Healthcare Support Workers Research Articles

National census of UK endoscopy services in 2023

BackgroundThe Joint Advisory Group on Gastrointestinal Endoscopy (JAG) conducts a biennial census of UK endoscopy services. The 2023 census aimed to assess the current status of endoscopy services and compare them with pre-pandemic census benchmark data.MethodsAn electronic survey was sent to all JAG participating services in April 2023. Key domains included activity, waiting times, workforce and safety. Whole census and service level paired comparison was made with 2019 census data.ResultsThere were 334 census responses representing 443 JAG-participating services (86.7% response rate). NHS services were operating at 110% of pre-pandemic activity levels. In the first 3 months of 2023, 53.6% of NHS services met urgent suspected cancer waiting time targets, 26.5% met routine waits and 26.2% met surveillance waits. The proportion of NHS services meeting all three targets decreased from 40.9% to 21.9% between 2019 and 2023. Compared with 2019, the proportion of independent sector activity has significantly increased. Insourcing activity has significantly increased and is being used by 57.9% of NHS services. Staff shortages were the most cited reasons for services not meeting waiting time targets or providing training. Absence through sickness rates for Band 2–6 nursing and healthcare support workers were significantly higher in 2023 compared with 2019 (p<0.001).ConclusionThe 2023 census presents a system under strain. While overall activity is above pre-pandemic levels, this is set against workforce concerns, increasing staff absences and reliance on insourcing for additional activity. This census re-emphasises the need to proactively plan for rising demand, while maximising all current available resources.

Developing a foundation information and academic skills programme for potential Student Nursing Associates.

This article outlines the development of 'Prepare to Progress', a preapplication programme for potential Student Nursing Associate (SNA) applicants at Gloucestershire Hospitals NHS Foundation Trust. Created collaboratively by the Trust's Library and Knowledge Services and Professional Education teams, the programme aims to provide realistic course expectations, teach study skills and boost confidence in using library services. Evaluation results indicate increased understanding of the SNA course, improved application decision-making, and enhanced academic confidence among participants. The programme demonstrates the valuable role of library services in preparing healthcare support workers for further education and addressing library anxiety. The study suggests benefits for both participants and library services.

Healthcare support worker recognition event: introduction

Healthcare support worker recognition event: introduction

Best Practices in the Nursing Care of Patients With Injuries From Violence: An Integrative Review.

The number of patients who have experienced violence is increasing worldwide. These patients have specific psychosocial and forensic needs and can present unique challenges to the health care workers caring for them. To identify best practices for the care of patients with injuries from violence in the emergency department or inpatient setting. The framework for integrative reviews by Whittemore and Knafl was used to conduct a literature search in MEDLINE, CINAHL, and ProQuest Nursing and Allied Health databases. Fourteen qualitative, quantitative, and mixed-methods studies from peer-reviewed journals were included in the review. Themes included identifying patients as survivors of intimate partner violence or child abuse, the need to collect forensic evidence, the need for emotional support of patients and their loved ones, support for health care workers caring for patients with injuries from violence, prevention of further violence, and the challenges of caring for patients with injuries from violence with concurrent substance use disorders. Best practices for these aspects of care are summarized on the basis of literature analysis. Screening procedures are needed to identify survivors of intimate partner violence and child abuse. Forensic evidence preservation policies should be in place. For survivors of sexual assault, a sexual assault nurse examiner should be available. Hospital systems should provide psychosocial resources for patients' and health care workers' mental health, implement violence reduction programs, and provide bias training. More research is needed to determine efficacy of care models and best practice.

Revisiting the prevalence of psychological symptoms among health care workers in Saudi Arabia during COVID-19.

