Care Center Staff Research Articles

Child Care Center Staff Readiness to Change in an Early Childhood Obesity Prevention Program.

The childcare center (CCC) setting has the potential to be a strong foundation that supports the introduction of sustainable healthy lifestyle behaviors to prevent childhood obesity. It is important to assess barriers and facilitators to healthy weight development initiatives via program evaluation, including measuring CCC staff readiness to change. The overall goal of this study was to assess the readiness level over 1 school year among CCC staff who participated in "Healthy Caregivers-Healthy Children" (HC2), a cluster randomized controlled trial that evaluated the effectiveness of a childhood obesity prevention program from 2015 to 2018 in 24 low-income, racially/ethnically diverse centers. A secondary outcome was to assess how a CCC's stage of readiness to change was associated with CCC nutrition and physical activity environment, measured via the Environment and Policy Assessment and Observation (EPAO) tool. Mixed-models analysis with the CCC as the random effect assessed the impact of readiness to change over time on EPAO outcomes. Eighty-eight CCC teachers and support staff completed the HC2 readiness to change survey in August 2015 and 68 in August 2016. Only teachers and staff randomized to the treatment arm of the trial were included. Readiness to change and the EPAO. Results showed the majority of CCC staff in advanced stages of readiness to change at both time points. For every increase in readiness to change stage over 1 year (eg, precontemplation to contemplation), there was a 0.28 increase in EPAO nutrition scores (95% confidence interval [CI], 0.04-0.53; P = .02) and a 0.52 increase in PA score (95% CI, 0.09-0.95; P = .02). This analysis highlights the importance between CCC staff readiness to change and the CCC environment to support healthy weight development. Future similar efforts can include consistent support for CCC staff who may not be ready for change to support successful outcomes.

Emergency department staff views of NHS 111 First: qualitative interview study in England

BackgroundNHS 111 is a phone and online urgent care triage and assessment system that aims to reduce UK ED demand. In 2020, 111 First was introduced to triage patients before...

Lower Emotional Exhaustion among Employees Is Associated with Intentional Incorporation of Animals into Residential Care Settings

Secondary effects of animal-integrated programming on residential care center (RCC) staff and organizational culture are not well understood. We explored emotional exhaustion among RCC employees both in facilities that incorporated animals and those that did not incorporate animals into the therapeutic environment. We conducted a survey throughout a large midwestern RCC system in the United States to determine relationships between organizational culture, emotional exhaustion, and the intentionality by which animals were incorporated into programming. Data were analyzed by examining associations between variables of interest using chi-square or t-tests, and linear mixed-effects modeling was used to identify potential confounding effects due to differences in children served within RCCs. Staff from RCCs that used animals intentionally reported lower emotional exhaustion (p = 0.006), and higher average workplace safety (p = 0.024) and psychological safety (p < 0.001). Integrating animals into RCC programming is associated with elements of a strong organizational culture. It is possible that animal-integrated programming has a positive impact on the facility culture and workforce, and/or that RCCs with strong pre-existing cultures are more likely to use animal-integrated programming.

The Awareness towards Safety and Health of Children among Child Care Centre Staff

The focus of this paper is to measure the awareness towards safety and health (SH) of children among Child Care Centre (CCC) staff and owners. The SH of children who stayed in CCC while their parents are working should be taken seriously. When choosing the CCC, considerations for safety and health should be considered in addition to the CCC's price and location. This study used the quantitative technique with 119 respondents, including owners and employees of CCC who voluntarily enrolled in the risk assessment course for owners and employees of CCC. In conclusion, the majority of respondents were unable to distinguish between risk and hazard in the CCC before enrolling in the course and will require additional training in the future on safety and health.

Training of health referents at child care centers. Experience in Argentina.

An adequate child care helps to mitigate the effects of social adversity. Health prevention is a part of it. This is an innovative training program for health referents in child care centers that cater to vulnerable populations in Buenos Aires, Argentina. It consisted in training child care center staff, followed by the implementation, over 4 months, of an improvement plan developed by each participant in their center, with ongoing advisory support. In total, 26 participants from 19 centers completed the program. In total, 35 out of 49 goals proposed in the plans were achieved, including the certification in cardiopulmonary resuscitation, staff and family training, development of center policies, and improved resource management. Preventive care offered in child care centers may be improved via a simple and inexpensive intervention, including in unfavorable conditions.

