Behavior Of Healthcare Workers Research Articles

P-721. Risk Factors Associated with COVID-19 Among Fully Vaccinated Healthcare Workers in Lima, Peru

Abstract Background Healthcare workers (HCWs) are an important target group for COVID-19 vaccination. In February 2021, Peru launched a COVID-19 vaccination campaign among HCWs using a BBIBP-CorV inactivated whole-virus vaccine (Sinopharm). We aim to understand risk factors for SARS-CoV-2 infection after vaccination using a cohort of HCWs in two hospitals in Lima, Peru. Methods Between August 2021-June 2022, HCW who received at least two COVID-19 Sinopharm vaccine doses were enrolled in the cohort and followed for 6 months. Participants provided a self-collected nasal swab weekly for SARS-CoV-2 by reverse transcriptase polymerase chain reaction testing. SARS-CoV-2 infection was confirmed by a positive PCR test result at least 14 days after receiving the second vaccine dose. Adjusted hazard ratios (aHR) were used to identify associations with infection accounting for potential confounding. Person-time was calculated based on days between negative PCR results, capped at 10 days; in cases of infection, the time between positive and negative tests was halved, with half the days considered at risk. Results Of 670 vaccinated HCWs, 111 (16.6%) tested positive for SARS-CoV-2 during the follow-up period. In adjusted models, prior report of COVID-19 illness in the previous 12-months was associated with reduced risk of infection (aHR: 0.98 [95% CI:0.97‒0.99], p=0.026). Being beyond 6 months since the last vaccination was significantly associated with an increased risk of infection (aHR: 3.22 [95% CI:1.66‒6.23], p=0.0001) as well as working in an outpatient setting (aHR: 1.94 [95% CI:1.06‒3.53], p=0.031). Conclusion In this cohort of healthcare workers undergoing regular asymptomatic COVID testing, our findings suggest evidence of waning protection at 6 months post-vaccination BBIBP- CorV. Additionally, preliminary indications suggest that healthcare worker behaviors or specific occupational exposures may contribute to increased infection risk even following vaccination. In addition, these results support the inclusion of HCWs as a priority group for additional booster doses of COVID-19 vaccine at 6 months after the most recent dose. Disclosures All Authors: No reported disclosures

HSD39 Beliefs and Behaviors of Healthcare Workers Towards Influenza Vaccination: A Systematic Review

HSD39 Beliefs and Behaviors of Healthcare Workers Towards Influenza Vaccination: A Systematic Review

Nursing practice of the prevention and control guidelines for vascular catheter-related bloodstream infections.

To apply the Ottawa Model of Research Use to translate the Guidelines for the Prevention and Control of Vascular Catheter-Associated Bloodstream Infections. The Ottawa model of research use is used to provide a framework and guidance. This study was organized by the Nursing Department of the Affiliated Hospital of Hebei Engineering University, and the Intravenous Therapy Group was responsible for the implementation of the study. The hospital's intravenous therapy administrators, members of the sedation team, and specialist nurses will be organized to evaluate the importance, exactness, and clinical practicability of 34 entries. Twelve clinical departments and intravenous therapy clinics with a high number of central venous catheters were used as sites for translating evidence from this project. The evidence-based team assessed the practice environment, potential practitioners, and clinical status of clinical translation of evidence through symposia, review of relevant systems, operational procedures, on-site inspections, and questionnaires. They compare evidence with existing processes and decide on change strategies. Before and after the application of the evidence, there was a significant increase in the knowledge, belief, and behavior of healthcare workers on CLABSI prevention and control, especially in the acquisition of related knowledge (χ2 = 26.648 p < 0.001). The associated implementation rate was also significantly improved, with a significant decrease in CLABSI incidence from 0.29 per 1000 to 0.11 per 1000 (χ2 = 8.625 p = 0.004). The assessment of the integration of issues showed that 8 aspects, including workflow, knowledge mastery, monitoring reports, and aseptic operations, do not meet the qualified standards. Through this clinical change, a perfect prevention and control system has been established, and the level of knowledge, belief, and behavior of medical staff in preventing CLABSI has been improved, while the incidence of CLABSI has been reduced.

