Staff Of Health Care Institutions Research Articles

Factors associated with internal contamination of nurses by antineoplastic drugs based on biomonitoring data from a previous study.

Internal contamination of healthcare professionals by antineoplastic drugs (ADs) remains a current occupational health issue, particularly because these compounds are classified as dangerous to handle by the NIOSH. In order to improve preventive actions, a study of the factors associated with this internal contamination was conducted among nursing staff in health care institutions. This study is a statistical analysis of metadata from a cross-sectional observational study conducted among nurses in two French hospitals. The internal contamination of each nurse was assessed in a previous study and was defined by whether or not at least one studied AD was detected in at least one urine sample. Three urine samples and a self-questionnaire were collected for each participant. Analysis of five ADs (cyclophosphamide, ifosfamide, metabolite of 5-fluorouracil, methotrexate, doxorubicin) were performed by liquid chromatography coupled to tandem mass spectrometry. A multivariate stepwise descending regression model was used to determine factors associated with internal contamination by coupling data from a self-questionnaire with internal contamination data. A total of 74 nurses participated to the study and 68 were included for this work: 39 nurses with and 29 without detectable internal ADs contamination. Two protective factors of internal contamination could be identified: a high "glove wearing score" (OR: 0.957; 95%CI: 0.93-0.98; p<0.01) and a high "total number of years handling ADs and/or caring for patients treated with ADs" (OR: 0.797; 95%CI: 0.67-0.91; p<0.01). In addition, three factors contributing to internal contamination were identified, namely "feeling sufficiently informed about tasks exposing to ADs" (OR: 9.585; 95%CI: 2.23-57.05; p<0.01), "disposal of a waste bin containing equipment used for administration of the ADs studied" (OR: 8.04; 95%CI: 1.87-46.08; p<0.01) and "changing sheets and/or making bed of a patient treated by one of the ADs studied" (OR: 10.479; 95%CI: 1.43-133.30; p<0.05). Thus, the use of gloves when handling ADs directly or indirectly and the contaminating nature of certain tasks should be taken into account when (1) implementing preventive actions in health care services and (2) training and informing exposed staff. Further studies would be desirable to confirm these results and extend them to other professional categories.

The Importance of Physical Activity in Preventing Fatigue and Burnout in Healthcare Workers.

The workers of the health sector are important to the country's economy in many ways. Healthy and rested workers are highly valuable to the public health sector and give a good perception of their work to patients and society. It is thus important to have a sufficient number of healthy working staff in healthcare institutions who do not have work fatigue and burnout. A total of 987 employees-doctors, professional staff, and others-of a large healthcare institution in Hungary voluntarily participated in a survey regarding their lifestyle and physical activity habits and answered the questions anonymously. Women reported less leisure time (p < 0.02), with 54.9% of female respondents saying that they did not exercise regularly, and fatigue was more common among them (p < 0.001). In this respect, the healthcare workers' responses did not differ from those of the overall population. The most common sports were cycling (17.7%), running (15.4%), and working out in a gym (12.3%). Reasons for not participating in sports included lack of time (70.2%) and fatigue (43.9%) as the most frequent responses. Healthcare workers are exposed to a number of risks that require particular attention to maintain their health. Employers should thus focus on implementing programs that prevent burnout and promote healthy lifestyles.

PREDICTORS OF THE DEVELOPMENT OF EMOTIONAL BURNOUT AND THE MOTIVATIONAL COMPONENT OF THE MEDICAL STAFF OF HEALTH CARE INSTITUTIONS IN UKRAINE

