Performance Of Healthcare Workers Research Articles

The Effects of Empowerment on Health Care Worker Performance During the COVID-19 Pandemic in Saudi Arabia.

Background and Objectives:In this study, we assessed the potential impact of employee empowerment on health care workers' performance during the novel coronavirus SARS-CoV-2 (COVID-19) pandemic. In particular, we aimed to determine the empowerment practices that would have the greatest positive effect on employee performance. Understanding the relationship between performance and empowerment can help health care providers better manage worker stress during any global crisis. This understanding is crucial in guiding policies and interventions aimed at maintaining health care workers' psychological well-being and their overall performance.Methods:This cross-sectional study evaluated the relationship between employee empowerment and performance, determining the best empowerment practices for health care leaders to utilize. Frontline health care workers (n = 100) selected using convenience and snowball sampling completed the survey between March 15 and 31, 2020. This is the period when the pandemic just started to accelerate in Saudi Arabia. We conducted Pearson's correlation analysis to assess whether there was a relationship between performance and health care workers' empowerment practice, and stepwise linear regression analysis to investigate the impact each of these empowerment practices on health care workers' performance.Results:Our results indicate that health care workers' performance can be expected to increase the most through 2 empowerment practices: giving employees the discretion to change work processes and offering performance-based rewards (R2 = 0.301, P < .05).Conclusion:Our findings suggest that health care leaders must invest in these 2 practices to better equip frontline health care workers. During a global crisis, additional discretion granted to employees helps reduce their anxiety and burnout and hence empowers them with the flexibility to adapt to unforeseen circumstances and improve the quality of their interactions with health service recipients.

Financially incentivized knowledge assessments to improve provider compliance with treatment guidelines: a cluster-randomized controlled trial

BackgroundDespite increasing access to health care, under-5 mortality remains high in many parts of Sub-Saharan Africa. Interventions to improve quality of care have mostly focused on additional training for medical staff, but generally shown little impact. We will assess the impact of financially incentivized quarterly provider knowledge assessment on compliance with Integrated Management of Childhood Illness (IMCI) protocols in Congo, DRC.MethodsOut of a total of 1738 facilities currently receiving results-based financing under an ongoing health financing program, 110 facilities were chosen for this study. All health care workers providing outpatient services to children under age 5 in these facilities will be included in the study. Facilities were randomized with equal probability to control and treatment. Treatment facilities will receive quarterly medical staff knowledge assessments using interactive vignettes. Performance on these vignettes will be rewarded through financial bonus payments to facilities. A baseline survey of health worker knowledge was conducted in 2018. An endline assessment is scheduled to start in the second half of 2021. The primary outcome of interest is health worker compliance with Integrated Management of Childhood Illness (IMCI) guidelines. Compliance will be verified through direct observation of medical staff-patient interactions.DiscussionThis is to our knowledge the first trial assessing whether linking health financing to health care worker performance on knowledge assessments can increase compliance with under-5 case management protocols.Trial registrationClinicalTrials.gov NCT04634019. Registered on November 18, 2020.

Establishing Healthcare Worker Performance and Safety in Providing Critical Care for Patients in a Simulated Ebola Treatment Unit: Non-Randomized Pilot Study.

