WorldWideScience

Sample records for healthcare workers revisited

  1. Pre-event Smallpox Vaccination for Healthcare Workers Revisited – the Need for a Carefully Screened Multidisciplinary Cadre

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    Malone, JD D.

    2007-03-01

    Abstract As healthcare institutions are a focus of smallpox transmission early in an epidemic, several mathematical models support pre-event smallpox vaccination of healthcare workers (HCWs). The deciding factor for HCW voluntary vaccination is the risk of disease exposure versus the risk of vaccine adverse events. In a United States military population, with careful screening to exclude atopic dermatitis/eczema and immunosuppression, over 1 million vaccinia vaccinations were delivered with 1 fatality attributed to vaccination. Among 37,901 U.S. civilian volunteer healthcare workers vaccinated, 100 serious adverse events were reported including 10 ischemic cardiac episodes and six myocardial infarctions – 2 were fatal. This older population had a higher rate of adverse events due to age related coronary artery disease. T-cell mediated inflammatory processes, induced by live vaccinia vaccination, may have a role in the observed acute coronary artery events. With exclusion of individuals at risk for coronary artery disease, atopic dermatitis/eczema, and immunosuppression, HCWs can be smallpox vaccinated with minimal risk. A smallpox pre-vaccinated multidisciplinary cadre (physician, nurse, infection control practitioner, technician) will supply leadership to deal with fear and uncertainty while limiting spread and initial mortality of smallpox. Stochastic – from the Greek meaning “skillful in aiming” – is currently interpreted as arising from chance and involving probability. This issue’s article “Containing a large bioterrorist smallpox attack: a computer simulation approach” by Longini et al. is a discrete time, stochastic computer simulation model that offers additional planning guidance for a smallpox (variola virus) outbreak (1). Although interpretation of the model’s information may differ, Longini’s article concludes “Given that surveillance and containment measures are in place, preemptive vaccination of hospital workers would further

  2. [Tuberculosis in healthcare workers].

    Science.gov (United States)

    Nienhaus, A

    2009-01-01

    Perception and knowledge of the TB-infection risk in healthcare workers (HCWs) changed profoundly in Germany during the past few years. Molecular-epidemiological studies and a comprehensive review of the existing evidence concerning the infection risk for HCWs lead to the conclusion that TB in HCWs is often caused by infection at the workplace. In the Hamburg Fingerprint Study, 80 % of the TB cases in HCWs were caused by infections at the workplace. In a similar Dutch study 43 % of all cases were work-related. Besides of the well-known risks in TB wards and laboratories, an increased risk for infection should be assumed for paramedics, in emergency rooms, for HCWs caring for the elderly or for workers with close contact to high-risk groups (homeless people, i. v. drug users, migrants from high-incidence countries). TB in a HCW working in these fields can be recognised as an occupational disease (OD) without identifying a particular source of infection. For all other HCWs, the German occupational disease law requires the identification of a source case before TB in an HCW can be accepted as an OD. Even though the proportion of work-related TB in HCWs is higher than was assumed before previously, the prevalence of latent TB infection (LTBI) is lower than expected. In an ongoing evaluation study of the interferon-gamma release assay (IGRA) LTBI prevalence in HCWs is 10 %. Prevention strategies in Germany should be reconsidered in the light of these new findings.

  3. Recommended Vaccines for Healthcare Workers

    Science.gov (United States)

    ... Those Vaccinating HCWs Healthcare workers (HCWs) are at risk for exposure to serious, and sometimes deadly, diseases. If you ... about these diseases and the benefits and potential risks associated with the vaccines, read the ... hospital inpatients, and developmentally disabled facility residents; search for ...

  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. 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

  6. Healthcare workers' knowledge, attitudes, practices on post ...

    African Journals Online (AJOL)

    Healthcare workers' knowledge, attitudes, practices on post exposure ... in the same proportions leading to increased risk of exposure to and transmission of HIV through ... This hospital based study of 316 health care workers (HCW) in Dar Es ...

  7. Contact Allergy in Danish Healthcare Workers

    DEFF Research Database (Denmark)

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

    2015-01-01

    . 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...

  8. Occupational stress among healthcare workers in Japan.

    Science.gov (United States)

    Ito, Shinya; Fujita, Shigeru; Seto, Kanako; Kitazawa, Takefumi; Matsumoto, Kunichika; Hasegawa, Tomonori

    2014-01-01

    High distress levels in healthcare workers in Japan may deteriorate safe service provision. To clarify job stress of healthcare workers, we compared Brief Job Stress Questionnaire (BJSQ) scores among physicians, nursing staff and administrative workers. Healthcare workers (n=9,137) in 20 hospitals in Japan were asked to answer BJSQ. BJSQ is job stress questionnaire to measure "Job Stressors", "Stress Responses" and "Social Supports". The "Total Health Risk" of the healthcare workers was 10% higher than the national average. While the physicians felt the stress of the quantitative and qualitative job overload, they had support from supervisors and coworkers and showed mild "Stress Responses". The nursing staff felt the stress of the quantitative and qualitative job overload at the same level as the physicians, but they did not have sufficient support from supervisors and coworkers, and showed high "Stress Responses". The administrative workers did not have sufficient support from supervisors and coworkers, but they experienced less stress as measured by the quantitative and qualitative job overload than the physicians or the nursing staff and showed moderate "Stress Responses". Further studies are needed to clarify the mechanisms and the influence of other factors to the stress trait in healthcare workers.

  9. [Sex workers: limited access to healthcare].

    Science.gov (United States)

    Gloor, E; Meystre-Agustoni, G; Ansermet-Pagot, A; Vaucher, P; Durieux-Paillard, S; Bodenmann, P; Cavassini, M

    2011-06-29

    Sex workers constitute a heterogeneous group possessing a combination of vulnerability factors such as geographical instability, forced migration, substance addiction and lack of legal residence permit. Access to healthcare for sex workers depends on the laws governing the sex market and on migration policies in force in the host country. In this article, we review different European health strategies established for sex workers, and present preliminary results of a pilot study conducted among 50 sex workers working on the streets in Lausanne. The results are worrying: 56% have no health insurance, 96% are migrants and 66% hold no legal residence permit. These data should motivate public health departments towards improving access to healthcare for this vulnerable population.

  10. [Use of respiratory masks in healthcare workers].

    Science.gov (United States)

    Ciotti, C; Bouvet, E; Abiteboul, D

    2008-08-01

    Two different types of filtering respiratory masks are available in healthcare settings. The first ones are used to protect patients from droplets coming from the mouth of healthcare workers (HCW) and the second ones are protective masks. For the moment, we lack information regarding application of Ministry of Health recommendations and on adherence of HCW to mask use. Geres, the HCW exposure risk study group, and the INRS, are now conducting a survey in several hospitals in France to evaluate the use of respiratory masks in healthcare settings. Two phases are planned. Phase I is a self survey using a questionnaire for occupational doctors and hygienists and phase II includes three steps on HCW behavior: evaluation of knowledge and practice concerning respiratory masks, evaluation of respiratory mask use, evaluation of wear and fit test in a context of airborne isolation with a FFP1 and FFP2 respiratory mask. Phase I is finished and phase II is beginning. The first phase I data show that the Ministry's recommendations are observed: respiratory masks are available, written recommendations are present; information and training are organized for healthcare workers. Phase II results are not available yet.

  11. 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 agedrubella antibodies is high in HCW, but workers agedrubella.

  12. 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; in Healthcare Workers, Working Group for the Study of the Immune Status

    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 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. PMID:24356729

  13. Why healthcare workers are sick of TB

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    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.

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

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    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.

  15. Ethics of mandatory vaccination for healthcare workers.

    Science.gov (United States)

    Galanakis, E; Jansen, A; Lopalco, P L; Giesecke, J

    2013-11-07

    Healthcare workers (HCWs) are at increased risk of contracting infections at work and further transmitting them to colleagues and patients. Immune HCWs would be protected themselves and act as a barrier against the spread of infections and maintain healthcare delivery during outbreaks, but vaccine uptake rates in HCWs have often been low. In order to achieve adequate immunisation rates in HCWs, mandatory vaccination policies are occasionally implemented by healthcare authorities, but such policies have raised considerable controversy. Here we review the background of this debate, analyse arguments for and against mandatory vaccination policies, and consider the principles and virtues of clinical, professional, institutional and public health ethics. We conclude that there is a moral imperative for HCWs to be immune and for healthcare institutions to ensure HCW vaccination, in particular for those working in settings with high-risk groups of patients. If voluntary uptake of vaccination by HCWs is not optimal, patients’ welfare, public health and also the HCW’s own health interests should outweigh concerns about individual autonomy: fair mandatory vaccination policies for HCWs might be acceptable. Differences in diseases, patient and HCW groups at risk and available vaccines should be taken into consideration when adopting the optimal policy.

  16. Prevalence of needle stick injuries among healthcare workers at the ...

    African Journals Online (AJOL)

    Abe Olugbenga

    stick injury among healthcare workers at the Federal Medical Centre (FMC), Owerri. Materials ... (6%), stress had (6%), overfilled disposal boxes also recorded (2%) and lack of experience .... hospital workers in Malaysian Hospital reported ...

  17. Healthcare worker competencies for disaster training

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    Kelen Gabor D

    2006-03-01

    Full Text Available Abstract Background Although training and education have long been accepted as integral to disaster preparedness, many currently taught practices are neither evidence-based nor standardized. The need for effective evidence-based disaster training of healthcare staff at all levels, including the development of standards and guidelines for training in the multi-disciplinary health response to major events, has been designated by the disaster response community as a high priority. We describe the application of systematic evidence-based consensus building methods to derive educational competencies and objectives in criteria-based preparedness and response relevant to all hospital healthcare workers. Methods The conceptual development of cross-cutting competencies incorporated current evidence through a systematic consensus building process with the following steps: (1 review of peer-reviewed literature on relevant content areas and educational theory; (2 structured review of existing competencies, national level courses and published training objectives; (3 synthesis of new cross-cutting competencies; (4 expert panel review; (5 refinement of new competencies and; (6 development of testable terminal objectives for each competency using similar processes covering requisite knowledge, attitudes, and skills. Results Seven cross-cutting competencies were developed: (1 Recognize a potential critical event and implement initial actions; (2 Apply the principles of critical event management; (3 Demonstrate critical event safety principles; (4 Understand the institutional emergency operations plan; (5 Demonstrate effective critical event communications; (6 Understand the incident command system and your role in it; (7 Demonstrate the knowledge and skills needed to fulfill your role during a critical event. For each of the cross-cutting competencies, comprehensive terminal objectives are described. Conclusion Cross-cutting competencies and objectives

  18. 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

  19. Occupational Respiratory Allergic Diseases in Healthcare Workers.

    Science.gov (United States)

    Mazurek, Jacek M; Weissman, David N

    2016-11-01

    Healthcare workers (HCWs) are exposed to a range of high and low molecular weight agents that are allergic sensitizers or irritants including cleaners and disinfectants, natural rubber latex, and various medications. Studies have shown that exposed HCWs are at risk for work-related rhinitis and asthma (WRA). Work-related rhinitis may precede development of WRA and should be considered as an early marker of WRA. Avoidance of causative exposures through control strategies such as elimination, substitution, engineering controls, and process modification is the preferred primary prevention strategy for preventing development of work-related allergic diseases. There is limited evidence for the effectiveness of respirators in preventing occupational asthma. If sensitizer-induced WRA is diagnosed, it is important to avoid further exposure to the causative agent, preferably by more rigorous application of exposure control strategies to the workplace. This review focuses on allergic occupational respiratory diseases in HCWs.

  20. 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....

  1. The pregnant healthcare worker: fact and fiction.

    Science.gov (United States)

    Lynch, Laura; Spivak, Emily Sydnor

    2015-08-01

    A pregnant healthcare worker (HCW) may be at risk of occupational exposure to pathogens associated with increased maternal morbidity and mortality as well as perinatal complications. In this article, we review recent literature on infectious diseases commonly encountered in the healthcare setting and of highest concern for a pregnant HCW, focusing on prevention and management of exposures. Pregnancy does not seem to be an independent risk factor for occupationally acquired infectious diseases. Vaccination and standard precautions continue to be the most effective means of preventing transmission to HCWs. Pandemic 2009 influenza A (H1N1) is associated with increased risk of fetal death, highlighting the importance of influenza vaccination. A recent meta-analysis highlights the safety of influenza vaccination during pregnancy. New treatments for hepatitis C have not been studied in pregnancy but pose an important area for research and advancement. Cytomegalovirus immunoglobulin may play a role in postexposure prophylaxis but recent results are inconclusive. Primary prevention with vaccination and use of appropriate infection control precautions is imperative for prevention of occupationally acquired infectious diseases. Pregnant HCWs with occupational exposure to communicable diseases should be evaluated immediately for appropriate postexposure prophylaxis and followed for development of active infection.

  2. 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 factors ... The respondents' ages, level of education, occupation and gender were also ... paramedic and health information management students and their students in ...

  3. 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 ... Scenario-based assumptions were made for the values of parameters following a review of .... This study was approved by the Ethical Committee of Hawassa ... healthcare workers attributable to a workplace percutaneous.

  4. Measles Outbreak among Previously Immunized Adult Healthcare Workers, China, 2015

    OpenAIRE

    Zhengyi Zhang; Yuan Zhao; Lili Yang; Changhong Lu; Ying Meng; Xiaoli Guan; Hongjin An; Meizhong Zhang; Wenqin Guo; Bo Shang; Jing Yu

    2016-01-01

    Measles is caused by measles virus belonging to genus Morbillivirus of the family Paramyxoviridae. Vaccination has played a critical role in controlling measles infection worldwide. However, in the recent years, outbreaks of measles infection still occur in many developing countries. Here, we report an outbreak of measles among healthcare workers and among the 60 measles infected patients 50 were healthcare workers including doctors, nurses, staff, and medics. Fifty-one patients (85%) tested ...

  5. 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

  6. Are residential and nursing homes adequately screening overseas healthcare workers?

    Directory of Open Access Journals (Sweden)

    Loveday Rachel

    2008-08-01

    Full Text Available Abstract Background There has been significant growth in the number of healthcare workers born outside the UK or recruited to the UK from countries with a high prevalence of TB, Hepatitis and other blood borne infections. Government policy recognises the need for occupational health procedures to facilitate treatment for these individuals and to reduce the risk of transmission of disease to patients. The aim of this study was to undertake a survey of nursing and residential homes in South East England, to assess whether homes had occupational health screening policies for healthcare workers who have originated from overseas, and what level of occupational health screening had been undertaken on these employees. Methods An anonymous survey was sent to all 500 homes in West Sussex assessing occupational health practices for "overseas health care workers", defined as health care workers who had been born outside the UK. Results Only one employer (0.8% reported they had an occupational health screening policy specific for healthcare workers who originate from overseas. Over 80% of homes who had recruited directly had no evidence of screening results for HIV, TB, Hepatitis B and C. The commonest countries of origin for staff were the UK, Philippines, Poland, South Africa, Zimbabwe, and India. Conclusion This study suggests that screening of overseas healthcare workers is not routine practice for residential or nursing care homes and requires further input from Primary Care Trust's, Health Care Commission, Commission for Social Care Inspection, and Professional bodies.

  7. [Healthcare for migrant workers in Israel].

    Science.gov (United States)

    Fried, Mordechai

    2003-06-01

    An estimated 300.000 migrant workers are currently living in Israel, which is about 5% of the general population. More then half of this population is undocumented and have very limited access to public health care. Due to the financial difficulties within the Israel's public health system, the entity is unable to deal with the needs of migrant workers. Hence, when these migrant workers need inpatient care, hospitals have to bear the costs and this situation creates a divergence between medical and economic considerations. The open clinic of "Physicians for Human Rights", which is operated by volunteer physicians and nurses, is able to provide medical aid for mild and transient illnesses, but not for chronic diseases. Israeli physicians are regularly confronted with ethical issues, regarding the therapy they would like to provide to undocumented migrant workers, but are unable to do so. In Europe, undocumented migrant workers have better access to public health care than in Israel. The Israeli public health system should permit all migrant workers to insure themselves at affordable prices, or another inexpensive insurance system should be created for them.

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

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    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.

  9. Contamination of healthcare workers' hands with bacterial spores.

    Science.gov (United States)

    Sasahara, Teppei; Ae, Ryusuke; Watanabe, Michiyo; Kimura, Yumiko; Yonekawa, Chikara; Hayashi, Shunji; Morisawa, Yuji

    2016-08-01

    Clostridium species and Bacillus spp. are spore-forming bacteria that cause hospital infections. The spores from these bacteria are transmitted from patient to patient via healthcare workers' hands. Although alcohol-based hand rubbing is an important hand hygiene practice, it is ineffective against bacterial spores. Therefore, healthcare workers should wash their hands with soap when they are contaminated with spores. However, the extent of health care worker hand contamination remains unclear. The aim of this study is to determine the level of bacterial spore contamination on healthcare workers' hands. The hands of 71 healthcare workers were evaluated for bacterial spore contamination. Spores attached to subject's hands were quantitatively examined after 9 working hours. The relationship between bacterial spore contamination and hand hygiene behaviors was also analyzed. Bacterial spores were detected on the hands of 54 subjects (76.1%). The mean number of spores detected was 468.3 CFU/hand (maximum: 3300 CFU/hand). Thirty-seven (52.1%) and 36 (50.7%) subjects were contaminated with Bacillus subtilis and Bacillus cereus, respectively. Nineteen subjects (26.8%) were contaminated with both Bacillus species. Clostridium difficile was detected on only one subject's hands. There was a significant negative correlation between the hand contamination level and the frequency of handwashing (r = -0.44, P < 0.01) and a significant positive correlation between the hand contamination level and the elapsed time since last handwashing (r = 0.34, P < 0.01). Healthcare workers' hands may be frequently contaminated with bacterial spores due to insufficient handwashing during daily patient care.

  10. Risk factors for burnout among healthcare workers in an urban ...

    African Journals Online (AJOL)

    Risk factors for burnout among healthcare workers in an urban Hospital. ... Nigerian Journal of Family Practice ... Their human resources for health suffer a number of psychosocial hazards, including burnout. This study sought to determine the prevalence and risk factors of burnout using a burnout assessment approach ...

  11. Home healthcare workers and the Fair Labor Standards Act.

    Science.gov (United States)

    Fowler, Rebecca M

    2008-04-01

    In a major industry shift, long term care is moving from nursing homes and institutions to the private home. This change results from a number of factors, including the lower cost of home-based care. These lower costs can be traced to a number of exemptions from the Fair Labor Standards Act requirements for minimum wage and premium overtime payments which apply to many home healthcare workers. These include the companionship, live-in, and professional exemptions. As the home healthcare industry has grown, home healthcare workers have challenged the applicability of these exemptions. This article will explore the issues reflected in those challenges and their resolution, and provide suggestions to help employers ensure that their employees fall within the exemptions.

  12. 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.

  13. 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.

  14. Relevance of latex aeroallergen for healthcare workers

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    X. Baur

    1996-01-01

    Full Text Available The dispersion of latex allergen bound on glove powder has been shown to be of clinical importance to latex-sensitized medical staff and patients. To investigate whether latex aeroallergen is associated with the development of latex allergic reactions in health care workers, air samples were collected in 33 hospital rooms and two physicians' offices. Concentrations of latex allergens in the samples were determined by a competitive inhibition immunoassay and related to reported hypersensitivity reactions and to specific IgE results of 111 staff members engaged in these rooms. Latex aeroallergen (up to 205 ng/m3 could be detected in all rooms where powdered latex gloves were used and ventilation systems were not installed. Conjunctivitis (n=10, rhinitis (n=12 and dyspnea (n=4 were reported exclusively by employees working in such contaminated rooms. Also workers with latex-specific IgE antibodies (n=l 7 were found only in these rooms. Urticaria in personnel (n=26 was reported in rooms with and without detectable allergen load. All symptoms were significantly associated with latex-specific IgE antibodies. Our results demonstrate that immediate-type sensitization and allergic symptoms are associated with detectable latex aeroallergen.

  15. From healthcare support worker to registered nurse.

    Science.gov (United States)

    Driffield, Amanda

    2016-09-01

    Workforce planning, education and training are essential for achieving an appropriate mix of skilled and motivated staff, but the NHS's financial challenges mean new ways of providing safe staffing levels and balancing the books are required. This article describes the development of an education programme for band 1 to band 4 unregistered support workers that led to the introduction of an assistant practitioner (AP) role. It also explains how the programme evolved from a one-year certificate in higher education to a foundation degree in health care, and has since produced over 100 APs in a range of clinical areas who deliver high quality, competent and patient-centred care in a cost-effective, sustainable way.

  16. Work-related stress in healthcare workers.

    Science.gov (United States)

    Tomei, G; Ricci, S; Fidanza, L; Sacco, C; De Cesare, D P; Ricci, P; Pimpinella, B; Giubilati, R; Suppi, A; Anzelmo, V; Tomei, F; Casale, T; Rosati, M V

    2016-01-01

    In the assessment of work-related stress it is crucial to find the factors that generate and increase it in order to identify categories of individuals at risk, to plan interventions for prevention, elimination or reduction of risk. The aim of the study is to assess the subjective stress in 68 workers of a large Italian company dealing with human health, through the use of a questionnaire-indicating tool, elaborated by the Italian National Institute for insurance against accidents at work (INAIL) and developed by the Health and Safety Executive (HSE). We studied a final sample of 68 individuals (34 drivers/rescuers and 34 video display unit (VDU) operators). The questionnaire consists of 35 items (divided into six areas) with five possible answers each, that cover working conditions considered potential causes of stress. The drivers/rescuers had a better performance than the VDU operators, especially in the areas "demand", "relationships" and "role". We compared men and women in the two groups, finding that, in VDU operators, women had a better performance than men in all areas, except "role" and "changes", in which the overall scores were the same in men and women. In the drivers/rescuers women showed more critical scores in the items "relationships" and "change". The results show that: the questionnaire-indicating tool is useful, with a demonstrated effectiveness for the occupational physician during the visits and proven validity; additional future efforts should focus on understanding the psycho-social, organizational and individual problems related to stress and the consequent implementation of preventive measures.

  17. Tuberculosis and the implications for healthcare workers in hospitals.

    Science.gov (United States)

    Aziz, Ann-Marie

    In response to concerns about the rising incidence of tuberculosis (TB) in the United Kingdom, the National Institute for Health and Clinical Excellence has issued fresh guidance on TB and its management for prevention and control. Inadequate infection control procedures have been cited as the main contributing factors to institutional outbreaks of the disease. The control and prevention ofTB in hospitals is best achieved by three approaches: early diagnosis, good isolation management and adoption of personal protective equipment. Implementing appropriate infection control policies and procedures can reduce transmission of TB, help increase healthcare workers' awareness and compliance with practice and improve patients' stay in hospitals. This article highlights the role of healthcare workers in minimizing the risk of transmission of TB and reviews the current infection control recommendations for the management of patients with TB.

  18. Transmission of Enterobacter aerogenes septicemia in healthcare workers.

    Science.gov (United States)

    Jha, Piyush; Kim, Choon-Mee; Kim, Dong-Min; Chung, Jong-Hoon; Yoon, Na-Ra; Jha, Babita; Kim, Seok Won; Jang, Sook Jin; Ahn, Young-Joon; Chung, Jae Keun; Jeon, Doo Young

    2016-01-01

    Enterobacter aerogenes is recognized as an important bacterial pathogen in hospital-acquired infections. This report describes two unusual cases of septicemia caused by E. aerogenes in immunocompetent healthcare workers. E. aerogenes was isolated from blood cultures of the two patients experiencing septicemia. The clinical isolates were initially identified as E. aerogenes using a VITEK II automated system and 16S rRNA sequence analysis, and; both isolates involved in the outbreak shared a common pulse-field gel electrophoresis pattern. The similarities between the two cases included the simultaneous development of gastroenteritis symptoms, severe sepsis and thrombocytopenia after taking intravenous injections of ketorolac tromethamine. A common source of normal saline, a 100 mL bottle, was used for diluting the analgesic in both cases. In addition to the general population, healthcare workers, especially those who are also intravenous drug abusers, should be considered subjects that could cause a transmission of Enterobacter infection.

  19. 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.

  20. Measles Outbreak among Previously Immunized Adult Healthcare Workers, China, 2015

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    Zhengyi Zhang

    2016-01-01

    Full Text Available Measles is caused by measles virus belonging to genus Morbillivirus of the family Paramyxoviridae. Vaccination has played a critical role in controlling measles infection worldwide. However, in the recent years, outbreaks of measles infection still occur in many developing countries. Here, we report an outbreak of measles among healthcare workers and among the 60 measles infected patients 50 were healthcare workers including doctors, nurses, staff, and medics. Fifty-one patients (85% tested positive for IgM antibodies against the measles virus and 50 patients (83.3% tested positive for measles virus RNA. Surprisingly, 73.3% of the infected individuals had been previously immunized against measles. Since there is no infection division in our hospital, the fever clinics are located in the Emergency Division. In addition, the fever and rash were not recognized as measles symptoms at the beginning of the outbreak. These factors result in delay in isolation and early confirmation of the suspected patients and eventually a measles outbreak in the hospital. Our report highlights the importance of following a two-dose measles vaccine program in people including the healthcare workers. In addition, vigilant attention should be paid to medical staff with clinical fever and rash symptoms to avoid a possible nosocomial transmission of measles infection.

  1. Measles Outbreak among Previously Immunized Adult Healthcare Workers, China, 2015

    Science.gov (United States)

    Zhang, Zhengyi; Zhao, Yuan; Yang, Lili; Lu, Changhong; Meng, Ying; Guan, Xiaoli; An, Hongjin; Zhang, Meizhong; Guo, Wenqin; Shang, Bo; Yu, Jing

    2016-01-01

    Measles is caused by measles virus belonging to genus Morbillivirus of the family Paramyxoviridae. Vaccination has played a critical role in controlling measles infection worldwide. However, in the recent years, outbreaks of measles infection still occur in many developing countries. Here, we report an outbreak of measles among healthcare workers and among the 60 measles infected patients 50 were healthcare workers including doctors, nurses, staff, and medics. Fifty-one patients (85%) tested positive for IgM antibodies against the measles virus and 50 patients (83.3%) tested positive for measles virus RNA. Surprisingly, 73.3% of the infected individuals had been previously immunized against measles. Since there is no infection division in our hospital, the fever clinics are located in the Emergency Division. In addition, the fever and rash were not recognized as measles symptoms at the beginning of the outbreak. These factors result in delay in isolation and early confirmation of the suspected patients and eventually a measles outbreak in the hospital. Our report highlights the importance of following a two-dose measles vaccine program in people including the healthcare workers. In addition, vigilant attention should be paid to medical staff with clinical fever and rash symptoms to avoid a possible nosocomial transmission of measles infection. PMID:27366157

  2. 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.

  3. Prevalence of musculoskeletal pain syndromes in primary healthcare unit workers

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    Evelin Diana Goldenberg Meirelles Mariano da Costa

    2007-03-01

    Full Text Available Objective: To assess the prevalence of pain syndromes and theirrelation with stress in healthcare workers at primary healthcareunits. Methods: A total of 540 workers of 10 primary healthcareunits were assessed in partnership with the Hospital Israelita AlbertEinstein (HIAE, in São Paulo, in 2005, through the Prevalence of PainSyndromes in the General Population Survey and the Lipp’s StressSymptom Inventory for Adults. Statistical analysis was carriedthrough univariate and multivariate analyses using accurate binarylogistic regression models adjusted for the following variables: stress,sex, dyslipidemia and hypertension. Ratios were compared usingFisher-Freeman-Halton test. Results: 86.93% were women, 54.63%of females were married, the majority worked at daytime and hadattended high school. General prevalence of pain was 54.26% (56.57%of women and 38.24% of men. Schooling was inversely proportionalto onset of pain. Health agents were twice more likely to presentpain than other professionals. Pain likelihood increased by 1.98%each year, and by 20.7% within 10 years. The groups with chronicpain presented statistical significance with stress (p < 0.001.There was no statistical difference in use of medications, number ofphysiotherapy sessions and lost work days in the groups with chronicpain when compared with the group with acute pain. Both chronicand acute pain groups were statistically significant in all variableswhen compared with the group with no pain. Stress, dyslipidemiaand arterial hypertension were positively associated with pain.Employees with stress presented a 4.19-fold higher likelihood ofpresenting pain as compared to those with no stress. Conclusion:The prevalence of pain syndromes among primary healthcare unitsworkers was 54.63%, and it was influenced by schooling and stresslevels. Most workers affected were female. Preventive measuresmust be established for healthcare workers.

  4. 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.

  5. 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.

  6. Influenza immunisation: attitudes and beliefs of UK healthcare workers

    Science.gov (United States)

    Smedley, Julia; Poole, Jason; Waclawski, Eugene; Stevens, Anthony; Harrison, John; Watson, John; Hayward, Andrew; Coggon, David

    2007-01-01

    Aim To explore attitudes to influenza immunisation and rates of uptake among staff working in acute hospitals in the UK. Method A cross‐sectional survey of 11 670 healthcare workers in six UK hospitals was carried out using a postal questionnaire. Results Among 6302 responders (54% of those mailed), 19% had taken up influenza immunisation during winter 2002/3. Vaccination was well tolerated, with a low prevalence of side effects (13%) and associated time off work (2%). The majority of subjects who accepted vaccination (66%) were most strongly influenced by the personal benefits of protection against influenza. Prevention of sickness absence and protection of patients were the prime motivation for only 10% and 7% of subjects, respectively. Among 3967 who declined vaccination, the most common primary demotivators were concern about safety (31%) and efficacy (29%). 22% were most strongly deterred by lack of time to attend for vaccination. Free text answers indicated that 37% declined because of a perceived low ratio of personal benefits to adverse effects. Subjects said they would be persuaded to take up vaccination in future by easier access (36%), more information about personal benefit and risk (34%) and more information about effects on staff absence (24%). Conclusions These findings indicate that the uptake of influenza immunisation among UK healthcare workers remains low. There is some scope for increasing uptake by improving accessibility and encouragement from professional peers. However, the results suggest that perception of small personal benefit in relation to risk mitigates, importantly, against higher uptake of routine annual influenza vaccination. Thus, resource might better be allocated to ensuring efficient management in epidemic years. The effect of publicity about pandemic influenza on risk perception and vaccine uptake among healthcare workers during winter 2005/6 warrants further study. PMID:17182640

  7. 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.

  8. Antineoplastic drug contamination in the urine of Canadian healthcare workers.

    Science.gov (United States)

    Hon, Chun-Yip; Teschke, Kay; Shen, Hui; Demers, Paul A; Venners, Scott

    2015-10-01

    The purpose of this study was to quantify the urine concentration of non-metabolized cyclophosphamide (CP), a commonly administered antineoplastic drug, among potentially exposed Canadian healthcare workers and to identify factors associated with the drug concentration levels. Participants were asked to provide two sets of 24-h urine samples (at two different sampling events), and the level of CP was quantified using high-performance liquid chromatography-tandem mass spectrometry. In addition to demographic information, participants were surveyed regarding their frequency of handling of antineoplastic drugs, safe drug handling training, and known contact with CP on their work shift. Descriptive and inferential statistical analyses were performed. A backward stepwise linear mixed effect model was conducted to identify the factors associated with urine concentration levels. We collected 201 urine samples, and 55 % (n = 111) had levels greater than the LOD of 0.05 ng/mL. The mean urinary CP concentration was 0.156 ng/mL, the geometric mean was 0.067 ng/mL, the geometric standard deviation was 3.18, the 75th percentile was 0.129 ng/mL, and the range was drug administration unit, but were not responsible for administering the drugs to patients, i.e., volunteers, oncologists, ward aides, and dieticians, had the largest proportion of samples exceeding the LOD. We did not find any correlation between the urinary concentration levels and known contact with CP during the work shift. Two factors were found to be significantly associated with urinary CP concentration: (1) Workers who had a duty to handle antineoplastic drugs had higher concentration levels, and (2) workers who had not received safe drug handling training had higher levels of CP in their urine compared with those who had. The presence of non-metabolized CP in urine confirms that, despite the existence of control measures, a broad range of healthcare workers are at risk of exposure to antineoplastic drugs. A

  9. Updates on Knowledge, Attitude and Preventive Practices on Tuberculosis among Healthcare Workers

    Science.gov (United States)

    Wahab, Farhanah Abd; Abdullah, Sarimah; Abdullah, Jafri Malin; Jaafar, Hasnan; Noor, Siti Suraiya Md; Mohammad, Wan Mohd Zahiruddin Wan; Yusoff, Abdul Aziz Mohamed; Tharakan, John; Bhaskar, Shalini; Sangu, Muthuraju; Mahmood, Mohd Shah; Kassim, Fauziah; Rafia, Md. Hanip; Haspani, Mohammed Safari Mohammed; Alias, Azmi; Pando, Rogelio Hernández

    2016-01-01

    Ranking as the most communicable disease killer worldwide, tuberculosis, has accounted with a total of 9.6 million new tuberculosis cases with 1.5 million tuberculosis-related deaths reported globally in 2014. Tuberculosis has remain as an occupational hazard for healthcare workers since 1920s and due to several tuberculosis outbreaks in healthcare settings in the early 1990s, the concern about the transmission to both patients and healthcare workers has been raised. Healthcare workers have two to three folds greater the risk of active tuberculosis than the general population. Several studies on knowledge, attitude and practices on tuberculosis among healthcare workers worldwide have revealed that majority of the participated healthcare workers had good knowledge on tuberculosis. Most of the healthcare workers from South India and South Africa also reported to have positive attitude whereas a study in Thailand reported that most of the healthcare providers have negative attitude towards tuberculosis patients. Nevertheless, majority of the healthcare workers have low level of practice on tuberculosis prevention. An improved communication between healthcare workers and the patients as well as their families is the key to better therapeutic outcomes with good knowledge, attitude and preventive practice towards tuberculosis. PMID:28090176

  10. 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

  11. Prevalence of Clostridium difficile colonization among healthcare workers.

    Science.gov (United States)

    Friedman, N Deborah; Pollard, James; Stupart, Douglas; Knight, Daniel R; Khajehnoori, Masoomeh; Davey, Elise K; Parry, Louise; Riley, Thomas V

    2013-10-04

    Clostridium difficile infection (CDI) has increased to epidemic proportions in recent years. The carriage of C. difficile among healthy adults and hospital inpatients has been established. We sought to determine whether C. difficile colonization exists among healthcare workers (HCWs) in our setting. A point prevalence study of stool colonization with C. difficile among doctors, nurses and allied health staff at a large regional teaching hospital in Geelong, Victoria. All participants completed a short questionnaire and all stool specimens were tested by Techlab® C.diff Quik Check enzyme immunoassay followed by enrichment culture. Among 128 healthcare workers, 77% were female, of mean age 43 years, and the majority were nursing staff (73%). Nineteen HCWs (15%) reported diarrhoea, and 12 (9%) had taken antibiotics in the previous six weeks. Over 40% of participants reported having contact with a patient with known or suspected CDI in the 6 weeks before the stool was collected. C. difficile was not isolated from the stool of any participants. Although HCWs are at risk of asymptomatic carriage and could act as a reservoir for transmission in the hospital environment, with the use of a screening test and culture we were unable to identify C. difficile in the stool of our participants in a non-outbreak setting. This may reflect potential colonization resistance of the gut microbiota, or the success of infection prevention strategies at our institution.

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

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    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.

  13. Job Stress and Job Satisfaction among Health-Care Workers of Endoscopy Units in Korea

    OpenAIRE

    Nam, Seung-Joo; Chun, Hoon Jai; Moon, Jeong Seop; Park, Sung Chul; Hwang, Young-Jae; Yoo, In Kyung; Lee, Jae Min; Kim, Seung Han; Choi, Hyuk Soon; Kim, Eun Sun; Keum, Bora; Jeen, Yoon Tae; Lee, Hong Sik; Kim, Chang Duck

    2016-01-01

    Background/Aims: The management of job-related stress among health-care workers is critical for the improvement of healthcare services; however, there is no existing research on endoscopy unit workers as a team. Korea has a unique health-care system for endoscopy unit workers. In this study, we aimed to estimate job stress and job satisfaction among health-care providers in endoscopy units in Korea. Methods: We performed a cross-sectional survey of health-care providers in the endoscopy units...

  14. 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 stress was significantly positively correlated with affective commitment (β = 0.15; p stress was significantly inversely correlated with affective commitment (β = -0.40; p workers. Presenteeism can be addressed by increasing affective commitment and challenge stress and by limiting hindrance stress among healthcare workers in China.

  15. 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

  16. Association of State Laws and Healthcare Workers' Influenza Vaccination Rates.

    Science.gov (United States)

    Lin, Chyongchiou Jeng; Nowalk, Mary Patricia; Raymund, Mahlon; Sweeney, Patricia M; Zimmerman, Richard K

    2016-02-01

    State laws are being used to increase healthcare worker (HCW) influenza vaccine uptake. Approximately 40% of states have enacted such laws but their effectiveness has been infrequently studied. Data sources for this study were the 2000-2011 U.S. National Health Interview Survey Adult Sample File and a summary of U.S. state HCW influenza vaccination laws. Hierarchical linear modeling was used for two time periods: 1) 2000-2005 (before enactment of many state laws) and 2) 2006-2011 (a time of increased enactment of state HCW influenza vaccination legislation). During 2000-2005, two states had HCW influenza vaccination laws and HCW influenza vaccination rates averaged 22.5%. In 2006-2011, 19 states had such laws and vaccination rates averaged 50.9% (p law score. Although laws varied widely in scope and applicability, states with HCW influenza vaccination laws reported higher HCW vaccination rates.

  17. Unequal access to public healthcare facilities: theory and measurement revisited

    Directory of Open Access Journals (Sweden)

    Stefano Mainardi

    2007-12-01

    Full Text Available Adequate coverage and efficiency of public health services are high priorities for sustainable growth and development. In many countries, public healthcare continues to fall short of demand, and remains unevenly distributed among the population. As in other areas of project appraisal, studies on social equity and access to public utilities are fraught with theoretical and empirical questions. Based on the concepts of marginal disutility with respect to distance, safety thresholds and `equally distributed equivalent' distance, the paper first reassesses utility theory assumptions supporting the rationale for functional re-specifications. Partly drawing on these theoretical refinements, the analysis formulates a stochastic cost frontier hurdle model with an endogenously determined hospital distance threshold. For illustrative purposes, this model is applied to pooled biennial communal data for Chile. Healthcare accessibility in terms of travel cost/time is proxied by distances of administrative centres from the nearest emergency hospitals over the period 2000-2003.

  18. Postmodernism for healthcare workers in 13 easy steps.

    Science.gov (United States)

    Rolfe, G

    2001-01-01

    Despite a growing literature on postmodernism in nursing and other healthcare disciplines, it continues to be dogged by mistrust, misunderstanding and outright hostility. Presenting the philosophy of postmodernism is a particularly difficult task, and most attempts fall into one of two traps: either the writer is a well-read and committed postmodernist in which case the writing tends to make too many assumptions about the background knowledge of the reader; or else the writer has only a passing knowledge of 'popular' postmodernism, in which case the writing often falls back on over-simplistic concepts which do not do justice to the issues and which are often completely misconceived. The problem is further compounded by the difficulty of writing about one discourse (I am using the word in its postmodern sense-all such 'jargon' is explained in the paper) from within a different and potentially hostile one. For the postmodernists, rational debate with their modernist colleagues is all but impossible, since (as we shall see) the logic and language of the dominant discourse of modernism rules out and refuses to acknowledge that of postmodernism (and vice versa). Postmodern texts therefore rely less on rational argument than on persuasive narrative and a deliberate subversion of many of the usual practices of writing. This introduction to postmodernism for healthcare workers attempts to straddle the two discourses in both its form and its content, and offers a mixture of argument, example and speculation.

  19. 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.

  20. Building healthcare workers' confidence to work with same-sex parented families.

    Science.gov (United States)

    von Doussa, Henry; Power, Jennifer; McNair, Ruth; Brown, Rhonda; Schofield, Margot; Perlesz, Amaryll; Pitts, Marian; Bickerdike, Andrew

    2016-06-01

    This article reports on a qualitative study of barriers and access to healthcare for same-sex attracted parents and their children. Focus groups were held with same-sex attracted parents to explore their experiences with healthcare providers and identify barriers and facilitators to access. Parents reported experiencing uncomfortable or anxiety-provoking encounters with healthcare workers who struggled to adopt inclusive or appropriate language to engage their family. Parents valued healthcare workers who were able to be open and honest and comfortably ask questions about their relationships and family. A separate set of focus groups were held with mainstream healthcare workers to identity their experiences and concerns about delivering equitable and quality care for same-sex parented families. Healthcare workers reported lacking confidence to actively engage with same-sex attracted parents and their children. This lack of confidence related to workers' unfamiliarity with same-sex parents, or lesbian, gay and bisexual culture, and limited opportunities to gain information or training in this area. Workers were seeking training and resources that offered information about appropriate language and terminology as well as concrete strategies for engaging with same-sex parented families. For instance, workers suggested they would find it useful to have a set of 'door opening' questions they could utilize to ask clients about their sexuality, relationship status or family make-up. This article outlines a set of guidelines for healthcare providers for working with same-sex parented families which was a key outcome of this study.

  1. 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.

  2. Legal considerations surrounding mandatory influenza vaccination for healthcare workers in the United States.

    Science.gov (United States)

    Randall, Lisa H; Curran, Eileen A; Omer, Saad B

    2013-04-03

    Recent years have brought increased focus on the desirability of vaccinating more healthcare workers against influenza. The concern that novel 2009 H1N1 influenza A would spark a particularly severe influenza season in 2009-2010 spurred several institutions and one state to institute mandatory vaccination policies for healthcare workers, and several new mandates have been introduced since then. Some healthcare workers, however, have voiced objections in the media and in legal proceedings. This paper reviews the characteristics of influenza and how it is transmitted in the healthcare setting; surveys possible constitutional, administrative, and common law arguments against mandates; assesses the viability of those arguments; and identifies potential new legal strategies to support influenza vaccine mandates. It is intended to assist those involved in the regulation and administration of public and private healthcare institutions who may be considering approaches to mandates but have concerns about legal challenges. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Knowledge, Attitude and Behaviours towards Recommended Vaccinations among Healthcare Workers

    Science.gov (United States)

    La Torre, Giuseppe; Scalingi, Stefania; Garruto, Veronica; Siclari, Marco; Chiarini, Massimiliano; Mannocci, Alice

    2017-01-01

    Healthcare workers (HCWs) are an important group of professionals exposed to biological risk during their work activities. So, the aim of this study is to perform a survey on the knowledge, attitude and behaviour of Italian HCWs towards the vaccinations recommended by the Ministry of Health. A cross-sectional study was carried out during the period September 2014–August 2015 in the Lazio region. The study was conducted by recruiting HCWs and biomedical students. The sample was comprised of 571 responders, of whom 12.4% were physicians, 18.9% were nurses, 34.3% were other HCW, and 34.3% were biomedical students (medical and nurses students). Hepatitis B virus (HBV) is perceived as a risk for personal health by 457 (80%) participants; TB is also worrying (434; 76%). Moreover, HBV (70.9%) and tuberculosis (TB) (79.2%) are perceived as a risk for health, while influenza is not considered so by most participants (46.2%). There is an underestimation of the role of influenza, perceived as a risk for 137 respondents (24%). The vaccination rate among these HCWs is highest for Hepatitis B virus (HBV) (82%), and lowest for influenza (28.5%) and varicella (40.3%). The vast majority of responders are in favour of HBV (77.8%) and TB (64.8%) vaccines. For other vaccinations there is less interest (between 33% and 40% for measles, mumps, rubella, pertussis and influenza). This study shows that knowledge of recommended occupational vaccinations is insufficient in HCWs, with few exceptions represented by HBV and TB. There is a need for novel approaches in this field, with the aim of enhancing vaccine coverage among HCW. PMID:28272332

  4. Measles Outbreak Among Previously Immunized Healthcare Workers, the Netherlands, 2014.

    Science.gov (United States)

    Hahné, Susan J M; Nic Lochlainn, Laura M; van Burgel, Nathalie D; Kerkhof, Jeroen; Sane, Jussi; Yap, Kioe Bing; van Binnendijk, Rob S

    2016-12-15

     We investigated a measles outbreak among healthcare workers (HCWs) by assessing laboratory characteristics, measles vaccine effectiveness, and serological correlates for protection.  Cases were laboratory-confirmed measles in HCWs from hospital X during weeks 12-20 of 2014. We assessed cases' severity and infectiousness by using a questionnaire. We tested cases' sera for measles immunoglobulin M, immunoglobulin G, avidity, and plaque reduction neutralization (PRN). Throat swabs and oral fluid samples were tested by quantitative polymerase chain reaction. We calculated attack rates (ARs) by vaccination status and estimated measles vaccine effectiveness as 1 - [ARvaccinated/ARunvaccinated].  Eight HCWs were notified as measles cases; 6 were vaccinated with measles vaccine twice, 1 was vaccinated once, and 1 was unvaccinated. All 6 twice-vaccinated cases had high avidity and PRN titers. None reported severe measles or onward transmission. Two of 4 investigated twice-vaccinated cases had pre-illness PRN titers of >120 mIU/mL. Among 106 potentially exposed HCWs, the estimated effectiveness of 2 doses of measles vaccine was 52% (95% confidence interval [CI], -207%-93%).  Measles occurred in 6 twice-vaccinated HCWs, despite 2 having adequate pre-exposure neutralizing antibodies. None of the twice-vaccinated cases had severe measles, and none had onward transmission, consistent with laboratory findings suggesting a secondary immune response. Improving 2-dose MMR coverage among HCWs would have likely reduced the size of this outbreak. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  5. Vaccine hesitancy among healthcare workers in Europe: A qualitative study.

    Science.gov (United States)

    Karafillakis, Emilie; Dinca, Irina; Apfel, Franklin; Cecconi, Sabrina; Wűrz, Andrea; Takacs, Judit; Suk, Jonathan; Celentano, Lucia Pastore; Kramarz, Piotr; Larson, Heidi J

    2016-09-22

    Healthcare workers (HCWs) are often referred to as the most trusted source of vaccine-related information for their patients. However, the evidence suggests that a number of HCWs are vaccine-hesitant. This study consists of 65 semi-structured interviews with vaccine providers in Croatia, France, Greece, and Romania to investigate concerns HCWs might have about vaccination. The results revealed that vaccine hesitancy is present in all four countries among vaccine providers. The most important concern across all countries was the fear of vaccine side effects. New vaccines were singled out due to perceived lack of testing for vaccine safety and efficacy. Furthermore, while high trust in health authorities was expressed by HCWs, there was also strong mistrust of pharmaceutical companies due to perceived financial interests and lack of communication about side effects. The notion that it is a doctor's responsibility to respond to hesitant patients was reported in all countries. Concerns were also seen to be country- and context-specific. Strategies to improve confidence in vaccines should be adapted to the specific political, social, cultural and economic context of countries. Furthermore, while most interventions focus on education and improving information about vaccine safety, effectiveness, or the need for vaccines, concerns raised in this study identify other determinants of hesitancy that need addressing. The representativeness of the views of the interviewed HCWs must be interpreted with caution. This a qualitative study with a small sample size that included geographical areas where vaccination uptake was lower or where hesitancy was more prevalent and it reflects individual participants' beliefs and attitudes toward the topic. As HCWs have the potential of influencing patient vaccination uptake, it is crucial to improve their confidence in vaccination and engage them in activities targeting vaccine hesitancy among their patients.

  6. The knowledge, attitudes and behaviors on immunization of healthcare workers

    Directory of Open Access Journals (Sweden)

    Zehra Karacaer

    2015-10-01

    Full Text Available Background: The objective of this study was to identify the knowledge, attitudes and behaviors of healthcare workers (HCWs working in our center about Hepatitis B Virus (HBV, seasonal flu (SF and measles-mumps-rubella (MMR vaccinations and reasons not to be vaccinated. Methods: This study was a descriptive survey conducted among HCWs of our hospital between 1 to 31 May 2014. The data were collected by a face-to-face questionnaire form consisting of 41 questions. Collected data were analyzed via SPSS 22,0, p <0.05 was considered significant Results: 219 HCWs participated in the study. The study group included 113 men. A median age of 39 years (minmax: 24-66. The median service duration of HCWs was 17 years (min-max: 1-35. Education levels of personnels were primary (primary -secondary-high school, colleges-university, master's degree-PhD ( respectively 45, 136, 38 people. The median score of correct information, the right attitude and the correct behavior were 7 (min-max: 1-10, 35 (min-max: 27-47, 5 (min-max: 0- 9, respectively. People who never got vaccinated against SF and who got vaccinated every year were calculated 46.6% and 20.1%. H1N1, HBV and measles vaccination rate were 46.6%, 82.6% and 18.3%, respectively. Not believing vaccine's protectiveness for SF (34,9%, concerned about safety for H1N1(44,4%, neglected for HBV (36,8%, got sick before for measles (36,3% were the factors most influential in refusal to get vaccinated. Conclusions: It is important that correct and sufficient information is accessed on issues such as effectiveness, side effects of vaccines in order to increase the rate of vaccination of HCWs [TAF Prev Med Bull 2015; 14(5.000: 353-363

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

    NARCIS (Netherlands)

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

    2012-01-01

    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

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

    Directory of Open Access Journals (Sweden)

    Shyamanta

    2015-11-01

    Full Text Available 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 has been approved by the institutional ethical committee. After obtaining informed consent, doctors, nurses and other healthcare workers who are working in the Emergency Department of the Gauhati Medical College Hospital, Guwahati, will form the study population. RESULT Sixty two healthcare workers will constitute the sample for the present study. The Assamese translation of the Maslach Burnout Inventory (MBI is the chosen tool to assess burnout. The data on demography, factors influencing the level of burnout, and the degree of burnout will be collected through structured questionnaires. The analysis is planned by both descriptive (such as mean, standard deviation, and frequency distribution as well as inferential (non-parametric test such as Chi-square statistics. CONCLUSION Knowledge about the degree of burnout among the emergency healthcare workers and the factors influencing burnout in hospital can help in devising methods to recharge the resources and motivation of the workforce and thus the organisation and thereby improve the overall performance of the healthcare system and patient outcomes.

  9. Job Stress and Job Satisfaction among Health-Care Workers of Endoscopy Units in Korea.

    Science.gov (United States)

    Nam, Seung-Joo; Chun, Hoon Jai; Moon, Jeong Seop; Park, Sung Chul; Hwang, Young-Jae; Yoo, In Kyung; Lee, Jae Min; Kim, Seung Han; Choi, Hyuk Soon; Kim, Eun Sun; Keum, Bora; Jeen, Yoon Tae; Lee, Hong Sik; Kim, Chang Duck

    2016-05-01

    The management of job-related stress among health-care workers is critical for the improvement of healthcare services; however, there is no existing research on endoscopy unit workers as a team. Korea has a unique health-care system for endoscopy unit workers. In this study, we aimed to estimate job stress and job satisfaction among health-care providers in endoscopy units in Korea. We performed a cross-sectional survey of health-care providers in the endoscopy units of three university-affiliated hospitals in Korea. We analyzed the job stress levels by using the Korean occupational stress scale, contributing factors, and job satisfaction. Fifty-nine workers completed the self-administered questionnaires. The job stress scores for the endoscopy unit workers (46.39±7.81) were relatively lower compared to those of the national sample of Korean workers (51.23±8.83). Job stress differed across job positions, with nurses showing significantly higher levels of stress (48.92±7.97) compared to doctors (42.59±6.37). Job stress and job satisfaction were negatively correlated with each other (R (2) =0.340, pstress and job satisfaction significantly differ according to job positions. Job demand, insufficient job control, and job insecurity are the most important stressors in the endoscopy unit.

  10. Sleep Health of Healthcare Workers in Kano, Nigeria

    African Journals Online (AJOL)

    2017-05-16

    May 16, 2017 ... Department of Otorhinolaryngology, Bayero University/Aminu. Kano Teaching Hospital .... pharmacists, laboratory scientists, administrative office workers, and other .... sign of underlying physical or mental health issues.[15]. Furthermore ... Ghalichi et al. included only the emergency medical service workers ...

  11. Regional disparities in the distribution of healthcare workers: evidence from Iran, Chaharmahal and Bakhtiari province.

    Science.gov (United States)

    Ezati Asar, Mohamad; Varehzardi, Ramin; Rajabi Vasokolaei, Ghasem; Haghi, Mehdi; Fazelipor, Morteza

    2015-02-09

    A health care service is a prerequisite for sustainable development. This requires access to balanced health workers in different geographic areas. The first step is to identify inequality in access to health workers in different areas. This study is a descriptive study was carried out on the cities in Chaharmahal and Bakhtiari province. TOPSIS technique was used to rank the cities in terms of regional disparities in the distribution of health workers. The findings revealed that distinct disparities in the distribution of healthcare workers across Chaharmahal and Bakhtiari province. Shahrekord and Ardal cities were classified as 1st and 7th respectively. Policy makers should consider priority (regional planning, budget and resources allocation) according to the distribution of healthcare workers.

  12. Influenza vaccination for healthcare workers: from a simple concept to a resistant issue?

    Science.gov (United States)

    Gavazzi, Gaëtan

    2009-06-01

    Different strategies for the management of influenza epidemics are particularly important in elderly population. High morbidity and mortality rates are associated with influenza in the elderly, and annual vaccination against flu is considered to be the best cost-effective strategy. However, its efficiency is reduced in older adults and only half of them are protected. Several studies show that vaccinating healthcare workers is an efficient way of decreasing mortality rates in nursing home residents within influenza season. National and international public health authorities recommend therefore healthcare worker vaccinations for up to 5 years. However, influenza healthcare worker vaccination coverages are still low. Here we summarize data regarding the justification of healthcare worker vaccination, the efficiency of this strategy, the reasons of the reluctance of vaccination, the means and results of interventional programs and, then, focus on the debate of a mandatory healthcare worker influenza vaccination. Because several interventional programs are efficient but still need high financial and human support, only a strong political-will can improve this chosen strategy.

