Hospital Health Staff Research Articles

Drug prescriptions in elderly hospitalized patients with cognitive impairment in the Italian Dementia Friendly Hospital project.

The aim of the study was to characterize drug prescription patterns in elderly patients hospitalized in acute wards as a function of cognitive status and staff training. We recorded clinical parameters reflecting health status and drug prescriptions at admission, during hospital stay, and at discharge before and after a short staff training on the needs of aged cognitively impaired patients. Participants aged 65 and older had a Mini-Mental State Examination (MMSE) score ≥16. The number of prescriptions, sedative and anticholinergic load, and drug-drug interactions were evaluated. Of the 116 older patients analyzed, 59 patients were cognitively impaired, and 57 were cognitively normal with an MMSE value > 24. Fifty-nine patients (28 CN, 31 CI) were assisted by the hospital health staff after training. Participants presented a widespread polypharmacy. Cognitively impaired patients received more prescriptions, more inappropriate prescriptions, had a greater sedative load, and were exposed to more interactions. Staff training had no effect on the prescription pattern. The results suggest that hospitalized cognitively impaired patients are overprescribed psychotropic drugs and have an excessive sedative and anticholinergic load. Interventions designed to improve dementia care practices in health staff that are not also designed to manage drug polypharmacy do not modify prescription patterns.

Ventilation Strategies to Mitigate Air Pollution Impact on Hospital Professionals in Intensive Care Units in the Democratic Republic of Congo

This study critically examines the impact of indoor air quality (IAQ) on occupant health in two critical care units (ICUs) at Jason Sendwe Hospital (JSH) and General Carrier de Mine Hospital (GCMH) within the Southern DRC metropolitan area, focusing on their impact on occupant health and well-being. Utilizing a mixed methods approach that includes health questionnaires, continuous environmental monitoring (monitoring CO2, VOCs, PM2.5, PM10, temperature, and relative humidity), and computational fluid dynamics (CFD) analysis, this research aims to identify correlations between environmental factors and the health of hospital staff and patients. The investigation was conducted across both the rainy and dry seasons, revealing significant seasonal variations in IEQ parameters and exploring the incidence of symptoms commonly associated with sick building syndrome among hospital staff. Higher CO2, VOCs, and particulate matter levels during the dry season indicated the inadequacy of current ventilation strategies to maintain optimal air quality. This study proposes the implementation of air filtration and purification systems and the refurbishment of natural ventilation systems as effective measures to improve IAQ. Additionally, alternative ventilation strategies, including occupancy reduction and the integration of supply and exhaust ventilation, were explored to address the challenges of inadequate ventilation. The findings reveal the urgent need for hospitals to adopt ventilation strategies that ensure the health and well-being of occupants, highlighting the importance of continuous IAQ monitoring, community engagement, and the integration of advanced ventilation technologies in healthcare settings. This comprehensive exploration offers valuable insights for improving ventilation in ICUs, contributing to creating healthier indoor environments in hospital settings, especially in regions facing unique environmental challenges.

Exploring the Use of the AEDET Hospital Evaluation Toolkit to Create a Better Healing Environment for Cancer Patients beyond the Global North

Today, numerous studies have shown that the physical environment in hospitals can significantly influence patients’ well-being, comfort, and recovery. However, this is currently neglected in hospitals in the Global South. Therefore, there is an urgent need to increase awareness to make it more applicable worldwide. Thus, this study focuses on improving the healing environment standards by exploring the impact of evidence-based design and patient-centered care in hospitals for cancer patients, particularly the architectural space quality, on patient health outcomes as well as hospital staff health and well-being. In Global North countries such as the UK, the achieving excellence design evaluation toolkit (AEDET) is used by their National Health Services to assess the effectiveness of various environmental attributes. However, these toolkits have not been designed for and do not work well within Global South countries, such as Northern Cyprus. To examine and compare the effectiveness of different physical environmental attributes and to evaluate user responses, the post-occupancy evaluation method and the AEDET toolkit were used in this study. These were applied to both public and private hospitals in Northern Cyprus, involving cancer patients, staff, and professionals (n = 220). The findings reveal the strengths and weaknesses in terms of environmental comfort based on the aspects of the evidence-based design of the hospitals such as natural light, air quality, noise, view, infection control, etc., to create a more optimal physical environment for better psychological outcomes. They also reveal that these toolkits are not fit for purpose for Global South contexts and require adaptations. This is the first study to propose an adaptation of the AEDET toolkit to assist architects in designing healthcare facilities that are responsive to the requirements of hospital patients and staff and to promote the quality of a healing environment for improved health and well-being outcomes.

