Staff In Tertiary Hospital Research Articles

Protection of Omicron Bivalent Vaccine, Previous Infection, and Their Induced Neutralizing Antibodies Against Symptomatic Infection With Omicron XBB.1.16 and EG.5.1.

Data are limited on the protective role of the Omicron BA bivalent vaccine, previous infection, and their induced neutralizing antibodies against Omicron XBB.1.16 and EG.5.1 infection. We conducted a nested case-control analysis among tertiary hospital staff in Tokyo who had received ≥3 doses of COVID-19 vaccines and donated blood samples in June 2023 (1 month before the Omicron XBB.1.16 and EG.5.1 wave). We identified 206 symptomatic cases between June and September 2023 and selected their controls with 1:1 propensity score matching. We examined the association of vaccination, previous infection, and preinfection live virus neutralizing antibody titers against Omicron XBB.1.16 and EG.5.1 with the risk of COVID-19 infection. Previous infection during the Omicron BA- or XBB-dominant phase was associated with a significantly lower infection risk during the XBB.1.16 and EG.5.1-dominant phase than infection-naive status, with 70% and 100% protection, respectively, whereas Omicron BA bivalent vaccination showed no association. Preinfection neutralizing titers against XBB.1.16 and EG.5.1 were 39% (95% CI, 8%-60%) and 28% (95% CI, 8%-44%) lower in cases than matched controls. Neutralizing activity against XBB.1.16 and EG.5.1 was somewhat detectable in the sera of individuals with previous infection but barely detectable in those who were infection naive and received the Omicron bivalent vaccine. In the era when the Omicron XBB vaccine was unavailable, the Omicron BA bivalent vaccine did not confer the neutralizing activity and protection against Omicron XBB.1.16 and EG.5.1 symptomatic infection. The previous infection afforded neutralizing titers and protection against symptomatic infection with these variants.

Assessment of radiation knowledge and awareness among radiology staff in tertiary hospitals: a study in Wuxi, China

A number of previous studies have shown that the knowledge of radiation dose and its associated carcinogenic risk among radiology staff is inadequate. Underestimation of radiation dose and cancer risk in diagnostic procedures is prevalent, which may lead to suboptimal scanning parameters and potential overuse of radiation in daily practice. This study aimed to evaluate the knowledge of radiation dose and associated risks in common diagnostic radiological examinations among radiology staff in comprehensive tertiary hospitals in Wuxi, China. An online questionnaire survey was conducted among radiology staff from seven general tertiary hospitals.

The Effectiveness of Stress Reduction Strategies for Operating Room Nursing Staff in Tertiary Hospitals on the Prevention of Metabolic Syndrome

The increase in global life expectancy, driven by economic growth, has resulted in a progressively aging population, thereby emphasizing the imperative for comprehensive elderly care services. In China, the proportion of individuals aged 60 and above has reached 18.70%, with projections indicating a rise to 34.9% by 2050. This statistics underscores the pressing need for competent professionals in the elderly care sector. However, the current education system encounters difficulties in meeting the industry's standards, leading to a disparity between training provisions and societal demands. In light of this, the present study aims to investigate the social adaptability of higher vocational graduates specialized in elderly care services, with a specific focus on areas encompassing independent living, cognitive abilities, interpersonal skills, vocational competence, and teamwork. The findings emphasize the necessity of tailored interventions to enhance the well-being and effectiveness of these graduates. In response, several strategies are proposed, including the cultivation of transformative mindsets, character development, local alignment with development goals, and immersive field practice. This research underscores the pivotal role of higher education institutions in producing qualified professionals equipped to address the multifaceted challenges posed by an aging society.

Preinfection Neutralizing Antibodies, Omicron BA.5 Breakthrough Infection, and Long COVID: A Propensity Score-Matched Analysis.

