RESUMO
INTRODUCTION: Investigations about the interrelationships of nurses' safety climate, quality of care, and standard precautions (SP) adherence and compliance remain particularly scarce in the literature. Thus, we tested a model of the associations between nurses' safety climate, quality of care, and the factors influencing adherence and compliance with SPs utilizing the structural equation modeling (SEM) approach. DESIGN: Cross-sectional design complying with STROBE guidelines. METHODS: Using convenience sampling, nurses (n = 730) from the Philippines were recruited. Data were collected between April and September 2022 using four validated self-report measures. Spearman Rho, mediation and path analyses, and SEM were employed for data analysis. RESULTS: Acceptable model fit indices were shown by the emerging model. The safety climate is positively associated with quality of care and factors influencing adherence to and compliance with SPs. Quality of care directly affected factors influencing adherence to SPs. The factors influencing adherence to SPs directly affected SP compliance. Quality of care mediated between safety climate and the factors influencing adherence to SPs. Factors influencing adherence to SPs mediated between safety climate, quality of care, and SP compliance. CONCLUSIONS: The study's variables are not distinct but overlapping nursing concepts that must be examined collectively. Nurse administrators can utilize the emerging model to formulate strategies and regulations for evaluating and enhancing nurses' safety climate, quality of care, and SP adherence and compliance. CLINICAL RELEVANCE: Our findings may impact policymaking, organizational, and individual levels to improve nurses' clinical practice. PATIENT OR PUBLIC CONTRIBUTION: This study had no patient contribution or public funding.
Assuntos
Fidelidade a Diretrizes , Qualidade da Assistência à Saúde , Humanos , Estudos Transversais , Filipinas , Feminino , Fidelidade a Diretrizes/estatística & dados numéricos , Adulto , Qualidade da Assistência à Saúde/estatística & dados numéricos , Qualidade da Assistência à Saúde/normas , Masculino , Cultura Organizacional , Inquéritos e Questionários , Pessoa de Meia-Idade , Precauções Universais/estatística & dados numéricos , Recursos Humanos de Enfermagem Hospitalar/estatística & dados numéricos , Recursos Humanos de Enfermagem Hospitalar/psicologia , Gestão da Segurança/normasRESUMO
AIM: This study aimed to analyse the effects of servant leadership on nurses' emotional failure and compliance with standard precautions and to explore the moderating effect of individual resilience. DESIGN: A cross-sectional survey. METHODS: This descriptive cross-sectional study was conducted from October 9 to November 1, 2022. The convenience sampling method was used to collect questionnaire data from 924 clinical nurses in a third-class general hospital in Chongqing, China. RESULTS: The emotional exhaustion and compliance with standard precautions were at the general level. Servant leadership mediated by emotional exhaustion had a significant positive predictive effect on compliance with standard precautions. Personal resilience played a negative moderating role in the relationship between servant leadership and emotional exhaustion. For nurses with low resilience, servant leadership had a greater impact on emotional exhaustion. CONCLUSION: The current compliance with standard precautions for clinical nurses is not high due to emotional exhaustion. The level of servant leadership can alleviate nurses' emotional exhaustion and improve compliance with standard precautions. Especially for nurses with low personal resilience, the care and support of department leaders are needed. IMPACT: We found that the compliance with standard precautions is not high, and the link between emotional exhaustion, servant leadership and compliance with standard precautions provides a basis for further patient care. NO PATIENT OR PUBLIC CONTRIBUTION: There was no patient or public involvement. IMPACT STATEMENT: Nurses are the key population for hospital infection prevention and control, and their level of compliance with standard precautions is of great significance for hospital infection prevention and control. However, in practice, nurses' compliance with standard precautions is generally low. Most of the previous studies on nurses' compliance with standard precautions were conducted from the perspective of individual nurses, based on the staff's 'knowledge, belief, and action' to study the current status of compliance with standard precautions and the factors affecting adherence, with less attention paid to the influence of psychological, environmental, and organizational factors. Therefore, the study focuses on the impact of servant leadership and emotional exhaustion on standard precautionary adherence, which is of great significance for good care management at the organizational level. It also explored how the impact of servant leadership on emotional exhaustion varies across levels of resilience, which is important for accurately identifying different types of nursing staff and targeting assistance.
