Third Of Health Care Workers Research Articles

The Wellbeing of Healthcare Workers during COVID-19 Era in Public Primary Health Facilities in Johannesburg, South Africa.

As the world grappled with the COVID-19 pandemic, healthcare workers (HCWs) continued to provide uninterrupted health care service delivery; therefore, this disproportionately affected their wellbeing. Our study explored the wellbeing of HCWs during the COVID-19 era in public health facilities in the City of Johannesburg, Gauteng province, South Africa. A qualitative study was conducted among twenty (20) HCWs through face-to-face in-depth interviews (IDIs) in the form of semi-structured interviews, audiotapes, and transcribed verbatim, and thematically analyzed with NVivo version 10. The findings showed that over half of HCWs (aged between 27 and 60 years) tested positive for COVID-19. Also, one third of HCWs' family members tested positive while some died due to COVID-19 infection. Informed by the workers' wellbeing framework, four themes emerged with fourteen sub-themes. Firstly, unsafe work environment was characterized by human resource related challenges such as increased workload; staff shortage; insufficient resources, e.g., personal protective equipment (PPE); poor policies in terms of compensation/allowance for being infected with COVID-19; poor health services; and death of colleagues. Secondly, poor health outcomes were described as strained emotional (psychosocial distress) and physical (respiratory related conditions) wellbeing. Thirdly, home and community environments were negatively impacted by interrupted relationships with family and friends, and experiences of deaths of loved ones. Finally, HCWs engaged personal wellbeing strategies through self-motivation; staying positive; family support; and participating in resilience-promoting extra mural activities to cope during the pandemic. In conclusion, the wellbeing of HCWs was aggravated during the COVID-19 era and led to low morale and compromised healthcare quality. This study advocates for promotion of greater resilience, and psychological and physical safety of HCWs through evidence-based, multilevel-multicomponent interventions at the workplace, home, and community environments in addition to strengthening public health policies and response to future pandemics.

Conducting verbal autopsy by telephone interview during the pandemic to support mortality surveillance: a feasibility study in Malaysia.

ObjectiveVerbal autopsy (VA) through face-to-face interviews with caregivers is a way to determine cause of death without medical certification. In Malaysia, the use of VA has improved mortality statistics. However, during the coronavirus disease 2019 (COVID-19) pandemic, face-to-face interviews were delayed, reducing VA data collection and affecting data for mortality surveillance. This study aims to investigate the feasibility and acceptability of conducting VA interviews via telephone calls, and the quality of the data gathered.MethodsThe study was conducted in Malaysia from September to October 2020 using a cross-sectional design. Participants were health-care workers from established VA teams across the country. They conducted VA interviews via telephone and provided feedback through a customized online form. Data collected from the form were used to assess the feasibility, acceptability and quality of the telephone interviews using IBM SPSS version 23.ResultsResponses were received from 113 participants. There were 74 (65.5%) successful interviews, representing 91% of the 81 cases who were able to be contacted. More than two thirds of health-care workers provided positive feedback on the telephone interview method for themselves and the interviewees. Only 10.8% of causes of death were unusable.DiscussionThis study provides preliminary evidence that VA via telephone interview is feasible, acceptable and can be used as an alternative to face-to-face interviews without affecting data quality. During times when face-to-face interviews are not advisable, VA telephone interviews can be used for data collection for mortality surveillance.

Use of an algorithm based on routine blood laboratory tests to exclude COVID-19 in a screening-setting of healthcare workers.