Post-traumatic growth, moral sensitivity and service behaviour among healthcare workers in the post-pandemic era of COVID-19 in mainland China: a cross-sectional study

ObjectivesTo investigate how post-traumatic growth (PTG) and moral sensitivity influence service behaviour among healthcare workers (HCWs) in mainland China post-COVID-19, with a focus on the mediating role of moral sensitivity.DesignCross-...

A multi-nudge-based behavioural insight into ward nurses' respiratory rate measurement: An observational study.

This study observed changes in respiratory rate measurement (RRM) and identified barriers and challenges in clinical practice that influence healthcare worker behaviour, aiming to improve RRM in a hospital setting. An observational study was conducted. We observed and analysed changes in the behaviour of healthcare workers at a hospital where multi-nudges were introduced to improve RRM. We checked respiration rate using electronic data and discovered that the original measurement rates were low. Measurement rates rapidly increased after posters were added. Barriers such as time constraints and measurement equipment were also noted. RRM was found to be effective in promoting behavioural economics in medical settings. The results show that incorporating behavioural science principles into medical interventions has the potential to positively change behaviour. By increasing nurses' awareness of respiratory rate measurement and addressing barriers to it, the measurement rate of respiratory rate can also increase, leading to more accurate patient evaluations and triage. WHAT PROBLEM DID THE STUDY ADDRESS?: The proportion of respiratory rate measurements leading to rapid response system (RRS) calls was low. WHAT WERE THE MAIN FINDINGS?: The study observed that a multi-nudge approach effectively changes the behaviour of ward nurses, resulting in enhanced quality of medical care. WHERE AND ON WHOM WILL THE RESEARCH HAVE AN IMPACT?: This research can serve as a valuable reference for leaders promoting healthcare quality projects, by offering a method to encourage behavioural change. This study complied with the EQUATOR guidelines and its reporting adheres to the STROBE checklist. No patient or public contribution.

Evaluation of the knowledge, attitudes and behavior of healthcare workers concerning influenza vaccination in a training and research hospital in Türkiye

Introduction and aim. Although increasing vaccination rates among healthcare workers (HCWs) is crucial for protecting their own health and preventing the spread of infections to patients, vaccination rates remain low. The purpose of this study is to evaluate the knowledge, attitudes, and behavior of healthcare workers concerning seasonal influenza vaccination in a training and research hospital in Türkiye. Material and methods. This cross-sectional descriptive study was conducted among 364 healthcare workers working in a training and research hospital in Ankara, Türkiye. A face-to-face questionnaire was completed by selected participants that included questions about their sociodemographic characteristics, receiving seasonal influenza vaccination, reasons for not receiving vaccination, attitudes and behavior towards seasonal influenza vaccination recommendations for their surroundings, knowledge of who should get the vaccine, and their immunization history. Results. Among the participants, 58.5% stated that they had never received an influenza vaccination, 35.7% mentioned not receiving the regular influenza vaccination, and only 5.8% reported receiving the influenza vaccination regularly every year. Reasons for not getting vaccinated included not trusting the influenza vaccine’s protection (60.1%), not believing they are in the risk group (38.9%), and not finding a suitable time to get vaccinated (36.1%). A total of 57.1% of the healthcare workers recommended the influenza vaccine for their surroundings. Conclusion. Influenza vaccination rates among healthcare workers are quite low. To maximize influenza vaccine uptake, awareness programs are needed to correct the misconceptions health care workers have about the vaccine, and diverse strategies should be implemented to encourage them to get vaccinated, thereby promoting influenza vaccination.

Relationship Between Level of Knowledge and Nurse Compliance in the Implementation of Standard Operational Procedures (SOP) for Infusing in the Emergency Installation Unit.

