Hospital Staff Research Articles

Effect of interventions to improve safety culture on healthcare workers in hospital settings: a systematic review of the international literature

BackgroundIn an era of safety systems, hospital interventions to build a culture of safety deliver organisational learning methodologies for staff. Their benefits to hospital staff are unknown. We examined the...

Decreased patient discharges on weekends part 3: what do the leaders tell us?

Emergency department (ED) crowding is a significant challenge to providing safe and quality care to patients. We know that hospital and ED crowding is exacerbated on Mondays because fewer in-patients are discharged on the weekend. We evaluated barriers and potential solutions to improve in-patient flow and diminished weekend discharges, in hopes of decreasing the severe ED crowding observed on Mondays. In this observational study, we conducted interviews of (a) leaders at The Ottawa Hospital, a major academic health sciences centre (nursing, allied health, physicians), and (b) leaders of community facilities (long-term care and chronic hospital) that receive patients from the hospital, and (c) home care. Each interview was conducted individually and addressed perceived barriers to the discharge of hospital in-patients on weekends as well as potential solutions. An inductive thematic analysis was conducted whereby themes were organized into a summary table of barriers and solutions. We interviewed 40 leaders including 30 nursing, physician, and allied health leaders from the hospital as well as 10 senior personnel from community facilities and home care. Many barriers to weekend discharges were identified, highlighting that this problem is complex with many interdependent internal and external factors. Fortunately, many specific potential solutions were suggested, in immediate, short-term and long-term time horizons. While many solutions require additional resources, others require a culture change whereby hospital and community stakeholders recognize that services must be provided consistently, seven days a week. We have identified the complex and interdependent barriers to weekend discharges of in-patients. There are numerous specific opportunities for hospital staff and services, physicians, and community facilities to provide the same patient care on weekends as on weekdays. This will lead to improved patient flow and safety, and to decreased ED crowding on Mondays.

The establishment of a multiple myeloma clinical registry in the Asia–Pacific region: The Asia–Pacific Myeloma and Related Diseases Registry (APAC MRDR)

BackgroundMultiple myeloma (MM) is the second most common haematological cancer worldwide. Along with related diseases including monoclonal gammopathy of undetermined significance (MGUS), plasma cell leukaemia (PCL) and plasmacytoma, MM incidence is rising, yet it remains incurable and represents a significant disease burden. Clinical registries can provide important information on management and outcomes, and are vital platforms for clinical trials and other research. The Asia–Pacific Myeloma and Related Diseases Registry (APAC MRDR) was developed to monitor and explore variation in epidemiology, treatment regimens and their impact on clinical outcomes across this region. Here we describe the registry’s design and development, initial data, progress and future plans.MethodsThe APAC MRDR was established in 2018 as a multicentre collaboration across the Asia–Pacific, collecting prospective data on patients newly diagnosed with MM, MGUS, PCL and plasmacytoma in Korea, Singapore, Malaysia and Taiwan, with China recently joining. Development of the registry required a multidisciplinary team of clinicians, researchers, legal and information technology support, and financial resources, as well as local clinical context from key opinion leaders in the APAC region. Written informed consent is obtained and data are routinely collected throughout treatment by hospital staff. Data are stored securely, meeting all local privacy and ethics requirements. Data were collected from October 2018 to March 2024.ResultsOver 1700 patients from 24 hospitals have been enrolled onto the APAC MRDR to date, with the majority (86%) being newly diagnosed with MM. Bortezomib with an immunomodulatory drug was most frequently used in first-line MM therapy, and lenalidomide-based therapy was most common in second-line. Establishment and implementation challenges include regulatory and a range of operational issues.ConclusionThe APAC MRDR is providing ‘real-world’ data to participating sites, clinicians and policy-makers to explore factors influencing outcomes and survival, and to support high quality studies. It is already a valuable resource that will continue to grow and support research and clinical collaboration in MM and related diseases across the APAC region.