COVID-19 is an ongoing pandemic leading to exhaustion of the hospital care system. Our health care system has to deal with a high level of sick leave of health care workers (HCWs) with COVID-19 related complaints, in whom an infection with SARS-CoV-2 has to be ruled out before they can return back to work. The aim of the present study is to investigate if the recently described CoLab-algorithm can be used to exclude COVID-19 in a screening setting of HCWs. In the period from January 2021 till March 2021, HCWs with COVID-19-related complaints were prospectively collected and included in this study. Next to the routinely performed SARS-CoV-2 RT-PCR, using a set of naso- and oropharyngeal swab samples, two blood tubes (one EDTA- and one heparin-tube) were drawn for analysing the 10 laboratory parameters required for running the CoLab-algorithm. In total, 726 HCWs with a complete CoLab-laboratory panel were included in this study. In this group, 684 HCWs were tested SARS-CoV-2 RT-PCR negative and 42 cases RT-PCR positive. ROC curve analysis showed an area under the curve (AUC) of 0.853 (95% CI: 0.801-0.904). At a safe cut-off value for excluding COVID-19 of -6.525, the sensitivity was 100% with a specificity of 34% (95% CI: 21 to 49%). No SARS-CoV-2 RT-PCR cases were missed with this cut-off and COVID-19 could be safely ruled out in more than one third of HCWs. The CoLab-score is an easy and reliable algorithm that can be used for screening HCWs with COVID-19 related complaints. A major advantage of this approach is that the results of the score are available within 1 hour after collecting the samples. This results in a faster return to labour process of a large part of the COVID-19 negative HCWs (34%), next to a reduction in RT-PCR tests (reagents and labour costs) that can be saved.

Determinants of the willingness to get the third COVID-19 vaccine dose among health care workers

ObjectiveTo characterize the willingness to get the third COVID-19 vaccine dose among health care workers (HCWs). MethodsA cross-sectional study using a self-administered questionnaire proposed on a voluntary basis to all HCWs of a French teaching hospital in October and November 2021. ResultsOf 1,655 HCWs who completed the questionnaire, 64.2% were willing to receive the third dose, 20.1% were hesitant, and 15.7% were reluctant. On multivariate analysis, older age (P<0.0001), medical and executive staff, willingness to receive the flu vaccine (OR=5.72 [4.24–7.64]), previous vaccine scheme with ChAdOx1 nCoV-19 (AstraZeneca) (OR=2.13 [1.58–2.87]), and history of COVID-19 with a complete COVID-19 vaccine scheme (OR=2.77 [1.04–7.41]) were independent predictors of HCWs’ willingness to get the third dose. ConclusionsOne third of HCWs were hesitant or opposed to a third COVID-19 vaccine dose. Better knowledge of determinants of the willingness to get this third dose may improve communication and vaccine strategy.

COMPARISON OF DEPRESSION, ANXIETY AND STRESS SCORE AMONG CLINICAL AND NON-CLINICAL HEALTHCARE WORKERS DURING THE COVID-19 PANDEMIC

Objective: To assess the psychological impact of COVID-19 pandemic on healthcare workers.&#x0D; Study Design: Cross sectional study.&#x0D; Place and duration of Study: Armed Forces Institute of Cardiology/National Institute of Health Diseases in June 2020.&#x0D; Methodology: A total of 317 healthcare professionals, of different designations, affiliated with different public and private sector hospitals in Pakistan participated in this project. They were asked to complete Depression, anxiety and stress scales-42 (DASS-42).&#x0D; Results: Out of 317 healthcare workers, 107 (33.75%), 111 (35.02%), 103(32.49%) were depressed, anxious and stressed respectively. Female gender was associated with a higher prevalence of depression, anxiety and stress.&#x0D; Conclusion: More than one third of healthcare workers were depressed, anxious or stressed during the COVID-19 pandemic. Two out of five female healthcare workers were suffering from depression, anxiety or stress.Keywords:, , .

СОСТОЯНИЕ ПСИХОЛОГИЧЕСКОГО ЗДОРОВЬЯ ВРАЧЕЙ И МЕДСЕСТЕР, ЗАНЯТЫХ В ЛЕЧЕНИИ И УХОДЕ ЗА КОРОНАВИРУСНЫМИ БОЛЬНЫМИ

The quality of work of healthcare workers (doctors and nurses) is directly dependent on the state of their psychological health, as well as on their ability to adequately and promptly respond to the occurrence of pathological stress reactions and neurotic disorders. In May-June 2020, 373 medical workers were interviewed in the Sverdlovsk region, including 86 specialist doctors and 287 paramedical workers involved in the treatment and care of patients with coronavirus decease COVID-19 who are in hospital. The results of the study showed: the level of psychological stability among doctors and nurses is quite low; the state of adaptation to extreme situations is unsatisfactory. One third of the subjects reported increased exhaustion and neurotization, the loss of the most important guidelines and values, which was accompanied by extremely negative and intense external and internal emotions. The indices of the private scales of neurotization indicate the development of tendencies towards psychological instability and maladjustment, which can lead to acute and chronic psychogenic disorders. From one fifth to one third of healthcare workers are susceptible to various disorders of psychological stability and neurotization. All this indicates the need for psychological support and the development of strategies for psychotherapeutic work with doctors and nurses involved in the treatment and care of patients in the event of emergencies.