To analyze the existing literature on the prevalence of psychological symptoms in healthcare workers (HCWs) in Saudi Arabia during the COVID-19 pandemic. The review will evaluate the assessment methods used for measuring the prevalence of psychological symptoms and critically review the literature's findings concerning psychological support for HCWs. All articles were selected from the PubMed database and reviewed for potential inclusion in March 2023. The articles were screened following the preferred reporting items for systematic reviews and meta-analyses protocol. Assessment of the quality and risk of bias in the included studies was guided using the prevalence critical appraisal tool criteria. We identified 7 articles that investigated the prevalence of psychological symptoms among HCWs in Saudi Arabia during the COVID-19 pandemic. We determined the studies' characteristics and classified and explained various themes. These themes included the prevalence of psychological symptoms found in HCWs, the study designs, the tools used to assess psychological symptoms in HCWs, and the potential impact of the studies on the mental health challenges faced by HCWs due to COVID-19. We also examined the quality and risk of bias in the included studies. This review's findings provide valuable insights into the psychological symptoms experienced by HCWs during the pandemic. To ensure the consistency of the results, it is essential to reevaluate the prevalence of these symptoms and use a culturally sensitive approach to translating the measures. This review lays the groundwork for future research on psychological symptoms and the interpretation of measurement outcomes.PROSPERO No. ID: CRD42024479813.

Support workers knowledge, skills and education relating to dementia – a national survey

Background Dementia affects over 55 million people globally, projected to double by 2050. In the UK, non-registered staff, including healthcare assistants (HCAs) and clinical support workers, provide a significant portion of dementia care, yet receive limited training. This study explores the knowledge, training, and attitudes of support workers towards dementia. Methods A cross-sectional web-based survey was conducted from February 1 to April 1, 2024, targeting support workers in England. The survey included demographic information, dementia knowledge (using the Dementia Knowledge Assessment Scale, DKAS), and attitudes (using the Dementia Attitudes Scale, DAS). Data were analysed using descriptive statistics, ANOVA, t-tests, and Pearson’s correlation. Results One hundred and nine support workers responded, predominantly female (90%) and white British (76.4%), from various NHS settings and occupational groups. The majority (79.8%) had received dementia training, primarily from their organisations. Challenges included managing behavioural and psychological symptoms and communication difficulties. There was no significant correlation between years of experience and dementia knowledge (r = -0.019) or attitudes (r = -0.057). However, higher occupational grades were associated with greater dementia knowledge (p = <0.01). A moderate positive correlation was found between dementia knowledge and attitudes (r = 0.35, p = <0.01). Despite high levels of knowledge, support workers often feel inadequately prepared to provide optimal dementia care, indicating a need for more comprehensive training. Challenges in communication and managing symptoms highlight areas for improvement. The study suggests that better training can improve both knowledge and attitudes, enhancing care quality for people living with dementia. Conclusion Support workers play a crucial role in dementia care but require more robust training programs to meet the growing demands. Enhanced training can improve their knowledge and attitudes, leading to better care outcomes for people with dementia.

Association of depressive symptoms with incidence and mortality rates of COVID-19 over 2 years among healthcare workers in 20 countries: multi-country serial cross-sectional study

BackgroundLong-term deterioration in the mental health of healthcare workers (HCWs) has been reported during and after the COVID-19 pandemic. Determining the impact of COVID-19 incidence and mortality rates on the mental health of HCWs is essential to prepare for potential new pandemics. This study aimed to investigate the association of COVID-19 incidence and mortality rates with depressive symptoms over 2 years among HCWs in 20 countries during and after the COVID-19 pandemic.MethodsThis was a multi-country serial cross-sectional study using data from the first and second survey waves of the COVID-19 HEalth caRe wOrkErS (HEROES) global study. The HEROES study prospectively collected data from HCWs at various health facilities. The target population included HCWs with both clinical and non-clinical roles. In most countries, healthcare centers were recruited based on convenience sampling.As an independent variable, daily COVID-19 incidence and mortality rates were calculated using confirmed cases and deaths reported by Johns Hopkins University. These rates represent the average for the 7 days preceding the participants’ response date. The primary outcome was depressive symptoms, assessed by the Patient Health Questionnaire-9. A multilevel linear mixed model (LMM) was conducted to investigate the association of depressive symptoms with the average incidence and mortality rates.ResultsA total of 32,223 responses from the participants who responded to all measures used in this study on either the first or second survey, and on both the first and second surveys in 20 countries were included in the analysis. The mean age was 40.1 (SD = 11.1), and 23,619 responses (73.3%) were from females. The 9323 responses (28.9%) were nurses and 9119 (28.3%) were physicians. LMM showed that the incidence rate was significantly and positively associated with depressive symptoms (coefficient = 0.008, standard error 0.003, p = 0.003). The mortality rate was significantly and positively associated with depressive symptoms (coefficient = 0.049, se = 0.020, p = 0.017).ConclusionsThis is the first study to show an association between COVID-19 incidence and mortality rates with depressive symptoms among HCWs during the first 2 years of the outbreak in multiple countries. This study’s findings indicate that additional mental health support for HCWs was needed when the COVID-19 incidence and mortality rates increase during and after the early phase of the pandemic, and these findings may apply to future pandemics.Trial registrationClinicaltrials.gov, NCT04352634.