Introduction: Emergency Department is the main entry point for hospital services in providing first aid to patients. One of the common infections in hospitals is nosocomial infection. The success of controlling nosocomial infections in infusion procedures is not determined by advanced equipment but by the behavior of healthcare workers in properly caring for patients.. Objectives: This study aims to analyze the relationship between knowledge level and nurses' compliance with the Standard Operating Procedure (SOP) for Infusion Placement in the Emergency Department of RSU dr. H. Koesnadi Bondowoso.. Methods: The study was conducted in January 2016 at the Emergency Department of RSU dr. H. Koesnadi Bondowoso. A correlational design with a cross-sectional approach was used. The population consisted of all nurses in the Emergency Department, with a total sample of 18 participants, selected using total sampling technique. Data were collected through questionnaires and observation sheets, then analyzed using SPSS "Spearman Rho" with a significance level of 5%. Results: The Spearman Rho test results at a 5% significance level (α) showed a P value of 0.001, concluding that p ≤ 0.05, so H1 is accepted, and Ho is rejected. This indicates a significant relationship between knowledge level and nurses' compliance with the SOP for Infusion Placement in the Emergency Department of RSU dr. H. Koesnadi Bondowoso. Conclusions: The findings demonstrate that nurses' knowledge is fundamental in adhering to the SOP for Infusion Placement, thereby preventing nosocomial infections.

Patient Safety Culture in Pre-Post Partum and Perinatology Units

Introduction: Effective patient safety practices in pre-post partum and perinatology units are crucial for ensuring high-quality care for mothers and children. These practices are expected to reduce maternal and child mortality rates, which remain significant. Patient safety implementation in hospitals depends largely on the patient safety culture within each institution. Objective: This study aimed to assess the application of patient safety culture in pre-post partum and perinatology wards. Methods: The research employed a mixed-methods approach with a sequential explanatory design. Quantitative data were gathered using the AHRQ (Agency for Health Research and Quality) questionnaire. Meanwhile, the qualitative research used an instrumental case study approach insights were derived from in-depth interviews with 52 nurses working in these units. Results: Results show an overall positive response rate of 67.8% across the 12 dimensions of patient safety culture, indicating satisfactory levels. The dimension with the highest positive response rate is teamwork at 38%, while openness had the lowest at 6%. Challenges in patient safety program implementation include lack of safety culture surveys, inadequate incident reporting systems, high blaming culture, lack of support, delayed case reporting, and financial constraints. Reporting, analysis, and evaluation are predominantly limited to internal hospital processes. Conclusion: The obstacles encountered in implementing a patient safety culture are the behavior of healthcare workers and the lack of optimal support from management. The recommendations given are the formation of a Patient Safety Committee, education about safety culture for healthcare workers, Monitoring and evaluation of the patient safety program that has been implemented.

Associations between negative patient safety climate and infection prevention practices

The relationships among positive perceptions of safety climate and better healthcare worker behaviors have been increasingly documented in the literature. The potential influence of negative perceptions is underexplored and has not been examined in relationship to infection prevention practices. We begin to address this gap using data collected as part of a multi-site, cross-sectional study. This brief report describes associations identified between negative perceptions of patient safety climate and standard precaution adherence of hospital-based nurses.

Exploring factors affecting the unsafe behavior of health care workers’ in using respiratory masks during COVID-19 pandemic in Iran: a qualitative study

BackgroundThe use of respiratory masks has been one of the most important measures to prevent the spread of COVID-19 among health care workers during the COVID-19 pandemic. Therefore, correct and safe use of breathing masks is vital. The purpose of this study was to exploring factors affecting the unsafe behavior of health care workers’ in using respiratory masks during the COVID-19 pandemic in Iran.MethodsThis study was carried out using the conventional qualitative content analysis. Participants were the number of 26 health care workers selected by purposive sampling method. Data collection was conducted through in-depth semi-structured interviews. Data analysis was done using the content analysis approach of Graneheim and Lundman. This study aligns with the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist and was conducted between December 2021 and April 2022.ResultsThe factors affecting the unsafe behavior of health care workers while using respiratory masks were divided into 3 main categories and 8 sub-categories. Categories included discomfort and pain (four sub-categories of headache and dizziness, skin discomfort, respiratory discomfort, feeling hot and thirsty), negative effect on performance (four sub-categories of effect on physical function, effect on cognitive function, system function vision, and hearing), and a negative effect on the mental state (two subcategories of anxiety and depression).ConclusionThe findings can help identify and analyze possible scenarios to reduce unsafe behaviors at the time of using breathing masks. The necessary therapeutic and preventive interventions regarding the complications of using masks, as well as planning to train personnel for the correct use of masks with minimal health effects are suggested.

