Healthcare Support Staff Research Articles

Exposure to needlestick injury among healthcare support staff in Greater Accra, Ghana: a cross-sectional study

ObjectivesThis study aims to determine the prevalence and predisposing factors of a needlestick injury (NSI) among healthcare support staff in the Greater Accra region, Ghana.MethodsAn analytical cross-sectional survey was carried...

Splash of body fluids among healthcare support staff in Ghana: a cross-sectional study.

Exposure to splash of body fluids is one of the common ways of transmitting blood-borne infections from patients to healthcare practitioners. Globally, there is a paucity of evidence on exposure to splash of body fluids among hospital housekeepers. This study, therefore, investigated splash of body fluid and its predisposing factors among healthcare support staff in the Greater Accra region, Ghana. An analytic cross-sectional survey was conducted among support staff in 10 major hospitals between 30 January and 31 May 2023. A multi-stage sampling procedure was the overarching technique employed, and study participants were recruited through simple random and probability proportional-to-size sampling techniques. The data analyses were conducted using STATA 15 software. The preliminary association between exposure to splash of body fluids and predisposing factors was established through Chi-square, Fisher's exact, and Mann-Whitney U tests. Log-binomial regression analyses were employed to validate the factors related to splash of body fluids at a significance level of p-value < 0.05. The investigation was conducted among 149 healthcare support staff. The exposure to splash of body fluids over the past 1 year was 53.7% (95% CI: 45.3%-61.9%). The types of body fluids that were mostly encountered through these splash exposures were amniotic fluids (36.3%) and urine (23.8%). Several factors were found to be significantly associated with splash of body fluids, namely: employed as a healthcare assistant [APR = 1.61 (1.16, 2.22)], holding a supervisory position [APR = 0.24 (0.11, 0.51)], having a system in place for reporting body fluid splashes [APR = 0.61 (0.44, 0.85)], male healthcare support staff [APR = 0.62 (0.41, 0.93)], and adherence to standard precautions most of the time [APR = 1.66 (1.11, 2.48)]. Healthcare support staff were highly exposed to splash of body fluids. Gender, supervisory role, category of worker, reporting systems, and adherence to standard precautions were associated with exposure to splash of body fluids. Facility managers are advised to enhance the efficiency of reporting systems.

Spatial Variations in the Nasal Microbiota of Staff Working in a Healthcare-Associated Research Core Facility

Objective: Workers in the healthcare sector are exposed to a multitude of bacterial genera. The location of their work contributes significantly to shaping personal microbiomes. In this study, we investigated the role of the workspace on the nasal bacteriome of staff working in a healthcare-associated research facility. Methods: The anterior nares of 10 staff working in different laboratories on the ground and first floor of the research facility were aseptically swabbed. Genomic DNA from each sample was used to amplify the V3 and V4 regions of the 16S rRNA gene. The amplified products were sequenced using the MiSeq sequencer (Illumina). Operational taxonomic units were filtered through MG-RAST v.3.6. Taxonomic profiling and visualizations were performed in MicrobiomeAnalyst v2.0. Results: The Wilcoxson Sum test at median abundances (p < 0.05) indicated that seven taxa (Micromonosporaceae, Micromonospora, Lactobacillaceae, Lactobacillus, Betaproteobacteria, Burkholderiales, Pectobacterium) were significantly diverse between ground-floor and first-floor workers. The analysis of similarity coefficient was 0.412 (p < 0.03) between the ground and the first-floor workers. Random forest analysis predicted 15 features that were significantly different (p < 0.05) in individuals working in different laboratories. Species richness and evenness also differed according to the placement of individuals in respective laboratories. Conclusion: These findings add to the knowledge that the healthcare support staff are at a speculated occupational risk. A slight shift in the abundances of bacterial genera and species might lead to unwanted consequences. Continual monitoring is thus warranted.

Ten Practice Changes in COVID-19 Intensive Care Unit of a Tertiary Care Teaching Hospital in India during the Peak of Pandemic: Adapt and Improve.

