Healthcare Staff Research Articles

Implementation of a magnet hospital model: attracting and retaining healthcare staff in a Swedish hospital

PurposeStaff shortages in the healthcare sector increase the competition for qualified staff. A magnet hospital is intended to attract, and retain healthcare professionals. This article aims to investigate the challenges related to implementation of a magnet hospital model, and given these challenges, to analyse the interplay between different organisational levels in a Swedish hospital.Design/methodology/approachThe data collection followed the implementation of a magnet hospital model and consisted of 14 meeting observations, 31 interviews and 13 document analyses.FindingsThe model implementation was driven by a top-down approach, with accompanying bottom-up activities, involving healthcare professionals, to ensure adaption to the hospital’s conditions at different organisational levels. The findings revealed that the model was more appealing to top management, seeking a standardised solution to attract and retain nurses. Clinic managers preferred tailor-made solutions for managing their employee resourcing challenges. Difficulties in translating and contextualising the model to the hospital’s conditions created challenges at every organisational level. Some were contained within a level while others spread to the organisational level below and turned into something else.Originality/valueApart from unique empirical material depicting the implementation of a magnet hospital model as an effort to attract and retain healthcare professionals, the value of this study lies in the attention given to the challenges that arise when responsibility for implementing a management model is shifted from top management to change agents tasked with facilitating and executing the organisational change.

Effective Utilization of Pre Engineering building (PEB) construction for Development of Rapid Healthcare facilitates in Medical Emergency

World is developing at a faster pace in all spheres of technology. The parameters whichdetermine the development have changed a lot in the recent past and will keep changing in future too.Rapid rise in levels of education, high rates of technological innovations and applications, ever faster andcheaper communication that dissolves physical and social barriers both within countries andinternationally, greater availability and easier access to information, and the further opening up of globalmarkets are the set of catalytic forces that is accelerating the speed of social change throughout theworld.Pre Engiering building is one of the best application of fast track construction Pre-Engineered Buildingconcept involves the steel building systems which are predesigned and prefabricated .The presentconstruction methodology calls for the best aesthetic look, high quality fast construction, costeffective innovative touch. One has to think for alternative construction system like pre-engineeredsteel buildings. In recent years, the introduction of Pre Engineered Building (PEB) concept in the designof structures has helped in optimizing design. In this report the detail explore of pre engineering as afast tack construction’s application discuss . As the world battles the ongoing COVID-19 pandemic, ithas become very clear that societies depend on functioning healthcare facilities. The sufficientavailability of hospital beds, healthcare staff, protective gear or ventilators can make all the differencebetween a situation that is still manageable and a severe crisis. for this infrastructure facilities should beprepare in short time ,For this EPS Pannel and UPVC panels will be use for rapid construction ofhealthcare facilities

A case report of system configuration issue in medical imaging due to system upgrade- changes in hardware and software.

Although the rapid growth in the efficiency of medical imaging is undeniable, the expansion of health information technology (HIT) into medical imaging has not been as seamless or well-integrated as it was thought to be. The socio-technical complexities in medical imaging associated with HIT systems can cause risks to patient harm and inconvenience, both individually and collectively, often in new, unforeseen, and unexpected ways. This study reflects a retrospectively collected single incident report related to medical imaging HIT systems, aiming to develop a set of preventive and corrective strategies. A combination of multiple deductive approaches (existing frameworks), i.e., HIT Classification Systems and 18-step medical imaging process workflow and inductive method (content analysis), were used to analyze the incident. The incident was identified as a "system configuration"-related software issue, contributed by system upgrade- changes in hardware and software. The incident was determined to occur during steps 10-12, i.e., "study selection and retrieval," "calling up of patient's referral," and "image review and interpretation," causing severe disruptions in the clinical workflow for several weeks. We propose 16 preventive and corrective strategies grouped under four key areas based on the socio-technical aspects associated with HIT systems. The key areas are (i) preparation and integration for upgraded systems, (ii) training for medical imaging specialists, (iii) contingency planning/immediate backup system, and (iv) system design and configuration. These strategies are expected to help healthcare staff, analysts, reporters, researchers, and relevant stakeholders improve care delivery and patient safety in medical imaging in the context of any system upgrades.

