion effect on happiness. Self-compassion is meaningfully and independently associated with happiness and well-being in healthcare professionals. Our results may have practical implications by providing specific self-compassion components to be targeted in future programs aimed at enhancing well-being in healthcare professionals. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Occupational exposures among healthcare workers: A teaching hospital sample

    OpenAIRE

    Derya Öztürk Engin; Asuman İnan; Nurgül Ceran; Zeynel Abiddin Demir; Özgür Dağli; Emin Karagül; Seyfi Özyürek

    2014-01-01

    Objective: Healthcare workers (HCWs) are at risk for occupational injury associated with contaminated blood and body fluids. This study aims to examine the frequency and type of occupational injuries and to determine best practices after exposure. Methods: A cross-sectional study was conducted in Haydarpaşa Teaching Hospital in December 2010. The questionnaires were completed by healthcare workers with face-to-face interviews. The questionnaire was evaluated occupational injuries in the ho...

  2. Mental disorders among workers in the healthcare industry: 2014 national health insurance data.

    Science.gov (United States)

    Kim, Min-Seok; Kim, Taeshik; Lee, Dongwook; Yook, Ji-Hoo; Hong, Yun-Chul; Lee, Seung-Yup; Yoon, Jin-Ha; Kang, Mo-Yeol

    2018-01-01

    Numerous studies have shown that healthcare professionals are exposed to psychological distress. However, since most of these studies assessed psychological distress using self-reporting questionnaires, the magnitude of the problem is largely unknown. We evaluated the risks of mood disorders, anxiety disorders, sleep disorders, and any psychiatric disorders in workers in healthcare industry using Korea National Health Insurance (NHI) claims data from 2014, which are based on actual diagnoses instead of self-evaluation. We used Korea 2014 NHI claims data and classified employees as workers in the healthcare industry, based on companies in the NHI database that were registered with hospitals, clinics, public healthcare, and other medical services. To estimate the standardized prevalence of the selected mental health disorders, we calculated the prevalence of diseases in each age group and sex using the age distribution of the Korea population. To compare the risk of selected mental disorders among workers in the healthcare industry with those in other industries, we considered age, sex, and income quartile characteristics and conducted propensity scored matching. In the matching study, workers in healthcare industry had higher odds ratios for mood disorders (1.13, 95% CI: 1.11-1.15), anxiety disorders (1.15, 95% CI: 1.13-1.17), sleep disorders (2.21, 95% CI: 2.18-2.24), and any psychiatric disorders (1.44, 95% CI: 1.43-1.46) than the reference group did. Among workers in healthcare industry, females had higher prevalence of psychiatric disorders than males, but the odds ratios for psychiatric disorders, compared to the reference group, were higher in male workers in healthcare industry than in females. The prevalence of mood disorders, anxiety disorders, sleep disorders, and all psychiatric disorders for workers in the healthcare industry was higher than that of other Korean workers. The strikingly high prevalence of sleep disorders could be related to the frequent

  3. Hand eczema among healthcare professionals in the Netherlands : prevalence, absenteeism, and presenteeism

    NARCIS (Netherlands)

    van der Meer, Esther W. C.; Boot, Cecile R. L.; van der Gulden, Joost W. J.; Jungbauer, Frank H. W.; Coenraads, Pieter Jan; Anema, Johannes R.

    Background. Healthcare professionals have a high risk of developing hand eczema. Hand eczema can interfere with their work. Objectives. To investigate the prevalence of self-reported hand eczema among healthcare professionals in the Netherlands, and to investigate absenteeism and presenteeism

  4. Healing or harming? Healthcare provider interactions with injured workers and insurers in workers' compensation systems.

    Science.gov (United States)

    Kilgour, Elizabeth; Kosny, Agnieszka; McKenzie, Donna; Collie, Alex

    2015-03-01

    Healthcare providers (HCPs) are influential in the injured worker's recovery process and fulfil many roles in the delivery of health services. Interactions between HCPs and insurers can also affect injured workers' engagement in rehabilitation and subsequently their recovery and return to work. Consideration of the injured workers' perceptions and experiences as consumers of medical and compensation services can provide vital information about the quality, efficacy and impact of such systems. The aim of this systematic review was to identify and synthesize published qualitative research that focused on the interactions between injured workers, HCPs and insurers in workers' compensation systems in order to identify processes or interactions which impact injured worker recovery. A search of six electronic databases for literature published between 1985 and 2012 revealed 1,006 articles. Screening for relevance identified 27 studies which were assessed for quality against set criteria. A final 13 articles of medium and high quality were retained for data extraction. Findings were synthesized using a meta-ethnographic approach. Injured workers reported that HCPs could play both healing and harming roles in their recovery. Supportive patient-centred interaction with HCPs is important for injured workers. Difficult interactions between HCPs and insurers were highlighted in themes of adversarial relations and organisational pressures. Insurer and compensation system processes exerted an influence on the therapeutic relationship. Recommendations to improve relationships included streamlining administrative demands and increasing education and communication between the parties. Injured workers with long term complex injuries experience difficulties with healthcare in the workers' compensation context. Changes in insurer administrative demands and compensation processes could increase HCP participation and job satisfaction. This in turn may improve injured worker recovery

  5. It's all about the money? A qualitative study of healthcare worker motivation in urban China.

    Science.gov (United States)

    Millar, Ross; Chen, Yaru; Wang, Meng; Fang, Liang; Liu, Jun; Xuan, Zhidong; Li, Guohong

    2017-07-07

    China's healthcare reform programme continues to receive much attention. Central to these discussions has been how the various financial incentives underpinning reform efforts are negatively impacting on the healthcare workforce. Research continues to document these trends, however, qualitative analysis of how these incentives impact on the motivation of healthcare workers remains underdeveloped. Furthermore, the application of motivational theories to make sense of healthcare worker experiences has yet to be undertaken. The purpose of our paper is to present a comparative case study account of healthcare worker motivation across urban China. It draws on semi structured interviews (n = 89) with a range of staff and organisations across three provinces. In doing so, the paper analyses how healthcare worker motivation is influenced by a variety of financial incentives; how motivation is influenced by the opportunities for career development; and how motivation is influenced by the day to day pressures of meeting patient expectations. The experience of healthcare workers in China highlights how a reliance on financial incentives has challenged their ability to maintain the values and ethos of public service. Our findings suggest greater attention needs to be paid to the motivating factors of improved income and career development. Further work is also needed to nurture and develop the motivation of healthcare workers through the building of trust between fellow workers, patients, and the public. Through the analysis of healthcare worker motivation, our paper presents a number of ways China can improve its current healthcare reform efforts. It draws on the experience of other countries in calling for policy makers to support alternative approaches to healthcare reform that build on multiple channels of motivation to support healthcare workers.

  6. Hand-arm vibration disorder among grass-cutter workers in Malaysia.

    Science.gov (United States)

    Azmir, Nor Azali; Ghazali, Mohd Imran; Yahya, Musli Nizam; Ali, Mohamad Hanafi

    2016-09-01

    Prolonged exposure to hand-transmitted vibration from grass-cutting machines has been associated with increasing occurrences of symptoms and signs of occupational diseases related to hand-arm vibration syndrome (HAVS). A cross-sectional study was carried out using an adopted HAVS questionnaire on hand-arm vibration exposure and symptoms distributed to 168 male workers from the grass and turf maintenance industry who use hand-held grass-cutting machines as part of their work. The prevalence ratio and symptom correlation to HAVS between high and low-moderate exposure risk groups were evaluated. There were positive HAVS symptoms relationships between the low-moderate exposure group and the high exposure group among hand-held grass-cutting workers. The prevalence ratio was considered high because there were indicators that fingers turned white and felt numb, 3.63, 95% CI [1.41, 9.39] and 4.24, 95% CI [2.18, 8.27], respectively. Less than 14.3% of workers stated that they were aware of the occupational hand-arm vibration, and it seemed to be related to the finger blanching and numbness. The results suggest that HAVS is under-diagnosed in Malaysia, especially in the agricultural sectors. More information related to safety and health awareness programmes for HAVS exposure is required among hand-held grass-cutting workers.

  7. Association between health worker motivation and healthcare quality efforts in Ghana.

    Science.gov (United States)

    Alhassan, Robert Kaba; Spieker, Nicole; van Ostenberg, Paul; Ogink, Alice; Nketiah-Amponsah, Edward; de Wit, Tobias F Rinke

    2013-08-14

    Ghana is one of the sub-Saharan African countries making significant progress towards universal access to quality healthcare. However, it remains a challenge to attain the 2015 targets for the health related Millennium Development Goals (MDGs) partly due to health sector human resource challenges including low staff motivation. This paper addresses indicators of health worker motivation and assesses associations with quality care and patient safety in Ghana. The aim is to identify interventions at the health worker level that contribute to quality improvement in healthcare facilities. The study is a baseline survey of health workers (n = 324) in 64 primary healthcare facilities in two regions in Ghana. Data collection involved quality care assessment using the SafeCare Essentials tool, the National Health Insurance Authority (NHIA) accreditation data and structured staff interviews on workplace motivating factors. The Spearman correlation test was conducted to test the hypothesis that the level of health worker motivation is associated with level of effort by primary healthcare facilities to improve quality care and patient safety. The quality care situation in health facilities was generally low, as determined by the SafeCare Essentials tool and NHIA data. The majority of facilities assessed did not have documented evidence of processes for continuous quality improvement and patient safety. Overall, staff motivation appeared low although workers in private facilities perceived better working conditions than workers in public facilities (P motivation interventions should be integrated into quality improvement strategies especially in government-owned healthcare facilities where working conditions are perceived to be the worst.

  8. Minor mental disorders in Taiwanese healthcare workers and the associations with psychosocial work conditions.

    Science.gov (United States)

    Cheng, Wan-Ju; Cheng, Yawen

    2017-04-01

    Healthcare workers face multiple psychosocial work hazards intrinsic to their work, including heavy workloads and shift work. However, how contemporary adverse psychosocial work conditions, such as workplace justice and insecurity, may contribute to increased mental health risks has rarely been studied. This study aimed to search for modifiable psychosocial work factors associated with mental health disorders in Taiwanese healthcare workers. A total of 349 healthcare workers were identified from 19,641 employees who participated in a national survey of Taiwan. Minor mental disorder was assessed using the five-item brief symptom rating scale. We compared psychosocial work characteristics and the prevalence of minor mental disorder in healthcare workers with that in a sociodemographically matched sample, and examined the associations of psychosocial work conditions with mental health status. Healthcare workers were found to have a higher prevalence of minor mental disorder than general workers, and they were more likely to have longer working hours, heavier psychological job demands, higher job control, more workplace violence, and a higher prevalence of shift work. Among healthcare workers, experiences of workplace violence, lower workplace justice, heavier psychological job demands, and job insecurity were associated with a higher risk for minor mental disorder, even after controlling for working hours and shift work. Despite the fact that healthcare workers work longer hours and shift work, there were several modifiable psychosocial work conditions that should be targeted to improve their mental health. Copyright © 2016. Published by Elsevier B.V.

  9. Vaccines for preventing hepatitis B in healthcare workers (an updated protocol)

    DEFF Research Database (Denmark)

    Borch, Anders; Kolster, Chastine; Gluud, Christian

    2017-01-01

    This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the beneficial and harmful effects of hepatitis B vaccines in healthcare workers.......This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the beneficial and harmful effects of hepatitis B vaccines in healthcare workers....

  10. Factors influencing healthcare worker's participation in physical ...

    African Journals Online (AJOL)

    African Journal for Physical Activity and Health Sciences ... in one public hospital in South Africa: Do healthcare workers have barriers to exercise? ... Binary logistic regression was used to determine the association between barriers, attitude, ...

  11. Association of the dominant hand and needle stick injuries for ...

    African Journals Online (AJOL)

    The EPInet system started 2003 in Taiwan under C-MESH. When healthcare workers sustain sharp injury, they complete the injury report form, and report to infection control personnel, who then transmitted the data to EPINet website monthly. Results 93.5% of the healthcare workers reported being right handed and only ...

  12. Job Stress and Presenteeism among Chinese Healthcare Workers: The Mediating Effects of Affective Commitment

    OpenAIRE

    Tianan Yang; Yina Guo; Mingxu Ma; Yaxin Li; Huilin Tian; Jianwei Deng

    2017-01-01

    Background: Presenteeism affects the performance of healthcare workers. This study examined associations between job stress, affective commitment, and presenteeism among healthcare workers. Methods: To investigate the relationship between job stress, affective commitment, and presenteeism, structural equation modeling was used to analyze a sample of 1392 healthcare workers from 11 Class A tertiary hospitals in eastern, central, and western China. The mediating effect of affective commitment o...

  13. Hand Hygiene in Healthcare Settings 1 PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    2010-08-19

    This 30 second PSA encourages people to wash their hands often while in the hospital or visiting someone in the hospital. It also encourages them to remind their healthcare providers to wash their hands, too.  Created: 8/19/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 8/19/2010.

  14. Hand Hygiene in Healthcare Settings 2 PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    2010-08-19

    This 30 second PSA encourages people to wash their hands often while in the hospital or visiting someone in the hospital. It also encourages them to remind their healthcare providers to wash their hands, too.  Created: 8/19/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 8/19/2010.

  15. Hand exposure of nuclear medicine workers

    International Nuclear Information System (INIS)

    Jankowski, J.; Wrzesien, M.; Olszewski, J.

    2007-01-01

    Full text: Workers of Nuclear Medicine units labelling radiopharmaceuticals with technetium 99mTc are exposed to gamma radiation. The general opinion that individual dosimetry, with the aid of personal dose meters worn on the radiopharmacists' body, reflects true exposure of that occupational group is false. The use of ring dose meters worn on the fingers does not provide a true indication of the exposure of the radiopharmacists' hands. Measurements performed in 2001 - 2005 by the Institute of Occupational Medicine, with the use of dose meters placed on radiopharmacists' fingers, revealed that the equivalent dose to the hands ranged from 5.5 mSv to 95 mSv. Mean annual dose was 29 mSv. The finger dose meter is usually worn at the base of the middle finger, even if it is the fingertips that are most exposed to the radiation. In 2004-2005, we determined the distributions of the doses to the radiopharmacists' hands. The determinations were performed during one working day. During those determinations, thermo luminescence detectors were placed at 19 locations on the left and right hands. The subjects were 13 workers of 5 nuclear medicine units. The recorded doses ranged from 0.02 to 28 mSv for the left hand, and from 0.01 to 18 mSv for the right hand. The results show that the tips of the thumb, index finger and middle finger were the most exposed areas. The chances that the skin of those three fingertips receives yearly doses in excess of the current limit of 500 mSv are fairly high. It is recommended, therefore, to use annual dose constraints for the dose recorded by the ring dose meter at the level of 100 mSv per year as a safe limit to protect workers from the risk of exceeding the limit value for the dermal exposure. Whenever the dose value approaches 100 mSv/u, where u is the number of determinations of the partial doses performed during the period of one year, steps must be undertaken to explain the reasons why such a level has been reached and suitable

  16. Minor mental disorders in Taiwanese healthcare workers and the associations with psychosocial work conditions

    OpenAIRE

    Cheng, Wan-Ju; Cheng, Yawen

    2017-01-01

    Healthcare workers face multiple psychosocial work hazards intrinsic to their work, including heavy workloads and shift work. However, how contemporary adverse psychosocial work conditions, such as workplace justice and insecurity, may contribute to increased mental health risks has rarely been studied. This study aimed to search for modifiable psychosocial work factors associated with mental health disorders in Taiwanese healthcare workers. Methods: A total of 349 healthcare workers were ...

  17. Community health workers: a bridge to healthcare for people who inject drugs.

    Science.gov (United States)

    Morgan, Kirsty; Lee, Jessica; Sebar, Bernadette

    2015-04-01

    Although people who inject drugs (PWIDs) have increased healthcare needs, their poor access and utilisation of mainstream primary healthcare services is well documented. To address this situation, community health workers (CHWs) who have personal experience of drug injecting in addition to healthcare training or qualifications are sometimes utilised. However, the role peer workers play as members of clinical primary healthcare teams in Australia and how they manage the healthcare needs of PWID, has been poorly documented. A qualitative ethnomethodological approach was used to study the methods used by CHWs. Data was collected using participant observation of CHWs in a PWID-targeted primary healthcare centre. CHW healthcare consultations with PWID were audio-recorded and transcribed verbatim. Transcripts along with field notes were analysed using membership categorisation and conversation analysis techniques to reveal how CHWs' personal and professional experience shapes their healthcare interactions with PWID clients. CHWs' personal experience of injecting drug use is an asset they utilise along with their knowledge of clinical practice and service systems. It provides them with specialised knowledge and language--resources that they draw upon to build trust with clients and accomplish transparent, non-judgmental interactions that enable PWID clients to be active participants in the management of their healthcare. Existing literature often discusses these principles at a theoretical level. This study demonstrates how CHWs achieve them at a micro-level through the use of indexical language and displays of the membership categories 'PWID' and 'healthcare worker'. This research explicates how CHWs serve as an interface between PWID clients and conventional healthcare providers. CHWs deployment of IDU-specific language, membership knowledge, values and behaviours, enable them to interact in ways that foster transparent communication and client participation in

  18. Influence of rub-in technique on required application time and hand coverage in hygienic hand disinfection

    Directory of Open Access Journals (Sweden)

    Feil Yvonne

    2008-10-01

    Full Text Available Abstract Background Recent data indicate that full efficacy of a hand rub preparation for hygienic hand disinfection can be achieved within 15 seconds (s. However, the efficacy test used for the European Norm (EN 1500 samples only the fingertips. Therefore, we investigated hand coverage using sixteen different application variations. The hand rub was supplemented with a fluorescent dye, and hands were assessed under UV light by a blind test, before and after application. Fifteen non-healthcare workers were used as subjects for each application variation apart from one test which was done with a group of twenty healthcare workers. All tests apart from the reference procedure were performed using 3 mL of hand rub. The EN 1500 reference procedure, which consists of 6 specific rub-in steps performed twice with an aliquot of 3 ml each time, served as a control. In one part of this study, each of the six steps was performed from one to five times before proceeding to the next step. In another part of the study, the entire sequence of six steps was performed from one to five times. Finally, all subjects were instructed to cover both hands completely, irrespective of any specific steps ("responsible application". Each rub-in technique was evaluated for untreated skin areas. Results The reference procedure lasted on average 75 s and resulted in 53% of subjects with at least one untreated area on the hands. Five repetitions of the rub-in steps lasted on average 37 s with 67% of subjects having incompletely treated hands. One repetition lasted on average 17 s, and all subjects had at least one untreated area. Repeating the sequence of steps lasted longer, but did not yield a better result. "Responsible application" was quite fast, lasting 25 s among non-healthcare worker subjects and 28 s among healthcare workers. It was also effective, with 53% and 55% of hands being incompletely treated. New techniques were as fast and effective as "responsible

  19. Job Stress and Presenteeism among Chinese Healthcare Workers: The Mediating Effects of Affective Commitment.

    Science.gov (United States)

    Yang, Tianan; Guo, Yina; Ma, Mingxu; Li, Yaxin; Tian, Huilin; Deng, Jianwei

    2017-08-29

    Presenteeism affects the performance of healthcare workers. This study examined associations between job stress, affective commitment, and presenteeism among healthcare workers. To investigate the relationship between job stress, affective commitment, and presenteeism, structural equation modeling was used to analyze a sample of 1392 healthcare workers from 11 Class A tertiary hospitals in eastern, central, and western China. The mediating effect of affective commitment on the association between job stress and presenteeism was examined with the Sobel test. Job stress was high and the level of presenteeism was moderate among healthcare workers. Challenge stress and hindrance stress were strongly correlated (β = 0.62; p < 0.05). Affective commitment was significantly and directly inversely correlated with presenteeism (β = -0.27; p < 0.001). Challenge stress was significantly positively correlated with affective commitment (β = 0.15; p < 0.001) but not with presenteeism. Hindrance stress was significantly inversely correlated with affective commitment (β = -0.40; p < 0.001) but was significantly positively correlated with presenteeism (β = 0.26; p < 0.001). This study provides important empirical data on presenteeism among healthcare workers. Presenteeism can be addressed by increasing affective commitment and challenge stress and by limiting hindrance stress among healthcare workers in China.

  20. Job Stress and Presenteeism among Chinese Healthcare Workers: The Mediating Effects of Affective Commitment

    Directory of Open Access Journals (Sweden)

    Tianan Yang

    2017-08-01

    Full Text Available Background: Presenteeism affects the performance of healthcare workers. This study examined associations between job stress, affective commitment, and presenteeism among healthcare workers. Methods: To investigate the relationship between job stress, affective commitment, and presenteeism, structural equation modeling was used to analyze a sample of 1392 healthcare workers from 11 Class A tertiary hospitals in eastern, central, and western China. The mediating effect of affective commitment on the association between job stress and presenteeism was examined with the Sobel test. Results: Job stress was high and the level of presenteeism was moderate among healthcare workers. Challenge stress and hindrance stress were strongly correlated (β = 0.62; p < 0.05. Affective commitment was significantly and directly inversely correlated with presenteeism (β = −0.27; p < 0.001. Challenge stress was significantly positively correlated with affective commitment (β = 0.15; p < 0.001 but not with presenteeism. Hindrance stress was significantly inversely correlated with affective commitment (β = −0.40; p < 0.001 but was significantly positively correlated with presenteeism (β = 0.26; p < 0.001. Conclusions: This study provides important empirical data on presenteeism among healthcare workers. Presenteeism can be addressed by increasing affective commitment and challenge stress and by limiting hindrance stress among healthcare workers in China.

  1. Why healthcare workers are sick of TB

    Directory of Open Access Journals (Sweden)

    Arne von Delft

    2015-03-01

    Full Text Available Dr Thato Mosidi never expected to be diagnosed with tuberculosis (TB, despite widely prevalent exposure and very limited infection control measures. The life-threatening diagnosis of primary extensively drug-resistant TB (XDR-TB came as an even greater shock. The inconvenient truth is that, rather than being protected, Dr Mosidi and thousands of her healthcare colleagues are at an increased risk of TB and especially drug-resistant TB. In this viewpoint paper we debunk the widely held false belief that healthcare workers are somehow immune to TB disease (TB-proof and explore some of the key factors contributing to the pervasive stigmatization and subsequent non-disclosure of occupational TB. Our front-line workers are some of the first to suffer the consequences of a progressively more resistant and fatal TB epidemic, and urgent interventions are needed to ensure the safety and continued availability of these precious healthcare resources. These include the rapid development and scale-up of improved diagnostic and treatment options, strengthened infection control measures, and focused interventions to tackle stigma and discrimination in all its forms. We call our colleagues to action to protect themselves and those they care for.

  2. Leisure-time physical inactivity among healthcare workers.

    Science.gov (United States)

    Rocha, Saulo Vasconcelos; Barbosa, Aline Rodrigues; Araújo, Tania Maria

    2018-01-15

    To estimate the prevalence of leisure-time physical inactivity (LTPI) and associated factors among healthcare workers. The cross-sectional study carried out with 2684 healthcare workers from 4 municipalities from the northeast region, Brazil. The LTPI was assessed by dichotomous question. The association between LTPI and the various independent variables was examined through the multinomial logistic regression analysis (crude and adjusted). The prevalence of LTPI was 47.9% (95% confidence interval (CI): 46.01-48.80). The adjusted analysis (sociodemographic and occupational characteristics) showed that women and individuals with higher levels of education were more LTPI (p = 0.05). The prevalence of LTPI was high among the population investigated, especially among women and individuals with higher education. These results show the importance of developing actions to encourage adherence to physical activity during leisure time among workers, especially among the most vulnerable groups (people with higher education and women), given the benefits of this behavior to health. Int J Occup Med Environ Health 2018;31(3):251-260. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  3. The Promise of the Internet of Things in Healthcare: How Hard Is It to Keep?

    OpenAIRE

    Marques, R; Gregório, João; Mira da Silva , M; Lapão, L

    2016-01-01

    Internet of Things is starting to be implemented in healthcare. An example is the automated monitoring systems that are currently being used to provide healthcare workers with feedback regarding their hand hygiene compliance. These solutions seem effective in promoting healthcare workers self-awareness and action regarding their hand hygiene performance, which is still far from desired. Underlying these systems, an indoor positioning component (following Internet of Things paradigm) is used t...

  4. Compensation patterns for healthcare workers in British Columbia, Canada.

    Science.gov (United States)

    Alamgir, H; Siow, S; Yu, S; Ngan, K; Guzman, J

    2009-06-01

    This report examines relationships between the acceptance of compensation claims, and employee and workplace characteristics for healthcare workers in British Columbia, Canada to determine suitability of using only accepted claims for occupational epidemiology research. A retrospective cohort of full-time healthcare workers was constructed from an active incident surveillance database. Incidents filed for compensation over a 1-year period were examined for initial claim decision within a 6-month window relative to sub-sector of employment, age, sex, seniority, occupation of workers, and injury category. Compensation costs and duration of time lost for initially accepted claims were also investigated. Multiple logistic regression models with generalised estimating equations (GEEs) were used to calculate adjusted relative odds (ARO) of claims decision accounting for confounding factors and clustering effects. Employees of three health regions in British Columbia filed 2274 work-related claims in a year, of which 1863 (82%) were initially accepted for compensation. Proportion of claims accepted was lowest in community care (79%) and corporate office settings (79%) and highest in long-term care settings (86%). Overall, 46% of claims resulting from allergy/irritation were accepted, in contrast to 98% acceptance of claims from cuts and puncture wounds. Licensed practical nurses had the lowest odds of claims not accepted compared with registered nurses (ARO (95% CI) = 0.55 (0.33 to 0.91)), whereas management/administrative staff had the highest odds (ARO = 2.91 (1.25 to 6.79)) of claims not accepted. A trend was observed with higher seniority of workers associated with lower odds of non-acceptance of claims. Analysis from British Columbia's healthcare sector suggests variation in workers' compensation acceptance exists across sub-sectors, occupations, seniority of workers, and injury categories. The patterns observed, however, were independent of age and sex of workers

  5. Bacteriological aspects of hand washing: A key for health promotion and infections control

    Directory of Open Access Journals (Sweden)

    Ramezan Ali Ataee

    2017-01-01

    Full Text Available The aim of this review is to show the historical aspects of hands washing for healthy life and explains how can reduce the transmission of community-acquired infectious agents by healthcare workers and patients. This review article is prepared based on available database. The key words used were hands washing, risk assessment, hands hygiene, bacterial flora, contamination, infection, nosocomial, tap water, sanitizer, bacterial resistance, hands bacterial flora, washing methods, antiseptics, healthcare workers, healthcare personnel, from PubMed, ScienceDirect, Embase, Scopus, Web of Sciences, and Google Scholar. Data were descriptively analyzed. The insistence on hand washing has a history of 1400 years. The research results indicate that the bacteria released from the female washed hands in wet and dry condition was lower than from the male′s hands with a significance level (3 CFU vs. 8 CFU; confidence interval 95%, P ≤ 0.001. The valuable results of the study indicated that released amount of bacterial flora from wet hands is more than 10 times in compared to dry hands. In addition, established monitoring systems for washing hands before and after patient′s manipulation as well as after toilet were dominant indices to prevent the transfer of infectious agents to the patients. Increasing awareness and belief of the healthcare workers have shown an important role by about 30% reduction in the transfection. Hand washing could reduce the episodes of transmission of infectious agents in both community and healthcare settings. However, hand washing is an important key factor to prevent transmission of infectious agents to patients. There is no standard method for measuring compliance. Thus, permanent monitoring of hand washing to reduce the transmission of infections is crucial. Finally, the personnel must believe that hand washing is an inevitable approach to infection control.

  6. Self-care among healthcare social workers: An exploratory study.

    Science.gov (United States)

    Miller, J Jay; Lianekhammy, Joann; Pope, Natalie; Lee, Jacquelyn; Grise-Owens, Erlene

    2017-01-01

    Despite growing interest in self-care, few studies have explicitly examined the self-care practices of healthcare social workers. This exploratory study investigated self-care among practitioners (N = 138) in one southeastern state. Overall, data suggest that healthcare social workers only moderately engaged in self-care. Additionally, analyses revealed significant differences in self-care practices by financial stability, overall health, and licensure status, respectively. Interestingly, perceived health status and current financial situation were significant predictors for overall self-care practices. After a brief review of the literature, this narrative will explicate findings, elucidate discussion points, identify salient implications, and conclude with areas for future research.

  7. Competence of Healthcare Workers in Sexual Health Education for Female Adolescents at Schools

    OpenAIRE

    Mozhgan Javadnoori; Sanaz Zangeneh; Mitra Tadayon; Mohamadreza Akhoond

    2016-01-01

    Background & aim: Sexual health education is one of the responsibilities of healthcare workers at schools, which can reduce the risk of sexually transmitted diseases such as AIDS, unwanted pregnancy, abortion, substance abuse, sexual violence, and suicidal tendencies. This study aimed to investigate healthcare workers’ competence in sexual health education for female adolescents at schools. Methods:This cross-sectional study was conducted on 300 healthcare workers, responsible for sexual heal...

  8. [Beliefs - Misbeliefs, answering essential questions about hand hygiene from the view of the evidences].

    Science.gov (United States)

    Szél, Borbála; Nagy, Kamilla; Milassin, Márta; Tálosi, Gyula

    2017-02-01

    Contaminated hands can play pivotal role in the development and spread of healthcare-associated infections. Consequently hand hygiene practice performed with adequate technique and with adequate timing is an essential implement for patient safety. Inhibition of the practice of high level hand hygiene by the misconceptions or deficient knowledge of healthcare workers may lead to negative influence on the quality of patient care. Erroneous beliefs or "rumourous knowledge" acquired from colleagues can not only influence the attitude of healthcare workers, but can also give rise to insufficient hand hygiene compliance. Finding, interpreting and imparting the related evidence by delivering continuing education and lectures, highlighting the theoretical and practical know-how on hand hygiene could help to understand and imprint the evidence-based practice and adequate technique in the essential issue of hand hygiene. Orv. Hetil., 2017., 158(6), 212-219.

  9. Mapping educational opportunities for healthcare workers on antimicrobial resistance and stewardship around the world.

    Science.gov (United States)

    Rogers Van Katwyk, Susan; Jones, Sara L; Hoffman, Steven J

    2018-02-05

    Antimicrobial resistance is an important global issue facing society. Healthcare workers need to be engaged in solving this problem, as advocates for rational antimicrobial use, stewards of sustainable effectiveness, and educators of their patients. To fulfill this role, healthcare workers need access to training and educational resources on antimicrobial resistance. To better understand the resources available to healthcare workers, we undertook a global environmental scan of educational programs and resources targeting healthcare workers on the topic of antimicrobial resistance and antimicrobial stewardship. Programs were identified through contact with key experts, web searching, and academic literature searching. We summarized programs in tabular form, including participating organizations, region, and intended audience. We developed a coding system to classify programs by program type and participating organization type, assigning multiple codes as necessary and creating summary charts for program types, organization types, and intended audience to illustrate the breadth of available resources. We identified 94 educational initiatives related to antimicrobial resistance and antimicrobial stewardship, which represent a diverse array of programs including courses, workshops, conferences, guidelines, public outreach materials, and online-resource websites. These resources were developed by a combination of government bodies, professional societies, universities, non-profit and community organizations, hospitals and healthcare centers, and insurance companies and industry. Most programs either targeted healthcare workers collectively or specifically targeted physicians. A smaller number of programs were aimed at other healthcare worker groups including pharmacists, nurses, midwives, and healthcare students. Our environmental scan shows that there are many organizations working to develop and share educational resources for healthcare workers on antimicrobial

  10. 75 FR 11922 - Apria Healthcare, Including On-Site Leased Workers From Corestaff, Ultimate Staffing (Roth...

    Science.gov (United States)

    2010-03-12

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-71,054C] Apria Healthcare..., 2009, applicable to workers of Apria Healthcare, including on-site leased workers from Corestaff... subject firm. The workers are engaged in activities related to the information technology and patient...

  11. Systemic mistakes in hand hygiene practice in Ukraine: detection, consequences and ways of elimination

    Science.gov (United States)

    Klymenko, Iryna; Kampf, Günter

    2015-01-01

    Aim: Every year, millions of people around the world suffer from different infectious diseases, considerable part of which are hospital-acquired infections. WHO considers hand hygiene as a priority measure aimed to reduce the level of infection. We evaluated various aspects related to the situational behavior and prioritization regarding hand hygiene measures among the healthcare workers of Ukraine. Method: Identification of system mistakes in hand hygiene was carried out first of all by direct and indirect observation of the activities of medical and pharmaceutical personnel in their everyday practice as well as during their participation in trainings on routine hand hygiene. Questionnaires also were used to estimate the level of hand hygiene compliance of participants of the study. During this period 112 training courses, 315 master-classes and presentations on proper hand hygiene were realized. The target audience included health care workers of medical centers, clinics, maternity hospitals, health care organizations and staff of pharmacies and pharmaceutical manufacturing enterprises in all regions of Ukraine. 638 respondents took part in anonymous survey on hand hygiene practice. Results: The most common mistakes were to regard hand washing and hand disinfection equally, to wash hands before doing a hand disinfection, to neglect the five moments for hand hygiene and to ignore hand hygiene before and after wearing protective gloves. Practitioners, medical attendants, pharmacy and pharmaceutical industry workers highlighted the need for practical and understandable instructions of various hand hygiene procedures, including the clarification of the possible technical mistakes. This became a ground for us to create individual master classes on hand hygiene for each cluster of healthcare workers. Conclusions: Changing hand hygiene behavior and attitude is possible by beginning to observe clinical practice and by involving healthcare workers in teaching and training

  12. Thermographic Evaluation of the Hands of Pig Slaughterhouse Workers Exposed to Cold Temperatures.

    Science.gov (United States)

    Tirloni, Adriana Seára; Reis, Diogo Cunha Dos; Ramos, Eliane; Moro, Antônio Renato Pereira

    2017-07-26

    Brazil was rated the fourth leading producer and exporter of pork meat in the world. The aim of this study was to evaluate the temperature of the hands of pig slaughterhouse workers and its relation to the thermal sensation of the hands and the use of a cutting tool. The study included 106 workers in a pig slaughterhouse. An infrared camera FlirThermaCAM E320 (Flir Systems, Wilsonville, OR, USA) was used to collect the images of the dorsal and palmar surfaces of both hands. A numerical scale was used to obtain the thermal sensation. Chi-square test, Pearson correlation and Student's t test or Wilcoxon were used ( p ≤ 0.05). The majority of workers felt cold in the hands (66%) and workers who used the knife felt the coldest. There was an association between the thermal sensation and the use of knife ( p = 0.001). Workers who used the tool showed correlation between the thermal sensation and the temperatures of the left fingers, with a difference between the temperatures of the right and left hands of those who used the knife ( p ≤ 0.05). The hands (left) that manipulated the products presented the lowest temperatures. Findings indicate that employers of pig slaughterhouses should provide gloves with adequate thermal insulation to preserve the health of workers' hands.

  13. [Types of conflicts and conflict management among Hungarian healthcare workers].

    Science.gov (United States)

    Csupor, Éva; Kuna, Ágnes; Pintér, Judit Nóra; Kaló, Zsuzsa; Csabai, Márta

    2017-04-01

    Efficient communication, conflict management and cooperation are the key factors of a successful patient care. This study is part of an international comparative research. The aim of this study is to unfold conflicts among healthcare workers. 73 healthcare workers were interviewed using a standardized interview protocol. The in-person interviews used the critical incident method. 30 interviews (15 doctors, 15 nurses) were analysed with the Atlas.ti 7 content analysis software. The sources, types, effects of conflicts and conflict management strategies were investigated. The content analysis unfolded the specificities of conflicts in healthcare based on personal experiences. Organizational hierarchy was a substantial source of conflict, especially among physicians, which originates from implicit rules. As a result of the avoiding conflict management the conflicts remain partly unresolved which has negative individual and group effect. Our conceptual framework helps to develop a proper intervention specific to healthcare. Orv. Hetil., 2017, 158(16), 625-632.

  14. Latex allergy: assessment of knowledge, appropriate use of gloves and prevention practice among hospital healthcare workers.

    Science.gov (United States)

    Al-Niaimi, F; Chiang, Y Z; Chiang, Y N; Williams, J

    2013-01-01

    Healthcare workers and patients are often exposed to natural rubber latex (NRL) through contact with gloves and various healthcare products, which can potentially cause allergic reactions, with varying degrees of severity. In 2008, the Royal College of Physicians published their first evidence-based guidance on occupational health interventions for latex allergy, which emphasized the importance of healthcare workers having knowledge of latex allergy. This study aimed to survey the knowledge of healthcare workers (n = 156) about latex gloves and NRL allergy, routine prevention practice and the appropriate use of gloves in patient care. Healthcare workers in a large teaching hospital were surveyed using a standard questionnaire. We found that only 1% of healthcare workers were able to correctly match the appropriate gloves to the specifically designed procedure. More than half (n = 74.53%) were unable to recognize the presentation of type 1 allergy to NRL. Of the 156 participants, 131 (84%) considered that they would benefit from training about NRL allergy and the use of different types of gloves in clinical care. This survey indicates the importance of education regarding appropriate use of gloves and prevention of NRL allergy among healthcare workers, and dermatologists should play an important role in facilitating this. © The Author(s). CED © 2012 British Association of Dermatologists.

  15. Preventing occupational stress in healthcare workers

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    Jani H. Ruotsalainen

    Full Text Available ABSTRACT: BACKGROUND: Healthcare workers can suffer from occupational stress which may lead to serious mental and physical health problems. OBJECTIVES: To evaluate the effectiveness of work and person-directed interventions in preventing stress at work in healthcare workers. METHODS: Search methods: We searched the Cochrane Depression Anxiety and Neurosis Group trials Specialised Register, MEDLINE, PsychInfo and Cochrane Occupational Health Field database. Selection criteria: Randomised controlled clinical trials (RCT of interventions aimed at preventing psychological stress in healthcare workers. For work-directed interventions interrupted time series and prospective cohort were also eligible. Data collection and analysis: Two authors independently extracted data and assessed trial quality. Meta-analysis and qualitative synthesis were performed where appropriate. MAIN RESULTS: We identified 14 RCTs, three cluster-randomised trials and two crossover trials, including a total of 1,564 participants in intervention groups and 1,248 controls. Two trials were of high quality. Interventions were grouped into 1 person-directed: cognitive-behavioural, relaxation, music-making, therapeutic massage and multicomponent; and 2 work-directed: attitude change and communication, support from colleagues and participatory problem solving and decision-making, and changes in work organisation. There is limited evidence that person-directed interventions can reduce stress (standardised mean difference or SMD -0.85; 95% CI -1.21, -0.49; burnout: Emotional Exhaustion (weighted mean difference or WMD -5.82; 95% CI -11.02, -0.63 and lack of Personal Accomplishment (WMD -3.61; 95% CI -4.65, -2.58; and anxiety: state anxiety (WMD -9.42; 95% CI -16.92, -1.93 and trait anxiety (WMD -6.91; 95% CI -12.80, -1.01. One trial showed that stress remained low a month after intervention (WMD -6.10; 95% CI -8.44, -3.76. Another trial showed a reduction in Emotional Exhaustion (Mean

  16. Exploring the self-compassion of health-care social workers: How do they fare?

    Science.gov (United States)

    Lianekhammy, Joann; Miller, J Jay; Lee, Jacquelyn; Pope, Natalie; Barnhart, Sheila; Grise-Owens, Erlene

    2018-05-03

    Indubitably, the challenges facing health-care social workers are becoming increasingly complex. Whilst these problematic professional circumstances compound the need for self-compassion among health-care social workers, few studies, if any, have explicitly examined self-compassion among this practitioner group. This cross-sectional study explored self-compassion among a sample of practitioners (N = 138) in one southeastern state. Results indicate that health-care social workers in this sample engage in self-compassion only moderately. Further, occupational and demographic/life characteristics (e.g., age, years practicing social work, average hours worked per week, health status, and relationship status, among others) are able to predict self-compassion scores. After a terse review of relevant literature, this paper will explicate findings from this study, discuss relevant points derived from said findings, and identify salient implication for health-care social work praxis.

  17. Safe injection practice among health-care workers in Gharbiya Governorate, Egypt.

    Science.gov (United States)

    Ismail, N A; Aboul Ftouh, A M; El-Shoubary, W H; Mahaba, H

    2007-01-01

    We assessed safe injection practices among 1100 health-care workers in 25 health-care facilities in Gharbiya Governorate. Questionnaires were used to collect information and 278 injections were observed using a standardized checklist. There was a lack of infection control policies in all the facilities and a lack of many supplies needed for safe injection. Proper needle manipulation before disposal was observed in only 41% of injections, safe needle disposal in 47.5% and safe syringe disposal in 0%. Reuse of used syringes and needles was reported by 13.2% of the health-care workers and 66.2% had experienced a needle-stick injury. Only 11.3% had received a full course of hepatitis B vaccination.

  18. Self-reported reasons for hand hygiene in 3 groups of health care workers.

    Science.gov (United States)

    McLaughlin, Anne Collins; Walsh, Fran

    2012-09-01

    The hands of health care workers continue to be the main vector for nosocomial infection in hospitals. The purpose of the current research was to capture the health beliefs and self-reported behaviors of US health care workers to better understand why workers avoid hand hygiene and what prompts them to wash. An online survey of health care workers assessed their reasons for washing their hands, reasons for not washing, and what cues prompted the decision to wash or not wash in a variety of locations. The findings were that hand hygiene could be cued by an external situation but tended to be motivated internally. Hand hygiene was avoided because of situational barriers. The reasons for performing hand hygiene can be situated in the internally motivated Theory of Planned Behavior; however, the reasons for not performing hand hygiene tend to be situational and affected by the environment. The results may be used to design programs, products, and systems that promote appropriate hand hygiene practices. Principles for design of these programs and products are provided. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  19. Conceptualisation of job-related wellbeing, stress and burnout among healthcare workers in rural Ethiopia: a qualitative study.

    Science.gov (United States)

    Selamu, Medhin; Thornicroft, Graham; Fekadu, Abebaw; Hanlon, Charlotte

    2017-06-19

    Wellbeing of healthcare workers is important for the effective functioning of health systems. The aim of this study was to explore the conceptualisations of wellbeing, stress and burnout among healthcare workers in primary healthcare settings in rural Ethiopia in order to inform the development of contextually appropriate interventions. A qualitative study was conducted in a rural zone of southern Ethiopia. A total of 52 frontline primary healthcare workers participated in in-depth interviews (n = 18) or Focus Group Discussions (FGDs) (4 groups, total n = 34). There were 35 facility based healthcare professionals and 17 community-based health workers. Data were analysed using thematic analysis. Most participants conceptualised wellbeing as absence of stress rather than as a positive state. Many threats to wellbeing were identified. For facility-based workers, the main stressors were inadequate supplies leading to fears of acquiring infection and concerns about performance evaluation. For community health workers, the main stressor was role ambiguity. Workload and economic self-sufficiency were a concern for both groups. Burnout and its symptoms were recognised and reported by most as a problem of other healthcare workers. Derogatory and stigmatising terms, such as "chronics", were used to refer to those who had served for many years and who appeared to have become drained of all compassion. Most participants viewed burnout as inevitable if they continued to work in their current workplace without career progression. Structural and environmental aspects of work emerged as potential targets to improve wellbeing, combined with tackling stigmatising attitudes towards mental health problems. An unmet need for intervention for healthcare workers who develop burnout or emotional difficulties was identified. Ethiopian primary healthcare workers commonly face job-related stress and experience features of burnout, which may contribute to the high turnover of staff and

  20. Quality of life among healthcare workers: a multicentre cross-sectional study in Italy.

    Science.gov (United States)

    Kheiraoui, F; Gualano, M R; Mannocci, A; Boccia, A; La Torre, G

    2012-07-01

    To evaluate the quality of life among doctors, nurses, and occupational safety and health technologists (OSHT). Cross-sectional study was undertaken in a population of healthcare workers in 10 Italian regions. The Italian version of short form-36 (SF-36) was anonymously and voluntarily self-administered by participants to assess the perceived health-related quality of life (HRQOL). The HRQOL scores for the sample and the Italian population were compared. A multiple linear regression was performed to assess the influence of age, gender, role, socializing time, working time, years spent in healthcare and years spent in the specific department on the SF-36 score. The sample included 324 healthcare workers [57.1% women, mean age 39.0 (standard deviation 10.2) years]: 52.6% were medical doctors, 36.8% were nurses and 10.5% were OSHTs. Workers with a career of >15 years achieved a general health score lower than that of workers with a shorter career, while those who spent more time in socializing activities achieved a higher mental health score. The multivariate analysis showed that increasing age is positively related to role emotional levels (β = 0.243; P = 0.002), while it appears to be inversely related to general health (β = -0.218; P = 0.007) and physical function (β = -0.246; P = 0.001). Nurses had lower scores for bodily pain (β = -0.214; P social function (β = -0.242; P = 0.001) and role emotional (β = -0.211; P = 0.006) compared with doctors. Compared with the general Italian population, healthcare workers had higher scores for general health, physical function, role physical, bodily pain and mental health, and lower scores for vitality, social function and role emotional. Healthcare workers have different levels of HRQOL related to their professional role. In particular, nurses have lower quality of life. These results may help to identify the main roles and attitudes that could cause frustration, dissatisfaction and emotional stress in healthcare

  1. Infection control and practice of standard precautions among healthcare workers in northern Nigeria

    Directory of Open Access Journals (Sweden)

    O E Amoran

    2013-01-01

    patients′ care products, 12.6% reported wash their hand before wearing the gloves, 10.7% washed hands after removal of gloves, and 72.4% changed gloves after each patient. Only 3.3% had a sharp disposal system in their various workplaces. Majority (98.6% of the respondents reported that the major reason for noncompliance to universal precautions is the nonavailability of the equipments. There was a statistically significant difference in the practice of standard precaution among those that were exposed to blood products and body fluid compared to those that had not been exposed in the last 6 months (c2 = 3.96, P = 0.03, public healthcare providers when compared to private health workers (c2 = 22.32, P = 0.001, among those working in secondary and tertiary facilities compared to primary healthcare centers (c2 = 14.64, P = 0.001 and urban areas when compared to rural areas (c2 = 4.06, P = 0.02. The only predictor of practice of standard precaution was exposure to blood and body fluid in the last 6 months odds ratio (OR = 4.56 (confidence interval (CI = 1.00-21.28. Conclusions: This study implies that inadequate workers′ knowledge and environment related problems, including the lack of protective materials and other equipments and utilities required to ensure safety of HCWs is a crucial issue that need urgent attention. Institution of a surveillance system for hospital acquired infection to improve consistent use of standard precautions among health workers is recommended in Nigeria and other low income countries in Africa.

  2. Healthcare workers' behaviors and personal determinants associated with providing adequate sexual and reproductive healthcare services in sub-Saharan Africa: a systematic review.

    Science.gov (United States)

    Jonas, Kim; Crutzen, Rik; van den Borne, Bart; Reddy, Priscilla

    2017-03-13

    Healthcare workers may affect the utilization of sexual and reproductive healthcare (SRH) services, and quality of care thereof, for example by their behaviours or attitudes they hold. This can become a hindrance to accessing and utilizing SRH services, particularly by young people, and thus a better understanding of these behaviours and associated factors is needed to improve access to and utilization of SRH services. A systematic review of literature was conducted to identify studies focusing on healthcare workers' behaviors and personal determinants associated with providing adequate SRH services in sub-Saharan Africa (January 1990 - October 2015). Five databases were searched until 30th October 2015, using a search strategy that was adapted based on the technical requirements of each specific database. Articles were independently screened for eligibility by two researchers. Of the 125-screened full-text articles, 35 studies met all the inclusion criteria. Negative behaviours and attitudes of healthcare workers, as well as other personal determinants, such as poor knowledge and skills of SRH services, and related factors, like availability of essential drugs and equipment are associated with provision of inadequate SRH services. Some healthcare workers still have negative attitudes towards young people using contraceptives and are more likely to limit access to and utilization of SRH by adolescents especially. Knowledge of and implementation of specific SRH components are below optimum levels according to the WHO recommended guidelines. Healthcare workers' negative behaviours and attitudes are unlikely to encourage women in general to access and utilize SRH services, but more specifically young women. Knowledge of SRH services, including basic emergency obstetric care (EmOC) is insufficient among healthcare workers in SSA. A protocol for this systematic review was registered with PROSPERO and the registration number is: CRD42015017509 .

  3. Hand-arm vibration in tropical rain forestry workers.

    Science.gov (United States)

    Futatsuka, M; Inaoka, T; Ohtsuka, R; Sakurai, T; Moji, K; Igarashi, T

    1995-01-01

    Working conditions and health hazards including vibration syndrome related to forestry work using chain-saws were studied in Papua New Guinea and Indonesia. The subjects comprised 291 workers including 97 chain-saw operators. The health examination consisted of peripheral circulatory and sensory tests in the upper extremities. The vibration spectrum measured at the handle of the chain-saw indicated that these acceleration levels would lead to a moderately high risk of hand-arm vibration syndrome (HAVS). The peripheral circulatory function tests revealed dysfunction after more than five years vibration exposure. However, in general, the results of the function tests and subjective complaints showed fewer health problems compared to those of Japanese forestry workers. The reason of such differences of vibration effects seem to be the following: (1) warmer climate (more than 25 degrees C throughout the year), (2) young workers and short work experience. (3) short time vibration exposures on working days in the natural forests, (4) seasonal changes in logging work (5) healthy workers effects. Thus, we found no clear evidence that the workers of our study suffered from HAVS. A principal component analysis was applied. The factor score of the components of the reactive dynamics of peripheral circulation differed significantly after more than five years' exposure. On the other hand, we cannot deny the possibility that subclinical dysfunction of peripheral circulation may be caused by chain-saw operation in the tropics in future. Further investigations on the HAVS among forestry workers in the tropic environment are needed.

  4. Hand hygiene after touching a patient's surroundings: the opportunities most commonly missed.

    Science.gov (United States)

    FitzGerald, G; Moore, G; Wilson, A P R

    2013-05-01

    Healthcare workers generally underestimate the role of environmental surfaces in the transmission of infection, and compliance with hand hygiene following contact with the environment is generally lower than following direct patient contact. To reduce the risk of onward transmission, healthcare workers must identify the need to wash hands with specific tasks or events. To observe the movement of staff in critical care and general wards and determine the routes most commonly travelled and the surfaces most frequently touched with and without appropriate hand hygiene. Fifty-eight 90 min sessions of unobtrusive observation were made in open bays and isolation rooms. Link analysis was used to record staff movement from one location to another as well as the frequency of motion. Hand-hygiene audits were conducted using the World Health Organization 'five moments for hand hygiene' observational tool. In critical care, the majority of movement occurred within the bed space. The bedside computer and equipment trolley were the surfaces most commonly touched, often immediately after patient contact. In the general ward, movement between bed spaces was more common and observed hand hygiene ranged from 25% to 33%. Regardless of ward type, observed hand-hygiene compliance when touching the patient immediately on entering an isolation room was less than 30%. Healthcare workers must be made aware that bacterial spread can occur even during activities of perceived low risk. Education and intervention programmes should focus on the potential contamination of ward computers, case notes and door handles. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  5. Are healthcare workers' mobile phones a potential source of nosocomial infections? Review of the literature.

    Science.gov (United States)

    Ulger, Fatma; Dilek, Ahmet; Esen, Saban; Sunbul, Mustafa; Leblebicioglu, Hakan

    2015-10-29

    Mobile communication devices help accelerate in-hospital flow of medical information, information sharing and querying, and contribute to communications in the event of emergencies through their application and access to wireless media technology. Healthcare-associated infections remain a leading and high-cost problem of global health systems despite improvements in modern therapies. The objective of this article was to review different studies on the relationship between mobile phones (MPs) and bacterial cross-contamination and report common findings. Thirty-nine studies published between 2005 and 2013 were reviewed. Of these, 19 (48.7%) identified coagulase-negative staphylococci (CoNS), and 26 (66.7%) identified Staphylococcus aureus; frequency of growth varied. The use of MPs by healthcare workers increases the risk of repetitive cyclic contamination between the hands and face (e.g., nose, ears, and lips), and differences in personal hygiene and behaviors can further contribute to the risks. MPs are rarely cleaned after handling. They may transmit microorganisms, including multiple resistant strains, after contact with patients, and can be a source of bacterial cross-contamination. To prevent bacterial contamination of MPs, hand-washing guidelines must be followed and technical standards for prevention strategies should be developed.

  6. Hand safety for specialty crop production workers: a pilot study investigating frequencies of minor open-wound hand injuries and presence of pathogenic bacteria.

    Science.gov (United States)

    Pate, M L; Nummer, B

    2013-10-01

    The purpose of this study was to quantify the presence of minor open-wound hand injuries in addition to Salmonella, Staphylococcus aureus, coliforms, and Escherichia coli on the hands of farm workers who hand-harvest fruit crops in Utah. Data collection was conducted on four farms without USDA Good Agricultural Practices (GAP) certification and on two farms with GAP certification. This study identified essential safety issues that need to be addressed for improving the effectiveness of safety training for migrant farm workers. Farms that have a food safety audit program in place are less likely to have farm workers exposed to pathogenic bacteria and open-wound injuries to their hands. High frequency of S. aureus may indicate a potentially higher risk for wound infection within this worker population. This could lead to infections that are resistant to the antibiotics commonly used to treat ordinary staph infections, resulting in greater work loss time and medical expenses for these workers. Higher frequencies of bacterial presence on workers' hands on non-certified farms indicate a need to identify essential practices to improve worker hygiene habits and on-farm management practices to promote healthy hygiene. Open-wound injuries to migrant farm workers during hand-harvesting could create additional health problems with the possibility of infection and the spread of diseases. Continued research is needed to understand workers' acceptance of these injuries and barriers to personal protection.

  7. Competence of Healthcare Workers in Sexual Health Education for Female Adolescents at Schools

    Directory of Open Access Journals (Sweden)

    Mozhgan Javadnoori

    2016-04-01

    Full Text Available Background & aim: Sexual health education is one of the responsibilities of healthcare workers at schools, which can reduce the risk of sexually transmitted diseases such as AIDS, unwanted pregnancy, abortion, substance abuse, sexual violence, and suicidal tendencies. This study aimed to investigate healthcare workers’ competence in sexual health education for female adolescents at schools. Methods:This cross-sectional study was conducted on 300 healthcare workers, responsible for sexual health education at schools in 2015. A valid and reliable researcher-made questionnaire was completed by the healthcare workers in order to assess their competence in sexual health education at healthcare centers of Khuzestan, Iran. To assess the competence of the participants (i.e., knowledge, attitude, confidence, and performance, descriptive statistics were calculated for quantitative variables. Also, mean, standard deviation, frequency, and percentage were calculated for qualitative variables. Pearson’s correlation test was performed to assess the relationship between the subjects’ knowledge, attitude, confidence, and performance. Also, the association between demographic variables and participants’ knowledge, attitude, confidence, and performance was evaluated, using analysis of variance (ANOVA. Data were analyzed, using SPSS version 21.0. Results: Knowledge, attitude, and confidence of healthcare workers in sexual health education were desirable. However, the subjects showed a poor performance in teaching students the required skills to control their emotions, instincts, homosexual tendencies, and masturbation. There was a significant correlation between performance, attitude, and confidence, knowledge and attitude, performance and confidence, and confidence, performance, and attitude (P

  8. Prevalence and factors associated with occupational burnout among HIV/AIDS healthcare workers in China: a cross-sectional study

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    Zhengxue Qiao

    2016-04-01

    Full Text Available Abstract Background Burnout is a psychosomatic syndrome characterized by three dimensions (emotional exhaustion [EE], feelings of depersonalization [DP], and reduced personal accomplishment [PA]. We determined the prevalence of burnout and mental health status between HIV/AIDS healthcare workers and other healthcare workers, and determined the factors associated with burnout of HIV/AIDS healthcare workers. Methods All participants were asked to complete a self-administered questionnaire. The participants were recruited from the departments of infectious diseases in four hospitals which treated HIV/AIDS. The questionnaire included demographics, the Maslach Burnout Inventory-General Survey (MBI-GS, the Symptom Checklist 90 (SCL-90, the Eysenck Personality Questionnaire (EPQ, and the Trait Coping Style Questionnaire (TCSQ. Results A total of 512 questionnaires were distributed; 501 questionnaires were completed and collected (the response rate was 97.9 %. After eliminating nine invalid questionnaires (1.80 %, 264 physicians and nurses caring for HIV/AIDS and 228 physicians and nurses caring for other infectious diseases provided valid responses (98.2 %. The HIV/AIDS healthcare workers’ scores on the emotional exhaustion (F = 6.350, p = 0.012 and depersonalization dimensions (F = 8.533, p = 0.004 were significantly higher than other healthcare workers. The HIV/AIDS healthcare workers had higher total scores and positive items on the Symptom Checklist 90 (SCL-90 compared with other healthcare workers. Low job satisfaction, serious somatization, interpersonal sensitivity, poor quality of sleep, high psychoticism scores, and use of negative coping styles were frequently associated with burnout. Conclusions Burnout was shown to be highly prevalent in HIV/AIDS healthcare workers, 76.9 % of whom met the accepted criteria for burnout. In addition, compared with other healthcare workers, HIV/AIDS healthcare workers experienced lower

  9. The ACCOMPLISH study. A cluster randomised trial on the cost-effectiveness of a multicomponent intervention to improve hand hygiene compliance and reduce healthcare associated infections

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    Steyerberg Ewout W

    2011-09-01

    Full Text Available Abstract Background Public health authorities have recognized lack of hand hygiene in hospitals as one of the important causes of preventable mortality and morbidity at population level. The implementation strategy ACCOMPLISH (Actively Creating COMPLIance Saving Health targets both individual and environmental determinants of hand hygiene. This study aims to evaluate the cost-effectiveness of a multicomponent implementation strategy aimed at the reduction of healthcare associated infections in Dutch hospital care, by promotion of hand hygiene. Methods/design The ACCOMPLISH package will be evaluated in a two-arm cluster randomised trial in 16 hospitals in the Netherlands, in one intensive care unit and one surgical ward per hospital. Intervention A multicomponent package, including e-learning, team training, introduction of electronic alcohol based hand rub dispensers and performance feedback. Variables The primary outcome measure will be the observed hand hygiene compliance rate, measured at baseline and after 6, 12 and 18 months; as a secondary outcome measure the prevalence of healthcare associated infections will be measured at the same time points. Process indicators of the intervention will be collected pre and post intervention. An ex-post economic evaluation of the ACCOMPLISH package from a healthcare perspective will be performed. Statistical analysis Multilevel analysis, using mixed linear modelling techniques will be conducted to assess the effect of the intervention strategy on the overall compliance rate among healthcare workers and on prevalence of healthcare associated infections. Questionnaires on process indicators will be analysed with multivariable linear regression, and will include both behavioural determinants and determinants of innovation. Cost-effectiveness will be assessed by calculating the incremental cost-effectiveness ratio, defined here as the costs for the intervention divided by the difference in prevalence of

  10. Adherence to malaria diagnosis and treatment guidelines among healthcare workers in Ogun State, Nigeria

    Directory of Open Access Journals (Sweden)

    Oluyomi F. Bamiselu

    2016-08-01

    Full Text Available Abstract Background Malaria case management remains a vital component of malaria control strategies. Despite the introduction of national malaria treatment guidelines and scale-up of malaria control interventions in Nigeria, anecdotal evidence shows some deviations from the guidelines in malaria case management. This study assessed factors influencing adherence to malaria diagnosis and treatment guidelines among healthcare workers in public and private sectors in Ogun State, Nigeria. Methods A comparative cross-sectional study was carried out among 432 (216 public and 216 private healthcare workers selected from nine Local Government Areas using a multistage sampling technique. A pre-tested interviewer administered questionnaire was used to collect information on availability and use of malaria Rapid Diagnostic Test (mRDT and artemisinin combination therapy (ACT, for management of uncomplicated malaria. Adherence was defined as when choice of antimalarials for parasitological confirmed malaria cases was restricted to recommended antimalarial medicines. Association between adherence and independent variables were tested using Chi-square at 5 % level of significance. Results Malaria RDT was available in 81.9 % of the public health facilities and 19.4 % of the private health facilities (p = 0.001. Its use was higher among public healthcare workers (85.2 % compared to 32.9 % in private facilities (p = 0.000. Presumptive diagnosis of malaria was higher among private healthcare workers (94.9 % compared to 22.7 % public facilities (p = <0.0001. The main reason for non-usage of mRDT among private healthcare workers was its perceived unreliability of mRDT (40.9 %. Monotherapy including artesunate (58.3 % vs 12.5 %, amodiaquine (38.9 % vs 8.3 % and chloroquine (26.4 % vs 4.2 % were significantly more available in private than public health facilities, respectively. Adherence to guidelines was significantly higher among public

  11. Challenge or hindrance: Does job stress affect presenteeism among Chinese healthcare workers?

    Science.gov (United States)

    Yang, Tianan; Ma, Mingxu; Zhu, Mingjing; Liu, Yuanling; Chen, Qian; Zhang, Shiyang; Deng, Jianwei

    2018-03-27

    We examined the effects of challenge stress and hindrance stress on general health and presenteeism among Chinese healthcare workers. Structural equation modeling was used to evaluate data from a national hospital survey in China (n = 1392). Job stress, general health, and presenteeism were measured by the Perceived Ability to Work Scale, the 8-item Short-Form Health Survey, and the Challenge- and Hindrance-Related Self-reported Stress Scale. Challenge stress and hindrance stress were significantly positively correlated (β = 0.62, SE = 0.021; p stress was directly negatively associated with presenteeism (β = -0.05, SE = 0.037; p stress was positively associated with presenteeism (β = 0.25, SE = 0.040; p health. Hospital managers should provide healthcare workers with an appropriate level of challenge, but employee health is the most important consideration. Further efforts targeting job stress and health of junior healthcare workers are required.

  12. Exposures related to hand eczema

    DEFF Research Database (Denmark)

    Ibler, K.S.; Jemec, G.B.E.; Agner, T.

    2012-01-01

    Background. Hand eczema is common in healthcare workers, owing to intensive exposure to wet work and skin irritants. Targeted interventions and vocational guidance based on documented exposures and risk factors are needed. Objectives. The aims of the study were to investigate the relationship bet...

  13. Magnified Bacteria Powerful Motivator for Hand Hygiene Compliance.

    Science.gov (United States)

    Gregory, Ashley

    2016-08-01

    Infection prevention specialists at Henry Ford Hospital in Detroit have found that showing healthcare workers magnified pictures of bacteria found ontheir hands and in their surrounding units can be a powerful motivator for improved hand hygiene compliance. When tested in four units during a one-month period, the intervention boosted hand hygiene compliance by an average of 24%. Investigators note that to be successful, the intervention must be paired with an effective compliance monitoring program. For the study, investigators visited each unit twice per week, during which they would swab various items as well as employees' hands using and adenosine triphosphate (ATP) meter, a hand-held device that measures living organisms. During each unit visit, infection prevention specialists would show unit personnel pictures from a compilation of 12 magnified images of bacteria that had been lifted from the unit. This was to demonstrate what the bacteria would look like under a microscope. The unsavory pictures produced immediate increases in had hygiene compliance, and prompted healthcare workers to see who could produce the best ATP meter readings on subsequent infection prevention specialist visits.

  14. [Prevalence of antibodies to hepatitis A virus in healthcare workers and associated variables].

    Science.gov (United States)

    Carreras-Valls, Rosa; Valverde-Lozano, Judit; Benito-Carreras, Dolors; Inglés-Torruella, Joan; Vilardell-Ynaraja, Miquel; Garre-Olmo, Josep; Gil-Soto, Rosa; Escalé-Roca, Margarita

    2013-01-01

    Vaccination against hepatitis A is recommended in risk groups, including healthcare workers. The objective of this study was to determine the prevalence of antibodies to HAV (IgG) among workers in the healthcare setting in order to establish criteria for vaccination. A cross-sectional, analytic, observational study of 4,864 employees was undertaken in four healthcare companies in Catalonia (Spain). The variables gathered included personal data, professional category, location of employment, and serology. The overall prevalence of antibodies to HAV was 52.7%. The prevalence significantly increased with greater age. The mean age of seropositive workers was 41.5 years compared with 34.3 in workers with negative serology. The highest prevalence of antibodies was found in cleaning employees (74.2%) and catering staff (75.3%). Given the high prevalence of seronegative adults susceptible to infection and the characteristics of their professional activities, vaccination of all staff working in health institutions should be considered. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

  15. Knowledge, opinions and practices of healthcare workers related to ...

    African Journals Online (AJOL)

    Liska Janse van Rensburg

    Methods: For this descriptive cross-sectional study, all the healthcare workers in the ma- ... Only 6% could comprehensively explain the term “exclusive breastfeeding” as per ..... tients will benefit from improved training sessions and effec-.

  16. Frequency of Hand Decontamination of Intraoperative Providers and Reduction of Postoperative Healthcare-Associated Infections: A Randomized Clinical Trial of a Novel Hand Hygiene System.

    Science.gov (United States)

    Koff, Matthew D; Brown, Jeremiah R; Marshall, Emily J; O'Malley, A James; Jensen, Jens T; Heard, Stephen O; Longtine, Karen; O'Neill, Melissa; Longtine, Jaclyn; Houston, Donna; Robison, Cindy; Moulton, Eric; Patel, Hetal M; Loftus, Randy W

    2016-08-01

    BACKGROUND Healthcare provider hands are an important source of intraoperative bacterial transmission events associated with postoperative infection development. OBJECTIVE To explore the efficacy of a novel hand hygiene improvement system leveraging provider proximity and individual and group performance feedback in reducing 30-day postoperative healthcare-associated infections via increased provider hourly hand decontamination events. DESIGN Randomized, prospective study. SETTING Dartmouth-Hitchcock Medical Center in New Hampshire and UMass Memorial Medical Center in Massachusetts. PATIENTS Patients undergoing surgery. METHODS Operating room environments were randomly assigned to usual intraoperative hand hygiene or to a personalized, body-worn hand hygiene system. Anesthesia and circulating nurse provider hourly hand decontamination events were continuously monitored and reported. All patients were followed prospectively for the development of 30-day postoperative healthcare-associated infections. RESULTS A total of 3,256 operating room environments and patients (1,620 control and 1,636 treatment) were enrolled. The mean (SD) provider hand decontamination event rate achieved was 4.3 (2.9) events per hour, an approximate 8-fold increase in hand decontamination events above that of conventional wall-mounted devices (0.57 events/hour); Phand hygiene system was not associated with a reduction in healthcare-associated infections (odds ratio, 1.07 [95% CI, 0.82-1.40], P=.626). CONCLUSIONS The hand hygiene system evaluated in this study increased the frequency of hand decontamination events without reducing 30-day postoperative healthcare-associated infections. Future work is indicated to optimize the efficacy of this hand hygiene improvement strategy. Infect Control Hosp Epidemiol 2016;37:888-895.