  13. Prevalence of delayed-type and immediate-type hypersensitivity in healthcare workers with hand eczema.

    Science.gov (United States)

    Ibler, Kristina S; Jemec, Gregor B E; Garvey, Lene H; Agner, Tove

    2016-10-01

    Occupational contact dermatitis is common in healthcare workers. Although irritant contact dermatitis resulting from wet work is the most frequently reported cause, healthcare workers also constitute high-risk group for the development of allergic contact dermatitis and contact urticaria. To evaluate the prevalence of delayed-type and immediate-type hypersensitivity in 120 healthcare workers with hand eczema. One hundred and twenty healthcare workers from three major hospitals in Denmark with self-reported hand eczema within the last year participated in the study. Patch tests included baseline series plus selected allergens, and prick tests included standard inhalational allergens plus natural rubber latex and chlorhexidine. Levels of IgE specific for latex, chlorhexidine and ethylene oxide were measured. Of the participants, 53% had positive patch test reactions. The most frequent positive patch test reactions were to nickel, thiomersal, fragrances, rubber chemicals, and colophonium. The prevalence of natural rubber latex allergy as diagnosed by prick testing was 2.5%, and chlorhexidine allergy (both contact allergy and IgE-mediated allergy) was found in Ethylene oxide allergy was not identified in any of the participants. Our results confirm previous reports on contact allergy patterns in healthcare workers. Testing for natural rubber latex allergy is still important, but increased risks of chlorhexidine and ethylene oxide allergy could not be confirmed. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. 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.

  15. 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

  16. Attitude of Health-Care Workers to HIV/

    African Journals Online (AJOL)

    respectively among trained nurses and auxiliary nurses were unaware that HIV could be ... KEY WORDs: HIV/AIDS, health care workers, knowledge, attitude, discrimination, stigmatigation ..... infection prevention measures with emphasis on.

  17. Prevalence of delayed-type and immediate-type hypersensitivity in healthcare workers with hand eczema

    DEFF Research Database (Denmark)

    Ibler, Kristina Sophie; Jemec, Gregor B E; Garvey, Lene H.

    2016-01-01

    ) was found in Ethylene oxide allergy was not identified in any of the participants. Conclusions: Our results confirm previous reports on contact allergy patterns in healthcare workers. Testing for natural rubber latex allergy is still important, but increased risks of chlorhexidine and ethylene oxide......Background: Occupational contact dermatitis is common in healthcare workers. Although irritant contact dermatitis resulting from wet work is the most frequently reported cause, healthcare workers also constitute high-risk group for the development of allergic contact dermatitis and contact...... in the study. Patch tests included baseline series plus selected allergens, and prick tests included standard inhalational allergens plus natural rubber latex and chlorhexidine. Levels of IgE specific for latex, chlorhexidine and ethylene oxide were measured. Results: Of the participants, 53% had positive...

  18. Influence of Role Models and Hospital Design on the Hand Hygiene of Health-Care Workers

    OpenAIRE

    2003-01-01

    We assessed the effect of medical staff role models and the number of health-care worker sinks on hand-hygiene compliance before and after construction of a new hospital designed for increased access to handwashing sinks. We observed health-care worker hand hygiene in four nursing units that provided similar patient care in both the old and new hospitals: medical and surgical intensive care, hematology/oncology, and solid organ transplant units. Of 721 hand-hygiene opportunities, 304 (42%) we...

  19. The influence of healthcare workers' occupation on Health Promoting Lifestyle Profile.

    Science.gov (United States)

    Profis, Maya; Simon-Tuval, Tzahit

    2016-10-08

    To compare the adoption of healthy lifestyle behaviors, including: spiritual growth, nutrition, physical activity, interpersonal relations, health responsibility, and stress management, of healthcare workers with workers of other professions. Cross-sectional observational study among a convenience sample of 285 healthcare workers and 137 of other professions. The Health-Promoting Lifestyle Profile-II (HPLP-II), a 52-item measure regarding the six components of healthy lifestyle. Demographic characteristics, education, income, work duration and self-rated health were also collected. Multivariable linear models were specified for each of the components of healthy lifestyle. Both groups were comparable in their age, family status, income and self-rated health. Results of multivariable linear models revealed that healthcare workers adopt better nutrition (β=0.228, p<0.001), more physical activity (β=0.133, p=0.049), and greater health responsibility (β=0.131, p=0.016), compared to other professions. Such differences were not found with regard to spiritual growth (β=0.097, p=0.121), interpersonal relations (β=0.039, p=0.444), or stress management (β=0.053, p=0.299). Healthcare workers adopt better healthy lifestyle only in components that may be perceived to have direct influence on health outcomes, namely nutrition, physical activity, and health responsibility. Further research that will explore the reasons for the observed differences may enable designing health-improving interventions.

  20. 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.

  1. [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.

  2. The Prevalence of Childhood Adversity among Healthcare Workers and Its Relationship to Adult Life Events, Distress and Impairment

    Science.gov (United States)

    Maunder, Robert G.; Peladeau, Nathalie; Savage, Diane; Lancee, William J.

    2010-01-01

    Objective: We investigated the prevalence of childhood adversity among healthcare workers and if such experiences affect responses to adult life stress. Methods: A secondary analysis was conducted of a 2003 study of 176 hospital-based healthcare workers, which surveyed lifetime traumatic events, recent life events, psychological distress, coping,…

  3. 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...

  4. The Prevalence of Childhood Adversity among Healthcare Workers and Its Relationship to Adult Life Events, Distress and Impairment

    Science.gov (United States)

    Maunder, Robert G.; Peladeau, Nathalie; Savage, Diane; Lancee, William J.

    2010-01-01

    Objective: We investigated the prevalence of childhood adversity among healthcare workers and if such experiences affect responses to adult life stress. Methods: A secondary analysis was conducted of a 2003 study of 176 hospital-based healthcare workers, which surveyed lifetime traumatic events, recent life events, psychological distress, coping,…

  5. Healthy workplaces and teamwork for healthcare workers need public engagement.

    Science.gov (United States)

    Matthews, Sue; Macdonald-Rencz, Sandra

    2007-01-01

    This response challenges the healthcare system to take full responsibility for the work environments created for health human resources. While the need for healthy work environments and teamwork in healthcare are inarguable, the fact is they are not a reality in today's health system. The authors suggest strategies to address this issue and identify the person or groups that should take responsibility, including governments, organizations, individuals and the public. Strategies include ensuring that policies do not contradict one another and holding each level responsible for the outcomes of a healthy work environment - retention and recruitment of health human resources, better patient/client outcomes and healthcare costs. The need for strong and appropriate leadership for health human resources with "content knowledge" is discussed, along with recommendations for measuring the performance and success of healthy work environments and teamwork. The authors conclude that collaboration at the micro, meso and macro levels is required to facilitate the true change that is needed to improve the work environments of health human resources.

  6. Ventilation of wards and nosocomial outbreak of severe acute respiratory syndrome among healthcare workers

    Institute of Scientific and Technical Information of China (English)

    江山平; 黄莉文; 陈锡龙; 王景峰; 伍卫; 尹松梅; 陈为宪; 詹俊; 严励; 马丽萍; 李建国; 黄子通

    2003-01-01

    Objective To identify valid measures for preventing outbreaks of severe acute respiratory syndrome (SARS) among protected healthcare workers in isolation units.Methods Architectural factors, admitted SARS cases and infection of healthcare workers in different isolation wards between January 30 and March 30, 2003 were analyzed.Results Four types of isolation wards were analyzed, including the ward where the thirty-first bed was located on the twelfth floor, the laminar flow ward in the Intensive Care Unit where the tenth bed was located on the fifteenth floor, the ward where the twenty-seventh bed was located on the thirteenth floor of the Lingnan Building, and thirty wards on the fourteenth to eighteenth floors of the Zhongshan Building. The ratios (m2/m3) of the area of the ventilation windows to the volume of the rooms were 0, 0, 1∶ 95 and 1∶ 40, respectively. Numbers of SARS cases in the wards mentioned above were 1, 1, 1 and 96, respectively. Total times of hospitalization were 43, 168, 110 and 1272 hours, respectively. The infection rates of the healthcare workers in the areas mentioned above were 73.2%, 32.1%, 27.5% and 1.7%, respectively. The difference in the infection rates was of statistical significance.Conclusions Isolating SARS cases in wards with good ventilation could reduce the viral load of the ward and might be the key to preventing outbreaks of SARS among healthcare workers along with strict personal protection measures in isolation units.

  7. 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...

  8. Modelling the return on investment of preventively vaccinating healthcare workers against pertussis

    NARCIS (Netherlands)

    Tariq, Luqman; Mangen, Marie-Josee J.; Hovels, Anke; Frijstein, Gerard; de Boer, Hero

    2015-01-01

    Background: Healthcare workers (HCWs) are at particular risk of acquiring pertussis and transmitting the infection to high-risk susceptible patients and colleagues. In this paper, the return on investment (ROI) of preventively vaccinating HCWs against pertussis to prevent nosocomial pertussis outbre

  9. Latently and uninfected healthcare workers exposed to TB make protective antibodies against Mycobacterium tuberculosis.

    Science.gov (United States)

    Li, Hao; Wang, Xing-Xing; Wang, Bin; Fu, Lei; Liu, Guan; Lu, Yu; Cao, Min; Huang, Hairong; Javid, Babak

    2017-05-09

    The role of Igs in natural protection against infection by Mycobacterium tuberculosis (Mtb), the causative agent of TB, is controversial. Although passive immunization with mAbs generated against mycobacterial antigens has shown protective efficacy in murine models of infection, studies in B cell-depleted animals only showed modest phenotypes. We do not know if humans make protective antibody responses. Here, we investigated whether healthcare workers in a Beijing TB hospital-who, although exposed to suprainfectious doses of pathogenic Mtb, remain healthy-make antibody responses that are effective in protecting against infection by Mtb. We tested antibodies isolated from 48 healthcare workers and compared these with 12 patients with active TB. We found that antibodies from 7 of 48 healthcare workers but none from active TB patients showed moderate protection against Mtb in an aerosol mouse challenge model. Intriguingly, three of seven healthcare workers who made protective antibody responses had no evidence of prior TB infection by IFN-γ release assay. There was also good correlation between protection observed in vivo and neutralization of Mtb in an in vitro human whole-blood assay. Antibodies mediating protection were directed against the surface of Mtb and depended on both immune complexes and CD4+ T cells for efficacy. Our results indicate that certain individuals make protective antibodies against Mtb and challenge paradigms about the nature of an effective immune response to TB.

  10. Modelling the return on investment of preventively vaccinating healthcare workers against pertussis

    NARCIS (Netherlands)

    Tariq, Luqman; Mangen, Marie-Josee J.; Hovels, Anke; Frijstein, Gerard; de Boer, Hero

    2015-01-01

    Background: Healthcare workers (HCWs) are at particular risk of acquiring pertussis and transmitting the infection to high-risk susceptible patients and colleagues. In this paper, the return on investment (ROI) of preventively vaccinating HCWs against pertussis to prevent nosocomial pertussis

  11. 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

    -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......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...

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

    Directory of Open Access Journals (Sweden)

    Folake O. Samuel

    2016-03-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Folake O. Samuel

    2016-03-01

    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.

  14. 78 FR 66780 - Salter Labs, a Subsidiary of Roundtable Healthcare Partners Including On-Site Leased Workers From...

    Science.gov (United States)

    2013-11-06

    ... Employment and Training Administration Salter Labs, a Subsidiary of Roundtable Healthcare Partners Including..., applicable to workers of Salter Labs, a subsidiary of RoundTable Healthcare Partners, including on-site... of Salter Labs, a subsidiary of RoundTable Healthcare Partners. The Department has determined...

  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

    2016-01-01

    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

  16. 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

  17. 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.

  18. [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.

  19. Speaking up behaviours (safety voices) of healthcare workers: A metasynthesis of qualitative research studies.

    Science.gov (United States)

    Morrow, Kelly J; Gustavson, Allison M; Jones, Jacqueline

    2016-12-01

    A critical characteristic of effective teams in any setting is when each member is willing to speak up to share thoughts and ideas to improve processes. In spite of attempts by healthcare systems to encourage employees to speak up, employee silence remains a common cause of communication breakdowns, contributing to errors and suboptimal care delivery. Nurses in particular have reported low confidence in their communication abilities, and cite the belief that speaking up will not make a difference. To develop an understanding of how nurses and other healthcare workers relate to safety voice behaviors and how this might influence clinical practice. A search of the PubMed, CINAHL, and Academic Search Premier databases was conducted using keywords employee, nurse, qualitative, speak up, silence, safety, voice, and safety voice identified 372 articles with 11 retained after a review of the abstracts. Studies took place in Australia, Bulgaria, Canada, Hong Kong, East Africa, Ireland, Korea, New Zealand, Sweden, Switzerland, and the United States representing 504 healthcare workers including 354 nurses. This interpretive meta-synthesis of 11 qualitative articles published from 2005 to 2015 was conducted using a social constructivist approach with thematic analysis. The four themes identified are: 1) hierarchies and power dynamics negatively affect safety voice, 2) open communication is unsafe and ineffective, 3) embedded expectations of nurse behavior affect safety voice, and 4) nurse managers have a powerful positive or negative affect on safety voice. Healthcare workers worldwide report multiple social and hierarchy related fears surrounding the utilization of safety voice behaviors. Hesitance to speak up is pervasive among nurses, as is low self-efficacy related to safety voice. The presence of caring leaders, peer support, and an organizational commitment to safe, open cultures, may improve safety voice utilization among nurses and other healthcare workers. Copyright

  20. Wet work exposure and hand eczema among healthcare workers - a cross-sectional study.

    Science.gov (United States)

    Hamnerius, N; Svedman, C; Bergendorff, O; Björk, J; Bruze, M; Pontén, A

    2017-07-19

    Hand eczema is more common in healthcare workers compared to the general population. The hands are subject to changing occupational exposures due to mandatory hygiene regulations for health care workers. To describe the exposure due to hygiene procedures and investigate the associations between occupational hand washing, use of non-sterile gloves, and hand disinfectant and self-reported hand eczema. Cross-sectional study with an electronic questionnaire distributed to 28 762 hospital employees in southern Sweden. Respondents working as nurses, assistant nurses or physicians constituted the group of healthcare workers analysed. Adjustments were made for gender, age, wet work at home, life-style factors and atopic dermatitis. 12 288 (43%) responded including 9051 healthcare workers. In this group the 1-year prevalence of self-reported hand eczema was 21%. On a daily basis, 30% reported hand washing with soap >20 times at work, 45% used hand disinfectants >50 times, and 54% used non-sterile gloves > 2 hours. After adjustment for confounding factors, a dose-dependent association with self-reported hand eczema was found for the daily number of hand washes with soap at work and time working with disposable gloves, but not for alcoholic disinfectant use. Hand washing outside work was not associated with self-reported hand eczema in the adjusted multivariate analysis. In this study, we found a higher 1-year prevalence of self-reported hand eczema among Swedish healthcare workers than reported in the general population. Hand washing with soap and use of disposable gloves were associated with the occurrence of self-reported hand eczema in a dose-dependent way. Use of hand disinfectant was not associated with self-reported hand eczema. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  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.

  2. UPMC MyHealth: managing the health and costs of U.S. healthcare workers.

    Science.gov (United States)

    Parkinson, Michael D; Peele, Pamela B; Keyser, Donna J; Liu, Yushu; Doyle, Stephen

    2014-10-01

    Workplace wellness programs hold promise for managing the health and costs of the U.S. workforce. These programs have not been rigorously tested in healthcare worksites. To evaluate the impact of MyHealth on the health and costs of UPMC healthcare workers. Five-year observational study conducted in 2013 with subgroup analyses and propensity-matched pair comparisons to more accurately interpret program effects. UPMC, an integrated health care delivery and financing system headquartered in Pittsburgh, Pennsylvania. Participants included 13,627 UPMC employees who were continuously enrolled in UPMC-sponsored health insurance during the study period and demonstrated participation in MyHealth by completing a Health Risk Assessment in both 2007 and 2011, as well as 4,448 other healthcare workers employed outside of UPMC who did not participate in the program. A comprehensive wellness, prevention, and chronic disease management program that ties achievement of health and wellness requirements to receipt of an annual credit on participants' health insurance deductible. Health-risk levels, medical, pharmacy, and total healthcare costs, and Healthcare Effectiveness Data and Information Set performance rates for prevention and chronic disease management. Significant improvements in health-risk status and increases in use of preventive and chronic disease management services were observed in the intervention group. Although total healthcare costs increased significantly, reductions in costs were significant for those who moved from higher- to the lowest-risk levels. The contrast differences in costs between reduced- and maintained-risk groups was also significant. Matched pair comparisons provided further evidence of program effects on observed reductions in costs and improvements in prevention, but not improvements in chronic disease management. Incorporating incentivized health management strategies in employer-sponsored health insurance benefit designs can serve as a useful

  3. Organizational features of workplace and job engagement among Swiss healthcare workers.

    Science.gov (United States)

    Setti, Ilaria; Argentero, Piergiorgio

    2011-12-01

    The aim of this study was to determine the engagement level among healthcare workers in a Swiss hospital, identifying organizational predictors that could affect it. A four-part survey (a demographic questionnaire, Maslach Burnout Inventory-General Survey, Areas of Worklife Scale, and the General Health Questionnaire) was completed by 206 nurses and physicians. With regards to organizational predictors of job engagement, energy was primarily influenced by workload, involvement by values, and efficacy by reward. Moreover, we found that engagement might affect psychophysical health conditions: better health generally corresponds to higher levels of engagement. These results confirm that engagement is influenced by organizational variables and that engaged employees are generally more healthy and efficient. Therefore, interventions to minimize the impact of work stressors and to improve engagement are needed. Effective management of excessive workload, higher levels of autonomy, and greater job support are vital to limit psychological problems of healthcare workers.

  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. 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...... and individual counselling based on patch and prick testing and assessment of work and domestic related exposures. The control was treatment as usual. Main outcome measures: The primary outcome was clinical severity of disease at five month follow-up measured by scores on the hand eczema severity index...

  6. 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

    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......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...

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

    OpenAIRE

    Fiona Cocker; Nerida Joss

    2016-01-01

    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...

  8. Hepatitis B Vaccination Coverage and Sharp Injuries Among Healthcare Workers in Hamadan, Iran

    Directory of Open Access Journals (Sweden)

    Hashemi

    2014-08-01

    Full Text Available Background Hepatitis B virus (HBV is one of the most common pathogens associated with needle stick and sharp injuries (NSSIs among healthcare workers. Objective The aim of this study was to evaluate HBV vaccination coverage and NSSIs among healthcare workers in Hamadan. Materials and Methods This cross-sectional study was performed on teaching hospitals personnel in 2010. A two-part questionnaire was designed for data collection. All participants completed the first part, which concerned demographic data, history of HBV vaccination, and hepatitis B surface antibody (HBsAb testing. If a history of NSSI during the preceding year was noted, the second part was completed that consisted of data about characteristics of injury including time, place, and method as well as the measures taken after the injuries. Results Out of 700 healthcare workers, 585 had a complete course of HBV vaccination and only 45.7% had checked the titer of HBsAb. A total of 294 participants (42% had positive results for HBsAb titer. The rate of accidental NSSI was 24.1% during the preceding year and 48.5% of NSSIs were during blood sampling or intravenous catheter insertion. Conclusion Hepatitis B vaccination of all nonimmune healthcare workers and measuring HBsAb after vaccination can reduce the risk of nosocomial transmission of HBV to medical staff. Furthermore, the risk of blood-borne disease transmission can be reduced by educating medical personnel on effective methods of reducing the risk of NSSIs as well as taking appropriate measures when NSSIs occur.

  9. The knowledge and practice of breast self-examination among healthcare workers in Kayseri, Turkey.

    Science.gov (United States)

    Güleser, Gülsüm Nihal; Unalan, Demet; Akyldz, Hzr Yakup

    2009-01-01

    Breast cancer is the most common cancer type and cause of death among women in many countries. Monthly breast self-examination (BSE) is an effective diagnostic method for breast cancer. This study aimed to determine the knowledge level and practice frequency of BSE among healthcare workers in Kayseri, Turkey. Data were collected via a questionnaire that was prepared based on information in the literature. The questionnaire was composed of 2 sections: sociodemographic characteristics and practice and knowledge related to BSE. The sample group included 246 healthcare workers. Mann-Whitney U, Kruskal-Wallis H, (post hoc) Dunn, and chi tests were used in the analyses of data. The mean (SD) age of the respondents was 29.0 (5.6) years. Most (58.1%) were married, and a family history of breast cancer was reported by 12.2%. Of the respondents, 35% stated that they did not know how to conduct an examination of their breasts. Although 52.4% (n = 129) of the women reported that they performed BSE, only 17.0% (n = 22) reported doing so on a monthly basis. The practice of BSE was significantly associated with older, more educated medical secretaries; a positive personal history of breast problems; and a positive family history of breast cancer (P < .05). Healthcare workers had a low mean level of knowledge about the practice of BSE (mean [SD] score, 11.70 [10.07]; range, 0-40). The scores of the women who stated that they practiced BSE were significantly higher (P = .000) than those who reported that they did not. Healthcare workers need to improve their knowledge of and sensitivity toward BSE.

  10. Influence of role models and hospital design on hand hygiene of healthcare workers.

    Science.gov (United States)

    Lankford, Mary G; Zembower, Teresa R; Trick, William E; Hacek, Donna M; Noskin, Gary A; Peterson, Lance R

    2003-02-01

    We assessed the effect of medical staff role models and the number of health-care worker sinks on hand-hygiene compliance before and after construction of a new hospital designed for increased access to handwashing sinks. We observed health-care worker hand hygiene in four nursing units that provided similar patient care in both the old and new hospitals: medical and surgical intensive care, hematology/oncology, and solid organ transplant units. Of 721 hand-hygiene opportunities, 304 (42%) were observed in the old hospital and 417 (58%) in the new hospital. Hand-hygiene compliance was significantly better in the old hospital (161/304; 53%) compared to the new hospital (97/417; 23.3%) (pwash hands were significantly less likely to wash their own hands (odds ratio 0.2; confidence interval 0.1 to 0.5); phand-hygiene compliance is influenced significantly by the behavior of other health-care workers. An increased number of hand-washing sinks, as a sole measure, did not increase hand-hygiene compliance.

  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

    2017-02-20

    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. 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.

  13. 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.

  14. 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.

  15. Compliance with Standard Precautions and Associated Factors among Healthcare Workers in Gondar University Comprehensive Specialized Hospital, Northwest Ethiopia.

    Science.gov (United States)

    Haile, Tariku Gebre; Engeda, Eshetu Haileselassie; Abdo, Abdella Amano

    2017-01-01

    Background. In many studies, compliance with standard precautions among healthcare workers was reported to be inadequate. Objective. The aim of this study was to assess compliance with standard precautions and associated factors among healthcare workers in northwest Ethiopia. Methods. An institution-based cross-sectional study was conducted from March 01 to April 30, 2014. Simple random sampling technique was used to select participants. Data were entered into Epi info 3.5.1 and were exported to SPSS version 20.0 for statistical analysis. Multivariate logistic regression analyses were computed and adjusted odds ratio with 95% confidence interval was calculated to identify associated factors. Results. The proportion of healthcare workers who always comply with standard precautions was found to be 12%. Being a female healthcare worker (AOR [95% CI] 2.18 [1.12-4.23]), higher infection risk perception (AOR [95% CI] 3.46 [1.67-7.18]), training on standard precautions (AOR [95% CI] 2.90 [1.20-7.02]), accessibility of personal protective equipment (AOR [95% CI] 2.87 [1.41-5.86]), and management support (AOR [95% CI] 2.23 [1.11-4.53]) were found to be statistically significant. Conclusion and Recommendation. Compliance with standard precautions among the healthcare workers is very low. Interventions which include training of healthcare workers on standard precautions and consistent management support are recommended.

  16. Compliance with Standard Precautions and Associated Factors among Healthcare Workers in Gondar University Comprehensive Specialized Hospital, Northwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Tariku Gebre Haile

    2017-01-01

    Full Text Available Background. In many studies, compliance with standard precautions among healthcare workers was reported to be inadequate. Objective. The aim of this study was to assess compliance with standard precautions and associated factors among healthcare workers in northwest Ethiopia. Methods. An institution-based cross-sectional study was conducted from March 01 to April 30, 2014. Simple random sampling technique was used to select participants. Data were entered into Epi info 3.5.1 and were exported to SPSS version 20.0 for statistical analysis. Multivariate logistic regression analyses were computed and adjusted odds ratio with 95% confidence interval was calculated to identify associated factors. Results. The proportion of healthcare workers who always comply with standard precautions was found to be 12%. Being a female healthcare worker (AOR [95% CI] 2.18 [1.12–4.23], higher infection risk perception (AOR [95% CI] 3.46 [1.67–7.18], training on standard precautions (AOR [95% CI] 2.90 [1.20–7.02], accessibility of personal protective equipment (AOR [95% CI] 2.87 [1.41–5.86], and management support (AOR [95% CI] 2.23 [1.11–4.53] were found to be statistically significant. Conclusion and Recommendation. Compliance with standard precautions among the healthcare workers is very low. Interventions which include training of healthcare workers on standard precautions and consistent management support are recommended.

  17. Improved hand hygiene technique and compliance in healthcare workers using gaming technology.

    Science.gov (United States)

    Higgins, A; Hannan, M M

    2013-05-01

    In 2009, the World Health Organization recommended the use of a 'multi-faceted, multi-modal hand hygiene strategy' (Five Moments for Hand Hygiene) to improve hand hygiene compliance among healthcare workers. As part of this initiative, a training programme was implemented using an automated gaming technology training and audit tool to educate staff on hand hygiene technique in an acute healthcare setting. To determine whether using this automated training programme and audit tool as part of a multi-modal strategy would improve hand hygiene compliance and technique in an acute healthcare setting. A time-series quasi-experimental design was chosen to measure compliance with the Five Moments for Hand Hygiene and handwashing technique. The study was performed from November 2009 to April 2012. An adenosine triphosphate monitoring system was used to measure handwashing technique, and SureWash (Glanta Ltd, Dublin, Ireland), an automated auditing and training unit, was used to provide assistance with staff training and education. Hand hygiene technique and compliance improved significantly over the study period (P hand hygiene programme can encourage staff participation in learning, and ultimately improve hand hygiene compliance and technique in the acute healthcare setting. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  18. Healthcare workers' attitudes towards working during pandemic influenza: A multi method study

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    Petts Judith

    2008-06-01

    Full Text Available Abstract Background Healthcare workers (HCWs will be key players in any response to pandemic influenza, and will be in the front line of exposure to infection. Responding effectively to a pandemic relies on the majority of medical, nursing, laboratory and hotel services staff continuing to work normally. Planning assumes that during a pandemic normal healthcare service levels will be provided, although it anticipates that as caseloads increase only essential care will be provided. The ability of the NHS to provide expected service levels is entirely dependent upon HCWs continuing to work as normal. Methods/design This study is designed as a two-phase multi-method study, incorporating focus groups and a questionnaire survey. In phase one, qualitative methods will be used to collect the views of a purposive sample of HCWs, to determine the range of factors associated with their responses to the prospect of working through pandemic influenza. In phase two, the findings from the focus groups, combined with the available literature, will be used to inform the design of a survey to determine the generalisability of these factors, enabling the estimation of the likely proportion of HCWs affected by each factor, and how likely it is that they would be willing and/or able to continue to work during an influenza pandemic. Discussion There are potentially greater than normal health risks for some healthcare workers working during a pandemic, and these workers may be concerned about infecting family members/friends. HCWs will be as liable as other workers to care for sick family members and friends. It is vital to have information about how motivated HCWs will be to continue to work during such a crisis, and what factors might influence their decision to work/not to work. Through the identification and subsequent management of these factors it may be possible to implement strategies that will alleviate the concerns and fears of HCWs and remove potential

  19. 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.

  20. Characterizing occupational risk perception: the case of biological, ergonomic and organizational hazards in Spanish healthcare workers.

    Science.gov (United States)

    Portell, Mariona; Gil, Rosa M; Losilla, Josep M; Vives, Jaume

    2014-01-01

    Understanding how risk is perceived by workers is necessary for effective risk communication and risk management. This study adapts key elements of the psychometric perspective to characterize occupational risk perception at a worker level. A total of 313 Spanish healthcare workers evaluated relevant hazards in their workplaces related to biological, ergonomic and organizational factors. A questionnaire elicited workers' ratings of 3 occupational hazards on 9 risk attributes along with perceived risk. Factor and regression analyses reveal regularities in how different risks are perceived, while, at the same time, the procedure helps to summarize specificities in the perception of each hazard. The main regularity is the weight of feeling of dread/severity in order to characterize the risk perceived (β ranges from .22 to .41; p risk. Thus, participants consider their knowledge of the risk related to biological, ergonomic, and organizational hazards to be higher than the knowledge attributed to the occupational experts (mean differences 95% CIs [.10, .30], [.54, .94], and [0.52, 1.05]). We demonstrate the application of a feasible and systematic procedure to capture how workers perceive hazards in their immediate work environment.

  1. Impact of technical sources of variation on the hand microbiome dynamics of healthcare workers.

    Directory of Open Access Journals (Sweden)

    Mariana Rosenthal

    Full Text Available We assessed the dynamics of hand microbial community structure of 34 healthcare workers from a single surgical intensive care unit over a short (3 week time period, whilst taking into account the technical sources of variability introduced by specimen collection, DNA extraction, and sequencing. Sample collection took place at 3 different time points. Only the sampling collection method appeared to have a significant impact on the observed hand microbial community structure among the healthcare workers. Analysis of samples collected using glove-juice showed a slightly more similar microbial composition within individual hand samples over time than between the hands of different individuals over time. This was not true for samples collected using a swab, where samples from a single individual were no more similar to each other over time than those among other individuals over time, suggesting they were essentially independent. DNA extraction techniques (lysozyme only versus enzyme cocktail and sequencing (replicate set 1 versus 2 using Ion Torrent Personal Genome Machine, were not influential to the microbial community structures. Glove-juice sample collection may likely be the method of choice in hand hygiene studies in the healthcare setting.

  2. Managing an Online Survey about Influenza Vaccination in Primary Healthcare Workers

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    Diana Toledo

    2015-01-01

    Full Text Available Online surveys are increasingly used due to their speed and efficiency. The aim of this study was to analyze factors that may have contributed to the quality and speed of response of an online survey on influenza vaccination in primary healthcare workers. A multicenter study including family physicians, nurses and pediatricians from primary healthcare teams from seven Spanish Autonomous Communities was designed. The centers were selected by simple random sampling. The survey remained active and accessible for 56 days and four reminders were sent. The odds ratios (OR and their 95% confidence intervals (CI were calculated to assess the association of sociodemographic variables and responding to the survey before the second reminder. Complete, validated information was obtained from 1965 primary healthcare workers. The total response rate was 36.2%. More nurses (46.3% responded before the second reminder and more family physicians (52.8% after the second reminder. The adjusted OR shows that family physicians responded later (AOR 1.46, 95% CI 1.2–1.8 than nurses. The responses obtained in the first 24 h after the initial sending and the reminders accounted for 41.7% of the completed surveys, indicating the importance of reminders.

  3. Knowledge, attitude and practice of healthcare workers concerning Crimean-Congo hemorrhagic fever in Western Iran

    Institute of Scientific and Technical Information of China (English)

    Mojtaba Salimi; Abbas Aghaei Afshar; Mojtaba Limoee; Soraya Babakhani; Omid Chatrabgoun; Ahmad Ali Hanafi-Bojd; Gidiglo Godwin Nutifafa

    2016-01-01

    Objective: To determine the knowledge, attitude and practice of healthcare workers in Kermanshah Province about Crimean-Congo hemorrhagic fever (CCHF). Methods: This study was conducted in 2014 on healthcare personnel in different job categories including physicians, nurses, midwives, laboratory staff and network health staff of Kermanshah Province by direct interview. Results: A total of 367 respondents who had more than 5 years of experience in their jobs were interviewed. Among them 91%of physicians and nurses, 97%of midwives and health workers and 96%of laboratory staff stated that they had not been confronted with CCHF patients so far. Regarding knowledge, 76%of physicians, 78%of nurses, 77%of midwives and 58%of laboratory staff believed that the disease is remediable. Most of the interviewed participants stated that the disease pertains to people who are in close contact with domestic animals, but they did not consider their own occupations as one of the risk factors. More than 70% of the respondents believed that the disease may exist in the province or their work field. Generally, the knowledge about CCHF was inadequate, with nurses having the lowest level of knowledge. Conclusions: Knowledge of Kermanshah healthcare staff about CCHF was poor, especially nurses in a high risk job category. Therefore, it is necessary to conduct specific training programs for the disease identification, transmission, prevention, and treatment as well as the use of personal protection and safety devices.

  4. Knowledge, attitude and practice of healthcare workers concerning Crimean-Congo hemorrhagic fever in Western Iran

    Institute of Scientific and Technical Information of China (English)

    Mojtaba Salimi; Abbas Aghaei Afshar; Mojtaba Limoee; Soraya Babakhani; Omid Chatrabgoun; Ahmad Ali Hanafi-Bojd; Gidiglo Godwin Nutifafa

    2016-01-01

    Objective: To determine the knowledge, attitude and practice of healthcare workers in Kermanshah Province about Crimean-Congo hemorrhagic fever(CCHF).Methods: This study was conducted in 2014 on healthcare personnel in different job categories including physicians, nurses, midwives, laboratory staff and network health staff of Kermanshah Province by direct interview.Results: A total of 367 respondents who had more than 5 years of experience in their jobs were interviewed. Among them 91% of physicians and nurses, 97% of midwives and health workers and 96% of laboratory staff stated that they had not been confronted with CCHF patients so far. Regarding knowledge, 76% of physicians, 78% of nurses, 77% of midwives and 58% of laboratory staff believed that the disease is remediable. Most of the interviewed participants stated that the disease pertains to people who are in close contact with domestic animals, but they did not consider their own occupations as one of the risk factors. More than 70% of the respondents believed that the disease may exist in the province or their work field. Generally, the knowledge about CCHF was inadequate, with nurses having the lowest level of knowledge.Conclusions: Knowledge of Kermanshah healthcare staff about CCHF was poor,especially nurses in a high risk job category. Therefore, it is necessary to conduct specific training programs for the disease identification, transmission, prevention, and treatment as well as the use of personal protection and safety devices.

  5. Tuberculosis Transmission from Healthcare Workers to Patients and Co-workers: A Systematic Literature Review and Meta-Analysis

    Science.gov (United States)

    Schepisi, Monica Sañé; Sotgiu, Giovanni; Contini, Silvia; Puro, Vincenzo; Ippolito, Giuseppe; Girardi, Enrico

    2015-01-01

    Healthcare workers (HCWs) are at risk of becoming infected with tuberculosis (TB), and potentially of being infectious themselves when they are ill. To assess the magnitude of healthcare-associated TB (HCA-TB) transmission from HCWs to patients and colleagues, we searched three electronic databases up to February 2014 to select primary studies on HCA-TB incidents in which a HCW was the index case and possibly exposed patients and co-workers were screened.We identified 34 studies out of 2,714 citations. In 29 individual investigations, active TB was diagnosed in 3/6,080 (0.05%) infants, 18/3,167 (0.57%) children, 1/3,600 (0.03%) adult patients and 0/2,407 HCWs. The quantitative analysis of 28 individual reports showed that combined proportions of active TB among exposed individuals were: 0.11% (95% CI 0.04–0.21) for infants, 0.38% (95% CI 0.01–1.60) for children, 0.09% (95% CI 0.02–0.22) for adults and 0.00% (95% CI 0.00–0.38) for HCWs. Combined proportions of individuals who acquired TB infection were: 0.57% (95% CI 7.28E-03 – 2.02) for infants, 0.9% (95% CI 0.40–1.60) for children, 4.32% (95% CI 1.43–8.67) for adults and 2.62% (95% CI 1.05–4.88) for HCWs. The risk of TB transmission from HCWs appears to be lower than that recorded in other settings or in the healthcare setting when the index case is not a HCW. To provide a firm evidence base for the screening strategies, more and better information is needed on the infectivity of the source cases, the actual exposure level of screened contacts, and the environmental characteristics of the healthcare setting. PMID:25835507

  6. Hepatitis B vaccination status among healthcare workers in a tertiary care hospital in Tripoli, Libya.

    Science.gov (United States)

    Ziglam, Hisham; El-Hattab, Mabrouk; Shingheer, Noura; Zorgani, Abdulaziz; Elahmer, Omar

    2013-08-01

    The prevalence of hepatitis B virus (HBV) among healthcare workers (HCWs) in hospitals in developing countries is high. However, the vaccination status of these workers and its relationship with occupational factors are not well documented. The aim of this study was to evaluate the susceptibility of HCWs to HBV infection in the representative Tripoli Central Hospital in Libya and prepare a practical guideline to protect HCWs from occupational exposure. In this cross-sectional study, a questionnaire survey was administered to 2705 healthcare workers of a university hospital in Tripoli. The questionnaire included vaccination status. Compliance with preventive practices against HBV infection was also assessed. The overall vaccination coverage (anti-HBs) was 78.1%. Furthermore, 82.6% of HCWs had received at least one dose of vaccine, but only 72% reported that they were fully vaccinated. The prevalence of hepatitis B surface antigen was 1.1%. The mean prevalence of hepatitis B core antibody (anti-HBc) was 17.3%. HCWs at hospitals are frequently exposed to blood-borne infections. Vaccines should be more readily available for Libyan HCWs, and current vaccination programs should be enforced. Copyright © 2013 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  7. Improvement of knowledge, attitude and perception of healthcare workers about ADR, a pre- and post-clinical pharmacists' interventional study

    Science.gov (United States)

    Mohebbi, Niayesh; Hendoiee, Narjes; Keshtkar, Abbas-Ali; Dashti-Khavidaki, Simin

    2012-01-01

    Purpose Healthcare workers have a main role in detection, assessment and spontaneous reporting of adverse drug reactions (ADRs), and improvement of their related knowledge, attitude and perception is essential. The goal of this study was evaluation of clinical pharmacists' interventions in improvement of knowledge, attitude and perception of healthcare workers about ADRs in a teaching referral hospital, Tehran, Iran. Method Changes in knowledge, attitude and perception of healthcare workers of Imam teaching hospital about ADRs were evaluated before and after clinical pharmacists' interventions including workshops, meetings and presentations. Results From the 100 participated subjects, 82 of them completed the study. 51% of the health workers have been aware of the Iranian Pharmacovigilance Center at the ministry of health before intervention and after that all the participants knew this centre. About awareness and detection of ADRs in patients, 69 (84.1%) healthcare workers recognised at least one, and following interventions, it was improved to 73 (89%). Only seven (8.5%) subjects have reported ADRs in before intervention phase that were increased significantly to 18 (22%) after intervention. Conclusion Clinical pharmacists' interventions were successful in improvement of healthcare workers' knowledge, attitude and perception about ADRs and spontaneous reporting in our hospital. PMID:22246555

  8. Local skin reaction following an accidental injection from a BCG vaccine in a healthcare worker

    Directory of Open Access Journals (Sweden)

    Kundan Mittal

    2011-02-01

    Full Text Available Exposure to blood-borne pathogens from sharp injuriescontinue to pose a significant risk to healthcare workers(HCW. The number of sharps injuries sustained by HCW is stillunclear, primarily due to under-reporting of events.Healthcare professionals are at risk of sustaining such injuriesfrom hollow-bore needles. Sharps injuries are associated withrisk of infection with blood-borne pathogens such as humanimmunodeficiency virus (HIV, hepatitis B virus (HBV hepatitisC virus (HCV and other live organisms. Here we are reportinga case of an adverse reaction in a HCW due to an accidentalsharps injury by a needle used to administer the BacillusCalmittee Gurien (BCG vaccine.

  9. Vaccinating healthcare workers: Level of implementation, barriers and proposal for evidence-based policies in Turkey.

    Science.gov (United States)

    Ozisik, Lale; Tanriover, Mine Durusu; Altınel, Serdar; Unal, Serhat

    2017-01-06

    The role of healthcare workers in life-long vaccination is very important in the means of 2 sided infection, rising patient awareness and being a role model for the patients. Numerous organizations publish guidelines for vaccination of HCWs, while healthcare facilities develop vaccination policies according to the accreditation standards. Nevertheless, vaccination rates among HCWs are far below targets. The obstacles to getting vaccinated or recommending vaccination may include rather universal factors such as the vaccine paradox, however in the case of HCWs, probably a different set of factors are included. The aims of this article are to gain an overview of vaccination strategies for HCWs, to assess the coverage rates of HCWs and make in-depth analyses of the potential barriers to vaccination and potential factors to motivate HCWs for vaccination in Turkey and to compare them with the global picture to improve implementation of policies concerning vaccination of HCWs.

  10. Folding and unfolding manual wheelchairs: an ergonomic evaluation of health-care workers.

    Science.gov (United States)

    White, Heather A; Lee Kirby, R

    2003-11-01

    The objective of this study was to test the hypotheses (i) that health-care workers vary greatly in the methods used to fold and unfold selected manual wheelchairs, and (ii) that many of the methods used include bent and twisted back postures that are known to be associated with a high risk of injury. We studied 20 health-care workers in a rehabilitation center. Subjects folded and unfolded two wheelchairs of cross-brace design, one with and one without a sling seat. As outcome measures, we used a questionnaire, time taken, visual analog scales of perceived exertion and back strain, folded width, videotape and Ovako Working Posture Analysis System (OWAS) back scores (1-4). Subjects used up to 14 different combinations of approach, hand placement and back posture to accomplish the tasks. The mean OWAS scores were in the 2.4-3.1 range and 49 (42%) of the 118 scores recorded were class 4 (back simultaneously "bent and twisted", considered to be associated with the highest risk of injury). We also observed methods that appeared to be safe and effective. Age, gender, profession, experience and seat condition did not generally influence the outcome measures. We conclude that health-care workers use a variety of methods to fold and unfold wheelchairs, many of which include bent and twisted back postures that may carry a risk of injury. Further study is needed to confirm this risk, to identify more ergonomically sound wheelchair designs and to develop better methods of carrying out the common and important task of folding and unfolding wheelchairs.

  11. 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

    2016-12-28

    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.

  12. Precautionary practices of healthcare workers who disinfect medical and dental devices using high-level disinfectants.

    Science.gov (United States)

    Henn, Scott A; Boiano, James M; Steege, Andrea L

    2015-02-01

    BACKGROUND High-level disinfectants (HLDs) are used throughout the healthcare industry to chemically disinfect reusable, semicritical medical and dental devices to control and prevent healthcare-associated infections among patient populations. Workers who use HLDs are at risk of exposure to these chemicals, some of which are respiratory and skin irritants and sensitizers. OBJECTIVE To evaluate exposure controls used and to better understand impediments to healthcare workers using personal protective equipment while handling HLDs. DESIGN Web-based survey. PARTICIPANTS A targeted sample of members of professional practice organizations representing nurses, technologists/technicians, dental professionals, respiratory therapists, and others who reported handling HLDs in the previous 7 calendar days. Participating organizations invited either all or a random sample of members via email, which included a hyperlink to the survey. METHODS Descriptive analyses were conducted including simple frequencies and prevalences. RESULTS A total of 4,657 respondents completed the survey. The HLDs used most often were glutaraldehyde (59%), peracetic acid (16%), and ortho-phthalaldehyde (15%). Examples of work practices or events that could increase exposure risk included failure to wear water-resistant gowns (44%); absence of standard procedures for minimizing exposure (19%); lack of safe handling training (17%); failure to wear protective gloves (9%); and a spill/leak of HLD during handling (5%). Among all respondents, 12% reported skin contact with HLDs, and 33% of these respondents reported that they did not always wear gloves. CONCLUSION Findings indicated that precautionary practices were not always used, underscoring the importance of improved employer and worker training and education regarding HLD hazards.

  13. Role of psychological empowerment in the reduction of burnout in Canadian healthcare workers.

    Science.gov (United States)

    Boudrias, Jean-Sébastien; Morin, Alexandre J S; Brodeur, Marie-Michèle

    2012-03-01

    In this study, we investigated the role of psychological empowerment as a protective factor for burnout among workers exposed to work-related stressors (e.g. daily hassles, overload, job changes). A cross-sectional questionnaire study was conducted, with a convenience sample of 401 healthcare workers. Hierarchical multiple regressions were performed to test main and moderating effects of empowerment cognitions. Results revealed partial support for the hypotheses. Only the job meaningfulness cognition exerts a beneficent main effect on all burnout symptoms beyond the effect of stressors. Some moderating effects differing according to burnout dimensions were also found. Most interestingly, high levels of empowerment cognitions accentuate the effect of change-related resources in the reduction of emotional exhaustion. Because psychological empowerment has beneficial effects, organizations could rely on different strategies to enhance it.

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

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    Lesley T. Bhebhe

    2014-10-01

    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

  15. 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.

  16. High incidence of occupational exposures among healthcare workers in Erbil, Iraq.

    Science.gov (United States)

    Hosoglu, Salih; Ahmad, Zana; Tahseen, Mohammed Sami; Diyar, Zehra; Selbes, Sami; Çolak, Ali

    2014-10-15

    The current status of percutaneous injury and mucous exposures (PMEs) of hospital workers and factors associated with the injuries have not been studied in Iraq. This study aimed to evaluate the epidemiology of PMEs with blood or body fluids that leads serious risks for healthcare workers (HCWs). An analytic, cross-sectional survey study was conducted among HCWs in Erbil city center, Iraq. The study was performed at sevenhospitals, and 177 participants were included. The dependent variable was the occurrence of PMEs in the last year, and the independent variables were age, sex, occupation of HCWs, working site, and work duration. A total of 177 HCW participants included 57 nurses/midwives (32.2%), 59 doctors (33.3%), 27 laboratory workers (15.3%), and 34 paramedics/multipurpose workers (19.2%) from seven hospitals. The study concluded that 67.8% of the participants reported at least one occupational PME in the last year. In all, 13.3/person/year PME incidents were reported for nurses, 9.74/person/year for paramedics/multipurpose workers, 6.71/person/year for doctors, and 3.37/person/year laboratory workers. The mean number of PME incidents was 8.91/person/year. HCWs showed 85.0% compliance with wearing mask in risky situations. The most dangerous action for occupational exposure was blood taking (39.0%). In the univariate analysis, none of the investigated variables were found to be significantly related to PME. Occupational injuries and exposures in Iraqi HCWs are extremely common; awareness about protection is not sufficient. Nurses were found to be the highest risk group among HCWs. Preventive actions should be taken to avoid infection.

  17. Knowledge and attitude of healthcare workers and patients on healthcare associated infections in a regional hospital in Ghana

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    Irene Ocran

    2014-04-01

    Full Text Available Objective: To assess knowledge and attitude of healthcare workers (HCWs and patients on healthcare associated infections (HAIs in the central regional hospital in Ghana. Methods: The purposive random sampling method was used to administer questionnaires over a period of 6 months to HCWs and patients visiting the hospital. Results: A total of 210 patients and 71 HCWs were sampled. One hundred and three (53.8% patients had some knowledge of HAIs with 52 (28.4% being informed by a HCW compared with 63 (88.7% of HCWs who were well informed about HAIs. Ninety-seven (46.2% responding patient always washed their hands while 65 (31% and 48 (22.9% respectively sometimes or never washed their hands within or after leaving the hospital. Out of those who washed their hands, 64 (39.5% always washed with soap while 46 (28.4% did sometimes. This positively and significantly correlated (r=0.440, P<0.001 with knowledge on HAIs which was however insignificant in HCWs (r=0.025, P=0.835. As many as 48 (67.6% of HCWs believed that authorities in the hospital had done little to prevent HAIs with the main reason being that the hospital was unclean. Whereas, 112 (53.3% of patients considered the hospital clean. Twenty-seven (38% of HCWs had had confirmed HAIs of which cholera made up 12 (16.9% while 94 (44.8% of patients believed they had had unconfirmed HAIs. Conclusions: Although knowledge on HAIs is adequate, low compliance on preventive techniques resulting in high HAIs indicates attitudinal change is the best means of prevention.

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

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    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

  19. Knowledge, Attitudes, and Behaviors about Breast Self-Examination and Mammography among Female Primary Healthcare Workers in Diyarbakır, Turkey

    OpenAIRE

    Özgür Erdem; İzzettin Toktaş

    2016-01-01

    Aim. This study aims to determine the knowledge level of the female primary healthcare workers about breast cancer and to reveal their attitude and behaviors about breast self-examination and mammography. Methods. This cross-sectional study was conducted on female primary healthcare workers who work in family health centres. 91% (n = 369) of female primary healthcare workers agreed to participate in the study. The questionnaire consisted of three parts: sociodemographic characteristics, knowl...

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

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    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.

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

    Science.gov (United States)

    Tzeng, Dong-Sheng; Chung, Wei-Ching; Lin, Chi-Hung; Yang, Chun-Yuh

    2012-09-08

    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. 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. 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. 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.

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

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    Miranda Brouwer

    Full Text Available 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.

  3. Attitudes of healthcare workers in U.S. hospitals regarding smallpox vaccination

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    O'Brien Megan A

    2003-06-01

    Full Text Available Abstract Background The United States is implementing plans to immunize 500,000 hospital-based healthcare workers against smallpox. Vaccination is voluntary, and it is unknown what factors drive vaccine acceptance. This study's aims were to estimate the proportion of workers willing to accept vaccination and to identify factors likely to influence their decisions. Methods The survey was conducted among physicians, nurses, and others working primarily in emergency departments or intensive care units at 21 acute-care hospitals in 10 states during the two weeks before the U.S. national immunization program for healthcare workers was announced in December 2002. Of the questionnaires distributed, 1,165 were returned, for a response rate of 81%. The data were analyzed by logistic regression and were adjusted for clustering within hospital and for different number of responses per hospital, using generalized linear mixed models and SAS's NLMIXED procedure. Results Sixty-one percent of respondents said they would definitely or probably be vaccinated, while 39% were undecided or inclined against it. Fifty-three percent rated the risk of a bioterrorist attack using smallpox in the United States in the next two years as either intermediate or high. Forty-seven percent did not feel well-informed about the risks and benefits of vaccination. Principal concerns were adverse reactions and the risk of transmitting vaccinia. In multivariate analysis, four variables were associated with willingness to be vaccinated: perceived risk of an attack, self-assessed knowledge about smallpox vaccination, self-assessed previous smallpox vaccination status, and gender. Conclusions The success of smallpox vaccination efforts will ultimately depend on the relative weight in people's minds of the risk of vaccine adverse events compared with the risk of being exposed to the disease. Although more than half of the respondents thought the likelihood of a bioterrorist smallpox

  4. Development study of attitudes towards domestic violence scale in healthcare workers

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    Nevin Hotun Şahin

    2009-09-01

    Full Text Available Objective: The purpose of this study is to develop a attitude scale to determine the healthcare workers’ (nurse,midvifwery and sanitary servant  approach to the domestic violence. Material and Method: The scale articles are prepared by the researcher according to the related literature and by interviewing with the referees who work on this subject. There are totally 31 articles in the item pool. The draft scale with the testing purpose is re-organized with 20 items according to the content analyses of the Content Validity Index (CVI from referees. In Istanbul, the draft scale is applied to a total of 400 healthcare workers who work in Bakırköy Neurological Disorders Hospital (Ruh ve Sinir Hastalıkları Hastanesi (n=239, Şişli Etfal (n=80 and Medical Park (n=81.Results: The scale’s Kaiser-Meyer-Olkin (KMO coefficient is found 0.79 and Barlett Test significance value is found 0.000. The total item correlations of the scale change between 0.26-0.49 and, their factorial loading change between 0.65-0.32. The Cronbach- alpha reliability number is found as 0.72. As a result of the factorial analysis that is performed, we developed the 4 factor scale which explains 51.227% of the total variance with 13 item in the  “Scale of  Attitude Toward  Domestic Violence”  . Conclusion: Analyses show that the scale has acceptable level of effectiveness according to its structural specifications and internal consistency. However the scale has to be applied to people other than the healthcare workers and the reliability and validity studies have to be realized.  

  5. Development study of attitudes towards domestic violence scale in healthcare workers

    Directory of Open Access Journals (Sweden)

    Nevin Hotun Şahin

    2009-09-01

    Full Text Available Objective: The purpose of this study is to develop a attitude scale to determine the healthcare workers’ (nurse,midwifery and sanitary servant approach to the domestic violence. Material and Method: The scale articles are prepared by the researcher according to the related literature and by interviewing with the referees who work on this subject. There are totally 31 articles in the item pool. The draft scale with the testing purpose is re-organized with 20 items according to the content analyzes of the Content Validity Index (CVI from referees. In Istanbul, the draft scale is applied to a total of 400 healthcare workers who work in Bakırköy Neurological Disorders Hospital (Ruh ve Sinir Hastalıkları Hastanesi (n=239, Şişli Etfal (n=80 and Medical Park (n=81.Results: The scale’s Kaiser-Meyer-Olkin (KMO coefficient is found 0.79 and Barlett Test significance value is found 0.000. The total item correlations of the scale change between 0.26-0.49 and, their factorial loading change between 0.65-0.32. The Cronbach- alpha reliability number is found as 0.72. As a result of the factorial analysis that is performed, we developed the 4 factor scale which explains 51.227% of the total variance with 13 item in the “Scale of Attitude Toward Domestic Violence”. Conclusion: Analyses show that the scale has acceptable level of effectiveness according to its structural specifications and internal consistency. However the scale has to be applied to people other than the healthcare workers and the reliability and validity studies have to be realized.

  6. 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.

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

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    O E Amoran

    2013-01-01

    Full Text Available Background: Healthcare-associated infections (HAIs have been reported to be a serious problem in the healthcare services as they are common causes of illness and mortality among hospitalized patients including healthcare workers (HCWs. Compliance with these standard precautions has been shown to reduce the risk of exposure to blood and body fluids. Aims: This study therefore assesses the level of knowledge and compliance with standard precautions by the various cadre of HCWs and the factors influencing compliance in hospital environment in Nasarawa State, Northern Nigeria. Settings and Design: Nasarawa State has a current human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS prevalence rate of 10.0%, which was higher than most states in Nigeria with a high level of illiteracy and ignorance. Majority of the people reside in the rural areas while a few are found in the towns, informal settlements with no direct access to healthcare facilities are common. Materials and Methods: This study is an analytical, cross-sectional study. Proportional sampling technique was used to obtain a representative sample and a structured self-administered questionnaire was used to collect relevant information from the healthcare providers working in Nasarawa State from January to February 2009. Statistical analysis used: To describe patient characteristics, we calculated proportions and medians. For categorical variables, we compared proportions using chi-square tests. A logistic regression model was produced with infection control as outcome variable to identify associated factors. Results: A total of 421 HCWs were interviewed, Majority (77.9% correctly describe universal precaution and infection control with 19.2, 19.2, and 28.0%, respectively unable to recognize vaccination, postexposure prophylaxis, and surveillance for emerging diseases as standard precaution for infection control. About 70.1% usually wear gloves before handling patients or

  8. Effect of Positive Psychological Intervention on Posttraumatic Growth among Primary Healthcare Workers in China: A Preliminary Prospective Study.

