Healthcare Workplace Research Articles

Measures Taken By Indian Hospitals toward Healthcare Worker and Workplace Safety during COVID-19 Pandemic

Background: Healthcare workers at hospital settings were increasingly vulnerable to the COVID-19 virus and it was therefore essential to ensure that steps were taken to reduce the risk of both nosocomial transmissions to patients under their care as well as to each other. The aim of this study was to analyze the effect of measures taken by various Indian hospitals, toward the safety of their healthcare workers during the pandemic. Materials and Methods: The data were collected as the part of a competition conducted among the interested healthcare organizations (HCOs) on measures taken by Indian hospitals toward healthcare worker and workplace safety during the COVID-19 pandemic. Information about the various health and safety measures undertaken was collected from 93 Indian hospitals, through a self-reported questionnaire, which were compiled and analyzed. Results: The HCOs demonstrated 100% compliance with providing adequate personal-protective equipment based on risk stratification and physical distancing precautions, with 94% of organizations redesigning their workflows, accordingly. They also showed 97% compliance to mandatory handwashing protocols and 99% compliance to thermal screening. However, only 52% provided psychological counseling for workers, 35% provided medical care for dependents, 31% undertook WASH (water, sanitation and hygiene) certifications, and 40% obtained feedback from staff for areas of improvement. Out of the 110,679 staff involved in clinical care among the 93 HCO, 6189 staff (6%) tested positive for COVID-19, being higher (13%) among staff working in the COVID-19 wards compared to 4% among those working in the non-COVID-19 wards. Conclusion: Healthcare workers are at a higher risk of exposure to SARS-CoV-2 infection and can also transmit infections to the community. The HCOs surveyed incorporated innovative solutions to tackle the threat of COVID-19, which demonstrated success with relatively low incidence of infections among the staff evaluated. This study highlights strengths and exposes weaknesses, which should be considered for disaster mitigation plans as an effective step toward future pandemic preparedness.

Improving Policy and Legislation Related to Healthcare Workplace Violence

Abstract Our group conducted the first known New Hampshire survey on healthcare staff experience of workplace violence. Study questions focused on experiences of workplace violence, incident reporting mechanisms, and the availability and benefit of workplace violence training programs. Results were consistent with recently published literature: violence against healthcare workers remains a serious public health problem that is under-reported, understudied, “tolerated and largely ignored.” We will discuss the aspects of policy and legislative responses to workplace violence that have been insufficient to address this problem. We also will present some strategies that, if implemented, could lead to improved policy and legislation that may be more proactive in reducing such violence.

An Aging Nursing Workforce: Thematic Analysis from the Nurstory Project

Background: Nursing in the United States of America is an aging workforce. This study sought to better understand the lived experience of aging nurses. Because nurses work in systems where other forms of interpersonal power dynamics may influence internalized and external stereotype an approach based on intersectional theory was applied. Methods: A qualitative thematic narrative analysis of an existing data set of first-person digital stories in the Nurstory project, authored by a group of nurses, was the data source. An emergent coding method was applied. The collection of five digital stories were analyzed. Results: All stories were first person accounts of experiences that represented their internalized reflections and elements of ageism in how their age interacted with their work environment. Dominant themes included: 1) Role constriction 2) Strength 3) Tired and (re)Tired 4) Age perceived and 5)Loneliness. Conclusions: These aging nursing stories add to the contextual layers of the aging healthcare workplace and aging nursing workforce. These individual experiences offer a nuanced understanding of the internalized responses to aging and ageism. These stories highlight socially constructed and socially reinforced attitudes that are complicated by the personal and occupational expectations of nurse’s work, their role and embedded hierarchies in healthcare. Stories such as these are important individual and collective indicators of lived experiences that offer a deeper understanding into the intersections of social identity and aging, that when listened to, can offer insight and a way forward in addressing the stereotype, discrimination and social inequities of ageism.

Identifying and exploring resistance to the registered nursing associate role

Ruari Cassidy discusses factors that affect cohesion and acceptance of new roles in the healthcare workplace, in the context of the registered nursing associate role.