  17. Study of External Radiation Expose Dose on Hands of Nuclear Medicine Workers

    International Nuclear Information System (INIS)

    Park, Jun Chul; Pyo, Sung Jae

    2012-01-01

    The aims of this study are to assess external radiation exposed doses of body and hands of nuclear medicine workers who handle radiation sources, and to measure radiation exposed doses of the hands induced by a whole body bone scan with high frequency and handling a radioactive sources like 99m Tc-HDP and 18 F-FDG in the PET/CT examination. Skillful workers, who directly dispense and inject from radiation sources, were asked to wear a TLD on the chest and ring finger. Then, radiation exposed dose and duration exposed from daily radiation sources for each section were measured by using a pocket dosimeter for the accumulated external doses and the absorbed dose to the hands. In the survey of four medical institutions in Incheon Metropolitan City, only one of four institutions has a radiation dosimeter for local area like hands. Most of institutions uses radiation shielding devices for the purpose of protecting the body trunk, not local area. Even some institutions were revealed not to use such a shielding device. The exposed doses on the hands of nuclear medicine workers who directly handles radioactive sources were approximately twice as much as those on the body. The radiation exposure level for each section of the whole body bone scan with high frequency and that of the PET/CT examination showed that radiation doses were revealed in decreasing order of synthesis of radioactive medicine and installation to a dispensing container, dispensing, administering and transferring. Furthermore, there were statistically significant differences of radiation exposure doses of the hands before and after wearing a syringe shielder in administration of a radioactive sources. In this study, although it did not reach the permissible effective dose for nuclear medicine, the occupational workers were exposed by relatively higher dose level than the non-occupational workers. Therefore, the workers, who closely exposed to radioactive sources should be in compliance with safety

  18. Estimation of hand index for male industrial workers of Haryana State

    African Journals Online (AJOL)

    Hand index derived from measured hand dimensions can be used to estimate differences related to sex, age and race in forensic and legal sciences. It has been calculated as percentage of hand breadth over the hand length; which suggests that the male industrial workers population of state belong to mesocheir group of ...

  19. Antimicrobial efficacy of alcohol-based hand gels.

    Science.gov (United States)

    Guilhermetti, M; Marques Wiirzler, L A; Castanheira Facio, B; da Silva Furlan, M; Campo Meschial, W; Bronharo Tognim, M C; Botelho Garcia, L; Luiz Cardoso, C

    2010-03-01

    In recent years, several commercial alcohol-based hand gels have appeared on the market to improve the hand-cleansing compliance of healthcare workers. Although the antimicrobial efficacy of these products has been reported in different countries, few studies have investigated this subject in Brazil. In this study, we assessed the antimicrobial efficacy of 12 alcohol-based hand gels produced in Brazil, containing 70% w/w or v/v ethyl alcohol as the active ingredient, according to the European Standard EN 1500 (EN 1500). The following alcohol gels were tested: Hand Gel, Voga Gel, Solumax Solugel, Doctor Clean, Rio Gel, Clear Gel, Sevengel, Hand CHC, Gel Bac, WBL-50 Gel, Sanigel and Soft Care Gel. In addition, 70% w/w ethyl alcohol and three alcohol-based hand rubs (Sterillium, Sterillium Gel, and Spitaderm), commonly used in Europe and effective according to EN 1500, were also tested. All the products tested, except for two, were approved by the EN 1500 test protocol with a 60s application. The results confirmed the antimicrobial efficacy of the majority of the alcohol gels produced in Brazil for hand hygiene of healthcare workers. Copyright 2009 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.

  20. Safe injections and waste management among healthcare workers at a regional hospital in northern Tanzania.

    Science.gov (United States)

    Nilsson, Josefine; Pembe, Andrea B; Urasa, Miriam; Darj, Elisabeth

    2013-01-01

    Unsafe injections and substandard waste management are public health issues exposing healthcare workers and the community to the risk of infections. The objective of this study was to assess the knowledge and practice of safe injections and health care waste management among healthcare workers at a regional hospital in northern Tanzania. This cross sectional descriptive study was conducted in a regional hospital in northern Tanzania. Data was collected through a self-administered questionnaire with additional observations of the incinerator, injections, waste practices, and the availability of medical supplies. Data was analysed in SPSS descriptive statistics and chi-square tests were performed. A total of 223 of 305 (73%) healthcare workers from different cadres were included in the study. The majority of healthcare workers had adequate knowledge and practice of safe injections, but inadequate knowledge about waste management. The majority of the staff reported knowledge of HIV as a risk factor, however, had less knowledge about other blood-borne infections. Guidelines and posters on post exposure prophylaxes and waste management -were present at the hospital, however, the incinerator had no fence or temperature gauge. In conclusion, healthcare workers reported good knowledge and practice of injections, and high knowledge of HIV transmission routes. However, the hospital is in need of a well functioning incinerator and healthcare workers require sufficient medical supplies. There was a need for continual training about health care waste management and avoidance of blood-borne pathogens that may be transmitted through unsafe injections or poor health care waste management.

  1. Developing a diabetes prevention education programme for community health-care workers in Thailand: formative findings.

    Science.gov (United States)

    Sranacharoenpong, Kitti; Hanning, Rhona M

    2011-10-01

    The aim of this study was to investigate barriers to and supports for implementing a diabetes prevention education programme for community health-care workers (CHCWs) in Chiang Mai province, Thailand. The study also aimed to get preliminary input into the design of a tailored diabetes prevention education programme for CHCWs. Thailand has faced under-nutrition and yet, paradoxically, the prevalence of diseases of over-nutrition, such as obesity and diabetes, has escalated. As access to diabetes prevention programme is limited in Thailand, especially in rural and semi-urban areas, it becomes critical to develop a health information delivery system that is relevant, cost-effective, and sustainable. Health-care professionals (n = 12) selected from health centres within one district participated in in-depth interviews. In addition, screened people at risk for diabetes participated in interviews (n = 8) and focus groups (n = 4 groups, 23 participants). Coded transcripts from audio-taped interviews or focus groups were analysed by hand and using NVivo software. Concept mapping illustrated the findings. Health-care professionals identified potential barriers to programme success as a motivation for regular participation, and lack of health policy support for programme sustainability. Health-care professionals identified opportunities to integrate health promotion and disease prevention into CHCWs' duties. Health-care professionals recommended small-group workshops, hands-on learning activities, case studies, and video presentations that bring knowledge to practice within their cultural context. CHCWs should receive a credit for continuing study. People at risk for diabetes lacked knowledge of nutrition, diabetes risk factors, and resources to access health information. They desired two-way communication with CHCWs. Formative research supports the need for an effective, sustainable programme to support knowledge translation to CHCWs and at-risk populations in the

  2. Bridging the gap among healthcare workers and decision-makers ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Bridging the gap among healthcare workers and decision-makers through improved ... Through this project, researchers will build on insights gained from previous ... and identify the critical factors required for the scale-up and integration of the ...

  3. Role of parents in the promotion of hand hygiene in the paediatric setting: a systematic literature review.

    Science.gov (United States)

    Bellissimo-Rodrigues, F; Pires, D; Zingg, W; Pittet, D

    2016-06-01

    When a child is hospitalized, parents have to share their role to protect the child with the hospital, and establish a partnership with healthcare workers to deliver safe care to the child, including undertaking good hand hygiene practices. To review the scientific evidence about the participation of parents in the promotion of hand hygiene in paediatric settings. A systematic search of MEDLINE, EMBASE and SciELO databases was undertaken using the following terms: ('hand hygiene'[MeSH] OR 'hand hygiene' OR 'hand disinfection'[MeSH] OR hand disinf* OR hand wash* OR handwash* OR hand antisep*) AND (parent OR caregiver OR mother OR father OR family OR families OR relatives). The Integrated Quality Criteria for Review of Multiple Study Designs tool was used for quality assessment. The literature search yielded 1645 articles, and 11 studies met the inclusion criteria for the final analysis. Most studies were observational, and were based on questionnaires or interviews. Most parents had little knowledge about the indications to perform hand hygiene, but recognized hand hygiene as a relevant tool for the prevention of healthcare-associated infections. Their willingness to remind healthcare workers about a failed opportunity to perform hand hygiene was variable and, overall, rather low. Parents felt more comfortable about reminding healthcare workers about hand hygiene if they had previously been invited to do so. Literature on the subject is scarce. The promotion of hand hygiene by parents should be further explored by research as a potential intervention for enhancing patient safety in paediatric settings. Copyright © 2016. Published by Elsevier Ltd.

  4. The hand hygiene compliance of student nurses during clinical placements.

    Science.gov (United States)

    Sundal, Jorun Saetre; Aune, Anne Grethe; Storvig, Eline; Aasland, Jenny Kristin; Fjeldsaeter, Kaja Linn; Torjuul, Kirsti

    2017-12-01

    To observe student nurses' overall and moment-specific hand hygiene compliance during clinical placement. Hand hygiene is the single most important measure to prevent healthcare-associated infections. However, research has shown low compliance among healthcare workers. During clinical placements, student nurses perform various nursing tasks and procedures to a large number of patients, requiring extensive patient contact. It is crucial that they practice correct hand hygiene to prevent healthcare-associated infections. Open, standardised and nonparticipating observations. Twenty-nine student nurses were observed three times for 20 ± 10 min during clinical placement in a Norwegian university hospital. To measure compliance, we used WHO's Hand Hygiene Observation tool, based on the model "My five moments for hand hygiene". Overall hand hygiene compliance in the student group was 83.5%. Highest moment-specific compliance was after touching patient surroundings, after touching patients and after body fluid exposure risk. Lowest moment-specific compliance was recorded before touching patients or patient surroundings, and before clean/aseptic procedures. Nurse education needs to be improved both theoretically and during clinical placements in order to advance and sustain compliance among student nurses. Increasing healthcare workers' compliance with hand hygiene guidelines remains a challenge to the clinical community. In order to reduce healthcare-associated infections, it is important to educate student nurses to comply with the guidelines during clinical placements. Identifying student nurses' hand hygiene performance is the first step towards developing teaching methods to improve and sustain their overall and moment-specific compliance. As a measure to ensure student compliance during clinical placements, mentors should be aware of their influence on students' performance, act as hand hygiene ambassadors, encourage students to comply with established guidelines

  5. The Promise of the Internet of Things in Healthcare: How Hard Is It to Keep?

    Science.gov (United States)

    Marques, Rita; Gregório, João; Mira Da Silva, Miguel; Lapão, Luís Velez

    2016-01-01

    Internet of Things is starting to be implemented in healthcare. An example is the automated monitoring systems that are currently being used to provide healthcare workers with feedback regarding their hand hygiene compliance. These solutions seem effective in promoting healthcare workers self-awareness and action regarding their hand hygiene performance, which is still far from desired. Underlying these systems, an indoor positioning component (following Internet of Things paradigm) is used to collect data from the ward regarding healthcare workers' position, which will be later used to make some assumptions about the usage of alcohol-based handrub dispensers and sinks. We found that building such a system under the scope of the healthcare field is not a trivial task and it must be subject to several considerations, which are presented, analyzed and discussed in this paper. The limitations of present Internet of Things technologies are not yet ready to address the demanding field of healthcare.

  6. Occupational safety among dental health-care workers

    Science.gov (United States)

    Shimoji, Shigehiro; Ishihama, Kohji; Yamada, Hidefumi; Okayama, Masaki; Yasuda, Kouichi; Shibutani, Tohru; Ogasawara, Tadashi; Miyazawa, Hiroo; Furusawa, Kiyofumi

    2010-01-01

    Compared to other health-care workers, dental health-care workers come in close contact with patients and use a variety of sharp and high-speed rotating instruments. It is important to understand the characteristics of the occupational accidents that occur. We reviewed incident reports from April 1, 2005, to March 31, 2010, at Matsumoto Dental University Hospital. In addition, questionnaires dealing with identification of occupational safety issues, especially splash exposures, were conducted for dentists, dental hygienists, and nurses. Thirty-two occupational injuries were reported during the study period, including 23 sharp instrument injuries (71.9%), 6 splash exposures (18.8%), and 3 others. Of the six splash exposures, only two cases involved potential contamination with blood or other potentially infectious patient material. Of the 66 workers who experienced sharps injuries, 20 workers (30.3%, 20/66) reported them to the hospital work safety team. The questionnaire revealed high incident of splash exposures and conjunctiva exposures: 87.9% (51/58) and 60.3% (35/58) in dentists and 88.6% (39/44) and 61.4% (27/44) in dental hygienists. The compliance rate for routine use of protective eyewear was 60.3% (35/58) for dentists and 34.1% (15/44) for hygienists. Of the presented informational items included in the questionnaire, those that strongly persuaded respondents to use protective eyewear were ‘splatters from the patient’s mouth contain blood’ (90%, 99/110) and ‘dental operations at our clinic are performed based only on a questionnaire without serious examinations for HBV, HCV, and HIV’ (71.8%, 79/110). The reason of low compliance of protective eyewear among dentists might relate to fine dental procedures. Appropriate information is important for the motive of wearing personal protective equipment, and an early educational program may have a potential to increase compliance with the use of that equipment. PMID:23745061

  7. Motivators and barriers to mammography screening uptake by female health-care workers in primary health-care centres: a cross-sectional study.

    Science.gov (United States)

    Nazzal, Zaher; Sholi, Hisham; Sholi, Suha B; Sholi, Mohammad B; Lahaseh, Rawya

    2018-02-21

    Mammography screening is an effective tool for early detection and management of breast cancer. Female health-care workers' awareness of breast cancer screening is important because their beliefs and behaviours could influence other women. The aim of this study was to assess mammography screening uptake by female health-care workers at primary health-care centres and to identify the primary motivators and barriers that affect uptake. This cross-sectional study included all governmental primary health-care centres in the West Bank. Governorates were grouped into three regions as follows: north West Bank (Nablus, Jenin, Tulkarm, Tubas, Qalqiliya, and Salfit), middle West Bank (Jerusalem, Jericho, and Ramallah), and south West Bank (Hebron, and Bethlehem). The study population included all female health-care workers older than 40 years. Those who performed mammography for a suspected mass or other breast abnormalities were excluded. A self-administered questionnaire was used to collect data on demographic characteristics, knowledge about mammography screening, the extent and regularity of mammography screening, and motivators and barriers influencing their mammography screening uptake. The rate of mammography screening uptake was calculated. χ 2 test and t tests were used to assess screening motivators and barriers. The study was approved by the Institutional Review Board of the An-Najah National University. Participation was voluntary, and written consent was obtained from each participant. 299 female health-care workers completed a self-administered questionnaire. The mean age of the participants was 46 years (SD 4·7). 284 (95%) women had adequate knowledge about breast cancer and mammography screening, and 149 (50%) women reported having had at least one mammogram. 62 (21%) women had had regular scheduled mammograms. The most frequent reported motivators were the perceived benefit that early detection of breast cancer is important for its management (269 [90

  8. Patients-to-healthcare workers HIV transmission risk from sharp ...

    African Journals Online (AJOL)

    Biruck Desalegn * biruck471@yahoo.ca, Hunachew Beyene & Ryo Yamada

    2012-08-20

    Aug 20, 2012 ... Keywords: risk of HIV transmission, healthcare workers, Hawassa City. Résumé ... Journal des Aspects Sociaux du VIH/SIDA. 1. Downloaded by ..... tively low risk of contracting HIV regardless of the safety of medical practice ...

  9. Self-reported hand eczema among dental workers in Japan - a cross-sectional study.

    Science.gov (United States)

    Minamoto, Keiko; Watanabe, Takeshi; Diepgen, Thomas L

    2016-10-01

    Dental workers are considered to have a high risk of developing occupational hand eczema. To estimate the prevalence of work-related hand eczema and associated risk factors in dental workers in Japan. A self-administered questionnaire was sent by mail to all dental clinics of Kumamoto City, Japan. In addition, patch testing with 24 dentistry-related allergens was offered. In total, 46.4% of dental workers (n = 528: response 31.4%, based on 97 clinics) reported a lifetime history of chronic hand eczema. The 1-year prevalence was 36.2%. According to logistic regression analysis, the most important risk factors for the 1-year prevalence were a personal history of atopic dermatitis [odds ratio (OR) 4.7, 95% confidence interval (CI): 2.2-8.8], asthma and/or allergic rhinitis (OR 2.0, 95%CI: 1.3-3.0), dry skin (OR 1.7, 95%CI: 1.1-2.7), shorter duration of work (OR 2.0, 95%CI: 1.2-3.5 for up to 10 years versus >20 years), and washing hands >10 times per day (OR 1.6, 95%CI: 1.0-2.5). Fifty-four workers were patch tested. Rubber chemicals and acrylates were the most frequent occupationally relevant contact allergens. Dental workers in Japan have a high prevalence of hand eczema. Health education to prevent hand eczema and more frequent patch testing are needed. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. A Prospective Controlled Trial of an Electronic Hand Hygiene Reminder System.

    Science.gov (United States)

    Ellison, Richard T; Barysauskas, Constance M; Rundensteiner, Elke A; Wang, Di; Barton, Bruce

    2015-12-01

    Background.  The use of electronic hand hygiene reminder systems has been proposed as an approach to improve hand hygiene compliance among healthcare workers, although information on efficacy is limited. We prospectively assessed whether hand hygiene activities among healthcare workers could be increased using an electronic hand hygiene monitoring and reminder system. Methods.  A prospective controlled clinical trial was conducted in 2 medical intensive care units (ICUs) at an academic medical center with comparable patient populations, healthcare staff, and physical layout. Hand hygiene activity was monitored concurrently in both ICUs, and the reminder system was installed in the test ICU. The reminder system was tested during 3 administered phases including: room entry/exit chimes, display of real-time hand hygiene activity, and a combination of the 2. Results.  In the test ICU, the mean number of hand hygiene events increased from 1538 per day at baseline to 1911 per day (24% increase) with the use of a combination of room entry/exit chimes, real-time displays of hand hygiene activity, and manager reports (P performance returned to baseline (1473 hand hygiene events per day) during the follow-up phase. There was no significant change in hand hygiene activity in the control ICU during the course of the trial. Conclusions.  In an ICU setting, an electronic hand hygiene reminder system that provided real-time feedback on overall unit-wide hand hygiene performance significantly increased hand hygiene activity.

  11. Patient experiences of partnering with healthcare professionals for hand hygiene compliance: a systematic review.

    Science.gov (United States)

    Butenko, Samantha; Lockwood, Craig; McArthur, Alexa

    2017-06-01

    Healthcare-associated infections pose a significant risk to patients in acute healthcare settings such as hospitals. Increasingly, patients are encouraged to be active participants and partner with healthcare professionals to positively influence their own safety and overall experience throughout their healthcare journey. Patient-focused safety initiatives include the empowerment of patients to be active partners with healthcare professionals in order to influence the hand hygiene behaviors and compliance of the healthcare professionals providing care to them. Partnering within the context of healthcare, and between the patient and healthcare professional, can be considered as a general concept that involves the empowerment of patients to participate in their care. Terms used to describe patient partnering within healthcare vary and include patient participation, patient-centeredness, patient empowerment and patient engagement. Although patients appear generally to have positive attitudes and intentions about engaging in their safety and partnering in the healthcare setting, their intentions and actual behaviors vary considerably. Patients appear less likely to engage in behaviors that require questioning of the perceived or real authority of healthcare professionals. A patient's intention and subsequent act of partnering with healthcare professionals for hand hygiene compliance by the healthcare professional are influenced by complex internal, external and social factors as well as cultural, behavioral and systematic factors. To determine the best available evidence in relation to the experiences of the patient partnering with healthcare professionals for hand hygiene compliance. The current review considered qualitative (critical or interpretive) papers that included adult in-patients and healthcare professionals (medical and nursing staff), in the acute hospital-care setting. Adult was considered to be any person aged 18 years or over. It should be noted that

  12. Back Pain Prevalence- Do Healthcare Workers and Trainees Have ...

    African Journals Online (AJOL)

    Aim: To determine the level of knowledge of healthcare workers on the risk ... that the knowledge of the respondents on the possible causative effects of postures, ... educational status and gender do not influence the level of knowledge of the ...

  13. Mobile Device Security: Perspectives of Future Healthcare Workers.

    Science.gov (United States)

    Hewitt, Barbara; Dolezel, Diane; McLeod, Alexander

    2017-01-01

    Healthcare data breaches on mobile devices continue to increase, yet the healthcare industry has not adopted mobile device security standards. This increase is disturbing because individuals are often accessing patients' protected health information on personal mobile devices, which could lead to a data breach. This deficiency led the researchers to explore the perceptions of future healthcare workers regarding mobile device security. To determine healthcare students' perspectives on mobile device security, the investigators designed and distributed a survey based on the Technology Threat Avoidance Theory. Three hundred thirty-five students participated in the survey. The data were analyzed to determine participants' perceptions about security threats, effectiveness and costs of safeguards, self-efficacy, susceptibility, severity, and their motivation and actions to secure their mobile devices. Awareness of interventions to protect mobile devices was also examined. Results indicate that while future healthcare professionals perceive the severity of threats to their mobile data, they do not feel personally susceptible. Additionally, participants were knowledgeable about security safeguards, but their knowledge of costs and problems related to the adoption of these measures was mixed. These findings indicate that increasing security awareness of healthcare professionals should be a priority.

  14. Knowledge, opinions and practices of healthcare workers related to infant feeding in the context of HIV

    Directory of Open Access Journals (Sweden)

    Liska Janse van Rensburg

    2016-12-01

    Conclusion: Healthcare workers' knowledge did not conform favourably with the current WHO guidelines. These healthcare workers were actively involved in the care of patients in the maternity wards where HIV-infected mothers regularly seek counselling on infant feeding matters.

  15. Risky sexual behaviour and human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) among healthcare workers.

    Science.gov (United States)

    Khamisa, Natasha; Mokgobi, Maboe

    2018-01-01

    South Africa is known to have one of the highest prevalence rates of human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) globally, with one in seven healthcare workers being HIV-positive. An HIV-positive healthcare workforce is less equipped to respond to the increasing spread of the epidemic. Assessment of the factors contributing to high HIV prevalence rates among healthcare workers is important in planning the development of human resources. This review sought to identify and understand predominant risky sexual behaviours among healthcare workers in HIV and AIDS-affected countries. This study reviewed articles focusing on sexual behaviour among healthcare workers. Major health science databases (e.g. ProQuest, Cochrane, PubMed and CINAHL) were searched for combinations of keywords including 'healthcare workers', 'risky sexual behaviour' and 'HIV and AIDS'. Articles from a range of countries met inclusion and exclusion criteria. Findings of the study revealed three main contributing factors: unprotected sex, multiple sex partners and sexual violence. Sexual violence emerged as the dominant risk factor in the majority of the studies. Most research was conducted in developed countries where the HIV infection rate is much lower than it is in developing countries. More research needs to be conducted in developing countries and appropriate strategies should be implemented to reduce sexual violence among healthcare workers. Appropriate procedures on reporting sexual violence coupled with education on HIV and AIDS as well as influencing attitudes and belief systems could assist in reducing the spread of HIV and AIDS within the healthcare workforce while minimising the effect on patient care.

  16. Are healthcare workers immune to rubella?

    Science.gov (United States)

    Borràs, Eva; Campins, Magda; Esteve, María; Urbiztondo, Luis; Broner, Sonia; Bayas, José María; Costa, Josep; Domínguez, Angela

    2014-01-01

    Healthcare workers (HCW) have high exposure to infectious diseases, some of which, such as rubella, are vaccine-preventable. The aim of this study was to determine the immunity of HCW against rubella. We performed a seroprevalence study using a self-administered survey and obtained blood samples to determine rubella Immunoglobulin G (IgG) antibody levels in HCW during preventive examinations by five Primary Care Basic Prevention Units and six tertiary hospitals in Catalonia. Informed consent was obtained. IgG was determined using an antibody capture microparticle direct chemiluminometric technique. The odss ratio (OR) and 95% confidence intervals (CI) were calculated. Logistic regression was made to calculate adjusted OR. Of 642 HCW who participated (29.9% physician, 38.8% nurses, 13.3% other health workers and 18% non-health workers), 46.6% were primary care workers and 53.4% hospital workers. Of total, 97.2% had rubella antibodies. HCW aged 30-44 years had a higher prevalence of antibodies (98.4%) compared with HCW aged<30 years (adjusted OR 3.92; 95% CI 1.04-14.85). The prevalence was higher in nurses than in other HCW (adjusted OR: 5.57, 95% CI 1.21-25.59). Antibody prevalence did not differ between females and males (97.4% vs. 97.1%, P 0.89), type of center (97.7% vs. 96.8%, P 0.51) or according to history of vaccination (97.3% vs. 96.8%, P 0.82). Seroprevalence of rubella antibodies is high in HCW, but workers aged<30 years have a higher susceptibility (5.5%). Vaccination should be reinforced in HCW in this age group, due to the risk of nosocomial transmission and congenital rubella.

  17. Creutzfeldt-Jakob Disease Fact Sheet for Healthcare Workers and Morticians

    Science.gov (United States)

    ... here Home » Disorders » Patient & Caregiver Education » Fact Sheets Creutzfeldt-Jakob Disease Fact Sheet for Healthcare Workers and Morticians Creutzfeldt-Jakob disease (CJD) is a rare, fatal brain disorder that ...

  18. Hand disinfection in a neonatal intensive care unit: continuous electronic monitoring over a one-year period.

    Science.gov (United States)

    Helder, Onno K; van Goudoever, Johannes B; Hop, Wim C J; Brug, Johannes; Kornelisse, René F

    2012-10-08

    Good hand hygiene compliance is essential to prevent nosocomial infections in healthcare settings. Direct observation of hand hygiene compliance is the gold standard but is time consuming. An electronic dispenser with built-in wireless recording equipment allows continuous monitoring of its usage. The purpose of this study was to monitor the use of alcohol-based hand rub dispensers with a built-in electronic counter in a neonatal intensive care unit (NICU) setting and to determine compliance with hand hygiene protocols by direct observation. A one-year observational study was conducted at a 27 bed level III NICU at a university hospital. All healthcare workers employed at the NICU participated in the study. The use of bedside dispensers was continuously monitored and compliance with hand hygiene was determined by random direct observations. A total of 258,436 hand disinfection events were recorded; i.e. a median (interquartile range) of 697 (559-840) per day. The median (interquartile range) number of hand disinfection events performed per healthcare worker during the day, evening, and night shifts was 13.5 (10.8 - 16.7), 19.8 (16.3 - 24.1), and 16.6 (14.2 - 19.3), respectively. In 65.8% of the 1,168 observations of patient contacts requiring hand hygiene, healthcare workers fully complied with the protocol. We conclude that the electronic devices provide useful information on frequency, time, and location of its use, and also reveal trends in hand disinfection events over time. Direct observations offer essential data on compliance with the hand hygiene protocol. In future research, data generated by the electronic devices can be supplementary used to evaluate the effectiveness of hand hygiene promotion campaigns.

  19. Accession strategy to hand hygiene by healthcare professionals

    Directory of Open Access Journals (Sweden)

    Danielle Galdino de Paula

    2017-05-01

    Full Text Available Background and Objective: Healthcare-associated infections are serious health threat to hospitalized patients and contribute to increased mortality and morbidity. Hand hygiene is the simplest individual measure and lower cost in order to prevent the spread of infections in health care services. The study seeks to analyze the publications related to the strategies used to improve adherence of health professionals to hand hygiene in hospital. Contents: Integrative literature review. The descriptors were used in isolation and the associated descriptor AND;OR, by the following inclusion criteria: work full text of Article kind, published in the period 2008-2015, in Portuguese and English and used the electronic databases MEDLINE , LILACS and SCIELO. The analysis determined eleven strategies most used to improve adherence to hand hygiene in hospital. Conclusion: The availability of better resources and the use of a single strategy sometimes was not enough to increase membership, and often necessary to apply various strategies together with health professionals. KEYWORDS: Cross infection. Hand hygiene. Health personnel.

  20. A Prospective Controlled Trial of an Electronic Hand Hygiene Reminder System

    Science.gov (United States)

    Ellison, Richard T.; Barysauskas, Constance M.; Rundensteiner, Elke A.; Wang, Di; Barton, Bruce

    2015-01-01

    Background. The use of electronic hand hygiene reminder systems has been proposed as an approach to improve hand hygiene compliance among healthcare workers, although information on efficacy is limited. We prospectively assessed whether hand hygiene activities among healthcare workers could be increased using an electronic hand hygiene monitoring and reminder system. Methods. A prospective controlled clinical trial was conducted in 2 medical intensive care units (ICUs) at an academic medical center with comparable patient populations, healthcare staff, and physical layout. Hand hygiene activity was monitored concurrently in both ICUs, and the reminder system was installed in the test ICU. The reminder system was tested during 3 administered phases including: room entry/exit chimes, display of real-time hand hygiene activity, and a combination of the 2. Results. In the test ICU, the mean number of hand hygiene events increased from 1538 per day at baseline to 1911 per day (24% increase) with the use of a combination of room entry/exit chimes, real-time displays of hand hygiene activity, and manager reports (P hand hygiene to room entry/exit events also increased from 26.1% to 36.6% (40% increase, P hand hygiene events per day) during the follow-up phase. There was no significant change in hand hygiene activity in the control ICU during the course of the trial. Conclusions. In an ICU setting, an electronic hand hygiene reminder system that provided real-time feedback on overall unit-wide hand hygiene performance significantly increased hand hygiene activity. PMID:26430698

  1. Smartphone text message service to foster hand hygiene compliance in health care workers.

    Science.gov (United States)

    Kerbaj, Jad; Toure, Youssoupha; Soto Aladro, Alberto; Boudjema, Sophia; Giorgi, Roch; Dufour, Jean Charles; Brouqui, Philippe

    2017-03-01

    Health care-associated infections are a major worldwide public health issue. Hand hygiene is a major component in the prevention of pathogen transmission in hospitals, and hand hygiene adherence by health care workers is low in many studies. We report an intervention using text messages as reminders and feedback to improve hand hygiene adherence. The study is a historical comparison proof-of-concept study. Eighteen health care workers were monitored during 12 months by a radiofrequency identification system. Afterward we sent 2 types of text messages, congratulation or encouragement, and we studied the evolution of hand hygiene adherence. We recorded 15,723 hand hygiene opportunities, 8,973 before intervention and 6,750 during and after the intervention. Using a multilevel logistic regression analysis, we found a significant increase in hand hygiene adherence during the intervention (odds ratio, 1.68) compared with the historical period. Despite limitations due to the type of study, a text message encouraging personnel to be more vigilant is effective in increasing hand hygiene adherence in health care workers. Text message feedback should be incorporated into multimodal approaches for improving hand hygiene compliance. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  2. Latex glove sensitivity amongst diagnostic imaging healthcare personnel: a self-reporting investigation

    International Nuclear Information System (INIS)

    Healy, Jan; Brennan, Patrick C.; Bowden, Julie Anne

    2003-01-01

    The use of latex gloves has risen dramatically among healthcare workers resulting in an increase in the number of workers experiencing reactions to gloves. Little evidence of reactions among Irish healthcare workers is available. The current, self-reporting study investigated the prevalence to latex gloves amongst four professional groups within three Diagnostic Imaging Departments. Prevalence is similar to that demonstrated elsewhere with 18.3% of individuals expressing latex associated symptoms. Symptoms included itching and redness of hands, dry cracked skin, soreness of eyes and upper respiratory tract complaints. These results indicate that latex hypersensitivity is a real problem amongst Irish healthcare workers. This preliminary work provides the basis of a much larger controlled study currently being planned

  3. Physical hazard safety awareness among healthcare workers in Tanta university hospitals, Egypt.

    Science.gov (United States)

    El-Sallamy, Rania M; Kabbash, Ibrahim Ali; El-Fatah, Sanaa Abd; El-Feky, Asmaa

    2017-05-17

    Hospital workers are exposed to many occupational hazards that may threaten their health and safety. Physical hazards encountered in hospital working environment include temperature, illumination, noise, electrical injuries, and radiation. To assess the awareness of healthcare workers (HCWs) about physical hazards in Tanta university hospitals, this cross-sectional study included 401 HCWs (physicians, nurses, technicians, and workers) from seven departments (general surgery, orthopedics, radiology, ophthalmology, kitchen, incinerator, and laundry). Data were collected through interview questionnaire to assess six types of physical hazards (noise, electric hazards, temperature, radiation, fire, and lighting,). Most of the physicians (63.7%) were aware of the level of noise. All physicians, nurses, technicians, and majority of workers reported that hearing protective devices were not available, and all HCWs reported that periodic hearing examination was not performed. Most of the nurses (75.2%) and workers (68.5%) did not attended emergency training, and more than two thirds of all HCWs were not briefed about emergency evacuation. Most HCWs were not given appropriate radiation safety training before starting work (88% of workers, 73.7% of nurses, 65.7% of physicians, and 68.3% of technicians). The majority of physicians, nurses, and technicians (70.5, 65.4, and 53.7%) denied regular environmental monitoring for radiation level inside work place. Health education programs on health and safety issues regarding physical hazards should be mandatory to all healthcare workers to improve their awareness and protect them from undue exposures they may face due to lack of adequate awareness and knowledge. There is urgent need of expanding the occupational healthcare services in Egypt to cover all the employees as indicated by the international recommendations and the Egyptian Constitution, legislation, and community necessity.

  4. Healthcare professionals’ hand hygiene knowledge and beliefs in the United Arab Emirates

    Science.gov (United States)

    Ng, Wai Khuan; Shaban, Ramon Z.; van de Mortel, Thea

    2016-01-01

    Background: Hand hygiene at key moments during patient care is considered an important infection prevention and control measure to reduce healthcare-associated infections. While there is extensive research in Western settings, there is little in the United Arab Emirates where particular cultural and religious customs are thought to influence hand hygiene behaviour. Aim: To examine the hand hygiene knowledge and beliefs of health professionals at a tertiary care hospital in the United Arab Emirates. Methods: A mixed methods design employed a survey followed by focus groups with nurses and doctors. Findings: A total of 109 participants (13.6%) completed the survey: 96 nurses (88%) and 13 doctors (12%). Doctors’ hand hygiene knowledge was slightly higher than that of nurses (78.5% versus 73.5%). There was no significant difference in scores on the hand hygiene beliefs scale between nurses (M = 103.06; SD = 8.0) and doctors (M = 99.00; SD = 10.53; t (80) = 1.55; p = 0.13, two-tailed). Seven categories emerged following transcript analysis. Discussion: Hand hygiene knowledge scores suggest further hand hygiene education is required, especially on alcohol-based hand rub use. Addressing doctors’ beliefs is particularly important given the leadership roles that doctors play in healthcare settings. PMID:28989517

  5. Improving adherence to hand hygiene practice: a multidisciplinary approach.

    OpenAIRE

    Pittet, D.

    2001-01-01

    Hand hygiene prevents cross-infection in hospitals, but health-care workers' adherence to guidelines is poor. Easy, timely access to both hand hygiene and skin protection is necessary for satisfactory hand hygiene behavior. Alcohol- based hand rubs may be better than traditional handwashing as they require less time, act faster, are less irritating, and contribute to sustained improvement in compliance associated with decreased infection rates. This article reviews barriers to appropriate han...

  6. Quantitative impact of direct, personal feedback on hand hygiene technique.

    Science.gov (United States)

    Lehotsky, Á; Szilágyi, L; Ferenci, T; Kovács, L; Pethes, R; Wéber, G; Haidegger, T

    2015-09-01

    This study investigated the effectiveness of targeting hand hygiene technique using a new training device that provides objective, personal and quantitative feedback. One hundred and thirty-six healthcare workers in three Hungarian hospitals participated in a repetitive hand hygiene technique assessment study. Ultraviolet (UV)-labelled hand rub was used at each event, and digital images of the hands were subsequently taken under UV light. Immediate objective visual feedback was given to participants, showing missed areas on their hands. The rate of inadequate hand rubbing reduced from 50% to 15% (P < 0.001). However, maintenance of this reduced rate is likely to require continuous use of the electronic equipment. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  7. An investigation of factors influencing healthcare workers' use and acceptance of e-learning in post-school healthcare education.

    Science.gov (United States)

    Mikalsen, Marius; Walderhaug, Ståle

    2009-01-01

    The objective of the study presented here was to perform an empirical investigation on factors affecting healthcare workers acceptance and utilisation of e-learning in post-school healthcare education. E-learning benefits are realised when key features of e-learning are not only applied, but deemed useful, compatible with the learning process and supportive in order to reach the overall goals of the learning process. We conducted a survey of 14 state-enrolled nurses and skilled-workers within the field of healthcare in Norway. The results show that perceived compatibility and subjective norm explain system usage of the e-learning tool amongst the students. We found that the fact that the students considered the e-learning to be compatible with the course in question had a positive effect on e-learning tool usage. We also found support for factors such as facilitating conditions and ease of use leads to the e-learning tool being considered useful.

  8. Effect of workplace- versus home-based physical exercise on pain in healthcare workers

    DEFF Research Database (Denmark)

    Jakobsen, Markus Due; Sundstrup, Emil; Brandt, Mikkel

    2014-01-01

    BACKGROUND: The prevalence and consequences of musculoskeletal pain is considerable among healthcare workers, allegedly due to high physical work demands of healthcare work. Previous investigations have shown promising results of physical exercise for relieving pain among different occupational......, physical exercise performed during working hours at the workplace may be costly for the employers in terms of time spend. Thus, it seems relevant to compare the efficacy of workplace- versus home-based training on musculoskeletal pain. This study is intended to investigate the effect of workplace...... to increase adherence and avoid contamination between interventions. Two hundred healthcare workers from 18 departments located at three different hospitals is allocated to 10 weeks of 1) workplace based physical exercise performed during working hours (using kettlebells, elastic bands and exercise balls...

  9. The Compliance Rates of Hand Hygiene in Intensive Care Unit and Surgical Services at a State Hospital in Turkey

    Directory of Open Access Journals (Sweden)

    Serap Süzük

    2015-12-01

    Full Text Available Objective: The most efficient and most cost effective method for preventing health care associated infections is hand hygiene. Although hand hygiene is the most effective and simple method, compliance rates are very low among health care workers. It was aimed to evaluate the rates of compliance of healthcare workers in a state hospital. Material and Method: In this study, totally 112 healthcare workers (31 doctors and 81 nurses were evaluated with the 5-indication observation method in a period between January and July 2013. Results: A total of 754 (65.9% out of 1.144 cases were resulted in accurate hand washing and hand-rubbing. When the intensive care unit and surgical clinics were evaluated together, it was found that hand hygiene compliance rates were 51.26% in 199 cases and 66.85% in 591 cases for doctors and nurses, respectively. Conclusion: Consequently, we think that pre-informed observations are important training instruments for hand hygiene compliance.

  10. SWITCH: Al Wakra Hospital Journey to 90% Hand Hygiene Practice Compliance, 2011 – 2015

    Science.gov (United States)

    Visan, Feah Altura -; Zakaria, Almunzer; Castro, Jenalyn; Alhasanat, Omar; Ismail, Khalil Al; Ansari, Naser Al; Hamed, Manal

    2017-01-01

    Hand Hygiene is the cheapest and simplest way to prevent the spread of infection, however international compliance is below than 40% (WHO, 2009). In the experience of Al Wakra Hospital, the improvement in hand hygiene compliance highlighted not just interventions towards training and education but also behavioral motivation and physical allocations of hand hygiene appliances and equipment. Through motivating the behavioral, emotional, physical and intellectual dimensions of the different healthcare worker professions, hand hygiene compliance has increased from 60.78% in 2011 to 94.14% by the end of December 2015. It took 25 months of continuous and collaborative work with different healthcare workers to reach the 90% hand hygiene target. “Together, we have reached our goals and together we fight against infections! Because we always strive for excellence in everything we do – that is our vision here in Al Wakra Hospital.” PMID:28469905

  11. Are female healthcare workers at higher risk of occupational injury?

    Science.gov (United States)

    Alamgir, Hasanat; Yu, Shicheng; Drebit, Sharla; Fast, Catherine; Kidd, Catherine

    2009-05-01

    Differential risks of occupational injuries by gender have been examined across various industries. With the number of employees in healthcare rising and an overwhelming proportion of this workforce being female, it is important to address this issue in this growing sector. To determine whether compensated work-related injuries among females are higher than their male colleagues in the British Columbia healthcare sector. Incidents of occupational injury resulting in compensated days lost from work over a 1-year period for all healthcare workers were extracted from a standardized operational database and the numbers of productive hours were obtained from payroll data. Injuries were grouped into all injuries and musculoskeletal injuries (MSIs). Detailed analysis was conducted using Poisson regression modelling. A total of 42 332 employees were included in the study of whom 11% were male and 89% female. When adjusted for age, occupation, sub-sector, employment category, health region and facility, female workers had significantly higher risk of all injuries [rate ratio (95% CI) = 1.58 (1.24-2.01)] and MSIs [1.43 (1.11-1.85)] compared to their male colleagues. Occupational health and safety initiatives should be gender sensitive and developed accordingly.

  12. Risky sexual behaviour and human immunodeficiency virus (HIV and acquired immune deficiency syndrome (AIDS among healthcare workers

    Directory of Open Access Journals (Sweden)

    Natasha Khamisa

    2018-01-01

    Full Text Available Background: South Africa is known to have one of the highest prevalence rates of human immunodeficiency virus (HIV and acquired immune deficiency syndrome (AIDS globally, with one in seven healthcare workers being HIV-positive. An HIV-positive healthcare workforce is less equipped to respond to the increasing spread of the epidemic. Objectives: Assessment of the factors contributing to high HIV prevalence rates among healthcare workers is important in planning the development of human resources. This review sought to identify and understand predominant risky sexual behaviours among healthcare workers in HIV and AIDS-affected countries. Methods: This study reviewed articles focusing on sexual behaviour among healthcare workers. Major health science databases (e.g. ProQuest, Cochrane, PubMed and CINAHL were searched for combinations of keywords including ‘healthcare workers’, ‘risky sexual behaviour’ and ‘HIV and AIDS’. Articles from a range of countries met inclusion and exclusion criteria. Results: Findings of the study revealed three main contributing factors: unprotected sex, multiple sex partners and sexual violence. Sexual violence emerged as the dominant risk factor in the majority of the studies. Most research was conducted in developed countries where the HIV infection rate is much lower than it is in developing countries. Conclusion: More research needs to be conducted in developing countries and appropriate strategies should be implemented to reduce sexual violence among healthcare workers. Appropriate procedures on reporting sexual violence coupled with education on HIV and AIDS as well as influencing attitudes and belief systems could assist in reducing the spread of HIV and AIDS within the healthcare workforce while minimising the effect on patient care.

  13. Prevalence of Hand-transmitted Vibration Exposure among Grass-cutting Workers using Objective and Subjective Measures

    Science.gov (United States)

    Azmir, N. A.; Yahya, M. N.

    2017-01-01

    Extended exposure to hand-transmitted vibration from vibrating machine is associated with an increased occurrence of symptoms of occupational disease related to hand disorder. The present case study is to determine the prevalence and correlation of significant subjective as well as objective variables that induce to hand arm vibration syndrome (HAVS) among hand-held grass-cutting workers in Malaysia. Thus, recommendations are made for grass-cutting workers and grass maintenance service management based on findings. A cross sectional study using adopted subjective Hand Arm Vibration Exposure Risk Assessment (HAVERA) questionnaire from Vibration Injury Network on hand disorder signs and symptoms was distributed to a sample of one hundred and sixty eight male workers from grass and turf maintenance industry that use vibrating machine as part of their work. For objective measure, hand-transmitted vibration measurement was collected on site during operation by the following ISO 5349-1, 2001. Two groups were identified in this research comprising of high exposure group and low-moderate exposure group. Workers also gave information about their personal identification, social history, workers’ health, occupational history and machine safety inspection. There was positive HAVS symptoms relationship between the low-moderate exposure group and high exposure group among hand-held grass-cutting workers. The prevalence ratio (PR) was considered high for experiencing white colour change at fingers and fingers go numb which are 3.63 (1.41 to 9.39) and 4.24 (2.18 to 8.27), respectively. The estimated daily vibration exposure, A(8) differs between 2.1 to 20.7 ms-2 for right hand while 2.7 to 29.1 ms-2 for left hand. The subjects claimed that the feel of numbness at left hand is much stronger compared to right hand. The results suggest that HAVS is diagnosed in Malaysia especially in agriculture sector. The A(8) indicates that the exposure value is more than exposure limit value

  14. Obesity and health problems among South African healthcare workers

    African Journals Online (AJOL)

    Background: Obesity has reached epidemic proportions globally. In South Africa, 56% of white men, 49% of black men and 75% of black women have been reported to be overweight or obese. The focus of this study is on South African healthcare workers (HCW), because they are considered role models for health for ...

  15. Phenotypic and genotypic characterization of clinically relevant bacteria isolated from dental waste and waste workers' hands, mucosas and coats.

    Science.gov (United States)

    Tagliaferri, T L; Vieira, C D; de Carvalho, M A R; Ladeira, L C D; Magalhães, P P; de Macêdo Farias, L; Dos Santos, S G

    2017-10-01

    Infectious wastes are potential sources of pathogenic micro-organisms, which may represent a risk to the professionals who manage them. In this study, we aimed to characterize the infectious bacteria present in dental waste and waste workers. The dental waste produced over 24 h was collected and waste workers were sampled by swabbing. Isolate resistance profiles were characterized by Vitek ® and PCR and biofilm formation by Congo Red agar, string test and microtitre assay. To assess similarity between the waste and the workers' samples, a random amplified polymorphic DNA test was used. Twenty-eight bacteria were identified as clinically relevant. The most frequent gene was bla TEM present in five Gram-negative micro-organisms, and one bla SHV in Klebsiella pneumoniae. All Pseudomonas aeruginosa were positive to extracellular polymeric substances formation, except one isolated from a worker. Klebsiella pneumoniae had negative results for the string test. Pseudomonas aeruginosa showed better adherence at 25°C after 48 h of incubation and K. pneumonia had the best biofilm formation at the same temperature, after 24 h. The similarity between P. aeruginosa recovered from dental waste and from workers was low, however, it is important to note that a pathogen was found on a worker's hands and that improvements in biosafety are required. Infectious dental waste can contain clinically relevant bacteria with important resistance and biofilm profiles. These micro-organisms could be transmitted to waste workers, other professionals and patients if the principles of biosafety measures are neglected. To our knowledge, no study has ever evaluated the microbial characterization and the potential contamination risk of dental infectious waste and waste handlers. The presence of clinically relevant bacteria in the hands and nasal mucosa of waste workers highlights the need for studies in this field to clarify the risk of these pathogens in dental healthcare services, and to

  16. Perception and attitude of healthcare workers towards the use of a ...

    African Journals Online (AJOL)

    Perception and attitude of healthcare workers towards the use of a female condom in Gaborone, Botswana. ... Journal Home > Vol 21, No 1 (2016) > ... contracting the Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome ...

  17. Work-related quality of life of Ugandan healthcare workers.

    Science.gov (United States)

    Opollo, J G; Gray, J; Spies, L A

    2014-03-01

    To describe perceived work-related quality of life of Ugandan healthcare workers. A secondary aim was to seek participant input on ways to improve work environments. Poor patient outcomes, decreased employee motivation and decisions to leave the organization have been linked to poor work conditions. Interventions to correct healthcare worker shortage in developing countries require information about work quality of life. Descriptive cross-sectional study conducted in health and educational settings in Uganda in July 2011. Participants completed the Biographical Information Scale demographic questionnaire and the validated 24-item Work-Related Quality of Life scale. Sample included 146 healthcare workers employed in various settings. Participants reported poorer quality of work life on the work conditions, control at work and home-work interface subscales. Participants perceived stress at work to be low and experienced higher job career satisfaction. There was a significant relationship between work-related quality of life, gender and hours worked. Participants' suggestions to improve work life ranged from simple no-cost suggestions to more complex system level interventions. Work-related quality of life was low in this convenience sample. Perceived stress at work was lower than expected, but may have been due to nurses' expectations of a normal work assignment. Predominantly women, the participants had significant caregiving responsibilities. Nurses must acquire a seat at the table where crucial decisions about nursing and its future are made. By advancing leadership skills, nurses can effectively advocate for organizational changes that address broad factors related to increasing job satisfaction, and retaining and attracting nurses. Nurses can influence work quality of life individually and collectively by identifying workplace concerns, demanding safe work environments, fostering teamwork and enhancing professional growth. © 2014 International Council of Nurses.

  18. Workforce diversity among public healthcare workers in Nigeria: Implications on job satisfaction and organisational commitment

    Directory of Open Access Journals (Sweden)

    Ayodotun Stephen Ibidunni

    2018-06-01

    Full Text Available The aim of this research was to present a data article that identify the relationship between workforce diversity, job satisfaction and employee commitment among public healthcare workers in Nigeria. Copies of structured questionnaire were administered to 133 public healthcare workers from the Lagos state ministry of health in Nigeria. Using descriptive and structural equation modelling statistical analysis, the data revealed the relationship between workforce diversity and job satisfaction, workforce diversity and organisational commitment, and the role of job satisfaction on organisational commitment was also established. Keywords: Workforce diversity, Job satisfaction, Employee commitment, Public healthcare, Diversity management

  19. Nudging to improve hand hygiene.

    Science.gov (United States)

    Caris, M G; Labuschagne, H A; Dekker, M; Kramer, M H H; van Agtmael, M A; Vandenbroucke-Grauls, C M J E

    2018-04-01

    Hand hygiene is paramount to prevent healthcare-associated infections, but improving compliance is challenging. When healthcare workers seldom encounter healthcare-associated infections, they will consider the odds of causing infections through poor hand hygiene negligible. Cognitive biases such as these may induce non-compliance. Nudging, 'a friendly push to encourage desired behaviour', could provide an easily implemented, inexpensive measure to address cognitive biases and thus support hand hygiene interventions. To investigate whether behavioural nudges, displayed as posters, can increase the use of alcohol-based hand rub. We developed nudges based on a systematic review of previously described cognitive biases, and tested these through a cross-sectional survey among the target audience. We then conducted a controlled before-after trial on two hospital wards, to assess the effect of these nudges on the use of alcohol-based hand rub, measured with electronic dispensers. Poisson regression analyses adjusted for workload showed that nudges displayed next to dispensers increased their overall use on one ward [poster 1: relative risk: 1.6 (95% confidence interval: 1.2-2.2); poster 2: 1.7 (1.2-2.5)] and during doctor's rounds on both wards [poster 1: ward A: 1.7 (1.1-2.6); ward B: 2.2 (1.3-3.8)]. Use of dispensers without adjacent nudges did not increase. Nudges based on cognitive biases that play a role in hand hygiene, and displayed as posters, could provide an easy, inexpensive measure to increase use of alcohol-based hand rub. When applying nudges to change behaviour, it is important to identify the right nudge for the right audience. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  20. Hand hygiene-related clinical trials reported since 2010: a systematic review.

    Science.gov (United States)

    Kingston, L; O'Connell, N H; Dunne, C P

    2016-04-01

    Considerable emphasis is currently placed on reducing healthcare-associated infection through improving hand hygiene compliance among healthcare professionals. There is also increasing discussion in the lay media of perceived poor hand hygiene compliance among healthcare staff. Our aim was to report the outcomes of a systematic search for peer-reviewed, published studies - especially clinical trials - that focused on hand hygiene compliance among healthcare professionals. Literature published between December 2009, after publication of the World Health Organization (WHO) hand hygiene guidelines, and February 2014, which was indexed in PubMed and CINAHL on the topic of hand hygiene compliance, was searched. Following examination of relevance and methodology of the 57 publications initially retrieved, 16 clinical trials were finally included in the review. The majority of studies were conducted in the USA and Europe. The intensive care unit emerged as the predominant focus of studies followed by facilities for care of the elderly. The category of healthcare worker most often the focus of the research was the nurse, followed by the healthcare assistant and the doctor. The unit of analysis reported for hand hygiene compliance was 'hand hygiene opportunity'; four studies adopted the 'my five moments for hand hygiene' framework, as set out in the WHO guidelines, whereas other papers focused on unique multimodal strategies of varying design. We concluded that adopting a multimodal approach to hand hygiene improvement intervention strategies, whether guided by the WHO framework or by another tested multimodal framework, results in moderate improvements in hand hygiene compliance. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  1. Occupational Health Hazards among Healthcare Workers in Kampala, Uganda

    Directory of Open Access Journals (Sweden)

    Rawlance Ndejjo

    2015-01-01

    Full Text Available Objective. To assess the occupational health hazards faced by healthcare workers and the mitigation measures. Methods. We conducted a cross-sectional study utilizing quantitative data collection methods among 200 respondents who worked in 8 major health facilities in Kampala. Results. Overall, 50.0% of respondents reported experiencing an occupational health hazard. Among these, 39.5% experienced biological hazards while 31.5% experienced nonbiological hazards. Predictors for experiencing hazards included not wearing the necessary personal protective equipment (PPE, working overtime, job related pressures, and working in multiple health facilities. Control measures to mitigate hazards were availing separate areas and containers to store medical waste and provision of safety tools and equipment. Conclusion. Healthcare workers in this setting experience several hazards in their workplaces. Associated factors include not wearing all necessary protective equipment, working overtime, experiencing work related pressures, and working in multiple facilities. Interventions should be instituted to mitigate the hazards. Specifically PPE supply gaps, job related pressures, and complacence in adhering to mitigation measures should be addressed.

  2. Knowledge and Risk Perceptions of Occupational Infections Among Health-care Workers in Malaysia

    Directory of Open Access Journals (Sweden)

    Ganesh Chidambar Subramanian

    2017-09-01

    Full Text Available Health-care workers are at risk of exposure to occupational infections with subsequent risk of contracting diseases, disability, and even death. A systematic collection of occupational disease data is useful for monitoring current trends in work situations and disease exposures; however, these data are usually limited due to under-reporting. The objective of this study was to review literature related to knowledge, risk perceptions, and practices regarding occupational exposures to infectious diseases in Malaysian health-care settings, in particular regarding blood-borne infections, universal precautions, use of personal protective equipment, and clinical waste management. The data are useful for determining improvements in knowledge and risk perceptions among health-care workers with developments of health policies and essential interventions for prevention and control of occupational diseases.

  3. Compassion Fatigue among Healthcare, Emergency and Community Service Workers: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Fiona Cocker

    2016-06-01

    Full Text Available Compassion fatigue (CF is stress resulting from exposure to a traumatized individual. CF has been described as the convergence of secondary traumatic stress (STS and cumulative burnout (BO, a state of physical and mental exhaustion caused by a depleted ability to cope with one’s everyday environment. Professionals regularly exposed to the traumatic experiences of the people they service, such as healthcare, emergency and community service workers, are particularly susceptible to developing CF. This can impact standards of patient care, relationships with colleagues, or lead to more serious mental health conditions such as posttraumatic stress disorder (PTSD, anxiety or depression. A systematic review of the effectiveness of interventions to reduce CF in healthcare, emergency and community service workers was conducted. Thirteen relevant studies were identified, the majority of which were conducted on nurses (n = 10. Three included studies focused on community service workers (social workers, disability sector workers, while no studies targeting emergency service workers were identified. Seven studies reported a significant difference post-intervention in BO (n = 4 or STS (n = 3. This review revealed that evidence of the effectiveness of CF interventions in at-risk health and social care professions is relatively recent. Therefore, we recommend more research to determine how best to protect vulnerable workers at work to prevent not only CF, but also the health and economic consequences related to the ensuing, and more disabling, physical and mental health outcomes.

  4. Burnout and physical and mental health among Swedish healthcare workers

    NARCIS (Netherlands)

    Peterson, U.; Demerouti, E.; Bergström, G.; Samuelsson, M.; Asberg, M.; Nygren, A.

    2008-01-01

    Title. Burnout and physical and mental health among Swedish healthcare workers Aim. This paper is a report of a study to investigate how burnout relates to self-reported physical and mental health, sleep disturbance, memory and lifestyle factors. Background. Previous research on the possible

  5. HIV prevention among street-based sex workers (SSWs) in Chongqing, China: interviews with SSWs, clients and healthcare providers.

    Science.gov (United States)

    Zeng, Huan; Zhang, Lei; Zhao, Yong; Liu, Hui; Guo, Hang; Wang, Yang; Zhang, Zhen; Mao, Limin

    2016-11-01

    Street-based female sex workers (SSWs) are subjected to a relatively high risk of HIV transmission, even higher than establishment-based female sex workers in China. However, very few HIV intervention programmes have targeted this particular group to date. Based in Southwest China, this study aims to identify perceived barriers, demands and suggestions on HIV prevention from the perspectives of SSWs, clients and healthcare providers in Chongqing. Face-to-face, in-depth interviews were conducted in July 2008 with 23 participants. They were recruited by purposive, convenience sampling and included 12 SSWs, 5 male clients, 4 government healthcare providers and 2 outreach workers from a community-based non-governmental organisation. Thematic analysis was used. SSWs were largely rural-to-urban migrants with a low socioeconomic status. Most of their clients shared a similar background. Both SSWs and their clients demonstrated a low awareness of HIV infection and a lack of understanding of effective preventive strategies. Financial hardships, lack of family support, fear of police arrest and stigma in relation to sex work were identified as SSWs' major barriers for accessing healthcare services. Both SSWs and their clients indicated an urgent demand for accessing adequate HIV prevention and care programmes. On the other hand, government organisations trying to provide services to this group have also encountered obstacles, specifically their limited ability to establish mutual trust. Programmes provided by community-based non-governmental organisation, however, were perceived to be more attractive. In conclusion, there remains a substantial gap between the need of adequate HIV prevention services for SSWs and their clients and what is currently available. Strengthening inter-sectoral collaboration, providing specifically tailored health services, actively involving SSW peers and their clients, and reducing stigma in the society are keys to meet this urgent demand by SSWs

  6. Predictors of seasonal influenza vaccination among healthcare workers in hospitals : a descriptive meta-analysis

    NARCIS (Netherlands)

    Riphagen-Dalhuisen, Josien; Gefenaite, Giedre; Hak, Eelko

    Objective Vaccinating healthcare workers (HCWs) against influenza is one of the most important methods of decreasing influenza transmission among at-risk patients in healthcare facilities. However, despite recommendations, the rate of uptake of influenza vaccine among HCWs remains low. The objective

  7. Preventing healthcare-associated infections through human factors engineering.

    Science.gov (United States)

    Jacob, Jesse T; Herwaldt, Loreen A; Durso, Francis T

    2018-05-24

    Human factors engineering (HFE) approaches are increasingly being used in healthcare, but have been applied in relatively limited ways to infection prevention and control (IPC). Previous studies have focused on using selected HFE tools, but newer literature supports a system-based HFE approach to IPC. Cross-contamination and the existence of workarounds suggest that healthcare workers need better support to reduce and simplify steps in delivering care. Simplifying workflow can lead to better understanding of why a process fails and allow for improvements to reduce errors and increase efficiency. Hand hygiene can be improved using visual cues and nudges based on room layout. Using personal protective equipment appropriately appears simple, but exists in a complex interaction with workload, behavior, emotion, and environmental variables including product placement. HFE can help prevent the pathogen transmission through improving environmental cleaning and appropriate use of medical devices. Emerging evidence suggests that HFE can be applied in IPC to reduce healthcare-associated infections. HFE and IPC collaboration can help improve many of the basic best practices including use of hand hygiene and personal protective equipment by healthcare workers during patient care.

  8. Baseline evaluation of hand hygiene compliance in three major hospitals, Isfahan, Iran.

    Science.gov (United States)

    Ataei, B; Zahraei, S M; Pezeshki, Z; Babak, A; Nokhodian, Z; Mobasherizadeh, S; Hoseini, S G

    2013-09-01

    Hand hygiene is the mainstay of nosocomial infection prevention. This study was a baseline survey to assess hand hygiene compliance of healthcare workers by direct observation in three major hospitals of Isfahan, Iran. The use of different hand hygiene products was also evaluated. In 3078 potential opportunities hand hygiene products were available on 2653 occasions (86.2%). Overall compliance was 6.4% (teaching hospital: 7.4%; public hospital: 6.2%; private hospital: 1.4%). Nurses (8.4%) had the highest rates of compliance. Poor hand hygiene compliance in Isfahan hospitals necessitates urgent interventions to improve both hospital infrastructure and staff knowledge. © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  9. Quantitative evaluation of infection control models in the prevention of nosocomial transmission of SARS virus to healthcare workers: implication to nosocomial viral infection control for healthcare workers.

    Science.gov (United States)

    Yen, Muh-Yong; Lu, Yun-Ching; Huang, Pi-Hsiang; Chen, Chen-Ming; Chen, Yee-Chun; Lin, Yusen E

    2010-07-01

    Healthcare workers (HCWs) are at high risk of acquiring emerging infections while caring for patients, as has been shown in the recent SARS and swine flu epidemics. Using SARS as an example, we determined the effectiveness of infection control measures (ICMs) by logistic regression and structural equation modelling (SEM), a quantitative methodology that can test a hypothetical model and validates causal relationships among ICMs. Logistic regression showed that installing hand wash stations in the emergency room (p = 0.012, odds ratio = 1.07) was the only ICM significantly associated with the protection of HCWs from acquiring the SARS virus. The structural equation modelling results showed that the most important contributing factor (highest proportion of effectiveness) was installation of a fever screening station outside the emergency department (51%). Other measures included traffic control in the emergency department (19%), availability of an outbreak standard operation protocol (12%), mandatory temperature screening (9%), establishing a hand washing setup at each hospital checkpoint (3%), adding simplified isolation rooms (3%), and a standardized patient transfer protocol (3%). Installation of fever screening stations outside of the hospital and implementing traffic control in the emergency department contributed to 70% of the effectiveness in the prevention of SARS transmission. Our approach can be applied to the evaluation of control measures for other epidemic infectious diseases, including swine flu and avian flu.

  10. Reduction of Healthcare-Associated Infections by Exceeding High Compliance with Hand Hygiene Practices.

    Science.gov (United States)

    Sickbert-Bennett, Emily E; DiBiase, Lauren M; Willis, Tina M Schade; Wolak, Eric S; Weber, David J; Rutala, William A

    2016-09-01

    Improving hand hygiene from high to very high compliance has not been documented to decrease healthcare-associated infections. We conducted longitudinal analyses during 2013-2015 in an 853-bed hospital and observed a significantly increased hand hygiene compliance rate (pinfection rate (p = 0.0066).

  11. Development of a Data Collection Instrument for Violent Patient Encounters against Healthcare Workers

    Directory of Open Access Journals (Sweden)

    Samantha R. Hauff

    2012-12-01

    Full Text Available Introduction: Healthcare and social workers have the highest incidence of workplace violence ofany industry. Assaults toward healthcare workers account for nearly half of all nonfatal injuries fromoccupational violence. Our goal was to develop and evaluate an instrument for prospective collectionof data relevant to emergency department (ED violence against healthcare workers.Methods: Participants at a high-volume tertiary care center were shown 11 vignettes portrayingverbal and physical assaults and responded to a survey developed by the research team andpiloted by ED personnel addressing the type and severity of violence portrayed. Demographic andemployment groups were compared using the independent-samples Mann-Whitney U Test.Results: There were 193 participants (91 male. We found few statistical differences whencomparing occupational and gender groups. Males assigned higher severity scores to acts ofverbal violence versus females (mean M,F=3.08, 2.70; p<0.001. While not achieving statisticalsignificance, subgroup analysis revealed that attending physicians rated acts of verbal violencehigher than resident physicians, and nurses assigned higher severity scores to acts of sexual,verbal, and physical violence versus their physician counterparts.Conclusion: This survey instrument is the first tool shown to be accurate and reliable in characterizingacts of violence in the ED across all demographic and employment groups using filmed vignettesof violent acts. Gender and occupation of ED workers does not appear to play a significant role inperception of severity workplace violence

  12. Risk of Potential Exposure Incident in Non-healthcare Workers in Contact with Infectious and Municipal Waste

    Science.gov (United States)

    Kanisek, Sanja; Gmajnić, Rudika; Barać, Ivana

    2018-01-01

    Abstract Introduction The proper classification of sharp and infectious waste in situ by the healthcare workers is an important measure of prevention of sharps and other exposure incidents in non-healthcare workers, who handle such waste. The aim was to examine the practice of classifying sharp and infectious waste in family and dental practices. Methods An analysis of 50 bags of infectious and 50 bags of municipal waste from five family and five dental practices for five days in October 2016 at the Health centre Osijek. Results Healthcare workers in 70% of the practices deposited sharps in infectious waste. In 56% of infectious waste bags, sharp object were found. More risky bags of infectious waste were produced by family practices (64%), but with no significant differences in relation to dental practices (48%), (P=0.143). Disposing of infectious into municipal waste was the case in 90% of the practitioners, where in 60% of municipal waste bags, infectious waste was disposed. Dental practices produced more risky bags of municipal waste (76%) in relation to family practices (44%), but with no significant difference (P=0.714). Conclusions The results of this research point to importance of performing audits of proper disposal of sharps and infectious waste to reduce the risks of injury to non-healthcare workers who come into contact with the said waste. Given results could be used for framing written protocols of proper disposal of sharps and infectious waste that should be visibly available in family and dental practices and for education of healthcare workers. PMID:29651317

  13. Influenza vaccination for healthcare workers in the UK: appraisal of systematic reviews and policy options

    Science.gov (United States)

    Kliner, Merav; Keenan, Alex; Sinclair, David; Ghebrehewet, Sam; Garner, Paul

    2016-01-01

    Background The UK Department of Health recommends annual influenza vaccination for healthcare workers, but uptake remains low. For staff, there is uncertainty about the rationale for vaccination and evidence underpinning the recommendation. Objectives To clarify the rationale, and evidence base, for influenza vaccination of healthcare workers from the occupational health, employer and patient safety perspectives. Design Systematic appraisal of published systematic reviews. Results The quality of the 11 included reviews was variable; some included exactly the same trials but made conflicting recommendations. 3 reviews assessed vaccine effects in healthcare workers and found 1 trial reporting a vaccine efficacy (VE) of 88%. 6 reviews assessed vaccine effects in healthy adults, and VE was consistent with a median of 62% (95% CI 56 to 67). 2 reviews assessed effects on working days lost in healthcare workers (3 trials), and 3 reported effects in healthy adults (4 trials). The meta-analyses presented by the most recent reviews do not reach standard levels of statistical significance, but may be misleading as individual trials suggest benefit with wide variation in size of effect. The 2013 Cochrane review reported absolute effects close to 0 for laboratory-confirmed influenza, and hospitalisation for patients, but excluded data on clinically suspected influenza and all-cause mortality, which had shown potentially important effects in previous editions. A more recent systematic review reports these effects as a 42% reduction in clinically suspected influenza (95% CI 27 to 54) and a 29% reduction in all-cause mortality (95% CI 15 to 41). Conclusions The evidence for employer and patient safety benefits of influenza vaccination is not straightforward and has been interpreted differently by different systematic review authors. Future uptake of influenza vaccination among healthcare workers may benefit from a fully transparent guideline process by a panel representing all

  14. Examining Perceptions about Mandatory Influenza Vaccination of Healthcare Workers through Online Comments on News Stories.

    Directory of Open Access Journals (Sweden)

    Yang Lei

    Full Text Available The aim of this study was to understand online public perceptions of the debate surrounding the choice of annual influenza vaccinations or wearing masks as a condition of employment for healthcare workers, such as the one enacted in British Columbia in August 2012.Four national and 82 local (British Columbia Canadian online news sites were searched for articles posted between August 2012 and May 2013 containing the words "healthcare workers" and "mandatory influenza vaccinations/immunizations" or "mandatory flu shots and healthcare workers." We included articles from sources that predominantly concerned our topic of interest and that generated reader comments. Two researchers coded the unedited comments using thematic analysis, categorizing codes to allow themes to emerge. In addition to themes, the comments were categorized by: 1 sentiment towards influenza vaccines; 2 support for mandatory vaccination policies; 3 citing of reference materials or statistics; 4 self-identified health-care worker status; and 5 sharing of a personal story.1163 comments made by 648 commenters responding to 36 articles were analyzed. Popular themes included concerns about freedom of choice, vaccine effectiveness, patient safety, and distrust in government, public health, and the pharmaceutical industry. Almost half (48% of commenters expressed a negative sentiment toward the influenza vaccine, 28% were positive, 20% were neutral, and 4% expressed mixed sentiment. Of those who commented on the policy, 75% did not support the condition to work policy, while 25% were in favour. Of the commenters, 11% self-identified as healthcare workers, 13% shared personal stories, and 18% cited a reference or statistic.The perception of the influenza vaccine in the comment sections of online news sites is fairly poor. Public health agencies should consider including online forums, comment sections, and social media sites as part of their communication channels to correct

  15. The effectiveness of methicillin-resistant Staphylococcus aureus colonisation screening in asymptomatic healthcare workers in an Irish orthopaedic unit.