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    Xu, Xin; Hu, Mu-Li; Song, Yu; Lu, Zhang-Xiu; Chen, You-Qiao; Wu, Da-Xing; Xiao, Tao

    2016-12-20

    Posttraumatic growth (PTG) is defined as positive psychological change in the wake of highly challenging circumstances. Healthcare workers in particular are more vulnerable to stressors and trauma than the general population. The current study examined the use and effectiveness of a novel positive psychological intervention based on Chinese traditional culture to improve PTG in hospital healthcare workers. The intervention was provided to 579 healthcare workers at hospitals in Guilin, Shenzhen and Xiangtan. Scores on the Posttraumatic Growth Inventory (PTGI) and its subscales were significantly higher after intervention than before (p < 0.001). Of the five aspects of PTG, the aspect of "new possibilities" benefited the most from intervention (Cohen's d = 0.45). PTG in women, nurses and college graduates increased to a greater extent than other participants after intervention. It was concluded that our novel intervention is effective at improving PTG in medical staff.

  9. Occupational exposures in healthcare workers in University Hospital Dubrava--10 year follow-up study.

    Science.gov (United States)

    Serdar, Tihana; Derek, Lovorka; Unić, Adriana; Marijancević, Domagoj; Marković, Durda; Primorac, Ana; Petrovecki, Mladen

    2013-09-01

    Occupational hazardous exposure in healthcare workers is any contact with a material that carries the risk of acquiring an infection during their working activities. Among the most frequent viral occupational infections are those transmitted by blood such as hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV). Therefore, they represent a significant public health problem related to the majority of documented cases of professionally acquired infections. Reporting of occupational exposures in University Hospital Dubrava has been implemented in connection with the activity of the Committee for Hospital Infections since January 2002. During the period of occupational exposures' monitoring (from January 2002 to December 2011) 451 cases were reported. The majority of occupational exposures were reported by nurses and medical technicians (55.4%). The most common type of exposure was the needlestick injury (77.6%). 27.9% of the accidents occurred during the blood sampling and 23.5% during the surgical procedure. In 59.4% of the exposed workers aHBs-titer status was assessed as satisfactory. Positive serology with respect to HBV was confirmed in 1.6% of patients, HCV in 2.2% of patients and none for HIV. Cases of professionally acquired infections were not recorded in the registry. Consequences of the occupational exposure could include the development of professional infection, ban or inability to work further in health care services and last but not least a threat to healthcare workers life. It is therefore deemed necessary to prevent occupational exposure to blood-borne infections. The most important preventive action in respect to HBV, HCV and HIV infections is nonspecific pre-exposure prophylaxis.

  10. Awareness and attitude of healthcare workers to cosmetic surgery in osogbo, Nigeria.

    Science.gov (United States)

    Adedeji, Opeyemi Adeniyi; Oseni, Ganiyu Oladiran; Olaitan, Peter Babatunde

    2014-01-01

    This study aimed at understanding the level of awareness and elucidates the attitude and disposition of healthcare workers to cosmetic surgery in Osogbo, Nigeria. A questionnaire-based survey was done at LAUTECH Teaching Hospital, Osogbo, in 2012. Questionnaires were administered to 213 workers and students in the hospital. These were then analysed using SPSS version 16.0 with frequencies, means, and so forth. Respondents were 33 doctors, 32 nurses, 79 medical students, 60 nursing students, 4 administrative staff, 1 pharmacist, and 4 ward maids. There is fair awareness about cosmetic surgery generally with 94.5% and its availability in Nigeria with 67.0%. A fewer proportion of the respondents (44.5%) were aware of the facility for cosmetic surgery in their locality. A large percentage (86.5%) favorably considers facilities outside Nigeria when making choice of facility to have cosmetic surgery done. 85.5% considered the information about cosmetic surgery reliable while 19.0% objected going for cosmetic surgery of their choice even if done free. Only 34.0% consider cosmetic surgery socially acceptable. Although the awareness of health workers about cosmetic surgery is high, their disposition to it is low. There is a need to increase the awareness in order to increase cosmetic surgery practice in Nigeria.

  11. Infectious diseases in healthcare workers – an analysis of the standardised data set of a German compensation board

    OpenAIRE

    Nienhaus Albert; Kesavachandran Chandrasekharan; Wendeler Dana; Haamann Frank; Dulon Madeleine

    2012-01-01

    Abstract Introduction Healthcare workers (HCW) are exposed to infectious agents. Disease surveillance is therefore needed in order to foster prevention. Methods The data of the compensation board that covers HCWs of non-governmental healthcare providers in Germany was analysed for a five-year period. For hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, the period analysed was extended to the last 15 years. The annual rate of occupational infectious diseases (OIDs) per 100,000 e...

  12. 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.

  13. [Influenza vaccination in health-care workers: an effective method to reduce the consequences of influenza in health care users].

    Science.gov (United States)

    de Jong, J C

    2007-09-29

    Only few usable studies into the effect of influenza vaccination of health-care workers on sick leave and influenza among their patients are available in the literature. However, together these studies provide consistent evidence that this vaccination is effective and cost effective, reducing the death rate from all causes of residents of nursing homes for the elderly by 27-44%. Therefore, measures to raise the vaccination rate among health-care workers, which is at present under 25%, are highly recommended. However, more studies in this field are needed.

  14. Influenza immunization coverage for healthcare workers in a community hospital in Qatar (2011-2012 and 2012-2013 seasons).

    Science.gov (United States)

    Garcell, Humberto Guanche; Ramirez, Eduardo Crespo

    2014-02-01

    Influenza vaccination is recommended for all healthcare workers (HCW) to prevent transmission within healthcare facilities. We conducted a descriptive study on influenza vaccination coverage during 2011-2012 and 2012-2013 campaigns in a community hospital in Qatar. 61.7% of the HCW were immunized in the first campaign, with an increase of up to 71.1% (p<0.05) in the second one, which was mainly due to better compliance of doctors (46.9% and 69.2%, respectively). Our results show proper coverage rates according US standards and highlight the need to implement additional strategies to improve health workers adherence of influenza, vaccination.

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

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    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.

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

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    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.

  17. Perception and practice regarding infection control measures amongst healthcare workers in district government hospitals of Mangalore, India

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    Yamini

    2012-01-01

    Full Text Available Introduction: Healthcare workers must know the various measures for their own protection. They should improve organization of work, implement standard precautions and dispose biomedical waste properly to prevent occupational exposure. This study aimed at assessing the perception and practice of infection control measures amongst the healthcare workers in Mangalore. Materials and Methods: This cross-sectional study was conducted by using a pretested semi-structured proforma, by interview cum observational technique. One hundred and twenty healthcare workers (70 hospital staff including nurses and technicians at the two Government District Hospitals and 50 final-year MBBS students were selected using convenient sampling and their perception and practice regarding infection control measures were studied. Results: Of the 120 participants, the majority (85.8% was aware of disposing used needles and syringes in puncture-resistant containers but only 55.7% were actually practicing it. Three-fourths (75.8% of the participants were aware about not recapping the needles after use but on observation, only 35.4% were practicing this. All healthcare workers were aware about the indication for using masks and gloves while handling patients, while only 77.1% were using them. We also found that only 61.8% washed their hands after attending every patient, 94.3% cleaned the area with a sterile swab before giving injections and only 35.7% of the labs/ wards/ operation theatres had three colored bags. Few (11.7% of the workers have already been exposed to infectious blood samples and some (19.2% are still not immunized against Hepatitis B. Conclusion: There is a need for improvement in the perception and practice of infection control measures among healthcare workers for both self and patient′s protection. They should also get themselves immunized against Hepatitis B and report accidental exposure to infectious samples to the infection control committee.

  18. Workers' compensation claims related to natural rubber latex gloves among Oregon healthcare employees from 1987–1998

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    Kammeyer-Mueller John

    2002-09-01

    Full Text Available Abstract Background Occupational reaction to natural rubber latex (NRL glove use by healthcare employees has been an area of increasing concern. Unfortunately, there is little data demonstrating the prevalence and severity of actual reactivity to NRL. Method Occupational reaction to NRL was estimated using workers' compensation claims filed by healthcare employees in Oregon for the period of 1987–1998. For the first ten years, these claims were estimated by source and conditions consistent with NRL glove reactions, while in the last two years a specific code developed in 1997 for NRL glove reactions was also employed. Results The claim rate was on average 0.58 per 10,000 healthcare workers annually, which constituted 0.29% of all workers' compensation claims. The most common condition experienced was dermatitis (80% and most common body part affected was the hands (55.4%. The majority of claimants, 45 (69.2%, reported taking less than a month off work, suggesting most reactions were minor in nature, although one fatality was reported. The average NRL claim cost was $8,309.48. Overall the average cost per insured healthcare worker was approximately $0.50 per year. The occupational groups with the highest number of claims were nurses (30.8% of claimants and nursing aides and orderlies (24.6% of claimants. Conclusions In comparison with other workers' compensation claims filed by healthcare workers during this period, 0.25% of the total was potentially related to NRL gloves. The rare incidence of respiratory and ocular claims is inconsistent with the hypothesis that asthmatic or conjunctival reactions to NRL gloves are common.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    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...... 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...

  20. Acceptability of interferon-gamma release assays among healthcare workers who receive routine employee tuberculosis testing.

    Science.gov (United States)

    Hirsch-Moverman, Yael; Wall, Kirsten; Weinfurter, Paul; Munk, Elizabeth; Moran, Joyce Ann; Maiuris, Allison; Khan, Amera; DeLuca, Nichlas

    2013-01-01

    Healthcare workers (HCWs) undergo annual testing for latent tuberculosis infection (LTBI). Compare acceptability of tuberculin skin test (TST) and interferon-gamma release assay (IGRA) among HCWs. HCWs at four medical centers in the US were administered an acceptability questionnaire including a brief objective description of both tests and eliciting attitudes regarding TST and IGRAs, confidence in results, and likelihood of taking LTBI treatment. Of 406 participants, 75% had never heard of IGRAs. IGRAs were preferred to TST. Belief in accuracy of hypothetical positive results of TST or IGRA and willingness to accept LTBI treatment were similar across tests. When presented with hypothetical discordant results, HCWs expressed more confidence in IGRAs. Perceived accuracy of results was the most important factor in test preferences. Although HCWs preferred and indicated more confidence in IGRAs, the likelihood that HCWs would believe LTBI diagnosis and initiate treatment based on positive results was similar for TST and IGRAs.

  1. Serosurveillance of vaccine preventable diseases and hepatitis C in healthcare workers from Lao PDR.

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    Antony P Black

    Full Text Available Healthcare workers (HCW have an increased risk of exposure to infectious diseases and are a potential source of infections for their patients. The Lao People's Democratic Republic (Lao PDR has no national policy regarding HCW vaccinations and routine vaccination coverage is low within the general population. This cross-sectional serostudy determines the level of exposure and risk of infection in Lao HCW against 6 vaccine preventable diseases and hepatitis C.1128 HCW were recruited from 3 central, 2 provincial and 8 district hospitals. Sera were tested by ELISA for the presence of antibodies and antigens to hepatitis B, hepatitis C, measles, rubella, varicella zoster, tetanus and diphtheria.Only 53.1% of the HCW had protective anti-hepatitis B surface antigen antibodies (anti-HBs with 48.8% having anti-hepatitis B core antibodies (anti-HBc, indicating previous exposure and 8.0% were hepatitis B surface antigen carriers. 3.9% were hepatitis C seropositive. Measles and rubella antibodies were detected in 95.4% and 86.2% of the HCW, with 11.9% of females being unprotected against rubella. Antibodies against varicella zoster, tetanus and diphtheria were detected in 95%, 78.8% and 55.3%, respectively. Seroprevalence varied according to age, gender and number of children.An unacceptably high proportion of Lao HCW remain susceptible to infection with hepatitis B, diphtheria, tetanus and rubella. Furthermore, a high number of healthcare workers are chronically infected with hepatitis B and C viruses. These data emphasize the need for a robust HCW vaccination policy in addition to increased awareness within this subpopulation.

  2. 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.

  3. Agents of change: The role of healthcare workers in the prevention of nosocomial and occupational tuberculosis.

    Science.gov (United States)

    Nathavitharana, Ruvandhi R; Bond, Patricia; Dramowski, Angela; Kotze, Koot; Lederer, Philip; Oxley, Ingrid; Peters, Jurgens A; Rossouw, Chanel; van der Westhuizen, Helene-Mari; Willems, Bart; Ting, Tiong Xun; von Delft, Arne; von Delft, Dalene; Duarte, Raquel; Nardell, Edward; Zumla, Alimuddin

    2017-03-01

    Healthcare workers (HCWs) play a central role in global tuberculosis (TB) elimination efforts but their contributions are undermined by occupational TB. HCWs have higher rates of latent and active TB than the general population due to persistent occupational TB exposure, particularly in settings where there is a high prevalence of undiagnosed TB in healthcare facilities and TB infection control (TB-IC) programmes are absent or poorly implemented. Occupational health programmes in high TB burden settings are often weak or non-existent and thus data that record the extent of the increased risk of occupational TB globally are scarce. HCWs represent a limited resource in high TB burden settings and occupational TB can lead to workforce attrition. Stigma plays a role in delayed diagnosis, poor treatment outcomes and impaired well-being in HCWs who develop TB. Ensuring the prioritization and implementation of TB-IC interventions and occupational health programmes, which include robust monitoring and evaluation, is critical to reduce nosocomial TB transmission to patients and HCWs. The provision of preventive therapy for HCWs with latent TB infection (LTBI) can also prevent progression to active TB. Unlike other patient groups, HCWs are in a unique position to serve as agents of change to raise awareness, advocate for necessary resource allocation and implement TB-IC interventions, with appropriate support from dedicated TB-IC officers at the facility and national TB programme level. Students and community health workers (CHWs) must be engaged and involved in these efforts. Nosocomial TB transmission is an urgent public health problem and adopting rights-based approaches can be helpful. However, these efforts cannot succeed without increased political will, supportive legal frameworks and financial investments to support HCWs in efforts to decrease TB transmission. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  4. Hepatitis B vaccination coverage in healthcare workers in Gauteng Province, South Africa.

    Science.gov (United States)

    Burnett, Rosemary J; François, Guido; Mphahlele, M Jeffrey; Mureithi, John G; Africa, Patricia N; Satekge, Mpho M; Mokonoto, D Maggie; Meheus, André; van Sprundel, Marc

    2011-06-06

    Hepatitis B (HB) virus (HBV) is highly endemic and HBV infection is a major public health problem in sub-Saharan Africa. Percutaneous/parenteral transmission is an important mode of spread of HBV in the healthcare setting, thus healthcare workers (HCWs) and their patients are at risk for acquiring HBV infections. This study was conducted on three HCW populations in Gauteng Province during 2009, in order to (1) determine HB vaccination coverage of HCWs, and (2) investigate demographic predictors of vaccination uptake. Being a doctor was a statistically significant predictor of vaccination uptake (odds ratio [OR]: 3.2; 95% confidence interval [CI]: 1.48-6.72; p-value: 0.003), while working in the private sector was also statistically significantly associated with vaccination uptake (OR: 1.73; 95% CI: 1.01-2.98; chi-square p-value: 0.035). The majority (67.9% [491/723]) of HCWs had received at least 1 dose of vaccine, but where data on number of doses was available, only 19.9% (94/472) were fully vaccinated. In conclusion, there is a need to increase HB vaccination uptake in Gauteng HCWs through a policy that is properly implemented and routinely monitored and evaluated, and this policy must ensure that all three doses of vaccine are administered.

  5. Knowledge, attitudes and vaccination coverage of healthcare workers regarding occupational vaccinations.

    Science.gov (United States)

    Loulergue, P; Moulin, F; Vidal-Trecan, G; Absi, Z; Demontpion, C; Menager, C; Gorodetsky, M; Gendrel, D; Guillevin, L; Launay, O

    2009-06-24

    Immunization of healthcare workers (HCWs) is a major issue for infection control in healthcare facilities. The aim of this study was to evaluate knowledge regarding occupational vaccinations, HBV, varicella and influenza vaccination rates and attitudes towards influenza vaccine among HCWs. A cross-sectional survey was conducted in two wards (Medicine and Paediatrics) of a 1182-bed teaching hospital in Paris, France. A standardized, anonymous, self-administered questionnaire was used. Of 580 HCWs, 395 (68%) completed the questionnaire. Knowledge about the occupational vaccinations of HCWs was low. HBV (69%), tuberculosis (54%) and influenza (52%) were the most cited vaccinations. Paediatric staff was more aware of influenza and pertussis immunizations (pvaccination rate was 93%, among whom 65% were aware of their immune status. Influenza vaccination rate for 2006-2007 was 30% overall, ranging from 50% among physicians to 20% among paramedical staff (pvaccine efficacy, although paramedics feared side effects. Influenza vaccination was associated with knowledge of vaccine recommendations [OR=1.75, 95% CI: 1.13-2.57] and contact with patients [OR=3.05, 95% CI: 1.50-5.91]. Knowledge of recommended occupational vaccinations is insufficient in HCWs, except for HBV and influenza. Although the HBV vaccine coverage of HCWs is satisfactory, a large proportion of them is unaware of immune status. Influenza vaccine coverage remains low, especially among paramedical staff because of fear of side effects. As vaccine coverage is associated with knowledge, educational campaigns should be strengthened to increase the adhesion of HCWs to vaccinations.

  6. 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.

  7. Tuberculosis among Healthcare Workers in Southeastern China: A Retrospective Study of 7-Year Surveillance Data

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    Bin Chen

    2014-11-01

    Full Text Available The baseline prevalence and characteristics of tuberculosis (TB among general healthcare workers (HCWs in southeastern China remains unknown. We conducted a retrospective study based on the TB surveillance data in Zhejiang Province from 2005 to 2011, which were extracted from the national Tuberculosis Information Management System (TIMS. We calculated and compared annual notification rates of different occupational groups and analyzed the epidemiological and clinical characteristics. The annual TB notification rates among general HCWs declined steadily from 2005 to 2011. On average, HCWs showed annual TB notification rates lower than the general population but higher than teachers. Recorded HCW TB patients averaged 35.5 years of age, with females outnumbering males (58.0% > 42.0%. The proportion of pulmonary tuberculosis (PTB was higher among male than in the female patients (88.5% > 83.4%, P = 0.031. Our study suggested that general HCWs run a higher occupational risk than teachers although the two groups are socioeconomically comparable and that the priority should be given to the young female HCWs for TB prevention in healthcare institutions.

  8. Daily disinfection of high-touch surfaces in isolation rooms to reduce contamination of healthcare workers' hands.

    Science.gov (United States)

    Kundrapu, Sirisha; Sunkesula, Venkata; Jury, Lucy A; Sitzlar, Brett M; Donskey, Curtis J

    2012-10-01

    In a randomized nonblinded trial, we demonstrated that daily disinfection of high-touch surfaces in rooms of patients with Clostridium difficile infection and methicillin-resistant Staphylococcus aureus colonization reduced acquisition of the pathogens on hands after contacting high-touch surfaces and reduced contamination of hands of healthcare workers caring for the patients.

  9. 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.

  10. Frequency of Klebsiella pneumoniae carbapenemase (KPC) and non-KPC-producing Klebsiella contamination of Healthcare workers and the environment

    Science.gov (United States)

    Rock, Clare; Thom, Kerri A.; Masnick, Max; Johnson, J. Kristie; Harris, Anthony D.; Morgan, Daniel J

    2014-01-01

    We examined contamination of healthcare worker (HCW) gown and gloves after caring for patients with Klebsiella Producing Carbapenemase-producing and non-KPC-producing Klebsiella as a proxy for horizontal transmission. Contamination rate with Klebsiella is similar to MRSA and VRE, with 14% (31/220) of HCW-patient interactions resulting in contamination of gloves and gowns. PMID:24602950

  11. When passion becomes a nightmare: the burnout syndrome in healthcare workers. A case study.

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    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.

  12. The Relationship between Organizational Justice and Quality Performance among Healthcare Workers: A Pilot Study

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    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.

  13. Applying the Lessons of SARS to Pandemic Influenza: An Evidence-based Approach to Mitigating the Stress Experienced by Healthcare Workers

    OpenAIRE

    Maunder, Robert G.; Peladeau, Nathalie; Leszcz, Molyn; Romano, Donna; Savage, Diane; Rose, Marci; Adam, Mary Anne; Schulman, Rabbi Bernard

    2008-01-01

    We describe an evidence-based approach to enhancing the resilience of healthcare workers in preparation for an influenza pandemic, based on evidence about the stress associated with working in healthcare during the SARS outbreak. SARS was associated with significant long-term stress in healthcare workers, but not with increased mental illness. Reducing pandemic-related stress may best be accomplished through interventions designed to enhance resilience in psychologically healthy people. Appli...

  14. 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

  15. [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).

  16. Influenza vaccination among healthcare workers in a multidisciplinary University hospital in Italy

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    Marchisio Paola

    2008-12-01

    Full Text Available Abstract Background Annual influenza vaccination is recommended for healthcare workers (HCWs in order to reduce the morbidity associated with influenza in healthcare settings. The aim of this study was to evaluate the current vaccination status of the HCWs in one of Italy's largest multidisciplinary University Hospitals. Methods Between February 1 and March 31, 2006, we carried out a cross-sectional study of influenza vaccination coverage among HCWs at the University Hospital Fondazione IRCCS "Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena", Milan, Italy. After receiving a brief description of the aim of the study, 2,143 (95%: 1,064 physicians; 855 nurses; 224 paramedics of 2,240 HCWs self-completed an anonymous questionnaire. Results Influenza vaccination coverage was very low in all specialties, varying from 17.6% in the Emergency Department to 24.3% in the Surgery Department, and knowledge of influenza epidemiology and prevention was poor. The factors positively associated with being vaccinated were an age of ≥ 45 years, considering influenza a potentially severe disease, and being aware of the high-risk categories for which influenza vaccination is strongly recommended; those that negatively associated with being vaccinated were being female, working in the Medicine Department, and being a nurse or paramedic. Conclusion Despite strong recommendations, influenza vaccination coverage seemed to be very low among HCWs of all specialties, with differences between areas and types of employment. Specific continuous educational and vaccination programs for different targets should be urgently organized to reduce morbidity and mortality in high-risk patients, contain nosocomial outbreaks, and ensure an appropriate socioeconomic impact.

  17. Access, Education and Policy Awareness: Predictors of Influenza Vaccine Acceptance Among VHA Healthcare Workers.

    Science.gov (United States)

    Eaton, Jennifer Lipkowitz; Mohr, David C; McPhaul, Kathleen M; Kaslow, Richard A; Martinello, Richard A

    2017-08-01

    OBJECTIVE To identify predictors of influenza vaccine acceptance among VHA healthcare workers (HCWs), with emphasis on modifiable factors related to promotion campaigns. DESIGN Survey. SETTING National single-payer healthcare system with 140 hospitals and 321,000 HCWs. PARTICIPANTS National voluntary sample of HCWs in the Veterans Health Administration (VHA) system. METHODS We invited a random sample of 5% of all VHA HCWs to participate. An 18-item intranet-based survey inquired about occupation, vaccination status, employer policy, and local campaign efforts. RESULTS The response rate was 17.4%. Of 2,502 initial respondents, 2,406 (96.2%) provided usable data. This sample includes respondents from all 140 VA hospitals. Self-reported influenza vaccination rates were highest among physicians (95.6%) and licensed independent providers (88.3%). Nonclinical staff (80.7%) reported vaccine uptake similar to other certified but nonlicensed providers (81.2%). The strongest predictor of vaccine acceptance among VHA HCWs was individual awareness of organizational policy. Vaccine acceptance was also higher among HCWs who reported more options for access to vaccination and among those in facilities with more education activities. CONCLUSIONS Influenza vaccine acceptance varied significantly by employee awareness of employer policy and on-site access to vaccine. Employer-sponsored activities to increase access continue to show positive returns across occupations. Local influenza campaign efforts to educate HCWs may have reached saturation in this target group. These results suggest that focused communications to increase HCW awareness and understanding of employer policy can drive further increase in influenza vaccination acceptance. Infect Control Hosp Epidemiol 2017;38:970-975.

  18. Knowledge, Attitudes, and Behaviors about Breast Self-Examination and Mammography among Female Primary Healthcare Workers in Diyarbakır, Turkey.

    Science.gov (United States)

    Erdem, Özgür; Toktaş, İzzettin

    2016-01-01

    Aim. This study aims to determine the knowledge level of the female primary healthcare workers about breast cancer and to reveal their attitude and behaviors about breast self-examination and mammography. Methods. This cross-sectional study was conducted on female primary healthcare workers who work in family health centres. 91% (n = 369) of female primary healthcare workers agreed to participate in the study. The questionnaire consisted of three parts: sociodemographic characteristics, knowledge about breast self-examination, and actual practice of breast self-examination. Results. The mean (SD) age of the female primary healthcare workers was 33.1 ± 6.8 (range, 20-54 years). The healthcare workers who practiced breast self-examination had significantly higher knowledge level (P = 0.001) than those who had not. The respondents had high knowledge level of breast self-examination; however, the knowledge level of breast cancer and mammography screen was low. Conclusions. While the female primary healthcare workers in this study had adequate knowledge of breast self-examination, this is not reflected in their attitudes and practices. Emphasis should be laid on breast self-examination in undergraduate and postgraduate courses for primary healthcare workers, since they are mostly involved in patient education.

  19. Knowledge, Attitudes, and Behaviors about Breast Self-Examination and Mammography among Female Primary Healthcare Workers in Diyarbakır, Turkey

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    Özgür Erdem

    2016-01-01

    Full Text Available Aim. This study aims to determine the knowledge level of the female primary healthcare workers about breast cancer and to reveal their attitude and behaviors about breast self-examination and mammography. Methods. This cross-sectional study was conducted on female primary healthcare workers who work in family health centres. 91% (n=369 of female primary healthcare workers agreed to participate in the study. The questionnaire consisted of three parts: sociodemographic characteristics, knowledge about breast self-examination, and actual practice of breast self-examination. Results. The mean (SD age of the female primary healthcare workers was 33.1±6.8 (range, 20–54 years. The healthcare workers who practiced breast self-examination had significantly higher knowledge level (P=0.001 than those who had not. The respondents had high knowledge level of breast self-examination; however, the knowledge level of breast cancer and mammography screen was low. Conclusions. While the female primary healthcare workers in this study had adequate knowledge of breast self-examination, this is not reflected in their attitudes and practices. Emphasis should be laid on breast self-examination in undergraduate and postgraduate courses for primary healthcare workers, since they are mostly involved in patient education.

  20. Mobile learning for HIV/AIDS healthcare worker training in resource-limited settings

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    Zolfo Maria

    2010-09-01

    Full Text Available Abstract Background We present an innovative approach to healthcare worker (HCW training using mobile phones as a personal learning environment. Twenty physicians used individual Smartphones (Nokia N95 and iPhone, each equipped with a portable solar charger. Doctors worked in urban and peri-urban HIV/AIDS clinics in Peru, where almost 70% of the nation's HIV patients in need are on treatment. A set of 3D learning scenarios simulating interactive clinical cases was developed and adapted to the Smartphones for a continuing medical education program lasting 3 months. A mobile educational platform supporting learning events tracked participant learning progress. A discussion forum accessible via mobile connected participants to a group of HIV specialists available for back-up of the medical information. Learning outcomes were verified through mobile quizzes using multiple choice questions at the end of each module. Methods In December 2009, a mid-term evaluation was conducted, targeting both technical feasibility and user satisfaction. It also highlighted user perception of the program and the technical challenges encountered using mobile devices for lifelong learning. Results With a response rate of 90% (18/20 questionnaires returned, the overall satisfaction of using mobile tools was generally greater for the iPhone. Access to Skype and Facebook, screen/keyboard size, and image quality were cited as more troublesome for the Nokia N95 compared to the iPhone. Conclusions Training, supervision and clinical mentoring of health workers are the cornerstone of the scaling up process of HIV/AIDS care in resource-limited settings (RLSs. Educational modules on mobile phones can give flexibility to HCWs for accessing learning content anywhere. However lack of softwares interoperability and the high investment cost for the Smartphones' purchase could represent a limitation to the wide spread use of such kind mLearning programs in RLSs.

  1. Mobile learning for HIV/AIDS healthcare worker training in resource-limited settings.

    Science.gov (United States)

    Zolfo, Maria; Iglesias, David; Kiyan, Carlos; Echevarria, Juan; Fucay, Luis; Llacsahuanga, Ellar; de Waard, Inge; Suàrez, Victor; Llaque, Walter Castillo; Lynen, Lutgarde

    2010-09-08

    We present an innovative approach to healthcare worker (HCW) training using mobile phones as a personal learning environment.Twenty physicians used individual Smartphones (Nokia N95 and iPhone), each equipped with a portable solar charger. Doctors worked in urban and peri-urban HIV/AIDS clinics in Peru, where almost 70% of the nation's HIV patients in need are on treatment. A set of 3D learning scenarios simulating interactive clinical cases was developed and adapted to the Smartphones for a continuing medical education program lasting 3 months. A mobile educational platform supporting learning events tracked participant learning progress. A discussion forum accessible via mobile connected participants to a group of HIV specialists available for back-up of the medical information. Learning outcomes were verified through mobile quizzes using multiple choice questions at the end of each module. In December 2009, a mid-term evaluation was conducted, targeting both technical feasibility and user satisfaction. It also highlighted user perception of the program and the technical challenges encountered using mobile devices for lifelong learning. With a response rate of 90% (18/20 questionnaires returned), the overall satisfaction of using mobile tools was generally greater for the iPhone. Access to Skype and Facebook, screen/keyboard size, and image quality were cited as more troublesome for the Nokia N95 compared to the iPhone. Training, supervision and clinical mentoring of health workers are the cornerstone of the scaling up process of HIV/AIDS care in resource-limited settings (RLSs). Educational modules on mobile phones can give flexibility to HCWs for accessing learning content anywhere. However lack of softwares interoperability and the high investment cost for the Smartphones' purchase could represent a limitation to the wide spread use of such kind mLearning programs in RLSs.

  2. Frequent transient hepatitis C viremia without seroconversion among healthcare workers in Cairo, Egypt.

    Directory of Open Access Journals (Sweden)

    Aline Munier

    Full Text Available BACKGROUNDS: With 10% of the general population aged 15-59 years chronically infected with hepatitis C virus (HCV, Egypt is the country with the highest HCV prevalence worldwide. Healthcare workers (HCWs are therefore at particularly high risk of HCV infection. Our aim was to study HCV infection risk after occupational blood exposure among HCWs in Cairo. METHODOLOGY/PRINCIPAL FINDINGS: The study was conducted in 2008-2010 at Ain Shams University Hospital, Cairo. HCWs reporting an occupational blood exposure at screening, having neither anti-HCV antibodies (anti-HCV nor HCV RNA, and exposed to a HCV RNA positive patient, were enrolled in a 6-month prospective cohort with follow-up visits at weeks 2, 4, 8, 12 and 24. During follow-up, anti-HCV, HCV RNA and ALT were tested. Among 597 HCWs who reported a blood exposure, anti-HCV prevalence at screening was 7.2%, not different from that of the general population of Cairo after age-standardization (11.6% and 10.4% respectively, p = 0.62. The proportion of HCV viremia among index patients was 37%. Of 73 HCWs exposed to HCV RNA from index patients, nine (12.3%; 95%CI, 5.8-22.1% presented transient viremia, the majority of which occurred within the first two weeks after exposure. None of the workers presented seroconversion or elevation of ALT. CONCLUSIONS/SIGNIFICANCE: HCWs of a general University hospital in Cairo were exposed to a highly viremic patient population. They experienced frequent occupational blood exposures, particularly in early stages of training. These exposures resulted in transient viremic episodes without established infection. These findings call for further investigation of potential immune protection against HCV persistence in this high risk group.

  3. Japanese Encephalitis in Assam, India: Need to Increase Healthcare Workers' Understanding to Improve Health Care.

    Directory of Open Access Journals (Sweden)

    Akram Ahmad

    Full Text Available Japanese encephalitis (JE is a major cause of high morbidity and mortality in several states across India. However, in 2014, a sharp rise was observed in the number of cases of JE in north-eastern Assam state, and 51% of the total cases of JE in India were reported from the Assam in the same year. In this regard, a study was conducted to evaluate the knowledge and attitudes of healthcare workers in Darrang, a district of Assam highly affected by JE.A cross sectional study was conducted for 2 months among HCWs in the major district hospital of Darrang, Assam. A pre-tested, self-administered questionnaire was used to collect data from the participants. Convenience sampling approach was used to collect data from different departments of the hospitals. Descriptive and logistic regression analyses were used to express the results.The knowledge of HCWs regarding JE was poor with a mean knowledge score of 11.02±2.39 (out of 17, while their attitudes were positive with a mean attitudes score of 43.16± 2.47 (ranging from 13 to 52. Overall, 40.4% and 74.3% of participants demonstrated good knowledge and positive attitudes respectively. Cut-off score for good knowledge and positive attitudes toward JE was set as ≥12 and >40 respectively. Older participants (40-49 years and experienced workers (>10 years were significantly associated with good knowledge as compared to their referent group (p<0.05, while knowledge of nurses and other orderlies were significantly lower than physicians (p<0.01. Similar factors were associated with the positive attitudes of the participants with the exception of experience. Television was the major source of information regarding JE reported by HCWs (79%.Although the knowledge was not optimized, HCWs exhibited positive attitudes towards JE. Future research is required to design, implement and evaluate interventions to improve the knowledge of JE among HCWs.

  4. A conversation on health in Canada: revisiting universality and the centrality of primary healthcare.

    Science.gov (United States)

    White, Franklin; Nanan, Debra

    2009-01-01

    In 2006, British Columbia launched a public consultation on how to strengthen the health system. We report on the processes and the inputs and views submitted and examine the perceived importance of universality and primary healthcare (PHC). Public response revealed strong support for the Canada Health Act, which upholds 5 principles: public administration, comprehensiveness, universality, portability, and accessibility, and also a need for the system to be more open to innovation. It recognized that keys to improving population health and efficiency gains within the health system lie within the scope of PHC and that prevention, demand management, and self-management are all part of PHC.

  5. Increasing the coverage of influenza vaccination in healthcare workers: review of challenges and solutions.

    Science.gov (United States)

    To, K W; Lai, A; Lee, K C K; Koh, D; Lee, S S

    2016-10-01

    Seasonal influenza vaccine uptake rate of healthcare workers (HCWs) varies widely from 90% worldwide. Perception of vaccine efficacy and side-effects are conventional factors affecting the uptake rates. These factors may operate on a personal and social level, impacting the attitudes and behaviours of HCWs. Vaccination rates were also under the influence of the occurrence of other non-seasonal influenza pandemics such as avian influenza. Different strategies have been implemented to improve vaccine uptake, with important ones including the enforcement of the local authority's recommendations, promulgation of practice guidelines, and mandatory vaccination polices. Practised in some regions in North America, mandatory policies have led to higher vaccination rate, but are not problem-free. The effects of conventional educational programmes and campaigns are in general of modest impact only. Availability of convenient vaccination facilities, such as mobile vaccination cart, and role models of senior HCWs receiving vaccination are among some strategies which have been observed to improve vaccination uptake rate. A multi-faceted approach is thus necessary to persuade HCWs to participate in a vaccination programme, especially in areas with low uptake rate.

  6. 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

  7. Healthcare workers' perceptions of the duty to work during an influenza pandemic.

    Science.gov (United States)

    Damery, S; Draper, H; Wilson, S; Greenfield, S; Ives, J; Parry, J; Petts, J; Sorell, T

    2010-01-01

    Healthcare workers (HCWs) are often assumed to have a duty to work, even if faced with personal risk. This is particularly so for professionals (doctors and nurses). However, the health service also depends on non-professionals, such as porters, cooks and cleaners. The duty to work is currently under scrutiny because of the ongoing challenge of responding to pandemic influenza, where an effective response depends on most uninfected HCWs continuing to work, despite personal risk. This paper reports findings of a survey of HCWs (n = 1032) conducted across three National Health Service trusts in the West Midlands, UK, to establish whether HCWs' likelihood of working during a pandemic is associated with views about the duty to work. The sense that HCWs felt that they had a duty to work despite personal risk emerged strongly regardless of professional status. Besides a strong sense that everyone should pull together, all kinds of HCWs recognised a duty to work even in difficult circumstances, which correlated strongly with their stated likelihood of working. This suggests that HCWs' decisions about whether or not they are prepared to work during a pandemic are closely linked to their sense of duty. However, respondents' sense of the duty to work may conflict with their sense of duty to family, as well as other factors such as a perceived lack of reciprocity from their employers. Interestingly, nearly 25% of doctors did not consider that they had a duty to work where doing so would pose risks to themselves or their families.

  8. Effects of music on immunity and physiological responses in healthcare workers: a randomized controlled trial.

    Science.gov (United States)

    Lai, Hui-Ling; Liao, Kuang-Wen; Huang, Chiung-Yu; Chen, Pin-Wen; Peng, Tai-Chu

    2013-04-01

    Research-based evidence supports the effectiveness of soothing music in improving stress-related psycho-physiological indices in a clinical setting. However, there is currently insufficient scientific knowledge of the effects of music on immune markers of stress in humans. Therefore, the aims of the study were to compare the effects of music and quiet rest on the levels of interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α), interleukin-10 (IL-10), heart rate and mean arterial pressure among healthcare workers. By using a randomized controlled trial design, 60 nurses were randomly assigned to the stimulating or sedating music or rest groups for 30 min. Participants' psychoneuroimmunological parameters were measured using enzyme-linked immunosorbent assays. General estimating equation was used to analyse data. Results revealed that IL-6, TNF-α and IL-10 were not detectable in this population. No significance differences in heart rate were found among the three groups. However, the stimulating music group had significantly higher mean arterial pressure levels than the sedating music group but no differences between the quiet rest group and the sedating music group. Music with different tempi had little effect on mean arterial pressure. Any effect of music on immune markers of stress requires further research.

  9. Prevalence of needlestick injuries and other high risk exposures among healthcare workers in Jamaica.

    Science.gov (United States)

    Foster, T M; Lee, M G; McGaw, C D; Frankson, M A

    2010-03-01

    To assess the prevalence of needlestick injuries (NSIs) and other high risk exposures among healthcare workers at two hospitals in Jamaica. Employing a cross-sectional study design, medical personnel (physicians, nurses) at two hospitals in Jamaica, were studied, utilizing a structured questionnaire consisting of 14 items to collect data on needle stick injuries and other injuries. There were 67 needlestick injuries in 47 persons. Of those sustaining an injury, 52% of physicians and 40% of nurses had NSIs. Re-capping needles accounted for 21% of injuries, various minor procedures, 21%, injury during surgery, 19.4% and taking blood, 12%. In those sustaining NSIs, 47% were reported and 26% of reported cases received counselling. Appropriate blood tests were performed on 34% and post-exposure prophylaxis (PEP) for HIV was administered to 30%. Hollow bore needles caused 47.8% of injuries, 25.4% occurred with suture needles and 19.4% with intravenous branulas. Other occupational exposure was reported by 31%, including blood on hands and other body parts 39%, blood to face and eyes, 18%, splashed with liquor, 18%, splashed with bloody fluid, 11% and contact with vomitus and urine in eye, 4%. Needlestick injuries and other high risk exposures were high; incident reporting and post exposure management were inadequate. A comprehensive programme to address factors that contribute to the occurrence of NSIs and other occupational exposures is urgently needed.

  10. Machinima and Video-Based Soft-Skills Training for Frontline Healthcare Workers.

    Science.gov (United States)

    Conkey, Curtis A; Bowers, Clint; Cannon-Bowers, Janis; Sanchez, Alicia

    2013-02-01

    Multimedia training methods have traditionally relied heavily on video-based technologies, and significant research has shown these to be very effective training tools. However, production of video is time and resource intensive. Machinima technologies are based on videogaming technology. Machinima technology allows videogame technology to be manipulated into unique scenarios based on entertainment or training and practice applications. Machinima is the converting of these unique scenarios into video vignettes that tell a story. These vignettes can be interconnected with branching points in much the same way that education videos are interconnected as vignettes between decision points. This study addressed the effectiveness of machinima-based soft-skills education using avatar actors versus the traditional video teaching application using human actors in the training of frontline healthcare workers. This research also investigated the difference between presence reactions when using avatar actor-produced video vignettes as compared with human actor-produced video vignettes. Results indicated that the difference in training and/or practice effectiveness is statistically insignificant for presence, interactivity, quality, and the skill of assertiveness. The skill of active listening presented a mixed result indicating the need for careful attention to detail in situations where body language and facial expressions are critical to communication. This study demonstrates that a significant opportunity exists for the exploitation of avatar actors in video-based instruction.

  11. 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.

  12. Healthcare

    Science.gov (United States)

    ... Workers can file a complaint with OSHA by calling 1-800-321-OSHA (6742), online via eComplaint ... 321-6742 (OSHA) TTY www.OSHA.gov FEDERAL GOVERNMENT White House Affordable Care Act Disaster Recovery Assistance ...

  13. 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.

  14. Educating Medical Laboratory Technologists: Revisiting Our Assumptions in the Current Economic and Health-Care Environment

    Directory of Open Access Journals (Sweden)

    Regina Linder

    2012-08-01

    Full Text Available Health care occupies a distinct niche in an economy struggling to recover from recession. Professions related to the care of patients are thought to be relatively resistant to downturns, and thus become attractive to students typically drawn to more lucrative pursuits. Currently, a higher profile for clinical laboratory technology among college students and those considering career change results in larger and better prepared applicant pools. However, after decades of contraction marked by closing of programs, prospective students encounter an educational system without the capacity or vigor to meet their needs. Here discussed are some principles and proposals to allow universities, partnering with health-care providers, government agencies, and other stakeholders to develop new programs, or reenergize existing ones to serve our students and patients. Principles include academic rigor in biomedical and clinical science, multiple points of entry for students, flexibility in format, cost effectiveness, career ladders and robust partnerships.

  15. 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 workplace prevents deterioration of work ability among female healthcare workers. ClinicalTrials.gov NCT01921764 . Registered 10 August 2013.

  16. Effect of workplace- versus home-based physical exercise on musculoskeletal pain among healthcare workers: a cluster randomized controlled trial.

    Science.gov (United States)

    Jakobsen, Markus D; Sundstrup, Emil; Brandt, Mikkel; Jay, Kenneth; Aagaard, Per; Andersen, Lars L

    2015-03-01

    Numerous studies has shown that regular physical exercise can reduce musculoskeletal pain, but the optimal setting to achieve high adherence and effectiveness remains unknown. This study investigated the effect of workplace versus home-based physical exercise on musculoskeletal pain among healthcare workers. 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 5×10 minutes per week and up to 5 group-based coaching sessions on motivation for regular physical exercise, or (ii) home-based physical exercise (HOME) performed during leisure time for 5×10 minutes per week. Both groups received ergonomic counseling on patient handling and use of lifting aides. Average pain intensity (0-10 scale) in the low back and neck/shoulder was the primary outcome. 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 (PWorkplace physical exercise is more effective than home-based exercise in reducing musculoskeletal pain, increasing muscle strength and reducing the use of analgesics among healthcare workers.

  17. Prevalence and incidence of latent tuberculosis infection in georgian healthcare workers.

    Directory of Open Access Journals (Sweden)

    Jennifer A Whitaker

    Full Text Available BACKGROUND: Tuberculosis is a major occupational hazard in low and middle-income countries. Limited data exist on serial testing of healthcare workers (HCWs with interferon-γ release assays (IGRAs for latent tuberculosis infection (LTBI, especially in low and middle-income countries. We sought to evaluate the rates of and risk factors for LTBI prevalence and LTBI test conversion among HCWs using the tuberculin skin test (TST and QuantiFERON-TB Gold In-tube assay (QFT-GIT. METHODS: A prospective longitudinal study was conducted among HCWs in the country of Georgia. Subjects completed a questionnaire, and TST and QFT-GIT tests were performed. LTBI testing was repeated 6-26 months after baseline testing. RESULTS: Among 319 HCWs enrolled, 89% reported prior BCG vaccination, and 60% worked in TB healthcare facilities (HCFs. HCWs from TB HCFs had higher prevalence of positive QFT-GIT and TST than those from non-TB HCFs: 107/194 (55% vs. 30/125 (31% QFT-GIT positive (p<0.0001 and 128/189 (69% vs. 64/119 (54% TST positive (p = 0.01. There was fair agreement between TST and QFT-GIT (kappa = 0.42, 95% CI 0.31-0.52. In multivariate analysis, frequent contact with TB patients was associated with increased risk of positive QFT-GIT (aOR 3.04, 95% CI 1.79-5.14 but not positive TST. Increasing age was associated with increased risk of positive QFT-GIT (aOR 1.05, 95% CI 1.01-1.09 and TST (aOR 1.05, 95% CI 1.01-1.10. High rates of HCW conversion were seen: the QFT-GIT conversion rate was 22.8/100 person-years, and TST conversion rate was 17.1/100 person-years. In multivariate analysis, female HCWs had decreased risk of TST conversion (aOR 0.05, 95% CI 0.01-0.43, and older HCWs had increased risk of QFT-GIT conversion (aOR 1.07 per year, 95% CI 1.01-1.13. CONCLUSION: LTBI prevalence and LTBI test conversion rates were high among Georgian HCWs, especially among those working at TB HCFs. These data highlight the need for increased implementation of TB

  18. Healthcare workers' attitudes to working during pandemic influenza: a qualitative study

    Directory of Open Access Journals (Sweden)

    Petts Judith I

    2009-02-01

    Full Text Available Abstract Background Healthcare workers (HCWs will play a key role in any response to pandemic influenza, and the UK healthcare system's ability to cope during an influenza pandemic will depend, to a large extent, on the number of HCWs who are able and willing to work through the crisis. UK emergency planning will be improved if planners have a better understanding of the reasons UK HCWs may have for their absenteeism, and what might motivate them to work during an influenza pandemic. This paper reports the results of a qualitative study that explored UK HCWs' views (n = 64 about working during an influenza pandemic, in order to identify factors that might influence their willingness and ability to work and to identify potential sources of any perceived duty on HCWs to work. Methods A qualitative study, using focus groups (n = 9 and interviews (n = 5. Results HCWs across a range of roles and grades tended to feel motivated by a sense of obligation to work through an influenza pandemic. A number of significant barriers that may prevent them from doing so were also identified. Perceived barriers to the ability to work included being ill oneself, transport difficulties, and childcare responsibilities. Perceived barriers to the willingness to work included: prioritising the wellbeing of family members; a lack of trust in, and goodwill towards, the NHS; a lack of information about the risks and what is expected of them during the crisis; fear of litigation; and the feeling that employers do not take the needs of staff seriously. Barriers to ability and barriers to willingness, however, are difficult to separate out. Conclusion Although our participants tended to feel a general obligation to work during an influenza pandemic, there are barriers to working, which, if generalisable, may significantly reduce the NHS workforce during a pandemic. The barriers identified are both barriers to willingness and to ability. This suggests that pandemic planning

  19. 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

  20. Mask-wearing and respiratory infection in healthcare workers in Beijing, China

    Directory of Open Access Journals (Sweden)

    Peng Yang

    Full Text Available OBJECTIVES: The aim of the study was to determine rates of mask-wearing, of respiratory infection and the factors associated with mask-wearing and of respiratory infection in healthcare workers (HCWs in Beijing during the winter of 2007/2008. METHODS: We conducted a survey of 400 HCWs working in eight hospitals in Beijing by face to face interview using a standardized questionnaire. RESULTS: We found that 280/400 (70.0% of HCWs were compliant with mask-wearing while in contact with patients. Respiratory infection occurred in 238/400 (59.5% subjects from November, 2007 through February, 2008. Respiratory infection was higher among females (odds ratio [OR], 2.00 [95% confidence interval {CI}, 1.16-3.49] and staff working in larger hospitals (OR, 1.72 [95% CI, 1.092.72], but was lower among subjects with seasonal influenza vaccination (OR, 0.46 [95% CI, 0.280.76], wearing medical masks (reference: cotton-yarn; OR, 0.60 [95% CI, 0.39-0.91] or with good mask-wearing adherence (OR, 0.60 [95% CI, 0.37-0.98]. The risk of respiratory infection of HCWs working in low risk areas was similar to that of HCWs in high risk area. CONCLUSION: Our data suggest that female HCWs and staffs working in larger hospitals are the focus of prevention and control of respiratory infection in Beijing hospitals. Mask-wearing and seasonal influenza vaccination are protective for respiratory infection in HCWs; the protective efficacy of medical masks is better than that of cotton yarn ones; respiratory infection of HCWs working in low risk areas should also be given attention.

  1. 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; P

  2. TB in healthcare workers in the UK: a cohort analysis 2009-2013.

    Science.gov (United States)

    Davidson, Jennifer A; Lalor, Maeve K; Anderson, Laura F; Tamne, Surinder; Abubakar, Ibrahim; Thomas, H Lucy

    2017-07-01

    To describe the burden of TB in healthcare workers (HCWs) in the UK and determine whether HCWs are at increased risk of TB due to occupational exposure. Retrospective cohort analysis of national UK TB surveillance and genotyping data between 2009 and 2013. The rate of TB in HCWs compared with non-HCWs to calculate incidence rate ratios stratified by country of birth. 2320 cases of TB in HCWs were notified in the study period, 85% were born abroad. The TB rate in HCWs was 23.4 (95% CI 22.5 to 24.4) per 100 000 compared with 16.2 (95% CI 16.0 to 16.3) per 100 000 in non-HCWs. After stratifying by country of birth, there was not an increased TB incidence in HCWs for the majority of countries of birth, including in the UK-born. Using combined genotyping and epidemiological data, only 10 confirmed nosocomial transmission events involving HCWs were identified between 2010 and 2012. Of these, only two involved transmission to patients. The lack of an increased risk of TB after stratifying by country of birth, and the very few transmission events involving nosocomial transmission in the UK suggests that TB in HCWs in the UK is not generally acquired through UK occupational exposure. The majority of cases in foreign-born HCWs are likely to result from reactivation of latent TB infection (LTBI) acquired abroad, and is not likely to be prevented by BCG vaccination in the UK. Testing and treatment of LTBI in HCWs with exposure to high TB burden countries should be the focus of occupational health prevention activities. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  3. Mask-wearing and respiratory infection in healthcare workers in Beijing, China

    Directory of Open Access Journals (Sweden)

    Peng Yang

    2011-04-01

    Full Text Available OBJECTIVES: The aim of the study was to determine rates of mask-wearing, of respiratory infection and the factors associated with mask-wearing and of respiratory infection in healthcare workers (HCWs in Beijing during the winter of 2007/2008. METHODS: We conducted a survey of 400 HCWs working in eight hospitals in Beijing by face to face interview using a standardized questionnaire. RESULTS: We found that 280/400 (70.0% of HCWs were compliant with mask-wearing while in contact with patients. Respiratory infection occurred in 238/400 (59.5% subjects from November, 2007 through February, 2008. Respiratory infection was higher among females (odds ratio [OR], 2.00 [95% confidence interval {CI}, 1.16-3.49] and staff working in larger hospitals (OR, 1.72 [95% CI, 1.092.72], but was lower among subjects with seasonal influenza vaccination (OR, 0.46 [95% CI, 0.280.76], wearing medical masks (reference: cotton-yarn; OR, 0.60 [95% CI, 0.39-0.91] or with good mask-wearing adherence (OR, 0.60 [95% CI, 0.37-0.98]. The risk of respiratory infection of HCWs working in low risk areas was similar to that of HCWs in high risk area. CONCLUSION: Our data suggest that female HCWs and staffs working in larger hospitals are the focus of prevention and control of respiratory infection in Beijing hospitals. Mask-wearing and seasonal influenza vaccination are protective for respiratory infection in HCWs; the protective efficacy of medical masks is better than that of cotton yarn ones; respiratory infection of HCWs working in low risk areas should also be given attention.

  4. Risk assessment for healthcare workers after a sentinel case of rabies and review of the literature.

    Science.gov (United States)

    Kan, Virginia L; Joyce, Patrick; Benator, Debra; Agnes, Kathleen; Gill, Janet; Irmler, Monica; Clark, Arlene; Giannakos, George; Gabourel, Audrey; Gordin, Fred M

    2015-02-01

    After a case of rabies, healthcare workers (HCWs) had fear of contagion from the infected patient. Although transmission of rabies to HCWs has never been documented, high-risk exposures theoretically include direct contact of broken skin and/or mucosa with saliva, tears, oropharyngeal secretions, cerebrospinal fluid, and neural tissue. Urine/kidney exposure posed a concern, as our patient's renal transplant was identified as the infection source. Our risk assessment included (1) identification of exposed HCWs; (2) notification of HCWs; (3) risk assessment using a tool from the local health department; (4) supplemental screening for urine/kidney exposure; and (5) postexposure prophylaxis (PEP) when indicated. A total of 222 HCWs including diverse hospital staff and medical trainees from university affiliates were evaluated. Risk screening was initiated within 2 hours of rabies confirmation, and 95% of HCWs were assessed within the first 8 days. There were 8 high-risk exposures related to broken skin contact or mucosal splash with the patient's secretions, and 1 person without high-risk contact sought and received PEP outside our hospital. Nine HCWs (4%) received PEP with good tolerance. Due to fear of rabies transmission, additional HCWs without direct patient contact required counseling. There have been no secondary cases after our sentinel rabies patient. Rabies exposure represents a major concern for HCWs and requires rapid, comprehensive risk screening and counseling of staff and timely PEP. Given the lack of human-to-human rabies transmission from our own experience and the literature, a conservative approach seems appropriate for providing PEP to HCWs. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  5. 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 F.); 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

  6. MRSA Prevalence and Associated Risk Factors among Health-Care Workers in Non-outbreak Situations in the Dutch-German EUREGIO

    NARCIS (Netherlands)

    Sassmannshausen, Ricarda; Deurenberg, Ruud H.; Koeck, Robin; Hendrix, Ron; Jurke, Annette; Rossen, John W. A.; Friedrich, Alexander W.

    2016-01-01

    Preventing the spread of methicillin-resistant Staphylococcus aureus (MRSA) in healthcare facilities is a major infection control target. However, only a few studies have assessed the potential role of healthcare workers (HCWs) for MRSA dissemination. To investigate the MRSA prevalence and the risk

  7. The evolution of the resistance of Staphylococcus aureus found on healthcare workers correlated with local consumption of antibiotics

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    César Roberto Busato

    2006-06-01

    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.

  8. Threshold of musculoskeletal pain intensity for increased risk of long-term sickness absence among female healthcare workers in eldercare.

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    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.

  9. 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.

  10. Health Reform and its Impact on Healthcare Workers: A Case Study of the National Clinical Hospital of Cordova, Argentina

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    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.

