Inoculation injuries in hospitals in Trinidad and Tobago

This paper reviews the frequency of inoculation injures, which occurred in hospitals in Trinidad and Tobago from 1991 to 1997, inclusive. A total of 397 cases of inoculation injuries were detected. Significantly more of this injures occurred during diagnostic or therapeutic procedures (231, or 58.2 percent: G=41.2, df 9, p < 0.001) than during disposal of needles and other sharps (136, or 34.3 percent), certain situations remote from patient care (21, or 5.2 percent), and "rogue incidents" related to unsafe disposal with later injury to janitors or others (9, or 2.3 percent). No statistically significant monthly or seasonal variations occurred in the incidence of reported inoculation injuries. The two institutions that saw the largest number of patients, the Port-of-Spain General and San Fernando General Hospitals, accounted for the largest number of cases of inoculation injury, with 139 (35.0 percent) and 135 (34.0 percent), respectively. Interestingly enough, there were 42 reported inoculation incidents at the St. Ann's Hospital for the Mentally Impaired and 23 (52.5 percent of these were bites, most of them occurring during attempted procedures. Nurses were the main recipients of inoculation injuries (287 cases, or > 72 percent), followed by doctors (9.3 percent), and ward maids (6.2 percent). The main modes of inoculation were needle sticks (305, pr 76.8 percent). Bites (34, 8.6 percent) injuries with sharps other than needles (29, or 7.3 percent), and splashes (29, or 7.3 percent) were the other types seen. One recipient was found to be infected with HIV following accidental inoculation. The infection control methodologies used in hospitals in Trinidad and Tobago was reviewed and recommendations for preventing injuries are outlined.(AU)

Hepatitis A among health workers in Paris hospitals. Occupational Health Physicians of Paris Hospital (AP-HP)

To design a vaccination strategy against hepatitis A among hospital employees, we carried out a serological survey against hepatitis A virus (HAV) infection in 10 university hospitals in the Paris area. Subjects under 60 years of age were consecutively enrolled by occupational health services and tested for IgG to HAV by ELISA. Of the 1,516 subjects recruited, 926 were health workers (HW), 322 clerks, and 268 cooks or kitchen employees. Among HW and clerks the HAV seroprevalence was 53.8 percent (95 percent CI: 44.0-65.6), increasing with age and being higher among Europe (83.6 percent vs 45.6 percent, P < .001). Age correlated closely with the duration of hospital work, so only age was taken into account for further analysis. The HAV seroprevalences among HW and clerks originating from Europe were close (48.8 percent vs 42.6 percent) and remained so after adjustment for age. HAV seroprevalences in HW caring for adults and those caring for children were also similar (45.2 percent vs 40.1 percent). Seroprevalence was higher in assistant nurses than in nurses (51.3 percent vs 39.8 percent, P < .02). Among cooks and kitchen employees, 53.4 percent were HAV-seropositive. This study shows that hospital employees need not routinely be vaccinated against HAV; the decision should be taken by the occupational physician according to the type of work, but should be routine for cooks and kitchen employees. The need for prevaccinal screening for anti-HAV should be assessed in the light of employees' geographical origin and age.(Au)

Ministry of Health: management review

Presents a review of five areas of the health services infrastructure, viz. General Hospital, Richmond Hill institutions, Princess Alice Hospital. Princess Royal Hospital and community health services. Details of the organizational structure and proposals for improved administrative practices and working conditions are given. Includes statistical data on medical, nursing and administrative personnel

Hepatitis B antibody levels in health-care workers of a large general hospital in Barbados

In order to assess the immune status to Hepatitis B in a general hospital population in the Caribbean, we studied the antibody level to Hepatitis B surface antigen (anti HBs) and to core antigen (anti HBc) in 90 health-care workers at the Queen Elizbeth Hospital in Barbados, West Indies. There was one asymptomatic carrier with Hepatitis B antigen (HBsAg). Thirteen (14.6 percent) of the remaining 89 possessed anti HBs; 10 of these (11.2 percent) were considered to be immune, and three non-immune. The 10 immune subjects were also positive for anti HBc whereas the other three "non-immune" positives were not. One person in the study had strong anti HBc immunity but was negative for anti HBs. There appeared to be no relationship between immunity and age, sex, profession or duration of work years. From the study, 76 individuals (84 percent were easily identified as being susceptible to Hepatitis B and were candidates for HBV vaccine. (AU)

Worker discontent in large and medium size service oriented organizations: a methodology and an analysis based upon two hospitals

The major objectives of this study are threefold: firstly, we seek to examine job satisfaction and worker mobility within the context of a developing country. We shall compare our findings with assumptions and theories currently existing in a North American context. Secondly, we seek to provide a study on job satisfaction and worker mobility which is integrated with findings in control theory, analytical biology and anthropology. Using this approach the worker is viewed as a living self adaptive system in which control is effected via a feedback process which ensures that a state of homeostatis is maintained between the worker and the two groups which have been responsible for survival of the human species viz. the nuclear family and the work group. Our third and final objective is to present a dynamic methodology which can be used by personnel departments in large organizations from the viewpoint of job satisfaction. Our aim is to suggest a research process rather than to create a static instrument. In Chapters one and two we discuss in detail the nature of our practical and theoretical objectives. In Chapter one we seek to express those concerns which prompted this particular study, and provide the reader wuth a general outline of the analytical approach which has been embraced by our methodlogy. In chapter two we discuss our research design, the theory upon which it is based and the relationship of this theory to existing theories. Chapters three and four are both devoted to the presentation and interpretation of empirical results. In Chapter three, five dimensional components of job satisfaction are isolated and relationships to each other is discussed. In Chapter four tactical responses to dissatisfaction are examined. Chapter five is devoted towards presenting a model of job satisfaction, its causes and its effects. In Chapter six we suggest that a crucial function of the personnel department in large and medium size organization should be on-going research aimed at presenting to management and unions a model of the organization from the viewpoint of job satisfaction and worker mobility. Personnel managers should have well defined research skills similar to that possessed by economists, accountants etc. We present a methodology and we suggest a goal towards which on-going research should be directed(AU)\

A community health aide training programme

The Department of Social and Preventive Medicine, University of the West Indies, reports on a four-month experimental training programme for Community Health Aides drawn from a low to middle socio-economic community. The overall aim was to give the Aides a basic minimum training so that they could function as auxiliaries under supervision, relieving highly trained personnel to utilize their skills and training more effectively. The aides who were trained have worked during the past year in various positions, namely: in comprehensive health care programmes, in physiotherapy, as field workers in research projects, and in family planning. Evaluation of the programme indicates that these workers have performed satisfactorily and that a community health aide can be a very useful member of the health team in our developing communities (Summary)