The experiences of early childhood development care centre staff in providing care and learning support in a low socioeconomic community in South Africa

ABSTRACT The aim of this study was to explore the experiences of early childhood development (ECD) centre staff in providing care and learning support to children living in a high-risk, low socioeconomic community. We interviewed 14 staff from an ECD centre. Interviews were audio-recorded, transcribed verbatim and analysed thematically. We derived four over-arching themes which demonstrated contextual-, parent-, child- and staff-related factors that influenced ECD staff’s daily work experiences. Challenges relating to poverty, violence, trauma, and substance exposure cut across each theme. Providing a safe and nurturing learning place for children was essential to staff and allowed them an opportunity to deal with some challenges. Characteristics of staff such as passion, resourcefulness, and commitment, went a long way in providing motivation to overcome challenges. Finding ways to support ECD staff working in low socioeconomic environments are important avenues for further research to prevent staff burnout, and to promote optimal child development.

Child Care Center Hand Hygiene Programs' Cost-Effectiveness in Preventing Respiratory Infections.

We previously demonstrated that a hand hygiene program, including hand sanitizer and educational measures, for day care center (DCC) staff, children, and parents was more effective than a soap-and-water program, with initial observation, in preventing respiratory infections (RIs) in children attending DCCs. We analyzed the cost-effectiveness of these programs in preventing RIs. A cluster, randomized, controlled and open study of 911 children aged 0 to 3 years, attending 24 DCCs in Almeria. Two intervention groups of DCC-families performed educational measures and hand hygiene, one with soap-and-water (SWG) and another with hand sanitizer (HSG). The control group (CG) followed usual hand-washing procedures. RI episodes, including symptoms, treatments, medical contacts, complementary analyses, and DCC absenteeism days, were reported by parents. A Bayesian cost-effectiveness model was developed. There were 5201 RI episodes registered. The adjusted mean societal costs of RIs per child per study period were CG: €522.25 (95% confidence interval [CI]: 437.10 to 622.46); HSG: €374.53 (95% CI: 314.90 to 443.07); SWG: €494.51 (95% CI: 419.21 to 585.27). The indirect costs constituted between 35.7% to 43.6% of the total costs. Children belonging to the HSG had an average of 1.39 fewer RI episodes than the CG and 0.93 less than the SWG. It represents a saving of societal cost mean per child per study period of €147.72 and €119.15, respectively. The HSG intervention was dominant versus SWG and CG. Hand hygiene programs that include hand sanitizer and educational measures for DCC staff, children, and parents are more effective and cost less than a program with soap and water and initial observation in children attending DCCs.

The future of dentistry post-COVID-19: perspectives from Urgent Dental Care centre staff in England.

Introduction While routine dentistry was suspended during the COVID-19 pandemic, Urgent Dental Care centres (UDCs) were established to support patients with urgent dental needs.Aim The study aimed to provide insights and recommendations on future dental reform based on the perspectives of frontline staff delivering dental care in UDCs.Method A qualitative research study using a phenomenological approach. A hybrid approach that incorporated both a deductive and an inductive approach to analysis was adopted.Results The sample included 29 dentists and nine dental nurses providing care at UDCs in England during the pandemic. The following predominant themes were identified: patient care and access, practice viability, workforce sustainability, identity of dentistry and contract reform.Conclusions The pandemic has highlighted the desire from the dental profession for urgent reform of the current NHS dental contract in England. This was directed towards a more resilient, responsive and equitable dental service that is better prepared for current and future challenges.Supplementary InformationZusatzmaterial online: Zu diesem Beitrag sind unter 10.1038/s41415-021-3405-1 für autorisierte Leser zusätzliche Dateien abrufbar.

Frontline experiences and perceptions of Urgent Dental Care centre staff in England during the COVID-19 pandemic: a qualitative study.

