Frontline nurses' experiences of managing visitor restrictions during the COVID-19 pandemic in a Danish university hospital - Lessons learned.

BACKGROUND: Worldwide visitor restrictions forced nurses to separate patients from their relatives. However, the experience of implementing shifting restrictions from the frontline nurses' perspectives in a Danish context has yet to be assessed. AIM: The aim of this descriptive qualitative study was to explore frontline nurses' experiences of managing shifting visitor restrictions in a Danish somatic university hospital during the COVID-19 pandemic. METHODS: An online questionnaire, including open-ended questions, was developed. Data were analysed using descriptive statistics and content analysis. FINDINGS: 116 nurses from 29 departments participated; they were informed about restrictions primarily by their charge nurses and hospital intranet. Shifting visitor restrictions compelled the nurses to constantly adjust and negotiate their practices. When deciding to suggest deviating from the restrictions, they shared their decision-making with colleagues. Visitor restrictions left the hospital environment quieter, but they also created a lack of overview and predictability, an emotional burden, and a negative impact on the quality of care. CONCLUSION: Restricting relatives' access challenged the nurses' professional values, and it seems to have affirmed their appreciation of relatives' role as important partners in contemporary hospital-based health care.

Women doctors and their careers in a large university hospital in Spain at the beginning of the 21st century.

BACKGROUND: The feminization of medicine has risen dramatically over the past decades. The aim of this article was to compare the advance of women with that of men and determine the differences between hierarchical status and professional recognition achieved by women in medicine. METHODS: A retrospective study was carried out in the Hospital Clinic Barcelona, Spain, of the period from 1996 to 2008. Data relating to temporary and permanent positions, hierarchy and career promotion achieved, specialty, age and the sex of the participants were analysed with the ANOVA test and logistic regression using the generalized estimated equation. RESULTS: After completion of specialist training, fewer women than men doctors obtained permanent positions. The ratios between the proportions of women and men remained 1.2 for permanent non-hierarchal medical positions and below 0.2 for higher hierarchal levels. Fewer women than men with hierarchy and fewer women than men achieved the rank of consultant. Promotion to consultant and senior consultant was lower than that to senior specialist, being higher in specialties with gender parity and in masculinised specialties. On comparing the two genders using a statistical model, the probability of continuous promotion decreased with the year of the application and the age of the applicant, except in women. CONCLUSIONS: Despite the number of women training as specialists having increased to 50%, women remained in temporary positions twofold longer than men. Compared to women, men showed significant representation in hierarchal medical positions, and women showed a lower adjusted probability of internal professional promotion throughout the study period.

Identifying individual and organizational predictors of accidental exposure to blood (AEB) among hospital healthcare workers: A longitudinal study.

BACKGROUND: Accidental exposure to blood (AEB) poses a risk of bloodborne infections for healthcare workers (HCWs) during hospital activities. In this study, we identified individual behavioral and organizational predictors of AEB among HCWs. METHODS: The study was a prospective, 1-year follow-up cohort study conducted in university hospitals in Paris, France. Data were collected from the Stress at Work and Infectious Risk in Patients and Caregivers (STRIPPS) study. Eligible participants included nurses, nursing assistants, midwives, and physicians from 32 randomly selected wards in 4 hospitals. AEB occurrences were reported at baseline, 4 months, 8 months, and 12 months, and descriptive statistical and multilevel risk-factor analyses were performed. RESULTS: The study included 730 HCWs from 32 wards, predominantly nurses (52.6%), nursing assistants (41.1%), physicians (4.8%), and midwives (1.5%). The incidence rate of AEB remained stable across the 4 visits. The multilevel longitudinal analysis identified several significant predictors of AEB occurrence. Individual-level predictors included younger age, occupation as nurses or midwives, irregular work schedule, rotating shifts, and lack of support from supervisors. The use of external nurses was the most significant ward-level predictor associated with AEB occurrence. CONCLUSIONS: AEBs among HCWs are strongly associated with organizational predictors, highlighting the importance of complementing infection control policies with improved staff management and targeted training. This approach can help reduce AEB occurrences and enhance workplace safety for HCWs.

Core Data Human Resources for Health: Stocks and Flows ­ Education ­ Management. Montserrat 2011. Tracking Regional Goals for Human Resources for Health: A Shared Commitment