Health Care in the Steel City

Everybody knows that service jobs have replaced industrial jobs and that a huge part of those service jobs, about 20 million, are in health care—in hospitals, clinics, nursing homes, and home care. But the interrelated process through which that happened and the consequences for labor markets are rarely as palpable as they are in Gabriel Winant's new book on Pittsburgh, The Next Shift: The Fall of Industry and the Rise of Health Care in Rust Belt America. Epic in scope, Winant explores the inner and outer workings of two iconic industries across the entire period from World War II to today, showing how union-won health insurance birthed and shaped the US health care system. By focusing on one city, or metropolitan area, Winant is able to combine the complicated economics of steel and health care with sensitive, often intimate, observations of working-class life in workplaces, families, and neighborhoods based on interviews, diaries, and memoirs. Also distinctive is the consistent attention the book pays to the racial and gender relations in a predominantly white male steel industry, its families and neighborhoods, and in health care workplaces that are overwhelmingly female and African American, especially at the lower-wage end. Jack Metzgar, whose part-memoir Striking Steel: Solidarity Remembered was one of Winant's wide variety of sources, challenges several of Winant's big-picture claims.

Lexicogrammatical aspects in English for dentistry acquisition materials

In the 21st century, globalization and massive migration have increased the global demand for effective transnational communication skills in English in the health care workplace and academic contexts, including dentistry. English for Dentistry falls under the umbrella of English for Specific Purposes (ESP): this refers to teaching and learning English as a foreign language in a particular domain. While the role of grammar acquisition in ESP courses is often understated in the key theoretical literature on ESP, this article highlights the importance of lexicogrammatical knowledge. Dentistry students and practitioners in Latvia highly value the accuracy in communication since the knowledge of various syntactic and morphological rules of grammar and their use in the dentistry-related context contribute to the accuracy required in the performance of different communicative tasks, for instance, asking for, explaining, and providing information, giving instructions. Besides, if dentists are unable, for example, to explain a diagnosis, agree on treatment options with the patient in a meaningfully accurate way, the dentist’s authority may be undermined, resulting in unsuccessful communication. The case study reports on the tasks employing lexicogrammatical strategies in the material “Dentistry and Language Integrated Learning”, which has been developed by the authors of this article working in close collaboration with individual academic staff at the the Faculty of Medicine of the University of Latvia. The material piloted amongst both dentistry practitioners and students suggests that the applied strategies of morphological derivation, for instance, recognizing and building new words by gaining control of affixation devices, can be considered as useful tools in the new lexeme meaning-making process in dentistry. As a result, this study has attempted to support the assumption that ESP and content and language integrated learning (or CLIL) are compatible and can be efficiently mastered in the professional discourse development process.

The importance of ‘core’ clinical placements upon graduate self-perceived confidence and effectiveness in the healthcare workplace

Purpose: To explore the impact of not having a ‘core’ physio placement up on student confidence and perceived effectiveness upon entering the profession.

A Phenomenological Study of COVID-19’s Impact on U.S. Nursing Personnel

The COVID-19 pandemic overwhelmed the New York City area upon its arrival in the United States. Hospitals were unprepared to handle the influx of patients. This study explored nurse/nurse practitioner experiences when caring for COVID-19 patients in New York metropolitan hospitals, concentrating on physical well-being. Data collection involved in-depth interviews with eight participants. (A) physical safety of self, family members, colleagues, and patients greatly concerned participants; (B) caring for COVID-19 patients led to participants' physical exhaustion; and (C) most participants' sleep was impacted when caring for COVID-19 patients. This study identified issues involving U.S. health care workplace safety during the COVID-19 pandemic, namely availability of personal protective equipment, lack of centralized knowledge-sharing capabilities, sleep problems, anxiety regarding physical safety of self and others, and insufficient/undertrained staffing. It serves as a foundation for future research and calls for changes in U.S. hospital policies and procedures during crises.

An Ever-Growing Risk of Violence in the Healthcare Workplace

Physical workplace violence against healthcare providers has been reported as being shoved, bitten, strangled, shot, stabbed, and even killed. There have been publicized incidents of workplace violence. A nurse in New York was attacked by a patient she was checking in on during her rounds. He jumped out of bed, pushed her down and began stomping on her head. She was beaten so badly she remained in a coma for six years before she died. Her death has been ruled as a homicide.1 In 2019 a patient who had a knee replacement done months earlier came to an orthopedic surgery center and began shooting.