Leadership support and satisfaction of healthcare professionals in China’s leading hospitals: a cross-sectional study

BackgroundHealthcare professionals’ job satisfaction is a critical indicator of healthcare performance, pivotal in addressing challenges such as hospital quality outcomes, patient satisfaction, and staff retention rates. Existing evidence underscores the significant influence of healthcare leadership on job satisfaction. Our study aims to assess the impact of leadership support on the satisfaction of healthcare professionals, including physicians, nurses, and administrative staff, in China’s leading hospitals.MethodsA cross-sectional survey study was conducted on healthcare professionals in three leading hospitals in China from July to December 2021. These hospitals represent three regions in China with varying levels of social and economic development, one in the eastern region, one in the central region, and the third in the western region. Within each hospital, we employed a convenience sampling method to conduct a questionnaire survey involving 487 healthcare professionals. We assessed perceived leadership support across five dimensions: resource support, environmental support, decision support, research support, and innovation encouragement. Simultaneously, we measured satisfaction using the MSQ among healthcare professionals.ResultsThe overall satisfaction rate among surveyed healthcare professionals was 74.33%. Our study revealed significant support from senior leadership in hospitals for encouraging research (96.92%), inspiring innovation (96.30%), and fostering a positive work environment (93.63%). However, lower levels of support were perceived in decision-making (81.72%) and resource allocation (80.08%). Using binary logistic regression with satisfaction as the dependent variable and healthcare professionals’ perceived leadership support, hospital origin, job role, department, gender, age, education level, and professional designation as independent variables, the results indicated that support in resource provision (OR: 4.312, 95% CI: 2.412 ∼ 7.710) and environmental facilitation (OR: 4.052, 95% CI: 1.134 ∼ 14.471) significantly enhances healthcare personnel satisfaction.ConclusionThe findings underscore the critical role of leadership support in enhancing job satisfaction among healthcare professionals. For hospital administrators and policymakers, the study highlights the need to focus on three key dimensions: providing adequate resources, creating a supportive environment, and involving healthcare professionals in decision-making processes.

Improving patient care transitions from the intensive care unit to the ward by learning from everyday practice. A multicenter qualitative study

ObjectiveTo explore and describe the everyday practices (Work-As-Done) that hinder and facilitate patient care transitions from the intensive care unit (ICU) to the ward. Research method/designMultiple qualitative case studies in the ICU and various specialized wards of three Dutch hospitals. Adult patients planned to be transferred were purposively sampled on a variety of characteristics along with their relative (if present), and the ICU and ward nurses who were involved in the transition process. Data were collected by using multiple sources (i.e., observations, semi-structured interviews and a qualitative survey) and then systematically analyzed using the thematic analysis approach until saturation was reached. FindingsTwenty-six cases were studied. For each case, the actual transfer was observed. Sixteen patients, five relatives and 36 nurses were interviewed. Two patients completed the survey. Fifteen themes emerged from the data, showing that the quality of transitions is influenced by the extent to which nurses anticipate to patient-specific needs (e.g., providing timely and adequate information, orientation, mental support and aftercare) and to the needs of the counterpart to continue care (e.g., by preparing handovers) besides following standard procedures. Data also show that procedures sometimes interfere with what works best in practice (e.g., communication via a liaison service instead of direct communication between ICU and ward nurses). ConclusionsSubtle, non-technical nursing skills play an important role in comforting patients and in the coordination of care when patients are transferred from the ICU to the ward. Implications for clinical practiceThese Work-As-Done findings and their underlying narratives, that are often overlooked when focusing on quality improvement, can be used as material to reflect on own practice and raise awareness for its impact on patients. They may stimulate healthcare staff in crafting interventions for optimizing the transition process.

