OBSERVATION AND EVALUATION OF PROFESSIONAL BEHAVIOUR AMONG MEDICAL LABORATORY TECHNICIANS

BackgroundThe clinical laboratory services, as an essential part of health care, require appropriate staff capacity to assure satisfaction and improve outcomes for both patients and clinical staff. This study aimed to apply the Workload Indicators of Staffing Need (WISN) method for estimating required laboratory staff requirements for the high-volume clinical biochemical laboratories.MethodsIn 2019, we applied the WISN method in all 13 laboratories within the Center for Medical Biochemistry of the University Clinical Centre of Serbia (CMB UCCS). A review of annual routinely collected statistics, laboratory processes observations, and structured interviews with lab staff helped identify their health service and additional activities and duration of these activities. The study outcomes were WISN-based staff requirements, WISN ratio and difference, and a recommendation on the new staffing standards for two priority laboratory workers (medical biochemists and medical laboratory technicians).ResultsMedical biochemists’ and laboratory technicians’ annual available working time in 2019 was 1508 and 1347 working hours, respectively, for the workload of 1,848,889 samples. In general, the staff has four health service, eight support, and 15 additional individual activities. Health service activities per sample can take from 1.2 to 12.6 min. Medical biochemists and medical laboratory technicians spend almost 70% and more than 80% of their available working time, undertaking health service activities. The WISN method revealed laboratory workforce shortages in the CMB (i.e. current 40 medical biochemists and 180 medical laboratory technicians as opposed to required 48 medical biochemists and 206 medical laboratory technicians). Workforce maldistribution regarding the laboratory workload contributes to a moderate–high workload pressure of medical biochemists in five and medical laboratory technicians in nine organizational units.ConclusionsThe WISN method showed mainly a laboratory workforce shortages and workload pressure in the CMB UCCS. WISN is a simple, easy-to-use method that can help decision-makers and policymakers prioritize the recruitment and equitable allocation of laboratory workers, optimize their utilization, and develop normative guidelines in the field of clinical laboratory diagnostics. WISN estimates require periodic reviews.

Introduction: Hospital waste has been reported to be poorly handled and managed by the hospital staff and administration respectively, leading to environmental and health consequences within hospitals and to the population outside health facilities. Aim: To assess the knowledge and practice of healthcare waste management (HCWM) among healthcare workers at Yusuf Dantsoho Memorial Hospital (YDMH), Kaduna, Nigeria. Materials and Methods: A cross-sectional study was conducted amongst doctors, nurses, medical laboratory scientists and technicians, ward attendants, and cleaners at YDMH. A simple random sampling technique was used to select the study unit. A total of 73 health workers consented to an interview. The data was obtained through the administration of questionnaires on the knowledge of health workers while the practice was assessed by direct observation using a checklist. Data were collected and compiled using Microsoft Excel and analysed using IBM, SPSS version 23.0. Results: There were 39 (53.4%) males and 34 (46.4%) females in this study. The average age of participants was 36.8 ± 8.3 years. The study revealed good knowledge of waste management amongst nurses (88.18%), doctors (86.68%), medical laboratory scientists and technicians (77.48%), ward attendants (19.1%), and cleaners (17.5%), respectively. In practice, all the wards and departments observed do not have (0%) colour-coded plastic bags on their waste bins, with only 70% having their waste bins covered, 30% having posters to guide waste users displayed near the waste bins, and 0% waste treatment before disposal practice. The health facility’s method of final waste disposal is not in line with best practices. Conclusion: This study highlights the discrepancy and inadequacies of knowledge and practice of proper healthcare waste management among healthcare workers. The healthcare workers with adequate knowledge were the nurses, doctors, and medical laboratory scientists and technicians while the least knowledge was found amongst ward attendants and cleaners. The practice of healthcare waste management was poor across all professions. This calls for the need to train and retrain all health workers with emphasis on the ward attendants and cleaners. Also, there is a need for the provision of colour-coded waste bin liners in all wards and departments which should be adequately budgeted for by the management.