  11. Effectiveness of diabetes and hypertension management by rural primary health-care workers (Behvarz workers) in Iran: a nationally representative observational study.

    Science.gov (United States)

    Farzadfar, Farshad; Murray, Christopher J L; Gakidou, Emmanuela; Bossert, Thomas; Namdaritabar, Hengameh; Alikhani, Siamak; Moradi, Ghobad; Delavari, Alireza; Jamshidi, Hamidreza; Ezzati, Majid

    2012-01-07

    Non-communicable diseases and their risk factors are leading causes of disease burden in Iran and other middle-income countries. Little evidence exists for whether the primary health-care system can effectively manage non-communicable diseases and risk factors at the population level. Our aim was to examine the effectiveness of the Iranian rural primary health-care system (the Behvarz system) in the management of diabetes and hypertension, and to assess whether the effects depend on the number of health-care workers in the community. We used individual-level data from the 2005 Non-Communicable Disease Surveillance Survey (NCDSS) for fasting plasma glucose (FPG) and systolic blood pressure (SBP), body-mass index, medication use, and sociodemographic variables. Data for Behvarz-worker and physician densities were from the 2006 Population and Housing Census and the 2005 Outpatient Care Centre Mapping Survey. We assessed the effectiveness of treatment on FPG and SBP, and associations between FPG or SBP and Behvarz-worker density with two statistical approaches: a mixed-effects regression analysis of the full NCDSS sample adjusting for individual-level and community-level covariates and an analysis that estimated average treatment effect on data balanced with propensity score matching. NCDSS had data for 65,619 individuals aged 25 years or older (11,686 of whom in rural areas); of these, 64,694 (11,521 in rural areas) had data for SBP and 50,202 (9337 in rural areas) had data for FPG. Nationally, 39·2% (95% CI 37·7 to 40·7) of individuals with diabetes and 35·7% (34·9 to 36·5) of those with hypertension received treatment, with higher treatment coverage in women than in men and in urban areas than in rural areas. Treatment lowered mean FPG by an estimated 1·34 mmol/L (0·58 to 2·10) in rural areas and 0·21 mmol/L (-0·15 to 0·56) in urban areas. Individuals in urban areas with hypertension who received treatment had 3·8 mm Hg (3·1 to 4·5) lower SBP than

  12. Primary healthcare worker knowledge related to prenatal and immediate newborn care: a cross sectional study in Masindi, Uganda.

    Science.gov (United States)

    Ayiasi, Richard Mangwi; Criel, Bart; Orach, Christopher Garimoi; Nabiwemba, Elizabeth; Kolsteren, Patrick

    2014-02-11

    Global neonatal mortality remains unacceptably high. Health workers who attend to prenatal and postnatal mothers need to be knowledgeable in preventive and curative care for pregnant women and their newborn babies. This study aimed to determine the level of knowledge related to prenatal and immediate newborn care among primary healthcare workers in Masindi, Uganda. A cross-sectional study was conducted. Interviews comprised of 25 multiple-choice questions were administered to health workers who were deployed to offer prenatal and postnatal care in Masindi in November 2011. Questions were related to four domains of knowledge: prenatal care, immediate newborn care, management of neonatal infections and identifying and stabilizing Low-Birth Weight (LBW) babies. Corresponding composite variables were derived; level of knowledge among health workers dichotomized as 'adequate' or 'inadequate'. The chi-square statistic test was used to examine associations with independent variables including level of training (nursing assistant, general nurse or midwife), level of care (hospital/health centre level IV or health centre level III/II) and years of service (five years or less, six years or more). 183 health workers were interviewed: general nurses (39.3%), midwives (21.9%) and nursing assistants (38.8%). Respectively, 53.6%, 46.5%, 7.1% and 56.3% were considered to have adequate knowledge in prenatal care, newborn care, management of neonatal infections and identifying/stabilizing LBW babies. Being a general nurse was significantly associated with having adequate knowledge in identifying and stabilizing LBW babies (p care being hospital/health centre level IV was not significantly associated with having adequate knowledge in prenatal or newborn care with reference to health centres of level III/II. Knowledge regarding prenatal and newborn care among primary healthcare workers in Masindi was very low. The highest deficit of knowledge was in management of neonatal infections

  13. 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

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    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

  14. Screening of health-care workers for latent tuberculosis infection in a Tertiary Care Hospital

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    Anand Bimari Janagond

    2017-01-01

    Full Text Available Background: Health-care workers (HCWs are at increased risk of acquiring tuberculosis (TB than the general population. While national-level data on the burden of TB in general population is available from reliable sources, nationally representative data on latent tuberculosis infection (LTBI burden in HCWs in the high burden countries is lacking. Methods: A prospective study was carried out to assess the risk of TB infection among HCWs who directly engage in medical duties. HCWs were recruited between January 2014 and December 2015. A structured questionnaire was used for risk assessment of TB infection among HCWs, including sociodemographic characteristics (e.g., age, gender, period of professional work, and employed position, knowledge of TB prevention and control, and history of professional work. A single-step tuberculin skin test (TST using 5 international units (IU; 0.1 ml of tuberculin (purified protein derivative from Mycobacterium bovis Bacillus Calmette–Guérin [BCG]. TB infection was determined using a TST induration ≥10 mm as a cutoff point for TST positivity. TST-positive participants were further subjected to detailed clinical evaluation and chest radiography to rule out active TB. The associations between TB infection and the sociodemographic characteristics, duration of possible exposure to TB while on medical duties, BCG vaccination, and knowledge about TB were estimated using Chi-square test. A two-sided P < 0.05 indicated statistical significance. Results: A total of 206 eligible HCWs signed the informed consent and completed the questionnaires between January 2014 and December 2015. The age of the participants ranged from 18 to 71 years, with a mean age of 27.13 years. TST induration size (mean 6.37 mm the TST results suggested that 36.8% (76/206 were infected with TB using a TST induration ≥10 mm as a cut-off point. All 76 TST-positive HCWs showed no evidence of active TB in clinical evaluation and chest radiography

  15. 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

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

    Directory of Open Access Journals (Sweden)

    R Kapil

    2015-01-01

    Full Text Available Aim: 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. Materials and Methods: 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. Results: 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. Conclusions: 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

  17. Surveillance of occupational blood and body fluid exposures among French healthcare workers in 2004.

    Science.gov (United States)

    Venier, A G; Vincent, A; L'heriteau, F; Floret, N; Senechal, H; Abiteboul, D; Reyreaud, E; Coignard, B; Parneix, P

    2007-10-01

    To estimate the incidence rate of reported occupational blood and body fluid exposures among French healthcare workers (HCWs). Prospective national follow-up of HCWs from January 1 to December 31, 2004. University hospitals, hospitals, clinics, local medical centers, and specialized psychiatric centers were included in the study on a voluntary basis. At participating medical centers, every reported blood and body fluid exposure was documented by the occupational practitioner in charge of the exposed HCW by use of an anonymous, standardized questionnaire. A total of 375 medical centers (15% of French medical centers, accounting for 29% of hospital beds) reported 13,041 blood and body fluid exposures; of these, 9,396 (72.0%) were needlestick injuries. Blood and body fluid exposures were avoidable in 39.1% of cases (5,091 of 13,020), and 52.2% of percutaneous injuries (4,986 of 9,552) were avoidable (5.9% due to needle recapping). Of 10,656 percutaneous injuries, 22.6% occurred during an injection, 17.9% during blood sampling, and 16.6% during surgery. Of 2,065 splashes, 22.6% occurred during nursing activities, 19.1% during surgery, 14.1% during placement or removal of an intravenous line, and 12.0% during manipulation of a tracheotomy tube. The incidence rates of exposures were 8.9 per 100 hospital beds (95% confidence interval [CI], 8.7-9.0 exposures), 2.2 per 100 full-time-equivalent physicians (95% CI, 2.4-2.6 exposures), and 7.0 per 100 full-time-equivalent nurses (95% CI, 6.8-7.2 exposures). Human immunodeficiency virus serological status was unknown for 2,789 (21.4%) of 13,041 patients who were the source of the blood and body fluid exposures. National surveillance networks for blood and body fluid exposures help to better document their characteristics and risk factors and can enhance prevention at participating medical centers.

  18. Healthcare workers and measles-mumps-rubella (MMR) status: how worried should we be about further outbreaks?

    Science.gov (United States)

    Basu, S; Giri, P; Adisesh, A; McNAUGHT, R

    2014-08-01

    Recently, a number of outbreaks of measles and mumps have occurred within the UK and Europe. Healthcare workers (HCWs) are at risk of contracting and transmitting disease to patients and staff. To examine this risk at the point of entry to healthcare, we assessed the serological results of new HCWs presenting for pre-placement clearance without evidence of measles-mumps-rubella (MMR) immunity between 1 April 2010 and 31 March 2012. Overall rates of serological positivity to MMR across all age groups were 88·2%, 68·8% and 93·9%, respectively. With regard to measles and mumps, there were statistically significant decreases in the percentage of HCWs born after 1980 that had positive serology (P outbreak within this cohort of HCWs appears low.

  19. Web-based training for primary healthcare workers in rural China: a qualitative exploration of stakeholders' perceptions.

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    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.

  20. Low detection of Vibrio cholerae carriage in healthcare workers returning to 12 Latin American countries from Haiti.

    Science.gov (United States)

    Llanes, R; Somarriba, L; Hernández, G; Bardaji, Y; Aguila, A; Mazumder, R N

    2015-04-01

    SUMMARY This investigation was undertaken to characterize the prevalence of intestinal Vibrio cholerae in healthcare workers (HCWs) returning from Haiti due to the ongoing cholera epidemic. Eight hundred and fifty asymptomatic HCWs of the Cuban Medical Brigade, who planned to leave Haiti, were studied by laboratory screening of stool culture for V. cholerae. A very low percentage (0.23%) of toxigenic V. cholerae serogroup O1, serotype Ogawa was found. To the best of our knowledge, this study represents the largest reported screening study for V. cholerae infection in asymptomatic HCWs returning from a cholera-affected country. Cholera transmission to health personnel highlights a possible risk of transmitting cholera during mobilization of the population for emergency response. Aid workers are encouraged to take precautions to reduce their risk for acquiring cholera and special care should be taken by consuming safe water and food and practising regular hand washing.

  1. Pseudomonas spp. ISOLATED FROM THE ORAL CAVITY OF HEALTHCARE WORKERS FROM AN ONCOLOGY HOSPITAL IN MIDWESTERN BRAZIL

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    Ana Beatriz Mori LIMA

    2015-12-01

    Full Text Available This cross-sectional study, performed in an oncology hospital in Goiania, aimed to characterize the prevalence of oral colonization and antimicrobial susceptibility of Pseudomonas spp. isolated from the saliva of healthcare workers. Microorganisms were subjected to biochemical tests, susceptibility profile, and phenotypic detection. Of 76 participants colonized with Gram negative bacilli, 12 (15.8% harbored Pseudomonas spp. Of all isolates, P. aeruginosa (75.0%, P. stutzeri (16.7%, and P. fluorescens (8.3%, were resistant to cefoxitin, and therefore likely to be AmpC producers. The results are clinically relevant and emphasize the importance of surveillance to minimize bacterial dissemination and multiresistance.

  2. Methicillin-resistant Staphylococcus aureus nasal carriage among patients and healthcare workers in a hospital in Kelantan, Malaysia.

    Science.gov (United States)

    Al-Talib, Hassanain; Yean, Chan Yean; Hasan, Habsah; Nik Zuraina, N M N; Ravichandran, Manickam

    2013-01-01

    Staphylococcus aureus nasal carriage is a common source of nosocomial infection and colonization. The aim of the present study was to assess the burden of methicillin-resistant S. aureus nasal carriage, its association with factors of interest including its genetic relationships. The prevalence of S. aureus nasal carriage was found to be 28.7%. This study showed that patients with a history of previous antibiotic intake, nasogastric tube, and longer hospitalization had a significantly high risk of being MRSA nasal carriers. The genetic relationship of all 34 nasal MRSA isolates revealed four major clusters of isolates, and there was a relationship between MRSA isolated from inpatients and healthcare workers.

  3. 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...

  4. Healthcare organization-education partnerships and career ladder programs for health care workers.

    Science.gov (United States)

    Dill, Janette S; Chuang, Emmeline; Morgan, Jennifer C

    2014-12-01

    Increasing concerns about quality of care and workforce shortages have motivated health care organizations and educational institutions to partner to create career ladders for frontline health care workers. Career ladders reward workers for gains in skills and knowledge and may reduce the costs associated with turnover, improve patient care, and/or address projected shortages of certain nursing and allied health professions. This study examines partnerships between health care and educational organizations in the United States during the design and implementation of career ladder training programs for low-skill workers in health care settings, referred to as frontline health care workers. Mixed methods data from 291 frontline health care workers and 347 key informants (e.g., administrators, instructors, managers) collected between 2007 and 2010 were analyzed using both regression and fuzzy-set qualitative comparative analysis (QCA). Results suggest that different combinations of partner characteristics, including having an education leader, employer leader, frontline management support, partnership history, community need, and educational policies, were necessary for high worker career self-efficacy and program satisfaction. Whether a worker received a wage increase, however, was primarily dependent on leadership within the health care organization, including having an employer leader and employer implementation policies. Findings suggest that strong partnerships between health care and educational organizations can contribute to the successful implementation of career ladder programs, but workers' ability to earn monetary rewards for program participation depends on the strength of leadership support within the health care organization.

  5. Seasonal influenza risk in hospital healthcare workers is more strongly associated with household than occupational exposures: results from a prospective cohort study in Berlin, Germany, 2006/07.

    Science.gov (United States)

    Williams, Chris J; Schweiger, Brunhilde; Diner, Genia; Gerlach, Frank; Haaman, Frank; Krause, Gérard; Nienhaus, Albert; Buchholz, Udo

    2010-01-12

    Influenza immunisation for healthcare workers is encouraged to protect their often vulnerable patients but also due to a perceived higher risk for influenza. We aimed to compare the risk of influenza infection in healthcare workers in acute hospital care with that in non-healthcare workers over the same season. We conducted a prospective, multicentre cohort study during the 2006/07 influenza season in Berlin, Germany. Recruited participants gave serum samples before and after the season, and completed questionnaires to determine their relevant exposures and possible confounding factors. The main outcome measure was serologically confirmed influenza infection (SCII), defined as a fourfold or greater rise in haemagglutination inhibition antibody titres to a circulating strain of influenza (with post-season titre at least 1:40).Weekly mobile phone text messages were used to prompt participants to report respiratory illnesses during the influenza season. A logistic regression model was used to assess the influence of potential risk factors. We recruited 250 hospital healthcare workers (mean age 35.7 years) and 486 non-healthcare workers (mean age 39.2 years) from administrative centres, blood donors and colleges.Overall SCII attack rate was 10.6%. Being a healthcare worker was not a risk factor for SCII (relative risk 1.1, p = 0.70). The final multivariate model had three significant factors: living with children (odds ratio [OR] 3.7, p = 0.005), immunization (OR 0.50, p = 0.02), and--among persons living in households without children--ownership of a car (OR 3.0, p = 0.02). Living with three or more children (OR 13.8, p risk than living with one or two children (OR 5.3, p = 0.02). 30% of participants with SCII reported no respiratory illness. Healthcare workers were at slightly higher risk of reporting any respiratory infection than controls (adjusted OR 1.3, p = 0.04, n = 850). Our results suggest that healthcare workers in hospitals do not have a higher risk of

  6. 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.

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    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.

  7. Does self-efficacy mediate the relationship between transformational leadership behaviours and healthcare workers' sleep quality? A longitudinal study.

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    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.

  8. [Antibiotic ointments and methicillin-resistant Staphylococcus aureus with a reservoir in a healthcare worker in a tertiary hospital].

    Science.gov (United States)

    Molina-Cabrillana, Jesús; Del Rosario-Quintana, Cristóbal; Tosco-Núñez, Tomas; Dorta-Hung, Elena; Quori, Anna; Martín-Sánchez, Antonio M

    2013-10-01

    Methicillin-resistant Staphylococcus aureus (MRSA) has become an important hospital-acquired pathogen, with transfer of the organism from a carrier or infected patient to uninfected patients by the hands or clothing of staff as the main mode of transmission. Investigation of a cluster of new cases of MRSA resistant to mupirocin and fusidic acid, using epidemiological and microbiological resources. From September 2010 to February 2012, sixteen patients had at least one culture positive for MRSA resistant to mupirocin and fusidic acid. Some not apparently related cases and outbreaks appeared. By analysing cultures taken from patients and staff using pulsed-field gel electrophoresis, it was demonstrated that most likely this situation was started by an auxiliary nurse who was a carrier of the MRSA. Healthcare worker decontamination using oral antibiotic therapy was unsuccessful. Eventually, the situation was controlled by placing the carrier in a different job, with no further cases to date (September, 2012). This report illustrates the risk of nosocomial transmission linked to care delivered by healthcare workers. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  9. Methicilin Resistant Staphylococcus aureus Carriage amongst Healthcare Workers of the Critical Care Units in a Nigerian Hospital

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    A. Fadeyi

    2010-01-01

    Full Text Available Problem statement: Methicilin Resistant Staphylococcus Aureus (MRSA Nosocomial Infection (NI outbreaks and prevalence among various populations are well reported in literature particularly for developed countries. NI due to MRSA is a known cause of increased hospital stay, cost, morbidity and mortality especially among the critically ill. There is paucity of information on MRSA in developing nations including the carriage by critical healthcare givers who are potential transmitters. In most hospital in developing countries like Nigeria, there is neither surveillance system or control policy for MRSA. Approach: We screened healthcare workers in the critical care units of the University of Ilorin Teaching Hospital (UITH, Ilorin, Nigeria for MRSA and determined vancomycin susceptibility of the isolates. Swabs of both anterior nares and web spaces of the hands were taken, transported and incubated in Tween 80 at 35°C overnight aerobically before inoculation onto Mannitol Salt Agar (MSA. Inoculated MSA were incubated aerobically at 35°C for 18-24 h. Staphylococcus aureus was identified as Gram positive cocci with positive catalase, coagulase and DNAse test. MRSA were identified by combined oxacillin and cefoxitin discs diffusion method. Sensitivity to vancomycin was by vancomycin discs diffusion and vancomycin agar screen plating. Results: Of the 198 healthcare workers screened, 104 had MRSA either in the nose, hand or both giving a carriage rate of 52.5%. Nasal carriage (38.9% was higher than hand (25.3%. Doctors (22.7% and Nurses (16.7% were the predominant carriers. MRSA isolates were resistant to commonly available antibiotics. Only 1 (1.3% of the nasal isolates was vancomycin resistant. Conclusion: MRSA carriage among healthcare workers in the critical care units of the Nigerian hospital is high with doctors and nurses being the major carriers. The MRSA isolates were multi-drug resistant which may lead to increased morbidity and mortality if

  10. Effects of Green Tea Catechins and Theanine on Preventing Influenza Infection among Healthcare Workers: A Randomized Controlled Trial

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    Niino Hitoshi

    2011-02-01

    Full Text Available Abstract Background Experimental studies have revealed that green tea catechins and theanine prevent influenza infection, while the clinical evidence has been inconclusive. This study was conducted to determine whether taking green tea catechins and theanine can clinically prevent influenza infection. Methods Design, Setting, and Participants: A randomized, double-blind, placebo-controlled trial of 200 healthcare workers conducted for 5 months from November 9, 2009 to April 8, 2010 in three healthcare facilities for the elderly in Higashimurayama, Japan. Interventions: The catechin/theanine group received capsules including green tea catechins (378 mg/day and theanine (210 mg/day. The control group received placebo. Main Outcome Measures: The primary outcome was the incidence of clinically defined influenza infection. Secondary outcomes were (1 laboratory-confirmed influenza with viral antigen measured by immunochromatographic assay and (2 the time for which the patient was free from clinically defined influenza infection, i.e., the period between the start of intervention and the first diagnosis of influenza infection, based on clinically defined influenza infection. Results Eligible healthcare workers (n = 197 were enrolled and randomly assigned to an intervention; 98 were allocated to receive catechin/theanine capsules and 99 to placebo. The incidence of clinically defined influenza infection was significantly lower in the catechin/theanine group (4 participants; 4.1% compared with the placebo group (13 participants; 13.1% (adjusted OR, 0.25; 95% CI, 0.07 to 0.76, P = 0.022. The incidence of laboratory-confirmed influenza infection was also lower in the catechin/theanine group (1 participant; 1.0% than in the placebo group (5 participants; 5.1%, but this difference was not significant (adjusted OR, 0.17; 95% CI, 0.01 to 1.10; P = 0.112. The time for which the patient was free from clinically defined influenza infection was significantly

  11. Efficacy of a new educational tool to improve Handrubbing technique amongst healthcare workers: a controlled, before-after study.

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    Andrew J Stewardson

    Full Text Available INTRODUCTION: Hand hygiene is a key component of infection control in healthcare. WHO recommends that healthcare workers perform six specific poses during each hand hygiene action. SureWash (Glanta Ltd, Dublin, Ireland is a novel device that uses video-measurement technology and immediate feedback to teach this technique. We assessed the impact of self-directed SureWash use on healthcare worker hand hygiene technique and evaluated the device's diagnostic capacity. METHODS: A controlled before-after study: subjects in Group A were exposed to the SureWash for four weeks followed by Group B for 12 weeks. Each subject's hand hygiene technique was assessed by blinded observers at baseline (T0 and following intervention periods (T1 and T2. Primary outcome was performance of a complete hand hygiene action, requiring all six poses during an action lasting ≥20 seconds. The number of poses per hand hygiene action (maximum 6 was assessed in a post-hoc analysis. SureWash's diagnostic capacity compared to human observers was assessed using ROC curve analysis. RESULTS: Thirty-four and 29 healthcare workers were recruited to groups A and B, respectively. No participants performed a complete action at baseline. At T1, one Group A participant and no Group B participants performed a complete action. At baseline, the median number of poses performed per action was 2.0 and 1.0 in Groups A and B, respectively (p = 0.12. At T1, the number of poses per action was greater in Group A (post-intervention than Group B (control: median 3.8 and 2.0, respectively (p<0.001. In Group A, the number of poses performed twelve weeks post-intervention (median 3.0 remained higher than baseline (p<0.001. The area under the ROC curves for the 6 poses ranged from 0.59 to 0.88. DISCUSSION: While no impact on complete actions was demonstrated, SureWash significantly increased the number of poses per hand hygiene action and demonstrated good diagnostic capacity.

  12. A Comparison of Two-Step Tuberculin Skin Test between Health-Care Workers and Nonhospital Employees

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    Iraj Nikokar

    2010-09-01

    Full Text Available Background: The tuberculin test is widely used to identify tuberculosisinfection. Some individuals infected with Mycobacteriumtuberculosis may have an initial negative skin test reactionto tuberculin. The two step purified protein derivative skin testcan decrease misinterpretation of tuberculin test .This study wasaimed at comparing the two- step tuberculin skin test and boosterphenomenon in health care workers and non hospital employees.Methods: One hundred and eighty five health service employeesfrom Razi University Hospital and 181 non hospitalemployees were subjected to an initial tuberculin skin test.Those who were negative on the first test underwent a secondone 2 weeks later. The reactions to the tests were measured 72hours later. Tests with an induration of ≥ 10 mm was consideredpositive. Moreover, second tests with an induration of atleast 6 mm increase relative to the relevant first tests wereconsidered positive.Results: Compared to non hospital employees (n=79, 43.6%, asignificantly higher number of health care workers (n=113,61.1% were positive on the first tuberculin test. 18.5 % of healthcare workers and 31.5% of non hospital employees demonstrateda boosted reaction after the second tuberculin test. The occurrenceof boosted reaction was significantly associated with ageboth groups. There was no association between the presence ofBCG scars and the occurrence of boosted reaction.Conclusion: the present study shows that the prevalence of TBwas higher among health care worker than non hospital employees.Moreover, it demonstrated that non hospital employeeshad a higher age-associated booster reaction to the second tuberculinskin test than health care workers. Therefore, to avoidmissing false negative cases, it would be necessary to do a secondtuberculin test for subjects with a negative reaction to theinitial test, especially in subjects older than 40 years.

  13. Work engagement and occupational stress in nurses and other healthcare workers: the role of organisational and personal factors.

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    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.

  14. Operationalization of the Ghanaian Patients' Charter in a Peri-urban Public Hospital: Voices of Healthcare Workers and Patients.

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    Yarney, Lily; Buabeng, Thomas; Baidoo, Diana; Bawole, Justice Nyigmah

    2016-04-23

    Health is a basic human right necessary for the exercise of other human rights. Every human being is, therefore, entitled to the highest possible standard of health necessary to living a life of dignity. Establishment of patients' Charter is a step towards protecting the rights and responsibilities of patients, but violation of patients' rights is common in healthcare institutions, especially in the developing world. This study which was conducted between May 2013 and May 2014, assessed the operationalization of Ghana's Patients Charter in a peri-urban public hospital. Qualitative data collection methods were used to collect data from 25 healthcare workers and patients who were purposively selected. The interview data were analyzed manually, using the principles of systematic text condensation. The findings indicate that the healthcare staff of the Polyclinic are aware of the existence of the patients' Charter and also know some of its contents. Patients have no knowledge of the existence or the contents of the Charter. Availability of the Charter, community sensitization, monitoring and orientation of staff are factors that promote the operationalization of the Charter, while institutional implementation procedures such as lack of complaint procedures and low knowledge among patients militate against operationalization of the Charter. Public health facilities should ensure that their patients are well-informed about their rights and responsibilities to facilitate effective implementation of the Charter. Also, patients' rights and responsibilities can be dramatized and broadcasted on television and radio in major Ghanaian languages to enhance awareness of Ghanaians on the Charter.

  15. Methicillin-resistant Staphylococcus aureus nasal cariage among hospitalized patients and healthcare workers in the Clinical center of Serbia

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    Ćirković Ivana

    2014-01-01

    Full Text Available The aim of the present study was to provide the first comprehensive analysis of methicillin-resistant Staphylococcus aureus (MRSA carriage among patients and healthcare workers (HCWs in the largest healthcare facility in Serbia. Specimens from anterior nares obtained from 195 hospitalized patients and 105 HCWs were inoculated after broth enrichment onto chromogenic MRSA-ID medium. In total, 21 of 300 specimens yielded MRSA. Among hospitalized patients, 7.7% were colonized with MRSA, and 5.7% HCWs were colonized with MRSA. Five out of 21 (23.8% tested MRSA strains were classified as community-associated MRSA (CA-MRSA, and four of them were isolated from HCWs. The remaining 16 MRSA strains had characteristics of healthcare-associated MRSA (HA-MRSA, and two of them were isolated from HCWs. The HA-MRSA strains isolated from HCWs were indistinguishable from HA-MRSA of the same cluster isolated from patients. This finding reveals the circulation of HA-MRSA strains between patients and HCWs in the Clinical Center of Serbia. [Projekat Ministarstva nauke Republike Srbije, br. ON 175039

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

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    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.

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

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    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.

  18. Seasonal influenza risk in hospital healthcare workers is more strongly associated with household than occupational exposures: results from a prospective cohort study in Berlin, Germany, 2006/07

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    Haaman Frank

    2010-01-01

    Full Text Available Abstract Background Influenza immunisation for healthcare workers is encouraged to protect their often vulnerable patients but also due to a perceived higher risk for influenza. We aimed to compare the risk of influenza infection in healthcare workers in acute hospital care with that in non-healthcare workers over the same season. Methods We conducted a prospective, multicentre cohort study during the 2006/07 influenza season in Berlin, Germany. Recruited participants gave serum samples before and after the season, and completed questionnaires to determine their relevant exposures and possible confounding factors. The main outcome measure was serologically confirmed influenza infection (SCII, defined as a fourfold or greater rise in haemagglutination inhibition antibody titres to a circulating strain of influenza (with post-season titre at least 1:40. Weekly mobile phone text messages were used to prompt participants to report respiratory illnesses during the influenza season. A logistic regression model was used to assess the influence of potential risk factors. Results We recruited 250 hospital healthcare workers (mean age 35.7 years and 486 non-healthcare workers (mean age 39.2 years from administrative centres, blood donors and colleges. Overall SCII attack rate was 10.6%. Being a healthcare worker was not a risk factor for SCII (relative risk 1.1, p = 0.70. The final multivariate model had three significant factors: living with children (odds ratio [OR] 3.7, p = 0.005, immunization (OR 0.50, p = 0.02, and - among persons living in households without children - ownership of a car (OR 3.0, p = 0.02. Living with three or more children (OR 13.8, p Conclusions Our results suggest that healthcare workers in hospitals do not have a higher risk of influenza than non-healthcare workers, although their risk of any respiratory infection is slightly raised. Household contacts seem to be more important than exposure to patients. Car ownership is a

  19. Mobile health treatment support intervention for HIV and tuberculosis in Mozambique: Perspectives of patients and healthcare workers.

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    Nhavoto, José António; Grönlund, Åke; Klein, Gunnar O

    2017-01-01

    Studies have been conducted in developing countries using SMS to communicate with patients to reduce the number of missed appointments and improve retention in treatment, however; very few have been scaled up. One possible reason for this could be that patients or staff are dissatisfied with the method in some way. This paper reports a study of patients' and healthcare workers' (HCW) views on an mHealth intervention aiming to support retention in antiretroviral therapy (ART) and tuberculosis (TB) treatment in Mozambique. The study was conducted at five healthcare centres in Mozambique. Automated SMS health promotions and reminders were sent to patients in a RCT. A total of 141 patients and 40 HCWs were interviewed. Respondents rated usefulness, perceived benefits, ease of use, satisfaction, and risks of the SMS system using a Likert scale questionnaire. A semi-structured interview guide was followed. Interviews were transcribed and thematic analysis was conducted. Both patients and HCW found the SMS system useful and reliable. Most highly rated positive effects were reducing the number of failures to collect medication and avoiding missing appointments. Patients' confidence in the system was high. Most perceived the system to improve communication between health-care provider and patient and assist in education and motivation. The automatic recognition of questions from patients and the provision of appropriate answers (a unique feature of this system) was especially appreciated. A majority would recommend the system to other patients or healthcare centres. Risks also were mentioned, mostly by HCW, of unintentional disclosure of health status in cases where patients use shared phones. The results suggest that SMS technology for HIV and TB should be used to transmit reminders for appointments, medications, motivational texts, and health education to increase retention in care. Measures must be taken to reduce risks of privacy intrusion, but these are not a main

  20. 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.

  1. Occupational Exposure to Blood and Other Body Fluids Among Healthcare Workers in Three Teaching Hospitals, Southeast Iran

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    Tabatabaei

    2016-06-01

    Full Text Available Background Healthcare workers (HCWs regularly face the risk of exposure to sharp injuries and splashes as an occupational hazard, which presents a major risk for acquiring blood-borne infectious agents. Objectives This study aimed to determine the occurrence of needlestick injuries (NSIs and other high-risk occupational exposures to blood and body fluids (BBFs among HCWs in three teaching hospitals affiliated with the Zahedan University of Medical Sciences. Patients and Methods A cross-sectional study was carried out from March 2013 to December 2014. Information on self-reported incidents, circumstances surrounding occupational exposure, and post-exposure management were collected from an ongoing surveillance system. Descriptive statistics and chi square tests were used for data analysis. Results A total of 236 incidents of occupational exposure were registered during the study period. Nurses (82, 34.7% were most frequently exposed to BBFs, followed by physicians (57, 24.2%. Two hundred and nineteen (92.8% of the personnel sustained NSIs, and 17 (7.2% had splashes to mucus membranes. The incidents were most frequently reported from the internal medicine ward (19.1% followed by the operating theater (17.1%. Subjects with splashes to mucus membranes were more likely to postpone seeking medical advice following exposure, as compared with needlestick cases (23.5% versus 5%, P < 0.016. A significantly greater proportion of pediatric and emergency department staff were found to delay post-exposure measures (P < 0.040. Conclusions The relatively high prevalence of percutaneous injuries and splashes in this study emphasized the importance of improved prevention strategies, better hospital surveillance for occupational exposure, and enhanced training of healthcare workers.

  2. Improving hand hygiene compliance among healthcare workers: an intervention study in a Hospital in Guizhou Province, China

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    Xia Mu

    Full Text Available Abstract Objective Hand hygiene (HH is a critical component for controlling hospital-acquired infection (HAI. The present study was designed to develop an intervention approach to improve compliance with HH among healthcare workers in a hospital setting. Methods The HH intervention study was conducted in Guizhou Provincial People's Hospital, Guiyang, China and organized by its Department of HAI Management. It was an observational, prospective, quasiexperimental (before-after intervention study. The study was divided into two phases: the baseline phase and the intervention phase. The investigative team included clinical monitoring staff and infection control practitioners who received a series of instructions on HH compliance, monitoring skills, and measurement of the use of HH products. Results Based on 27,852 observations in a 17-month period, the rate of compliance with HH improved from 37.78% at baseline to 75.90% after intervention. Significant improvement in compliance and an increase in consumption of HH products was observed after intervention. The per patient-day consumption of alcohol-based hand rub products and handwash agents increased by 4.75 mL and 4.55 mL, respectively. The consumption of paper towels increased 3.41 sheets per patient-day. During the same period, the prevalence rate of HAI decreased 0.83%. Conclusions This study demonstrates that a significant improvement in compliance with HH can be achieved through a systemic, multidimensional intervention approach involving all categories of healthcare workers in a hospital setting, which may result in a decrease of the HAI rate.

  3. A survey of UK healthcare workers' attitudes on volunteering to help with the Ebola outbreak in West Africa.

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    Lance Turtle

    Full Text Available To understand the barriers and enablers for UK healthcare workers who are considering going to work in the current Ebola outbreak in West Africa, but have not yet volunteered.After focus group discussions, and a pilot questionnaire, an anonymous survey was conducted using SurveyMonkey to determine whether people had considered going to West Africa, what factors might make them more or less likely to volunteer, and whether any of these were modifiable factors.The survey was publicised among doctors, nurses, laboratory staff and allied health professionals. 3109 people answered the survey, of whom 472 (15% were considering going to work in the epidemic but had not yet volunteered. 1791 (57.6% had not considered going, 704 (22.6% had considered going but decided not to, 53 (1.7% had volunteered to go and 14 (0.45% had already been and worked in the epidemic.For those considering going to West Africa, the most important factor preventing them from volunteering was a lack of information to help them decide; fear of getting Ebola and partners' concerns came next. Uncertainty about their potential role, current work commitments and inability to get agreement from their employer were also important barriers, whereas clarity over training would be an important enabler. In contrast, for those who were not considering going, or who had decided against going, family considerations and partner concerns were the most important factors.More UK healthcare workers would volunteer to help tackle Ebola in West Africa if there was better information available, including clarity about roles, cover arrangements, and training. This could be achieved with a well-publicised high quality portal of reliable information.

  4. 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 (T1) and after (T2, T3) 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 T1 to T2. No changes were detected in burnout, engagement, or job satisfaction over time. Moderated regression analyses (at T3) 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.

  5. Interprofessional Teamwork and Collaboration Between Community Health Workers and Healthcare Teams

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    Franklin, Catherine M.; Jean M. Bernhardt; Ruth Palan Lopez; Ellen R. Long-Middleton; Sheila Davis

    2015-01-01

    Objectives: Community Health Workers (CHWs) serve as a means of improving outcomes for underserved populations. However, their relationship within health care teams is not well studied. The purpose of this integrative review was to examine published research reports that demonstrated positive health outcomes as a result of CHW intervention to identify interprofessional teamwork and collaboration between CHWs and health care teams. Methods: A total of 47 studies spanning 33 years were reviewed...

  6. Interprofessional Teamwork and Collaboration Between Community Health Workers and Healthcare Teams

    OpenAIRE

    Catherine M. Franklin; Jean M. Bernhardt; Ruth Palan Lopez; Ellen R. Long-Middleton; Sheila Davis

    2015-01-01

    Objectives: Community Health Workers (CHWs) serve as a means of improving outcomes for underserved populations. However, their relationship within health care teams is not well studied. The purpose of this integrative review was to examine published research reports that demonstrated positive health outcomes as a result of CHW intervention to identify interprofessional teamwork and collaboration between CHWs and health care teams. Methods: A total of 47 studies spanning 33 years were reviewed...

  7. FluMob: Enabling Surveillance of Acute Respiratory Infections in Health-care Workers via Mobile Phones

    Science.gov (United States)

    Lwin, May Oo; Yung, Chee Fu; Yap, Peiling; Jayasundar, Karthikayen; Sheldenkar, Anita; Subasinghe, Kosala; Foo, Schubert; Jayasinghe, Udeepa Gayantha; Xu, Huarong; Chai, Siaw Ching; Kurlye, Ashwin; Chen, Jie; Ang, Brenda Sze Peng

    2017-01-01

    Singapore is a hotspot for emerging infectious diseases and faces a constant risk of pandemic outbreaks as a major travel and health hub for Southeast Asia. With an increasing penetration of smart phone usage in this region, Singapore’s pandemic preparedness framework can be strengthened by applying a mobile-based approach to health surveillance and control, and improving upon existing ideas by addressing gaps, such as a lack of health communication. FluMob is a digitally integrated syndromic surveillance system designed to assist health authorities in obtaining real-time epidemiological and surveillance data from health-care workers (HCWs) within Singapore, by allowing them to report influenza incidence using smartphones. The system, integrating a fully responsive web-based interface and a mobile interface, is made available to HCW using various types of mobile devices and web browsers. Real-time data generated from FluMob will be complementary to current health-care- and laboratory-based systems. This paper describes the development of FluMob, as well as challenges faced in the creation of the system. PMID:28367433

  8. FluMob: Enabling Surveillance of Acute Respiratory Infections in Health-care Workers via Mobile Phones.

    Science.gov (United States)

    Lwin, May Oo; Yung, Chee Fu; Yap, Peiling; Jayasundar, Karthikayen; Sheldenkar, Anita; Subasinghe, Kosala; Foo, Schubert; Jayasinghe, Udeepa Gayantha; Xu, Huarong; Chai, Siaw Ching; Kurlye, Ashwin; Chen, Jie; Ang, Brenda Sze Peng

    2017-01-01

    Singapore is a hotspot for emerging infectious diseases and faces a constant risk of pandemic outbreaks as a major travel and health hub for Southeast Asia. With an increasing penetration of smart phone usage in this region, Singapore's pandemic preparedness framework can be strengthened by applying a mobile-based approach to health surveillance and control, and improving upon existing ideas by addressing gaps, such as a lack of health communication. FluMob is a digitally integrated syndromic surveillance system designed to assist health authorities in obtaining real-time epidemiological and surveillance data from health-care workers (HCWs) within Singapore, by allowing them to report influenza incidence using smartphones. The system, integrating a fully responsive web-based interface and a mobile interface, is made available to HCW using various types of mobile devices and web browsers. Real-time data generated from FluMob will be complementary to current health-care- and laboratory-based systems. This paper describes the development of FluMob, as well as challenges faced in the creation of the system.

  9. Awareness of human papilloma virus, cervical cancer and HPV vaccine in healthcare workers and students of medical and nursing schools

    Directory of Open Access Journals (Sweden)

    Nilgün Güdücü

    2012-09-01

    Full Text Available Objectives: Establishment of the knowledge and theneed to make conscious in medicine students, nursingstudents and nurses due to the effective role of updatingconscious of the health workers, we aimed to assessthe knowledge of nurses and students of İstanbul BilimUniversity and affiliated hospitals about HPV and cervicalcancer.Materials and methods: Because healthcare personnelilluminate and influences the public, the survey wasconducted to medicine students of the first three years,nursing students and nurses. The reason of choosing thefirst three years of medicine students is with the beginingof the gynecology courses at the 4th year of education inmedical faculty, learning takes the place of awareness.Totally 743 participants were asked to survey but 603subjects responded (81.2% then the surveys that wasnot asked for the identity information were taken into considerationResults: Nurses and students of nursing had betterknowledge about smear test when compared to studentsof medicine (first 3 years and other healthcare personnel.Only 52% accepted to get a daughter vaccinated.The main reasons for vaccine rejection were the concernsabout vaccine safety (41%, cost of the vaccine (10%and sexual promiscuity (5% after vaccination. Religiousaspects were not considered as an obstacle.Conclusions: The awareness of HPV, cervical cancerand HPV vaccination should be increased. J Clin Exp Invest2012; 3(3: 318-325Key words: HPV, HPV vaccine, cervical cancer, knowledge

  10. Infectious diseases in healthcare workers – an analysis of the standardised data set of a German compensation board

    Directory of Open Access Journals (Sweden)

    Nienhaus Albert

    2012-07-01

    Full Text Available Abstract Introduction Healthcare workers (HCW are exposed to infectious agents. Disease surveillance is therefore needed in order to foster prevention. Methods The data of the compensation board that covers HCWs of non-governmental healthcare providers in Germany was analysed for a five-year period. For hepatitis B virus (HBV and hepatitis C virus (HCV infections, the period analysed was extended to the last 15 years. The annual rate of occupational infectious diseases (OIDs per 100,000 employees was calculated. For needlestick injuries (NSI a rate per 1,000 employees was calculated. Results Within the five years from 2005 to 2009 a total of 384 HCV infections were recognised as OIDs (1.5/100,000 employees. Active TB was the second most frequent cause of an OID. While the numbers of HBV and HCV infections decreased, the numbers for active TB did not follow a clear pattern. Needlestick injuries (NSIs were reported especially often at hospitals (29.9/1,000 versus 7.4/1,000 employees for all other HCWs. Conclusion Although they are declining, HCV infections remain frequent in HCWs, as do NSIs. Whether the reinforcement of the recommendations for the use of safety devices in Germany will prevent NSIs and therefore HCV infections should be closely observed.

  11. Ethics in human resource management: potential for burnout among healthcare workers in ART and community care centres.

    Science.gov (United States)

    Mala, Ramanathan; Santhosh, Kumar M; Anshul, Avijit; Aarthy, R

    2010-01-01

    This paper examines ethical dilemmas in providing care for people with HIV/AIDS. Healthcare providers in this sector are overworked, particularly in the high prevalence states. They are faced with the dual burden of the physical and the emotional risks of providing this care. The emotional risks result from their inability to control their work environment, while having to deal with the social and cultural dimensions of patients' experiences. The physical risk is addressed to some extent by post exposure prophylaxis. But the emotional risk is largely left to the individual and there is little by way of institutional responsibility for minimising this. The guidelines for training workers in care and support programmes do not include any detailed institutional mechanisms for reducing workplace stress. This aspect of the programme needs to be examined for its ethical justification. The omission of institutional mechanisms to reduce the emotional risks experienced by healthcare providers in the HIV/AIDS sector could be a function of lack of coordination across different stakeholders in programme development. This can be addressed in further formulations of the programme. Whatever the reasons may be for overlooking these needs, the ethics of this choice need to be carefully reviewed.

  12. 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.

  13. A tribute to Sheik Humarr Khan and all the healthcare workers in West Africa who have sacrificed in the fight against Ebola virus disease: Mae we hush.

    Science.gov (United States)

    Bausch, Daniel G; Bangura, James; Garry, Robert F; Goba, Augustine; Grant, Donald S; Jacquerioz, Frederique A; McLellan, Susan L; Jalloh, Simbirie; Moses, Lina M; Schieffelin, John S

    2014-11-01

    The Kenema Government Hospital Lassa Fever Ward in Sierra Leone, directed since 2005 by Dr. Sheikh Humarr Khan, is the only medical unit in the world devoted exclusively to patient care and research of a viral hemorrhagic fever. When Ebola virus disease unexpectedly appeared in West Africa in late 2013 and eventually spread to Kenema, Khan and his fellow healthcare workers remained at their posts, providing care to patients with this devastating illness. Khan and the chief nurse, Mbalu Fonnie, became infected and died at the end of July, a fate that they have sadly shared with more than ten other healthcare workers in Kenema and hundreds across the region. This article pays tribute to Sheik Humarr Khan, Mbalu Fonnie and all the healthcare workers who have acquired Ebola virus disease while fighting the epidemic in West Africa. Besides the emotional losses, the death of so many skilled and experienced healthcare workers will severely impair health care and research in affected regions, which can only be restored through dedicated, long-term programs.

  14. What are the barriers to access to mental healthcare and the primary needs of asylum seekers? A survey of mental health caregivers and primary care workers.

    Science.gov (United States)

    Bartolomei, Javier; Baeriswyl-Cottin, Rachel; Framorando, David; Kasina, Filip; Premand, Natacha; Eytan, Ariel; Khazaal, Yasser

    2016-09-29

    We aimed to assess the opinion of primary care workers, social workers, translators and mental health caregivers who work with asylum seekers about the latter's unmet needs and barriers to access to mental healthcare. We used a Likert scale to assess the opinion of 135 primary care workers (general practitioners, nurses, social workers and translators) and mental health caregivers about the proportion of asylum seekers with psychiatric disorders, their priority needs and their main barriers to mental health services. Insufficient access to adequate financial resources, poor housing and security conditions, access to employment, professional training and legal aid were considered as priority needs, as were access to dental and mental healthcare. The main barriers to access to mental healthcare for asylum seekers included a negative representation of psychiatry, fear of being stigmatized by their own community and poor information about existing psychiatric services. We found a good correlation between the needs reported by healthcare providers and those expressed by the asylum-seeking population in different studies. We discuss the need for greater mobility and accessibility to psychiatric services among this population.

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

    NARCIS (Netherlands)

    Meer, E.W. van der; Boot, C.R.L.; Twisk, J.W.R.; Coenraads, P.J.; Jungbauer, F.H.; Gulden, J.W.J. van der; Anema, J.R.

    2014-01-01

    OBJECTIVES: 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. METHODS: The Hands4U study is a randomised controlled trial. A total of

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

    NARCIS (Netherlands)

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

    Objectives 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. Methods The Hands4U study is a randomised controlled trial. A total of 48

  17. 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...

  18. Views of policymakers, healthcare workers and NGOs on HIV pre-exposure prophylaxis (PrEP): a multinational qualitative study.

    Science.gov (United States)

    Wheelock, Ana; Eisingerich, Andreas B; Gomez, Gabriela B; Gray, Emily; Dybul, Mark R; Piot, Peter

    2012-01-01

    To examine policymakers and providers' views on pre-exposure prophylaxis (PrEP) and their willingness to support its introduction, to inform policy and practice in this emerging field. Semistructured qualitative interview study. Peru, Ukraine, India, Kenya, Uganda, Botswana and South Africa. 35 policymakers, 35 healthcare workers and 21 non-governmental organisation representatives involved in HIV prevention. Six themes emerged from the data: (1) perceived HIV prevention landscape: prevention initiatives needed to be improved and expanded; (2) PrEP awareness: 50 of 91 participants had heard of PrEP; (3) benefits of PrEP: one component of the combination prevention arsenal that could help prioritise HIV prevention, empower key populations and result in economic gains; (4) challenges of PrEP: regimen complexity, cost and cost-effectiveness, risk compensation, efficacy and effectiveness, stigmatisation and criminalisation, information and training and healthcare system capacity; (5) programmatic considerations: user eligibility, communication strategy, cost, distribution, medication and HIV testing compliance and (6) early versus late implementation: participants were divided as to whether they would support an early introduction of PrEP in their country or would prefer to wait until it has been successfully implemented in other countries, with around half of those we spoke to supporting each option. Very few said they would not support PrEP at all. Despite the multiple challenges identified, there was general willingness to support the introduction of PrEP. Yet, strengthening existing HIV prevention efforts was also deemed necessary. Our results suggest that an effective PrEP programme would be delivered in healthcare facilities and involve non-governmental organisations and the community and consider the needs of mobile populations. Comprehensive information packages and training for users and providers would be critical. The cost of PrEP would be affordable and

  19. Operationalization of the Ghanaian Patients’ Charter in a Peri-urban Public Hospital: Voices of Healthcare Workers and Patients

    Directory of Open Access Journals (Sweden)

    Lily Yarney

    2016-09-01

    Full Text Available Background Health is a basic human right necessary for the exercise of other human rights. Every human being is, therefore, entitled to the highest possible standard of health necessary to living a life of dignity. Establishment of patients’ Charter is a step towards protecting the rights and responsibilities of patients, but violation of patients’ rights is common in healthcare institutions, especially in the developing world. This study which was conducted between May 2013 and May 2014, assessed the operationalization of Ghana’s Patients Charter in a peri-urban public hospital. Methods Qualitative data collection methods were used to collect data from 25 healthcare workers and patients who were purposively selected. The interview data were analyzed manually, using the principles of systematic text condensation. Results The findings indicate that the healthcare staff of the Polyclinic are aware of the existence of the patients’ Charter and also know some of its contents. Patients have no knowledge of the existence or the contents of the Charter. Availability of the Charter, community sensitization, monitoring and orientation of staff are factors that promote the operationalization of the Charter, while institutional implementation procedures such as lack of complaint procedures and low knowledge among patients militate against operationalization of the Charter. Conclusion Public health facilities should ensure that their patients are well-informed about their rights and responsibilities to facilitate effective implementation of the Charter. Also, patients’ rights and responsibilities can be dramatized and broadcasted on television and radio in major Ghanaian languages to enhance awareness of Ghanaians on the Charter.

  20. Knowledge and attitudes toward HIV, hepatitis B virus, and hepatitis C virus infection among health-care workers in Malawi

    Directory of Open Access Journals (Sweden)

    Jasintha Mtengezo

    2016-01-01

    Full Text Available Objective: The highest prevalence of HIV infection occurs in Sub-Saharan Africa and hepatitis B virus (HBV, and hepatitis C virus (HCV prevalence are the second highest in Sub-Saharan Africa including Malawi. Health-care workers (HCWs play an important role in the prevention of, response to, and management of these infectious diseases. There is, however, no published research about the level of knowledge and attitudes toward HIV, HBV, and HCV infection among Malawian HCWs. The purpose of this study was to explore and determine the knowledge of and attitudes toward HIV, HBV, and HCV among a targeted population of Malawian HCWs. Methods: A cross-sectional community-based participatory research with 194 HCWs was completed employing health survey method. The project was a collaborative effort between nursing faculties in the USA and Malawian. A one-way analysis of variance (ANOVA with the Bonferroni adjustment for multiple comparisons was used to assess the differences in knowledge and attitude among three subgroups of HCWs. Results: Of 194 of Malawian HCWs surveyed, 41% were support staff, 37% were nursing students, and 22% were health-care professionals. Both health-care professionals and support staff had high knowledge scores related to HIV/AIDS, and their attitudes were mainly positive. However, a series of one-way ANOVAs revealed significant differences in knowledge and attitude toward HIV/AIDs, HBV, and HCV among HCWs (P < 0.01. The majority had less knowledge about HBV and HCV and more negative attitudes toward hepatitis. Conclusions: This study highlights the ongoing need for reducing negative attitudes toward HIV, HBV, and HCV; and providing health education among HCWs, especially focusing on HBV and HCV prevention. The findings of the research project can be used to develop interventions addressing low HBV- and HCV-related knowledge and attitudes.

  1. Operationalization of the Ghanaian Patients’ Charter in a Peri-urban Public Hospital: Voices of Healthcare Workers and Patients

    Science.gov (United States)

    Yarney, Lily; Buabeng, Thomas; Baidoo, Diana; Bawole, Justice Nyigmah

    2016-01-01

    Background: Health is a basic human right necessary for the exercise of other human rights. Every human being is, therefore, entitled to the highest possible standard of health necessary to living a life of dignity. Establishment of patients’ Charter is a step towards protecting the rights and responsibilities of patients, but violation of patients’ rights is common in healthcare institutions, especially in the developing world. This study which was conducted between May 2013 and May 2014, assessed the operationalization of Ghana’s Patients Charter in a peri-urban public hospital. Methods: Qualitative data collection methods were used to collect data from 25 healthcare workers and patients who were purposively selected. The interview data were analyzed manually, using the principles of systematic text condensation. Results: The findings indicate that the healthcare staff of the Polyclinic are aware of the existence of the patients’ Charter and also know some of its contents. Patients have no knowledge of the existence or the contents of the Charter. Availability of the Charter, community sensitization, monitoring and orientation of staff are factors that promote the operationalization of the Charter, while institutional implementation procedures such as lack of complaint procedures and low knowledge among patients militate against operationalization of the Charter. Conclusion: Public health facilities should ensure that their patients are well-informed about their rights and responsibilities to facilitate effective implementation of the Charter. Also, patients’ rights and responsibilities can be dramatized and broadcasted on television and radio in major Ghanaian languages to enhance awareness of Ghanaians on the Charter. PMID:27694679

  2. Negative correlation between mycological surfaces pollution in hospital emergency departments and blood monocytes phagocytosis of healthcare workers.

    Science.gov (United States)

    Lewicki, Sławomir; Bielawska-Drózd, Agata; Winnicka, Izabela; Leszczyński, Paweł; Cieślik, Piotr; Korniłłowicz-Kowalska, Teresa; Bohacz, Justyna; Jaroszuk-Ściseł, Jolanta; Skopińska-Różewska, Ewa; Kocik, Janusz

    2015-01-01

    The aim of the present study was to find a possible relationship between the presence of yeast and filamentous fungi in hospital emergency departments and the activity levels of blood granulocytes and monocytes in emergency personnel. The study of mycological pollution was conducted in winter; the samples were collected from 10 Warsaw hospitals emergency departments (HE D) and in 10 control locations (office spaces) and included air samples and swabbing of floor and walls. The blood for immunological investigation was taken in spring, from 40 men, 26 to 53 years old, healthcare workers of these departments, who have been working for at least 5 years in their current positions, and from 36 corresponding controls, working in control offices. Evaluation of blood leukocyte subpopulations was done by hematological analyzer and cytometry analysis and monocyte and granulocyte phagocytosis by Phagotest. There were no significant differences in the level of mycological contamination between the test and control places. The qualitative analysis of the surfaces and air samples revealed a prevalence of strains belonging to Aspergillus spp. and Penicillium spp. genus. Statistical analysis revealed the existence of negative correlation between the number of phagocytizing blood monocytes and fungi spores content on floor and wall surfaces in hospital emergency departments (r = -0.3282, p correlation between the number of phagocytizing monocytes in the blood of office workers and fungi pollution of control offices (r = 0.4421, p < 0.01).