Introduction Following the World Health Organisation declaration of COVID-19 as a global pandemic, routine dental care in the UK ceased, and Urgent Dental Care centres (UDCs) were established to offer remote and face-to-face urgent dental treatment for those in need.Aim To explore perceptions and psychosocial experiences of frontline staff providing care at UDCs in England during COVID-19.Method A qualitative research study using a phenomenological approach. Semi-structured interviews were conducted remotely. Using line-by-line coding, data were analysed using a hybrid approach that incorporated both a deductive, theoretical process and an inductive, data-driven process.Results Participants included 29 dentists and nine dental nurses from UDCs across England. Twelve themes were identified and grouped into positive and negative experiences. Positive experiences were: role fulfilment and having a sense of purpose; team unity and collective coping strategies; and strategic teamwork and preparedness for effective organisation of care. Negative experiences included: feeling undervalued and frustrated due to fragmented guidance and communication; sense of unfairness generated by relational challenges; patient demand outstripping UDC capacity; complex decision-making; uncertainty over safety; suffocating PPE hindering effective communication; ineffective communication channels across healthcare sectors; lack of commitment to remote video consultations; and variable referral quality.Conclusions Participants reported experiencing a number of emotional challenges that appeared to be exacerbated by an unsupportive environment, often due to lack of leadership. However, positive experiences and coping strategies were also identified. Collective and sustained efforts at system level to improve the resilience and mental wellbeing of the current and future dental workforce and integration of dentistry into wider healthcare infrastructures are needed.Supplementary InformationZusatzmaterial online: Zu diesem Beitrag sind unter 10.1038/s41415-021-3375-3 für autorisierte Leser zusätzliche Dateien abrufbar.

Assessment of Attitude of Primary Care Medical Staff Toward Patient Safety Culture in Primary Health-care Centers--Al-Ahsa, Saudi Arabia.

IntroductionAn effective leadership is critical to the development of a safety culture within an organization. Patient safety in primary health care is an emerging field of research of increasing importance.ObjectiveThis study has been conducted to explore the safety culture attitude toward patient safety to improve the quality and patient safety in primary health-care centers.MethodsA cross-sectional survey involving 288 medical staff in primary health-care centers in Al-Ahsa was conducted using an Arabic translated safety attitude questionnaire to assess the safety attitudes among health care center staff toward patient safety culture.ResultsThis study showed that the attitude of medical staff in primary health-care centers is somewhat positive toward patient safety culture where the average of job satisfaction score in the current study was higher at 80% and the overall score for safety climate was 68%. The overall score for safety attitudes was highest in Al-Ayoun Health Center (79%) and lowest in Al Faisaliah Health Center (58%). The score of teamwork and stress recognition was high and statistically significant (p<0.05) among females. However, staff perception toward management was significantly higher (p<0.05) among males. Staff perception toward management was significantly low (p<0.05) among clinicians. The overall score for safety attitudes was remarkably high (p<0.05) among those with less than 10 years' experience, the overall safety culture score was significantly high (p<0.05) among administrative staff and all correlations were significant (p<0.01) except for recognition of stress with teamwork, job satisfaction, management perception, and safety climate. In addition, there were different attitudes toward patient safety culture between gender and physician vs non-physician and management staff vs non-management staff.ConclusionThe findings suggested that certain improvements are needed, especially in the field of communication and stress recognition with regard to patient safety culture.

Comparative Study of Occupational Burnout and Job Stress of Frontline and Non-Frontline Healthcare Workers in Hospital Wards during COVID-19 Pandemic.

Background:Paying attention to the issue of mental health in the workplace, especially with current pandemic conditions of COVID-19 is of significant importance. Therefore, this study aimed to determine the factors affecting occupational burnout among health care center staff during the pandemic of coronavirus infection.Methods:The present study was a case-control study carried out in the first half of the year 2020 on medical staff working in hospitals in Tehran. The sample size was 324 individuals, including 175 employees working in general (non-COVID) wards and 149 people working in COVID-19 wards. Demographic characteristics questionnaire and two standard questionnaires of Maslach Burnout Inventory and Parker and DeCotiis Job Stress Scale were distributed.Results:Total score of job stress and its two dimensions (time and pressure) had a significant relationship with different levels of occupational burnout. Logistic regression analyses showed significant relations between job stress with emotional exhaustion (95% CI, 1.11–1.19, OR=1.15) and depersonalization. Participants in both wards experienced statistically significant increasing trends given the different components of occupational burnout concurrently by increasing their total stress score.Conclusion:Hospital staff’s levels of stress and occupational burnout regardless of where they worked (COVID-19 wards or general wards) were not significantly different and existed among the members of both groups. On the other hand, job stress and its dimensions (time pressure and anxiety) had a significant relationship with the main dimensions of occupational burnout.