Multicenter investigation of predictors to self-report vaccination and seroprotection against Hepatitis B among healthcare workers

Objective: The Healthcare Workers (HCWs) are professionals with occupational exposure risk to Hepatitis B virus (HBV). Vaccination status has been widely explored; however, few investigations had confirmed the HBV immunity by serological test. Method: We performed a multicenter study based on a dual approach to understand the predictive factors of vaccination and seroprotection to HBV among HCWs. A cross-section design investigation was carried out among 371 workers from Alagoas state (Brazil); all of them from the public health service. Multiple Poisson Regression Models were constructed using vaccination and seroprotection as dependent factor. Results: The overall self-report of vaccination was 70.4% and the confirmation by immune response was 72.2%. Three predictive factors were associated with vaccination: education level; use of the PPE during work, and personal serological evaluation. Two predictive factors were associated with seroprotection: education level and use of the PPE during work. Conclusion: Our findings showed some evidence that almost one third of healthcare workers were not immune to HBV, and factors such as education and use of the protective equipment can predict the susceptibility to HBV.

Impact of the COVID-19 pandemic on the mental health and well-being of UK healthcare workers.

The coronavirus disease 2019 (COVID-19) pandemic has had a significant psychological impact on healthcare workers (HCWs). There is an urgent need to understand the risk and protective factors associated with poor mental well-being of UK HCWs working during the COVID-19 pandemic. Shortly after the April 2020 UK COVID-19 peak 2773 HCWs completed a survey containing measures of anxiety, depression, post-traumatic stress disorder and stress, as well as questions around potential predictors such as roles, COVID-19 risk perception and workplace-related factors. Respondents were classified as high or low symptomatic on each scale and logistic regression revealed factors associated with severe psychiatric symptoms. Change in well-being from pre- to during COVID-19 was also quantified. Nearlya third of HCWs reported moderate to severe levels of anxiety and depression, and the number reporting very high symptoms was more than quadruple that pre-COVID-19. Several controllable factors were associated with the most severe level of psychiatric symptoms: insufficient personal protective equipment availability, workplace preparation, training and communication, and higher workload. Being female, 'front line', previous psychiatric diagnoses, traumatic events, and being an allied HCW or manager were also significantly associated with severe psychiatric symptoms. Sharing stress, resilience and ethical support for treatment decisions were significantly associated with low psychiatric symptoms. Front-line workers showed greater worsening of mental health compared with non-front-line HCWs. Poor mental well-being was prevalent during the COVID-19 response, however, controllable factors associated with severe psychiatric symptoms are available to be targeted to reduce the detrimental impact of COVID-19 and other pandemics on HCW mental health.

Work Related Violence As A Predictor Of Stress And Correlated Disorders In Emergency Department Healthcare Professionals.

The aim of the study was to investigate the frequency, type, causes and consequences of violence and aggression experienced by Emergency Department workers during their interactions with patient, their relatives or companions and whether the phenomenon of violence at work is a specific risk factor predicting stress and possible stress related pathologies in emergency health workers. The study proposes a model of effective intervention for the prevention and management of violence and stress. A cross-sectional retrospective study was performed with a sample of 323 healthcare workers at Department of Emergency and Acceptance of Level II and the Psychiatric Services of Diagnosis and Care of the University Hospital Policlinico Umberto I, in Rome, Italy, between June 2016 and February 2017. Data collection was conducted by a psychiatrist by means of a questionnaire method administered to each participant and by carrying out individual interviews. The two questionnaires used, both the Health Violence Questionnaire (QVS) and the Workers' Stress Perception Questionnaire (SPQR) were designed ad hoc, after some test sessions intended for the creation of their content. Eighty-seven percent of emergency healthcare workers experienced workplace violence by patients or their relatives. More than half of healthcare workers reported multiple consequences on their emotional sphere, in particular female healthcare professionals and all those who have suffered frequent incidents of violence. Regarding the effects on lifestyle, one third reported an increase in consumption of tobacco, food and sleep disorders and changes from social relationships to social isolation and avoidance of some places. More than one third of healthcare workers reported consequences on their well-being and health, especially the female workers. Distress was associated with frequent workplace violence. Healthcare workers who experienced frequent violence indicated lack of support from hospital administration and ED management as barriers to reporting workplace violence. The study confirms the diffusion of the workplace violence by patients and/or their relatives against the emergency healthcare professionals, related to the gender, the professional qualification, the role in the organization and the workplace. Almost all male and female healthcare workers reported they had suffered the effects on lifestyle, working habits and wellbeing and health following the workplace violence. Precipitating factors to violent incidents identified by healthcare professionals are consistent with the research literature. Commitment from hospital administrators, ED managers and hospital security is necessary to facilitate improvement and ensure a safer workplace for ED healthcare workers. Our study emphasizes the importance of analyzing, in addition to general job demands, the specific job demands such as the phenomenon of violence, considered a key risk factor, predictor of stress and possible mental disorders in healthcare workers operating in high-risk environments. This study confirms the importance of application of the modified model by Brough and Biggs of integrated multidimensional intervention on the prevention and management of workplace violence and work stress and shall be implemented on all three levels: individual, organizational and situational. The study also highlights the need to implement support strategies for the victims of violence.