  3. Hepatitis B vaccination status among healthcare workers in a tertiary care hospital in Haldwani City of Nainital, Uttarakhand, India

    Directory of Open Access Journals (Sweden)

    Subhash Chandra Joshi

    2014-01-01

    Full Text Available Background: Healthcare workers (HCWs have a high risk of hepatitis B virus (HBV infection. The prevalence of HBV among HCWs in hospitals in developing countries is high. However, the vaccination status of these workers in hospitals in Haldwani city is not well documented. Objectives: The aim was to assess the hepatitis B vaccination status among HCWs in a tertiary care hospital in Haldwani city of Nainital, Uttarakhand, India. Materials and Methods: In this cross-sectional study, 367 HCWs were randomly selected. Information pertaining to demographic and vaccination status was collected by interviewing them with the help of predesigned and pretested interview schedule. Result: The overall proportions of complete, incomplete and unvaccinated respondents with hepatitis B vaccine were 48.5%, 21.8%, and 29.7% respectively. In relation to designation of respondents, 35 (53.8%, 65 (77.4%, 61 (51.7%, 12 (40.0% and 5 (7.2% of respondents who were residents, interns, nurses, technicians and nursing attendants respectively had received Hepatitis B vaccination as against those who had partially received and not received vaccination and this differences were statistically significant. The most common reason for acceptance of vaccine was protection against Hepatitis-B infection (39.9% and the commonest reason for not getting vaccinated was negligence (43.1% Conclusion: These results conclude that because of low immunization coverage, HCWs are at greater risk of getting Hepatitis B infection at the hospital.

  4. Latex allergy in healthcare workers: an epidemiological study in a Spanish hospital.

    Science.gov (United States)

    Diéguez, Maria Carmen; Pulido, Zeida; de la Hoz, Belén; Blanco, Rosa; Cerecedo, Inmaculada; Fernández-Caldas, Enrique; Swanson, Michel

    2007-01-01

    To design an effective prevention program in health care workers who are allergic to latex it is necessary to know the current epidemiological situation. The objectives were to determine the main factors associated with latex allergy and to quantify levels of airborne latex particles in different areas of our hospital. A cross-sectional study was conducted using a questionnaire completed by health care workers. Those who answered the first questionnaire were given a second one to fill out and an allergological study (skin-prick test and latex-specific IgE antibodies) was performed. Latex aeroallergen particles were collected with a Quan-tec-air in different areas of the hospital. The first questionnaire was sent to 2551 health care workers. Eight hundred forty-one (33.14%) subjects returned the completed questionnaire and were given the second questionnaire. One hundred fifty-four completed second questionnaire. We identified 28 patients who were allergic to latex, and 126 patients who were not allergic to latex. In the allergic population there were more nurses aides. More allergic patients were found in the Surgery Department, Intensive Care Unit (ICU), and Vascular Radiology Unit (VRU). Allergic patients were more likely to use a higher number of latex gloves and during more hours than nonallergic workers. In the Surgery Department, ICU, VRU, and Laboratory Department more pairs of latex gloves were used and during more hours. The medium level of latex aeroallergens in 24 determinations in 14 areas of the hospital was 8.12 ng/m3 (SD, 13.32 ng/m3; range, 0.3-57.7 ng/m3). The higher levels were found in Laboratory (n = 2; mean (M) 23; SD, 25.95 ng/m3) and Surgery Departments (n = 11; M, 7.43; SD, 16.98 ng/m3; Kruskal Wallis test, p = 0.09). Latex allergy is an important health problem for health care workers, especially for those working in surgical areas or in those places where more latex gloves are used; in these areas higher levels of airborne latex particles

  5. What Polish hospital healthcare workers and lay persons know about counterfeit medicine products?

    Science.gov (United States)

    Binkowska-Bury, Monika; Wolan, Maja; Januszewicz, Paweł; Mazur, Artur; Fijalek, Zbigniew E

    2012-12-01

    To report on Polish hospital health care workers' and lay persons' knowledge about counterfeit medicine products. Cross-sectional design was used. Two types of questionnaire survey about counterfeit medicine, separate for health care professionals and lay persons were completed by 201 physicians and nurses, and 450 adult Polish residents between October 2008 and January 2009. Physicians and nurses working in hospitals are more aware of counterfeit medicine than lay persons and more often notice the presence of drugs from unknown sources. Nearly 90% of physicians, 80% of nurses, and more than 40% of representatives of the lay persons had heard about the possibility of importing illegal medicine from Ukraine or China. The majority of medical workers does not know the procedure for reporting suspicious medicine and do not warn their patients against purchasing medicine from unknown sources. Increase education of nurses and physicians about counterfeit medicine particularly including the procedure of reporting suspicious medicine from unknown sources. In practice, reinforce a role of nurses and physicians in warning their patients against purchasing medicine from unknown sources and educate them about possible health hazards and life risks.

  6. [Preparation of healthcare workers against the threat of Ebola virus disease in Ivory Coast].

    Science.gov (United States)

    Kouassi, Damus Paquin; Ekra, Kouadio Daniel; Angbo-Effi, Odile; Kouakou Ahoussou, Éric Martial; Bliabo, Guy Modeste; Yéo, Nawa Samuel; Coulibaly, Daouda; Dagnan, N Cho Simplice

    2016-01-01

    Since the declaration of the Ebola virus disease outbreak in West Africa, the government of Ivory Coast has organized the training of medical staff in all health regions of the country. This study was conducted one month after this training in order to assess the knowledge, attitudes and practices of health workers concerning Ebola virus disease in an Ivory Coast health region their preparation in relation to this disease. In May-June 2014, we conducted a descriptive cross-sectional study of 176 health workers from private and public health facilities in 5 health districts. Among the respondents, 15.5% attended the training on Ebola disease organized by the Ministry of Health. They knew that the disease is transmitted from animals to humans by body fluids (85.6%), and from human to human by body fluids of a sick person or a cadavre (82.8%). 96% said they were at risk of contracting the disease. In view of the persistent threat of the disease, ignorance of certain aspects of the disease could be a weakness in the prevention of nosocomial transmission of the disease. Knowledge of the disease should lead to adoption of prevention measures. However, routine use of protection equipment, including gloves, depends on its availability. The lack of infection prevention and control equipment could be a weak point in preparation of the response to an Ebola disease outbreak.

  7. The Patient Participation Culture Tool for healthcare workers (PaCT-HCW) on general hospital wards: A development and psychometric validation study.

    Science.gov (United States)

    Malfait, S; Eeckloo, K; Van Daele, J; Van Hecke, A

    2016-09-01

    Patient participation is an important subject for modern healthcare. In order to improve patient participation on a ward, the ward's culture regarding patient participation should first be measured. In this study a measurement tool for patient participation culture from the healthcare worker's perspective, the Patient Participation Culture Tool for healthcare workers (PaCT-HCW), was developed and psychometrically evaluated. The aim of this study was to develop and validate a tool that measures the healthcare worker-related factors of patient participation and information sharing and dialogue in patient participation from the healthcare worker's perspective in order to represent the patient participation culture on general and university hospital wards. A four-phased validation study was conducted: (1) defining the construct of the PaCT-HCW, (2) development of the PaCT-HCW, (3) content validation, and (4) psychometric evaluation. The Belgian Federal Government invited all Flemish general and university hospitals by e-mail to distribute the PaCT-HCW in their organization. Fifteen general hospitals took part in the study. Units for surgery, general medicine, medical rehabilitation, geriatric and maternal care were included. Intensive care-units, emergency room-units, psychiatric units and units with no admitted patients (e.g. radiology) were excluded. The respondents had to be caregivers, with hands-on patient contact, who worked on the same ward for more than six months. Nursing students and other healthcare workers with short-time internship on the ward were excluded. The tool was completed by 1329 respondents on 163 wards. The PaCT-HCW was psychometrically evaluated by use of an exploratory factor analysis and calculation of the internal consistency. A model containing eight components was developed through a literature review, individual interviews, and focus interviews. The developed model showed high sampling adequacy and the Bartlett's test of sphericity was

  8. Compassion fatigue and satisfaction: a cross-sectional survey among US healthcare workers.

    Science.gov (United States)

    Smart, Denise; English, Ashley; James, Jennifer; Wilson, Marian; Daratha, Kenn B; Childers, Belinda; Magera, Chris

    2014-03-01

    Professional quality of life among healthcare providers can impact the quality and safety of patient care. The purpose of this research was to investigate compassion satisfaction and compassion fatigue levels as measured by the Professional Quality of Life Scale self-report instrument in a community hospital in the United States. A cross-sectional survey study examined differences among 139 RNs, physicians, and nursing assistants. Relationships among individual and organizational variables were explored. Caregivers for critical patients scored significantly lower on the Professional Quality of Life subscale of burnout when compared with those working in a noncritical care unit. Linear regression results indicate that high sleep levels and employment in critical care areas are associated with less burnout. Identification of predictors can be used to design interventions that address modifiable risks. © 2013 Wiley Publishing Asia Pty Ltd.

  9. Extrinsic and intrinsic factors impacting on the retention of older rural healthcare workers in the north Victorian public sector: a qualitative study.

    Science.gov (United States)

    Warburton, Jeni; Moore, Melissa L; Clune, Samantha J; Hodgkin, Suzanne P

    2014-01-01

    Workforce shortages in Australia's healthcare system, particularly across rural areas, are well documented. Future projections suggest that as the healthcare workforce ages and retires, there is an urgent need for strategies to retain older skilled employees. Very few qualitative studies, with theoretical underpinning, have focused on the retention of older rural nurses and allied healthcare workers. This study aimed to address these gaps in research knowledge. This qualitative study is phase 2 of a large mixed-methods study to determine the factors that impact on the retention of older rural healthcare workers across northern Victoria, Australia. The initial phase, drawing on the effort-reward imbalance model found high levels of imbalance across a large sample of this population. The present study builds on these findings to explore in more depth the organisational (extrinsic) and individual/social (intrinsic) factors associated with retention. A purposeful stratified sample was drawn from participants at the survey phase (phase 1) and invited to take part in a semistructured telephone interview. A diverse group of 17 rural healthcare workers (nurses and allied health) aged 55 years or more, employed in the north Victorian public sector, were interviewed. The data were transcribed and later analysed thematically and inductively. Data were categorised into extrinsic and intrinsic factors that influenced their decisions to remain in their roles or leave employment. The main extrinsic factors included feeling valued by the organisation, workload pressures, feeling valued by clients, collegial support, work flexibility, and a lack of options. The main intrinsic factors included intention to retire, family influences, work enjoyment, financial influences, health, sense of self, and social input. Given the noted imbalance between (high) effort and (low) reward among participants overall, strategies were identified for improving this balance, and in turn, the retention

  10. Back muscle response to sudden trunk loading can be modified by training among healthcare workers

    DEFF Research Database (Denmark)

    Pedersen, Mogens Theisen; Essendrop, Morten; Skotte, Jørgen H.

    2007-01-01

    . Available data suggest that a delayed muscle reflex response to sudden trunk loading may increase the risk of low back injuries. We have previously shown that training may alter the response to sudden trunk loading in healthy subjects and decrease the time elapsed until stopping of the forward movement...... of the trunk (stopping time). Data on the possibilities of a training-induced improvement in the reflex response among workers exposed to sudden trunk loading on the job are, however, nonexistent, and there is no evidence of long-term benefits, i.e., the sustainability of a positive training effect. Methods......Study Design. Experimental study of the effect of physical training on the reaction to sudden back loading. Objective. To investigate the effect and sustainability of "on the job training" on the reaction to sudden back loading among employees at a geriatric ward. Summary of Background Data...

  11. Awareness, attitudes and behavior of hospital healthcare workers towards a mandatory vaccination directive: two years on.

    Science.gov (United States)

    Seale, Holly; Leask, Julie; Macintyre, C Raina

    2011-05-12

    In 2007, the state of New South Wales, Australia instituted a policy directive with compulsory provisions for health care workers to be vaccinated. This study sought to identify staff awareness and attitudes two years after it was implemented. It involved a self administered paper-based questionnaire of HCWs in two tertiary-referral teaching hospitals in Sydney, Australia in 2009. In the early phase, general awareness of the policy was incomplete and detailed knowledge was poor. However, support levels were high. Two years later, while the respondents indicated that they were aware that there was a policy in place, very few of the respondents were able to accurately describe its requirements. Regardless of the level of knowledge, support for the policy was still high (83% vs. 91%, respectively). Despite the high levels of general support for the vaccine policy directive in NSW, this study indicates that including influenza vaccination into the policy could be challenging.

  12. Peptic Ulcer Disease in Healthcare Workers: A Nationwide Population-Based Cohort Study.

    Science.gov (United States)

    Lin, Hong-Yue; Weng, Shih-Feng; Lin, Hung-Jung; Hsu, Chien-Chin; Wang, Jhi-Joung; Su, Shih-Bin; Guo, How-Ran; Huang, Chien-Cheng

    2015-01-01

    Health care workers (HCWs) in Taiwan have heavy, stressful workloads, are on-call, and have rotating nightshifts, all of which might contribute to peptic ulcer disease (PUD). We wanted to evaluate the PUD risk in HCWs, which is not clear. Using Taiwan's National Health Insurance Research Database, we identified 50,226 physicians, 122,357 nurses, 20,677 pharmacists, and 25,059 other HCWs (dieticians, technicians, rehabilitation therapists, and social workers) as the study cohort, and randomly selected an identical number of non-HCW patients (i.e., general population) as the comparison cohort. Conditional logistical regression analysis was used to compare the PUD risk between them. Subgroup analysis for physician specialties was also done. Nurses and other HCWs had a significantly higher PUD risk than did the general population (odds ratio [OR]: 1.477; 95% confidence interval [CI]: 1.433-1.521 and OR: 1.328; 95% CI: 1.245-1.418, respectively); pharmacists had a lower risk (OR: 0.884; 95% CI: 0.828-0.945); physicians had a nonsignificantly different risk (OR: 1.029; 95% CI: 0.987-1.072). In the physician specialty subgroup analysis, internal medicine, surgery, Ob/Gyn, and family medicine specialists had a higher PUD risk than other physicians (OR: 1.579; 95% CI: 1.441-1.731, OR: 1.734; 95% CI: 1.565-1.922, OR: 1.336; 95% CI: 1.151-1.550, and OR: 1.615; 95% CI: 1.425-1.831, respectively). In contrast, emergency physicians had a lower risk (OR: 0.544; 95% CI: 0.359-0.822). Heavy workloads, long working hours, workplace stress, rotating nightshifts, and coping skills may explain our epidemiological findings of higher risks for PUD in some HCWs, which might help us improve our health policies for HCWs.

  13. Applying the lessons of SARS to pandemic influenza: an evidence-based approach to mitigating the stress experienced by healthcare workers.

    Science.gov (United States)

    Maunder, Robert G; Leszcz, Molyn; Savage, Diane; Adam, Mary Anne; Peladeau, Nathalie; Romano, Donna; Rose, Marci; Schulman, Bernard

    2008-01-01

    We describe an evidence-based approach to enhancing the resilience of healthcare workers in preparation for an influenza pandemic, based on evidence about the stress associated with working in healthcare during the SARS outbreak. SARS was associated with significant long-term stress in healthcare workers, but not with increased mental illness. Reducing pandemic-related stress may best be accomplished through interventions designed to enhance resilience in psychologically healthy people. Applicable models to improve adaptation in individuals include Folkman and Greer's framework for stress appraisal and coping along with psychological first aid. Resilience is supported at an organizational level by effective training and support, development of material and relational reserves, effective leadership, the effects of the characteristics of "magnet hospitals," and a culture of organizational justice. Evidence supports the goal of developing and maintaining an organizational culture of resilience in order to reduce the expected stress of an influenza pandemic on healthcare workers. This recommendation goes well beyond the provision of adequate training and counseling. Although the severity of a pandemic is unpredictable, this effort is not likely to be wasted because it will also support the health of both patients and staff in normal times.

  14. How the exposure to trauma has hindered physicians' capacity to heal: prevalence of PTSD among healthcare workers

    Directory of Open Access Journals (Sweden)

    Damian Jacob Sendler

    Full Text Available Background and Objectives: Post-traumatic stress disorder (PTSD is a condition affecting individuals exposed to trauma in the past. This article evaluates the prevalence of PTSD in practicing physicians and how it influences work performance. Methods: A review of the literature, followed by data extraction and meta-analysis were performed. Articles were searched for in PubMed, Web of Science, and Medline using keywords: ("physician" AND "ptsd", as well as Meshterms ("stress disorders, post-traumatic" AND "physicians". Since 1980, 1363 unique hits published in English were identified and filtered by pre-specified inclusion criteria to yield a sample of 110 full-text articles examining the prevalence of PTSD among healthcare workers. Among these, 9 articles represented an accurate examination of the prevalence of PTSD among physicians only. Information was extracted on the demographic, as well as PTSD prevalence data, from these studies for final comparison. Results Across all studies (n = 9 we examined, the prevalence of PTSD among physicians of both genders (n = 1616 was 14.8%, and the range was between 4.4% to 28%. This estimation is higher than the general prevalence of PTSD in the adult population of 3-4%, yet lower than prevalence found among people traumatized by war or torture, a range of 20-45%. Since only 50% of the studies examined here stratified PTSD prevalence among physicians by gender, we could not accurately conclude gender differences. Conclusions Our findings prompt a need for further investigation into the development of support programs for healthcare providers, aimed at reducing the traumatic stress experienced by physicians at work.

  15. The Effects of Trivialization of Workplace Violence on Its Victims: Profession and Sex Differences in a Cross-Sectional Study among Healthcare and Law Enforcement Workers.

    Science.gov (United States)

    Geoffrion, Steve; Goncalves, Jane; Boyer, Richard; Marchand, André; Guay, Stéphane

    2017-04-01

    Workers from the law enforcement and healthcare sectors tend to normalize or mute their victimization from workplace violence (WPV). This study aims to assess the impact of the trivialization of WPV on psychological consequences for workers who have been affected by a WPV incident. The second aim is to assess the moderating effect of sex on the trivialization of WPV. The third and overarching aim is to assess the moderating effect of professional identity on the relations between individual and organizational factors and psychological consequences following a WPV incident. The findings are based on a convenience sample of 377 (204 female and 173 male) workers from the law enforcement and healthcare sectors. Individual factors (sex, age, professional identity, prior victimization, witnessing WPV, injuries, and trivialization of violence) and perceived support factors (colleagues' support and employer's support) were used as predictor variables of psychological consequences in hierarchical linear regression models. Sex was used as a moderator of trivialization while professional identity was used as a moderator of all predictors. When individual and social support factors were controlled for, normalizing violence was negatively associated with psychological consequences while perceiving a taboo associated with complaining about WPV was positively associated for all participants. When these relations were moderated by the sex of the participants and then by their professional identity, normalization was found to decrease psychological consequences only for male healthcare workers. To help employees cope with WPV, organizations should promote strategies adapted to profession and sex differences. For male healthcare workers, normalization as a cognitive coping strategy should be formally recognized. For both professions and sexes, organizational strategies that counter the perceived taboo of complaining about violence should be reinforced.

  16. 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.

  17. Persistence of immunologic memory in long-term hemodialysis patients and healthcare workers given hepatitis B vaccine: role of a booster dose on antibody response.

    Science.gov (United States)

    Peces, R; Laurés, A S

    2001-10-01

    Hepatitis B (HB) vaccine is effective in producing protection against HB virus infection, but the persistence of immunity remains largely unknown. Seventy-six hemodialysis (HD) patients (60 after primary HB vaccination and 16 with natural immunity) and 46 healthcare workers (32 after primary HB vaccination and 14 with natural immunity) were followed up for 10 years to evaluate the persistence of immunity. Ten years after vaccination, the analysis showed a lower seroconversion rate (38 vs. 75%, p < 0.001) in HD patients as compared with healthcare workers. In the follow-up period, the protective immunity developed through HB virus infection also showed a lower seroconversion rate (44 vs. 86%, p < 0.025) in HD patients as compared with healthcare workers. To assess the status of immunologic memory, we administered a booster dose of HB vaccine 3-12 years (mean 6.7 +/- 0.6 years) after primary vaccination in a selected group of 37 HD patients who presented a decline of their antibodies or were nonresponders. In another group of 12 healthcare workers who had a decline of their antibodies, we also administered a booster dose of HB vaccine 5-8 years (mean 5.8 +/- 0.3 years) after primary vaccination. Nineteen of the 37 HD patients (51%) presented an anamnestic response to the booster dose, and 15 of these (40%) were high responders. All of the healthcare workers responded to the booster dose with a high antibody response. We conclude that patients undergoing HD not only have lower rates of immunization to HB than healthy adults, but also that these are frequently transient. Booster doses after a primary course of vaccine are effective in about the half of HD patients who presented a decline of their antibodies or were nonresponders but whether they are necessary is unclear. The majority of healthcare workers continue to have high levels of protective HBs antibody for at least 10 years and routine boosters are not required. Copyright 2001 S. Karger AG, Basel

  18. Interprofessional Teamwork and Collaboration Between Community Health Workers and Healthcare Teams

    Science.gov (United States)

    Bernhardt, Jean M.; Lopez, Ruth Palan; Long-Middleton, Ellen R.; Davis, Sheila

    2015-01-01

    Objectives: Community Health Workers (CHWs) serve as a means of improving outcomes for underserved populations. However, their relationship within health care teams is not well studied. The purpose of this integrative review was to examine published research reports that demonstrated positive health outcomes as a result of CHW intervention to identify interprofessional teamwork and collaboration between CHWs and health care teams. Methods: A total of 47 studies spanning 33 years were reviewed using an integrative literature review methodology for evidence to support the following assumptions of effective interprofessional teamwork between CHWs and health care teams: (1) shared understanding of roles, norms, values, and goals of the team; (2) egalitarianism; (3) cooperation; (4) interdependence; and(5) synergy. Results: Of the 47 studies, 12 reported at least one assumption of effective interprofessional teamwork. Four studies demonstrated all 5 assumptions of interprofessional teamwork. Conclusions: Four studies identified in this integrative review serve as exemplars for effective interprofessional teamwork between CHWs and health care teams. Further study is needed to describe the nature of interprofessional teamwork and collaboration in relation to patient health outcomes. PMID:28462254

  19. Interprofessional Teamwork and Collaboration Between Community Health Workers and Healthcare Teams: An Integrative Review.

    Science.gov (United States)

    Franklin, Catherine M; Bernhardt, Jean M; Lopez, Ruth Palan; Long-Middleton, Ellen R; Davis, Sheila

    2015-01-01

    Community Health Workers (CHWs) serve as a means of improving outcomes for underserved populations. However, their relationship within health care teams is not well studied. The purpose of this integrative review was to examine published research reports that demonstrated positive health outcomes as a result of CHW intervention to identify interprofessional teamwork and collaboration between CHWs and health care teams. A total of 47 studies spanning 33 years were reviewed using an integrative literature review methodology for evidence to support the following assumptions of effective interprofessional teamwork between CHWs and health care teams: (1) shared understanding of roles, norms, values, and goals of the team; (2) egalitarianism; (3) cooperation; (4) interdependence; and(5) synergy. Of the 47 studies, 12 reported at least one assumption of effective interprofessional teamwork. Four studies demonstrated all 5 assumptions of interprofessional teamwork. Four studies identified in this integrative review serve as exemplars for effective interprofessional teamwork between CHWs and health care teams. Further study is needed to describe the nature of interprofessional teamwork and collaboration in relation to patient health outcomes.

  20. Interprofessional Teamwork and Collaboration Between Community Health Workers and Healthcare Teams

    Directory of Open Access Journals (Sweden)

    Catherine M. Franklin

    2015-03-01

    Full Text Available Objectives: Community Health Workers (CHWs serve as a means of improving outcomes for underserved populations. However, their relationship within health care teams is not well studied. The purpose of this integrative review was to examine published research reports that demonstrated positive health outcomes as a result of CHW intervention to identify interprofessional teamwork and collaboration between CHWs and health care teams. Methods: A total of 47 studies spanning 33 years were reviewed using an integrative literature review methodology for evidence to support the following assumptions of effective interprofessional teamwork between CHWs and health care teams: (1 shared understanding of roles, norms, values, and goals of the team; (2 egalitarianism; (3 cooperation; (4 interdependence; and(5 synergy. Results: Of the 47 studies, 12 reported at least one assumption of effective interprofessional teamwork. Four studies demonstrated all 5 assumptions of interprofessional teamwork. Conclusions: Four studies identified in this integrative review serve as exemplars for effective interprofessional teamwork between CHWs and health care teams. Further study is needed to describe the nature of interprofessional teamwork and collaboration in relation to patient health outcomes.

  1. Interprofessional Teamwork and Collaboration Between Community Health Workers and Healthcare Teams

    Directory of Open Access Journals (Sweden)

    Catherine M. Franklin

    2015-03-01

    Full Text Available Objectives: Community Health Workers (CHWs serve as a means of improving outcomes for underserved populations. However, their relationship within health care teams is not well studied. The purpose of this integrative review was to examine published research reports that demonstrated positive health outcomes as a result of CHW intervention to identify interprofessional teamwork and collaboration between CHWs and health care teams. Methods: A total of 47 studies spanning 33 years were reviewed using an integrative literature review methodology for evidence to support the following assumptions of effective interprofessional teamwork between CHWs and health care teams: (1 shared understanding of roles, norms, values, and goals of the team; (2 egalitarianism; (3 cooperation; (4 interdependence; and(5 synergy. Results: Of the 47 studies, 12 reported at least one assumption of effective interprofessional teamwork. Four studies demonstrated all 5 assumptions of interprofessional teamwork. Conclusions: Four studies identified in this integrative review serve as exemplars for effective interprofessional teamwork between CHWs and health care teams. Further study is needed to describe the nature of interprofessional teamwork and collaboration in relation to patient health outcomes.

  2. Effectiveness of seasonal influenza vaccination in healthcare workers: a systematic review.

    Science.gov (United States)

    Ng, A N M; Lai, C K Y

    2011-12-01

    Vaccination is considered a key measure to protect vulnerable groups against influenza infection. The objectives of this review are to determine the effect of influenza vaccinations in reducing laboratory-confirmed influenza infections, influenza-like illnesses (ILIs), working days lost among vaccinated HCWs, and associated adverse effects after vaccination. Twenty-two healthcare-related databases and internet resources, as well as reference lists, and the bibliographies of all of the retrieved articles were examined. All randomized controlled trials (RCTs) comparing the effectiveness of any kind of influenza vaccine among all groups of HCWs with a placebo/vaccine other than the influenza vaccine/no intervention were included in the review. Only three RCTs matched the inclusion criteria. There is a limited amount of evidence suggesting that receiving influenza vaccination reduces laboratory-confirmed influenza infections in HCWs. No evidence can be found of influenza vaccinations significantly reducing the incidence of influenza, number of ILI episodes, days with ILI symptoms, or amount of sick leave taken among vaccinated HCWs. There is insufficient data to assess the adverse effects after vaccination. There is no definitive conclusion on the effectiveness of influenza vaccinations in HCWs because of the limited number of related trials. Further research is necessary to evaluate whether annual vaccination is a key measure to protect HCWs against influenza infection and thus increase their confidence in the vaccine. In the mean time, the direction of promoting influenza vaccination to HCWs can be shifted from staff protection to patient protection, with accurate information to address concerns and misconceptions.

  3. [Adverse events self-declaration system and influenza vaccination coverage of healthcare workers in a tertiary hospital].

    Science.gov (United States)

    Velasco Munoz, Cesar; Sequera, Víctor-Guillermo; Vilajeliu, Alba; Aldea, Marta; Mena, Guillermo; Quesada, Sebastiana; Varela, Pilar; Olivé, Victoria; Bayas, José M; Trilla, Antoni

    2016-02-19

    During the influenza vaccination campaign 2011-2012 we established a self-declaration system of adverse events (AEs) in healthcare workers (HCW). The aim of this study is to describe the vaccinated population and analyse vaccination coverage and self-declared AEs after the voluntary flu vaccination in a university hospital in Barcelona. Observational study. We used the HCW immunization record to calculate the vaccination coverage. We collected AEs using a voluntary, anonymous, self-administered survey during the 2011-2012 flu vaccination campaign. We performed a logistic regression model to determine the associated factors to declare AEs. The influenza vaccination coverage in HCW was 30.5% (n=1,507/4,944). We received completed surveys from 358 vaccinated HCW (23.8% of all vaccinated). We registered AEs in 186 respondents to the survey (52.0% of all respondents). Of these, 75.3% (n=140) reported local symptoms after the flu vaccination, 9.7% (n=18) reported systemic symptoms and 15.1% (n=28) both local and systemic symptoms. No serious AEs were self-reported. Female sex and aged under 35 were both factors associated with declaring AEs. Our self-reporting system did not register serious AEs in HCW, resulting in an opportunity to improve HCW trust in flu vaccination. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  4. Self-reported adverse reactions in 4337 healthcare workers immunizations against novel H1N1 influenza

    Directory of Open Access Journals (Sweden)

    Seybold Joachim

    2011-08-01

    Full Text Available Abstract Purpose The use of the 2009 H1N1 vaccine has generated much debate concerning safety issues among the general population and physicians. It was questioned if this is a safe vaccine. Therefore, we investigated the safety of an inactivated monovalent H1N1 pandemic influenza vaccine Methods We focused on the H1N1 pandemic influenza vaccine Pandemrix® and applied a self reporting questionnaire in a population of healthcare workers (HCWs and medical students at a major university hospital. Results In total, 4337 individuals were vaccinated, consisting of 3808 HCWs and 529 medical students. The vaccination rate of the employees was higher than 40%. The majority of individuals were vaccinated in November 2009. In total, 291 of the 4337 vaccinations were reported to lead to one or more adverse reactions (6.7%. Local reactions were reported in 3.8%, myalgia and arthralgia in 3.7%, fatigue in 3.7%, headache in 3.1%. Conclusions Our data together with available data from several national and international institutions points to a safe pandemic influenza vaccine.

  5. Adherence to an occupational blood borne pathogens exposure management program among healthcare workers and other groups at risk in Argentina

    Directory of Open Access Journals (Sweden)

    Marisa Miceli

    2005-12-01

    Full Text Available We conducted a retrospective review of 130 occupational blood borne pathogens exposure (BBP-OE records at Centro de Estudios Médicos e Investigaciones Clínicas, a university hospital with an ongoing educational program and a postexposure management program for healthcare workers (HCWs since 1995, in order to evaluate adherence to a hospital BBP-OE management program. We compared HCWs from our institution (Group 1 and HCWs from independent institutions that contract our postexposure management program (Group 2. Compliance with standard precautions in Group 1 was inadequate in 77%, 23%, and 16% of nurses, physicians, and others, respectively. A greater proportion of HCWs in Group 1 (74% vs. 40% reported occupational accidents within two hours after exposure (p = 0.0001. No difference was observed regarding compliance with adherence to schedule, partial adherence, and loss at follow-up (14%, 33%, and 53%; p > 0.05. Adherence to the standard of care for BBP-OE, including postexposure prophylaxis, was low (HIV: 53% and HBV: 63%. Knowledge of the seropositive status of the source patient did not improve adherence. We conclude that postexposure programs do not guarantee appropriate behavior by HCWs. General interventions and ongoing personnel education to modify individual attitudes are needed, as are continued efforts to assess HCWs' experiences with these programs, as well as the identification of strategies to improve adherence.

  6. Willingness of European healthcare workers to undergo vaccination against seasonal influenza: current situation and suggestions for improvement

    Directory of Open Access Journals (Sweden)

    George Kassianos

    2015-01-01

    Full Text Available Uptake of vaccination against seasonal influenza in healthcare workers (HCWs is, in general, low (vaccine coverage of 6–54%, as is awareness of its importance, and has been decreasing in most European Union (EU countries in recent years. By virtue of their working environment, HCWs are at an increased risk of influenza infection and of subsequently transmitting the virus to vulnerable patients, in whom disease burden is significant. It could be argued that a similar or higher target vaccination rate to that recommended for older age groups and people with chronic medical conditions (75% should be applied to HCWs, and the European Council recommends Member States to improve vaccination coverage in this population. In this context, better education of HCWs is needed to increase awareness and highlight the importance of HCW vaccination for the benefit of public health, particularly for their patients, who may be at risk of serious complications that could lead to disability or death. Secondary to these professional responsibilities, personal benefits (as well as benefits to close family and friends should also be emphasised. Misconceptions that create barriers to vaccination need to be discussed openly and objections placed in the context of public health.

  7. Compliance of Healthcare Workers with Hand Hygiene Practices in Neonatal and Pediatric Intensive Care Units: Overt Observation

    Directory of Open Access Journals (Sweden)

    Ayşe Karaaslan

    2014-01-01

    Full Text Available Background. The objective of this study was to assess the compliance of hand hygiene (HH of healthcare workers (HCWs in the neonatal and pediatric intensive care unit in a tertiary university hospital in Istanbul. Methods. An observational study was conducted on the compliance of HH for the five World Health Organization (WHO indications. HCWs were observed during routine patient care in day shift. The authors also measured the technique of HH through hand washing or hand hygiene with alcohol-based disinfectant. Results. A total of 704 HH opportunities were identified during the observation period. Overall compliance was 37.0% (261/704. Compliance differed by role: nurses (41.4% and doctors (31.9% [P=0.02, OR: 1.504, CI 95%: 1.058–2.137]. HCWs were more likely to use soap and water (63.6% compared to waterless-alcohol-based hand hygiene (36.3% [P<0.05]. Conclusion. Adherence to hand hygiene practice and use of alcohol-based disinfectant was found to be very low. Effective education programs that improve adherence to hand hygiene and use of disinfectants may be helpful to increase compliance.

  8. Healthcare worker-related MRSA cluster in a German neonatology level III ICU: a true European story.

    Science.gov (United States)

    Scheithauer, S; Trepels-Kottek, S; Häfner, H; Keller, D; Ittel, T; Wagner, N; Heimann, K; Schoberer, M; Schwarz, R; Haase, G; Waitschies, B; Orlikowsky, T; Lemmen, S

    2014-03-01

    Here we investigated a cluster of eight newly Methicillin-resistant Staphylococcus aureus (MRSA)-colonized neonates at an ICU, and present data on molecular strain characterization as well as the source identification process in which we analyze the impact of MRSA-colonized HCWs. Molecular strain characterization revealed a unique pattern which was identified as spa-type t 127--an extremely rare strain type in Germany. Environmental sampling and screening of parents of colonized neonates proved negative. However, staff screening identified one healthcare worker (HCW; 1/134) belonging to a group of recently employed Romanian HCWs who was colonized with the spa 127 strain. Subsequent screening also detected MRSA in 9/51 Romanian HCWs (18%) and 7/9 (14% of all) isolates showed the same molecular pattern as the index case (spa/PFGE type). All carriers were successfully decolonized, after which no new patient cases occurred. As a result, we have now implemented a universal screening programme of all new employees as part of our infection control management strategy. MRSA-colonized HCWs can act as a source for in hospital transmission. Since HCWs from high endemic countries are particular prone to being colonized, they may pose a risk to patients.

  9. Adherence to an occupational blood borne pathogens exposure management program among healthcare workers and other groups at risk in Argentina

    Directory of Open Access Journals (Sweden)

    Marisa Miceli

    Full Text Available We conducted a retrospective review of 130 occupational blood borne pathogens exposure (BBP-OE records at Centro de Estudios Médicos e Investigaciones Clínicas, a university hospital with an ongoing educational program and a postexposure management program for healthcare workers (HCWs since 1995, in order to evaluate adherence to a hospital BBP-OE management program. We compared HCWs from our institution (Group 1 and HCWs from independent institutions that contract our postexposure management program (Group 2. Compliance with standard precautions in Group 1 was inadequate in 77%, 23%, and 16% of nurses, physicians, and others, respectively. A greater proportion of HCWs in Group 1 (74% vs. 40% reported occupational accidents within two hours after exposure (p = 0.0001. No difference was observed regarding compliance with adherence to schedule, partial adherence, and loss at follow-up (14%, 33%, and 53%; p > 0.05. Adherence to the standard of care for BBP-OE, including postexposure prophylaxis, was low (HIV: 53% and HBV: 63%. Knowledge of the seropositive status of the source patient did not improve adherence. We conclude that postexposure programs do not guarantee appropriate behavior by HCWs. General interventions and ongoing personnel education to modify individual attitudes are needed, as are continued efforts to assess HCWs' experiences with these programs, as well as the identification of strategies to improve adherence.

  10. Knowledge, attitudes and anxiety towards influenza A/H1N1 vaccination of healthcare workers in Turkey

    Directory of Open Access Journals (Sweden)

    Tanriverdi Derya

    2010-09-01

    Full Text Available Abstract Background This study aimed to analyze the factors associated with knowledge and attitudes about influenza A (H1N1 and vaccination, and possible relations of these factors with anxiety among healthcare workers (HCW. Methods The study used a cross-sectional descriptive design, and it was carried out between 23 November and 4 December 2009. A total of 300 HCW from two hospitals completed a questionnaire. Data collection tools comprised a questionnaire and the State-Trait Anxiety Inventory (STAI. Results Vaccination rate for 2009 pandemic influenza A(H1N1 among HCW was low (12.7%. Most of the respondents believed the vaccine was not safe and protective. Vaccination refusal was mostly related to the vaccine's side effects, disbelief to vaccine's protectiveness, negative news about the vaccine and the perceived negative attitude of the Prime Minister to the vaccine. State anxiety was found to be high in respondents who felt the vaccine was unsafe. Conclusions HCW considered the seriousness of the outbreak, their vaccination rate was low. In vaccination campaigns, governments have to aim at providing trust, and media campaigns should be used to reinforce this trust as well. Accurate reporting by the media of the safety and efficacy of influenza vaccines and the importance of vaccines for the public health would likely have a positive influence on vaccine uptake. Uncertain or negative reporting about the vaccine is detrimental to vaccination efforts.

  11. Adding justice to the clinical and public health ethics arguments for mandatory seasonal influenza immunisation for healthcare workers.

    Science.gov (United States)

    Lee, Lisa M

    2015-08-01

    Ethical considerations from both the clinical and public health perspectives have been used to examine whether it is ethically permissible to mandate the seasonal influenza vaccine for healthcare workers (HCWs). Both frameworks have resulted in arguments for and against the requirement. Neither perspective resolves the question fully. By adding components of justice to the argument, I seek to provide a more fulsome ethical defence for requiring seasonal influenza immunisation for HCWs. Two critical components of a just society support requiring vaccination: fairness of opportunity and the obligation to follow democratically formulated rules. The fairness of opportunity is informed by Rawls' two principles of justice. The obligation to follow democratically formulated rules allows us to focus simultaneously on freedom, plurality and solidarity. Justice requires equitable participation in and benefit from cooperative schemes to gain or profit socially as individuals and as a community. And to be just, HCW immunisation exemptions should be limited to medical contraindications only. In addition to the HCWs fiduciary duty to do what is best for the patient and the public health duty to protect the community with effective and minimally intrusive interventions, HCWs are members of a just society in which all members have an obligation to participate equitably in order to partake in the benefits of membership. 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.

  12. Exploring workplace related health resources from a salutogenic perspective. Results from a focus group study among healthcare workers in Sweden.

    Science.gov (United States)

    Bringsén, Asa; Andersson, H Ingemar; Ejlertsson, Göran; Troein, Margareta

    2012-01-01

    The aim of this study was to explore healthcare workers' opinions on workplace related health resources relevant to promotion of their health. 16 registered nurses and 19 assistant nurses, from a medical emergency ward at a medium sized hospital in the south of Sweden, participated in the study. Eight focus group interviews were conducted, the material was condensed and conventional qualitative content analysis was used to elicit and identify patterns in the expressed opinions of the participants. The analysis yielded four themes that were labelled the reward, the team, the mission and the context. An explanatory model was constructed consisting of concentric circles, with the reward at the core. The qualitative analysis also revealed two divergent patterns; some of the participants associated positive health with stability while others referred to flexibility. The results from this study have contributed to the body of knowledge regarding salutogenic health indicators in the field of work and health research in particular as well as in health promotion in general. The findings show that individuals can have diverse responses to any given work situation, and this should be taken into account before implementation of salutogenic health promotion programs.

  13. A content analysis of the UK press response to the diagnosis of Ebola in a British healthcare worker.

    Science.gov (United States)

    Hobbs, Constance; Myles, Puja; Pritchard, Catherine

    2016-09-27

    The Ebola epidemic led to considerable media attention, which may influence public risk perception. Therefore, this study analysed the UK press response following diagnosis of a British healthcare worker (HCW) with Ebola. Using the Nexis database, the frequency of Ebola-related articles in UK national newspaper articles was mapped. This was followed by a content analysis of Ebola-related articles in the four newspapers with highest UK net readership from November 2014 to February 2015. During the 16-week study period, 1349 articles were found. The day with the highest number of Ebola-related articles was 31 December 2014, the day after the diagnosis of Ebola in a UK HCW. Seventy-seven articles were included in the content analysis. Content analysis demonstrated a shift from West African to UK-focused articles, increased discussion of border control, UK policy decisions and criticism, and an increased number of articles with a reassuring/threatening message. UK press coverage of Ebola increased following a HCW's diagnosis, particularly regarding discussion of screening measures. This is likely to have increased risk perception of Ebola in the UK population and may have contributed to subsequent strengthening of UK screening policy beyond World Health Organisation requirements. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. Revisiting the concept of severe mental illness: severity indicators and healthcare spending in psychotic, depressive and dissociative disorders.

    Science.gov (United States)

    Gonzalez Vazquez, Ana Isabel; Seijo Ameneiros, Natalia; Díaz Del Valle, Juan Carlos; Lopez Fernandez, Ester; Santed Germán, Miguel Angel

    2017-08-10

    The concept of severe mental illness (SMI) has been related to bipolar or psychotic diagnosis, or to some cases of depressive disorders. Other mental health problems such as personality disorders or posttraumatic dissociative conditions, which can sometimes lead to relevant functional impairments, remain separate from the SMI construct. This study aimed to evaluate the clinical severity as well as healthcare spending on dissociative disorders (DDs). This diagnostic group was compared with two other groups usually considered as causing severe impairment and high healthcare spending: bipolar and psychotic disorders, and unipolar depression. From a random sample of 200 psychiatric outpatients, 108 with unipolar depression (N = 45), psychotic/bipolar (N = 31) or DDs (N = 32) were selected for this study. The three groups were compared by the severity of their disorder and healthcare indicators. Of the three groups, those with a DD were more prone to and showed higher indices of suicide, self-injury, emergency consultations, as well as psychotropic drug use. This group ranked just below psychotic/bipolar patients in the amount of psychiatric hospitalisations. Despite a certain intra-professional stigma regarding DDs, these data supported the severity of these posttraumatic conditions, and their inclusion in the construct of SMI.

  15. 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

  16. 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

  17. 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

  18. 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

  19. Self-reported occupational exposure to HIV and factors influencing its management practice: a study of healthcare workers in Tumbi and Dodoma Hospitals, Tanzania

    OpenAIRE

    Mashoto, Kijakazi O; Mubyazi, Godfrey M; Mohamed, Hussein; Malebo, Hamisi M

    2013-01-01

    Background Blood borne infectious agents such as hepatitis B virus (HBV), hepatitis C virus (HCV) and human immune deficiency virus (HIV) constitute a major occupational hazard for healthcare workers (HCWs). To some degree it is inevitable that HCWs sustain injuries from sharp objects such as needles, scalpels and splintered bone during execution of their duties. However, in Tanzania, there is little or no information on factors that influence the practice of managing occupational exposure to...

  20. Evaluation of the time resolved fluorescence immunoassay (TRFIA) for the detection of varicella zoster virus (VZV) antibodies following vaccination of healthcare workers

    Science.gov (United States)

    McDonald, S.L.R.; Maple, P.A.C.; Andrews, N.; Brown, K.E.; Ayres, K.L.; Scott, F.T.; Bassam, M. Al; Gershon, A.A.; Steinberg, S.P.; Breuer, J.

    2017-01-01

    Determination of varicella zoster virus (VZV) immunity in healthcare workers without a history of chickenpox is important for identifying those in need of vOka vaccination. Post immunisation, healthcare workers in the UK who work with high risk patients are tested for seroconversion. To assess the performance of the time-resolved fluorescence immunoassay (TRFIA) for the detection of antibody in vaccinated as well as unvaccinated individuals, a cut-off was first calculated. VZV-IgG specific avidity and titres six weeks after the first dose of vaccine were used to identify subjects with pre-existing immunity among a cohort of 110 healthcare workers. Those with high avidity (≥60%) were considered to have previous immunity to VZV and those with low or equivocal avidity (130 mIU/mL which best discriminated between the two groups and this was confirmed by ROC analysis. Using this value, the sensitivity and specificity of TRFIA cut-off were 90% (95% CI 79–96), and 78% (95% CI 61–90) respectively in this population. A subset of samples tested by the gold standard Fluorescence Antibody to Membrane Antigen (FAMA) test showed 84% (54/64) agreement with TRFIA. PMID:21192976

  1. 农民工社区医疗卫生服务的现状及对策%Status quo and countermeasures for community healthcare of migrant workers

    Institute of Scientific and Technical Information of China (English)

    刘洁

    2011-01-01

    As urbanization moves on in China, the ongoing health reform tums to focus on the problems of "Too difficult and too expensive to see doctors" for migrant workers. The paper covered the present medical and healthcare services available to migrant workers. From the aspects of government,community and migrant workers, the paper analyzed problems found in services offered by community healthcare centers. In the end, the author came up with recommendations to rationalize such services by means of community healthcare centers.%随着我国城镇化进程的不断推进,解决好农民工"看病难"、"看病贵"的问题是深化医疗卫生体制改革的重要内容.文章介绍了农民工医疗卫生服务的现状,基于农民工对社区卫生服务机构的可及性较高,文章从政府、社会和农民工三个角度分析了社区卫生服务中心服务在农民工医疗卫生服务方面存在的问题,同时针对三个方面提出利用社区卫生服务中心完善农民工医疗卫生服务合理化建议.

  2. Prevalence and factors associated with percutaneous injuries and splash exposures among health-care workers in a provincial hospital, Kenya, 2010.

    Science.gov (United States)

    Mbaisi, Everline Muhonja; Ng'ang'a, Zipporah; Wanzala, Peter; Omolo, Jared

    2013-01-01

    Accidental occupational exposure of healthcare workers to blood and body fluids after skin injury or mucous membrane contact constitutes a risk for transmission of blood-borne pathogens. Such pathogens include Human Immunodeficiency Virus (HIV), Hepatitis B virus (HBV) and Hepatitis C virus (HCV). We conducted a study to determine the prevalence and associated factors for percutaneous injuries and splash exposures among health-care workers in Rift Valley provincial hospital. A cross-sectional study was carried out from October to November 2010. Self reported incidents, circumstances surrounding occupational exposure and post-exposure management were sought by use of interviewer administered questionnaire. Descriptive, bivariate and multiple logistic regression (forward stepwise procedure) analyses were performed. The level of significance was set at 0.05. Twenty five percent of health-care workers interviewed (N=305) reported having been exposed to blood and body fluids in the preceding 12 months. Percutaneous injuries were reported by 19% (n=305) and splash to mucous membrane by 7.2%. Higher rates of percutaneous injuries were observed among nurses (50%), during stitching (30%), and in obstetric and gynecologic department (22%). Health workers aged below 40 years were more likely to experience percutaneous injuries (OR=3.7; 95% CI=1.08-9.13) while previous training in infection prevention was protective (OR=0.52; 95% CI=0.03-0.90). Forty eight percent (n=83) reported the incidents with 20% (n=83) taking PEP against HIV. Percutaneous injuries and splashes are common in Rift Valley Provincial hospital. Preventive measures remain inadequate. Health institutions should have policies, institute surveillance for occupational risks and enhance training of health care workers.

  3. 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

    National Research Council Canada - National Science Library

    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

    2009-01-01

    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...

  4. The prevalence of latex sensitisation and allergy and associated risk factors among healthcare workers using hypoallergenic latex gloves at King Edward VIII Hospital, KwaZulu-Natal South Africa: a cross-sectional study

    National Research Council Canada - National Science Library

    Phaswana, Shumani Makwarela; Naidoo, Saloshni

    2013-01-01

    The present study describes latex sensitisation and allergy prevalence and associated factors among healthcare workers using hypoallergenic latex gloves at King Edward VIII Hospital in KwaZulu-Natal, South Africa...

  5. [Conceptions and typology of conflicts between workers and managers in the context of primary healthcare in the Brazilian Unified National Health System (SUS)].

    Science.gov (United States)

    Carvalho, Brígida Gimenez; Peduzzi, Marina; Ayres, José Ricardo de Carvalho Mesquita

    2014-07-01

    This study aimed to analyze perceptions of conflict between workers and managers in primary healthcare units and to present a typology of conflicts on the job. This was a comprehensive interpretive case study with a critical hermeneutic approach. Data collection techniques included: focus group with managers, workplace observation, and worker interviews, conducted from April to November 2011. The results were triangulated and indicated the coexistence of distinct concepts of conflict, typified in six modalities: lack of collaboration at work; disrespect resulting from asymmetrical relations between workers; problematic employee behavior; personal problems; asymmetry with other management levels; and inadequate work infrastructure. The relevance of (non)mutual recognition, as proposed by Axel Honneth, stood out in the interpretation of the causes and practical implications of these conflicts.

  6. Healthcare workers as parents: attitudes toward vaccinating their children against pandemic influenza A/H1N1

    Directory of Open Access Journals (Sweden)

    Torun Fuat

    2010-10-01

    Full Text Available Abstract Background Both the health care workers (HCWs and children are target groups for pandemic influenza vaccination. The coverage of the target populations is an important determinant for impact of mass vaccination. The objective of this study is to determine the attitudes of HCWs as parents, toward vaccinating their children with pandemic influenza A/H1N1 vaccine. Methods A cross-sectional questionnaire survey was conducted with health care workers (HCWs in a public hospital during December 2009 in Istanbul. All persons employed in the hospital with or without a health-care occupation are accepted as HCW. The HCWs who are parents of children 6 months to 18 years of age were included in the study. Pearson's chi-square test and logistic regression analysis was applied for the statistical analyses. Results A total of 389 HCWs who were parents of children aged 6 months-18 years participated study. Among all participants 27.0% (n = 105 reported that themselves had been vaccinated against pandemic influenza A/H1N1. Two third (66.1% of the parents answered that they will not vaccinate their children, 21.1% already vaccinated and 12.9% were still undecided. Concern about side effect was most reported reason among who had been not vaccinated their children and among undecided parents. The second reason for refusing the pandemic vaccine was concerns efficacy of the vaccine. Media was the only source of information about pandemic influenza in nearly one third of HCWs. Agreement with vaccine safety, self receipt of pandemic influenza A/H1N1 vaccine, and trust in Ministry of Health were found to be associated with the positive attitude toward vaccinating their children against pandemic influenza A/H1N1. Conclusions Persuading parents to accept a new vaccine seems not be easy even if they are HCWs. In order to overcome the barriers among HCWs related to pandemic vaccines, determination of their misinformation, attitudes and behaviors regarding the

  7. An assessment of hand hygiene practices of healthcare workers of a semi-urban teaching hospital using the five moments of hand hygiene

    Directory of Open Access Journals (Sweden)

    Emmanuel Olushola Shobowale

    2016-01-01

    Full Text Available Background: Hand hygiene has been described as the cornerstone and starting point in all infection control programs, with the hands of healthcare staff being the drivers and promoters of infection in critically ill patients. The objectives of this study were to access healthcare workers compliance with the World Health Organization (WHO prescribed five moments of hand hygiene as it relates to patient care and to determine the various strata of healthcare workers who are in default of such prescribed practices. Methods: The study was an observational, cross-sectional one. Hand hygiene compliance was monitored using the hand hygiene observation tool developed by the WHO. A nonidentified observer was used for monitoring compliance with hand hygiene. The observational period was over a 60-day period from August 2015 to October 2015. Results: One hundred and seventy-six observations were recorded from healthcare personnel. The highest number of observations were seen in surgery, n = 40. The following were found to be in noncompliance before patient contact - anesthetist P = 0.00 and the Intensive Care Unit P = 0.00 while compliance was seen with senior nurses (certified registered nurse anesthetist [CRNA] P = 0.04. Concerning hand hygiene after the removal of gloves, the following were areas of noncompliance - the emergency room P = 0.00, CRNA P = 0.00, dental P = 0.04, and compliance was seen with surgery P = 0.01. With regards to compliance after touching the patient, areas of noncompliance were the anesthetists P = 0.00, as opposed to CRNA P = 0.00, dental P = 0.00, and Medicine Department P = 0.02 that were compliant. Overall, the rates of compliance to hand hygiene were low. Discussion: The findings however from our study show that the rates of compliance in our local center are still low. The reasons for this could include lack of an educational program on hand hygiene; unfortunately, healthcare workers in developing settings such as ours

  8. Occurrence of Needlestick and Injuries among Health-care Workers of a Tertiary Care Teaching Hospital in North India

    Science.gov (United States)

    Goel, Varun; Kumar, Dinesh; Lingaiah, Raghavendra; Singh, Sarman

    2017-01-01

    Introduction: Occupational hazards such as accidental exposure to sharp, cuts, and splashes are common among health-care workers (HCWs). Aims and Objectives: To determine the occurrence of self-reported occupational exposures to these hazards and to know the prevalent practices following the exposure. The second aim was to know the baseline antibody levels against hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) immediately after these accidents. Methods: An observational prospective study was done in the HCWs of a tertiary care academic health organization of North India from January 2011 to December 2013. At the time of self-reporting of injury, a questionnaire was administered. Blood sample of HCWs and of the source, if identified, was collected for baseline HBV, HCV, and HIV serum markers. The exposed HCWs were followed up and repeat testing was done after 3–4 weeks for seroconversion up to 6 months. Results: A total of 476 injuries were reported. Needlestick injury of fingers was the most common. Doctors were found to have the highest exposure rate (73.7%) distantly followed by nurses (19.1%). A significant number of the HCWs (125, 26.3%) vaccinated in past had hepatitis B surface antibody (anti-HBs) titers <10 mIU/mL (protection defined as anti-HBs level ≥10 mIU/ml). Only 44 sources were found to be seropositive (11 for HIV, 9 for HCV, and 24 for HBV). No seroconversion was seen in any of the exposed HCWs after 6 months. Conclusions: The incidence of needlestick and sharp injuries is most often encountered in emergency wards. Anti-HBs titers were suboptimal in many of the HCWs requiring a booster dose of HBV vaccination. PMID:28042212

  9. Evaluation of the tuberculin skin test and the interferon-γ release assay for TB screening in French healthcare workers

    Directory of Open Access Journals (Sweden)

    Raffi Francois

    2009-11-01

    Full Text Available Abstract Introduction Using French cut-offs for the Tuberculin Skin Test (TST, results of the TST were compared with the results of an Interferon-γ Release Assay (IGRA in Healthcare Workers (HCW after contact to AFB-positive TB patients. Methods Between May 2006 and May 2007, a total of 148 HCWs of the University Hospital in Nantes, France were tested simultaneously with IGRA und TST. A TST was considered to indicate recent latent TB infection (LTBI if an increase of >10 mm or if TST ≥ 15 mm for those with no previous TST result was observed. For those with a positive TST, chest X-ray was performed and preventive chemotherapy was offered. Results All HCWs were BCG-vaccinated. The IGRA was positive in 18.9% and TST ≥ 10 mm was observed in 65.5%. A recent LTBI was believed to be highly probable in 30.4% following TST. Agreement between IGRA and TST was low (kappa 0.041. In 10 (16.7% out of 60 HCWs who needed chest X-ray following TST the IGRA was positive. In 9 (20% out of 45 HCWs to whom preventive chemotherapy was offered following TST the IGRA was positive. Of those considered TST-negative following the French guidelines, 20.5% were IGRA-positive. In a two-step strategy - positive TST verified by IGRA - 18 out of 28 (64.3% IGRA-positive HCWs would not have been detected using French guidelines for TST interpretation. Conclusion The introduction of IGRA in contact tracings of BCG-vaccinated HCWs reduces X-rays and preventive chemotherapies. Increasing the cut-off for a positive TST does not seem to be helpful to overcome the effect of BCG vaccination on TST.

