Personnel Working In Hospitals Research Articles

Gambaran Budaya Kerja Organisasi Terhadap Adaptasi Rekam Medis Elektronik dalam Pelayanan Kesehatan di Rumah Sakit

Electronic Medical Records (EMR) have become a vital system aimed at enhancing the efficiency of patient data management in hospitals. EMR is not just an innovation but a necessity that all healthcare services in Indonesia must adhere to, aligning with the targets set forth in the National Medium-Term Development Plan (RPJMN). In this context, several supportive factors play a pivotal role in EMR implementation, including organizational work culture, human resources, infrastructure, governance, and leadership. This research aimed to provide insight into hospital preparedness in the context of organizational work culture to ensure the smoother implementation of EMR. The research employed a quantitative approach with descriptive analysis. The research subjects were medical record personnel working in hospitals, with data collected from 15 hospitals of various types in the East Java region. The results of this study highlight several critical aspects of organizational work culture that influence EMR implementation, including training, socialization, mentoring, commitment, support from medical record personnel, and an understanding of how technology can enhance service quality. Nevertheless, the research also identified a prevailing perception that EMR is merely an Information Technology project, which could act as a potential hindrance to successful implementation. This research served as a reminder to hospitals about the importance of paying attention to these aspects as part of comprehensive preparations for EMR implementation. Consequently, it is anticipated that EMR implementation can proceed more efficiently and effectively, delivering greater benefits to patients and overall healthcare service delivery.

Adaptation, validity, and reliability of the Resilience Scale SV-RES in hospital health professionals in Mexico

Introduction. Resilience is the capacity in which the qualities and resources of the individual help in the successful coping of adverse situations. Studying the construct of resilience requires seeing it as a process and not only a characteristic of the individual. Saavedra's resilient response is a model that fits this idea and explains resilience satisfactorily. Having a measuring instrument for health personnel working in hospitals would allow discovering its benefits as a protective factor in the workplace. Objective. Adapt and validate the Resilience Scale SV-RES in hospital health professionals in Mexico. Method. Based on recent research literature, including response models and modified and adapted items from the Resilience Scale SV-RES, a total of 909 health professionals responded. Distribution, factor analysis, and internal consistency tests were performed. Results. The process led to a scale of 28 items grouped into six factors with an overall internal consistency of (α = .908) and 50.5% of explained variance. Discussion and conclusion. The Resilience Scale SV-RES has adequate psychometric properties that make it appropriate to measure the resilience capacity of hospital health professionals in Mexico.

Psychological, psychiatric and neurological aspects of COVID-19

To analyze neurological, psychological and psychiatric aspects of COVID-19, as well as to study the current state of the problem. The study included 103 patients with COVID-19. The main research method was clinical/psychopathological. To study the impact of activities related to the care of patients with COVID-19 in a hospital setting, the medical and psychological state of 197 hospital workers involved in the treatment of patients with COVID-19 was assessed. The level of anxiety distress was assessed with the Psychological Stress Scale (PSM-25), distress indicators corresponded to values of more than 100 points. The severity of anxiety and depressive symptoms was assessed using the Hospital Anxiety and Depression Scale (HADS). When considering psychopathological disorders in the context of COVID-19, it is necessary to distinguish between two main groups of disorders: mental disorders during the pandemic, and mental disorders directly caused by the causative agent SARS-CoV-2. The analysis of psychological and psychiatric aspects in various periods of the initial stage of COVID-19 showed that each of them was characterized by specific features depending on the nature of the influence of different pathogenic factors. In the structure of nosogenic mental disorders in patients with COVID-19 (103 patients), the following clinical forms were identified: acute reaction to stress (9.7%), anxiety-phobic disorders (41.7%), depressive symptoms (28.1%), hyponosognosic nosogenic reactions (20.5%). At the same time, the majority of the patients had manifestations of somatogenic asthenia (93.2%). A comparative analysis of neurological and psychological/psychiatric aspects of COVID-19 showed that the main mechanisms of the impact of highly contagious coronaviruses, including the SARS-CoV-2, on the central nervous system are: cerebral thrombosis and cerebral thromboembolism, damage to the neurovascular unit, neurodegeneration, including that induced by cytokines, and immune-mediated demyelinating nerve damage. Neurological and psychological/psychiatric aspects of COVID-19 should be taken into account both at the stage of disease treatment and in the post-infection period due to the pronounced neurotropism of SARS-CoV-2 and its effect on the neurovascular unit. Along with helping patients, an important aspect is the preservation of the mental health of medical personnel working in hospitals for infectious diseases, due to special working conditions and a high level of professional stress.