СТРУКТУРА ЗАБОЛЕВАНИЙ ПАРОДОНТА У ПАЦИЕНТОВ ПСИХИАТРИЧЕСКОГО СТАЦИОНАРА В ВОЗРАСТНОМ АСПЕКТЕ

The literature provides information on the high prevalence of periodontal diseases and hard tooth tissues in patients in a psychiatric hospital. The relationship between periodontal microbiota and psychiatric pathology and the need to maintain oral health among this group of patients is discussed. The aim of the investigation was the study of the structure of periodontal diseases in patients of a psychiatric hospital, in various age groups. Material and methods of research. In the Republican Clinical Psychiatric Hospital named after V.N. Bekhterev (Kazan) in the period from 2014 to 2018, 200 patients (95 women and 105 men) aged 35 to 65 years (average age 56,26 ± 6,74) were examined. The questionnaire recorded the patient's age, sex, diagnosis of the underlying disease, dental formula, a standard periodontal diagram was filled in. The maximum depth of the periodontal pocket was determined by sequential measurements. The results of the study. In 100% of patients in a psychiatric hospital, periodontal tissue damage was detected, of which 86.5% in the form of chronic periodontitis. The maximum number of patients with periodontitis was detected in the age group of 51–60 years. The largest number of teeth removed in patients over 70 years of age. There was a direct strong correlation between age and the number of teeth removed (rp = 0.923; p < 0.001). The maximum depth of the periodontal pocket was also in the age group of 51–60 years and amounted to 4,25 ± 1,14 mm. A direct strong correlation of the depth of the periodontal pocket with the number of teeth removed was revealed. The deeper the patient has pathological pockets, the more teeth are removed (rp = 0.892). Conclusions. The results of the study suggest the need to develop training programs for patients and psychiatric hospital staff to improve the quality of life of patients and general health.

Analysis of the effectiveness of hygiene measures and COVID-19 vaccination at a tertiary-care university hospital during the first two years of the SARS-CoV-2 pandemic

ObjectiveAssessment of the effectiveness of protective measures at a tertiary-care hospital during the SARS-CoV-2 infection waves to provide advice for future pandemics. DesignRetrospective cohort study among hospital staff using in-house surveillance data. SettingUniversity Hospital Erlangen (UKER), a tertiary-care provider in Bavaria, Germany. MethodsWe outline the preventive measures introduced at UKER and retrospectively assess their effectiveness using anonymized monitoring data that were collected during the SARS-CoV-2 pandemic from February 2020 to the end of January 2022. Analysed data includes the incidence of SARS-CoV-2 infections among employees, the frequency of high-risk contacts with infected patients or staff members and breakthrough infections considering the context of exposure. ResultsThe cumulative incidence of SARS-CoV-2 infections among UKER employees was higher before, but lower after the vaccination campaign when compared to the general population. Healthcare workers (HCW), notably physicians and nurses, were especially at risk of infection compared to other UKER employees with less direct patient contact (OR 1.36 [95% CI 1.18-1.57 p<0.001]). Breakthrough infections mostly occurred after exposure during private life, i.e. in situations without protective equipment. The frequency of high-risk contacts during direct patient care remained stable after SARS-CoV-2 vaccination. Prior to vaccination, 5.2% of HCW with direct patient care tested positive for SARS-CoV-2 within 14 days. After vaccination until the onset of the Omicron wave, conversion rate dropped to 0%. ConclusionsThis study provides real-world data on the effectiveness of vaccination, contact tracing, personal protective equipment and general hygiene measures during the SARS-CoV-2 pandemic. Based on our findings, we recommend a protective approach combining all these preventive measures.

Caring for the caregivers: A cross-sectional study of the burden experienced by family caregivers of children with cancer in South Gujarat

Caring for the caregivers: A cross-sectional study of the burden experienced by family caregivers of children with cancer in South Gujarat

High Prevalence and Risk Factors Associated with Vitamin D Deficiency Among Chinese Hospital Staff: A Cross-Sectional Study

High Prevalence and Risk Factors Associated with Vitamin D Deficiency Among Chinese Hospital Staff: A Cross-Sectional Study

Nurse Staffing, Work Hours, Mandatory Overtime, and Turnover in Acute Care Hospitals Affect Nurse Job Satisfaction, Intent to Leave, and Burnout: A Cross-Sectional Study