    LENUS (Irish Health Repository)

    Edmundson, S P

    2012-01-31

    Methicillin-resistant Staphylococcus aureus (MRSA) infections are associated with increased mortality, costs and length of stay compared to non-MRSA infections. This observational 4-year study analyses the impact of screening and treating orthopaedic healthcare workers for MRSA colonisation. A total of 1,011 swabs were taken from 566 healthcare workers. Positive healthcare workers were treated with topical mupirocin to both anterior nares. The prevalence of MRSA colonisation on initial testing was 4.77%. The rate of positive MRSA colonisation of those tested on more than one occasion fell from 5.88% to 2.71% (p = 0.055) on subsequent screening. All healthcare workers receiving treatment were successfully cleared of colonisation; however, some required more than one course of treatment. These results show that there could be a role for screening and treating orthopaedic staff for MRSA colonisation as part of a strategy to reduce the prevalence of MRSA infections in orthopaedic units.

  16. The impact of the Hand Hygiene New Zealand programme on hand hygiene practices in New Zealand's public hospitals.

    Science.gov (United States)

    Freeman, Joshua; Dawson, Louise; Jowitt, Deborah; White, Margo; Callard, Hayley; Sieczkowski, Christine; Kuriyan, Ron; Roberts, Sally

    2016-10-14

    To detail the progress made by Hand Hygiene New Zealand (HHNZ) since 2011 and also describe the challenges experienced along the way and the factors required for delivery of a successful hand hygiene programme at a national level. HHNZ is a multimodal culture-change programme based on the WHO '5 moments for hand hygiene' approach. The key components of the programme include clinical leadership, auditing of hand hygiene compliance with thrice yearly reporting of improvement in hand hygiene practice, biannual reporting of the outcome marker, healthcare-associated Staphylococcus aureus bacteraemia (HA-SAB), effective communication with key stakeholders and the use of the front-line ownership (FLO) principles for quality improvement. The nationally aggregated hand hygiene compliance has increased from 62% in June 2012 to 81% in March 2016. There has been improvement across all 'moments', all healthcare worker groups and a range of different clinical specialties. The rate of HA-SAB has remained stable. The HHNZ programme has led to significant improvements in hand hygiene practice in DHBs throughout New Zealand. The principles of FLO are now widely used to drive hand hygiene improvement in New Zealand DHBs.

  17. Occupational skin diseases in Czech healthcare workers from 1997 to 2009.

    Science.gov (United States)

    Machovcová, A; Fenclová, Z; Pelclová, D

    2013-04-01

    The healthcare sector ranked in second place among economic sectors in the Czech Republic, with about 11.4 % of all occupational diseases in 2009. Skin diseases constituted about 20 % of all occupational diseases. The aim of this study was to analyze the causes and trends in allergic and irritant-induced skin diseases in the healthcare sector. The data concerning occupational skin diseases (Chapter IV of the Czech List of Occupational Diseases, non-infectious skin illnesses) in the healthcare sector were analyzed from the Czech National Registry of Occupational Diseases from 1997 until 2009. The trends in the total counts and most frequent causes were evaluated. During the past 13 years, a total of 545 skin diseases were acknowledged in healthcare workers. Allergic contact dermatitis was diagnosed in 464 (85 %), irritant contact dermatitis in 71 (13 %) and contact urticaria in 10 subjects (2 %). Ninety-five percent of the patients were females. The overall incidence in individual years varied between 1.0 and 2.9 cases per 10,000 full-time employees per year. Disinfectants were the most frequent chemical agents causing more than one third of all allergic skin diseases (38 %), followed by rubber components (32 %) and cleaning agents (10 %). A general downward trend of diagnosed cases of occupational skin diseases in heath care workers in the Czech Republic over the past 13 years was demonstrated.

  18. Processes of change used by healthcare workers to participate in ...

    African Journals Online (AJOL)

    The aim of this study was to identify processes of change that healthcare workers (HCWs) use to progress from one stage of physical activity (PA) to another. This was a retrospective quantitative descriptive design involving 163 HCWs who were previously exposed to different education and motivation to exercise for a ...

  19. Effort-reward imbalance and quality of life of healthcare workers in military hospitals: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Tzeng Dong-Sheng

    2012-09-01

    Full Text Available Abstract Background Taiwan’s National Defense Bureau has been merging its hospitals and adjusting hospital accreditation levels since the beginning of 2006. These changes have introduced many stressors to the healthcare workers in these hospitals. This study investigates the association between job stress, psychological morbidity and quality of life in healthcare workers in three military hospitals. Methods We posted surveys to 1269 healthcare workers in three military hospitals located in southern Taiwan. The surveys included the General Health Questionnaire (GHQ, the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF, and the Effort-Reward Imbalance (ERI Questionnaire. High effort-reward (ER ratio and overcommitment were defined when scores fell into the upper tertile of the total distribution. Results The survey was completed by 791 healthcare workers. On average, women reported a higher ERI than men. High ERI was associated with younger age, higher psychological morbidity, and poor physical and psychological QOL domains in this population. High ER ratio and high overcommitment were associated with psychological morbidity and poor QOL in both sexes. However, high ER ratio was not significantly associated with the social QOL domain in either sexes or the physical QOL domain in males. Conclusions There was a clear association between ERI and QOL in the healthcare workers in the military hospitals under reorganization and accreditation in this study. We found ER ratio and overcommitment to be suitable indicators of job stress.

  20. Current patient and healthcare worker attitudes to eHealth and the personally controlled electronic health record in major hospitals.

    Science.gov (United States)

    Armani, R; Mitchell, L E; Allen-Graham, J; Heriot, N R; Kotsimbos, T; Wilson, J W

    2016-06-01

    The current health system in Australia is comprised of both electronic- and paper-based medical records. The Federal Government has approved funding for the development of an individual health identifier and a universally adopted online health repository. To determine attitudes and beliefs of patients and healthcare workers regarding the use of stored medical information and the personally controlled electronic health record (PCEHR) in selected major hospitals in Victoria. Qualitative survey of patients and healthcare workers (n = 600 each group) conducted during 2014 across five major hospitals in Melbourne to measure the awareness, attitudes and barriers to electronic health and the PCEHR. Of the patients, 93.3% support the concept of a shared electronic healthcare record, 33.7% were aware of the PCEHR and only 11% had registered. The majority of healthcare workers believed that the presence of a shared health record would result in an increased appropriateness of care and patient safety by reducing adverse drug events and improving the timeliness of care provided. However, only 46% of healthcare workers were aware of the PCEHR. This study provides a baseline evaluation of perceptions surrounding eHealth and PCHER in acute health services in five metropolitan centres. While there appears to be a readiness for adoption of these strategies for healthcare documentation, patients require motivation to register for the PCEHR, and healthcare workers require more information on the potential benefits to them to achieve more timely and efficient care. © 2016 Royal Australasian College of Physicians.

  1. Reducing stigma in healthcare and law enforcement: a novel approach to service provision for street level sex workers.

    Science.gov (United States)

    Bodkin, Kate; Delahunty-Pike, Alannah; O'Shea, Tim

    2015-04-09

    Providing services for street level sex workers requires a multidisciplinary approach, addressing both health and safety concerns typical of their age and gender and those that arise specific to their line of work. Despite being a diverse population, studies have identified some specific health needs for sex workers including addictions treatment, mental health. Additionally, studies have shown a higher risk of physical and sexual assault for this population. The Persons at Risk program (PAR) in London, Ontario, Canada was started in 2005 to address the specific needs of street level sex workers by using a harm-reduction model for policing and healthcare provision. This qualitative study evaluated this model of care in terms of improving access to healthcare and essential police services for street level sex workers. A total of 14 semi-structured interviews were conducted with current and former female street level sex workers enrolled in the PAR program. In addition, 3 semi-structured interviews were conducted with health and law enforcement professionals. The research team then analyzed and coded the transcripts using qualitative description to identify key themes in the data. Results indicated that participants represent a vulnerable population with increased safety concerns and healthcare needs relating to addictions, mental health and infectious disease. Despite this, participants reported avoiding healthcare workers and police officers in the past because of fear of stigma or repercussions. All participants identified the harm reduction approach of the PAR program as being essential to their continued engagement with the program. Other important aspects included flexible hours, the location of the clinic, streamlined access to mental health and addictions treatment and the female gender of the police and healthcare worker. The PAR program provides sex workers access to much needed primary healthcare that is flexible and without judgment. In addition, they are

  2. Glove Use and Glove Education in Workers with Hand Dermatitis.

    Science.gov (United States)

    Rowley, Kyle; Ajami, Daana; Gervais, Denise; Mooney, Lindsay; Belote, Amy; Kudla, Irena; Switzer-McIntyre, Sharon; Holness, D Linn

    2016-01-01

    Occupational skin diseases are common. The occurrence of occupational skin diseases represents a failure of primary prevention strategies that may include the use of personal protective equipment, most commonly gloves. The objective of this study was to describe current glove use and education practices related to gloves in workers being assessed for possible work-related hand dermatitis. Participants included consecutive patients being assessed for possible work-related hand dermatitis. A self-administered questionnaire obtained information on demographics, workplace characteristics and exposures, glove use, and education regarding gloves. Ninety percent of the 105 participants reported using gloves. Only 44% had received training related to glove use in the workplace. Major gaps in training content included skin care when using gloves, warning signs of skin problems, and glove size. If the worker indicated no glove training received, the majority reported they would have used gloves if such training was provided. Although the majority of workers being assessed wore gloves, the minority had received training related to glove use. Particular gaps in training content were identified. Those who had not received training noted they would likely have used gloves if training had been provided.

  3. Implementing and sustaining a hand hygiene culture change programme at Auckland District Health Board.

    Science.gov (United States)

    Roberts, Sally A; Sieczkowski, Christine; Campbell, Taima; Balla, Greg; Keenan, Andrew

    2012-05-11

    In January 2009 Auckland District Health Board commenced implementation of the Hand Hygiene New Zealand (HHNZ) programme to bring about a culture change and to improve hand hygiene compliance by healthcare workers. We describe the implementation process and assess the effectiveness of this programme 36 months after implementation. In keeping with the HHNZ guideline the implementation was divided into five steps: roll-out and facility preparation, baseline evaluation, implementation, follow-up evaluation and sustainability. The process measure was improvement in hand hygiene compliance and the outcome measure was Staphylococcus aureus clinical infection and bacteraemia rates. The mean (95% CI; range) baseline compliance rates for the national reporting wards was 35% (95% CI 24-46%, 25-61%). The overall compliance by the 7th audit period was 60% (95% CI 46-74; range 47-91). All healthcare worker groups had improvement in compliance. The reduction in healthcare-associated S. aureus bacteraemia rates following the implementation was statistically significant (p=0.027). Compliance with hand hygiene improved following implementation of a culture change programme. Sustaining this improvement requires commitment and strong leadership at a senior level both nationally and within each District Health Board.

  4. [Global management of patients with ebola viral disease, experience of the Healthcare workers Treatment of Conakry, Guinea].

    Science.gov (United States)

    Savini, H; Maugey, N; Aletti, M; Facon, A; Koulibaly, F; Cotte, J; Janvier, F; Cordier, P Y; Dampierre, H; Ramade, S; Foissaud, V; Granier, H; Sagui, E; Carmoi, T

    2016-10-01

    The Healthcare Workers Treatment Center of Conakry, Guinea, was inaugurated in january 2015. It is dedicated to the diagnosis and the treatment of healthcare workers with probable or confirmed Ebola viral disease. It is staffed by the french army medical service. The french military team may reconcile their medical practice and the ethno-cultural imperatives to optimise the patient adherence during his hospitalization.

  5. Interventions to improve patient hand hygiene: a systematic review.

    Science.gov (United States)

    Srigley, J A; Furness, C D; Gardam, M

    2016-09-01

    Nosocomial pathogens may be acquired by patients via their own unclean hands, but there has been relatively little emphasis on patient hand hygiene as a tool for preventing healthcare-associated infections (HCAIs). The aim of this systematic review was to determine the efficacy of patient hand hygiene interventions in reducing HCAIs and improving patient hand hygiene rates compared to usual care. Electronic databases and grey literature were searched to August 2014. Experimental and quasi-experimental studies were included if they evaluated a patient hand hygiene intervention conducted in an acute or chronic healthcare facility and included HCAI incidence and/or patient hand hygiene rates as an outcome. All steps were performed independently by two investigators. Ten studies were included, most of which were uncontrolled before-after studies (N=8). The majority of interventions (N=7) were multi-modal, with components similar to healthcare worker hand hygiene programmes, including education, reminders, audit and feedback, and provision of hand hygiene products. Six studies reported HCAI outcomes and four studies assessed patient hand hygiene rates; all demonstrated improvements but were at moderate to high risk of bias. In conclusion, interventions to improve patient hand hygiene may reduce the incidence of HCAIs and improve hand hygiene rates, but the quality of evidence is low. Future studies should use stronger designs and be more selective in their choice of outcomes. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  6. [Effects on female healthcare workers of the ministry of health campaign against tobacco smoking.

    Science.gov (United States)

    La Torre, Giuseppe; Guastamacchia, Sergio; Barbagallo, Alfio; Mannocci, Alice

    2017-11-01

    Smoking prevalence among health care workers is higher in comparison with general population and the prevalence of women who smoke is higher than among men. In the prevention strategies the multimedia campaign may be a positive impact on the fight against tobacco. Objective. The aim of the study was to assess the impact of the last Italian campaign against smoking (Il fumo fammale) in the health care women workers. A cross-sectional study was conducted in Latium and Sicily (Italy) in 2015, through an interview on memories and impressions about the spots and after a new vision of the spot and eventually other comments. 357 individuals entered the study, 204 female health care workers and 153 from the general population. The female health care workers were more skeptical than the general population. The impressions aroused in the healthcare workers versus the general population were: sadness (OR=2.96;IC95%:1.17-7.49), indifference (OR=5.57;IC95%:2.43-12.77); while a cue to reflect was more considered from general population than health care workers (OR=0.13;IC95%:0.07-0.23). The female professionals health referred the main characteristics of the spot as no original, no impactful, no persuasive and boring too. In conclusion the multimedia campaign to fight against the smoking should be useful, but the psico-behavioural factors have applied and considered when it is implemented; to reduce the tobacco consumption in the healthcare workers can make them an example for the people of healthy life styles and they are a start up of prevention mechanism too. Furthermore it is important to consider the healthcare professional's opinions for future healthy communications and multimedia campaign on tobacco harm. Copyright© by Aracne Editrice, Roma, Italy.

  7. Workforce diversity among public healthcare workers in Nigeria: Implications on job satisfaction and organisational commitment.

    Science.gov (United States)

    Ibidunni, Ayodotun Stephen; Falola, Hezekiah Olubusayo; Ibidunni, Oyebisi Mary; Salau, Odunayo Paul; Olokundun, Maxwell Ayodele; Borishade, Taiye Tairat; Amaihian, Augusta Bosede; Peter, Fred

    2018-06-01

    The aim of this research was to present a data article that identify the relationship between workforce diversity, job satisfaction and employee commitment among public healthcare workers in Nigeria. Copies of structured questionnaire were administered to 133 public healthcare workers from the Lagos state ministry of health in Nigeria. Using descriptive and structural equation modelling statistical analysis, the data revealed the relationship between workforce diversity and job satisfaction, workforce diversity and organisational commitment, and the role of job satisfaction on organisational commitment was also established.

  8. Occupational safety among dental health-care workers

    Directory of Open Access Journals (Sweden)

    Shigehiro Shimoji

    2010-10-01

    Full Text Available Shigehiro Shimoji1, Kohji Ishihama1,2, Hidefumi Yamada1, Masaki Okayama1, Kouichi Yasuda1,3, Tohru Shibutani3,4, Tadashi Ogasawara2,5, Hiroo Miyazawa2,3, Kiyofumi Furusawa11Department of Oral and Maxillofacial Surgery, Matsumoto Dental University, Shiojiri, Japan; 2Infection Control Team, 3Risk Management Working Team, Matsumoto Dental University Hospital, Shiojiri, Japan; 4Department of Dental Anesthesiology, 5Department of Special Care Dentistry, Matsumoto Dental University, Shiojiri, JapanAbstract: Compared to other health-care workers, dental health-care workers come in close contact with patients and use a variety of sharp and high-speed rotating instruments. It is important to understand the characteristics of the occupational accidents that occur. We reviewed incident reports from April 1, 2005, to March 31, 2010, at Matsumoto Dental University Hospital. In addition, questionnaires dealing with identification of occupational safety issues, especially splash exposures, were conducted for dentists, dental hygienists, and nurses. Thirty-two occupational injuries were reported during the study period, including 23 sharp instrument injuries (71.9%, 6 splash exposures (18.8%, and 3 others. Of the six splash exposures, only two cases involved potential contamination with blood or other potentially infectious patient material. Of the 66 workers who experienced sharps injuries, 20 workers (30.3%, 20/66 reported them to the hospital work safety team. The questionnaire revealed high incident of splash exposures and conjunctiva exposures: 87.9% (51/58 and 60.3% (35/58 in dentists and 88.6% (39/44 and 61.4% (27/44 in dental hygienists. The compliance rate for routine use of protective eyewear was 60.3% (35/58 for dentists and 34.1% (15/44 for hygienists. Of the presented informational items included in the questionnaire, those that strongly persuaded respondents to use protective eyewear were ‘splatters from the patient’s mouth contain blood

  9. Hand hygiene in the intensive care unit.

    Science.gov (United States)

    Tschudin-Sutter, Sarah; Pargger, Hans; Widmer, Andreas F

    2010-08-01

    Healthcare-associated infections affect 1.4 million patients at any time worldwide, as estimated by the World Health Organization. In intensive care units, the burden of healthcare-associated infections is greatly increased, causing additional morbidity and mortality. Multidrug-resistant pathogens are commonly involved in such infections and render effective treatment challenging. Proper hand hygiene is the single most important, simplest, and least expensive means of preventing healthcare-associated infections. In addition, it is equally important to stop transmission of multidrug-resistant pathogens. According to the Centers for Disease Control and Prevention and World Health Organization guidelines on hand hygiene in health care, alcohol-based handrub should be used as the preferred means for routine hand antisepsis. Alcohols have excellent in vitro activity against Gram-positive and Gram-negative bacteria, including multidrug-resistant pathogens, such as methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci, Mycobacterium tuberculosis, a variety of fungi, and most viruses. Some pathogens, however, such as Clostridium difficile, Bacillus anthracis, and noroviruses, may require special hand hygiene measures. Failure to provide user friendliness of hand hygiene equipment and shortage of staff are predictors for noncompliance, especially in the intensive care unit setting. Therefore, practical approaches to promote hand hygiene in the intensive care unit include provision of a minimal number of handrub dispensers per bed, monitoring of compliance, and choice of the most attractive product. Lack of knowledge of guidelines for hand hygiene, lack of recognition of hand hygiene opportunities during patient care, and lack of awareness of the risk of cross-transmission of pathogens are barriers to good hand hygiene practices. Multidisciplinary programs to promote increased use of alcoholic handrub lead to an increased compliance of healthcare

  10. Knowledge and practice regarding dengue and chikungunya: a cross-sectional study among Healthcare workers and community in Northern Tanzania.

    Science.gov (United States)

    Kajeguka, Debora C; Desrochers, Rachelle E; Mwangi, Rose; Mgabo, Maseke R; Alifrangis, Michael; Kavishe, Reginald A; Mosha, Franklin W; Kulkarni, Manisha A

    2017-05-01

    To investigate knowledge and prevention practices regarding dengue and chikungunya amongst community members, as well as knowledge, treatment and diagnostic practices among healthcare workers. We conducted a cross-sectional survey with 125 community members and 125 healthcare workers from 13 health facilities in six villages in the Hai district of Tanzania. A knowledge score was generated based on participant responses to a structured questionnaire, with a score of 40 or higher (of 80 and 50 total scores for community members and healthcare workers, respectively) indicating good knowledge. We conducted qualitative survey (n = 40) to further assess knowledge and practice regarding dengue and chikungunya fever. 15.2% (n = 19) of community members had good knowledge regarding dengue, whereas 53.6%, (n = 67) of healthcare workers did. 20.3% (n = 16) of participants from lowland areas and 6.5% (n = 3) from highland areas had good knowledge of dengue (χ 2 = 4.25, P = 0.03). Only 2.4% (n = 3) of all participants had a good knowledge score for chikungunya. In the qualitative study, community members expressed uncertainty about dengue and chikungunya. Some healthcare workers thought that they were new diseases. There is insufficient knowledge regarding dengue and chikungunya fever among community members and healthcare workers. Health promotion activities on these diseases based on Ecological Health Mode components to increase knowledge and improve preventive practices should be developed. © 2017 John Wiley & Sons Ltd.

  11. Personal factors affecting ethical performance in healthcare workers during disasters and mass casualty incidents in Iran: a qualitative study.

    Science.gov (United States)

    Kiani, Mehrzad; Fadavi, Mohsen; Khankeh, Hamidreza; Borhani, Fariba

    2017-09-01

    In emergencies and disasters, ethics are affected by both personal and organizational factors. Given the lack of organizational ethical guidelines in the disaster management system in Iran, the present study was conducted to explain the personal factors affecting ethics and ethical behaviors among disaster healthcare workers. The present qualitative inquiry was conducted using conventional content analysis to analyze the data collected from 21 in-depth unstructured interviews with healthcare workers with an experience of attending one or more fields of disaster. According to the data collected, personal factors can be classified into five major categories, including personal characteristics such as age and gender, personal values, threshold of tolerance, personal knowledge and reflective thinking. Without ethical guidelines, healthcare workers are intensely affected by the emotional climate of the event and guided by their beliefs. A combination of personal characteristics, competences and expertise thus form the basis of ethical conduct in disaster healthcare workers.

  12. DEGREE OF BURNOUT AMONG EMERGENCY HEALTHCARE WORKERS AND FACTORS INFLUENCING LEVEL OF BURNOUT: A STUDY PROTOCOL

    OpenAIRE

    Shyamanta; Sashibha; Navoneela; Marami; Bornali; Sakhee; Anjana; Dipesh

    2015-01-01

    BACKGROUND Burnout is a feeling of failure and exhaustion. It is felt both at the physical and emotional level. Depletion of the person’s resources is a consequence and also has an impact on the organisation. Nature of the work itself makes emergency healthcare workers vulnerable to burnout. METHOD This study is designed to measure the degree of burnout among emergency healthcare workers in a hospital and to identify the factors that influence burnout. The study h...

  13. Access to and utilisation of healthcare services by sex workers at ...

    African Journals Online (AJOL)

    North Star Alliance (North Star) is a public-private partnership providing a healthcare service package in roadside wellness clinics (RWCs) to at-risk populations along transport corridors in sub-Saharan Africa. Objectives. To inform future service development for sex workers and describe North Star's contribution to ...

  14. Health care workers' compliance with hand hygiene regulations: Positive effects of a poster

    NARCIS (Netherlands)

    Karreman, Joyce; Berendsen, Femke; Pol, Bert; Dorman, Hilde

    2015-01-01

    Health care workers in nursing homes do not always comply with hand hygiene regulations, such as not wearing jewelry. Non-compliance with these regulations is a threat to patients' safety. We did two studies to investigate if compliance could be improved by a poster that reminds health care workers

  15. Influenza vaccination for healthcare workers in the UK: appraisal of systematic reviews and policy options.

    Science.gov (United States)

    Kliner, Merav; Keenan, Alex; Sinclair, David; Ghebrehewet, Sam; Garner, Paul

    2016-09-13

    The UK Department of Health recommends annual influenza vaccination for healthcare workers, but uptake remains low. For staff, there is uncertainty about the rationale for vaccination and evidence underpinning the recommendation. To clarify the rationale, and evidence base, for influenza vaccination of healthcare workers from the occupational health, employer and patient safety perspectives. Systematic appraisal of published systematic reviews. The quality of the 11 included reviews was variable; some included exactly the same trials but made conflicting recommendations. 3 reviews assessed vaccine effects in healthcare workers and found 1 trial reporting a vaccine efficacy (VE) of 88%. 6 reviews assessed vaccine effects in healthy adults, and VE was consistent with a median of 62% (95% CI 56 to 67). 2 reviews assessed effects on working days lost in healthcare workers (3 trials), and 3 reported effects in healthy adults (4 trials). The meta-analyses presented by the most recent reviews do not reach standard levels of statistical significance, but may be misleading as individual trials suggest benefit with wide variation in size of effect. The 2013 Cochrane review reported absolute effects close to 0 for laboratory-confirmed influenza, and hospitalisation for patients, but excluded data on clinically suspected influenza and all-cause mortality, which had shown potentially important effects in previous editions. A more recent systematic review reports these effects as a 42% reduction in clinically suspected influenza (95% CI 27 to 54) and a 29% reduction in all-cause mortality (95% CI 15 to 41). The evidence for employer and patient safety benefits of influenza vaccination is not straightforward and has been interpreted differently by different systematic review authors. Future uptake of influenza vaccination among healthcare workers may benefit from a fully transparent guideline process by a panel representing all relevant stakeholders, which clearly communicates

  16. Global medicine: Is it ethical or morally justifiable for doctors and other healthcare workers to go on strike?

    Science.gov (United States)

    2013-01-01

    Background Doctor and healthcare worker (HCW) strikes are a global phenomenon with the potential to negatively impact on the quality of healthcare services and the doctor-patient relationship. Strikes are a legitimate deadlock breaking mechanism employed when labour negotiations have reached an impasse during collective bargaining. Striking doctors usually have a moral dilemma between adherence to the Hippocratic tenets of the medical profession and fiduciary obligation to patients. In such circumstances the ethical principles of respect for autonomy, justice and beneficence all come into conflict, whereby doctors struggle with their role as ordinary employees who are rightfully entitled to a just wage for just work versus their moral obligations to patients and society. Discussion It has been argued that to deny any group of workers, including "essential workers" the right to strike is akin to enslavement which is ethically and morally indefensible. While HCW strikes occur globally, the impact appears more severe in developing countries challenged by poorer socio-economic circumstances, embedded infrastructural deficiencies, and lack of viable alternative means of obtaining healthcare. These communities appear to satisfy the criteria for vulnerability and may be deserving of special ethical consideration when doctor and HCW strikes are contemplated. Summary The right to strike is considered a fundamental right whose derogation would be inimical to the proper functioning of employer/employee collective bargaining in democratic societies. Motivations for HCW strikes include the natural pressure to fulfil human needs and the paradigm shift in modern medical practice, from self-employment and benevolent paternalism, to managed healthcare and consumer rights. Minimizing the incidence and impact of HCW strikes will require an ethical approach from all stakeholders, and recognition that all parties have an equal moral obligation to serve the best interests of society

  17. Global medicine: is it ethical or morally justifiable for doctors and other healthcare workers to go on strike?

    Science.gov (United States)

    Chima, Sylvester C

    2013-01-01

    Doctor and healthcare worker (HCW) strikes are a global phenomenon with the potential to negatively impact on the quality of healthcare services and the doctor-patient relationship. Strikes are a legitimate deadlock breaking mechanism employed when labour negotiations have reached an impasse during collective bargaining. Striking doctors usually have a moral dilemma between adherence to the Hippocratic tenets of the medical profession and fiduciary obligation to patients. In such circumstances the ethical principles of respect for autonomy, justice and beneficence all come into conflict, whereby doctors struggle with their role as ordinary employees who are rightfully entitled to a just wage for just work versus their moral obligations to patients and society. It has been argued that to deny any group of workers, including "essential workers" the right to strike is akin to enslavement which is ethically and morally indefensible. While HCW strikes occur globally, the impact appears more severe in developing countries challenged by poorer socio-economic circumstances, embedded infrastructural deficiencies, and lack of viable alternative means of obtaining healthcare. These communities appear to satisfy the criteria for vulnerability and may be deserving of special ethical consideration when doctor and HCW strikes are contemplated. The right to strike is considered a fundamental right whose derogation would be inimical to the proper functioning of employer/employee collective bargaining in democratic societies. Motivations for HCW strikes include the natural pressure to fulfil human needs and the paradigm shift in modern medical practice, from self-employment and benevolent paternalism, to managed healthcare and consumer rights. Minimizing the incidence and impact of HCW strikes will require an ethical approach from all stakeholders, and recognition that all parties have an equal moral obligation to serve the best interests of society. Employers should implement

  18. A communication skills intervention for community healthcare workers reduces perceived patient aggression: a pretest-postest study.

    Science.gov (United States)

    Swain, Nicola; Gale, Christopher

    2014-09-01

    Previous studies have shown that healthcare workers experience high levels of aggression from patients. Prevention packages to address this have received little research support. Communication skills have been shown to influence individuals' experience of aggression and are also amenable to training. This study aims to deliver a communication skills training package that will reduce the experience of aggression in the workplace for healthcare workers. An interactive, multimedia communication skills package was developed that would be suitable for community healthcare workers. The training consisted of four workshops, including teaching, discussion and DVD illustrative examples. These were based on research and clinical experience. This intervention was delivered in two community care organisations over several months. Fifty-six community healthcare workers took part in the trial in small groups. There were 46 females and 10 males with a median age of 45-54 years. For each group a series of four communication skills workshops were given. Measurements of perceived aggression and wellbeing were taken before the workshops, at the end of the workshops, one month after and two months after. Results show statistically significant reductions in perceived aggression one and two months after baseline measures (pcommunication skills training programme is both enjoyable and shows decreases in perceived aggression, distress, and increases in general mental wellness. A full RCT of this intervention is warranted. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. A Randomized Trial to Determine the Impact of an Educational Patient Hand-Hygiene Intervention on Contamination of Hospitalized Patient's Hands with Healthcare-Associated Pathogens.

    Science.gov (United States)

    Sunkesula, Venkata C K; Kundrapu, Sirisha; Knighton, Shanina; Cadnum, Jennifer L; Donskey, Curtis J

    2017-05-01

    We conducted a non-blinded randomized trial to determine the impact of a patient hand-hygiene intervention on contamination of hospitalized patients' hands with healthcare-associated pathogens. Among patients with negative hand cultures on admission, recovery of pathogens from hands was significantly reduced in those receiving the intervention versus those receiving standard care. Infect Control Hosp Epidemiol 2017;38:595-597.

  20. Physical exercise at the workplace prevents deterioration of work ability among healthcare workers

    DEFF Research Database (Denmark)

    Jakobsen, Markus D; Sundstrup, Emil; Brandt, Mikkel

    2015-01-01

    BACKGROUND: Imbalance between individual resources and work demands can lead to musculoskeletal disorders and reduced work ability. The purpose of this study was to investigate the effect of workplace- versus home-based physical exercise on work ability among healthcare workers. METHODS: Two...... hundred female healthcare workers (Age: 42.0, BMI: 24.1, work ability index [WAI]: 43.1) from 18 departments at three Danish hospitals participated (Copenhagen, Denmark, Aug 2013-Jan 2014). Participants were randomly allocated at the cluster level to 10 weeks of: 1) workplace physical exercise (WORK...... of lifting aides. The main outcome measure was the change from baseline to 10-week follow-up in WAI. RESULTS: Significant group by time interaction was observed for WAI (p effect size (Cohens'd = 0...

  1. Predictors of hand hygiene practice among Saudi nursing students: A cross-sectional self-reported study.

    Science.gov (United States)

    Cruz, Jonas P; Bashtawi, Meshrif A

    2016-01-01

    Hand hygiene is an important component of infection control, which is critical to ensuring patients' safety in hospitals. Nursing students are regarded as healthcare workers in training and can also be vehicles of cross-contamination within the hospital. Thus, this study aimed to identify the predictors of hand hygiene practice among Saudi nursing students. A descriptive, cross-sectional, self-reported study was conducted among 198 Saudi nursing students. Knowledge, attitude, and practice of hand hygiene were assessed using the WHO Hand Hygiene Knowledge Questionnaire for Health-Care Workers and its adopted scales. A regression analysis was performed to identify the predictors of hand hygiene practice. The respondents demonstrated moderate knowledge of hand hygiene (mean 13.20±2.80). The majority displayed a moderate attitude toward hand hygiene (52.1%), while only a few reported a poor attitude (13.1%). Approximately 68.7%, 29.8%, and 1.5% of the respondents reported moderate, good, and poor practice of hand hygiene, respectively. Having a good attitude toward hand hygiene, being male, being aware that hand hygiene is an effective intervention in preventing healthcare-associated infections (HAIs), attendance at hand hygiene trainings and seminars, and being in the lower academic level of nursing education were identified as predictors of better hand hygiene practice. The importance of ensuring a positive attitude toward hand hygiene and improving awareness of hand hygiene is emphasized, as are educational interventions. Educational interventions should be implemented to reinforce knowledge and instill a positive attitude toward hand hygiene. Copyright © 2015 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  2. Sources of motivation and frustration among healthcare workers administering antiretroviral treatment for HIV in rural Zimbabwe.

    Science.gov (United States)

    Campbell, C; Scott, K; Madenhire, C; Nyamukapa, C; Gregson, S

    2011-07-01

    The roll-out of accessible and affordable antiretroviral (ARV) drugs for people living with HIV in low-income countries is drastically changing the nature of HIV-related healthcare. The Zimbabwean Ministry of Health has renewed efforts to make antiretroviral treatment (ART) for HIV free and publically available across the country. This paper describes the findings from a multi-method qualitative study including interviews and a focus group with healthcare workers (mostly nurses), totalling 25 participants, and field notes from over 100 hours of ethnographic observation in three rural Zimbabwean health centres. These health centres began providing free ARV drugs to HIV-positive people over one year prior to the research period. We examined sources of motivation and frustration among nurses administering ART in these resource-poor health centres. The findings suggest that healthcare workers administering ART in challenging circumstances are adept at drawing strength from the dramatic physical and emotional recoveries made possible by ART and from their personal memories of the suffering caused by HIV/AIDS among close friends or family. However, healthcare staff grappled with extreme resource shortages, which led to exhaustion and frustration. Surprisingly, only one year into ART provision, healthcare workers did not reference the professional challenges of their HIV work before ART became available, suggesting that medical breakthroughs such as ART rapidly come to be seen as a standard element of nursing. Our findings provide a basis for optimism that medical breakthroughs such as ART can reinvigorate healthcare workers in the short term. However, we caution that the daily challenges of nursing in poor environments, especially administering an ongoing and resource-intensive regime such as ART, must be addressed to enable nurses to continue delivering high-quality ART in sub-Saharan Africa.

  3. Effect of workplace- versus home-based physical exercise on pain in healthcare workers: study protocol for a single blinded cluster randomized controlled trial.

    Science.gov (United States)

    Jakobsen, Markus D; Sundstrup, Emil; Brandt, Mikkel; Kristensen, Anne Zoëga; Jay, Kenneth; Stelter, Reinhard; Lavendt, Ebbe; Aagaard, Per; Andersen, Lars L

    2014-04-07

    The prevalence and consequences of musculoskeletal pain is considerable among healthcare workers, allegedly due to high physical work demands of healthcare work. Previous investigations have shown promising results of physical exercise for relieving pain among different occupational groups, but the question remains whether such physical exercise should be performed at the workplace or conducted as home-based exercise. Performing physical exercise at the workplace together with colleagues may be more motivating for some employees and thus increase adherence. On the other hand, physical exercise performed during working hours at the workplace may be costly for the employers in terms of time spend. Thus, it seems relevant to compare the efficacy of workplace- versus home-based training on musculoskeletal pain. This study is intended to investigate the effect of workplace-based versus home-based physical exercise on musculoskeletal pain among healthcare workers. This study was designed as a cluster randomized controlled trial performed at 3 hospitals in Copenhagen, Denmark. Clusters are hospital departments and hospital units. Cluster randomization was chosen to increase adherence and avoid contamination between interventions. Two hundred healthcare workers from 18 departments located at three different hospitals is allocated to 10 weeks of 1) workplace based physical exercise performed during working hours (using kettlebells, elastic bands and exercise balls) for 5 × 10 minutes per week and up to 5 group-based coaching sessions, or 2) home based physical exercise performed during leisure time (using elastic bands and body weight exercises) for 5 × 10 minutes per week. Both intervention groups will also receive ergonomic instructions on patient handling and use of lifting aides etc. Inclusion criteria are female healthcare workers working at a hospital. Average pain intensity (VAS scale 0-10) of the back, neck and shoulder (primary outcome) and physical

  4. Preventing tuberculosis in healthcare workers of the radiology department: a Malaysian perspective.

    Science.gov (United States)

    Tan, Lh; Kamarulzaman, A

    2006-01-01

    Tuberculosis (TB) is a well recognised occupational hazard for healthcare workers (HCWs). Concerns on the safety of healthcare settings in Malaysia was raised following a report of 25 HCWs working in 11 general hospitals in Malaysia who were infected with TB in 2004 being publicised in the media recently. As the disease burden in general is high in Malaysia, due attention should be given to this disease in our healthcare facilities including the radiology department, an often neglected area in TB infection control programmes. This article focuses on the key control measures that can be implemented in radiology departments in a developing country with limited resources.

  5. Second-hand smoke exposure and mitigation strategies among home visitation workers.

    Science.gov (United States)

    Keske, Robyn R; Rees, Vaughan W; Behm, Ilan; Wadler, Brianna M; Geller, Alan C

    2013-07-01

    Protection of workers from second-hand smoke (SHS) in occupational settings is an important policy priority, yet little attention has been given to SHS protection for home visitation health workers, who number almost 2 million in the USA. Self-reported SHS exposure, SHS mitigation strategies and suggestions for further SHS exposure reduction approaches were obtained from home visitation health workers in Massachusetts. A cross-sectional survey was conducted among Massachusetts Early Intervention workers (N=316) at their state-wide conference in April 2010. Eighty-three per cent of respondents reported at least 1 hour per month of SHS exposure, and 16% reported at least 11 hours per month. Nevertheless, only 22% of workers counselled clients on maintaining a smoke-free home. Fewer than 30% of workers had ever voiced concerns to their employing agency, and just 12% had raised their concerns directly with clients. Only 14% stated that their agency had rules designed to protect workers from SHS. SHS exposure occurs frequently among home visitation health workers. The data point to a substantial population who are not protected from SHS exposure by formal policies.

  6. The persistent gap in health-care coverage between low- and high-income workers in Washington State: BRFSS, 2003-2007.

    Science.gov (United States)

    Fan, Z Joyce; Anderson, Naomi J; Foley, Michael; Rauser, Eddy; Silverstein, Barbara A

    2011-01-01

    We examined the disparities in health-care coverage between low- and high-income workers in Washington State (WA) to provide support for possible policy decisions for uninsured workers. We examined data from the WA Behavioral Risk Factor Surveillance System 2003-2007 and compared workers aged 18-64 years of low income (annual household income income (annual household income ≥$35,000) on proportions and sources of health-care coverage. We conducted multivariable logistic regression analyses on factors that were associated with the uninsured. Of the 54,536 survey respondents who were working-age adults in WA, 13,922 (25.5%) were low-income workers. The proportions of uninsured were 38.2% for low-income workers and 6.3% for high-income workers. While employment-based health benefits remained a dominant source of health insurance coverage, they covered only 40.2% of low-income workers relative to 81.5% of high-income workers. Besides income, workers were more likely to be uninsured if they were younger; male; Hispanic; less educated; not married; current smokers; self-employed; or employed in agriculture/forestry/fisheries, construction, and retail. More low-income workers (28.7%) reported cost as an issue in paying for health services than did their high-income counterparts (6.7%). A persistent gap in health-care coverage exists between low- and high-income workers. The identified characteristics of these workers can be used to implement policies to expand health insurance coverage.

  7. Percutaneous injuries among healthcare workers at a general hospital

    Directory of Open Access Journals (Sweden)

    Ibak Gönen, Mehmet Faruk Geyik

    2011-06-01

    Full Text Available Objectives: Percutaneous injuries (PCIs remain a common incident among healthcare workers (HCWs despite the introductionof safety programs. The aim of this study was to assess the PCIs, required precautions, and applications after the injuries among healthcare workers in a small general hospital.Materials and methods: We assessed the occurrence of PCIs at a General Hospital (EGH from January 2007 to November2010. During this period, all injury cases among HCWs were reported to the Infection Control Committee (ICC using percutaneous injury notification form. The injury notification forms were evaluated retrospectively.Results: Totally 275 health personnel were working in our hospital, 36 healthy workers have been exposed to PCIs during this period. The incidence of PCIs was 2,9/10000 in 2007, 3,1/10000 in 2008, 3,8/10000 in 2009 and 3,9/10000 patient-days in 2010. Injured staff were recorded as, 16 nurses (44%, 12 cleaning staffs (34%, and eight (22% doctors. The device leading to damage was most frequently the needle-channel. Ten sources (27% were detected positive for hepatitis B virus (HBV, four (11% for hepatitis C virus (HCV, and two (5% for Crimean-Congo hemorrhagic fever virus (CCHFV. No case of seroconversion has been recognized for any of the above mentioned infections.Conclusions: Percutaneous injuries remain to occur among HCWs. Since some the sources were infected, the health personnel are endangered for infections due to PCIs. The health personnel should presume that all patients are infected,and thus should work following universal precautions to avoid complications about the PCIs. J Microbiol Infect Dis 2011;1(1:26-30.

  8. Using evidence-based medicine to protect healthcare workers from pandemic influenza: Is it possible?

    Science.gov (United States)

    Gralton, Jan; McLaws, Mary-Louise

    2011-01-01

    To use evidence-based principles to develop infection control algorithms to ensure the protection of healthcare workers and the continuity of health service provision during a pandemic. : Evidence-based algorithms were developed from published research as well as "needs and values" assessments. Research evidence was obtained from 97 studies reporting the protectiveness of antiviral prophylaxis, seasonal vaccination, and mask use. Needs and values assessments were undertaken by international experts in pandemic infection control and local healthcare workers. Opportunity and resources costs were not determined. The Australian government commissioned the development of an evidence-based algorithm for inclusion in the 2008 revision of the Australian Health and Management Plan for Pandemic Influenza. Two international infection control teams responsible for healthcare worker safety during the Severe Acute Respiratory Syndrome outbreak reviewed the evidence-based algorithms. The algorithms were then reviewed for needs and values by eight local clinicians who were considered key frontline clinicians during the contain and sustain phases. The international teams reviewed for practicability of implementation, whereas local clinicians reviewed for clinician compliance. Despite strong evidence for vaccination and antiviral prophylaxis providing significant protection, clinicians believed they required the additional combinations of both masks and face shields. Despite the equivocal evidence for the efficacy of surgical and N95 masks and the provision of algorithms appropriate for the level of risk according to clinical care during a pandemic, clinicians still demanded N95 masks plus face shields in combination with prophylaxis and novel vaccination. Conventional evidence-based principles could not be applied to formulate recommendations due to the lack of pandemic-specific efficacy data of protection tools and the inherent unpredictability of pandemics. As an alternative

  9. HIV status disclosure to perinatally-infected adolescents in Zimbabwe: a qualitative study of adolescent and healthcare worker perspectives.

    Directory of Open Access Journals (Sweden)

    Khameer K Kidia

    Full Text Available Due to the scale up of antiretroviral therapy, increasing numbers of HIV-infected children are living into adolescence. As these children grow and surpass the immediate threat of death, the issue of informing them of their HIV status arises. This study aimed to understand how perinatally-infected adolescents learn about their HIV-status as well as to examine their preferences for the disclosure process.In-depth interviews were conducted with 31 (14 male, 17 female perinatally-infected adolescents aged 16-20 at an HIV clinic in Harare, Zimbabwe, and focused on adolescents' experiences of disclosure. In addition, 15 (1 male, 14 female healthcare workers participated in two focus groups that were centred on healthcare workers' practices surrounding disclosure in the clinic. Purposive sampling was used to recruit participants. A coding frame was developed and major themes were extracted using grounded theory methods.Healthcare workers encouraged caregivers to initiate disclosure in the home environment. However, many adolescents preferred disclosure to take place in the presence of healthcare workers at the clinic because it gave them access to accurate information as well as an environment that made test results seem more credible. Adolescents learned more specific information about living with an HIV-positive status and the meaning of that status from shared experiences among peers at the clinic.HIV-status disclosure to adolescents is distinct from disclosure to younger children and requires tailored, age-appropriate guidelines. Disclosure to this age group in a healthcare setting may help overcome some of the barriers associated with caregivers disclosing in the home environment and make the HIV status seem more credible to an adolescent. The study also highlights the value of peer support among adolescents, which could help reduce the burden of psychosocial care on caregivers and healthcare workers.

  10. The impact of national-level interventions to improve hygiene on the incidence of irritant contact dermatitis in healthcare workers: changes in incidence from 1996 to 2012 and interrupted times series analysis.

    Science.gov (United States)

    Stocks, S J; McNamee, R; Turner, S; Carder, M; Agius, R M

    2015-07-01

    Reducing healthcare-associated infections (HCAI) has been a priority in the U.K. over recent decades and this has been reflected in interventions focusing on improving hygiene procedures. To evaluate whether these interventions coincided with an increased incidence of work-related irritant contact dermatitis (ICD) attributed to hand hygiene or/and other hygiene measures in healthcare workers (HCWs). A quasi-experimental (interrupted time series) design was used to compare trends in incidence of ICD in HCWs attributed to hygiene before and after interventions to reduce HCAI with trends in the same periods in control groups (ICD in other workers). Cases of ICD reported to a U.K. surveillance scheme from 1996 to 2012 were analysed. The time periods compared were defined objectively based on the dates of the publication of national evidence-based guidelines, the U.K. Health Act 2006 and the Cleanyourhands campaign. The reported incidence of ICD in HCWs attributed to hygiene has increased steadily from 1996 to 2012 [annual incidence rate ratio (95% confidence interval): hand hygiene only 1.10 (1.07-1.12); all hygiene 1.05 (1.03-1.07)], whereas the incidence in other workers is declining. An increase in incidence of ICD in HCWs attributed to hand hygiene was observed at the beginning of the Cleanyourhands campaign. The increasing incidence of ICD in HCWs combined with the popularity of interventions to reduce HCAI warrants increased efforts towards identifying products and implementing practices posing the least risk of ICD. © 2015 British Association of Dermatologists.

  11. Workers with hand dermatitis and workplace training experiences: A qualitative perspective.

    Science.gov (United States)

    Zack, Bethany; Arrandale, Victoria H; Holness, Dorothy Linn

    2017-01-01

    Workplace training may help to prevent contact dermatitis, a common work-related disease. Information on the characteristics of existing workplace training programs and worker perceptions of this training is limited. Fourteen workers with suspected occupational contact dermatitis participated in one-on-one, semi-structured interviews. An inductive thematic analysis approach was used to identify interview themes. Workers expressed a desire for hands-on training with content relevant to their job tasks, favored training from supervisors who had practical experience, and were conflicted about employer motivations for providing training. Few workers had received training on skin protection. In many cases, the training workers had received differed greatly from their desired training. Although, workers with contact dermatitis describe having received workplace training, some question its value and effectiveness. This perspective may be attributed not only to the content and methods of training but also the health and safety culture of the workplace. Am. J. Ind. Med. 60:69-76, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  12. Workplace violence and the meaning of work in healthcare workers: A phenomenological study.

    Science.gov (United States)

    Lamothe, Josianne; Guay, Stephane

    2017-01-01

    Workplace violence (WPV) has been associated with turnover intentions and reduced job satisfaction, yet the mechanisms behind such associations are still nebulous. Studying the way people make sense of their work in the context of WPV could lead to a better understanding of its consequences. The objective of this exploratory study is to identify key features of meaning of work (MOW) in a group of healthcare workers and explain how these features can change following an act of WPV. Researchers recruited 15 healthcare workers (11 women - 4 men) who had previously been the victim of a serious physical or sexual assault by a patient. A phenomenological approach was used. Two main themes were identified: MOW and relationships with others and MOW and relationship with the self. WPV might have the potential to trigger negative changes in the way some workers perceive their colleagues, their patients and their organisation. It can also interfere with their sense of self-accomplishment; all workers however, were still able to find positive meaning in 'contribution' and 'autonomy'. WPV has the potential to change certain aspects of MOW that could help explain why WPV is associated with lowered job satisfaction, compassion fatigue, and higher turnover. Also, finding meaning through contribution and autonomy can be a form of resilience.

  13. The social integration of healthcare agency workers in long-term care facilities: A cross-sectional study.

    Science.gov (United States)

    Lapalme, Marie-Ève; Doucet, Olivier

    2018-06-01

    Patient care quality is a key concern for long-term care facilities and is directly related to effective collaboration between healthcare professionals. The use of agency staff in long-term care facilities creates important challenges in terms of coordination and communication within work units. The purpose of this study is to assess the mediating effect of common in-group identity in the relationship between permanent employees' perceptions regarding the use of agency workers -namely distributive justice, perceptions of threat, perceived similarities with agency workers, and leader inclusiveness toward agency staff- and the permanent employees' adoption of collaborative behaviours. Cross-sectional study. Three long-term care facilities. 290 regular healthcare employees (nurses and care attendants). Data were obtained through questionnaires filled out by employees. Hypotheses were tested using structural equation analyses. The results showed the indirect effects of perceived distributive justice, perceived similarity and leader inclusiveness toward agency workers on permanent employees' cooperation behaviours through common group identification. Perceptions of threat were not related to common group identification or collaborative behaviours. The results also showed that common in-group identification is related to cooperation behaviours only for employees without previous experience as agency workers. This study suggests that permanent healthcare employees who feel they are fairly compensated relative to agency workers, who consider these workers as similar to them, and who believe their supervisor appreciates agency workers' contributions tend to develop a common in-group identity, which fosters collaborative behaviours. Managers of long-term care facilities who wish to foster collaboration among their blended workforce should thus create an environment conducive of a more inclusive identity, particularly if their employees have no previous experience as agency

  14. Occupational skin disease among Australian healthcare workers: a retrospective analysis from an occupational dermatology clinic, 1993-2014.

    Science.gov (United States)

    Higgins, Claire L; Palmer, Amanda M; Cahill, Jennifer L; Nixon, Rosemary L

    2016-10-01

    Healthcare workers (HCWs) are at risk of developing occupational skin disease (OSD). To ascertain the causes of OSD in Australian HCWs in a tertiary referral clinic. A retrospective review was performed of patients assessed at the Occupational Dermatology Clinic in Melbourne from 1993 to 2014. Of 685 HCWs assessed in the clinic over a period of 22 years, 555 (81.0%) were diagnosed with OSD. The most common diagnosis was irritant contact dermatitis (ICD) (79.1%), followed by allergic contact dermatitis (ACD) (49.7%). Natural rubber latex allergy was also relatively frequent (13.0%). The major substances causing ACD were rubber glove chemicals (thiuram mix and tetraethylthiuram disulfide), preservatives (formaldehyde, formaldehyde releasers, and isothiazolinones), excipients in hand cleansers, which are hard-to-avoid weak allergens, and antiseptics. ACD caused by commercial hand cleansers occurred more frequently than ACD caused by alcohol-based hand rubs (ABHRs). Occupational ICD was mostly caused by water/wet work and hand cleansers, and environmental irritants such as heat and sweating. Understanding the causes of OSD in HCWs is important in order to develop strategies for prevention. We suggest that skin care advice should be incorporated into hand hygiene education. The use of ABHRs should be encouraged, weak allergens in skin cleansers should be substituted, and accelerator-free gloves should be recommended for HCWs with OSD. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Factors influencing the implementation of integrated management of childhood illness (IMCI) by healthcare workers at public health centers & dispensaries in Mwanza, Tanzania.

    Science.gov (United States)

    Kiplagat, Augustine; Musto, Richard; Mwizamholya, Damas; Morona, Domenica

    2014-03-25

    Integrated Management of Childhood Illness (IMCI) was developed by the World Health Organization (WHO) and the United Nations International Children's Fund (UNICEF) and aims at reducing childhood morbidity and mortality in resource-limited settings including Tanzania. It was introduced in 1996 and has been scaled up in all districts in the country. The purpose of this study was to identify factors influencing the implementation of IMCI in the health facilities in Mwanza, Tanzania since reports indicates that the guidelines are not full adhered to by the healthcare workers. A cross-sectional study design was used and a sample size of 95 healthcare workers drawn from health centers and dispensaries within Mwanza city were interviewed using self-administered questionnaires. Structured interview was also used to get views from the city IMCI focal person and the 2 facilitators. Data were analyzed using SPSS and presented using figures and tables. Only 51% of healthcare workers interviewed had been trained. 69% of trained Healthcare workers expressed understanding of the IMCI approach. Most of the respondents (77%) had a positive attitude that IMCI approach was a better approach in managing common childhood illnesses especially with the reality of resource constraint in the health facilities. The main challenges identified in the implementation of IMCI are low initial training coverage among health care workers, lack of essential drugs and supplies, lack of onsite mentoring and lack of refresher courses and regular supportive supervision. Supporting the healthcare workers through training, onsite mentoring, supportive supervision and strengthening the healthcare system through increasing access to essential medicines, vaccines, strengthening supply chain management, increasing healthcare financing, improving leadership & management were the major interventions that could assist in IMCI implementation. The healthcare workers can implement better IMCI through the

  16. Reducing stigma among healthcare providers to improve mental health services (RESHAPE): protocol for a pilot cluster randomized controlled trial of a stigma reduction intervention for training primary healthcare workers in Nepal.

    Science.gov (United States)

    Kohrt, Brandon A; Jordans, Mark J D; Turner, Elizabeth L; Sikkema, Kathleen J; Luitel, Nagendra P; Rai, Sauharda; Singla, Daisy R; Lamichhane, Jagannath; Lund, Crick; Patel, Vikram

    2018-01-01

    Non-specialist healthcare providers, including primary and community healthcare workers, in low- and middle-income countries can effectively treat mental illness. However, scaling-up mental health services within existing health systems has been limited by barriers such as stigma against people with mental illness. Therefore, interventions are needed to address attitudes and behaviors among non-specialists. Aimed at addressing this gap, RE ducing S tigma among H ealthc A re P roviders to Improv E mental health services (RESHAPE) is an intervention in which social contact with mental health service users is added to training for non-specialist healthcare workers integrating mental health services into primary healthcare. This protocol describes a mixed methods pilot and feasibility study in primary care centers in Chitwan, Nepal. The qualitative component will include key informant interviews and focus group discussions. The quantitative component consists of a pilot cluster randomized controlled trial (c-RCT), which will establish parameters for a future effectiveness study of RESHAPE compared to training as usual (TAU). Primary healthcare facilities (the cluster unit, k  = 34) will be randomized to TAU or RESHAPE. The direct beneficiaries of the intervention are the primary healthcare workers in the facilities ( n  = 150); indirect beneficiaries are their patients ( n  = 100). The TAU condition is existing mental health training and supervision for primary healthcare workers delivered through the Programme for Improving Mental healthcarE (PRIME) implementing the mental health Gap Action Programme (mhGAP). The primary objective is to evaluate acceptability and feasibility through qualitative interviews with primary healthcare workers, trainers, and mental health service users. The secondary objective is to collect quantitative information on health worker outcomes including mental health stigma (Social Distance Scale), clinical knowledge (mh

  17. Increasing the frequency of hand washing by healthcare workers does not lead to commensurate reductions in staphylococcal infection in a hospital ward

    Directory of Open Access Journals (Sweden)

    Kerr Kevin G

    2008-09-01

    Full Text Available Abstract Background Hand hygiene is generally considered to be the most important measure that can be applied to prevent the spread of healthcare-associated infection (HAI. Continuous emphasis on this intervention has lead to the widespread opinion that HAI rates can be greatly reduced by increased hand hygiene compliance alone. However, this assumes that the effectiveness of hand hygiene is not constrained by other factors and that improved compliance in excess of a given level, in itself, will result in a commensurate reduction in the incidence of HAI. However, several researchers have found the law of diminishing returns to apply to hand hygiene, with the greatest benefits occurring in the first 20% or so of compliance, and others have demonstrated that poor cohorting of nursing staff profoundly influences the effectiveness of hand hygiene measures. Collectively, these findings raise intriguing questions about the extent to which increasing compliance alone can further reduce rates of HAI. Methods In order to investigate these issues further, we constructed a deterministic Ross-Macdonald model and applied it to a hypothetical general medical ward. In this model the transmission of staphylococcal infection was assumed to occur after contact with the transiently colonized hands of HCWs, who, in turn, acquire contamination only by touching colonized patients. The aim of the study was to evaluate the impact of imperfect hand cleansing on the transmission of staphylococcal infection and to identify, whether there is a limit, above which further hand hygiene compliance is unlikely to be of benefit. Results The model demonstrated that if transmission is solely via the hands of HCWs, it should, under most circumstances, be possible to prevent outbreaks of staphylococcal infection from occurring at a hand cleansing frequencies Conclusion Although our study confirmed hand hygiene to be an effective control measure, it demonstrated that the law of

  18. Healthcare personnel perceptions of hand hygiene monitoring technology.

    Science.gov (United States)

    Ellingson, Katherine; Polgreen, Philip M; Schneider, Amy; Shinkunas, Laura; Kaldjian, Lauris C; Wright, Donald; Thomas, Geb W; Segre, Alberto M; Herman, Ted; McDonald, L Clifford; Sinkowitz-Cochran, Ronda

    2011-11-01

    To assess healthcare personnel (HCP) perceptions regarding implementation of sensor-based electronic systems for automated hand hygiene adherence monitoring. Using a mixed-methods approach, structured focus groups were designed to elicit quantitative and qualitative responses on familiarity, comfort level, and perceived impact of sensor-based hand hygiene adherence monitoring. A university hospital, a Veterans Affairs hospital, and a community hospital in the Midwest. Focus groups were homogenous by HCP type, with separate groups held for leadership, midlevel management, and frontline personnel at each hospital. Overall, 89 HCP participated in 10 focus groups. Levels of familiarity and comfort with electronic oversight technology varied by HCP type; when compared with frontline HCP, those in leadership positions were significantly more familiar with ([Formula: see text]) and more comfortable with ([Formula: see text]) the technology. The most common concerns cited by participants across groups included lack of accuracy in the data produced, such as the inability of the technology to assess the situational context of hand hygiene opportunities, and the potential punitive use of data produced. Across groups, HCP had decreased tolerance for electronic collection of spatial-temporal data, describing such oversight as Big Brother. While substantial concerns were expressed by all types of HCP, participants' recommendations for effective implementation of electronic oversight technologies for hand hygiene monitoring included addressing accuracy issues before implementation and transparent communication with frontline HCP about the intended use of the data.

  19. Alert Workplace From Healthcare Workers' Perspective: Behavioral and Environmental Strategies to Improve Vigilance and Alertness in Healthcare Settings.

    Science.gov (United States)

    Sagah Zadeh, Rana; Shepley, Mardelle; Sadatsafavi, Hessam; Owora, Arthur Hamie; Krieger, Ana C

    2018-04-01

    This study aims to identify the behavioral and environmental strategies that healthcare workers view as helpful for managing sleepiness, improving alertness, and therefore optimizing workplace safety. Reduced alertness is a common issue in healthcare work environments and is associated with impaired cognitive performance and decision-making ability as well as increased errors and injuries. We surveyed 136 healthcare professionals at a primary care clinic, an acute care hospital, and a mental health clinic. Nonstructured, semistructured, and structured questionnaires were used to elicit relevant information which was analyzed using qualitative content analysis and logistic regression models, respectively. In order by frequency of endorsement: dietary intervention; physical mobility; cognitive, sensory, or social stimulation; personal lifestyle strategies; and rest/nap opportunities were reported as behavioral strategies used to address workplace alertness. Compared to other environmental features, daylight and thermal comfort were perceived to be more important to addressing workplace alertness ( p based guidelines is needed to address sleepiness and alertness to improve workplace safety in healthcare facilities.

  20. Minor mental disorders in Taiwanese healthcare workers and the associations with psychosocial work conditions

    Directory of Open Access Journals (Sweden)

    Wan-Ju Cheng

    2017-04-01

    Conclusion: Despite the fact that healthcare workers work longer hours and shift work, there were several modifiable psychosocial work conditions that should be targeted to improve their mental health.

  1. Social workers' role in tempering inequality in healthcare in hospitals and clinics: a study in Israel.

    Science.gov (United States)

    Baum, Nehami; Shalit, Hani; Kum, Yishay; Tal, Malka

    2016-09-01

    The paper presents an empirical examination of the role social workers play in tempering inequality in medical care. Data were collected in 2011 through face-to-face, semi-structured, in-depth interviews with 60 social workers employed in hospitals and clinics in Israel and selected through purposive sampling. The interviews probed the social workers' perceptions of the scope, causes and manifestations of inequality in health and healthcare and the actions they took to ameliorate it. The interviews were analysed using grounded theory. The findings show that all the social workers were acutely aware of the inequalities in their places of work, regarded reducing the inequalities as a major part of their role and made efforts to do so. They facilitated communication between doctors and patients of low socioeconomic status and advocated for such patients with medical staff and administration, as well as with the country's medical and social welfare bureaucracies. The paper details the means they used and the challenges they faced. The study highlights the important role that social workers play in reducing inequality in healthcare. © 2015 John Wiley & Sons Ltd.

  2. Nosocomial pathogens associated with the mobile phones of healthcare workers in a hospital in Anyigba, Kogi state, Nigeria.

    Science.gov (United States)

    Nwankwo, E O; Ekwunife, N; Mofolorunsho, K C

    2014-06-01

    Mobile phones of healthcare workers (HCWs) could be colonized by potential bacteria pathogens. The aim of this research is to evaluate the bacterial contamination and antibiotic sensitivity pattern of isolates from mobile phones of HCWs in Grimad hospital. A total of 112 swab samples were collected from the mobile phones of HCWs and students in June 2012 in Anyigba. While 56 samples were from HCWs in Grimad hospital, 56 samples were obtained from non-healthcare workers (NHCWs) who served as the control. The samples were all screened for bacterial pathogens by standard bacteriological procedures. Antibiotic susceptibility testing was done by the disc diffusion technique. The rate of bacterial contamination of mobile phones of HCWs was 94.6%. Bacteria isolated from mobile phones of HCWs were more resistant to antibiotics than NHCWs phones. Staphylococcus Epidermidis (42.9%) was the most frequently isolated bacteria followed by Bacillus spp. (32.1%), Staphylococcus Aureus (25%), Pseudomonas Aeruginosa (19.6%), Escherichia Coli (14.3%), Streptococcus spp. (14.3%), Proteus spp. (12.5%), Klebsiella spp. (7.1%), and Acinetobacter spp. (5.3%). Cotrimoxazole, ampicillin and tetracycline showed high levels of resistance while gentamicin, ciprofloxacin and ceftriaxone exhibited encouraging results. The presence of bacteria pathogens associated with nosocomial infection was identified. Transmission of pathogens can be reduced by hand hygiene and regular cleaning of mobile phones. Copyright © 2013 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

  3. How secure is your information system? An investigation into actual healthcare worker password practices.

    Science.gov (United States)

    Cazier, Joseph A; Medlin, B Dawn

    2006-09-27

    For most healthcare information systems, passwords are the first line of defense in keeping patient and administrative records private and secure. However, this defense is only as strong as the passwords employees chose to use. A weak or easily guessed password is like an open door to the medical records room, allowing unauthorized access to sensitive information. In this paper, we present the results of a study of actual healthcare workers' password practices. In general, the vast majority of these passwords have significant security problems on several dimensions. Implications for healthcare professionals are discussed.

  4. Outcomes of an infection prevention project focusing on hand hygiene and isolation practices.

    Science.gov (United States)

    Aragon, Daleen; Sole, Mary Lou; Brown, Scott

    2005-01-01

    Nosocomial infections are a major health problem for hospitalized patients and their families. Since the 1800s, hand hygiene has been recognized as the single best method to prevent the spread of pathogens and nosocomial infections. Despite this fact, many healthcare workers do not adhere to hand hygiene policies. The Centers for Disease Control and Prevention issued a guideline for hand hygiene practices in 2002. Multifaceted approaches to improve hand hygiene have been shown to increase compliance among healthcare workers and subsequently reduce infections. A performance improvement project was initiated to implement this guideline and other strategies to prevent nosocomial infection. This article summarizes the performance improvement processes and the preliminary outcomes on adherence to infection prevention policies related to hand hygiene and isolation practices. Clinically and statistically significant increases were noted for hand hygiene prior to patient care and in wearing masks when indicated. Nurses and patient care technicians had the greatest increases in compliance. Increases in hand hygiene after patient contact and wearing of gown and gloves were also noted, but results were not statistically significant. Nosocomial infection rates from antibiotic-resistant organisms decreased in the first surveillance, but rates increased during the 1-year surveillance. Consumption of alcohol-based foam disinfectant doubled from baseline. Findings are consistent with other published studies. The project will continue with further reinforcement and education over the second year.

  5. Deficiencies in education and experience in the management of acute kidney injury among Malawian healthcare workers.

    Science.gov (United States)

    Evans, R; Rudd, P; Hemmila, U; Dobbie, H; Dreyer, G

    2015-09-01

    Acute kidney injury (AKI) is a common but under-recognised disease process, which carries a high risk of mortality or chronic complications, such as chronic kidney disease and other organ dysfunction. Management of AKI, however, is suboptimal, both in developed settings and in Malawi. This is partly because of deficiencies in AKI education and training. To establish current levels of AKI education in a range of healthcare workers in Malawi. An AKI symposium was held in Blantyre in March 2015. Delegates were asked to complete a survey at the start of the symposium to assess their clinical experience and education in the management of AKI. From 100 delegates, 89 nurses, clinical officers, and physicians, originating from 11 different districts, responded to the survey. Twenty-two percent of healthcare workers (including 28% of district workers of the various cadres and 31% of nurses) had never received teaching on any aspect of renal disease, and 50% (including 63% of district workers and 61% of nurses) had never received teaching specifically on AKI. Forty-four percent did not feel confident managing AKI, and 98% wanted more support managing patients with renal disease. Thirty-four percent (including 55% of district workers) were unaware that haemodialysis was available at Queen Elizabeth Central Hospital (QECH) for the treatment of AKI and 53% (74% of district workers) were unaware that peritoneal dialysis was available for the treatment of AKI in children. Only 33% had ever referred a patient with AKI to QECH. There are deficiencies in education about, and clinical experience in, the management of AKI among Malawian healthcare workers, in addition to limited awareness of the renal service available at QECH. Urgent action is required to address these issues in order to prevent morbidity and mortality from AKI in Malawi.

  6. Changes in working conditions for home healthcare workers and impacts on their work activity and on their emotions

    Directory of Open Access Journals (Sweden)

    Corinne Van De Weerdt

    2015-06-01

    Full Text Available Home healthcare is steadily growing in many countries. Nevertheless, it is known that home healthcare workers are frequently exposed to a variety of potentially serious occupational hazards. Working conditions have changed to become more emotionally and physically demanding on workers. Emotional labor is increasingly high in this profession. Time pressure is increasingly common. This paper describes an ergonomic study analyzing the working conditions of nursing assistants and nurses, as well as the impacts of their work in terms of job satisfaction, emotions at work, relationships with the others, and occupational stress. The study shows that changing working conditions are making it increasingly difficult for home healthcare workers to do their work properly. We can confirm that such workers use strategies to try to cope. They use individual strategies to preserve the relational dimension of their work activity. These strategies are specifically centered around preserving the relationships with patients, and coping with the demands of the job. The study also shows that workers use strategies to express emotions and to conceal them from others. Finally, the paper presents the recommendations that were discussed with the manager and workers for improving working conditions and that led to practical proposals: e.g. implementing certain items of equipment better suited to difficult care, encouraging assistance between workers when operations so require through appropriate organizational measures, extending emotion-focused work discussion groups with management involvement.