Improving the provision of supportive care for patients with Ebola is an important quality improvement initiative. We designed a simulated Ebola Treatment Unit (ETU) to assess performance and safety of healthcare workers (HCWs) performing tasks wearing personal protective equipment (PPE) in hot (35 °C, 60% relative humidity) or thermo-neutral (20 °C, 20% relative humidity) conditions. In this pilot phase to determine the feasibility of study procedures, HCWs in PPE were non-randomly allocated to hot or thermo-neutral conditions to perform peripheral intravenous (PIV) and midline catheter (MLC) insertion and endotracheal intubation (ETI) on mannequins. Eighteen HCWs (13 physicians, 4 nurses, 1 nurse practitioner; 2 with prior ETU experience; 10 in hot conditions) spent 69 (10) (mean (SD)) minutes in the simulated ETU. Mean (SD) task completion times were 16 (6) min for PIV insertion; 33 (5) min for MLC insertion; and 16 (8) min for ETI. Satisfactory task completion was numerically higher for physicians vs. nurses. Participants’ blood pressure was similar, but heart rate was higher (p = 0.0005) post-simulation vs. baseline. Participants had a median (range) of 2.0 (0.0–10.0) minor PPE breaches, 2.0 (0.0–6.0) near-miss incidents, and 2.0 (0.0–6.0) health symptoms and concerns. There were eight health-assessment triggers in five participants, of whom four were in hot conditions. We terminated the simulation of two participants in hot conditions due to thermal discomfort. In summary, study tasks were suitable for physician participants, but they require redesign to match nurses’ expertise for the subsequent randomized phase of the study. One-quarter of participants had a health-assessment trigger. This research model may be useful in future training and research regarding clinical care for patients with highly infectious pathogens in austere settings.

Performance of Health Care Workers in Doffing of Personal Protective Equipment Using Real-Time Remote Audio-Visual Doffing Surveillance System: Its Implications for Bio-Safety Amid COVID-19 Pandemic.

BackgroundVery little has been reported about health care workers' (HCWs) adherence to the Centers for Disease Control and Prevention (CDC) guidelines of doffing personal protective equipment (PPE) amid the COVID-19 pandemic. Real-time remote audio-visual doffing surveillance (RADS) system for assisting doffing might reduce the risk of self-contamination. We used this system to determine the incidence of the breach in biosafety during doffing of PPE among HCWs involved in the care of Covid-19 patients.MethodsA total of 100 HCWs were enrolled in this observational study who performed duties in the COVID intensive care unit (ICU) of our tertiary care centre. With a real-time RADS system, trained observers from remote locations assisted HCWs during doffing of PPE and noted breach at any step using the CDC doffing checklist. The breach was considered major if committed during removal of gloves/gown/N-95 or if ≥3 errors occurred in any other steps.ResultsOverall, 40% of the HCWs committed a breach during doffing at least one step. The majority of the errors were observed during hand hygiene (34%), followed by glove removal (12%) and N-95 removal (8%). Nineteen percent of HCWs committed the major breach, out of which 37.5% were done by house-keeping sanitation staff (p = 0.008 and RR 2.85; 95% CI of 1.313-6.19), followed by technicians (22.5%), nursing staff (16.7%) and resident doctors (6.5%).ConclusionsPerforming doffing using a real-time RADS system is associated with a relatively low incidence of a breach in biosafety compared with earlier studies using an onsite standard observer. Overall adherence of HCWs to the CDC guidelines of doffing PPE was satisfactory. This study highlights the importance of the RADS system during doffing of PPE in a health care setting amid the COVID-19 pandemic.

The Effect of Training Programs on the Performance of Healthcare Workers at Benghazi Medical Center (BMC)

Background: Healthcare workers (HCWs) are considered as one of the cornerstones and play an important role inside the healthcare sector. However, health care workers (HCWs) in developing countries frequently work in challenging environments, mainly dealing with sciences and technology development. Thus, attention to involve the HCWs into training programs to meet their needs and to achieve a better level of work performance and to provide better health services in their institutions.&#x0D; Methods: A descriptive cross-sectional study, aimed to explore the effects of training programs on healthcare workers performance at Benghazi Medical Center (BMC) in Benghazi city, Libya. 51 questionnaires were collected from March 2019 and end in June 2019 by using the impact of training on workers performance. Data were fed to statistical software package version 20.0 SPSS. Approval of the Ethical Committee of faculty of public health was obtained.&#x0D; Results: High percentage (72.5%) of the study respondents had undergone training programs with healthcare institutions. The results also show that the majority of these respondents (59.5%) participated in training on the purpose of performance consideration and 75% associate training to their enhanced performance at work.&#x0D; Conclusion: It may be indicated that training to a big extent can lead to an improved worker's performance but still it is not the only factor that can enhance worker's performance rather it is a combination of factors. Thus, further researches can be done on different factors in the healthcare sector, specifically concerning workers' performance factors such as training needs assessment, training programs design, development, are significant to study for exploring their effects on the workers' performance in the healthcare sector.