Objectives: This study examined the impact of nurse staffing, working hours, mandatory overtime, and turnover on nurse outcomes in acute care hospitals. Previous studies have focused on the single characteristics of sub-optimal nurse staffing but have not considered them comprehensively.Methods: Data were collected in July–September 2022 using convenience sampling and an online survey (N = 397). For the analysis, 264 nurses working as staff nurses at 28 hospitals met the inclusion criteria. Univariate analysis and multivariable generalized estimating equation (GEE) were performed.Results: Both nurse staffing (β = −0.036, standard error [SE] = 0.011) and turnover (β = −0.006, SE = 0.003) were significant factors affecting job satisfaction. In the multivariable GEE, only mandatory overtime (β = 0.395, SE = 0.116) was significantly related to intent to leave. Nurse staffing, work hours, mandatory overtime, and turnover were not significantly related to burnout. Subjective health status and workload were significantly associated with burnout.Conclusion: Nurse staffing policies and improvement programs in hospitals should be implemented to improve nurses’ job satisfaction. Labor policy should ban mandatory overtime.

Factors that influence young people’s experiences of emergency suicide care in Australia: a qualitative study

Young people in Australia are increasingly presenting to the emergency department in suicide crisis, where their experiences influence present and future treatment outcomes. Previous research on emergency suicide care has predominantly focused on adults’ experiences. This qualitative study aims to identify the factors that influence perceived positive and negative experiences of emergency suicide care for young people. Semi-structured interviews were conducted with 17 young people aged 16-24 years old (mean age = 18.4 years) who presented to an Australian hospital in the past 12 months for a suicide crisis. Young people reflected on the care they received in the emergency department, and the factors that influenced the quality of care. Data underwent reflexive thematic analysis. Most young people reported a negative hospital experience, attributed to resource constraints and invalidating staff responses, reflecting underlying stigma around suicide. Conversely, when young people reported positive experiences, this was largely attributed to empathetic connections with staff. Our findings highlight the importance of compassionate care from hospital staff for young people’s experience of emergency suicide care. Future research with young people is needed to co-design and trial interventions that promote compassionate care and address the barriers with resource constraints in hospitals.

The Role of Resilience as Mediation in Burnout Work Environment on the Performance of RSUD Sidoarjo Employees in the Era of the Pandemic Covid 19

Background: The influence of resilience on burnout is so important for hospital staff to stay focused when providing services to patients, making researchers want to see how much influence resilience has on burnout work environment on employee performance. Purpose: To analyze the influence of the Role of Resilience as Mediation in the Burnout Work Environment on the Performance of RSUD Sidoarjo Employees in the Covid 19 Covid-pandemic era. Method: The research method used is cross-sectional analytic research. The population is 1,745 people who work at the Sidoarjo Regional General Hospital with proportional random sampling, the sample obtained is 326 employees. The measuring instrument used is a questionnaire. The data analysis used is path analysis. Results: The research results show that indirectly physical work environment variables through resilience do not significantly affect performance (0.173 &gt; 0.163). For physical variables resilience does not significantly affect performance (0.008 &gt; -0.022). Psychological variables through resilience do not significantly affect performance (-0.017 &gt; -0.074). Then the behavioral variable through resilience does not significantly affect performance (-0.055 &gt; -0.253). Conclusion: No there is a role of resilience in overcoming burnout work environment on performance. Resilience indirectly through physical, psychological, and behavior in the work environment has a significant effect on performance.

Prescribing Change: Unpacking Privatization's Impact on Government Teaching Hospitals in Punjab, Pakistan