In its 2006 annual report, the World Health Organization (WHO) described the Human Resources for Health (HRH) situation among its 192 member states. This report recognized the widely varying data availability, with many non-OECD nations having limited access to information on their health workforce. National data were collected as part of this effort, using three approaches: WHO national surveys conducted through its regional and country offices, contacting various national administrative sources, or data "compiled from a previous version of the WHO's global database on the health workforce." Data from many Caribbean nations were collected using this third approach, which obtained very little detail, with information that had not been updated for a number of years. To improve this paucity of information, the Human Resources for Health Unit of the Pan-American Health Organization (PAHO) has partnered with the Ministries of Health in the Eastern Caribbean Countries(ECC) to support the systematic collection and country-level analysis of HRH data as part of the Region's 10-year commitment to health workforce development. The purpose of this data collection project was to establish a Core Data Set for the countries of the Caribbean region comprising the required information to establish the current status of HRH in each country. This core data investigation took place in Barbados in November 2007, and following on from this, a number of the Eastern Caribbean Countries conducted the same project study. There are seven Eastern Caribbean countries involved in this project (Barbados, Dominica, Grenada, Saint Lucia, Saint Vincent and the Grenadines, Anguilla and Montserrat), which has proceeded in two work phases: Phase 1, Data collection for Core Data Set, and Phase 2, Data collection to establish baseline indicators for the 20 Regional Goals for Human Resources in Health. This report describes the first initiative in Montserrat and its result. (AU)

Core Data Human Resources for Health: Stocks and Flows ­ Education ­ Management. Anguilla 2011. Tracking Regional Goals for Human Resources for Health: A Shared Commitment

In its 2006 annual report, the World Health Organization (WHO) described the Human Resources for Health (HRH) situation among its 192 member states. This report recognized the widely varying data availability, with many non-OECD nations having limited access to information on their health workforce. National data were collected as part of this effort, using three approaches: WHO national surveys conducted through its regional and country offices, contacting various national administrative sources, or data "compiled from a previous version of the WHO's global database on the health workforce". Data from many Caribbean nations were collected using this third approach, which obtained very little detail, with information that had not been updated for a number of years. To improve this paucity of information, the Human Resources for Health Unit of the Pan-American Health Organization (PAHO) has partnered with the Ministries of Health in the Eastern Caribbean Countries (ECC) to support the systematic collection and country-level analysis of HRH data as part of the Region's 10-year commitment to health workforce development. The purpose of this data collection project was to establish a Core Data Set for the countries of the Caribbean region comprising the required information to establish the current status of HRH in each country. This core data investigation took place in Barbados in November 2007, and following on from this, a number of the Eastern Caribbean Countries conducted the same project study. There are seven Eastern Caribbean countries involved in this project (Barbados, Dominica, Grenada, Saint Lucia, Saint Vincent and the Grenadines, Anguilla and Montserrat), which has proceeded in two work phases: Phase 1, Data collection for Core Data Set, and Phase 2, Data collection to establish baseline indicators for the 20 Regional Goals for Human Resources in Health. This report describes the first initiative in Anguilla and its result. (AU)

Core Data Human Resources for Health: Stocks and Flows ­ Education ­ Management. Belize 2009. Tracking Regional Goals for Human Resources for Health: A Shared Commitment

The Government of Belize Health Sector Reform Program (2007-2011) emphasized strengthening the organizational and regulatory capacity of the public sector, service rationalization and improving coverage and quality of services, and the establishment of a National Health Insurance Scheme (NHIS). A principal aim of the reform program included a national policy to identify, streamline and better manage HRH. To that end, policies are being considered to (a) improve the distribution of HRH across the country; (b) to manage migration; and (c) to define guidelines for a HRH monitoring and evaluation strategy. The Belize Health Information System (BHIS) integrates health information and provides all citizens with an electronic health record. As part of this program, an HRH module has been developed as a key component of the information system, which will enhance the capacity to better manage HRH and provide up-to-date quantitative data for analysts and decision-makers. In support of the Belize Health Sector Reform Program, a national HRH unit (or technical post) and team, regional HRH planning committees, an HRH information system and an HRH strategic plan were all identified as priorities for action. (AU)

Core Data Human Resources for Health: Stocks and Flows ­ Education ­ Management. Barbados 2009. Tracking Regional Goals for Human Resources for Health: A Shared Commitment

In its 2006 annual report, the World Health Organization reported on Human Resources for Health (HRH) among its member states. For many Caribbean nations, there were little data available. To improve this paucity of information, the PanAmerican Health Organization (PAHO) has partnered with the Ministry of Health of Barbados to support the systematic collection and analysis of HRH data in Barbados as part of the country's 10-year commitment to health workforce development. This report is the result of this partnership, and summarises data from Barbados, one of fi ve Eastern Caribbean nations included in the project. In November 2007 a project Core Data Set was collectively defi ned through consensus among the participating Caribbean countries, and data collection in Barbados started in June 2008. The core dataset includes qualitative, quantitative and descriptive data items. Data were collected from a range of data sources, including census information, personnel and other administrative databases, and professional registration data. This report describes the general considerations and specifi c methodologies followed in assembling the Barbados HRH data set. Details of this new national resource are described, and summary statistics present an overview of the health workforce in Barbados. The report focuses on the number of healthcare workers per 10,000 population­"the density per 10,000". Using this summary measure there are 13.1 doctors, 39.7 nurses and midwives, and 17.2 nursing assistants for every 10,000 people in Barbados. (AU)