Risk Factors for Occupational Blood Exposure, Compliance with Policies of Infection Prevention and Control, and Costs Associated with Post Exposure Management Among Nursing Staff.

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.

The Challenges of Advance Care Planning for Acute Care Registered Nurses.

STUDY BACKGROUND: The practice of acute care nurses is shaped by organizational factors such as lack of privacy, heavy workloads, unclear roles, lack of time, and lack of specific policies and procedures. We know little about the social and organizational structures and processes that influence nurses' uptake of valuable patient-centered discussions like advance care planning (ACP). ACP is beneficial for patients, their substitute decision makers, and healthcare providers. PURPOSE: To describe the operational, organizational, and societal influences shaping nurses' ACP work in acute care settings. METHODS: This ethnographic study purposively sampled 14 registered nurses and 9 administrators who worked in two acute care hospitals in Northeastern Ontario. Methods consisted of 23 open-ended, semi-structured interviews, 20 hours of observational fieldwork, and a collection of publicly available organizational documents. Data were inductively analyzed using an iterative constant comparative approach. RESULTS: Nurses were challenged to meet multiple competing demands, leaving them to scramble to manage complex and critically ill acute care patients while also fulfilling organizational tasks aligned with funding metrics, accreditation, and strategic planning priorities. Such factors limited nurses' capacity to engage their patients in ACP. CONCLUSIONS: Acute care settings that align patient values and medical treatment need to foster ACP practices by revising organizational policies and processes to support this outcome, analyzing the tasks of healthcare providers to determine who might best address it, and budgeting how to support it with additional resources.

Depression and anxiety between nurses and nursing assistants working in long-term care facilities during the COVID-19 pandemic.

AIM: This study investigated the levels of depression and anxiety in nurses and nursing assistants working in long-term care facilities during the COVID-19 pandemic. We also explored the potential causes of depression and anxiety in nurses and nursing assistants working in long-term care facilities during the pandemic. BACKGROUND: The COVID-19 pandemic has had a considerable impact on long-term care facilities. The high infection and mortality rates for COVID-19 have resulted in an increased workload for caregivers. INTRODUCTION: The COVID-19 pandemic exposed caregivers working in long-term care facilities to higher risks of anxiety and depression. Additionally, the high risk of infection in the work environment and concerns about spreading COVID-19 to family members and long-term care facility residents led to various forms of stress among caregivers. METHODS: The present study was a cross-sectional study. Questionnaires were used to investigate depression and anxiety among regarding nurses and nursing assistants working in long-term care facilities during the pandemic. RESULTS: The depression and anxiety levels of the nurses were higher than nursing assistants, but had no statistically significant difference (p = 0.551). The factors influencing levels of depression and anxiety in nurses contained facility affiliation and experience working. In terms of nursing assistants, age, marital status, and facility affiliation were correlated with the levels of depression and anxiety. DISCUSSION: The pandemic has severely impacted caregivers. In the process of implementing pandemic prevention measures and providing care for COVID-19 patients, safeguarding the psychological health of caregivers is also essential. CONCLUSION: The levels of depression and anxiety in nurses were higher than in nursing assistants working in long-term care facilities during the pandemic. IMPLICATION FOR NURSING AND HEALTH POLICY: Long-term care facilities managers are recommended to enhance the education and training process for caregivers. Managers are also recommended to ensure provision of sufficient amounts of pandemic prevention equipment and resources.

Examining the Impact of Burnout on Hospital Nurses Engaged in Shift Work: Insights From a Nationwide Cross-Sectional Study in Malaysia.