Breast Cancer Patient Flap Management after Mastectomy: A Best Practice Implementation Project

BackgroundBreast cancer is a prevalent malignancy in women, with mastectomy as the main surgery. Common post-mastectomy complications are seroma (15%-81%), infections (2.9%-3.8%), and flap necrosis (10%-18%), severely impacting quality of life and costs. Howerever, there's a lack of standardized flap care protocols and limited staff knowledge. ObjectivesThis study aims to apply best evidence for flap management post-mastectomy to standardize practices, reduce complications, and enhance patient's quality of life. MethodsThis project followed JBI PACES and GRiP principles, implementing evidence-based practices in a Chinese tertiary hospital between January and May 2023. It entailed evidence identification, integration into clinical context, protocol development, baseline audits, barrier/enabler analysis. The study compared pre- and post-evidence implementation rates of flap complications, healthcare staff's knowledge/skill scores on mastectomy flap management, and audit indicator adherence by both staff and patients. ResultsAfter evidence application, flap ischemia/necrosis rates dropped from 8.57% to 5.56% (P<0.001), wound infection rates after surgery reduced from 5.71% to 2.78% (P<0.001), and seroma rates decreased from 17.14% to 2.78% (P<0.001). Healthcare staff's knowledge and skill scores for flap management following mastectomy increased from 50.67±18.32 pre-implementation to 98.33±4.01 (t=-13.90, p<0.001). Audit criterion compliance rates increased from 8.57% to 94.29% to between 91.67% and 100%, with statistically significant differences in all 15 criteria (P<0.001). ConclusionsEvidence-based management of flaps after mastectomy improves healthcare staff's knowledge and skills, enhances nursing quality, effectively reduces flap complications in patients, and boosts their quality of life. micro abstractThis study implemented evidence-based practices for post-mastectomy flap management at a Chinese tertiary hospital, reducing complications: flap ischemia/necrosis from 8.57% to 5.56%, infections from 5.71% to 2.78%, and seroma from 17.14% to 2.78%. Healthcare staff's knowledge and skills improved significantly, boosting compliance with audit criteria. Results indicate enhancements in nursing quality and patient quality of life.

The consequences of micro-discretions and boundaries in the social prescribing link worker role in England: a realist evaluation.

Social prescribing addresses non-medical factors affecting health and well-being. Link workers are key to its delivery by connecting people to relevant support, often in the voluntary, community and social enterprise sector. Funding from the National Health Service means that link workers are becoming a common part of primary care in England. To explore and understand the implementation of link workers in primary care in England. A realist evaluation addressed the question - When implementing link workers in primary care to sustain outcomes - what works, for whom, why and in what circumstances? Link workers and staff associated with seven primary care sites across England. Researchers spent 3 weeks with each link worker, going to meetings with them, watching them interact with patients, with healthcare staff and with voluntary, community and social enterprise organisations. In addition, interviews were conducted with 61 patients and 93 professionals (voluntary, community and social enterprise representatives and healthcare staff, including link workers). Follow-up interviews were conducted with 41 patients and with link workers 9-12 months later. Data were coded and developed into statements to identify how context around the link worker triggers mechanisms that lead to intended and unintended outcomes. We found that link workers exercise micro-discretions in their role - actions and advice-giving based on personal judgement of a situation, which may not always reflect explicit guidance or protocols. Our analysis highlighted that micro-discretions engender positive connections (with patients, healthcare staff, the voluntary, community and social enterprise sector) and promote buy-in to the link worker role in primary care. Micro-discretions supported delivery of person-centred care and enhanced job satisfaction. Data also highlighted that lack of boundaries could place link workers at risk of overstepping their remit. Our research focused on link workers attached to primary care; findings may not be applicable to those working in other settings. Data were collected around seven link worker cases, who were selected purposively for variation in terms of geographical spread and how/by whom link workers were employed. However, these link workers were predominately white females. Enabling link workers to exercise micro-discretions allows for responsiveness to individual patient needs but can result in uncertainty and to link workers feeling overstretched. Poor link worker retention may, in part, be associated with a lack of clarity around their role. Research to explore how this shapes intention to leave their job is being conducted by authors of this paper. This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number NIHR130247.