Millions of healthcare workers experience percutaneous exposure to bloodborne communicable infectious disease pathogens annually, with the risk of contracting occupationally acquired infections. In this study, we aimed to assess the status of occupational safety and outbreak preparedness in Congolese nurses and laboratory technicians in Kongo central and the Katanga area, amidst multiple ongoing public health emergencies in the Democratic Republic of the Congo (DRC). This was a multicenter analytical cross-sectional study conducted in five referral hospitals located in Kongo central province and the Katanga area between 2019 and 2020 amidst Ebola, Yellow fever, Cholera and Chikungunya outbreaks. Participants were adult A0 grade nurses, A1 nurses, A2 nurses and medical laboratory technicians (N = 493). They answered a structured, self-administered questionnaire related to hospital hygiene and standard precautions for occupational infection prevention. The majority of the respondents were females (53.6%), and 30.1% of them have never participated in a training session on hospital infection prevention during their career. The proportions of those who have been immunized against hepatitis B virus (HBV) was markedly low, at 16.5%. Of the respondents, 75.3% have been using safety-engineered medical devices (SEDs), whereas 93.5% consistently disinfected medical devices after use. Moreover, 78% of the respondents used gloves during medical procedures and 92.2% wore masks consistently. A large majority of the respondents, 82.9%, have been recapping the needles after use. Regarding participation in outbreak response, 24.5% and 12.2% of the respondents were Chikungunya and Cholera epidemic responders, respectively; 1.8% have served in Ebola outbreak sites. The proportion of the respondents who sustained at least one percutaneous injury by needlestick or sharp device, blood/body fluid splash or both in the previous 12-month period was high, 89.3% (41.8% for injury, 59.2% for BBF event), and most of them (73%) reported over 11 events. Compared to laboratory technicians, nurses had higher odds for sustaining percutaneous injury and BBF events [OR = 1.38 (0.16); p < 0.01], whereas respondents with longer working experience were less likely to sustain those events [OR = 0.47 (0.11); p < 0.001]. Findings from this study suggest that Congolese nurses and laboratory technicians experience a high frequency of injury and BBF events at work, and remain at high risk for occupationally acquired infection. There is a need for periodic capacity-building training for the healthcare workforce to improve infection prevention in health settings, the provision of sufficient and appropriate PPE and SEDs, post-exposure follow-up and keeping records of occupational injuries in hospitals in Congolese healthcare settings.

Background: Standard precautions prevent the spread of infections in healthcare settings. Incompliance with infection control guidelines of healthcare workers (HCWs) may increase their risk of exposure to infectious disease, especially under pandemics. The purpose of this study was to assess the level of compliance with the infection prevention and control practices among HCWs in different healthcare settings and its relationship with their views on workplace infection control measures during the COVID-19 pandemic. Methods: Nurses in Hong Kong were invited to respond to a cross-sectional online survey, in which their views on workplace infection and prevention policy, compliance with standard precautions and self-reported health during pandemics were collected. Results: The respondents were dissatisfied with workplace infection and prevention policy in terms of comprehensiveness (62%), clarity (64%), timeliness (63%), and transparency (60%). For the protective behavior, the respondents did not fully comply with the standard precautions when they were involved in medical care. Their compliance was relatively low when having proper patient handling (54%) and performing invasive procedures (46%). A multivariate analysis model proved that the level of compliance of the standard precautions was positively associated with the satisfaction on infection control and prevention policy among high risk group (0.020; 95% CI: 0.005–0.036), while older respondents had higher level of compliance among the inpatient and outpatient groups (coefficient range: 0.065–0.076). The higher level of compliance was also significantly associated with working in designated team and having chronic condition of the respondents among high-risk and inpatient groups. Conclusions: Standard precautions are the most important elements to reduce cross-transmission among HCWs and patients while the satisfaction on infection control and prevention policy would increase the compliance among the high-risk group. An overall suboptimal compliance and poor views on the infection prevention and control guidelines is a warning signal to healthcare system especially during pandemics.

Perioperative Nurses: Key to Surgical Site Infection Prevention.