Assuntos
Esgotamento Profissional , Fidelidade a Diretrizes , Liderança , Recursos Humanos de Enfermagem Hospitalar , Humanos , Estudos Transversais , Feminino , Adulto , Masculino , Esgotamento Profissional/psicologia , Recursos Humanos de Enfermagem Hospitalar/psicologia , Recursos Humanos de Enfermagem Hospitalar/estatística & dados numéricos , Inquéritos e Questionários , Fidelidade a Diretrizes/estatística & dados numéricos , China , Pessoa de Meia-Idade , Resiliência Psicológica , Exaustão EmocionalRESUMO
BACKGROUND: In recent years, there has been a marked growth in the use of ionizing radiation in medical imaging for both diagnosis and therapy, which in turn has led to increased radiation exposure among healthcare workers. AIM: The purpose of this study was to assess the level of safety compliance awareness among healthcare workers exposed to ionizing radiation. RESEARCH DESIGN: A descriptive cross-sectional design was used for this investigation. SETTING: This study was conducted online, using social media sites such as WhatsApp, Instagram, and Facebook. SUBJECTS: A purposive sample of 384 Egyptian healthcare workers was enrolled in the current study. TOOL: A safety compliance awareness questionnaire was used in this study to collect pertinent data. RESULTS: The result of this study showed that 65.4% and 64.1% of the studied sample chose the correct answers that mammography and CT scans involve the use of x-rays. However, 64.3% and 67.2% of the studied sample chose the wrong answers, saying that MRI and Ultrasound involve the use of X-rays. Moreover, 47.14%, 43.5%, and 57% of the studied sample never used a dosimeter, did not follow dosimeter controls, and did not wear a lead collar. CONCLUSION: Most of the healthcare workers studied had poor knowledge about radiation exposure safety. Moreover, most of the healthcare workers in the current study demonstrated inadequate practice compliance concerning radiation protection procedures. RECOMMENDATION: Should encourage hospital training programs to include radiation safety topics in their training plans for healthcare workers.
RESUMO
AIMS: The aim was to investigate the interrelationships of nurses' safety climate, quality of care, and adherence to and compliance with standard precautions (SPs). BACKGROUND: Investigations about nurses' safety climate and quality care and their association with adherence to and compliance with SPs remain remarkably scant across literature, specifically among developing countries like the Philippines. DESIGN: Cross-sectional design and structural equation modeling (SEM) approach while complying with STROBE guidelines. METHODS: Participant nurses were recruited using convenience sampling (n = 870). Four validated self-report instruments were used to collect data from February to August 2022. Spearman rho, SEM, mediation, and path analyses were employed for data analysis. RESULTS: The emerging model showed acceptable model fit parameters. The safety climate positively influenced the quality of care and adherence to and compliance with SPs. Quality of care directly affected adherence to SPs, while adherence to SPs directly affected compliance with SPs. The quality of care mediated the relationship between safety climate and adherence to SPs. Whereas adherence to SPs mediated the relationships between safety climate and compliance with SPs and the quality of care and compliance with SPs. CONCLUSIONS: Nurses' safety climate directly affected the quality of care and SPs adherence and compliance. The quality of care mediated the impact of safety climate on SPs adherence. Finally, SPs adherence demonstrated a mediating effect among quality of care, safety climate, and SPs compliance. IMPLICATIONS FOR NURSING POLICY AND PRACTICE: Nursing policymakers and administrators can use the findings to design strategic policies and sustainable in-service educational courses fostering and maintaining nurses' safety climate, quality of care, and SPs adherence and compliance.