Hostel support workers’ experiences navigating healthcare alongside people experiencing homelessness: a qualitative study in the UK

ObjectivesThis study aimed to explore how hostel support workers (HSWs) experience navigating healthcare alongside people experiencing homelessness (PEH). PEH experience poor health outcomes, increased mortality and face many barriers when...

What Matters to Patients on the Day of Surgery—A Flash Mob Study

PurposeTo explore what matters to patients on the day of surgery, to describe how a flash mob study was conducted in a perioperative setting and to provide recommendations for future studies adopting the flash mob design. DesignFlash mob study. MethodsOn June 6 to June 7, 2023, a 24-hour flash mob study was carried out in eight Danish perioperative units. Eligible for inclusion were adult patients scheduled for elective or acute surgery. After giving informed consent, patients answered two qualitative questions: what mattered to them on the day of surgery, and whether the staff were aware of this. Data were analyzed using content analysis. Patient characteristics were presented using descriptive statistics. FindingsPatients expressed a need to feel safe and cared for, be informed, and to receive proper anesthesia and postoperative care. Twenty-nine percent had not told health care staff, most often because they had not been asked about what mattered to them and because they did not want to be a nuisance. ConclusionsThe flash mob study was feasible and provided insight into patients' perspectives on the day of surgery. To gain insight into what matters on the day of surgery, health care professionals must actively ask patients. Furthermore, the flash mob proved to be an opportunity to create attention to what matters to patients on the day of surgery.

ALARA principles in practice: reduced frame and pulse rates for middle meningeal artery embolization.

As the prevalence of neuroendovascular interventions increases, it is critical to mitigate unnecessary radiation for patients, providers, and health care staff. Our group previously demonstrated reduced radiation dose and exposure during diagnostic angiography by reducing the default pulse and frame rates. We applied the same technique for basic neuroendovascular interventions. We performed a retrospective review of prospectively acquired data after implementing a quality improvement protocol in which pulse rate and frame rate were reduced from 15 p/s to 7.5 p/s and 7.5 f/s to 4.0 f/s respectively. We studied consecutive, unilateral middle meningeal artery embolizations treated with particles. Total radiation dose, radiation per angiographic run, total radiation exposure, and exposure per run were calculated. Multivariable log-linear regression was performed to account for patient body mass index (BMI), number of angiographic runs, and number of vessels catheterized. A total of 20 consecutive, unilateral middle meningeal artery embolizations were retrospectively analyzed. The radiation reduction protocol was associated with a 39.2% decrease in the total radiation dose and a 37.1% decrease in radiation dose per run. The protocol was associated with a 41.6% decrease in the total radiation exposure and a 39.5% decrease in exposure per run. Radiation reduction protocols can be readily applied to neuroendovascular interventions without increasing overall fluoroscopy time and reduce radiation dose and exposure by 39.2% and 41.6% respectively. We strongly encourage all interventionalists to be cognizant of pulse rate and frame rate when performing routine interventions.

Quality improvement project (QIP): evaluating a pilot suicide awareness, screening and signposting training intervention for dental care professionals in a dental teaching hospital and school

Scotland’s 2022 suicide prevention strategy recommends building skills and knowledge among healthcare staff who play a role in preventing suicide. A quality improvement project (QIP) in relation to this was...