1. Elaine M Keohane, PhD CLS(NCA)[⇑][1] 1. is Professor, Department of Clinical Laboratory Sciences, University of Medicine and Dentistry of New Jersey, Newark NJ 2. Mary Ellen Schaad, MT(ASCP) 1. is Technical Manager, Clinical Laboratory, Meridian Health System, Neptune NJ 3. Karen Feeney, MPA MT(ASCP)DLM 1. is Administrative Director, Department of Laboratories, Bayshore Community Hospital, Holmdel NJ 1. Address for correspondence: Elaine M Keohane PhD CLS(NCA), University of Medicine and Dentistry of New Jersey, School of Health Related Professions, 65 Bergen Street, Newark NJ 07107. (973) 972-5510, (973) 972-8527 (fax). keohanem{at}umdnj.edu The clinical laboratory personnel shortage has reached significant proportions in many areas of the country and there is growing concern about its impact on the accessibility and quality of clinical laboratory services. For the years 2002–2012, the U.S. Bureau of Labor Statistics projected a need for 138,000 new clinical laboratory technologists and technicians, or approximately 13,800 per year, due to growth and attrition from the field.1 On the other hand, in 2002, there were only 3,548 clinical laboratory technician/medical laboratory technician (CLT/MLT) and clinical laboratory scientist/medical technologist (CLS/MT) graduates in the U.S.2 If the current imbalance between vacancies and graduates continues, the national shortage of clinical laboratory personnel may grow by more than 10,000 laboratorians per year. In surveys conducted by the American Society for Clinical Pathology (ASCP), vacancy rates in 2000 for medical technologists (MTs) and medical laboratory technicians (MLTs) were 11.1% and 14.3% nationally and 14.9% and 24.5% in the northeast; in 2002 those rates showed a decrease to 7% and 8.6% nationally and 8.3% and 3.5% in the northeast. Although the vacancy rates in the latter study decreased to single digits, the vacancies are nevertheless noteworthy in terms of the actual number of vacant positions, taking into consideration a national workforce estimated at 297,000 clinical laboratory technologists and technicians.1 A Coalition for New Jersey Clinical Laboratory Personnel was formed in April 2002 to study the extent of and address a perceived shortage of clinical laboratory personnel in New Jersey. This coalition consists of twenty-eight members representing hospital… ABBREVIATIONS: CT = cytotechnologist; HLT = histotechnologist; HT = histotechnician; MLT = medical laboratory technician; MT = medical technologist. [1]: #corresp-1

To evaluate SMART, Medicos Dip Stick and an Institut Pasteur (IP) cholera dipstick tests for accuracy and ease of use. Every 50th patient presenting with diarrhoea at ICDDR,B between 1 April 2003 and 30 November 2003 was enrolled. The rapid diagnostic tests were performed by field and laboratory technicians, and sensitivity (Se), specificity (Sp), positive (PPV) and negative (NPV) predictive values calculated. We isolated Vibrio cholerae O1 from 116 (38%) of 304 patients. The Se, Sp, PPV and NPV of the SMART test were 58%, 95%, 84% and 84% for field technicians, and 83%, 88%, 83% and 88% for laboratory technicians. The Se, Sp, PPV and NPV of the IP dipstick test were 93%, 67%, 63% and 94% for field technicians, and 94%, 76%, 70% and 95% for laboratory technicians. The Se, Sp, PPV and NPV of the Medicos test were 84%, 79%, 71% and 90% for field technicians, and 88%, 80%, 72% and 92% for laboratory technicians. A high proportion of indeterminates (30%) hampered the performance of the SMART test. The IP dipstick had the highest Se, irrespective of technician skill level. The IP dipstick is the most appropriate rapid diagnostic assay for the detection of V. cholerae O1 in locations where the skill level of personnel may be low, such as remote areas or refugee camp settings. High cost may limit the utility of any diagnostic test in the developing world.