Introduction: Shift workers follow nonstandard schedules that encompass overnight duty, rotational timetables, or permanent night work which can lead to misaligned core circadian physiology. Shift work has been associated with sleep deprivation, burnout, and metabolic syndrome among healthcare workers. Objective: We aimed to examine if shift nurses working in Malaysian public hospitals are more predisposed to burnout and to determine the predictors of burnout in this profession. Method: This national-level cross-sectional study was conducted among nurses in public hospitals in Malaysia between July and November 2019 using self-administered questionnaires. Maslach Burnout Inventory-Human Service Survey was used to determine burnout. Multistage stratified sampling was used to recruit nurses from 32 hospitals. A complex sampling analysis was performed. Results: Among the 1,491 hospital nurses, more than half (70.8%) of them followed shift work schedules. Shift nurses were mostly below 40 years old (80.9%), diploma holders (87.2%), and of lower professional grades (64.2%). The prevalence of overall burnout, as well as the domains of emotional exhaustion and depersonalization, was higher among shift nurses (27.1%) as compared to their counterparts (22.4%). Nurses who performed more than six night shifts per month were 2.6 times more predisposed to burnout. Conclusion: Shift work is integral to ensure round-the-clock nursing care for patients. However, nurses are increasingly faced with more shift duties due to heavy patient loads and staff shortages. Modified work schedules must be implemented to provide sufficient rest time for shift nurses to mitigate burnout. Additionally, proper human resource projection and distribution are imperative to prevent worsening burnout.

Surgical counting interruptions in operating rooms.

BACKGROUND: Operating rooms are complex working environments with high workloads and high levels of cognitive demand. The first surgical count which occurs during the chaotic preoperative stage and is considered a critical phase, is a routine task in ORs. Interruptions often occur during the first surgical count; however, little is known about the first surgical counting interruptions. This study aimed to observe and analyse the sources, outcomes, frequency of the first surgical counting interruptions and responses to interruptions. METHODS: A retrospective observational study was carried out to examine the occurrence of the first surgical counting interruptions between 1st August 2023 and 30th September 2023. The data were collected using the "Surgical Counting Interruption Event Form", which was developed by the researchers specifically for this study. RESULTS: A total of 66 circulating nurses (CNs) and scrub nurses (SNs) were observed across 1015 surgeries, with 4927.8 min of surgical count. The mean duration of the first surgical count was 4.85 min, with a range of 1.03 min to 9.51 min. In addition, 697 interruptions were identified, with full-term interruptions occurring an average of 8.7 times per hour. The most frequent source of interruption during the first surgical counts was instruments (N = 144, 20.7%). The first surgical counting interruptions mostly affected the CN (336 times; 48.2%), followed by the ORNs (including CNs and SNs) (243 times; 34.9%) and the SN (118 times; 16.9%). Most of the outcomes of interruptions were negative, and the majority of the nurses responded immediately to interruptions. CONCLUSIONS: The frequency of the first surgical counting interruption is high. Managers should develop interventions for interruptions based on different surgical specialties and different nursing roles.

Characterizing nursing time with patients using computer vision.

BACKGROUND: Compared to other providers, nurses spend more time with patients, but the exact quantity and nature of those interactions remain largely unknown. The purpose of this study was to characterize the interactions of nurses at the bedside using continuous surveillance over a year long period. METHODS: Nurses' time and activity at the bedside were characterized using a device that integrates the use of obfuscated computer vision in combination with a Bluetooth beacon on the nurses' identification badge to track nurses' activities at the bedside. The surveillance device (AUGi) was installed over 37 patient beds in two medical/surgical units in a major urban hospital. Forty-nine nurse users were tracked using the beacon. Data were collected 4/15/19-3/15/20. Statistics were performed to describe nurses' time and activity at the bedside. RESULTS: A total of n = 408,588 interactions were analyzed over 670 shifts, with >1.5 times more interactions during day shifts (n = 247,273) compared to night shifts (n = 161,315); the mean interaction time was 3.34 s longer during nights than days (p < 0.0001). Each nurse had an average of 7.86 (standard deviation [SD] = 10.13) interactions per bed each shift and a mean total interaction time per bed of 9.39 min (SD = 14.16). On average, nurses covered 7.43 beds (SD = 4.03) per shift (day: mean = 7.80 beds/nurse/shift, SD = 3.87; night: mean = 7.07/nurse/shift, SD = 4.17). The mean time per hourly rounding (HR) was 69.5 s (SD = 98.07) and 50.1 s (SD = 56.58) for bedside shift report. DISCUSSION: As far as we are aware, this is the first study to provide continuous surveillance of nurse activities at the bedside over a year long period, 24 h/day, 7 days/week. We detected that nurses spend less than 1 min giving report at the bedside, and this is only completed 20.7% of the time. Additionally, hourly rounding was completed only 52.9% of the time and nurses spent only 9 min total with each patient per shift. Further study is needed to detect whether there is an optimal timing or duration of interactions to improve patient outcomes. CLINICAL RELEVANCE: Nursing time with the patient has been shown to improve patient outcomes but precise information about how much time nurses spend with patients has been heretofore unknown. By understanding minute-by-minute activities at the bedside over a full year, we provide a full picture of nursing activity; this can be used in the future to determine how these activities affect patient outcomes.