  7. Prevalence of Tuberculosis Infection Among Health-Care Workers in Hamadan, West of Iran

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    Hashemi

    2014-04-01

    Full Text Available Background The risk of occupationally acquired tuberculosis (TB remains a concern, even now that the infection has been under control to a great extent. Objectives The aim of this study was to ascertain the prevalence of latent TB infection and pulmonary TB, and to assess the risk factors for TB, among health care workers in Hamadan. Patients and Methods Tuberculin skin test was performed on 245 health care workers, in two educational hospitals. The reaction was considered as "positive" if the induration diameter was ≥ 10 mm. Individuals with a positive test > than 15 mm were encouraged to seek further medical evaluation, including a chest-x-ray and a smear and sputum culture of the sputum for acid-fast bacilli, in those with radiographic changes indicating TB. Results Out of 245 health-care workers included in this study, 92 (38% had positive tuberculin test. There was a significant association between aging and tuberculin positivity. There was also a significant association between the length of employment and tuberculin positivity. Ward attendants had higher rates of positive test results, compared with other occupational groups. Conclusions It was concluded that latent TB infection is common among health-care workers in the studied region. Age, occupational group and employment length were found to be strongly associated with tuberculin positivity.

  8. How front-line healthcare workers respond to stock-outs of essential medicines in the Eastern Cape Province of South Africa.

    Science.gov (United States)

    Hodes, R; Price, I; Bungane, N; Toska, E; Cluver, L

    2017-08-25

    Shortages of essential medicines are a daily occurrence in many of South Africa (SA)'s public health facilities. This study focuses on the responses of healthcare workers to stock-outs, investigating how actors at the 'front line' of public health delivery understand, experience and respond to shortages of essential medicines and equipment in their facilities. Findings are based on focus groups, observations and interviews with healthcare workers and patients at healthcare facilities in the Eastern Cape Province of SA, conducted as part of the Mzantsi Wakho study. The research revealed a discrepancy between 'informal' definitions of stock-outs and their reporting through formal stock-out management channels. Front-line healthcare workers had designed their own systems for classifying the severity of stock-outs, based on the product in question, and on their potential to access stocks from other facilities. Beyond formal systems of procurement and supply, healthcare workers had established vast networks of alternative communication and action, often using personal resources to procure medical supplies. Stock-outs were only reported when informal methods of stock-sharing did not secure top-up supplies. These findings have implications for understanding the frequency and severity of stock-outs, and for taking action to prevent and manage stock-outs effectively.

  9. Stress and Burnout in Health-Care Workers after the 2009 L’Aquila Earthquake: A Cross-Sectional Observational Study

    OpenAIRE

    Antonella Mattei; Fabiana Fiasca; Mariachiara Mazzei; Stefano Necozione; Valeria Bianchini

    2017-01-01

    Burnout is a work-related mental health impairment, which is now recognized as a real problem in the context of the helping professions due to its adverse health outcomes on efficiency. To our knowledge, the literature on the postdisaster scenario in Italy is limited by a focus on mental health professionals rather than other health-care workers. Our cross-sectional study aims to evaluate the prevalence of burnout and psychopathological distress in different categories of health-care workers,...

  10. Stress and Burnout in Health-Care Workers after the 2009 L’Aquila Earthquake: A Cross-Sectional Observational Study

    Science.gov (United States)

    Mattei, Antonella; Fiasca, Fabiana; Mazzei, Mariachiara; Necozione, Stefano; Bianchini, Valeria

    2017-01-01

    Burnout is a work-related mental health impairment, which is now recognized as a real problem in the context of the helping professions due to its adverse health outcomes on efficiency. To our knowledge, the literature on the postdisaster scenario in Italy is limited by a focus on mental health professionals rather than other health-care workers. Our cross-sectional study aims to evaluate the prevalence of burnout and psychopathological distress in different categories of health-care workers, i.e., physicians, nurses, and health-care assistants, working in different departments of L’Aquila St. Salvatore General Hospital 6 years after the 2009 earthquake in order to prevent and reduce work-related burnout. With a two-stage cluster sampling, a total of 8 departments out of a total of 28 departments were selected and the total sample included 300 health-care workers. All the participants completed the following self-reporting questionnaires: a sociodemographic data form, a Maslach Burnout Inventory and a General Health Questionnaire 12 Items (GHQ-12). Statistically significant differences emerged between the total scores of the GHQ-12: post hoc analysis showed that the total average scores of the GHQ-12 were significantly higher in doctors than in health-care assistants. A high prevalence of burnout among doctors (25.97%) emerged. Using multivariate analysis, we identified a hostile relationship with colleagues, direct exposure to the L’Aquila earthquake and moderate to high levels of distress as being burnout predictors. Investigating the prevalence of burnout and distress in health-care staff in a postdisaster setting and identifying predictors of burnout development such as stress levels, time-management skills and work-life balance will contribute to the development of preventative strategies and better organization at work with a view to improving public health efficacy and reducing public health costs, given that these workers live in the disaster

  11. Stress and Burnout in Health-Care Workers after the 2009 L'Aquila Earthquake: A Cross-Sectional Observational Study.

    Science.gov (United States)

    Mattei, Antonella; Fiasca, Fabiana; Mazzei, Mariachiara; Necozione, Stefano; Bianchini, Valeria

    2017-01-01

    Burnout is a work-related mental health impairment, which is now recognized as a real problem in the context of the helping professions due to its adverse health outcomes on efficiency. To our knowledge, the literature on the postdisaster scenario in Italy is limited by a focus on mental health professionals rather than other health-care workers. Our cross-sectional study aims to evaluate the prevalence of burnout and psychopathological distress in different categories of health-care workers, i.e., physicians, nurses, and health-care assistants, working in different departments of L'Aquila St. Salvatore General Hospital 6 years after the 2009 earthquake in order to prevent and reduce work-related burnout. With a two-stage cluster sampling, a total of 8 departments out of a total of 28 departments were selected and the total sample included 300 health-care workers. All the participants completed the following self-reporting questionnaires: a sociodemographic data form, a Maslach Burnout Inventory and a General Health Questionnaire 12 Items (GHQ-12). Statistically significant differences emerged between the total scores of the GHQ-12: post hoc analysis showed that the total average scores of the GHQ-12 were significantly higher in doctors than in health-care assistants. A high prevalence of burnout among doctors (25.97%) emerged. Using multivariate analysis, we identified a hostile relationship with colleagues, direct exposure to the L'Aquila earthquake and moderate to high levels of distress as being burnout predictors. Investigating the prevalence of burnout and distress in health-care staff in a postdisaster setting and identifying predictors of burnout development such as stress levels, time-management skills and work-life balance will contribute to the development of preventative strategies and better organization at work with a view to improving public health efficacy and reducing public health costs, given that these workers live in the disaster

  12. Stress and Burnout in Health-Care Workers after the 2009 L’Aquila Earthquake: A Cross-Sectional Observational Study

    Directory of Open Access Journals (Sweden)

    Antonella Mattei

    2017-06-01

    Full Text Available Burnout is a work-related mental health impairment, which is now recognized as a real problem in the context of the helping professions due to its adverse health outcomes on efficiency. To our knowledge, the literature on the postdisaster scenario in Italy is limited by a focus on mental health professionals rather than other health-care workers. Our cross-sectional study aims to evaluate the prevalence of burnout and psychopathological distress in different categories of health-care workers, i.e., physicians, nurses, and health-care assistants, working in different departments of L’Aquila St. Salvatore General Hospital 6 years after the 2009 earthquake in order to prevent and reduce work-related burnout. With a two-stage cluster sampling, a total of 8 departments out of a total of 28 departments were selected and the total sample included 300 health-care workers. All the participants completed the following self-reporting questionnaires: a sociodemographic data form, a Maslach Burnout Inventory and a General Health Questionnaire 12 Items (GHQ-12. Statistically significant differences emerged between the total scores of the GHQ-12: post hoc analysis showed that the total average scores of the GHQ-12 were significantly higher in doctors than in health-care assistants. A high prevalence of burnout among doctors (25.97% emerged. Using multivariate analysis, we identified a hostile relationship with colleagues, direct exposure to the L’Aquila earthquake and moderate to high levels of distress as being burnout predictors. Investigating the prevalence of burnout and distress in health-care staff in a postdisaster setting and identifying predictors of burnout development such as stress levels, time-management skills and work-life balance will contribute to the development of preventative strategies and better organization at work with a view to improving public health efficacy and reducing public health costs, given that these workers live in the

  13. Effect of workplace- versus home-based physical exercise on pain in healthcare workers: study protocol for a single blinded cluster randomized controlled trial

    Science.gov (United States)

    2014-01-01

    Background The prevalence and consequences of musculoskeletal pain is considerable among healthcare workers, allegedly due to high physical work demands of healthcare work. Previous investigations have shown promising results of physical exercise for relieving pain among different occupational groups, but the question remains whether such physical exercise should be performed at the workplace or conducted as home-based exercise. Performing physical exercise at the workplace together with colleagues may be more motivating for some employees and thus increase adherence. On the other hand, physical exercise performed during working hours at the workplace may be costly for the employers in terms of time spend. Thus, it seems relevant to compare the efficacy of workplace- versus home-based training on musculoskeletal pain. This study is intended to investigate the effect of workplace-based versus home-based physical exercise on musculoskeletal pain among healthcare workers. Methods/Design This study was designed as a cluster randomized controlled trial performed at 3 hospitals in Copenhagen, Denmark. Clusters are hospital departments and hospital units. Cluster randomization was chosen to increase adherence and avoid contamination between interventions. Two hundred healthcare workers from 18 departments located at three different hospitals is allocated to 10 weeks of 1) workplace based physical exercise performed during working hours (using kettlebells, elastic bands and exercise balls) for 5 × 10 minutes per week and up to 5 group-based coaching sessions, or 2) home based physical exercise performed during leisure time (using elastic bands and body weight exercises) for 5 × 10 minutes per week. Both intervention groups will also receive ergonomic instructions on patient handling and use of lifting aides etc. Inclusion criteria are female healthcare workers working at a hospital. Average pain intensity (VAS scale 0-10) of the back, neck and shoulder

  14. Return to Work for Nurses With Hand Dermatitis.

    Science.gov (United States)

    Chen, Jennifer; Gomez, Pilar; Kudla, Irena; DeKoven, Joel; Holness, D Linn; Skotnicki, Sandra

    2016-01-01

    Occupational skin disease is common in healthcare workers. If the healthcare worker develops moderate to severe dermatitis, return to work (RTW) may be challenging. The study objectives were to review the impact of an RTW program on the work status of nurses with occupational hand dermatitis and to identify successful intervention methods and strategies. Nurses who received RTW services at a tertiary occupational medicine clinic were identified, and information related to their diagnosis and RTW was abstracted from their charts. Eighteen nurses with irritant hand dermatitis who received RTW services were identified. Twelve nurses (67%) were performing administrative duties because of their skin condition when admitted to the RTW program, and others were performing patient care with modifications. A graduated RTW trial was commonly implemented with optimized skin care management and monitoring by physicians and the RTW coordinator. Upon discharge, 14 nurses (78%) had returned to their nursing roles with direct patient care, 3 (17%) were working as nurses in non-patient care roles, and 1 (6%) was on permanent disability. A graduated RTW trial to reduce cumulative irritant exposure is a crucial strategy to facilitate nurses' transition back to work and to maintain direct patient care nursing roles.

  15. The Attitude of Psychiatric and Non-psychiatric Health-care Workers Toward Suicide in Malaysian Hospitals and Its Implications for Training.

    Science.gov (United States)

    Siau, Ching Sin; Wee, Lei-Hum; Yacob, Sapini; Yeoh, Seen Heng; Binti Adnan, Tassha Hilda; Haniff, Jamaiyah; Perialathan, Komathi; Mahdi, Aziman; Rahman, Abu Bakar; Eu, Choon Leng; Binti Wahab, Suzaily

    2017-08-01

    This research is aimed to examine the attitude of health-care workers toward suicidal patients in Malaysian hospitals, comparing responses from psychiatric and non-psychiatric workers, and to identify specific needs in suicide prevention and management training. This is a multi-site cross-sectional study. The authors conducted a survey based on a translated self-administered questionnaire to participants from seven core hospital departments. While most health-care workers regardless of department and specialty took their duty to prevent suicide seriously, a large majority of them expressed negative attitudes such as finding suicidal behavior irritating, and more than half believed suicidal attempts were a way of making others sorry. However, psychiatric workers were less likely to have judgmental attitudes that included believing suicide attempters as being selfish or trying to get sympathy from others. As there were more similarities than differences in health-care workers' attitudes toward suicide, recommendations on basic and continuous suicide prevention and management training among hospital workers were made. The interventions focused on improving knowledge, affective, and skill-based areas that were aimed to correct the wrongful understanding of and to minimize the negative attitudes toward suicidal individuals indicated by the study results.

  16. Mobile phone use among patients and health workers to enhance primary healthcare: A qualitative study in rural South Africa.

    Science.gov (United States)

    Anstey Watkins, Jocelyn Olivia Todd; Goudge, Jane; Gómez-Olivé, Francesc Xavier; Griffiths, Frances

    2018-02-01

    Mobile phones have the potential to improve access to healthcare information and services in low-resourced settings. This study investigated the use of mobile phones among patients with chronic diseases, pregnant women, and health workers to enhance primary healthcare in rural South Africa. Qualitative research was undertaken in Mpumalanga in 2014. Semi structured in-depth interviews were conducted with 113 patients and 43 health workers from seven primary healthcare clinics and one district hospital. Data were thematically analysed. We found that some health workers and patients used their own mobile phones for healthcare, bearing the cost themselves. Patients used their mobile phones to remind themselves to take medication or attend their clinic visits, and they appreciated receiving voice call reminders. Some patients and health workers accessed websites and used social media to gather health information, but lacked web search strategies. The use of the websites and social media was intermittent due to lack of financial ability to afford airtime among these patients and health workers. Many did not know what to search for and where to search. Doctors have developed their own informal mobile health solutions in response to their work needs and lack of resources due to their rurality. Physical and social factors influence the usability of mobile phones for healthcare, and this can shape communication patterns such as poor eyesight. The bottom-up use of mobile phones has been evolving to fill the gaps to augment primary care services in South Africa; however, barriers to access remain, such as poor digital infrastructure and low digital literacy. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  17. When healthcare workers get sick: exploring sickness absenteeism in British Columbia, Canada.

    Science.gov (United States)

    Gorman, Erin; Yu, Shicheng; Alamgir, Hasanat

    2010-01-01

    To determine the demographic and work characteristics of healthcare workers who were more likely to take sickness absences from work in British Columbia, Canada. Payroll data were analyzed for three health regions. Sickness absence rates were determined per person-year and then compared across demographic and work characteristics using multivariate Poisson regression models. The direct costs to the employer due to sickness absences were also estimated. Female, older, full-time workers, long-term care workers and those with a lower hourly wage were more likely to take sickness absences and had similar trends with respect to the costs due to sickness absence. For occupations, licensed practical nurses, care aides and facility support workers had higher rates of sickness absence. Registered nurses, and those workers paid high hourly wages were associated with highest sickness related costs. It is important to understand the demographic and work characteristics of those workers who are more likely to take sickness absences in order to make sure that they are not experiencing additional hazards at work or facing detrimental workplace conditions. Policy makers need to establish healthy, safe and in turn more productive workplaces. Further research is needed on how interventions can reduce sickness absence.

  18. The effect of contact precautions on healthcare worker activity in acute care hospitals.

    Science.gov (United States)

    Morgan, Daniel J; Pineles, Lisa; Shardell, Michelle; Graham, Margaret M; Mohammadi, Shahrzad; Forrest, Graeme N; Reisinger, Heather S; Schweizer, Marin L; Perencevich, Eli N

    2013-01-01

    Contact precautions are a cornerstone of infection prevention but have also been associated with less healthcare worker (HCW) contact and adverse events. We studied how contact precautions modified HCW behavior in 4 acute care facilities. Prospective cohort study. Four acute care facilities in the United States performing active surveillance for methicillin-resistant Staphylococcus aureus. Trained observers performed "secret shopper" monitoring of HCW activities during routine care, using a standardized collection tool and fixed 1-hour observation periods. A total of 7,743 HCW visits were observed over 1,989 hours. Patients on contact precautions had 36.4% fewer hourly HCW visits than patients not on contact precautions (2.78 vs 4.37 visits per hour; [Formula: see text]) as well as 17.7% less direct patient contact time with HCWs (13.98 vs 16.98 minutes per hour; [Formula: see text]). Patients on contact precautions tended to have fewer visitors (23.6% fewer; [Formula: see text]). HCWs were more likely to perform hand hygiene on exiting the room of a patient on contact precautions (63.2% vs 47.4% in rooms of patients not on contact precautions; [Formula: see text]). Contact precautions were found to be associated with activities likely to reduce transmission of resistant pathogens, such as fewer visits and better hand hygiene at exit, while exposing patients on contact precautions to less HCW contact, less visitor contact, and potentially other unintended outcomes.

  19. Flexible working arrangements in healthcare: a comparison between managers of shift workers and 9-to-5 employees.

    Science.gov (United States)

    Mercer, Danielle; Russell, Elizabeth; Arnold, Kara A

    2014-01-01

    This study examined healthcare managers' perceptions of flexible working arrangements and implementation barriers. Work-life conflict can lead to negative health implications, but flexible working arrangements can help manage this conflict. Little research has examined its implementation in 24/7/365 healthcare organizations or within groups of employees working 9 AM to 5 PM (9-5) versus shift-work hours. Questionnaires regarding perceptions to, benefits of, and barriers against flexible working arrangements were administered to managers of 9-5 workers and shift workers in an Atlantic Canadian healthcare organization. Few differences in perceptions and benefits of flexible working arrangements were found between management groups. However, results indicate that the interaction with patients and/or the immediacy of tasks being performed are barriers for shift-work managers. The nature of healthcare presents barriers for managers implementing flexible working arrangements, which differ only based on whether the job is physical (shift work) versus desk related (9-5 work).

  20. Developing cross-cultural healthcare workers: content, process and mentoring

    Directory of Open Access Journals (Sweden)

    Mark A Strand

    2016-01-01

    Full Text Available Career service in cross-cultural healthcare mission work is the ambition of many people around the world. However, premature termination of this expected long-term service mitigates against achieving the goals of the individual and the organization. The lingering challenge of high rates of missionary attrition impacts the long-term effectiveness of the work and the health and well-being of the workers. One of the keys to reducing premature attrition is cross-cultural training for these individuals, provided it offers the right content, through the best medium, at the time of greatest perceived need by the missionary. This paper applies the Dreyfus Model of skills acquisition to the process of mentoring career healthcare missionaries in a progressive manner, utilizing a mentoring method. These missionaries can flourish in their work and more effectively achieve their individual and organizational goals through strategic mentorship that clearly defines a pathway for growing their cross-cultural skills.

  1. Knowledge, attitudes and behaviour of healthcare workers regarding influenza and vaccination in Salerno, Italy

    Directory of Open Access Journals (Sweden)

    Maria Grazia Panico

    2011-03-01

    Full Text Available

    Abstract
    Background: Influenza vaccination coverage among healthcare workers (HCWs is unacceptably low despite
    the recommendations of health authorities.
    Objective: The aim of the study is to assess the knowledge base of healthcare workers in Local Health Services (LHS regarding influenza vaccination and to identify the factors that inhibit or motivate vaccination among HCWs.
    Methods: A cross sectional study was carried out between July and October 2003 within the five Hospitals of the LHS “Azienda Sanitaria Salerno2”, Salerno, Italy. In July 2003, we prepared a standardized anonymous questionnaire for a sample of 280 healthcare workers aimed at surveying their knowledge base and attitudes
    towards influenza and vaccination. The HCWs were recruited by random selection using the stratified layered sampling method. On the basis of the results of our survey, a hospital vaccination campaign was undertaken. Statistical analysis was carried out using the EpiInfo 6.06 program. Data were analyzed through frequency distribution. Statistical comparison was performed using the Chi-square tests and a p-value <0,05 was considered statistically significant*.
    Results: During the 2003-2004 influenza season, 230 (81% out of 280 employees answered the questionnaire. 31 respondents (13.5% were physicians, 94 (40.9% were nurses and 105 (45.6% were workers employed in supporting services. The vaccination rate among Health Care workers of this Local Health Service (LHS unit was about 15.0%. The reasons most frequently cited by HCWs for noncompliance with vaccination were confidence in their own personal health, the fear of adverse reactions to the vaccine
    and the doubt they had about vaccine efficacy.
    Conclusions: We conclude that those responsible for influenza vaccination programs might consider a specifically tailored

  2. Biomedical waste management: Study on the awareness and practice among healthcare workers in a tertiary teaching hospital

    Directory of Open Access Journals (Sweden)

    L Joseph

    2015-01-01

    Full Text Available Bio-medical waste has a higher potential of infection and injury to the healthcare worker, patient and the surrounding community. Awareness programmes on their proper handling and management to healthcare workers can prevent the spread of infectious diseases and epidemics. This study was conducted in a tertiary care hospital to assess the impact of training, audits and education/implementations from 2009 to 2012 on awareness and practice of biomedical waste segregation. Our study reveals focused training, strict supervision, daily surveillance, audits inspections, involvement of hospital administrators and regular appraisals are essential to optimise the segregation of biomedical waste.

  3. Biomedical waste management: study on the awareness and practice among healthcare workers in a tertiary teaching hospital.

    Science.gov (United States)

    Joseph, L; Paul, H; Premkumar, J; Paul, R; Michael, J S

    2015-01-01

    Bio-medical waste has a higher potential of infection and injury to the healthcare worker, patient and the surrounding community. Awareness programmes on their proper handling and management to healthcare workers can prevent the spread of infectious diseases and epidemics. This study was conducted in a tertiary care hospital to assess the impact of training, audits and education/implementations from 2009 to 2012 on awareness and practice of biomedical waste segregation. Our study reveals focused training, strict supervision, daily surveillance, audits inspections, involvement of hospital administrators and regular appraisals are essential to optimise the segregation of biomedical waste.

  4. Features of burnout syndrome development in healthcare workers with different types of work motivation

    Directory of Open Access Journals (Sweden)

    Vezhnovets T.A.

    2016-05-01

    Full Text Available The article presents the results of researches of peculiarities of burnout syndrome formation in healthcare workers with different types of work motivation. It is discovered that the syndrome is formed for each motivational type as mechanism of psychological protection against the action of certain stressful factors, namely: for instrumental type – an excessive concentration on obtaining material rewards; for professional type – an excessive control of emotions in substantial professional communications and high psycho-emotional overload; for patriotic type – high level of dependence on social approval, a high level of communicative activity, a high level of psycho-emotional overload, for economical type – distrust, for lumpenized – any labor. Prevention of burnout syndrome in healthcare workers has to be realized taking into account peculiarities of psycho-traumatic factors depending on the type of work motivation.

  5. Factors affecting pain relief in response to physical exercise interventions among healthcare workers.

    Science.gov (United States)

    Jakobsen, M D; Sundstrup, E; Brandt, M; Andersen, L L

    2017-12-01

    The aim of this study is to identify factors associated with musculo-skeletal pain reduction during workplace-based or home-based physical exercise interventions among healthcare workers. Two hundred female healthcare workers (age: 42.0, BMI: 24.1, average pain intensity: 3.1 on a scale of 0-10) from three hospitals participated. Participants were randomly allocated at the cluster level (18 departments) to 10 weeks of (i) workplace physical exercise (WORK) performed in groups during working hours for 5 × 10 minutes per week and up to five group-based coaching sessions on motivation for regular physical exercise, or (ii) home-based physical exercise (HOME) performed alone during leisure-time for 5 × 10 minutes per week. Linear mixed models accounting for cluster identified factors affecting pain reduction. On average 2.2 (SD: 1.1) and 1.0 (SD: 1.2) training sessions were performed per week in WORK and HOME, respectively. The multi-adjusted analysis showed a significant effect on pain reduction of both training adherence (P=.04) and intervention group (P=.04) with participants in WORK experiencing greater reductions compared with HOME. Obesity at baseline was associated with better outcome. Leisure-time exercise, daily patient transfer, age, and chronic pain did not affect the changes in pain. In conclusion, even when adjusted for training adherence, performing physical exercise at the workplace is more effective than home-based exercise in reducing musculo-skeletal pain in healthcare workers. Noteworthy, obese individuals may especially benefit from physical exercise interventions targeting musculo-skeletal pain. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Health care workers' hand contamination levels and antibacterial efficacy of different hand hygiene methods used in a Vietnamese hospital.

    Science.gov (United States)

    Salmon, Sharon; Truong, Anh Thu; Nguyen, Viet Hung; Pittet, Didier; McLaws, Mary-Louise

    2014-02-01

    Handwashing with soap or another antisepsis disinfectant solution is a common practice in Vietnam, but the availability and quality of tap water is unpredictable. We assessed the risk for hand contamination and compared the efficacy of 5 hand hygiene methods in a tertiary Vietnamese hospital. Five fingertip imprints of the dominant hand of 134 health care workers (HCWs) were sampled to establish the average bacterial count before and after hand hygiene action using (1) alcohol-based handrub (ABHR), (2) plain soap and water handwashing with filtered and unfiltered water, or (3) 4% chlorhexidine gluconate hand antisepsis with filtered and unfiltered water. Average bacterial contamination of hands before hand hygiene was 1.65 log(10). Acinetobacter baumannii, Klebsiella pneumoniae, and Staphylococcus aureus were the most commonly isolated bacterial pathogens. The highest average count before hand hygiene was recovered from HCWs without direct patient contact (2.10 ± 0.11 log(10)). Bacterial counts were markedly reduced after hand hygiene with ABHR (1.4 log(10); P hand, even without direct patient contact. ABHR as an additional step may overcome the effect of high bacterial counts in unfiltered water when soap and water handwashing is indicated. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

  7. The CRADLE vital signs alert: qualitative evaluation of a novel device designed for use in pregnancy by healthcare workers in low-resource settings.

    Science.gov (United States)

    Nathan, Hannah L; Boene, Helena; Munguambe, Khatia; Sevene, Esperança; Akeju, David; Adetoro, Olalekan O; Charanthimath, Umesh; Bellad, Mrutyunjaya B; de Greeff, Annemarie; Anthony, John; Hall, David R; Steyn, Wilhelm; Vidler, Marianne; von Dadelszen, Peter; Chappell, Lucy C; Sandall, Jane; Shennan, Andrew H

    2018-01-05

    Vital signs measurement can identify pregnant and postpartum women who require urgent treatment or referral. In low-resource settings, healthcare workers have limited access to accurate vital signs measuring devices suitable for their environment and training. The CRADLE Vital Signs Alert (VSA) is a novel device measuring blood pressure and pulse that is accurate in pregnancy and designed for low-resource settings. Its traffic light early warning system alerts healthcare workers to the need for escalation of care for women with hypertension, haemorrhage or sepsis. This study evaluated the usability and acceptability of the CRADLE VSA device. Evaluation was conducted in community and primary care settings in India, Mozambique and Nigeria and tertiary hospitals in South Africa. Purposeful sampling was used to convene 155 interviews and six focus groups with healthcare workers using the device (n = 205) and pregnant women and their family members (n = 41). Interviews and focus groups were conducted in the local language and audio-recorded, transcribed and translated into English for analysis. Thematic analysis was undertaken using an a priori thematic framework, as well as an inductive approach. Most healthcare workers perceived the CRADLE device to be easy to use and accurate. The traffic lights early warning system was unanimously reported positively, giving healthcare workers confidence with decision-making and a sense of professionalism. However, a minority in South Africa described manual inflation as tiring, particularly when measuring vital signs in obese and hypertensive women (n = 4) and a few South African healthcare workers distrusted the device's accuracy (n = 7). Unanimously, pregnant women liked the CRADLE device. The traffic light early warning system gave women and their families a better understanding of the importance of vital signs in pregnancy and during the postpartum period. The CRADLE device was well accepted by healthcare workers

  8. Transmission of Staphylococcus aureus between health-care workers, the environment, and patients in an intensive care unit: a longitudinal cohort study based on whole-genome sequencing.

    Science.gov (United States)

    Price, James R; Cole, Kevin; Bexley, Andrew; Kostiou, Vasiliki; Eyre, David W; Golubchik, Tanya; Wilson, Daniel J; Crook, Derrick W; Walker, A Sarah; Peto, Timothy E A; Llewelyn, Martin J; Paul, John

    2017-02-01

    Health-care workers have been implicated in nosocomial outbreaks of Staphylococcus aureus, but the dearth of evidence from non-outbreak situations means that routine health-care worker screening and S aureus eradication are controversial. We aimed to determine how often S aureus is transmitted from health-care workers or the environment to patients in an intensive care unit (ICU) and a high-dependency unit (HDU) where standard infection control measures were in place. In this longitudinal cohort study, we systematically sampled health-care workers, the environment, and patients over 14 months at the ICU and HDU of the Royal Sussex County Hospital, Brighton, England. Nasal swabs were taken from health-care workers every 4 weeks, bed spaces were sampled monthly, and screening swabs were obtained from patients at admission to the ICU or HDU, weekly thereafter, and at discharge. Isolates were cultured and their whole genome sequenced, and we used the threshold of 40 single-nucleotide variants (SNVs) or fewer to define subtypes and infer recent transmission. Between Oct 31, 2011, and Dec 23, 2012, we sampled 198 health-care workers, 40 environmental locations, and 1854 patients; 1819 isolates were sequenced. Median nasal carriage rate of S aureus in health-care workers at 4-weekly timepoints was 36·9% (IQR 35·7-37·3), and 115 (58%) health-care workers had S aureus detected at least once during the study. S aureus was identified in 8-50% of environmental samples. 605 genetically distinct subtypes were identified (median SNV difference 273, IQR 162-399) at a rate of 38 (IQR 34-42) per 4-weekly cycle. Only 25 instances of transmission to patients (seven from health-care workers, two from the environment, and 16 from other patients) were detected. In the presence of standard infection control measures, health-care workers were infrequently sources of transmission to patients. S aureus epidemiology in the ICU and HDU is characterised by continuous ingress of distinct

  9. Effort-reward imbalance at work and job dissatisfaction in Chinese healthcare workers: a validation study.

    Science.gov (United States)

    Li, Jian; Yang, Wenjie; Cheng, Yawen; Siegrist, Johannes; Cho, Sung-Il

    2005-04-01

    The aim of this study was to test the reliability and validity of the Chinese version of the 23-item effort-reward imbalance (ERI) questionnaire and to analyze its association with job dissatisfaction in a sample of Chinese healthcare workers. A self-reported survey was conducted, in university hospitals of China, among 192 male and 608 female healthcare workers. Appropriate internal consistencies of the three scales: effort, reward, and overcommitment, were obtained. Exploratory factor analysis replicated the theoretically assumed structure of the ERI construct in men and women. Evidence of criterion validity was obtained from cross-correlations of the scales and from their correlations with gender, education and job dissatisfaction. Finally, all three scales were associated with an elevated odds ratio of job dissatisfaction, and the effect was strongest for the ERI ratio as predicted by theory. Based on the results of this study the Chinese version of the ERI questionnaire is considered a reliable and valid instrument for measuring psychosocial stress at work. It is applicable to Chinese working populations and, in particular, to the healthcare sector.

  10. Serological survey of hepatitis B immunity in healthcare workers in Catalonia (Spain).

    Science.gov (United States)

    Domínguez, A; Urbiztondo, L; Bayas, J M; Borrás, E; Broner, S; Campins, M; Costa, J; Esteve, M

    2017-02-01

    Healthcare workers (HCW) are exposed to preventable infectious diseases, notably hepatitis B (HB). The aim of this study was to determine the immunity of HCW against hepatitis B. We made a seroprevalence study using a self-administered survey and obtained blood samples. Antibodies against the HB surface antigen (anti-HBs) and against the HB core antigen (anti-HBc) were studied. The odds ratio (OR) and 95% confidence intervals (CI) were calculated. The adjusted OR were calculated using logistic regression. Of the 644 HCW who participated (29.7% physicians, 38.7% nurses, 13.4% other clinical workers and 18.3% non-clinical workers), 46.4% were primary care workers and 53.6% hospital workers. The overall prevalence of anti-HBs was 64.4%. HCW aged 44 y with respect to those aged 25-34 y. 75.6% of HCW stated they were vaccinated, but only 39.3% had a vaccination card. In HCW who stated they were unvaccinated, 10.8% had a vaccinated serological pattern (anti-HBc-negative and anti-HBs -positive). Written, updated vaccination records are essential to reliably determine the vaccination status.

  11. Hand Hygiene Adherence Among Health Care Workers at Japanese Hospitals: A Multicenter Observational Study in Japan.

    Science.gov (United States)

    Sakihama, Tomoko; Honda, Hitoshi; Saint, Sanjay; Fowler, Karen E; Shimizu, Taro; Kamiya, Toru; Sato, Yumiko; Arakawa, Soichi; Lee, Jong Ja; Iwata, Kentaro; Mihashi, Mutsuko; Tokuda, Yasuharu

    2016-03-01

    Although proper hand hygiene among health care workers is an important component of efforts to prevent health care-associated infection, there are few data available on adherence to hand hygiene practices in Japan. The aim of this study was to examine hand hygiene adherence at teaching hospitals in Japan. An observational study was conducted from July to November 2011 in 4 units (internal medicine, surgery, intensive care, and/or emergency department) in 4 geographically diverse hospitals (1 university hospital and 3 community teaching hospitals) in Japan. Hand hygiene practice before patient contact was assessed by an external observer. In a total of 3545 health care worker-patient observations, appropriate hand hygiene practice was performed in 677 (overall adherence, 19%; 95% confidence interval, 18%-20%). Subgroup rates of hand hygiene adherence were 15% among physicians and 23% among nurses. The ranges of adherence were 11% to 25% between hospitals and 11% to 31% between units. Adherence of the nurses and the physicians to hand hygiene was correlated within each hospital. There was a trend toward higher hand hygiene adherence in hospitals with infection control nurses, compared with hospitals without them (29% versus 16%). The hand hygiene adherence in Japanese teaching hospitals in our sample was low, even lower than reported mean values from other international studies. Greater adherence to hand hygiene should be encouraged in Japan.

  12. Association between health worker motivation and healthcare quality efforts in Ghana

    OpenAIRE

    Alhassan, Robert Kaba; Spieker, Nicole; van Ostenberg, Paul; Ogink, Alice; Nketiah-Amponsah, Edward; de Wit, Tobias F Rinke

    2013-01-01

    Background Ghana is one of the sub-Saharan African countries making significant progress towards universal access to quality healthcare. However, it remains a challenge to attain the 2015 targets for the health related Millennium Development Goals (MDGs) partly due to health sector human resource challenges including low staff motivation. Purpose This paper addresses indicators of health worker motivation and assesses associations with quality care and patient safety in Ghana. The aim is to i...

  13. NEEDLESTICK INJURY AMONG HEALTHCARE WORKERS IN A TERTIARY CARE HOSPITAL, KERALA

    OpenAIRE

    Chintha Sujatha; Jacquilene Vadasseril; Govind Jayaprakash; John K. Joy

    2017-01-01

    BACKGROUND Needlestick Injury (NSI) is a major occupational health and safety issue among Healthcare Workers (HCWs). In India, incidence of NSI is high, but surveillance is poor with scarce authentic data. The aim of the study is to determine the occurrence of NSI, its associated factors and assessment of knowledge and practice of preventive measures and post exposure prophylaxis among HCWs in a tertiary care hospital in Kerala. MATERIALS AND METHODS A cross-sectional study ...

  14. Prevalence of Escherichia Coli O157:H7 and Enterobacteriaceae on Hands of Workers in Halal Cattle Abattoirs in Peninsular Malaysia.

    Science.gov (United States)

    Shamsul, Bahri Mohd Tamrin; Adamu, Muhammad Tukur; Mohd Desa, Mohd Nasir; Khairani-Bejo, Siti

    2016-09-01

    Several occupational diseases of multiple origins are encountered among abattoir workers. Presence of indicator microorganisms (coliforms) on hands of workers can be used a gauge for hygienic practices. A cross-sectional study was performed to assess the prevalence of E.coli and enterobacteriaceae among Halal abattoir workers in some government halal abattoirs of Malaysia. A total of one hundred and sixty-five hand swab samples were collected from workers of Halal abattoirs in Malaysia. The samples were subjected to microbiological analysis for characterisation and serotyping. The results have shown that no Escherichia coli O157:H7 was isolated on the hands of abattoir workers before and after work. However, a total prevalence of 9.7% was recorded for all samples during work. For non-O157:H7, total prevalence of 33.3% during work and 13% after work were obtained. High prevalence was recorded in sample taken during work from Tampin, Jasin and Kemaman (100% each) while low prevalence where observed in Shah Alam, Banting and Ipoh (20% each). Based on the findings the hygienic practices of hand washing among the workers in few locations was found to be low especially after work.

  15. Googling your hand hygiene data: Using Google Forms, Google Sheets, and R to collect and automate analysis of hand hygiene compliance monitoring.

    Science.gov (United States)

    Wiemken, Timothy L; Furmanek, Stephen P; Mattingly, William A; Haas, Janet; Ramirez, Julio A; Carrico, Ruth M

    2018-06-01

    Hand hygiene is one of the most important interventions in the quest to eliminate healthcare-associated infections, and rates in healthcare facilities are markedly low. Since hand hygiene observation and feedback are critical to improve adherence, we created an easy-to-use, platform-independent hand hygiene data collection process and an automated, on-demand reporting engine. A 3-step approach was used for this project: 1) creation of a data collection form using Google Forms, 2) transfer of data from the form to a spreadsheet using Google Spreadsheets, and 3) creation of an automated, cloud-based analytics platform for report generation using R and RStudio Shiny software. A video tutorial of all steps in the creation and use of this free tool can be found on our YouTube channel: https://www.youtube.com/watch?v=uFatMR1rXqU&t. The on-demand reporting tool can be accessed at: https://crsp.louisville.edu/shiny/handhygiene. This data collection and automated analytics engine provides an easy-to-use environment for evaluating hand hygiene data; it also provides rapid feedback to healthcare workers. By reducing some of the data management workload required of the infection preventionist, more focused interventions may be instituted to increase global hand hygiene rates and reduce infection. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  16. A training intervention on child feeding among primary healthcare workers in Ibadan Municipality

    Directory of Open Access Journals (Sweden)

    Folake O. Samuel

    2016-09-01

    Full Text Available Introduction: Health workers at the primary level are well positioned to provide health information and counselling on child feeding to mothers on antenatal visits. The study was designed to evaluate the effect of training on the knowledge, attitudes and provision of infant and young child feeding (IYCF information and counselling among primary healthcare (PHC workers. Methods: A two-stage cluster sample was used to select health workers for training on IYCF in Ibadan, Nigeria. Baseline, immediate and 4-week post-training surveys were conducted to assess knowledge, attitudes and practices of health workers regarding IYCF. Paired t-tests were used to measure differences (p < 0.05 before and after the training. Results: A total of 124 health workers were trained on current global IYCF recommendations. Participants included community health extension workers (59.7%, nurses (27.4%, community health officers (11.3%, and pharmacy technicians (1.6%. Mean age was 41.8 ± 8.2 years and 95.2% were women. Knowledge of health workers regarding IYCF, particularly complementary feeding, was low at baseline but improved significantly following the training intervention. Attitudes and practices regarding provision of IYCF were suboptimal among health workers at the PHC facilities, but this improved with training. Conclusion: Health workers at the PHC level need regular retraining exercises to ensure effective counselling on IYCF.

  17. Association between work engagement and perceived exertion among healthcare workers

    Directory of Open Access Journals (Sweden)

    Rodrigo Luiz Carregaro

    Full Text Available INTRODUCTION: Complaints and musculoskeletal discomforts are common manifestations of individuals affected by work-related disorders (WRMD, and the influence of individual and/or psychosocial risk factors may play a significant role in WRMD development. OBJECTIVE: To evaluate and to compare work engagement (WE and ratings of perceived exertion (RPE and to assess the association between indexes of WE and RPE among healthcare workers. MATERIALS AND METHODS: Seventeen female subjects (36 ± 11 years, 1.58 ± 0.06 m and 59 ± 9 kg participated, all officially employed on a nonprofit agency. The Nordic Questionnaire was used to evaluate musculoskeletal complaints and the Borg Scale used to evaluate the RPE. The Utrecht Work Engagement Scale quantified WE (vigor, dedication and absorption domains. Participants were divided into two groups, according to their sectors: healthcare clinics and institution for the elderly. The independent student t test was used to verify differences between groups and the chi-square test to verify associations between variables. RESULTS: All subjects reported musculoskeletal complaints, mainly in the low back (58%. RPE did not differ between groups, while in the vigor, it was found a significant statistically difference (p = 0.035. An association between RPE and vigor and RPE and dedication was establish (p = 0.02 and p = 0.036, respectively. CONCLUSION: The association between WE and RPE suggests that workers with lower indexes of vigor and dedication may perceive greater physical demand, which can be imposed by work demands.

  18. Implementation of the WHO multimodal Hand Hygiene Improvement Strategy in a University Hospital in Central Ethiopia.

    Science.gov (United States)

    Pfäfflin, Frieder; Tufa, Tafese Beyene; Getachew, Million; Nigussie, Tsehaynesh; Schönfeld, Andreas; Häussinger, Dieter; Feldt, Torsten; Schmidt, Nicole

    2017-01-01

    The burden of health-care associated infections in low-income countries is high. Adequate hand hygiene is considered the most effective measure to reduce the transmission of nosocomial pathogens. We aimed to assess compliance with hand hygiene and perception and knowledge about hand hygiene before and after the implementation of a multimodal hand hygiene campaign designed by the World Health Organization. The study was carried out at Asella Teaching Hospital, a university hospital and referral centre for a population of about 3.5 million in Arsi Zone, Central Ethiopia. Compliance with hand hygiene during routine patient care was measured by direct observation before and starting from six weeks after the intervention, which consisted of a four day workshop accompanied by training sessions and the provision of locally produced alcohol-based handrub and posters emphasizing the importance of hand hygiene. A second follow up was conducted three months after handing over project responsibility to the Ethiopian partners. Health-care workers' perception and knowledge about hand hygiene were assessed before and after the intervention. At baseline, first, and second follow up we observed a total of 2888, 2865, and 2244 hand hygiene opportunities, respectively. Compliance with hand hygiene was 1.4% at baseline and increased to 11.7% and 13.1% in the first and second follow up, respectively (p hand hygiene was consistent across professional categories and all participating wards and was independently associated with the intervention (adjusted odds ratio, 9.18; 95% confidence interval 6.61-12.76; p hand hygiene actions. The median hand hygiene knowledge score overall was 13 (interquartile range 11-15) at baseline and increased to 17 (15-18) after training (p hand hygiene is feasible and sustainable in a resource-constrained setting using a multimodal improvement strategy. However, absolute compliance remained low. Strong and long-term commitment by hospital management and

  19. Survey of attitudes and practices of Irish nursing students towards hand hygiene, including handrubbing with alcohol-based hand rub.

    Science.gov (United States)

    Kingston, Liz M; O'Connell, Nuala H; Dunne, Colum P

    2017-05-01

    Hand hygiene is widely recognised as the most important measure a healthcare worker can take in preventing the spread of healthcare associated infections. As a member of the healthcare team, nursing students have direct patient contact during clinical practice; hence, good hand hygiene practice among nursing students is essential. Low to moderate levels of hand hygiene knowledge and poor attitudes and practices are reported among nursing students. However, less is known about their attitudes and practices of handrubbing with ABHR, even though handrubbing is the recommended optimum practice in most situations. The aim of this study was to explore attitudes and practices of hand hygiene, in particular handrubbing with alcohol-based hand rub, among nursing students in Ireland. This survey employed a descriptive, self-report design using a questionnaire to gather data. It was administered electronically to all undergraduate nursing students (n=342) in the Department of Nursing and Midwifery at the University of Limerick, Ireland in March and April 2015. Response rate was 66%. Attitudes towards hand hygiene were generally positive. Compliance with hand hygiene after contact with body fluid was high (99.5%) and before a clean or aseptic procedure (98.5%). However, suboptimal practices emerged, before touching a patient (85%), after touching a patient (87%) and after touching patients' surroundings (61%), with first year students more compliant than fourth year students. 16% of students were not aware of the clinical contraindications for using alcohol-based hand rub and 9% did not know when to use soap and water and when to use alcohol-based hand rub. Educators and practitioners play an important role in ensuring that nursing students develop appropriate attitudes towards hand hygiene and engage in optimal handrubbing practices. Raising awareness among nursing students of their responsibility in preventing the occurrence and reducing the transmission of HCAI as an on

  20. Hand hygiene for the prevention of nosocomial infections.

    Science.gov (United States)

    Kampf, Günter; Löffler, Harald; Gastmeier, Petra

    2009-10-01

    The WHO regards hand hygiene as an essential tool for the prevention of nosocomial infection, but compliance in clinical practice is often low. The relevant scientific literature and national and international evidence-based recommendations (Robert Koch Institute [Germany], WHO) were evaluated. Hygienic hand disinfection has better antimicrobial efficacy than hand-washing and is the procedure of choice to be performed before and after manual contact with patients. The hands should be washed, rather than disinfected, only when they are visibly soiled. Skin irritation is quite common among healthcare workers and is mainly caused by water, soap, and prolonged wearing of gloves. Compliance can be improved by training, by placing hand-rub dispensers at the sites where they are needed, and by physicians setting a good example for others. Improved compliance in hand hygiene, with proper use of alcohol-based hand rubs, can reduce the nosocomial infection rate by as much as 40%.

  1. A comparative study on the level of satisfaction among regular and contractual health-care workers in a Northern city of India.

    Science.gov (United States)

    Dixit, Jyoti; Goel, Sonu; Sharma, Vijaylakshmi

    2017-01-01

    Job satisfaction greatly determines the productivity and efficiency of human resources for health. The current study aims to assess the level of satisfaction and factors influencing the job satisfaction among regular and contractual health-care workers. A cross-sectional quantitative study was conducted from January to June 2015 among health care workers ( n = 354) at all levels of public health-care facilities of Chandigarh. The correlation between variables with overall level of satisfaction was computed for regular and contractual health-care workers. Stepwise multiple linear regression was done to elucidate the major factors influencing job satisfaction. Majority of the regular health-care staff was highly satisfied (86.9%) as compared to contractual staff (10.5%), which however was moderately satisfied (55.9%). Stepwise regression model showed that work-related matters (β = 1.370, P job (β = 0.530, P satisfaction level. Under the National Rural Health Mission, contract appointments have improved the overall availability of health-care staff at all levels of public health facilities. However, there are concerns regarding their level of motivation with various aspects related to the job, which need to be urgently addressed so as to improve the effectiveness and efficiency of health services.

  2. Vaccination coverage among social and healthcare workers in ten countries of Samu-social international sites.

    Science.gov (United States)

    Marshall, Esaie; Salmon, Dominique; Bousfiha, Nadia; Togola, Yacouba; Ouedraogo, François; Santantonio, Maud; Dieng, Coumba Khadidja; Tartière, Suzanne; Emmanuelli, Xavier

    2017-09-18

    We aim to determine the vaccination coverage of social and healthcare workers in International sites of Samusocial, providing emergency care to homeless people, and to assess factors associated with having received necessary doses at adulthood. Data on immunization coverage of social and healthcare workers were provided by a cross-sectional survey, conducted from February to April 2015 among 252 Samusocial workers in 10 countries. Vaccination status and characteristics of participants were collected through a self-administered questionnaire. Prevalence rate ratio (PRR) of vaccination status was calculated using Poisson regression models. Among 252 Samusocial social and health workers who felt a questionnaire, median age was 39years, 42.1% were female, 88.9% were in contact with homeless beneficiaries (19.1% health workers). Overall, 90.1% of Samusocial staff felt adult vaccinations was useful and 70.2% wished to receive booster doses in future. Vaccination coverage at adulthood was satisfactory for diphtheria and poliomyelitis (96%), but low for influenza (20.8%), meningococcus (50.5%), hepatitis B (56.3%), yellow fever (58.1%), measles (81.3%) and pertussis (90.7%). The main reasons for not having received vaccination booster doses were forgetting the dates of booster doses (38.4%) and not having received the information (13.5%). In adjusted analysis, prevalence of up-to-date for vaccination schedule was 35% higher among health workers than among social workers (aPRR=1.35, 95%CI: 1.01-1.82, P=0.05) and was 56% higher among workers who had a documentary evidence of vaccination than in those who did not (aPRR=1.56, 95%CI: 1.19-2.02, P=0.001). The Samusocial International workers vaccine coverage at adulthood was insufficient and disparate by region. It is necessary to strengthen the outreach of this staff and increase immunization policy for hepatitis B, diphtheria, tetanus, and measles, as well as for yellow fever, rabies and meningococcal ACYW135 vaccines in at

  3. Herd protection effect of N95 respirators in healthcare workers.

    Science.gov (United States)

    Chen, Xin; Chughtai, Abrar Ahmad; MacIntyre, Chandini Raina

    2017-12-01

    Objective To determine if there was herd protection conferred to unprotected healthcare workers (HCWs) by N95 respirators worn by colleagues. Methods Data were analysed from a prospective cluster randomized clinical trial conducted in Beijing, China between 1 December 2008 and 15 January 2009. A minimum compliance level (MCL) of N95 respirators for prevention of clinical respiratory illness (CRI) was set based on various compliance cut-offs. The CRI rates were compared between compliant (≥MCL) and non-compliant (protection from use of N95 respirators by colleagues within a hospital ward.

  4. Hand injuries in foreign labour workers in an Irish university hospital.

    LENUS (Irish Health Repository)

    Sattler, Thorsten

    2009-01-01

    The present study reports on a new, rapidly growing patient subpopulation presenting with hand injuries to the Department of Plastic Surgery in Cork University Hospital (Ireland). The impact of the 10 new European Union accession states on the trauma workload is examined. The associated growth in expenditure on interpreter services is also examined. Potential risk factors in the foreign workers\\' new working environment is explored.

  5. Effect of workplace- versus home-based physical exercise on musculoskeletal pain among healthcare workers

    DEFF Research Database (Denmark)

    Jakobsen, Markus D.; Sundstrup, Emil; Brandt, Mikkel

    2015-01-01

    among healthcare workers. METHODS: The randomized controlled trial (RCT) comprised 200 female healthcare workers from 18 departments at 3 hospitals. Participants were randomly allocated at the cluster level to ten weeks of: (i) workplace physical exercise (WORK) performed during working hours for 5.......05). Between-group differences at follow-up (WORK versus HOME) was -0.7 points for pain intensity [95% confidence interval (95% CI) -1.0- -0.3], 5.5 Nm for back muscle strength (95% CI 2.0-9.0), and -0.4 days per week for use of analgesics (95% CI -0.7- -0.2). The effect size for between-group differences...... intensity (0-10 scale) in the low back and neck/shoulder was the primary outcome. RESULTS: Per week, 2.2 (SD 1.1) and 1.0 (SD 1.2) training sessions were performed in WORK and HOME groups, respectively. Pain intensity, back muscle strength and use of analgesics improved more following WORK than HOME (P

  6. A national survey of the impact of rapid scale-up of antiretroviral therapy on health-care workers in Malawi: effects on human resources and survival.

    Science.gov (United States)

    Makombe, Simon D; Jahn, Andreas; Tweya, Hannock; Chuka, Stuart; Yu, Joseph Kwong-Leung; Hochgesang, Mindy; Aberle-Grasse, John; Pasulani, Olesi; Schouten, Erik J; Kamoto, Kelita; Harries, Anthony D

    2007-11-01

    To assess the human resources impact of Malawis rapidly growing antiretroviral therapy (ART) programme and balance this against the survival benefit of health-care workers who have accessed ART themselves. We conducted a national cross-sectional survey of the human resource allocation in all public-sector health facilities providing ART in mid-2006. We also undertook a survival analysis of health-care workers who had accessed ART in public and private facilities by 30 June 2006, using data from the national ART monitoring and evaluation system. By 30 June 2006, 59 581 patients had accessed ART from 95 public and 28 private facilities. The public sites provided ART services on 2.4 days per week on average, requiring 7% of the clinician workforce, 3% of the nursing workforce and 24% of the ward clerk workforce available at the facilities. We identified 1024 health-care workers in the national ART-patient cohort (2% of all ART patients). The probabilities for survival on ART at 6 months, 12 months and 18 months were 85%, 81% and 78%, respectively. An estimated 250 health-care workers lives were saved 12 months after ART initiation. Their combined work-time of more than 1000 staff-days per week was equivalent to the human resources required to provide ART at the national level. A large number of ART patients in Malawi are managed by a small proportion of the health-care workforce. Many health-care workers have accessed ART with good treatment outcomes. Currently, staffing required for ART balances against health-care workers lives saved through treatment, although this may change in the future.

  7. Rate of Compliance with Hand Hygiene by Dental Healthcare Personnel (DHCP) within a Dentistry Healthcare First Aid Facility.

    Science.gov (United States)

    de Amorim-Finzi, Marcília Batista; Cury, Mauro Vieira Cezar; Costa, Cláudio Rodrigues R; Dos Santos, Angelis Costa; de Melo, Geraldo Batista

    2010-07-01

    To evaluate the compliance with the opportunities of hand hygiene by dentistry school healthcare professionals, as well as the higher choice products. Through direct observation, the oral healthcare team-professors, oral and maxillofacial surgery residents, graduation students-for daily care were monitored: before performing the first treatment of the shift, after snacks and meals, and after going to the bathroom (initial opportunities) as well as between patients' care, and after ending the shift (following opportunities). The professors' category profited 78.4% of all opportunities while residents and graduation students did not reach 50.0% of compliance. Statistically significant data (Pwater and soap (82.2%), followed by 70% alcohol (10.2%), and both (7.6%). Although gloves were worn in all procedures, we concluded that the hygiene compliance by these professionals was under the expectation.

  8. Substance Use in Healthcare Workers: Importance of Stress Perception, Smoking Temptation, Social Support, and Humor.

    Science.gov (United States)

    Ramos, Stephen Daniel; Kelly, Morgan; Schepis, Ty

    2018-04-16

    Research indicates healthcare workers' personal substance use may affect quality of care. Investigating factors that correlate with coping through substance use may provide insight into improving quality care. This study aims to examine potential correlates of coping through substance use among healthcare workers, with a particular focus on humor, social support, stress perception, and smoking temptation. Participants, recruited from healthcare facilities, anonymously completed a 30-minute questionnaire of psychometrically valid measurements. In a sample of primarily female (75.7%), age 20-39 (74.8%), floor staff (i.e., doctors, nurses, technicians/assistants; 61.2%), perceived stress [β = .036, t(98) = 2.55, p = .012], smoking temptation [β = .036, t(98) = 2.21, p = .030], and coping through humor [β = .163, t(98) = 2.033, p = .045] were significant correlates of the coping through substance use, with all relationships positively co-varying. Social support at work did not predict coping through substance use [β = -.032, t(98) = -.814, p > .05]. Furthermore, negative affect/situation smoking temptation was associated with increased coping through substance use [β = .246, t(99) = 2.859, p = .005] and habit/craving temptation was associated with decreased coping through substance use [β = -.260, t(99) = -2.201, p = .030; however, positive affect/social temptation was not [β = .054, t(99) = -.553, p > .05]. Conclusions/Importance: These findings suggest that coping with humor may relate to coping through substance use, while social support at work is either unrelated to coping through substance use in this sample or may not be adequately assessed with the measure used. Consistent with the literature, negative affect/situation was associated with increased coping through substance use. However, habit/craving was negatively predictive. Further research should explore the variables related to coping through substance use among healthcare workers.

  9. Migrant workers’ occupation and healthcare-seeking preferences for TB-suspicious symptoms and other health problems: a survey among immigrant workers in Songkhla province, southern Thailand

    Directory of Open Access Journals (Sweden)

    Naing Tinzar

    2012-10-01

    Full Text Available Abstract Background Much of the unskilled and semi-skilled workforce in Thailand comprises migrant workers from neighbouring countries. While, in principle, healthcare facilities in the host country are open to those migrants registered with the Ministry of Labour, their actual healthcare-seeking preferences and practices, as well as those of unregistered migrants, are not well documented. This study aimed to describe the patterns of healthcare-seeking behaviours of immigrant workers in Thailand, emphasizing healthcare practices for TB-suspicious symptoms, and to identify the role of occupation and other factors influencing these behaviours. Methods A survey was conducted among 614 immigrant factory workers (FW, rubber tappers (RT and construction workers (CW, in which information was sought on socio-demography, history of illness and related healthcare-seeking behaviour. Mixed effects logistic regression modeling was employed in data analysis. Results Among all three occupations, self-medication was the most common way of dealing with illnesses, including the development of TB-suspicious symptoms, for which inappropriate drugs were used. Only for GI symptoms and obstetric problems did migrant workers commonly seek healthcare at modern healthcare facilities. For GI illness, FW preferred to attend the in-factory clinic and RT a private facility over government facilities owing to the quicker service and greater convenience. For RT, who were generally wealthier, the higher cost of private treatment was not a deterrent. CW preferentially chose a government healthcare facility for their GI problems. For obstetric problems, including delivery, government facilities were utilized by RT and CW, but most FW returned to their home country. After adjusting for confounding, having legal status in the country was associated with overall greater use of government facilities and being female and being married with use of both types of modern healthcare

  10. Awareness and knowledge of disease surveillance and notification by health-care workers and availability of facility records in Anambra state, Nigeria

    Science.gov (United States)

    Nnebue, Chinomnso C.; Onwasigwe, Chika N.; Adogu, Prosper O. U; Onyeonoro, Ugochukwu U.

    2012-01-01

    Background: Disease surveillance and notification (DSN) is part of the Health Management Information System (HMIS) which comprises databases, personnel, and materials that are organized to collect data which are utilized for informed decision making. The knowledge about DSN is very important for the reporting of notifiable diseases. Objective: The aim of this study is to examine the awareness and knowledge of health-care workers about DSN, and availability of facility records in Anambra State, Nigeria. Materials and Methods: The study was a descriptive cross-sectional one in which relevant data were collected from health-care workers selected by a multistage sampling technique. Qualitative information was also elicited by key informant interviews, whereas an observational checklist, preceded by a desk review was used to examine the availability of facility records. Results: Although 89.8% of the health-care workers were aware of the DSN system, only 33.3, 31.1, and 33.7% of them knew the specific uses of forms IDSR 001, IDSR 002, and IDSR 003 (IDSR: Integrated Diseases Surveillance and Response), respectively. Knowledge of use of the various forms at the facility and local government area (LGA) levels were generally low, although the observational checklist revealed that IDSR 001 and IDSR 002 forms were predominantly found in primary health-care facilities. HMIS forms were less likely to be available in secondary health-care facilities (χ2=7.67, P=0.005). Conclusions: Regular training and retraining of concerned health-care workers on DSN at the LGA level is recommended. This should run concurrently with adequate and regular provision of IDSR forms, copies of the standard case definitions, and other necessary logistics to the health-care facilities by the local and state governments. PMID:23661882

  11. Workplace Violence and Job Performance among Community Healthcare Workers in China: The Mediator Role of Quality of Life.

    Science.gov (United States)

    Lin, Wei-Quan; Wu, Jiang; Yuan, Le-Xin; Zhang, Sheng-Chao; Jing, Meng-Juan; Zhang, Hui-Shan; Luo, Jia-Li; Lei, Yi-Xiong; Wang, Pei-Xi

    2015-11-20

    To explore the impact of workplace violence on job performance and quality of life of community healthcare workers in China, especially the relationship of these three variables. From December 2013 to April 2014, a total of 1404 healthcare workers were recruited by using the random cluster sampling method from Community Health Centers in Guangzhou and Shenzhen. The workplace violence scale, the job performance scale and the quality of life scale (SF-36) were self-administered. The structural equation model constructed by Amos 17.0 was employed to assess the relationship among these variables. Our study found that 51.64% of the respondents had an experience of workplace violence. It was found that both job performance and quality of life had a negative correlation with workplace violence. A positive association was identified between job performance and quality of life. The path analysis showed the total effect (β = -0.243) of workplace violence on job performance consisted of a direct effect (β = -0.113) and an indirect effect (β = -0.130), which was mediated by quality of life. Workplace violence among community healthcare workers is prevalent in China. The workplace violence had negative effects on the job performance and quality of life of CHCs' workers. The study suggests that improvement in the quality of life may lead to an effective reduction of the damages in job performance caused by workplace violence.

  12. Prevalence of Escherichia Coli O157:H7 and Enterobacteriaceae on Hands of Workers in Halal Cattle Abattoirs in Peninsular Malaysia

    Science.gov (United States)

    Shamsul, Bahri Mohd Tamrin; Adamu, Muhammad Tukur; Mohd Desa, Mohd Nasir; Khairani-Bejo, Siti

    2016-01-01

    Background Several occupational diseases of multiple origins are encountered among abattoir workers. Presence of indicator microorganisms (coliforms) on hands of workers can be used a gauge for hygienic practices. Methods A cross-sectional study was performed to assess the prevalence of E.coli and enterobacteriaceae among Halal abattoir workers in some government halal abattoirs of Malaysia. A total of one hundred and sixty-five hand swab samples were collected from workers of Halal abattoirs in Malaysia. The samples were subjected to microbiological analysis for characterisation and serotyping. Results The results have shown that no Escherichia coli O157:H7 was isolated on the hands of abattoir workers before and after work. However, a total prevalence of 9.7% was recorded for all samples during work. For non-O157:H7, total prevalence of 33.3% during work and 13% after work were obtained. High prevalence was recorded in sample taken during work from Tampin, Jasin and Kemaman (100% each) while low prevalence where observed in Shah Alam, Banting and Ipoh (20% each). Conclusions Based on the findings the hygienic practices of hand washing among the workers in few locations was found to be low especially after work. PMID:27904427

  13. A consensus for occupational health management of healthcare workers infected with human immunodeficiency virus, hepatitis B virus, and / or hepatitis C virus.

    Science.gov (United States)

    Ishimaru, Tomohiro; Wada, Koji; Smith, Derek R

    2017-05-25

    Occupational health management plays an important role in the prevention of provider-to-patient transmission in healthcare workers infected with human immunodeficiency virus (HIV), hepatitis B virus (HBV), and/or hepatitis C virus (HCV). Therefore, the Japan Society for Occupational Health's Research Group on Occupational Health for Health Care Workers has proposed a consensus for the management of healthcare workers infected with HIV, HBV, and/or HCV based on recent evidence for each concerned group. The consensus recommends that: (1) employers in medical institutions should establish a policy of respecting the human rights of healthcare workers, management strategies for occupational blood exposure, and occupational health consultation; (2) occupational health staff should appropriately assess the risk of provider-to-patient transmission of HIV, HBV, and/or HCV infection and rearrange their tasks if necessary. When conducting risk assessment, occupational health staff should obtain informed consent and then cooperate with the physician in charge as well as infection control experts in the workplace; (3) healthcare workers infected with HIV, HBV, and/or HCV should disclose their employment to their treating physician and consult with their doctor regarding the need for special considerations at work; and (4) supervisors and colleagues in medical institutions should correctly understand the risks of HIV, HBV, and HCV infection and should not engage in any behavior that leads to discrimination against colleagues infected with HIV, HBV, and/or HCV.

  14. Cultivating secondary traumatic growth among healthcare workers: the role of social support and self-efficacy.

    Science.gov (United States)

    Shoji, Kotaro; Bock, Judith; Cieslak, Roman; Zukowska, Katarzyna; Luszczynska, Aleksandra; Benight, Charles C

    2014-09-01

    This 2-study longitudinal investigation examined the indirect effects of secondary traumatic stress (STS) on secondary traumatic growth via two mediators: perceived social support and secondary trauma self-efficacy. In particular, we tested if the 2 hypothetical mediators operate sequentially, that is, with secondary trauma self-efficacy facilitating social support (i.e., cultivation hypothesis) and/or social support enhancing self-efficacy (i.e., enabling hypothesis). Participants in Study 1 (N = 293 at Time 1, N = 115 at Time 2) were behavioral healthcare providers working with U.S. military personnel suffering from trauma. Study 2 was conducted among Polish healthcare workers (N = 298 at Time 1, N = 189 at Time 2) providing services for civilian survivors of traumatic events. In both studies, multiple mediational analyses showed evidence for the cultivation hypothesis. The relationship between STS at Time 1 and secondary traumatic growth at Time 2 was mediated sequentially by secondary trauma self-efficacy at Time 1 and social support at Time 2. The enabling hypothesis was not supported. Education and development programs for healthcare workers may benefit from boosting self-efficacy with the intent to facilitate perceived social support. © 2014 Wiley Periodicals, Inc.

  15. Nasal carriage rate of methicillin resistant Staphylococcus aureus among Iranian healthcare workers: a systematic review and meta-analysis.

    Science.gov (United States)

    Emaneini, Mohammad; Jabalameli, Fereshteh; Rahdar, Hosseinali; Leeuwen, Willem B van; Beigverdi, Reza

    2017-01-01

    Globally, methicillin-resistant Staphylococcus aureus (MRSA) remains a major cause of healthcare-associated infections. Healthcare workers (HCWs), patients and the environment may act as reservoirs for the spread of MRSA to patients and other HCWs. Screening and eradication of MRSA colonization is an effective method of reducing the MRSA infection rate. There are limited data on the prevalence of MRSA among Iranian HCWs. We performed a systematic search by using different electronic databases including Medline (via PubMed), Embase, Web of Science, and Iranian Databases (from January 2000 to July 2016). Meta-analysis was performed using the Comprehensive Meta-Analysis (Biostat V2.2) software. The meta-analyses showed that the prevalence of S. aureus and MRSA among HCWs were 22.7% [95% confidence interval (CI): 19.3-26.6] and 32.8% (95% CI: 26.0-40.4) respectively. The high rate of nasal MRSA carriage among Iranian HCWs has been attributed to poor compliance to hand hygiene, injudicious use of antibiotics, and ineffective infection control and prevention measures. The rational use of antibiotics plus strict infection control are the main pillars for controlling multidrug resistant microorganisms such as MRSA in the hospital setting. These measurements should be applied nationally.

  16. The Prevalence Of Careers And Microbial Spectrum Of Health Care Worker,s Hand And Relation Between Detergent Used For Washing

    Directory of Open Access Journals (Sweden)

    Khodada A

    2004-09-01

    Full Text Available Background: Many of hospital acquired infections that cause so much morbidity and mortality and have great economical burden are transmitted via contaminated hands of health care workers (HCW.Prevalence of these infections can decrease up to 30% with hygienic measures. In this study we assessed the prevalence of careers and microbial spectrum of HCW,s hand and relation between detergent used for washing and reduction of microbial load of HCW, s hand. Materials and Methods: This study was done in two part: Descriptive part (cross sectional and analytical part (before –after. Cases were Consist of all staff Working in wards of center of pediatrics hospital (Including attends, residents, interns, nurses and workers. In first part ,we assess hand microbial spectrum and contamination load of 72 staff and in second part, we assessed and compared hand microbial spectrum and load before and after of washing with four detergent : plain soap (60 staff , liquid soap (60 staff , betadin scrub in ward (60 staff and betadin scrub in operating room manner (26 staff. Results: %87.5 of personnel had positive cultures-.The most prevalent bacteria were staph. epidermidis (%79.4, staph. oreus (%42.9, klebsiella (%12.7, E-coli (%12.7. The rate of reduction or negative cultures in groups used betadin were greater than the first two group (P-value <0/05.Thirty staff (10 with plain soap,10 with liquid soap and 10 with operating room betadin scrub dried their hands after washing. Forty percent of first, fifty percent of second and ninety percent of third group have negative culture after drying. Also 11 samples were drawn from faucets that all of them were positive. Conclusion: Prevalence of careers is high among HCWS and drying of hands can an important role in hospital infection rate. Faucets have heavy contamination and can transmit bacteria to hands after washing. For theses reasons education and of staff to correct hand washing and drying before every contact

  17. The challenges of training, support and assessment of healthcare support workers: A qualitative study of experiences in three English acute hospitals.