Data are limited on the role of preinfection humoral immunity protection against Omicron BA.5 infection and long coronavirus disease (COVID) development. We conducted nested case-control analysis among tertiary hospital staff in Tokyo who donated blood samples in June 2022 (1 month before Omicron BA.5 wave), approximately 6 months after receiving a third dose of COVID-19 mRNA vaccine. We measured live virus-neutralizing antibody titers against wild type and Omicron BA.5, and anti-receptor-binding domain (RBD) antibody titers at preinfection, and compared them between cases and propensity-matched controls. Among the breakthrough cases, we examined association between preinfection antibody titers and incidence of long COVID. Preinfection anti-RBD and neutralizing antibody titers were lower in cases than controls. Neutralizing titers against wild type and Omicron BA.5 were 64% (95% confidence interval [CI], 42%-77%) and 72% (95% CI, 53%-83%) lower, respectively, in cases than controls. Individuals with previous Omicron BA.1/BA.2 infections were more frequent among controls than cases (10.3% vs 0.8%), and their Omicron BA.5 neutralizing titers were 12.8-fold higher than infection-naive individuals. Among cases, preinfection antibody titers were not associated with incidence of long COVID. Preinfection immunogenicity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may play a role in protecting against the Omicron BA.5 infection but not preventing long COVID.

Burnout, depression, anxiety and insomnia among medical staff during the COVID-19 epidemic in Shanghai.

Coronavirus disease 2019 (COVID-19) has progressively impacted our daily lives, resulting in unexpected physical and mental stress on medical staff. This study is designed to investigate the levels of and risk factors for burnout, depression, anxiety, and insomnia among medical staff during the COVID-19 epidemic breakout in Shanghai, China. This cross-sectional survey was conducted from May 1 to May 31, 2022, among medical staff who were on the frontline during the epidemic breakout in Shanghai from different institutions. The MBI-HSS was used to assess burnout, PHQ-9, GAD-7 and ISI were used to evaluate mental status and insomnia. A total of 543 valid questionnaires were collected. The depersonalization, depression, anxiety, and insomnia scores of medical staff were significantly higher during the pandemic in Shanghai compared with norms, while lack of personal achievement scores were decreased. Working time, work unit, work environment and age are important influencers of burnout, depression and anxiety of medical staff. Long working hours are the most likely causes of burnout and emotional disorders. Medical staff in primary hospitals were most likely to suffer from burnout and emotional disorders, while medical staff in tertiary hospitals had a reduced sense of personal achievement. Young medical staff are prone to negative emotions such as depression and anxiety, while older medical staff have a lower sense of personal accomplishment. Medical staff who were not in the shelter hospitals or designated hospitals were more likely to have problems of emotional exhaustion, depersonalization and anxiety than those who were in the shelter hospitals or designated hospitals. Contracting COVID-19 had no effect on medical staff. Emotional exhaustion and depersonalization were positively correlated with anxiety, depression, and sleep disorders while personal achievement was negatively correlated with these factors. Medical staff in Shanghai had high burnout, depression, anxiety and insomnia levels during the epidemic outbreak in Shanghai. During the COVID-19, medical staff may suffer different psychological problems which should be concerned. Care and supports about burnout, mental health and insomnia need to be taken to promote the mental health of medical staff according to different characteristics of medical staff.

Interfacility Transfer Guidelines for Isolated Facial Trauma: A Multidisciplinary Expert Consensus.

The objective of this study was to develop guidelines for the transfer of patients with isolated craniomaxillofacial trauma. A national, multidisciplinary expert panel was assembled from leadership in national organizations and contributors to published literature on facial reconstruction. The final panel consisted of five plastic surgeons, four otolaryngologist-head and neck surgeons, and four oral and maxillofacial surgeons. The expert panelists' opinions on transfer guidelines were collected using the modified Delphi process. Consensus was predefined as 90 percent or greater agreement per statement. After four Delphi consensus building rounds, 13 transfer guidelines were established, including statements on fractures of the frontal sinus, orbit, midface, and mandible, as well as soft-tissue injuries. Twelve guidelines reached consensus. The decision to transfer a patient with craniomaxillofacial trauma to another facility is complex and multifactorial. While a percentage of overtriage is acceptable to promote safe disposition of trauma patients, unnecessarily high rates of secondary overtriage divert emergency medical services, increase costs, delay care, overload tertiary trauma centers, and result in tertiary hospital staff providing primary emergency coverage for referring hospitals. These craniomaxillofacial transfer guidelines were designed to serve as a tool to improve and streamline the care of facial trauma patients. Such efforts may decrease the additional health care expenditures associated with secondary overtriage while decompressing emergency medical systems and tertiary emergency departments.