Lack of financial support is one of the main causes of low-quality services in Government teaching hospitals of developing countries. Recent recommendations for privatization of government teaching hospitals were aimed at improving the services to that of private teaching hospitals. The strategy is expected to increase the efficiency &amp; performance of government teaching hospitals and generate revenues for their continued improvements. The measuring dimensions   of hospital performance not only predict the financial performance of a hospital, but also provide assessment on steps required for betterment of the Government teaching hospital. The non-financial performance of a hospital setting is based on non-financial variables such as Reliability, waiting time, sanitary facility, hygiene and information unique to particular treatment. Good human resource practices are one of the key components that may predict the monetary &amp; non-monetary performances of a hospital. This study demonstrated these variables along with their dimensions across the whole public teaching hospitals settings in Lahore Punjab with a sample size of 300 respondents. Respondents were highly qualified Doctors, Nurses and administration staff of public teaching hospitals Lahore, Punjab. Smart PLS-4 was used as a statistical tool and ran reliability, mediation analysis and linear correlation for research findings. The results have been found significant that hospital performance can be increased through privatization. Although there are some limitations such as it was limited to public teaching hospitals only. Public DHQs (District Head-quarters), THQs (Tehsil Head-quarters) &amp; RHC (Rural Health Centers) were not part of study. The opted variables to assess the hospital performance were not total markers, so for future research there is a path for researchers to opt the rest variables to explore the further significance.

The effect of electronic medical records on medication errors, workload, and medical information availability among qualified nurses in Israel– a cross sectional study

BackgroundErrors in medication administration by qualified nursing staff in hospitals are a significant risk factor for patient safety. In recent decades, electronic medical records (EMR) systems have been implemented in hospitals, and it has been claimed that they contribute to reducing such errors. However, systematic research on the subject in Israel is scarce. This study examines the position of the qualified nursing staff regarding the impact of electronic medical records systems on factors related to patient safety, including errors in medication administration, workload, and availability of medical information.MethodsThis cross-sectional study examines three main variables: Medication errors, workload, and medical information availability, comparing two periods– before and after EMR implementation based on self-reports. A final sample of 591 Israeli nurses was recruited using online private social media groups to complete an online structured questionnaire. The questionnaires included items assessing workload (using the Expanding Nursing Stress Scale), medical information availability (the Carrington-Gephart Unintended Consequences of Electronic Health Record Questionnaire), and medical errors (the Medical Error Checklists). Items were assessed twice, once for the period before the introduction of electronic records and once after. In addition, participants answered open-ended questions that were qualitatively analyzed.ResultsNurses perceive the EMR as reducing the extent of errors in drug administration (mean difference = -0.92 ± 0.90SD, p < 0.001), as well as the workload (mean difference = -0.83 ± 1.03SD, p < 0.001) by ∼ 30% on average, each. Concurrently, the systems are perceived to require a longer documentation time at the expense of patients’ treatment time, and they may impair the availability of medical information by about 10% on average.ConclusionThe results point to nurses’ perceived importance of EMR systems in reducing medication errors and relieving the workload. Despite the overall positive attitudes toward EMR systems, nurses also report that they reduce information availability compared to the previous pen-and-paper approach. A need arises to improve the systems in terms of planning and adaptation to the field and provide appropriate technical and educational support to nurses using them.

Web-accessible critical limits and critical values for urgent clinician notification.

To survey the World Wide Web for critical limits/critical values, assess changes in quantitative low/high thresholds since 1990-93, streamline urgent notification practices, and promote global accessibility. We identified Web-posted lists of critical limits/values at university hospitals. We compared 2023 to 1990-93 archived notification thresholds. We found critical notification lists for 26 university hospitals. Laboratory disciplines ranged widely (1-10). The median number of tests was 62 (range 21-116); several posted policies. The breadth of listings increased. Statistically significant differences in 2023 vs. 1990 critical limits were observed for blood gas (pO2, pCO2), chemistry (glucose, calcium, magnesium), and hematology (hemoglobin, platelets, PTT, WBC) tests, and for newborn glucose, potassium, pO2, and hematocrit. Twenty hospitals listed ionized calcium critical limits, which have not changed. Fourteen listed troponin (6), troponin I (3), hs-TnI (3), or troponin T (2). Qualitative critical values expanded across disciplines, encompassing anatomic/surgical pathology. Bioterrorism agents were listed frequently, as were contagious pathogens, although only three hospitals listed COVID-19. Only one notification list detailed point-of-care tests. Two children's hospital lists were Web-accessible. Urgent notifications should focus on life-threatening conditions. We recommend that hospital staff evaluate changes over the past three decades for clinical impact. Notification lists expanded, especially qualitative tests, suggesting that automation might improve efficiency. Sharing notification lists and policies on the Web will improve accessibility. If not dependent on the limited scope of secondary sources, artificial intelligence could enhance knowledge of urgent notification and critical care practices in the 21st Century.

