Hospital-based Health Care Personnel Research Articles

Comparison of morbidity and absenteeism due to COVID-19 and seasonal influenza in a large cohort of health care personnel in the 2022 to 2023 season

To compare the morbidity and work absenteeism associated with coronavirus disease 2019 (COVID-19) and influenza among health care personnel (HCP) in 2022 to 2023. We followed 5,752 hospital-based HCP in Greece from November 14, 2022 through May 28, 2023. Symptomatic HCP was tested for SARS-CoV-2 and influenza by real-time polymerase chain reaction and/or rapid antigen detection test. The association between the duration of absenteeism and the type of disease was estimated by multivariable regression models. A total of 734 COVID-19 cases and 93 influenza cases were studied. The mean duration of absence per COVID-19 case was 5.8days compared with a mean of absence of 3.6days per influenza case (P value <.001). Overall, COVID-19 accounted for 4,245days missed during the study period compared with 333days missed due to influenza. Multivariable regressionestimates indicated that HCP with COVID-19 had 1.91 more days of absenteeism (95% confidence interval 1.67-2.15) compared with those with influenza, on average. As SARS-CoV-2 becomes endemic, COVID-19 remains the prevalent cause of morbidity and absenteeism among HCP, accounting for considerably more workdays missed compared with influenza. HCP should be up-to-date with COVID-19 booster vaccinations and annual influenza vaccination in order to protect them as well as health care systems from HCP absenteeism.

Spiritual Support Staff Influence Stress Among Hospital-Based Health Care Personnel: A Cross-Sectional Study.

Stress negatively affects well-being, relating to poor physical, emotional, and occupational outcomes for health care personnel. Health care professionals faced extreme stressors in the context of the COVID-19 pandemic, making occupational stress relief a top priority for hospital administrators. Many health systems employ specially trained spiritual support staff as one strategy to alleviate work-related stressors. It is unclear whether health care personnels' perceptions of the availability of spiritual care staff influence self-reported stress. The purpose of this study was to explore relationships between perceived stress and perceptions of availability of spiritual support among acute care health care personnel. This study analyzed cross-sectional, survey-based data collected between February and April 2022 from 1352 interdisciplinary health care staff working in a large, nonprofit Catholic health system in the Western United States. Bivariate tests and multivariate linear regression models were conducted to test for factors influencing perceived stress. Results support that high stress was prevalent in the sample. Perceived availability of spiritual support staff in the hospital and seeking coworker and professional support for work-related stress all independently influence stress in this population when controlling for confounders. Stress of health care personnel may be influenced by the perceived availability of specially trained spiritual support staff. Hospital administrators should advocate for spiritual support staff availability in all health care settings as one strategy to mitigate occupational stress that health care professionals may experience through providing high-stakes patient care. Further research is warranted to uncover targeted spirituality-related strategies to reduce stress and preserve well-being of health care personnel.

COVID-19 vaccination coverage among hospital-based healthcare personnel reported through the Department of Health and Human Services Unified Hospital Data Surveillance System, United States, January 20, 2021-September 15, 2021

To protect both patients and staff, healthcare personnel (HCP) were among the first groups in the United States recommended to receive the COVID-19 vaccine. We analyzed data reported to the U.S. Department of Health and Human Services (HHS) Unified Hospital Data Surveillance System on COVID-19 vaccination coverage among hospital-based HCP. After vaccine introduction in December 2020, COVID-19 vaccine coverage rose steadily through April 2021, but the rate of uptake has since slowed; as of September 15, 2021, among 3,357,348 HCP in 2,086 hospitals included in this analysis, 70.0% were fully vaccinated. Additional efforts are needed to improve COVID-19 vaccine coverage among HCP.