Health care professionals under programmes for addictions. Personality characteristics of the patients, barriers to treatment and challenges

Physicians have privileged information regarding the importance of leading a healthy and drug-free lifestyle, but in everyday reality, they are subject to extreme stressors (work stress, compassion fatigue, burnout syndrome) that have a profound emotional impact. As a result, it is not uncommon for physicians to present substance use disorders and dependencies. Recently, greater attention has been paid to specific factors that may lead to substance use disorder. Despite these efforts, there is a lack of prevention policies and substance use disorders are excluded in the list of occupational diseases. The idiosyncrasies of the tasks and particularities of the behavior of health care workers create a major challenge for the design of effective and safe programs for the health care professional with addictions and their patients. The objective of this work is to carry out an analytical review of the existing literature related to the implementation of specific treatments for health professionals to address SUD. After a tour of the mental health programs in place for health workers in different regions of the world and local resources, a discussion of current information on mental health disorders, as well as prevention and occupational health policies, is presented. In this population, the challenges that must be faced in our reality to create a specific treatment for this population are summarized.

Simulation to improve healthcare pathway and inequities for people with disabilities.

Introduction: The Convention on the Rights of People with Disabilities (1) reported that people with disabilities do not have equitable access to health services. People with intellectual disabilities, especially the ageing, are more susceptible to somatic disease and other lifestyle diseases than the general population (2, 3, 4, 5, 6). &#x0D; General practitioners' (GP) competence in the field of intellectual disability is largely experience-based, not systematic and research-based (7). In municipalities, approximately half of healthcare workers (HCWs) at municipal housing for people with intellectual disabilities are unskilled. These HCWs have experienced not being taken seriously when calling either their patients’ GP or accident and emergency (A&amp;E) department to report that the resident is 'not well', resulting in residents receiving inadequate healthcare. Municipal leaders and educators decided to address the inadequate clinical observation and communication skills among HCWs with a simulation-based training program (SBTP), to improve competence and treatment of residents when escalating levels of care.&#x0D; Methods: Based on national recommendations about ""Early detection of deteriorating condition"" and the urgency of the covid-pandemic, the SBTP was quickly rolled out to all HCW. The SBTP consisted of both theoretical teaching and e-learning in ABCDE, training in the tool NEWS2, as well as the communication technique ISBAR. Baseline NEWS2 scores were established for all residents.&#x0D; Based on positive experience with SBTP in donning and doffing of personal protection equipment (8) in the municipality early in the pandemic, and uncertainty about safer care for sick corona patients in residential homes, leaders requested continued use SMTP to improve observational skills.&#x0D; Results &amp; Discussion: Evidence of improved competency at work and resulting improved escalation of care came fast.&#x0D; One example was of a resident with backpain whose relatives’ recommended painkillers. HCWs performed NEWS2 scoring, discovered pathological changes, contacted A&amp;E, received treatment advice, continually followed up on NEWS2 measurements, secured ambulance help &amp; reaction based on baseline NEWS2, and admission where sepsis was discovered. Similarly, another group of HCWs performed NEWS2 scoring on a patient with presenting manic symptoms, discovered clinical signs of somatic illness, which lead to a completely different medication than expected. These cases were seen as post-SBTP improvements in HCWs behavior, and patient safety.&#x0D; &#x0D; SBTP to improve observational skills in the municipality has led to better differential diagnosis in the early stage, more precise communication with GP and A&amp;E which in turn has led to better healthcare pathways for a vulnerable patient group.&#x0D; Keywords: simulation, observational competence, competence, health rights&#x0D;

Front-Line Health Care Workers' COVID-19 Infection Contamination Risks: A Human Factors and Risk Analysis Study of Personal Protective Equipment.