Acute Low Respiratory Infections in Children from 2 Months to 15 Years of Age in the Pediatric Department of the Commune II Reference Health Center in Bamako (Mali)

Introduction: Acute lower respiratory infections (ALRIs) in paediatrics include a heterogeneous group of conditions affecting the lower respiratory tract in children. They constitute a real public health problem, particularly in developing countries. Patient and Method: This was a retrospective, descriptive study from 1 January to 31 December 2018, i.e. 2 years. All children aged 2 months to 15 years hospitalized for ARFU were included. Results: In our study, the prevalence of ARBI was 14.47%. The sex ratio was 1.16 in favour of boys. The under-5s were the most represented 97.5%. The peaks of hospitalizations were found in October 18.2%, November 16.5% and August 14%. According to the Expanded Programme on Immunisation, 12.5% of the children were not correctly vaccinated. The reasons for consultation of our patients were respiratory distress with 25.6% followed by cough and cold 24.5%. Fever was associated with 70.2%. The clinical forms were dominated by: pneumonia 47.9% followed by superinfected bronchiolitis 33.1% and acute bronchitis 19%. The majority were treated with the combination of Ceftriaxone and gentamycin, i.e. 62.8% as first-line treatment. The evolution was favourable in 90.9% of cases with 5% death, 2.5% discharge against medical advice and 1.6% referral to higher level. Conclusion: Low-grade ARI is a public health problem in commune II of Bamako. Raising public awareness of the early signs of low-grade ARI, strict adherence to the expanded programme of immunisation, and upgrading of community and hospital health staff will help to reduce mortality from low-grade ARI.

Investigating the effectiveness of tele-counseling for the mental health of staff in hospitals and COVID-19 clinics: a clinical control trial.

To investigate the effectiveness of tele-counseling for the mental health of staff working in hospitals and reference clinics during the COVID-19 outbreak. In the first stage of the study, using a convenience sampling strategy, 313 staff members working at Iran's hospitals and COVID-19 clinics answered a Hospital Anxiety and Depression Scale and the Short Health Anxiety Inventory online. In a second stage, 95 staff members who were willing to participate in the intervention were randomly assigned to the intervention (n = 51) or control (n = 44) groups. The intervention consisted of seven intensive tele-counseling sessions. In the first stage, the percentages of anxiety and depression related to coronavirus were 79.2% and 82.1% and the mean health anxiety score was 17.42. In the intervention phase, anxiety related to coronavirus and to perceived risk of illness (likelihood of illness) were significantly lower in the intervention group in comparison with the control group (p = 0.001). Depression related to coronavirus and anxiety related to the negative consequences of infection were non-significantly reduced in the intervention group compared to the control group (p = 0.08 and 0.12; respectively). Continuous monitoring of the negative psychological impacts on medical staff of outbreaks as well as implementation of appropriate interventions to respond to them should be emphasized in order to improve staff mental health.

Desafios em saúde mental durante a pandemia: relato de experiência

Resumo A readequação do atendimento em saúde mental durante a pandemia de covid-19 foi facilitada por mudanças na legislação médica vigente. O teleatendimento trouxe oportunidades para tratar, acompanhar e identificar os transtornos mentais de modo diferente. Este artigo tem por objetivo relatar a experiência do serviço de saúde mental de um hospital universitário e da residência médica em psiquiatria durante este período. A assistência ambulatorial incluiu teleatendimento e consultas presenciais conforme a gravidade, e foi criado o projeto Acolhimento em Saúde Mental em Tempos de Pandemia para assistir os profissionais do hospital. Espera-se que no futuro o teleatendimento seja usado como ferramenta para o cuidado em saúde mental, sendo ainda necessário treinar os profissionais e avaliar a qualidade desse recurso.