Physical activity and exercise in chronic kidney disease: consensus statements from the Physical Exercise Working Group of the Italian Society of Nephrology

The Italian Society of Nephrology has tasked its Working Group on Physical Exercise with developing a consensus statement document on physical activity and exercise in patients with chronic kidney disease (CKD). This paper consists of 16 points that were discussed, and approved using the mini-Delphi method by 15 members of the working group. Each statement is based on a comprehensive review of the literature, clinical experience, and expert opinions. Overall, the statements affirm that regular physical activity and exercise training offer numerous benefits to CKD patients, including improved physical function, enhanced cardiometabolic and neuromuscular function, cognitive benefits, and an overall improvement in quality of life. Furthermore, exercise may provide nephroprotection and reduce mortality. These advantages are observed across all CKD stages, whether on conservative therapy or kidney replacement therapy (hemodialysis or peritoneal dialysis), and in kidney transplant recipients. Moreover, when physical activity and exercise training are implemented with appropriate precautions, they are safe in CKD patients. Gradual physical activity and customized exercise programs should be tailored to the patient's exercise tolerance, potentially enhancing compliance. Clinicians are encouraged to use a series of questionnaires and tests to assess the patient's level of physical activity and performance. However, exercise and physical activity are poorly implemented in clinical practice due to many barriers related to patients and healthcare staff. Overcoming these barriers requires the proactive role of the nephrologists, who should actively incorporate exercise training and promote physical activity within routine care plans. Adopting a multidisciplinary team approach, which includes nephrologists, nurses, exercise professionals, and dietitians, is crucial for providing comprehensive rehabilitation for CKD patients. Integrating new technologies and remote check ups could further enhance the effectiveness of these interventions.Graphical abstract

Fading Focus: Addressing the Association Between Challenge Stressors, Role Blurring, Insomnia, Fatigue, and Workplace Cognitive Failure.

The primary goal of the present study is to inspect the plausible job-related (i.e., challenge stressors and role blurring) and individual factors (i.e., fatigue and insomnia) that potentially lead to work-related cognitive failures among healthcare staff. Through the judgmental sampling technique, data was collected from healthcare personnel in Iran. The results revealed that challenge stressors in the form of time pressure, job responsibility, and work overload are significantly related to role blurring. Moreover, role blurring increases fatigue and insomnia among medical staff, and both insomnia and fatigue cause workplace cognitive failure. The results also confirm the mediation effect of role blurring in the association between challenge stressors, insomnia, and fatigue. According to the results, insomnia and fatigue similarly mediate the role blurring on workplace cognitive failure association. Theoretical implications, useful suggestions for practitioners, and prospective research avenues are debated in the study.

Tight Application of a Surgical Tourniquet Prior to Inflation Increases Venous Pressure In the Upper Limb; Potentially Resulting in Increased Blood Loss and Poorer Visibility

Tourniquets are commonly used in extremity surgery to help provide a bloodless operative field to improve visibility and reduce length of procedures. With the development of WALANT (wide awake, local anaesthetic, no tourniquet) techniques, many surgeons undertake surgery without tourniquet inflation. The correct technique of pneumatic tourniquet application is poorly understood by healthcare staff. The application of a tight tourniquet when applied for optional use or use for only a portion of a procedure, rather than for inflation throughout can cause venous engorgement of an extremity leading to increased blood loss and reduced operative field visualisation thereby discouraging surgeons from persevering with WALANT strategies. To determine the effect of tourniquet application tension on limb volume prior to skin incision. 30 volunteers had the volume of their non-dominant forearm measured post-inflation of a surgical tourniquet using two different application techniques. Tight application was defined as the tourniquet fastened using a dynamometer to a tension of 100N. Loose application was defined as the tourniquet fastened using a dynamometer to a tension of 50N. The tourniquet was then inflated to 200mmHg after both application techniques. Exsanguination was performed by elevation of the arm for 1min prior to tourniquet inflation. At 5min the forearm volume was measured using a volume displacement technique. 93% of participants (28/30) had a higher volume of water displaced when the tourniquet was applied tightly. The mean difference between the loose and tight applications was 30.06mls. The increase in volume in tightly applied tourniquets is believed to result from increased intravascular volume. This increase in blood volume can lead to increased intra-operative blood loss and poor intra-operative visualisation when operating without tourniquet inflation. Loose application of the tourniquet pre-inflation appears to prevent sequestration of venous blood in the limb, therefore decreasing operative blood loss and improving view for operating. Level 1; Symptom Prevalence Study.

