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Weinreich, Heidi Marie. "Burnout among National Association of Social Workers Healthcare Social Workers." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/611.
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Burnout is a common occurrence for many healthcare social workers, though little academic literature addresses the impacts of the organizational environment on burnout among healthcare social workers. The purpose of this correlational study was to evaluate what organizational factors predict burnout in the healthcare environment while considering sociodemographic and organizational factors. An adaptation of Maslach's multidimensional theory of burnout served as the framework for this study. Surveys were distributed to members of the National Association of Social Workers who are employed in healthcare environments, resulting in a sample size of 237 useable responses. A multiple linear regression statistical analysis indicated that workload, reward, values, and level of care predicted emotional exhaustion, and therefore the potential for burnout (p < .001). Findings were consistent with the theoretical framework employed. Policy implications include the need for healthcare environments to develop standard operating procedures to address organizational barriers for social workers that contribute to social workers burnout. Implications for social change include an identified need to address burnout through healthcare organizations, professional associations, and academia using education, intervention, and policy.
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Kling, Rakel Nessa. "Promoting the health of healthcare workers : evaluating patient violence in healthcare." Thesis, University of British Columbia, 2007. http://hdl.handle.net/2429/32674.
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Introduction:
The high rate of violence in the healthcare sector supports the need for greater prevention efforts. This study had two main objectives: 1) identify risk factors for violence province- wide and 2) investigate the effectiveness of a violence risk assessment system in reducing the risk of violence in an acute care hospital in British Columbia.
Methods:
Study 1: Data was extracted for a one-year period from the Workplace Health Indicator Tracking and Evaluation (WHITE ™) database for all employee reports of violent incidents for four of the six British Columbia Health Authorities. Risk factors for violence were identified through comparisons of incident rates (number of incidents/100,000 worked hours) by work characteristics, and by regression models.
Study 2: Hospital violence incident rates (number of incidents/ 100,000 worked hours)were calculated pre, during and post implementation of the Alert System, a violence risk assessment system, at one acute care hospital. Then, using a retrospective case control study design, multivariable conditional logistic regression was used to model the effect of the Alert System (flag status yes or no) on the risk of a patient violent incident.
Results:
Study 1: Across health authorities, three groups at particularly high risk for violence were
identified: very small healthcare facilities, the care aide occupation, and pediatric departments in acute care hospitals.
Study 2: The violent incident rate decreased during the Alert System implementation period, but subsequently returned to pre-implementation levels. In the case-control analyses, patients flagged for violence were associated with an increased rather than decreased risk for violence.
Conclusions:
Study 1: The specific risk factors that put health care groups at an increased risk of violence should be examined so that targeted prevention or intervention efforts can be implemented. The identification of high-risk groups supports the importance of a province-wide surveillance system.
Study 2: Although useful at identifying violent patients, the Alert System does not appear to provide the resources or procedures needed by health care workers to prevent a patient from progressing to a violent incident once flagged.
These studies suggest that violence in healthcare should be studied and prevented using a
multifaceted approach.Medicine, Faculty of
Population and Public Health (SPPH), School of
Graduate
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Adedokun, Amos. "Perceptions of Healthcare Workers Toward Influenza Vaccination." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/4992.
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Even though influenza vaccinations were provided free to all healthcare workers in the United States, healthcare workers were not 100% compliant. The non-compliance with influenza vaccinations may expose their patients, their families, and the public at large to a high-risk source of influenza infection. This study's research questions included how registered nurses perceived influenza and influenza vaccination; registered nurses' self-reported incidents with influenza vaccination; and factors that contributed to registered nurses' non-compliance with influenza vaccination. Guided by the theory of reasoned action and the theory of planned behavior, the purpose of this qualitative study was to determine the factors that contributed to the non-compliance of registered nurses with receiving the influenza vaccination. Twenty participants from a healthcare facility in Florida were interviewed using an interview guide. Audio data was transcribed to text data; text data was coded and thematically analyzed by using ATLAS.ti software. Results revealed that 70% of registered nurses were afraid of influenza vaccination, while 80% of them saw influenza vaccination as ineffective; 90% of them had bad experiences or have seen colleagues/friends who have had bad experiences after influenza vaccination. In addition, 40% of registered nurses claimed that they already had good immunity, while 20% of them declined influenza vaccination because of personal choices. Research findings from this study may be utilized to bring positive social change to society at large. The findings may be utilized to enhance existing strategies or policies or even help formulate new policies and strategies that would address the concerns of HCWs, especially registered nurses.
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Hittle, Beverly M. "Elusive Sleep: Healthcare Workers, Shift Work, and Implications for Worker Health and Patient Safety." University of Cincinnati / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1562059911010694.
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Liu, Qianfang, and 刘黔芳. "A literature review on healthcare volunteerism." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193800.
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Shrinking health care resources, especially the lack of health care staffs is an important public health challenge in the 21st century. One of the good practical solutions is to use volunteers as free supplementary human resources in healthcare settings. This literature review purposes to identify benefits of healthcare volunteerism, which covers three levels related to the benefits of healthcare volunteerism in terms of economic value analyses, patients’ satisfaction and safety, as well as benefits to volunteers and healthcare staff. Furthermore, this review aims to draw out the key health care policy issues and implications that healthcare organizers should take into consideration when setting up and implementing an effective, efficient and economical volunteering initiative. PubMed and Medline were searched using Medical Subject Heading (MeSH) and inclusion and exclusion criteria were applied, finally, sixteen studies were retrieved. Limitations of this literature review were also mentioned.published_or_final_version
Public Health
Master
Master of Public Health
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Lech, Patricia Griffith. "The Increase in Disabled Workers and Healthcare Provider Incentives." Fogler Library, University of Maine, 2009. http://www.library.umaine.edu/theses/pdf/LechPG2009.pdf.