Working with influenza-like illness: Presenteeism among US health care personnel during the 2014-2015 influenza season

Health care personnel (HCP) working while experiencing influenza-like illness (ILI) contribute to influenza transmission in health care settings. Studies focused on certain HCP occupations or work settings have demonstrated that some HCP often continue to work while ill. Using a national nonprobability Internet panel survey of 1,914 HCP during the 2014-2015 influenza season, we calculated the frequency of working with self-reported ILI (ie, fever and cough or sore throat) and examined reasons for working with ILI by occupation and work setting. Overall, 414 (21.6%) HCP reported ILI, and 183 (41.4%) reported working with ILI (median, 3 days; range, 0-30 days). Pharmacists (67.2%) and physicians (63.2%) had the highest frequency of working with ILI. By work setting, hospital-based HCP had the highest frequency of working with ILI (49.3%). The most common reasons for working while ill included still being able to perform job duties and not feeling bad enough to miss work. Among HCP at long-term care facilities, the most common reason was inability to afford lost pay. More than 40% of HCP with ILI work while ill. To reduce HCP-associated influenza transmission, potential interventions could target HCP misconceptions about working while ill and paid sick leave policies.

A qualitative analysis of the impact of healthcare personnel influenza vaccination requirements in California

ObjectiveUsing qualitative methods, we explored the implementation of California's 2007 influenza immunization requirements of hospital-based health care personnel (HCP). MethodsWe conducted nine case studies of California hospitals with different HCP vaccination rates and policies. Case studies consisted of interviewing 13 hospital representatives and analyzing relevant hospital documents, including influenza policies. We also conducted 13 semi-structured phone interviews with key state and county public health officials, union representatives, and officials of various professional healthcare organizations. ResultsOur qualitative results suggest that California's vaccination requirements likely did not increase influenza vaccination uptake among HCP. The law was not strong enough to compel hospitals with low and medium vaccination rates to improve their vaccination efforts, and hospitals with high vaccination rates were able to comply fully with the law by continuing to do what they were already doing – namely offering vaccinations to HCP, providing education about the risks of influenza and the benefits of vaccination, and obtaining signed declinations from those who refuse vaccination. Nonetheless, we found that by publicly raising the issue of influenza vaccination in the context of public safety and healthcare quality, California's law encouraged hospitals to develop and implement data systems to monitor the effectiveness of vaccination promotion efforts and prompted discussions, and, in some cases, adoption of stricter vaccination requirements at hospital or county levels. ConclusionsOur findings generally support the literature that suggests that permissive influenza vaccination requirements, though politically feasible, provide little direct incentive for hospitals to focus efforts on increasing HCP vaccination rates.

Using a validated health promotion tool to improve patient safety and increase health care personnel influenza vaccination rates

This study employed the risk perception attitude (RPA) framework to determine whether health care personnel (HCP) influenza-related risk perceptions and efficacy beliefs could be used to segment individuals into meaningful groups related to vaccination uptake, absenteeism, and patient safety beliefs. After pilot interviews, a questionnaire was administered to 318 hospital-based HCP (80%) andnonclinical support staff (20%) in Lexington, KY, in 2011. Follow-up interviews were conducted with 29 respondents. Cluster analysis was used to create 4 groups that correspond to the RPA framework: responsive (high risk, strong efficacy), avoidance (high risk, weak efficacy), proactive (low risk, strong efficacy), and indifference (low risk, weak efficacy). A significant association was found between membership in 1 or more of the 4 RPA groups and the 3 study variables of interest: influenza vaccination uptake (F7,299=2.51, P<.05), influenza-related absenteeism (F7,269=3.6, P<.001), and perceptions of patient safety climate (F7,304=6.21, P<.001). A subset of respondents indicated the principal reasons for not getting vaccinated were "had one before and got sick anyway," "concerned about vaccine safety," and "no convenient time." In follow-up interviews, HCP indicated that employee vaccinations were altruistic, increased herd immunity, and important for patient safety. The RPA framework is a valid health promotion tool for improving patient safety, targeting specific groups for interventions, and improving HCP influenza vaccination rates.