Intention to get Vaccinated against COVID-19 in Iranian Hospital Staff: Application of the Theory of Planned Behavior.

This study aimed to identify the predictors of the intention to receive the COVID-19 vaccine among Iranian health care workers (HCWs) based on the Theory of Planned Behavior (TPB). The study was a descriptive cross-sectional study that was conducted on 473 personnel working in hospitals of Hamadan, in May 2021 and before COVID-19 vaccination on hospital staff. The multi-stage sampling method was used for choosing participants. The survey included socio-demographic, questions related to TPB dimensions, and intention to receive a COVID-19 vaccine. Qualitative and quantitative data analyses were performed using the Chi-square test and T-test, respectively. Predictors of COVID-19 vaccination intention were determined using the logistic regression model. Seventy percent of 361 eligible respondents stated their willingness to receive COVID-19 vaccine. The participants with the intention to receive COVID-19 vaccine had higher scores of attitude (7.25 ± 3.92 vs. 4.40 ± 5.14) and norm (3.04 ± 2.92 vs. -0.5 ± 3.18) (P < 0.001). Having an underlying disease and being married were significantly associated with the intention to receive COVID-19 vaccine (P < 0.05). Higher attitude and norm scores as a construct of the TPB were associated with an increase in intention to receive COVID-19 vaccine. The results of this study showed that the vaccination intention was affected by social, demographic, health, and behavioral features, such as age, marital status, underlying diseases, subjective norms, and attitude. Therefore, age groups below 50, single people, and those with no underlying diseases were eligible to be the target of interventional programs.

A Review of Occupational Hazards in Health Sector: Risks and Awareness

Background: Healthcare personnel working in hospitals and healthcare institutions across the world are more vulnerable to occupational dangers than those working in other fields.

Relationship Between Specialties of Managers and Crisis Management Function in Hospitals in Tehran

Background: Nowadays, doing any activity at any level without having specialized knowledge in that special field is impossible. The practice and implementation of crisis management including reduction, preparedness, response, and reconstruction requires the knowledge compatible with any measure which puts into practice all the existing and accessible information in its best way. Based on these facts, the present research investigates the relationship between specialties of managers and crisis management function in hospitals in Tehran.&#x0D; Methods: The present study was conducted through survey method of research with a descriptive-analytical and correlational design. The statistical population included personnel working in hospitals in Tehran. For sampling procedure, randomized sampling was used. Based on Cochran formula, the size of samples was determined which included 80 hospital personnel encompassing 20 crisis management specialists.&#x0D; Results: Considering the results obtained, there was a significant relationship between managers’ expertise and crisis management performance (p&lt;0.005, R = 0.24). According to the regression analysis, 6% of the changes in crisis management performance were associated with the managers’ expertise.&#x0D; Conclusion: Given the relationship between the managers’ expertise and the performance of crisis management in Tehran Hospitals, it seems that with more focus on the expertise of hospital managers and the importance of training and skills of managers in appointing them to managerial positions, crisis management in hospitals has been more successful.

The role of spiritual intelligence in the effectiveness of crisis management A survey research for the opinions of a sample of medical personnel working in hospitals Designated to receive patients (COVID19) in the city of Sulaymaniyah/Iraq

The aim of the research is to study the relationship of spiritual intelligence and its effect on the effectiveness of crisis management in some hospitals in the city of Sulaymaniyah,. a hypothetical model was created that clarifies the relationship between the dimensions of spiritual intelligence and the effectiveness of managing the crisis , and the research adopted the descriptive analytical approach and adopted a questionnaire form as a tool to collect and analyze data according to the (Thurston) decimal scale The questionnaire was submitted electronically to the research community, and (60) responses were obtained , and a set of conclusions were reached, including: The existence of a relationship and moral impact between the dimensions of spiritual intelligence and effectiveness Managing the crisis by removing it individually and collectively, providing high levels of spiritual intelligence among the medical cadres working in the research hospitals It contributed greatly to effective crisis management, and a set of recommendations was presented .