Assuntos
Fidelidade a Diretrizes , Qualidade da Assistência à Saúde , Humanos , Estudos Transversais , Feminino , Filipinas , Fidelidade a Diretrizes/estatística & dados numéricos , Adulto , Qualidade da Assistência à Saúde/normas , Masculino , Cultura Organizacional , Pessoa de Meia-Idade , Recursos Humanos de Enfermagem Hospitalar/psicologia , Análise de Classes Latentes , Gestão da Segurança/normasRESUMO
Background and aim: The coronavirus disease-2019 (COVID-19) pandemic is a global threat spreading like a wildfire and taking the world by its storm. It has challenged the healthcare delivery systems and disrupted them in a way no one ever imagined before. We at Apollo Hospitals, Chennai, Tamil Nadu, India received many patients in the COVID critical care unit (CCU) and found a gradual lack of bundle care compliance resulting in an upsurge of central line-associated bloodstream infection (CLABSI) amid the patients. Materials and methods: A qualitative research approach and quasi-experimental research design were selected to assess the knowledge of the 150 frontline COVID CCU nurses regarding the CLABSI bundle and its prevention strategies. Results: This study revealed that 57% [mean (M) = 12.6; standard deviation (SD) = 2.37] of nurses had inadequate knowledge of the CLABSI bundle and its prevention strategies, in the pretest and scored 80% (M = 6.7; SD = 2.28) in the post-test, with "t" = 22.06 at p < 0.00001 after the hands-on training. The percentage of compliance to CLABSI bundle care increased to 83% and thereafter in an increasing trend. This was clearly evident through the reduction in the preventable CLABSI rate among critically ill COVID-19 patients. Conclusion: Nurses are on the frontline in preventing and controlling healthcare-associated infections (HAIs). Fighting with all the visible and invisible challenges, our research focused on hands-on training for frontline warriors to adhere to the CLABSI bundle care which drove us to the reduction in preventable CLABSI rate in our hospital through improved CLABSI bundle compliance. How to cite this article: Premkumar S, Ramanathan Y, Varghese JJ, Morris B, Nambi PS, Ramakrishnan N, et al. "Nurse-The Archer" Fighting Against the Hidden Enemy. Indian J Crit Care Med 2023;27(4):246-253.
RESUMO
Introduction: COVID-19 pandemic forced several countries to establish sanitary and lockdown measures to prevent the spreading of the virus. Only necessary workers were allowed to work, including health workers in hospitals. Objectives: This study explores the association between some variables and sanitary measures compliance among health workers during a pandemic. Method: A total of 299 Health workers were recruited online using social networks. Participants completed questionnaires evaluating personality, coping, Anxiety and depression, psychological flexibility and sanitary measures compliance. Results: Correlations indicated most observant participants were more likely to present efficient coping and more based on problem solving. Also, Honesty-Humility as a personality trait was positively correlated to a better compliance. Regressions indicated the perceived utility of sanitary measures was the strongest predictor for compliance among health workers. Honesty-Humility and sanitary risks perception were predictors for compliance. Conclusions: This study conducted among health workers points indicates variables associated with higher compliance. Our results suggest compliance and non-compliance as health behaviours or risk behaviours are linked to perceived threats. This perception is linked to health workers' knowledges, their coping strategies, and personality.
Introduction: La pandémie COVID-19 a obligé de nombreux pays à mettre en place des mesures sanitaires et de confinement afin d'en ralentir la propagation. Seules les professions nécessaires ont poursuivi leurs activités, dont les professionnels de santé en milieu hospitalier. Objectif: Cette étude a pour but l'exploration de facteurs en jeu dans l'observance des mesures sanitaires auprès du personnel médical hospitalier en période de pandémie. Méthode: Un total de 299 professionnels de santé a été recruté via les réseaux sociaux. Les participants ont complété des questionnaires évaluant la personnalité, le coping, l'anxiété et la dépression, la flexibilité psychologique et l'observance des mesures sanitaires. Résultats: Les corrélations effectuées ont montré que les participants les plus observants sont ceux qui présentaient un coping efficace, et principalement axé sur la résolution de problèmes. De plus, l'honnêteté comme trait de personnalité était corrélée positivement à une meilleure observance. Nos régressions ont indiqué que l'utilité perçue des mesures sanitaires est le plus solide prédicteur de l'observance chez les professionnels de santé. L'honnêteté et la perception des risques sanitaires sont apparues comme des facteurs prédicteurs de l'observance. Conclusion: Cette étude menée auprès de professionnels de santé a permis de mettre en évidence certains facteurs associés à une meilleure observance. Nos résultats suggèrent que l'observance et la non-observance en tant que comportements de santé ou à risques est influencée par la perception des menaces. Cette perception est liée aux connaissances des professionnels de santé, le coping à l'Åuvre et la personnalité.