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Gillespie, Gordon Lee II. "Violence Against Healthcare Workers in a Pediatric Emergency Department." University of Cincinnati / OhioLINK, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1212109392.
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Dawson-Amoah, Catherine Gyamfua. "Determinants of HIV Stigma Among Healthcare Workers in Ghana." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1531.
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HIV-related stigma and discrimination is a complex concept that affects HIV reduction interventions. HIV-related stigma occurs among healthcare providers resulting in reduction of quality of care of people living with HIV. Social psychological research into stigma reduction has led to the development of many stigma reduction interventions, but has not resolved the underlying problem. This study was designed to identify predictors of stigmatizing behavior among healthcare workers in Ghana using the social cognitive theory (SCT) for use in developing an evidence-based intervention. The study used a cross-sectional research design incorporating a preexisting survey, Measuring HIV Stigma and Discrimination Among Health Staff: Comprehensive Questionnaire. Survey data were analyzed using descriptive, multiple regression analysis and Pearson's coefficient to estimate the relationship between the dependent variable, HIV related stigmatizing behavior, and independent variables, personal attributes and environmental factors. The key findings from the analysis were that the personal attributes of healthcare workers predicted their stigmatizing behavior (R2= 0.674, p < 0.05). There was, however, no significant relationship between environmental factors and stigmatizing behavior and between personal attributes and environmental factors. The social change implications may be to reduce stigma among healthcare workers toward people living with HIV and in turn increase the willingness of healthcare workers to engage with people living with HIV and provide quality service to them.
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Whitby, Robert Michael Public Health & Community Medicine Faculty of Medicine UNSW. "Why healthcare workers don't wash their hands: a behavioural explanation." Awarded by:University of New South Wales. Public Health & Community Medicine, 2009. http://handle.unsw.edu.au/1959.4/44959.
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Hand-washing compliance was examined by thematic analysis of focus group discussions in nurses, mothers and children. Perceptions in these groups were identical, with the purpose of hand-cleansing seen as self-protection from infection. This assessment is not grounded in microbiology, but is strongly driven by emotion. Two types of hand-cleansing (???hand-hygiene???) behaviour were identified: (a) ???inherent??? hand-washing. This behaviour is taught by mothers to their children early in life. The behaviour occurs when hands have been visibly or ???emotionally??? soiled or feel sticky, and drives most hand-hygiene undertaken in the community; and (b) ???elective??? hand-hygiene, which occurs in the absence of perceived threat. As patient contact by healthcare workers is frequently assessed by healthcare workers as not posing risk, healthcare workers omit much elective hand-hygiene, leading to potential cross-infection. Modelling responses of 754 nurses on the Theory of Planned Behaviour for these two hand-hygiene behaviours in the healthcare setting explained 64% of elective hand-hygiene and 76% of inherent hand-washing intention. Translation of hand-washing behaviour patterns of the community into the healthcare setting is the predominant driver of all hand-hygiene in healthcare workers. In-hospital elective hand-hygiene behaviour is further significantly predicted by belief in the benefit from the activity, peer pressure and role modelling of senior physicians and administrators. For inherent hand-washing intent, only attitudes and peer behaviour are predictive. Time constraints, commonly implicated to explain poor compliance, are important mostly to elective hand-hygiene. Reduction in necessary effort by introducing an alcohol-based hand rub without a concomitant behavioural modification program will therefore have only minimal impact. Further components essential to hand-hygiene programs have been identified. These accord with the outcomes of the modelling and include the need for institutional recognition of hand-hygiene as a priority, overt clinician leadership support, and reinforcement of purpose by both education and performance feedback. In the long-term, society would be best served by altering the entire paradigm of hand-hygiene behaviour with nationwide campaigns based on principles of social marketing. Ideally, hand-hygiene should be taught by mothers and reinforced in early education programs as behaviour that is self-protective but with the defining theme: ???clean your hands, and protect others, not just yourself.???
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Chan, Wai-ling Winnie. "Outbreak of SARS among healthcare workers in a regional hospital." Click to view the E-thesis via HKUTO, 2005. http://sunzi.lib.hku.hk/hkuto/record/B39725108.
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陳惠玲 and Wai-ling Winnie Chan. "Outbreak of SARS among healthcare workers in a regional hospital." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2005. http://hub.hku.hk/bib/B39725108.
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De, Beer Corena. "Clinical and laboratory investigation of latex allergy in healthcare workers." Thesis, Stellenbosch : Stellenbosch University, 2004. http://hdl.handle.net/10019.1/49883.