Adverse Effects Induced by Long-term Use of Hand Sanitizers Among Health Staff During COVID-19

Background: The present study examines the various complications and impurities of alcoholbased hand sanitizers during COVID-19 among health workers in Hamadan City, Iran. Methods: This cross-sectional study was conducted on 178 healthcare workers in different hospitals affiliated with the Hamadan University of Medical Sciences. The inclusion criteria included health personnel working in hospitals dedicated to the care and treatment of patients with COVID-19 in Hamadan City. A researcher-made questionnaire was used to collect data. Afterward, to evaluate the quality and impurities of the alcohol-based hand sanitizers used by healthcare workers, various samples were collected and analyzed using gas chromatographymass spectrometry (GC-MS). Stata software version 14-2 was used to analyze the data. Results: The highest and the lowest percentages of ethanol in washing solutions and gels were 68.24% and 60.71%, respectively. Among them, the frequency of using gel, solution, and spray was 93.82%, 42.13%, and 49.44%, respectively. Skin and breathing sensitivity were the most common symptoms in 44.38% and 27.68% of the health workers, respectively. Skin dryness (50%) and sore throat (25.84%) were the most common complications observed in skin and respiratory symptoms among health workers, respectively. Conclusion: Our findings implied that the prevalence of various complications related to the use of alcohol-based hand sanitizers is high among health workers, which highlights the role of using appropriate alcohol-based hand rubs with suitable formulations in the hospital environment to reduce the adverse health effects caused by their long-term and extensive use among health workers.

Anxiety Status and Associated Factors of Health Personnel Working in a Tertiary Hospital in Turkey in the COVID-19 Pandemic

Aim: This research was conducted to evaluate the anxiety status and related factors of tertiary hospital personnel working in a densely populated area of ​​Turkey during the COVID-19 pandemic. Methods: A total of 555 participants were included in this cross-sectional, prospective study. A socio-demographic data form was created and the Beck Anxiety Scale was applied to participants for evaluating anxiety status. Results: The rate of men 64.86% (n=360) and women 35.14% (n=195). The distribution of anxiety scores was in the range of 8.39±9.16. 58.2% of them (n=323) had low, 41.8% (n=232) had high anxiety scores. Factors like age, gender, marital status, working status in areas where treatment/care is provided to suspected/positive patients with COVID-19, and fear of carrying infection from work to home are found to be statistically significantly related to anxiety. Conclusion: High anxiety scores were measured in almost half of the participants. Taking measures to improve risk factors can reduce the damaging effects of the challenging working conditions due to the ongoing COVID-19 pandemic on hospital personnel. Keywords: anxiety, COVID-19, health, health personnel, pandemics

Evaluation of skin damage owing to protecting measures against COVID-19 among health staff in the west of Iran

Background So far, studies have not been performed regarding skin damage owing to protective measures against coronavirus disease 2019 (COVID-19) by health staff in Iran. Therefore, the present study was performed to assess skin damages owing to protecting measures against COVID-19 among health workers in Hamadan City located in the west of Iran. Materials and methods This cross-sectional study was conducted on 273 health staff working in hospitals affiliated to Hamadan University of Medical Sciences. The inclusion criteria were health personnel working in hospitals involved in the care and treatment of patients with COVID-19 in the city of Hamadan. The authors used a researcher-developed questionnaire to gather data. All the analyses were done using Stata version 14-2. P value less than 0.05 was considered as significant. Results The most common skin signs and symptoms of COVID-19 in health staff were dryness, redness, and itch, representing in 83.78, 53, and 40.99% of hospital staff, respectively. All participants used hand disinfectants, with a frequency in the range of 1–5 times in 29.33% and more than 20 times in 19.79% of them. Using a mask for more than 6 h in daily practice was significantly associated with skin dryness (P=0.007), skin redness (P=0.001), scaling (P=0.019), and skin pain (P=0.005). Conclusion The findings showed that the prevalence of skin damages related to using protective equipment is high, and simple interventions may help preserve health workers to care for patients infected by COVID-19.