RESUMO
BACKGROUND: Healthcare workers' (HCWs) compliance with infection prevention and control (IPC) measures during the COVID-19 pandemic is crucial to reducing the spread of infection to their colleagues, families, and community. This study assessed the risk perception and compliance with personal protective equipment (PPE) usage, hand hygiene, and specific IPC measures and explored the factors associated with compliance among nurses during the third wave of the COVID-19 pandemic in Egypt. METHODS: A hospital-based cross-sectional survey was conducted at the Alexandria Main University Hospital (AMUH) in Alexandria city from May to August 2021, where 354 nurses were included with a response rate of 94.9%. A structured interviewer-administered questionnaire was used for data collection. Univariate and multivariate logistic regression analyses were conducted. RESULTS: The overall compliance with PPE usage, hand hygiene, and IPC measures was 81.9%. The mean risk perception score was 40.9 ± 3.3. More than 95% of nurses were aware of the high risk of COVID-19 infection at their workplace, the serious consequences of the disease, and the risk that can be minimized by using PPE, whereas a relatively low percentage of nurses believed that the risk of COVID-19 infection could be reduced by using a surgical mask (19.2%) or gloves (50.5%). Good compliance was independently predicted by risk perception (OR = 1.25; 95% CI = 1.13, 1.39), and knowledge about PPE usage and hand hygiene (OR = 3.53; 95%CI = 2.40, 5.19). Facilitators of compliance with the PPE usage were attending suspected or confirmed COVID-19 cases in their hospital ([Formula: see text] = 9.82), comfort to use the PPE ([Formula: see text] = 9.16), availability of PPE ([Formula: see text] = 8.96), hospital policy ([Formula: see text] = 8.74), and senior compliance ([Formula: see text] = 6.5). CONCLUSIONS: Nurses at AMUH reported high risk perceptions. The rate of compliance with PPE usage, hand hygiene, and IPC measures was 81.9%. The personal risk perception and knowledge about the PPE usage and hand hygiene are the keys to improving compliance in a healthcare facility.
RESUMO
OBJECTIVE. Medicare permits radiologists to bill for trainee work but only in narrowly defined circumstances and with considerable consequences for noncompliance. The purpose of this article is to introduce relevant policy rationale and definitions, review payment requirements, outline documentation and operational considerations for diagnostic and interventional radiology services, and offer practical suggestions for academic radiologists striving to optimize regulatory compliance. CONCLUSION. As academic radiology departments advance their missions of service, teaching, and scholarship, most rely on residents and fellows to support expanding clinical demands. Given the risks of technical noncompliance, institutional commitment and ongoing education regarding teaching supervision compliance are warranted.
Assuntos
Reembolso de Seguro de Saúde , Internato e Residência , Medicare , Radiologia/economia , Radiologia/educação , Humanos , Estados UnidosRESUMO
INTRODUCTION: The World Health Organization has suggested the solution to health system waste caused by incorrect billing and fraud is policing and prosecution. However, a growing body of evidence suggests leakage may not always be fraudulent or corrupt, with researchers suggesting medical practitioners may sometimes struggle to understand increasingly complex legal requirements around health financing and billing transactions, which may be improved through education. To explore this phenomenon further, we undertook a scoping review of the literature to identify the medical billing education needs of medical practitioners and whether those needs are being met. METHODS: Eligible records included English language materials published between 1 January 2000 and 4 May 2020. Searches were conducted on MEDLINE, PubMed, Google Scholar, CINAHL, LexisNexis and Heinonline. RESULTS: We identified 74 records as directly relevant to the search criteria. Despite undertaking a comprehensive, English language search, with no country restrictions, studies meeting the inclusion criteria were limited to three countries (Australia, Canada, US), indicating a need for further work internationally. The literature suggests the education needs of medical practitioners in relation to medical billing compliance are not being met and medical practitioners desire more education on this topic. Evidence suggests education may be effective in improving medical billing compliance and reducing waste in health systems. There is broad agreement amongst medical education stakeholders in multiple jurisdictions that medical billing should be viewed as a core competency of medical education, though there is an apparent inertia to include this competency in medical education curricula. Penalties for non-compliant medical billing are serious and medical practitioners are at risk of random audits and investigations for breaches of sometimes incomprehensible, and highly interpretive regulations they may never have been taught. CONCLUSION: Despite acknowledged significance of waste in health systems due to poor practitioner knowledge of billing practices, there has been very little research to date on education interventions to improve health system efficiency at a practitioner level.
