Behavior Of Healthcare Workers Research Articles

Nursing practice of guidelines for prevention and control of 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 IV 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.

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.

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

AbstractBackground13 000 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.ObjectivesTo explore the sun‐protective attitudes and behaviours of healthcare workers, and the effect of a digital hospital‐based campaign on these findings.MethodsThis 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.ResultsEight 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.ConclusionsPositive 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.

Normalized Deviance from Approved Personal Protective Equipment (PPE) Donning and Doffing Protocol—Towards a Hazard Reduction Index

Introduction:Reusing PPE is not recommended but was common during COVID-19 pandemic. Limited guidance on proper PPE use and its reuse heightened the hazards to health care worker (HCW) safety. Emerging data on PPE use suggests that most HCWs were contaminated by donning and doffing of PPE while adhering to standards of care.Method:A prospective observational study was conducted to understand HCW behaviors in donning, doffing, and reusing PPE. Emergency Department physicians and nurses were video-recorded donning, doffing, and reusing PPE within a simulated acute care environment. Participants performed five donning and doffing PPE procedures. PPE kit included gown, face shields, and N95 respirator masks. Participants had access to disposable gloves and hand sanitizer. Recordings were reviewed and coded independently by two trained coders based on checklist of key behaviors. Agreement between coders was high (81.9%). All participants reported completing PPE training.Results:28 videos of participants capturing 278 procedures were reviewed. None of the participants followed the CDC’s order for donning across five scenarios. Majority of participants failed to perform hand hygiene before donning or re-donning PPE or when doffing PPE. For contaminant spread risk, 92.85% (n=26) touched patient-facing side of PPE during re-donning and/or doffing PPE (M= 3.75, SD= 2.37, Median = 4; 0-9 times). The most common area of self-contamination was hands (n= 111 across all participants in 5 donning/doffing sequences). Touching patient-facing side of PPE was more likely to occur during donning than doffing (70.5% vs. 20.1% of sequences).Conclusion:The study found wide variation in PPE donning/doffing practices among HCW in violation of CDC guidance. This first study to review PPE reuse through a human factors lens, identifyied deviant behaviors that contribute to HCW self-contamination. Efforts are needed to redesign PPE and develop effective ways to train staff using PPE equipment safely.

SG-APSIC1127: Digital transformation of the central sterile supply department: Justify by tracking system

Background: Avoidable infections in healthcare (healthcare-associated infections or HAIs) occur globally. The causes of HAI are influenced by a complex combination of gaps in policies, infrastructure, organization, knowledge, healthcare worker behavior, and patient-related factors. Through knowledge, best practices, and infrastructure improvement, the infection prevention and control (IPC) team aims to prevent harm to patients and healthcare workers due to HAIs. The most common HAIs are surgical site infections (SSIs) caused by harmful device-reuse practices, inadequate sterilization, and/or inadequate decontamination procedures. Disinfection and sterilization of instruments and medical devices play very important roles in HAI and SSI prevention. World Health Organization (WHO) Collaborating Centre in Quality Improvement Program certification, the first pilot project in Thailand, included the Central Sterilizing Services Association of Thailand and 15 hospital central sterile supply departments (CSSDs). This quality improvement program for sterilization reprocessing aimed to prevent harm to patients and healthcare workers due to HAIs. Objectives: We sought to reduce damage to instruments caused by inadequate reprocessing sterilization to zero incidents. We sought to reduce inadequate packing to ≤3 events per month. We sought to reduce the need to resterilize instruments by &gt;80%. Methods: A root-cause analysis meeting was held by CSSD staff, and an IT vendor was consulted about developing an electronic alert system. The following changes were implemented: Staff packed instruments using a list of pictures for each set. Sticker labels were applied showing the proper number of pieces in the set. Identification O-rings were added to instruments with inventory dates, serial numbers, and instructions for use. Stickers were added to indicate the method of sterilization, such as ethylene oxide gas only or hydrogen peroxide only. Results: Reports of damage due to the sterilization process decreased to zero. No events related to the packing process were reported, and resterilization of instruments decreased by 98.94%. Conclusions: In this project, we implemented a quality improvement process and tracking system, reduced defects, and increased healthcare worker competency to improve patient safety.

Analysis of Knowledge, Attitudes and Behaviours of Health Care Workers towards Vaccine-Preventable Diseases and Recommended Vaccinations: An Observational Study in a Teaching Hospital.

Background: Recommended vaccinations are the cheapest and most effective measure to reduce the risk of transmission and related complications, especially in high-risk healthcare settings. This study aimed to evaluate the knowledge, attitudes and behaviours of HCWs in relation to national recommendations. Methods: A transversal study was conducted through administration of a questionnaire by personal interview. The following care units were involved: Paediatric, Neonatal, Cardiac Surgery and General Intensive Care Units and Infectious Diseases Unit. Results: The study sample comprised 308 HCWs. Half the sample were aware of the vaccination recommendations, with occupation and age found to be predictive factors (OR = 9.38, 95%CI: 2.07−42.41; OR = 0.36, 95%CI: 0.22−0.60). A higher percentage defined the diseases as a risk for their patients’ health, although this perception was lower in the over-40 age group. In several cases, there were statistically significant differences between the care units (p < 0.001). Around three-quarters of the sample agreed that vaccination should be mandatory; willingness to undergo a future booster vaccination was statistically correlated with the variables of age and care unit (p < 0.001, p = 0.03). Conclusion: The protection of health in the workplace can be achieved through some strategic actions, such as the implementation of educational strategies, and protocols for the monitoring of immunocompetence and the improvement of vaccination.

Patient Safety Culture and Speaking Up Among Health Care Workers

Although previous research showed the importance of safety culture on health care workers' speaking up behaviors, it is not clear how particular safety culture domains are associated with the speaking up behaviors of hospital staff. Also, researchers have suggested that health care workers' speaking up behaviors vary by profession, but there has been limited research into such differences. Thus, this study examined differences in perceptions of patient safety culture and the promotive and prohibitive speaking up behaviors of health care workers by profession and investigated the relationships between patient safety culture and the two types of speaking up behaviors. A descriptive correlational study was conducted using secondary data collected through an online survey of health care workers at a private, nonprofit, tertiary-level teaching hospital in South Korea. The sample (N=831) consisted of nurses (54.0%), physicians (13.0%), and other licensed and unlicensed hospital personnel (33.0%). Analyses of variance were conducted to examine differences in study variables by profession. Hierarchical regression analyses were conducted to evaluate the effects of the seven patient safety culture factors on promotive and prohibitive voice after controlling for tenure and profession. Perceptions of safety culture and promotive voice behaviors were higher for physicians compared with nurses. Communication openness, reporting patient adverse events, and unit supervisors' and hospital managements' support for patient safety were significant predictors of both types of voice behaviors. Hospital administrators and unit managers should create a supportive environment where staff feel free to voice their concerns and suggestions. They should also pay attention to the varying perspectives held by different groups of hospital workers and their different voice behaviors. Knowing which dimensions of patient safety culture are most strongly related to health care workers' voice behaviors can guide patient safety improvement activities in health care organizations.