During the peak of the coronavirus disease-2019 (COVID-19) pandemic, 10 practice-changing decisions were adopted which led to an improved standard of clinical care in the face of overwhelming burden to the healthcare setup. Formation of a control unit with the piggyback team, briefing before donning, replacement of personal protective equipment (PPE) with impermeable surgical gowns, a dedicated prone team and the prone bundle of care, weaning-extubation and tracheostomy protocol, online audiovisual family-patient meet, daily rounds by hospital infection control committee member, each one clean one policy, focused onsite training of healthcare support staff and discharge policy with post-discharge follow-up were the 10 important changes adopted.How to cite this articleSoni L, Pangasa N, Baidya DK, Subramaniam R. Ten Practice Changes in COVID-19 Intensive Care Unit of a Tertiary Care Teaching Hospital in India during the Peak of Pandemic: Adapt and Improve. Indian J Crit Care Med 2022;26(6):710–711.

Evaluation of Knowledge, Attitude and Practice of Voluntary Blood Donation among Healthcare Support Staff of a Tertiary Health Facility in Uyo, Nigeria

Background: Blood transfusion is a veritable intervention in many clinical situations. However, the provision of safe, readily available, affordable and adequate supply of blood and blood products is still a major public health challenge in developing countries like ours. Healthcare support staff are expected to be conversant with donor blood procurement processes and the challenges of blood supply, therefore should take the lead in forestalling the occurrence of blood supply deficits.&#x0D; Aims: To assess the knowledge, attitude and practice of voluntary blood donation among non-physician healthcare workers.&#x0D; Methods: This was a cross-sectional study carried out at the University of Uyo Teaching Hospital, Uyo as part of the 2021 World Blood Donor Day Programme. A total of 120 Staff were recruited. Pre-tested questionnaire were used to assess their knowledge, attitude and practice of voluntary blood donation.&#x0D; Results: The mean age of the respondents was 36.9+9.8 years, range 18-58 years with females accounting for 51.7%. Sixty percent were married, 86.7% attained tertiary level of education and majority of the respondents (20.8%) were nurses. Most of the study participants had good knowledge and positive disposition towards blood donation. However, only 25.8% had donated blood in the past with 38.7% being voluntary. Male staff were more likely to donate (P = 0.001). There were no statistically significant associations between blood donation practice and marital status, level of education and professional status of the respondents (P values – 0.083, 0.557 and 0.05 respectively)&#x0D; Conclusion: There is need for active education program to encourage the healthcare workers and the general populace to participate in voluntary blood donation.

Knowledge, Practices and Attitude of Health Care Support Personnel on COVID-19: A Comparative Study Bhutan and Sri Lanka

Background: Health care support personnel are more vulnerable to COVID-19 due to the nature of their work. Their comparatively lower education qualifications, the important service they provide and associated risks of infection to themselves and others are high. This study attempts to explore and compare the knowledge, practices, and attitude of health care support personnel in Bhutan and Sri Lanka.&#x0D; Methods: A descriptive cross-sectional study using a purposive stratified sampling method with a questionnaire administered on knowledge, practices, and attitude was conducted from September 2020 to June 2021. The analysis was run using SPSS 21.&#x0D; Results: There were 775 (383 Sri Lankans, 392 Bhutanese) respondents. They consist of attendants (204), health care assistants (labourers) (355), cleaners (140), ambulance drivers (35) and security guards (41). Their levels of education were Grade 12 (24.5%), Grade 10 (41.2%), Grade 8-5(22.2%), and no formal education (12.1%). The majority (66.3%) had a ‘good’ knowledge level of COVID-19. Sri Lankan and Bhutanese mean knowledge score is 7.55 and 7.44 respectively (p&lt;0.05). Overall, not much difference is observed in Practice related to COIVD-19 in both countries. Sri Lankans reported less fear of contact with COVID patients than Bhutanese (p&lt;0.05), but more Bhutanese feel safe at work than Sri Lankans (p&lt;0.05). More Bhutanese (90.8%) report satisfaction with measures taken by their hospital compared to Sri Lankans (49.3%).&#x0D; Conclusion: Sri Lanka reports slightly higher knowledge test means compared to Bhutan. While more Bhutanese report fear of contact with COVID-19 patients, more Bhutanese report satisfaction with measures taken by their hospitals for their safety, comparatively. It is important to explore the low levels of appreciation perceived, fears reported, and study ways to improve the psychological well-being of healthcare support staff.