The Impact of COVID-19 on Healthcare Workers Moral Emotions and Workplace Commitment

The novel coronavirus (COVID-19) pandemic is a major heath crisis that is continuing to have a profound impact on healthcare organizations worldwide. As infection rates surge, there has been global shortages of personal protective equipment, critical medications, ventilators, and hospital beds, meaning that healthcare workers are facing increasingly difficult workplace situations. In this conceptual study, we argue that these situations can lead to moral emotions of contempt, anger, and disgust. This paper explores these moral emotions and their impact healthcare workers’ organizational commitment in the context of COVID-19. Drawing from the moral emotions and organizational commitment literatures, we develop a process model to demonstrate how healthcare workers’ professional commitment is amplified while their organizational commitment is decreased. The potential for positive organizational outcomes from negative moral emotions is discussed, followed by theoretical and practical contributions of the model, and finally, directions for future research are identified.

'Work is a motivator in life' Strategies in managing work participation among highly educated employees with depression.

Work participation among employees with depression is hampered due to cognitive impairments. Although studies show higher levels of work disability among people with a lower education, highly educated employees may encounter specific challenges in fulfilling their work role due to the cognitive impairments of depression, as they often perform cognitively demanding jobs. There is little knowledge about their challenges and opportunities with regard to work participation. To investigate how highly educated employees with depression manage work participation by focusing on their views on opportunities and challenges in fulfilling their work role. Eight individual interviews with highly educated employees with depression were conducted. Transcripts were analysed using qualitative content analysis. The analysis revealed four categories: struggling with acknowledging depression and disclosure; fear of being stigmatised at work; work is a motivator in life; and striving to fulfil the work role at the expense of private life activities. Highly educated employees with depression need guidance regarding the disclosure of information about health issues and work ability. To successfully manage their work role, they need a clear plan with outlined tasks, demands and goals. Healthcare professionals and workplaces should support them in setting limits with regard to work tasks and working hours.

Being an older nurse or midwife in the healthcare workplace- A qualitative descriptive study.

To explore the experiences of being an older nurse or midwife employed in the healthcare workplace. A qualitative descriptive study. Semi-structured interviews were conducted with nurses and midwives who self-identified as older workers. All Australian states were represented and given recruitment was undertaken nationally, most interviews were conducted via telephone. Data were collected between November 2018 and October 2019. Audio recordings were transcribed verbatim and then thematically analysed. A total of 50 nurses and midwives were recruited, aged between 46 and 74years. Three themes were identified. Ageing body: Being an older worker meant increased fatigue and physical changes affecting their ability to function at full capacity. Youth focus: For many, being an older worker was about being viewed as a poor-quality worker, with limited access to education and promotional opportunities because of their age. Wise worker: For a small number of older nurses and midwives, it was about being valued and respected for their knowledge, experience and skills. Participants self-identifying as older nurses or midwives represented a wide age range. Spanning across the age spectrum, many experienced fatigue, physical changes or loss of value to the workplace which often impacted on their working lives. The findings contributed to an understanding about what it is to be an older nurse or midwife in terms of how their contribution is regarded and valued by others in the workplace. This study highlighted there is a need for support of older nurses and midwives in managing age-related fatigue and physical changes. It also suggests consideration of a wise-worker model as a means to recognize the important contribution that older workers can offer.

A Holistic Transcendental Leadership Model for Enhancing Innovation, Creativity and Well-Being in Health Care.

Burnout in health care employees and leaders is at an all-time high. Strategies to address burnout can fall short of addressing the broad range of underlying causes, including both organizational culture and personal factors. The National Academies of Medicine has set forth recommendations to address health care burnout from a leadership-based systems level that focuses on the whole employee, body, mind, and spirit. Across generations and societies, there is a growing trend toward spirituality and meaning as a critical component of both personal life and work. Among the working-age millennials, values of purpose and greater societal good take precedent and impact work choices and behaviors. Spiritually based values such as a sense of purpose, the transcendence of the self and ego, and the acknowledgment of something greater than our collective selves, are present in both popular culture and research on transcendental models of leadership. This article presents a model of holistic transcendental leadership that can be leveraged in the health care workplace to enhance innovation and creativity, while placing a novel emphasis on the physical, emotional, and spiritual well-being at the individual, group, and organizational level.

Are schools drivers of COVID-19 infections-an analysis of outbreaks in Colorado, USA in 2020.