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Thesis (PhD)--Stellenbosch University, 2004.ENGLISH ABSTRACT: Healthcare workers (HCWs) wear latex gloves to protect themselves and their patients against the transmission of microbial, viral and bloodborne diseases. These individuals are primarily exposed to latex via cutaneous (direct contact) and mucocutaneous (inhalation of airborne allergens on glove powder) routes. Repeated exposure leads to the formation of circulating latex-specific IgE and subsequent sensitisation with varying clinical expression. The airconditioning system of the Tygerberg Hospital (TBH) complex was investigated for the presence of aerosolised cornstarch glove powder and proteins. Dust samples were collected from 14 areas with different levels of latex glove usage. Dust samples were spectrophotometrically compared to a calibration graph of pure glove powder. The detection of starch and proteins in all the dust samples confirmed the presence of glove powder and possibly airborne latex allergens in the airconditioning ducts. As expected, the high exposure areas showed the highest concentrations of both starch and proteins. It is possible that other proteins than latex were involved, but the confirmed high level of protein contamination should be a cause for concern. Correlation between starch and protein levels was highly significant (p<0.01) in all instances. A total of 500 questionnaires were circulated for completion by HCWs from TBH. The response rate was 69.8%. After considering specific inclusion criteria, a study group of 152 individuals was compiled (28 males, 124 females). All subjects had current latex exposure and suffered from at least three pre-defined symptoms. Serum was collected from all subjects and dermal fluid from 31 subjects. Total IgE and latex specific IgE analysis were done on all serum and dermal fluid samples. Latex-specific IgE was positive (>0.35 IU/ℓ) in 23 serum and six dermal fluid samples. Skin prick tests (SPTs)for latex were done on 59 subjects with negative serum latex-specific IgE and 34 had positive results. Twelve subjects with negative latex-specific IgE and latex SPTs underwent patch tests with the European Standard Series, a piece of latex glove and glove powder in petrolatum. Three subjects had positive results to one or more of these allergens. Western blot analysis for latex was done on all positive sera and dermal fluid collected from these subjects. Western blot analysis for latex proved to be more sensitive than the capRAST, because it was able to identify specific bands in samples with negative capRAST results. All subjects showed a band for Hev b 1, which has been confirmed as a powder-bound airborne allergen. Hev b 6.01 is associated with HCWs with cutaneous symptoms and this band was recognised by 81% of the subjects. These findings confirmed that airborne and cutaneous routes are the major routes of exposure in HCWs. According to their laboratory results, subjects were divided into the following subgroups and compared statistically: Group A (serum positive, n=23), Group B (SPT positive, n=34) and Group C (negative, n=25). Group D (withdrawn, n=70) could not be used for statistical comparisons, due to incomplete results. An overall latex allergy prevalence of 38% was found. Group A differed significantly from Group B and Group C for most clinical and special investigations. Group A and B were also combined to represent all subjects with positive results (Cohort AB). The Allergy Score and Class were highly significant when Cohort AB was compared to Group C. The selection of clinical symptoms was confirmed to be relevant and work-related deterioration on any of the symptoms should bear a high index of suspicion in the evaluation of latex allergy. Numerical indices and specific symptoms showed high positive predictive values and the Allergy Score produced statistical significance in the positive subgroups when compared to the negative subgroup. Paired statistical significance was confirmed between the Allergy Score and occupational exposure (number of years, hours and pairs per week). The areas with the highest occupational latex exposure in HCWs are the face and hands. Different occupations also have different levels of exposure and two subgroups of HCWs (16 laboratory technologists and 13 theatre staff) were investigated for sebum content on different facial areas and the palms and dorsal areas of both hands. Baseline measurements were done before putting on gloves. In 21 subjects follow up measurements were done following three to four hours of occupational exposure, but before washing their hands. Baseline and follow up values were compared for all the different anatomical regions. Levels on the forehead and cheeks increased over time, while the level on the nose decreased. All hand regions decreased significantly during occupational exposure, suggesting that glove powder contributes to dryness of the skin. In conclusion, the problem posed by latex allergy will not be solved overnight and will probably remain a major occupational hazard for years to come. It is currently not possible to avoid exposure to latex, but it is imperative to institute safety measures to prevent further sensitisation in predisposed individuals and manage those already affected.
AFRIKAANSE OPSOMMING: Gesondheidswerkers dra lateks handskoene om hulleself en hulle pasiënte te beskerm teen die oordrag van mikrobiale, virale en bloed-gedraagde siektes. Die lateks blootstelling vind hier hoofsaaklik plaas via kutane (direkte velkontak) en mukokutane (inaseming van lug-gedraagde allergene op hanskoen poeier) roetes. Herhaalde blootstelling veroorsaak sirkulerende lateksspesifieke IgE en sensitisasie met variërende kliniese beelde. Die lugreëlingstelsel van die Tygerberg hospitaalkompleks is ondersoek vir die teenwoordigheid van handskoenpoeier (stysel) en lateks proteïene. Stofmonsters is versamel in 14 areas wat verskillende blootstellingsvlakke verteenwoordig het. Die stofmonsters is spektrofotometries vergelyk met "n kalibrasiekurwe van suiwer hanskoenpoeier. Stysel en proteïene kon in al die stofmonsters aangetoon word en het die teenwoordigheid van handskoenpoeier en moontlike luggedraagde lateks proteïene in die lugreëlingstelsel bevestig. Soos verwag kon word, het die hoogste stysel en proteïen waardes in hoë blootstellingsareas voorgekom. Hoogs beduidende statistiese korrelasies (p<0.01) tussen die stysel en proteïenvlakke kon aangedui word in alle monsters. "n Totaal van 500 vraelyste is gesirkuleer vir voltooiing deur TBH gesondheidswerkers, waarvan 