Investigating the Effectiveness of Tele-Counseling on Mental Health of Staff in Coronavirus Reference Clinics and Hospitals

Background: The aim of this study was to investigate the effectiveness of tele-counseling on the mental health of staff in hospitals and coronavirus reference clinics where the screening and referral of suspected individuals are carried out in Iran. Methods: In the first stage, using convenience sampling method, 313 staff in the reference clinics and hospitals answered to the online demographic questions, The Hospital Anxiety and Depression Scale (HADS) and the Short Health Anxiety Inventory (SHAI). In the second step, seven intensive tele-counseling sessions were hold for 51 staff in the intervention group and their scores were compared with the scores of 44 staff in the control group who agreed to participate in the study. Outcomes: In the first stage, anxiety and depression related to coronavirus were 79.2% and 82.1%. The mean of health anxiety scores was 17.42. Depression related to coronavirus and anxiety of negative consequences not-significantly reduced after the sessions in the intervention group in comparison to the control group (p=0.08 and 0.12) at end of study. Anxiety related to coronavirus and anxiety of illness likelihood were significantly lower than control group in the intervention group at the end of the study (p=0.001 and 0.001). Interpretation: It seems continuous surveillance and monitoring of the psychological consequences for medical staff in outbreaks should be emphasized as a part of preparedness efforts worldwide. Trial Registration: Iranian Registry of Clinical Trial (IRCT code: IRCT20170611034452N11) Funding Statement: This research was supported in part by the deputy of research, Kerman University of Medical Sciences (grant No. 98001242). Declaration of Interests: None to be declared. Ethics Approval Statement: The study was approved by the medical ethics committee of Kerman University of Medical Sciences (ethical code: IR.KMU.REC.1398.737). The study was also conducted in accordance with the Declaration of Helsinki.

Impact of Psychosocial Stress on the Morbidity of Healthcare Professionals

Abstract We have analysed the impact of psychosocial risks on the health of hospital staff, in an attempt to determine whether there is a correlation between the risk level assessed and the number of days of medical absenteeism through diseases with psychosocial stress as a contributory or aggravating factor. There is a strong correlation between the risk level assessed by sectors of activity and the number of days of medical absenteeism through diseases caused or favoured, potentially aggravated by occupational psychosocial stress.

Effect of knowledge management on health entrepreneurship through organizational learning capacity in hospitals of Guilan province

Background: Because of the importance of community health and the growing need for health care Health organizations have expanded their scope and with an entrepreneurial approach seeking to upgrade their performance. Knowledge is the most important capital of organizations and key factor in economics. The purpose of this study was to investigate the effect of knowledge management on organizational entrepreneurship through learning capacity. Methods: This research was an applied type, and in terms of method, it was a descriptive survey. The statistical population of the research was the Hospital health staff of Guilan province in 2016, the statistical sample estimated 370 by Morgan table. This research was conducted with three standard knowledge management questionnaires, organizational entrepreneurship and learning capacity with structural equation modeling and smartpls2 software. The reliability of the research tools were calculated Organizational Entrepreneurship 0.88, Knowledge Management 0.93, and Learning Capacity 0.85, respectively. Results: Knowledge management 0.46 and organizational learning capacity have positive effect on organizational entrepreneurship. Also, knowledge distribution 0.94 and knowledge storage 90% and interaction with environment 0.84 and participatory decision-making 0.82 were identified as the most important factors of knowledge management and organizational learning capacity. Conclusion: Managers are encouraged to pay attention to organizational learning capacity and knowledge management skills to increase organizational entrepreneurship. Improvement and attention to knowledge management and the expansion of organizational learning capacity can strengthen entrepreneurship. Therefore, health managers and policymakers should consider these issues.

Scorpion composition and scorpionism in a high-risk area, the southwest of Iran.

BackgroundScorpions are usually defined as predatory arachnids having venomous and painful stings. Scorpionism is considered as one of the health and medical problems in undeveloped tropical and subtropical countries in the world that endangers thousands of people annually.ObjectiveThis study was done for identification of scorpion fauna and scorpionism location in a high-risk area in southwest of Iran.MethodsThis study was carried out in Andimeshk district located in Khuzestan province which has the highest frequency of scorpionism in Iran. In total, 4 urban and 15 rural areas with various climates and topography were selected for monthly scorpion collection in 2016. Additionally, clinical data was obtained from questionnaires over a 5-year period (2012 to 2016) which were completed by physicians and health staff in hospitals and health centers. The data were analyzed by IBM-SPSS Version 20.ResultsA total of 850 scorpion samples with the most frequency in rural areas were collected. Eight species belonging to three families; Buthidae, Scorpionidae and Hemiscorpiidae were identified. A. crassicauda was the dominant species followed by H. lepturus. The largest collection due to scorpion’s activity was recorded in summer. The five-year prevalence of scorpion sting were 9.1/1000 inhabitants. The highest frequency of scorpionism was observed in the male age group of 25–34 years. Most cases had been treated with polyvalent scorpion antivenom within 6–12 hours of the sting.ConclusionBased on the findings, six species of medically important scorpions that were previously reported from Iran were also collected and caught in this study area. The findings of this study can be useful for policymakers at the Andimeshk Healthcare Center to prevent scorpionism and provide appropriate treatment for scorpionism cases.