COVID-19 Vaccination and Intent Among Healthcare Personnel, U.S.

IntroductionHealthcare personnel are at increased risk for COVID-19 from workplace exposure. National estimates on COVID-19 vaccination coverage among healthcare personnel are limited.MethodsData from an opt-in Internet panel survey of 2,434 healthcare personnel, conducted on March 30, 2021–April 15, 2021, were analyzed to assess the receipt of ≥1 dose of a COVID-19 vaccine and vaccination intent. Multivariable logistic regression was used to assess the factors associated with COVID-19 vaccination and intent for vaccination.ResultsOverall, 68.2% of healthcare personnel reported a receipt of ≥1 dose of a COVID-19 vaccine, 9.8% would probably/definitely get vaccinated, 7.1% were unsure, and 14.9% would probably/definitely not get vaccinated. COVID-19 vaccination coverage was highest among physicians (89.0%), healthcare personnel working in hospitals (75.0%), and healthcare personnel of non-Hispanic White or other race (75.7%–77.4%). Healthcare personnel who received influenza vaccine in 2020–2021 (adjusted prevalence ratio=1.92) and those aged ≥60 years (adjusted prevalence ratio=1.37) were more likely to report a receipt of ≥1 dose of a COVID-19 vaccine. Non-Hispanic Black healthcare personnel (adjusted prevalence ratio=0.74), nurse practitioners/physician assistants (adjusted prevalence ratio=0.55), assistants/aides (adjusted prevalence ratio=0.73), and nonclinical healthcare personnel (adjusted prevalence ratio=0.79) were less likely to have received a COVID-19 vaccine. The common reasons for vaccination included protecting self (88.1%), family and friends (86.3%), and patients (69.2%) from COVID-19. The most common reason for nonvaccination was concern about side effects and safety of COVID-19 vaccine (59.7%).ConclusionsUnderstanding vaccination status and intent among healthcare personnel is important for addressing barriers to vaccination. Addressing concerns on side effects, safety, and effectiveness of COVID-19 vaccines as well as their fast development and approval may help improve vaccination coverage among healthcare personnel.

Effectiveness of Transference-focused Psychotherapy and Acceptance and Commitment Therapy in Promoting the Mental Health and Psychological Capital of Staff Working in Hospitals Covered by Social Security in Tehran Province

Objective: This study aimed to compare the effectiveness of Transference-focused Psychotherapy (TFP) and Acceptance and Commitment Therapy (ACT) on promoting the mental health and psychological capital of staff working in hospitals covered by social security in Tehran Province. Methods: The present study was a quasi-experimental research with pre-test and post-test. The statistical population of the present study was the personnel working in hospitals covered by social security in Tehran Province. A total of 120 personnel from three hospitals were randomly divided into two experimental groups and one control group (40 people in each group). All three groups answered the Mental Health Questionnaire (Symptom Checklist-90-R (SCL-90-R)) and Psychological Capital Questionnaire (PCQ) as a pre-test. Then, the transfer-oriented treatment group and the acceptance and commitment treatment group (during eight sessions) received the experimental intervention and the control group did not receive any kind of intervention. At the end of the sessions, all three groups answered the questions of the SCL-90-R and PCQ again. Multivariate analysis of covariance was used to analyze the collected data. Results: The results of the present study showed that both TFP and ACT were effective in promoting the mental health of staff working in hospitals covered by social security. There was also a difference between the effectiveness of TFP and ACT in promoting the mental health of staff working in hospitals covered by social security. Thus, in the TFP group, the components of anxiety, morbid fear, psychosis, and paranoia gained significantly lower scores compared to the ACT group. Regarding the components of psychological capital, the ACT group scored significantly lower than the TFP group. Conclusion: Both methods can be used by counselors and therapists to promote the mental health of staff working in hospitals covered by social security.