69.8% voltooide vraelyste terugontvang is. Na evaluering van insluitingskriteria, is "n studiegroep van 152 individue saamgestel (28 mans, 124 vrouens). Almal het huidige lateks blootstelling en ten minste drie het vooraf gedefinieerde simptome gerapporteer. Serum is van die hele groep versamel en dermale vog van 31 proefpersone. Totale IgE en lateks-spesifieke IgE vlakke is op alle serum en dermale vog bepaal. Positiewe resultate (>0.35 IU/ℓ) is verkry in 23 serum en ses dermaIe vog monsters. Velpriktoets vir lateks is op 59 proefpersone uitgevoer en 34 daarvan het positiewe resultate opgelewer. Twaalf proefpersone met negatiewe lateks-spesifieke IgE en velpriktoets resultate het kutane plaktoetse ondergaan met die Europese Standaard Reeks, "n stukkie lateks handskoen en handskoenpoeier in petrolatum. Drie proefpersone het positiewe resultate teen een of meer van die allergene gehad. Westerse kladanalise vir lateks is op alle positiewe serum gedoen, asook die dermale vogte van hierdie proefpersone. Westerse kladanalise vir lateks blyk baie meer sensitief te wees as die capRAST, aangesien dit spesifieke bande kon identifiseer in monsters capRAST resultate. Alle monsters het "n band getoon vir Hev b 1, "n poeier-gebinde, luggedraade allergeen. Hev b 6.01 is geassosieer met gesondheidswerkers met velsimptome en hierdie band is gevind in 81% van die monsters. Hierdie resultate bevestig dat die belangrikste blootstelling aan lateks in gesondheidswerkers deur die vel en inaseming plaasvind. Proefpersone is in die volgende drie groepe verdeel volgens laboratorium resultate en statisties vergelyk: Groep A (positiewe serum, n=23), Groep B (positiewe velpriktoetse, n=34) en Groep C (negatief, n=25). Groep D (onttrek, n=70) kon nie vir betekenisvolle statistiese vergelykings aangewend word nie, as gevolg van onvolledige resultate. 'n Finale lateks allergie prevalensie van 38% is gevind. Groep A het hoogs beduidend verskil van Groep B en C vir die meeste van die kliniese en spesiale laboratoriumondersoeke. Groep A en B is gekombineer om alle proefpersone in te sluit met positiewe resultate (Kohort AB). Die Allergie Telling en Klas van Kohort AB was hoogs beduidend in vergelyking met Groep C. Die gekose simptome is bevestig as relevant en enige werksverwante verergering van simptome moet met 'n hoë mate van agterdog bejeën word in lateks allergie. Numeriese indekse en spesifieke simptome het hoë positiewe voorspellingswaardes gelewer en die Allergie Telling was hoogs beduidend in die positiewe subgroep in vergelyking met die negatiewe subgroep. Gepaarde statistiese beduidenheid is ook gevind tussen die Allergie Telling en beroepsblootstelling (jare van blootstelling, uur en paar handskoene per week). Die meeste beroepsblootstelling aan lateks in gesondheidswerkers vind plaas op die hande en gesig. Verskillende beroepe het ook verskillende blootstellingsvlakke en two subgroepe gesondheidswerkers (16 laboratorium tegnoloë en 13 teater personeel) is ondersoek vir die sebumgehalte op veskillende areas van die gesig en hande. Basislynvlakke is gemeet voordat handskoene aangetrek is en in 21 gevalle is opvolgvlakke gemeet na drie tot vier uur beroepsblootstelling, maar voor die hande gewas is. Basislyn en opvolgvlakke is met mekaar vergelyk vir al die anatomiese areas. Die voorkop en wange het 'n toename in sebumgehalte getoon, terwyl dié van die neus afgeneem het. AI die areas op die hande toon 'n hoogs beduidende afname tydens beroepsblootstelling, wat impliseer dat hanskoenpoeier moontlik bydra tot droogheid van die vel. In samevatting, die lateks allergie probleem sal nie oornag opgelos word nie en sal waarskynlik 'n belangrike beroepsrisiko bly vir die aansienlike toekoms. Totale vermyding van lateks is tans onmoontlik en daarom is dit van uiterste belang om voorsorgmaatreëls in plek te stel om verdere sensitisasie in blootgestelde individue te verhoed en die wat reeds geaffekteer is, effektief te hanteer.
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Talat, Rehab. "Healthcare for Undocumented Workers in France and The United States." Wright State University / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=wright1403691584.
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Moreland, Annie. "Understanding healthcare workers' responses to violence and aggression at work." Thesis, University of Leeds, 2006. http://etheses.whiterose.ac.uk/340/.
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The primary objective of this study was to investigate whether there was evidence for the proposed mechanisms within the Ehlers and Clark (2000) cognitive model of Post-Traumatic Stress Disorder( PTSD). Two principal relationships were to be investigated: firstly, whether behavioural and cognitive strategies prevented change in the nature of the trauma memory and appraisals of the trauma and its sequelae over time; secondly, whether aspects of trauma memory and subsequent appraisals of the trauma and its sequelae mediated the relationship between peritraumatic cognitive processing and PTSD symptoms. The second research objective involved further validation of the Ehlers and Clark (2000) model. The study was conducted on a population of health service employees exposed to aggression and/or violence at work, using a prospective, longitudinal design.A low response rate meant that there was not sufficient power to test these relationships. The findings from Study I were a low response rate, low reporting of incidents of violenced rid aggression and low PTSD symptoms,particularly amongst ambulance workers. Findings from Study I led to a qualitative study being carried out to investigate: the possible reasons for the low response and reporting rate; the lack of PTSD symptoms; and to explore responses of ambulance workers to workplace violence and aggression. Twenty-four interviews were carried out with ambulance workers, and the data was analyzed using Thematic Analysis. PTSD symptoms were described by interviewees in themselves and their colleagues following incidents of violence and aggression Low response rates were discussed in the context of a general reluctance to report incidents and to show that they had not been affected by violence and aggression. The responses to violence and aggression took two forms, a macho or tough response and a reflective, sensitive approach. Colleague relationships were an important source of support for many of the ambulance workers and management were portrayed as uncaring. These findings were considered in the context of the literature and the Ehlers and Clark (2000) model.