Comparison of Alabama Nurse Experiences Between Practice Areas During the Early COVID-19 Pandemic.

BACKGROUND: According to the Total Worker Health® framework, safety culture including a reasonable workload among healthcare workers is essential to the security and well-being of patients, staff, and healthcare organizations. Evaluating the impact of the pandemic on the nursing workforce in different practice areas is critical for addressing workforce health and sustainability. The purpose of this study was to compare work and selfcare experiences among Alabama nurses between practice areas and the early pandemic years (2020 vs. 2021). METHODS: A secondary analysis of cross-sectional Alabama State Nurses Association (ASNA) survey data was conducted. Kruskal-Wallis analysis of variance, Wilcoxon rank, and false discovery rates were examined. RESULTS: There were 1,369 and 2,458 nurse survey responses in 2020 and 2021, respectively. By 2021, nurses reported worsening staff shortages, a greater need for retired and new graduate nurses to help with the workload burden, and perceptions of heavier emergency department workloads. Lower proportions of nurses reported the ability to engage in self-care activities and satisfaction with state and federal crisis management. Intensive care nurses were more likely to report staffing shortages while also reporting the lowest ability to engage in self-care. CONCLUSIONS: Overall, the Alabama nursing workforce perceived worsening work conditions in 2021 compared to when the pandemic began. Practice areas varied greatly in their responses, with acute and intensive care areas perceiving more difficult work conditions. Total Worker Health® programs should be designed to promote and support nurses' well-being based on their experience and the needs of specific practice areas.

Internationally Educated Nursing Staff Caring for Older Adults: A Scoping Study.

INTRODUCTION: Internationally Educated Nursing staff (IENs) are born and obtained their initial educational preparation in their home country before relocating to work in high-income countries (e.g., United States). Older adults are recipients of IENs' care. The study purpose was to synthesize relevant findings on IENs' experiences caring for older adults in various settings. METHOD: Arksey and O'Malley's framework approach to Scoping studies was employed. The PubMed, CINAHL, PsycINFO, Web of Science, and Google Scholar databases were searched. A labor and employment relations researcher and a health science librarian were consulted. RESULTS: Three main themes (transitional challenges; IENs' experiences working with older adults; factors affecting IEN service delivery) and seven subthemes emerged. DISCUSSION: Cultural beliefs and communication barriers posed particular challenges to IENs as they worked with Western peers, older adults, and families. Facilitating factors revealed can inform administrative leaders of practice initiatives. Research gaps and limitations identified can guide future study approaches.

Introduction of Unit-Dose Care in the 1,125 Bed Teaching Hospital: Practical Experience and Time Saving on Wards.

Purpose: The shortage of nursing staff as well as the slow progress in the German health care system's digitalisation has gained much attention due to COVID-19. Patient-specific medication management using the unit-dose dispensing system (UDDS) has the potential for a lasting and positive influence on both digitalisation and the relief of nursing staff. Methods: Nursing staff UDDS-acceptance was determined via a validated online survey. For the evaluation of stock keeping on the wards, the delivery quantities were determined for a comparative period before and after the introduction of the UDDS. The time required for on-ward medication-related processes on ward before and after the introduction of UDDS was recorded based on a survey form and the nursing relief in full-time equivalent (FTE) was calculated using the data obtained. Results: We show that nurses appreciate the UDDS and confirm a significant reduction in drug stocks on the wards. The UDDS reduces the time needed to dispense medications from 4.52 ± 0.35 min to 1.67 ± 0.15 min/day/patient. In relation to the entire medication process, this corresponds to a reduction of 50% per day and per patient. Based on 40,000 patients/year and a supply of 1,125 beds with unit-dose blisters, 7.36 FTE nursing staff can be relieved per year. In contrast, 6.5 FTE in the hospital pharmacy are required for supplying the hospitals. Conclusion: UDDS is well accepted by nurses, reduces stock levels on ward, and fulfils criteria as a nursing-relief measure.