The Prevalence of Post-traumatic Stress Disorder and Associated Factors among Staff in a Tertiary Hospital (Medical City) during COVID-19 Pandemic Crisis in Makkah, K.S.A., 2020

Background: Living a pandemic disaster is associated with mental health consequences including post-traumatic disorder (PTSD). The primary objective of this study is to determine the prevalence of PTSD among tertiary hospital staff working in King Abdullah Medical City (KAMC) in Saudi Arabia and the secondary objective is to determine the factors associated with the risk of developing post-traumatic stress disorder. Methods: A descriptive cross-sectional design were used through an electronic survey questionnaire that sent to all KAMC staff who are working during early COVID-19 from June 2020 till June 2021. 118 from 235 were responded and included in the study. The Posttraumatic Diagnostic Scale (PDS-5) was used. It is a reliable and valid tool in measuring the PTSD symptoms and severity. Results: The prevalence of PTSD among KAMC staff were found 50.2 % (Moderate 35.6%, Moderate to severe 38.1%, and Severe 26.3%). The gender found near significant P value in the avoidance domain and Arousal and reactivity domain (0.066), (0.073) respectively. In regards to nationality, the Arousal and reactivity domain showed a significant P value (0.03) among Saudi and non-Saudi while the other domain showed no significant value. Conclusion: Our study highlights the importance of the psychological stress and traumatic events in staff working during a disaster such as COVID-19 pandemics and the results should be taken in consideration to focus on the importance of mental health condition of working staff in a tertiary hospital.

Burnout Syndrome in a Military Tertiary Hospital Staff during the COVID-19 Contingency.

(1) Background: Burnout syndrome (BOS) is defined as a psychological state of physical and mental fatigue associated with work. The COVID-19 pandemic greatly impacted the physical and mental wellbeing of health professionals. The objective of this work was to determine the impact on personnel, monitoring the frequency of BOS throughout the pandemic. (2) Methods: The Maslach Burnout Inventory (MBI) was self-applied in four periods of the pandemic according to sociodemographic and employment characteristics. In this study, all hospital personnel were included; the association of BOS with sex, age, type of participant (civilian or military), military rank and profession was analyzed. (3) Results: The frequency of BOS was 2.4% (start of the pandemic), 7.9% (peak of the first wave), 3.7% (end of the first wave) and 3.6% (peak of the third wave). Emotional exhaustion (EE) was the most affected factor, and the groups most affected were men under 30 years of age, civilians, chiefs and doctors, especially undergraduate medical doctors and specialty resident doctors, and nursing personnel were less affected. (4) Conclusions: The low BOS levels show that the containment measures and military training implemented by the hospital authorities were effective, although the chief personnel were more affected in the first wave. It is probable that this combination allowed the containment of BOS, which was not observed in civilians.

Meta-analysis of the impact of role stress on the turnover intention of medical staff in tertiary hospitals.