Checking public health of a hospital in the Gilan Province using a questionnaire

Introduction: Public health in modern societies increases motivation and development of people at work, and also, in most cases, most people are dealing with daily life in addition to experience problems with different intensities and are experiencing stress. Some of the problems are transient and some have more permanent role; undoubtedly, peace is the first condition for a healthy psyche and in its shadow it can be reached as a counterbalance to everything else in life and progress. Of course, the purpose of the serenity, calm, and lack of concern is multiple and sometimes crippling. This study aimed to assess the general health of hospital staff in Gilan Province. Methodology: In this cross-sectional study, 57 individuals from different wards were selected in Gilan Province and responded to the questionnaire (General Health Questionnaire [GHQ]). In terms of depression GHQ-28 questionnaire and criteria provided by Noor bala et al. was used as the standard, then their responses were analyzed using SPSS software.[23] Results: The mean age of those surveyed was 31.5 years, 81% of those surveyed also married, and the rest were single. Based on these criteria, it was found that, 43 (75.4%) of employees, suffered from some degree of depression, and, only 14 (24.6%) did not suffer from depression. Conclusion: The study showed that a high percentage of staffs suffered from depression which indicated the importance of health facilities.

Sağlık Taraması İçin Başvuran Hastane Personelinde Serum HbsAg ve Anti-Hbs Düzeyleri İle Hepatit B Aşılanma Durumu

Objective: This study was performed to research the HBsAg and anti-HBs levels with the hepatitis B vaccination status in hospital staff admitted to family medicine outpatient clinic for health screening. Method: This descriptive study was being carried out in 519 hospital health staff admitted to family medicine outpatient clinic for health screening between 03.10.2015 and 30.12.2015. Socio-demographic characteristics and hepatitis B vaccination status of the participants were recorded on forms prepared in advance by researchers. Serum HBsAg and anti-HBs levels were measured. Antibody titers of 10 and below were considered negative and these staff were taken to 3 doses of hepatitis B vaccine program. Results: Of the participants, 35.6% (n=185) were female, 64,4% (n=334) were male and the mean age was 35.24 ± 8.35 years. One hundred and sixty-two (31.2%) had 0-10 mIU/ml, 14.5% (n=75) had 10-100 mIU/mL levels, 54.3% (n=282) ≥100 mIU/mL of the anti-HBsAg value. The serum HBsAg levels of the hospital staff were found as 97.7% (n=507) negative and 2.3% (n=12) positive. While there was no statistically significant difference between the gender and serum HBsAg levels, a statistically significant difference was found between the ages of the staff and serum HBsAg levels (p<0,001). Conclusion: Hepatitis B virus (HBV) is a pathogen that is at risk of health care workers. All health care workers at risk should be immunized against hepatitis B virus. One of the most effective methods in the prevention of hepatitis B infection was immunization. In this study, 68.8% were seropositivite and 2.3% were hepatitis B carriers in accordance with other studies in Turkey. Key words: Health staff, screening, hepatitis B vaccine, anti-HBs, HBs Ag. Amac: Bu calisma, saglik taramasi icin aile hekimligi poliklinigine basvuran hastane personelinde serum HBsAg ve anti-HBs duzeyleri ile, hepatit B asilanma durumlarini arastirmak icin yapilmistir. Yontem: Tanimlayici tipteki bu arastirma, 03.10.2015-30.12.2015 tarihleri arasinda, saglik taramasi icin poliklinigimize basvuran 519 hastane personelinde yapilmistir. Katilimcilarin sosyodemografik ozellikleri ve hepatit B asilanma durumlari, arastirmacilar tarafindan onceden hazirlanan formlara kaydedilmistir. Serum HBsAg ve anti-HBs duzeyleri olculdu. Antikor titresi 10 mIU/mL ve altindaki degerler negatif olarak kabul edildi ve bu personeller 3 doz Hepatit B asi programina alinmistir Bulgular: Katilimcilarin %35,6’si (n=185) kadin, %64,4’u (n=334) erkek, yas ortalamasi 35,24±8,35 yil idi. Yuz altmis iki kiside (%31,2) anti-HBs duzeyi 0-10 mIU/mL arasinda, %14,5’inde (n=75) 10-100 mIU/mL arasinda, %54,3’unde (n=282) ≥100 mIU/mL idi. Serum HBsAg duzeyi, hastane personelinin %97.7’sinde (n=507) negatif, % 2.3’unde (n=12) pozitif bulundu. HBsAg pozitifliginin cinsiyetle degil, yasla anlamli farklilik gosterdigi tespit edilmistir (p<0,001). Sonuc: Hepatit B virusu (HBV), hastane calisanlarinin risk altinda oldugu bir patojendir ve tum hastane personeli hepatit B virusune karsi bagisik olmalidir. Hepatit B enfeksiyonundan korunmada en etkili yontem asilamadir. Bu calismada bulunan % 68,8 oraninda antikor titresi pozitifligi ve % 2,3 oraninda hepatit B tasiyiciligi, ulkemizde yapilan diger calismalarla uyumludur. Anahtar kelimeler: Hastane personeli, tarama, hepatit B asisi, anti-HBs, HBsAg.