The aim: To study the stages and diseases of occupational and emotional burnout syndromes and characterize the changes in the psychophysiological state of the medical staff of health care institutions. Materials and methods: Manifestations and levels of predictors of the development of emotional burnout (PDEB), motivation of medical workers in the Vinnytsia region, and preventive measures of PDEB to improve the motivational component of medical workers. Statistical processing of the research results was performed in the licensed standardized package "Statistica 6.1 for Windows", and included the analysis of the nature of the distribution of characteristics using the Shapiro-Wilk's W test, and the analysis of di"erences using the Mann-Whitney test. The content analysis of domestic and foreign scienti#c sources and biblio-semantic and analytical research methods were used in the work. A sociological study was conducted on the dynamics of changes in the psycho-physiological state of health of medical staff of psychiatric hospitals and medical sta" of general health care facilities (CHP) in the Vinnytsia region, depending on gender and positions. Results: A survey has been conducted using psychodiagnostic methods of emotional burnout by Boyko V.V. and the adapted approach of Vodopyanova N.E. According to the results of K. Zamfir's method in A. Rean's modification, it was established that external negative motivation exceeds external positive motivation in health care staff, as in male doctors and female doctors from 3,2±0,8 to 2,7±1,0 score and the average medical staff of psychiatric profile in men 3,2±1,8 and 3,0±1,3 and the average medical staff of general pro#le 3,6±1,0 and 3,2±1,1, respectively, which re$ects the negative attitude of the medical staff at the present stage to the implementation of professional activities. Conclusions: Predictors of the development of emotional burnout are noted in the average female medical workers working in psychiatric institutions: "Stress" - 41.3±19.2 points versus 33.6±22.2 points (p>0.05), "Resistance " - 56.6±21.4 points against 40.5±16.6 points (p<0.05), "Exhaustion" - 41.5±21.4 points against 39.4±27.4 points (p >0.05) compared to men, who may be at risk of transition from a pre-morbid state (mild, moderate form of SPV) to a severe form of chronic psychosomatic or psychovegetative disorder.

Transition to Pandemic: Reality Shock and Role Development for the Novice Nurse.

Background The challenges related to the transition to professional nursing practice for the novice nurse have been well documented. In 2020, the transition to professional nursing was complicated by COVID-19. This research assimilated important qualitative perceptions related to the reasons novice nurses sought professional nursing practice and the impact of the pandemic on the decision to become a nurse, and identified the novice nurses' concerns related to COVID-19 and direct patient care. Method A qualitative survey was completed by recent BSN graduates. Data were analyzed using content analysis of the open-ended questions. Results New graduate RNs identified the following themes: helping and caring for others; being inspired by practicing nurses; apprehension; validation of professional choice; dangerous conditions; and underprepared to care for patients with COVID-19. Conclusion Nurse leaders should be cognizant that the transition experience of new nurses who began their practice during the pandemic may be more complex than that of previous new nurses. The information from this study presents an opportunity for the staff of health care institutions to be mindful of these factors as they mentor and support these much-needed new nurses. [J Contin Educ Nurs. 2022;53(12):557-564.].

COMMUNICATION ACTIVITIES OF HEALTH CARE INSTITUTIONS IN TERRITORIAL COMMUNITIES

The article substantiates the importance of expanding the areas of research of communicative activities of health care institutions of territorial communities, including under martial law. Communicative activity has been little studied in the context of public health. The role of communication activities of health care institutions in territorial communities has also been little studied. The analysis of scientific publications showed the absence of a single conceptual approach to the communication activities of health care institutions in territorial communities on the issues of public health preservation and disease prevention. The content of communication strategies of local self-government bodies is different from the communication strategies of health care institutions. Communication strategies of local self-government bodies are aimed at building interaction with different population groups, and not at public health issues and the role of health care institutions in this process. Healthcare communication strategies aim to increase patient awareness of health services and care, which should lead to more patients. Communication strategies are mostly related to institutional aspects and not to the methodology of health care institutions. There is no system of methods of communicative activity of the health care institution. The staff of health care institutions have a low level of organizational skills and the implementation of communicative activities. There are several directions of communications that are popular at the modern stage: development of communication strategies; organization of communications in healthcare institutions; use of external communication methods of health care institutions and authorities; recommendations on the creation of partnership relations between local self-government bodies, health care institutions and other interested parties; formation of communications during martial law to provide the population with access to medical services and medical assistance. The main methods of communication are informing, informative message, informative and explanatory activities. These methods differ in their focus. Local self-government bodies use them to form interaction with the population. and healthcare facilities use them to attract patients. There are no separate communication strategies of local self-government bodies for health care, public health, and determination of the place and role of health care institutions in this process. This requires the formation of a new conceptual approach to the communicative activity of health care institutions in territorial communities.