NS-64: Lessons learned: patient management and outcomes of Multiple Myeloma patients during the COVID-19 pandemic in New York City

New York City (NYC) was an epicenter of COVID-19 pandemic in the United States during spring 2020. During March–May 2020, approximately 203,000 confirmed COVID-19 cases were reported among NYC residents including 54,211 (26.6%) known to have been hospitalized and 18,679 (9.2%) who died. NYC had a higher confirmed coronavirus case volume than any country in the world, besides the United States. Here, we discuss how advanced practitioners Providers (APPs) and Health Care Support Staff in the Multiple Myeloma (MM) program at Mount Sinai Hospital in NYC modified patient care guidelines during the COVID-19 pandemic in an effort to balance the need for social distancing and optimizing patient care. Cognizant of these key factors during the pandemic, oncology APPs, nurses, physicians, and staff at Mount Sinai convened to determine how patients should be best managed. Important considerations in addition to remission status and type of therapy (IV/SC or oral) included the patient’s performance status and chemotherapy oral adherence. Based on these, the group determined: (1) Newly diagnosed patients or relapsed patients with significant cytopenias who need parenteral therapy should continue with the current therapy, but the number of visits should be decreased to limit exposure to other HCPs. If the patient has had a good response to treatment, consider changing to an oral regimen. (2) Patients in remission (complete remission, very good partial remission) should consider switching therapy to an oral regimen (immunomodulatory agents, proteasome inhibitors, dexamethasone, and/or Histone deacetylase inhibitors). (3) Stem cell harvest and stem cell transplant should be delayed if the patient continues to respond to the current therapyOutcomesDuring this time we had 58 MM patients diagnosed with COVID-19, 36 were hospitalized and 22 were managed at home. The median age was 67 years; 52% of patients were male and 63% were non-White. Hypertension (64%), hyperlipidemia (62%), obesity (37%), diabetes mellitus (28%), chronic kidney disease (24%), and lung disease (21%) were the most common comorbidities. In the total cohort, 14 patients (24%) died. Older age (>70 years), male sex, cardiovascular risk, and patients not in complete remission (CR) or stringent CR were significantly (p<0.05) associated with hospitalization. Although several demographic factors and comorbidities increased the risk of hospitalization and mortality, myeloma therapy did not influence outcomes. In fact, survival was comparable to the overall population of New York during the pandemic. Our data supports the need to maintain proactive management of MM patients by balancing their need for therapy with the increased risk of hospitalization and death in a subset of MM patients with COVID-19.

Adapting to the unexpected: Problematic work situations and resilience strategies in healthcare institutions during the COVID-19 pandemic’s first wave

The COVID-19 pandemic’s first wave required considerable adaptation efforts on the part of healthcare workers. The literature on resilient healthcare describes how the collective regulation strategies implemented by frontline employees make essential contributions to institutions’ abilities to cope with major crises. The present mixed-methodology study was thus conducted among a large sample of employees in a variety of Swiss healthcare institutions and focused on problematic real-world situations experienced by them and their managers during the pandemic’s first wave. It highlighted the anticipatory and adaptive strategies implemented by institutions, teams and individuals. The most frequently cited problematic situations involved organisational changes, interpersonal conflicts and workloads. In addition to the numerous top-down measures implemented by institutions, respondents also identified personal or team regulation strategies such as increasing staff flexibility, prioritising tasks, interprofessional collaboration, peer support or creating new communication channels to families. The present findings underlined the importance of taking greater account of healthcare support staff and strengthening managerial capacity to support interprofessional teams including those support staff.

Implementing the duty of candour: a guide for healthcare support staff

Implementing the duty of candour: a guide for healthcare support staff

Pre-placement examinations for newly recruited health care support staff.

ObjectiveWhile musculoskeletal disorders (MSD) and physical strength have been extensively studied in health care professionals, little attention has been paid to health care support staff, such as patient care assistants and operation patient assistants, whose jobs are physically demanding. The purpose of this paper was to examine the musculoskeletal symptoms and physical strength of newly recruited health care support staff.MethodConvenience sampling was conducted on 111 newly employed health care support staff in a public hospital. A custom-made pre-placement examination was performed. Data were analysed using descriptive, correlation, and regression analyses.ResultsNearly one-third (32%) of the newly recruited health care support staff had experienced musculoskeletal symptoms in at least one body part during the preceding 12 months. Two-thirds (68%) of subjects were physically inactive, and sixty percent was overweight or obese. Handgrip strength was weaker than the local norm. The subjects’ dominant handgrip strength, bilateral lifting, pushing, and pulling force were significantly correlated. Only bilateral lifting was significantly associated with MSD among the newly recruited health care workers.ConclusionsThis study reports the baseline prevalence of MSD symptoms in the newly recruited health care support staff. Their sedentary lifestyle and suboptimal physical strength may render them susceptible to occupational injuries and disease. An effective occupational health programme that provides periodic health surveillance should be considered for high-risk health care workers to allow proper interventions in a timely manner.