EP3 - Reducing general surgical inpatient falls: an allied health professionals’ perspective

Abstract Aims Understand the current view of inpatient falls on a general surgical ward from allied health professionals. Identifies ways to reduce inpatient falls in general surgery. Methods Staff from two acute surgical wards were surveyed in December 2023. Seven questions used Likert scales (1-to-5, 1=Not preventable at all/significantly reduces the risks of falls/not confident at all/unimportant 5= Entirely preventable /significantly increases the risks of falls/very confident/important). One question focused on recent fall involvement. Modal values were taken. Data was inputted using Google Docs and analysed in Microsoft Excel. Results 13 responded (5 nurses, 4 health care support workers, 4 sisters). 7/13 had been involved in a fall in the last six months. Staff felt that the current post-inpatient fall proforma slightly reduces further falls risk. Factors that staff felt significantly increases the risks of falls were reduced mobility, delirium, falls history and impaired cognition. Factors that staff felt significantly reduces the risk of falls were, identifying patients at risk of falls, measuring lying and standing blood pressure, identifying the level of supervision for patient mobilisation, therapy assessment, initiating geriatric/falls review of high-risk falls patients, medication review, education of patients on avoiding falls and early senior clinician involvement in falls. Most staff felt mostly confident (4) knowing how to reduce the risk of falls and managing falls. Conclusions Most staff are comfortable managing falls. The falls proforma needs further development incorporating areas identified in this study to help reduce inpatient falls.

Cardiac implantable electronic devices and patient care

Cardiac implantable electronic devices (CIEDs), such as pacemakers and implantable cardiac defibrillators, are an increasing popular treatment for arrhythmias. Patients with CIEDs are likely to appear in many clinical areas, with pacemakers being the most common type. As healthcare support workers are likely to find these patients in their care, it is vital that they understand the reasons why CIEDs are implanted and how to prepare/care for them. This article will cover the conduction system of the heart and introduce the most common types of CIED. The article also explores how the healthcare assistant and assistant practitioner can support senior staff in preparation, post procedural and community care.

Protecting the mental health of healthcare workers in Pakistan using telehealth during the COVID-19 pandemic

The role of telehealth and its effect on reducing mental health burden from COVID-19 is of pressing concern. It is pertinent that the psychological impact of the coronavirus disease 2019 (COVID-19) pandemic must be recognized within the group of health care workers. Telemental health services are area that require imminent intervention for the support of health care workers in Pakistan, as they are applicable and practically feasible.

Behavioral health support for health care workers during COVID-19: An observational study of a remote mindfulness intervention

While evidence exists for effective remote mindfulness-based interventions (MBI) with nurses, and during the COVID-19 pandemic, less literature exists supporting effectiveness in broader groups of healthcare workers (HCWs). A clinically validated MBI was evaluated in HCWs at an academic medical center during COVID-19. Remote 1.5-h, 6-week sessions met throughout 2021–2022. Sessions included social support, educational, and mindfulness components. Pre-post analyses (n = 52) evaluated anxiety, depression, burnout, self-rated general health, and Self-Compassion at baseline (Week 1), program conclusion (Week 6) and 3-months post-intervention using mixed effect linear regression models. Program acceptability was measured at Week 6 with a single-item question ranking usefulness across all six sessions. Anxiety (−3.4 [95% CI −4.9, −1.9]), depression (−6.2 [95% CI −8.7, −3.7]), and burnout (−0.33 [95% CI −0.6, −0.11]) were significantly reduced from Week 1 to Week 6. Reductions were maintained 3-months post-intervention. Self-Compassion significantly increased (0.3 [95% CI 0.2, 0.5]) from Week 1 to Week 6, and this increase was maintained 3-months post-intervention. There was no significant change in self-rated general health. All sessions were acceptable. These results support the implementation of remote MBI for HCWs given continued mental health burdens in this workforce.