Assuntos
Educação Médica , Austrália , Canadá , Currículo , Pessoal de Saúde , HumanosRESUMO
OBJECTIVE: To assess the degree of compliance with the recommendations of the 2009 and 2015 versions of the Spanish guidelines for managing asthma (Guía Española para el Manejo del Asma [GEMA]) and the effect of this compliance on controlling the disease. MATERIAL AND METHODS: We conducted an observational ambispective study between September 2015 and April 2016 in which 314 primary care physicians and 2864 patients participated. RESULTS: Using retrospective data, we found that 81 of the 314 physicians (25.8%; 95% CI 21.3-30.9) stated that they complied with the GEMA2009 recommendations. At the start of the study, 88 of the 314 physicians (28.0%; 95% CI 23.4-33.2) complied with the GEMA2015 recommendations. Poorly controlled asthma (OR, 0.19; 95% CI 0.13-0.28) and persistent severe asthma at the start of the study (OR, 0.20; 95% CI 0.12-0.34) were negatively associated with having well-controlled asthma by the end of the follow-up. In contrast, compliance with the GEMA2015 recommendations was positively associated with a greater likelihood that the patient would have well-controlled asthma by the end of the follow-up (OR, 1.70; 95% CI 1.40-2.06). CONCLUSIONS: Low compliance with the clinical guidelines for managing asthma is a common problem among primary care physicians. Compliance with these guidelines is associated with better asthma control. Actions need to be taken to improve primary care physician compliance with the asthma management guidelines.
RESUMO
BACKGROUND: This study examined the long-term effects of nurse-led, individualized education on self-efficacy, self-care compliance, and health-related quality of life (HRQoL) in middle-aged patients with new-onset acute coronary syndrome. METHODS: A quasi-experimental pretest-posttest design was used in the study. A cardiovascular nurse provided individualized education to the intervention group (n = 32), and self-efficacy, self-care compliance, and HRQoL at baseline and 3 and 12 months after discharge were compared to those of a control group (n = 30). Patients were recruited from a cardiovascular care unit at a university hospital between 2012 and 2013. Repeated measures analysis of variance was used to compare time-related changes. RESULTS: There was no significant difference in self-efficacy between the 2 groups over a fixed period (F = 3.47, p = 0.067) and showed no interaction between the 2 groups (F = 0.45, p = 0.636). However, significant differences were found in the main and interaction effects between the 2 groups and changes in self-care compliance over the follow-up period differed significantly between the 2 groups (F = 28.72, p < 0.001). Changes in mental HRQoL over the follow-up period differed significantly between the 2 groups (F = 33.34, p < 0.001) and significant interaction effect (F = 4.40, p = 0.040). CONCLUSIONS: Structured nurse-led education should be provided to middle-aged patients with new-onset acute coronary syndrome, as part of routine predischarge education, to increase self-care compliance and mental HRQoL and prevent secondary adverse events. TRIAL REGISTRATION: Trial registration number (TRN) is KCT0002454. The study was registered retrospectively with registration date July 9, 2017.
RESUMO
OBJECTIVE: To ascertain patients and physician views regarding hazard and compliance of oral liquid Vitamin D glass ampoule and tablets. METHODS: This cross sectional survey was conducted from November 1st 2016 to 15th December 2016. Patients who were prescribed Vitamin D glass ampoule from oral route in last three months were included along with physicians who routinely prescribe vitamin D after taking informed consent. The participants were asked about injuries related to the use of glass ampoule, ease of using this from, after taste preference of tablet or injectable form as well as demography. Data was analysed with SPSS version 24.0. RESULTS: Total 182 patients were included in the study with mean ± SD age of 39.4 ± 12.4 years. Majority of patients, 80.2% (142) said they prefer oral tablet in preference to injectable ampule in oral form if given choice while prescribing Vitamin D. Moreover 66.7% (64) doctors prefer to prescribe tablet form of Vitamin D instead of injection as oral form for vitamin D deficiency among their patients. One third of patients, 33% (n=59) sustained injury while breaking the ampule which included minor self-controlled bleeding by glass particles in 50% (n=35). Less than half of doctors 46.9% (n=45) said they taught their patients about usage of injectable Vitamin D ampules. CONCLUSION: Majority of patients prefer Vitamin D tablet instead of Oral liquid in glass ampoule if they got the choice among two. The results of this study provide important implications for our doctors about patients concern of hazard, after taste and compliance with orally administered Vitamin D glass ampoules.
