Health Care Workers In Vietnam Research Articles

Acceptability of seasonal influenza vaccines among health care workers in Vietnam in 2017

IntroductionA demonstration project in Vietnam provided 11,000 doses of human seasonal influenza vaccine free of charge to healthcare workers (HCWs) in 4 provinces of Vietnam. Through this project, we conducted an acceptability survey to identify the main reasons that individuals chose to be vaccinated or not to inform and improve future immunization activities. MethodsWe conducted a descriptive cross-sectional survey from May to August 2017 among HCWs at 13 selected health facilities. We employed logistic regression to determine the association between demographic and professional factors, and the decision to receive seasonal influenza vaccine. We performed post-hoc pairwise comparisons among reasons for and against vaccination using Chi square and Fisher’s exact tests (for cell sizes <5). ResultsA total of 1,450 HCWs participated in the survey, with a higher proportion of females than males (74% versus 26%). The median age of the participating HCWs was 35 years (median range 25.8–44.2). Among those surveyed, 700 (48%) HCWs were vaccinated against seasonal influenza during the first half of 2017. Younger HCWs under 30 and 30–39 years old were less likely to get vaccinated against seasonal influenza than HCWs ≥50 years old (OR = 0.5; 95%CI 0.4–0.8 and OR = 0.6; 95%CI 0.4–0.8 respectively). Nurses and other employees were more likely to get seasonal influenza vaccination than physicians (OR = 1.5; 95%CI 1.0–2.4 and OR = 2.0; 95%CI 1.2–3.2 respectively). The most common reason for accepting vaccination was fear of getting influenza (66%) and the most common reason for not getting vaccinated was concern about vaccine side effects (23%). ConclusionAcceptability of seasonal influenza vaccines in this setting varied among HCWs by age group and job category. Interventions to increase acceptance of vaccine among HCWs in this setting where influenza vaccine is being introduced free for the first time should include targeted risk communication on vaccine safety and efficacy.

Compliance with the Use of Medical and Cloth Masks Among Healthcare Workers in Vietnam.

Masks are often worn in healthcare settings to prevent the spread of infection from healthcare workers (HCWs) to patients. Masks are also used to protect the employee from patient-generated infectious organisms but poor compliance can reduce efficacy. The aim of this study was to examine the factors influencing compliance with the use of medical and cloth masks amongst hospital HCWs. HCWs compliance with the use of medical and cloth masks was measured over a 4-week period in a randomized controlled trial in Vietnam. HCWs were instructed to record their daily activities in diary cards. Demographic, clinical, and diary card data were used to determine the predictors of compliance and the relationship of compliance with infection outcomes. Compliance rates for both medical and cloth masks decreased during the 4 weeks: medical mask use decreased from 77 to 68% (P < 0.001) and cloth masks from 78 to 69% (P < 0.001). The presence of adverse events (adjusted RR 0.90, 95% CI 0.85-0.95), and performing aerosol-generating procedures (adjusted RR 0.78, 95% CI 0.73-0.82) were negatively associated with compliance, while contact with febrile respiratory illness patients was positively associated (adjusted RR 1.14, 95% CI 1.07-1.20). Being compliant with medical or cloth masks use (average use ≥70% of working time) was not associated with clinical respiratory illness, influenza-like illness, and laboratory-confirmed viral infection. Understanding the factors that affect compliance is important for the occupational health and safety of HCWs. New strategies and tools should be developed to increase compliance of HCWs. The presence of adverse events such as discomfort and breathing problems may be the main reasons for the low compliance with mask use and further studies should be conducted to improve the design/material of masks to improve comfort for the wearer.