A Survey on the Awareness of Occupational Therapists by the Adult Day Care Center Staff in Korea: Focusing on Managers or Center Directors

A Survey on the Awareness of Occupational Therapists by the Adult Day Care Center Staff in Korea: Focusing on Managers or Center Directors

Knowledge and attitudes toward infant BLS among babysitters and nursemaids working in rural northwest Jordan

Objectives: This study aimed to assess the knowledge and attitude of babysitters and nursemaids toward providing basic life support (BLS) to infants. Setting: This study was conducted at registered nurseries and daycare centers in rural northern Jordan. Participants: The study involved a convenience sample of 77 child caretakers who were looking after infants. Results: Findings showed that majority of participants were unaware of skills needed to manage foreign body aspiration or administer cardiopulmonary resuscitation on infants. More than two-thirds of the participants had never attended any training or educational session on managing foreign body aspiration among infants. Conclusions: The findings indicated that caregivers in kindergartens and nurseries in rural areas in Jordan lacked awareness of safe infant care. Basic resuscitation skills for urgent cases were insufficient, which could increase the risk of sudden and unexpected child death. Thus, this study strongly recommends training, such as a course on infant life support, for babysitters and care center staff.

Data Integrity-Based Methodology and Checklist for Identifying Implementation Risks of Physiological Sensing in Mobile Health Projects: Quantitative and Qualitative Analysis.

BackgroundMobile health (mHealth) technologies have the potential to bring health care closer to people with otherwise limited access to adequate health care. However, physiological monitoring using mobile medical sensors is not yet widely used as adding biomedical sensors to mHealth projects inherently introduces new challenges. Thus far, no methodology exists to systematically evaluate these implementation challenges and identify the related risks.ObjectiveThis study aimed to facilitate the implementation of mHealth initiatives with mobile physiological sensing in constrained health systems by developing a methodology to systematically evaluate potential challenges and implementation risks.MethodsWe performed a quantitative analysis of physiological data obtained from a randomized household intervention trial that implemented sensor-based mHealth tools (pulse oximetry combined with a respiratory rate assessment app) to monitor health outcomes of 317 children (aged 6-36 months) that were visited weekly by 1 of 9 field workers in a rural Peruvian setting. The analysis focused on data integrity such as data completeness and signal quality. In addition, we performed a qualitative analysis of pretrial usability and semistructured posttrial interviews with a subset of app users (7 field workers and 7 health care center staff members) focusing on data integrity and reasons for loss thereof. Common themes were identified using a content analysis approach. Risk factors of each theme were detailed and then generalized and expanded into a checklist by reviewing 8 mHealth projects from the literature. An expert panel evaluated the checklist during 2 iterations until agreement between the 5 experts was achieved.ResultsPulse oximetry signals were recorded in 78.36% (12,098/15,439) of subject visits where tablets were used. Signal quality decreased for 1 and increased for 7 field workers over time (1 excluded). Usability issues were addressed and the workflow was improved. Users considered the app easy and logical to use. In the qualitative analysis, we constructed a thematic map with the causes of low data integrity. We sorted them into 5 main challenge categories: environment, technology, user skills, user motivation, and subject engagement. The obtained categories were translated into detailed risk factors and presented in the form of an actionable checklist to evaluate possible implementation risks. By visually inspecting the checklist, open issues and sources for potential risks can be easily identified.ConclusionsWe developed a data integrity–based methodology to assess the potential challenges and risks of sensor-based mHealth projects. Aiming at improving data integrity, implementers can focus on the evaluation of environment, technology, user skills, user motivation, and subject engagement challenges. We provide a checklist to assist mHealth implementers with a structured evaluation protocol when planning and preparing projects.

Modeling specialty medicine access: Understanding key health system processes and players

ObjectivesTo map the specialty medicine process from prescription writing to the patient obtaining medication, identify perceived barriers to access, and highlight potential opportunities for improved efficiency as understood from the perspective of 3 key stakeholder groups: specialty disease clinicians, staff members, and specialty pharmacists. DesignQualitative research study using semi-structured individual interviews. Setting and participantsInterviews were conducted at a single large tertiary care center targeting clinicians and staff in the hepatitis C, oncology, cystic fibrosis, multiple sclerosis, and rheumatoid arthritis clinics. The second set of participants was pharmacists and technicians at specialty community pharmacies within one large retail chain that was not directly affiliated with the health system. ResultsFour conceptual models of specialty medicine access were described by participants. These models varied by disease state, available human resources, and medication. Clinics and specialty pharmacies were not fully aware of the others’ systems and contributions to the specialty medicine access process. Perceptions of inefficient communication resulted in frustration and higher perceived work burden. ConclusionThere is not a single streamlined pathway for clinics and patients to access specialty medicines in health systems that do not own their own specialty pharmacies. The current system architecture can lead to duplicative work, challenges in communication, and other inefficiencies. Future interventions should focus on streamlining communications between specialty pharmacies, clinics, manufacturers, and payors to create the most efficient access to specialty medicines.