H1N1 Influenza Vaccine Compliance among Hospital- and Non-Hospital-Based Healthcare Personnel

The 2009 pandemic H1N1 influenza vaccine had lower uptake compared to seasonal influenza vaccine, and most studies examining uptake of H1N1 vaccine focused on hospital-based healthcare personnel (HCP). Determinants of H1N1 vaccine uptake among HCP in all work settings need to be identified so that interventions can be developed for use in encouraging uptake of future pandemic or emerging infectious disease vaccines. To identify factors influencing nonhospital HCP H1N1 influenza vaccine compliance. An H1N1 influenza vaccine compliance questionnaire was administered to HCP working in myriad healthcare settings in March-June 2011. Surveys were used to assess H1N1 influenza vaccine compliance and examine factors that predicted H1N1 influenza vaccine uptake. In all, 3,188 HCP completed the survey. Hospital-based HCP had higher compliance than did non-hospital-based personnel (Χ2 = 142.2, P < .001). In logistic regression stratified by hospital setting versus nonhospital setting, determinants of H1N1 vaccination among non-hospital-based HCP included extent to which H1N1 vaccination was mandated or encouraged, perceived importance of vaccination, access to no-cost vaccine provided on-site, no fear of vaccine side effects, and trust in public health officials when they say that the influenza vaccine is safe. Determinants of hospital-based HCP H1N1 vaccine compliance included having a mandatory vaccination policy, perceived importance of vaccination, no fear of vaccine side effects, free vaccine, perceived seriousness of H1N1 influenza, and trust in public health officials. Non-hospital-based HCP versus hospital-based HCP reasons for H1N1 vaccine uptake differed. Targeted interventions are needed to increase compliance with pandemic-related vaccines.

Infection prevention and control competencies for hospital-based health care personnel

BackgroundInfection prevention and control education for hospital-based health care personnel has differed across organizations because of a lack of identified practice competencies. This gap also has resulted in variation of the educational curriculum in the academic setting and a lack of consistent preparation for emergency responses. The purpose of this study was to develop a list of competencies and measurable activities, or terminal objectives, for hospital-based health care personnel applicable for use during routine patient care activities as well as during natural and man-made disasters.MethodsCompetencies and terminal objectives related to infection prevention and control were developed using an evidence-based approach comprising the following steps: (a) review of the literature, (b) review of existing competencies and published curricula/training objectives, (c) synthesis of new competencies and terminal objectives, (d) expert panel review and competency refinement using the Delphi survey process, and (e) delineation of competencies by occupation. The 8 disciplines addressed were nurses (RNs and LPNs), nursing assistants, physicians, respiratory therapists, physical and occupational therapists, environmental services, laboratory professionals, and ancillary staff.ResultsAn initial list of competency statements and terminal objectives were compiled and then vetted by a Delphi panel of experts in infection prevention and control until > 80% agreement was achieved on all competency statements and terminal objectives.ConclusionThe final matrix of competencies and terminal objectives developed through this process may be used as a content framework for educational curricula and training materials for hospital-based health care personnel. The process also may be of use in determining the core competencies and terminal objectives regarding infection prevention and control for health care personnel in other settings. Validation of these results is an important next step.

The Relationship between Hospital-Based Healthcare Personnel Perceptions of Safety Culture and the Occurrence of Sharps Injuries

BACKGROUND/OBJECTIVES: Hospital-based healthcare personnel (HCP) sustain an estimated 385,000 sharps injuries (SI) each year in the United States. Sharps injury prevention efforts have been primarily focused on providing safer needle devices and reducing unsafe work practices. However, HCP perceptions of institutional safety culture have been associated with adherence to universal precautions and the risk of sustaining blood and body fluid exposures (BBFE). We examined perceptions of safety culture among HCP at a large multi-facility medical center to assess the relationship between HCP attitudes and the risk of SI. METHODS: A 33-item survey was mailed to the home addresses of 13,700 employees of Detroit Medical Center from June-July 2005. Data obtained included occupational demographics, perceptions of safety culture, knowledge of SI/BBFE reporting procedures, SI incident history, reasons for not reporting SI/BBFE, and post-BBFE care experiences. A 13-item safety culture construct measured perceptions of safety culture using a 5-point Likert scale; a total safety culture score was created for each respondent by adding the scores for each question. Associations between perceptions of safety culture and SI occurrence were assessed using bivariate associations and simple logistic regression. RESULTS: Of the 13,700 surveys mailed, 3,043 (22%) were returned. One-third of all respondents were employed in patient care services (nursing). Most (87%) respondents were familiar with hospital protocols for reporting SI/BBFE; 109 (3.6%) recalled sustaining an SI in the past 12 months. The average safety culture score was 49.4 (range 4-65; highest possible score=65); 568 (19%) gave positive responses (agreed or strongly agreed) to all questions. After adjusting for occupation, work shift, and knowledge of hospital reporting procedures, respondents with positive perceptions of safety culture (higher total safety culture score) were less likely (OR = 0.97, 95% CI=0.95, 0.99) to have sustained an SI in the previous 12 months. CONCLUSIONS: These results suggest that HCP perceptions of safety culture may influence the risk of sustaining an SI. Perceptions of safety culture should be measured when designing an SI prevention program in hospitals.