The main directions of prevention of occupational infection viral hepatitis with a contact transmission mechanism in hospitals in Saint-Petersburg

The high level of hepatitis B and C infection in the modern period in the general population increases the frequency of contact of hospital specialists with patients with this infectious pathology. A significant concentration of infection sources in medical organizations and violations in the implementation of disinfection and sterilization algorithms and requirements for hand hygiene of medical workers create conditions for the nosocomial spread of viral hepatitis pathogens with a contact transmission echanism.The aim. Substantiation of the main directions of prevention of occupational infection viral hepatitis with a contact transmission mechanism in hospitals of Saint Petersburg.Materials and methods. A retrospective epidemiological analysis of the annual reports of Saint-Petersburg hospitals was carried out, which contain information on the number of new cases chronic forms of viral hepatitis among specialists of medical organizations and on the number personnel under dispensary supervision for these infectious diseases, as well as on the number of injuries received by hospital staff while performing functional duties, as well as vaccination coverage against viral hepatitis B, measles and diphtheria for the period from 2009 to 2022. The assessment of the equipment of megapolis healthcare institutions modern washing-disinfecting and sterilization equipment was also carried out.Results and discussion. The realization of the possibility of infecting hospital specialists viral hepatitis with a contact transmission mechanism is predetermined by the high concentration of patients with this pathology in healthcare institutions; the presence of occupational injuries during the implementation of medical and diagnostic procedures and disinfection and sterilization measures.Conclusion. A set of measures for early detection of sources of infections with a contact transmission mechanism among patients and staff; disinfection of medical devices using modern disinfection and sterilization equipment; revaccination against hepatitis B and equipping workplaces of specialists with personal protective equipment in full remains relevant for the prevention of occupational infection of medical workers.

Knowledge, awareness, and risk practices related to bacterial contamination of antiseptics, disinfectants, and hand hygiene products among healthcare workers in sub-saharan Africa: a cross-sectional survey in three tertiary care hospitals (Benin, Burkina Faso, and DR Congo)

BackgroundAntiseptics, disinfectants, and hand hygiene products can be contaminated with bacteria and cause healthcare-associated infections, which are underreported from low- and middle-income countries. To better understand the user-related risk factors, we conducted a knowledge, awareness, and practice survey among hospital staff in sub-Saharan Africa.MethodsSelf-administered questionnaire distributed among healthcare workers in three tertiary care hospitals (Burkina Faso, Benin, Democratic Republic of the Congo).Results617 healthcare workers (85.3% (para)medical and 14.7% auxiliary staff) participated. Less than half (45.5%) had been trained in Infection Prevention & Control (IPC), and only 15.7% were trained < 1 year ago. Near two-thirds (64.2%) preferred liquid soap for hand hygiene, versus 33.1% for alcohol-based hand rub (ABHR). Most (58.3%) expressed confidence in the locally available products. Knowledge of product categories, storage conditions and shelf-life was inadequate: eosin was considered as an antiseptic (47.5% of (para)medical staff), the shelf life and storage conditions (non-transparent container) of freshly prepared chlorine 0.5% were known by only 42.6% and 34.8% of participants, respectively. Approximately one-third of participants approved using tap water for preparation of chlorine 0.5% and liquid soap. Most participants (> 80%) disapproved recycling soft-drink bottles as liquid soap containers. Nearly two-thirds (65.0%) declared that bacteria may be resistant to and survive in ABHR, versus 51.0% and 37.4% for povidone iodine and chlorine 0.5%, respectively. Depicted risk practices (n = 4) were ignored by 30 to 40% of participants: they included touching the rim or content of stock containers with compresses or small containers, storing of cotton balls soaked in an antiseptic, and hand-touching the spout of pump dispenser. Filling containers by topping-up was considered good practice by 18.3% of participants. Half (52.1%) of participants acknowledged indefinite reuse of containers. Besides small differences, the findings were similar across the study sites and professional groups. Among IPC-trained staff, proportions recognizing all 4 risk practices were higher compared to non-trained staff (35.9% versus 23.8%, p < 0.0001).ConclusionsThe present findings can guide tailored training and IPC implementation at the healthcare facility and national levels, and sensitize stakeholders’ and funders’ interest.