  10. 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.

  11. 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

  12. 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

  13. Computer-assisted resilience training to prepare healthcare workers for pandemic influenza: a randomized trial of the optimal dose of training

    Directory of Open Access Journals (Sweden)

    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.

  14. 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)

    Huang, Szu-Fen; Liang, Huey-Wen; Chen, Li-Chin; Lin, Chia-Kuei; Huang, Hsiao-Fang; Hsieh, Ming-Yuan; Sun, Jui-Sheng

    2017-01-01

    Objective 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. Methods 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. Results 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). Conclusions 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. PMID:28166260

  15. 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

  16. 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.

  17. Risk for low back pain from different frequencies, load mass and trunk postures of lifting and carrying among female healthcare workers

    DEFF Research Database (Denmark)

    Holtermann, Andreas; Clausen, Thomas; Aust, Birgit

    2012-01-01

    PURPOSE: To investigate the risk of developing non-chronic and chronic low back pain (LBP) from frequency, load mass and trunk postures of occupational lifting and carrying among female healthcare workers. METHODS: A total of 9,847 workers in eldercare answered a questionnaire about occupational...... lifting and carrying frequency (rarely, occasionally and frequently), load mass (low: 1-7 kg, moderate: 8-30 kg and heavy: >30 kg), trunk posture (upright or forward bent back), and days with LBP in 2005. The odds ratio (OR) for developing non-chronic (1-30 days the last 12 months) and chronic (>30 days...... the last 12 months) LBP reported in 2006 from these characteristics of occupational lifting and carrying was investigated with multi-adjusted logistic regressions among female healthcare workers without LBP in 2005 (n = 1,612). RESULTS: Frequently lifting and carrying low load mass with forward bent back...

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

    Directory of Open Access Journals (Sweden)

    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. Mupirocin resistance in nasal carriage of Staphylococcus aureus among healthcare workers of a tertiary care rural hospital

    Directory of Open Access Journals (Sweden)

    Dardi Charan Kaur

    2014-01-01

    Full Text Available Introduction: Mupirocin (pseudomonic acid A is a topical antimicrobial agent with excellent antistaphylococcal and antistreptococcal activity. A nasal formulation is approved by the United States Food and Drug Administration for eradicating nasal carriage in adult patients as well as in health care personnel. Resistance to mupirocin has already been reported worldwide. The increasing prevalence of mupirocin resistance among Staphylococcus aureus and coagulase-negative Staphylococcus (CoNS species could be an important threat to the future use of mupirocin against methicillin-resistant S. aureus (MRSA. Thus, this study was carried out to find the prevalence of mupirocin resistance in S. aureus and CoNS by disc diffusion and to determine the rates of high-level and low-level mupirocin resistance in S. aureus and CoNS by disc diffusion. Materials and Methods: A total of 140 healthcare workers (HCWs (doctor, nursing staff, housekeeping staff were randomly selected. S. aureus and CoNS isolates were tested for mupirocin resistance by the disk diffusion method using 5 μg and 200 μg mupirocin discs. MRSA isolates were tested for antibiotics by Kirby-Bauer disc-diffusion method as per Clinical and Laboratory Standards Institute guidelines. Results: Out of 140 nasal swabs collected from HCWs, S. aureus was isolated in 38 (27.14%, and CoNS was isolated in 73 (52.14%. MRSA was isolated in 20 (14.28% and methicillin-resistant coagulase-negative Staphylococci (MRCoNS in 34 (24.29%. Methicillin-sensitive S. aureus (MSSA and MSCoNS isolates were 100% sensitive to mupirocin, but two isolates from MRSA (1.43% and five from MRCoNS (3.57% were mupirocin resistant. Conclusion: The presence of mupirocin resistance in MRSA and MRCoNS is a cause for concern. It could be limited by regular surveillance and effective infection control initiatives so to inform health care facilities to guide therapeutic and prophylactic use of mupirocin.

  20. 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, pworkers' 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. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. The impact of attachment insecurity and sleep disturbance on symptoms and sick days in hospital-based health-care workers.

    Science.gov (United States)

    Maunder, Robert G; Hunter, Jonathan J; Lancee, William J

    2011-01-01

    Adult attachment insecurity is associated with many health outcomes and may be associated with sleep disturbance. The purpose of this study was to test the hypothesis that sleep disturbance mediates the relationship between attachment insecurity and three measures of health (perceived general health, physical symptoms and sick days) in a group that is at high risk of sleep disturbance: hospital based health-care workers. One hundred thirty-one nondepressed female hospital workers completed self-report measures of adult attachment, sleep disturbance, depressive symptoms (excluding sleep-related items) and health outcomes. The hypothesis of mediation was tested with sequential regression analyses. Both attachment anxiety and attachment avoidance were significantly associated with impairment in global sleep quality (ρ=.20 and .19, respectively, Pworkers in a high-stress occupation. Copyright © 2011 Elsevier Inc. All rights reserved.

  2. Detection of events of public health importance under the international health regulations: a toolkit to improve reporting of unusual events by frontline healthcare workers

    Directory of Open Access Journals (Sweden)

    Bitar Dounia

    2011-09-01

    Full Text Available Abstract Background The International Health Regulations (IHR (2005 require countries to notify WHO of any event which may constitute a public health emergency of international concern. This notification relies on reports of events occurring at the local level reaching the national public health authorities. By June 2012 WHO member states are expected to have implemented the capacity to "detect events involving disease or death above expected levels for the particular time and place" on the local level and report essential information to the appropriate level of public health authority. Our objective was to develop tools to assist European countries improve the reporting of unusual events of public health significance from frontline healthcare workers to public health authorities. Methods We investigated obstacles and incentives to event reporting through a systematic literature review and expert consultations with national public health officials from various European countries. Multi-day expert meetings and qualitative interviews were used to gather experiences and examples of public health event reporting. Feedback on specific components of the toolkit was collected from healthcare workers and public health officials throughout the design process. Results Evidence from 79 scientific publications, two multi-day expert meetings and seven qualitative interviews stressed the need to clarify concepts and expectations around event reporting in European countries between the frontline and public health authorities. An analytical framework based on three priority areas for improved event reporting (professional engagement, communication and infrastructure was developed and guided the development of the various tools. We developed a toolkit adaptable to country-specific needs that includes a guidance document for IHR National Focal Points and nine tool templates targeted at clinicians and laboratory staff: five awareness campaign tools, three

  3. The choice of healthcare providers for febrile children after introducing non-professional health workers in a malaria endemic area in Papua New Guinea

    Directory of Open Access Journals (Sweden)

    Takahiro eTsukahara

    2015-12-01

    Full Text Available Background: Disease burden of malaria in Papua New Guinea (PNG is the highest in Asia and the Pacific, and prompt access to effective drugs is the key strategy for controlling malaria. Despite the rapid economic growth, primary healthcare services have deteriorated in rural areas; the introduction of non-professional health workers [village health volunteers (VHVs] is expected to improve antimalarial drug deliveries. Previous studies on PNG suggested that distance from households negatively affected the utilization of health services; however, price effect on healthcare demand decisions has not been explored. Empirical studies on household’s affordability as well as accessibility of healthcare services contribute to policy implications such as efficient introduction of out-of-pocket costs and effective allocation of health facilities. Therefore, we investigate price responsiveness and other determinants of healthcare provider choice for febrile children in a malaria endemic rural area wherein VHVs were introduced.Methods: Cross-sectional surveys were conducted using a structured questionnaire distributed in a health center’s catchment area of East Sepik Province in the 2011/2012 rainy seasons. Caretakers were interviewed and data on fever episodes of their children in the preceding two weeks were collected. Mixed logit model was employed to estimate the determinants of healthcare provider choice.Results: Among 257 fever episodes reported, the main choices of healthcare providers were limited to self-care, VHV, and a health center. Direct cost and walking distance negatively affected the choice of a VHV and the health center. An increase of VHV’s direct cost or walking distance did not much affect predicted probability of the health center, but rather that of self-care. While, drug availability and illness severity increased the choice probability of a VHV and the health center. Conclusion: The results suggest that the net healthcare demand

  4. Combining Healthcare-Based and Participatory Approaches to Surveillance: Trends in Diarrheal and Respiratory Conditions Collected by a Mobile Phone System by Community Health Workers in Rural Nepal.

    Directory of Open Access Journals (Sweden)

    David J Meyers

    Full Text Available Surveillance systems are increasingly relying upon community-based or crowd-sourced data to complement traditional facilities-based data sources. Data collected by community health workers during the routine course of care could combine the early warning power of community-based data collection with the predictability and diagnostic regularity of facility data. These data could inform public health responses to epidemics and spatially-clustered endemic diseases. Here, we analyze data collected on a daily basis by community health workers during the routine course of clinical care in rural Nepal. We evaluate if such community-based surveillance systems can capture temporal trends in diarrheal diseases and acute respiratory infections.During the course of their clinical activities from January to December 2013, community health workers recorded healthcare encounters using mobile phones. In parallel, we accessed condition-specific admissions from 2011-2013 in the hospital from which the community health program was based. We compared diarrhea and acute respiratory infection rates from both the hospital and the community, and assigned three categories of local disease activity (low, medium, and high to each week in each village cluster with categories determined by tertiles. We compared condition-specific mean hospital rates across categories using ANOVA to assess concordance between hospital and community-collected data.There were 2,710 cases of diarrhea and 373 cases of acute respiratory infection reported by community health workers during the one-year study period. At the hospital, the average weekly incidence of diarrhea and acute respiratory infections over the three-year period was 1.8 and 3.9 cases respectively per 1,000 people in each village cluster. In the community, the average weekly rate of diarrhea and acute respiratory infections was 2.7 and 0.5 cases respectively per 1,000 people. Both diarrhea and acute respiratory infections

  5. Continuing medical and dental education on the global stage: the nexus of supporting international Christian healthcare workers and developing educators

    Directory of Open Access Journals (Sweden)

    Lyubov D Slashcheva

    2016-01-01

    Full Text Available One of the challenges facing international healthcare missionaries is that of maintaining up-to-date knowledge and staying current with professional certification. Since 1978, annual programs by the Christian Medical and Dental Associations have offered professional continuing education to thousands of US healthcare professionals serving as missionaries in the regions of Africa, Asia, and, in more recent years, globally. In addition, conference programming is designed to prepare, train, and support healthcare missionaries to, in turn, serve as educators in their places of ministry. The program is designed for both professional education and personal encouragement. Utilizing historical documents from program facilitation and interviews from those involved with its implementation, this paper describes the history, vision, and favorable quantitative growth and qualitative impact on participants. The program continues to grow as healthcare missionaries are educated near their places of service, while reinforcing their own roles as educators.

  6. Identifying barriers to healthcare to reduce health disparity in Zuni Indians using focus group conducted by community health workers.

    Science.gov (United States)

    Shah, Vallabh O; Ghahate, Donica M; Bobelu, Jeanette; Sandy, Phillip; Newman, Sara; Helitzer, Deborah L; Faber, Thomas; Zager, Philip

    2014-02-01

    The Zuni Pueblo is home to an economically disadvantaged population, which faces a public health challenge from the interrelated epidemics of obesity, diabetes and kidney disease. Efforts to decrease the impact of these epidemics have been complicated by historical, economic and cultural barriers, which may limit healthcare utilization. The NIH supported Zuni Health Initiative (ZHI) conducted a study to identify barriers to healthcare in the Zuni Pueblo. Community health representatives (CHRs) led 14 one-hour focus group sessions at which a total of 112 people participated posed unique questions that took into account the Zuni culture to elicit information on perceived barriers to healthcare. Audiotapes were translated and transcribed by bilingual ZHI staff. We reduced the text to thematic categories, constructed a coding dictionary and inserted the text into NVivo 9 program. We identified nine themes emerged regarding the barriers experienced in receiving healthcare and adhering to medical advice. These included distance; transportation; embarrassment; relating to healthcare professionals; navigating the medical system; awareness of available resources; waiting times; adhering to medication; and incentives in health promotion. In conclusion the implementation of culturally appropriate community-based health promotion programs and preventive screening techniques will improve access to healthcare and diminish health disparities. © 2013 Wiley Periodicals, Inc.

  7. Health system reform in peri-urban communities: an exploratory study of policy strategies towards healthcare worker reform in Epworth, Zimbabwe

    Directory of Open Access Journals (Sweden)

    Bernard Hope Taderera

    2016-12-01

    Full Text Available Background: Human resources for health (HRH remains a critical challenge, according to the Kampala Declaration and Agenda for Global Action of 2008 and the 2030 Sustainable Development Agenda. Available literature on health system reforms does not provide a detailed narrative on strategies that have been used to reform HRH challenges in peri-urban communities. This study explores such strategies implemented in Epworth, Zimbabwe, during 2009–2014, and the implications these strategies might have on other peri-urban areas. Design: Qualitative and quantitative methods were used in an exploratory and cross-sectional design. Purposive sampling was used to select key informants, a sample of healthcare workers that participated in in-depth interviews and community members who took part in focus group discussions. Secondary data were collected through a documentary search. Qualitative data were analysed through thematic analysis. Quantitative secondary data were examined using descriptive statistics and then compared with qualitative data to reinforce analysis. Results: The HRH reform policy strategies that were identified included ministerial intervention; policy review; and revival of the human resource for health planning, financial planning, multi-sector collaboration, and community engagement. These had some positive effects; however, desired outcomes were undermined by financial, material, human resource, and social constraints. Conclusions: Despite constraints, the strategies helped revive the health delivery system in Epworth. In turn, this had a favourable outlook on post-2008 efforts by the Global Health Alliance towards healthcare worker reform and the 2030 Sustainable Development Agenda in peri-urban communities.

  8. Health system reform in peri-urban communities: an exploratory study of policy strategies towards healthcare worker reform in Epworth, Zimbabwe.

    Science.gov (United States)

    Taderera, Bernard Hope; Hendricks, Stephen James Heinrich; Pillay, Yogan

    2016-01-01

    Human resources for health (HRH) remains a critical challenge, according to the Kampala Declaration and Agenda for Global Action of 2008 and the 2030 Sustainable Development Agenda. Available literature on health system reforms does not provide a detailed narrative on strategies that have been used to reform HRH challenges in peri-urban communities. This study explores such strategies implemented in Epworth, Zimbabwe, during 2009-2014, and the implications these strategies might have on other peri-urban areas. Qualitative and quantitative methods were used in an exploratory and cross-sectional design. Purposive sampling was used to select key informants, a sample of healthcare workers that participated in in-depth interviews and community members who took part in focus group discussions. Secondary data were collected through a documentary search. Qualitative data were analysed through thematic analysis. Quantitative secondary data were examined using descriptive statistics and then compared with qualitative data to reinforce analysis. The HRH reform policy strategies that were identified included ministerial intervention; policy review; and revival of the human resource for health planning, financial planning, multi-sector collaboration, and community engagement. These had some positive effects; however, desired outcomes were undermined by financial, material, human resource, and social constraints. Despite constraints, the strategies helped revive the health delivery system in Epworth. In turn, this had a favourable outlook on post-2008 efforts by the Global Health Alliance towards healthcare worker reform and the 2030 Sustainable Development Agenda in peri-urban communities.

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

    OpenAIRE

    2015-01-01

    Introduction 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 ...

  10. The Prevalence of Accidental Needle Stick Injury and their Reporting among Healthcare Workers in Orthopaedic Wards in General Hospital Melaka, Malaysia.

    Science.gov (United States)

    Bhardwaj, A; Sivapathasundaram, N; Yusof, Mf; Minghat, Ah; Swe, Kmm; Sinha, Nk

    2014-07-01

    Background :Accidental needle-stick injuries (NSIs) are a hazard for health-care workers and general public health. Orthopaedic surgeons may be more prone to NSIs due to the prevalence of bone spikes in the operative field and the use of sharp orthopaedic instruments such as drills, saws and wires. A hospital-based cross sectional study was conducted in the orthopedic wards of Melaka General Hospital. The prevalence of NSIs was 32 (20.9%) and majority of it occurred during assisting in operation theatre 13(37.4%). Among them six (18.8%) were specialist, 12(37.5%) medical officer, 10 (31.2%) house officer and four staff nurses (12.5%). Among the respondents 142 (92.8%) had been immunized against Hepatitis B and 148 (96.7%) participants had knowledge regarding universal precaution. The incidence of NSI among health care workers at orthopaedics ward was not any higher in comparison with the similar studies and it was found out that the prevalence was more in junior doctors compared with specialist and staff nurses and it was statistically significant. Needle sticks injury, health care workers, and standard precaution.

  11. Healthcare workers' occupational exposure to bloodborne pathogens: a 5-year observation in selected hospitals of the Małopolska province.

    Science.gov (United States)

    Różańska, Anna; Szczypta, Anna; Baran, Magda; Synowiec, Edyta; Bulanda, Małgorzata; Wałaszek, Marta

    2014-10-01

    The study presents data concerning occupational exposures among the staff of 5 hospitals in the Małopolska province in 2008-2012, taking into account the frequency and circumstances of exposure formation, occupational groups of hospital workers, as well as diversification of the reported rates in subsequent years between the hospitals and in each of them. An additional objective of the analysis was to assess the practical usefulness of the reported data for planning and evaluation of the effectiveness of procedures serving to minimize the risk of healthcare workers' exposure to pathogens transmitted through blood. Data were derived from occupational exposure registries kept by 5 hospitals of varying sizes and operational profiles from the Małopolska province from the years 2008-2012. Seven hundred and seventy-five cases of exposure were found in a group of 3165 potentially exposed workers in the analyzed period. Most cases were observed in nurses (68%) and these were mainly various types of needlestick injuries (78%). Exposure rates with respect to all workers ranged from 2.6% to 8.3% in individual hospitals, but the differences in their values registered in the hospitals in subsequent years did not bear any statistical significance, in a way similar to the rates calculated separately for each occupational group. There was no upward or downward trend in the number of reported cases of exposure to bloodborne pathogens in the studied period in any of the hospitals. Statistically significant differences in the percentages of exposures were reported between individual hospitals in some years of the analyzed period, which confirms the need for registries in individual units in order to plan and evaluate the effectiveness of preventative measures.

  12. Analysis of structural relationship among the occupational dysfunction on the psychological problem in healthcare workers: a study using structural equation modeling

    Science.gov (United States)

    Kyougoku, Makoto

    2015-01-01

    Purpose. The purpose of this study is to demonstrate the hypothetical model based on structural relationship with the occupational dysfunction on psychological problems (stress response, burnout syndrome, and depression) in healthcare workers. Method. Three cross sectional studies were conducted to assess the following relations: (1) occupational dysfunction on stress response (n = 468), (2) occupational dysfunction on burnout syndrome (n = 1,142), and (3) occupational dysfunction on depression (n = 687). Personal characteristics were collected through a questionnaire (such as age, gender, and job category, opportunities for refreshment, time spent on leisure activities, and work relationships) as well as the Classification and Assessment of Occupational Dysfunction (CAOD). Furthermore, study 1 included the Stress Response Scale-18 (SRS-18), study 2 used the Japanese Burnout Scale (JBS), and study 3 employed the Center for Epidemiological Studies Depression Scale (CES-D). The Kolmogorov–Smirnov test, confirmatory factor analysis (CFA), exploratory factor analysis (EFA), and path analysis of structural equation modeling (SEM) analysis were used in all of the studies. EFA and CFA were used to measure structural validity of four assessments; CAOD, SRS-18, JBS, and CES-D. For examination of a potential covariate, we assessed the correlation of the total and factor score of CAOD and personal factors in all studies. Moreover, direct and indirect effects of occupational dysfunction on stress response (Study 1), burnout syndrome (Study 2), and depression (Study 3) were also analyzed. Results. In study 1, CAOD had 16 items and 4 factors. In Study 2 and 3, CAOD had 16 items and 5 factors. SRS-18 had 18 items and 3 factors, JBS had 17 items and 3 factors, and CES-D had 20 items and 4 factors. All studies found that there were significant correlations between the CAOD total score and the personal factor that included opportunities for refreshment, time spent on leisure

  13. Analysis of structural relationship among the occupational dysfunction on the psychological problem in healthcare workers: a study using structural equation modeling.

    Science.gov (United States)

    Teraoka, Mutsumi; Kyougoku, Makoto

    2015-01-01

    Purpose. The purpose of this study is to demonstrate the hypothetical model based on structural relationship with the occupational dysfunction on psychological problems (stress response, burnout syndrome, and depression) in healthcare workers. Method. Three cross sectional studies were conducted to assess the following relations: (1) occupational dysfunction on stress response (n = 468), (2) occupational dysfunction on burnout syndrome (n = 1,142), and (3) occupational dysfunction on depression (n = 687). Personal characteristics were collected through a questionnaire (such as age, gender, and job category, opportunities for refreshment, time spent on leisure activities, and work relationships) as well as the Classification and Assessment of Occupational Dysfunction (CAOD). Furthermore, study 1 included the Stress Response Scale-18 (SRS-18), study 2 used the Japanese Burnout Scale (JBS), and study 3 employed the Center for Epidemiological Studies Depression Scale (CES-D). The Kolmogorov-Smirnov test, confirmatory factor analysis (CFA), exploratory factor analysis (EFA), and path analysis of structural equation modeling (SEM) analysis were used in all of the studies. EFA and CFA were used to measure structural validity of four assessments; CAOD, SRS-18, JBS, and CES-D. For examination of a potential covariate, we assessed the correlation of the total and factor score of CAOD and personal factors in all studies. Moreover, direct and indirect effects of occupational dysfunction on stress response (Study 1), burnout syndrome (Study 2), and depression (Study 3) were also analyzed. Results. In study 1, CAOD had 16 items and 4 factors. In Study 2 and 3, CAOD had 16 items and 5 factors. SRS-18 had 18 items and 3 factors, JBS had 17 items and 3 factors, and CES-D had 20 items and 4 factors. All studies found that there were significant correlations between the CAOD total score and the personal factor that included opportunities for refreshment, time spent on leisure

  14. Analysis of structural relationship among the occupational dysfunction on the psychological problem in healthcare workers: a study using structural equation modeling

    Directory of Open Access Journals (Sweden)

    Mutsumi Teraoka

    2015-11-01

    Full Text Available Purpose. The purpose of this study is to demonstrate the hypothetical model based on structural relationship with the occupational dysfunction on psychological problems (stress response, burnout syndrome, and depression in healthcare workers.Method. Three cross sectional studies were conducted to assess the following relations: (1 occupational dysfunction on stress response (n = 468, (2 occupational dysfunction on burnout syndrome (n = 1,142, and (3 occupational dysfunction on depression (n = 687. Personal characteristics were collected through a questionnaire (such as age, gender, and job category, opportunities for refreshment, time spent on leisure activities, and work relationships as well as the Classification and Assessment of Occupational Dysfunction (CAOD. Furthermore, study 1 included the Stress Response Scale-18 (SRS-18, study 2 used the Japanese Burnout Scale (JBS, and study 3 employed the Center for Epidemiological Studies Depression Scale (CES-D. The Kolmogorov–Smirnov test, confirmatory factor analysis (CFA, exploratory factor analysis (EFA, and path analysis of structural equation modeling (SEM analysis were used in all of the studies. EFA and CFA were used to measure structural validity of four assessments; CAOD, SRS-18, JBS, and CES-D. For examination of a potential covariate, we assessed the correlation of the total and factor score of CAOD and personal factors in all studies. Moreover, direct and indirect effects of occupational dysfunction on stress response (Study 1, burnout syndrome (Study 2, and depression (Study 3 were also analyzed.Results. In study 1, CAOD had 16 items and 4 factors. In Study 2 and 3, CAOD had 16 items and 5 factors. SRS-18 had 18 items and 3 factors, JBS had 17 items and 3 factors, and CES-D had 20 items and 4 factors. All studies found that there were significant correlations between the CAOD total score and the personal factor that included opportunities for refreshment, time spent on leisure

  15. Improving performance and happiness among healthcare workers through a body-mind approach in a healthcare setting in Sri Lanka.

    Science.gov (United States)

    Gunathunga, M W

    2016-10-17

    Cognitive ergonomics in the work place has become a serious concern with the need to keep people happy at work while maintaining high productivity. Hence, it is worth exploring how the outcomes of lifestyle-based mind development programs can bring about happiness in workplace while keeping productivity and quality of services high. The objective of the present work was to test a body-mind technique to improve cognitive ergonomics in a health care work setting. Principal investigator explored many body-mind techniques before selecting the present method of "insight meditation" which he mastered before applying it on a group of scholars who made it a part of their lifestyle. Later it was introduced to a sample of 500 volunteer health personnel in the western province to generate a ripple effect of happiness at work. Initial qualitative information indicated improvement of some aspects of cognitive ergonomics among those who practiced it. There was a relief from stress during the practice sessions and improvements in the commitment to work and in team spirit. A demand was observed for further training. A quasi-experimental study to test the improvements is underway. Health workers showed interest in the mind training and potential benefits to individuals and the institutions were observed.

  16. A method for the prescription of inexpensive spectacles by non-specialist healthcare workers: S-Glasses.

    LENUS (Irish Health Repository)

    Treacy, M P

    2013-04-01

    Globally, 153 million people are visually impaired from uncorrected refractive error. The aim of this research was to verify a method whereby autorefractors could be used by non-specialist health-workers to prescribe spectacles, which used a small stock of preformed lenses that fit frames with standardised apertures. These spectacles were named S-Glasses (Smart Glasses).

  17. 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.

  18. 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.

  19. The predictive validity and effects of using the transtheoretical model to increase the physical activity of healthcare workers in a public hospital in South Africa.

    Science.gov (United States)

    Skaal, Linda; Pengpid, Supa

    2012-12-01

    There have been studies conducted on the effectiveness of the transtheoretical model (TTM) in improving the level of physical activity at worksites worldwide, but no such studies have been conducted in South Africa. The aim of this study was to determine the predictive validity and effects of using the Transtheoretical Model to increase the physical activity of healthcare workers in a public hospital in South Africa. A quasi-experimental design in the form of a single-group, pretest-posttest model was used to examine the possible relationship between an exposure to interventions, attitude, knowledge, and an increased level of physical activity. Two hundred hospital staff members (medical and nonmedical staff) were randomly selected for participation in the study. The following variables were measured: TTM stages of physical activity, knowledge and attitudes, fitness level, body mass index, and level of exposure to the intervention. The interventions designed were based on the concept of progressing stages of physical activity in TTM stage sequences: (1) pamphlets about physical activity and health, (2) posters, fun runs, and sports day, and (3) a second set of posters, a daily radio program, and aerobic classes. Post-intervention, participants had significantly increased their stages of physical activity, attitudes, and knowledge compared with their pre-tests. Mean scores of TTM (3.70) and knowledge (3.65) were significantly (p < 0.05) greater at post-test. Overall accuracies of TTM at pre-test correctly predicted TTM at post-test by an average of 66.9%. The use of TTM to identify the stage of physical activity of healthcare workers has enabled the researcher to design intervention programs specific to the stage of exercise behavior of hospital staff. The predictors (TTM1), exposure levels, knowledge, attitudes, and processes of change have significant contributions to the outcome (TTM2).

  20. MRSA Prevalence and Associated Risk Factors among Health-care Workers in Non-outbreak Situations in the Dutch-German EUREGIO

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    Ricarda Sassmannshausen

    2016-08-01

    Full Text Available Preventing the spread of methicillin-resistant Staphylococcus aureus (MRSA in healthcare facilities is a major infection control target. However, only a few studies have assessed the potential role of healthcare workers (HCWs for MRSA dissemination. To investigate the MRSA prevalence and the risk factors for MRSA colonization among HCWs, nasopharyngeal swabs were taken between June 2010 and January 2011 from 726 employees from nine acute care hospitals with different care levels within the German part of a Dutch-German border region (EUREGIO. The isolated MRSA strains were investigated using spa typing. The overall MRSA prevalence among HCWs in a non-outbreak situation was 4.6% (33 of 726, and was higher in nurses (5.6 %, 29 of 514 than in physicians (1.2%, 1 of 83. Possible risk factors associated with MRSA colonization were a known history of MRSA carriage and the presence of acne. Intensive contact with patients may facilitate MRSA transmission between patients and HCWs. Furthermore, an accumulation of risk factors was accompanied by an increased MRSA prevalence in HCW.

  1. Does community emergency care initiative improve the knowledge and skill of healthcare workers and laypersons in basic emergency care in India?

    Directory of Open Access Journals (Sweden)

    Sanjeev Bhoi

    2016-01-01

    Full Text Available Background: Due to lack of training in emergency care, basic emergency care in India is still in its infancy. We designed All India Institute of Medical Sciences basic emergency care course (AIIMS BECC to address the issue. Aim: To improve the knowledge and skill of healthcare workers and laypersons in basic emergency care and to identify impact of the course. Materials and Methods: Prospective study conducted over a period of 4 years. The target groups were medical and nonmedical personnel. Provider AIIMS BECC is of 1 day duration including lectures on cardio-pulmonary resuscitation, choking, and special scenarios. Course was disseminated via lectures, audio-visual aids, and mannequin training. For analysis, the participants were categorized on the basis of their education and profession. A pre- and a post-course evaluation were done and individual scores were given out of 20 and compared among all the groups and P value was calculated. Results: A total of 1283 subjects were trained. 99.81% became providers and 2.0% were trained as instructors. There was a significant improvement in knowledge among all the participants irrespective of their education level including medicos/nonmedicos. However, participants who had higher education (graduates and postgraduates and/or belonged to medical field had better knowledge gain as compared to those who had low level of education (≤12th standard and were nonmedicos. Conclusion: BECC is an excellent community initiative to improve knowledge and skill of healthcare and laypersons in providing basic emergency care.

  2. The Prevalence of Accidental Needle Stick Injury and their Reporting among Healthcare Workers in Orthopaedic Wards in General Hospital Melaka, Malaysia

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    Bhardwaj A

    2014-07-01

    Full Text Available Accidental needle-stick injuries (NSIs are a hazard for health-care workers and general public health. Orthopaedic surgeons may be more prone to NSIs due to the prevalence of bone spikes in the operative field and the use of sharp orthopaedic instruments such as drills, saws and wires. A hospital-based cross sectional study was conducted in the orthopedic wards of Melaka General Hospital. The prevalence of NSIs was 32 (20.9% and majority of it occurred during assisting in operation theatre 13(37.4%. Among them six (18.8% were specialist, 12(37.5% medical officer, 10 (31.2% house officer and four staff nurses (12.5%. Among the respondents 142 (92.8% had been immunized against Hepatitis B and 148 (96.7% participants had knowledge regarding universal precaution. The incidence of NSI among health care workers at orthopaedics ward was not any higher in comparison with the similar studies and it was found out that the prevalence was more in junior doctors compared with specialist and staff nurses and it was statistically significant.

  3. Vaccination against the 2009 pandemic influenza A (H1N1) among healthcare workers in the major teaching hospital of Sicily (Italy).

    Science.gov (United States)

    Amodio, Emanuele; Anastasi, Giovanna; Marsala, Maria Grazia Laura; Torregrossa, Maria Valeria; Romano, Nino; Firenze, Alberto

    2011-02-01

    The aim of the study was to investigate factors involved in vaccination acceptance among healthcare workers (HCWs) and adverse reactions rates associated with pandemic influenza vaccination. The study was carried out in the major teaching hospital of Sicily from November 2009 to February 2010 on 2267 HCWs. A total of 407 (18%) HCWs were vaccinated against the 2009 pandemic influenza A (H1N1). A logistic regression analysis indicates an increased risk of non-vaccination against pandemic influenza in females (OR=1.6; 95% CI=1.3-2.1) compared to males, in nurses/technicians/administrative workers (OR=1.7; 95% CI=1.3-2.2) compared to doctors/biologists, and in HCWs who were non-vaccinated against seasonal influenza in 2008-2009 (OR=4.9; 95% CI=3.7-6.5) compared to vaccinated HCWs. Overall, 302 (74.2%) out of 407 questionnaires distributed to vaccinated HCWs were returned within the observation period. One hundred fifty-two workers (50.3%) experienced at least one adverse reaction (30.1%, local reactions; 6.6% systemic reactions and 13.6% both of them). The most frequent side effect of vaccination was pain at the injection site (43.4%). Twelve (3.9%) out of 302 HCWs stated they experienced influenza-like illness episodes during the follow-up period. The use of an adjuvanted vaccine against pandemic influenza A (H1N1) appears to be an effective and safe preventive strategy, showing a prevalence of both local and systemic adverse reactions not very different from that seen after vaccination with non-adjuvanted seasonal influenza vaccine. Despite this finding, vaccination coverage among HCWs remains very low, suggesting the need to implement educational campaigns directed to groups with lower coverage rates.

  4. Texas passes first law for safe patient handling in America: landmark legislation protects health-care workers and patients from injury related to manual patient lifting.

    Science.gov (United States)

    Hudson, Mary Anne

    2005-01-01

    On June 17,2005, Texas Governor Rick Perry (R) signed into law Senate Bill 1525, making Texas the first state in the nation to require hospitals and nursing homes to implement safe patient handling and movement programs. Governor Perry is to be commended for this heroic first stand for safe patient handling in America. The landmark legislation will take effect January 1, 2006, requiring the establishment of policy to identify, assess, and develop methods of controlling the risk of injury to patients and nurses associated with lifting, transferring, repositioning, and movement of patients; evaluation of alternative methods from manual lifting to reduce the risk of injury from patient lifting, including equipment and patient care environment; restricting, to the extent feasible with existing equipment, manual handling of all or most of a patient's weight to emergency, life-threatening, or exceptional circumstances; and provision for refusal to perform patient handling tasks believed to involve unacceptable risks of injury to a patient or nurse. Manually lifting patients has been called deplorable, inefficient, dangerous to nurses, and painful and brutal to patients; manual lifting can cause needless suffering and injury to patients, with dangers including pain, bruising, skin tears, abrasions, tube dislodgement, dislocations, fractures, and being dropped by nursing staff during attempts to manually lift. Use of safe, secure, mechanical lift equipment and gentle friction-reducing devices for patient maneuvering tasks could eliminate such needless brutality. Research has proven that manual patient lifting is extremely hazardous to health-care workers, creating substantial risk of low-back injury, whether with one or two patient handlers. Studies on the use of mechanical patient lift equipment, by either nursing staff or lift teams, have proven repeatedly that most nursing staff back injury is preventable, leading to substantial savings to employers on medical and

  5. Work-family conflict and enrichment from the perspective of psychosocial resources: comparing Finnish healthcare workers by working schedules.

    Science.gov (United States)

    Mauno, Saija; Ruokolainen, Mervi; Kinnunen, Ulla

    2015-05-01

    We examined work-family conflict (WFC) and work-family enrichment (WFE) by comparing Finnish nurses, working dayshifts (non-shiftworkers, n = 874) and non-dayshifts. The non-dayshift employees worked either two different dayshifts (2-shiftworkers, n = 490) or three different shifts including nightshifts (3-shiftworkers, n = 270). Specifically, we investigated whether different resources, i.e. job control, managers' work-family support, co-workers' work-family support, control at home, personal coping strategies, and schedule satisfaction, predicted differently WFC and WFE in these three groups. Results showed that lower managers' work-family support predicted higher WFC only among 3-shiftworkers, whereas lower co-workers' support associated with increased WFC only in non-shiftworkers. In addition, shiftworkers reported higher WFC than non-shiftworkers. However, the level of WFE did not vary by schedule types. Moreover, the predictors of WFE varied only very little across schedule types. Shiftwork organizations should pay more attention to family-friendly management in order to reduce WFC among shiftworkers.

  6. Effectiveness of Personal Protective Equipment for Healthcare Workers Caring for Patients with Filovirus Disease: A Rapid Review.

    Directory of Open Access Journals (Sweden)

    Mona Hersi

    Full Text Available A rapid review, guided by a protocol, was conducted to inform development of the World Health Organization's guideline on personal protective equipment in the context of the ongoing (2013-present Western African filovirus disease outbreak, with a focus on health care workers directly caring for patients with Ebola or Marburg virus diseases.Electronic databases and grey literature sources were searched. Eligibility criteria initially included comparative studies on Ebola and Marburg virus diseases reported in English or French, but criteria were expanded to studies on other viral hemorrhagic fevers and non-comparative designs due to the paucity of studies. After title and abstract screening (two people to exclude, full-text reports of potentially relevant articles were assessed in duplicate. Fifty-seven percent of extraction information was verified. The Grading of Recommendations Assessment, Development and Evaluation framework was used to inform the quality of evidence assessments.Thirty non-comparative studies (8 related to Ebola virus disease were located, and 27 provided data on viral transmission. Reporting of personal protective equipment components and infection prevention and control protocols was generally poor.Insufficient evidence exists to draw conclusions regarding the comparative effectiveness of various types of personal protective equipment. Additional research is urgently needed to determine optimal PPE for health care workers caring for patients with filovirus.

  7. 医务人员手卫生规范执行状况调查%INVESTIGATION ON THE IMPLEMENTATION SITUATION OF STANDARD FOR HAND HYGIENE FOR HEALTHCARE WORKER

    Institute of Scientific and Technical Information of China (English)

    李玲; 张浩; 刘翠林; 尚晶

    2013-01-01

    目的 了解医院实施手卫生行业标准情况,为进一步落实手卫生措施提供依据.方法 采用问卷调查方式,对甘肃省部分医院执行《医务人员手卫生规范》情况进行了调查.结果 共调查14所医院的医护人员203人,分布在新生儿室、重症监护病房、感染性疾病科、口腔科、门诊采血室.各项手卫生设施配有率范围在26.11%~91.63%之间;外科手消毒设施配有率为19.70%~82.27%;各种洗手方法知晓率为31.03% ~96.55%;外科手消毒原则知晓率为82.76% ~89.66%.结论 甘肃省医院手卫生设施配备与手卫生行业标准存在差距,医务人员手卫生规范知晓率亟待提高.%Objective To know the implementation status of Standard for Hand Hygiene for Healthcare Workers in hospitals,and to provide guides for carrying out the hand hygiene measures further.Methods ' Questionnaires are used to survey the implementation situation of Standard for Hand Hygiene for Healthcare Workers in some hospitals of Gansu province.Results 203 medical staff from 14 hospitals are investigated who are working for newborn nursery,ICU,department of infectious diseases,department of stomatology,outpatient blood collection room.The rate range of being equipped with the hand hygiene facilities is between 26.11% to 91.63% ; the rate of being equipped with surgical hand antisepsis facilities is between 19.70% to 82.27% ; the rate of knowing various handwashing methods is between 31.03% to 96.55% ; the rate of knowing the principles of surgical hand antisepsis is between 82.76% to 89.66%.Conclusion There is difference between the equipment rate of hand hygiene facilities in hospitals of Gansu province and the standard rate of the hand hygiene sector and the medical staff need to improve their knowledge of Standard for Hand for Healthcare Worker.

  8. The 2017 Academic College of Emergency Experts and Academy of Family Physicians of India position statement on preventing violence against health-care workers and vandalization of health-care facilities in India.

    Science.gov (United States)

    Chauhan, Vivek; Galwankar, Sagar; Kumar, Raman; Raina, Sunil Kumar; Aggarwal, Praveen; Agrawal, Naman; Krishnan, S Vimal; Bhoi, Sanjeev; Kalra, O P; Soans, Santosh T; Aggarwal, Vandana; Kubendra, Mohan; Bijayraj, R; Datta, Sumana; Srivastava, R P

    2017-01-01

    There have been multiple incidents where doctors have been assaulted by patient relatives and hospital facilities have been vandalized. This has led to mass agitations by Physicians across India. Violence and vandalism against health-care workers (HCWs) is one of the biggest public health and patient care challenge in India. The sheer intensity of emotional hijack and the stress levels in both practicing HCWs and patient relative's needs immediate and detail attention. The suffering of HCWs who are hurt, the damage to hospital facilities and the reactionary agitation which affects patients who need care are all together doing everything to damage the delivery of health care and relationship between a doctor and a patient. This is detrimental to India where illnesses and Injuries continue to be the biggest challenge to its growth curve. The expert group set by The Academic College of Emergency Experts and The Academy of Family Physicians of India makes an effort to study this Public Health and Patient Care Challenge and provide recommendations to solve it.

  9. Tuberculosis en trabajadores de la salud: importancia de los programas de vigilancia y control Tuberculosis in healthcare workers: importance of surveillance and control programs

    Directory of Open Access Journals (Sweden)

    Luis Ostrosky-Zeichner

    2000-02-01

    Full Text Available OBJETIVO: Describir los resultados de la vigilancia de tuberculosis en trabajadores de la salud en un centro hospitalario de tercer nivel. MATERIAL Y MÉTODOS: Se revisaron los registros de vigilancia de trabajadores durante 1992-1998, analizando variables demográficas, laborales, antecedentes clínicos, así como pruebas previas, prueba de la tuberculina (PPD, refuerzos y seguimiento. Como medida de asociación se utilizó la razón de momios (RM con su respectiva significancia y los intervalos de confianza; la comparación entre diferentes subgrupos se realizó con la prueba ji², y se determinó tiempo de conversión con análisis de Kaplan Meier. RESULTADOS: Se vigilaron 1 617 trabajadores, 68%, mujeres y 32%, hombres. La edad promedio fue 26.9±7.6 (15-68 años. Del total, 30.5% eran enfermeras; 14.6%, médicos residentes, y 14.1%, internos. Un 65.8% provenía del Distrito Federal. El 71.6% tenía BCG, y 15.1%, PPD previo. El PPD al ingreso fue positivo en 39.6% de los casos; negativo, en el 48.3%, y sin lectura, en el 12.1% restante. Se aplicaron 483 refuerzos (booster en aquellos inicialmente negativos, y se encontraron 49 positivos. Se vigiló la conversión a PPD+ por aplicaciones periódicas en 231 trabajadores, y se encontró dicha conversión en 100 de ellos (43.3%. El tiempo promedio para detectar la conversión fue de 22.8±12.4 meses. La tasa de conversión a los 12 meses fue de 20%. Únicamente 50 trabajadores (50% recibieron y aceptaron profilaxis con isoniazida. CONCLUSIONES: Un alto porcentaje de trabajadores son PPD+ al ingreso. Los refuerzos detectan 10% más de casos. La tasa de conversión enfatiza la necesidad de organizar estos programas en México.OBJECTIVE: To describe tuberculosis surveillance results among healthcare workers of a tertiary care center. MATERIAL AND METHODS: All medical records of workers from 1992-1998 were reviewed. Demographics, labor, medical history, previous testing, PPD, booster shots and

  10. Effect of Workplace- versus Home-Based Physical Exercise on Muscle Response to Sudden Trunk Perturbation among Healthcare Workers: A Cluster Randomized Controlled Trial

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    Markus D. Jakobsen

    2015-01-01

    Full Text Available 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, or (2 home-based physical exercise (HOME performed during leisure time for 5 × 10 minutes per week. Mechanical and neuromuscular (EMG response to randomly assigned unloading and loading trunk perturbations and questions of fear avoidance were assessed at baseline and 10-week follow-up. Results. No group by time interaction for the mechanical trunk response and EMG latency time was seen following the ten weeks (P = 0.17–0.75. However, both groups demonstrated within-group changes (P<0.05 in stopping time during the loading and unloading perturbation and in stopping distance during the loading 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<0.05 and −0.14 (−0.30 to 0.02 (P=0.09, respectively. WORK and HOME performed 2.2 (SD: 1.1 and 1.0 (SD: 1.2 training sessions per week, respectively. Conclusions. Although training adherence was higher following WORK compared to HOME this additional training volume did not lead to significant between-group differences in the responses to sudden trunk perturbations. However, WORK led to reduced fear avoidance and reduced muscle preactivity prior to the perturbation onset, compared with HOME. This trial is registered with Clinicaltrials.gov (NCT01921764.

  11. Workplace violence and occupational stress in healthcare workers: a chicken-and-egg situation-results of a 6-year follow-up study.

    Science.gov (United States)

    Magnavita, Nicola

    2014-09-01

    Violence at work (WV) is an important occupational hazard for health care workers (HCWs). A number of surveys addressing the causes and effects of WV have shown that it is associated with work-related stress. However, it is not clear what direction this relationship takes, that is, whether job strain facilitates aggression against HCWs or WV is the cause of job strain. From 2003 to 2009, HCWs from a public health care unit were asked to self-assess their level of work-related stress and to report aggression that occurred in the 12-month period preceding their routine medical examination. In 2009, physical and mental health and job satisfaction were also assessed. A total of 698 out of 723 HCWs (96.5%) completed the study. Job strain and lack of social support were predictors of the occurrence of nonphysical aggression during the ensuing year. HCWs who experienced WV reported high strain and low support at work in the following year. The experience of nonphysical violence and a prolonged state of strain and social isolation were significant predictors of psychological problems and bad health at follow-up. The relationship between work-related distress and WV is bidirectional. The monitoring of workers through questionnaires distributed before their periodic examination is a simple and effective way of studying WV and monitoring distress. The findings of the present study may facilitate the subsequent design of participatory intervention for the prevention of violence in healthcare facilities. This should always be accompanied by measures designed to reduce strain and improve social support. © 2014 Sigma Theta Tau International.

  12. Healthcare workers under a mandated H1N1 vaccination policy with employment termination penalty: a survey to assess employee perception.

    Science.gov (United States)

    Winston, Lori; Wagner, Stephanie; Chan, Shu

    2014-08-20

    The ethical debate over mandatory healthcare worker (HCW) influenza vaccination is a heated one. Our study hospital instituted a mandatory employee influenza vaccination policy for the 2009-2010 influenza season during the highly publicized pandemic of the H1N1 "Swine Flu." Under this mandate there was no informed declination option, and termination of employment was the consequence for noncompliance. Our objective was to examine HCW perceptions of the H1N1 influenza virus, the vaccine, and the strict mandated vaccination policy. A survey was designed, distributed, and anonymously collected. In total, 202 completed questionnaires were obtained via accidental sampling by the investigators achieving a 100% response rate. Data analysis showed that 31.7% of surveyed HCWs felt the mandate was an infringement on their rights and 3.5% of HCWs would electively seek employment elsewhere. Significantly more nurses and clerks/technicians were opposed to the mandate compared to other types of employees. 96% felt that the mandating hospital should be liable should a significant adverse effect occur from receiving the vaccine. While the mandate helped to increase HCW influenza vaccination rates dramatically, the strict consequence of employment termination created negative feelings of coercion. Adopting a policy that includes a declination option with mandatory masking during influenza season might be a more widely acceptable and still adequate approach.

  13. Experiences of Kenyan healthcare workers providing services to men who have sex with men: qualitative findings from a sensitivity training programme

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    Elise M van der Elst

    2013-12-01

    Full Text Available Introduction: Men who have sex with men (MSM in Kenya are at high risk for HIV and may experience prejudiced treatment in health settings due to stigma. An on-line computer-facilitated MSM sensitivity programme was conducted to educate healthcare workers (HCWs about the health issues and needs of MSM patients. Methods: Seventy-four HCWs from 49 ART-providing health facilities in the Kenyan Coast were recruited through purposive sampling to undergo a two-day MSM sensitivity training. We conducted eight focus group discussions (FGDs with programme participants prior to and three months after completing the training programme. Discussions aimed to characterize HCWs’ challenges in serving MSM patients and impacts of programme participation on HCWs’ personal attitudes and professional capacities. Results: Before participating in the training programme, HCWs described secondary stigma, lack of professional education about MSM, and personal and social prejudices as barriers to serving MSM clients. After completing the programme, HCWs expressed greater acknowledgement of MSM patients in their clinics, endorsed the need to treat MSM patients with high professional standards and demonstrated sophisticated awareness of the social and behavioural risks for HIV among MSM. Conclusions: Findings provide support for this approach to improving health services for MSM patients. Further efforts are needed to broaden the reach of this training in other areas, address identified barriers to HCW participation and evaluate programme effects on patient and HCW outcomes using rigorous methodology.

  14. Spread of Tst-Positive Staphylococcus aureus Strains Belonging to ST30 Clone among Patients and Healthcare Workers in Two Intensive Care Units.

    Science.gov (United States)

    Papadimitriou-Olivgeris, Matthaios; Drougka, Eleanna; Fligou, Fotini; Dodou, Vasiliki; Kolonitsiou, Fevronia; Filos, Kriton S; Anastassiou, Evangelos D; Petinaki, Efthimia; Marangos, Markos; Spiliopoulou, Iris

    2017-09-04

    Staphylococcus aureus is a major cause of infections. Toxic shock syndrome toxin (TSST-1) and Panton-Valentine leukocidin (PVL) are associated with severe clinical syndromes. S. aureus colonizing isolates recovered from healthcare workers and patients in the intensive care unit (ICU) of a university hospital comprising Group A were compared with those from adult non-ICU carriers (Group B). mecA, lukS/lukF-PV (Panton-Valentine leukocidin, PVL), and tst (toxic shock syndrome toxin) gene carriage was detected by PCR. Clones were identified in all methicillin-resistant S. aureus (MRSA) and toxin-positive methicillin-susceptible strains (MSSA) by pulsed-field gel electrophoresis (PFGE), agr groups, and multi locus sequencing typing (MLST). Group A included 90 S. aureus isolates, whereas Group B 53. PVL was more frequently found among MRSA vs. MSSA (p < 0.001) and in strains of Group B as compared to Group A (p < 0.001), consistent with the spread of ST80-IV. Higher incidence of tst gene carriage was identified among MSSA vs. MRSA (P 0.005) belonging mainly to ST30, and Group A vs. Group B (P 0.002). The wide dissemination of ST80-IV mainly in the community is responsible for a high percentage of PVL-positive MRSA, while silent spread of tst-positive S. aureus clones among ICU patients and personnel poses a threat of hospital transmission and possible severe infections.

  15. Influenza vaccine effectiveness among healthcare workers in comparison to hospitalized patients: A 2004-2009 case-test, negative-control, prospective study.

    Science.gov (United States)

    Vanhems, P; Baghdadi, Y; Roche, S; Bénet, T; Regis, C; Lina, B; Robert, O; Voirin, N; Ecochard, R; Amour, S

    2016-01-01

    The objective of this study was to calculate Vaccine Effectiveness (VE) in healthcare workers (HCW) and to compare VE between patients and HCW. A case-control investigation based on the prospective study was conducted between 2004 and 2009 in a teaching hospital. All HCW with influenza-like illness (ILI) from participating units (n = 24) were included, and vaccination status was characterized by interview. A total of 150 HCW presented ILI; 130 (87%) were female, 27 (18%) were positive for influenza, and 42 (28%) were vaccinated. Adjusted VE was 89% (95% CI 39 to 98). Among patients, adjusted VE was 42% (95% CI -39 to 76). The difference of VE (VEhcw - VEpat) was 46.15% (95% CI 2.41 to 144). The VE ratio (VEhcw / VEpat) was 2.09 (95% CI -1.60 to 134.17). Influenza VE differed between HCW and patients when the flu season was taken into account. This finding confirms the major impact of host determinants on influenza VE.

  16. Influenza vaccine effectiveness among healthcare workers in comparison to hospitalized patients: A 2004-2009 case-test, negative-control, prospective study

    Science.gov (United States)

    Vanhems, P; Baghdadi, Y; Roche, S; Bénet, T; Regis, C; Lina, B; Robert, O; Voirin, N; Ecochard, R; Amour, S

    2016-01-01

    The objective of this study was to calculate Vaccine Effectiveness (VE) in healthcare workers (HCW) and to compare VE between patients and HCW. A case-control investigation based on the prospective study was conducted between 2004 and 2009 in a teaching hospital. All HCW with influenza-like illness (ILI) from participating units (n = 24) were included, and vaccination status was characterized by interview. A total of 150 HCW presented ILI; 130 (87%) were female, 27 (18%) were positive for influenza, and 42 (28%) were vaccinated. Adjusted VE was 89% (95% CI 39 to 98). Among patients, adjusted VE was 42% (95% CI −39 to 76). The difference of VE (VEhcw - VEpat) was 46.15% (95% CI 2.41 to 144). The VE ratio (VEhcw / VEpat) was 2.09 (95% CI −1.60 to 134.17). Influenza VE differed between HCW and patients when the flu season was taken into account. This finding confirms the major impact of host determinants on influenza VE. PMID:26327520

  17. Tuberculin Skin Test and QuantiFERON(®)-TB Gold In-Tube Test for Diagnosing Latent Tuberculosis Infection among Thai Healthcare Workers.

    Science.gov (United States)

    Khawcharoenporn, Thana; Apisarnthanarak, Anucha; Sangkitporn, Somchai; Rudeeaneksin, Janisara; Srisungngam, Sopa; Bunchoo, Supranee; Phetsuksiri, Benjawan

    2016-05-20

    A cross-sectional study was conducted on the performance of the tuberculin skin test (TST) and QuantiFERON(®)-TB Gold In-Tube test (QFT-IT) for detecting latent tuberculosis infection among Thai healthcare workers (HCWs). Each HCW underwent both the TST and QFT-IT during the annual health screening. Among the 260 HCWs enrolled, the median age was 30 years (range 19-60 years), 92% were women, 64% were nurses and nurse assistants, 78% were Bacillus Calmette Guérin vaccinated, and 37% had previously taken the TST. Correlation between TST reaction size and the interferon-γ level was weak (r = 0.29; P tuberculosis diagnosis, the cut-off for TST reactivity with the best performance was ≥13 mm with a sensitivity, specificity, false positivity, and false negativity of 71%, 70%, 30%, and 29%, respectively (area under the curve 0.73; P < 0.001). The independent factor associated with a false reactive TST was a previous TST (adjusted odds ratio 1.83; P = 0.04). Our findings suggest that the QFT-IT may be the preferred test among HCWs with previous TST. In settings where the QFT-IT is not available, appropriate cut-offs for TST reactivity should be evaluated for use among HCWs.