Work at inpatient care units is associated with an increased risk of SARS-CoV-2 infection; a cross-sectional study of 8679 healthcare workers in Sweden

Background During the Covid-19 pandemic, the protection of healthcare workers has been in focus throughout the world, but the availability and quality of personal protective equipment has at times and in some settings been suboptimal. Materials and methods A total of 8679 healthcare workers and healthcare support staff in the county of Uppsala, north of Stockholm, were included in this cross-sectional study. All subjects were analysed for IgG anti-SARS-CoV-2, and predictors for positive serostatus were analysed in a logistic regression model including demographic parameters and self-reported employment characteristics. Results Overall, 577 (6.6%) were classified as seropositive, with no statistically significant differences between healthcare workers and support staff. Among healthcare workers, age (OR 0.987 per year, 95% CI 0.980–0.995), time to sampling (OR 1.019 per day, 95% CI 1.004–1.035), and employment at an outpatient care unit (OR 0.620, 95% CI 0.487–0.788) were statistically significantly associated with risk of infection. Covid-19 specific units were not at particular risk, compared to other units with comparable characteristics and staff demography. Conclusion Our findings indicate that SARS-CoV-2 transmission is related to inpatient healthcare work, and illustrate the need for a high standard of basic hygiene routines in all inpatient care settings.

Nursing workforce—fit for practice: an overview of the RCN education and training directory

In October 2019, the UK Government responded to the Health and Social Care Committee report on sexual health. The response focused on five key areas; a new national strategy, funding...

Emotional experience of people with advanced liver disease: Secondary data analysis.

Patients with advanced liver disease live mainly in the community with treatment of complications provided for in-hospital. The illness trajectory of advanced liver disease is uncertain and most do not have access to end of life care. Gaps in knowledge and understanding of the patient experience of this condition have been identified. Secondary analysis of 15 transcripts from in-depth interviews with people with advanced liver disease collected as part of a previous longitudinal study on the experience of liver disease. Transcripts were thematically analysed for emotional content. Fear, anger, sadness and guilt clearly featured in the person's experience of advanced liver disease. Certain causal factors were identified as provoking these emotional responses, including shock of diagnosis, uncertainty concerning illness, lack of coordinated care, worrying symptoms and sudden death. Humour emerged as a coping mechanism. People living with advanced liver disease experience distressing emotions. It is helpful for clinicians, nurses and other healthcare support staff to have an appreciation of the person's emotional concerns in order to provide holistic care typical of a palliative approach.

Relationships between healthcare staff characteristics and the conduct of vital signs observations at night: Results of a survey and factor analysis.

AimTo explore the association of healthcare staff with factors relevant to completing observations at night.DesignOnline survey conducted with registered nurses, midwives, healthcare support staff and student nurses who had worked at least one night shift in a National Health Service hospital in England.MethodsExploratory factor analysis and mixed effects regression model adjusting for role, number of night shifts worked, experience and shift patterns.ResultsSurvey items were summarized into four factors: (a) workload and resources; (b) prioritization; (c) safety culture; (d) responsibility and control. Staff experience and role were associated with conducting surveillance tasks. Nurses with greater experience associated workload and resources with capacity to complete work at night. Responses of student nurses and midwives showed higher propensity to follow the protocol for conducting observations. Respondents working night shifts either exclusively or occasionally perceived that professional knowledge rather than protocol guided care tasks during night shifts.

A survey of therapists views on reducing sedentary behaviour in an acute clinical setting

Reducing sedentary behaviour is a priority in both the clinical and research settings. This survey aimed to gather the views on reducing sedentary behaviour from physiotherapy, occupational therapy and healthcare support staff working in the acute healthcare setting. Sixty-nine occupational therapy and physiotherapy staff completed an online survey during March and April 2018. The results were analysed by manual thematic analysis. Barriers to sedentary behaviour have been categorised under the following themes: patient factors, cultural factors, environmental factors and organisational factors. Solutions to facilitate change were themed as: move early and often, self-management, education, culture, environment, collaboration, social engagement, roles and sharing. The findings provide a basis for changing behaviour from a practitioner perspective.