The home health nurse clinician's role in the prevention of nonorganic failure to thrive.

Home health nurse clinicians are invaluable in the detection of children at risk for nonorganic failure to thrive (NOFTT). The literature has emphasized the role of hospital-based health care personnel in evaluating NOFTT, a strategy that relies heavily on the parent for initiation of services. Since one of the most commonly agreed-on causes of NOFTT is a disturbance in the mother-child relationship, case-finding efforts need to be community-based and less reliant on parental recognition. Because the most effective interventions take place in the child's home setting, the home health nurse clinician is in a unique position to assess the home environment for dysfunctional family interactions and behaviors and then to use the ongoing relationship with the family to implement prevention strategies for NOFTT, including teaching, modeling, and coaching effective parenting. Home-based nursing also provides the means for necessary follow-up of these families to ensure the success of the strategies.

Patient-controlled analgesia: a review of effectiveness of therapy and an evaluation of currently available devices.

Patient-controlled analgesia (PCA) is a major advance in the management of pain in postoperative and cancer patients. The success of PCA has resulted in a proliferation of marketed devices to administer small bolus doses of parenteral pain-control drugs at fixed intervals controlled by the patient with the push of a button. Because patients demonstrate marked individual variation in pain medication requirements, PCA devices should be able to accommodate rapidly changing requirements for drugs with a minimum amount of effort on behalf of health care personnel. Crude electronic devices were developed in the late 1960s and the early 1970s and usually consisted of a syringe pump connected to some sort of timing device. Most modern PCA devices marketed in the past five years are much more sophisticated devices that are microprocessor based and some newer devices even generate hard copy for a permanent record of drug administration. Although many such devices are available (including a totally disposable PCA device), few have undergone extensive clinical evaluation. A review of the literature shows many devices are available for use without a single publication to document the safety and utility of the device in the routine patient care situation. Use of the PCA method of pain control will grow, and all hospital-based health care personnel should become familiar with their use and limitations.

Susceptibility of hospital based health care personnel to varicella-zoster virus infections

Varicella-zoster virus (VZV) transmission poses a major infection risk for health care workers in the hospital environment. Immunologically normal adults who contract varicella have 9 to 25 times the risk of major morbidity or death from infection compared with healthy children. Moreover, varicella infection during pregnancy is associated with a high rate of complications and the risk of the congenital varicella syndrome. To evaluate susceptibility to VZV infection among hospital workers, the employee health service screened 241 personnel for VZV antibody by the indirect fluorescent antibody technique. Overall, 7 (2.9%) of 241 personnel lacked VZV antibody and were therefore presumed susceptible to infection. Susceptibility varied dramatically by age and was significantly higher among persons 35 years of age and younger (7/93 = 7.5%) than among those aged 36 years and older (0/148 = 0%, p = 0.001). Persons 35 years old or younger with a clinical history of chickenpox or herpes zoster were much less likely to lack immunity (3/71 = 4.2%) than those stating they had no history of either (4/11 = 36.4%, p = 0.005). Screening strategies for VZV immunity in hospital employees could be made more efficient by performing serologic tests only on those persons aged 35 years or younger with a negative or uncertain history of the disease. Persons who lack antibody may be considered for preexposure immunization with live attenuated varicella vaccine as an alternative to varicella-zoster immune globulin or enforced absence from patient care after exposure to a VZV-infected patient.