Qualitative findings from focus group discussions on hand hygiene compliance among health care workers in Vietnam

It is accepted by hospital clinical governance that every clinician's "duty of care" includes hand hygiene, yet globally, health care workers (HCWs) continue to struggle with compliance. Focus group discussions were conducted to explore HCWs' barriers to hand hygiene in Vietnam. Twelve focus group discussions were conducted with HCWs from 6 public hospitals across Hanoi, Vietnam. Discussions included participants' experiences with and perceptions concerning hand hygiene. Tape recordings were transcribed verbatim and then translated into English. Thematic analysis was conducted by 2 investigators. Expressed frustration with high workload, limited access to hand hygiene solutions, and complicated guidelines that are difficult to interpret in overcrowded settings were considered by participants to be bona fide reasons for noncompliance. No participant acknowledged hand hygiene as a duty of care practice for her or his patients. Justification for noncompliance was the observation that visitors did not perform hand hygiene. HCWs did acknowledge a personal duty of care when hand hygiene was perceived to benefit her or his own health, and then neither workload or environmental challenges influenced compliance. Limited resources in Vietnam are amplified by overcrowded conditions and dual bed occupancy. Yet without a systematic systemic duty of care to patient safety, changes to guidelines and resources might not immediately improve compliance. Thus, introducing routine hand hygiene must start with education programs focusing on duty of care.

Current practices and barriers to the use of facemasks and respirators among hospital-based health care workers in Vietnam

BackgroundThis study aimed to examine the knowledge, attitudes, and practices towards the use of facemasks among hospital-based health care workers (HCWs) in Hanoi, Vietnam.MethodsA qualitative study incorporating 20 focus groups was conducted between August 2010 and May 2011. HCWs from 7 hospitals in Vietnam were invited to participate.ResultsIssues associated with the availability of facemasks (medical and cloth masks) and respirators was the strongest theme to emerge from the discussion. Participants reported that it is not unusual for some types of facemasks to be unavailable during nonemergency periods. It was highlighted that the use of facemasks and respirators is not continuous, but rather is limited to selected situations, locations, and patients. Reuse of facemasks and respirators is also common in some settings. Finally, some participants reported believing that the reuse of facemasks, particularly cloth masks, is safe, whereas others believed that the reuse of masks put staff at risk of infection.ConclusionsIn low and middle-income countries, access to appropriate levels of personal protective equipment may be restricted owing to competing demands for funding in hospital settings. It is important that issues around reuse and extended use of medical masks/respirators and decontamination of cloth masks are addressed in policy documents to minimize the risk of infection.

A New Paradigm for Disease Surveillance in Vietnam

Medical surveillance data from all government health clinics in Vietnam are currently collected through a slow, paper-driven process. Short message service (SMS) technology delivered through mobile phones offers a simple solution to improving the speed through which disease surveillance information can be collected. Identifying health concerns earlier with this mobile-based disease surveillance system has the potential to improve the care for patients seen at community health clinics as well as predict more quickly that a medical emergency, such as a pandemic, will occur. Thus, we piloted the feasibility of an SMS-based disease surveillance system designed for healthcare workers in Vietnam to directly report disease information on diarrhea and influenza-like illness to a central data repository using their mobile phones and an intuitive, user-friendly platform. This article reports data from 1,579 patient data entries in 20 Vietnamese health clinics during a 6-month period.