Seroepidemiology of HBV infection among health-care workers in South Sulawesi, Indonesia

BackgroundHepatitis B virus (HBV) infection is a world health problem with an estimated 257 million chronically infected people. Indonesia, with 7.1% prevalence of hepatitis B surface antigen (HBsAg), is classified as a moderately endemic country. Healthcare workers (HCWs) are at high occupational risk for HBV infection and potentially becoming transmitters for further infections. In Indonesia, the extent of hepatitis B among HCWs and specific control strategy are not available. This study evaluated the seroprevalence of HBV infection and associated risk factors in HCWs from four areas in South Sulawesi, Indonesia.MethodsA total of 467 HCWs (median age 28 years, male/female 89/378) were recruited. All HCWs were classified into three age groups (< 20–29, 30–39, and ≥ 40 years old), three work types (administration, non-intervention, and intervention), and three service periods (< 5, 5–9, and ≥ 10 years). Data on socio-demographic characteristics and risk factors were obtained by questionnaire and serum samples were tested for HBV markers (HBsAg, its antibody [anti-HBs], and antibody to core antigen [anti-HBc]. Chi-square or Fisher’s exact test was used to determine differences in categorical variables, while risk factors were reported as odds ratios (OR).ResultsThe prevalence of current HBV infection (HBsAg+), exposure to HBV (anti-HBc+), and immunity to HBV (anti-HBs+) was 6.2, 19.2, and 26.1%, respectively. Two thirds (66.17%) of all HCWs did not express any of HBV markers. In relation to the age groups, intervention work-type, and service period of HCWs, increasing trends were observed in the exposure to HBV (p < 0.001, p < 0.001, and p < 0.010, respectively) and the immunity to HBV by natural infection (HBsAg-, anti-HBc+, anti-HBs+) (p = 0.004, p < 0.001, and p < 0.010, respectively). Needlestick injury contributed the highest risk factor (OR = 1.71; 95% CI: 1.05–2.77; p = 0.029) for infection acquisition, which mostly occurred in the intervention group (p = 0.046).ConclusionExposure to HBV showed significant association with HCWs’ age, work type, and service period. Needlestick injury was the highest risk factor for the acquisition of HBV, with highest events in the intervention work-type. Two thirds of HCWs were still susceptible to HBV infection. Intervention strategies at the national level are required to mount prevention, control, and management of HBV infection in HCWs.

Seroprevalence of Blood Borne Pathogens among Health Care Workers and Their Hepatitis B Vaccination Status in Tertiary Care Hospitals in India