Trends and determinants of clinical staff retention in the English NHS: a double retrospective cohort study

ObjectivesTo investigate how demographic, contractual and organisational factors are related to the retention of hospital workers in the English NHS. The study will specifically examine the trends in age-retention profiles.DesignA...

Study of behavioral and psychosocial factors relating to needle stick injuries in nursing staff of a tertiary care cancer hospital of Punjab, India

Background and Objectives: Needle stick injury (NSI) is the most dreaded occupational health hazard affecting a health- care worker (HCW) psychologically and physically. The risk of infection post needle stick injury ranges between 1.9% to greater than 40% for HBV infections, 2.7-10% for HCV and 0.2-0.44% for HIV infections. As per National AIDS Control Organisation (NACO) records, nursing staff is at highest risk (43%) followed by physicians (28%). The main objective of this study was to evaluate knowledge of nursing staff about needle stick injuries and to study factors leading to such incidents in their working areas, impart them knowledge regarding the same and fill gaps in knowledge.&#x0D; Materials and Methods: This is a cross-sectional retrospective analysis involving nursing staff and students. p values were calculated using SPSS software.&#x0D; Results: Overall NSI prevalence among nursing staff and students was 51.6% whereas in more exposed and less exposed group was 47.45% and 10.16% respectively (p=0.2056). The most common cause of NSI incident was recapping of needle (38.5%) followed by transferring needle to sharp container (35%).&#x0D; Conclusion: Consequences of NSI are serious and this study has tried to emphasize on the need to study the factors leading to NSI.&#x0D;  

Hospital corridors as lived spaces: The reconfiguration of social boundaries during the early stages of the Covid pandemic.

This article explores the meanings and uses of a hospital corridor through 98 diary entries produced by the staff of an English specialist hospital during the early stages of the COVID-19 pandemic. Drawing on Lefebvre's (1991, The production of space. Blackwell) threefold theorisation of space, corridors are seen as conceived, perceived and lived spaces, produced through and enabling the reconfiguration and reinterpretation of social interactions. The diaries depict two distinct versions of the central hospital corridor: its 'normal' operation prior to the pandemic when it was perceived as a social and symbolic space for collective sensemaking and the 'COVID-19 empty corridor' described as a haunting place that divided hospital staff along ostensibly new social and moral boundaries that impacted negatively on lived work experiences and staff relationships. The mobilisation of the central hospital corridor in the daily social construction of meaning and experience during a period of organisational and societal crisis suggests that corridors should not be only seen as a material backdrop for work relationships but as social entities that come into being and are maintained and reproduced through the (lack of) performance of social relations.

Understanding responsibility for health inequalities in children’s hospitals in England: a qualitative study with hospital staff

ObjectivesThis study aimed to understand how staff in children’s hospitals view their responsibility to reduce health inequalities for the children and young people who access their services.DesignWe conducted an exploratory...

Depleted Nerves

This essay explores the impact of shell-shock on individual soldiers, the collective understanding of wartime trauma during and after the First World War, and the discourse of mental health in the medical field and public sphere. Additionally, it aims to identify when the discourse of psychological trauma began to shift toward more contemporary understandings of mental health. In order to draw out the voices of Canadian soldiers who were not able to openly discuss their emotions due to the stigmatisation surrounding shell-shock, this study will utilise various sources such as soldier diaries, battalion orders, and the Library and Archives of Canada database. Moreover, this essay aims to uncover how shell-shock was suppressed by wartime officials and those with the power to appropriately aid soldiers inflicted with shell-shock. In order to search for the reticence and silence of shell-shock, I examine the censorship of soldiers' experiences on the homefront, the secrecy surrounding war-related trauma in the general public, and the hyper-masculinized attitudes within battalions that viewed shell-shock symptoms as a manifestation of mental weakness. While I focus primarily on Canadian soldiers during World War I within this essay, it is acknowledged that all soldiers, hospital staff, and those affected by the war were susceptible to various forms of Post Traumatic Stress Disorder.