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Rai, Rajni. "Identifying occupational hazards among healthcare workers in Australia and Bhutan." Thesis, Curtin University, 2021. http://hdl.handle.net/20.500.11937/85006.
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This research project examined the epidemiology of occupational exposures to hazardous chemicals and agents among healthcare workers in Australia and Bhutan. Data from three population-based cross-sectional studies conducted in 2011, 2014 and 2016 in Australia were analysed and a cross-sectional survey was conducted in 2019 in three hospitals in Bhutan. The results indicate that a substantial proportion of healthcare workers in both countries were occupationally exposed to hazardous chemicals with exposure to asthmagens being the most common.
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Moniz, Francisco Fernandes Correia do Canto. "Healthcare provider effciency in workers' compensation : an approach with Machine Learning." Master's thesis, Instituto Superior de Economia e Gestão, 2019. http://hdl.handle.net/10400.5/19400.
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Mestrado em Actuarial ScienceO ramo de Acidentes de Trabalho é uma linha de negócio obrigatória e com bastante competitividade. Nos últimos anos, temos observado um crescimento na popularidade de "Data Science" e esta transformação passa também por atualizar os modelos e processos internos aplicados em seguros. Após um Acidente de Trabalho, é recomendado ao beneficiário um prestador clínico para acompanhar o seu tratamento. Usando várias variáveis sociais e patológicas modelamos custos médicos e de transportes, dependendo estes do prestador clínico principal do lesado. Esta metodologia permite que os gestores de sinistros tenham acesso não só à melhor recomendação como também a uma estimativa de custos. Os modelos de custo esperado e frequência foram desenvolvidos usando o algoritmo "Extreme Gradient Boosting" em vez de modelos mais tradicionais como os GLM. Este é um algoritmo de "Machine Learning" útil para previsão tanto em regressão como em classificação. Para problemas com muitos dados, este algoritmo tende a prever com maior precisão e rapidez. Para uma utilização eficaz do modelo as variáveis categóricas são codificadas em numéricas através de "target encoding". Isto é, as observações são agrupadas de acordo com os níveis da variável e com o ano de ocorrência, e é calculada a média da variável de resposta para cada nível com as observações dos 3 anos antecedentes. Por fim, para avaliar o valor acrescentado do modelo desenvolvido, calculamos os custos incorridos caso optássemos pela recomendação em prática. A nova recomendação consegue poupar até 1,7 milhões de euros por ano entre despesas médicas e de transportes.
Workers' Compensation is a mandatory and very competitive Line of Business (LoB) for Insurance Companies. Companies cannot raise premiums too much from fear of losing market share, but they also cannot lower them as it needs to be financially viable. With the growing popularity of Data Science models, internal processes are being adapted to more precise and advanced models. Following a work accident, a healthcare provider is recommended to the injured workers. It was our main objective in this internship to optimize this recommendation system. Our solution provides an estimate of medical and transportation cost which depends on the healthcare provider. With this project, claim managers can have access to the most efficient healthcare unit, as well as an estimate of the corresponding liability. Models for the cost were developed using Extreme Gradient Boosting (XGB) as an alternative to the staple, Generalized Linear Models (GLM). By changing the loss function we applied XGB to both regression and classification problems and achieved more precise predictions. To encode categorical variables in numerical values, we developed an algorithm that groups costs according to each level of a variable for the past 3 years and then computes its average. This encoding technique is similar to target encoding. To assess the added value of this model, we compute the costs for the current recommendation applied. The new recommendation recognizes cheaper alternatives and predicts savings in total expenses of up to 1,7 million Euros.
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Ishau, Simileoluwa O. "Dermal Exposure and Risk to Aerosolized Pharmaceuticals in Home Healthcare Workers." University of Cincinnati / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1581333497402733.
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Kokota, Demoubly. "An evaluation of mhGAP training for primary healthcare workers in Mulanje, Malawi." Master's thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/16699.