The Achievements of the Poison Control Center of Bach Mai Hospital, Vietnam

Last editorial of the Asia Pacific Journal of Medical Toxicology addressed the important role of poison control centers in the improvement of public health (1). In Vietnam, poison control center (PCC) of Bach Mai Hospital has been the only national one for civilians. The establishment and activities of this center can be considered as one of the pioneers in the East Asia. History and setting (2,4) The PCC is a division of Bach Mai Hospital, a tertiary general hospital with approximately 2000 beds. The hospital is a public teaching hospital. The department of clinical toxicology or poison treatment center (PTC) was separated from the department of emergency and intensive care of Bach Mai Hospital in 1998. From this treatment center, the PCC of Bach Mai Hospital was established in 2003 and has been working as the only national PCC. Organization (2,4) The Bach Mai PCC is directed by 3 physicians who are specialized in critical care medicine and have been working for PTC from its beginning. Other staff members of the PCC include 7 physicians, 2 bachelors of chemistry, 1 technician, 27 nurses and 3 medical assistants. The PCC has a unit of clinical toxicology with 35 patient beds, toxicology laboratory and poison information unit. In this setting, clinical and scientific measures including management of poisoned patients, toxicology analysis, training and education for healthcare workers in the management and prevention of poisoning, toxicologic research, cooperation with domestic and international agencies regarding the poisonings, public education, providing poison information, treatment and prevention advice and participation in regional and international congresses and associations have been tracked. Achievements (2,3,5,6) Training and education: (a) For healthcare workers in Vietnam; teaching toxicology module or training courses on the management of poisonings at graduate and postgraduate levels for physicians, residents, medical students, and nurses at the center and in different regions of Vietnam is in progress (7094 students). Moreover, 46 CME courses were organized in 42 provinces nationwide. (b) For international healthcare workers; training course on the diagnosis and management of acute poisonings for 27 physicians from India in cooperation with World Health Organization was performed. Clinical activities: Approximately 1700-1800 poisoned patients are annually treated in the center which majority of them includes pesticides, snakebite, hymenoptera evenomation and toxic mushrooms. Treatment protocols and regimens for common and life-threatening poisonings have been developed and brought about great successes, especially with regards to organophosphate poisoning, snakebite, hymenoptera evenomation and nereistoxin insecticide poisoning. Research: Most studies have been focused on devising protocols and application of techniques for decontamination, antidote administration and enhanced elimination of poisons including emulsified charcoal, snake antivenoms, gastric lavage with closed circuit, plasma exchange, continuous veno-venous hemofiltration/hemodialysis and charcoal and resin hemoperfusion. Mortality rate: The PCC has played an important role in the improvement of death rate. The death rate due to poisonings was reduced from 8.5% to 1.9% after the department of clinical toxicology (PTC) was set up in 1998. The mortality was further reduced to 0.37% in 2005 after the establishment of the PCC. The current death rate (2012) is 1.99% primarily contributed by emerging paraquat poisoning. Organization of charity activities: A large number of severely poisoned patients who were in poor economical status and had treatment costs exceeding the payment competency of the health insurance benefited from these activities. Toxicology analysis: Analysis of many common poisons of concern have been carried out including pesticides, pharmaceuticals, drugs of abuse, alkaloids with quick tests, thin layer chromatography and high pressure liquid chromatography. Publications: Nineteen books (in Vietnamese) on toxicology, emergency medicine and intensive care medicine, nursing, accident and injuries prevention (chief author and co-authors) have been published by the PCC, to date. International cooperation: The PCC successfully hosted the 9th Scientific Congress of Asia Pacific Association of Medical Toxicology at Bach Mai Hospital in 2010 which was attended by 200 delegates from 19 countries

HIV-related stigma: Impact on healthcare workers in Vietnam

Stigma has been identified as a major barrier to HIV response. While much is known about stigma directed towards people living with HIV (PLHIV), less is known about stigma experienced by health workers who treat PLHIV. This study aims to explore the perceptions and experiences of health workers regarding how stigma influences their work with HIV-positive patients. The study employed a qualitative design involving individual semi-structured in-depth interviews with 14 health workers, purposively selected from hospitals and detention centres for people who use drugs and sex workers in Hanoi, Vietnam. Findings showed that the stigma experienced by health workers may be organised around several themes: (1) lack of social prestige associated with HIV work; (2) fear of infection expressed by family members; (3) feelings of being devalued within the healthcare field; and (4) work-related stress and burnout, especially for staff working in detention centres for drug users and female sex workers. Efforts are needed to improve the public image of HIV work, scale up stigma reduction, enhance stress management and create a safe and supportive working environment for health workers.

Survey of bowel patterns in a population of health care workers in Vietnam

Survey of bowel patterns in a population of health care workers in Vietnam