Using Web 2.0 applications by teaching staff in health care institutions' field training

The study aimed to study the current use of Web 2.0 applications such as Wiki, Blogs, Facebook, Wikipedia by teaching staff in field training at health care institutions, in Saudi Arabia by identifying the most widely used web applications. The study also aimed to identify the obstacles of using Web 2.0 applications in field training at health care institutions. A descriptive approach was used in this research. The four-dimensional study tools were applied to 46 teaching staff social work, who are the training supervisors at health care institutions. The results indicated that the most common Web 2.0 application used by teaching staff in field training at health care institutions is the application of Wikipedia, whilst many obstacles were found to the use of Web 2.0 applications in field training at health care institutions. These included the many teaching hours per week by teaching staff social work, students' weakness in the use of the English language, the lack of periodic maintenance for computers and Internet connection at colleges, and the lack of exchanging experiences and knowledge between universities regarding using Web 2.0 applications in education. Based on these results, recommendations were made for increasing teaching staff ' awareness of the importance of using Web 2.0 applications when teaching social work.

Illegitimate HIS access by healthcare professionals: scenarios, use cases and audit trail-based detection model

Abstract Healthcare institutions face serious security challenges, namely confidentiality, integrity and availability of patient’s data due to the amounts of sensitive data collected on Health Information Systems (HIS) and the complex data management processes in health care. This paper describes scenarios of undue HIS access by staff in healthcare institutions, use cases (UC) that model the activities on HIS and identify the variables on audit trails (AT) logs that can be used to detect illegitimate actions on patients’ data. Firstly, a survey was conducted through discussion meetings with Information Systems Director (ISD), Data Protection Officer (DPO) and a jurist to discuss their concerns about patient data access, followed by interviews to professionals from healthcare institutions to gather information about their routines and HIS access practices. Then, undue access scenarios were described and UC of activities on HIS which allow their detection were modelled. Lastly, necessary log variables were identified in order to produce algorithms for illegitimate accesses detection. UC and variables selected were matched with the specific requirements of Ministers Council Resolution (MCR) nr.41/2018 which provides guidelines for technology to be compliant with General Data Protection Regulations (GDPR). Discussions with ISD, DPO and the jurist, and professionals’ interviews allowed us to describe nine scenarios of undue access. For each scenario we modelled one UC. 32 variables from different type of logs were identified for illegitimate access detection, of which 14 are mandatory according to MCR nr. 41/2018. Despite we might have some limitations related to poor HIS log quality, the mandatory data that logs must comply will be very useful for the development of UC presented. In addition, it is possible to request systems’ vendors the improvement of logs’ data to meet the detail we propose for this model, which may be very useful to comply not only with GDPR requirements but also with the Standard “Management of Information” (MOI.11) of Joint Commission International Standards for Hospitals (JCI) certification. As future work, we intend to develop the algorithms for the UC modelled, that will detect suspicious activities and produce alarmistic in their presence, testing them in real environment of a hospital to help Information Systems department and DPO on investigation and prevention of data breaches.

Seizing opportunities for change at the operational level.

Purpose - This paper presents a method for handling everyday opportunities for improvement, led by floor staff in healthcare institutions. More than 400,000 incidents and accidents were recorded in Quebec healthcare institutions in 2013. The burden of treatment falls on hospital floor staff. The purpose of this paper is to raise the visibility of this problem and support staff better in their efforts to handle opportunities for improvement. Design/methodology/approach - Based on issues identified in the literature, which have been found to exist in various organizations, the method involved reviewing practices in the field, proposing a solution, and testing it to assess its relevance and limitations. The method was tested in partnership with the Centre Hospitalier de l'Université de Montréal, in the internal medicine unit at Hôtel-Dieu campus. The test lasted three months. Indicators from this test have been compared to results in the literature. Findings - The proposed method presents a 68 per cent increase in ideas generated per person and per week compared to the reference study. The mean time for closing actions was about 41 per cent better (lower) than in the reference case. Research limitations/implications - The test lasted 15 weeks; a longer test is needed to collect more data. Practical implications - The first practical implication of this study was the creation of a method allowing employees to seize opportunities for improvement in their daily work. The application of this method revealed: first, the operational nature of the proposal (empowerment of the work team); second, the operationalization of continuous improvement (71 per cent of ideas were finalized while the initiative was monitored); third, the smooth operation of the mechanism for facilitating continuous improvement (organization of weekly meetings and team participation in these meetings in 90 per cent of cases); and fourth, a shared feeling that intra- and inter-team communication had been strengthened. Originality/value - The main value of this paper is that it proposes a simple problem-solving process that gives employees an opportunity to improve their daily work. The originality of this paper resides in comparing results to a standard case and observing an improvement. This paper proposes a new problem-solving structure and tests it scientifically.