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Includes bibliographical referencesIntroduction: There is a large treatment gap for people with mental disorders in Africa and other low resourced countries, estimated to be between 70% and 90%. The treatment gap is mainly due to the lack of trained mental health professionals and inadequate mental health service resources in Africa. There has been a growing global movement championed by the World Health Organisation (WHO) to integrate mental health into primary health care as the most effective way of reducing this treatment gap. This study aimed to investigate the impact of WHO Mental Health Gap Action Programme (mhGAP) training and supervision on primary health workers' knowledge, attitudes, confidence and detection rate of major mental disorders in the district of Mulanje, Malawi. Method: The study was a quantitative evaluation using a quasi-experimental method (single cohort pre- and post-measures) and an interrupted time-series design. Forty-three primary healthcare workers from Mulanje, Malawi completed pre- and post- training questionnaires assessing knowledge, attitudes and confidence regarding the assessment and management of major mental disorders. Rates of diagnosis of major mental disorders were obtained from clinic registers for 5 months prior to and 7 months following training. Results: The results showed a significant change on knowledge and confidence scores but not attitudes. The mean knowledge score showed a statistically significantly increase from 11.8 (standard deviation [SD]: 0.33) before training to 15.1 (SD: 0.38) immediately after training; t(42) = 7.79, p <.01. Mean knowledge score was also significantly higher six month post training (13.9, SD: 2.52) than before training; t(42) = 4.57, p < .01. Similarly, the mean confidence score increased significantly from 39.9 (SD): 7.68) before training to 49.6 (SD: 06.14) immediately after training; t(84) = 8.43, p <.01. Mean confidence score was also significantly higher six month post training (46.8, SD: 6.03) than before training; t(84) = 6.60, p <.01. There was no overall significant difference in mean CAMI scores before, immediately after and 6 months after training in all four of the CAMI components. The F-test statistic and P-value for Authoritarianism, Benevolence, Social Restrictiveness and Community Mental Health Ideology were: F2, 126, 0.05 = 2.5; p =.09, F2, 126, 0.05 = 0.1; p =.9, F2, 126, 0.05 = 0.03; p = 1.0 and F2, 126, 0.05 = 0.04; p = 1.0, respectively. In the months January to May 2014 (before training), median number of cases per month was 77 (inter quartile range [IQR]: 65-87) whereas after training (months June to December) median number of cases was 186 (IQR: 175-197) showing a significant increase in median number of cases before and after the training; p =0.001. Conclusion: The results show clear improvements in the knowledge, confidence and detection of severe mental illness in primary care in Mulanje and demonstrate the potential for narrowing the treatment gap by rolling out mhGAP training nationally in Malawi. The findings of this study add to the growing evidence for policy makers of the effectiveness of mental health training and supervision of primary care workers in a resource-constrained country. Further research is needed to evaluate factors that may lead to change in health worker attitudes, to evaluate training and supervision programmes using more robust evaluation designs, such as randomised controlled trials, and to assess the scale up of mhGAP programmes at larger population levels.
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Small, Tamara. "Workplace Violence Prevention Training: A Cross-sectional Study of Home Healthcare Workers." University of Cincinnati / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1595850151324948.
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Taylor, Guy O. "Perspectives of Sierra Leoneans Healthcare Workers' Mental Health During the Ebola Outbreak." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7086.
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The mental health of healthcare workers during the Ebola outbreak in West Africa was a serious concern for healthcare professionals and the mental health field. One area in West Africa where healthcare workers played a significant role during the Ebola outbreak of 2014 and 2015 was Sierra Leone. This qualitative research study was designed to explore the perceptions of Sierra Leoneans healthcare workers' mental health, how they coped, and treatment they received while providing care for Ebola virus patients. This study, with a phenomenological research approach, used purposeful sampling to recruit 10 healthcare workers to participate in semi structured, open-ended interviews. The stress theory model and a hermeneutic phenomenology conceptual framework were used as a lens of analysis to understand the views of healthcare workers who worked directly with Ebola virus patients in Freetown, Sierra Leone. The results of the analysis of the collected data produced 9 major themes. The major themes suggest that healthcare workers experienced mental health symptoms such as depression and anxiety, personal thoughts and feelings such as insomnia, and suicidal ideation. Strategies for coping included using the Bible; and the detrimental impact included facing discrimination after the Ebola outbreak. Most of the healthcare workers blame the government for not providing adequate coping resources, which led to the personal consequence of hopelessness. This study may benefit mental health professionals working in an epidemic. Additionally, this study may contribute to social change by providing a deeper understanding of the mental health system and healthcare workers in Freetown, Sierra Leone.
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SAKAMOTO, JUNICHI, MD HARUN-OR-RASHID, ONPRASONK SUWATTANA, and ONPRASONK WIDSANUGORN. "HEALTHCARE WORKERS’ KNOWLEDGE AND PRACTICES REGARDING EXPANDED PROGRAM ON IMMUNIZATION IN KALASIN, THAILAND." Nagoya University School of Medicine, 2011. http://hdl.handle.net/2237/15360.
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Hon, Chun-Yip. "Healthcare workers and antineoplastic drugs : evaluating the risks and identifying determinants of exposure." Thesis, University of British Columbia, 2012. http://hdl.handle.net/2429/42505.
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Healthcare workers’ exposure to antineoplastic drugs may occur through handling of the drugs and/or via contact with drug-contaminated surfaces. However, studies have been limited to select departments and/or certain job titles. This may lead to an underestimate of the risk as the drugs circulate within a facility known as the hospital medication system (process flow of drugs).
This study aimed to answer the following questions related to antineoplastic drugs and the hospital medication system: 1) is contamination found on surfaces located throughout, 2) are workers throughout occupationally exposed (dermal and urinary contamination), and 3) what factors are associated with surface contamination and occupational exposure?
Site observations were conducted to identify which surfaces may be contaminated and the job categories that may contact these surfaces. Wipe samples were collected from potentially-contaminated surfaces and the hands of at-risk healthcare workers. Urine samples were collected from these same workers. Participants were asked to complete a questionnaire regarding their knowledge and usual protective habits regarding antineoplastic drugs and surveyed about contact with these agents on their work shift.