    Science.gov (United States)

    Sarre, Sophie; Maben, Jill; Aldus, Clare; Schneider, Justine; Wharrad, Heather; Nicholson, Caroline; Arthur, Antony

    2018-03-01

    Ever-growing demands on care systems have increased reliance on healthcare support workers. In the UK, their training has been variable, but organisation-wide failures in care have prompted questions about how this crucial section of the workforce should be developed. Their training, support and assessment has become a policy priority. This paper examines: healthcare support workers' access to training, support and assessment; perceived gaps in training provision; and barriers and facilitators to implementation of relevant policies in acute care. We undertook a qualitative study of staff caring for older inpatients at ward, divisional or organisational-level in three acute National Health Service hospitals in England in 2014. 58 staff working with older people (30 healthcare support workers and 24 staff managing or working alongside them) and 4 healthcare support worker training leads. One-to-one semi-structured interviews included: views and experiences of training and support; translation of training into practice; training, support and assessment policies and difficulties of implementing them. Transcripts were analysed to identify themes. Induction training was valued, but did not fully prepare healthcare support workers for the realities of the ward. Implementation of hospital policies concerning supervision and formal assessment of competencies varied between and within hospitals, and was subject to availability of appropriate staff and competing demands on staff time. Gaps identified in training provision included: caring for people with cognitive impairment; managing the emotions of patients, families and themselves; and having difficult conversations. Access to ongoing training was affected by: lack of time; infrequent provision; attitudes of ward managers to additional support workforce training, and their need to balance this against patients' and other staff members' needs; and the use of e-learning as a default mode of training delivery. With the

  18. Successful implementation of the World Health Organization hand hygiene improvement strategy in a referral hospital in Mali, Africa.

    Science.gov (United States)

    Allegranzi, Benedetta; Sax, Hugo; Bengaly, Loséni; Richet, Hervé; Minta, Daouda K; Chraiti, Marie-Noelle; Sokona, Fatoumata Maiga; Gayet-Ageron, Angèle; Bonnabry, Pascal; Pittet, Didier

    2010-02-01

    To assess the feasibility and effectiveness of the World Health Organization hand hygiene improvement strategy in a low-income African country. A before-and-after study from December 2006 through June 2008, with a 6-month baseline evaluation period and a follow-up period of 8 months from the beginning of the intervention. University Hospital, Bamako, Mali. Participants. Two hundred twenty-four healthcare workers. The intervention consisted of introducing a locally produced, alcohol-based handrub; monitoring hand hygiene compliance; providing performance feedback; educating staff; posting reminders in the workplace; and promoting an institutional safety climate according to the World Health Organization multimodal hand hygiene improvement strategy. Hand hygiene infrastructure, compliance, healthcare workers' knowledge and perceptions, and handrub consumption were evaluated at baseline and at follow-up. Severe deficiencies in the infrastructure for hand hygiene were identified before the intervention. Local handrub production and quality control proved to be feasible, affordable, and satisfactory. At follow-up, handrubbing was the quasi-exclusive hand hygiene technique (93.3%). Compliance increased from 8.0% at baseline to 21.8% at follow-up (P appreciation of each strategy component by staff. Multimodal hand hygiene promotion is feasible and effective in a low-income country. Access to handrub was critical for its success. These findings motivated the government of Mali to expand the intervention nationwide. This experience represents a significant advancement for patient safety in developing countries.

  19. Closing the gap: training for healthcare workers and people with disabilities on the interrelationship of HIV and disability.

    Science.gov (United States)

    Hanass-Hancock, Jill; Alli, Farzana

    2015-01-01

    HIV and disability are interrelated providing a double burden to HIV endemic countries in East and Southern Africa and their already fragile health systems. Although literature reveals that people with disabilities are particularly vulnerable to HIV and that HIV, its opportunistic infections and treatments can cause disability, only few interventions target this issue and none have been evaluated in this region. Formative evaluation was undertaken with regard to the effectiveness of a workshop-based intervention for healthcare workers and people with disabilities on the intersection of disability and HIV in order to inform the further development of this intervention. The formative evaluation assessed participants' perception of the inclusion of disability in HIV services and of opportunities to initiate change after the workshops. It also captured their experiences in utilising knowledge and skills after the workshops using quantitative (short checklist and ranking exercise) and qualitative (semi-structured interviews) methods of inquiry. Frequencies and conventional content analysis were used in the analysis of the data. This study presents an example of applied research conducted under real-world conditions. 60 healthcare workers and people with disabilities took part in this pilot workshop training and participated in the formative evaluation. Healthcare workers and people with disabilities alike identified various barriers to access health services. Reasonable accommodation was perceived as being mainly absent by most participants, while some participants indicated a lack of physical accessibility in the form of universal design. Participants also identified a lack of integration of services and disability-related skills within the healthcare staff. Participants reported a number of enablers, success and challenges while implementing the knowledge from the workshops related to structural issues, service provision and integration. While participants worked on

  20. Access to and utilisation of healthcare services by sex workers at truck-stop clinics in South Africa: A case study

    NARCIS (Netherlands)

    Fobosi, S. C.; Lalla-Edward, S. T.; Ncube, S.; Buthelezi, F.; Matthew, P.; Kadyakapita, A.; Slabbert, M.; Hankins, C. A.; Venter, W. D. F.; Gomez, G. B.

    2017-01-01

    Background. Sex worker-specific health services aim to respond to the challenges that this key population faces in accessing healthcare. These services aim to integrate primary healthcare (PHC) interventions, yet most services tend to focus on prevention of HIV and sexually transmitted infections

  1. Knowledge about childhood autism and opinion among healthcare workers on availability of facilities and law caring for the needs and rights of children with childhood autism and other developmental disorders in Nigeria.

    Science.gov (United States)

    Bakare, Muideen O; Ebigbo, Peter O; Agomoh, Ahamefule O; Eaton, Julian; Onyeama, Gabriel M; Okonkwo, Kevin O; Onwukwe, Jojo U; Igwe, Monday N; Orovwigho, Andrew O; Aguocha, Chinyere M

    2009-02-12

    In designing programs to raise the community level of awareness about childhood autism in sub-Saharan Africa, it is logical to use the primary healthcare workers as contact point for education of the general public. Tertiary healthcare workers could play the role of trainers on childhood autism at primary healthcare level. Assessing their baseline knowledge about childhood autism to detect areas of knowledge gap is an essential ingredient in starting off such programs that would be aimed at early diagnosis and interventions. Knowledge of the healthcare workers on availability of facilities and law that would promote the required interventions is also important. This study assessed the baseline knowledge about childhood autism and opinion among Nigerian healthcare workers on availability of facilities and law caring for the needs and rights of children with childhood autism and other developmental disorders. A total of one hundred and thirty four (134) consented healthcare workers working in tertiary healthcare facilities located in south east and south-south regions of Nigeria were interviewed with Socio-demographic, Knowledge about Childhood Autism among Health Workers (KCAHW) and Opinion on availability of Facilities and Law caring for the needs and rights of children with Childhood Autism and other developmental disorders (OFLCA) questionnaires. The total mean score of participated healthcare workers on KCAHW questionnaire was 12.35 +/- 4.40 out of a total score of 19 possible. Knowledge gap was found to be higher in domain 3 (symptoms of obsessive and repetitive pattern of behavior), followed by domains 1 (symptoms of impairments in social interaction), 4 (type of disorder autism is and associated co-morbidity) and 2 (symptoms of communication impairments) of KCAHW respectively among the healthcare workers. Knowledge about childhood autism (KCA) as measured by scores on KCAHW questionnaire was significantly associated with age group distribution of the

  2. Knowledge about childhood autism and opinion among healthcare workers on availability of facilities and law caring for the needs and rights of children with childhood autism and other developmental disorders in Nigeria

    Directory of Open Access Journals (Sweden)

    Igwe Monday N

    2009-02-01

    Full Text Available Abstract Background In designing programs to raise the community level of awareness about childhood autism in sub-Saharan Africa, it is logical to use the primary healthcare workers as contact point for education of the general public. Tertiary healthcare workers could play the role of trainers on childhood autism at primary healthcare level. Assessing their baseline knowledge about childhood autism to detect areas of knowledge gap is an essential ingredient in starting off such programs that would be aimed at early diagnosis and interventions. Knowledge of the healthcare workers on availability of facilities and law that would promote the required interventions is also important. This study assessed the baseline knowledge about childhood autism and opinion among Nigerian healthcare workers on availability of facilities and law caring for the needs and rights of children with childhood autism and other developmental disorders. Method A total of one hundred and thirty four (134 consented healthcare workers working in tertiary healthcare facilities located in south east and south-south regions of Nigeria were interviewed with Socio-demographic, Knowledge about Childhood Autism among Health Workers (KCAHW and Opinion on availability of Facilities and Law caring for the needs and rights of children with Childhood Autism and other developmental disorders (OFLCA questionnaires. Results The total mean score of participated healthcare workers on KCAHW questionnaire was 12.35 ± 4.40 out of a total score of 19 possible. Knowledge gap was found to be higher in domain 3 (symptoms of obsessive and repetitive pattern of behavior, followed by domains 1 (symptoms of impairments in social interaction, 4 (type of disorder autism is and associated co-morbidity and 2 (symptoms of communication impairments of KCAHW respectively among the healthcare workers. Knowledge about childhood autism (KCA as measured by scores on KCAHW questionnaire was significantly

  3. Supportive supervision and constructive relationships with healthcare workers support CHW performance: Use of a qualitative framework to evaluate CHW programming in Uganda.

    Science.gov (United States)

    Ludwick, Teralynn; Turyakira, Eleanor; Kyomuhangi, Teddy; Manalili, Kimberly; Robinson, Sheila; Brenner, Jennifer L

    2018-02-13

    While evidence supports community health worker (CHW) capacity to improve maternal and newborn health in less-resourced countries, key implementation gaps remain. Tools for assessing CHW performance and evidence on what programmatic components affect performance are lacking. This study developed and tested a qualitative evaluative framework and tool to assess CHW team performance in a district program in rural Uganda. A new assessment framework was developed to collect and analyze qualitative evidence based on CHW perspectives on seven program components associated with effectiveness (selection; training; community embeddedness; peer support; supportive supervision; relationship with other healthcare workers; retention and incentive structures). Focus groups were conducted with four high/medium-performing CHW teams and four low-performing CHW teams selected through random, stratified sampling. Content analysis involved organizing focus group transcripts according to the seven program effectiveness components, and assigning scores to each component per focus group. Four components, 'supportive supervision', 'good relationships with other healthcare workers', 'peer support', and 'retention and incentive structures' received the lowest overall scores. Variances in scores between 'high'/'medium'- and 'low'-performing CHW teams were largest for 'supportive supervision' and 'good relationships with other healthcare workers.' Our analysis suggests that in the Bushenyi intervention context, CHW team performance is highly correlated with the quality of supervision and relationships with other healthcare workers. CHWs identified key performance-related issues of absentee supervisors, referral system challenges, and lack of engagement/respect by health workers. Other less-correlated program components warrant further study and may have been impacted by relatively consistent program implementation within our limited study area. Applying process-oriented measurement tools are

  4. Economic impact of hand and wrist injuries: Health-care costs and productivity costs in a population-based study

    NARCIS (Netherlands)

    C.E. de Putter (Dennis); R.W. Selles (Ruud); S. Polinder (Suzanne); M.J.M. Panneman (Martien); S.E.R. Hovius (Steven); E.F. van Beeck (Ed)

    2012-01-01

    textabstractBackground: Injuries to the hand and wrist account for approximately 20% of patient visits to emergency departments and may impose a large economic burden. The purpose of this study was to estimate the total health-care costs and productivity costs of injuries to the hand and wrist and

  5. The web of silence: a qualitative case study of early intervention and support for healthcare workers with mental ill-health.

    Science.gov (United States)

    Moll, Sandra E

    2014-02-08

    There is a high rate of stress and mental illness among healthcare workers, yet many continue to work despite symptoms that affect their performance. Workers with mental health issues are typically ostracized and do not get the support that they need. If issues are not addressed, however, they could become worse and compromise the health and safety, not only of the worker, but his/her colleagues and patients. Early identification and support can improve work outcomes and facilitate recovery, but more information is needed about how to facilitate this process in the context of healthcare work. The purpose of this study was to explore the key individual and organizational forces that shape early intervention and support for healthcare workers who are struggling with mental health issues, and to identify barriers and opportunities for change. A qualitative, case study in a large, urban healthcare organization was conducted in order to explore the perceptions and experiences of employees across the organization. In-depth interviews were conducted with eight healthcare workers who had experienced mental health issues at work as well as eight workplace stakeholders who interacted with workers who were struggling (managers, coworkers, union leaders). An online survey was completed by an additional 67 employees. Analysis of the interviews and surveys was guided by a process of interpretive description to identify key barriers to early intervention and support. There were many reports of silence and inaction in response to employee mental health issues. Uncertainty in identifying mental health problems, stigma regarding mental ill health, a discourse of professional competence, social tensions, workload pressures, confidentiality expectations and lack of timely access to mental health supports were key forces in preventing employees from getting the help that they needed. Although there were a few exceptions, the overall study findings point to many barriers to supporting

  6. The web of silence: a qualitative case study of early intervention and support for healthcare workers with mental ill-health

    Science.gov (United States)

    2014-01-01

    Background There is a high rate of stress and mental illness among healthcare workers, yet many continue to work despite symptoms that affect their performance. Workers with mental health issues are typically ostracized and do not get the support that they need. If issues are not addressed, however, they could become worse and compromise the health and safety, not only of the worker, but his/her colleagues and patients. Early identification and support can improve work outcomes and facilitate recovery, but more information is needed about how to facilitate this process in the context of healthcare work. The purpose of this study was to explore the key individual and organizational forces that shape early intervention and support for healthcare workers who are struggling with mental health issues, and to identify barriers and opportunities for change. Methods A qualitative, case study in a large, urban healthcare organization was conducted in order to explore the perceptions and experiences of employees across the organization. In-depth interviews were conducted with eight healthcare workers who had experienced mental health issues at work as well as eight workplace stakeholders who interacted with workers who were struggling (managers, coworkers, union leaders). An online survey was completed by an additional 67 employees. Analysis of the interviews and surveys was guided by a process of interpretive description to identify key barriers to early intervention and support. Results There were many reports of silence and inaction in response to employee mental health issues. Uncertainty in identifying mental health problems, stigma regarding mental ill health, a discourse of professional competence, social tensions, workload pressures, confidentiality expectations and lack of timely access to mental health supports were key forces in preventing employees from getting the help that they needed. Although there were a few exceptions, the overall study findings point to

  7. Attitudes, knowledge and practices of healthcare workers regarding occupational exposure of pulmonary tuberculosis

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    Lesley T. Bhebhe

    2014-01-01

    Full Text Available Background: Healthcare-associated tuberculosis (TB has become a major occupational hazard for healthcare workers (HCWs. HCWs are inevitably exposed to TB, due to frequent interaction with patients with undiagnosed and potentially contagious TB. Whenever there is a possibility of exposure, implementation of infection prevention and control (IPC practices is critical.Objective: Following a high incidence of TB among HCWs at Maluti Adventist Hospital in Lesotho, a study was carried out to assess the knowledge, attitudes and practices of HCWs regarding healthcare-associated TB infection and infection controls.Methods: This was a cross-sectional study performed in June 2011; it involved HCWs at Maluti Adventist Hospital who were involved with patients and/or sputum. Stratified sampling of 140 HCWs was performed, of whom, 129 (92.0% took part. A self-administered, semi-structured questionnaire was used.Results: Most respondents (89.2% had appropriate knowledge of transmission, diagnosis and prevention of TB; however, only 22.0% of the respondents knew the appropriate method of sputum collection. All of the respondents (100.0% were motivated and willing to implement IPC measures. A significant proportion of participants (36.4% reported poor infection control practices, with the majority of inappropriate practices being the administrative infection controls (> 80.0%. Only 38.8% of the participants reported to be using the appropriate N-95 respirator.Conclusion: Poor infection control practices regarding occupational TB exposure were demonstrated, the worst being the first-line administrative infection controls. Critical knowledge gaps were identified; however, there was encouraging willingness by HCWs to adapt to recommended infection control measures. Healthcare workers are inevitably exposed to TB, due to frequent interaction with patients with undiagnosed and potentially contagious TB. Implementation of infection prevention and control practices is

  8. The relationship between organizational justice and quality performance among healthcare workers: a pilot study.

    Science.gov (United States)

    Mohamed, Salwa Attia

    2014-01-01

    Organization justice refers to the extent to which employees perceive workplace procedure, interactions, and outcomes to be fair in nature. So, this study aimed to investigate the relationship between organizational justice and quality performance among health care workers. The study was conducted at the Public Hospital in Fayoum, Egypt. The study included a convenience sample of 100 healthcare workers (60 nurses and 40 physicians) that were recruited. Tools used for data collection included (1) questionnaire sheet which is used to measure health workers' perception of organizational justices. It includes four types: distributive, procedural, interpersonal, and informational justice. (2) Quality performance questionnaire sheet: this tool was used to examine health workers' perception regarding their quality performance. It contained three types: information, value, and skill. The results revealed that a positive correlation was found between organizational justice components and quality performance among the various categories of health workers' perception (P ≤ 0.05). It has been recommended to replicate the study on a larger probability sample from different hospital settings to achieve more generalizable results and reinforce justice during organization of ministry centers in Egypt.

  9. Workplace Violence and Job Performance among Community Healthcare Workers in China: The Mediator Role of Quality of Life

    Science.gov (United States)

    Lin, Wei-Quan; Wu, Jiang; Yuan, Le-Xin; Zhang, Sheng-Chao; Jing, Meng-Juan; Zhang, Hui-Shan; Luo, Jia-Li; Lei, Yi-Xiong; Wang, Pei-Xi

    2015-01-01

    Objective: To explore the impact of workplace violence on job performance and quality of life of community healthcare workers in China, especially the relationship of these three variables. Methods: From December 2013 to April 2014, a total of 1404 healthcare workers were recruited by using the random cluster sampling method from Community Health Centers in Guangzhou and Shenzhen. The workplace violence scale, the job performance scale and the quality of life scale (SF-36) were self-administered. The structural equation model constructed by Amos 17.0 was employed to assess the relationship among these variables. Results: Our study found that 51.64% of the respondents had an experience of workplace violence. It was found that both job performance and quality of life had a negative correlation with workplace violence. A positive association was identified between job performance and quality of life. The path analysis showed the total effect (β = −0.243) of workplace violence on job performance consisted of a direct effect (β = −0.113) and an indirect effect (β = −0.130), which was mediated by quality of life. Conclusions: Workplace violence among community healthcare workers is prevalent in China. The workplace violence had negative effects on the job performance and quality of life of CHCs’ workers. The study suggests that improvement in the quality of life may lead to an effective reduction of the damages in job performance caused by workplace violence. PMID:26610538

  10. Healthcare workers' challenges in the implementation of tuberculosis infection prevention and control measures in Mozambique

    NARCIS (Netherlands)

    Brouwer, Miranda; Coelho, Eliana; Mosse, Carla das Dores; Brondi, Luciana; Winterton, Laura; van Leth, Frank

    2014-01-01

    Healthcare Workers (HCWs) have a higher frequency of TB exposure than the general population and have therefore an occupational TB risk that infection prevention and control (IPC) measures aim to reduce. HCWs are crucial in the implementation of these measures. The objective of the study was to

  11. [The contribution of indigenous community health workers to special healthcare for Brazilian indigenous peoples].

    Science.gov (United States)

    Diehl, Eliana Elisabeth; Langdon, Esther Jean; Dias-Scopel, Raquel Paiva

    2012-05-01

    Indigenous community health workers are part of a strategy developed by Brazil in the last two decades to promote a special healthcare model for indigenous peoples. Their role is designed to deal with various aspects of the special health policy, including the link between the heath team and the community and mediation between scientific and indigenous medical knowledge. Despite a significant increase in the number of indigenous community health workers in recent years, an evaluation of their responsibilities and contributions to the success of special care had not been conducted previously. This article, based on a literature review and original research by the authors, analyzes the role of the indigenous community health workers vis-à-vis their training and participation in health teams in different contexts in Brazil. Considering the importance assigned to the role of indigenous community health workers, this analysis reveals various ambiguities and contradictions that hinder both their performance and their potential contribution to the special health services.

  12. Estimation of sickness absenteeism among Italian healthcare workers during seasonal influenza epidemics.

    Directory of Open Access Journals (Sweden)

    Maria Michela Gianino

    Full Text Available To analyze absenteeism among healthcare workers (HCWs at a large Italian hospital and to estimate the increase in absenteeism that occurred during seasonal flu periods.Retrospective observational study.The absenteeism data were divided into three "epidemic periods," starting at week 42 of one year and terminating at week 17 of the following year (2010-2011, 2011-2012, 2012-2013, and three "non-epidemic periods," defined as week 18 to week 41 and used as baseline data. The excess of the absenteeism occurring among HCWs during periods of epidemic influenza in comparison with baseline was estimated. All data, obtained from Hospital's databases, were collected for each of the following six job categories: medical doctors, technical executives (i.e., pharmacists, nurses and allied health professionals (i.e., radiographers, other executives (i.e., engineers, nonmedical support staff, and administrative staff. The HCWs were classified by: in and no-contact; vaccinated and unvaccinated.5,544, 5,369, and 5,291 workers in three years were studied. The average duration of absenteeism during the epidemic periods increased among all employees by +2.07 days/person (from 2.99 to 5.06, and the relative increase ranged from 64-94% among the different job categories. Workers not in contact with patients experienced a slightly greater increase in absenteeism (+2.28 days/person, from 2.73 to 5.01 than did employees in contact with patients (+2.04, from 3.04 to 5.08. The vaccination rate among HCWs was below 3%, however the higher excess of absenteeism rate among unvaccinated in comparison with vaccinated workers was observed during the epidemic periods (2.09 vs 1.45 days/person.The influenza-related absenteeism during epidemic periods was quantified as totaling more than 11,000 days/year at the Italian hospital studied. This result confirms the economic impact of sick leave on healthcare systems and stresses on the necessity of encouraging HCWs to be immunized

  13. Estimation of sickness absenteeism among Italian healthcare workers during seasonal influenza epidemics.

    Science.gov (United States)

    Gianino, Maria Michela; Politano, Gianfranco; Scarmozzino, Antonio; Charrier, Lorena; Testa, Marco; Giacomelli, Sebastian; Benso, Alfredo; Zotti, Carla Maria

    2017-01-01

    To analyze absenteeism among healthcare workers (HCWs) at a large Italian hospital and to estimate the increase in absenteeism that occurred during seasonal flu periods. Retrospective observational study. The absenteeism data were divided into three "epidemic periods," starting at week 42 of one year and terminating at week 17 of the following year (2010-2011, 2011-2012, 2012-2013), and three "non-epidemic periods," defined as week 18 to week 41 and used as baseline data. The excess of the absenteeism occurring among HCWs during periods of epidemic influenza in comparison with baseline was estimated. All data, obtained from Hospital's databases, were collected for each of the following six job categories: medical doctors, technical executives (i.e., pharmacists), nurses and allied health professionals (i.e., radiographers), other executives (i.e., engineers), nonmedical support staff, and administrative staff. The HCWs were classified by: in and no-contact; vaccinated and unvaccinated. 5,544, 5,369, and 5,291 workers in three years were studied. The average duration of absenteeism during the epidemic periods increased among all employees by +2.07 days/person (from 2.99 to 5.06), and the relative increase ranged from 64-94% among the different job categories. Workers not in contact with patients experienced a slightly greater increase in absenteeism (+2.28 days/person, from 2.73 to 5.01) than did employees in contact with patients (+2.04, from 3.04 to 5.08). The vaccination rate among HCWs was below 3%, however the higher excess of absenteeism rate among unvaccinated in comparison with vaccinated workers was observed during the epidemic periods (2.09 vs 1.45 days/person). The influenza-related absenteeism during epidemic periods was quantified as totaling more than 11,000 days/year at the Italian hospital studied. This result confirms the economic impact of sick leave on healthcare systems and stresses on the necessity of encouraging HCWs to be immunized against

  14. A systematic review on hand hygiene knowledge and compliance in student nurses.

    Science.gov (United States)

    Labrague, L J; McEnroe-Petitte, D M; van de Mortel, T; Nasirudeen, A M A

    2017-10-27

    Hand hygiene competence is one of the critical outcomes in nursing education. Ensuring nursing students recognize the what, when and how of hand hygiene is critical in the light of the increasing rates of healthcare-associated infections. To systematically appraise and synthesize articles on hand hygiene knowledge and compliance among nursing students. This is a systematic review of scientific articles published from 2006 to 2016. The primary databases used were as follows: PubMed, Embase, Cumulative Index to Nursing & Allied Health Literature, Proquest and PsychINFO. Key search terms utilized were as follows: 'handwashing', 'hand hygiene', 'compliance', 'knowledge', 'practice' and 'nursing students'. Nineteen studies met the review criteria. The findings revealed a low-to-moderate knowledge of and compliance with hand hygiene among nursing students. In addition, there were significantly higher rates of hand hygiene compliance in nursing students when compared to medical students. Relatively few studies attempted to identify predictors of hand hygiene knowledge and compliance. This review demonstrated suboptimal knowledge and compliance to hand hygiene among student nurses. In addition, this review also highlighted the paucity of studies that examined individual and organizational factors, which influence nursing students hand hygiene knowledge and compliance. The findings of this review emphasized the role of nurse educators in enhancing hand hygiene competence in nursing students. Implementation of empirically tested strategies such as utilizing multidimensional interventions, scenario-based hand hygiene simulation activities and hand hygiene education programmes that would enhance nursing students' hand hygiene knowledge and compliance is an asset. Hospital and nursing administrators should ensure continuous support and monitoring to guarantee that hand hygiene programmes are institutionalized in every healthcare setting by every healthcare worker. © 2017

  15. Postincident Support for Healthcare Workers Experiencing Occupational Violence and Aggression.

    Science.gov (United States)

    Shea, Tracey; Cooper, Brian; De Cieri, Helen; Sheehan, Cathy; Donohue, Ross; Lindsay, Sarah

    2018-05-10

    To investigate the relative contributions of workplace type, occupational violence and aggression (OVA) strategies and interventions along with perceptions of the occupational health and safety (OHS) environment on the likelihood of receiving postincident support following the experience of OVA. We used a cross-sectional study design with an online survey to collect data from employees in nursing and midwifery in Victoria, Australia. Survey data collected from 3,072 members of the Australian Nursing and Midwifery Federation (Victorian branch) were analyzed using logistic regression. Of the 3,072 respondents who had experienced OVA in the preceding 12 months, 1,287 (42%) reported that they had received postincident support. Hierarchical logistic regression revealed that the OHS environment was the dominant factor that predicted the likelihood of workers receiving postincident support. Working in a positive OHS environment characterized by higher levels of leading indicators of OHS, prioritization of OHS, supervisor support for safety, and team psychological safety was the stronger predictor of postincident support. Being employed in a workplace that offered training in the management and prevention of OVA also increased the likelihood of receiving postincident support. While training in the management and prevention of OVA contributed to the likelihood of receiving postincident support, a greater emphasis on the OHS environment was more important in predicting the likelihood that workers received support. This study identifies workplace practices that facilitate the provision of postincident support for healthcare workers. Facilitating effective postincident support could improve outcomes for workers, their patients and workplaces, and society in general. © 2018 Sigma Theta Tau International.

  16. Preventing occupational stress in healthcare workers.

    Science.gov (United States)

    Ruotsalainen, Jani H; Verbeek, Jos H; Mariné, Albert; Serra, Consol

    2015-04-07

    Healthcare workers can suffer from occupational stress as a result of lack of skills, organisational factors, and low social support at work. This may lead to distress, burnout and psychosomatic problems, and deterioration in quality of life and service provision. To evaluate the effectiveness of work- and person-directed interventions compared to no intervention or alternative interventions in preventing stress at work in healthcare workers. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PsycINFO, CINAHL, NIOSHTIC-2 and Web of Science up to November 2013. Randomised controlled trials (RCTs) of interventions aimed at preventing psychological stress in healthcare workers. For organisational interventions, interrupted time-series and controlled before-and-after (CBA) studies were also eligible. Two review authors independently extracted data and assessed trial quality. We used Standardised Mean Differences (SMDs) where authors of trials used different scales to measure stress or burnout. We combined studies that were similar in meta-analyses. We used the GRADE system to rate the quality of the evidence. In this update, we added 39 studies, making a total of 58 studies (54 RCTs and four CBA studies), with 7188 participants. We categorised interventions as cognitive-behavioural training (CBT) (n = 14), mental and physical relaxation (n = 21), combined CBT and relaxation (n = 6) and organisational interventions (n = 20). Follow-up was less than one month in 24 studies, one to six in 22 studies and more than six months in 12 studies. We categorised outcomes as stress, anxiety or general health.There was low-quality evidence that CBT with or without relaxation was no more effective in reducing stress symptoms than no intervention at one month follow-up in six studies (SMD -0.27 (95% Confidence Interval (CI) -0.66 to 0.13; 332 participants). But at one to six months follow-up in seven studies (SMD -0.38, 95% CI -0.59 to -0

  17. Assessment of exposure to hand-arm vibration and its related health effects in workers employed in stone cutting workshops of Hamadan city

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    Roya Bayat

    2016-06-01

    Full Text Available Introduction: The workers employed in stone cutting workplace are exposed to hand-arm vibration and its complications. The aim of this study was to evaluate the exposure to hand-arm vibration and its health effects on workers in the stone cutting workshops. Methods: In this descriptive-analytic study, 40 workers of Hamadan city stone cutting who worked with stone cutting machines were examined. Measuring exposure to hand-arm vibration was performed by standard methods ISO 5349. Symptoms related hand-arm vibration syndrome using a questionnaire construction was studied. Data were analyzed using SPSS software. Results: Results showed that 8-hour equivalent acceleration of hand-arm vibration exposure in stonecuttingworkers was exceeds the permissible exposure levels of country (Pv<0.05. Most average hand and arm vibration acceleration was measured in the Z axis. The average vibration acceleration hand-arm and cutting transverse and longitudinal cutting significant difference was observed (Pv<0.05. Conclusion: In regard to exposure level of stone cutting workers compared with the national exposure limit, the training of health care, non-smoking, and use of anti-vibration gloves, work rotations canthe effective in reducing the risk of health effects. Furthermore, it seems essential to track the health effects associated with human vibration by use of screening tests in the work place seem.

  18. Healthcare workers and health care-associated infections: knowledge, attitudes, and behavior in emergency departments in Italy

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    Marinelli Paolo

    2010-02-01

    Full Text Available Abstract Background This survey assessed knowledge, attitudes, and compliance regarding standard precautions about health care-associated infections (HAIs and the associated determinants among healthcare workers (HCWs in emergency departments in Italy. Methods An anonymous questionnaire, self-administered by all HCWs in eight randomly selected non-academic acute general public hospitals, comprised questions on demographic and occupational characteristics; knowledge about the risks of acquiring and/or transmitting HAIs from/to a patient and standard precautions; attitudes toward guidelines and risk perceived of acquiring a HAI; practice of standard precautions; and sources of information. Results HCWs who know the risk of acquiring Hepatitis C (HCV and Human Immunodeficiency Virus (HIV from a patient were in practice from less years, worked fewer hours per week, knew that a HCW can transmit HCV and HIV to a patient, knew that HCV and HIV infections can be serious, and have received information from educational courses and scientific journals. Those who know that gloves, mask, protective eyewear, and hands hygiene after removing gloves are control measures were nurses, provided care to fewer patients, knew that HCWs' hands are vehicle for transmission of nosocomial pathogens, did not know that a HCW can transmit HCV and HIV to a patient, and have received information from educational courses and scientific journals. Being a nurse, knowing that HCWs' hands are vehicle for transmission of nosocomial pathogens, obtaining information from educational courses and scientific journals, and needing information were associated with a higher perceived risk of acquiring a HAI. HCWs who often or always used gloves and performed hands hygiene measures after removing gloves were nurses, provided care to fewer patients, and knew that hands hygiene after removing gloves was a control measure. Conclusions HCWs have high knowledge, positive attitudes, but low

  19. Informal workers and access to healthcare: a qualitative study of facilitators and barriers to accessing healthcare for beer promoters in the Lao People's Democratic Republic.

    Science.gov (United States)

    Sychareun, Vanphanom; Vongxay, Viengnakhone; Thammavongsa, Vassana; Thongmyxay, Souksamone; Phummavongsa, Phouthong; Durham, Jo

    2016-04-18

    Informal workers often face considerable risks and vulnerabilities as a consequence of their work and employment conditions. The purpose of this study was to examine the interplay between the experience of informal work and access to health, using as an example, female beer promoters employed in the informal economy, in the Lao People's Democratic Republic. In-depth interviews were undertaken with 24 female beer promoters working in beer shops, restaurants and entertainment venues in Vientiane City. The recruitment strategy of snowball sampling was used. Interviews explored the beer promoter's experience of the organization of work, perceived healthcare needs, access to healthcare and insurance, and health seeking practices. The data was analysed thematically and subsequently using Bourdieu's concepts of habitus, capital and field. Most of the beer promoters included in the study were 18 years of age, single, had worked as beer promoters for more than one year and just over half were working to support their higher education. The beer promoters demonstrated a holistic view of health, also viewing good health as contributing to being beautiful - an important attribute in their work. Many reported that their work conditions, including the noisy environment, exposure to second-hand tobacco smoke, long hours on their feet and sexual harassment negatively affected their physical and mental health. Only four participants had any form of health insurance with access to healthcare constrained by individual characteristics, health system factors and the conditions of their informal employment. Drawing on the work of Bourdieu, the study shows how both employment and illness are linked to habitus embodied in everyday practices, access to capital and the position the female beer promoters hold in the social hierarchy in the field of employment.

  20. [Overview of sharps injuries among health-care workers].

    Science.gov (United States)

    Gopar-Nieto, Rodrigo; Juárez-Pérez, Cuauhtémoc Arturo; Cabello-López, Alejandro; Haro-García, Luis Cuauhtémoc; Aguilar-Madrid, Guadalupe

    2015-01-01

    Sharps injuries are one of the most frequent health-care related accidents. It is estimated globally that 35 million workers are at risk; in Mexico there is no data available for this type of injuries. They are associated with lack of training, instrument and procedure risk, fatigue and stress. The occupational distribution is nurses 45 %, technicians 20 %, doctors 20 % and maintenance workers 5 %. The most commonly associated procedures are injection, venipuncture, suture, and insertion and manipulation of IV catheters. Hepatitis B is the most commonly transmitted agent. Emotional distress is huge as well as the cost of prophylaxis and follow-up. More than half of the injuries are not notified. The most common reasons for not reporting are: the belief that the exposure has low risk of infection, the lack of knowledge of reporting systems and the assumption that it is difficult to notify. Many strategies have been created to reduce the incidence of sharps injuries, such as: identifying the risk of blood exposure, the creation of politics to minimize the risk, the education and training to create a safe workplace, the enhancing of the reporting system, the use of double-gloving and using safety-engineered sharps devices. In many countries these politics have reduced the incidence of sharps injuries as well as the economic burden.

  1. Preparedness and the importance of meeting the needs of healthcare workers : A qualitative study on Ebola

    NARCIS (Netherlands)

    Belfroid, E.; van Steenbergen, J.; Timen, A.; Ellerbroek, P.; van Huis, A.M.; Hulscher, M.

    Background: Healthcare workers (HCWs) face specific challenges in infectious disease outbreaks, which provide unusual, new events with exposure risk. The fear of infection or new, unknown tasks in an unfamiliar setting, for example, may complicate outbreak management. Aim: To gain insight into how

  2. Human resource for health reform in peri-urban areas: a cross-sectional study of the impact of policy interventions on healthcare workers in Epworth, Zimbabwe.

    Science.gov (United States)

    Taderera, Bernard Hope; Hendricks, Stephen James Heinrich; Pillay, Yogan

    2017-12-16

    The need to understand how healthcare worker reform policy interventions impact health personnel in peri-urban areas is important as it also contributes towards setting of priorities in pursuing the universal health coverage goal of health sector reform. This study explored the impact of post 2008 human resource for health reform policy interventions on healthcare workers in Epworth, a peri-urban community in Harare, Zimbabwe, and the implications towards health sector reform policy in peri-urban areas. The study design was exploratory and cross-sectional and involved the use of qualitative and quantitative methods in data collection, presentation, and analysis. A qualitative study in which data were collected through a documentary search, five key informant interviews, seven in-depth interviews, and five focus group discussions was carried out first. This was followed by a quantitative study in which data were collected through a documentary search and 87 semi-structured sample interviews with healthcare workers. Qualitative data were analyzed thematically whilst descriptive statistics were used to examine quantitative data. All data were integrated during analysis to ensure comprehensive, reliable, and valid analysis of the dataset. Three main factors were identified to help interpret findings. The first main factor consisted policy result areas that impacted most successfully on healthcare workers. These included the deployment of community health workers with the highest correlation of 0.83. Policy result areas in the second main factor included financial incentives with a correlation of 0.79, training and development (0.77), deployment (0.77), and non-financial incentives (0.75). The third factor consisted policy result areas that had the lowest satisfaction amongst healthcare workers in Epworth. These included safety (0.72), equipment and tools of trade (0.72), health welfare (0.65), and salaries (0.55). The deployment of community health volunteers impacted

  3. Knowledge and Risk Perceptions of Occupational Infections Among Health-care Workers in Malaysia

    OpenAIRE

    Subramanian, Ganesh Chidambar; Arip, Masita; Saraswathy Subramaniam, T.S.

    2017-01-01

    Health-care workers are at risk of exposure to occupational infections with subsequent risk of contracting diseases, disability, and even death. A systematic collection of occupational disease data is useful for monitoring current trends in work situations and disease exposures; however, these data are usually limited due to under-reporting. The objective of this study was to review literature related to knowledge, risk perceptions, and practices regarding occupational exposures to infectious...

  4. Importance of hand germ contamination in health-care workers as possible carriers of nosocomial infections Importância da contaminação das mãos por germes, em trabalhadores da saúde, como possíveis transmissores de infecções hospitalares

    Directory of Open Access Journals (Sweden)

    Mónica NOGUERAS

    2001-06-01

    Full Text Available The importance of hands in the transmission of nosocomial infection has been world wide admitted. However, it is difficult to induce this behavior in health-care workers. The aim of the present work was to point out the importance of hand bacteria colonization, the influence of hand washing and of patient physical examination. One hundred health-care workers were randomly divided in two groups: Group A without hand washing previous to patient physical examination or handling (PPE; group B with hand washing previous to PPE. Direct fingerprint samples in Columbia agar before and after PPE were obtained. The colonies were counted and identified by conventional techniques, and antibiograms according to NCCLS were performed. Before PPE group A participants showed a high number of bacteria regarding group B participants (73.9 Vs 20.7; p A importância das mãos na transmissão de infecções hospitalares é aceita mundialmente. Todavia, é difícil introduzir este procedimento entre os trabalhadores da saúde. Este trabalho pretendeu evidenciar a colonização das mãos por bactérias e a influência da lavagem de mãos e o exame físico dos pacientes. 100 profisionais de saúde foram divididos, ao acaso em dois grupos: A - sem lavagem de mãos antes do exame físico ou manejo dos pacientes (PPE; B - com lavagem prévia das mãos antes do PPE. Foram obtidas amostras de impressões digitais em agar Columbia antes e depois do PPE. As colônias foram contadas e identificadas por técnicas convencionais e antibiogramas de acordo com NCCLS. Antes do PPE os participantes do grupo A apresentaram elevado número de bactérias em relação ao grupo B (73.9 vs. 20.7; p < 0.001; 44 dos 50 participantes eram portadores potenciais de bactérias patogênicas. Nenhum participante do grupo B era portador de bactéria potencialmente patogênica antes do PPE. Este grupo mostrou um aumento no número de bactérias depois do PPE (20.7 UFC antes vs. 115.9 UFC depois; p

  5. Hand hygiene noncompliance and the cost of hospital-acquired methicillin-resistant Staphylococcus aureus infection.

    Science.gov (United States)

    Cummings, Keith L; Anderson, Deverick J; Kaye, Keith S

    2010-04-01

    Hand hygiene noncompliance is a major cause of nosocomial infection. Nosocomial infection cost data exist, but the effect of hand hygiene noncompliance is unknown. To estimate methicillin-resistant Staphylococcus aureus (MRSA)-related cost of an incident of hand hygiene noncompliance by a healthcare worker during patient care. Two models were created to simulate sequential patient contacts by a hand hygiene-noncompliant healthcare worker. Model 1 involved encounters with patients of unknown MRSA status. Model 2 involved an encounter with an MRSA-colonized patient followed by an encounter with a patient of unknown MRSA status. The probability of new MRSA infection for the second patient was calculated using published data. A simulation of 1 million noncompliant events was performed. Total costs of resulting infections were aggregated and amortized over all events. Duke University Medical Center, a 750-bed tertiary medical center in Durham, North Carolina. Model 1 was associated with 42 MRSA infections (infection rate, 0.0042%). Mean infection cost was $47,092 (95% confidence interval [CI], $26,040-$68,146); mean cost per noncompliant event was $1.98 (95% CI, $0.91-$3.04). Model 2 was associated with 980 MRSA infections (0.098%). Mean infection cost was $53,598 (95% CI, $50,098-$57,097); mean cost per noncompliant event was $52.53 (95% CI, $47.73-$57.32). A 200-bed hospital incurs $1,779,283 in annual MRSA infection-related expenses attributable to hand hygiene noncompliance. A 1.0% increase in hand hygiene compliance resulted in annual savings of $39,650 to a 200-bed hospital. Hand hygiene noncompliance is associated with significant attributable hospital costs. Minimal improvements in compliance lead to substantial savings.

  6. A multimodal intervention to improve hand hygiene in ICUs in Buenos Aires, Argentina: a stepped wedge trial.

    Science.gov (United States)

    Rodriguez, Viviana; Giuffre, Carolina; Villa, Silvia; Almada, Griselda; Prasopa-Plaizier, Nittita; Gogna, Monica; Gibbons, Luz; García Elorrio, Ezequiel

    2015-10-01

    Hand hygiene is a cost-effective measure to reduce microbial transmission (Teare EL, Cookson B, French GL, et al. UK handwashing initiative. J Hosp Infect. 1999;43:1-3.) and is considered to be the most important measure to prevent healthcare-associated infections (Pittet D, Allegranzi B, Sax H, Evidence-based model for hand transmission during patient care and the role of improved practices. Lancet Infect Dis 2006;6:641-52). Unfortunately, the compliance rate of healthcare workers (HCWs) with recommended hand hygiene procedures is less than expected. In order to estimate the effect of a multimodal intervention on improving healthcare workers' compliance with hand hygiene in eleven intensive care units (ICUs) from 11 hospitals of Buenos Aires, a randomized cluster-stepped wedge trial was designed. A multimodal intervention was designed based on practices characterized by being evidence-based, low cost and suggested by qualitative research: (i) leadership commitment, (ii) surveillance of materials needed to comply with hand hygiene and alcohol consumption, (iii) utilization of reminders, (iv) a storyboard of the project and (v) feedback (hand hygiene compliance rate). The study enrolled 705 participants, comprising nurses (66.4%), physicians (25.8%) and other HCW (7.8%) along 9 months of observation. Compliance with hand hygiene in the control group was 66.0% (2354/3565) vs. 75.6% (5190/6864) in the intervention group. Univariate analysis showed an association between the intervention and hand hygiene compliance (odds ratio, OR 1.17; 95% confidence interval (CI), 1.13-1.22). The effect was still present after adjustment by calendar's time and providers' characteristics-age, gender and profession (OR 1.08; 95% CI, 1.03-1.14). His study supports that a multimodal intervention was effective to improve compliance with hand hygiene in ICUs. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care

  7. Preventing and managing workplace violence against healthcare workers in Emergency Departments.

    Science.gov (United States)

    D'Ettorre, Gabriele; Pellicani, Vincenza; Mazzotta, Mauro; Vullo, Annamaria

    2018-02-21

    Healthcare workers (HCWs) employed in Emergency Departments (EDs) frequently face with patients becoming violent because of long wait or diseases or under the influence of alcohol or drugs. Globally, workplace violence (WPV) in EDs is a major challenge to safety for HCWs, involving significant consequences to the victims, patients, and healthcare organizations. We reviewed the current literature with the aim to explore the topics focused on and to detect new evidences about approaching the issue of WPV toward HCWs in EDs. A search for articles regarding WPV toward HCWs employed in EDs and published from January 2007 through December 2017 was performed; using predetermined criteria for inclusion, selected articles were reviewed and qualitatively assessed for the aims of the review. We found 60 papers which matched our inclusion criteria; the topics, discussed in order of frequency from highest to lowest, were: "Risk Assessment", "Occurrence Rates", "Risk Management", and "Physical/non Physical Consequences". Dementia, schizophrenia, anxiety, acute stress reaction, suicidal ideation, and alcohol and drug intoxication were found as predictors of physical violence perpetrated by patients against HCWs. A strategic way to the effective management of WPV should prioritize training courses focused on: constructing HCW-patient relationship, improving the workers' communication skills, accurate reporting of each violent incident, and improving the labor context through management commitment and employee involvement in WPV prevention programs. A special effort is required in implementing workplace design effective in minimizing stressful conditions in waiting rooms which turned out to be the most frequent site of assaults.

  8. The Latest in Vaccine Policies: Selected Issues in School Vaccinations, Healthcare Worker Vaccinations, and Pharmacist Vaccination Authority Laws.

    Science.gov (United States)

    Barraza, Leila; Schmit, Cason; Hoss, Aila

    2017-03-01

    This paper discusses recent changes to state legal frameworks for mandatory vaccination in the context of school and healthcare worker vaccination. It then discusses state laws that allow pharmacists the authority to vaccinate.

  9. The Effectiveness of Hands-on Health Informatics Skills Exercises in the Multidisciplinary Smart Home Healthcare and Health Informatics Training Laboratories.

    Science.gov (United States)

    Sapci, A H; Sapci, H A

    2017-10-01

    This article aimed to evaluate the effectiveness of newly established innovative smart home healthcare and health informatics laboratories, and a novel laboratory course that focuses on experiential health informatics training, and determine students' self-confidence to operate wireless home health monitoring devices before and after the hands-on laboratory course. Two web-based pretraining and posttraining questionnaires were sent to 64 students who received hands-on training with wireless remote patient monitoring devices in smart home healthcare and health informatics laboratories. All 64 students completed the pretraining survey (100% response rate), and 49 students completed the posttraining survey (76% response rate). The quantitative data analysis showed that 95% of students had an interest in taking more hands-on laboratory courses. Sixty-seven percent of students had no prior experience with medical image, physiological data acquisition, storage, and transmission protocols. After the hands-on training session, 75.51% of students expressed improved confidence about training patients to measure blood pressure monitor using wireless devices. Ninety percent of students preferred to use a similar experiential approach in their future learning experience. Additionally, the qualitative data analysis demonstrated that students were expecting to have more courses with hands-on exercises and integration of technology-enabled delivery and patient monitoring concepts into the curriculum. This study demonstrated that the multidisciplinary smart home healthcare and health informatics training laboratories and the hands-on exercises improved students' technology adoption rates and their self-confidence in using wireless patient monitoring devices. Schattauer GmbH Stuttgart.

  10. The Effects of Social Influence on Nurses' Hand Hygiene Behaviors.

    Science.gov (United States)

    Piras, Susan E; Minnick, Ann; Lauderdale, Jana; Dietrich, Mary S; Vogus, Timothy J

    2018-04-01

    The aim of this article is to describe the associations of nurses' hand hygiene (HH) attitudes, subjective norms, and perceived behavioral control with observed and self-reported HH behavior. Hand hygiene is an essential strategy to prevent healthcare-associated infections. Despite tremendous efforts, nurses' HH adherence rates remain suboptimal. This quantitative descriptive study of ICU nurses in the southeastern United States was guided by the theory of planned behavior. The self-administered Patient Safety Opinion Survey and iScrub application, which facilitates observation, comprised the data set. Nurses' observed HH median was 55%; tendency to self-report was a much higher 90%. Subjective norm and perceived control scores were associated with observed and self-reported HH (P < .05) but not attitude scores or reports of intention. Nurses' subjective norm and perceived control are associated with observed and self-reported HH performance. Healthcare workers overestimate their HH performance. Findings suggest future research to explore manipulators of these variables to change nurses' HH behavior.

  11. Effect of Workplace- versus Home-Based Physical Exercise on Muscle Response to Sudden Trunk Perturbation among Healthcare Workers

    DEFF Research Database (Denmark)

    Jakobsen, Markus D; Sundstrup, Emil; Brandt, Mikkel

    2015-01-01

    Objectives. The present study investigates the effect of workplace- versus home-based physical exercise on muscle reflex response to sudden trunk perturbation among healthcare workers. Methods. Two hundred female healthcare workers (age: 42 [SD 11], BMI: 24 [SD 4], and pain intensity: 3.1 [SD 2.......2] on a scale of 0-10) from 18 departments at three hospitals were randomized at the cluster level to 10 weeks of (1) workplace physical exercise (WORK) performed in groups during working hours for 5 × 10 minutes per week and up to 5 group-based coaching sessions on motivation for regular physical exercise...... perturbation. Furthermore, EMG preactivation of the erector spinae and fear avoidance were reduced more following WORK than HOME (95% CI -2.7--0.7 (P training sessions per week, respectively...

  12. The evolution of the resistance of Staphylococcus aureus found on healthcare workers correlated with local consumption of antibiotics

    Directory of Open Access Journals (Sweden)

    César Roberto Busato

    Full Text Available OBJECTIVE: Correlate the evolution of the resistance of Staphylococcus aureus collected from healthcare workers with the local consumption of antibiotics. MATERIAN AND METHODS: Open prospective research.Study Site. General Reference Hospital with 200 beds in a 700,000 inhabitant region, in Ponta Grossa, Paraná, Brazil. RESULTS: Two collections (samples of Staphylococcus aureus isolates were obtained from healthcare-workers during an approximate four-year interval. Samples 1 (n= 200 and 2 (n= 270 had this bacterium in 63 (32% and 90 (33% of the patients, respectively. At the same time, the annual consumption of antibiotics in DDD/1,000 patient-days was determined. The variation of resistance was significantly smaller (m.s.d.=12.11 for gentamycin (p<0.01 and (m.s.d.=9.22 for Tobramycin (p<0.05. The correlation between variation in resistance and antibiotic consumption was not significant. Workers studied in the two samples showed a significant (p<0.01 frequency (c²=10.44 for persistent nasal carriage and for non carriage. Methicillin resistant Staphylococcus aureus was found in 12 (6% patients of sample 1 and 11 patients (4% of sample 2. CONCLUSION: Stability of resistance allows us to maintain therapeutic outlines. The variation in bacterial resistance in the twice-sampled population (n=105 indicated the selection pressure of the hospital environment. The resistance that was found is representative of the hospital microbiota; this relationship represents a biological model, based on the healthcare-workers' interaction with colonizing bacteria and nosocomial infections. New studies could improve this model for other bacteria, to determine the tendency for resistance and help guide the antibiotic use.

  13. [Perception of nosocomial risk among healthcare workers at "Hopital Principal" in Dakar, Senegal (survey 2004)].

    Science.gov (United States)

    Chevalier, B; Margery, J; Wade, B; Ka, S; Diatta, B; Gueye, M; Mbaye, P S; Debonne, J M

    2008-12-01

    Nosocomial Infection (NI) is also observed in healthcare facilities in non-Western countries. The purpose of this report is to describe the findings of a survey undertaken to evaluate hygiene procedures implemented at the "Hopital Principal" in Dakar, Senegal and to assess perception and awareness of nosocomial risk among the hospital staff. A total of 264 healthcare workers were interviewed. Mean age was 39 years (range, 18-60) and the sex ratio was 1.3 (150 men/114 women). Sixty (22.7%) had university degrees, 106 (40.2%) had secondary school diplomas, 50 (18.9%) had attended middle school, and 13 (4.9%) had no schooling. Analysis of interview data showed that 56.1% (157/264) defined NI as infection acquired at the hospital but that only 9.8% (n=26) knew that a minimum 48-hour delay was necessary to distinguish nosocomial from community acquired infection. While understanding about NI was correlated with education level, data showed that 1 out of 3 physicians (13/39) failed to give the exact definition. Hand contact was cited as the second route of transmission. Isolation precautions were understood by 22.7% of personnel (60/264). Systematic handwashing was reported by 363% (96/264) but observation demonstrated that it was not performed properly regardless of the category of personnel. Care protocols were understood by 54.6% of persons interviewed (144/264). A hygiene-training course had been attended by 52.2% (n=138). Two thirds of the staff (69.7%: 54/264) was able to identify the hygiene nurse. Ninety-eight health care providers (37.1%) were familiar with the CLIN (Comités de Lutte contre les Infections Nosocomiales).

  14. Web-based training for primary healthcare workers in rural China: a qualitative exploration of stakeholders' perceptions.

    Directory of Open Access Journals (Sweden)

    Zhixia Zhang

    Full Text Available Equitable access to basic public health services is a priority in China. However, primary healthcare workers' competence to deliver public health services is relatively poor because they lack professional training. Since the availability of web-based training has increased in China, the current study explored stakeholders' perceptions of a web-based training program on basic public health services to understand their thoughts, experiences, and attitudes about it.Six focus group discussions with primary healthcare workers and three with directors of township hospitals, county-level Health Bureaus, and county-level Centers for Disease Control and Prevention were conducted in Yichang City during 2013. Semi-structured topic guides were used to facilitate qualitative data collection. Audio recordings of the sessions were transcribed verbatim and theme analysis was performed.Most of the study's participants, especially the village doctors, had insufficient knowledge of basic public health services. The existing training program for primary healthcare workers consisted of ineffective traditional face-to-face sessions and often posed accessibility problems for the trainees. Most of the study's participants had a positive attitude about web-based learning and expressed a strong desire to receive this novel training approach because of its flexibility and convenience. The perceived barriers to utilizing the web-based training method included poor computer literacy, lack of personal interaction, inadequate infrastructure, and lack of time and motivation. The facilitators of this approach included the training content applicability, the user-friendly and interactive learning format, and policy support.Web-based training on basic public health services is a promising option in rural China. The findings of the study will contribute knowledge to implementation of web-based training in similar settings.

  15. Prevalence of transfusion-transmitted viral pathogens among health-care workers and risk mitigation programme in a paediatric tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Charu Nayyar

    2017-01-01

    Full Text Available The health-care workers (HCWs are at an occupational risk of exposure to blood-borne pathogens, mainly, HIV, hepatitis B virus (HBV and hepatitis C virus. HBV is currently the only blood-borne virus for which a vaccine is available. All health-care institutions must encourage the HCWs to undergo screening for blood-borne pathogens.

  16. The web of silence: a qualitative case study of early intervention and support for healthcare workers with mental ill-health

    OpenAIRE

    Moll, Sandra E

    2014-01-01

    Background There is a high rate of stress and mental illness among healthcare workers, yet many continue to work despite symptoms that affect their performance. Workers with mental health issues are typically ostracized and do not get the support that they need. If issues are not addressed, however, they could become worse and compromise the health and safety, not only of the worker, but his/her colleagues and patients. Early identification and support can improve work outcomes and facilitate...

  17. Physical exercise at the workplace prevents deterioration of work ability among healthcare workers: cluster randomized controlled trial.

    Science.gov (United States)

    Jakobsen, Markus D; Sundstrup, Emil; Brandt, Mikkel; Jay, Kenneth; Aagaard, Per; Andersen, Lars L

    2015-11-25

    Imbalance between individual resources and work demands can lead to musculoskeletal disorders and reduced work ability. The purpose of this study was to investigate the effect of workplace- versus home-based physical exercise on work ability among healthcare workers. Two hundred female healthcare workers (Age: 42.0, BMI: 24.1, work ability index [WAI]: 43.1) from 18 departments at three Danish hospitals participated (Copenhagen, Denmark, Aug 2013-Jan 2014). Participants were randomly allocated at the cluster level to 10 weeks of: 1) workplace physical exercise (WORK) performed during working hours for 5x10 min per week and up to 5 group-based coaching sessions on motivation for regular physical exercise, or 2) home-based physical exercise (HOME) performed during leisure time for 5x10 min per week. Both groups received ergonomic counseling on patient handling and use of lifting aides. The main outcome measure was the change from baseline to 10-week follow-up in WAI. Significant group by time interaction was observed for WAI (p WORK compared with HOME corresponding to a small effect size (Cohens'd = 0.24). Within-group changes indicated that between-group differences were mainly caused by a reduction in WAI in HOME. Of the seven items of WAI, item 2 (work ability in relation to the demands of the job) and item 5 (sickness absence during the past year) were improved in WORK compared with HOME (P work ability among female healthcare workers. ClinicalTrials.gov NCT01921764 . Registered 10 August 2013.

  18. A comparative study on the level of satisfaction among regular and contractual health-care workers in a Northern city of India

    Directory of Open Access Journals (Sweden)

    Jyoti Dixit

    2017-01-01

    Full Text Available Introduction: Job satisfaction greatly determines the productivity and efficiency of human resources for health. The current study aims to assess the level of satisfaction and factors influencing the job satisfaction among regular and contractual health-care workers. Materials and Methods: A cross-sectional quantitative study was conducted from January to June 2015 among health care workers (n = 354 at all levels of public health-care facilities of Chandigarh. The correlation between variables with overall level of satisfaction was computed for regular and contractual health-care workers. Stepwise multiple linear regression was done to elucidate the major factors influencing job satisfaction. Results: Majority of the regular health-care staff was highly satisfied (86.9% as compared to contractual staff (10.5%, which however was moderately satisfied (55.9%. Stepwise regression model showed that work-related matters (β = 1.370, P < 0.01, organizational facilities (β = 1.586, P < 0.01, privileges attached to the job (β = 0.530, P < 0.01, attention to the suggestions (β = 0.515, P < 0.01, chance of promotion (β = 0.703, P < 0.01, and human resource issues (β = 1.0721, P < 0.01 are strong predictors of overall satisfaction level. Conclusion: Under the National Rural Health Mission, contract appointments have improved the overall availability of health-care staff at all levels of public health facilities. However, there are concerns regarding their level of motivation with various aspects related to the job, which need to be urgently addressed so as to improve the effectiveness and efficiency of health services.

  19. Healthcare

    Science.gov (United States)

    Carnevale, Anthony P.; Smith, Nicole; Gulish, Artem; Beach, Bennett H.

    2012-01-01

    This report, provides detailed analyses and projections of occupations in healthcare fields, and wages earned. In addition, the important skills and work values associated with workers in those fields of healthcare are discussed. Finally, the authors analyze the implications of research findings for the racial, ethnic, and class diversity of the…

  20. Clean Hands for Life: results of a large, multicentre, multifaceted, social marketing hand-hygiene campaign.

    Science.gov (United States)

    Forrester, L A; Bryce, E A; Mediaa, A K

    2010-03-01

    A year-long multifaceted hand-hygiene campaign entitled Clean Hands for Life targeting individual, environmental and organisational factors that influence healthcare worker (HCW) hand-hygiene behaviour was implemented in 36 acute and long-term care facilities in Vancouver Coastal Health region. The campaign involved rotation of ten novel posters, two poster contests, and distribution of multiple promotional items. A social marketing approach was used to implement and monitor the effectiveness of the campaign. Evaluation included quality assurance surveys, staff surveys (baseline, mid- and post-campaign), and focus groups. A total of 141 poster contest submissions was received, 5452 staff surveys completed and 14 focus groups conducted. Overall knowledge of the importance of hand-hygiene and intention to clean hands was high at baseline. No significant differences were observed when mid- and post-campaign scores were compared to baseline. The majority (89.5%) of HCWs reported that they preferred soap and water over alcohol hand gel. A significant increase in the self-reported use of hand-hygiene products was observed particularly among HCWs not providing direct patient care. Barriers to hand-hygiene included inappropriate placement of sinks, traffic flow issues, inadequately stocked washrooms, workload and time constraints. Organisational support was visible throughout the campaign. The results showed that social marketing is an effective approach in engaging HCWs. Hand-hygiene campaigns that focus almost exclusively on increasing awareness among HCWs may not be as successful as multifaceted campaigns or campaigns that target identified barriers to hand-hygiene. Copyright 2009 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.

  1. [Accident with biological material at the prehospital mobile care: reality for health and non-healthcare workers].

    Science.gov (United States)

    Tipple, Anaclara Ferreira Veiga; Silva, Elisangelo Aparecido Costa; Teles, Sheila Araújo; Mendonça, Katiane Martins; Souza, Adenícia Custódia Silva E; Melo, Dulcelene Sousa

    2013-01-01

    Analytical transversal study that was conducted with the objectives of identifying the prevalence and characterizing the accidents with biological material among professionals in pre-hospital service (PHS) and comparing the risk behaviors adopted by healthcare and non-healthcare groups that can affect the occurrence and seriousness of such accidents. Data were obtained by questionnaire applied to all PHS workers in Goiânia-GO. The study revealed a high prevalence of accidents involving biological material which, although higher for the healthcare group, also affected the non-healthcare group. There were significant (p accidents in both groups: not using gloves, masks or eye protectors; inappropriate disposal of sharps; inadequate dress; re-capping of needles; and a lack of immunization against hepatitis B. The results underscore the importance of both groups in adhering to preventive measures, and further point to the need to structure and implement vigilance and control system for this type of accident.

  2. Awareness and attitude to deceased kidney donation among health-care workers in Sokoto, Nigeria.

    Science.gov (United States)

    Agwu, Ngwobia Peter; Awosan, Kehinde Joseph; Ukwuani, Solomon Ifeanyi; Oyibo, Emmanuel Ugbede; Makusidi, Muhammad Aliyu; Ajala, Rotimi Abiodun

    2018-01-01

    Access to renal replacement therapy by the increasing population of patients with end-stage kidney disease across Sub-Saharan Africa, including Nigeria, has become a major public health challenge. Although deceased kidney donation constitutes a viable source, its uptake by patients is contingent on its acceptance by health-care workers. The aim of this study is to assess the awareness and attitude to deceased kidney donation among health-care workers in Sokoto, Nigeria. A cross-sectional study was conducted among 470 staff of Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria (attending a 1-week seminar), selected by universal sampling. Data were collected with a set of pretested, self-administered, and semi-structured questionnaire. The mean age of the respondents was 34.1 ± 7.8 years, and most of them (77.7%) were aged donation, only about half (51.9%) were willing to accept deceased kidney donation. Furthermore, 43.4% were willing to give consent to donate deceased relative's kidney, and 26.1% were willing to carry an organ donation card. Predictors of willingness to accept deceased kidney donation were male sex, being a medical doctor or laboratory scientist and being a Moslem (Odds ratio >2, P donation is crucial to promoting its acceptance among them.

  3. Second-hand smoke exposure among workers of restaurants, bars, and nightclubs in Lagos State

    Directory of Open Access Journals (Sweden)

    Oluwakemi Ololade Odukoya

    2017-01-01

    Full Text Available Background: The Lagos State Regulation of Smoking Law was passed in February 2014 and stipulates the total restriction of tobacco smoking in listed public places. Workers in hospitality venues are at a high risk of exposure to second-hand smoke (SHS. Therefore, their awareness of the health risks, attitudes toward SHS and their reported levels of exposure may play a crucial role in developing an effective monitoring, implementation, and enforcement mechanism. Methods: We conducted a cross-sectional, descriptive study among workers in restaurants, bars, and nightclubs registered with the Lagos State Ministry of Tourism in the second quarter of the year 2014. We used a multistage sampling technique to select one respondent each from the 300 centers randomly selected to participate in the survey. Data were collected using a modified version of the World Health Organization Global tobacco surveillance system tools. Univariate and bivariate analysis were carried out. Exposure to SHS in the workplace and in other public places was treated as the outcome variable in the bivariate analysis. Results: Majority (75.3% of the respondents were aged between 21 and 40 years with a mean age of 27.7 + 8.6 years. Many (66% were waiters/waitresses and spent more than 8 h a day. Most (60.6% of the venues were indoor only establishments, and 26.8% had no form of smoking restrictions. Majority of the respondents were exposed to SHS at work, and this was higher in bars and nightclubs. A bivariate analysis of results showed that workers were exposed to SHS at work irrespective of workplace smoking restrictions or respondents smoking status. Conclusion: Our study demonstrates that second-hand smoke exposure is very high (65% in smokers; 65.6% in nonsmokers among workers in restaurants, bars, and nightclubs in Lagos State. We are therefore of the opinion that strict enforcement of law would ensure the protection of these workers.

  4. Comparison of Healthcare Workers Transferring Patients Using Either Conventional Or Robotic Wheelchairs: Kinematic, Electromyographic, and Electrocardiographic Analyses

    Directory of Open Access Journals (Sweden)

    Hiromi Matsumoto

    2016-01-01

    Full Text Available Objectives. The aim of this study was to compare the musculoskeletal and physical strain on healthcare workers, by measuring range of motion (ROM, muscle activity, and heart rate (HR, during transfer of a simulated patient using either a robotic wheelchair (RWC or a conventional wheelchair (CWC. Methods. The subjects were 10 females who had work experience in transferring patients and another female adult as the simulated patient to be transferred from bed to a RWC or a CWC. In both experimental conditions, ROM, muscle activity, and HR were assessed in the subjects using motion sensors, electromyography, and electrocardiograms. Results. Peak ROM of shoulder flexion during assistive transfer with the RWC was significantly lower than that with the CWC. Values for back muscle activity during transfer were lower with the RWC than with the CWC. Conclusions. The findings suggest that the RWC may decrease workplace injuries and lower back pain in healthcare workers.

  5. A lean Six Sigma team increases hand hygiene compliance and reduces hospital-acquired MRSA infections by 51%.

    Science.gov (United States)

    Carboneau, Clark; Benge, Eddie; Jaco, Mary T; Robinson, Mary

    2010-01-01

    A low hand hygiene compliance rate by healthcare workers increases hospital-acquired infections to patients. At Presbyterian Healthcare Services in Albuquerque, New Mexico a Lean Six Sigma team identified the reasons for noncompliance were multifaceted. The team followed the DMAIC process and completed the methodology in 12 months. They implemented multiple solutions in the three areas: Education, Culture, and Environment. Based on methicillin-resistant Staphylococcus aureus (MRSA) mortality research the team's results included an estimated 2.5 lives saved by reducing MRSA infections by 51%. Subsequently this 51% decrease in MRSA saved the hospital US$276,500. For those readers tasked with increasing hand hygiene compliance this article will provide the knowledge and insight needed to overcome multifaceted barriers to noncompliance.

  6. Air, hand wipe, and surface wipe sampling for Bisphenol A (BPA) among workers in industries that manufacture and use BPA in the United States.