RESUMO
BACKGROUND: One of the major factors affecting treatment compliance and outcome in patients is the wide range of side effects (SEs) associated with antidepressants. In the present study, we aimed to assess the extent to which Israeli primary care (PC) physicians and psychiatrists discuss the SEs of selective serotonin reuptake inhibitors (SSRIs) with patients prior to the onset of treatment. METHODS: A cross-sectional questionnaire survey was conducted among PC physicians (N = 123) and psychiatrists (N = 105). Questionnaires were distributed using a mixed-modality design, combining a web survey and in-person delivery of questionnaires. RESULTS: A significant percentage of our respondents reported that they rarely discuss psychological (60 %) or severe (29 %) SEs of SSRIs. Nearly half (41 %) admitted to avoiding discussion of impact on suicidal ideation. Specialists were noted to discuss and evaluate SEs significantly more than residents, and Psychiatrists more than PC physicians. Specifically, psychiatrists more often discussed the possibility of sexual dysfunction (t (225) = 2.23; p < 0.05) and suicidal ideation (t (225) = 2.11; p < 0.05). CONCLUSIONS: It seems that PC physicians and psychiatrists surveyed in this study do not share sufficient information regarding the SEs of SSRIs with their patients at the onset of treatment. In improving this practice, the integration of proper SE management into educational interventions has potential in enhancing compliance and improving expertise and level of care.
RESUMO
AIM: We are using multimodal technique to improve hand hygiene (HH) compliance among all health care staff for the past 1-year. This cross-sectional observational study was conducted in the surgical ICU to assess adherence to HH among nurses and allied healthcare workers, at the end of the training year. MATERIALS AND METHODS: This was a cross-sectional observational study using direct observation technique. A single observer collected all HH data. During this analysis, 1500 HH opportunities were observed. HH compliance was tested for all 5 moments as per WHO guidelines. RESULTS: Overall compliance as per WHO Guidelines was 78%. Nurses had an adherence rate of 63%; allied staff adherence was 86.5%. Compliance was 93% after patient contact versus 63% before patient contact. Nurses'compliance before aseptic procedures was lowest at 39%. 92% staff was aware of the facts viz. Diseases prevented by hand washing, ideal duration of HH, reduction of health care associated infections, etc. CONCLUSION: After 1-year of aggressive multimodal intervention in improving HH compliance, we have an overall compliance of 78%. It implies that sustained performance and compliance to HH can be ensured by ongoing training. Direct observation remains a widely used, easily reproducible method for monitoring compliance.
RESUMO
BACKGROUND: During the COVID-19 pandemic, with many nurses being infected, understanding compliance with standard precautions (SP) among nurses in Kazakhstan is crucial for improving infection prevention and control and preparedness for future emergencies. The study aimed to assess Kazakh nurses' SP compliance amid the COVID-19 pandemic and examine the factors associated with their compliance. METHODS: Quantitative, cross-sectional design. This research surveyed 241 clinical nurses in Astana, Kazakhstan using a standardized tool from December 2021 to April 2022. RESULTS: This study found 76.0% SP compliance among the nurses. The highest compliance was observed in the dimension "Decontamination of spills and used articles" (86.0% compliance rate), followed by "Use of protective devices" (83.5% compliance rate), "Prevention of cross-infection from person to person" (72.7% compliance rate), "Disposal of sharps" (65.4% compliance rate), and "Disposal of waste" (56.0% compliance rate). Nurses' age and educational qualification influences the nurses' SP compliance. DISCUSSION: While the nurses' compliance rate in this study was moderate, specific areas warrant more attention, such as their compliance with proper waste and sharps disposal. CONCLUSIONS: This study highlighted the experiences of nurses in Kazakhstan on their compliance with SP during the pandemic.