Introduction: Health services create conditions for occupational risks related to the health and safety of health workers. The management of safe and healthy working conditions in healthcare is the basis of public healthcare. Aim: The aim of the study is to study and analyze the dangerous medical practices related to the exposure of blood and body fluids in high-risk medical staff—medical laboratory technicians in medical diagnostic laboratories in Varna. Results: The results of the surveys among 107 people, including 5 managers of clinical laboratories, 49 laboratory technicians, and 53 clients/patients, confirm the working hypotheses. Failure to follow the rules of safe technique at work creates conditions for exposure to bloodborne infections. The most common reasons lie in the capping of used needles, non-use of gloves, or improper disposal of a sharp object in inappropriate containers. The immune status of medical laboratory technicians is not checked regularly, and non-immunized persons also work. The results of the surveyed clients reveal insufficient awareness of the risk exposures and the spread of bloodborne infections. It is worrying that 23% of them assume that doctors are fully responsible for the prevention of blood-borne virus infections. Conclusion: Bloodborne infections pose a significant risk to both society and healthcare professionals, but they can be prevented by measures aimed at minimizing the risk of infections: prevention of high-risk practices, compliance with universal precautions, the introduction of low-risk instruments and devices, and hepatitis B vaccination.

In health care industry, satisfaction of employees of all categories (medical, paramedical, and non-medical) towards their work and organization is paramount, because it determines not only commitment, involvement, morale, and productivity of employees, but also decides satisfaction of patients and promotion of organization’s reputation. Although all categories of employees contribute, in different ways, to the patient care activities, the contribution of medical laboratory technicians plays a crucial role in assisting doctors and surgeons to diagnose the underlying diseases of patients. Thus, medical laboratory technicians play a supplier role, and their primary duty is to satisfy the doctors and surgeons, who are actually their internal customers. Therfore, job satisfaction of laboratory technicians is paramount in bringing out right outcome from medical personnel. Lack of satisfaction of medical laboratory technicians would paralyse right diagnosis of the patients, which in turn not only endangers the life of patients, but also paralyses the reputation of organizations. In view of this concept, this survey, as a quantitative and empirical based descriptive research work, has been undertaken in Tirunelveli city of Tamil Nadu, India with the objective of analysing the perception of the medical laboratory technicians working at the private multi-speciality hospitals. The study has chosen 100 respondents using both convenience and judgement sampling techniques, and from the chosen respondents the primary data have been collected administering the structured self-made questionnaire. The secondary data have been collected from both books and journals. The study has used the tools – percentage, mean, standard deviation and co-efficient of variation – to analyse the primary data. The analysis of the data have discovered that majority of the respondents has perceived the following factors as “highly dissatisfied”: two-shift work system with 12-hour duty, equality in allocation of work load, unambiguous job description, and clarity of what management expects from employees, performing multiple tasks at the same time, respect from higher authorities and medical personnel, receiving orders from multiple sources bypassing the hierarchy. Similarly, most respondents have perceived the following factors as “dissatisfied”: fairness in the work schedule, fairness in changes made in the work, approach of the higher officials in front of patients and other staffs and performing non-professional tasks.

A care escalation framework to address lapses in donning and doffing of personal protective equipment during the COVID-19 pandemic

Knowledge, Attitudes, and Beliefs of Pediatric Health Care Workers: Understanding the Response to COVID-19.

A young society for medical laboratory technicians

This survey based descriptive research has been undertaken in Tirunelveli city, Tamilnadu as a comparative study to analyse and differentiate the level of awareness of medical laboratory technicians towards safety measures of occupational hazards. The subject of this research is medical laboratory technicians. The study has stratified the subject into two groups namely medical laboratory technicians working in multi speciality hospitals and diagnostic centres using stratified random sampling technique and sampled 60 medical laboratory technicians from each group respectively by judgement sampling technique. Thus, a total of 120 medical laboratory technicians have been sampled from both groups. The study has analysed fifteen variables to understand the level of awareness of occupational hazards. Percentage analysis and weighted average methods have been employed to analyse the data. The result of the study has highlighted that the awareness level of medical laboratory technicians working in both kinds of organizations about the safety measures of occupational hazards are almost same level. The study has given suitable suggestions to improve the awareness level of medical laboratory technicians in terms of safety measures of occupational hazards.

Effect of chlorhexidine bathing in preventing infections and reducing skin burden and environmental contamination: A review of the literature.

Clinical presentation of Covid-19 in health care workers from a French University Hospital