    Science.gov (United States)

    Hines, Cynthia J; Jackson, Matthew V; Christianson, Annette L; Clark, John C; Arnold, James E; Pretty, Jack R; Deddens, James A

    2017-11-01

    For decades, bisphenol A (BPA) has been used in making polycarbonate, epoxy, and phenolic resins and certain investment casting waxes, yet published exposure data are lacking for U.S. manufacturing workers. In 2013-2014, BPA air and hand exposures were quantified for 78 workers at six U.S. companies making BPA or BPA-based products. Exposure measures included an inhalable-fraction personal air sample on each of two consecutive work days (n = 146), pre- and end-shift hand wipe samples on the second day (n = 74 each), and surface wipe samples (n = 88). Potential determinants of BPA air and end-shift hand exposures (after natural log transformation) were assessed in univariate and multiple regression mixed models. The geometric mean (GM) BPA air concentration was 4.0 µg/m 3 (maximum 920 µg/m 3 ). The end-shift GM BPA hand level (26 µg/sample) was 10-times higher than the pre-shift level (2.6 µg/sample). BPA air and hand exposures differed significantly by industry and job. BPA air concentrations and end-shift hand levels were highest in the BPA-filled wax manufacturing/reclaim industry (GM Air = 48 µg/m 3 , GM Hand-End = 130 µg/sample) and in the job of working with molten BPA-filled wax (GM Air = 43 µg/m 3 , GM Hand-End = 180 µg/sample), and lowest in the phenolic resins industry (GM Air = 0.85 µg/m 3 , GM Hand-End = 0.43 µg/sample) and in the job of flaking phenolic resins (GM AIR = 0.62 µg/m 3 , GM Hand-End = 0.38 µg/sample). Determinants of increased BPA air concentration were industry, handling BPA containers, spilling BPA, and spending ≥50% of the shift in production areas; increasing age was associated with lower air concentrations. BPA hand exposure determinants were influenced by high values for two workers; for all other workers, tasks involving contact with BPA-containing materials and spending ≥50% of the shift in production areas were associated with increased BPA hand levels. Surface wipe BPA levels were significantly lower in

  7. An educational intervention to improve hand hygiene compliance in Vietnam.

    Science.gov (United States)

    Phan, Hang Thi; Tran, Hang Thi Thuy; Tran, Hanh Thi My; Dinh, Anh Pham Phuong; Ngo, Ha Thanh; Theorell-Haglow, Jenny; Gordon, Christopher J

    2018-03-07

    Hand hygiene compliance is the basis of infection control programs. In developing countries models to improve hand hygiene compliance to reduce healthcare acquired infections are required. The aim of this study was to determine hand hygiene compliance following an educational program in an obstetric and gynecological hospital in Vietnam. Health care workers from neonatal intensive care, delivery suite and a surgical ward from Hung Vuong Hospital, Ho Chi Minh City, Vietnam undertook a 4-h educational program targeting hand hygiene. Compliance was monitored monthly for six months following the intervention. Hand hygiene knowledge was assessed at baseline and after six months of the study. There were 7124 opportunities over 370 hand hygiene recording sessions with 1531 opportunities at baseline and 1620 at 6 months following the intervention. Hand hygiene compliance increased significantly from baseline across all sites (43.6% [95% Confidence interval CI: 41.1-46.1] to 63% [95% CI: 60.6-65.3]; p hygiene compliance increased significantly after intervention (p hygiene compliance for an extended period of time. Hand hygiene knowledge increased during the intervention. This hand hygiene model could be used in developing countries were resources are limited.

  8. Effect of workplace- versus home-based physical exercise on muscle response to sudden trunk perturbation among healthcare workers

    DEFF Research Database (Denmark)

    Jakobsen, Markus D.; Sundstrup, Emil; Brandt, Mikkel

    2015-01-01

    .2] on a scale of 0-10) from 18 departments at three hospitals were randomized at the cluster level to 10 weeks of (1) workplace physical exercise (WORK) performed in groups during working hours for 5 × 10 minutes per week and up to 5 group-based coaching sessions on motivation for regular physical exercise...... perturbation. Furthermore, EMG preactivation of the erector spinae and fear avoidance were reduced more following WORK than HOME (95% CI -2.7--0.7 (P WORK and HOME performed 2.2 (SD: 1.1) and 1.0 (SD: 1.2) training sessions per week, respectively......Objectives. The present study investigates the effect of workplace- versus home-based physical exercise on muscle reflex response to sudden trunk perturbation among healthcare workers. Methods. Two hundred female healthcare workers (age: 42 [SD 11], BMI: 24 [SD 4], and pain intensity: 3.1 [SD 2...

  9. Narrating health and scarcity: Guyanese healthcare workers, development reformers, and sacrifice as solution from socialist to neoliberal governance.

    Science.gov (United States)

    Walker, Alexis

    2017-08-01

    In oral history interviews, Guyanese healthcare workers emphasize continuity in public health governance throughout the late twentieth century, despite major shifts in broader systems of governance during this period. I argue that these healthcare workers' recollections reflect long-term scarcities and the discourses through which both socialist politicians and neoliberal reformers have narrated them. I highlight the striking similarities in discourses of responsibility and efficiency advanced by socialist politicians in 1970s Guyana and by World Bank representatives designing the country's market transition in the late 1980s, and the ways these discourses have played out in Guyana's health system. Across diverging ideologies, politicians and administrators have promoted severe cost-control as the means to a more prosperous future, presenting short-term pains as necessary to creating new, better, leaner ways of life. In the health sector this has been enacted through a focus on self-help, and on nutrition as a tool available without funds dedicated for pharmaceuticals, advanced medical technologies, or a fully staffed public health system. I argue that across these periods Guyanese citizens have been offered a very similar recipe of ongoing sacrifice. I base my analysis on oral histories with forty-six healthcare workers conducted between 2013 and 2015 in Guyana in Regions 3, 4, 5, 9, and 10, as well as written records from World Bank and Guyanese national archives; I analyze official discourses as well as recollections and experiences of public health governance by those working in Guyana's health system. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Using Gamification Combined with Indoor Location to Improve Nurses' Hand Hygiene Compliance in an ICU Ward.

    Science.gov (United States)

    Lapão, Luís Velez; Marques, Rita; Gregório, João; Pinheiro, Fernando; Póvoa, Pedro; Mira da Silva, Miguel

    2016-01-01

    Healthcare acquired infections are among the biggest unsolved problems in healthcare, implying an increasing number of deaths, extra-days of hospital stay and hospital costs. Performing hand hygiene is a simple and inexpensive prevention measure, but healthcare workers compliance with it is still far from optimal. Recognized hurdles are lack of time, forgetfulness, wrong technique and lack of motivation. This study aims at exploring gamification to promote nurses' HH compliance self-awareness and action. Real-time data collected from an indoor location system will provide feedback information to a group of nurses working in an ICU ward. In this paper both the research's motivation and methods is presented, along with the first round of results and its discussion.

  11. Improving physician hand hygiene compliance using behavioural theories: a study protocol

    Directory of Open Access Journals (Sweden)

    Squires Janet E

    2013-02-01

    Full Text Available Abstract Background Healthcare-associated infections affect 10% of patients in Canadian acute-care hospitals and are significant and preventable causes of morbidity and mortality among hospitalized patients. Hand hygiene is among the simplest and most effective preventive measures to reduce these infections. However, compliance with hand hygiene among healthcare workers, specifically among physicians, is consistently suboptimal. We aim to first identify the barriers and enablers to physician hand hygiene compliance, and then to develop and pilot a theory-based knowledge translation intervention to increase physicians’ compliance with best hand hygiene practice. Design The study consists of three phases. In Phase 1, we will identify barriers and enablers to hand hygiene compliance by physicians. This will include: key informant interviews with physicians and residents using a structured interview guide, informed by the Theoretical Domains Framework; nonparticipant observation of physician/resident hand hygiene audit sessions; and focus groups with hand hygiene experts. In Phase 2, we will conduct intervention mapping to develop a theory-based knowledge translation intervention to improve physician hand hygiene compliance. Finally, in Phase 3, we will pilot the knowledge translation intervention in four patient care units. Discussion In this study, we will use a behavioural theory approach to obtain a better understanding of the barriers and enablers to physician hand hygiene compliance. This will provide a comprehensive framework on which to develop knowledge translation interventions that may be more successful in improving hand hygiene practice. Upon completion of this study, we will refine the piloted knowledge translation intervention so it can be tested in a multi-site cluster randomized controlled trial.

  12. Noise-induced hearing loss in construction workers being assessed for hand-arm vibration syndrome.

    Science.gov (United States)

    House, Ronald A; Sauvé, John T; Jiang, Depeng

    2010-01-01

    Construction workers are at risk of noise-induced hearing loss (NIHL) but often have no periodic audiometric testing. The participants were construction workers assessed for Hand-Arm Vibration Syndrome (HAVS) at the Occupational Health Clinic, St. Michael's Hospital, Toronto, Ontario. Audiometry was offered and 169 of the 191 workers assessed for HAVS agreed to have the audiometric test. The objective was to examine the prevalence of hearing loss in these 169 workers and to determine the effect on hearing of duration of work in construction (as a proxy for noise exposure) and the severity of vibration white finger (VWF) which previous studies have suggested is a marker for increased individual susceptibility for NIHL. VWF was measured by the Stockholm vascular scale. All participants were men, median age of 57 (range: 28-75), median number of years worked in construction of 35 (range: 4-52). All of the Spearman rank correlations between years worked in construction and the hearing levels at each audiometric frequency were statistically significant (p hearing loss at or above the level at which a workers' compensation pension would be granted in Ontario and the prevalence of this auditory outcome had a statistically significant increase as years worked in construction increased. Multivariate linear regression indicated that VWF also had a statistically significant effect on hearing loss for all audiometric frequencies combined after controlling for years worked in construction. Improved prevention of hearing loss in construction workers is needed.

  13. Effect of electronic real-time prompting on hand hygiene behaviors in health care workers.

    Science.gov (United States)

    Pong, Steven; Holliday, Pamela; Fernie, Geoff

    2018-03-02

    Poor hand hygiene by health care workers is a major cause of nosocomial infections. This research evaluated the ability of an electronic monitoring system with real-time prompting capability to change hand hygiene behaviors. Handwashing activity was measured by counting dispenser activations on a single nursing unit before, during, and after installation of the system. The effect of changing the prompt duration on hand hygiene performance was determined by a cluster-randomized trial on 3 nursing units with 1 acting as control. Sustainability of performance and participation was observed on 4 nursing units over a year. All staff were eligible to participate. Between June 2015 and December 2016, a total of 459,376 hand hygiene opportunities and 330,740 handwashing events from 511 staff members were recorded. Dispenser activation counts were significantly influenced by use of the system (χ 2 [3] = 75.76; P Hand hygiene performance dropped from 62.61% to 24.94% (odds ratio, 0.36; 95% confidence interval, 0.34-0.38) when the prompting feature was removed. Staff participation had a negative trajectory of -0.72% (P Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  14. Threshold of musculoskeletal pain intensity for increased risk of long-term sickness absence among female healthcare workers in eldercare.

    Directory of Open Access Journals (Sweden)

    Lars L Andersen

    Full Text Available PURPOSE: Musculoskeletal disorders increase the risk for absenteeism and work disability. However, the threshold when musculoskeletal pain intensity significantly increases the risk of sickness absence among different occupations is unknown. This study estimates the risk for long-term sickness absence (LTSA from different pain intensities in the low back, neck/shoulder and knees among female healthcare workers in eldercare. METHODS: Prospective cohort study among 8,732 Danish female healthcare workers responding to a questionnaire in 2004-2005, and subsequently followed for one year in a national register of social transfer payments (DREAM. Using Cox regression hazard ratio (HR analysis we modeled risk estimates of pain intensities on a scale from 0-9 (reference 0, where 0 is no pain and 9 is worst imaginable pain in the low back, neck/shoulders and knees during the last three months for onset of LTSA (receiving sickness absence compensation for at least eight consecutive weeks during one-year follow-up. RESULTS: During follow-up, the 12-month prevalence of LTSA was 6.3%. With adjustment for age, BMI, smoking and leisure physical activity, the thresholds of pain intensities significantly increasing risk of LTSA for the low back (HR 1.44 [95%CI 1.07-1.93], neck/shoulders (HR 1.47 [95%CI 1.10-1.96] and knees (HR 1.43 [95%CI 1.06-1.93] were 5, 4 and 3 (scale 0-9, respectively, referencing pain intensity of 0. CONCLUSION: The threshold of pain intensity significantly increasing the risk for LTSA among female healthcare workers varies across body regions, with knee pain having the lowest threshold. This knowledge may be used in the prevention of LTSA among health care workers.

  15. Knowledge and implementation of the National Malaria Control Programme among health-care workers in primary health-care centers in Ogun State, Nigeria

    Directory of Open Access Journals (Sweden)

    Temitope Wunmi Ladi-Akinyemi

    2018-01-01

    Full Text Available Background: Lack of capacity to implement programs effectively and low public education about malaria is some of the factors that Nigeria governments must address to effectively combat malaria. Methods: This descriptive cross-sectional study assessed the knowledge and implementation of the National Malaria Control Programme (NMCP among health-care workers in the primary health-care centers in Ogun state. Three hundred and twenty-five respondents were recruited into the study using cluster sampling method. A pretested self-administered questionnaire was used to collect necessary information. Analysis and statistical calculation was done using SPSS version 20.0. Relationships between categorical variables were tested using Chi-square test with P value at 0.05. Results: One hundred and twenty-five (38.5% of the respondents were from Ado-odo/Ota local government areas (LGAs, 120 (36.9% of the respondents were from Ijebu-ode LGA and 80 (24.6% were from Ewekoro LGA. About 37.8% of the respondents were within age range of 45–54 years, with mean of 41.7 ± 8.5. Over 90% of the respondents knew the mode of transmission of malaria, <50% of them could identified case definition of simple and complicated malaria. Large percentage of the respondents knew the signs and symptoms of simple malaria. The respondents who were older (P = 0.004 with more than 15-year work experience (P = 0.006 had good knowledge score of the NMCP. Conclusion: Knowledge and implementation of NMCP by health-care workers in some of the LGAs in this study was inadequate. Regular visit to the health facilities, especially those in the remote areas by the staff of malaria control unit were recommended.

  16. Factors influencing recruitment and retention of healthcare workers in rural and remote areas in developed and developing countries: an overview

    Directory of Open Access Journals (Sweden)

    Gisèle Irène Claudine Mbemba

    2016-12-01

    Full Text Available Shortage of healthcare workers in rural and remote areas remains a growing concern both in developed and developing countries. This review aims to synthesize the significant factors impacting healthcare professionals’ recruitment and retention in rural and remote areas, and to identify those relevant for developing countries. This paper included the following steps: exploring scientific literature through predetermined criteria and extracting relevant information by two independents reviewers. The AMSTAR tool was used to assess the methodological quality. Of the 224 screened publications, 15 reviews were included. Four reviews focused on recruitment factors, and another four reviews focused on retention factors. The remaining focused both on recruitment and retention factors. The most important factors influencing recruitment were rural background and rural origin, followed by career development. Opportunities for professional advancement, professional support networks and financial incentives were factors impacting retention. While the main factors influencing recruitment and retention have been largely explored in the literature, the evidence on strategies to reduce the shortage of healthcare workers in rural area, particularly in developing countries, is low. Further research in this field is needed.

  17. Burnout among healthcare workers at L'Aquila: its prevalence and associated factors.

    Science.gov (United States)

    Mattei, Antonella; Fiasca, Fabiana; Mazzei, Mariachiara; Abbossida, Vincenzo; Bianchini, Valeria

    2017-12-01

    Burnout, which is now recognized as a real problem in terms of its negative outcome on healthcare efficiency, is a stress condition that can be increased by exposure to natural disasters, such as the 2009 L'Aquila earthquake. This study aims to evaluate burnout syndrome, its associated risk factors and stress levels, and the individual coping strategies among healthcare professionals at L'Aquila General Hospital. A cross-sectional study of 190 healthcare workers was conducted. There was a questionnaire for the collection of the socio-demographic, occupational and anamnestic data, and the Maslach Burnout Inventory, the General Health Questionnaire-12 items (GHQ-12) and the Brief COPE were used. The burnout dimensions showed high scores in Emotional Exhaustion (38.95%), in Depersonalization (23.68%) and in lack of Personal Accomplishment (23.16%), along with the presence of moderate to high levels of distress (54.21%). In addition to factors already known to be associated with burnout (job perception and high levels of distress) exposure to an earthquake emerged as a factor independently associated with the syndrome. Adaptive coping strategies such as religiosity showed a significant and negative relationship with burnout. Our research highlights the need for interventions directed at a reduction in workload and work-stressors and an improvement of adaptive coping strategies, especially in a post-disaster workplace.

  18. Patient safety culture shapes presenteeism and absenteeism: a cross-sectional study among Croatian healthcare workers.

    Science.gov (United States)

    Brborović, Hana; Brborović, Ognjen

    2017-09-26

    Healthcare workers have high rates of injuries and illnesses at the workplace, and both their absence from work due to illness (absenteeism) or working ill (presenteeism) can compromise patient safety and the quality of health care delivered. Following this premise, we wanted to determine whether presenteeism and absenteeism were associated with patient safety culture (PSC) and in what way. Our sample consisted of 595 Croatian healthcare workers (150 physicians and 445 nurses) who answered the short-form WHO Health and Work Performance Questionnaire and the Hospital Survey on Patient Safety Culture. The results have confirmed the association with both presenteeism and absenteeism in several PSC dimensions, but not as we expected based on the premise from which we started. Opposite to our expectations, lower job performance (as a measure of presenteeism) was associated with higher PSC instead of lower PSC. Absenteeism, in turn, was associated with lower PSC, just as we expected. These findings suggest that it is the PSC that shapes presenteeist and absenteeist behaviour and not the other way around. High PSC leads to presenteeism, and low PSC to absenteeism. We also believe that the presenteeism questionnaires should be adjusted to health care and better define what lower performance means both quantitatively and qualitatively in a hospital setting.

  19. Effectiveness and limitations of hand hygiene promotion on decreasing healthcare-associated infections.

    Directory of Open Access Journals (Sweden)

    Yee-Chun Chen

    Full Text Available BACKGROUND: Limited data describe the sustained impact of hand hygiene programs (HHPs implemented in teaching hospitals, where the burden of healthcare-associated infections (HAIs is high. We use a quasi-experimental, before and after, study design with prospective hospital-wide surveillance of HAIs to assess the cost effectiveness of HHPs. METHODS AND FINDINGS: A 4-year hospital-wide HHP, with particular emphasis on using an alcohol-based hand rub, was implemented in April 2004 at a 2,200-bed teaching hospital in Taiwan. Compliance was measured by direct observation and the use of hand rub products. Poisson regression analyses were employed to evaluate the densities and trends of HAIs during the preintervention (January 1999 to March 2004 and intervention (April 2004 to December 2007 periods. The economic impact was estimated based on a case-control study in Taiwan. We observed 8,420 opportunities for hand hygiene during the study period. Compliance improved from 43.3% in April 2004 to 95.6% in 2007 (p<.001, and was closely correlated with increased consumption of the alcohol-based hand rub (r = 0.9399. The disease severity score (Charlson comorbidity index increased (p = .002 during the intervention period. Nevertheless, we observed an 8.9% decrease in HAIs and a decline in the occurrence of bloodstream, methicillin-resistant Staphylococcus aureus, extensively drug-resistant Acinetobacter baumannii, and intensive care unit infections. The intervention had no discernable impact on HAI rates in the hematology/oncology wards. The net benefit of the HHP was US$5,289,364, and the benefit-cost ratio was 23.7 with a 3% discount rate. CONCLUSIONS: Implementation of a HHP reduces preventable HAIs and is cost effective.

  20. The Mediating Effects of Burnout on the Relationship between Anxiety Symptoms and Occupational Stress among Community Healthcare Workers in China: A Cross-Sectional Study

    Science.gov (United States)

    Ding, Yanwei; Qu, Jianwei; Yu, Xiaosong; Wang, Shuang

    2014-01-01

    Background Several occupational stress studies of healthcare workers have predicted a high prevalence of anxiety symptoms, which can affect their quality of life and the care that they provide. However, few studies have been conducted among community healthcare workers in China. We attempted to explore whether burnout mediates the association between occupational stress and anxiety symptoms. Methods A cross-sectional survey was completed in Liaoning Province, China from November to December 2012. A total of 1,752 healthcare workers from 52 Community Health Centers participated in this study, and all participants were given self-administered questionnaires. These questionnaires addressed the following aspects: the Zung Self-Rating Anxiety Scale, the Chinese version of the effort-reward imbalance scale and the Maslach Burnout Inventory–General Survey. Finally, the study included 1,243 effective respondents (effective response rate, 70.95%). Hierarchical linear regression analysis, performed with SPSS 17.0, was used to estimate the effect of burnout. Results The prevalence of anxiety symptoms among the community healthcare workers was 38.0%. After adjusting for demographic characteristics, the effort–reward ratio and overcommitment positively predicted anxiety symptoms. Meanwhile, the effort–reward ratio and overcommitment were positively related to the emotional exhaustion and cynicism subscales of burnout. In addition, the emotional exhaustion and cynicism subscales were positively related to anxiety symptoms. Thus, there is a link between burnout, occupational stress and anxiety symptoms. Conclusions Burnout mediates the effect of occupational stress on anxiety symptoms. To effectively reduce the impact of occupational stress on anxiety symptoms, burnout management should be considered. PMID:25211025

  1. A case study of healthcare professional views on the meaning of data produced by hand hygiene auditing.

    Science.gov (United States)

    Dawson, Carolyn H

    2015-11-01

    Measurement of hand hygiene (HH), crucial for patient safety, has acknowledged flaws stemming from methods available. Even direct observation, the World Health Organization gold standard, may lead to behaviour changes which can affect outcome validity. However, it remains important to understand current levels of HH to allow targeted interventions to be developed. This has resulted in wider adoption of auditing processes. This study addressed how healthcare professionals perceive data generated by HH auditing processes. Qualitative study involving participatory observation and semi-structured interviews with 30 healthcare professionals recruited from a large National Health Service (NHS) two-hospital site in England. Healthcare professionals perceived two main problems with HH measurement, both associated with feedback: (1) lack of clarity with regard to feedback; and (2) lack of association between training and measurement. In addition, concerns about data accuracy led the majority of participants (22/30) to conclude audit feedback is often 'meaningless'. Healthcare professionals require meaningful data on compliance with HH to engender change, as part of a multimodal strategy. Currently healthcare professionals perceive that data lack meaning, and are not seen as drivers to improve HH performance. Potential opportunities to change practice and improve HH are being missed.

  2. Implementation of the WHO multimodal Hand Hygiene Improvement Strategy in a University Hospital in Central Ethiopia

    Directory of Open Access Journals (Sweden)

    Frieder Pfäfflin

    2017-01-01

    workers’ perception surveys revealed high appreciation of the different strategy components. Conclusion Promotion of hand hygiene is feasible and sustainable in a resource-constrained setting using a multimodal improvement strategy. However, absolute compliance remained low. Strong and long-term commitment by hospital management and health-care workers may be needed for further improvement.

  3. Prevalence of Hepatitis B Antibodies in Health-Care Workers in Yasuj Hospitals

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    B Sarkari

    2007-01-01

    Full Text Available ABSTRACT: Introduction & Objective: Hepatitis B is a common infection in the world and one of the main health problems in our country. Over 350 million people are infected with Hepatitis B virus in the world and are chronic carriers of this infection. Health care workers are at risk of infection with blood born viruses including hepatitis B (HBV. This study was conducted to find out the rate of anti-HBs antibodies among the health-care workers (HCW in Yasuj hospitals, Southwest of Iran. Materials & Methods: This is a cross sectional descriptive study in which 212 staff was randomly selected from different wards of the hospitals in Yasuj. Blood samples were taken from each individual and tested for hepatitis B surface antibody (anti-HBs by ELISA. Those who had anti-HBs titer > 10 IU/ml were considered as positive. Collected data were analyzed by SPSS software using descriptive data analysis and chi-square test. Results: 61.3% of the subjects were female and 38.7% were male. 93.9% of the subjects had a history of one to three doses of hepatitis B vaccination. Results of this study showed that 185 (87.3% of the staff have anti hepatitis B antibodies (Anti-HBs. Among the staff that was negative for anti-HBs antibody, 12 had a history of hepatitis B vaccination (at least one dose. Female employees were more positive than males (93% vs. 78% and this difference was statistically significant (p<0.05. Moreover, a positive correlation was found between the titer of antibody and sex where females had a higher titer of antibody in comparison with males (p<0.05. No correlation was found between the workplace of HCW and positive anti-HBS. Conclusion: Result of this study indicates that more than 85 percent of the health-care workers in Yasuj have reasonable immunity against hepatitis B infection. A small proportion of HCWs had no immunity against HBV. The second course of hepatitis B vaccine should be delivered to those who had no immunity against hepatitis B

  4. Suspected allergic contact dermatitis to iodopropynyl butylcarbamate in an alcohol hand rub commonly used in Australian health-care settings.

    Science.gov (United States)

    Toholka, Ryan; Nixon, Rosemary

    2014-02-01

    We report a case of suspected allergic contact dermatitis to the preservative and uncommon allergen iodopropynyl butylcarbamate, found in Microshield Angel hand gel, a skin cleanser commonly used in Australian health-care settings. © 2013 The Australasian College of Dermatologists.

  5. A successful strategy for increasing the influenza vaccination rate of healthcare workers without a mandatory policy outside of the United States: a multifaceted intervention in a Japanese tertiary care center.

    Science.gov (United States)

    Honda, Hitoshi; Sato, Yumiko; Yamazaki, Akinori; Padival, Simi; Kumagai, Akira; Babcock, Hilary

    2013-11-01

    Although mandatory vaccination programs have been effective in improving the vaccination rate among healthcare workers, implementing this type of program can be challenging because of varied reasons for vaccine refusal. The purpose of our study is to measure improvement in the influenza vaccination rate from a multifaceted intervention at a Japanese tertiary care center where implementing a mandatory vaccination program is difficult. Before-and-after trial. Healthcare workers at a 550-bed, tertiary care, academic medical center in Sapporo, Japan. We performed a multifaceted intervention including (1) use of a declination form, (2) free vaccination, (3) hospital-wide announcements during the vaccination period, (4) prospective audit and real-time telephone interview for healthcare workers who did not receive the vaccine, (5) medical interview with the hospital executive for noncompliant (no vaccine, no declination form) healthcare workers during the vaccination period, and (6) mandatory submission of a vaccination document if vaccinated outside of the study institution. With the new multifaceted intervention, the vaccination rate in the 2012-2013 season increased substantially, up to 97%. This rate is similar to that reported in studies with a mandatory vaccination program. Improved vaccination acceptance, particularly among physicians, likely contributed to the overall increase in the vaccination rate reported in the study. Implementation of comprehensive strategies with strong leadership can lead to substantial improvements in vaccine uptake among healthcare workers even without a mandatory vaccination policy. The concept is especially important for institutions where implementing mandatory vaccination programs is challenging.

  6. Monitoring the hand hygiene compliance of health care workers in a general intensive care unit: Use of continuous closed circle television versus overt observation.

    Science.gov (United States)

    Brotfain, Evgeni; Livshiz-Riven, Ilana; Gushansky, Alexander; Erblat, Alexander; Koyfman, Leonid; Ziv, Tomer; Saidel-Odes, Lisa; Klein, Moti; Borer, Abraham

    2017-08-01

    A variety of hand hygiene monitoring programs (HHMPs) have come into use in hospitals throughout the world. In the present study, we compare continuous closed circle television (CCTV) with overt observation for monitoring the hand hygiene compliance of health care workers (HCWs) in a general intensive care unit (GICU). This is a cross-sectional and comparative study. In this study, we use a novel hand hygiene CCTV monitoring system for hand hygiene performance monitoring. The study population incorporated all the GICU HCWs, including registered nurses, staff physicians, and auxiliary workers. All HCWs of our GICU were observed, including ICU registered nurses, ICU staff physicians, and auxiliary workers participated in the present study. Overall, each observer team did 50 sessions in each arm of the study. Total number of hand hygiene opportunities was approaching 500 opportunities. The compliance rates when only overt observations were performed was higher than when only covert observations were performed with a delta of approximately 10% (209 out of 590 [35.43%] vs 130 out of 533 [24.39%]; P hand hygiene. However, there is no clear basis for incorporating a CCTV observation modality into a health care system that already operates an overt observation program. We have shown that CCTV methodology records a different distribution of opportunities for performing hand hygiene and of actual performances of hand hygiene compared with overt observation. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  7. Nasal and hand carriage rate of methicillin resistant Staphylococcus aureus (MRSA) among health care workers in Mekelle Hospital, North Ethiopia.

    Science.gov (United States)

    Gebreyesus, Araya; Gebre-Selassie, Solomon; Mihert, Adane

    2013-01-01

    Methicillin resistant Staphylococcus aureus (MRSA) is significant major pathogen responsible for hospital and community based infections. The aim of this study was to assess the nasal and hand carriage of methicillin resistant Staphylococcus aureus in health care workers of Mekelle Hospital The study was carried out during November 2010 to January 2011. Swab samples from both anterior nares and hands were taken. The samples were cultured on mannitol salt agar and incubated aerobically at 37 degrees C for 48 hours. Staphylococcus aureus was identified as nmannitol fermenter and coagulase test positive. Antimicrobial susceptibility test for MRSA was done by disk diffusion method using oxacillin disks. Data were analysed using SPSS version 16 software. Out of the 177 health care workers screened, 36 (20.3%) of them were methicillin resistant Staphylococcus aureus carriers in their hand and anterior nares. More females, 25(14.1%) were colonized by methicillin resistant Staphylococcus aureus than males 11 (6.2%) (P = 0.044). Nasal carriage of MRSA of 25 (14.1%) was higher than hand carriage 11 (6.2%) (p resistant Staphylococcus aureus carriage rates of 26 (13.6%) and 4 (2.3%), respectively. The isolated MRSA were resistant to multiple antibiotics. The highest resistance was observed for ampicillin (88.9%) and tetracycline (86.1%). Two (5.6%) of the nasal isolates were vancomycin resistant. Methicillin resistant Staphylococcus aureus carriage among health care workers in this study was high. The carriage rate was higher among nurses and doctors. The MRSA isolates were multi drug resistant to other antibiotics. So, the result of this study emphasizes the need of regular surveillance of health care workers. It also calls a need for an effective infection prevention and control program.

  8. Computer-assisted resilience training to prepare healthcare workers for pandemic influenza: a randomized trial of the optimal dose of training

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    Vincent Leslie

    2010-03-01

    Full Text Available Abstract Background Working in a hospital during an extraordinary infectious disease outbreak can cause significant stress and contribute to healthcare workers choosing to reduce patient contact. Psychological training of healthcare workers prior to an influenza pandemic may reduce stress-related absenteeism, however, established training methods that change behavior and attitudes are too resource-intensive for widespread use. This study tests the feasibility and effectiveness of a less expensive alternative - an interactive, computer-assisted training course designed to build resilience to the stresses of working during a pandemic. Methods A "dose-finding" study compared pre-post changes in three different durations of training. We measured variables that are likely to mediate stress-responses in a pandemic before and after training: confidence in support and training, pandemic-related self-efficacy, coping style and interpersonal problems. Results 158 hospital workers took the course and were randomly assigned to the short (7 sessions, median cumulative duration 111 minutes, medium (12 sessions, 158 minutes or long (17 sessions, 223 minutes version. Using an intention-to-treat analysis, the course was associated with significant improvements in confidence in support and training, pandemic self-efficacy and interpersonal problems. Participants who under-utilized coping via problem-solving or seeking support or over-utilized escape-avoidance experienced improved coping. Comparison of doses showed improved interpersonal problems in the medium and long course but not in the short course. There was a trend towards higher drop-out rates with longer duration of training. Conclusions Computer-assisted resilience training in healthcare workers appears to be of significant benefit and merits further study under pandemic conditions. Comparing three "doses" of the course suggested that the medium course was optimal.

  9. Regular use of a hand cream can attenuate skin dryness and roughness caused by frequent hand washing

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    Kampf Günter

    2006-02-01

    Full Text Available Abstract Background Aim of the study was to determine the effect of the regular use of a hand cream after washing hands on skin hydration and skin roughness. Methods Twenty-five subjects washed hands and forearms with a neutral soap four times per day, for 2 minutes each time, for a total of two weeks. One part of them used a hand cream after each hand wash, the others did not (cross over design after a wash out period of two weeks. Skin roughness and skin hydration were determined on the forearms on days 2, 7, 9 and 14. For skin roughness, twelve silicon imprint per subject and time point were taken from the stratum corneum and assessed with a 3D skin analyzer for depth of the skin relief. For skin hydration, five measurements per subject and time point were taken with a corneometer. Results Washing hands lead to a gradual increase of skin roughness from 100 (baseline to a maximum of 108.5 after 9 days. Use of a hand cream after each hand wash entailed a decrease of skin roughness which the lowest means after 2 (94.5 and 14 days (94.8. Skin hydration was gradually decreased after washing hands from 79 (baseline to 65.5 after 14 days. The hand wash, followed by use of a hand cream, still decreased skin hydration after 2 days (76.1. Over the next 12 days, however, skin hydration did not change significantly (75.6 after 14 days. Conclusion Repetitive and frequent hand washing increases skin dryness and roughness. Use of a hand cream immediately after each hand wash can confine both skin dryness and skin roughness. Regular use of skin care preparations should therefore help to prevent both dry and rough skin among healthcare workers in clinical practice.

  10. Comparative efficacy of interventions to promote hand hygiene in hospital: systematic review and network meta-analysis

    Science.gov (United States)

    Hongsuwan, Maliwan; Limmathurotsakul, Direk; Lubell, Yoel; Lee, Andie S; Harbarth, Stephan; Day, Nicholas P J; Graves, Nicholas; Cooper, Ben S

    2015-01-01

    Objective To evaluate the relative efficacy of the World Health Organization 2005 campaign (WHO-5) and other interventions to promote hand hygiene among healthcare workers in hospital settings and to summarize associated information on use of resources. Design Systematic review and network meta-analysis. Data sources Medline, Embase, CINAHL, NHS Economic Evaluation Database, NHS Centre for Reviews and Dissemination, Cochrane Library, and the EPOC register (December 2009 to February 2014); studies selected by the same search terms in previous systematic reviews (1980-2009). Review methods Included studies were randomised controlled trials, non-randomised trials, controlled before-after trials, and interrupted time series studies implementing an intervention to improve compliance with hand hygiene among healthcare workers in hospital settings and measuring compliance or appropriate proxies that met predefined quality inclusion criteria. When studies had not used appropriate analytical methods, primary data were re-analysed. Random effects and network meta-analyses were performed on studies reporting directly observed compliance with hand hygiene when they were considered sufficiently homogeneous with regard to interventions and participants. Information on resources required for interventions was extracted and graded into three levels. Results Of 3639 studies retrieved, 41 met the inclusion criteria (six randomised controlled trials, 32 interrupted time series, one non-randomised trial, and two controlled before-after studies). Meta-analysis of two randomised controlled trials showed the addition of goal setting to WHO-5 was associated with improved compliance (pooled odds ratio 1.35, 95% confidence interval 1.04 to 1.76; I2=81%). Of 22 pairwise comparisons from interrupted time series, 18 showed stepwise increases in compliance with hand hygiene, and all but four showed a trend for increasing compliance after the intervention. Network meta-analysis indicated

  11. Clean Hands Count

    Medline Plus

    Full Text Available ... Published on May 5, 2017 This video for healthcare providers is intended to promote or encourage adherence ... role in their care by asking or reminding healthcare providers to clean their hands. See: https://www. ...

  12. Healthcare Robotics

    OpenAIRE

    Riek, Laurel D.

    2017-01-01

    Robots have the potential to be a game changer in healthcare: improving health and well-being, filling care gaps, supporting care givers, and aiding health care workers. However, before robots are able to be widely deployed, it is crucial that both the research and industrial communities work together to establish a strong evidence-base for healthcare robotics, and surmount likely adoption barriers. This article presents a broad contextualization of robots in healthcare by identifying key sta...

  13. Decrease in Anti-HBs Antibodies over Time in Medical Students and Healthcare Workers after Hepatitis B Vaccination

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    H. V. Sahana

    2017-01-01

    Full Text Available Background. Hepatitis B is one of the most important occupational hazards among healthcare workers (HCWs. This study aimed to measure the anti-HBs titres among the medical students and HCWs vaccinated against hepatitis B virus and to determine the association between anti-HBs levels and time since vaccination. Materials and Methods. In this cross-sectional study, medical students and healthcare workers who had received all three doses of hepatitis B vaccination and completed at least six months after vaccination since the last dose were included. 3 ml blood was collected from subjects (n=340 and anti-HBs titre was estimated using ELISA. Results. A total of 340/400 subjects were aged between 18 and 60 years; 204 were females and 136 males. The median and interquartile range for time since vaccination were 5 and 5 years, respectively. Duration since vaccination was ≤5 years in 223 (65.5%, 6–10 years in 84 (24.7%, and >10 years in 33 (9.70%; among them, antibody titres were >10 mIU/ml in 94.1%, 79.7%, and 72.7% subjects, respectively. There was significant decline in antibody titres as duration of postvaccination increased. Conclusion. The proportion of subjects who were unprotected after 5 and 10 years after vaccination were 20% and 27%, respectively. The need for a booster dose can be made mandatory at least for healthcare professionals.

  14. [Health-care utilization in elderly (Spain 2006-2012): Influence of health status and social class].

    Science.gov (United States)

    Aguilar-Palacio, Isabel; Carrera-Lasfuentes, Patricia; Solsona, Sofía; Sartolo, M Teresa; Rabanaque, M José

    2016-04-01

    to explore health-care utilization (primary and specialized health-care, hospitalizations, day hospital and emergency services) and overuse in elderly in Spain, considering the influence of health status, sex, social class and its temporal trend. cross sectional study in two phases. Spain. people surveyed in the National Health Surveys 2006 and 2011-12. Health status was measured using self-rated and diagnosed health (number and diagnoses). Social class was obtained from the last occupation of the main supporter (manual and non-manual workers). Logistic regression analyses were conducted adjusting by sex, age, health status, social class and year, obtaining its predictive capacity. the percentage of elderly population with health-care utilization decreased during the period analyzed. Women who belonged to the manual workers category presented the highest prevalence of low health (low self-rated health in 2006: 70.6%). Low health status was associated with a higher utilization of health-care services. Self-rated health was a better predictor of health-care utilization and overuse than diagnosed health, getting the highest predictive capacity for specialized health-care (C = 0.676). Old people from low social class used with higher frequency primary health-care and emergency services. On the other hand, specialized health-care and day hospital were more used by high social classes. inequalities in health and health-care utilization have been observed in elderly according social class. It is necessary to consider self-rated health as a health-care utilization predictor and to review our health-care services accessibility and equity. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  15. Healthcare workers' challenges in the implementation of tuberculosis infection prevention and control measures in Mozambique.

    Science.gov (United States)

    Brouwer, Miranda; Coelho, Eliana; Mosse, Carla das Dores; Brondi, Luciana; Winterton, Laura; van Leth, Frank

    2014-01-01

    Healthcare Workers (HCWs) have a higher frequency of TB exposure than the general population and have therefore an occupational TB risk that infection prevention and control (IPC) measures aim to reduce. HCWs are crucial in the implementation of these measures. The objective of the study was to investigate Mozambican HCWs' perceptions of their occupational TB risk and the measures they report using to reduce this risk. In addition, we explored the challenges HCWs encounter while using these TBIPC measures. Focus group discussion. Analysis according content method. Four categories of HCWs: auxiliary workers, medical (doctors and clinical officers), nurses and TB program staff. HCWs are aware of their occupational TB risk and use various measures to reduce their risk of infection. HCWs find it challenging to employ measures that minimize such risks and a lack of clear guidelines contributes to these challenges. HCWs' and patient behavior further complicate the use of TBIPC measures. HCWs in Mozambique perceive a high occupational risk of TB infection. They report several challenges using measures to reduce this risk such as shortage of material, lack of clear guidelines, insufficient motivation and inadequate training. Robust training with motivational approaches, alongside supervision and support for HCWs could improve implementation of TBIPC measures. Healthcare management should address the areas for improvement that are beyond the individual HCW's control.

  16. Hand Hygiene: Knowledge and Attitudes of Fourth-Year Clerkship Medical Students at Alfaisal University, College of Medicine, Riyadh, Saudi Arabia.

    Science.gov (United States)

    Hamadah, Reem; Kharraz, Razan; Alshanqity, Airabab; AlFawaz, Danah; Eshaq, Abdulaziz M; Abu-Zaid, Ahmed

    2015-08-24

    Little is known about the clerkship (clinical) medical students' knowledge of hand hygiene as the single most important precautionary measure to reduce nosocomial healthcare-associated infections. The aim of this study is to explore the knowledge of, and attitudes towards, hand hygiene practices among fourth-year clerkship medical students at Alfaisal University, College of Medicine, Riyadh, Saudi Arabia. A cross-sectional, paper-based, Yes/No formatted questionnaire was administered to explore the students' knowledge of, and attitudes towards, hand hygiene practices. Data were decoded in Microsoft Excel sheet and presented as numbers and percentages. One hundred and eleven students (n=111/147) participated in the questionnaire (response rate: 76%). Although the majority of students had a fair knowledge of hand hygiene practices, a number of them had some misconceptions. Only 14% of students correctly agreed to the statement: "Traditional hand washing (water, plus regular soap) decreases the number of germs." Furthermore, only 32% of students correctly answered that "hand washing with a regular soap, instead of an antiseptic soap, is better in limiting the transmission of clostridium difficile infections". Almost all students (93%) agreed to the importance of hand hygiene education in medical curricula and its awareness in healthcare centers. Despite the importance of hand hygiene, only 13% of students reviewed the respective WHO and CDC guidelines before starting their clinical training in the teaching hospital. The students' inadequate knowledge about hand hygiene needs to be enriched by well-structured curricular and extra-curricular programs as well as more positive attitudes by healthcare workers.

  17. How 'healthy' are healthcare organizations? Exploring employee healthcare utilization rates among Dutch healthcare organizations.

    Science.gov (United States)

    Bronkhorst, Babette

    2017-08-01

    Occupational health and safety research rarely makes use of data on employee healthcare utilization to gain insight into the physical and mental health of healthcare staff. This paper aims to fill this gap by examining the prevalence of two relevant types of healthcare utilization among staff working in healthcare organizations: physical therapy and mental healthcare utilization. The paper furthermore explores what role employee and organizational characteristics play in explaining differences in healthcare utilization between organizations. A Dutch healthcare insurance company provided healthcare utilization records for a sample of 417 organizations employing 136,804 healthcare workers in the Netherlands. The results showed that there are large differences between and within healthcare industries when it comes to employee healthcare utilization. Multivariate regression analyses revealed that employee characteristics such as age and gender distributions, and healthcare industry, explain some of the variance between healthcare organizations. Nevertheless, the results of the analyses showed that for all healthcare utilization indicators there is still a large amount of unexplained variance. Further research into the subject of organizational differences in employee healthcare utilization is needed, as finding possibilities to influence employee health and subsequent healthcare utilization is beneficial to employees, employers and society as a whole.

  18. The Impact of Environmental Design on Doffing Personal Protective Equipment in a Healthcare Environment: A Formative Human Factors Trial.

    Science.gov (United States)

    Herlihey, Tracey A; Gelmi, Stefano; Cafazzo, Joseph A; Hall, Trevor N T

    2017-06-01

    OBJECTIVE To explore the impact of environmental design on doffing personal protective equipment in a simulated healthcare environment. METHODS A mixed-methods approach was used that included human-factors usability testing and qualitative questionnaire responses. A patient room and connecting anteroom were constructed for testing purposes. This experimental doffing area was designed to overcome the environmental failures identified in a previous study and was not constructed based on any generalizable hospital standard. RESULTS In total, 72 healthcare workers from Ontario, Canada, took part in the study and tested the simulated doffing area. The following environmental design changes were tested and were deemed effective: increasing prominence of color-coded zones; securing disinfectant wipes and hand sanitizer; outlining disposal bins locations; providing mirrors to detect possible contamination; providing hand rails to assist with doffing; and restricting the space to doff. Further experimentation and iterative design are required with regard to several important features: positioning the disposal bins for safety, decreasing the risk of contamination and user accessibility; optimal positioning of mirrors for safety; communication within the team; and positioning the secondary team member for optimal awareness. Additional design suggestions also emerged during this study, and they require future investigation. CONCLUSIONS This study highlights the importance of the environment on doffing personal protective equipment in a healthcare setting. Iterative testing and modification of the design of the environment (doffing area) are important to enhancing healthcare worker safety. Infect Control Hosp Epidemiol 2017;38:712-717.

  19. Hand washing in operating room: a procedural comparison

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    Alessia Stilo

    2016-09-01

    Full Text Available BACKGROUND Hand washing has been considered a measure of personal hygiene for centuries and it is known that an improper hand hygiene by healthcare workers is responsible for about 40% of nosocomial infections. Therefore, surgical hand preparation is a critical element for healthcare safety in order to reduce microbial contamination of  surgical wound in case of non detected break of the gloves. The aim of our study is to evaluate the efficacy three antiseptics: Povi-iodine scrub; EPG (Ethanol, Hydrogen Peroxide, Glycerol, recommended by WHO, and common marseille soap type in a liquid formulation. METHODS It was designed a randomized, double-blind, single-center study conducted in the University Hospital of Messina, from January to June 2013. We asked operators to put the fingertips of their right hand (if not left-handed for one minute on the PCA medium, before washing with the three types of antiseptics, and after washing and drying. Drying was made using sterile gauzes or disposable wipes. Then, we measured the number of colony forming units per mL (CFU/mL and calculated the percentage of microbial load reduction. RESULTS 211 samples have been considered for statistical analysis: in 42 samples, in fact, initial microbial load was lower than after washing. Washing with EPG reduced CFU/ml from  a mean of 38,9 to 4,1 (86,5% reduction, washing with povi-iodine scrub from 59,55 to 12,9 (75,9% reduction and washing with Marseille soap from 47,26 to 12,7 (64,3% reduction. CONCLUSIONS Our study shows that washing with EPG has superior efficacy in CFU reduction. Antiseptic hand washing, however, cannot be considered the only measure to reduce infections: the anomaly of some results (initial microbial load lower than after washing  demonstrates that drying is an essential phase in the presurgical preparation. Therefore, hand hygiene must be part of a more complex strategy of surveillance and control of nosocomial infections

  20. "The Invisible Staff": A Qualitative Analysis of Environmental Service Workers' Perceptions of the VA Clostridium difficile Prevention Bundle Using a Human Factors Engineering Approach.

    Science.gov (United States)

    Yanke, Eric; Moriarty, Helene; Carayon, Pascale; Safdar, Nasia

    2018-06-11

    Using a novel human factors engineering approach, the Systems Engineering Initiative for Patient Safety model, we evaluated environmental service workers' (ESWs) perceptions of barriers and facilitators influencing adherence to the nationally mandated Department of Veterans Affairs Clostridium difficile infection (CDI) prevention bundle. A focus group of ESWs was conducted. Qualitative analysis was performed employing a visual matrix display to identify barrier/facilitator themes related to Department of Veterans Affairs CDI bundle adherence using the Systems Engineering Initiative for Patient Safety work system as a framework. Environmental service workers reported adequate cleaning supplies/equipment and displayed excellent knowledge of CDI hand hygiene requirements. Environmental service workers described current supervisory practices as providing an acceptable amount of time to clean CDI rooms, although other healthcare workers often pressured ESWs to clean rooms more quickly. Environmental service workers reported significant concern for CDI patients' family members as well as suggesting uncertainty regarding the need for family members to follow infection prevention practices. Small and cluttered patient rooms made cleaning tasks more difficult, and ESW cleaning tasks were often interrupted by other healthcare workers. Environmental service workers did not feel comfortable asking physicians for more time to finish cleaning a room nor did ESWs feel comfortable pointing out lapses in physician hand hygiene. Multiple work system components serve as barriers to and facilitators of ESW adherence to the nationally mandated Department of Veterans Affairs CDI bundle. Environmental service workers may represent an underappreciated resource for hospital infection prevention, and further efforts should be made to engage ESWs as members of the health care team.

  1. Prevalence and correlates of symptoms of post-traumatic stress disorder among Chinese healthcare workers exposed to physical violence: a cross-sectional study.

    Science.gov (United States)

    Shi, Lei; Wang, Lingling; Jia, Xiaoli; Li, Zhe; Mu, Huitong; Liu, Xin; Peng, Boshi; Li, Anqi; Fan, Lihua

    2017-08-01

    Post-traumatic stress disorder (PTSD) is a common psychological maladjustment to undergoing a traumatic event. Our aim was to measure the prevalence of PTSD among Chinese healthcare workers exposed to physical violence' and explore the associations of their demographic characteristics, social support, personality traits' and coping styles with their PTSD symptoms. A cross-sectional study was conducted using the Workplace Violence Scale, Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C), Social Support Rating Scale (SSRS), Eysenck Personality Questionnaire-Revised Short Scale and Trait Coping Style Questionnaire. We used convenience sampling method to collect data from March 2015 to September 2016. Healthcare workers (n=2706) from 39 public hospitals located in Heilongjiang, Hebei and Beijing provinces of China completed the questionnaires (effective response rate=84.25%). Overall, the prevalence of physical violence in the previous 12 months was 13.60% (n=2706). The prevalence of PTSD among the healthcare workers who experienced physical violence was 28.0% (n=368). Most of the victims of physical violence (50.80%) did not exhibit PTSD symptoms based on their PCL-C scores, and 47.0% did not manifest the diagnostic criteria for PTSD after experiencing physical violence. The level of PTSD symptoms was negatively correlated with their scores on the SSRS (r=-0.188, pPTSD symptoms (β=-0.376, p=0.001). However, the effect of positive coping was not significant in men. The results suggest that the aftermath of physical violence contributes to the current prevalence of PTSD. The positive effects of social support on PTSD symptoms suggest that it has practical implications for interventions to promote psychological health. The healthcare workers' coping styles influenced the development of PTSD symptoms. Therefore, adopting effective coping styles and receiving social support have potential roles in the recovery from trauma after experiencing physical

  2. Workplace interpersonal conflicts among the healthcare workers: Retrospective exploration from the institutional incident reporting system of a university-affiliated medical center.

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    Jih-Shuin Jerng

    Full Text Available There have been concerns about the workplace interpersonal conflict (WIC among healthcare workers. As healthcare organizations have applied the incident reporting system (IRS widely for safety-related incidents, we proposed that this system might provide a channel to explore the WICs.We retrospectively reviewed the reports to the IRS from July 2010 to June 2013 in a medical center. We identified the WICs and typed these conflicts according to the two foci (task content/process and interpersonal relationship and the three properties (disagreement, interference, and negative emotion, and analyzed relevant data.Of the 147 incidents with WIC, the most common related processes were patient transfer (20%, laboratory tests (17%, surgery (16% and medical imaging (16%. All of the 147 incidents with WIC focused on task content or task process, but 41 (27.9% also focused on the interpersonal relationship. We found disagreement, interference, and negative emotion in 91.2%, 88.4%, and 55.8% of the cases, respectively. Nurses (57% were most often the reporting workers, while the most common encounter was the nurse-doctor interaction (33%, and the majority (67% of the conflicts were experienced concurrently with the incidents. There was a significant difference in the distribution of worker job types between cases focused on the interpersonal relationship and those without (p = 0.0064. The doctors were more frequently as the reporter when the conflicts focused on the interpersonal relationship (34.1% than not on it (17.0%. The distributions of worker job types were similar between those with and without negative emotion (p = 0.125.The institutional IRS is a useful place to report the workplace interpersonal conflicts actively. The healthcare systems need to improve the channels to communicate, manage and resolve these conflicts.

  3. Workplace interpersonal conflicts among the healthcare workers: Retrospective exploration from the institutional incident reporting system of a university-affiliated medical center.

    Science.gov (United States)

    Jerng, Jih-Shuin; Huang, Szu-Fen; Liang, Huey-Wen; Chen, Li-Chin; Lin, Chia-Kuei; Huang, Hsiao-Fang; Hsieh, Ming-Yuan; Sun, Jui-Sheng

    2017-01-01

    There have been concerns about the workplace interpersonal conflict (WIC) among healthcare workers. As healthcare organizations have applied the incident reporting system (IRS) widely for safety-related incidents, we proposed that this system might provide a channel to explore the WICs. We retrospectively reviewed the reports to the IRS from July 2010 to June 2013 in a medical center. We identified the WICs and typed these conflicts according to the two foci (task content/process and interpersonal relationship) and the three properties (disagreement, interference, and negative emotion), and analyzed relevant data. Of the 147 incidents with WIC, the most common related processes were patient transfer (20%), laboratory tests (17%), surgery (16%) and medical imaging (16%). All of the 147 incidents with WIC focused on task content or task process, but 41 (27.9%) also focused on the interpersonal relationship. We found disagreement, interference, and negative emotion in 91.2%, 88.4%, and 55.8% of the cases, respectively. Nurses (57%) were most often the reporting workers, while the most common encounter was the nurse-doctor interaction (33%), and the majority (67%) of the conflicts were experienced concurrently with the incidents. There was a significant difference in the distribution of worker job types between cases focused on the interpersonal relationship and those without (p = 0.0064). The doctors were more frequently as the reporter when the conflicts focused on the interpersonal relationship (34.1%) than not on it (17.0%). The distributions of worker job types were similar between those with and without negative emotion (p = 0.125). The institutional IRS is a useful place to report the workplace interpersonal conflicts actively. The healthcare systems need to improve the channels to communicate, manage and resolve these conflicts.

  4. Determinants of success and sustainability of the WHO multimodal hand hygiene promotion campaign, Italy, 2007-2008 and 2014.

    Science.gov (United States)

    Moro, Maria Luisa; Morsillo, Filomena; Nascetti, Simona; Parenti, Mita; Allegranzi, Benedetta; Pompa, Maria Grazia; Pittet, Didier

    2017-06-08

    A national hand hygiene promotion campaign based on the World Health Organization (WHO) multimodal, Clean Care is Safer Care campaign was launched in Italy in 2007. One hundred seventy-five hospitals from 14 of 20 Italian regions participated. Data were collected using methods and tools provided by the WHO campaign, translated into Italian. Hand hygiene compliance, ward infrastructure, and healthcare workers' knowledge and perception of healthcare-associated infections and hand hygiene were evaluated before and after campaign implementation. Compliance data from the 65 hospitals returning complete data for all implementation tools were analysed using a multilevel approach. Overall, hand hygiene compliance increased in the 65 hospitals from 40% to 63% (absolute increase: 23%, 95% confidence interval: 22-24%). A wide variation in hand hygiene compliance among wards was observed; inter-ward variability significantly decreased after campaign implementation and the level of perception was the only item associated with this. Long-term sustainability in 48 of these 65 hospitals was assessed in 2014 using the WHO Hand Hygiene Self-Assessment Framework tool. Of the 48 hospitals, 44 scored in the advanced/intermediate categories of hand hygiene implementation progress. The median hand hygiene compliance achieved at the end of the 2007-2008 campaign appeared to be sustained in 2014. This article is copyright of The Authors, 2017.

  5. Prevalence and correlates of symptoms of post-traumatic stress disorder among Chinese healthcare workers exposed to physical violence: a cross-sectional study

    Science.gov (United States)

    Shi, Lei; Wang, Lingling; Jia, Xiaoli; Li, Zhe; Mu, Huitong; Liu, Xin; Peng, Boshi; Li, Anqi; Fan, Lihua

    2017-01-01

    Objectives Post-traumatic stress disorder (PTSD) is a common psychological maladjustment to undergoing a traumatic event. Our aim was to measure the prevalence of PTSD among Chinese healthcare workers exposed to physical violence‚ and explore the associations of their demographic characteristics, social support, personality traits‚ and coping styles with their PTSD symptoms. Methods A cross-sectional study was conducted using the Workplace Violence Scale, Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C), Social Support Rating Scale (SSRS), Eysenck Personality Questionnaire-Revised Short Scale and Trait Coping Style Questionnaire. We used convenience sampling method to collect data from March 2015 to September 2016. Healthcare workers (n=2706) from 39 public hospitals located in Heilongjiang, Hebei and Beijing provinces of China completed the questionnaires (effective response rate=84.25%). Results Overall, the prevalence of physical violence in the previous 12 months was 13.60% (n=2706). The prevalence of PTSD among the healthcare workers who experienced physical violence was 28.0% (n=368). Most of the victims of physical violence (50.80%) did not exhibit PTSD symptoms based on their PCL-C scores, and 47.0% did not manifest the diagnostic criteria for PTSD after experiencing physical violence. The level of PTSD symptoms was negatively correlated with their scores on the SSRS (r=−0.188, pviolence contributes to the current prevalence of PTSD. The positive effects of social support on PTSD symptoms suggest that it has practical implications for interventions to promote psychological health. The healthcare workers’ coping styles influenced the development of PTSD symptoms. Therefore, adopting effective coping styles and receiving social support have potential roles in the recovery from trauma after experiencing physical violence. PMID:28765135

  6. Attitudes towards second hand smoke amongst a highly exposed workforce: survey of London casino workers.

    Science.gov (United States)

    Pilkington, P A; Gray, S; Gilmore, A B; Daykin, N

    2006-06-01

    To examine knowledge, attitudes and experiences of London casino workers regarding exposure to second hand smoke (SHS) in the workplace. Postal survey of 1568 London casino workers in 25 casinos who were members of the TGWU or GMB Trade Unions. Of the workers, 559 responded to the survey (36% response), 22% of whom were current smokers. Of the respondents, 71% report being nearly always exposed to heavy levels of SHS at work, and most (65%) want all working areas in their casino to be smoke-free. The majority (78%) are bothered by SHS at work, while 91% have wanted to move away from where they are working because of it. Fifty-seven per cent believe their health has suffered as a result of SHS. Of the workers who smoke at work, 59% believe that they would try to quit smoking if no one was allowed to smoke in the casino. The majority of responders are bothered by SHS, and many are concerned about the health impacts. Most want all working areas in their casino to be smoke-free. Despite difficulties in generalizing from this limited sample, these findings add weight to the argument that the legislation on smoking in public places in England should encompass all workplaces, without exemption.

  7. Latex Allergy In Health Care Workers

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    Hayriye Sarıcaoğlu

    2013-05-01

    Full Text Available Background and Design: We aimed to determine the frequency of latex allergy in our hospital and to to evaluate the clinical and demographical features of the cases.Materials and Methods: A detailed questionnaire was administered to healthcare workers by a physician. Skin prick test with latex and patch test with rubber chemicals and a piece of latex glove were performed for all healthcare workers. Latex-specific IgE was measured in serum.Results: The study sample consisted of 36 nurses, 14 doctors, and 50 healthcare workers. While 46 subjects had symptoms, 54 subjects had no symptoms. The relationship of clinical disease with working duration, exposure duration (hour/day, history of atopy, and drug/food allergies was statistically significant. Five nurses and 1 healthcare worker had positive skin prick test. Two of them had positive latex-specific IgE. Positive skin prick test statistically significantly correlated with occupation, working duration, exposure duration (hour/day and positive latex-specific IgE. Two nurses and 2 healthcare workers had positive latex-specific IgE. Two of them had positive skin prick test. Positive latexspecific IgE statistically significantly correlated with working duration, exposure duration, and positive skin prick test. Patch test with a piece of latex glove was negative in all subjects. Three healthcare workers had positive patch test with thiuram-mix, one of them had also positive patch test with mercaptobenzothiazole.Discussion: One of the risk factors for latex allergy is occupations involving frequent exposure to latex products. Latex allergy should be taken into consideration if type I hypersensitivity reactions occur in occupational groups at risk for anaphylactic reaction.

  8. Healthcare waste management: current practices in selected healthcare facilities, Botswana.

    Science.gov (United States)

    Mbongwe, Bontle; Mmereki, Baagi T; Magashula, Andrew

    2008-01-01

    Healthcare waste management continues to present an array of challenges for developing countries, and Botswana is no exception. The possible impact of healthcare waste on public health and the environment has received a lot of attention such that Waste Management dedicated a special issue to the management of healthcare waste (Healthcare Wastes Management, 2005. Waste Management 25(6) 567-665). As the demand for more healthcare facilities increases, there is also an increase on waste generation from these facilities. This situation requires an organised system of healthcare waste management to curb public health risks as well as occupational hazards among healthcare workers as a result of poor waste management. This paper reviews current waste management practices at the healthcare facility level and proposes possible options for improvement in Botswana.

  9. Protecting healthcare workers in an acute care environment during epidemics: lessons learned from the SARS outbreak

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    John Casken

    2011-01-01

    Full Text Available During the 2002-2003 the SARS outbreak resulted in 8,450 illnesses and 812 deaths. Out of these documented cases 1706 were among healthcare workers (HCWsThe purpose of this paper is to focus on and examine the details of infection control (IC measures and which of these measures appear to be the most effective in stopping disease spread. Historically, HCWs have had poor compliance with the use of IC measures prior to the SARS outbreak. A number of lessons were learned from the SARS epidemic that should be incorporated into healthcare institutions policies and procedures. They include the following: an emphasis on the correct and immediate use of IC measures; an increased focus on HCWs recognizing early perceived threats; healthcare institutions should mandate routine in-house education with periodic updates on IC measures; administrators need to acknowledge and encourage role models among staff; engineeringcontrols should be put in place to protect staff from pathogens; and finally, there should be clear and constant communication between administration and staff.

  10. Impact of observing hand hygiene in practice and research: a methodological reconsideration.

    Science.gov (United States)

    Gould, D J; Creedon, S; Jeanes, A; Drey, N S; Chudleigh, J; Moralejo, D

    2017-02-01

    The purpose of hand hygiene is to break the chain of healthcare-associated infection. In many countries hand hygiene is regularly audited as part of quality assurance based on recommendations from the World Health Organization. Direct observation is the recommended audit method but is associated with disadvantages, including potential for being observed to alter usual behaviour. The Hawthorne effect in relation to hand hygiene is analogous with productivity improvement by increasing the frequency with which hand hygiene is undertaken. Unobtrusive and/or frequent observation to accustom staff to the presence of observers is considered an acceptable way of reducing the Hawthorne effect, but few publications have discussed how to implement these techniques or examine their effectiveness. There is evidence that awareness of being watched can disrupt the usual behaviour of individuals in complex and unpredictable ways other than simple productivity effect. In the presence of auditors, health workers might defer or avoid activities that require hand hygiene, but these issues are not addressed in guidelines for practice or research studies. This oversight has implications for the validity of hand hygiene audit findings. Measuring hand hygiene product use overcomes avoidance tactics. It is cheaper and generates data continuously to assess the compliance of all clinicians without disrupting patient care. Disadvantages are the risk of overestimating uptake through spillage, wastage, or use by visitors and non-clinical staff entering patient care areas. Electronic devices may overcome the Hawthorne and avoidance effects but are costly and are not widely used outside research studies. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  11. Healthcare waste management in selected government and private hospitals in Southeast Nigeria

    OpenAIRE

    Angus Nnamdi Oli; Callistus Chibuike Ekejindu; David Ufuoma Adje; Ifeanyi Ezeobi; Obiora Shedrack Ejiofor; Christian Chibuzo Ibeh; Chika Flourence Ubajaka

    2016-01-01

    Objective: To assess healthcare workers' involvement in healthcare waste management in public and private hospitals. Methods: Validated questionnaires (n = 660) were administered to randomly selected healthcare workers from selected private hospitals between April and July 2013. Results: Among the healthcare workers that participated in the study, 187 (28.33%) were medical doctors, 44 (6.67%) were pharmacists, 77 (11.67%) were medical laboratory scientist, 35 (5.30%) were waste handlers...

  12. Three years of national hand hygiene campaign in Germany: what are the key conclusions for clinical practice?

    Science.gov (United States)

    Reichardt, C; Königer, D; Bunte-Schönberger, K; van der Linden, P; Mönch, N; Schwab, F; Behnke, M; Gastmeier, P

    2013-02-01

    The World Health Organization (WHO) started the 'Clean Care is Safer Care' campaign in 2005. Since then, more than 120 countries have pledged to improve hand hygiene as a keystone of their national or subnational healthcare-associated infection prevention programmes. Thirty-eight countries have implemented national campaigns. Germany started a national campaign to improve hand hygiene compliance on 1 January 2008. The campaign, 'AKTION Saubere Hände', is funded by the German Ministry of Health and was initiated by the National Reference Centre for the Surveillance of Nosocomial Infections, the Society for Quality Management in Health Care and the German Coalition for Patient Safety. The campaign is designed as a multi-modal campaign based on the WHO implementation strategy. Since the end of 2010, more than 700 healthcare institutions have been actively participating in the campaign, among which are 28 university hospitals. Voluntarily participating hospitals have to implement the following measures: active support by hospital administrators of local campaign implementation, participation in a one-day introductory course, education of healthcare workers at least once a year, measurement of alcohol-based hand-rub consumption (AHC) and feedback on resulting data, implementation of the WHO 'My Five Moments for Hand Hygiene' model, increase in hand-rub availability, participation in national hand hygiene day at least every two years, and participation in national campaign network workshops at least once every two years. Observational studies to measure hand hygiene compliance are optional. Overall, there has been a significant increase of 11% in hand hygiene compliance in 62 hospitals that observed compliance before and after intervention. A total of 129 hospitals provided AHC data for three years and achieved an overall increase of 30.7%. The availability of alcohol-based hand rub increased from 86.8% to > 100% in intensive care units and from 63.6% to 91.3% in non

  13. Hand-it-on”

    DEFF Research Database (Denmark)

    Dieckmann, Gerhard Peter; Graae Zeltner, Louise; Helsø, Anne-Mette

    2016-01-01

    Non-technical skills (NTS) are an integral part of the abilities healthcare professionals need to optimally care for patients. Integrating NTS into the already complex tasks of healthcare can be a challenge for clinicians. Integrating NTS into simulation-based training increases the demands...... and where they can apply them in their work. It complements existing approaches to teaching NTS by limiting the complexity of the game and by removing medical content, allowing learners to concentrate on NTS. Hand-it-on is relevant for groups and teams working across the range of different healthcare...... and the replication of Hand-it-on by many simulation teams support its value....

  14. Factors associated with good TB infection control practices among primary healthcare workers in the Free State Province, South Africa.

    Science.gov (United States)

    Engelbrecht, Michelle; Janse van Rensburg, André; Kigozi, Gladys; van Rensburg, Hcj Dingie

    2016-11-04

    Despite the availability of TB infection control guidelines, and good levels of healthcare worker knowledge about infection control, often these measures are not well implemented. This study sought to determine the factors associated with healthcare workers' good TB infection control practices in primary health care facilities in the Free State Province, South Africa. A cross-sectional self-administered survey among nurses (n = 202) and facility-based community healthcare workers (n = 34) as well as facility observations were undertaken at all 41 primary health care facilities in a selected district of the Free State Province. The majority of respondents were female (n = 200; 87.7 %) and the average age was 44.19 years (standard deviation ±10.82). Good levels of knowledge were recorded, with 42.8 % (n = 101) having an average score (i.e. 65-79 %) and 31.8 % (n = 75) a good score (i.e. ≥ 80 %). Most respondents (n = 189; 80.4 %) had positive attitudes towards TB infection control practices (i.e. ≥ 80 %). While good TB infection control practices were reported by 72.9 % (n = 161) of the respondents (i.e. ≥75 %), observations revealed this to not necessarily be the case. For every unit increase in attitudes, good practices increased 1.090 times (CI:1.016-1.169). Respondents with high levels of knowledge (≥80 %) were 4.029 (CI: 1.550-10.469) times more likely to have good practices when compared to respondents with poor levels of knowledge (control were the main factors associated with good infection control practices. Although many respondents reported good infection control practices - which was somewhat countered by the observations - there are areas that require attention, particularly those related to administrative controls and the use of personal protective equipment.

  15. Evaluating sickness absence duration by musculoskeletal and mental health issues: a retrospective cohort study of Scottish healthcare workers.