An observational study of the impact of professional walking aid prescription on gait parameters for individuals with suspected balance impairments

BackgroundThe primary management strategy for gait impairment is the adoption of a walking aid. However, there are no established criteria upon which to base a decision regarding the need for a walking aid. It appears clinicians prescribe aids based on preference, clinical experience and intuition rather than standardised objective rationale. This may contribute to the inconsistent gait response to walking aids reported in the published literature. Understanding gait changes resulting from gait aid usage may have significant impact on clinical practice by improving confidence of prescribing clinicians and compliance of walking aid usage by patients, maximising the benefits of use, and reducing any risks associated with non-use or inappropriate use, of the walking aid. Research questionDo professionally prescribed walking aids improve gait parameters? MethodsThis is a secondary data analysis of a cross-sectional study where participants, identified by healthcare staff requiring a mobility assessment due to potential balance impairment of any cause, walked a 20-m straight walking course under three different walking conditions (no aid, walking stick and 4-wheeled walker). Fifty-eight participants were recruited. Commonly reported spatial and temporal gait parameters were assessed using a validated gait analysis device. Changes in gait parameters across the three conditions were compared, noting the individual's professionally prescribed aid and interpreting changes in parameters towards outcomes of the ‘no aid required group’. Results and significanceGait cycle, cadence, stance, swing and stride length during unaided walking were significantly changed when a walking stick was prescribed (p < 0.05). Stance, swing, double support, stride length, speed, max toe clearance and minimum toe clearance were significantly changed when a 4-wheel walker was prescribed (p < 0.05). Professional walking aid prescription improves some gait parameters. A greater number and magnitude of gait parameter improvements were seen in people requiring a 4-wheel walker than people requiring a walking stick.

Economic Evaluation of Remote Monitoring for Implantable Cardiac Devices: Evidence from a Remote-Care Study.

The adoption of remote monitoring (RM) is especially relevant for patients with implantable cardiac devices due to their high risk of hospitalization and the need for frequent outpatient visits. Though RM can help with early detection of cardiac episodes, it may also increase the number of tasks healthcare providers engage in to monitor patients' health. The adoption of RM may increase healthcare providers' workloads, potentially impacting the quality of care and increasing the risk of clinician-provider burnout. Little is known about the link between RM adoption and changes in healthcare providers' workloads. Using data from a non-randomized clinical trial conducted in 2021-2022 at a University Hospital in Korea, we examined the relationship between RM adoption and changes in patient time savings and healthcare providers' workloads. The clinical trial included patients with a cardiac implantable electronic device compatible with the Biotronik Home Monitoring System. For patients, RM was associated with a 41-minute decrease in total visit duration, attributed to reductions in both wait time (37 minutes; P<0.001) and total examination time (3.7 minutes; P=0.137). For healthcare providers, RM was linked to an increase in overall workload by 107.9 minutes per patient. The increase was primarily due to managing RM alerts (91.8 minutes) and preparing monthly patient reports (19.9 minutes). Our findings suggest that RM was associated with a decrease of 1540 KRW (44%) in average cost of care per minute. RM is associated with time-saving patient benefits and increased healthcare providers' workloads. Even though this was a single-center study with a small number of patients, our research highlights the importance of carefully examining changes in healthcare staff workloads linked to the adoption of RM within the national health insurance system.

How can we measure psychological safety in mental healthcare staff? Developing questionnaire items using a nominal groups technique.