Infectious risks escalate with complex donning and doffing personal protective equipment (PPE) protocols. Recent studies suggest that PPE donning and doffing behaviors that deviate from protocol during PPE reuse compounded the risks of health care worker (HCW) self-contamination. This study quantified the occurrence of behaviors associated with known risks in PPE use and reuse. We conducted a prospective study of emergency department HCWs and video-recorded PPE donning and doffing 5 times in simulated patient encounters. Trained coders recorded HCW behaviors according to an evidence-based guide. All 28 participants deviated from the Centers for Disease Control and Prevention (CDC) sanctioned donning and doffing protocol order, and most were documented to have (92.85%) self-contaminated at least once during each simulated clinical encounter. Behaviors that compounded self-contamination due to PPE reuse were also observed. Wide variation in PPE donning and doffing behaviors was found among front-line, experienced HCWs. Future work is needed to determine which deviations put HCWs at increased risk for accidental self-contamination and what changes are needed to the CDC protocol for protecting HCW from infections.

Knowledge, Attitudes, Anxiety, and Preventive Behaviors Related to COVID-19 Among Healthcare Providers: A Developing Country's Perspective.

Background In early 2020, the rapid global spread of coronavirus disease 2019 (COVID-19) presented healthcare workers (HCWs) with an unprecedented challenge. The constant influx of new information about the virus created knowledge gaps, and the relentless demands of their work schedules left many feeling overwhelmed. This paper explores the knowledge, attitudes, anxiety levels, and preventive behaviors of HCWs in the twin cities of Pakistan, Rawalpindi and Islamabad, related to the COVID-19 pandemic. In the face of this crisis, it is essential to gain insights into the experiences and needs of these frontline heroes. Methodology We conducted a descriptive web-based cross-sectional study among healthcare professionals to delve into the multifaceted aspects of their experiences. This included analyzing sociodemographic characteristics, knowledge levels, attitudes, practices, and the psychological implications of the pandemic. By employing both quantitative and qualitative analysis, we aimed to provide a comprehensive understanding of these parameters. Results Out of the 1150 responses collected, it became evident that breathing problems were the most recognized symptom of COVID-19 among HCWs. Impressively, 95.7% of participants believed in the primarily symptomatic nature of treatment, although 37% held the misconception that antibiotics were effective against the virus. Another noteworthy discovery was that 68.2% of HCWs favored testing before initiating treatment, yet a concerning 22.7% of treated patients received no testing. A significant proportion, approximately 19.6%, experienced heightened anxiety levels during the pandemic, leading to an increased frequency of handwashing. In terms of preventive behaviors, a majority of respondents displayed a heightened sense of caution. Nearly 59.1% reported avoiding the use of others' accessories and emphasized not reusing face masks. Furthermore, 84.1% of participants preferred staying at home during quarantine. Conclusion The study reveals the profound impact of COVID-19 on healthcare providers in Pakistan's twin cities, highlighting elevated anxiety levels among most. This underscores the urgent need for mental health support. Beyond physical effects, the pandemic significantly strains their psychological well-being. To address this stress, vital strategies include workload reduction, structured shifts, stressor minimization, and improved knowledge sharing. Cultivating a healthy work environment is equally crucial for healthcare providers' overall well-being. These insights are essential for crafting policies and interventions to better protect and support frontline workers in a developing nation like Pakistan, demonstrating healthcare professionals' resilience and dedication amid unprecedented challenges.

Peri-Pandemic Acceptance of Influenza and COVID-19 Vaccination by Swiss Healthcare Workers in Primary Care 2020/21: A Cross-Sectional Study.

Objectives: To assess and compare influenza and COVID-19 vaccination uptake of Swiss healthcare workers (HCWs) in primary care 2020/21. Methods: Influenza and COVID-19 vaccination uptake and recommendation behaviours of HCWs in the primary care were assessed using an online semi-structured questionnaire. Associations between vaccination rates and age, language, gender, profession, vaccination history, vaccination training and recommendation behaviours were evaluated using descriptive and multivariable logistic regression analyses. Results: Vaccinated against COVID-19 in 2020/21 were 91.8% of the 1,237 participating HCWs, while 60.1% were vaccinated against influenza. Physicians and pharmacists presented the highest influenza vaccination rates (87.3%, 73.7%, respectively) compared to nurses (45.8%) and medical practice assistants (52.5%) while COVID-19 vaccination rates were high across all professions. Influenza and COVID-19 vaccination rates were significantly associated with age, profession, vaccination history, vaccination training and recommendation behaviours. Conclusion: Acceptance for influenza vaccination has increased during the pandemic but is lower than that for COVID-19 among the HCWs. Demographics, vaccination status and vaccination training impact the vaccination behaviour among HCWs and should be considered in future campaigns to increase vaccination uptake.