Effect of Recruitment and deployment practices on Performance of Healthcare Workers in Kenya.

This study sought to determine the Effect of Recruitment and deployment practices on the Performance of Healthcare Workers, a case of Nursing officers, Ministry of Health, Nyeri County in Kenya. Various organisations employ different human resources initiatives to increase efficiency. The most common initiatives employed to improve efficiency include performance contracts, internal contracting, contracting-out and outsourcing of services, among others. Employing such initiatives are considered among the primary Human Resource Management (HRM) practices, which are aimed at determining the equilibrium between workforce supply and the ability of healthcare practitioners to practise effectively and efficiently to ensure improved and quality care in healthcare systems. This study adopted a cross-sectional descriptive research design. The respondents constituted all nursing staff and managers in Nyeri County health facilities and at the County Director’s Office. Stratified random sampling was used to come up with a sample of 248 respondents. Data was collected using a questionnaire. Descriptive statistics were used in the analysis of data with the help of SPSS 23. Chi-square analysis was used to establish relationships. The researcher found that recruitment processes in Nyeri County comprised internships (f=109, 44%) and field placements (f=82, 33%). Selections were made via individual interviews (f=225, 91%), while job orientation (f=237, 96%) was the main technique. The researchers found that there were gaps in the deployment practices with a mean value of 2.73, SD=1.132. Deployment in some departments was deemed disciplinary action (M=3.09, SD=1.325), and managers response to deployment needs per department or ward or facility (M=3.07, SD=1.218) were rated to a moderate extent. The study concluded that recruitment does not affect the performance of health workers. Although the county was found to use only a few recruitments, selection and orientation approaches and techniques, this did not affect the Healthcare Workers. The study further concluded that deployment practices do not affect the performance of Healthcare Workers.

Patients’ trust in the health care system and physiotherapists

Introduction: The assessment of the health-care system by its beneficiaries is based on evaluation of the public perception in regards to the performance of healthcare workers, the functioning of the health system, the effectiveness of health policy measures, and a number of other components. The aim of this study was to determine patients’ trust in the work of physiotherapists and the health-care system; determine the quality of communication between the patient and the physiotherapist and determine the quality of cooperation between healthcare workers in the provision of health services.Methods: The study is descriptive, conducted in five cities: Banja Luka, Bihać, Herceg Novi, Nikšić, and Podujevo. The confidence in health-care questionnaire developed by Calnan and Sanford (2004) was used as a research instrument, containing six areas of research: Attitude toward the patient, Health policy and patient care, Professionalism and expertise, Quality of health care, Communication and information, and Quality of cooperation.Results: The mean age of the subjects was 41 years, 24 females and 26 males. Subjects expressed the greatest satisfaction on subscales I - Attitude toward the patient (27.44 ± 3.59 out of 30) and IV - Quality of health care (36.60 ± 4.19 out of 40), which represents 91.5% of the possible maximum. This is followed by subscale V - Communication and information (20.8 ± 3.17 out of 25) corresponding to 83.2% of the possible maximum, followed by subscale III - Professionalism and expertise (15.68 ± 3.29 out of 20) which represents 78.4% of the possible maximum. Subjects showed the least satisfaction on subscales II - Health policy and patient care (16.94 ± 5.56 out of 25), which represents 67.8% of the possible maximum, and subscales VI - Quality of cooperation (9.94 ± 0.42 out of 15) which corresponds to 66.3% of the possible maximum.Conclusions: The research showed a high degree of satisfaction of subjects in various fields, which indicates a high degree of confidence in the work of physiotherapists and the health-care system. Research on a larger sample in needed for creation and implementation of the guidelines in the strategic documents of the countries in the region and for improvement of health policies and patient care.

Facilitating health care workers' self-determination: The impact of a self-leadership intervention on work engagement, health, and performance.