&lt;p&gt;&lt;strong&gt;BACKGROUND &amp;amp; AIM: &lt;/strong&gt;Occupational exposure to blood-borne pathogens, mainly human immunodeficiency virus (HIV), hepatitis B (HBV) and hepatitis C (HCV), poses a serious risk to healthcare workers (HCWs), especially in developing countries, due to the high prevalence of these pathogens and fewer safety precautions. The aim of this study was to investigate the seroprevalence of HBV, HCV, and HIV infections and to measure the vaccination practices in HCWs at three tertiary care hospitals in Delhi, India.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;METHOD:&lt;/strong&gt; In a descriptive (cross-sectional) study, the HCWs of three tertiary hospitals were selected by simple random sampling and divided into four different groups (nurses, laboratory and operational theater technicians, doctors and housekeeping workers). The participants were screened for the presence of hepatitis B surface antigen (HBs Ag), antibody to hepatitis B surface antigen (anti HBs), antibody to hepatitis C (anti HCV), and antibody to HIV (anti HIV). From June 2010 to April 2012, a structured questionnaire was administered to 850 HCWs after obtaining consent.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;RESULTS: &lt;/strong&gt;Among 850 HCWs, 51.8% were nurses and 50.6% were female with a mean (SD) age of 34(8.7) years. The overall seroprevalence of HBsAg, anti-HCV, and anti-HIV was 1.1%, 0.3%, and 0.1%, respectively. There was a high proportion of HBsAg positivity among housekeeping workers (4.9%) followed by nurses (3.3%). Out of 9 positive cases of HBsAg, 66% (6) were never vaccinated and out of a total of 11 positive subjects, 72 % (8) had previous exposure in the workplace. Complete HBV vaccination was done in 78.2% (605) of the HCWs and 11.3% (75) were partially vaccinated. Only 20.1% had checked their anti-HBs. Protective (&amp;gt;10 IU/mL) anti-HBs was seen in 70.6% (600) of the participants, indicating that nearly one third of HCWs were not protected against HBV infection. The majority of the study subjects (63.6%) believed that they were immunized against hepatitis B and did not need to check the immunity titer.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;CONCLUSION: &lt;/strong&gt;Not all HCWs were vaccinated and the majority of vaccinated subjects did not know their immunity level. Housekeeping workers had a high seropositivity rate of infections and a low rate of vaccination against HBV. Institutional policy and training were found to be of paramount importance to improve the quality of health in HCWs.&lt;/p&gt;

Prevalence of hepatitis B virus infection among health care workers in a tertiary hospital in Tanzania

BackgroundSub-Saharan Africa has a high prevalence of hepatitis B virus (HBV) infections. Health care workers (HCWs) are at high risk of contracting HBV infection through their occupation. Vaccination of HCWs against HBV is standard practice in many countries, but is often not implemented in resource-poor settings. We aimed with this cross-sectional study to determine HBV prevalence, HCW vaccination status, and the risk factors for HCWs contracting HBV infection in Tanzania.MethodsWe enrolled 600 HCWs from a tertiary Tanzanian hospital. Their demographics, medical histories, HBV vaccination details and risk factors for contracting blood-borne infections were collected using a standardized questionnaire. Serum samples were tested for HBV and hepatitis C virus (HCV) markers by ELISA techniques, PCR and an anti-HBs rapid test. HCWs were divided in two subgroups: those at risk of contracting HBV (rHCW 79.2 %) via exposure to potentially infectious materials, and those considered not at risk of contracting HBV (nrHCW, 20.8 %).ResultsThe overall prevalence of chronic HBV infection (HBsAg+, anti-HBc+, anti-HBs-) was 7.0 % (42/598). Chronic HBV infection was found in 7.4 % of rHCW versus 5.6 % of nrHCW (p-value = 0.484). HCWs susceptible to HBV (HBsAg-, anti-HBc-, anti-HBs-) comprised 31.3 %. HBV immunity achieved either by healed HBV infection (HBsAg-, anti-HBc+, anti-HBs+) or by vaccination (HBsAg-, anti-HBc-, anti-HBs+) comprised 36.5 % and 20.2 %, respectively. 4.8 % of participants had indeterminate results (HBsAg-, anti-HBc+, anti-HBc-IgM-, anti-HBs-). Only 77.1 % of HCWs who received a full vaccination course had an anti-HBs titer >10 ml/U. An anti-HBs point-of-care test was 80.7 % sensitive and 96.9 % specific. There was a significantly higher risk for contracting HBV (anti-HBc+) among those HCW at occupational risk (rHCW) of older age (odds ratios (OR) in rHCW 3.297, p < 0.0001 vs. nrHCW 1.385, p = 0.606) and among those HCW being employed more than 11 years (OR 2.51, p < 0.0001***). HCV prevalence was low (HCV antibodies 1.2 % and HCV-RNA 0.3 %).ConclusionsChronic HBV infection is common among Tanzanian HCWs. One third of HCWs were susceptible to HBV infection, highlighting the need for vaccination. Due to high prevalence of naturally acquired immunity against HBV pre-testing might be a useful tool to identify susceptible individuals.