Awareness of health care workers with appropriate infection control practices related to multi-patient use of Close Loop Medication Administration device

Portable computerized devices represent a potential source of healthcare infections. The objective was to assess the knowledge, attitudes, and practices (KAP) of healthcare workers (HCWs) toward infection control practices used with Close Loop Medication Administration (CLMA) devices. Additionally, to quantify the impact of education and training on the bacterial burden on CLMA devices. The study design consisted of two steps: a cross-sectional study was conducted among HCWs working in a tertiary care center in Riyadh, Saudi Arabia. A 32-item questionnaire was used to assess KAP information. The second step was environmental samples collected from the surfaces of CLMA devices before and after implementing a multifaceted intervention. A total of 325 HCWs were included in the study. The mean age was 32.6±7.4 years. The majority were females (92%) and nurses (91.3%). The overall KAP score was 74.8%, 74.2% adequate knowledge, 79.3% positive attitude, and 71.3% appropriate practices. KAP score was better (≥ median KAP score) among HCWs working in laboratory and organ transplant units (P<0.001). It was also better among those with a longer duration of work experience (P<0.001) and those who received related training (P<0.001). Approximately 75% of HCWs expressed their need for more information about CLMA. Post-interventional samples had much lower bacterial burden, with the positive rate reduced from 51.4% before intervention to 16.8% after intervention (P<0.001). Awareness and behavior of HCWs about appropriate infection control practices related to portable devices is still inadequate. A multifaceted intervention including education and training significantly reduces the bioburden on portable devices.

Dominant barriers in accessing modern health care services among vulnerable community in central India: An explicit observation

The study aimed to identify barriers/impediments in accessing health care facilities in vulnerable tribal community. A community-based cross-sectional observation on health service utilization was carried out among the vulnerable Saharia tribe in Sheopur district of Madhya Pradesh. The data was gathered by skilled investigators from influencing community members during August to October 2020. Relevant information’s was collected from 212 respondents from 40 villages. Out of 40 village, 16(40%) of which were health facility villages located &amp;#60;5 km radius of health centers i.e. PHCs, SHCs and HWCs, and 24(60%) from non-health facility villages located &amp;#62;5 km radius of any of these health centers.The study found that three common barriers emerged; majorly as lack of awareness, misconception of child immunization and inadequate behavior of health care workers in both health facility village (located&amp;#60;5 km radius of health centers) and non-health facility village(located&amp;#62;5 km radius of health centers). Further, these barriers are considerably affected in non-health facility village along with the public transportation facility and poor road conditions (45.3%) in comparison to health facility villages’ (32.1%).Identified barriers in accessing health care facility is more startling in non-health facility villages as compared to health facility villages. These explored barriers need to be minimized through effective implementation research and strategy among vulnerable community in favor of achieving universal health coverage (UHC) particular in rural and remote regions.

Role of basic infection control practices to curtail the outbreak of ventilator-associated pneumonia caused by Klebsiella pneumoniae in a tertiary care hospital’s trauma intensive care unit