Stripped of their professional status: overseas educated nurses working as unregistered practitioners in their host country

Background: Many of the overseas qualified nurses educated work as health care assistants and support workers for a decreased wage without scope for professional advancement. There is an imperative to ease their entry to the nursing register. Aim: To gather and provide evidence to the regulatory bodies regarding the demographics of this cohort of nurses and the challenges they face in attempting to register as a nurse. Design: This study used a mixed-method explanatory sequential design. The survey was completed by 857 unregistered nurses followed by five in-depth interviews. Results from both phases were triangulated. Results: The results signpost to the characteristics and challenges of these nurses working as unqualified grades of staff for a decreased wage without scope for professional advance. Discussion and conclusion: The downward occupational spiral of internationally educated nurses underscores the paradoxical nature of the pedagogical application of transition theory, as these nurses are compelled to revert to a novice status.

Healthcare professionals' perspective on psychosocial support: Lessons learned during a pandemic.

Assessing the level of psychosocial assistance provided for healthcare workers (HCWs) at and outside of work is crucial. This study aimed to evaluate the psychosocial support provided to HCWs and analyze its effectiveness during COVID-19 at one of the biggest hospitals in Saudi Arabia, King Abdulaziz Medical City, Riyadh. In this study, we hypothesized that psychosocial support for HCWs will enhance their performance and total welfare. This study followed a cross-sectional analytic design, and its sample comprised 380 HCWs from many specialties. Two well-known psychosocial scales, DASS-21 and MSPSS, were used to assess the availability of institutional psychosocial support and the levels of depression, anxiety, and stress among HCWs. The majority of HCWs reported a tremendous increase in working hours and level of anxiety during COVID-19, and they denied receiving institutional support at work. Moreover, the majority reported receiving support from family and friends. Primarily, the most statistically significant finding in this study was that female HCWs had much higher levels of stress and anxiety during COVID-19 than their equivalent male colleagues. In addition, a significant difference was found regarding the presence of immediate supervisors for HCWs and its effectiveness in burden relief. The results show a marginally significant association between psychosocial support and the mental health of HCWs during COVID-19. However, we found a slightly favorable effect on the minority of HCWs who received regular check-ins or targeted interventions or had immediate supervisors.

Wellbeing, support and intention to leave: a survey of nurses, midwives and healthcare support workers in Wales

Background/Aims Low morale and burnout is a widely acknowledged problem among healthcare professionals, with implications for staffing levels and quality of care. This study aimed to provide insight into the wellbeing of nurses, midwives and healthcare support workers, and propose strategies to support a resilient workforce and organisational development. Methods An online survey was conducted with 462 nursing and midwifery staff at one NHS health board in Wales. Validated scales were used to measure key indicators, such as workload, bullying and burnout. Descriptive analysis was undertaken of the quantitative data and content analysis of the qualitative data. Results The survey found high levels of work intensification and burnout, with considerable proportions of respondents reporting intentions to leave their job and profession. Low levels of organisational support and trust in senior management were reported, which qualitative analysis indicated was contributing to intention to leave. Conclusions Healthcare leaders need to place more importance on the wellbeing of staff and consider the impact of workplace climate. An inclusive, localised approach to challenges in the working climate is recommended to effectively promote a resilient and sustainable workforce.

Delegation of insulin administration: a survey of community nursing teams in England.

In community nursing, the administration of insulin for people with type 2 diabetes can be delegated by registered nurses to healthcare support workers. Although a voluntary framework in England provides national guidance, little is known about its uptake. The project aim was to determine the roll-out, characteristics and support needs in relation to the delegation of insulin administration in community settings. An online survey was disseminated to community nursing services in England via social media and nursing networks. Of the 115 responding organisations, 81% (n=93) had an insulin delegation programme, with most initiated since 2018. From these services, 41% (n=3704) of insulin injections were delegated daily, with benefits for patients, staff and services reported, along with some challenges. Delegation of insulin administration is an established and valued initiative. Awareness of the national voluntary framework is increasing. National guidance is considered important to support governance arrangements and safety.