Collaborative risk awareness training – an evaluation

A collaborative risk awareness-training package was designed by service users and staff to enhance understanding and the ability to tolerate discussion about risk. Service users contributed to the design as well as the delivery of the training. A training needs analysis and focus group with service users helped develop this training. Two questionnaires were developed to measure the effectiveness of the training, which was delivered by a PowerPoint presentation. Overall the training was found to significantly improve the knowledge and attitudes of nursing and health care support staff who attended. Service users involved in the training overall reported gaining a very positive experience, which they felt improved their self-worth and motivation.

Education for healthcare clinical support workers.

This article reviews the current situation regarding the provision of education and training for healthcare clinical support workers (HCSWs). In the UK, there has been an increasing reliance on unqualified clinical support staff to provide a significant proportion of the direct patient care in all healthcare settings. HCSWs routinely undertake several nursing activities that were traditionally the responsibility of nursing students or junior staff nurses. There is a need for an urgent review of the training of healthcare support staff. A 'tick box' approach to training, with an emphasis on classroom-based or on-the-job learning, makes it difficult for HCSWs to integrate theory into practice, and supports a transactional approach to caring rather than a relational approach to caregiving. Lessons from the educational experiences of other healthcare groups should be applied to the training of HCSWs. An immersive, participatory teaching and learning strategy is one approach that could be used.

Effective Communication in Outbreak Management – Experiences and Suggestions by European Public Health Experts

Background: The 2009/2010 A/H1N1 pandemic affected 214 countries and led to ˜18.500 reported deaths. Major communication difficulties within Europe were observed along with a low vaccination uptake and limited public trust in official recommendations. Therefore the overall aim of the EU funded E-com@EU project is to improve risk communication strategies during major epidemic outbreaks in Europe. Within this framework the objective of this study is to analyse the experiences and suggestions of European Public Health Experts who were directly involved in the risk-communication process during the A/H1N1 pandemic. Methods: Semi-structured qualitative interviews with 25 European stakeholders were conducted. The experts came from eight European countries (Germany, Italy, The Netherlands, Poland, Romania, Spain, Sweden and United Kingdom) and three different management levels: Micro level (physicians, health-care staff), Meso level (local public health authorities) and Macro level (national health authorities). The interviews were analysed using Mayrings' qualitative content analysis methodology. Results: During the pandemic some stakeholders were overwhelmed by the sheer amount of daily information and wished for a manageable number of reliable sources that summarize the information precisely. Personal and telephone meetings to exchange information were highly valued. Using new media like short video clips or social media to disseminate relevant information to the public was suggested. The considerable role of influential persons, health care support staff and the media in the decision making process of the public was also pointed out. Discussion: Although recall-bias (pandemic in 2009/10, interviews in 2013/14) and language barriers may have played a role, the results clearly indicate that there is a need to develop evidence-based risk-communication strategies for Europe in preparation for major pandemics. For example establishing better relations between public health and media representatives is required. Investing in measures to increase the society's trust in public health authorities is another area for improvement.

Views and experiences of nurses and health-care assistants in nursing care homes about the Gold Standards Framework.

To explore the views and experiences of nurses and health-care support staff about the use of the Gold Standards Framework (GSF) for end-of-life care (EoLC) for older people in nursing care homes (NCHs) with GSF accreditation. A qualitative descriptive study was conducted with three purposively selected NCHs in London. Individual interviews were conducted with NCH managers (n=3) and in each NCH, a focus group was conducted with registered nurses (RNs) and health-care assistants (HCAs): focus group 1, n=2 RN, n=2 HCA; focus group 2, n=2 RN, n=3 HCA; focus group 3, n=3 RN, n=3 HCA. Interviews were audio-recorded, transcribed and analysed using framework analysis. Three core themes were identified: (i) a positive regard for the GSF for care homes (GSFCH); (ii) challenges around EoLC for older people; and (iii) difficulties in using the GSFCH. RNs, HCAs and managers regarded the training and support afforded by the GSFCH programme to inform EoLC for older residents positively. The framework has the potential to promote a coordinated approach to EoLC for older people. In the post accreditation period, there is a need for ongoing support and development to help embed the key tenets of the GSFCH in the culture of caring.

Valuing the contribution of healthcare support staff

Valuing the contribution of healthcare support staff