Adherence to Infection Prevention and Control Practices among Health Care Workers and its Outcome in Non-COVID Areas in a Tertiary Care Hospital

International Journal of Medicine and Public Health,2021,11,3,146-149.DOI:10.5530/ijmedph.2021.3.26Published:August 2021Type:Original ArticleAdherence to Infection Prevention and Control Practices among Health Care Workers and its Outcome in Non-COVID Areas in a Tertiary Care HospitalMini Palathingal Narayanan, Anuja Mohan, Priya Chandran, Durga Neelakandan, and Beena Philomina Jose Mini Palathingal Narayanan1,*, Anuja Mohan1, Priya Chandran2, Durga Neelakandan1, Beena Philomina Jose1 1Department of Microbiology, Government Medical College Kozhikode, Kerala, INDIA. 2Department of Community Medicine, Government Medical College Kozhikode, Kerala, INDIA. Abstract:Aim and Objective: 1. To study the adherence to Infection Prevention and Control (IPC) practices by health care workers in Non-COVID areas. 2. To compare the proportion of COVID affected health care workers among those adhering to proper IPC and those with non-adherence. Background: Hospitals serve as frontline health care institutions caring for the increased number of COVID-19 patients. The health care personnel working in hospitals are at increased risk of acquiring the disease during the pandemic. It is the prime responsibility of the Hospital Infection Control Committee to protect the health care workers (HCW) and prevent nosocomial transmission. Materials and Methods: In the cross sectional study,all health care workers from non-COVID areas of the hospital who were exposed to COVID-19 patient during the study period were assessed according to the risk assessment criteria. Results: A total of 1049 health care workers had contact with COVID-19 patients. Of this only 6 health care workers were diagnosed with COVID-19. Conclusion: The HCW diagnosed with COVID-19 was less than one percentage of exposed. This implies the impact that the IPC training had on the HCW which made them ensure their own safety and prevent the nosocomial spread of SARS-CoV-2 within the hospital. Keywords:Adherence, Frontline health care workers, Nosocomial infectionView:PDF (150.3 KB)

Caring for healthcare providers in COVID-19.

There is concern for the mental health of healthcare providers during the COVID-19 pandemic. In this article, we focus on the protective strategies that all people, but in this case healthcare providers, use when facing danger and how specific preventive responses could reduce the mental health burden to nurses, doctors, and emergency medical personnel working in hospitals. Our primary contributions are to demonstrate that healthcare providers are not a homogeneous group regarding mental health risks and that, consequently, individuals might need different forms of preventive and ameliorative response. We propose some (a) universally beneficial approaches, (b) strategy-specific approaches, and (c) strategy-specific contra-indicated approaches. Our two central points are that there are important psychological differences among healthcare providers and that these create different mental health needs in the COVID-19 crisis and require different protective solutions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Knowledge and self-expressed competency of the health personnel regarding disaster and its preparedness

Disasters cause great harm to the existing infrastructure and threaten the future of sustainable development. The occurrence of disasters and related causalities are one of the realities of man’s life. The aim of this study is to assess the knowledge and self-expressed competency of the health personnel regarding disaster and its preparedness in selected hospitals, Mangaluru. Objectives of the study are to assess the knowledge regarding disaster and its preparedness among health personnel, to determine the self-expressed competency of health personnel on disaster and its preparedness and to correlate knowledge with self-expressed competency of health personnel on disaster and its preparedness. Descriptive research design was used. Study sample consists of 200 health personnel working in hospitals in Mangaluru, who were available at the time of data collection and who fulfilled the inclusion criteria. The data was collected using self-administered structured knowledge questionnaire and five point self-expressed competency rating scale. Result: Majority 42 (79.24%) of the doctors had good level of knowledge whereas majority 80 (66.67%) of nurses and 13(48.15%) of paramedical staffs had average knowledge regarding disaster and its preparedness Overall knowledge score was high among doctors with mean percentage of 80.55% with mean and SD of 32.22 ± 2.177. Next highest was among nurses with mean percentage of 67.29% with mean and SD of 26.55 ± 5.272. Least was among paramedical staffs with mean percentage of 66.38% with mean and SD of 28.275 ± 4.516. Regarding level of self-expressed competency among subjects, 47 (88.67%) doctors showed high level of competency, among nurses 55 (45.83%) of them showed high level of competency, among paramedical 7 (25.92%) of them showed high level of competency regarding disaster and its preparedness. There was positive correlation between level of knowledge and self-expressed competency of health personnel regarding disaster and it

ANMCO POSITION PAPER: The cardiological clinical activities in the transition phase of the COVID-19 pandemic.