2024 SIAC guidelines on cardiorespiratory rehabilitation in pediatric patients with congenital heart disease

The 2024 Interamerican Society of Cardiology (SIAC) guidelines on cardiorespiratory rehabilitation (CRR) in pediatric patients with congenital heart disease aim to gather and evaluate all relevant evidence available on the topic to unify criteria and promote the implementation of CRR programs in this population in Latin America and other parts of the world. Currently, there is no unified CRR model for the pediatric population. Consequently, our goal was to create these CRR guidelines adapted to the characteristics of congenital heart disease and the physiology of this population, as well as to the realities of Latin America. These guidelines are designed to serve as a support for health care workers involved in the care of this patient group who wish to implement a CRR program in their workplace. The guidelines include an easily reproducible program model that can be implemented in any center. The members of this Task Force were selected by the SIAC on behalf of health care workers dedicated to the care of pediatric patients with congenital heart disease. To draft the document, the selected experts performed a thorough review of the published evidence.

Positive Leadership within Breast Imaging: Impact on Burnout, Intent to Leave, and Engagement.

Background High rates of provider burnout and turnover, as well as staffing shortages, are creating crises within radiology departments. Identifying ways to support health care workers, such as the Positively Energizing Leadership program, is important during these ongoing crises. Purpose To identify the relationship between leadership behaviors and workplace climate and health care worker outcomes (ie, burnout, intent to leave, and engagement) and to determine whether the positive leadership program could improve workplace climate and health care worker outcomes. Materials and Methods This prospective study involved two parts. First, a web-based survey was administered to faculty and staff in a breast imaging unit of a large academic medical center in February 2021 to identify relationships between leadership behaviors and workplace climate and health care worker outcomes. Second, a web-based survey was administered in February 2023, following the implementation of a positive leadership program, to determine improvement in engagement and reduction of burnout and intent to leave since 2021. Multiple regression, the Sobel test, Pearson correlation, and the t test were used, with a conservative significance level of P < .001. Results The sample consisted of 88 respondents (response rate, 95%) in 2021 and 85 respondents (response rate, 92%) in 2023. Leadership communication was associated with a positive workplace climate (β = 0.76, P < .001) and a positive workplace climate was associated with improved engagement (β = 0.53, P < .001), reduction in burnout (β = -0.42, P < .001), and reduction in intent to leave (β = -0.49, P < .001). Following a 2-year positive leadership program, improved perceptions were observed for leadership communication (pretest mean, 4.59 ± 1.51 [SD]; posttest mean, 5.80 ± 1.01; t = 5.97, P < .001), workplace climate (pretest mean, 5.09 ± 1.43; posttest mean, 5.77 ± 1.11; t = 3.35, P < .001), and engagement (pretest mean, 5.27 ± 1.20, posttest mean, 5.68 ± 0.96; t = 2.50, P < .01), with a reduction in burnout (pretest mean, 2.69 ± 0.94; posttest mean, 2.18 ± 0.74; t = 3.50, P < .001) and intent to leave (pretest mean, 3.12 ± 2.23; posttest mean, 2.56 ± 1.84; t = 1.78, P < .05). Conclusion After implementation of a positive leadership program in a radiology department breast imaging unit, burnout and intention to leave decreased among health care workers, while engagement increased. © RSNA, 2024 See also the editorial by Thrall in this issue.

Navigating challenges and workarounds: A qualitative study of healthcare and support workers' perceptions on providing care to people seeking sanctuary.