Ethical considerations on the value of patient knowledge in long-term care: a qualitative study of patients suffering from Korsakoff 's syndrome.

This study explores experiences of patients suffering from Korsakoff's syndrome. It contributes to improved reflection on the value of patient knowledge. An ethics of care perspective states the importance of moving to patients in their vulnerable state of being, and to figure out patients' individual needs necessary to provide good care. The information given by patients suffering from Korsakoff's syndrome might be mistaken, invented and even not true. The value of these patients' experiences and knowledge had not been researched to date. Data from six in-depth interviews were analysed concurrently through the constant comparative method. The principles of voluntariness, confidentiality and anonymity were respected during the research process. Four important themes within patients' knowledge emerged: health condition, involuntary admission into the nursing home, the daily routine and interpretation of the caring abilities of healthcare professionals. The findings show that our respondents were able to provide a window into their inner perspective. This study deepens our understanding of the value of patient knowledge in situations where patients see the world in a different manner as do healthcare professionals. The conversations revealed personal subjective knowledge which our respondents create and live by. Healthcare professionals are encouraged to discover and affirm the understandings of these patients, and not be prepossessed due to the diagnosis or general nursing home rules. Understanding patients' unique knowledge through appreciation of the complexity and richness of different views on the situation can assist to give a more humane response to individual needs and pain. Health staff in healthcare institutions are encouraged to evaluate the - unintended - effect of rigidly applied nursing home rules, and the government is challenged to rethink its policy about care, and provide more resources permitting relational care that nurtures the dignity of patients suffering from Korsakoff's syndrome.

Distribution of outbreak reporting in health care institutions by day of the week

The notion that outbreaks are more likely to occur on Friday is prevalent among staff in health care institutions. However, there is little evidence to support or discredit this notion. We postulated that outbreaks were no more likely to be reported on any particular day of the week. A total of 901 institutional outbreaks in Toronto health care facilities were tabulated according to type, outbreak setting, and day of the week reported. A χ(2) goodness-of-fit test compared daily values for 7-day per week and 5-day per week periods. Post hoc partitioning was used to pinpoint specific day(s) of the week that differed significantly. Fewer outbreaks were reported on Saturdays and Sundays. Further analysis examined the distribution of outbreak reporting specifically focusing on the Monday to Friday weekday period. Among the weekdays, higher proportions of outbreaks were reported on Mondays and Fridays. Our null hypothesis was rejected. Overall, Mondays and Fridays had the highest occurrence of outbreak reporting. We suggest that this might be due to "deadline" and "catch-up" reporting related to the "weekend effect," whereby structural differences in weekend staffing affect detection of outbreaks. Such delays warrant reexamination of surveillance processes for timely outbreak detection independent of calendar cycle.

Eliminating Inequities in Health Care

Antiracism training for staff of health care institutions is a promising intervention strategy to address racial and ethnic disparities in health care. In 2001, Southern County Public Health Department (SCPHD) staff completed a mandatory Dismantling Racism (DR) training, and some continued with an optional DR process to challenge institutional racism within their agency. To explore factors influencing participation in optional DR activities (i.e., caucuses and Change Team), a process evaluation was conducted involving in-depth interviews with 28 SCPHD administrators and staff members, whose participation in the DR process varied. Findings demonstrate that familiarity with and receptiveness to the relationship between racism and health care inequities influenced participation in DR activities. Perceived relevance and impact of the DR process on the organization and staff were also major factors affecting participation. Improvements for implementing such efforts including the consideration of institutional power and other implications for addressing racial health care inequities through antiracism initiatives are discussed.