Infections by SARS CoV2 - COVID-19 became in a short time a worldwide health emergency. The present SARS-CoV-2 pandemic induced in a short time, an unprecedented impact on public health and on the pre-existing care pathways. In order to appropriately address this epidemiological emergency, urgent solutions were needed, such as remodelling or stopping hospitalization and deferrable clinical activities to avoid spreading the SARS-CoV-2 infection. After the first emergency lockdown phase, care pathways must guarantee healthcare to patients and preserve the safety of the healthcare personnel and of all the other subjects that refer to the cardiological surgeries. Rigorous prescriptive appropriateness of the requested exams with consequent reduction of unnecessary examinations is an essential requirement to preserve prioritized diagnostic and care pathways to patients in need, minimizing the risks connected to the SARS-CoV-2 contagion in hospitals. Telemedicine services represent a valid answer to cardiovascular disease patients’ need for care and assistance, including those in quarantine and voluntary isolation. These services successfully contribute to fight the spread of the virus guaranteeing at the same time therapy and support through remote services that must therefore be considered a resource to be implemented and enhanced. This document has to be used by the healthcare personnel working in hospitals and in district offices, if applicable, and aims at managing patients, in complete safety and considered not suspect/not probable (‘not at risk’) of SARS-CoV-2 infection, eligible for diagnostic activity and subsequent therapy in outpatient surgeries. In particular, this document provides indications for patient evaluation to prevent COVID-19 exposure, gives general indications on managing appointments and waiting rooms, on how to strictly adhere to environmental safety measures, on the proper use of Individual Protective Equipment (IPE). It also provides specific indications for outpatient service procedures, like electrocardiogram, cardiologic examination, cardiologic checkup, Dynamic Holter Electrocardiogram, Transthoracic Echocardiography, Echo Stress, Transoesophageal Echocardiography, Bike Ergometer stress test, Ergospirometry, Outpatient Checkup of implantable electronic cardiac devices.

A FOLLOW-UP STUDY OF THE OCCUPATIONAL HAND ECZEMA AND SKIN DAMAGE RISK IN HEALTHCARE PROVIDERS FROM ROMANIA IN TIME OF COVID-19

The aim of this work was to estimate the prevalence and risk factors of self-reported, work-related occupational hand eczema, targeting personnel working in hospitals and ambulatory units throughout Romania. A standardized questionnaire was specifically addressed to healthcare professionals from different medical fields. Out of 245 healthcar e providers who took part in the survey, 161 (65.71%) were nurses, and 235 (95.92) women, which confirms that women are prevalent in this working sector. The latex powder-gloves were the most frequently implied trigger factor, 223 (91.02%) responders reported the daily use of protective gloves and 37 (15.12%) of them have reported the protective gloves as a possible cause for skin lesions. Also, an important part of responders testified a prolonged contact with water, which confirms the importance of wet environment in inducing occupational hand eczema. In addition, X-ray photoelectron spectroscopy (XPS) analysis of powder free latex gloves was performed in order to establish a correlation between the elemental composition and risk factors for hand eczema. The results support the implication of Cd and Ca, which were detected on the inner faces of the gloves, to the toxicity to the skin.

Üniversite Öğrencilerinin ve Çalışanlarının Güneşten Koruma Davranışının Değerlendirilmesi: Anket Çalışması