Management of health crisis in nursing homes by adapting hospital-at-home integrated care programs: a local experience from Catalonia

Introduction: It is essential to find new models of care adapted to older residents in social institutions, due to the increasing health complexity of users of these long term care settings. If hospital staff could be effective in managing health crisis in nursing homes, in a more integrated approach, it is unclear. Description of practice: New integrated care units were created in Catalonia, using Intermediate Care resources, in order to manage health crisis of older patients without using conventional hospitalization. A key supportive point of this project for the future is developing hospital-at-home interventions in older patients in the community, including nursing home. Interventions could be run after: a. direct assessment at nursing home or an Emergency Department visit (Admission Avoidance strategy); b. a short hospital stay (Early Discharge strategy). At nursing home, an individualized care plan was defined for each suitable case (medical stability with no severity criteria), sharing objectives with the staff of the setting, in order to stabilize health status and improve conditions associated with acute illness (as functional decline, delirium or nutritional risk). Targeted population and stakeholders: It was developed to attend nursing home residents of the urban area of Badalona, North of Barcelona. A previous analysis found that they have high risk baseline characteristics as old age and multiple chronic conditions related with morbidity and disability. More than a half of the users have low to severe grade of dementia. 15th International Conference on Integrated Care, Edinburgh, UK, March 25-27, 2015 1 International Journal of Integrated Care – Volume 15, 27 May – URN:NBN:NL:UI:10-1-117026 – http://www.ijic.org/ A team of specialized hospital health staff and staff from rehabilitation community services developed an innovative program based on Comprehensive Geriatric Assessment for the management of health crisis leading to acute disability in this population, as a local experience. It is being evaluated for future implementation to other areas in Catalonia. Highlights (innovation, impact and outcomes) Innovations:The model of care from acute and postacute geriatric units was adapted to users in the community with a pragmatic approach. Impact: It is an opportunity to maintain highly vulnerable complex older patients in the community, by avoiding hospital admissions o shortening hospital stay in low severity health crisis. Outcomes: N 89 cases attended through 2 years. Main characteristics of patients were (median and IQR or %): age 86 (81-89.5), 77.5% female, number of geriatric conditions 4 (2-6), 57% of patients had dementia. Delirium was detected in 25% of acute health crisis. Main diagnostic groups were: 43% medical, 49% orthopaedic and 8% stroke (Admission Avoidance/Early Discharge strategy: 59/41%). Resolution of health crisis (medical and functional stabilization without hospital readmission) was possible in 80% of cases. Length of hospital-at-home intervention was 46 days. Conclusion: This alternative to conventional hospitalization program in nursing home seems possible and adapted to older patients at risk. Both strategies, admission avoidance and early discharge, could be included, for several medical and surgical conditions. The majority of cases could be managed without new hospitalizations. Discussion: Several organization changes are needed in order to develop this innovative approach. In our experience, hospital staff collaborated with community services, as a functional team. A good targeting process is necessary to avoid risks for patients and nursing homes. Health care technology need to be available to provide intense care outside the hospital. To implement this experience in our social and health system, changes in payment of services need to be considered. Lessons learnt: Integrating hospital care and community services in an individualized intervention in nursing homes for health crisis is an opportunity for the health and social systems. Several changes are needed in order to support implementation of this local experience to the whole system in Catalonia.