Perceptions of Collaboration for Facilitating Judicial Social Work Among Community Comprehensive Care Center Staff, Attorneys and Judicial Scriveners

Perceptions of Collaboration for Facilitating Judicial Social Work Among Community Comprehensive Care Center Staff, Attorneys and Judicial Scriveners

8 Different approaches needed to manage ED demand among different age-groups

Background/objectivesA variety of interventions have been proposed to manage rising demand for Emergency and Urgent Care, described by an NHS England review as unsustainable in the long term. However it...

Staff Workshop Improves Child Care Center Menus in South Central Texas: A Best Food for Families, Infants, and Toddlers (Best Food FITS) Intervention

ObjectiveTo assess the efficacy of an educational workshop for child care center staff to improve menus. MethodsStaff from 18 centers attended a nutrition educational workshop that included an activity that compared center menus to MyPlate standards. Four weeks of menus collected before and after the workshop were imported into SuperTracker; the Food Details report produced menu data clustered by day and center. Changes in pre-post menus were assessed using Healthy Eating Index scores and the SAS software macro, MIXCORR. ResultsAfter the workshop, there was a lower probability that fruit juice (P = .03) and starchy vegetables (P = .004) and a higher probability that non-starchy vegetables (P < .001) and whole grains (P = .004) were on menus; amounts of refined grains (P = .004), savory snacks (P < .001), and cheese (P = .004) were significantly lower. Total Healthy Eating Index scores improved after the workshop (P = .009). Conclusions and ImplicationsComparing 4 weeks of menus revealed menu changes. Workshop interventions show promise for improving children's health.

Pulmonary Hypertension Care Center Network: Improving Care and Outcomes in Pulmonary Hypertension

Pulmonary hypertension (PH) is a chronic, progressive, life-threatening disease that requires expert multidisciplinary care. To facilitate this level of care, the Pulmonary Hypertension Association established across the United States a network of pulmonary hypertension care centers (PHCCs) with special expertise in PH, particularly pulmonary arterial hypertension, to raise the overall quality of care and outcomes for patients with this life-threatening disease. Since the inception of PHCCs in September 2014, to date 35 centers have been accredited in the United States. This model of care brings together physicians and specialists from other disciplines to provide care, facilitate basic and clinical research, and educate the next generation of providers. PHCCs also offer additional opportunities for improvements in PH care. The patient registry offered through the PHCCs is an organized system by which data are collected to evaluate the outcomes of patients with PH. This registry helps in detecting variations in outcomes across centers, thus identifying opportunities for improvement. Multiple tactics were undertaken to implement the strategic plan, training, and tools throughout the PHCC network. In addition, strategies to foster collaboration between care center staff and individuals with PH and their families are the cornerstone of the PHCCs. The Pulmonary Vascular Network of the American College of Chest Physicians believes this to be a positive step that will improve the quality of care delivered in the United States to patients with PH.

Integrated Pest Management Intervention in Child Care Centers Improves Knowledge, Pest Control, and Practices

IntroductionTo reduce young children's exposure to pests and pesticides, an integrated pest management (IPM) intervention was provided for child care center staff. MethodsThe 7-month IPM education and consultation intervention was conducted by trained nurse child care health consultants in 44 child care centers in California. IPM knowledge surveys were completed by child care staff, objective IPM assessments were completed by research assistants pre- and postintervention, and activity logs were completed by the nurses. ResultsThere were significant increases in IPM knowledge for the child care staff who attended workshops. There were reductions in the prevalence of pests and increases in IPM practices at the postintervention compared with the preintervention time point. The nurses consulted an average of 5.4 hours per center. DiscussionA nurse-led IPM intervention in child care centers can reduce exposure to harmful substances for young children attending child care centers.