Effectiveness of a hand hygiene training intervention in improving knowledge and compliance rate among healthcare workers in a respiratory disease hospital.

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.

Stress and Occupational Coping among Brazilian Nurses in Critical Care Units during the COVID-19 Pandemic.

OBJECTIVE: To investigate the effects of sociodemographic and working condition variables, as well as the coping strategies used by nurses, on their occupational stress during the COVID-19 pandemic. METHODS: A cross-sectional study was conducted with 104 nurses who worked in intensive and emergency care at a public hospital in the state of São Paulo, Brazil. Data collection was performed in person and online using a questionnaire assessing sociodemographic and occupational characteristics, the Nursing Stress Inventory, and the Occupational Coping Scale. RESULTS: The participants had a high level of stress (median = 132), especially in the 'interpersonal relations' domain (median = 63), and made little use of occupational coping strategies (median = 87). Income (p = 0.027), work shift (p = 0.028), being on leave from work (p = 0.020), number of hospitals with employment ties (p = 0.001), and relationship with management were independently associated with the levels of stress among the nurses. CONCLUSION: In the present study, the high levels of stress among nurses were influenced by financial and work-related factors as well as interpersonal relationships. No significant association was found between stress among the nurses and the use of occupational coping strategies.

Enhancing feedback by health coaching: the effectiveness of mixed methods approach to long-term physical activity changes in nurses. An intervention study.

BACKGROUND: Although knowledge of the barriers and motivators to physical activity participation among nurses is increasing, the factors influencing motivation methods' effectiveness are not completely defined. This study aimed to identify the methods that support increasing the level of daily physical activity and the factors that influence the effectiveness of motivation methods among nurses. METHODS: This study was based on an intervention study protocol. All registered nurses in clinical settings were invited to participate in the study. The study involved 71 professionally active nurses. A self-reported questionnaire was used to collect sociodemographic and employment data. The level of physical activity was assessed using the International Physical Activity Questionnaire, and the daily number of steps was assessed using a pedometer. Body composition was measured using a bioimpedance method, and the 5-year risk of cardiovascular events was assessed using the Harvard Score. The intervention included self-monitoring daily steps using a pedometer and completing a diary daily for one month. Additionally, a few-minute speech was sent to each participant via email on the intervention's 7th, 14th, and 21st days. RESULTS: The analysis revealed a higher value of physical activity recorded in the follow-up compared to the initial and final measurement in the Recreation domain [Met] (p < 0.001) and a higher value of daily steps in the follow-up compared to the final measurement (p = 0.005). Participants with a higher Harvard Score were more likely to increase their daily number of steps (OR = 6.025; 95% CI = 1.70-21.41), and nurses working in hospital wards were less likely to do so (OR = 0.002; 95% CI = 0.00-0.41). CONCLUSIONS: Recommendations for physical activity in the nursing population should focus on increasing leisure time physical activity and regular risk assessment of cardiovascular events. A mixed methods approach, such as feedback enhanced by health coaching, effectively achieves long-term physical activity changes in nurses.

Survey of European Blood and Marrow Transplant (EBMT) nurses to explore the current topical skin management of chronic cutaneous graft versus host disease in the real-world clinical environment.

PURPOSE: To understand the current practice in relation to the management of topical therapy for cutaneous chronic Graft versus Host Disease (ccGvHD) and access to extracorporeal photopheresis (ECP) within European allogeneic haematopoietic cell transplantation centres by a survey of nurses. METHOD: This was a multicentre cross-national study at eligible European Blood and Marrow Transplant centres. Eligibility required more than 30% of treated patients having allogeneic haematopoietic cell transplant. Centres performing only autologous stem cell transplants were excluded from the study. RESULTS: 12% of respondents were unaware of whether their centre had a policy or not for monitoring chronic cutaneous graft versus host disease. Over half had the affiliation of a dermatologist for referral, but only 19% had access to a specialist nurse. Patient education was routinely provided in most of the centres (86%). Results suggested as the severity of a patient's chronic cutaneous graft versus host disease increased, there was a reduction in the amount of topical emollients and steroids employed. Following topical therapies, systemic treatments, and other modalities such as ECP were employed with less focus directed towards topical care. CONCLUSIONS: Topical treatment is the backbone of any treatment paradigm for chronic cutaneous graft versus host disease, however, there is no universally agreed algorithm. Improved skin care may lead to a reduction in the amount of systemic therapy required, thus increasing patients' quality of life. There is little standardisation in the topical management of chronic cutaneous graft versus host disease, despite skin being the most cited organ affected by chronic graft versus host disease, this should be addressed.