KARABÜK EĞİTİM ARAŞTIRMA HASTANESİ’NDE ÇALIŞAN SAĞLIK PERSONELİNİN HİZMET İÇİ EĞİTİMLERE BAKIŞI

Yaşam boyu eğitimin bir gereği olarak karşımıza çıkan hizmet içi eğitim, çalışanlara mesleklerinde daha başarılı, üretici ve mutlu olmasını sağlayacak bilgi, beceri ve tutumlar kazandırmayı amaçlar. Hizmet içi eğitim; özel ve tüzel kişilere ait iş yerlerinde, belirli bir maaş veya ücret karşılığında işe alınmış veya çalışmakta olan kişilere, görevleriyle ilgili gerekli bilgi, beceri ve tutumları kazandırmak üzere verilen eğitimdir. Hiç kuşkusuz Tıp bilimi hızla gelişmekte ve her geçen gün yeni tedavi yöntemleri, yeni teknolojiler ortaya çıkmaktadır. Bu değişime ayak uydurmak ve kaliteli bir hizmet verebilmek için, sağlık çalışanları, tüm çalışma hayatları boyunca var olan bilgilerini tekrarlamaya, geliştirmeye, yeni bilgiler öğrenmeye ve öğrendiklerini uygulamaya geçirmeye açık olmalıdır. Hizmet alanı insan sağlığı olan bir kurumda hizmet içi eğitim muhakkak çok önemsenen ve vazgeçilmez bir konudur. Sağlık sektöründe çalışan personele, ihtiyaç ve ilgileri doğrultusunda, kurumun olanaklarıyla, kurum yöneticilerinin katılım ve işbirliği ile düzenlenen hizmet içi eğitim programları, bireysel ve kurumsal verimliliğin artırılması, çalışanların mesleki güven duygularının gelişmesi, kurum içi iletişim ve ilişkilerin güçlenmesi gibi birçok fayda sağlar. Bu çalışma; Karabük Eğitim ve Araştırma Hastanesi’nde görev yapmakta olan ebe ve hemşirelerin hizmet içi eğitim programları ile ilgili görüşlerini öğrenmek ve istenen kalitede hizmet içi eğitim programları yapılmasına olanak sağlayacak uygulanabilir öneriler geliştirmek amacıyla yapılmıştır.

KARABÜK EĞİTİM ARAŞTIRMA HASTANESİ’NDE ÇALIŞAN SAĞLIK PERSONELİNİN HİZMET İÇİ EĞİTİMLERE BAKIŞI

In service training as a necessecity of long life learning programme aims to make the workers more successful, creative and happy at their jobs.The aim of this study is to discuss the importance of inservice training for health staff. For this aim, first the teoretical framework was given. In this context, several aspects such as health staff adaptation process towards new developments in their career, how they can be effective and the importance of inservice training for health staff were discussed. In-service training provide knowledge and skills health staff in order to they use new educational technologies effectively and increase their performance. Briefly, This study discusses the aims and principles of in-service training for health staff in termsof different aspects. This study is conducted to learn Karabük Training and Research Hospital health staff on the professional development training and to give suggestions which is appliable to develop better professional development programmes.

Surveillance and response system for maternal deaths in Sri Lanka: an audit

BackgroundMany women in low-income countries die from pregnancy-related causes. Review of maternal deaths can help to prevent such deaths and improve delivery of maternal care services, but audits of maternal deaths are not easy to do in resource-poor settings. We audited probable maternal deaths reported during 2012 in Sri Lanka. MethodsWe analysed data for death collected by the Family Health Bureau, which coordinates audits of maternal death in Sri Lanka. Field and hospital health staff are required to notify deaths, do post mortems, investigate, and report to national level each maternal death. We analysed each death related to three delays: in seeking health care, in reaching a health facility, and in treatment. We asked health-care workers in 26 districts to suggest strategies to change and improve service delivery. FindingsOf 218 probable maternal deaths, we classified 134 as maternal deaths (WHO definition) and calculated the national maternal mortality rate (37·7 per 100 000 live births). Haemorrhage (n=22) and heart disease (n=15) were leading causes of death. Women who died tended to be well educated (n=109, 81%) and from rural regions (n=106, 79%). 92 (69%) of these women died in the postnatal period. Delays in seeking health care contributed to 64 deaths (71%), whereas delays in receiving treatment contributed to 54 (60%) and delays in reaching a health facility contributed to two (2%). Not promoting family planning, substandard management, and inadequate field post-natal care were identified as deficiencies. InterpretationSri Lanka implements a systematic surveillance of maternal deaths at low cost, with involvement of key partners to further reduce deaths and improve care. Such a system is replicable in any setting if launched methodically and in collaboration with committed partners. FundingNone.