Objective: We aims of our study are as follows: 1) to determine the data and socio-demographic characteristics related to sun protective behavior during the summer months in the population who came for education and work from every region of the country, 2) to compare sun protective behaviors and intentional sun exposure factors in the highly educated population (college graduate or university students) as well as intentional sun exposure factors. We intend to reflect in this study the use of sunscreen cream and the knowledge and behavior about sun protection methods of the students of University (SU) and hospital personnel working in University Faculty of Medicine Research and Training Hospital(SURTH). Material and methods: The study was held on the subjects consisting of student and staff volunteers of SU and SURTH. One thousand three hundred eighty-nine (69.2%) of these volunteers were students in SU, 616 (30.7%) of them were staff working in SURTH. Results The study was conducted on 2005 individuals with face-to-face interviews. Of the participants, 53.4% (n = 1070) were male and 46.6% (n = 935) were female. Conclusion The incidence of malignant melanoma and other skin cancers is increasing. We believe that the researches and warnings were still inadequate on these issues. The behaviors of protection from the sun were not caused because they want to be healthy, they were caused to avoid the inconvenience due to the sun while driving and playing sports.

Determinant factors in applying electronic medical records in healthcare.

Electronic Medical Record (EMR) offers remarkable facilities such as reducing medical errors, decreasing healthcare costs and promoting quality of healthcare services by collecting, storing and displaying information at the point of care. This study was carried out to identify the determinants of electronic medical record (EMR) adoption by presenting a comprehensive model. This was a cross-sectional study in which 330 healthcare personnel working in hospitals affiliated to Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran, were selected as the study sample. A proposed conceptual path model of technology, organization and environment (TOE), and technology acceptance model (TAM) was developed to identify the determinants of EMR adoption. The model was authorized by structural equation modeling (SEM) and represented by Analysis of Moment Structures (AMOS). The results of the study showed that the integrated model of TOE-TAM explained 68 percent (R2 = 0.68) of the variance of EMR adoption. The findings also evidenced that perceived ease of use, perceived usefulness, technological context, organization context and environmental context have significant effect on EMR adoption. The study findings suggest that the proposed conceptual integrated model of TOE-TAM is a favourable model for identifying the relevant factors of EMR adoption. The present study clearly recognized nine significant determinants that affect end-users' intention when comprehensive implementation of ERMs is considered.

Assessment of Rehabilitation Infrastructure in Peru

ObjectiveTo assess rehabilitation infrastructure in Peru in terms of the World Health Organization (WHO) health systems building blocks. DesignAnonymous quantitative survey; questions were based on the WHO's Guidelines for Essential Trauma Care and rehabilitation professionals' input. SettingLarge public hospitals and referral centers and an online survey platform. ParticipantsConvenience sample of hospital personnel working in rehabilitation and neurology (N=239), recruited through existing contacts and professional societies. InterventionsNot applicable. Main Outcome MeasuresOutcome measures were for 4 WHO domains: health workforce, health service delivery, essential medical products and technologies, and health information systems. ResultsRegarding the domain of health workforce, 47% of physical therapists, 50% of occupational therapists, and 22% of physiatrists never see inpatients. Few reported rehabilitative nurses (15%) or prosthetist/orthotists (14%) at their hospitals. Even at the largest hospitals, most reported ≤3 occupational therapists (54%) and speech-language pathologists (70%). At hospitals without speech-language pathologists, physical therapists (49%) or nobody (34%) perform speech-language pathology roles. At hospitals without occupational therapists, physical therapists most commonly (59%) perform occupational therapy tasks. Alternate prosthetist/orthotist task performers are occupational therapists (26%), physical therapists (19%), and physicians (16%). Forty-four percent reported interdisciplinary collaboration. Regarding the domain of health services, the most frequent inpatient and outpatient rehabilitation barriers were referral delays (50%) and distance/transportation (39%), respectively. Regarding the domain of health information systems, 28% reported rehabilitation service data collection. Regarding the domain of essential medical products and technologies, electrophysical agents (88%), gyms (81%), and electromyography (76%) were most common; thickened liquids (19%), swallow studies (24%), and cognitive training tools (28%) were least frequent. ConclusionsRehabilitation emphasis is on outpatient services, and there are comparatively adequate numbers of physical therapists and physiatrists relative to rehabilitation personnel. Financial barriers seem low for accessing existing services. There appear to be shortages of inpatient rehabilitation, specialized services, and interdisciplinary collaboration. These may be addressed by redistributing personnel and investing in education and equipment for specialized services. Further examination of task sharing's role in Peru's rehabilitation services is necessary to evaluate its potential to address deficiencies.