Commitment Of Healthcare Workers Research Articles

"Well, I Signed Up to Be a Soldier; I Have Been Trained and Equipped Well": Exploring Healthcare Workers' Experiences during COVID-19 Organizational Changes in Singapore, from the First Wave to the Path towards Endemicity.

(1) Background: As COVID-19 transmission continues despite vaccination programs, healthcare workers (HCWs) face an ongoing pandemic response. We explore the effects of this on (1) Heartware, by which we refer to morale and commitment of HCWs; and identify how to improve (2) Hardware, or ways of enabling operational safety and functioning. (2) Methods: Qualitative e-diary entries were shared by HCWs during the early phases of the outbreak in Singapore from June to August 2020. Data were collected via an online survey of n = 3616 HCWs of all cadres. Nine institutions—restructured hospitals (n = 5), affiliated primary partners (n = 2) and hospices (n = 2)—participated. Applied thematic analysis was undertaken and organized according to Heartware and Hardware. Major themes are in italics (3) Results: n = 663 (18%) HCWs submitted a qualitative entry. Dominant themes undermining (1) Heartware consisted of burnout from being overworked and emotional exhaustion and at times feeling a lack of appreciation or support at work. The most common themes overriding morale breakers were a stoic acceptance to fight, adjust and hold the line, coupled with motivation from engaging leadership and supportive colleagues. The biggest barrier in (2) Hardware analysis related to sub-optimal segregation strategies within wards and designing better protocols for case detection, triage, and admissions criteria. Overall, the most cited enabler was the timely and well-planned provision of Personal Protective Equipment (PPE) for front-liners, though scope for scale-up was called for by those not considered frontline. Analysis maps internal organizational functioning to wider external public and policy-related narratives. (4) Conclusions: COVID-19 surges are becoming endemic rather than exceptional events. System elasticity needs to build on known pillars coupling improving safety and care delivery with improving HCW morale. Accordingly, a model capturing such facets of Adaptive Pandemic Response derived from our data analyses is described. HCW burnout must be urgently addressed, and health systems moved away from reactive “wartime” response configurations.

Concerns, attitudes, and intended practices of Caribbean healthcare workers concerning COVID-19 vaccination: A cross-sectional study

SummaryBackgroundThe Caribbean has a long history of being a global leader in immunization, and one factor contributing to this success has been the commitment of healthcare workers in promoting the benefits of vaccines. Healthcare workers play a critical role in building trust between the public and the immunization program and are generally cited as the most trusted source of information on vaccination. Healthcare workers themselves, therefore, must be confident in vaccination as a public health good and able to transmit this confidence to those who trust them. However, just as with the general public, healthcare workers develop confidence at different rates and may be susceptible to misinformation about vaccines.MethodsDuring April and May 2021, the Pan American Health Organization (PAHO) conducted a mixed-methods survey to assess vaccination attitudes, opinions, and reasoning of 1197 healthcare workers across 14 Caribbean countries.FindingsSeventy-seven percent of respondents expressed clear intention to be vaccinated for COVID-19 as soon as possible. Intention to be vaccinated as soon as possible was expressed by lower proportions of nurses (66%) and allied health professionals (62%) than physicians (85%) and by younger respondents than older ones (64% vs. 85%, respectively; p < 0.001 for all these comparisons). Across 32 questions about attitudes and opinions, vaccine hesitancy was consistently expressed by higher proportions of nurses and allied health professionals than physicians and by younger respondents than older ones.InterpretationInsights from the survey are helping PAHO address healthcare worker concerns with informative messages and supporting countries in policy development to increase vaccine confidence and coverage among Caribbean healthcare workers.FundingThis work has been sponsored by the World Health Organization/Pan American Health Organization, the Government of Germany and The Gavi Alliance.

The Incidence of Enterobiasis in Children Attending Educational Institutions of the Tyumen Region

Introduction: Enterobiasis remains a predominant invasion in the structure of parasitic diseases. At the same time, judging by the incidence rates of enterobiasis, the activity of the epidemic process differs significantly from one region to another and even between cities of one and the same region. The purpose of our study was to assess the intensity of the epidemic process of enterobiasis based on incidence rates and pinworm testing coverage in children aged 3 to 6 years attending preschools and schoolchildren aged 7 to 14 years in the Tyumen Region. Materials and methods: We analyzed data on the incidence of enterobiasis (per 100 thousand population) and pinworm testing coverage (%) per 100 children of two age groups (3 to 6 and 7 to 14 years old) by municipalities of the Tyumen Region in 2013–2017. The interval data were analyzed using methods of variation statistics. To test the hypothesis that the differences between samples were random, a univariate analysis of variance was used. Additionally, the mean difference was calculated and its 95 % confidence interval was determined. The strength of the relationship between two variables was measured using the coefficient of determination, i.e. the square of the Pearson correlation coefficient. Results: We gave a comparative characteristic of the intensity of the epidemic process of enterobiasis based on the incidence and pinworm testing coverage data in 3 to 14-year-old children attending educational institutions of the Tyumen Region in 2013–2017 and assessed the deterministic relationship between the incidence rates of enterobiasis and the commitment of healthcare workers to pinworm detection testing in organized groups of children. Conclusions: We established that the incidence of pinworm infection in the child population of the Tyumen Region differed significantly between the administrative territories. It should be noted, however, that a relatively high incidence of enterobiasis in some areas was mainly attributed to a high pinworm testing coverage of children while in other areas a low coverage underestimated the incidence rate of enterobiasis and created a false impression of epidemiological welfare.