Knowledge of occupational exposure to HIV: a cross sectional study of healthcare workers in Tumbi and Dodoma hospitals, Tanzania.

BackgroundInsufficient knowledge on blood-borne pathogens has been identified as a factor that influences occupational exposure to needle stick and sharps injuries. The objective of this study was to assess healthcare workers’ knowledge on occupational exposure to HIV.MethodsA cross sectional survey was conducted at Tumbi designated regional hospital and Dodoma regional hospital, Tanzania in February 2012. A self-administered questionnaire was used to capture information on knowledge of occupational exposure to HIV infection.ResultsA total of 401 healthcare workers responded to a self-administered questionnaire. High proportion of healthcare workers (96.3%) understood that they are at risk of occupational exposure to HIV. The majority of healthcare workers trained on post exposure prophylaxis procedure and use of personal protective equipment were clinicians (87.1% and 71.4% respectively) and nurses (81.8% and 74.6% respectively). Over a quarter of the healthcare workers were not aware of whom to contact in the event of occupational exposure. One third of healthcare workers did not have comprehensive knowledge on causes of occupational HIV transmission and did not know when post exposure prophylaxis is indicated. Healthcare workers not trained on the use of person protective equipment were less likely to have comprehensive knowledge on occupational exposure to HIV (OR = 0.5; 95% CI 0.3 – 0.9). Knowledge on causes of occupational exposure varied with the cadre of healthcare workers. Nurses were more likely to have comprehensive knowledge on occupational exposure to HIV than non-clinical staff (OR = 2.6; 95% CI 1.5 – 4.5).ConclusionA substantial proportion of studied healthcare workers had little knowledge on occupational exposure to HIV and was not aware of a contact person in the event of occupational exposure to HIV. Training on post exposure prophylaxis and infection prevention and control including the use of person protective equipment provided to nurses and clinicians should be extended to other clinical and non-clinical hospital staff.

Prevalence of Latent TB Infection among Health Care Workers in Three Main TB Health Facilities, Baghdad, Iraq, 2013

Background: Tuberculosis infection represents a global health problem and a great risk to Health Care Workers. Identifying individuals, particularly Health Care Workers with latent tuberculosis infection will support tuberculosis control through chemoprophylaxis and prevent cross-infection. The aim of this study was to assess the prevalence and some risk factors for latent tuberculosis infection among Health Care Workers in three tuberculosis health institutions in Baghdad. Methods: A cross-sectional study was conducted in 2013 in Baghdad- Iraq on Health Care Workers working in the Specialized Respiratory &amp; Chest Diseases Center (Tuberculosis institute), Ibn Zuhur Hospital for Chest Diseases and Al-Resafa Health District TB Clinic in Al-Sadr City. Information about age, gender and occupation was obtained. All subjects received a Mantoux tuberculin skin test. Induration of ≥10 mm was considered a positive test. Results: A total of 212 Health Care Workers were enrolled, 71.7% of them were males; none had recently received BCG vaccine. Fifty nine (27.8%) had a positive tuberculin skin test. Physicians (38.2%) and nurses &amp; paramedicals (31%) have the highest rates of positive result than other occupations. The highest rate of positive results was seen among Health Care Workers in Specialized Respiratory &amp; Chest Diseases Center (55.1%). There was a significant association between positive TST response with the occupation (job title) and the working site. No significant association was seen with age or gender (P&gt;0.05).&#x0D; Conclusion: Around one third of Health Care Workers in these tuberculosis facilities had latent tuberculosis infection. Job and work place were significant determinants.

Defizite bei der Prävention der ZVK-assoziierten Sepsis: Wissenslücken oder Complianceprobleme?