There have been growing concerns about the well-being of staff in inpatient mental health settings, with studies suggesting that they have higher burnout and greater work-related stress levels than staff in other healthcare sectors. When addressing staff well-being, psychological safety can be a useful concept. However, there is no measure of psychological safety that is suitable for use in inpatient mental health settings. Edmondson (1999) is the most commonly used measure of psychological safety, but it was designed for use in general physical healthcare settings. As inpatient mental health settings are unique environments, transferability of knowledge from physical to mental healthcare settings cannot be assumed. We sought to develop questionnaire items that capture psychological safety among healthcare staff working in acute inpatient mental healthcare settings. We used the nominal group technique, a consensus method involving rounds of discussion, idea generation, and item rating/ranking to identify priorities. Twenty-eight stakeholders participated, including 4 who had lived experience of mental health problems, 11 academics and 18 healthcare professionals (8 participants identified with more than 1 category). The study involved a workshop with three parts: (i) an overview of current research and limitations of the Edmondson (1999) measure as outlined above, (ii) discussion on what items should be retained from the Edmondson (1999) measure, and (iii) discussion on what items should be added to the Edmondson (1999) measure. Twenty-one items were generated and retained to capture psychological safety in inpatient mental health settings. These measure professionals' sense of being valued by their team and organization, feeling supported at work, feeling physically safe and protected from physical harm, and knowing they can raise concerns about risk and safety. This is the first study to generate questionnaire items suitable for measuring staff psychological safety in mental health settings. These have been generated via a consensus method to ensure stakeholders' views are reflected. Further research is needed to evaluate factor structure, internal reliability, and convergent validity.

Cultural intervention based on "Bhuppa Bhabhu Ghuru Rato" to overcome early marriage in Torjun Sampang

Pondok Pesantren Darussalam Torjun is addressing the high incidence of early marriages, which significantly impact students' education. Data shows that 41 percent of women in Torjun Village marry before 21, leading to issues like low educational attainment, health risks, and economic challenges. To combat this, a cultural intervention program, BHUPPA-BHABHU-GHURU-RATO, was developed in collaboration with partners. The program aims to increase students' knowledge about early marriage and assertive communication, raise parental awareness of early marriage impacts, and provide a curriculum and educational media on the subject. The initiative targets 77 students, 20 parents, 5 school administrators, health center staff, religious affairs office staff, and the sub-district head. The methods include psychoeducation and the dissemination of curriculum and educational media. The program comprises two parts: community empowerment, involving activities for students, parents, school administrators, and government officials, and cadre development, focusing on peer counseling and persuasive communication training. Results showed a 16 percent increase in students' understanding of early marriage dangers, a 3 percent increase in assertive communication knowledge, and a 10 percent increase in parental awareness. The program's sustainability is supported by curriculum integration, the use of educational media, and the Anti-Early Marriage Knights system.

Prevalence of Sleepiness and Associated Factors Among Healthcare Staff: A Cross-Sectional Study in A University Hospital in Palestine

Prevalence of Sleepiness and Associated Factors Among Healthcare Staff: A Cross-Sectional Study in A University Hospital in Palestine

High blood pressure is correlated with anthropometric status in adults in Gribig district, Central Java, Indonesia

Background: More than 17 million deaths worldwide are caused by cardiovascular disease due to high blood pressure. According to the World Health Organization (WHO), around 1.3 billion adults will have high blood pressure in 2021. Obesity is a significant factor influencing blood pressure. Waist circumference measurements and body mass index (BMI) can be used to identify obesity issues. Objective: The aim was to analyze the correlation between BMI, waist circumference, and blood pressure among adults at Primary Health Care in Kudus, Central Java, Indonesia. Methods: This cross-sectional study evaluated BMI, waist circumference, blood pressure, and questionnaire. Men and women aged 18-59 (healthcare staff, patient caregivers, and patients) who agreed to become study subjects were included. Participants with a history of diseases, current conditions, medication intake that affects blood pressure, and pregnancy were excluded. Samples were taken using purposive sampling and the Pearson test as a statistical analysis. Results: The analysis showed a significant correlation between the BMI of patients with systolic blood pressure (p=0.000) and diastolic blood pressure (p=0.000). A moderate relationship was found between BMI and systolic blood pressure(r=0.473) and diastolic blood pressure (r=0.439). Moreover, waist circumference was significantly correlated with systolic blood pressure (p=0.000) and diastolic blood pressure (p=0.000). Conclusion: A significant correlation exists between BMI and waist circumference with blood pressure among adults at the Primary Health Care in Kudus, Central Java, Indonesia.