Revisions in TB programme - boon or bane? A qualitative study exploring barriers and facilitators among health care workers in private and public sector, Kerala

BackgroundDespite many serious and organized efforts worldwide, Tuberculosis (TB) remains one of the major public health concerns in many countries. India accounts for more than one quarter of global TB cases and deaths each year. India's National Tuberculosis Elimination Programme (NTEP) is the largest TB control program in the world, placing more than 100,000 patients on treatment every month. There have been so many revisions in the programme guidelines in the last 5 years. As we are gearing up for TB elimination in India, knowledge regarding the barriers is very crucial in the successful undertaking of these revised guidelines. Exploring perceptions of health care workers, both from the private and public sector will help to design appropriate strategies at the field level. ObjectiveTo explore the barriers and facilitators among health care workers in the implementation of revised NTEP guidelines in a selected district of central Kerala. MethodologyThis qualitative study was conducted among health care workers from all levels involved in the implementation of NTEP from private and public sector. Qualitative data was collected through Focus Group Discussions (FGD) and Key Informant Interviews using a topic guide till data saturation. All discussions were audio recorded with the consent of participants. Sociogram was plotted to confirm equal participation of interviewees. A total of 4 FGDs (2 from each sector) and 12 Key informant interviews (7 from public sector and 5 from private sector) were conducted after obtaining written consent from the participants. ResultsOverall awareness about revisions was found to be good. However, the study identified a “Gap between planners and implementers”. Frequent nature of revisions without understanding the practical difficulties in the field, additional job responsibilities, inadequate knowledge among grass root level workers/private practioners in small clinics and increased side effects were the major barriers identified. In addition to that, insufficient logistics, not enthusiastic in learning revisions, fear of losing patients, delay in communication, decreased compliance with new regimen, increased out of pocket expenditure and grey areas in the current guidelines were also adversely affecting the successful implementation At the same time, facilitators like positive attitude and commitment of health care workers, introduction of M-health technology, strong public private partnership, inclusion of costly investigations in the revised guidelines, good administrative support, financial assistance, innovative initiatives like Treatment Support Groups (TSGs) and concept of Family Directly Observed Treatment Short-Course increased the effectiveness of the programme to a large extent. ConclusionThe study identified gaps in knowledge, attitude and practice of revised guidelines at the field level. Gap between ‘Planners and implementers could impede the successful implementation of TB Elimination programme and needs to be addressed.

Prevention of Neonatal healthcare-associated infections: Current update

Looking at the neonatal mortality due to infectious diseases like sepsis and healthcare-associated infections (HAIs) in India. It is necessary to collate the evidence that is feasible to practice in the Indian healthcare system to prevent further morbidity or related mortality. This review focuses on the levels of evidences and the practices followed in neonatal settings to prevent HAIs. The articles published in a peer-reviewed journal published in the last 20 years were included. Articles were focusing more on central line-associated bloodstream infections, catheter-associated infections, and non-specific HAIs. There is dearth of studies related to VAP prevention and its effect among neonates. Many articles focused on hand washing practices, surveillance, continuous educational program and adherence to it is the prime focus to prevent HAIs. Monitoring using checklist is one of the tool practiced at many settings but with lot of challenges. We conclude that multimodal integrated approach by active and passive surveillance, hand washing practices and commitment of healthcare workers following the set policy can bring a change in the current status of neonatal mortality due to HAIs.