This study aimed to conduct a meta-analysis on the effect of role stress on the turnover intention of medical staff in tertiary hospitals. Based on the inclusion and exclusion criteria of literatures, we searched the English language databases Science Direct, PubMed, Springerlink, CBM, ISI, and Web of Science for studies published between January 2000 and October 2020 on the effect of role stress on the turnover intention of medical staff in tertiary hospitals. Publications were strictly screened according to the standards, and RevMan5.3 was adopted to conduct a meta-analysis of the relevant data. The influence of role stress and its various dimensions, such as role conflict, role ambiguity, and role overload on medical staff in tertiary hospitals turnover intention was analyzed. The Q test was adopted for heterogeneity analysis and the Egger's test adopted to detect publication bias. A total of 12 publications meeting the requirements were included in this study. The results showed that the combined correlation coefficient r between total role stress and turnover intention was 0.2503 (95% CI: 0.2235‒0.3489). There was also a positive correlation between role stress and the turnover intention of medical staff in tertiary hospitals (r=0.2503). The meta-analysis results of each dimension of role stress showed turnover intention was positively correlated with role conflict (r=0.2838), role ambiguity (r=0.2628), and role overload (r=0.2687). The greater the role stress of medical staff in tertiary hospitals, the stronger the turnover intention. Measures must be taken to avoid the loss of medical staff and improve the quality of medical services.

Knowledge, attitudes and practice towards epilepsy among medical staff in Southern China: Does the level of hospitals make a difference?

PurposeTo assess knowledge, attitudes, and practice (KAP) toward epilepsy among medical staff from different levels of hospitals in Southern China. MethodAn adapted and structured questionnaire was administered to medical personnel from tertiary (n = 451) and basic-level (n = 448) hospitals in Southern China. The questionnaire comprised of three domains which consisted of 6 items for awareness, 12 items for knowledge and a 14 item scale for attitudes. ResultsAlmost 40% of medical staff in basic-level hospitals held that epilepsy could be caused by evil spirits/eyes, or transmitted from other patients, which was almost 6 times higher than that of tertiary hospitals. The mean score from general knowledge about epilepsy was higher among medical staff in tertiary hospitals than in basic-level hospitals. The mean scores in the general and personal domain of the Chinese Public Attitudes Toward Epilepsy (CPATE) scale were both significantly lower among medical staff in tertiary hospitals, when compared to those of basic-level hospitals. ConclusionsThe overall KAP from medical staff in response to seizures, was found to be better in tertiary hospitals than those of basic-level hospitals in Southern China, which was associated with the education level and impact of traditional culture. To date, there is a need for effective public intervention programs in China to improve the awareness of epilepsy and reduce discrimination among medical workers, especially for those working in basic-level hospitals in rural regions, to finally promote a better living environment for patients with epilepsy in China.

Evaluation results of occupational environment of nursing staff in a tertiary hospital in Guangxi

Objective To investigate and improve the occupational environment of nursing staff in tertiary hospitals. Methods By using questionnaire on nurse's occupational environment carried out by nursing center of National Institute of Health Planning Hospital Management, 672 nurses from a tertiary hospital in Guangxi were investigated without signature online on the national nursing quality data platform. Results The total score of occupational environment of 672 nurses was (69.85±20.73). Among all the items, the score of training plan for new nurses got a relatively high score (87.02±18.79) ; the score of clear occupational exposure process within hospital and its implementation was (84.57±19.91) ; and the items got low score included the chance of nurses to participate in hospital management decision (50.84±31.93) and an appropriate system of salary allotment (53.53±31.84). The scores of nurses with different educational background, working seniorities, professional titles and weather be enlisted were statistically significant (P<0.05) . Conclusions It is significant for the safety of patients and development of nursing department to establish a system which includes providing the chance for nurses to participate in hospital management, improving salary of nurses, emphasizing the development of nursing specialty and building a harmoniously occupational environment. Key words: Nurses; Occupational environment; Tertiary hospital

Survey on nosocomial infection knowledge of medical staff in a tertiary hospital of Beijing