Assuntos
COVID-19 , Fidelidade a Diretrizes , Controle de Infecções , Humanos , Cazaquistão , Estudos Transversais , COVID-19/prevenção & controle , COVID-19/epidemiologia , Fidelidade a Diretrizes/estatística & dados numéricos , Adulto , Feminino , Masculino , Controle de Infecções/métodos , Controle de Infecções/normas , Enfermeiras e Enfermeiros/psicologia , SARS-CoV-2 , Inquéritos e Questionários , Pessoa de Meia-Idade , Precauções Universais , Adulto JovemRESUMO
Objective: To examine the risk factors linked with occupational blood exposure (OBE) among nursing staff (NS), we pinpoint deficiencies in the compliance with policies of infection prevention and control, and assess the expenditures associated with infection prevention and control. Methods: Healthcare workers that completed an "Occupational Blood Exposure Report Form" were divided into NS (observation) group and non-NS (control) group. Univariate and multivariable analyses were conducted to compare both groups in various aspects. We also explored design patents intended to minimize occupational exposure. Results: The highest incidence of OBE was observed in the department of neurosurgery. Among NS, OBE incidence was found to be influenced by independent risk factors, such as gender, age, occupational title, work location, and incidence of sharps injuries. Protective factors against OBEs included the use of arterial blood gas needles and suture needles. Personal protective equipment (PPE) usage rates were low in both groups prior to OBEs (0.74% vs 0.00%, P > 0.05). Correct emergency management could be improved promptly by both groups following an OBE (P > 0.05). However, the observation group exhibited a higher proportion of blood expression after a sharps injury and a higher re-evaluation rate at 6 months post-exposure compared to the control group (P < 0.05). In 2018, the per capita costs of infection prevention and control for NS were the Chinese Yuan (RMB) 339.43 per individual. In response to these findings, two utility model patents have been authorized. Conclusion: The risk and protective factors related to the occurrence of OBEs were investigated in this study, suggesting that there is a need for improvement in the rate of PPE usage and the re-evaluation rate of OBEs among NS. Additionally, focused training on emergency blood expression and compliance with policies among non-NS personnel is deemed necessary.
RESUMO
INTRODUCTION: Upper respiratory tract infections (URTI) are common and a common cause of sick-leave for healthcare workers, and furthermore pose a threat especially for patients susceptible to other diseases. Sufficient use of respiratory protective equipment (RPE) may protect both the workers and the patients. The COVID-19 pandemic provided a unique opportunity to study the association between use of RPE and URTI in a real-life setting. The aim of this study was to examine if failure of RPE or non-compliance with RPE guidelines increases the risk of non-COVID-19 URTI symptoms among healthcare workers. METHODS: In a longitudinal cohort study, we collected self-reported data daily on work tasks, use of RPE, and URTI symptoms among healthcare workers with patient contact in 2 Danish Regions in 2 time periods during the COVID-19 pandemic. The association between failure of RPE or non-compliance with RPE guidelines and URTI symptoms was analyzed separately by generalized linear models. Persons tested positive for severe acute respiratory syndrome coronavirus 2 were censored from the analyses. The 2 waves of data collection were analyzed separately, as there were differences in recommendations of RPE during the 2 waves. RESULTS: We found that for healthcare workers performing work tasks with a risk of transmission of viruses or bacteria, failure of RPE was associated with an increased risk of URTI symptoms, RR: 1.65[0.53-5.14] in wave 1 and RR: 1.30[0.56-3.03] in wave 2. Also non-compliance with RPE guidelines was associated with an increased risk of URTI symptoms compared to the use of RPE in wave 1, RR: 1.28[0.87-1.87] and wave 2, RR: 1.39[1.01-1.91]. Stratifying on high- versus low-risk tasks showed that the risk related to failure and non-compliance was primarily associated with high-risk tasks, although not statistically significant. DISCUSSION: The study was conducted during the COVID-19 pandemic and thus may be affected by other preventive measures in society. However, this gave the opportunity to study the use of RPE in a real-life setting, also in departments that did not previously use RPE. The circumstances in the 2 time periods of data collection differed and were analyzed separately and thus the sample size was limited and affected the precision of the estimates. CONCLUSION: Failures of RPE and non-compliance with RPE guidelines may increase the risk of URTI, compared to those who reported use of RPE as recommended. The implications of these findings are that the use of RPE to prevent URTI could be considered, especially while performing high-risk tasks where other prevention strategies are not achievable.