Challenges and Adherence to Standard Precautions for Prevention of Percutaneous Injuries and Exposure to Blood Borne Pathogens in Clinical Practice: A Review

Background: Standard Precautions (SP) was introduced by Centre for Disease Control to minimise the risks of disease transmission in the process of healthcare. Many factors are thought to influence the knowledge and the practice of these measures. Objective: To review challenges and adherence to SP for the prevention of percutaneous injuries and exposure to patients’ blood in clinical practice. Methods: The World Wide Web sites such as, Pub Med central, Google scholar were searched using key words such as percutaneous, needle stick injuries, standard precautions, adherence. Relevant articles were reviewed and included based on defined criteria. Results: The prevalence of needle stick injuries (NSI) varies among health care workers (HCWs) and across countries and is as high as 73% among some groups. The knowledge of SP varied among HCWs in different nations; however the practice of SP was noted to be lower than knowledge across most studies. Majority of HCWs in developing countries that sustained NSI failed to report the incident to appropriate authorities. Adherence to Standard Precautions is influenced by lack of proper training, poor supplies, low commitment of HCWs and health facility managers etc. Conclusion: Needle stick injuries and exposure to patients’ blood remain a risk for disease transmission among HCWs. Despite appreciable knowledge of standard precautions, the practice has remained low across the globe. Factors that had positive influence on practice of SP such as use of devices with safety features, adherence to infection control guideline, comfortable working environment, repeated and intense training etc. should be adopted and promoted.

The Role of Spiritual Leadership and Professional Ethics in Organizational Commitment of Health Care Workers

Background and Aim: Spiritual leadership positively and significantly effects on spiritual well-being and organizational-personnel performance variables, through drawing faith in a vision and culture of excellence. The purpose of this study was to investigate the role of spiritual leadership and professional ethics in the organizational commitment of health care workers. Materials and Methods: In this descriptive-correlational study, the statistical population consisted of all health care workers who work in health facilities of the Urmia, Iran, in 2017. The sample size was estimated 240 people by Morgan table. Stratified random sampling method, and Fry’s Spiritual Leadership, Ghasemzadeh’s professional ethics and organizational Allen and Meyer ’ s commitment Questionnaire were used to collect data. SPSS 22 and Amos statistical soft wares were used to analyze the data. Findings: The direct effect of the spiritual leadership on professional ethics (0.37) and organizational commitment of the health care workers was significant (p=0.01). The direct effect of the spiritual leadership on organizational commitment of health care workers (0.69) also was significant (p=0.01). The indirect effect of the spiritual leadership on organizational commitment of health care workers also was significant (p=0.01). The fitting of the predictive model of the research variables was relatively good (62%) and suggests the alignment of the fitted model with the theoretical community of research. Conclusion: Based on the findings, it can be concluded that spiritual leadership influences on the organizational commitment of health care workers with the mediation role of professional ethics. Please cite this article as: Zahed Babelan A, Khaleg Khah A, Kazemi S, Gharibzadeh R. The Role of Spiritual Leadership and Professional Ethics in Organizational Commitment of Health Care Workers. Bioethics Journal 2017; 7(26): 23-30.

Lavado de manos: experiencias de dos comunidades autónomas

The Spanish Ministry of Health in accordance with WHO guidelines, promotes hand washing in hospitals, with the objective of reinforcing the commitment of health care workers to hand washing. In this study we described the results of the actions implemented in two communities, which were aimed at increasing hand-washing compliance among health care workers by means of a multimodal improvement programme. Cantabrian and Murcian health services. The project was carried out in three phases. Phase I: analysis of preimplantation situation by means of an observational study in open care units, and a cross study of self-perceived compliance to hand hygiene with a questionnaire. Phase II: Implementing of training plan and promoting the use of alcohol-based solutions. Phase III: Reassessment of the results achieved by means of a post- intervention observational study. There has been a significant increase in frequency of hand washing adherence in both communities. 40.5% 95% CI [38.2-42.4] vs. 46.2% 95% CI [44.0-48.4] (p < .001) in Cantabria, and 43% vs. 54% in Murcia. The need to implement recommendations must continue to be emphasized and new interventions developed to increase health workers compliance, as well as promote educational policies and ease of access to alcohol-based solutions.

Bioethical aspects of end-of-life care

Managing end-of-life care can be difficult because of the particular nature of intensive care support, which can separate the biological and the biographical aspects of life. Artificial organ support can temporarily delay death but, at the same time, may fail to restore a quality of life that the patient judges acceptable. For this reason, two concepts must be considered: that the mission of the healthcare system should be to care for patients according to their interests and wishes and that quality of care is related above all to the careful commitment of healthcare workers to the patient's best interests. Keeping these concepts in mind, the rule of the five Cs (competence, collegiality, communication, continuity of care and compassion) might be helpful in the management of end-of-life care. Unfortunately, neither the rule of the five Cs nor the careful use of moral principles in order to promote the patients' dignity can assure a universally acceptable decision. A reasonable level of 'moral certainty', however, might be achieved using a deliberative approach, which provides for the inclusion of all the different subjects involved in the decision-making process (patient, family, doctors, nurses and other carers), in order to reach the best possible decision in a specific situation.