Nursing and allied health workforce in Australian public rheumatology departments is inadequate: a cross-sectional observational study.

Rheumatological conditions are complex and impact many facets of daily life. Management of people with rheumatological conditions can be optimised through multidisciplinary care. However, the current access to nursing and allied health professionals in Australia is unknown. A cross-sectional study of nursing and allied health professionals in Australian public rheumatology departments for adult and paediatric services was conducted. The heads of Australian public rheumatology departments were invited to report the health professionals working within their departments, referral pathways, and barriers to greater multidisciplinary care. A total of 27/39 (69.2%) of the hospitals responded. The most common health professionals within departments were nurses (n = 23; 85.2%) and physiotherapists (n = 10; 37.0%), followed by pharmacists (n = 5; 18.5%), psychologists (n = 4; 14.8%), and occupational therapists (n = 4; 14.8%). No podiatrists were employed within departments. Referral pathways were most common for physiotherapy (n = 20; 74.1%), followed by occupational therapy (n = 15; 55.5%), podiatry (n = 13; 48.1%), and psychology (n = 6; 22%). The mean full-time equivalent of nursing and allied health professionals per 100,000 population in Australia was 0.29. Funding was identified as the most common barrier. In Australia, publicly funded multidisciplinary care from nurses and allied health professionals in rheumatology departments is approximately 1.5 days per week on average. This level of multidisciplinary care is unlikely to meet the needs of rheumatology patients. Research is needed to determine the minimum staffing requirements of nursing and allied health professionals to provide optimal care.

Digital stress perception among German hospital nurses and associations with health-oriented leadership, emotional exhaustion and work-privacy conflict: a cross-sectional study.

BACKGROUND: The use of digital information and communication technologies (ICT) can be accompanied by increased technostress for nursing staff, which in turn can be associated with health consequences. In addition, the use-related constant accessibility through ICT can have a negative impact on health-related recovery and regeneration phases. Health-promoting behaviors of supervisors can influence health complaints and conflicts between employees' work and private lives. The present study investigates whether there is a corresponding relationship between digital stressors (technostressors) as well as health-oriented leadership and health outcomes among nurses. METHODS: In a quantitative online survey, hospital nursing staff (n = 243) was asked about techno-invasion, social environment, emotional exhaustion, work-privacy conflict and on the supervisors' health-oriented staff-care dimensions awareness, value of health and health-oriented leadership behavior (HoL: awareness, value of health and health behavior). The associations of technostress, HoL and health outcomes were tested using regression analyses and performing a correlation. RESULTS: Significant positive associations between techno-invasion and health outcomes had been found. Social environment was not (positively) significantly related to either emotional exhaustion or work-privacy conflict. Health-oriented leadership moderated the association between social environment and work-privacy conflict. CONCLUSIONS: The results confirm the relevance of measures to reduce technostress and the importance of health-oriented leadership as a health-promoting resource. For practice, offers should be implemented for a balanced work and personal life of the nursing staff as well as establishing competence trainings for supervisors to learn and implement health-promoting behaviors. When technology use can't be reduced, options could be created to ensure that nurses' work and private lives become more balanced. These could represent mindfulness practices.

"The supreme discipline of Nursing"-A qualitative content analysis of nurses' opinions on caring for people eighty years of age and older.