  18. Prevalence of Influenza A (H1N1 Seropositivity in Unvaccinated Healthcare Workers in Scotland at the Height of the Global Pandemic

    Directory of Open Access Journals (Sweden)

    Kate Smith

    2011-01-01

    Full Text Available Background. We set out to identify the level of previous exposure to influenza A (H1N1 in unvaccinated healthcare workers (HCWs at the peak of the pandemic outbreak in the UK, with control samples collected prior to the outbreak. Methods. Cross-sectional study (seroprevalence assessed before and at pandemic peak, with questionnaire data collected at peak of outbreak in HCWs in Scotland. Results. The prevalence of seropositivity in 493 HCWs at pandemic peak was 10.3%, which was higher than the prepandemic level by 3.7 percentage points (95% CI 0.3% to 7.3%, P=0.048. Seropositivity rates for frontline and nonfrontline HCWs were similar. Conclusion. At pandemic peak, only 10.3% of HCWs were seropositive for influenza A (H1N1, so the great majority were still susceptible to infection at the introduction of the vaccination programme. Few studies have reported on seroprevalence in unvaccinated and asymptomatic participants, so our findings may have relevance to the wider population.

  19. 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.

  20. 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

    BACKGROUND: 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. 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...

  1. Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers: a systematic review.

    Directory of Open Access Journals (Sweden)

    Khai Tran

    Full Text Available Aerosol generating procedures (AGPs may expose health care workers (HCWs to pathogens causing acute respiratory infections (ARIs, but the risk of transmission of ARIs from AGPs is not fully known. We sought to determine the clinical evidence for the risk of transmission of ARIs to HCWs caring for patients undergoing AGPs compared with the risk of transmission to HCWs caring for patients not undergoing AGPs. We searched PubMed, EMBASE, MEDLINE, CINAHL, the Cochrane Library, University of York CRD databases, EuroScan, LILACS, Indian Medlars, Index Medicus for SE Asia, international health technology agencies and the Internet in all languages for articles from 01/01/1990 to 22/10/2010. Independent reviewers screened abstracts using pre-defined criteria, obtained full-text articles, selected relevant studies, and abstracted data. Disagreements were resolved by consensus. The outcome of interest was risk of ARI transmission. The quality of evidence was rated using the GRADE system. We identified 5 case-control and 5 retrospective cohort studies which evaluated transmission of SARS to HCWs. Procedures reported to present an increased risk of transmission included [n; pooled OR(95%CI] tracheal intubation [n = 4 cohort; 6.6 (2.3, 18.9, and n = 4 case-control; 6.6 (4.1, 10.6], non-invasive ventilation [n = 2 cohort; OR 3.1(1.4, 6.8], tracheotomy [n = 1 case-control; 4.2 (1.5, 11.5] and manual ventilation before intubation [n = 1 cohort; OR 2.8 (1.3, 6.4]. Other intubation associated procedures, endotracheal aspiration, suction of body fluids, bronchoscopy, nebulizer treatment, administration of O2, high flow O2, manipulation of O2 mask or BiPAP mask, defibrillation, chest compressions, insertion of nasogastric tube, and collection of sputum were not significant. Our findings suggest that some procedures potentially capable of generating aerosols have been associated with increased risk of SARS transmission to HCWs or were a risk

  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. Personal Decision-Making Criteria Related to Seasonal and Pandemic A(H1N1) Influenza-Vaccination Acceptance among French Healthcare Workers

    Science.gov (United States)

    Bouadma, Lila; Barbier, François; Biard, Lucie; Esposito-Farèse, Marina; Le Corre, Bertrand; Macrez, Annick; Salomon, Laurence; Bonnal, Christine; Zanker, Caroline; Najem, Christophe; Mourvillier, Bruno; Lucet, Jean Christophe; Régnier, Bernard; Wolff, Michel; Tubach, Florence

    2012-01-01

    Background Influenza-vaccination rates among healthcare workers (HCW) remain low worldwide, even during the 2009 A(H1N1) pandemic. In France, this vaccination is free but administered on a voluntary basis. We investigated the factors influencing HCW influenza vaccination. Methods In June–July 2010, HCW from wards of five French hospitals completed a cross-sectional survey. A multifaceted campaign aimed at improving vaccination coverage in this hospital group was conducted before and during the 2009 pandemic. Using an anonymous self-administered questionnaire, we assessed the relationships between seasonal (SIV) and pandemic (PIV) influenza vaccinations, and sociodemographic and professional characteristics, previous and current vaccination statuses, and 33 statements investigating 10 sociocognitive domains. The sociocognitive domains describing HCWs' SIV and PIV profiles were analyzed using the classification-and-regression–tree method. Results Of the HCWs responding to our survey, 1480 were paramedical and 401 were medical with 2009 vaccination rates of 30% and 58% for SIV and 21% and 71% for PIV, respectively (p<0.0001 for both SIV and PIV vaccinations). Older age, prior SIV, working in emergency departments or intensive care units, being a medical HCW and the hospital they worked in were associated with both vaccinations; while work shift was associated only with PIV. Sociocognitive domains associated with both vaccinations were self-perception of benefits and health motivation for all HCW. For medical HCW, being a role model was an additional domain associated with SIV and PIV. Conclusions Both vaccination rates remained low. Vaccination mainly depended on self-determined factors and for medical HCW, being a role model. PMID:22848342

  4. Is Universal HBV Vaccination of Healthcare Workers a Relevant Strategy in Developing Endemic Countries? The Case of a University Hospital in Niger

    Science.gov (United States)

    Pellissier, Gérard; Yazdanpanah, Yazdan; Adehossi, Eric; Tosini, William; Madougou, Boubacar; Ibrahima, Kaza; Lolom, Isabelle; Legac, Sylvie; Rouveix, Elisabeth; Champenois, Karen; Rabaud, Christian; Bouvet, Elisabeth

    2012-01-01

    Background Exposure to hepatitis B virus (HBV) remains a serious risk to healthcare workers (HCWs) in endemic developing countries owing to the strong prevalence of HBV in the general and hospital populations, and to the high rate of occupational blood exposure. Routine HBV vaccination programs targeted to high-risk groups and especially to HCWs are generally considered as a key element of prevention strategies. However, the high rate of natural immunization among adults in such countries where most infections occur perinatally or during early childhood must be taken into account. Methodology/Principal Findings We conducted a cross sectional study in 207 personnel of 4 occupational groups (medical, paramedical, cleaning staff, and administrative) in Niamey’s National Hospital, Niger, in order to assess the prevalence of HBV markers, to evaluate susceptibility to HBV infection, and to identify personnel who might benefit from vaccination. The proportion of those who declared a history of occupational blood exposure ranged from 18.9% in the administrative staff to 46.9% in paramedical staff. Only 7.2% had a history of vaccination against HBV with at least 3 injections. Ninety two percent were anti-HBc positive. When we focused on170 HCWs, only 12 (7.1%) showed no biological HBV contact. Twenty six were HBsAg positive (15,3%; 95% confidence interval: 9.9%–20.7%) of whom 8 (32%) had a viral load >2000 IU/ml. Conclusions/Significance The very small proportion of HCWs susceptible to HBV infection in our study and other studies suggests that in a global approach to prevent occupational infection by bloodborne pathogens, a universal hepatitis B vaccination of HCWs is not priority in these settings. The greatest impact on the risk will most likely be achieved by focusing efforts on primary prevention strategies to reduce occupational blood exposure. HBV screening in HCWs and treatment of those with chronic HBV infection should be however considered. PMID:22970218

  5. Ethical problems in an era where disasters have become a part of daily life: A qualitative study of healthcare workers in Turkey

    Science.gov (United States)

    2017-01-01

    Background Natural disasters, armed conflict, migration, and epidemics today occur more frequently, causing more death, displacement of people and economic loss. Their burden on health systems and healthcare workers (HCWs) is getting heavier accordingly. The ethical problems that arise in disaster settings may be different than the ones in daily practice, and can cause preventable harm or the violation of basic human rights. Understanding the types and the determinants of ethical challenges is crucial in order to find the most benevolent action while respecting the dignity of those affected people. Considering the limited scope of studies on ethical challenges within disaster settings, we set upon conducting a qualitative study among local HCWs. Methods Our study was conducted in six cities of Turkey, a country where disasters are frequent, including armed conflict, terrorist attacks and a massive influx of refugees. In-depth interviews were carried out with a total of 31 HCWs working with various backgrounds and experience. Data analysis was done concurrently with ongoing interviews. Results Several fundamental elements currently hinder ethics in relief work. Attitudes of public authorities, politicians and relief organizations, the mismanagement of impromptu humanitarian action and relief and the media's mindset create ethical problems on the macro-level such as discrimination, unjust resource allocation and violation of personal rights, and can also directly cause or facilitate the emergence of problems on the micro-level. An important component which prevents humanitarian action towards victims is insufficient competence. The duty to care during epidemics and armed conflicts becomes controversial. Many participants defend a paternalistic approach related to autonomy. Confidentiality and privacy are either neglected or cannot be secured. Conclusion Intervention in factors on the macro-level could have a significant effect in problem prevention. Improving

  6. Frequent Detection of Anti-Tubercular-Glycolipid-IgG and -IgA Antibodies in Healthcare Workers with Latent Tuberculosis Infection in the Philippines

    Directory of Open Access Journals (Sweden)

    Umme Ruman Siddiqi

    2012-01-01

    Full Text Available Anti-tubercular-glycolipid-IgG (TBGL-IgG and -IgA (TBGL-IgA antibodies, and the QuantiFERON-TB Gold test (QFT were compared in healthcare workers (HCWs, n=31 and asymptomatic human immunodeficiency virus-carriers (HIV-AC, n=56 in Manila. In HCWs, 48%, 51%, and 19% were positive in QFT, TBGL-IgG, and -IgA, respectively. The TBGL-IgG positivity was significantly higher (P=0.02 in QFT-positive than QFT-negative HCWs. Both TBGL-IgG- and -IgA-positive cases were only found in QFT-positive HCWs (27%. The plasma IFN-γ levels positively correlated with TBGL-IgA titers (r=0.74, P=0.005, but not TBGL-IgG titers in this group, indicating that mucosal immunity is involved in LTBI in immunocompetent individuals. The QFT positivity in HIV-AC was 31% in those with CD4+ cell counts >350/μL and 12.5% in low CD4 group (<350/μL. 59 % and 29% were positive for TBGL-IgG and -IgA, respectively, in HIV-AC, but no association was found between QFT and TBGL assays. TBGL-IgG-positive rates in QFT-positive and QFT-negative HIV-AC were 61% and 58%, and those of TBGL-IgA were 23% and 30%, respectively. The titers of TBGL-IgA were associated with serum IgA (P=0.02 in HIV-AC. Elevations of TBGL-IgG and -IgA were related to latent tuberculosis infection in HCWs, but careful interpretation is necessary in HIV-AC.

  7. Personal decision-making criteria related to seasonal and pandemic A(H1N1 influenza-vaccination acceptance among French healthcare workers.

    Directory of Open Access Journals (Sweden)

    Lila Bouadma

    Full Text Available BACKGROUND: Influenza-vaccination rates among healthcare workers (HCW remain low worldwide, even during the 2009 A(H1N1 pandemic. In France, this vaccination is free but administered on a voluntary basis. We investigated the factors influencing HCW influenza vaccination. METHODS: In June-July 2010, HCW from wards of five French hospitals completed a cross-sectional survey. A multifaceted campaign aimed at improving vaccination coverage in this hospital group was conducted before and during the 2009 pandemic. Using an anonymous self-administered questionnaire, we assessed the relationships between seasonal (SIV and pandemic (PIV influenza vaccinations, and sociodemographic and professional characteristics, previous and current vaccination statuses, and 33 statements investigating 10 sociocognitive domains. The sociocognitive domains describing HCWs' SIV and PIV profiles were analyzed using the classification-and-regression-tree method. RESULTS: Of the HCWs responding to our survey, 1480 were paramedical and 401 were medical with 2009 vaccination rates of 30% and 58% for SIV and 21% and 71% for PIV, respectively (p<0.0001 for both SIV and PIV vaccinations. Older age, prior SIV, working in emergency departments or intensive care units, being a medical HCW and the hospital they worked in were associated with both vaccinations; while work shift was associated only with PIV. Sociocognitive domains associated with both vaccinations were self-perception of benefits and health motivation for all HCW. For medical HCW, being a role model was an additional domain associated with SIV and PIV. CONCLUSIONS: Both vaccination rates remained low. Vaccination mainly depended on self-determined factors and for medical HCW, being a role model.

  8. Delineating a Retesting Zone Using Receiver Operating Characteristic Analysis on Serial QuantiFERON Tuberculosis Test Results in US Healthcare Workers

    Directory of Open Access Journals (Sweden)

    Wendy Thanassi

    2012-01-01

    Full Text Available Objective. To find a statistically significant separation point for the QuantiFERON Gold In-Tube (QFT interferon gamma release assay that could define an optimal “retesting zone” for use in serially tested low-risk populations who have test “reversions” from initially positive to subsequently negative results. Method. Using receiver operating characteristic analysis (ROC to analyze retrospective data collected from 3 major hospitals, we searched for predictors of reversion until statistically significant separation points were revealed. A confirmatory regression analysis was performed on an additional sample. Results. In 575 initially positive US healthcare workers (HCWs, 300 (52.2% had reversions, while 275 (47.8% had two sequential positive tests. The most statistically significant (Kappa = 0.48, chi-square = 131.0, P<0.001 separation point identified by the ROC for predicting reversion was the tuberculosis antigen minus-nil (TBag-nil value at 1.11 International Units per milliliter (IU/mL. The second separation point was found at TBag-nil at 0.72 IU/mL (Kappa = 0.16, chi-square = 8.2, P<0.01. The model was validated by the regression analysis of 287 HCWs. Conclusion. Reversion likelihood increases as the TBag-nil approaches the manufacturer's cut-point of 0.35 IU/mL. The most statistically significant separation point between those who test repeatedly positive and those who revert is 1.11 IU/mL. Clinicians should retest low-risk individuals with initial QFT results < 1.11 IU/mL.

  9. VOC contamination in hospital, from stationary sampling of a large panel of compounds, in view of healthcare workers and patients exposure assessment.

    Directory of Open Access Journals (Sweden)

    Vincent Bessonneau

    Full Text Available BACKGROUND: We aimed to assess, for the first time, the nature of the indoor air contamination of hospitals. METHODS AND FINDINGS: More than 40 volatile organic compounds (VOCs including aliphatic, aromatic and halogenated hydrocarbons, aldehydes, alcohols, ketones, ethers and terpenes were measured in a teaching hospital in France, from sampling in six sampling sites--reception hall, patient room, nursing care, post-anesthesia care unit, parasitology-mycology laboratory and flexible endoscope disinfection unit--in the morning and in the afternoon, during three consecutive days. Our results showed that the main compounds found in indoor air were alcohols (arithmetic means ± SD: 928±958 µg/m³ and 47.9±52.2 µg/m³ for ethanol and isopropanol, respectively, ethers (75.6±157 µg/m³ for ether and ketones (22.6±20.6 µg/m³ for acetone. Concentrations levels of aromatic and halogenated hydrocarbons, ketones, aldehydes and limonene were widely variable between sampling sites, due to building age and type of products used according to health activities conducted in each site. A high temporal variability was observed in concentrations of alcohols, probably due to the intensive use of alcohol-based hand rubs in all sites. Qualitative analysis of air samples led to the identification of other compounds, including siloxanes (hexamethyldisiloxane, octamethyltrisiloxane, decamethylcyclopentasiloxane, anesthetic gases (sevoflurane, desflurane, aliphatic hydrocarbons (butane, esters (ethylacetate, terpenes (camphor, α-bisabolol, aldehydes (benzaldehyde and organic acids (benzoic acid depending on sites. CONCLUSION: For all compounds, concentrations measured were lower than concentrations known to be harmful in humans. However, results showed that indoor air of sampling locations contains a complex mixture of VOCs. Further multicenter studies are required to compare these results. A full understanding of the exposure of healthcare workers and patients

  10. A prospective longitudinal study evaluating a T-cell-based assay for latent tuberculosis infection in health-care workers in a general hospital in Beijing

    Institute of Scientific and Technical Information of China (English)

    ZHANG Li-fan; LIU Xiao-qing; ZHANG Yao; DENG Guo-hua; Manish Pareek; Ajit Lalvani

    2013-01-01

    Background The health-care workers (HCWs) are at high risk of acquiring infection with Mycobacterium tuberculosis.The objectives of this study were to compare the performance of the T-SPOT.TB and tuberculin skin test (TST) for latent tuberculosis infection (LTBI),evaluate diagnostic concordance and risk factors for LTBI,and observe the progression to active tuberculosis (TB) disease among HCWs in a general hospital in Beijing.Methods The prospective cohort study enrolled HCWs in a tertiary general hospital in Beijing,China,to evaluate LTBI with T-SPOT.TB and TST.The subjects were evaluated every 12 months during the 60-month follow-up.Results Of 101 participating HCWs,96 and 101 had valid TST and T-SPOT.TB results,respectively.Twenty-nine (28.7%,95% confidence interval (CI),19.9%-37.5%) were defined as positive by T-SPOT.TB and 53 (55.2%,95% CI,45.2%-64.9%) were defined as positive by TST (using a ≥10 mm cutoff).An agreement between the two tests was poor (57.3%,K=0.18,95% CI,0.01%-0.52%).In multivariate analysis,direct exposure to sputum smear-positive TB patients was a significant risk factor for a positive T-SPOT.TB (OR 5.76; 95% CI 1.38-24.00).Pooled frequency of antigenspecific IFN-γ secreting T-cells for subjects who reported direct contact with sputum smear-positive TB patients was significantly higher than that for participants without direct contact (P=-0.045).One of 20 participants with positive result of T-SPOT.TB and TST developed active TB at 24-month follow-up.Conclusion T-SPOT.TB is a more accurate,targeted method of diagnosing LTBI than TST.

  11. Estimated risk of HIV acquisition and practice for preventing occupational exposure: a study of healthcare workers at Tumbi and Dodoma Hospitals, Tanzania.

    Science.gov (United States)

    Mashoto, Kijakazi O; Mubyazi, Godfrey M; Makundi, Emmanuel; Mohamed, Hussein; Malebo, Hamisi M

    2013-09-30

    Healthcare workers (HCWs) are at risk of acquiring human immuno-deficiency virus (HIV) and other infections via exposure to infectious patients' blood and body fluids. The main objective of this study was to estimate the risk of HIV transmission and examine the practices for preventing occupational exposures among HCWs at Tumbi and Dodoma Hospitals in Tanzania. This study was carried out in two hospitals, namely, Tumbi in Coast Region and Dodoma in Dodoma Region. In each facility, hospital records of occupational exposure to HIV infection and its management were reviewed. In addition, practices to prevent occupational exposure to HIV infection among HCWs were observed. The estimated risk of HIV transmission due to needle stick injuries was calculated to be 7 cases per 1,000,000 HCWs-years. Over half of the observed hospital departments did not have guidelines for prevention and management of occupational exposure to HIV infections and lacked well displayed health and safety instructions. Approximately, one-fifth of the hospital departments visited failed to adhere to the instructions pertaining to correlation between waste materials and the corresponding colour coded bag/container/safety box. Seventy four percent of the hospital departments observed did not display instructions for handling infectious materials. Inappropriate use of gloves, lack of health and safety instructions, and lack of use of eye protective glasses were more frequently observed at Dodoma Hospital than at Tumbi Hospital. The poor quality of the hospital records at the two hospitals hampered our effort to characterise the risk of HIV infection acquisition by HCWs. Greater data completeness in hospital records is needed to allow the determination of the actual risk of HIV transmission for HCWs. To further reduce the risk of HIV infection due to occupational exposure, hospitals should be equipped with sufficient personal protective equipment (PPE) and HCWs should be reminded of the importance of

  12. Using Computer Vision and Depth Sensing to Measure Healthcare Worker-Patient Contacts and Personal Protective Equipment Adherence Within Hospital Rooms.

    Science.gov (United States)

    Chen, Junyang; Cremer, James F; Zarei, Kasra; Segre, Alberto M; Polgreen, Philip M

    2016-01-01

    Background.  We determined the feasibility of using computer vision and depth sensing to detect healthcare worker (HCW)-patient contacts to estimate both hand hygiene (HH) opportunities and personal protective equipment (PPE) adherence. Methods.  We used multiple Microsoft Kinects to track the 3-dimensional movement of HCWs and their hands within hospital rooms. We applied computer vision techniques to recognize and determine the position of fiducial markers attached to the patient's bed to determine the location of the HCW's hands with respect to the bed. To measure our system's ability to detect HCW-patient contacts, we counted each time a HCW's hands entered a virtual rectangular box aligned with a patient bed. To measure PPE adherence, we identified the hands, torso, and face of each HCW on room entry, determined the color of each body area, and compared it with the color of gloves, gowns, and face masks. We independently examined a ground truth video recording and compared it with our system's results. Results.  Overall, for touch detection, the sensitivity was 99.7%, with a positive predictive value of 98.7%. For gowned entrances, sensitivity was 100.0% and specificity was 98.15%. For masked entrances, sensitivity was 100.0% and specificity was 98.75%; for gloved entrances, the sensitivity was 86.21% and specificity was 98.28%. Conclusions.  Using computer vision and depth sensing, we can estimate potential HH opportunities at the bedside and also estimate adherence to PPE. Our fine-grained estimates of how and how often HCWs interact directly with patients can inform a wide range of patient-safety research.

  13. Impact of the Raising Immunizations Safely and Effectively (RISE) Program on Healthcare Worker Influenza Immunization Rates in Long-Term Care Settings

    Science.gov (United States)

    Nace, David A.; Handler, Steven M.; Hoffman, Erika L.; Perera, Subashan

    2012-01-01

    Introduction and Rationale National influenza immunization rates for healthcare workers (HCW) in long-term care (LTC) remain unacceptably low. This poses a serious public health threat to residents. Prior work has suggested high staff turnover rates as a contributing factor to low immunization rates. There is a critical need to identify and deploy successful models of HCW influenza immunization programs to LTC facilities. This report describes one potential model that has been successfully initiated in a network of LTC facilities. Methods All facilities served by a single regional LTC pharmacy were invited to participate in a HCW influenza immunization program. This voluntary immunization program began in 2005 and continues to the present. As part of the program, the pharmacy promoted organizational change by assuming oversight and control of HCW immunization policies and processes for all facilities. Primary and secondary outcomes are the number of facilities reaching HCW influenza immunization rates of 60% and 80%. Results Fourteen of the sixteen LTC facilities participated. Facilities were diverse and included both nursing and assisted living facilities; unionized and nonunionized facilities; and urban, suburban and rural facilities. The pharmacy provided educational and communication materials, centralized data collection using a standardized definition for HCW immunization rates, and facility feedback. All fourteen LTC facilities achieved the primary goal of 60% and nearly two thirds reached the secondary goal of 80%. Twenty percent reached the new Healthy People 2020 goal of 90%. Discussion It is possible for LTC facilities to improve HCW immunization rates using a pharmacy based, voluntary HCW influenza immunization approach. Such an approach may help attenuate the negative influence of staff turnover on HCW immunizations. Attainment of the new Health People 2020 goals still remains a challenge and may require mandatory programs. PMID:23031265

  14. Healthcare worker adherence to follow-up after occupational exposure to blood and body fluids at a teaching hospital in Brazil.

    Science.gov (United States)

    Escudero, Daniela Vieira Silva; Furtado, Guilherme Henrique Campos; Medeiros, Eduardo Alexandrino

    2015-06-01

    Healthcare workers (HCWs) are at a high risk for exposure to pathogens in the workplace. The objective of this study was to evaluate HCW adherence to follow-up after occupational exposure to blood and body fluids at a tertiary care university hospital in the city of São Paulo, Brazil. Data were collected from 2102 occupational exposures to blood and body fluids reports, obtained from the Infection Control Division of the Universidade Federal de São Paulo/Escola Paulista de Medicina/Hospital São Paulo, in São Paulo, Brazil, occurring between January of 2005 and December of 2011. To evaluate adherence to post-exposure follow-up among the affected HCWs, we took into consideration follow-up visits for serological testing. For HCWs exposed to materials from source patients infected with human immunodeficiency virus (HIV), hepatitis B virus (HBV), or hepatitis C virus (HCV), as well as from source patients of unknown serological status, follow-up serological testing was scheduled for 3 and 6 months after the accident. For those exposed to materials from source patients co-infected with HIV and HCV, follow-up evaluations were scheduled for 3, 6, and 12 months after the accident. During the study period, there were 2056 accidental exposures for which data regarding the serology of the source patient were available. Follow-up evaluation of the affected HCW was recommended in 612 (29.8%) of those incidents. After the implementation of a post-exposure protocol involving telephone calls and official letters mailed to the affected HCW, adherence to follow-up increased significantly, from 30.5 to 54.0% (P = 0.028). Adherence was correlated positively with being female (P = 0.009), with the source of the exposure being known (P = 0.026), with the source patient being HIV positive (P = 0.029), and with the HCW having no history of such accidents (P = 0.047). Adherence to the recommended serological testing was better at the evaluation scheduled for 3 months after the exposure

  15. Correlates of Performance of Healthcare Workers in Emergency, Triage, Assessment and Treatment plus Admission Care (ETAT+ Course in Rwanda: Context Matters.

    Directory of Open Access Journals (Sweden)

    Celestin Hategekimana

    Full Text Available The Emergency, Triage, Assessment and Treatment plus Admission care (ETAT+ course, a comprehensive advanced pediatric life support course, was introduced in Rwanda in 2010 to facilitate the achievement of the fourth Millennium Development Goal. The impact of the course on improving healthcare workers (HCWs knowledge and practical skills related to providing emergency care to severely ill newborns and children in Rwanda has not been studied.To evaluate the impact of the ETAT+ course on HCWs knowledge and practical skills, and to identify factors associated with greater improvement in knowledge and skills.We used a one group, pre-post test study using data collected during ETAT+ course implementation from 2010 to 2013. The paired t-test was used to assess the effect of ETAT+ course on knowledge improvement in participating HCWs. Mixed effects linear and logistic regression models were fitted to explore factors associated with HCWs performance in ETAT+ course knowledge and practical skills assessments, while accounting for clustering of HCWs in hospitals.374 HCWs were included in the analysis. On average, knowledge scores improved by 22.8/100 (95% confidence interval (CI 20.5, 25.1. In adjusted models, bilingual (French & English participants had a greater improvement in knowledge 7.3 (95% CI 4.3, 10.2 and higher odds of passing the practical skills assessment (adjusted odds ratio (aOR = 2.60; 95% CI 1.25, 5.40 than those who were solely proficient in French. Participants who attended a course outside of their health facility had higher odds of passing the skills assessment (aOR = 2.11; 95% CI 1.01, 4.44 than those who attended one within their health facility.The current study shows a positive impact of ETAT+ course on improving participants' knowledge and skills related to managing emergency pediatric and neonatal care conditions. The findings regarding key factors influencing ETAT+ course outcomes demonstrate the importance of considering key

  16. 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.

  17. Technical support by Solthis for health-care workers in order to decentralise medical treatment for people living with HIV in the Ségou region of Mali

    Directory of Open Access Journals (Sweden)

    A. Akonde

    2009-01-01

    Full Text Available Medical treatment for people living with HIV/AIDS started in Mali as early as 1997 thanks to civil society. The national response was officialised by the adoption of the Malian Initiative for Access to Antiretroviral Therapy (Initiative Malienne d’Accès aux Antirétroviraux IMAARV. In 2004 ART, drugs against opportunistic infections and basic biological monitoring were made available free of charge by decree. In 2005, decentralisation of health-care to regions and circles became one of the main thrusts of the national strategy for the fight against the pandemic. Sub-Saharan African countries are making significant efforts to provide full geographical coverage of their national territory.It is in this “scaling-up” context that the Solthis NGO (Solidarité Thérapeutique et Initiatives contre le Sida began cooperating with Malian actors to extend access to quality treatment for patients living with HIV/AIDS in the city and region of Ségou. Based on a developmental approach, Solthis opted for continuing in situ technical support for national actors in the fight against AIDS. Thanks to the daily presence of a team “in the field” Solthis devotes a large part of its activities to capacity-building for health-care workers through an exchange of medical and scientific expertise. Efforts were also made to improve health-care workers’ working conditions and to make various tests and drugs accessible to patients infected with HIV. The initial aim was to encourage universal access to ART. Today, the Ségou programme supported by Solthis has developed over 1,500 new treatments in the region. In addition, every PMTCT centre in the region offers prevention and treatment services to mothers and children. Today, the Ségou region is an integral part of the IMAARV initiative as a decentralisation pilot project.Le traitement médical des malades atteints du VIH/SIDA a débuté au Mali dès 1997 grâce à la société civile. La r

  18. Lakatos Revisited.

    Science.gov (United States)

    Court, Deborah

    1999-01-01

    Revisits and reviews Imre Lakatos' ideas on "Falsification and the Methodology of Scientific Research Programmes." Suggests that Lakatos' framework offers an insightful way of looking at the relationship between theory and research that is relevant not only for evaluating research programs in theoretical physics, but in the social…

  19. 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.

  20. 医疗失效模式与效应分析在援塞抗疫医疗队员风险管理中的应用%Application of healthcare failure mode and effects analysis system in risk control of anti-Ebola for ;healthcare workers of Chinese Medical Team in Sierra Leone

    Institute of Scientific and Technical Information of China (English)

    张立; 沙莉

    2016-01-01

    Objective To investigate the application effects of the healthcare failure mode and effects analysis ( HFMEA) system on reducing infection risks of EVD for healthcare workers ( from Suzhou) in Chinese Medical Team in Sierra Leone. Methods Based on the requirement to use HFMEA system, the EVD exposure risks management team was set up to analyze the failure mode and causes of potential risks of EVD exposure, to calculate the Risk Priority Number ( RPN ) , and to take measures to solve priority issues. Results After administration of HFMEA, number of healthcare workers qualified for hand hygiene compliance, personal protective equipment ( PPE) donning and doffing, and epidemiological knowledge mastery was higher, compared to the number before HFMEA administration (χ2 =39. 30,47. 70;P<0. 01). During the two months in Sierra Leone and the 21-day medical observation period, none was infected with EVD. Positive assessment was given by 87. 0% of the healthcare workers. Conclusions Usage of HFMEA to evaluate RPN risks for healthcare workers in Chinese Medical Team, focuses on infection control management, revision and improvement of work processes and contingency plans, and assists team members to adapt to new circumstance, which can reduce the risks of EVD exposure for healthcare workers of Chinese Medical Team.%目的:探讨医疗失效模式与效应分析( HFMEA)在降低中国(江苏)援塞抗疫医疗队员感染埃博拉病毒病风险的应用效果。方法应用HFMEA的方法,成立埃博拉风险管理小组,针对有可能感染埃博拉病毒病的风险进行失效模式及潜在风险原因分析,计算优先风险指数( RPN),对需优先解决的问题进行措施改进。结果实施HFMEA管理后,手卫生依从率97.8%、个人防护装备穿脱正确率100%、埃博拉流行病学知识掌握率91.3%,均高于 HFMEA管理前,差异有统计学意义(χ2值分别为39.30,47.70;P<0.01);在援塞2个月期间及结束后直至医疗队员21 d医学

  1. 某军队医院聘用制医务人员满意度分析%An Analysis of Income and Job Satisfaction of Employed Healthcare Workers in a Military Central Hospital

    Institute of Scientific and Technical Information of China (English)

    徐蕾; 张运明; 李东华; 吴骋

    2015-01-01

    Objective The article aimed to achieve income satisfaction and job satisfaction of employed healthcare workers in a military central hospital as well as their relationship and to provide advice and policies to improve the professional stability and loyalty of the workers.Methods Questionnaires and interviews were used to survey 642 employed healthcare workers.Statistical methods, such as correlation analysis and logistic regression were used to analyze the data by software SAS9.3.Results Healthcare workers'satisfaction was 3.41, which has no relationship with income(r =0.105,P >0.05), yet has relationship with income satisfaction(r =0.356,P <0.001).Income satisfaction is relatively low.Dissatisfaction rate of workers from surgical departments was 56.41%, which was lower than 76% of medicine departments and 78.26% of accessory departments.Intention of quit was much strong in workers whose work time was less than 2 years or between 5 -8 years.Conclusion It is suggested to follow the orientation of health reform of Shanghai and to build harmonious working surroundings to im-prove job satisfaction.Income allocation system should be modified to improve income satisfaction.Scientific and effective system should be used to evaluate workers'performance and keep talents in military hospital.%目的:了解某军队中心医院聘用制医务人员收入满意度和工作满意度状况,以及两者之间的关系,针对发现的问题提出政策建议,以提高医务人员职业稳定性和忠诚度。方法对642名聘用制医务人员进行满意度开放式问卷调查,对数据运用 SAS 9.3软件进行统计描述,采用相关分析和 logistic 回归分析进行相关检验与影响因素筛选。结果聘用制医务人员工作满意度处于一般水平,为3.41分,与薪酬无相关关系(r =0.105,P >0.05),与收入满意度存在相关关系(r =0.356,P <0.001)。收入满意度总体较低,外科片对收入不

  2. Prevalence of latent tuberculosis infection in BCG-vaccinated healthcare workers by using an interferon-gamma release assay and the tuberculin skin test in an intermediate tuberculosis burden country.

    Science.gov (United States)

    Hung, Wan-Ting; Lee, Susan Shin-Jung; Sy, Cheng-Len; Wu, Kuang-Sheng; Chen, Jui-Kuang; Tsai, Hung-Chin; Chen, Yao-Shen

    2015-04-01

    The risk of healthcare workers (HCWs) acquiring tuberculosis (TB) infection is high. We determined the prevalence of latent TB infection (LTBI) in HCWs with a high Bacille Calmette-Guérin (BCG) vaccine coverage in an intermediate TB burden country by using an interferon-gamma release assay [QuantiFERON-TB Gold (QFT-G)] and by using the tuberculin skin test (TST). Risk factors associated with a positive test were determined. This prospective cross-sectional study enrolled HCWs from a medical center in Taiwan. Participants were grouped into workers without exposure (Group 1) and workers who self-reported a history of TB exposure (Group 2). All participants completed a questionnaire to collect demographic information and risk factors for acquiring TB. The QFT-G test and the TST were administered and risk factors for a positive test were analyzed. We recruited 193 HCWs [149 (77.2%) female workers] with a mean age of 35.6 years. All were BCG-vaccinated. The prevalence of LTBI was 88.8% (based on the TST) and 14.5% (based on the QFT-G test). There was no difference between HCWs with and without known exposure to TB. Agreement between the tests was poor (i.e., the kappa value was less than 0.05). Multivariable logistic regression showed that only the QFT-G test was associated with age (35 years or greater) (adjusted OR, 2.53; p = 0.03). By using the QFT-G test or TST, this study found a similar prevalence of LTBI in HCWs with and without known exposure to TB. This suggests that in intermediate TB burden countries exposure to TB may occur within the hospital and within the community. Compared to the TST, the QFT-G test was correlated better with age, which is a known risk factor for latent TB infection. Copyright © 2013. Published by Elsevier B.V.

  3. Intelligence Revisited

    Science.gov (United States)

    2005-05-01

    environment (i.e., culture , class, family, educational 2 Chapter 23 Intelligence Revisited opportunities, gender) shapes our intellect, and there are no...connectivity is going to be rather problematic, to say the least. A single nano-bot cruising this Disneyland of synaptic wonderment is certainly... cultures ). Embodiment – A sense of being anchored to our physical bodies. Agency – A sense of free will, wherein we are in charge of our own

  4. 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......BACKGROUND: 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. 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...

  5. 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

    Directory of Open Access Journals (Sweden)

    Ibler Kristina

    2010-08-01

    Full Text Available Abstract Background 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. 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 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. Trial registration The trial is registered in ClinicalTrials.Gov, NCT01012453.

  6. O medicamento na rotina de trabalho dos agentes comunitários de saúde da unidade básica de saúde Santa Cecília, em Porto Alegre, RS, Brasil Medicines in the work routine of community healthcare workers from Santa Cecília basic healthcare unit in Porto Alegre, RS, Brazil

    Directory of Open Access Journals (Sweden)

    Carla Cafarate Nunes

    2008-03-01

    Full Text Available Desde o estabelecimento do Sistema Único de Saúde (SUS, busca-se enfatizar a atenção básica e a saúde familiar. Uma das estratégias que vem sendo utilizada é o Programa de Saúde da Família (PSF constituído por equipes de profissionais que incluem os agentes comunitários de saúde. Entre os diversos problemas enfrentados pelas equipes de saúde da família está o uso irracional dos medicamentos. Este trabalho teve o objetivo de examinar o papel do medicamento na rotina dos agentes, estabelecer sua percepção em relação aos serviços da farmácia de uma unidade básica de saúde e identificar as necessidades de informação sobre medicamentos para elaboração de treinamento. Para tanto, foi realizada uma sessão utilizando-se a técnica grupo nominal, em que oito de onze agentes de saúde participaram respondendo a quatro perguntas. O medicamento foi considerado importante, com valorização das ações preventivas. A percepção em relação aos serviços da farmácia foi positiva. Segundo os agentes, as dúvidas sobre medicamentos, freqüentemente relatadas pela população, refletem falhas na consulta e na aquisição dos medicamentos. O agente de saúde é reconhecido pela população como o profissional que pode auxiliá-la no uso de medicamentos, promovendo o seu uso racional.Since the establishment of Brazil's National Health System (SUS, focus has been given to basic and family healthcare. One of the programs in progress has been the Family Health Project, performed by teams of professionals including Community Health Workers. Among the various problems faced by the family healthcare teams is the irrational use of medicines. This paper aims to examine the role of medicines in the workers' routine, establishing how they perceive the pharmacy service in a Basic Healthcare Unit, and identifying information needs about medicines, all these with the purpose of training design. To do so, a session using the nominal group

  7. Facteurs liés aux épisodes violents dans les soins: Résultats de l'enquête européenne Presst-Next = Factors associated with violence against healthcare workers: Results of the European Presst-Next study

    NARCIS (Netherlands)

    Estryn-Behar, Madeleine; Duville, Nathalie; Menini, Marie-Laurène; Camerino, Donatella; Le Foll, Serge; Nézet, le Olivier; Bocher, Rachel; Heijden, van der Beatrice; Conway, Paul Maurice; Hasselhorn, Hans-Martin

    2007-01-01

    Introduction: The respective roles of medical specialties and work organization on violent events against healthcare workers (HCW) in different countries was examined. Methods: Using the results of the Presst-Next study, we analyzed data from 27 134 HCW in 7 European countries. Multivariate logisti

  8. 65 Revisited

    OpenAIRE

    2010-01-01

    Pennebaker hat doch zurückgeblickt. In weiteren fünfundsechzig Minuten zeigt er mit 65 REVISITED neue und ergänzende Facetten von Bob Dylan auf seiner 1965er Tournee durch England aus bisher unveröffentlichtem und digital aufgearbeitetem Material. Couchman (2002, 94) betont, dass Dylan über vierzig Jahre nach DON‘T LOOK BACK (1965) noch immer nichts von seiner enigmatischen Ausstrahlung verloren habe. Das gleiche gilt auch für den Film und für seine Ergänzung.

  9. Emerging themes for sensitivity training modules of African healthcare workers attending to men who have sex with men: a systematic review

    OpenAIRE

    Dijkstra, Maartje; van der Elst, Elise M.; Micheni, Murugi; Gichuru, Evanson; Musyoki, Helgar; Duby, Zoe; Lange, Joep M.A.; Graham, Susan M.; Eduard J Sanders

    2015-01-01

    Sensitivity training of front-line African health care workers (HCWs) attending to men who have sex with men (MSM) is actively promoted through national HIV prevention programming in Kenya. Over 970 Kenyan-based HCWs have completed an eight-modular online training free of charge (http://www.marps-africa.org) since its creation in 2011. Before updating these modules, we performed a systematic review of published literature of MSM studies conducted in sub-Saharan Africa (sSA) in the period 2011...

  10. What is a "health" professional? The changing relationship of occupational therapists and social workers to therapy and healthcare in Quebec, 1940-1985.

    Science.gov (United States)

    Prud'homme, Julien

    2011-01-01

    Studies regarding the medicalization process generally focus on the way various physical and psychological conditions have been identified as "health" problems, within specific historical contexts. Less well known is how the therapeutic roles of certain "health" professionals were also a result of the confluence of particular historical events. By comparing the professional trajectories of Quebec's occupational therapists and hospital social workers from 1940 to 1985, this article demonstrates how professionals originally outside of the world of health care created new therapeutic roles for themselves within the constantly expanding institutional health care system.

  11. The use of a rating instrument to teach and assess communication skills of health-care workers in a clinic in the Western Cape.

    Science.gov (United States)

    Steyn, M; Borcherds, R; van der Merwe, N

    1999-06-01

    Research in health communication shows communication to be an important aspect of successful health-care. Moreover, training courses which provide feedback have been shown to improve health professionals' ability to conduct successful interviews. This article describes a rating instrument which was developed in order to facilitate teaching and assessing the communication aspects of health-care interviews. The instrument was found to be useful in a training programme offered to nursing staff of a TB Clinic in Mitchells Plain, Western Cape. The instrument appears as Table 1. In the Table categories of communication behaviours, each indicating an important aspect of the interaction, are given as the six headings. These are: establishing rapport and respect listening receptively confirming the patient sharing control informing effectively and checking perceptions. Within each category the more detailed specific behaviours are listed, allowing for close analysis of a care-giver's interviewing skill. The article briefly discusses the importance in effective communication between the care-giver and patient of each category of behaviours given in the instrument, supported by evidence from research. Lastly the article describes a "case study" on how the instrument has been successfully used in a training programme.

  12. A multifaceted strategy using mobile technology to assist rural primary healthcare doctors and frontline health workers in cardiovascular disease risk management: protocol for the SMARTHealth India cluster randomised controlled trial

    Science.gov (United States)

    2013-01-01

    Background Blood Pressure related disease affected 118 million people in India in the year 2000; this figure will double by 2025. Around one in four adults in rural India have hypertension, and of those, only a minority are accessing appropriate care. Health systems in India face substantial challenges to meet these gaps in care, and innovative solutions are needed. Methods We hypothesise that a multifaceted intervention involving capacity strengthening of primary healthcare doctors and non-physician healthcare workers through use of a mobile device-based clinical decision support system will result in improved blood pressure control for individuals at high risk of a cardiovascular disease event when compared with usual healthcare. This intervention will be implemented as a stepped wedge, cluster randomised controlled trial in 18 primary health centres and 54 villages in rural Andhra Pradesh involving adults aged ≥40 years at high cardiovascular disease event risk (approximately 15,000 people). Cardiovascular disease event risk will be calculated based on World Health Organisation/International Society of Hypertension’s region-specific risk charts. Cluster randomisation will occur at the level of the primary health centres. Outcome analyses will be conducted blinded to intervention allocation. Expected outcomes The primary study outcome is the difference in the proportion of people meeting guideline-recommended blood pressure targets in the intervention period vs. the control period. Secondary outcomes include mean reduction in blood pressure levels; change in other cardiovascular disease risk factors, including body mass index, current smoking, reported healthy eating habits, and reported physical activity levels; self-reported use of blood pressure and other cardiovascular medicines; quality of life (using the EQ-5D); and cardiovascular disease events (using hospitalisation data). Trial outcomes will be accompanied by detailed process and economic

  13. 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

  14. The impact of healthcare workers job environment on their mental-emotional health. Coping strategies: the case of a local general hospital

    Directory of Open Access Journals (Sweden)

    Aristotelis Koinis

    2015-04-01

    Full Text Available Workplace stress can influence healthcare professionals’ physical and emotional well-being by curbing their efficiency and having a negative impact on their overall quality of life. The aim of the present study was to investigate the impact that work environment in a local public general hospital can have on the health workers’ mental-emotional health and find strategies in order to cope with negative consequences. The study took place from July 2010 to October 2010. Our sample consisted of 200 healthcare professionals aged 21-58 years working in a 240-bed general hospital and the response rate was 91.36%. Our research protocol was first approved by the hospital’s review board. A standardized questionnaire that investigates strategies for coping with stressful conditions was used. A standardized questionnaire was used in the present study Coping Strategies for Stressful Events, evaluating the strategies that persons employ in order to overcome a stressful situation or event. The questionnaire was first tested for validity and reliability which were found satisfactory (Cronbach’s α=0.862. Strict anonymity of the participants was guaranteed. The SPSS 16.0 software was used for the statistical analysis. Regression analysis showed that health professionals’ emotional health can be influenced by strategies for dealing with stressful events, since positive re-assessment, quitting and seeking social support are predisposing factors regarding the three first quality of life factors of the World Health Organization Quality of Life -BREF. More specifically, for the physical health factor, positive re-assessment (t=3.370, P=0.001 and quitting (t=−2.564, P=0.011 are predisposing factors. For the ‘mental health and spirituality’ regression model, positive re-assessment (t=5.528, P=0.000 and seeking social support (t=−1.991, P=0.048 are also predisposing factors, while regarding social relationships positive re-assessment (t=4.289, P=0

  15. Exploration of knowledge of, adherence to, attitude and barriers toward evidence-based guidelines (EBGs for prevention of ventilator-associated pneumonia (VAP in healthcare workers of pediatric cardiac intensive care units (PCICUs: A Quali-Quantitative survey

    Directory of Open Access Journals (Sweden)

    Leila Jahansefat

    2016-09-01

    Full Text Available Implementation of evidence-based guidelines (EBGs is an effective measure for prevention of ventilator-associated pneumonia (VAP. Appropriate knowledge, attitude and adherence of healthcare workers (HCWs to EBGs are necessary factors for implementation of EBGs. This study was conducted with objective of evaluation of knowledge, attitude, and adherence of HCWs to EBGs for prevention of VAP and exploration of the barriers of their implementation in clinical practice. Totally, a total number of 45 HCWs of two pediatric cardiac surgery ICU (PCICUs participated in this quali-quantitative survey. Knowledge, attitude and adherence of participants was evaluated by a validated multiple-choice questionnaire and barriers of implementation of EBGs was extracted from participants’ answer to an open-ended question of our self-made questionnaire. Knowledge of HCWs was poor and significantly different between nurse assistants (RAs, nurses (RNs, and physicians (MDs (respectively, 1.25±0.95, 4.53±1.73, and 5.54±2.01, P=0.001. Likewise, attit ude of HCWs is not positive and significantly different between NAs, RNs, and MDs (respectively, 32.96±2.42, 34.00±2.44, 36.81±4.35, P=0.003. The adherence of HCWs is not good and different between RAs, RNs, and MDs (respectively, 11.50±1.00, 13.13±1.83, and 17.18±6.06, P= 0.17. The Barriers of implementation of EBGs was categorized into four category of individual, organizational, social, and educational factors. Unsatisfying status of knowledge, attitude, and adherence of HCWs is a challenging concern of health-care system, especially in PICUs. In addition to these well-known factors, poor implementation of EBGs is related to many other barriers which should recognized and taken into consideration for designation of infection controlling programs.

  16. Declaración de embarazo del personal sanitario del hospital universitario Ramón y Cajal: Año 2009 Pregnancy declaration of healthcare workers of the Ramon y Cajal university hospital: Year 2009

    Directory of Open Access Journals (Sweden)

    Gian C. Navarro Chumbes

    2011-06-01

    Full Text Available Introducción: según la Ley 31/1995 del 8 de noviembre de Prevención de Riesgos Laborales, Capítulo III artículo 26 "Protección de la Maternidad", el empresario deberá adoptar las medidas para evitar la exposición a riesgos en mujeres embarazadas y en periodos de lactancia. Objetivo: conocer las características del personal sanitario que declaró su embarazo al Servicio de Prevención de Riesgos Laborales (SPRL. Material y Métodos: el diseño del estudio es transversal, los datos fueron obtenidos del personal sanitario gestante que declaró su embarazo al SPRL durante el año 2009; se realizó análisis de estadística descriptiva de media +/- desviación estándar, así como porcentajes. Se consideraron significativas aquellas con un valor de significación Introduction: according to the Labour Risks Prevention Law 31/1995 of November the 8th, Chapter III, article 26 "Protection of Maternity", the employer must carry out all precautions in order to avoid exposure to risks in pregnant women as well as breastfeeding women. Objective: know all characters of healthcare workers that declared their pregnancy to the Labour Risks Prevention Service (LRPS. Method and materials: the study design is transversal; all data was obtained from the healthcare workers that declared their pregnancy to the LRPS in 2009; a descriptive statistic analysis of media +/- standard deviation and percentages was done. A value of p<0.05 was considered statistically significant. Results: 50 persons declared their pregnancy; age average was 33.10+/- 3.18 years. The age group that most frequent declared was 30-34 years (52 %, the average week of pregnancy at the moment of declaring was 12.01 +/- 5.18; the professional category that most frequently declared was UNQ (University Nursing Qualified 24.48 %. Conclusions: according to the results obtained and after contrasting them with the data of the Community of Madrid, other studies must be designed to find out if there

  17. Mobile healthcare.

    Science.gov (United States)

    Morgan, Stephen A; Agee, Nancy Howell

    2012-01-01

    Mobile technology's presence in healthcare has exploded over the past five years. The increased use of mobile devices by all segments of the US population has driven healthcare systems, providers, and payers to accept this new form of communication and to develop strategies to implement and leverage the use of mobile healthcare (mHealth) within their organizations and practices. As healthcare systems move toward a more value-driven model of care, patient centeredness and engagement are the keys to success. Mobile healthcare will provide the medium to allow patients to participate more in their care. Financially, mHealth brings to providers the ability to improve efficiency and deliver savings to both them and the healthcare consumer. However, mHealth is not without challenges. Healthcare IT departments have been reluctant to embrace this shift in technology without fully addressing security and privacy concerns. Providers have been hesitant to adopt mHealth as a form of communication with patients because it breaks with traditional models. Our healthcare system has just started the journey toward the development of mHealth. We offer an overview of the mobile healthcare environment and our approach to solving the challenges it brings to healthcare organizations.

  18. Mediating the effects of work-life conflict between transformational leadership and health-care workers' job satisfaction and psychological wellbeing.

    Science.gov (United States)

    Munir, Fehmidah; Nielsen, Karina; Garde, Anne H; Albertsen, Karen; Carneiro, Isabella G

    2012-05-01

    To explore the mediating effects of work-life conflict between transformational leadership and job satisfaction and psychological wellbeing. The importance of work-life balance for job satisfaction and wellbeing among health-care employees is well-recognized. Evidence shows that transformational leadership style is linked to psychological wellbeing. It is possible that transformational leadership is also associated with employees' perceptions of work-life conflict, thereby influencing their job satisfaction and wellbeing. A longitudinal design was used where staff working within Danish elderly care completed a questionnaire at baseline and 18-month follow-up (N=188). Regression analyses showed that transformational leadership style was directly associated with perceptions of work-life conflict, job satisfaction and psychological wellbeing. Work-life conflict mediated between transformational leadership and wellbeing, but not job satisfaction. The findings suggest transformational leadership style may improve perceptions of work-life balance and employee wellbeing. Managers should adopt transformational leadership styles to reduce work-life conflict and enhance the wellbeing of their staff. © 2011 Blackwell Publishing Ltd.

  19. Emerging themes for sensitivity training modules of African healthcare workers attending to men who have sex with men: a systematic review.

    Science.gov (United States)

    Dijkstra, Maartje; van der Elst, Elise M; Micheni, Murugi; Gichuru, Evanson; Musyoki, Helgar; Duby, Zoe; Lange, Joep M A; Graham, Susan M; Sanders, Eduard J

    2015-05-01

    Sensitivity training of front-line African health care workers (HCWs) attending to men who have sex with men (MSM) is actively promoted through national HIV prevention programming in Kenya. Over 970 Kenyan-based HCWs have completed an eight-modular online training free of charge (http://www.marps-africa.org) since its creation in 2011. Before updating these modules, we performed a systematic review of published literature of MSM studies conducted in sub-Saharan Africa (sSA) in the period 2011-2014, to investigate if recent studies provided: important new knowledge currently not addressed in existing online modules; contested information of existing module topics; or added depth to topics covered already. We used learning objectives of the eight existing modules to categorise data from the literature. If data could not be categorised, new modules were suggested. Our review identified 142 MSM studies with data from sSA, including 34 studies requiring module updates, one study contesting current content, and 107 studies reinforcing existing module content. ART adherence and community engagement were identified as new modules. Recent MSM studies conducted in sSA provided new knowledge, contested existing information, and identified new areas of MSM service needs currently unaddressed in the online training. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

  20. Reproductive Counseling by Clinic Healthcare Workers in Durban, South Africa: Perspectives from HIV-Infected Men and Women Reporting Serodiscordant Partners

    Directory of Open Access Journals (Sweden)

    L. T. Matthews

    2012-01-01

    Full Text Available Background. Understanding HIV-infected patient experiences and perceptions of reproductive counseling in the health care context is critical to inform design of effective pharmaco-behavioral interventions that minimize periconception HIV risk and support HIV-affected couples to realize their fertility goals. Methods. We conducted semistructured, in-depth interviews with 30 HIV-infected women (with pregnancy in prior year and 20 HIV-infected men, all reporting serodiscordant partners and accessing care in Durban, South Africa. We investigated patient-reported experiences with safer conception counseling from health care workers (HCWs. Interview transcripts were reviewed and coded using content analysis for conceptual categories and emergent themes. Results. The study findings indicate that HIV-infected patients recognize HCWs as a resource for periconception-related information and are receptive to speaking to a HCW prior to becoming pregnant, but seldom seek or receive conception advice in the clinic setting. HIV nondisclosure and unplanned pregnancy are important intervening factors. When advice is shared, patients reported receiving a range of information. Male participants showed particular interest in accessing safer conception information. Conclusions. HIV-infected men and women with serodiscordant partners are receptive to the idea of safer conception counseling. HCWs need to be supported to routinely initiate accurate safer conception counseling with HIV-infected patients of reproductive age.

  1. Outbreak of bullous impetigo caused by Staphylococcus aureus strains of phage type 3C/71 in a maternity ward linked to nasal carriage of a healthcare worker.