Intensive care units (ICUs) with high rates of central venous catheter (CVC) -associated bloodstream infections (BSI) were invited to implement a bundle on BSI prevention during an educational programme which was created by the German national reference center for surveillance of nosocomial infections (NRZ). Training of health care workers (HCWs) was the main component and will be presented in the following. The intervention was realized by local infection control staff from April 2006 to March 2007. Modules were lecture, script and poster. Before the intervention HCWs completed an anonymous multiple choice questionnaire about BSI prevention measures. Lectures could be modified in accordance to the ICUs knowledge of prevention measures. Processes and CVC-BSI rates were surveyed and analysed before and after the intervention and also during an additional 24-months follow-up period. Thirty-two ICUs with 1,622 HCWs realized the intervention. Knowledge of BSI prevention of 1,251 HCWs was assessed. Knowledge gaps could predominantly be shown for the favored insertion site and the changing intervals of intravenous tubing for aqueous infusions. One third of HCWs said that a daily CVC's dressing change was indicated. After the intervention ICUs showed a significant decrease in the pooled CVC-BSI rate. ICUs showed a significant decrease of the pooled CVC-BSI rate during the follow-up. In this first assessment of more than 1,200 HCWs' knowledge of BSI prevention in German ICUs knowledge gaps could be identified. During the 12-months intervention the implementation of evidence based IC recommendations improved and the pooled CVC-BSI rate decreased significantly.

Attitudes towards mandatory vaccination and vaccination coverage against vaccine-preventable diseases among health-care workers in tertiary-care hospitals

To assess the attitudes about mandatory vaccination and vaccination coverage against vaccine-preventable diseases among health-care workers (HCWs) working in tertiary-care hospitals in Greece. A questionnaire was distributed to HCWs working in four tertiary-care hospitals. In total, 505 HCWs participated in the survey. Self-reported completed vaccination rates were 18.8% against measles, 18.8% against mumps, 22.2% against rubella, 1.9% against varicella, 3.6% against hepatitis A, 56.5% against hepatitis B, and 35.7% against tetanus-diphtheria. Younger age groups had higher completed vaccination rates against measles, mumps, rubella, varicella, and hepatitis B compared with older HCWs (p-value<0.001). Self-reported susceptibility rates were 12.7% for measles, 18.9% for mumps, 15.8% for rubella, 15.2% for varicella, 89.9% for hepatitis A, 34.2% for hepatitis B, and 64.3% for tetanus-diphtheria. Sixty three percent of 451 HCWs who answered this question supported mandatory vaccinations for HCWs, with significant differences per target disease. Physicians more frequently supported a mandatory vaccination policy compared to nurses and other professions (72.1% versus 61.9% and 54.2%, respectively; p-value=0.028). Approximately two thirds of HCWs working in tertiary-care hospitals in Greece support mandatory vaccinations for HCWs, however suboptimal vaccination rates against vaccine-preventable diseases were recorded.

Susceptibilidad a la varicela en personal sanitario. Aceptación y respuesta a la vacunación

Background and objective To determine the prevalence of health care workers (HCW) susceptibility to varicella zoster virus (VZV). As a secondary objective, we describe the immunogenicity and reactogenicity of the vaccine. Subjects and methods A multicenter analytic cross-sectional study was conducted in 5 hospitals in Catalonia, Spain, in a total of 1,111 HCW, aged between 18-60 years. We studied the prevalence of anti-VZV antibodies (IgG) and obtained demographic, occupational and health related variables that were expected to be associated with immunogenicity, as well as past history of varicella. All susceptible HCW were vaccinated and we studied the immunogenicity (antibody detection) and reactogenicity of the 1st and 2nd doses of the vaccine. Detection of antibodies against VZV was obtained by ELISA. All negative results were confirmed with FAMA. Results Forty two subjects (3.8%) were negative. Susceptibility to VZV was associated (p < 0.05) with decreased age (29.6 years ± 8.5 vs. 32,5 ± 9,3 in non-susceptible individuals), having fewer siblings and having no previous clinical history of varicella. Postvaccination detection tests with ELISA showed a seroconversion rate of 52 and 86% after the 1st and 2nd doses of the vaccine respectively, and 100% when using FAMA. There were no significant adverse events. Conclusions Susceptibility to varicella among HCW is low. Positive past history of varicella is a good predictor of previous exposure to VZV, since 99% (687/696) of the individuals that declared having experienced the disease were immune. This would avoid prevaccination screening in nearly two thirds of HCW.