Drug residual was measurable on surfaces located throughout the hospital medication system. Determinants associated with increased surface contamination were the drug preparation and drug administration stages of the medication system as well as having more job categories responsible for drug transport. Up to 11 job categories per facility may have an exposure risk and the maximum dermal contamination levels for every job category exceeded the limit of detection. Factors associated with increased dermal contamination were working in acute care hospitals, female personnel, working as a porter, nurse, transport, unit clerk or other roles in the drug administration unit and having a duty to handle antineoplastic drugs. Urinary drug contamination of participants was higher than in non-hospital controls confirming that exposure is occurring in the workplace. Being a pharmacy receiver, pharmacy technician, porter, nurse, or unit clerk and a facility having more job categories responsible for drug transport were associated with increased urinary contamination.
This is believed to be the first study examining environmental contamination and occupational exposure to antineoplastic drugs across the entire hospital medication system.
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Laisser, Rose Mjawa. "Prevention of intimate partner violence : community and healthcare workers´ perceptions in urban Tanzania." Doctoral thesis, Umeå universitet, Epidemiologi och global hälsa, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-49743.
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Background: Intimate partner violence (IPV) against women is public health and human rights concern. The studies forming this thesis seek to understand healthcare worker and community attitudes and perceptions about IPV; their role in support, care and prevention of IPV, and the feasibility of introducing routine screening for IPV among women attending healthcare. Methods: Four interrelated studies were conducted in Temeke District, Dar es Salaam, Tanzania: 1) a content analysis of 16 in-depth interviews with healthcare workers about their experiences of meeting IPV clients, 2) a grounded theory analysis of seven focus group discussions that explore community perceptions, 3) a cross sectional study of 657 healthcare workers and students to understand their attitudes and perceptions about IPV and future roles in care and support, and 4) evaluation of a pilot intervention that introduces routine screening in an outpatient department. The pilot intervention included screening of 102 women, ten observations of healthcare worker interactions with women clients, three focus group discussions, and five narratives written by healthcare workers about their experiences with the screening tools. Results: Gender inequalities, attitudes, and poverty intersect in the explanation of IPV. Healthcare workers view low economic status among women, rigid gender norms, and stigma that influences women to stay in violent relationships. Alcohol abuse, multiple sexual partners and low levels of income among men were cited as triggers for IPV episodes. Between 20-67% of healthcare workers and students report meeting IPV clients at work. More than 9o% observed clients with unexplained feelings of sadness and/or loss of confidence. Resource and training limitations, heavy workloads and low salaries constrain services. A strong desire to make a difference in the care and support of IPV clients was present, but violence as a hidden agenda with a client resistance to disclosure was a challenge. The community study shows a transition in gender norms is making violence against women less acceptable. Conclusions and suggestions: Healthcare workers and the community strongly wish and are committed to support IPV prevention. Both groups understood the meaning, provocative factors and some IPV effects. This awareness contributes to their desire to be part of a change. At the central level, prevention of IPV should be on the governments’ policy agenda and should be prioritised. Education about gender-based violence must be incorporated into the curricula of healthcare workers. At community level, advocacy is necessary for changing harmful gender norms and measures to combat women’s poverty. Men should be engaged at all levels. Provision of information on the human rights perspectives of IPV should be strengthened and related to other types of violence.
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Olivero, Lara Humberto Jose. "Quantifying the Ergonomic Impact on Healthcare Workers Using a Needle-free Injector Device." Scholar Commons, 2013. http://scholarcommons.usf.edu/etd/4739.
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Background: Jet injectors are advantageous over needle injectors by eliminating sharps hazards. The Government Accountability Office estimates 29% preventable sharp injuries with an estimated direct cost of more than $500 million out of the CDC's reported incidence of 385,000 needle stick injuries per year among US hospital healthcare workers. Yet the forces required to set and trigger devices using spring mechanisms for medication delivery have not been explored. This laboratory experiment measured forces exerted by healthcare workers (HCWs) using a particular jet injector approved by FDA in 2011.
Objectives: In order to quantify the ergonomic impact on HCWs using a needle-free injector, the first objective was to evaluate the dynamic forces required to activate the trigger injector button and the reset station for the injector, with their respective means, for each of the parameters studied. The second objective was to compare these forces to those required to use four previously analyzed retractable intramuscular syringes with needles. Finally, the third objective was to assess potential psychophysics ergonomic impact on HCWs with use of these devices to formulate future design changes and recommendations for manufacturers and HCWs, respectively.
Methods: This laboratory experiment was conducted through a multi-disciplinary team approach. It included a total of 136 trials (10 validation trials, 116 experimental trials and 10 padded trials for soft tissue simulation), which were conducted using the PharmaJetTM Injector. A force gauge and a load cell were integrated into the triggering setup and reset station, correspondingly, enabling force measurements to be obtained directly from the human-machine interfaces. These force data allowed for observations of force profiles in time by the healthcare worker as researcher while preparing for and administering injections. Data collection used three software applications for force conversions and data manipulation. Data were analyzed using descriptive statistics and analytical results by using ANOVA for the trigger injector & reset station with multiple comparison tests for parametric and non-parametric distributions, respectively.
Results: The descriptive results indicated an average force for triggering the injector in the 116 trials was 15.92 lbs. (70.8 N) with a range of 9.77-26.46 lbs. (43.46-117.69 N). The measured forces for the reset station ranged from 5.35-82.78 lbs. (5.35-368.22 N) with an average of 25.32 lbs. (112.62 N) (SD 12.36). Spurious findings presented with tensile forces to fill the syringes resulting in hand strain in the first metacarpal joint after repetitive pinprick motion. The analytical results showed an ANOVA for trigger injector with a parametric-normal distribution with an F (2,133) Ratio 10.0472, p- value (F) 0.0001<0.05, showing statistical significance and with a Tukey's comparison test showing a significant difference in between the means of the padded trials vs. the validation & experimental trial groups. The ANOVA for the reset station showed a Kruskal Wallis H-statistic of 0.2568, p-value (H) 0.8795>0.05 presenting NO statistical significance with a Dunn's comparison test confirming NO difference in between the medians or mean ranks of all three groups.