    Science.gov (United States)

    Piechowicz, Lidia; Garbacz, Katarzyna; Budzyńska, Anna; Dąbrowska-Szponar, Maria

    2012-01-01

    We describe an outbreak of bullous impetigo (BI) that occurred in a maternity unit and show phenotypic and genotypic properties and relatedness of isolated Staphylococcus aureus strains. Clinical material was obtained from 11 affected neonates. Additionally, nasal swabs from 67 healthy care workers (HCWs) as well as 107 environmental swabs were investigated. All isolates were screened for exfoliative toxin genes (eta, etb), antibiotic susceptibility and phage typed. Chromosomal DNA was genotyped by MLVF method and PCR/RFLP of coagulase gene were tested. Affected neonates were infected by two clusters of eta-positive S. aureus of phage type 3C/71: (1) MLVF type A isolates resistant only to penicillin, and (2) MLVF type B isolates resistant to penicillin and erythromycin/clindamycin. All isolates were susceptible to methicillin. We found 19 of 67 HCWs to be S. aureus nasal carriers. Two nasal isolates from HCWs were related to the outbreak on the basis of phage typing, PCR detection of eta/etb genes, antibiotyping and genotyping. Additionally, environmental swabs from the maternity unit revealed a 3C/71 S. aureus in the mattress of a baby bed. This is the first documented case of an outbreak of BI caused by phage type 3C/71 eta-positive strain of S. aureus.

  2. The adoption of a new diagnostic technology for tuberculosis in two Brazilian cities from the perspective of patients and healthcare workers: a qualitative study.

    Science.gov (United States)

    de Camargo, Kenneth R; Guedes, Carla R; Caetano, Rosângela; Menezes, Alexandre; Trajman, Anete

    2015-07-21

    This article presents the qualitative component linked to a larger study of implementation of the Xpert™ MTB/Rif technology in two Brazilian cities. Despite intrinsic advantages of new health technologies, its introduction can be disruptive to existing routines, and it is thus important to understand how these innovations are perceived by the different groups involved in its regular use. This study was based on semi-structured interviews with patients, lab technicians, health care workers and managers involved with diagnosis and care of Tuberculosis (TB). The interviews had their content analyzed in order to abstract the different perspectives for the various actors. For patients the changes were not perceived as significant, since their greatest concerns were related to treatment and the stigma associated with TB. The professionals in general welcomed the new technique, which dramatically decreases the workload, time and reliability of diagnosis, in their view. However, we noted difficulties with the concomitant implementation of new IT technology for recording and reporting test results, which negatively impacted the time necessary to get lab diagnosis to physicians. Through this analysis we detected some bottlenecks in the surrounding environment, not necessarily linked to the technology itself but which could hamper considerably its advantages.

  3. Culture shock and healthcare workers in remote Indigenous communities of Australia: what do we know and how can we measure it?

    Science.gov (United States)

    Muecke, A; Lenthall, S; Lindeman, M

    2011-01-01

    Culture shock or cultural adaptation is a significant issue confronting non-Indigenous health professionals working in remote Indigenous communities in Australia. This article is presented in two parts. The first part provides a thorough background in the theory of culture shock and cultural adaptation, and a comprehensive analysis of the consequences, causes, and current issues around the phenomenon in the remote Australian healthcare context. Second, the article presents the results of a comprehensive literature review undertaken to determine if existing studies provide tools which may measure the cultural adaptation of remote health professionals. A comprehensive literature review was conducted utilising the meta-databases CINAHL and Ovid Medline. While there is a plethora of descriptive literature about culture shock and cultural adaptation, empirical evidence is lacking. In particular, no empirical evidence was found relating to the cultural adaptation of non-Indigenous health professionals working in Indigenous communities in Australia. In all, 15 international articles were found that provided empirical evidence to support the concept of culture shock. Of these, only 2 articles contained tools that met the pre-determined selection criteria to measure the stages of culture shock. The 2 instruments identified were the Culture Shock Profile (CSP) by Zapf and the Culture Shock Adaptation Inventory (CSAI) by Juffer. There is sufficient evidence to determine that culture shock is a significant issue for non-Indigenous health professionals working in Indigenous communities in Australia. However, further research in this area is needed. The available empirical evidence indicates that a measurement tool is possible but needs further development to be suitable for use in remote Indigenous communities in Australia.

  4. Designing eLearning courses to meet the digital literacy needs of healthcare workers in lower- and middle-income countries: Experiences from the Knowledge for Health Project

    Directory of Open Access Journals (Sweden)

    Rupali J. Limaye

    2015-12-01

    Full Text Available Traditional conceptualizations of knowledge management fail to incorporate the social aspects in which knowledge management work operates. Social knowledge management places people at the center of all knowledge management, including placing the end user at the center when developing eLearning packages, particularly within the context of digital health literacy. As many health professionals working in lower-resource settings face the digital divide, or experience unequal patterns of access and usage capabilities from computer-based information and communication technologies (ICTs, ensuring that eLearning packages are tailored for their specific needs is critical. Grounded in our conceptualization of social knowledge management, we outline two of our experiences with developing eLearning packages for health professionals working primarily in lower- and middle-income countries. The Global Health eLearning Center provides eLearning courses to health professionals primarily working in the lower- and middle-income country context. The courses have robust and exhaustive mechanisms in place to ensure that issues related to digital health literacy are not barriers to taking the courses and subsequently, applying the course material in practice. In Bangladesh, we developed a digital health package for frontline community fieldworkers that was loaded on netbook computers. To develop this package, community fieldworkers were provided support during the implementation phase to ensure that they were able to use the netbooks correctly with their clients. As new digital technologies proliferate, guaranteeing that global health workers have the prerequisite skills to utilize and apply digital health tools is essential for improving health care.

  5. Interferon Gamma Release Assay versus Tuberculin Skin Testing among Healthcare Workers of Highly Diverse Origin in a Moderate Tuberculosis Burden Country.

    Science.gov (United States)

    Al Hajoj, Sahal; Varghese, Bright; Datijan, Alria; Shoukri, Mohammed; Alzahrani, Ali; Alkhenizan, Abdallah; AlSaif, Abdulaziz; Althawadi, Sahar; Fernandez, Grace; Alrajhi, Abdulrahman

    2016-01-01

    Health care workers (HCW's) are always at an increased risk of contracting tuberculosis (TB) infection. In Saudi Arabia, Interferon Gamma Release Assay (IGRA) has not been evaluated as a screening tool for latent TB infection (LTBI) among HCW's considering their high demographic diversity. During February 2012 to January 2015 a cross sectional study has been conducted in a tertiary care center with maximum demographically diverse staff population in the capital city-Riyadh. After a short interview and consenting, all the candidates were subjected to tuberculin skin test (TST) and QuantiFERON TB gold In-tube test (QFT). A logistic regression analysis was carried out for establishing the associations between putative risk factors and the diagnostic tests. The candidates were classified according to geographical origin and a detailed analysis was conducted on the impact of their origin towards the results of TST and QFT. Of the 1595 candidates enrolled, 90.6% were BCG vaccinated, female (67.9%) and mainly nurses (53.2%). Candidates with high risk of suspected or confirmed TB patient exposure were 56.1% and 76.5% of them had origin were associated with TST positivity while Occupational TB exposure and geographical origin of the candidates were associated with QFT positivity. A regular follow up on recently TST converted candidates showed no progression to active TB. The putative factors associated with the discordance were origin of the candidate (p value Origin of the candidates has strong association with the results of TST and QFT. The discordant results particularly TST negative and QFT positive needs more detailed analysis.

  6. Hepatitis B: Its awareness, practice and frequency of vaccination among selected high risk health-care workers at tertiary care hospitals in Agartala city

    Directory of Open Access Journals (Sweden)

    Taranga Reang

    2015-04-01

    Full Text Available Background: Hepatitis B virus (HBV infection is a global problem and >350 million HBV carriers in the world. Objectives: The aim was to assess awareness, practice of selected high risk health care workers (HCW regarding risk for contracting hepatitis B and self-reported vaccination status. Materials and Methods: A cross-sectional study was conducted among 300 selected HCW of AGMC and GBP Hospital, TMC and Dr BRAM Teaching Hospital and Indira Gandhi Memorial Hospital, Agartala during Jan to March 2014. Results: About 72.1% respondents were females with overall mean age of 24.10 (standard deviation ±7.011. 67.5% females were within the age group of 18-23 years. Majority (70.4% of the participants were nursing students and Hindu (92.5% nuclear families (54.6%. Majority (69.3% of them were aware that hepatitis B transmission was possible through unsafe sex, infected blood/body fluid, contaminated syringe, needle and scalpel, 19.6% knew through infected blood and body fluids, 5.7% knew through contaminated syringe, needle and scalpel, 1.8% knew through unsafe sex. 59.3% had a history of contact with known hepatitis B case. 62.2% were vaccinated with three doses of hepatitis B vaccine. Majority of the participants had exposed to hepatitis B positive case while at work (P = 0.001. The exposed persons with known hepatitis B cases have consulted doctor, vaccinated and treated with medicines (P = 0.002; used needle destroyer (P = 0.012; vaccinated with 3 doses of hepatitis B vaccine (P = 0.001; and used sterile gloves while performing work (P = 0.000, especially while dealing with blood and body fluid. Conclusion: In spite of having good knowledge, the way they practice for prevention of hepatitis B infections were inadequate and need further improvement.

  7. Knowledge, Attitude And Practices of Healthcare Workers (HCWs Regarding Biomedical Waste (BMW Management: A Multispeciality Hospital Based CrossSectional Study In Eastern India

    Directory of Open Access Journals (Sweden)

    Ravishekar N. Hiremath

    2016-10-01

    Full Text Available Background: The evolving health care system of India, in its goal of solving health issues and minimizing possible health risks, has unavoidably created waste, which itself may be harmful for health. Inefficient and inadequate knowledge of managing health care waste may have detrimental effects on health and environment. Aim and Objectives: To asses level of Knowledge, Attitude, Practices (KAP about Biomedical Waste (BMW management among Health Care Workers (HCWs with an endeavor to improve the standards and protect the health of HCWs and the environment. Methodology: A Hospital- based cross sectional descriptive study was carried out at one of the Multispecialty Hospital in Eastern India. A total of 80 HCWs who were available at the time of study were included and the data were collected by means of 'personal interview technique' by using a pre-designed semi-structured questionnaire in Hindi (local language. The relevant data was collected, compiled and analyzed using SPSS 17.0 version. Results: Assessment of KAP with pre-decided scoring system showed, 17.5 % had excellent knowledge, 70% with good to average and 12.5% had poor knowledge with respect to BMW management. Knowledge status was not significantly associated with any of the sociodemographic characteristics. When asked about needle stick injuries, 88% felt that needle stick injury was a concern to them and 86% of them were well aware about the consequences of needle-stick injuries. Conclusion: Although the awareness level was high with various aspects of BMW management among HCWs compared to other studies, but still there exists scope for more improvement. Regular awareness capsule with proper BMW committee monitoring is the need of the hour. All measures to sensitize the HCWs against needle stick injuries including both pre and post incident measures need to be taken.

  8. Hand hygiene compliance of dermatological and venereological healthcare workers in a hospital%某医院皮肤性病科医务人员手卫生依从性现状调查

    Institute of Scientific and Technical Information of China (English)

    杨素莲; 陈国庆; 张德葵; 陈海燕; 区凤仙; 朱国兴; 陆春; 赖维

    2016-01-01

    目的:调查皮肤性病科医务人员手卫生依从性现状。方法通过自制调查问卷,对65例皮肤性病科医务人员进行手卫生依从性现场调查。结果绝大多数(86.2%)皮肤性病科医务人员知晓手卫生对控制医院感染的重要性,但其平均手卫生依从率只有54.06%。针对不同岗位医务人员的手卫生依从率比较,经χ2检验,可知不同岗位间的依从率不全相等(χ2=8.429,=0.015);其中,医技人员的平均手卫生依从率为47.74%,明显低于医师的55.13%和护理人员的56.35%。医务人员在接触患者前、无菌操作前、接触体液后、接触患者后和接触患者周围区域后的平均手卫生依从率依次为29.75%、71.59%、83.78%、51.47%和42.86%,经χ2检验,医务人员在上述不同时间的手卫生依从率不全相等(χ2=262.956,=0.000,);不同岗位医务人员不同时间的手卫生依从性比较,差异有统计学意义。表明工作繁忙是影响手卫生执行的首要因素,而洗手设施不完善对手卫生执行影响最小。结论皮肤性病科医务人员的手卫生依从性较低,需要采取宣教、培训、督导等干预措施,提高医务人员手卫生意识和依从性。%Objective To investigate hand hygiene compliance of healthcare workers in the Department of Dermatology and Venereology. Methods Sixty-five healthcare workers were surveyed on site regarding hand hygiene compliance through a self-designed questionnaire. Results The vast majority of healthcare workers un-derstood the importance of hand hygiene in controlling hospital-acquired infections. However, the overall hy-giene compliance rate was only 54.06% on average, while the hygiene compliance rates of medical staff from different positions were different (χ2=8.429, =0.015), with medical technicians having a significantly lower rate (47.74%) than doctors (55.13%) and nursers (56.35%). The hand hygiene compliance rates

  9. The Public Health Impact of the So-Called "Fluad Effect" on the 2014/2015 Influenza Vaccination Campaign in Italy: Ethical Implications for Health-Care Workers and Health Communication Practitioners.

    Science.gov (United States)

    Rosselli, Roberto; Martini, Mariano; Bragazzi, Nicola Luigi; Watad, Abdulla

    2017-01-01

    Seasonal influenza, causing complications, hospitalizations and deaths, generates a serious socio-economic burden, especially among elderly and high-risk subjects, as well as among adult individuals. Despite the availability and active free-of charge offer of influenza vaccines, vaccine coverage rates remain low and far from the target established by the Ministry of Health. Notwithstanding their effectiveness, vaccines are victims of prejudices and false myths, that contribute to the increasing phenomenon of vaccine hesitancy and loss of confidence. Media and, in particular, new media and information and communication technologies (ICTs) play a major role in disseminating health-related information. They are extremely promising devices for delivering health education and promoting disease prevention, including immunization. However, they can also have a negative impact on population's health attitudes and behaviors when channeling wrong, misleading information. During the 2014/2015 influenza vaccination campaign, the report of four deaths allegedly caused by administration of an adjuvanted influenza vaccine, Fluad - the so-called "Fluad case" - received an important media coverage, which contributed to the failure of the vaccination campaign, dramatically reducing the influenza vaccine uptake. In the extant literature, there is a dearth of information concerning the effect of the "Fluad case". The current study aims at quantifying the impact of the "Fluad effect" at the level of the Local Health Unit 3 (LHU3) ASL3 Genovese, Genoa, Italy. Ethical implications for health-care workers and health communication practitioners are also envisaged.

  10. 干部保健工作人员工作倦怠及其与职业紧张的关系%Job burnout among cadre healthcare workers and its relationship with occupational stress

    Institute of Scientific and Technical Information of China (English)

    徐盈; 李玺; 王晓辉; 李婉妮; 李桓; 王学良

    2015-01-01

    Objective To explore the degree of job burnout among cadre healthcare workers, as well as the influ-encing factors and the relationship between job burnout and occupational stress. Methods A total of 163 cadre healthcare workers in the Second Affiliated Hospital of Xi'an Jiaotong University were investigate for job burnout and occupational stress by Maslach burnout inventory-general survey (MBI-GS) and occupational stress inventory revised edition (OSR-R) respectively. Univariate analysis was performed to explore the influencing factors, and partial correlation analysis was ap-plied to investigate the relationship between job burnout and occupational stress. Results The mean MBI-GS scores were (14.28±7.54) for emotional exhaustion, (7.95±6.78) for cynicism, and (23.05±8.89) for reward and personal ac-complishment. Univariate analysis showed that cadre healthcare workers' emotional exhaustion, cynicism and reward and personal accomplishment were significantly influenced by age, length of service, occupational class, academic ti-tle, duty, working time per week, doctor-patient relationship and chronic disease (P<0.05). However, the reward and personal accomplishment were significantly influenced by marriage state (P=0.004) and salary (P=0.046). The emo-tional exhaustion were positively correlated with professional task (r=0.365, P<0.05) and individual tension (r=0.403, P<0.05). Cynicism was positively correlated with professional task (r=0.337, P<0.05) and individual tension (r=0.471, P<0.05). Reward and personal accomplishment were negatively correlated with professional task (r=-0.439, P<0.05), but positively correlated with individual coping resources (r=0.154, P<0.05). Conclusion The job burnout degree of cadre healthcare workers is too high, which is closely correlated with the occupational stress.%目的:了解我院干部保健工作人员的工作倦怠程度、影响因素及其与职业紧张之间的关系。方法以西安

  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. 医疗保健工作者满意度与职业紧张的关系%Relationship between job satisfaction and occupational stress among cadre healthcare workers

    Institute of Scientific and Technical Information of China (English)

    徐盈; 李玺

    2014-01-01

    Objective To understand the relationship between job satisfaction and occupation stress. Methods One hundred and forty seven cadre healthcare workers in the affiliated second hospital of medicine xi'an Jiaotong university were enrolled.Job satisfaction was measured with minnesota Sati -sfaction questionnaire (MSQ),occupation stress was measured with Job content questionnaire (JCQ)and Effort Reward Imbalance Ques-tionnaire(ERI).Multiple regression analysis were performed to explore the relationship between job satisfaction and occupation stress.Results The average score of job satisfaction was 60.97 ±1 1 .84.The score of job satisfaction among the different characteristic staffers were significant difference,including different marriage stage,professional title,duty,night shift,work time of each week,salary,doctor -patient relationship and chornic disease respec-tively(P <0.05).Conclusion The level of job satisfaction among cadre healthcare workers is low,it is necessary to take measures to decrease occupational stress and improve the job satisfaction and cadre healthcare service quality.%目的:了解医院医疗保健工作人员工作满意度及其与职业紧张之间的关系。方法以从事医疗保健工作的147名人员为调查对象,采用明尼苏达满意度问卷(MSQ)测量工作满意度,工作内容问卷(JCQ)和付出-回报失衡问卷(ERI)测量职业紧张,多元回归分析探讨工作满意度与职业紧张之间的关系。结果医疗保健工作人员工作满意度的平均得分为(60.97±11.84)分,不同特征的医疗保健工作人员的工作满意度得分比较,其中不同婚姻状况、职称、职务、有无夜班、每周工作时间、待遇、医患关系(矛盾)、有、无慢性病之间差异有统计学意义(P <0.05)。结论医疗保健工作人员工作满意度较低,应降低医疗保健工作人员的职业紧张,提高工作满意度,改善医疗保健服务质量。

  13. [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.

  14. 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

  15. Social marketing in healthcare

    Directory of Open Access Journals (Sweden)

    Radha Aras

    2011-08-01

    Full Text Available BackgroundSocial marketing is an important tool in the delivery ofhealthcare services. For any healthcare programme orproject to be successful, community/consumer participationis required. The four principles of social marketing can guidepolicymakers and healthcare providers to successfully planand implement health programmes.AimTo review the existing literature in order to project thebenefits of social marketing in healthcare.MethodA search of periodical literature by the author involvingsocial marketing and marketing concepts in health wascarried out. Items were identified initially through healthorientedindexing services such as Medline, Health STARand Cinahl, using the identifiers “social marketing“ and“marketing in health”. An extensive search was also carriedout on educational database ERIC.ResultsA literature review of various studies on social marketingindicated that the selection of the right product (accordingto the community need at the right place, with the rightstrategy for promotion and at the right price yields goodresults. However, along with technical sustainability(product, price, promotion and place, financialsustainability, institutional sustainability and marketsustainability are conducive factors for the success of socialmarketing.ConclusionThe purpose of this literature review was to ascertain thelikely effectiveness of social marketing principles andapproaches and behaviour change communication towardshealth promotion.It is important for all healthcare workers to understand andrespond to the public’s desires and needs and routinely useconsumer research to determine how best to help thepublic to solve problems and realise aspirations. Socialmarketing can optimise public health by facilitatingrelationship-building with consumers and making their liveshealthier.

  16. Spirituality and healthcare organizations.

    Science.gov (United States)

    Graber, D R; Johnson, J A

    2001-01-01

    In recent years, the place of spirituality in organizations has become increasingly discussed and advocated. On a personal level, this may involve achieving personal fulfillment or spiritual growth in the workplace. In the broader sense, spirituality is considered by many to be essential in an organization's interactions with employees, customers, and the community. This article describes a possible role for greater spirituality in healthcare organizations, whose cultures in recent decades have largely excluded spirituality or religiousness. This is the consequence of an analytical, scientific perspective on human health; a reductionist paradigm in biomedical research; and the inevitable bureaucratization occurring in large healthcare organizations. However, in recent decades, numerous scientific articles supporting a connection between faith or religiousness and positive health outcomes have been published. Because individuals seek meaning when experiencing severe illnesses, and humans universally respond to compassion and caring, spirituality among healthcare workers and managers appears highly appropriate. The article describes organizational barriers to the greater inclusion of spirituality in healthcare and presents several approaches to developing a more caring organization. These include eliciting extensive input from all staff and clinicians in identifying core or common values, ethics, and a philosophy of caring. Programs should ensure that the views of nonreligious staff and patients are respected and that clear guidelines are established for the extent and nature of affective or spiritual support for patients.

  17. A survey of healthcare workers' attitude towards their HIV positive coworkers in A- level hospitals in Beijing%北京市三甲医院医务人员对感染HIV的医务人员的态度

    Institute of Scientific and Technical Information of China (English)

    邬娜; 钮文异

    2011-01-01

    目的 调查分析北京市三甲医院医务人员,对于感染艾滋病病毒(HIV)的医务人员的态度.方法 采用方便抽样的方法,对北京市三甲医院的医务人员进行自填式问卷调查,并做描述性分析.结果 共调查医务人员392名,69.6%的人从未接受过HIV抗体检测,56.4%的人同意应该对医务人员强制进行HIV抗体检测,68.4%的人同意感染HIV的医务人员不能进行侵入性操作,40.8%的人同意感染HIV的医务人员在进行侵入性操作前,应该向病人说明自己的病情.以上四部分的态度与HIV暴露防护知识的相关系数没有统计学意义.结论 大部分医务人员从未接受过HIV抗体检测,是否在医务人员中进行HIV抗体检测、对感染HIV的医务人员的从业规范做出相关规定,还需要进一步的研究论证.%Objective To investigate the healthcare workers' (HCWs) attitude towards their HIV positive co-workers in A-level hospitals in Beijing. Methods Information was collected from HCWs who were selected by convenience sampling in two A-level hospitals in Beijing. The questionnaires covered the experience of having HIV antibody test, the attitude towards other HIV positive HCWs, universal HIV test among HCWs, restrictions on performing clinical procedures and disclosure of their health conditions to patients. Descriptive analysis was used. Results Among the 392 HCWs respondents, 69. 6% never tested their HIV conditions; 56. 4% agreed that mandatory HIV testing for HCWs was necessary; 68. 4% agreed that invasive procedures should not be performed by infected HCWs ; 40. 8% of respondents agreed that HIV positive conditions should be disclosed to the patients before invasive procedures were performed. The above attitudes showed no correlation with the knowledge of HIV protection. Conclusions Most of the HCWs have never tested their HIV conditions before. Whether universal HIV testing among HCWs is necessary and whether working guideline is to be

  18. Are medical residents a "core group" for future improvement of influenza vaccination coverage in health-care workers? A study among medical residents at the University Hospital of Palermo (Sicily).

    Science.gov (United States)

    Amodio, Emanuele; Tramuto, Fabio; Maringhini, Guido; Asciutto, Rosario; Firenze, Alberto; Vitale, Francesco; Costantino, Claudio; Calamusa, Giuseppe

    2011-10-19

    Despite international recommendations, vaccination coverage among European healthcare workers, including physicians, is widely recognized as unsatisfactory. In order to plan tailored vaccination campaigns and increase future coverage, we investigated reasons for refusing vaccination and determinants associated with influenza vaccine uptake among young health care workers. A survey was carried out during September and October 2010 on medical residents attending post-graduate Schools of the Medical Faculty at the University of Palermo (Italy). Each participant completed an anonymous web-based questionnaire including items on demographic and occupational characteristics, knowledge, attitudes and behaviours with regard to influenza and influenza vaccination, and main sources of information. A total of 202 (66.9%) out of 302 medical residents participated in the survey. During the 2009-2010 influenza vaccine campaign, 44 residents (21.8%) were vaccinated against seasonal influenza and 84 (41.6%) against pandemic influenza A (H1N1) 2009. For the impending 2010-2011 influenza season, 45 (22.3%) stated their intention to get vaccinated against seasonal influenza, 40 (19.8%) were uncertain and 117 (57.9%) were opposed. Considering themselves to be a high risk group for developing influenza was significantly associated with vaccination against both 2009-2010 seasonal (adj-OR=1.46; 95% CI=1.05-2.04) and pandemic A (H1N1) influenza (adj-OR 1.38; 95% CI=1.08-1.75). Intention to get vaccinated against 2010-2011 seasonal influenza was significantly more frequent in participants who had a high perception of efficacy/safety (adj-OR=1.49; 95% CI=1.05-2.12). After adjusting for confounding, vaccinations against seasonal 2009-2010 influenza, pandemic influenza A (H1N1) 2009 and seasonal 2010-2011 influenza were significantly more frequent in residents who were vaccinated against influenza at least once in the previous five influenza seasons. Influenza vaccination among medical

  19. Accreditation and participatory design in the healthcare sector

    DEFF Research Database (Denmark)

    Simonsen, Jesper; Scheuer, John Damm; Hertzum, Morten

    2015-01-01

    We revisit the role of participatory design approaches in the light of the accreditation regime currently imposed on the Danish healthcare sector. We describe effects-driven IT development as an instrument supporting sustained participatory design. Effects-driven IT development includes specifying...

  20. Comparison of PCR/Electron spray Ionization-Time-of-Flight-Mass Spectrometry versus Traditional Clinical Microbiology for active surveillance of organisms contaminating high-use surfaces in a burn intensive care unit, an orthopedic ward and healthcare workers

    Directory of Open Access Journals (Sweden)

    Yun Heather C

    2012-10-01

    Full Text Available Abstract Background Understanding nosocomial pathogen transmission is restricted by culture limitations. Novel platforms, such as PCR-based electron spray ionization-time-of-flight-mass spectrometry (ESI-TOF-MS, may be useful as investigational tools. Methods Traditional clinical microbiology (TCM and PCR/ESI-TOF-MS were used to recover and detect microorganisms from the hands and personal protective equipment of 10 burn intensive care unit (ICU healthcare workers providing clinical care at a tertiary care military referral hospital. High-use environmental surfaces were assessed in 9 burn ICU and 10 orthopedic patient rooms. Clinical cultures during the study period were reviewed for pathogen comparison with investigational molecular diagnostic methods. Results From 158 samples, 142 organisms were identified by TCM and 718 by PCR/ESI-TOF-MS. The molecular diagnostic method detected more organisms (4.5 ± 2.1 vs. 0.9 ± 0.8, p S. aureus in 13 samples vs. 21 by PCR/ESI-TOF-MS. Gram-negative organisms were less commonly identified than gram-positive by both methods; especially by TCM. Among all detected bacterial species, similar percentages were typical nosocomial pathogens (18-19% for TCM vs. PCR/ESI-TOF-MS. PCR/ESI-TOF-MS also detected mecA in 112 samples, vanA in 13, and KPC-3 in 2. MecA was associated (p S. aureus. No vanA was codetected with enterococci; one KPC-3 was detected without Klebsiella spp. Conclusions In this pilot study, PCR/ESI-TOF-MS detected more organisms, especially gram-negatives, compared to TCM, but the current assay format is limited by the number of antibiotic resistance determinants it covers. Further large-scale assessments of PCR/ESI-TOF-MS for hospital surveillance are warranted.

  1. Introduction of Syphilis Point-of-Care Tests, from Pilot Study to National Programme Implementation in Zambia: A Qualitative Study of Healthcare Workers' Perspectives on Testing, Training and Quality Assurance.

    Directory of Open Access Journals (Sweden)

    Éimhín M Ansbro

    Full Text Available Syphilis affects 1.4 million pregnant women globally each year. Maternal syphilis causes congenital syphilis in over half of affected pregnancies, leading to early foetal loss, pregnancy complications, stillbirth and neonatal death. Syphilis is under-diagnosed in pregnant women. Point-of-care rapid syphilis tests (RST allow for same-day treatment and address logistical barriers to testing encountered with standard Rapid Plasma Reagin testing. Recent literature emphasises successful introduction of new health technologies requires healthcare worker (HCW acceptance, effective training, quality monitoring and robust health systems. Following a successful pilot, the Zambian Ministry of Health (MoH adopted RST into policy, integrating them into prevention of mother-to-child transmission of HIV clinics in four underserved Zambian districts. We compare HCW experiences, including challenges encountered in scaling up from a highly supported NGO-led pilot to a large-scale MoH-led national programme. Questionnaires were administered through structured interviews of 16 HCWs in two pilot districts and 24 HCWs in two different rollout districts. Supplementary data were gathered via stakeholder interviews, clinic registers and supervisory visits. Using a conceptual framework adapted from health technology literature, we explored RST acceptance and usability. Quantitative data were analysed using descriptive statistics. Key themes in qualitative data were explored using template analysis. Overall, HCWs accepted RST as learnable, suitable, effective tools to improve antenatal services, which were usable in diverse clinical settings. Changes in training, supervision and quality monitoring models between pilot and rollout may have influenced rollout HCW acceptance and compromised testing quality. While quality monitoring was integrated into national policy and training, implementation was limited during rollout despite financial support and mentorship. We

  2. A pilot study of an mHealth application for healthcare workers: poor uptake despite high reported acceptability at a rural South African community-based MDR-TB treatment program.

    Directory of Open Access Journals (Sweden)

    Krisda H Chaiyachati

    Full Text Available As the South African province of KwaZulu-Natal addresses a growing multidrug-resistant tuberculosis (MDR-TB epidemic by shifting care and treatment from trained specialty centers to community hospitals, delivering and monitoring MDR-TB therapy has presented new challenges. In particular, tracking and reporting adverse clinical events have been difficult for mobile healthcare workers (HCWs, trained health professionals who travel daily to patient homes to administer and monitor therapy. We designed and piloted a mobile phone application (Mobilize for mobile HCWs that electronically standardized the recording and tracking of MDR-TB patients on low-cost, functional phones.We assess the acceptability and feasibility of using Mobilize to record and submit adverse events forms weekly during the intensive phase of MDR-TB therapy and evaluate mobile HCW perceptions throughout the pilot period.All five mobile HCWs at one site were trained and provided with phones. Utilizing a mixed-methods evaluation, mobile HCWs' usage patterns were tracked electronically for seven months and analyzed. Qualitative focus groups and questionnaires were designed to understand the impact of mobile phone technology on the work environment.Mobile HCWs submitted nine of 33 (27% expected adverse events forms, conflicting with qualitative results in which mobile HCWs stated that Mobilize improved adverse events communication, helped their daily workflow, and could be successfully expanded to other health interventions. When presented with the conflict between their expressed views and actual practice, mobile HCWs cited forgetfulness and believed patients should take more responsibility for their own care.This pilot experience demonstrated poor uptake by HCWs despite positive responses to using mHealth. Though our results should be interpreted cautiously because of the small number of mobile HCWs and MDR-TB patients in this study, we recommend carefully exploring the motivations

  3. The migrant worker: visible, yet invisible

    OpenAIRE

    Win, Aung

    2015-01-01

    Immigrant workers are a vulnerable and underserved population. The average life expectancy of the migrant worker is 49 years, compared to 77.2 years for most Americans. Immigrant workers have a higher disease burden than other populations and work in occupations with high hazard levels. In addition, they have low socioeconomic levels and face many barriers to accessing healthcare services. Undocumented immigrant workers are excluded in the Affordable Care Act. Health professionals must be att...

  4. Social marketing in healthcare.

    Science.gov (United States)

    Aras, Radha

    2011-01-01

    Social marketing is an important tool in the delivery of healthcare services. For any healthcare programme or project to be successful, community/consumer participation is required. The four principles of social marketing can guide policymakers and healthcare providers to successfully plan and implement health programmes. To review the existing literature in order to project the benefits of social marketing in healthcare. A search of periodical literature by the author involving social marketing and marketing concepts in health was carried out. Items were identified initially through health-oriented indexing services such as Medline, Health STAR and Cinahl, using the identifiers "social marketing" and "marketing in health". An extensive search was also carried out on educational database ERIC. A literature review of various studies on social marketing indicated that the selection of the right product (according to the community need) at the right place, with the right strategy for promotion and at the right price yields good results. However, along with technical sustainability (product, price, promotion and place), financial sustainability, institutional sustainability and market sustainability are conducive factors for the success of social marketing. The purpose of this literature review was to ascertain the likely effectiveness of social marketing principles and approaches and behaviour change communication towards health promotion. It is important for all healthcare workers to understand and respond to the public's desires and needs and routinely use consumer research to determine how best to help the public to solve problems and realise aspirations. Social marketing can optimise public health by facilitating relationship-building with consumers and making their lives healthier.

  5. Prevalência de transtornos psiquiátricos menores em trabalhadores da atenção primária à saúde das regiões Sul e Nordeste do Brasil Prevalence of minor psychiatric disorders among primary healthcare workers in the South and Northeast regions of Brazil

    Directory of Open Access Journals (Sweden)

    Alitéia Santiago Dilélio

    2012-03-01

    Full Text Available Os problemas de saúde mental estão entre os mais prevalentes em trabalhadores de saúde. Foram avaliados a prevalência de transtornos psiquiátricos menores e os fatores associados em trabalhadores da atenção primária à saúde. O delineamento foi transversal com base em 240 unidades básicas de saúde de 41 municípios acima de 100 mil habitantes de sete estados das regiões Sul e Nordeste do Brasil. Foram entrevistados 4.749 trabalhadores, e a prevalência de transtornos psiquiátricos menores foi de 16%, sem diferenças estatísticas por região e modelo de atenção. Foi maior em agentes comunitários de saúde e outros trabalhadores de nível médio (18%, menor em outros profissionais de nível superior (10%, ficando médicos (15% e profissionais de enfermagem (14,6% em posição intermediária (p Mental health problems are among the most prevalent conditions in health workers. We evaluated the prevalence of minor psychiatric disorders and associated factors among primary healthcare workers. The study design was cross-sectional and services-based, in 240 primary healthcare units in 41 municipalities (counties with more than 100 thousand inhabitants in seven States in the South and Northeast regions of Brazil. A total of 4,749 primary healthcare workers were interviewed, and prevalence of minor psychiatric disorders was 16%, with no statistical differences according to region or primary care model. The rate was higher in community health workers and other workers with secondary education (18% and lower in health professionals with university training (10%; while physicians (15% and nurses and nurse technicians (14.6% were in an intermediate situation (p < 0.001. Occupational characteristics showed the strongest association with the occurrence of minor psychiatric disorders according to the adjusted analysis, suggesting that their reduction requires improvements in work conditions in primary healthcare and in the management of the

  6. Italian healthcare workers' views on mandatory vaccination

    OpenAIRE

    Germinario Cinzia CG; Arbore Annamaria AA; Caputi Giovanni GC; Martinelli Domenico DM; Tafuri Silvio ST; Prato Rosa RP

    2009-01-01

    Abstract Background Mandatory vaccination has contributed to the success of immunisation programmes but voluntary vaccination allows people to be responsible for their own health. There are benefits from both policies and the arguments between them remain subject to debate within and without the scientific community, both nationally and internationally. The aim of this study is to assess the opinions of those who actually work in the Vaccination Service. Methods The survey was carried out usi...

  7. Italian healthcare workers' views on mandatory vaccination

    Directory of Open Access Journals (Sweden)

    Germinario Cinzia CG

    2009-06-01

    Full Text Available Abstract Background Mandatory vaccination has contributed to the success of immunisation programmes but voluntary vaccination allows people to be responsible for their own health. There are benefits from both policies and the arguments between them remain subject to debate within and without the scientific community, both nationally and internationally. The aim of this study is to assess the opinions of those who actually work in the Vaccination Service. Methods The survey was carried out using a self-administered standardised anonymous questionnaire given to all of the Vaccination Service employees in the Apulia Region. Results Of 302 completed questionnaire replies, 4.4% stated that mandatory vaccination should be abandoned now, 21.2% that it should be phased out, and 74.4% that it should be retained. Conclusion An educational program should be set up to explain to Vaccination staff the value and worth of voluntary compared to mandatory vaccination and why high vaccination rates do not have to depend on compulsion.

  8. 78 FR 28631 - Experian, Experian Healthcare (Medical Present Value (MPV)-Credit Services and Decision Analytics...

    Science.gov (United States)

    2013-05-15

    ... Employment and Training Administration Experian, Experian Healthcare (Medical Present Value (MPV)-- Credit... 4, 2013, applicable to workers of Experian, Experian Healthcare, (medical Present Value (MPV... Present Value (MPV)--Credit Services and Decision Analytics), Plymouth, Massachusetts...

  9. Healthcare waste management in selected government and private hospitals in Southeast Nigeria

    Directory of Open Access Journals (Sweden)

    Angus Nnamdi Oli

    2016-01-01

    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.

  10. Implementing the Emergency Triage, Assessment and Treatment plus admission care (ETAT+) clinical practice guidelines to improve quality of hospital care in Rwandan district hospitals: healthcare workers' perspectives on relevance and challenges.

    Science.gov (United States)

    Hategeka, Celestin; Mwai, Leah; Tuyisenge, Lisine

    2017-04-07

    An emergency triage, assessment and treatment plus admission care (ETAT+) intervention was implemented in Rwandan district hospitals to improve hospital care for severely ill infants and children. Many interventions are rarely implemented with perfect fidelity under real-world conditions. Thus, evaluations of the real-world experiences of implementing ETAT+ are important in terms of identifying potential barriers to successful implementation. This study explored the perspectives of Rwandan healthcare workers (HCWs) on the relevance of ETAT+ and documented potential barriers to its successful implementation. HCWs enrolled in the ETAT+ training were asked, immediately after the training, their perspective regarding (i) relevance of the ETAT+ training to Rwandan district hospitals; (ii) if attending the training would bring about change in their work; and (iii) challenges that they encountered during the training, as well as those they anticipated to hamper their ability to translate the knowledge and skills learned in the ETAT+ training into practice in order to improve care for severely ill infants and children in their hospitals. They wrote their perspectives in French, Kinyarwanda, or English and sometimes a mixture of all these languages that are official in the post-genocide Rwanda. Their notes were translated to (if not already in) English and transcribed, and transcripts were analyzed using thematic content analysis. One hundred seventy-one HCWs were included in our analysis. Nearly all these HCWs stated that the training was highly relevant to the district hospitals and that it aligned with their work expectation. However, some midwives believed that the "neonatal resuscitation and feeding" components of the training were more relevant to them than other components. Many HCWs anticipated to change practice by initiating a triage system in their hospital and by using job aids including guidelines for prescription and feeding. Most of the challenges stemmed

  11. Prevention of risk factors for occupational exposure to blood borne pathogens among healthcare workers%医务人员血源性职业暴露危险因素的预防

    Institute of Scientific and Technical Information of China (English)

    陈建伟; 韩立海; 孙吉花; 张霞; 邱会芬; 张洁

    2015-01-01

    OBJECTIVE To investigate the hign‐risk populations ,departments and operation activities associated with occupational exposure to blood borne pathogens among healthcare workers ,further discuss prevention strate‐gies for the hign‐risk factors .METHODS The monitoring report system for the occupational exposure to blood borne pathogens was established ,and the registration form of exposure cases was filled out by the healthcare workers after occurrence of exposure .The 61 reported cases were investigated from Jun .2012 to May 2013 .The software SPSS17 .0 was used for statistical analysis .RESULTS The majority of the 61 reported cases (80 .33% ) were junior nurses and student nurses . Occupational exposure more frequently occurred in general wards (54 .1% ) ,operating rooms (19 .67% ) and emergency rooms (9 .84% ) ,and was most frequently associated with clinical activities such as needle‐withdrawal after transfusion (39 .34% ) ,needle‐withdrawal after various injec‐tions ,punctures and blood drawing (13 .11% ) ,sutures during operation (11 .48% ) and centralized separation of needles (9 .48% ) .The reported cases in which operators did not wear gloves accounted for 86 .89% .It was the most difficult for post‐exposure prophylaxis after contact with unknown patients or unknown pathogens .Hepatitis B virus accounting for 54 .10% took the highest proportion among the sources of blood borne pathogens . CONCLUSION Occupational exposure to blood borne pathogens occurs most frequently in junior nurses and student nurses ,in general ward ,operating rooms and emergency rooms ,and is highly associated with certain unstandard‐ized clinical activities .The optimal prevention strategies for the exposure include well knowledge and concept of ap‐plication of standard precautions ,safely manipulation of safe sharp instruments and needles ,timely vaccination and active self‐report after occupational exposure .%目的:调查医务人员发生血源性职业暴露

  12. The orthopaedist's role in healthcare system governance.

    Science.gov (United States)

    Probe, Robert A

    2013-06-01

    Historically, physicians as participants in healthcare governance were shunned because of perceived potential for conflict of interest. This maxim is being revisited as health systems begin to appreciate the value presented by physician leaders. This overview of the orthopaedist's role in healthcare governance will be addressed in three sections: first to identify the need for change in American healthcare, second to examine the role that physicians should play in governing over this inevitable change, and third to outline strategies for effective participation for those physicians wishing to play a role in healthcare governance. The PubMed data set was queried applying the search commands "governance AND (healthcare OR hospital) AND (doctor OR physician OR surgeon)" for the time period 1969 to 2012. In addition, the bibliographies of relevant articles were reviewed. This search strategy returned 404 titles. Abstract and article review identified 19 relevant to the topic. Bibliographic review identified five more articles of relevance forming the foundation for this review. The delivery of American health care will require change to face current economic realities. Organizations that embrace this change guided by the insight of physician governors are well positioned to recognize the simultaneous improvement in value and quality. Although few physicians are formally trained for these roles, multiple paths to becoming effective governors are available. In this environment of rapid change in healthcare delivery, the medical insight of physician leadership will prove invaluable. Governing bodies should reach out to talented physicians and administratively talented physicians should rise to this challenge.

  13. 北京市某三甲医院医务人员流感疫苗接种意愿及影响因素分析%Analysis on the influencing factors of influenza vaccination among healthcare workers in a grade-a class-three hospital in Beijing

    Institute of Scientific and Technical Information of China (English)

    高玥; 赵云龙; 吴华; 杨雪松; 张文丽

    2015-01-01

    目的 了解北京市三甲医院医务人员对流感及流感疫苗的认知情况,探讨接种意愿的影响因素,为提高医务人员流感疫苗接种率及制定适合医疗机构的流感防控措施提供依据.方法 对某三甲医院369名医务人员进行问卷调查,分析流感疫苗接种意愿的影响因素.结果 年龄越小、2013年接种过流感疫苗、流感和流感疫苗相关知识回答正确率高者更愿意在2014年度接种流感疫苗.不愿意接种流感疫苗的原因主要为害怕疫苗的副反应,认为自己身体好、觉得自己感染流感病毒概率小、没有时间接种等.结论 应加大对医务人员流感及流感疫苗相关知识的培训,组织制定适合医疗机构的科学、规范的流感疫苗免疫策略,结合政策干预、实施优惠政策等措施来进一步提高医务人员的接种意愿及接种率.%Objective To know the awareness of healthcare workers on influenza and influenza vaccines,discuss the influencing factors of influenza vaccination,in order to increase the influenza vaccination rate of heahhcare workers and provide reference for influenza prevention and control in medical institutions.Methods A survey was carried out through a questionnaire,369 healthcare workers were included in the study.The data was statistically analyzed and we screened the influencing factors of influenza vaccination.Results Younger,the people who inoculated with influenza vaccine in 2013 and the healthcare workers who had more knowledge of influenza and influenza vaccines were significantly associated with higher acceptance of influenza vaccine.Fearing side effects of vaccine,considered that they would not get the flu and they had no time to inoculate were the main reasons of unwilling to receiving influenza vaccination.Conclusions We should increase the knowledge about influenza and influenza vaccine in healthcare workers though frequent trainings,organize to develop scientific and normative

  14. Labour economics and healthcare professional education.

    Science.gov (United States)

    Walsh, Kieran

    2015-01-01

    Healthcare professional education is the undergraduate, postgraduate and continuing professional development for doctors, nurses and allied healthcare professionals. Labour economics is the relationship between workers and employers, and the resultant effect on employment and wages. Healthcare professional education ultimately produces a workforce, and that workforce is governed by the rules of labour economics like any other workforce. Despite all of these largely incontrovertible facts, there has been remarkably little interest in the relationship between healthcare professional education and labour economics. This short article attempts to redress this shortcoming by describing some of the factors that can affect healthcare professional education and labour economics, and aims to mention some of the methods in which these two disciplines can interact with each other.

  15. Human factors systems approach to healthcare quality and patient safety

    Science.gov (United States)

    Carayon, Pascale; Wetterneck, Tosha B.; Rivera-Rodriguez, A. Joy; Hundt, Ann Schoofs; Hoonakker, Peter; Holden, Richard; Gurses, Ayse P.

    2013-01-01

    Human factors systems approaches are critical for improving healthcare quality and patient safety. The SEIPS (Systems Engineering Initiative for Patient Safety) model of work system and patient safety is a human factors systems approach that has been successfully applied in healthcare research and practice. Several research and practical applications of the SEIPS model are described. Important implications of the SEIPS model for healthcare system and process redesign are highlighted. Principles for redesigning healthcare systems using the SEIPS model are described. Balancing the work system and encouraging the active and adaptive role of workers are key principles for improving healthcare quality and patient safety. PMID:23845724

  16. Burden and Stress among Psychiatry Residents and Psychiatric Healthcare Providers

    Science.gov (United States)

    Zuardi, Antonio Waldo; Ishara, Sergio; Bandeira, Marina

    2011-01-01

    Purpose: The authors compared the levels of job burden and stress in psychiatry residents with those of other healthcare professionals at inpatient and outpatient psychiatric hospitals in a medium-sized Brazilian city. Method: In this study, the levels of job burden and stress of 136 healthcare workers and 36 psychiatry residents from six various…

  17. Burden and Stress among Psychiatry Residents and Psychiatric Healthcare Providers

    Science.gov (United States)

    Zuardi, Antonio Waldo; Ishara, Sergio; Bandeira, Marina

    2011-01-01

    Purpose: The authors compared the levels of job burden and stress in psychiatry residents with those of other healthcare professionals at inpatient and outpatient psychiatric hospitals in a medium-sized Brazilian city. Method: In this study, the levels of job burden and stress of 136 healthcare workers and 36 psychiatry residents from six various…

  18. Promoting multiculturalism in healthcare on a zero budget.

    Science.gov (United States)

    Grewal, S; Butler, V

    1996-01-01

    When a B.C. health commission proposed strategies for promoting cultural awareness in healthcare, members of one hospital staff took up the challenge. With no budget and in addition to their regular duties, they researched and developed practical tools for healthcare workers in the midst of Victoria's diverse community.

  19. Addressing language barriers to healthcare in India.

    Science.gov (United States)

    Narayan, Lalit

    2013-01-01

    In spite of a growing recognition of the importance of doctor-patient communication, the issue of language barriers to healthcare has received very little attention in India. The Indian population speaks over 22 major languages with English used as the lingua franca for biomedicine. Large-scale internal migration has meant that health workers are encountering increasing instances of language discordance within clinical settings. Research done predominantly in the West has shown language discordance to significantly affect access to care, cause problems of comprehension and adherence, and decrease the satisfaction and quality of care. Addressing language barriers to healthcare in India requires a stronger political commitment to providing non-discriminatory health services, especially to vulnerable groups such as illiterate migrant workers. Research will have to address three broad areas: the ways in which language barriers affect health and healthcare, the efficacy of interventions to overcome language barriers, and the costs of language barriers and efforts to overcome them. There is a need to address such barriers in health worker education and clinical practice. Proven strategies such as hiring multilingual healthcare workers, providing language training to health providers, employing in situ translators or using telephone interpretation services will have to be evaluated for their appropriateness to the Indian context. Internet-based initiatives, the proliferation of mobile phones and recent advances in machine translation promise to contribute to the solution. Copyright 2013, NMJI.

  20. The migrant worker: visible, yet invisible.

    Science.gov (United States)

    Win, Aung

    2015-01-22

    Immigrant workers are a vulnerable and underserved population. The average life expectancy of the migrant worker is 49 years, compared to 77.2 years for most Americans. Immigrant workers have a higher disease burden than other populations and work in occupations with high hazard levels. In addition, they have low socioeconomic levels and face many barriers to accessing healthcare services. Undocumented immigrant workers are excluded in the Affordable Care Act. Health professionals must be attuned to the health issues of new immigrants so that they can provide better services. In order to raise the health standards of America, health professionals must provide healthcare for all, including immigrant workers.

  1. Trade Unions, immigration and immigrants in Europe revisited: Unions’ attitudes and actions under new conditions

    NARCIS (Netherlands)

    Marino, S.; Penninx, R.; Roosblad, J.

    2015-01-01

    This paper revisits the comparative approach used by Penninx and Roosblad (Trade Unions, Immigration and Immigrants in Europe, 1960-1993. New York: Berghahn Books) to study trade unions’ attitudes and actions in relation to immigrant workers in seven Western European countries. It reassesses that ap

  2. Revisiting Okun's Relationship

    NARCIS (Netherlands)

    Dixon, R.; Lim, G.C.; van Ours, Jan

    2016-01-01

    Our paper revisits Okun's relationship between observed unemployment rates and output gaps. We include in the relationship the effect of labour market institutions as well as age and gender effects. Our empirical analysis is based on 20 OECD countries over the period 1985-2013. We find that the

  3. Revisiting city connectivity

    NARCIS (Netherlands)

    Mans, U.

    2014-01-01

    This article introduces a new perspective on city connectivity in order to analyze non-hub cities and their position in the world economy. The author revisits the different approaches discussed in the Global Commodity Chains (GCC), Global Production Networks (GPN) and World City Network (WCN) discou

  4. A Hydrostatic Paradox Revisited

    Science.gov (United States)

    Ganci, Salvatore

    2012-01-01

    This paper revisits a well-known hydrostatic paradox, observed when turning upside down a glass partially filled with water and covered with a sheet of light material. The phenomenon is studied in its most general form by including the mass of the cover. A historical survey of this experiment shows that a common misunderstanding of the phenomenon…

  5. Concept Image Revisited

    Science.gov (United States)

    Bingolbali, Erhan; Monaghan, John

    2008-01-01

    Concept image and concept definition is an important construct in mathematics education. Its use, however, has been limited to cognitive studies. This article revisits concept image in the context of research on undergraduate students' understanding of the derivative which regards the context of learning as paramount. The literature, mainly on…

  6. Revisiting the Okun relationship

    NARCIS (Netherlands)

    Dixon, R. (Robert); Lim, G.C.; J.C. van Ours (Jan)

    2017-01-01

    textabstractOur article revisits the Okun relationship between observed unemployment rates and output gaps. We include in the relationship the effect of labour market institutions as well as age and gender effects. Our empirical analysis is based on 20 OECD countries over the period 1985–2013. We

  7. The Faraday effect revisited

    DEFF Research Database (Denmark)

    Cornean, Horia; Nenciu, Gheorghe

    2009-01-01

    This paper is the second in a series revisiting the (effect of) Faraday rotation. We formulate and prove the thermodynamic limit for the transverse electric conductivity of Bloch electrons, as well as for the Verdet constant. The main mathematical tool is a regularized magnetic and geometric...

  8. A Hydrostatic Paradox Revisited

    Science.gov (United States)

    Ganci, Salvatore

    2012-01-01

    This paper revisits a well-known hydrostatic paradox, observed when turning upside down a glass partially filled with water and covered with a sheet of light material. The phenomenon is studied in its most general form by including the mass of the cover. A historical survey of this experiment shows that a common misunderstanding of the phenomenon…

  9. Electronic healthcare information security

    CERN Document Server

    Dube, Kudakwashe; Shoniregun, Charles A

    2010-01-01

    The ever-increasing healthcare expenditure and pressing demand for improved quality and efficiency of patient care services are driving innovation in healthcare information management. The domain of healthcare has become a challenging testing ground for information security due to the complex nature of healthcare information and individual privacy. ""Electronic Healthcare Information Security"" explores the challenges of e-healthcare information and security policy technologies. It evaluates the effectiveness of security and privacy implementation systems for anonymization methods and techniqu

  10. Licensed Healthcare Facilities

    Data.gov (United States)

    California Department of Resources — The Licensed Healthcare Facilities point layer represents the locations of all healthcare facilities licensed by the State of California, Department of Health...

  11. Licensed Healthcare Facilities

    Data.gov (United States)

    California Department of Resources — The Licensed Healthcare Facilities point layer represents the locations of all healthcare facilities licensed by the State of California, Department of Health...

  12. Contingent workers.

    Science.gov (United States)

    Guerrina, Ryan T; Burns, Candace M; Conlon, Helen

    2011-03-01

    Contingent workers compose a large portion of the U.S. work force. Contingent workers include temporary employees, contracted employees, day laborers, and freelancers. The skill level and educational requirements for their jobs vary from basic to highly advanced. Construction, housekeeping, engineering, and nursing have such positions. U.S. contingent workers are more likely to engage in occupations associated with increased risk of injury, and a variety of factors increase their risk of work injuries, particularly those leading to death. This article focuses on select occupational health and safety issues affecting contingent workers and their implications for occupational health nurses. Copyright 2011, SLACK Incorporated.

  13. Public Health Risks from Mismanagement of Healthcare Wastes in Shinyanga Municipality Health Facilities, Tanzania

    OpenAIRE

    Kizito Kuchibanda; Mayo, Aloyce W.

    2015-01-01

    The increase of healthcare facilities in Shinyanga municipality has resulted in an increase of healthcare wastes, which poses serious threats to the environment, health workers, and the general public. This research was conducted to investigate management practices of healthcare wastes in Shinyanga municipality with a view of assessing health risks to health workers and the general public. The study, which was carried out in three hospitals, involved the use of questionnaires, in-depth interv...

  14. Healthcare Students' Perceptions of a Simulated Interprofessional Consultation in an Outpatient Clinic

    Science.gov (United States)

    Pitout, H.; Human, A.; Treadwell, I.; Sobantu, N. A.

    2016-01-01

    Newly graduated healthcare workers should appreciate the importance of teamwork and each profession's unique role in a multi-disciplinary team. At Medunsa, an institution for higher education of healthcare professionals, each profession's teaching occurs independently. This study explores the perceptions of healthcare students and their…

  15. Community College Nursing and Allied Health Education Programs, and Iowa's Healthcare Workforce

    Science.gov (United States)

    McLaughlin, Michael P.

    2009-01-01

    As the nation's population ages and the Baby Boom generation nears retirement, the need for skilled healthcare workers in Iowa and across the nation grows. Healthcare is one of the fastest growing sectors of the U.S. economy, and one of the top industries for job growth and job creation in Iowa. The increase in the number of healthcare positions…