    Science.gov (United States)

    Demou, Evangelia; Smith, Shanley; Bhaskar, Abita; Mackay, Daniel F; Brown, Judith; Hunt, Kate; Vargas-Prada, Sergio; Macdonald, Ewan B

    2018-01-26

    Sickness absence (SA) among healthcare workers is associated with occupational and non-occupational risk factors and impacts employee health, healthcare delivery and patient health. At the same time, healthcare is one of the employment sectors with the highest rates of work-related ill health in the UK. Musculoskeletal (MSK) and mental health (MH) issues are leading causes of SA, but there is a lack of research on how certain MSK/MH conditions impact on SA duration. The study aim is to determine differences in SA duration by MH and MSK disorders in healthcare employees. Survival analyses were used to estimate SA duration due to MSK and MH problems over 6 years, and Cox's proportional hazards models to determine the HRs of returning to work, using a bespoke Scottish health board database with over 53 000 SA events. SA duration and time to return-to-work (RTW) were estimated for employees by age, gender, job and health conditions. MSK and MH conditions accounted for 27% and 6% of all SA events and 23.7% and 19.5% of all days lost, respectively. Average SA duration was 43.5 days for MSK and 53.9 days for MH conditions. For MSK conditions, employees with low back or neck pain had the fastest RTW (median P 50 : 7 days), whereas employees absent due to depression took the longest (P 50 : 54 days). The most influential sociodemographic variables affecting RTW were age, gender and job category. Using a unique and rich database, we found significant differences in SA duration by presenting condition in healthcare workers. MH conditions, and depression specifically, accounted for the most working days' absence. Significant variations in duration were also observed for MSK conditions. Our findings can inform public health practitioners and healthcare managers of the most significant factors impacting MSK-related and MH-related SA to develop and implement tailored and targeted workplace interventions. © Article author(s) (or their employer(s) unless otherwise stated in the

  16. Evaluation of hand hygiene compliance and associated factors with a radio-frequency-identification-based real-time continuous automated monitoring system.

    Science.gov (United States)

    Dufour, J-C; Reynier, P; Boudjema, S; Soto Aladro, A; Giorgi, R; Brouqui, P

    2017-04-01

    Hand hygiene is a major means for preventing healthcare-associated infections. One critical point in understanding poor compliance is the lack of relevant markers used to monitor practices systematically. This study analysed hand hygiene compliance and associated factors with a radio-frequency-identification-based real-time continuous automated monitoring system in an infectious disease ward with 17 single bedrooms. Healthcare workers (HCWs) were tracked while performing routine care over 171 days. A multi-level multi-variate logistics model was used for data analysis. The main outcome measures were hand disinfection before entering the bedroom (outside use) and before entering the patient care zone, defined as the zone surrounding the patient's bed (inside/bedside use). Variables analysed included HCWs' characteristics and behaviour, patients, room layouts, path chains and duration of HCWs' paths. In total, 4629 paths with initial hand hygiene opportunities when entering the patient care zone were selected, of which 763 (16.5%), 285 (6.1%) and 3581 (77.4%) were associated with outside use, inside/bedside use and no use, respectively. Hand hygiene is caregiver-dependent. The shorter the duration of the HCW's path, the worse the bedside hand hygiene. Bedside hand hygiene is improved when one or two extra HCWs are present in the room. Hand hygiene compliance at the bedside, as analysed using the continuous monitoring system, depended upon the HCW's occupation and personal behaviour, number of HCWs, time spent in the room and (potentially) dispenser location. Meal tray distribution was a possible factor in the case of failure to disinfect hands. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  17. Perceptions of telecare training needs in home healthcare services: a focus group study.

    Science.gov (United States)

    Guise, Veslemøy; Wiig, Siri

    2017-02-23

    The implementation and use of telecare requires significant changes to healthcare service organisation and delivery, including new ways of working for staff. Competency development and training for healthcare professionals is therefore required to enable necessary adaptation of clinical practice and ensure competent provision of telecare services. It is however unclear what skills healthcare staff need when providing care at a distance and there is little empirical evidence on effective training strategies for telecare practice. Training should however emphasise the experiences and preferences of prospective trainees to ensure its relevance to their educational needs. The aim of this study was to explore healthcare professionals' perceptions of training related to the general use of telecare, and to identify specific training needs associated with the use of virtual visits in the home healthcare services. Six focus group interviews were held with a total of 26 participants working in the home healthcare services in Norway, including registered nurses, enrolled nurses, physiotherapists, occupational therapists, social workers, health workers, and healthcare assistants. The data material was analysed by way of systematic text condensation. The analysis resulted in five categories relevant to telecare training for healthcare professionals: Purposeful training creates confidence and changes attitudes; Training needs depend on ability to cope with telecare; The timing of training; Training must facilitate practical insight into the patients' perspective; and Training content must focus on the telecare process. Findings are discussed in light of implications for the form and content of a training program for healthcare professionals on how to undertake virtual home healthcare visits. Appropriate preparation and training for telecare use is important for healthcare professionals and must be taken seriously by healthcare organisations. To facilitate the knowledge, skills

  18. UV-C decontamination of hand-held tablet devices in the healthcare environment using the Codonics D6000™ disinfection system.

    Science.gov (United States)

    Muzslay, M; Yui, S; Ali, S; Wilson, A P R

    2018-04-09

    Mobile phones and tablet computers may be contaminated with microorganisms and become a potential reservoir for cross-transmission of pathogens between healthcare workers and patients. There is no generally accepted guidance how to reduce contamination on mobile devices in healthcare settings. Our aim was to determine the efficacy of the Codonics D6000™ UV-C disinfection device. Daily disinfection reduced contamination on screens and on protective cases (test) significantly, but not all cases (control) could be decontaminated. The median aerobic colony count on the control and the test cases was 52 (IQR 33-89) cfu/25cm 2 and 22 (IQR 10.5-41) cfu/25cm 2 respectively before disinfection. Copyright © 2018. Published by Elsevier Ltd.

  19. Qualitative findings from focus group discussions on hand hygiene compliance among health care workers in Vietnam.

    Science.gov (United States)

    Salmon, Sharon; McLaws, Mary-Louise

    2015-10-01

    It is accepted by hospital clinical governance that every clinician's "duty of care" includes hand hygiene, yet globally, health care workers (HCWs) continue to struggle with compliance. Focus group discussions were conducted to explore HCWs' barriers to hand hygiene in Vietnam. Twelve focus group discussions were conducted with HCWs from 6 public hospitals across Hanoi, Vietnam. Discussions included participants' experiences with and perceptions concerning hand hygiene. Tape recordings were transcribed verbatim and then translated into English. Thematic analysis was conducted by 2 investigators. Expressed frustration with high workload, limited access to hand hygiene solutions, and complicated guidelines that are difficult to interpret in overcrowded settings were considered by participants to be bona fide reasons for noncompliance. No participant acknowledged hand hygiene as a duty of care practice for her or his patients. Justification for noncompliance was the observation that visitors did not perform hand hygiene. HCWs did acknowledge a personal duty of care when hand hygiene was perceived to benefit her or his own health, and then neither workload or environmental challenges influenced compliance. Limited resources in Vietnam are amplified by overcrowded conditions and dual bed occupancy. Yet without a systematic systemic duty of care to patient safety, changes to guidelines and resources might not immediately improve compliance. Thus, introducing routine hand hygiene must start with education programs focusing on duty of care. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  20. The risk of alcohol and drug dependence among healthcare workers as a result of excessive stress.

    OpenAIRE

    Chudá, Romana

    2012-01-01

    Charles University in Prague First Faculty of Medicine Department of Psychiatry, Center for Addictology School Year: 2007/2010 Abstract of the bachelor work Name: Romana Chudá Specialization: Adiktologie Matriculation year: 2007 Supervisor: MUDr. Petr Popov Opponent: MUDr. Dušan Randák Pages: 61 The title of the bachelor work: The risk of alcohol and drug dependence aminy healthcare workers as a result of excessive stress Abstract: The author has several times seen medical staff, who had been...

  1. Perfect match? Generation Y as change agents for information communication technology implementation in healthcare.

    Science.gov (United States)

    Yee, Kwang Chien; Miils, Erin; Airey, Caroline

    2008-01-01

    The current healthcare delivery model will not meet future healthcare demands. The only sustainable healthcare future is one that best leverages advances in technology to improve productivity and efficiency. Information communication technology (ICT) has, therefore, been touted as the panacea of future healthcare challenges. Many ICT projects in healthcare, however, fail to deliver on their promises to transform the healthcare system. From a technologist's perspective, this is often due to the lack of socio-technical consideration. From a socio-cultural perspective, however, there is often strong inertia to change. While the utilisation of user-centred design principles will generate a new wave of enthusiasm among technologists, this has to be matched with socio-cultural changes within the healthcare system. Generation Y healthcare workers might be the socio-cultural factor required, in combination with new technology, to transform the healthcare system. Generation Y has generated significant technology-driven changes in many other industries. The socio-cultural understanding of generation Y healthcare workers is essential to guide the design and implementation of ICT solutions for a sustainable healthcare future. This paper presents the initial analysis of our qualitative study which aims to generate in-depth conceptual insights of generation Y healthcare workers and their view of ICT in healthcare. Our results show that generation Y healthcare workers might assist future ICT implementation in healthcare. This paper, however, argues that significant changes to the current healthcare organisation will be required in order to unleash the full potential of generation Y workers and ICT implementation. Finally, this paper presents some strategies to empower generation Y workers as change agents for a sustainable future healthcare system.

  2. Addressing the intersection between alcohol consumption and antiretroviral treatment: needs assessment and design of interventions for primary healthcare workers, the Western Cape, South Africa.

    Science.gov (United States)

    Schneider, M; Chersich, M; Temmerman, M; Parry, C D

    2016-10-26

    At the points where an infectious disease and risk factors for poor health intersect, while health problems may be compounded, there is also an opportunity to provide health services. Where human immunodeficiency virus (HIV) infection and alcohol consumption intersect include infection with HIV, onward transmission of HIV, impact on HIV and acquired immunodeficiency syndrome (AIDS) disease progression, and premature death. The levels of knowledge and attitudes relating to the health and treatment outcomes of HIV and AIDS and the concurrent consumption of alcohol need to be determined. This study aimed to ascertain the knowledge, attitudes and practices of primary healthcare workers concerning the concurrent consumption of alcohol of clinic attendees who are prescribed antiretroviral drugs. An assessment of the exchange of information on the subject between clinic attendees and primary healthcare providers forms an important aspect of the research. A further objective of this study is an assessment of the level of alcohol consumption of people living with HIV and AIDS attending public health facilities in the Western Cape Province in South Africa, to which end, the study reviewed health workers' perceptions of the problem's extent. A final objective is to contribute to the development of evidence-based guidelines for AIDS patients who consume alcohol when on ARVs. The overall study purpose is to optimise antiretroviral health outcomes for all people living with HIV and AIDS, but with specific reference to the clinic attendees studied in this research. Overall the research study utilised mixed methods. Three group-specific questionnaires were administered between September 2013 and May 2014. The resulting qualitative data presented here supplements the results of the quantitative data questionnaires for HIV and AIDS clinic attendees, which have been analysed and written up separately. This arm of the research study comprised two, separate, semi-structured sets of

  3. Effect of Shift Work on Sleep, Health, and Quality of Life of Health-care Workers.

    Science.gov (United States)

    Nena, Evangelia; Katsaouni, Maria; Steiropoulos, Paschalis; Theodorou, Evangelos; Constantinidis, Theodoros C; Tripsianis, Grigorios

    2018-01-01

    Shift work is associated with sleep disruption, impaired quality of life, and is a risk factor for several health conditions. Aim of this study was to investigate the impact of shift work on sleep and quality of life of health-care workers (HCW). Tertiary University hospital in Greece. Cross-sectional study. Included were HCW, working either in an irregular shift system or exclusively in morning shifts. All participants answered the WHO-5 Well-Being Index (WHO-5) and a questionnaire on demographics and medical history. Shift workers filled the Shift Work Disorders Screening Questionnaire (SWDSQ). Descriptive statistics, Student's t -test, one-way analysis of variance (ANOVA), Pearson's r correlation coefficient, and multivariate stepwise linear regression analysis were applied. Included were 312 employees (87.9% females), 194 working in irregular shift system and 118 in morning shifts. Most shift-workers (58.2%) were somehow or totally dissatisfied with their sleep quality. Regression analysis revealed the following independent determinants for sleep impairment: parenthood ( P 3 night shifts/week ( P work >5 years in an irregular shift system ( P work impairs quality of life, whereas its duration and frequency, along with age and family status of employees can have adverse effects on sleep.

  4. Salmonella bacteraemia among healthcare workers and their dependents

    International Nuclear Information System (INIS)

    Raza, A.; Sultan, F.; Mahboob, A.; Nazeer, S. H.; Nizammudin, S.

    2014-01-01

    Objectives: To determine the incidence and resistance pattern of Salmonella infection in healthcare workers and their dependents. Methods: The retrospective analysis was conducted at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, and comprised records of employees and their dependents with bacteraemia from January 2007 to December 2011. Person-years were calculated using data from the human resources department. SPSS 19 was used for statistical analyses. Results: Of the total 2532 records available, 82(3.23%) patients were identified with Salmonella bacteraemia. Of them, 34(41.5%) patients were in age group 1-10, 15(18.3%) in 11-20, 26(31.7%) in 21-30, and 7(8.5%) were above 30 years. Besides, 48(58.5%) were males. Salmonella typhi was found in 44(53.7%) patients, Salmonella paratyphi A in 35(42.7%) and Salmonella species in 3(3.7%) patients. The yearly incidence of Salmonella infection in the study population ranged from 206 to 596 per 100000 person-years. Ciprofloxacin resistance was noted to be 56 (68.2%) followed by Ampicillin 29 (35.3%) and Co-trimoxazole 24 (29.2%). No strains were resistant to Cefiximeor Ceftriaxone. Conclusion: The yearly incidence of Salmonella bacteraemia ranged from 200 to 600 per 100000 person years. There was significant quinolone resistance among the isolates. (author)

  5. Why is patient safety so hard in low-income countries? A qualitative study of healthcare workers' views in two African hospitals.

    Science.gov (United States)

    Aveling, Emma-Louise; Kayonga, Yvette; Nega, Ansha; Dixon-Woods, Mary

    2015-02-25

    The views of practitioners at the sharp end of health care provision are now recognised as a valuable source of intelligence that can inform efforts to improve patient safety in high-income countries. Yet despite growing policy emphasis on patient safety in low-income countries, little research examines the views of practitioners in these settings. We aimed to give voice to how healthcare workers in two East African hospitals identify and explain the major obstacles to ensuring the safety of patients in their care. We conducted in-depth, face to face interviews with healthcare workers in two East African hospitals. Our sample included a total of 57 hospital staff, including nurses, physicians, technicians, clinical services staff, administrative staff and hospital managers. Hospital staff in low-income settings offered broadly encompassing and aspirational definitions of patient safety. They identified obstacles to patient safety across three major themes: material context, staffing issues and inter-professional working relationships. Participants distinguished between the proximal influences on patient safety that posed an immediate threat to patient care, and the distal influences that generated the contexts for such hazards. These included contexts of severe material deprivation, but also the impact of relational factors such as teamwork and professional hierarchies. Structures of authority, governance and control that were not optimally aligned with achieving patient safety were widely reported. As in high-income countries, the accounts of healthcare workers in low-income countries provide sophisticated and valuable insights into the challenges of patient safety. Though the impact of resource constraints and weak governance structures are particularly marked in low-income countries, the congruence between accounts of health workers in diverse settings suggest that the origins and solutions to patient safety problems are likely to be similar everywhere and are

  6. Pre-employment screening of latent tuberculosis infection among healthcare workers using tuberculin skin test and QuantiFERON-TB Gold test at a tertiary care hospital in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Mohamed El-Helaly

    2014-11-01

    Full Text Available Summary: Objective: To assess the agreement between the tuberculin skin test (TST and the QuantiFERON-TB Gold test (QFT-G as pre-employment screening tests for latent tuberculosis infection (LTBI among healthcare workers. Methods: A retrospective cross-sectional study was conducted among 1412 healthcare workers who were screened for LTBI during the period from August 2009 to May 2011 at a tertiary-care hospital in the Kingdom of Saudi Arabia (KSA. The studied population was screened for LTBI using both TST and QFT-G simultaneously. The agreement between both tests was quantified using the Kappa coefficient (κ. Results: Comparing the results of QFT-G with TST, the tests had a significant overall agreement of 73.7% (1040/1412; κ = 0.33; p < 0.01. Negative concordance comprised 60.1% of the results, and positive concordance comprised 13.5%. However, positive TST but negative QFT comprised 16.3% of the results, and negative TST but positive QFT-G comprised 10.1%. Concordance was significantly associated with young age, female gender, Saudi-born nationals, and early career but not job type (clinical versus non-clinical nor status of Bacillus Calmette–Guerin (BCG vaccination. Conclusions: This study demonstrated 73.7% overall agreement between TST and QFT-G results among healthcare workers during pre-employment screening for LTBI. The results need to be confirmed in future studies before recommending QFT-G as a pre-employment screening test for LTBI. Keywords: Latent tuberculosis infection, Healthcare workers, Tuberculin skin test, QuantiFERON-TB Gold test

  7. Physical exercise at the workplace prevents deterioration of work ability among healthcare workers

    DEFF Research Database (Denmark)

    Jakobsen, Markus D.; Sundstrup, Emil; Brandt, Mikkel

    2015-01-01

    BACKGROUND: Imbalance between individual resources and work demands can lead to musculoskeletal disorders and reduced work ability. The purpose of this study was to investigate the effect of workplace- versus home-based physical exercise on work ability among healthcare workers. METHODS: Two......) performed during working hours for 5x10 min per week and up to 5 group-based coaching sessions on motivation for regular physical exercise, or 2) home-based physical exercise (HOME) performed during leisure time for 5x10 min per week. Both groups received ergonomic counseling on patient handling and use...... of lifting aides. The main outcome measure was the change from baseline to 10-week follow-up in WAI. RESULTS: Significant group by time interaction was observed for WAI (p 

  8. Influence of lifestyle factors on long-term sickness absence among female healthcare workers

    DEFF Research Database (Denmark)

    Quist, Helle Gram; Thomsen, Birthe L; Christensen, Ulla

    2014-01-01

    BACKGROUND: While previous research has indicated that unhealthy lifestyle is associated with sickness absence, this association may be confounded by occupational class. To avoid this potential confounding, we examined the association between lifestyle factors (smoking, leisure-time physical......-time physical activity (trend test p-value = 0.01), so that increasing physical activity results in decreasing risk of LTSA. CONCLUSION: In female healthcare workers, an unhealthy lifestyle (too high/ too low body mass index, smoking, and low physical activity) is associated with higher risk of LTSA....... environment. Subsequently, they were followed for 12 months in a national register on social transfer payments (DREAM register). Cox's regression analyses, applied to grouped survival data, were used to estimate the prospective association between these lifestyle factors and LTSA. RESULTS: We found...

  9. [Fostering LGBT-friendly healthcare services].

    Science.gov (United States)

    Wei, Han-Ting; Chen, Mu-Hong; Ku, Wen-Wei

    2015-02-01

    LGBT (lesbian, gay, bisexual, transgender) patients suffer from stigma and discrimination when seeking healthcare. A large LGBT healthcare survey revealed that 56% of gay patients and 70% of transgender patients suffered some type of discrimination while seeking healthcare in 2014. The fostering of LGBT-friendly healthcare services is not just an advanced step of gender mainstreaming but also a fulfillment of health equality and equity. Additionally, LGBT-friendly healthcare services are expected to provide new opportunities for healthcare workers. Therefore, proactive government policies, education, research, and clinical practice should all encourage the development of these healthcare services. We look forward to a well-developed LGBT-friendly healthcare system in Taiwan.

  10. [Factors associated with influenza immunization in primary care health workers].

    Science.gov (United States)

    Montserrat-Capdevila, Josep; Godoy, Pere; Marsal, Josep Ramon; Barbé-Illa, Ferran

    2015-01-01

    To identify the influenza vaccination coverage in healthcare workers in primary care and to determine the factors associated with vaccination (2013-2014 season). A cross-sectional study was carried out among 287 healthcare workers who completed a questionnaire that included questions about knowledge, beliefs and attitudes to influenza and vaccination. We estimated the vaccine coverage and identified the variables associated with vaccination of healthcare workers by using non-conditional logistic regression models. The participation rate was 47.2%. Vaccination coverage was 60.3% and was higher in workers older than 55 years, women and pediatricians. The factors associated with healthcare worker vaccination were the perception that vaccination confers protection (aOR: 11.1; 95%CI: 3.41-35.9) and the perception that it is effective (aOR: 7.5; 95%CI: 0.9-59.3). No association was found between receiving the vaccine and knowledge of influenza or vaccination. However, an association was found with prescribing vaccination to pregnant women, to persons older than 65 years, and to immunosuppressed individuals. Strategies should be designed to increase coverage, based on changing negative attitudes of healthcare workers to vaccination. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  11. Knowledge, attitude and practice of pharmacists and health-care workers regarding oral contraceptives correct usage, side-effects and contraindications.

    Science.gov (United States)

    Sattari, M; Mokhtari, Z; Jabari, H; Mashayekhi, S O

    2013-06-01

    Despite the success of the Iranian family planning programme, the number of unwanted pregnancies remains high. To investigate whether health workers in Tabriz are providing correct information and counselling about OCP use, the current study was planned to examine the level of knowledge, attitude and practice of OCP providers. A sample of 150 health-care workers in health houses and 150 community/hospital pharmacists answered a questionnaire about knowledge of correct use of OCP, side-effects, contraindications, danger signs/symptoms and non-contraceptive benefits, and whether they counselled patients about these subjects. Knowledge of pharmacists and health workers was not as high as expected and in many topics they were counselling patients even when they had incorrect knowledge and in other areas they were not providing information to patients despite having the correct knowledge. Better continuing education for OCP providers and especially for pharmacists seems necessary.

  12. Use of an Innovative Personality-Mindset Profiling Tool to Guide Culture-Change Strategies among Different Healthcare Worker Groups.

    Directory of Open Access Journals (Sweden)

    M Lindsay Grayson

    Full Text Available Important culture-change initiatives (e.g. improving hand hygiene compliance are frequently associated with variable uptake among different healthcare worker (HCW categories. Inherent personality differences between these groups may explain change uptake and help improve future intervention design.We used an innovative personality-profiling tool (ColourGrid® to assess personality differences among standard HCW categories at five large Australian hospitals using two data sources (HCW participant surveys [PS] and generic institution-wide human resource [HR] data to: a compare the relative accuracy of these two sources; b identify differences between HCW groups and c use the observed profiles to guide design strategies to improve uptake of three clinically-important initiatives (improved hand hygiene, antimicrobial stewardship and isolation procedure adherence.Results from 34,243 HCWs (HR data and 1045 survey participants (PS data suggest that HCWs were different from the general population, displaying more individualism, lower power distance, less uncertainty avoidance and greater cynicism about advertising messages. HR and PS data were highly concordant in identifying differences between the three key HCW categories (doctors, nursing/allied-health, support services and predicting appropriate implementation strategies. Among doctors, the data suggest that key messaging should differ between full-time vs part-time (visiting senior medical officers (SMO, VMO and junior hospital medical officers (HMO, with SMO messaging focused on evidence-based compliance, VMO initiatives emphasising structured mandatory controls and prestige loss for non-adherence, and for HMOs focusing on leadership opportunity and future career risk for non-adherence.Compared to current standardised approaches, targeted interventions based on personality differences between HCW categories should result in improved infection control-related culture-change uptake. Personality

  13. Use of an Innovative Personality-Mindset Profiling Tool to Guide Culture-Change Strategies among Different Healthcare Worker Groups.

    Science.gov (United States)

    Grayson, M Lindsay; Macesic, Nenad; Huang, G Khai; Bond, Katherine; Fletcher, Jason; Gilbert, Gwendolyn L; Gordon, David L; Hellsten, Jane F; Iredell, Jonathan; Keighley, Caitlin; Stuart, Rhonda L; Xuereb, Charles S; Cruickshank, Marilyn

    2015-01-01

    Important culture-change initiatives (e.g. improving hand hygiene compliance) are frequently associated with variable uptake among different healthcare worker (HCW) categories. Inherent personality differences between these groups may explain change uptake and help improve future intervention design. We used an innovative personality-profiling tool (ColourGrid®) to assess personality differences among standard HCW categories at five large Australian hospitals using two data sources (HCW participant surveys [PS] and generic institution-wide human resource [HR] data) to: a) compare the relative accuracy of these two sources; b) identify differences between HCW groups and c) use the observed profiles to guide design strategies to improve uptake of three clinically-important initiatives (improved hand hygiene, antimicrobial stewardship and isolation procedure adherence). Results from 34,243 HCWs (HR data) and 1045 survey participants (PS data) suggest that HCWs were different from the general population, displaying more individualism, lower power distance, less uncertainty avoidance and greater cynicism about advertising messages. HR and PS data were highly concordant in identifying differences between the three key HCW categories (doctors, nursing/allied-health, support services) and predicting appropriate implementation strategies. Among doctors, the data suggest that key messaging should differ between full-time vs part-time (visiting) senior medical officers (SMO, VMO) and junior hospital medical officers (HMO), with SMO messaging focused on evidence-based compliance, VMO initiatives emphasising structured mandatory controls and prestige loss for non-adherence, and for HMOs focusing on leadership opportunity and future career risk for non-adherence. Compared to current standardised approaches, targeted interventions based on personality differences between HCW categories should result in improved infection control-related culture-change uptake. Personality

  14. Occupational tuberculosis in healthcare workers in sub-Saharan Africa: A Systematic Review.

    Science.gov (United States)

    Alele, Faith O; Franklin, Richard C; Emeto, Theophilus I; Leggat, Peter

    2018-04-27

    This article investigates the incidence, prevalence and factors associated with occupational tuberculosis (TB) in healthcare workers (HCWs) in sub-Saharan Africa (SSA). Studies were extracted from MEDLINE, PsycINFO, CINAHL, Cochrane Library, and SCOPUS databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement from inception to the 2 nd of June 2017. Twenty-one studies met the inclusion criteria. The median prevalence of latent TB infection in HCWS was 62% (IQR 22%) and the median incidence of TB disease was 3871/100,000 (IQR 9314/100,000). The risk factors associated with LTBI or active TB disease were workplace, history of contact with TB patients, and longer duration of employment. The findings of this review demonstrate that the risk of acquiring TB among HCWs in SSA is high. This may impact on the recruitment, longevity and retention of HCWs.

  15. Knowledge and attitude toward smoke-free legislation and second-hand smoking exposure among workers in indoor bars, beer parlors and discotheques in Osun State of Nigeria.

    Science.gov (United States)

    Onigbogi, Olanrewaju Olusola; Odukoya, Oluwakemi; Onigbogi, Modupe; Sekoni, Oluwakemi

    2015-04-01

    One of the requirements of the Osun State smoke-free legislation is to ensure smoke-free enclosed and partially enclosed workplaces. This survey was conducted to assess the knowledge and attitude of workers in indoor bars, beer parlors and discotheques to smoke-free legislation in general and the Osun State smoke-free law in particular. A convenience sampling of 36 hospitality centers was conducted. Interviewer-administered questionnaires were used to elicit responses about the objectives from non-smoking workers. The questionnaires had sections on knowledge of the Osun State smoke-free law, attitude toward the law and smoke-free legislation in general and exposure to second-hand tobacco smoke by the workers. Questions were also asked about the second-hand tobacco smoking status of these workers. The data were analyzed using SPSS version 15.0. We had 154 participants recruited into the study. There were 75 males (48.0%) and 79 females (52.0%). On the overall, respondents had a good knowledge of the effects of second-hand smoke on health (70.2%) with 75.0% of them being aware of the general smoke-free law and 67.3% being aware of the Osun State smoke-free law although none of them had ever seen a copy of the law. A high proportion (60.0%) was in support of the Osun smoke-free law although all of them think that the implementation of the law could reduce patronage and jeopardize their income. Attitude toward second-hand smoking was generally positive with 72.0% of them having no tolerance for second-hand tobacco smoke in their homes. Most participants (95.5%) had been exposed to tobacco smoke in the workplace within the past week. Despite the high level of awareness of the respondents about the dangers of second hand smoke and their positive attitude to smoke-free laws, nearly all were constantly being exposed to second hand smoke at work. This calls for policy level interventions to improve the implementation of the smoke-free law.

  16. Healthcare waste management in selected government and private hospitals in Southeast Nigeria

    Institute of Scientific and Technical Information of China (English)

    Angus Nnamdi Oli; Callistus Chibuike Ekejindu; David Ufuoma Adje; Ifeanyi Ezeobi; Obiora Shedrack Ejiofor; Christian Chibuzo Ibeh; Chika Flourence Ubajaka

    2016-01-01

    Objective:To assess healthcare workers’ involvement in healthcare waste management in public and private hospitals.Methods:Validated questionnaires(n = 660) were administered to randomly selected healthcare workers from selected private hospitals between April and July 2013.Results:Among the healthcare workers that participated in the study,187(28.33%) were medical doctors,44(6.67%) were pharmacists,77(11.67%) were medical laboratory scientist,35(5.30%) were waste handlers and 317(48.03%) were nurses.Generally,the number of workers that have heard about healthcare waste disposal system was above average 424(69.5%).More health-workers in the government(81.5%) than in private(57.3%) hospitals were aware of healthcare waste disposal system and more in government hospitals attended training on it.The level of waste generated by the two hospitals differed significantly(P=0.0086) with the generation level higher in government than private hospitals.The materials for healthcare waste disposal were significantly more available(P=0.001) in government than private hospitals.There was no significant difference(P = 0.285) in syringes and needles disposal practices in the two hospitals and they were exposed to equal risks(P =0.8510).Fifty-six(18.5%) and 140(45.5%) of the study participants in private and government hospitals respectively were aware of the existence of healthcare waste management committee with 134(44.4%) and 19(6.2%) workers confirming that it did not exist in their institutions.The existence of the committee was very low in the private hospitals.Conclusions:The availability of material for waste segregation at point of generation,compliance of healthcare workers to healthcare waste management guidelines and the existence of infection control committee in both hospitals is generally low and unsatisfactory.

  17. Healthcare Workers Emotions, Perceived Stressors and Coping Strategies During a MERS-CoV Outbreak.

    Science.gov (United States)

    Khalid, Imran; Khalid, Tabindeh J; Qabajah, Mohammed R; Barnard, Aletta G; Qushmaq, Ismael A

    2016-03-01

    Healthcare workers (HCWs) are at high risk of contracting Middle East respiratory syndrome coronavirus (MERS-CoV) during an epidemic. We explored the emotions, perceived stressors, and coping strategies of healthcare workers who worked during a MERS-CoV outbreak in our hospital. A cross-sectional descriptive survey design. A tertiary care hospital. HCWs (150) who worked in high risk areas during the April-May 2014 MERS-CoV outbreak that occurred in Jeddah, Saudi Arabia. We developed and administered a "MERS-CoV staff questionnaire" to study participants. The questionnaire consisted of 5 sections with 72 questions. The sections evaluated hospital staffs emotions, perceived stressors, factors that reduced their stress, coping strategies, and motivators to work during future outbreaks. Responses were scored on a scale from 0-3. The varying levels of stress or effectiveness of measures were reported as mean and standard deviation, as appropriate. Completed questionnaires were returned by 117 (78%) of the participants. The results had many unique elements. HCWs ethical obligation to their profession pushed them to continue with their jobs. The main sentiments centered upon fear of personal safety and well-being of colleagues and family. Positive attitudes in the workplace, clinical improvement of infected colleagues, and stoppage of disease transmission among HCWs after adopting strict protective measures alleviated their fear and drove them through the epidemic. They appreciated recognition of their efforts by hospital management and expected similar acknowledgment, infection control guidance, and equipment would entice them to work during future epidemics. The MERS-CoV outbreak was a distressing time for our staff. Hospitals can enhance HCWs experiences during any future MERS-CoV outbreak by focusing on the above mentioned aspects. © 2016 Marshfield Clinic.

  18. Work engagement and occupational stress in nurses and other healthcare workers: the role of organisational and personal factors.

    Science.gov (United States)

    Fiabane, Elena; Giorgi, Ines; Sguazzin, Cinzia; Argentero, Piergiorgio

    2013-09-01

    The aims of this study were to: (1) identify the role of organisational and personal factors in predicting work engagement in healthcare workers and (2) compare work engagement and occupational stress perceptions of healthcare professional categories. Healthcare professionals, with particular regard to nurses, are exposed to several job stressors that can adversely affect both their mental and physical health and also decrease work engagement. Work engagement can be considered as the positive opposite of burnout, and it is characterised by energy, involvement and professional efficacy. A cross-sectional survey research was conducted with self-report questionnaires. The Maslach Burnout Inventory-General Survey, the Areas of Worklife Scale and four scales from the Occupational Stress Indicator were administered to a sample of 198 hospital staff (registered nurses, nurse aides, physicians and physiotherapists), of which 110 participated in the study. The most significant predictors of energy were workload, mental health and job satisfaction; the best predictors of involvement were community, workload, mental health and job satisfaction; professional efficacy was best predicted by values and job satisfaction. In relation to the second aim, physiotherapists had the highest levels of occupational stress and disengagement from their work, while nurse aides were the most work-engaged and job-satisfied professional category, with positive perceptions of the work environment. Both organisational and personal factors were found to be significantly associated with work engagement. In this study, physiotherapists were the category with the highest risk of work-related psychological problems, whereas nurse aides had the lowest risk. Interventions aimed at improving clinical practice and psychological health of nurses and hospital staff should focus on workload, workers' personal expectations and job satisfaction. © 2013 Blackwell Publishing Ltd.

  19. Incidence of Raynaud's phenomenon in relation to hand-arm vibration exposure among male workers at an engineering plant a cohort study

    Directory of Open Access Journals (Sweden)

    Lundström Ronnie

    2008-06-01

    Full Text Available Abstract Background The objective of this study was to assess the incidence of Raynaud's phenomenon in relation to hand-arm vibration exposure in a cohort consisting of male office and manual workers. Methods The baseline population consisted of 94 office and 147 manual workers at an engineering plant. Raynaud's phenomenon (RP was assessed at baseline and at follow up (at 5, 10 and 15 years. A retrospective and a prospective cohort analysis of data were done. Hand-arm vibration exposure dose was defined as the product of exposure duration and the weighted hand-arm vibration exposure value according to ISO 5349-1. Results The retrospective/prospective incidence of Raynaud's phenomenon was 16/14 per 1000 exposure years among exposed and 2.4/5.0 per 1000 years among the not exposed. The retrospective dose response curve based on 4 dose classes showed that class 2, 3 and 4 had similar response and showed higher incidence than the not-exposed. The dose with RP response to hand-arm vibration corresponded to a 10 year A(8 value between 0.4–1.0 m/s2. Conclusion The results indicate that the EU directive on an action value for hand-arm vibration of 2.5 m/s2 is not too low. Rather, it suggests that employers should take on actions even at exposure values of 1 m/s2A(8.

  20. Febrile illness in healthcare workers caring for Ebola virus disease patients in a high-resource setting.

    Science.gov (United States)

    Fink, Douglas; Cropley, Ian; Jacobs, Michael; Mepham, Stephen

    2017-01-26

    Ebola virus disease (EVD) patients treated in high-resource facilities are cared for by large numbers of healthcare staff. Monitoring these healthcare workers (HCWs) for any illness that may represent transmission of Ebola virus is important both for the individuals and to minimise the community risk. International policies for monitoring HCWs vary considerably and their effectiveness is unknown. Here we describe the United Kingdom (UK) experience of illness in HCWs who cared for three patients who acquired EVD in West Africa. Five of these 93 high-level isolation unit (HLIU) HCWs presented with fever within 21 days of working on the unit; one of these five presented outside of the UK. This article discusses different approaches to monitoring of HCW symptom reporting. The potential impact of these approaches on HLIU staff recruitment, including travel restrictions, is also considered. An international surveillance system enhancing collaboration between national public health authorities may assist HLIU HCW monitoring in case they travel. This article is copyright of The Authors, 2017.

  1. Evaluation of a hand hygiene campaign in outpatient health care clinics.

    Science.gov (United States)

    Kukanich, Kate Stenske; Kaur, Ramandeep; Freeman, Lisa C; Powell, Douglas A

    2013-03-01

    To improve hand hygiene in two outpatient health care clinics through the introduction of a gel sanitizer and an informational poster. In this interventional study, health care workers at two outpatient clinics were observed for frequency of hand hygiene (attempts versus opportunities). Gel sanitizer and informational posters were introduced together as an intervention. Direct observation of the frequency of hand hygiene was performed during baseline, intervention, and follow-up. A poststudy survey of health care workers was also distributed and collected. In both clinics, the frequency of hand hygiene was poor at baseline (11% and 21%) but improved significantly after intervention (36% and 54%) and was maintained through the follow-up period (32% and 51%). Throughout the study, postcontact hand hygiene was observed significantly more often than precontact hand hygiene. In both clinics, health care workers reported a preference for soap and water; yet observations showed that when the intervention made gel sanitizer available, sanitizer use predominated. Fifty percent of the surveyed health care workers considered the introduction of gel sanitizer to be an effective motivating tool for improving hand hygiene. Hand hygiene performance by health care workers in outpatient clinics may be improved through promoting the use of gel sanitizer and using informational posters. Compared with surveys, direct observation by trained observers may provide more accurate information about worker preferences for hand hygiene tools.

  2. Comparing patient and healthcare worker experiences during a dengue outbreak in Singapore: understanding the patient journey and the introduction of a point-of-care test (POCT) toward better care delivery.

    Science.gov (United States)

    Tan, Qinghui; Hildon, Zoe J-L; Singh, Shweta; Jing, Jin; Thein, Tun Linn; Coker, Richard; Vrijhoef, Hubertus J M; Leo, Yee Sin

    2017-07-19

    In the aftermath of an upsurge in the number of dengue cases in 2013 and 2014, the SD BIOLINE Dengue Duo rapid diagnostic Point-of-Care Test (POCT) kit was introduced in Tan Tock Seng Hospital, Singapore in June 2013. It is known that the success of POCT usage is contingent on its implementation within the health system. We evaluated health services delivery and the Dengue Duo rapid diagnostic test kit application in Singapore from healthcare workers' perspectives and patient experiences of dengue at surge times. Focus group discussions were conducted with dengue patients, from before and after the POCT implementation period. In-depth interviews with semi-structured components with healthcare workers were carried out. A patient centred process mapping technique was used for evaluation, which mapped the patient's journey and was mirrored from the healthcare worker's perspective. Patients and healthcare workers confirmed a wide range of symptoms in adults, making it challenging to determine diagnosis. There were multiple routes to help seeking, and no 'typical patient journey', with patients either presenting directly to the hospital emergency department, or being referred there by a primary care provider. Patients groups diagnosed before and after POCT implementation expressed some differences between speed of diagnoses and attitudes of doctors, yet shared negative feelings about waiting times and a lack of communication and poor information delivery. However, the POCT did not in its current implementation do much to help waiting times. Healthcare workers expressed that public perceptions of dengue in recent years was a major factor in changing patient management, and that the POCT kit was helpful in improving the speed and accuracy of diagnoses. Health service delivery for dengue patients in Singapore was overall perceived to be of an acceptable clinical standard, which was enhanced by the introduction of the POCT. However, improvements can be focused on Adapting

  3. Exposure to second-hand smoke and direct healthcare costs in children – results from two German birth cohorts, GINIplus and LISAplus

    Directory of Open Access Journals (Sweden)

    Batscheider Ariane

    2012-10-01

    Full Text Available Abstract Background Although the negative health consequences of the exposure to second hand tobacco smoke during childhood are already known, evidence on the economic consequences is still rare. The aim of this study was to estimate excess healthcare costs of exposure to tobacco smoke in German children. Methods The study is based on data from two birth cohort studies of 3,518 children aged 9-11 years with information on healthcare utilisation and tobacco smoke exposure: the GINIplus study (German Infant Study On The Influence Of Nutrition Intervention Plus Environmental And Genetic Influences On Allergy Development and the LISAplus study (Influence of Life-Style Factors On The Development Of The Immune System And Allergies In East And West Germany Plus The Influence Of Traffic Emissions And Genetics. Direct medical costs were estimated using a bottom-up approach (base year 2007. We investigated the impact of tobacco smoke exposure in different environments on the main components of direct healthcare costs using descriptive analysis and a multivariate two-step regression analysis. Results Descriptive analysis showed that average annual medical costs (physician visits, physical therapy and hospital treatment were considerably higher for children exposed to second-hand tobacco smoke at home (indoors or on patio/balcony compared with those who were not exposed. Regression analysis confirmed these descriptive trends: the odds of positive costs and the amount of total costs are significantly elevated for children exposed to tobacco smoke at home after adjusting for confounding variables. Combining the two steps of the regression model shows smoking attributable total costs per child exposed at home of €87 [10–165] (patio/balcony and €144 [6–305] (indoors compared to those with no exposure. Children not exposed at home but in other places showed only a small, but not significant, difference in total costs compared to those with no exposure

  4. The Relationship between Organizational Justice and Quality Performance among Healthcare Workers: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Salwa Attia Mohamed

    2014-01-01

    Full Text Available Organization justice refers to the extent to which employees perceive workplace procedure, interactions, and outcomes to be fair in nature. So, this study aimed to investigate the relationship between organizational justice and quality performance among health care workers. The study was conducted at the Public Hospital in Fayoum, Egypt. The study included a convenience sample of 100 healthcare workers (60 nurses and 40 physicians that were recruited. Tools used for data collection included (1 questionnaire sheet which is used to measure health workers’ perception of organizational justices. It includes four types: distributive, procedural, interpersonal, and informational justice. (2 Quality performance questionnaire sheet: this tool was used to examine health workers’ perception regarding their quality performance. It contained three types: information, value, and skill. The results revealed that a positive correlation was found between organizational justice components and quality performance among the various categories of health workers’ perception (P≤0.05. It has been recommended to replicate the study on a larger probability sample from different hospital settings to achieve more generalizable results and reinforce justice during organization of ministry centers in Egypt.

  5. Responding to intimate partner violence: Healthcare providers' current practices and views on integrating a safety decision aid into primary care settings.

    Science.gov (United States)

    Alvarez, Carmen; Debnam, Katrina; Clough, Amber; Alexander, Kamila; Glass, Nancy E

    2018-04-01

    Supportive care for survivors of intimate partner violence (IPV) remains limited in primary care settings. Low-income and Spanish-speaking survivors of IPV are even more disadvantaged, given the dearth of linguistically and culturally appropriate interventions for IPV. We conducted semi-structured individual interviews with 17 healthcare workers, including physicians, nurses, and social workers, to describe how healthcare workers serving primarily low-income, Latina populations are currently screening and responding to IPV disclosure, and to explore the acceptability of integrating an interactive, personalized safety decision aid application-myPlan app-into the clinic setting. Despite recognition of IPV as a problem, none of the clinical sites had a protocol to guide screening and response to IPV disclosure. Screening practices varied across the sites, sometimes conducted by medical assistants prior to the provider visit and other times by the physician or nurse provider. When IPV was disclosed, it was often during assessment for a presenting problem such as poor sleep or anxiety. Most healthcare workers felt that clinical and community resources were limited for their patients experiencing IPV. The "warm hand-off" to a social worker was the most common response strategy when possible; otherwise, women were given information about available resources such as hotlines and safe houses. We discuss structural, family, and individual barriers to accessing safety resources for underserved women and review how an easily accessible safety decision app, such as myPlan, could be a resource for women to safely tailor an action plan for her situation. © 2018 Wiley Periodicals, Inc.

  6. TRADITIONAL CARDIOVASCULAR RISK-FACTORS AMONG HEALTHCARE WORKERS IN KELANTAN, MALAYSIA.

    Science.gov (United States)

    Hazmi, Helmy; Ishak, Wan Rosli Wan; Jalil, Rohana Abd; Hua, Gan Siew; Hamid, Noor Fadzlina; Haron, Rosliza; Shafei, Mohd Nazri; Ibrahim, Mohd Ismail; Bebakar, Wan Mohamad Wan; Ismail, Shaiful Bahri; Musa, Kamarul Imran

    2015-05-01

    We conducted a cross sectional study of cardiovascular risk factors among healthcare workers at four government hospitals in Kelantan, Malaysia. We randomly selected 330 subjects fulfilling the following study criteria: those who had been working for at least one year at that health facility, Malaysians citizens and those with some form of direct contact with patients. We conducted an interview, obtained physical measurements, a fasting blood sugar and fasting lipid profiles among 308 subjects. The mean age of the subjects was 43.5 years, 82% were female; 30.8%, 14.3%, 10.4%, 1.3% and 1.6% of the subjects had dyslipidemia, hypertension, diabetes mellitus, a history of stroke and a history of ischemic heart disease, respectively. Forty-two percent of subjects had at least one medical condition. The mean body mass index (BMI) was 27.0 kg/M2 (SD=4.8) and 24.3% had a BMI > or =30 kg/M2. The mean systolic and diastolic blood pressures were 121.5 mmHg (SD=14.0) and 76.5 mmHg (SD=9.7), respectively and the mean waist-hip ratio was 0.84 (SD=0.1). The mean fasting blood sugar, total cholesterol, triglyceride, high density lipoprotein and low density lipoprotein were 5.8 mmol/l (SD=2.4), 5.5 mmol/l (SD=1.0), 1.4 mmol/l (SD=0.9), 1.5 mmol/l (SD=0.3) and 3.5 mmol/l (SD=0.9), respectively. Our study population had a smaller proportion of hypertension than that of the general Malaysian population. They had higher fasting total cholesterol, slightly lower fasting blood sugar, with a large proportion of them, obese and had diabetes. Immediate intervention is needed to reduce the traditional cardiovascular risk factors in this population. Keywords: cardiovascular risk factors, health care workers, Malaysia

  7. 78 FR 70580 - Apria Healthcare LLC, Billing Department, Overland Park, Kansas; Notice of Negative Determination...

    Science.gov (United States)

    2013-11-26

    ... responsibilities, and the assertion that the worker's separation was due to outsourcing to ``Emdeon and India... Reconsideration By application dated September 19, 2013, a former worker of Apria Healthcare LLC, Billing...), applicable to workers and former workers of Apria Healthcare LLC, Billing Department, Overland Park, Kansas...

  8. Occupational exposure to second hand smoke and respiratory and sensory symptoms: A cross-sectional survey of hospital workers in Egypt

    Directory of Open Access Journals (Sweden)

    Ghada Radwan

    2014-02-01

    Full Text Available Objective: Exposure to Second Hand Smoke (SHS has been associated with an increased risk of respiratory symptoms, upper and lower respiratory tract diseases and an increased risk of asthma and chronic obstructive pulmonary disease. The majority of cases of mortality and morbidity is attributable to exposure of adults to SHS and is related to cardiovascular diseases and lung cancer. In Egypt, comprehensive smoke-free laws exist, however, in many workplaces they are poorly enforced consequently exposing workers to the detrimental health hazards of SHS. We aimed at determination of workplace exposure to Second Hand Smoke (SHS and its association with respiratory and sensory irritation symptoms in hospital workers in Port-said governorate in Egypt. Material and methods: A cross-sectional face to face survey was conducted by the use of a standardised questionnaire among 415 adult hospital workers; representing 50% of all employees (81% response rate; recruited from 4 randomly selected general hospitals in Port-said governorate in Egypt. Results: All hospitals employees reported exposure to SHS - on average 1.5 (SD = 2.5 hours of exposure per day. After controlling for potential confounders, exposure to SHS at work was significantly associated with an increased risk of wheezes (OR = 1.14, p < 0.01, shortness of breath (OR = 1.17, p < 0.01, phlegm (OR = 1.23, p < 0.01, running and irritated nose (OR = 1.14, p < 0.01 as well as a sore, scratchy throat (OR = 1.23. Conclusions: These findings point out that workplace exposure to SHS is evident in hospitals in Port-said governorate and that workers are adversely affected by exposure to it at work. This underlines the importance of rigorous enforcement of smoke-free policies to protect the workers' health in Egypt.

  9. Enhancement of hand hygiene compliance among health care workers from a hemodialysis unit using video-monitoring feedback.

    Science.gov (United States)

    Sánchez-Carrillo, Laura Arelí; Rodríguez-López, Juan Manuel; Galarza-Delgado, Dionisio Ángel; Baena-Trejo, Laura; Padilla-Orozco, Magaly; Mendoza-Flores, Lidia; Camacho-Ortiz, Adrián

    2016-08-01

    The importance of hand hygiene in the prevention of health care-associated infection is well known. Experience with hand hygiene compliance (HHC) evaluation in hemodialysis units is scarce. This study was a 3-phase, prospective longitudinal intervention study during a 5-month period in a 13-bed hemodialysis unit at a university hospital in Northern Mexico. The unit performs an average of 1,150 hemodialysis procedures per month. Compliance was evaluated by a direct observer and a video assisted observer. Feedback was given to health care workers in the form of educational sessions and confidential reports and video analysis of compliance and noncompliance. A total of 5,402 hand hygiene opportunities were registered; 5,201 during 7,820 minutes of video footage and 201 by direct observation during 1,180 minutes. Lower compliance during the baseline evaluation was observed by video monitoring compared with direct observation (P hand hygiene compliance. Video-assisted monitoring of hand hygiene is an excellent method for the evaluation of HHC in a hemodialysis unit; enhanced HHC can be achieved through a feedback program to the hemodialysis staff that includes video examples and confidential reports. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  10. Overcoming healthcare workers vaccine refusal--competition between egoism and altruism.

    Science.gov (United States)

    Betsch, C

    2014-12-04

    Vaccination reduces the risk of becoming infected with and transmitting pathogens. The role of healthcare workers (HCWs) in controlling and limiting nosocomial infections has been stressed repeatedly. This has also been recognised at a political level, leading the European Council of Ministers in 2009 to encourage coverage of 75% seasonal influenza vaccine in HCWs. Although there are policies, recommendations and well-tolerated vaccines, still many HCWs refuse to get vaccinated. This article uses literature from psychology and behavioural economics to understand vaccination decisions and the specific situation of HCWs. HCWs are expected to be highly motivated to protect others. However, their individual vaccination decisions follow the same principles (of weighting individual risks) as everyone else’s vaccination decisions. This will lead to decisional conflict in a typical social dilemma situation, in which individual interests are at odds with collective interests. Failure to get vaccinated may be the result. If we understand the motivations and mechanisms of HCWs’ vaccine refusal, interventions and campaigns may be designed more effectively. Strategies to increase HCWs’ vaccine uptake should be directed towards correcting skewed risk perceptions and activating pro-social motivation in HCWs.

  11. Knowledge and Attitude toward Smoke-Free Legislation and Second-Hand Smoking Exposure among Workers in Indoor Bars, Beer Parlors and Discotheques in Osun State of Nigeria

    Directory of Open Access Journals (Sweden)

    Olanrewaju Olusola Onigbogi

    2015-04-01

    Full Text Available Background One of the requirements of the Osun State smoke-free legislation is to ensure smoke-free enclosed and partially enclosed workplaces. This survey was conducted to assess the knowledge and attitude of workers in indoor bars, beer parlors and discotheques to smoke-free legislation in general and the Osun State smoke-free law in particular. Methods A convenience sampling of 36 hospitality centers was conducted. Interviewer-administered questionnaires were used to elicit responses about the objectives from non-smoking workers. The questionnaires had sections on knowledge of the Osun State smoke-free law, attitude toward the law and smoke-free legislation in general and exposure to second-hand tobacco smoke by the workers. Questions were also asked about the secondhand tobacco smoking status of these workers. The data were analyzed using SPSS version 15.0. Results We had 154 participants recruited into the study. There were 75 males (48.0% and 79 females (52.0%. On the overall, respondents had a good knowledge of the effects of second-hand smoke on health (70.2% with 75.0% of them being aware of the general smoke-free law and 67.3% being aware of the Osun State smoke-free law although none of them had ever seen a copy of the law. A high proportion (60.0% was in support of the Osun smoke-free law although all of them think that the implementation of the law could reduce patronage and jeopardize their income. Attitude toward second-hand smoking was generally positive with 72.0% of them having no tolerance for second-hand tobacco smoke in their homes. Most participants (95.5% had been exposed to tobacco smoke in the workplace within the past week. Conclusion Despite the high level of awareness of the respondents about the dangers of second hand smoke and their positive attitude to smoke-free laws, nearly all were constantly being exposed to second hand smoke at work. This calls for policy level interventions to improve the implementation of

  12. Hand hygiene prior to contact lens handling is problematical.

    Science.gov (United States)

    McMonnies, Charles W

    2012-04-01

    To establish guidelines for contact lens wearers' hand hygiene practices which achieve a balance between minimising risk of infection and reasonable expectations on the ability of patients to follow them. Evidence has been obtained from publications via PubMed, Advanced Medline Search, Cochrane Reviews, Google Scholar and using the key words hand hygiene, washing and contact lens. Guidelines for effective hand washing and the bother involved vary according to the level of hygiene required. High levels of non-compliance with hand hygiene practices, even among healthcare workers, gives an indication of how important the level of bother involved when following guidelines can be in contributing to non-compliance. Better patient education to improve hand washing techniques as well as patient attitudes toward hand hygiene are needed to reduce high non-compliance levels. Better hand hygiene techniques and higher frequency of their application give the prospect of reduced risk of infection and of any discomfort that arises from increased lens and ocular bioburden. In order that adoption rates might be maximised, the guidelines which have been distilled from this review attempt to strike a balance between technique redundancy and the associated higher levels of hygiene achieved and the possibility that the perception of too much bother involved could reduce participation rates. The guidelines have been expanded by the inclusion of suggested explanatory information in the expectation that helping patients to understand why the recommendations are made will have the effect of increasing their adoption. Copyright © 2011 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  13. New Wireless Network for Uganda's Healthcare Workers | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2010-11-10

    Nov 10, 2010 ... Physicians and health care workers working in locations without fixed-line ... face serious problems in sharing and accessing critical medical and public ... to be a powerful tool for doctors and health care workers in Uganda.

  14. Computer screen saver hand hygiene information curbs a negative trend in hand hygiene behavior

    NARCIS (Netherlands)

    K. Helder MScN (Onno); J.W.M. Weggelaar-Jansen (Anne Marie); D.J.C. Waarsenburg (Daniël); C.W.N. Looman (Caspar); J.B. van Goudoever (Hans); J. Brug (Hans); R.F. Kornelisse (René)

    2012-01-01

    markdownabstract__Abtract__ Background: Appropriate hand hygiene among health care workers is the most important infection prevention measure; however, compliance is generally low. Gain-framed messages (ie, messages that emphasize the benefits of hand hygiene rather than the risks of

  15. The effect of an interactive delirium e-learning tool on healthcare workers' delirium recognition, knowledge and strain in caring for delirious patients: a pilot pre-test/post-test study.

    Science.gov (United States)

    Detroyer, Elke; Dobbels, Fabienne; Debonnaire, Deborah; Irving, Kate; Teodorczuk, Andrew; Fick, Donna M; Joosten, Etienne; Milisen, Koen

    2016-01-15

    Studies investigating the effectiveness of delirium e-learning tools in clinical practice are scarce. The aim of this study is to determine the effect of a delirium e-learning tool on healthcare workers' delirium recognition, delirium knowledge and care strain in delirium. A pilot pre-posttest study in a convenience sample of 59 healthcare workers recruited from medical, surgical, geronto-psychiatric and rehabilitation units of a university hospital. The intervention consisted of a live information session on how to use the e-learning tool and, a 2-month self-active learning program. The tool included 11 e-modules integrating knowledge and skill development in prevention, detection and management of delirium. Case vignettes, the Delirium Knowledge Questionnaire, and the Strain of Care for Delirium Index were used to measure delirium recognition, delirium knowledge and experienced care strain in delirium respectively. Subgroup analyses were performed for healthcare workers completing 0 to 6 versus 7 to 11 modules. The delirium recognition score improved significantly (mean 3.1 ± SD 0.9 versus 2.7 ± 1.1; P = 0.04), and more healthcare workers identified hypoactive (P = 0.04) and hyperactive (P = 0.007) delirium in the posttest compared to the pretest phase. A significant difference in the change of recognition levels over time between the 0 to 6 and 7 to 11 module groups was demonstrated (P = 0.03), with an improved recognition level in the posttest phase within the 7 to 11 module group (P = 0.007). After adjustment for potential confounders, this difference in the change over time was not significant (P = 0.07) and no change in recognition levels within the 7 to 11 module group was noted (P = 0.19). The knowledge score significantly improved in the posttest compared to the pretest phase (mean 31.7 ± SD2.6 versus 28.3 ± 4.5; P e-learning tool improved healthcare workers' delirium recognition and knowledge. The effect

  16. Healthcare in Equatorial Guinea, West Africa: obstacles and barriers to care.

    Science.gov (United States)

    Reuter, Kim Eleanor; Geysimonyan, Aurora; Molina, Gabriela; Reuter, Peter Robert

    2014-01-01

    The provision of healthcare services in developing countries has received increasing attention, but inequalities persist. One nation with potential inequalities in healthcare services is Equatorial Guinea (Central-West Africa). Mitigating these inequalities is difficult, as the Equatoguinean healthcare system remains relatively understudied. In this study, we interviewed members of the healthcare community in order to: 1) learn which diseases are most common and the most common cause of death from the perspective of healthcare workers; and 2) gain an understanding of the healthcare community in Equatorial Guinea by describing how: a) healthcare workers gain their professional knowledge; b) summarizing ongoing healthcare programs aimed at the general public; c) discussing conflicts within the healthcare community and between the public and healthcare providers; d) and addressing opportunities to improve healthcare delivery. We found that some causes of death, such as serious injuries, may not be currently treatable in country, potentially due to a lack of resources and trauma care facilities. In addition, training and informational programs for both healthcare workers and the general public may not be effectively transmitting information to the intended recipients. This presents hurdles to the healthcare community, both in terms of having professional competence in healthcare delivery and in having a community that is receptive to medical care. Our data also highlight government-facility communication as an opportunity for improvement. Our research is an important first step in understanding the context of healthcare delivery in Equatorial Guinea, a country that is relatively data poor.

  17. Ward social workers' views of what facilitates or hinders collaboration with specialist palliative care team social workers: A grounded theory.

    Science.gov (United States)

    Firn, Janice; Preston, Nancy; Walshe, Catherine

    2017-07-14

    Inpatient, generalist social workers in discharge planning roles work alongside specialist palliative care social workers to care for patients, often resulting in two social workers being concurrently involved in the same patient's care. Previous studies identifying components of effective collaboration, which impacts patient outcomes, care efficiency, professional job satisfaction, and healthcare costs, were conducted with nurses and physicians but not social workers. This study explores ward social workers' perceptions of what facilitates or hinders collaboration with palliative care social workers. Grounded theory was used to explore the research aim. In-depth qualitative interviews with masters trained ward social workers (n = 14) working in six hospitals located in the Midwest, United States were conducted between February 2014 and January 2015. A theoretical model of ward social workers' collaboration with palliative care social workers was developed. The emerging model of collaboration consists of: 1) trust, which is comprised of a) ability, b) benevolence, and c) integrity, 2) information sharing, and 3) role negotiation. Effective collaboration occurs when all elements of the model are present. Collaboration is facilitated when ward social workers' perceptions of trust are high, pertinent information is communicated in a time-sensitive manner, and a flexible approach to roles is taken. The theoretical model of collaboration can inform organisational policy and social work clinical practice guidelines, and may be of use to other healthcare professionals, as improvements in collaboration among healthcare providers may have a positive impact on patient outcomes.

  18. Monitoring of Frequency and Antimicrobial Susceptibility of Pathogens on the Hands of Healthcare Workers in a Tertiary Hospital

    Directory of Open Access Journals (Sweden)

    Tselebonis Athanasios

    2016-09-01

    Full Text Available Objective: To monitor microbes, focusing on drug resistance, on the hands of the personnel of four departments of a tertiary hospital (ICU, neonatal unit, internal medicine ward and surgical ward and explore differences between departments, professions and genders.

  19. Labor markets and employment insecurity: impacts of globalization on service and healthcare-sector workforces.

    Science.gov (United States)

    Ostry, Aleck S; Spiegel, Jerry M

    2004-01-01

    Global changes in the economies of most developed nations have impacted the way healthcare is organized, even within largely public systems, and the working conditions of healthcare workers. Since the acceleration of globalization in the 1970s, service-sector workers in developed nations have faced high unemployment, increased skill requirements for most jobs, and a rise in non-traditional work arrangements. These secular shifts in service-sector labor markets have occurred against the background of an erosion of the welfare state and growing income inequality. As well, many healthcare systems, including Canada's, were severely downsized and restructured in the 1990s, exacerbating the underlying negative secular trends in the service sector, and worsening the working conditions for many healthcare workers. Globalization has altered the labor market and shifted working conditions in ways that have been unfavorable to many healthcare workers.

  20. Health Reform and its Impact on Healthcare Workers: A Case Study of the National Clinical Hospital of Cordova, Argentina

    Directory of Open Access Journals (Sweden)

    Carlos Álvarez

    2007-10-01

    Full Text Available Since the mid 1990’s, health in Argentina has no longer been considered a social function of the State but was transformed into a market commodity. Neoliberal decentralization favored the introduction of corporate methods and incentivized privatization. In practice, this led to self-management for hospitals, deregulation of social services and incorporation of private capital to the public health business. This exploratory study looks at the impact of these reforms in the public health services sector. It analyzes living and working conditions, changes produced in the organization of work and their effect on labor relations and on participation in union, political and social activities by workers at the National Clinical Hospital of Cordoba, Argentina. Data was primarily collected through an interview survey of a convenience sample of 68 workers from the non-teaching staff; this represents 10% of the total professional, administrative and maintenance staff of the hospital. The interviews demonstrate deterioration in income and living conditions. Hospital self-management for these workers led to increased competition, the fragmentation in the work spaces, tension and the distrust between co-workers, as well as increased intensity in the workload of some employees. The profile of these healthcare workers is structured and marked by silence, the resolution of the conflicts by means of individual action in the workplace, and minimal participation in social-political-union or community organizations.

  1. When biological scientists become health-care workers: emotional labour in embryology.

    Science.gov (United States)

    Fitzgerald, R P; Legge, M; Frank, N

    2013-05-01

    Can biological scientists working in medically assisted reproduction (MAR) have a role as health-care workers and, if so, how do they engage in the emotional labour commonly associated with health-care work? The scientists at Fertility Associates (FA) in New Zealand perform the technical and emotional cares associated with health-care work in an occupationally specific manner, which we refer to as a hybrid care style. Their emotional labour consists of managing difficult patients, 'talking up' bad news, finding strategies to sustain hope and meaning, and 'clicking' or 'not clicking' with individual patients. Effective emotional labour is a key component of patient-centred care and is as important to the experience of high-quality MAR as excellent clinical and scientific technique. This is a qualitative study based on open-ended interviews and ethnographic observations with 14 staff in 2 laboratories conducted over 2 separate periods of 3 weeks duration in 2007. Analysis of fieldnotes and interviews was conducted using thematic analysis and an NVivo qualitative database and compared for consistency across each interviewer. The participants were consenting biological scientists working in one of the two laboratories. Semi-structured interviews were conducted in 'quiet' work times, and supervised access was allowed to all parts of the laboratories and meeting places. Opportunities for participant review of results and cross comparison of independent analysis by authors increases the faithfulness of fit of this account to laboratory life. The study suggests that emotional labour is a part of routinized scientific labour in MAR laboratories for FA. This is a qualitative study and thus the findings are not generalizable to populations beyond the study participants. While little has been published of the emotional component of scientist's working lives, there may be a New Zealand style of doing scientific work in MAR laboratories which is patient centred and which

  2. An effective strategy for influenza vaccination of healthcare workers in Australia: experience at a large health service without a mandatory policy.

    Science.gov (United States)

    Heinrich-Morrison, Kristina; McLellan, Sue; McGinnes, Ursula; Carroll, Brendan; Watson, Kerrie; Bass, Pauline; Worth, Leon J; Cheng, Allen C

    2015-02-06

    Annual influenza vaccination of healthcare workers (HCWs) is recommended in Australia, but uptake in healthcare facilities has historically been low (approximately 50%). The objective of this study was to develop and implement a dedicated campaign to improve uptake of staff influenza annual vaccination at a large Australian health service. A quality improvement program was developed at Alfred Health, a tertiary metropolitan health service spanning 3 campuses. Pre-campaign evaluation was performed by questionnaire in 2013 to plan a multimodal vaccination strategy. Reasons for and against vaccination were captured. A campaign targeting clinical and non-clinical healthcare workers was then implemented between March 31 and July 31 2014. Proportional uptake of influenza vaccination was determined by campus and staff category. Pre-campaign questionnaire responses were received from 1328/6879 HCWs (response rate 20.4%), of which 76% were vaccinated. Common beliefs held by unvaccinated staff included vaccine ineffectiveness (37.1%), that vaccination makes staff unwell (21.0%), or that vaccination is not required because staff are at low risk for acquiring influenza (20.2%). In 2014, 6009/7480 (80.3%) staff were vaccinated, with significant improvement in uptake across all campuses and amongst nursing, medical and allied health staff categories from 2013 to 2014 (p strategy utilising social marketing and a customised staff database was successful in increasing influenza vaccination uptake by all staff categories. The sustainability of dedicated campaigns must be evaluated.

  3. Patient Hand Hygiene at Home Predicts Their Hand Hygiene Practices in the Hospital

    OpenAIRE

    Barker, Anna; Sethi, Ajay; Shulkin, Emily; Caniza, Rachell; Zerbel, Sara; Safdar, Nasia

    2014-01-01

    We examine factors associated with hand hygiene practices of hospital patients. Hygiene decreased compared to at home, and home practices were strongly associated with hospital practices. Understanding and leveraging the intrinsic value some patients associate with hand hygiene may be important for improving overall hospital hygiene and decreasing healthcare-associated infections.

  4. Computer screen saver hand hygiene information curbs a negative trend in hand hygiene behavior

    NARCIS (Netherlands)

    Helder, Onno K.; Weggelaar, Anne Marie; Waarsenburg, Daniël C. J.; Looman, Caspar W. N.; van Goudoever, Johannes B.; Brug, Johannes; Kornelisse, René F.

    2012-01-01

    Background: Appropriate hand hygiene among health care workers is the most important infection prevention measure; however, compliance is generally low. Gain-framed messages (ie, messages that emphasize the benefits of hand hygiene rather than the risks of noncompliance) may be most effective, but

  5. Social housing for workers – A new housing model for Ho Chi Minh City, Vietnam

    Science.gov (United States)

    Ngo, L. M.

    2018-04-01

    Urbanization in Ho Chi Minh City (HCMC), Vietnam is rapidly increasing. Therefore, social housing for workers who work at industrial park and processing areas, is indispensable. There are difficulties and conflicts which still remain in developing the social housing for those people in HCMC. For example, the demand of social housing is high, however employers and/or business owners did not fully pay their attentions on social houses to support the workers. On another hand, even if they built the houses, these one seem not to be sufficient for the demands and/or unable to be competed to the rental housing market from private landlords. Building a social housing model for those workers is a vital importance, this aims to improve the quality of life for the workers; for examples, healthcare, personal safety, social relationships, emotional well-being, quality of living environment, etc. In this research, we study the investment, management, and operation of the social housing for workers in HCMC. This also seeks a new housing model which will adapt the criteria towards the sustainable economic development of HCMC.

  6. What Healthcare Workers Should Know about Environmental Bacterial Contamination in the Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Vincenzo Russotto

    2017-01-01

    Full Text Available Intensive care unit- (ICU- acquired infections are a major health problem worldwide. Inanimate surfaces and equipment contamination may play a role in cross-transmission of pathogens and subsequent patient colonization or infection. Bacteria contaminate inanimate surfaces and equipment of the patient zone and healthcare area, generating a reservoir of potential pathogens, including multidrug resistant species. Traditional terminal cleaning methods have limitations. Indeed patients who receive a bed from prior patient carrying bacteria are exposed to an increased risk (odds ratio 2.13, 95% confidence intervals 1.62–2.81 of being colonized and potentially infected by the same bacterial species of the previous patient. Biofilm formation, even on dry surfaces, may play a role in reducing the efficacy of terminal cleaning procedures since it enables bacteria to survive in the environment for a long period and provides increased resistance to commonly used disinfectants. No-touch methods (e.g., UV-light, hydrogen peroxide vapour are under investigation and further studies with patient-centred outcomes are needed, before considering them the standard of terminal cleaning in ICUs. Healthcare workers should be aware of the role of environmental contamination in the ICU and consider it in the broader perspective of infection control measures and stewardship initiatives.