Objective To explore the nosocomial infection knowledge of medical staff in tertiary hospitals of Beijing, and identify the influencing factors of nosocomial infection knowledge among medical staff. Methods By random sampling method, 848 medical workers in a tertiary hospital were investigated by the self-designed questionnaire of medical workers′ knowledge about nosocomial infection control questionnaire. Results The average score of medical workers′ knowledge about nosocomial infection control was (68.78±11.70) . The univariate analysis on the influencing factors of nosocomial infection knowledge showed that, the scores of medical workers′ knowledge about nosocomial infection were significantly different among workers in different departments and with different professional titles (t=6.715, 53.166; P<0.05) . Conclusions The medical workers′ knowledge about nosocomial infection in tertiary hospitals is at a medium level. Aimed at the items with low knowledge score in different groups and different medical workers, we should enhance the training among medical workers to reduce the occurrence of nosocomial infection and the incidence rate of nosocomial infection. Key words: Medical staff; Knowledge; Infection control; Status survey; Tertiary hospital

Seroprotection to vaccine‐preventable diseases among workers at a Victorian tertiary hospital

ObjectiveTo determine seroprotection for the vaccine‐preventable diseases (VPDs) measles, mumps, rubella, varicella and hepatitis B among new employees seen at a Victorian tertiary hospital staff clinic. MethodsEmployees who presented to the staff clinic for immunisation assessment between 1 January 2012 and 31 December 2013 were included. Demographic data, self‐reported disease history and previous vaccination status were reviewed retrospectively to determine impact on serological results. ResultsA total of 1,901 new employees were included, 83% of whom were at risk of direct contact with blood or body substances. Overall, the proportion of workers seropositive to measles was 88%, mumps 90%, rubella 78%, varicella 93% and hepatitis B 80%. Staff born before 1966 were more likely to have positive measles or mumps serology but negative rubella or hepatitis B serology (p<0.05 for each). Staff who self‐reported measles (99% vs. 93%, p=0.03) or varicella infection (98% vs. 92%, p<0.001) were more likely to be seropositive, but those reporting previous vaccination to measles, mumps or rubella were no more likely to be seropositive. Conclusions and implicationsThis study demonstrated levels of seropositivity of 78–93% for the five VPDs. Despite recognised limitations of serological testing, 10–20% of new employees to a healthcare institution lacking seroprotection represents a potentially unacceptable risk of nosocomial transmission of these VPDs. Our findings support ongoing serological testing of new healthcare staff at risk of direct contact with blood or body substances.

THE EXPRESS STUDY: ENGLISH PROFICIENCY EFFECTS ON SURGICAL LENGTH OF STAY

required to stay close to the implanting hospital for extended periods of time. More recently, technological modifications in VAD mechanics have enabled patients and family members to become more independent. Therefore, patients want to recover closer to the supports and familiarity of their home hospital and community. In order to make this transition successful, VAD programs need to partner with smaller hospitals to educate and support staff, patients and families. Maintaining competency at remote sites is a challenge and training staff to be “VAD aware” should not be confused with “VAD expert”. Patients and families should be aware of the possible risks of being far from the VAD centre and balance these with the benefits before they decide to return home. The purpose of this paper is to share, using case study format, the experience of a quaternary hospital VAD team reaching out to support a tertiary hospital team in caring for the growing VAD population in that community. Administrative pitfalls and triumphs, care team training, and survey of the tertiary hospital staff will be presented.

CARDIAC RHYTHM DEVICES AND END OF LIFE CARE: DEVELOPMENT OF AN EDUCATIONAL TOOL FOR NURSE EDUCATORS AND INTERPROFESSIONALS

required to stay close to the implanting hospital for extended periods of time. More recently, technological modifications in VAD mechanics have enabled patients and family members to become more independent. Therefore, patients want to recover closer to the supports and familiarity of their home hospital and community. In order to make this transition successful, VAD programs need to partner with smaller hospitals to educate and support staff, patients and families. Maintaining competency at remote sites is a challenge and training staff to be “VAD aware” should not be confused with “VAD expert”. Patients and families should be aware of the possible risks of being far from the VAD centre and balance these with the benefits before they decide to return home. The purpose of this paper is to share, using case study format, the experience of a quaternary hospital VAD team reaching out to support a tertiary hospital team in caring for the growing VAD population in that community. Administrative pitfalls and triumphs, care team training, and survey of the tertiary hospital staff will be presented.