Abstract Background: Ventilator-associated pneumonia (VAP) is the most common hospital-acquired infection in intensive care units (ICUs), with high mortality and morbidity rates. Multidrug-resistant pathogens such as Klebsiella pneumoniae and Acinetobacter spp. generally cause VAP. Following an outbreak of VAP due to Klebsiella pneumonia in the trauma ICU (TICU), aggressive infection control practices and effective interventions were instituted to reduce the infection. We summarize the timely implementation and changes in infection control practices that helped reduce VAP incidence in an ICU. Materials and Methods: An intervention was done in the form of the implementation of infection control practices, training of healthcare workers (HCWs), and auditing of practices. Data were collected, and VAP rates were calculated pre- and postintervention. Results: Twenty-four VAP cases/1000 ventilator days due to multidrug-resistant Klebsiella pneumoniae were identified in April–May 2019. After the intervention in the form of training and auditing, there was a change in the behavior of healthcare workers. The hand hygiene compliance rate improved from 33% to 74%. Overall bundle adherence rate in the study period was 62.5%, with semirecumbent position (head end elevation) achieved in 95%, administration of deep vein thrombosis prophylaxis in 56%, peptic ulcer prophylaxis in more than 90% of patients, and daily oral care was achieved in 96% patients. Their VAP rate decreased to 8 cases/1000 ventilator days in June and July 2019 from 24/1000 ventilator days in April–May 2019. The difference was statistically significant (P &lt; 0.05). Conclusions: The VAP rates in TICUs were reduced by strengthening basic infection control practices.

The impact of a novel digital sun protection campaign on sun-related attitudes and behaviours of healthcare workers: A prospective observational study.

13000 cases of skin cancer are diagnosed annually in Ireland, with ultraviolet (UV) radiation exposure the strongest risk factor. Public health primary prevention campaigns focus on encouraging safe sun protective measures and skin cancer awareness. We designed a novel, digitally-animated hospital-based campaign targeting all aspects of sun-protective behaviour. To explore the sun-protective attitudes and behaviours of healthcare workers, and the effect of a digital hospital-based campaign on these findings. This was a cross-sectional prospective observational study involving hospital staff across the six hospitals that form the University of Limerick Hospital Group (ULHG). A two-phase online survey, the first taking place before campaign launch, and the second upon campaign completion. The digital campaign was displayed across all hospital sites from June to September 2021. Surveys comprised questions on sun-related attitudes and behaviours, including the internationally validated Sun Exposure Protection Index (SEPI) questionnaire. Eight hundred fifty-seven staff members completed survey 1 and 704 completed survey 2; 90% in each were female; 79% were aged 25-54; 71% reported skin types I-III. Best sun-protective habits pre-campaign included sunscreen use and avoiding sunburn, while wearing hats, protective clothing and seeking shade were least adopted. For 177 matched participants, there were small improvements in SEPI scores. SEPI Part 1 scores, reflecting improved risk behaviour, pre-campaign had a median of 11 (IQR 7), and 11 (IQR 6) post campaign. SEPI Part 2 scores, reflecting readiness to adopt sun-protective behaviours, improved from median 7 (IQR 8) to 6 (IQR 6). Post-campaign, small improvements were seen across some individual sun-protective behaviours and attitudes, particularly reducing time spent in the midday sun and on sun-seeking holidays, and improved readiness to seek shade and reduce sunbathing; 79% of all respondents post-campaign (n=556) reported raised skin cancer awareness, and 65% (n=458) said it influenced them to discuss sun protection with others. Positive improvements in attitudes and behaviours related to sun protection were seen following the digital campaign in this population of healthcare workers. These improvements along with increased willingness to discuss sun protection with others, including patients, has the potential to further benefit wider society, and supports future digital health promotion initiatives.

The impact of leadership styles on employee safety behaviour among Chinese healthcare workers: The moderating role of cooperation facilitation.

With the support of social exchange theory and social impact theory, this study aimed to examine the impact of transactional and transformational leadership on safety behaviour with the moderating role of cooperation facilitation in Chinese healthcare workers. This study used a simple random sampling method and data were collected from healthcare workers in Zhenjiang city, Jiangsu province, China. A total of 376 questionnaires were utilised and partial least squares structural equation modelling (PLS-SEM) technique was used for data analysis. The result showed that transactional and transformational leadership positively impact safety behaviour of health care workers. The findings also indicated that cooperation facilitation positively moderates the relationship between transactional and transformational leadership on safety behaviour. This study provides an insightful contribution that leadership must encourage the workers to cooperate in safety-related activities to make the work environment healthier and safer. Lastly, this study also discussed some theoretical and practical implications for researchers and policymakers.