  7. What Healthcare Workers Should Know about Environmental Bacterial Contamination in the Intensive Care Unit.

    Science.gov (United States)

    Russotto, Vincenzo; Cortegiani, Andrea; Fasciana, Teresa; Iozzo, Pasquale; Raineri, Santi Maurizio; Gregoretti, Cesare; Giammanco, Anna; Giarratano, Antonino

    2017-01-01

    Intensive care unit- (ICU-) acquired infections are a major health problem worldwide. Inanimate surfaces and equipment contamination may play a role in cross-transmission of pathogens and subsequent patient colonization or infection. Bacteria contaminate inanimate surfaces and equipment of the patient zone and healthcare area, generating a reservoir of potential pathogens, including multidrug resistant species. Traditional terminal cleaning methods have limitations. Indeed patients who receive a bed from prior patient carrying bacteria are exposed to an increased risk (odds ratio 2.13, 95% confidence intervals 1.62-2.81) of being colonized and potentially infected by the same bacterial species of the previous patient. Biofilm formation, even on dry surfaces, may play a role in reducing the efficacy of terminal cleaning procedures since it enables bacteria to survive in the environment for a long period and provides increased resistance to commonly used disinfectants. No-touch methods (e.g., UV-light, hydrogen peroxide vapour) are under investigation and further studies with patient-centred outcomes are needed, before considering them the standard of terminal cleaning in ICUs. Healthcare workers should be aware of the role of environmental contamination in the ICU and consider it in the broader perspective of infection control measures and stewardship initiatives.

  8. Cost-Effectiveness of a National Initiative to Improve Hand Hygiene Compliance Using the Outcome of Healthcare Associated Staphylococcus aureus Bacteraemia

    Science.gov (United States)

    Graves, Nicholas; Page, Katie; Martin, Elizabeth; Brain, David; Hall, Lisa; Campbell, Megan; Fulop, Naomi; Jimmeison, Nerina; White, Katherine; Paterson, David; Barnett, Adrian G.

    2016-01-01

    Background The objective is to estimate the incremental cost-effectiveness of the Australian National Hand Hygiene Inititiave implemented between 2009 and 2012 using healthcare associated Staphylococcus aureus bacteraemia as the outcome. Baseline comparators are the eight existing state and territory hand hygiene programmes. The setting is the Australian public healthcare system and 1,294,656 admissions from the 50 largest Australian hospitals are included. Methods The design is a cost-effectiveness modelling study using a before and after quasi-experimental design. The primary outcome is cost per life year saved from reduced cases of healthcare associated Staphylococcus aureus bacteraemia, with cost estimated by the annual on-going maintenance costs less the costs saved from fewer infections. Data were harvested from existing sources or were collected prospectively and the time horizon for the model was 12 months, 2011–2012. Findings No useable pre-implementation Staphylococcus aureus bacteraemia data were made available from the 11 study hospitals in Victoria or the single hospital in Northern Territory leaving 38 hospitals among six states and territories available for cost-effectiveness analyses. Total annual costs increased by $2,851,475 for a return of 96 years of life giving an incremental cost-effectiveness ratio (ICER) of $29,700 per life year gained. Probabilistic sensitivity analysis revealed a 100% chance the initiative was cost effective in the Australian Capital Territory and Queensland, with ICERs of $1,030 and $8,988 respectively. There was an 81% chance it was cost effective in New South Wales with an ICER of $33,353, a 26% chance for South Australia with an ICER of $64,729 and a 1% chance for Tasmania and Western Australia. The 12 hospitals in Victoria and the Northern Territory incur annual on-going maintenance costs of $1.51M; no information was available to describe cost savings or health benefits. Conclusions The Australian National Hand

  9. Cost-Effectiveness of a National Initiative to Improve Hand Hygiene Compliance Using the Outcome of Healthcare Associated Staphylococcus aureus Bacteraemia.

    Directory of Open Access Journals (Sweden)

    Nicholas Graves

    Full Text Available The objective is to estimate the incremental cost-effectiveness of the Australian National Hand Hygiene Inititiave implemented between 2009 and 2012 using healthcare associated Staphylococcus aureus bacteraemia as the outcome. Baseline comparators are the eight existing state and territory hand hygiene programmes. The setting is the Australian public healthcare system and 1,294,656 admissions from the 50 largest Australian hospitals are included.The design is a cost-effectiveness modelling study using a before and after quasi-experimental design. The primary outcome is cost per life year saved from reduced cases of healthcare associated Staphylococcus aureus bacteraemia, with cost estimated by the annual on-going maintenance costs less the costs saved from fewer infections. Data were harvested from existing sources or were collected prospectively and the time horizon for the model was 12 months, 2011-2012.No useable pre-implementation Staphylococcus aureus bacteraemia data were made available from the 11 study hospitals in Victoria or the single hospital in Northern Territory leaving 38 hospitals among six states and territories available for cost-effectiveness analyses. Total annual costs increased by $2,851,475 for a return of 96 years of life giving an incremental cost-effectiveness ratio (ICER of $29,700 per life year gained. Probabilistic sensitivity analysis revealed a 100% chance the initiative was cost effective in the Australian Capital Territory and Queensland, with ICERs of $1,030 and $8,988 respectively. There was an 81% chance it was cost effective in New South Wales with an ICER of $33,353, a 26% chance for South Australia with an ICER of $64,729 and a 1% chance for Tasmania and Western Australia. The 12 hospitals in Victoria and the Northern Territory incur annual on-going maintenance costs of $1.51M; no information was available to describe cost savings or health benefits.The Australian National Hand Hygiene Initiative was cost

  10. Interaction effects among multiple job demands: an examination of healthcare workers across different contexts.

    Science.gov (United States)

    Jimmieson, Nerina L; Tucker, Michelle K; Walsh, Alexandra J

    2017-05-01

    Simultaneous exposure to time, cognitive, and emotional demands is a feature of the work environment for healthcare workers, yet effects of these common stressors in combination are not well established. Survey data were collected from 125 hospital employees (Sample 1, Study 1), 93 ambulance service employees (Sample 2, Study 1), and 380 aged care/disability workers (Study 2). Hierarchical multiple regressions were conducted. In Sample 1, high cognitive demand exacerbated high emotional demand on psychological strain and job burnout, whereas the negative effect of high emotional demand was not present at low cognitive demand. In Sample 2, a similar pattern between emotional demand and time demand on stress-remedial intentions was observed. In Study 2, emotional demand × time demand and time demand × cognitive demand interactions again revealed that high levels of two demands were stress-exacerbating and low levels of one demand neutralized the other. A three-way interaction on job satisfaction showed the negative impact of emotional demand was exacerbated when both time and cognitive demands were high, creating a "triple disadvantage" of job demands. The results demonstrate that reducing some job demands helps attenuate the stressful effects of other job demands on different employee outcomes.

  11. Personal hand gel for improved hand hygiene compliance on the regional anesthesia team.

    Science.gov (United States)

    Parks, Colby L; Schroeder, Kristopher M; Galgon, Richard E

    2015-12-01

    Hand hygiene reduces healthcare-associated infections, and several recent publications have examined hand hygiene in the perioperative period. Our institution's policy is to perform hand hygiene before and after patient contact. However, observation suggests poor compliance. This is a retrospective review of a quality improvement database showing the effect of personal gel dispensers on perioperative hand hygiene compliance on a regional anesthesia team. Healthcare providers assigned to the Acute Pain Service were observed for compliance with hand hygiene policy during a quality improvement initiative. Provider type and compliance were prospectively recorded in a database. Team members were then given a personal gel dispensing device and again observed for compliance. We have retrospectively reviewed this database to determine the effects of this intervention. Of the 307 encounters observed, 146 were prior to implementing personal gel dispensers. Compliance was 34%. Pre- and post-patient contact compliances were 23 and 43%, respectively. For 161 encounters after individual gel dispensers were provided, compliance was 63%. Pre- and post-patient contact compliances were 53 and 72%, respectively. Improvement in overall compliance from 34 to 63% was significant. On the Acute Pain Service, compliance with hand hygiene policy improves when individual sanitation gel dispensing devices are worn on the person.

  12. Reorganisation of healthcare services for children and families: Improving collaboration, service quality, and worker well-being.

    Science.gov (United States)

    Martinussen, Monica; Kaiser, Sabine; Adolfsen, Frode; Patras, Joshua; Richardsen, Astrid M

    2017-07-01

    This study is an evaluation of a reorganisation of different services for children and their families in a Norwegian municipality. The main aim of the reorganisation was to improve interprofessional collaboration through integrating different social services for children and their parents. The evaluation was guided by the Job Demands-Resources Model with a focus on social and healthcare workers' experiences of their work, including job demands and resources, service quality, and well-being at work. The survey of the employees was conducted at three measurement points: before (T 1 ) and after (T 2 , T 3 ) the reorganisation took place, and included between 87 and 122 employees. A secondary aim was to examine the impact of different job resources and job demands on well-being (burnout, engagement, job satisfaction), and service quality. A one-way ANOVA indicated a positive development on many scales, such as collaboration, work conflict, leadership, and perceived service quality, especially from T 1 to T 2 . No changes were detected in burnout, engagement, or job satisfaction over time. Moderated regression analyses (at T 3 ) indicated that job demands were particularly associated with burnout, and job resources with engagement and job satisfaction. Perceived service quality was predicted by both job demands and resources, in addition to the interaction between workload and collaboration. The reorganisation seems to have contributed to a positive development in how collaboration, work conflict, leadership, and service quality were evaluated, but that other changes are needed to increase worker well-being. The value of the study rests on the findings that support co-locating and merging services for children and their families, and that collaboration is an important resource for healthcare professionals.

  13. NHS connecting for health: healthcare professionals, mobile technology, and infection control.

    Science.gov (United States)

    Brady, Richard R W; Chitnis, Shruti; Stewart, Ross W; Graham, Catriona; Yalamarthi, Satheesh; Morris, Keith

    2012-05-01

    Mobile phones improve the efficiency of clinical communication and are increasingly involved in all areas of healthcare delivery. Despite this, healthcare workers' mobile phones provide a known reservoir of pathogenic bacteria, with the potential to undermine infection control efforts aimed at the reducing bacterial cross-contamination in hospitals. This potential could be amplified further when employers require doctors to carry additional electronic devices for communication, without concurrently providing appropriate guidance on decontamination or use. Eighty-seven on-call doctors' mobile phones were sampled for bacterial growth prior to, and 12 h after, a cleaning intervention involving 70% isopropyl alcohol. Seventy-eight percent of doctors were aware that mobile phones could carry pathogenic bacteria, but only 8% cleaned their phones regularly. The cleaning intervention reduced the number of phones that grew bacteria by 79% (55% [48 of 87] before versus 16% [14 of 87] after cleaning). Eight percent of the phones grew Staphyloccus aureus, and 44.8% of phones grew Gram-positive cocci. All S. aureus isolates were methicillin-sensitive. Bacterial contamination was not associated with gender, specialty, or seniority of the phone user (p>0.05). Simple cleaning interventions can reduce the surface bioburden of hospital-provided doctors' mobile phones and therefore the potential for cross-contamination. This cleaning intervention is inexpensive, easily instituted, and effective. Healthcare workers should carry the minimum number of electronic devices on their person, maintain good hand hygiene, and clean their device appropriately in order to minimize the potential for cross-contamination in the work place.

  14. Occupational hand eczema and/or contact urticaria

    DEFF Research Database (Denmark)

    Carøe, Tanja K; Ebbehøj, Niels E; Bonde, Jens P

    2018-01-01

    BACKGROUND: Occupational hand eczema and/or contact urticaria may have social consequences such as change of profession or not remaining in the workforce. OBJECTIVES: To identify factors associated with job change in a cohort of participants with recognised occupational hand eczema....../contact urticaria METHODS: A registry-based study including 2703 employees with recognised occupational hand eczema/contact urticaria in Denmark in 2010/2011. Four to five years later the participants received a follow-up questionnaire, comprising questions on current job situation (response rate 58.0%). RESULTS...... to specific professions, cleaning personnel changed profession significantly more often than other workers [71.4% (OR = 2.26)], health care workers significantly less often than other workers [34.0% (OR = 0.36)]. CONCLUSION: Job change occurs frequently during the first years after recognition of occupational...

  15. A quasi-experimental study to determine the effects of a multifaceted educational intervention on hand hygiene compliance in a radiography unit.

    Science.gov (United States)

    O'Donoghue, Margaret; Ng, Suk-Hing; Suen, Lorna Kp; Boost, Maureen

    2016-01-01

    Whilst numerous studies have investigated nurses' compliance with hand hygiene and use of alcohol-based hand rub (ABHR), limited attention has been paid to these issues in allied health staff. Reports have linked infections to breaches in infection control in the radiography unit (RU). With advances in medical imaging, a higher proportion of patients come into contact with RU staff increasing the need for good hand hygiene compliance. This study aimed to evaluate effectiveness on compliance of an intervention to improve awareness of hand hygiene in the RU of a district hospital. A quasi-experimental study design including questionnaires assessing knowledge and attitudes of hand hygiene and direct observation of participants was used to evaluate an educational programme on hand hygiene of the RU of a large district hospital. All healthcare workers (HCW), comprising 76 radiographers, 17 nurses, and nine healthcare assistants (HCA), agreed to participate in the study. Of these, 85 completed the initial and 76 the post-test anonymous questionnaire. The hand hygiene compliance of all 102 HCW was observed over a 3-week period prior to and after the intervention. The 2-month intervention consisted of talks on hand hygiene and benefits of ABHR, provision of visual aids, wall-mounted ABHR dispensers, and personal bottles of ABHR. Before the intervention, overall hand hygiene compliance was low (28.9 %). Post-intervention, compliance with hand hygiene increased to 51.4 %. This improvement was significant for radiographers and HCA. Additionally, knowledge and attitudes improved in particular, understanding that ABHR can largely replace handwashing and there is a need to perform hand hygiene after environmental contact. The increased use of ABHR allowed HCW to feel they had enough time to perform hand hygiene. The educational intervention led to increased awareness of hand hygiene opportunities and better acceptance of ABHR use. The reduced time needed to perform hand

  16. A quasi-experimental study to determine the effects of a multifaceted educational intervention on hand hygiene compliance in a radiography unit

    Directory of Open Access Journals (Sweden)

    Margaret O’Donoghue

    2016-10-01

    Full Text Available Abstract Background Whilst numerous studies have investigated nurses’ compliance with hand hygiene and use of alcohol-based hand rub (ABHR, limited attention has been paid to these issues in allied health staff. Reports have linked infections to breaches in infection control in the radiography unit (RU. With advances in medical imaging, a higher proportion of patients come into contact with RU staff increasing the need for good hand hygiene compliance. This study aimed to evaluate effectiveness on compliance of an intervention to improve awareness of hand hygiene in the RU of a district hospital. Methods A quasi-experimental study design including questionnaires assessing knowledge and attitudes of hand hygiene and direct observation of participants was used to evaluate an educational programme on hand hygiene of the RU of a large district hospital. All healthcare workers (HCW, comprising 76 radiographers, 17 nurses, and nine healthcare assistants (HCA, agreed to participate in the study. Of these, 85 completed the initial and 76 the post-test anonymous questionnaire. The hand hygiene compliance of all 102 HCW was observed over a 3-week period prior to and after the intervention. The 2-month intervention consisted of talks on hand hygiene and benefits of ABHR, provision of visual aids, wall-mounted ABHR dispensers, and personal bottles of ABHR. Results Before the intervention, overall hand hygiene compliance was low (28.9 %. Post-intervention, compliance with hand hygiene increased to 51.4 %. This improvement was significant for radiographers and HCA. Additionally, knowledge and attitudes improved in particular, understanding that ABHR can largely replace handwashing and there is a need to perform hand hygiene after environmental contact. The increased use of ABHR allowed HCW to feel they had enough time to perform hand hygiene. Conclusions The educational intervention led to increased awareness of hand hygiene opportunities and better

  17. HIV-related disabilities: an extra burden to HIV and AIDS healthcare ...

    African Journals Online (AJOL)

    Background: Healthcare workers have been at the forefront of dealing with the impact of HIV and AIDS at all stages of the pandemic. This brings new challenges to include disability into HIV care. However, the implications for healthcare workers in an already fragile health system along with HIV-related disabilities in ...

  18. Responsibility for managing healthcare-associated infections: where does the buck stop?

    Science.gov (United States)

    Duerden, B I

    2009-12-01

    The prevention and control of healthcare-associated infections (HCAIs) requires a tripartite partnership between clinicians and carers, managers and government/Department of Health (DoH) across the whole health and social care community. Mandatory surveillance of meticillin-resistant Staphylococcus aureus bacteraemia and Clostridium difficile infection has shown a significant fall from peak numbers in 2003/04 and 2006, respectively, and there is now a zero tolerance approach to preventable infections and poor practice. Success so far has been based on senior management commitment, enhanced real-time surveillance, implementation of clinical protocols (high impact interventions, prudent prescribing), improved hand hygiene and environmental cleaning, and training and audit, backed up by a heightened performance management focus through targets and legislation (Code of Practice). DoH improvement teams have supported National Health Service trusts in implementing change. Responsibility for managing HCAI is a combination of managerial responsibility based upon compliance assurance that procedures and protocols are being implemented and personal professional responsibility of all clinicians and other healthcare workers.

  19. Training needs and evaluation of a neuro-HIV training module for non-physician healthcare workers in western Kenya.

    Science.gov (United States)

    Cettomai, Deanna; Kwasa, Judith; Birbeck, Gretchen L; Price, Richard W; Bukusi, Elizabeth A; Meyer, Ana-Claire

    2011-08-15

    Recent efforts to improve neurological care in resource-limited settings have focused on providing training to non-physician healthcare workers. A one-day neuro-HIV training module emphasizing HIV-associated dementia (HAD) and peripheral neuropathy was provided to 71 health care workers in western Kenya. Pre- and post-tests were administered to 55 participants. Mean age of participants was 29 years, 53% were clinical officers and 40% were nurses. Self-reported comfort was significantly higher for treating medical versus neurologic conditions (ptraining, participants identified more neuropathy etiologies (pre=5.6/9 possible correct etiologies; post=8.0/9; ptraining could correctly identify HAD diagnostic criteria, though there were fewer mis-identified criteria such as abnormal level of consciousness (pre=82%; post=43%; ptraining significantly improved knowledge about etiologies of neuropathy and decreased some misconceptions about HAD. Copyright © 2011 Elsevier B.V. All rights reserved.

  20. [The effectiveness of hand hygiene products on MRSA colonization of health care workers by using CHROMagar MRSA].

    Science.gov (United States)

    Koçak Tufan, Zeliha; Irmak, Hasan; Bulut, Cemal; Cesur, Salih; Kınıklı, Sami; Demiröz, Ali Pekcan

    2012-04-01

    The aims of this study were; to investigate the hand hygiene compliance of the health care workers (HCWs) during their routine patient care, to determine the methicillin-resistant Staphylococcus aureus (MRSA) hand colonization of the HCWs, to investigate the effect of different hand hygiene products on MRSA colonization and to evaluate the effectiveness of chromogenic agar for detecting MRSA. HCWs were investigated during their routine patient care and hand cultures were taken before and after hand wash/hygiene. Two different techniques were used to obtain the hand cultures: fingertip method (CHROMagar MRSA containing HygiSlide); and direct swab method and then inoculation to CHROMagar MRSA media. MRSA strains grown on those cultures were confirmed with conventional methods. A total of 100 HCWs (of them 61 were female; mean age: 32.7 ± 5.2 years; age range: 25-51 years) involving physicians (n= 33), nurses (n= 38) and health care assistants (n= 29), were included in the study. MRSA was detected in 39% and 11% before hand hygiene and in 13% and 6% after hand hygiene, with HygiSlide CHROMagar media and with CHROMagar in plate media, respectively. No difference were found regarding clinics, occupations, or the type of patient handling in those HCWs who were positive (n= 13) for MRSA colonization following hand hygiene, and those who were negative (n= 26). However, the type of the hand hygiene product used exhibited a statistical difference. None of the seven HCWs who used alcohol based hand rub revealed growth in the second culture while 10 of 19 (53%) HCWs who used soap and three of 13 (23%) HCWs who used chlorhexidine were still colonized with MRSA. In terms of reduction in the MRSA counts, the most effective one was the alcohol based hand rub while the soap was the least, since seven of 19 (37%) HCWs who used soap showed no reduction at all in the MRSA counts. A high ratio of hand colonization with MRSA was detected in our hospital staff (39%). It was shown that

  1. Does self-efficacy mediate the relationship between transformational leadership behaviours and healthcare workers' sleep quality? A longitudinal study.

    Science.gov (United States)

    Munir, Fehmidah; Nielsen, Karina

    2009-09-01

    This paper is a report of a study conducted to investigate the longitudinal relationship between transformational leadership behaviours and employees' sleep quality, and the mediating effects of self-efficacy. Although there is evidence for the influential role of transformational leadership on health outcomes, researchers have used either attitude outcomes (e.g. job satisfaction) or softer health measures, such as general well-being. Specific measures of well-being such as sleep quality have not been used, despite its association with working conditions. A longitudinal design was used to collect data from Danish healthcare workers at time 1 in 2005 (n = 447) and 18 months later at time 2 in 2007 (n = 274). Structural equation modelling was used to investigate the relationships between transformational leadership, self-efficacy and sleep quality at both time points independently (cross-sectionally) and longitudinally. For all constructs, time 2 measures were influenced by the baseline level. Direct relationships between transformational leadership and sleep quality were found. This relationship was negative cross-sectionally at both time points, but positive between baseline and follow-up. The relationship between leadership and employees' sleep quality was not mediated by employees' self-efficacy. Our results indicate that training managers in transformational leadership behaviours may have a positive impact on healthcare workers' health over time. However, more research is needed to examine the mechanisms by which transformational leadership brings about improved sleep quality; self-efficacy was not found to be the explanation.

  2. Hand Hygiene among Health Care Professionals - anno 2007

    DEFF Research Database (Denmark)

    Laustsen, Sussie; Kristensen, Brian

    2007-01-01

    A literature review shows that hand disinfection is superior to hand washing concerning the elimination of microorganisms. Alcohol-based hand rubs quickly and easily reduce the number of microorganisms on hands. It is important that healthcare professionals prevent the transmission of microorgani...

  3. Influencing factors on hand hygiene behavior of nursing students based on theory of planned behavior: A descriptive survey study.

    Science.gov (United States)

    Jeong, Sun Young; Kim, Kyung Mi

    2016-01-01

    Hand hygiene is the single most important measure to prevent transmission of infection, but the compliance rate of healthcare workers is relatively low. This study was conducted to identify the knowledge, beliefs, behavior, and affecting factors about hand hygiene among nursing students. A descriptive survey study. The study was carried out in two South Korean nursing schools. A total 208 nursing students participated in this study. Questionnaires were used to collect data. The percentage of correct answers in the survey section concerning hand hygiene knowledge was 68.1%. No significant difference in the knowledge, behavioral beliefs, normative beliefs, or control beliefs data was found related to general characteristics. Behavioral beliefs correlated with normative beliefs (r=.25, phand hygiene behavior (r=.17, p=.017), and control beliefs correlated with hand hygiene behavior (r=.18, p=.010). The results suggest that knowledge is not enough to change the beliefs related to hand hygiene; positive behavioral beliefs and strong control beliefs are also needed to increase hand hygiene compliance. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Patient aggression towards different professional groups of healthcare workers

    Directory of Open Access Journals (Sweden)

    Krystyna Kowalczuk

    2017-03-01

    Nurses are most exposed to different forms of patient aggression, with verbal attacks being most prevalent. Nurses employed at inpatient healthcare units experienced aggression more frequently than those working in outpatient healthcare units.

  5. Healthcare-associated infections in sub-Saharan Africa.

    Science.gov (United States)

    Rothe, C; Schlaich, C; Thompson, S

    2013-12-01

    Healthcare-associated infections (HCAIs) are the most frequent adverse consequences of healthcare worldwide, threatening the health of both patients and healthcare workers (HCWs). The impact of HCAI is particularly felt in resource-poor countries, with an already overstretched health workforce and a high burden of community-acquired infection. To provide an overview of the current situation in sub-Saharan Africa with regards to the spectrum of HCAI, antimicrobial resistance, occupational exposure and infection prevention. We reviewed the literature published between 1995 and 2013 and from other sources such as national and international agencies. Sparse data suggest that HCAIs are widespread in sub-Saharan Africa, with surgical site being the dominant focus of infection. Nosocomial transmission of multidrug-resistant tuberculosis is a considerable concern, as is the prevalence of meticillin-resistant S. aureus and resistant Enterobacteriaceae. In HCWs, vaccination rates against vaccine-preventable occupational hazards are low, as is reporting and subsequent human immunodeficiency virus-testing after occupational exposure. HCWs have an increased risk of tuberculosis relative to the general population. Compliance with hand hygiene is highly variable within the region. Injection safety in immunization programmes has improved over the past decade, mainly due to the introduction of autodestruct syringes. Despite the scarcity of data, the burden of HCAI in sub-Saharan Africa appears to be high. There is evidence of some improvement in infection prevention and control, though widespread surveillance data are lacking. Overall, measures of infection prevention and occupational safety are scarce. Copyright © 2013 The Healthcare Infection Society. All rights reserved.

  6. Impact of Community Health Workers on Use of Healthcare Services in the United States: A Systematic Review.

    Science.gov (United States)

    Jack, Helen E; Arabadjis, Sophia D; Sun, Lucy; Sullivan, Erin E; Phillips, Russell S

    2017-03-01

    As the US transitions to value-based healthcare, physicians and payers are incentivized to change healthcare delivery to improve quality of care while controlling costs. By assisting with the management of common chronic conditions, community health workers (CHWs) may improve healthcare quality, but physicians and payers who are making choices about care delivery also need to understand their effects on healthcare spending. We searched PubMed, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, PsycINFO, Embase, and Web of Science from the inception of each database to 22 June 2015. We included US-based studies that evaluated a CHW intervention for patients with at least one chronic health condition and reported cost or healthcare utilization outcomes. We evaluated studies using tools specific to study design. Our search yielded 2,941 studies after removing duplicates. Thirty-four met inclusion and methodological criteria. Sixteen studies (47%) were randomized controlled trials (RCTs). RCTs typically had less positive outcomes than other study designs. Of the 16 RCTs, 12 reported utilization outcomes, of which 5 showed a significant reduction in one or more of ED visits, hospitalizations and/or urgent care visits. Significant reductions reported in ED visits ranged from 23%-51% and in hospitalizations ranged from 21%-50%, and the one significant reduction in urgent care visits was recorded at 60% (p < 0.05 for all). Our results suggest that CHW interventions have variable effects, but some may reduce costs and preventable utilization. These findings suggest that it is possible to achieve reductions in care utilization and cost savings by integrating CHWs into chronic care management. However, variations in cost and utilization outcomes suggest that CHWs alone do not make an intervention successful. The paucity of rigorous studies and heterogeneity of study designs limited conclusions about factors associated with reduced

  7. Attitudes, knowledge and practices of healthcare workers regarding occupational exposure of pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Lesley T. Bhebhe

    2014-10-01

    Objective: Following a high incidence of TB among HCWs at Maluti Adventist Hospital in Lesotho, a study was carried out to assess the knowledge, attitudes and practices of HCWs regarding healthcare-associated TB infection and infection controls. Methods: This was a cross-sectional study performed in June 2011; it involved HCWs at Maluti Adventist Hospital who were involved with patients and/or sputum. Stratified sampling of 140 HCWs was performed, of whom, 129 (92.0% took part. A self-administered, semi-structured questionnaire was used. Results: Most respondents (89.2% had appropriate knowledge of transmission, diagnosis and prevention of TB; however, only 22.0% of the respondents knew the appropriate method of sputum collection. All of the respondents (100.0% were motivated and willing to implement IPC measures. A significant proportion of participants (36.4% reported poor infection control practices, with the majority of inappropriate practices being the administrative infection controls (> 80.0%. Only 38.8% of the participants reported to be using the appropriate N-95 respirator. Conclusion: Poor infection control practices regarding occupational TB exposure were demonstrated, the worst being the first-line administrative infection controls. Critical knowledge gaps were identified; however, there was encouraging willingness by HCWs to adapt to recommended infection control measures. Healthcare workers are inevitably exposed to TB, due to frequent interaction with patients with undiagnosed and potentially contagious TB. Implementation of infection prevention and control practices is critical whenever there is a possibility of exposure.

  8. Clean Hands Count

    Medline Plus

    Full Text Available ... now. Please try again later. Published on May 5, 2017 This video for healthcare providers is intended ... 36 Wash 'Em - Hand Hygiene Music Video - Duration: 5:46. Jefferson Health 413,702 views 5:46 ...

  9. Clean Hands Count

    Medline Plus

    Full Text Available ... empower patients to play a role in their care by asking or reminding healthcare providers to clean ... It's in your hands - prevent sepsis in health care' A 5 May 2018 advocacy message from WHO - ...

  10. Clean Hands Count

    Medline Plus

    Full Text Available ... reminding healthcare providers to clean their hands. See: https://www.cdc.gov/handhygiene/campa... . Comments on this ... are allowed in accordance with our comment policy: http://www.cdc.gov/SocialMedia/Tools/... This video can ...

  11. Buffering Effect of Job Resources in the Relationship between Job Demands and Work-to-Private-Life Interference: A Study among Health-Care Workers

    Directory of Open Access Journals (Sweden)

    Sara Viotti

    2016-12-01

    Conclusion: The present study suggests that the work context has a central importance in relation to the experience of WLI among health-care workers. The results indicated that intervention in the work context may help to contain WLI. Such interventions would especially be aimed at improving the social climate within the unit and quality of the organizational process.

  12. Compliance with hand hygiene: reference data from the national hand hygiene campaign in Germany.

    Science.gov (United States)

    Wetzker, W; Bunte-Schönberger, K; Walter, J; Pilarski, G; Gastmeier, P; Reichardt, Ch

    2016-04-01

    Hand hygiene is a key measure to prevent healthcare-associated infection. To promote hand hygiene nationally the German campaign 'Aktion Saubere Hände' was launched in January 2008, based on the World Health Organization's 'Clean Care is Safer Care' initiative. We report the first results from a full year of data collection on hand hygiene compliance recorded with the help of a renewed observation tool. Data were based on submissions from 109 participating hospitals collected from 576 wards between January 1st and December 31st, 2014. The overall median compliance was 73%, ranging from 55% (10th percentile) to 89% (90th percentile). The results demonstrated only small differences between adult and non-adult intensive care units (ICUs) with neonatal ICUs and paediatric non-ICUs maintaining higher compliance than adult care units. Performance among nurses was better than physicians, and overall rates of hand hygiene performance were significantly higher after patient contact than before. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  13. 78 FR 9054 - National Institute for Occupational Safety and Health Respiratory Protection for Healthcare...

    Science.gov (United States)

    2013-02-07

    ... Healthcare Workers'', and ``Advances toward Improved Respirators for Healthcare Workers''. Status: The... research to design and promote the appropriate use of PPE. Compliance with appropriate respirator use.... Poor compliance has been linked to safety culture, workload issues, time constraints, risk perception...

  14. When passion becomes a nightmare: the burnout syndrome in healthcare workers. A case study.

    Directory of Open Access Journals (Sweden)

    Lara Gitto

    2016-05-01

    Full Text Available The phenomenon of burnout is constantly increasing and the healthcare professionals are more exposed to burnout than other workers, given their close and continuous relationship with disadvantaged customers. An analysis of this phenomenon aimed at identifying the variables that are correlated with a higher probability to develop burnout may allow to recognize those workers who are likely to suffer from this syndrome, suggesting appropriate intervention strategies. This study has been carried out on a sample of 50 professional and pediatric nurses through the submission of a brief test aimed at measuring the risk of burnout. 26 per cent of the people in the sample of 50 nurses, working at different hospitals and public clinics in Messina, Italy, present a high risk of burnout; they would, therefore, benefit from the introduction of preventive measures aimed at contrasting this syndrome. Several variables are correlated positively and significantly with a high level of risk: age, marital status, the circumstance of having children, the years of activity and the type of employment are among these ones. Preventive measures should be implemented in the most critical cases: such measures have some costs, that are, however, lower than the pharmacological and psychological treatment of exhaustion. Hence, it should be advisable favoring direct strategies to identify and eliminate, as far as possible, the causes of burnout, rather than treating its consequences.

  15. Main and interactive effects of shiftwork, age and work stress on health in an Italian sample of healthcare workers

    DEFF Research Database (Denmark)

    Conway, Paul Maurice; Campanini, P; Sartori, S

    2008-01-01

    Among healthcare workers, shiftwork (mostly if nightwork is also included), ageing and work-related stress may be factors leading to impaired health. Such risk factors may also operate in interaction, resulting in an even increased harm for health. The present study aims at evaluating...... gastrointestinal disorders, poor work ability and job dissatisfaction. Work stress was the risk factor with the highest relevance for poor health. Ageing was associated with lower physical health. Few significant interactions were observed. Shiftwork with nights and high work stress significantly interacted...

  16. Back to basics: hand hygiene and isolation

    Science.gov (United States)

    Lin Huang, G. Khai; Stewardson, Andrew J.; Lindsay Grayson, M.

    2014-01-01

    Purpose of review Hand hygiene and isolation are basic, but very effective, means of preventing the spread of pathogens in healthcare. Although the principle may be straightforward, this review highlights some of the controversies regarding the implementation and efficacy of these interventions. Recent findings Hand hygiene compliance is an accepted measure of quality and safety in many countries. The evidence for the efficacy of hand hygiene in directly reducing rates of hospital-acquired infections has strengthened in recent years, particularly in terms of reduced rates of staphylococcal sepsis. Defining the key components of effective implementation strategies and the ideal method(s) of assessing hand hygiene compliance are dependent on a range of factors associated with the healthcare system. Although patient isolation continues to be an important strategy, particularly in outbreaks, it also has some limitations and can be associated with negative effects. Recent detailed molecular epidemiology studies of key healthcare-acquired pathogens have questioned the true efficacy of isolation, alone as an effective method for the routine prevention of disease transmission. Summary Hand hygiene and isolation are key components of basic infection control. Recent insights into the benefits, limitations and even adverse effects of these interventions are important for their optimal implementation. PMID:24945613

  17. Prevention of hand eczema in the metal-working industry: risk awareness and behaviour of metal worker apprentices.

    Science.gov (United States)

    Itschner, L; Hinnen, U; Elsner, P

    1996-01-01

    In the metal-working industry, occupational hand eczema is very common and often due to contact with cutting fluids. Since it can be avoided by adequate protective measures, prevention plays an important role. However, the effectiveness of prevention depends heavily on the employees' awareness of this health risk. The study aimed to collect information on the attitude of metal worker apprentices towards the risk of occupational skin disorders and skin protection since it is believed that their attitude at the beginning of the education will guide their future risk behaviour. By means of a questionnaire, 79 metal worker apprentices were interviewed about their awareness of dermal risk factors and their risk behaviour at work. The apprentices are very badly informed about skin diseases and skin care. Most of them are not concerned about developing occupational skin problems, and they declared having obtained very little information about this subject. Considering this finding, it seems urgent to intensify health and safety education already at the beginning of the apprenticeship.

  18. Contact among healthcare workers in the hospital setting: developing the evidence base for innovative approaches to infection control.

    Science.gov (United States)

    English, Krista M; Langley, Joanne M; McGeer, Allison; Hupert, Nathaniel; Tellier, Raymond; Henry, Bonnie; Halperin, Scott A; Johnston, Lynn; Pourbohloul, Babak

    2018-04-17

    Nosocomial, or healthcare-associated infections (HAI), exact a high medical and financial toll on patients, healthcare workers, caretakers, and the health system. Interpersonal contact patterns play a large role in infectious disease spread, but little is known about the relationship between health care workers' (HCW) movements and contact patterns within a heath care facility and HAI. Quantitatively capturing these patterns will aid in understanding the dynamics of HAI and may lead to more targeted and effective control strategies in the hospital setting. Staff at 3 urban university-based tertiary care hospitals in Canada completed a detailed questionnaire on demographics, interpersonal contacts, in-hospital movement, and infection prevention and control practices. Staff were divided into categories of administrative/support, nurses, physicians, and "Other HCWs" - a fourth distinct category, which excludes physicians and nurses. Using quantitative network modeling tools, we constructed the resulting HCW "co-location network" to illustrate contacts among different occupations and with locations in hospital settings. Among 3048 respondents (response rate 38%) an average of 3.79, 3.69 and 3.88 floors were visited by each HCW each week in the 3 hospitals, with a standard deviation of 2.63, 1.74 and 2.08, respectively. Physicians reported the highest rate of direct patient contacts (> 20 patients/day) but the lowest rate of contacts with other HCWs; nurses had the most extended (> 20 min) periods of direct patient contact. "Other HCWs" had the most direct daily contact with all other HCWs. Physicians also reported significantly more locations visited per week than nurses, other HCW, or administrators; nurses visited the fewest. Public spaces such as the cafeteria had the most staff visits per week, but the least mean hours spent per visit. Inpatient settings had significantly more HCW interactions per week than outpatient settings. HCW contact patterns and spatial

  19. Political drivers of epidemic response: foreign healthcare workers and the 2014 Ebola outbreak.

    Science.gov (United States)

    Nohrstedt, Daniel; Baekkeskov, Erik

    2018-01-01

    This study demonstrates that countries responded quite differently to calls for healthcare workers (HCWs) during the Ebola epidemic in West Africa in 2014. Using a new dataset on the scale and timing of national pledges and the deployment of HCWs to states experiencing outbreaks of the virus disease (principally, Guinea, Liberia, and Sierra Leone), it shows that few foreign nations deployed HCWs early, some made pledges but then fulfilled them slowly, and most sent no HCWs at all. To aid understanding of such national responses, the paper reviews five theoretical perspectives that offer potentially competing or complementary explanations of foreign government medical assistance for international public health emergencies. The study systematically validates that countries varied greatly in whether and when they addressed HCW deployment needs during the Ebola crisis of 2014, and offers suggestions for a theory-driven inquiry to elucidate the logics of foreign interventions in critical infectious disease epidemics. © 2018 The Author(s). Disasters © Overseas Development Institute, 2018.

  20. Is hand hygiene before putting on nonsterile gloves in the intensive care unit a waste of health care worker time?--a randomized controlled trial.

    Science.gov (United States)

    Rock, Clare; Harris, Anthony D; Reich, Nicholas G; Johnson, J Kristie; Thom, Kerri A

    2013-11-01

    Hand hygiene (HH) is recognized as a basic effective measure in prevention of nosocomial infections. However, the importance of HH before donning nonsterile gloves is unknown, and few published studies address this issue. Despite the lack of evidence, the World Health Organization and other leading bodies recommend this practice. The aim of this study was to assess the utility of HH before donning nonsterile gloves prior to patient contact. A prospective, randomized, controlled trial of health care workers entering Contact Isolation rooms in intensive care units was performed. Baseline finger and palm prints were made from dominant hands onto agar plates. Health care workers were then randomized to directly don nonsterile gloves or perform HH and then don nonsterile gloves. Postgloving finger and palm prints were then made from the gloved hands. Plates were incubated and colony-forming units (CFU) of bacteria were counted. Total bacterial colony counts of gloved hands did not differ between the 2 groups (6.9 vs 8.1 CFU, respectively, P = .52). Staphylococcus aureus was identified from gloves (once in "hand hygiene prior to gloving" group, twice in "direct gloving" group). All other organisms were expected commensal flora. HH before donning nonsterile gloves does not decrease already low bacterial counts on gloves. The utility of HH before donning nonsterile gloves may be unnecessary. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  1. Individual vulnerability to insomnia, excessive sleepiness and shift work disorder amongst healthcare shift workers. A systematic review.

    Science.gov (United States)

    Booker, Lauren A; Magee, Michelle; Rajaratnam, Shantha M W; Sletten, Tracey L; Howard, Mark E

    2018-03-27

    Shift workers often experience reduced sleep quality, duration and/or excessive sleepiness due to the imposed conflict between work and their circadian system. About 20-30% of shift workers experience prominent insomnia symptoms and excessive daytime sleepiness consistent with the circadian rhythm sleep disorder known as shift work disorder. Individual factors may influence this vulnerability to shift work disorder or sleep-related impairment associated with shift work. This paper was registered with Prospero and was conducted using recommended standards for systematic reviews and meta-analyses. Published literature that measured sleep-related impairment associated with shift work including reduced sleep quality and duration and increased daytime sleepiness amongst healthcare shift workers and explored characteristics associated with individual variability were reviewed. Fifty-eight studies were included. Older age, morning-type, circadian flexibility, being married or having children, increased caffeine intake, higher scores on neuroticism and lower on hardiness were related to a higher risk of sleep-related impairment in response to shift work, whereas physical activity was a protective factor. The review highlights the diverse range of measurement tools used to evaluate the impact of shift work on sleep. Use of standardised and validated tools would enable cross-study comparisons. Longitudinal studies are required to establish causal relationships between individual factors and the development of shift work disorder. Copyright © 2018 Elsevier Ltd. All rights reserved.

  2. Healthcare workers' participation in a healthy-lifestyle-promotion project in western Sweden

    Directory of Open Access Journals (Sweden)

    Börjesson Mats

    2011-06-01

    Full Text Available Abstract Background Healthcare professionals play a central role in health promotion and lifestyle information towards patients as well as towards the general population, and it has been shown that own lifestyle habits can influence attitudes and counselling practice towards patients. The purpose of this study was to explore the participation of healthcare workers (HCWs in a worksite health promotion (WHP programme. We also aimed to find out whether HCWs with poorer lifestyle-related health engage in health-promotion activities to a larger extent than employees reporting healthier lifestyles. Method A biennial questionnaire survey was used in this study, and it was originally posted to employees in the public healthcare sector in western Sweden, one year before the onset of the WHP programme. The response rate was 61% (n = 3207. In the four-year follow-up, a question regarding participation in a three-year-long WHP programme was included, and those responding to this question were included in the final analysis (n = 1859. The WHP programme used a broad all-inclusive approach, relying on the individual's decision to participate in activities related to four different themes: physical activity, nutrition, sleep, and happiness/enjoyment. Results The participation rate was around 21%, the most popular theme being physical activity. Indicators of lifestyle-related health/behaviour for each theme were used, and regression analysis showed that individuals who were sedentary prior to the programme were less likely to participate in the programme's physical activities than the more active individuals. Participation in the other three themes was not significantly predicted by the indicators of the lifestyle-related health, (body mass index, sleep disturbances, or depressive mood. Conclusion Our results indicate that HCWs are not more prone to participate in WHP programmes compared to what has been reported for other working populations, and despite a

  3. Workplace Violence against Health Care Workers in North Chinese Hospitals: A Cross-Sectional Survey.

    Science.gov (United States)

    Sun, Peihang; Zhang, Xue; Sun, Yihua; Ma, Hongkun; Jiao, Mingli; Xing, Kai; Kang, Zheng; Ning, Ning; Fu, Yapeng; Wu, Qunhong; Yin, Mei

    2017-01-19

    This research aimed to determine the prevalence of workplace violence (WPV) against healthcare workers, explore the frequency distribution of violence in different occupational groups, and determine which healthcare occupation suffers from WPV most frequently. Furthermore, the current study aimed to compare risk factors affecting different types of WPV in Chinese hospitals. A cross-sectional design was utilized. A total of 1899 healthcare workers from Heilongjiang, a province in Northeastern China, completed the questionnaire. Of the respondents, 83.3% reported exposure to workplace violence, and 68.9% reported non-physical violence. Gender, education, shift work, anxiety level, and occupation were significantly correlated with physical violence ( p gender, age, profession, anxiety, and shift work were predictive of workplace violence toward healthcare workers. Doctors appeared to experience non-physical workplace violence with particularly higher frequency when compared to nurses and other workers in hospitals. For healthcare workers, interventions aimed at WPV reduction should be enacted according to the types of violence, profession, and other factors underlying the various types of WPV in hospitals.

  4. Indigenous healthcare worker involvement for Indigenous adults and children with asthma.

    Science.gov (United States)

    Chang, Anne B; Taylor, Brett; Masters, I Brent; Laifoo, Yancy; Brown, Alexander Dh

    2010-05-12

    Asthma education is regarded as an important step in the management of asthma in national guidelines. Racial, ethnicity and socio-economic factors are associated with markers of asthma severity, including recurrent acute presentations to emergency health facilities. Worldwide, indigenous groups are disproportionately represented in the severe end of the asthma spectrum. Appropriate models of care are important in the successful delivery of services, and are likely contributors to improved outcomes for people with asthma. To determine whether involvement of an indigenous healthcare worker (IHW) in comparison to absence of an IHW in asthma education programs, improves asthma related outcomes in indigenous children and adults with asthma. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Airways Group Specialised Register, MEDLINE and EMBASE databases, review articles and reference lists of relevant articles. The latest search was in January 2010. All randomised controlled trials comparing involvement of an indigenous healthcare worker (IHW) in comparison to absence of an IHW in asthma education programs for indigenous people with asthma. Two independent review authors selected data for inclusion, a single author extracted the data. Both review authors independently assessed study quality. We contacted authors for further information. As it was not possible to analyse data as "intention-to-treat", we analysed data as "treatment received". Two studies fulfilled inclusion criteria involving 133 children randomised to an asthma education programme involving an IHW, compared to a similar education programme without an IHW. One study was not strictly Indigenous. 110 of these children completed the trials. Children's asthma knowledge score was significantly better in the group that had IHW education compared with control (mean difference 3.30; 95% CI 1.07 to 5.53), parents' asthma knowledge score (standardised mean difference (SMD) 1

  5. Sickness absence among health workers in belo horizonte, brazil.

    Science.gov (United States)

    Bassi, Iara; Assunção, Ada Ávila; Pimenta, Adriano Marçal; Benavides, Fernando G; Ubalde-Lopez, Monica

    2016-05-25

    To describe the prevalence of sickness absence and to analyze factors associated with the outcome according to gender in a sample of healthcare workers at the Belo Horizonte Health Department. This study was based on a Belo Horizonte Health Department survey carried out between September 2008 and January 2009. From a randomly selected sample of 2,205 workers, 1,808 agreed to participate. Workers were classified into Health Staff or Health Care. Other explanatory variables were social and demographic data, work characteristics, and personal health. The Poisson regression was applied to analyze factors associated with sickness absence by the prevalence ratio (PR). The overall prevalence of sickness absence was 31.5% (23.8% for men and 34.6% for women). In the final model, we found higher rates of sickness absence in both male and female workers involved in tasks with high psychosocial demands (PR=1.86 men; PR=1.38 women) and in those that reported using medication for treating chronic diseases (PR=1.96 men; PR=1.50 women). Women having a permanent job contract had a higher prevalence of sickness absence than those having a temporary job contract (PR=1.71). Our findings suggest a paradox in how healthcare is organized: good results in terms of its global objective of providing healthcare for citizens contrast with lack of effective measures for protecting healthcare workers.

  6. Diagnostics of hand-arm system disorders in workers who use vibrating tools.

    Science.gov (United States)

    Gemne, G

    1997-02-01

    A hand-arm vibration syndrome occurs in some workers who use hand held vibrating tools. It is recognised to consist of white fingers, diffusely distributed finger neuropathy, pain in the arm and hand, and a small excess risk of osteoarthrosis from percussion to the wrist and elbow. Carpal tunnel syndrome is mainly due to ergonomic factors other than vibration, but certain factors related to vibration may contribute to its development. A decrease in muscle power induced by vibration, and excessive hearing deficit have been postulated. The assessment of a disorder suspected of being induced by vibration includes deciding whether there is a disorder and, if so, whether the symptoms can be caused by vibration. To decide whether the symptoms can be caused by vibration epidemiological documentation and pathogenically reasonable theories must exist. A causal diagnosis finally requires and epidemiological decision whether or not the factual exposure has elicited the patient's symptoms. Epidemiological data on the quantitative association between vibration and excessive risks of white fingers and diffusely distributed neuropathy are incomplete. The symptomatic diagnosis of white fingers is still mainly based on anamnestic information. Available laboratory tests are incapable of grading the severity of individual cases. Recording the finger systolic blood pressure during cold provocation is a method of symptomatic diagnosis with reasonable levels of specificity, sensitivity, and predictive value. For diffusely distributed neuropathy these levels are lower than desired. Electrodiagnostic tests for carpal tunnel syndrome have sufficient validity. Proper exposure evaluation must be based on an appreciation of the character of the vibration as well as effective duration and intermittency. If this is not taken into account, the number of hours of exposure and intensity of vibration are likely to be non-commensurable variables, and the simple product of them is a questionable dose

  7. Impact of the Spanish smoking law on exposure to second-hand smoke and respiratory health in hospitality workers: a cohort study.

    Science.gov (United States)

    Fernández, Esteve; Fu, Marcela; Pascual, José A; López, María J; Pérez-Ríos, Mónica; Schiaffino, Anna; Martínez-Sánchez, Jose M; Ariza, Carles; Saltó, Esteve; Nebot, Manel

    2009-01-01

    A smoke-free law came into effect in Spain on 1st January 2006, affecting all enclosed workplaces except hospitality venues, whose proprietors can choose among totally a smoke-free policy, a partial restriction with designated smoking areas, or no restriction on smoking on the premises. We aimed to evaluate the impact of the law among hospitality workers by assessing second-hand smoke (SHS) exposure and the frequency of respiratory symptoms before and one year after the ban. We formed a baseline cohort of 431 hospitality workers in Spain and 45 workers in Portugal and Andorra. Of them, 318 (66.8%) were successfully followed up 12 months after the ban, and 137 nonsmokers were included in this analysis. We obtained self-reported exposure to SHS and the presence of respiratory symptoms, and collected saliva samples for cotinine measurement. Salivary cotinine decreased by 55.6% after the ban among nonsmoker workers in venues where smoking was totally prohibited (from median of 1.6 ng/ml before to 0.5 ng/ml, phospitality venues where smoking was totally banned. Among nonsmoker hospitality workers in bars and restaurants where smoking was allowed, exposure to SHS after the ban remained similar to pre-law levels. The partial restrictions on smoking in Spanish hospitality venues do not sufficiently protect hospitality workers against SHS or its consequences for respiratory health.

  8. Occupational Exposure to Alcohol-Based Hand Sanitizers: The Diagnostic Role of Alcohol Biomarkers in Hair.

    Science.gov (United States)

    Salomone, A; Bozzo, A; Di Corcia, D; Gerace, E; Vincenti, M

    2018-04-01

    Ethyl glucuronide (EtG) and fatty acid ethyl esters (FAEEs) in hair are effective direct biomarkers of ethanol ingestion, whose analytical determination can be used to discriminate between chronic and occasional ethanol intake. Ethanol is a compound widely used in some workplaces (e.g., clinics, hospitals) and is present in considerable amounts in mouthwash for oral cleaning, medications, cosmetic products, hydro-alcoholic disinfectants and antiseptics for hands. This study examined the ethyl alcohol exposure derived from hand disinfectants (in gel form) by simulating the typical occupational situation of medical-health workers (healthcare workers, nurses, surgeons, etc.) who frequently wash their hands with antiseptic sanitizer. Two types of hand disinfectants with 62% w/w of ethanol content were daily applied to the hands of a teetotaler for 20 times a day, for 4 consecutive weeks, thus simulating a typical workplace situation and a cumulative dermal exposure to ethanol of ~1,100 g. Different matrices (head, chest and beard hair, urine) were regularly sampled and analyzed using a ultra high-performance liquid chromatography tandem massspectrometry validated method for EtG and a (HS)SPME-GC-MS validated technique for FAEEs. The data obtained showed that a significant dermal absorption and/or inhalation of ethanol occurred, and that the use of detergents produce urinary EtG concentrations both higher than the cut-offs normally used for clinical and forensic analyses (either 100 and 500 ng/mL, depending on the context). The concentrations of the ethanol metabolites in the keratin matrices were, respectively, below the cut-off of 7 pg/mg for EtG and below 0.5 ng/mg for FAAEs (0.35 ng/mg for ethyl palmitate). In conclusion, the regular use of alcohol-based hand sanitizers can affect the concentration of urinary EtG and lead to positive analytical results, particularly when specimens are obtained shortly after sustained use of ethanol-containing hand sanitizer. On the

  9. Bridging the knowledge gap: an innovative surveillance system to monitor the health of British Columbia's healthcare workforce.

    Science.gov (United States)

    Gilligan, Tony; Alamgir, Hasanat

    2008-01-01

    Healthcare workers are exposed to a variety of work-related hazards including biological, chemical, physical, ergonomic, psychological hazards; and workplace violence. The Occupational Health and Safety Agency for Healthcare in British Columbia (OHSAH), in conjunction with British Columbia (BC) health regions, developed and implemented a comprehensive surveillance system that tracks occupational exposures and stressors as well as injuries and illnesses among a defined population of healthcare workers. Workplace Health Indicator Tracking and Evaluation (WHITE) is a secure operational database, used for data entry and transaction reporting. It has five modules: Incident Investigation, Case Management, Employee Health, Health and Safety, and Early Intervention/Return to Work. Since the WHITE database was first introduced into BC in 2004, it has tracked the health of 84,318 healthcare workers (120,244 jobs), representing 35,927 recorded incidents, resulting in 18,322 workers' compensation claims. Currently, four of BC's six healthcare regions are tracking and analyzing incidents and the health of healthcare workers using WHITE, providing OHSAH and healthcare stakeholders with comparative performance indicators on workplace health and safety. A number of scientific manuscripts have also been published in peer-reviewed journals. The WHITE database has been very useful for descriptive epidemiological studies, monitoring health risk factors, benchmarking, and evaluating interventions.

  10. Risk of hearing loss among workers with vibration-induced white fingers.

    Science.gov (United States)

    Pettersson, Hans; Burström, Lage; Hagberg, Mats; Lundström, Ronnie; Nilsson, Tohr

    2014-12-01

    We examined the risk of hearing loss for workers who use hand-held vibrating tools with vibration-induced white fingers (VWF) compared to workers without VWF. Data on 184 participants from a 21-year cohort were gathered with questionnaires and measurements. The effects on hearing status of VWF, hand-arm vibration exposure, smoking habits, age and two-way interactions of these independent variables were examined with binary logistic regression. Analyses were made for the right hand and ear as well as for the hand with VWF and the ear with worse categorized hearing status. Workers with VWF in their right hand had an increased risk of hearing loss (odds ratio 2.2-2.3) in the right ear. Workers with VWF in any hand did not have any increased risk of hearing loss in the ear with worse hearing status. This study supports the hypothesis that VWF increases the risk of hearing loss among workers who use hand-held vibrating tools in a noisy environment. © 2014 Wiley Periodicals, Inc.

  11. Preventing Absenteeism and Promoting Resilience Among Health Care Workers In Biological Emergencies

    Energy Technology Data Exchange (ETDEWEB)

    Lesperance, Ann M.; Miller, James S.

    2009-05-08

    The ability to ensure adequate numbers of medical staff represents a crucial part of the medical response to any disaster. However, healthcare worker absenteeism during disasters, especially in the event of an attack of biological terrorism or an epidemic such as pandemic influenza, is a serious concern. Though a significant rate of absenteeism is often included as a baseline assumption in emergency planning, published reports on strategies to minimize absenteeism are comparatively few. This report documents interviews with managers and emergency response planners at hospitals and public health agencies and reviews existing survey data on healthcare worker absenteeism and studies of disasters to glean lessons about the needs of healthcare workers during those disasters. Based on this research, expected rates of absenteeism and individual determinants of absenteeism are presented along with recommendations of steps that hospitals, emergency medical services departments, public health organizations, and government agencies can take to meet the needs of healthcare workers and minimize absenteeism during a biological event.

  12. Healthy worker effect in hairdressing apprentices

    DEFF Research Database (Denmark)

    Bregnhøj, Anne; Søsted, Heidi; Menné, Torkil

    2011-01-01

    potential healthy worker effect. Methods. During the first 2 weeks of training, 382 hairdressing apprentices were enrolled in this study. All apprentices completed a self-administered questionnaire, including previously validated questions regarding, for example, previous and present hand eczema, eczema...... and by 11.9% of the controls (p worker effect, as there was a lower reported incidence of hand eczema and eczema...

  13. Measuring readiness for and satisfaction with a hand hygiene e-learning course among healthcare workers in a paediatric oncology centre in Guatemala City.

    Science.gov (United States)

    Gonzalez, Miriam L; Melgar, Mario; Homsi, Maysam; Shuler, Ana; Antillon-Klussmann, Federico; Matheu, Laura; Ramirez, Marylin; Grant, Michael M; Lowther, Deborah L; Relyea, George; Caniza, Miguela A

    2016-01-01

    E-learning has been widely used in the infection control field and has been recommended for use in hand hygiene (HH) programs by the World Health Organization. Such strategies are effective and efficient for infection control, but factors such as learner readiness for this method should be determined to assure feasibility and suitability in low- to middle-income countries. We developed a tailored, e-learning, Spanish-language HH course based on the WHO guidelines for HH in healthcare settings for the pediatric cancer center in Guatemala City. We aimed to identify e-readiness factors that influenced HH course completion and evaluate HCWs' satisfaction. Pearson's chi-square test of independence was used to retrospectively compare e-readiness factors and course-completion status (completed, non-completed, and never-started). We surveyed 194 HCWs for e-readiness; 116 HCWs self-enrolled in the HH course, and 55 responded to the satisfaction survey. Most e-readiness factors were statistically significant between course-completion groups. Moreover, students were significantly more likely to complete the course if they had a computer with an Internet connection (P=0.001) and self-reported comfort with using a computer several times a week (p=0.001) and communicating through online technologies (p=0.001). Previous online course experience was not a significant factor (p=0.819). E-readiness score averages varied among HCWs, and mean scores for all e-readiness factors were significantly higher among medical doctors than among nurses. Nearly all respondents to the satisfaction survey agreed that e-learning was as effective as the traditional teaching method. Evaluating HCWs' e-readiness is essential while integrating technologies into educational programs in low- to middle-income countries.

  14. Colonization of patients, healthcare workers, and the environment with healthcare-associated Staphylococcus epidermidis genotypes in an intensive care unit: a prospective observational cohort study.

    Science.gov (United States)

    Widerström, Micael; Wiström, Johan; Edebro, Helén; Marklund, Elisabeth; Backman, Mattias; Lindqvist, Per; Monsen, Tor

    2016-12-09

    During the last decades, healthcare-associated genotypes of methicillin-resistant Staphylococcus epidermidis (HA-MRSE) have been established as important opportunistic pathogens. However, data on potential reservoirs on HA-MRSE is limited. The aim of the present study was to investigate the dynamics and to which extent HA-MRSE genotypes colonize patients, healthcare workers (HCWs) and the environment in an intensive care unit (ICU). Over 12 months in 2006-2007, swab samples were obtained from patients admitted directly from the community to the ICU and patients transferred from a referral hospital, as well as from HCWs, and the ICU environment. Patients were sampled every third day during hospitalization. Antibiotic susceptibility testing was performed according to EUCAST guidelines. Pulsed-field gel electrophoresis and multilocus sequence typing were used to determine the genetic relatedness of a subset of MRSE isolates. We identified 620 MRSE isolates from 570 cultures obtained from 37 HCWs, 14 patients, and 14 environmental surfaces in the ICU. HA-MRSE genotypes were identified at admission in only one of the nine patients admitted directly from the community, of which the majority subsequently were colonized by HA-MRSE genotypes within 3 days during hospitalization. Almost all (89%) of HCWs were nasal carriers of HA-MRSE genotypes. Similarly, a significant proportion of patients transferred from the referral hospital and fomites in the ICU were widely colonized with HA-MRSE genotypes. Patients transferred from a referral hospital, HCWs, and the hospital environment serve as important reservoirs for HA-MRSE. These observations highlight the need for implementation of effective infection prevention and control measures aiming at reducing HA-MRSE transmission in the healthcare setting.

  15. Predictive factors for percutaneous and mucocutaneous exposure among healthcare workers in a developing country

    Directory of Open Access Journals (Sweden)

    Zeynep Türe

    2016-09-01

    Full Text Available The aim of this study is to determine the risk factors for percutaneous and mucocutaneous exposures in healthcare workers (HCW in one of the largest centers of a middle income country, Turkey. This study has a retrospective design. HCWs who presented between August 2011 and June 2013, with Occupational Exposures (OEs (cases and those without (controls were included. Demographic information was collected from infection control committee documents. A questionnaire was used to ask the HCWs about their awareness of preventive measures. HCWs who work with intensive work loads such as those found in emergency departments or intensive care units have a higher risk of OEs. Having heavy workloads and hours increases the risk of percutaneous and mucocutaneous exposures. For that reason the most common occupation groups are nurses and cleaning staff who are at risk of OEs. Increasing work experience has reduced the frequency of OEs.

  16. Seroprevalence of hepatitis B and C among domestic and healthcare waste handlers in Belo Horizonte, Brazil.

    Science.gov (United States)

    Mol, Marcos Pg; Gonçalves, Jéssica P; Silva, Edvania A; Scarponi, Cristiane FdO; Greco, Dirceu B; Cairncross, Sandy; Heller, Leo

    2016-09-01

    Infection with the hepatitis B and C viruses may occur through contact with infected body fluids, including injury with infected sharps. Collectors of domestic or healthcare wastes are potentially exposed to these infections. The aim of this article is to investigate the risk factors associated with the prevalence of hepatitis B and C viruses (HBV and HCV) infection among domestic and healthcare waste workers in Belo Horizonte, Brazil. A cross-sectional study of hepatitis B and C infection was conducted from November 2014 to January 2015, through blood sample collection and interviews about socio-demographic factors with 61 workers exposed to healthcare waste ('exposed') and 461 exposed only to domestic wastes ('unexposed'). The prevalence of antibodies to HCV (Anti-HCV) antibodies was 3.3% in 'exposed' workers and 0.9% in 'unexposed', and of antibody to hepatitis B core antigen (Anti-HBc) was 9.8% and 5.6% in 'exposed' and 'unexposed' workers, respectively. Only 207 (44.9%) of those exposed to domestic waste and 45 (73.8%) of those handling healthcare waste were effectively immunised against hepatitis B virus (HBV). Exposures to domestic waste and to healthcare wastes were associated with similar risks of infection with HBV. The risk of hepatitis C virus (HCV) infection was marginally higher among healthcare waste workers compared with domestic waste workers, probably because of needlestick accidents owing to deficient sharps management systems. Immunisation against hepatitis B and screening tests to ensure the success of vaccination should be a condition for recruitment for both groups of waste workers. © The Author(s) 2016.

  17. The Feedback Intervention Trial (FIT) — Improving Hand-Hygiene Compliance in UK Healthcare Workers: A Stepped Wedge Cluster Randomised Controlled Trial

    Science.gov (United States)

    Fuller, Christopher; Michie, Susan; Savage, Joanne; McAteer, John; Besser, Sarah; Charlett, Andre; Hayward, Andrew; Cookson, Barry D.; Cooper, Ben S.; Duckworth, Georgia; Jeanes, Annette; Roberts, Jenny; Teare, Louise; Stone, Sheldon

    2012-01-01

    Introduction Achieving a sustained improvement in hand-hygiene compliance is the WHO’s first global patient safety challenge. There is no RCT evidence showing how to do this. Systematic reviews suggest feedback is most effective and call for long term well designed RCTs, applying behavioural theory to intervention design to optimise effectiveness. Methods Three year stepped wedge cluster RCT of a feedback intervention testing hypothesis that the intervention was more effective than routine practice in 16 English/Welsh Hospitals (16 Intensive Therapy Units [ITU]; 44 Acute Care of the Elderly [ACE] wards) routinely implementing a national cleanyourhands campaign). Intervention-based on Goal & Control theories. Repeating 4 week cycle (20 mins/week) of observation, feedback and personalised action planning, recorded on forms. Computer-generated stepwise entry of all hospitals to intervention. Hospitals aware only of own allocation. Primary outcome: direct blinded hand hygiene compliance (%). Results All 16 trusts (60 wards) randomised, 33 wards implemented intervention (11 ITU, 22 ACE). Mixed effects regression analysis (all wards) accounting for confounders, temporal trends, ward type and fidelity to intervention (forms/month used). Intention to Treat Analysis Estimated odds ratio (OR) for hand hygiene compliance rose post randomisation (1.44; 95% CI 1.18, 1.76;phand-hygiene compliance, in wards implementing a national hand-hygiene campaign. Further implementation studies are needed to maximise the intervention’s effect in different settings. Trial Registration Controlled-Trials.com ISRCTN65246961 PMID:23110040

  18. Occupational hand injuries: a current review of the prevalence and proposed prevention strategies for physical therapists and similar healthcare professionals.

    Science.gov (United States)

    Gyer, Giles; Michael, Jimmy; Inklebarger, James

    2018-03-01

    Hand injury is the second most common work-related musculoskeletal injury among physical therapists (PTs) and other manual therapy professionals such as osteopaths, physiotherapists, chiropractors, acupuncturists and massage therapists. However, the nature and extent of this problem have not been fully explored yet. Therefore, the objective of this study was to review the existing literature published on the prevalence, risk factors, consequences, and prevention of hand injuries among PTs and similar healthcare professionals. The lifetime prevalence of hand injuries was about 15%-46%, and the annual prevalence was reported as 5%-30%. Thumb injuries were found to be the most prevalent of all injuries, accounting more than 50% of all hand-related problems. The most significant risk factors for job-related hand injuries were performing manual therapy techniques, repetitive workloads, treating many patients per day, continued work while injured or hurt, weakness of the thumb muscles, thumb hypermobility, and instability at the thumb joints. PTs reported modifying treatment technique, taking time off on sick leave, seeking intervention, shifting the specialty area, and decreasing patient contact hours as the major consequences of these injuries. The authors recommend that PTs should develop specific preventive strategies and put more emphasis on the use of aids and equipment to reduce the risk of an unnecessary injury. Copyright © 2018 Shanghai Changhai Hospital. Published by Elsevier B.V. All rights reserved.

  19. Healthcare operations service redesign and implementation

    OpenAIRE

    Bamford, David; Thornton, H.; Bamford, Jim

    2008-01-01

    We report on a project that is increasing the effectiveness and efficiency of healthcare\\ud provision by getting “the right patient, the right equipment, the right healthcare worker\\ud to the right place at the right time for the right treatment to be carried out in the right\\ud way.” This is being done through: i) a review of the utilisation and disposition of all\\ud logistics/transport assets and an assessment of future demand/capacity issues and\\ud patterns for healthcare services; ii) the...

  20. Kepatuhan 5 Momen Hand Hygiene Pada Petugas di Laboratorium Klinik Cito Yogyakarta

    Directory of Open Access Journals (Sweden)

    Pangisti Dwi Ananingsih

    2016-01-01

    Full Text Available Hospital Associated Infection (HAIs is still a problem through out the world and in Indonesia. Health officials have a major role in the transmission of these infections. However, the low level of compliance of five moments of hand hygiene among health care workers is still one of the factors that cause a high spread of HAIs. To hand let his, it is necessary to counseling about the importance of 5 moments of hand hygiene for health worker towards patient health. Counseling can be done in various models, such as posters, training, and simulation. The study is a qualitative research with action research. Conducted in September 2015 inwards in Clinical Laboratory “Cito” Yogyakarta, the population as well as samples in this study were all health care workers in first floor of the Clinical Laboratory Cito Yogyakarta that consisting of nurses, analysts, doctors, radiographers, customer service, and cleaning service. 5 moments of hand hygiene compliance of the workers increasing after the poster socialitation, training, and simulation. The management is expected to give more attention in improving of 5 moments of hand hygiene for health worker in Clinical Laboratory Cito Yogyakarta.