The present study aims to test the impact of a self‐leadership intervention on the work engagement, performance, and health of health care workers. By integrating self‐determination theory and self‐leadership theory, we propose that when employees are trained how they can autonomously influence own cognitions and behaviour, this will impact their work engagement, perceived performance, and general health. To test the hypotheses, a longitudinal field experiment with three measurement waves was conducted (pre‐intervention, immediately after the intervention, and 2 months after the intervention). Health care professionals (n = 195) from five different organizations participated on voluntary basis and were randomly assigned to the intervention or control group. Results show that a self‐leadership training positively impacts work engagement and performance of health care workers. Furthermore, the improved work engagement also mediates the effects of the training on health and performance 2 months later. No direct effect was found on general health. Theoretical and practical implications are discussed.Practitioners points The self‐leadership intervention facilitates healthcare workers to develop self‐determination and autonomous motivation, which will positively impact their work engagement, health, and performanceParticipation in the self‐leadership intervention needs to be based on volition as this will contribute to the intrinsic motivation for actual self‐leadership development through training.

Frontline Health Care Workers' Mental Workload During the COVID-19 Pandemic: A Cross-Sectional Study.

Workload is an essential factor affecting the performance of health care workers (HCWs). High level of mental workload increased their risks of insomnia, anxiety, and depression. This study committed to investigate frontline HCWs' mental workload and analyze its influencing factors during the novel coronavirus disease 2019 (COVID-19) pandemic. A total of 802 frontline HCWs completed the online questionnaires. Their total mental workload score was 69.7 ± 16.4. Frontline HCWs were satisfied with their performance (4.0 ± 3.3) and showed a low level of frustration (8.3 ± 5.7). The most important dimensions of mental workload were "effort" (16.4 ± 13.7), "physical demand" (15.7 ± 4.7), and "mental demand" (12.9 ± 5.2). Frontline nurses and HCWs who have higher education level, longer working years, and higher professional title perceived higher mental workload scores (P < .05). In conclusion, frontline HCWs' mental workload was not high as seen during the COVID-19 pandemic in China. They have made tremendous efforts and dedication to caring for COVID-19 patients. Job-related factors, some of which can be eliminated by proper management skills, increased frontline HCWs mental workload.

The Role of Incentives on the Performance of Health Workers in a Public Sector Organization in Abuja, Nigeria

The aim of the research work is to ascertain the role of incentives on the performance of health workers in some selected public sector using Abuja as a case study. Data collection was by the used of self-administered questionnaires, which were distributed to Doctors and Nurses in some selected public health facilities in Abuja. The statistical Package for Social Sciences (SPSS) software was used for data leaning and analysis. The result obtained from the analysis shows that 64.1% agreed that incentives brings job satisfaction, 51.4% agreed that non-monetary incentives promotes organizational performance , 63.3% agreed that non-monetary incentives promotes good work relationship, 53.7% agreed that non-monetary incentives reduces stress, 65.3% agreed that incentives help in the achievement of organizational goal, 58.7% agreed that incentives serve as a motivation to employees, 57.5% agreed that incentives help workers to improve skills and qualifications in line with their job and 60.2% agreed that incentives increase the level of employee’s confidence on employer. It was concluded that incentives based on terms and conditions of employment play significant role on the performance of health workers in the public sector, performance based incentives play significant role on the performance of health workers in the public sector, there is significant government attention towards incentives and performance of health care workers in the public sector and non-financial incentives play significant role on the performance of health workers in the public sector.