Healthcare and support workers play a pivotal role in delivering quality services and support to people seeking sanctuary who have experienced poor physical and mental health linked to previous trauma, relocation and loss of freedoms. However, they often encounter various challenges in their daily work, ranging from communication barriers to resource constraints. This qualitative study seeks to delve into the perspectives of healthcare and support workers' experience of workarounds, employed to overcome barriers to providing care. This study aims to describe healthcare providers', practitioners' and health and third sector support workers' views on barriers and workarounds to providing care for people seeking sanctuary, to inform policy and practice. A qualitative study was carried out using semi-structured telephone interviews. This study focused on primary, secondary, community and specialist National Health Service (NHS) support services for people seeking sanctuary in Wales, United Kingdom (2018). We interviewed 32 healthcare providers, practitioners and support workers employed by primary care and third sector organisations. Our approach involved obtaining verbal informed consent before digitally recording and transcribing all interviews. To analyse the data, we used the Four Levels of Change for Improving Quality model as a guiding framework for interpretation. Our study findings reveal that certain respondents expressed challenges in meeting the needs of people seeking sanctuary; notably, their experience of delivering care differed by care settings. Specifically, those involved in providing specialist NHS care believed that there was room for improvement. Mainstream primary, secondary and community health practitioners faced limitations due to resource constraints and lacked tailored information to address the unique circumstances and needs of sanctuary seekers. To address these gaps, workarounds emerged at both individual and local levels (team/departmental and organisational level). These included establishing informal communication channels between providers, fostering cross service collaboration to fill gaps and adapting existing services to enhance accessibility. Understanding healthcare providers', practitioners' and support workers' perspectives offers invaluable insights into ways to enhance healthcare delivery to sanctuary seekers. Acknowledging challenges and harnessing innovative workarounds can foster a more effective and compassionate service for this vulnerable population. The HEAR study actively involved public contributors in the design, delivery and dissemination of the research. Two public contributors (S. M. and G. R.) who had personal experience of seeking asylum served as study co-applicants. They played pivotal roles in shaping the research by participating in its development and securing funding. Alongside other co-applicants, S. M. and G. R. formed the Research Management Group, overseeing study delivery. Their contributions extended to strategic decision-making and specific feedback at critical junctures, including participant recruitment, data collection, analysis and reporting. Additionally, S. M. and G. R. were instrumental in recruiting and supporting a team of peer researchers, enhancing respondent participation among people seeking sanctuary. To facilitate effective public involvement, we provided named contacts for support (A. K. and R. F.), research training, honoraria, reimbursement of expenses and accessible information in line with best practice.

An evidence-based guideline on treating lumbar disc herniation with traditional Chinese medicine.

Lumbar disc herniation (LDH), as one of the most common causes of lower back pain, imposes a heavy economic burden on patients and society. Conservative management is the first-line choice for the majority of LDH patients. Traditional Chinese medicine (TCM) is an important part of conservative treatment and has attracted more and more international attention. Evidence-based guideline. We formed a guideline panel of multidisciplinary experts. The clinical questions were identified on the basis of a systematic literature search and a consensus meeting. We searched the literature for direct evidence on the management of LDH and assessed its certainty-generated recommendations using the grading of recommendations, assessment, development, and evaluation (GRADE) approach. The guideline panel made 20 recommendations, which covered the use of Shentong Zhuyu decoction, Shenzhuo decoction, Simiao San decoction, Duhuo Jisheng decoction, Yaobitong capsule, Yaotongning capsule, Osteoking, manual therapy, needle knife, manual acupuncture, electroacupuncture, Chinese exercise techniques (Tai Chi, Baduanjin, or Yijinjing), and integrative medicine, such as combined non-steroidal anti-inflammatory drugs, neural nutrition, and traction. Recommendations were either strong or weak, or in the form of ungraded consensus-based statement. This is the first LDH treatment guideline for TCM and integrative medicine with a systematic search, synthesis of evidence, and using the GRADE method to rate the quality of evidence. We hope these recommendations can help support healthcare workers caring for LDH patients.

Surveilans Berbasis Santri : Strategi Meningkatkan Derajat Kesehatan di Pondok Pesantren

Community-based surveillance is a health effort to identify health problems/cases carried out by the community, which is then addressed by the community with the support of healthcare workers. This activity is one of the self-reliance patterns instilled in the community. Indonesia has more than 20,000 pesantrens as formal educational institutions. Unhealthy environments and inadequate facilities have led to various infectious diseases. Efforts to examine and treat infectious diseases have been carried out by pesantrens, but the problem persists due to unhealthy behavior. Health monitoring and responsibility from pesantren residents are necessary to improve health conditions in pesantrens. Based on this issue, community-based surveillance needs to be implemented in pesantrens. Empowering pesantren communities is a process to increase knowledge, awareness, and skills so that they can actively participate in efforts to prevent and control diseases through an educative and participatory approach while considering potential needs and local socio-cultural aspects. Therefore, a trained Santri-based Surveillance needs to be formed with the responsibility of health monitoring in pesantrens, in the hope of creating a healthy pesantren. Santri-based surveillance is part of community empowerment in pesantren areas