Healthcare workers as parents: attitudes toward vaccinating their children against pandemic influenza A/H1N1

BackgroundBoth the health care workers (HCWs) and children are target groups for pandemic influenza vaccination. The coverage of the target populations is an important determinant for impact of mass vaccination. The objective of this study is to determine the attitudes of HCWs as parents, toward vaccinating their children with pandemic influenza A/H1N1 vaccine.MethodsA cross-sectional questionnaire survey was conducted with health care workers (HCWs) in a public hospital during December 2009 in Istanbul. All persons employed in the hospital with or without a health-care occupation are accepted as HCW. The HCWs who are parents of children 6 months to 18 years of age were included in the study. Pearson's chi-square test and logistic regression analysis was applied for the statistical analyses.ResultsA total of 389 HCWs who were parents of children aged 6 months-18 years participated study. Among all participants 27.0% (n = 105) reported that themselves had been vaccinated against pandemic influenza A/H1N1. Two third (66.1%) of the parents answered that they will not vaccinate their children, 21.1% already vaccinated and 12.9% were still undecided. Concern about side effect was most reported reason among who had been not vaccinated their children and among undecided parents. The second reason for refusing the pandemic vaccine was concerns efficacy of the vaccine. Media was the only source of information about pandemic influenza in nearly one third of HCWs. Agreement with vaccine safety, self receipt of pandemic influenza A/H1N1 vaccine, and trust in Ministry of Health were found to be associated with the positive attitude toward vaccinating their children against pandemic influenza A/H1N1.ConclusionsPersuading parents to accept a new vaccine seems not be easy even if they are HCWs. In order to overcome the barriers among HCWs related to pandemic vaccines, determination of their misinformation, attitudes and behaviors regarding the pandemic influenza vaccination is necessary. Efforts for orienting the HCWs to use evidence based scientific sources, rather than the media for information should be considered by the authorities.

Obstetric Health Care Workers’ Attitudes and Beliefs Regarding Influenza Vaccination in Pregnancy

To explore obstetric health care workers' attitudes and beliefs regarding influenza vaccination in pregnancy. A survey consisting of 16 multiple-choice questions was administered to nurses, medical and nursing assistants, receptionists, and clinical administrators in obstetric settings. Survey questions addressed general knowledge of influenza and recommendations for vaccination during pregnancy, as well as personal beliefs about the acceptability of the vaccine in the pregnant population. The study was conducted at two sites, Women & Infants Hospital in Providence, RI, and Magee-Women's Hospital in Pittsburgh, PA. Variables were compared by Fisher exact test. Two hundred sixty-seven completed surveys were available for analysis, with a completion rate of 85%. Almost one third of health care workers surveyed do not believe that vaccines are a safe and effective way to decrease infections (31%) and a minority believe that vaccines are safe in pregnancy (36%). Just over half of health care workers know that pregnant women are at increased risk of complications from the flu (56.6%). Only 46% were able to correctly identify influenza symptoms, and only 65% would recommend influenza vaccination to a pregnant woman if indicated. A small percentage would be willing to give an avian influenza vaccine to pregnant women during a pandemic if it had not been tested in pregnancy (12.3%). Many obstetric health care workers lack knowledge regarding the safety and importance of influenza vaccination during pregnancy. Misinformed or inadequately informed health care workers may represent a barrier to influenza vaccine coverage of pregnant women. This lack of knowledge among the health care workforce takes on added importance in the setting of the H1N1 2009 swine-origin influenza pandemic. III.

Immune status and risk perception of acquisition of vaccine preventable diseases among health care workers

Risk perception of acquiring vaccine preventable diseases and the immune status of 187 health care workers (HCW) from a high-complexity university hospital in São Paulo, Brazil, were assessed. The vaccine preventable diseases more cited as at risk for acquisition were hepatitis B (94.1%), influenza (92.5%), meningococcal disease (90.3%), tuberculosis (85.0%), and varicella (72.7%). Previous disease or vaccination reported by HCW were hepatitis B (82.4%), tetanus (87.7%), diphtheria (81.8%), measles (86.6%), mumps (85.6%), rubella (85.0%), varicella (82.9%), and influenza (35.8%). One third of HCW reported previous percutaneous or mucosal occupational accidents, and 83.6% had notified the event to the Hospital Infection Control Committee. Despite good risk perception of acquiring vaccine preventable diseases, only 35.8% of individuals were fully immunized. Efforts should be made to increase influenza vaccination coverage among all professionals and to reduce the number of nonreported accidents, especially among physicians.