Perception of Effects of Shiftwork Questionnaire (PESQ) among Ambulance Service Staff in Saudi Arabia: An Exploratory Factor Analysis

Objective: Despite efforts in describing the impact of shiftwork on the performance of health care workers, the perception of ambulance service staff is largely unexplored. This study attempted to develop the Perception of Effects of Shiftwork Questionnaire (PESQ) using a factor analysis approach to determine the underlying dimensions. Methods: A 16-item Likert scale research instrument, designed to gather information about the perceived effects of shiftwork on the respondents’ health, social relationships, and career quality, was floated to 375 ambulance services personnel in Saudi Arabia during March and April 2021. Results: Based on factor analysis, the questionnaire has three dimensions with varying reliability, namely “perceived effects on social relationship” (α = 0.815), perceived effects on health (α = 0.787) and “perceived effects on career quality” (α = 0.602). Over-all, the research instrument had an acceptable internal consistency (α = 0.829). Conclusion: The three-dimension model was analyzed simultaneously using parallel analysis and confirms that the three-factor model is the most ideal for the research instrument. Further research, however, is recommended to improve the internal consistency of the items which measure the perceived effects on career quality.

Emotional Distress and Coping Strategies of Health Care Workers During Covid-19 Pandemic

Stress is perceived as a common, almost inevitable problem that most people face on a daily basis on all levels. In this field, a special sector, due to the multiple implications, is the occupational stress. Despite the theoretical or practical applicative development approached by specialists from various fields over time, the issue of stress still offers, perhaps today more than ever, the possibility and need of new analytical and investigative openings leading to more effective control of it. Mental health puts its mark on the medical act and implicitly on the patients, on their personality. Research demonstrates the many implications of emotional stress in the etiology of various mental and emotional disorders and imbalances that affect the professional performance of health care workers. The new coronavirus known as SARS-CoV-2 is an extremely contagious infectious disease which was declared pandemic by the World Health Organization on the 11th of March, this year. Ever since, during outbursts, health care workers are submitted to an enormous emotional load as they must balance the fundamental principles of their duty to treat patients with their duties to family and loved ones. The aims of our study were to evaluate the levels of stress, emotional distress, and the coping strategies among medical staff, during this public health emergency times.

Comparison of perceptions, attitudes and performance regarding collaborative oral health care among health-care workers

Collaborative oral health care among health-care workers (HCWs) is important to prevent oral and systemic diseases. The purpose of this study was to investigate the perceptions, attitudes and performance of HCWs regarding collaborative oral health care and to compare them among HCWs. The subjects were dentists (DTs), dental hygienists (DHs), hospital nurses (HNs), speech-language-hearing therapists (STs) and certified care workers (CCWs) in Fukuoka Prefecture, Japan. DTs were members of the Fukuoka Dental Association, and DHs worked in dental clinics. HNs worked in hospitals without dental departments. STs and CCWs were members of professional associations. Data were collected by a mail survey. The chi-square test and Kruskal-Wallis test were used to compare the data among HCWs. A total of 119 DTs, 91 DHs, 229 HNs, 119 STs and 121 CCWs participated in this study. The total response rate was 20.6%. There were significant differences in perceptions of what should be performed as part of oral health care among HCWs. Only 20%-60% of HCWs performed collaborative oral health care, while more than 75% were willing to perform such care. Levels of collaborative oral health care with other types of professionals and positive willingness to perform such care were lower among HNs than among the other HCWs. It is suggested that oral health professionals should recognise the presence of differences in the perceptions, attitudes and performance among other types of HCW and try to improve these to promote interprofessional collaboration of oral health care in hospitals.

Development of an instrument to measure the cultural competence of health care workers.

ABSTRACTOBJECTIVETo validate an instrument measuring the cultural competence in health care workers from Chile.METHODSUsing Sue & Sue’s theoretical model of cultural competence, we designed a scale, which was assessed by health care workers and experts. Subsequently, the scale was applied to a sample of 483 different health care workers, during 2018 in Santiago de Chile. The analysis included: exploratory and confirmatory factor analysis, estimation of reliability, and analysis of measurement bias. Finally, the level of cultural competence was calculated for every professional who participated in this study.RESULTSThe final scale include 14 items that are grouped into three dimensions concordant with the theoretical model: sensitivity to own prejudices, cultural knowledge, and skills to work in culturally diverse environments. This scale showed good fit in factor models, adequate reliability and lack of evidence of measurement bias. Regarding the performance of health care workers, sensitivity showed a lower level compared with the other dimensions evaluated.CONCLUSIONThe scale for measuring the level of cultural competence in health care workers (EMCC-14) is a reliable instrument, with initial support for its validity, which can be used in the Chilean context. Additionally, the results of this study could guide some possible interventions in the health sector to strengthen the level of cultural competence.