The impact of school closures/reopening on transmission of SARS-CoV-2 in the wider community remains contested. Outbreak data from Colorado, USA (2020), alongside data on implemented public health measures were analyzed. There were three waves (n=3169 outbreaks; 61 650 individuals). The first was led by healthcare settings, the second leisure/entertainment and the third workplaces followed by other settings where the trajectory was equally distributed amongst essential workplaces, non-essential workplaces, schools and non-essential healthcare.Non-acute healthcare, essential and non-essential workplace experienced more outbreaks compared to education, entertainment, large-group-living and social gatherings.Schools experienced 11% of identified outbreaks, yet involved just 4% of total cases. Conversely, adult-education outbreaks (2%) had disproportionately more cases (9%). Our findings suggest schools were not the key driver of the latest wave in infections. School re-opening coinciding with returning to work may have accounted for the parallel rise in outbreaks in those settings suggesting contact-points outside school being more likely to seed in-school outbreaks than contact points within school as the wave of outbreaks in all other settings occurred either prior to or simultaneously with the schools wave.School re-opening is a priority but requires mitigation measures to do so safely including staggering opening of different settings whilst maintaining low levels of community transmission.

Sociometric wearable devices for studying human behavior in corporate and healthcare workplaces.

Wearable sensor technology enables objective data collection of direct human interactions. The authors review sociometric wearable devices (SWD) and their application in healthcare. Human interactions captured by wearable sensors have been shown to correlate with social constructs such as teamworkand productivityin the office. Application of SWD in the field of healthcare requires special considerations: validation studies have shown technological disadvantagesin acute medical settings. Application of SWD in healthcare should be considered based on the strengths and weaknesses of the methodology. SWDcan also play an important roleininvestigation of human interaction and epidemic spread. Whenstudy designs and methodologies arecarefully considered, incorporation of SWD in healthcare researchhas promising potential for new insights.

COVID-19 infection across workplace settings in Qatar: a comparison of COVID-19 positivity rates of screened workers from March 1st until July 31st, 2020

IntroductionCOVID-19 transmission was significant amongst Qatar’s working population during the March–July 2020 outbreak. The study aimed to estimate the risk of exposure for COVID-19 across various workplace settings and demographics in the State of Qatar.MethodsA cross-sectional study was conducted utilizing surveillance data of all workplaces with 10 or more laboratory-confirmed cases of COVID-19. These workplaces were categorized using a mapping table adapted from the North American Industry Classification System (NAICS) codes, 2017 version. The data was then analyzed to estimate and compare the positivity rate as an indicator of the risk of developing COVID-19 infection across various workplace settings in the State of Qatar.ResultsThe highest positivity rate was reported amongst the Construction & Related (40.0%) and the Retail & Wholesale Trade sectors (40.0%), whereas, the lowest positivity rate was attributed to the healthcare workplace setting (11.0%). The highest incidence of COVID-19 infections occurred in South Asian nationalities and in the male gender. The private funded sector employees have seen higher positivity rate than employees of the governmental funded sector.ConclusionThe elevated risk of infection in Construction and Retail & Wholesale Trade is probably due to environmental and educational vulnerabilities. The predominant labor force of those workplace categories is South Asian craft and male manual workers. Alternatively, the better containment of the healthcare workplace setting can be attributed to the enforcement of infection control and occupational safety measures. These findings imply the importance of using preventive and surveillance strategies for high-risk workplace settings appropriately.

The Effects of Safety Climate on Psychosocial Factors: An Empirical Study in Healthcare Workplaces.

How to develop a better patient safety culture has been an important goal for healthcare organizations, but the effects of safety culture on psychosocial factors, such as emotional exhaustion and stress, have not been fully addressed. This study aimed to reconfigure important dimensions affecting safety culture and examine the associations between safety culture and psychosocial factors (emotional exhaustion and work-life balance). The partial least squaring technique was used to analyze the data, showing that job satisfaction (β = 0.320, P < 0.001), working conditions (β = 0.307, P < 0.001), and perception of management (β = 0.282, P < 0.001) positively affected the safety climate. The safety climate and work-life balance could reduce the occurrence of emotional exhaustion, whereas a high-stress environment would cause a higher level of emotional exhaustion. Given these findings, hospitals should endeavor to help employees feel safe and not threatened, reduce stress, and advise them to maintain a good work-life balance.

The Effects of Emergency Room Violence toward Nurse's Intention to Leave-Resilience as a Mediator.