Introduction: Nurses often experience stress and feel under time pressure when working with older people, increasing their job dissatisfaction. Especially people 80 years of age and older often require more complex and a greater measure of care, as the risk of care dependency is higher in this age group. This study was conducted to collect nurses' experiences and opinions regarding the care of people 80 years of age and older, as well as to learn more about how nurses perceive this care. Method: We analysed narratives collected in an Austrian nationwide, cross-sectional online study to investigate nurses' attitudes towards people 80 years of age and older and their perceptions regarding their care (N = 1197). Data were collected from May-October 2021 by using a convenience sampling method. In total, 149 participants filled in the free text field; these texts were analysed using a qualitative content analysis method. Results: Three main themes emerged from the analysis of the nurses' narratives: (1) 'opinions on people in need of care', (2) 'reputation of nursing profession', and (3) 'criticism of current nursing practice'. Most narratives were assigned to the subthemes 'positive opinions on nursing', 'ideal image of nursing', and 'shortage of staff'. Conclusion: Nurses considered their work with people aged 80 years and older to be meaningful and important, but they criticised working conditions which need to be improved. This could be achieved by offering further education and increasing nursing staff. Further research is needed to investigate nurses' needs and wishes regarding the care of people aged 80 years and older.

Prevalence of Latent Tuberculosis Infection Among Nurses Working in Critical Areas at a Tertiary Care Hospital in Riyadh, Saudi Arabia.

Introduction Tuberculosis is a critical health issue worldwide. Most infected persons are asymptomatic and categorized as having a latent tuberculosis infection (LTBI). Healthcare workers (HCWs) are more prone to being infected with tuberculosis and should be enrolled in a screening program for early detection. Objectives The study aims to estimate the prevalence of LTBI among nurses working in critical areas which include adult intensive care units, pediatric intensive care units, emergency departments, oncology departments, dialysis departments, tuberculosis labs, isolation rooms, and cardiac center intensive care units. Methods A record-based cross-sectional survey measured the prevalence of LTBI among nurses working in critical areas at Prince Sultan Military Medical City (PSMMC), Riyadh, Saudi Arabia. We reviewed the occupational health records of all nurses working in critical areas from June 1, 2021, to June 1, 2022. We recorded the data reviewed throughout the year in the Occupational Health Department at PSMMC. We excluded all participants with previously documented positive tuberculin skin test (TST) from the study. We analyzed the sociodemographic data, working years, working location, job title, and TST results. Results We included a total of 771 out of 2025 nurses in this study. Participants were mostly women (88%) and in the 26-35-year age group (67.7%). Most of the participants were originally from the Philippines (66.3%). The overall LTBI prevalence among nurses was 34.5%. The highest prevalence of LTBI was among nurses working in the cardiac intensive care unit (53.5%), and the lowest prevalence was among nurses working in the isolation department (8.9%; p-value <0.0001). Those who worked more in the hospital were significantly more infected with LTBI (p-value <0.04). Conclusion LTBI remains a significant health risk worldwide and in the Middle East as well as among HCWs. This underscores the necessity of comprehensive pre-hiring screening, annual screening, infection control protocols, and active management of HCWs with LTBI.

Association between organizational justice and serious psychological distress among hospital nursing staff during the COVID-19 pandemic: A cross-sectional study.

AIM: Amidst the COVID-19 pandemic, the association between organizational justice and psychological distress among hospital nursing staff is underexplored. Thus, this cross-sectional study, conducted in Fukuoka Prefecture, Japan, examined the relationship between organizational justice and serious psychological distress (SPD) among hospital nursing staff during COVID-19. METHODS: The study surveyed 783 hospital nursing staff using the Organizational Justice Questionnaire and Effort-Reward Imbalance Questionnaire. The Kessler K6 scale was used to measure SPD. Sociodemographic and occupational characteristics were controlled for as potential confounders. RESULTS: The prevalence of SPD was 14.4%, with a mean K6 score of 6.5. Moderate procedural justice (odds ratio [OR] = 2.38, 95% confidence interval [CI] = 1.14-4.94, p = .021) and low distributive justice (effort-reward imbalance) (OR = 3.66, 95% CI = 2.01-6.67, p < .001) were associated with SPD, even after adjustment for confounders. Interactional justice showed significance only in the crude model. Effort-reward imbalance had the strongest association with SPD. CONCLUSIONS: The findings showed that moderate procedural justice and low distributive justice were associated with SPD, highlighting the need for organizational interventions to address these factors. Imbalances in effort/reward had the greatest impact, highlighting the critical role of distributive justice in mental health. Thus, in the context of a pandemic, extreme procedural justice is not necessarily associated with mental health, and efforts to ensure distributive justice are critical to improving the mental health of hospital nursing staff. Moreover, organizational stressors should be addressed during disruptive conditions such as infectious disease outbreaks.