Tertiary paediatric hospital health professionals’ attitudes to lesbian, gay, bisexual and transgender parents seeking health care for their children

To ascertain health professionals' knowledge, attitudes and beliefs towards lesbian, gay, bisexual and transgender parents seeking health care for their children in a paediatric tertiary hospital setting which practises family-centred care. Lesbian, gay, bisexual and transgender parents are often reluctant to disclose their sexual orientation to health professionals for fear of discrimination and compromised quality of care. Staff knowledge, attitudes and beliefs can influence disclosure by parents, but little is known about knowledge, attitudes and beliefs in paediatric tertiary hospital staff towards lesbian, gay, bisexual and transgender parents accessing care for their children. Descriptive comparative study of health staff using a cross-sectional survey. A set of validated anonymous questionnaires was used to assess knowledge about homosexuality, attitudes towards lesbians and gay men, and gay affirmative practice. Three open-ended questions were also used to assess beliefs about encouraging disclosure of lesbian, gay, bisexual and transgender parenting roles and how this may impact on care. Of the 646 staff surveyed, 212 (32.8%) responded. Knowledge and attitudes were significantly associated with professional group, gender, Caucasian race, political voting behaviour, presence of religious beliefs, the frequency of attendance at religious services, the frequency of praying, and having a friend who was openly lesbian, gay, bisexual and transgender. This study highlighted that staff working in a tertiary paediatric hospital setting, with family-centred care models in place, held attitudes and beliefs that may impact on the experience of hospitalisation for lesbian, gay, bisexual and transgender parents, and the quality of care received by their children. To promote equitable care to all families, organisations should ensure that family-centred care policies and guidelines are adopted and appropriately implemented. In addition to formal education, affirmative health service action and innovative methods may be required.

Tertiary hospital staff and caesarean section risk

SummaryA matched case-control study was conducted to determine whether pregnant employees 0of a Nigerian teaching hospital are more at risk of caesarean than vaginal delivery. Cases (n = 167) were booked patients who had singleton emergency caesarean delivery in their last confinement at term while controls (n = 167) were similar patients who had vaginal delivery (spontaneous or assisted) during the same period. Cases and controls were matched for known clinical risk factors for caesarean section. The proportion of hospital staff members among the cases was 36/167 (21.6%), compared with 21/167 (12.6%) among the controls, a difference that reached statistical significance (p = 0.03). Matched analysis examining the association of place of work with caesarean delivery indicated that hospital staff members are almost twice at risk of caesarean section than vaginal delivery (Mantel-Haenszel OR: 1.83; CI: 1.08 – 3.85). Multivariate conditional logistic regression analysis examining the association of hospital personnel with caesarean delivery while controlling for potential confounding variables revealed an adjusted odds ratio of 1.79 (CI: 1.02 – 3.74). Appraisal of caesarean section rate in teaching hospitals in southwest Nigeria could benefit from critical evaluation of the risk of caesarean section among parturients who are members of staff.

Prevalence Of Hepatitis B Surface Antigen Among Tertiary Health Workers in Ilorin

A total of 181 tertiary hospital staff at the University of Ilorin Teaching Hospital were screened for the presence of Hepatitis B surface antigen (HBsAg) in their Sera. They were made up of 128 nursing staff, 36 doctors, and 17 laboratory staff, with a mean length of service of 12.3+7.6 years, and who actively work in contact with patients and laboratory specimens. Screening for HBsAg was carried out using the enzyme-linked immunosorbent assay (ELIZA) method. Fourteen (7.7%) of the staff were found to be positive for HBsAg. This was significantly lower than the percentage positives of 21.7% and 16.0% obtained among the blood donors and antenatal clinic patients respectively. The positivity rate was not affected by sex, age or length of service. The possible reasons for, and inferences from our findings are discussed. Nigerian Quarterly Journal of Hospital Medicine Vol. 9, No. 2 (June 1999) pp. 95-97