(1) Background: Healthcare workplace violence has been a focused issue in the whole world. The rate of the occurrence is pretty high in every country. The emergency room is a high risk and high frequency place for violence to occur. Under the medical service demands from people, it is quite easy to bring about conflicts. This leads to serious physical and mental harm to nurses. When suffering from physical and mental injuries, resilience is a protective factor away from negative influence. It is rare to explore and study how the nurses’ resilience ability, workplace violence and turnover intention are related. Thus, the aim of this study is to understand resilience as a mediator effect in emergency nurses toward the workplace violence. (2) Methods: A cross-sectional survey study was used to collect information from emergency room nurses of a medical center in northern Taiwan. There were 132 samples in total. Three research instruments were included as follows: Hospital Workplace Violence Prevention Questionnaire, Connor-Davidson Resilience Scale, and Turnover Intention Scale. Statistical analysis using t-test, ANOVA, Correlation, as well as Sobel test were used in this study. (3) Results: The results revealed that the average age was 29.5 ± 5.6. Almost 58% of nurses experienced workplace violence. Twelve percent of nurse had experienced physical violence and 53.8% had experienced mental violence. There was significant relationship between shift personnel and religious believers. To the people who suffered physical violence, there was a significant relationship between emergency room working years and the total working years. There was significant difference between those who had suffered mental violence and religious believers. Female nurses suffered mental violence to a much higher extent than male nurses. There was a significant relationship between nurses’ working years, the total working years, resilience, and turnover intention. Resilience was not the mediator for workplace violence toward turnover intention in this study. (4) Conclusions: The outcome of this study suggested that on an individual level, nurses can enhance self-protection and communication skills to decrease workplace violence. For emergency environment settings, designing a good working environment, visitors’ restriction, avoiding working alone, and enhancing supervising alarm system are recommended. As for hospital administrators, fitness for work and to set up a project team is necessary. These can be references in planning prevention on workplace violence and promoting quality of workplace and patient safety in the future.

Gender Differences in the Relationship Between Workplace Civility and Burnout Among VA Primary Care Providers.

Civility, or politeness, is an important part of the healthcare workplace, and its absence can lead to healthcare provider and staff burnout. Lack of civility is well-documented among mostly female nurses, but is not well-described among the gender-mixed primary care provider (PCP) workforce. Understanding civility and its relationship to burnout among male and female PCPs could help lead to tailored interventions to improve civility and reduce burnout in primary care. To analyze gender differences in civility, burnout, and the relationship between civility and burnout among male and female PCPs. Multi-level logistic regression analysis of a cross-sectional national survey. A total of 3216 PCP respondents (1946 women and 1270 men) in 135 medical centers from a 2019 national Veterans Health Administration (VA) survey. Outcomes: burnout; predictors: workplace civility and gender; controls: race, ethnicity, VA tenure, and supervisory status. Workplace civility was rated higher (p<0.001) among male (mean = 4.07, standard deviation [SD] = 0.36, range 1-5) compared to female (mean = 3.88, SD = 0.33) PCPs. Almost half of the sample reported burnout (47.6%), but this difference was not significant (p = 0.73) between the genders. Higher workplace civility was significantly related to lower burnout among female PCPs (odds ratio [OR] = 0.46, 95% confidence interval [CI] = 0.31 to 0.69), but not among male PCPs (OR = 0.71, 95% CI = 0.42 to 1.22). Interactions between civility and other demographic variables (race, ethnicity, VA tenure, or supervisory status) were not significantly related to burnout. Female PCPs report lower workplace civility than male PCPs. An inverse relationship between civility and burnout is present for women but not men. More research is needed on this phenomenon. Interventions tailored to gender- and primary care-specific needs should be employed to increase civility and reduce burnout among PCPs.

Simulation Interventions for the Classroom to Support the Acquisition of Interprofessional Competencies.

Interprofessional collaboration (IPC) supports the delivery of quality and safe healthcare. The acquisition of interprofessional competencies both pre-licensure and post-licensure are key to implementing this approach in the healthcare workplace. This report documents the development and implementation of a simulation intervention to support interprofessional education (IPE) in the undergraduate classroom for pre-licensure learners. The learning activity framework includes an exposure phase (e.g., didactic classroom instruction) and an immersion phase (e.g., simulation intervention and debriefing). Details on the debriefing process are included as it is key to achieving the learning objectives. The three learning activity pilot tests (n=150) revealed that learners recognized that interprofessional competencies were an important asset to support IPC. The pilot tests identified the need for further development in order for students to make a connection with the mastery phase (i.e., clinical placement). The next steps will include the development and incorporation of formative tools to assess learners’ progress, as well as a plan to evaluate the learning activity that will connect all three phases (exposure, immersion, and mastery) of the learning framework.