Assuntos
COVID-19 , Pessoal de Saúde , Infecções Respiratórias , SARS-CoV-2 , Humanos , COVID-19/prevenção & controle , COVID-19/epidemiologia , Dinamarca/epidemiologia , Estudos Longitudinais , Pessoal de Saúde/estatística & dados numéricos , Masculino , Feminino , Adulto , Infecções Respiratórias/epidemiologia , Pessoa de Meia-Idade , Dispositivos de Proteção Respiratória/estatística & dados numéricos , Dispositivos de Proteção Respiratória/normas , Fidelidade a Diretrizes/estatística & dados numéricos , PandemiasRESUMO
BACKGROUND: Hand hygiene compliance (HHC) is recognised as a major factor in the prevention of healthcare-associated infections. Healthcare workers (HCWs) compliance is still suboptimal. Simulation as an educational strategy may contribute to improved performance. OBJECTIVE: This study aimed to assess the effect of simulation interventions led by nursing students on HCWs' HHC. METHOD: A prospective quasi-experimental design with before and after intervention measurements was implemented in an 1150-bed tertiary hospital. Four consecutive periods, measuring before and after HHC, were examined in four hospital divisions. For each division, unique simulation activities were developed and led by nursing students, educators, and hospital leaders. Sixty seven students and 286 healthcare workers, along with two nurse educators, participated in the simulation sessions. HHC of all HCWs in the divisions was assessed by hospital infection control personnel. RESULTS: Hospital HHC rose across the four periods in all four divisions during this study. In three out of four periods and divisions, HHC increased significantly more in the simulation intervention groups compared to the overall hospital improvement. CONCLUSION: Student-led simulation for HCWs is an additional effective method to improve HHC. Nursing managers should consider joining forces with nursing educators to enable students to become agents of change in healthcare settings and encourage further collaboration.
Assuntos
Fidelidade a Diretrizes , Higiene das Mãos , Estudantes de Enfermagem , Humanos , Estudantes de Enfermagem/psicologia , Estudantes de Enfermagem/estatística & dados numéricos , Higiene das Mãos/normas , Higiene das Mãos/métodos , Higiene das Mãos/estatística & dados numéricos , Estudos Prospectivos , Fidelidade a Diretrizes/estatística & dados numéricos , Feminino , Adulto , Masculino , Treinamento por Simulação/métodos , Infecção Hospitalar/prevenção & controle , Pessoa de Meia-Idade , Pessoal de Saúde/educação , Pessoal de Saúde/psicologiaRESUMO
Background: Practicing hand hygiene (HH) is a crucial element of infection control, with healthcare workers (HCWs) playing a vital role in preventing the spread of infection. However, inadequate knowledge and non-compliance to HH protocols pose significant challenges in healthcare settings. This study aimed to evaluate the effectiveness of an HH training intervention in enhancing knowledge and staff compliance within a respiratory disease hospital. Method: A pre-and post-training study was conducted among the healthcare workers in a respiratory disease treatment facility. The intervention comprised a series of 3-hour training sessions conducted over five days, focusing on the World Health Organization's (WHO) recommended guideline "Your Five Moments For Hand Hygiene." These sessions covered proper HH techniques and underscored the repercussions of inadequate compliance. Educational materials related to HH were displayed in prominent locations throughout the facility. The knowledge levels and compliance rate were assessed before and after the intervention. Result: The intervention significantly improved HH knowledge levels and compliance rates among the participants. Marking a significant improvement, the compliance rate of HH protocols increased from 66.0% to 88.3% during the pre-to post-training period, with a concurrent increase in the mean knowledge score from 68.6% to 78.9%. Conclusion: This study underscores the potential of training and education in elevating HH compliance and knowledge among healthcare workers. The findings advocate that healthcare facilities routinely incorporate such interventions into their infection control programs, ultimately improving patient and healthcare worker safety.
RESUMO
BACKGROUND: Strengthening safety compliance behaviour can reduce the organizations' unexpected financial losses and prevent employees from continuous COVID-19. It drives this study to create a research framework involved by organizational, individual and social factors to predict employees' safety compliance behaviour. OBJECTIVE: This study examines how risk perceptions of COVID-19, employee well-being, workplace health and safety training, safety motivation and safety related stigma impact safety compliance behavior in times COVID-19 pandemic. METHODS: A self-administered questionnaire was disseminated to healthcare workers. In all, 344 acceptable questionnaires were derived for further analysis. RESULTS: The results revealed that the risk perception of COVID-19 and employee well-being has no significant relationship with safety compliance behavior. Similarly, safety related stigma also has no moderating effect on safety motivation and safety compliance behavior. However, workplace health and safety training and safety motivation have significant relationships with safety compliance behavior. CONCLUSION: This study contributes to the literature by illuminating on the importance of organizational, individual, social factors and how they can interact with safety compliance behaviour. Additionally, knowing the unique function of safety related stigma in building safety compliance behaviour may help guide future efforts and training initiatives to enhance workplace safety.