Medical bodies call on NHS trust boards to improve health of hospital staff

NHS board members must take proactive responsibility for the health and wellbeing of hospital staff, the Royal College of Physicians and Faculty of Occupational Medicine have said. The 2009 Boorman review of the health of NHS staff found a …

(P1-81) Differences between Radiation Dosages to Which the Radiology Department Staff and the Public were Exposed

IntroductionIn this study, the mean daily and annual radiation exposure of the radiology department staff, other hospital health staff, and public volunteers was compared at Maresal Cakmak Military Hospital in Erzurum, Turkey.MethodsThe NEB.211 Dose–Rate Meter with a Gaiger–Müller counter was used to measure the amount of radiation. Six radiology department health staff carried the NEB.211 device during seven working hours. At the end of the day, total absorbed dosages were noted. The same measurements were also done for the six health staff of the other departments and six non-hospital volunteers. Seventeen additional hours were noted for the non-hospital volunteers. The mean value of 17 hours of daily measurements (3.31 mSv) was added to the both group's working hours measurements and the total daily radiation amounts were calculated.ResultsThere was no statistical difference between each three groups in working hours (p = 0.087), daily and annual equivalent dosages (for both p = 0.099).DiscussionThe radiology department health staff was exposed to radiation under the border of equivalent dosage which is determined by Turkish Automic Energy Authority. Public volunteers were seen as they were exposed the radiation over the determined border of equivalent dosage. Nonetheless, with changes depending on living standards, the physical properties of living spaces and geographical circumstances per capita exposed annual dosage is about 2.4–2.8 mSv throughout the world. There was no significant statistical difference between the amounts of equivalent dosage which were exposed to the radiology department health staff, the other hospital staff and public members.

A piece of the puzzle &amp;mdash; the role of ethnic health staff in hospitals

The role of ethnic health staff in hospitals has not been clearly articulated for managers and practitioners. This paper describes findings from a study based on ethnic and allied health staff interviews and observations of ethnic health staff interactions. Care was provided to language concordant patients directly and by assisting practitioners to work within the patient's cultural paradigms and family schema. The scope of practice involved: engaging patients in a therapeutic relationship, patient assessment, linking assessment with care options, facilitating communication between patients and practitioners, education, smoothing hospital experiences, referral and interpreting. Ethnic health staff displayed a range of specialised skills that managers need to harness within multidisciplinary teams to reach patients from diverse backgrounds.

Increasing frequency of tuberculosis among staff in a South African district hospital: impact of the HIV epidemic on the supply side of health care

To describe the changing frequency of tuberculosis among staff in a South African hospital, and to compare incidence in health workers with that in ancillary staff, the number and type of cases of tuberculosis among staff diagnosed between 1991 and 1996 were ascertained. The incidence rate of tuberculosis among health workers and ancillary staff was compared with the age-specific rate in the community (20–59 years old). In 1991–1992, 2 cases of tuberculosis were diagnosed among hospital staff; but in 1993–1996 there were 20 cases diagnosed (annualized incidence rates 138/100000 and 690/100 000; P < 0·0001). Of 14 cases tested (64%), 12 (86%) were infected with human immunodeficiency virus (HIV). Most cases (82%) successfully completed treatment, but 4 died (18%). The incidence of tuberculosis amongst health workers ( 558 100 000 person-years of observation [PYO]) and ancillary staff ( 445 100000 PYO) was not significantly different ( P = 0·7), but it was lower than the incidence rate among 20–59 years old people in the community ( 1543 100000 ). Tuberculosis has increased amongst hospital staff, secondary to the impact of HIV. The HIV epidemic is having a substantial impact on the health of hospital staff and interventions to counter this are urgently needed.