Nursing Staff' Perception Regarding Factors Influencing Their Performance in General Hospital

Background: Health care organizations cannot succeed without productive nursing staff. In order to enhance efficiency in health interventions, improving the productivity and performance of health care workers is a major challenge. Performance of health care organizations depends on the knowledge, skills and motivation of individual employees. Aim of the study: To identify nursing staff perception regarding factors influencing their performance at Minia General Hospital. Design: Descriptive research design was utilized. Setting: The study was conducted at all departments of Minia General Hospital in Minia city. Sample: All nursing staffs who working at Minia General Hospital was included. Tools: Data was collected using one tool which was modified by researcher. Results: The nursing staffs of Minia General Hospital perceived the most factors influencing on their performance were; organization policies, work environment and supplies, reward effect, management style, work relation, job design influence and the last one was training and development opportunities. Also, there were highly positive statistically significant correlations between personal data regarding age and experience with training and development; in addition the reward effect had a highly statistically significant correlation with most performance factors and its dimensions except work relation factor and work environment and supplies. Conclusion: The majority of nursing staffs at Minia General Hospital had “moderate level” of perception about the whole factors influence on their performance. Recommendation: Developing and implementing training and development programs are necessary to acquire skills and knowledge about their competence which has a positive effect on staff performance.

Onsite healthcare worker acceptability and performance of the point-of-care Pima CD4 assay in Dar es Salaam, Tanzania.

BackgroundHealthcare workers’ acceptance of and ability to perform point-of-care testing is important for reliable and accurate results. The Alere Pima™ CD4 assay (Pima CD4) is the CD4 point-of-care test for HIV management in Tanzania.ObjectivesTo evaluate healthcare workers’ acceptance and performance of Pima CD4 testing.MethodsThe study was implemented in five high volume sites in Dar es Salaam, Tanzania, in 2011. Trained healthcare workers performed Pima testing using three whole-blood specimens collected from each patient: venous blood, fingerstick blood directly applied to a Pima cartridge (capillary-direct), and fingerstick blood collected in a microtube (capillary-microtube). Using a semi-structured interview guide, we interviewed 11 healthcare workers about specimen collection methods and Pima CD4 acceptability. Quantitative responses were analysed using descriptive statistics. Open-ended responses were summarised by thematic areas. Pima CD4 results were analysed to determine variation between cadres.ResultsHealthcare workers found Pima CD4 user-friendly and recommended its use in low volume, peripheral facilities. Both venous and capillary-direct blood were considered easy to collect, with venous preferred. Advantages noted with venous and capillary-microtube methods were the ability to retest, perform multiple tests, or delay testing. Pima CD4 results were trusted by the healthcare workers and were in agreement with laboratory Pima testing.ConclusionIn this point-of-care testing setting, the Pima CD4 assay was accepted by healthcare workers. Both venous and fingerstick capillary blood specimens can be used with Pima CD4, but fingerstick methods may require more intensive training on technique to minimise variation in results and increase acceptability.

An analysis of the relationship between occupational stress and employee job performance in public health care institutions: A case study of public hospitals in Harare

Orientation: Occupational stress has become a major challenge for employers with potentially damaging physiological and psychological effects on employees as it negatively affects their health and contribution to the effectiveness of organisations.Research purpose: The primary purpose of the study was to investigate the relationship between occupational stress and employee job performance.Motivation for the study: Public health care employees such as doctors, nurses, midwives and laboratory technicians had become more likely to have higher workload and inflexible working hours as they keep up with the increasing demand. Owing to shortages of staff, most of the health care employees had become stress ridden as they had to work for long working hours, face incompatible demands and find lack of support from superiors.Research approach/design and method: A quantitative research design was adopted for the study. A structured questionnaire was developed, validated and distributed to 260 employees and management personnel working in five selected government departments.Main findings: The study concluded that there is a negative relationship between increase in inflexibility in work hours and job performance. The findings also noted a negative relationship between work overload and job performance.Practical/managerial implications: The data collected from this study might form part of policy-making for both the government and the management of public health care institutions. Moreover, the findings on the stress factors affecting the performance of health care workers may be used to develop strategies and provide an environment that ensures improved employee performance.Contribution/value-add: The study is expected to enrich the empirical evidence on the stressors in public health care institutions and also provide recommendations for practitioners in investigating the relationship between occupational stress and employee job performance in the public sector.

Barriers and Facilitating Factors of Communication in Iranian Educational Health Care Centers: A Systematic Review

Context Communication, as an essential human skill, is one of the most influential factors in the performance of healthcare workers. In fact, the establishment of effective communication with the recipients of healthcare services and patients can increase their satisfaction and quality of life. Due to the paucity of comprehensive research in this area, the present study aimed to investigate the barriers and facilitating factors concerning communication among healthcare workers. Evidence Acquisition This systematic review was conducted by searching PubMed, Scopus, Web of Science, MagIran, Iranmedex, Google Scholar, and SID databases, using the following keywords: “communication”, “communication barrier”, “communication facilitator”, “health system”, “nurse”, “physician”, “faculty member”, “teacher”, “student”, “health manager”, and “patient”. All searches were conducted within a 10-year period from 2008 to 2018. Results According to our literature review, 44 articles (38 quantitative and 6 qualitative) met the inclusion criteria. In these studies, “pleasant greetings” and “tidy appearance” were the most important factors facilitating the patient-physician relationship, “teacher’s modesty”, “patience”, and “respect for students” were the main factors facilitating the teacher-student relationship, and finally, “responsibility”, “empathy”, and “companionship” were identified as the most significant factors in the patient-health care worker relationship. On the other hand, the most important barriers to communication in the clinical setting were “poor introduction of the healthcare provider to patients”, “high workload and fatigue”, and “lack of training on the principles of communication skills and environmental factors”. Conclusions Based on the findings, identifying the facilitating factors and barriers to communication is the most important step in the management of health services. Communication skills training can have a beneficial effect on the health education programs for the healthcare staff. In addition, it can improve the efficacy of health services.

Knowledge, perception, performance, and attitude regarding hand hygiene and related factors among infection control nurses in South Korea: A cross-sectional study

We assessed the current status of knowledge, perception, attitude, and role model regarding hand hygiene (HH) among infection control nurses (ICNs) and identified the factors influencing these variables. A structured questionnaire was adapted from a World Health Organization survey. Data were collected from November 8, 2017, to February 2, 2018. ICNs showed the following scores (mean ± SD): knowledge (19.5 ± 2.3), perception (69.9 ± 8.9), attitude (46.9 ± 5.8), and role model (39.2 ± 6.0). HH performance of health care workers (HCWs) was 75.2 ± 15.5. Mean HH performance scores of HCWs (P = .007) differed significantly according to infection control experience (3 groups: ≤12 months, 13-24 months, >24 months). Perception, attitude, and role model scores showed positive correlations with each other (P < .01). The regression model for HH performance of HCWs was calculated as follows: Y1 = 31.638 + 0.067X1 (perception of ICNs) + 0.133X2 (attitude of ICNs) + 0.825X3 (role model of ICNs) (P < .001; adjusted R2 = 0.115). Perception, attitude, and role model scores of ICNs were significant predictors of HH performance of HCWs. Specialized well-structured HH education programs should be developed for ICNs that will help improve HH performance of HCWs.

Preparedness and Performance of Health Care Workers Participating in Hajj season on the implementations of International health Regulations, Immunizations and Preventive health measures against Infectious diseases at King Abdul Aziz International Airport

Preparedness and Performance of Health Care Workers Participating in Hajj season on the implementations of International health Regulations, Immunizations and Preventive health measures against Infectious diseases at King Abdul Aziz International Airport