Conclusions: Triggering the injector and resetting the station required considerable effort in comparison to activating 4 retractable intramuscular syringes with needles from our previous studies, the range of mean forces were 3.63-17 lbs (16.19-77.53 N) for those syringes with the trigger injector maximum voluntary force of 71 N being above the recommend 56.6 N.The jet injector required more force per effort than 2 (4.4x) syringes & similar to other 2 syringes (0.9x) previously tested when considering the compression forces related with the trigger injector. Additional vector forces (displacement & gripping of reset station) could increase the cumulative effort affecting different musculoskeletal components when the whole components of the procedure are taken into account.
Suggestions for the manufacturer regarding design changes to facilitate HCWs' use of this device are warranted, since some of the summation forces during the 12 mini-steps could be avoided to achieve a higher efficiency. This information may be useful for health care facilities when choosing devices to protect their workers from ergonomic injuries.
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Elmashae, Yousef Saleh. "Evaluating the Aerosol Exposure and Respiratory Protection of Healthcare Workers in Different Environments." University of Cincinnati / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1512045176317312.
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van, Ginneken N. "The roles of primary-level health workers in delivering mental healthcare in India." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2015. http://researchonline.lshtm.ac.uk/2312607/.
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This research explored the history, effectiveness and feasibility of primary-level health workers (PHWs) in delivering care for mental, neurological and substance use (MNS) disorders in India, to better inform the organisation and delivery of mental health services at primary care and community levels. This thesis examined evidence for the effectiveness of PHWs in mental healthcare in low- and middle-income countries (LMICs) (Cochrane review – 38 included studies), and then focused on India. Seventeen oral history interviews described the experiences of integrating mental healthcare into primary care and 72 case-studies explored government and non-governmental models of PHW-delivered mental healthcare initiatives and their human resources. PHWs can be effective in delivering care for MNS disorders in LMICs. The case studies identified heterogeneous collaborative care models in India, most of which were delivered through community- rather than government- primary care. Other models (training and referral) which have less evidence for effectiveness were more widespread, and included the government model which was perceived as having ‘failed’. A new model was identified: community outreach services which were specialist-led but PHW-delivered. LHWs and care managers seemed more feasible and appropriate care managers than PHC doctors across models and provided more holistic psychosocial support. Specialists were valuable for PHWs’ and care managers’ training and ongoing support. Barriers to mental health care integration are discussed. Future research priorities are to assess whether variations of collaborative models are similarly effective to those described in HICs and whether these are feasible and effective if implemented at scale. Priorities for improving the DMHP would be to consider deploying care managers and LHWs and reorient as well as incentivise specialists to support them. Better inter-sectoral collaborations, health system strengthening and technical support at central- and state-government levels may improve leadership, implementation and evaluation of mental healthcare integration into primary care across India.
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Lekgothoane, Adelaide Maropeng. "Occupational injuries and diseases amongst healthcare workers of the department of health in Limpopo Province." Thesis, University of Limpopo (Medunsa Campus), 2012. http://hdl.handle.net/10386/777.
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Thesis (MPH) -- University of Limpopo, 2012.SUMMARY OCCUPATIONAL INJURIES AND DISEASES AMONGST HEALTHCARE WORKERS OF THE DEPARTMENT OF HEALTH IN LIMPOPO PROVINCE AIM: To analyse and provide data on the incidence of occupational injuries and the prevalence of occupational diseases amongst healthcare workers of Department of Health in Limpopo Province. OBJECTIVES: The specific objectives of the study were as follows: 1. To determine the most common occupational types of injuries and/or diseases amongst healthcare workers with regard to the demographic profile (i.e. age, gender, occupation, workstation) of healthcare workers; 2. To establish outcomes of these injuries and diseases fatalities regard to the demographic profile (i.e. age, gender, occupation, workstation) of healthcare workers; and 3. To assess the association between the predominant injuries and diseases with the profile of the health care workers METHOD: The researcher sourced data electronically from Department of Health as quarterly reports, four (4) for each year of the financial years 2007/2008, 2008/2009 and 2009/2010 respectively. The data was consolidated into financial years, cleaned out part of 2007 and 2010 so at to remain with 3 calendar years (2007, 2008 &2009) prior analysis. RESULTS: There were 725 per 100 000 healthcare workers affected by injuries and diseases during the study period. These injuries/and diseases affected more males than females above 40 years with the mean age being 43 years. Of the 631 injuries and diseases reported, 89% were injuries whist 11 % were diseases with most employees from Mopani district. The most common injuries which affected HCWs thus included needle stick injuries (24%), slip/trip/fall (23%), motor vehicle accidents (14%), injuries by external objects (10%) and assaults (7%). The most common diseases which affected HCWs were found to be TB (69%), diseases by chemical agents (12%), cholera (9%) and poisoning (2%). The needle stick injury affected clinical nurses (59%) more than other professionals; moreover, TB affected 63.6% of nurses. The captured outcome of this injury/disease was 4 fatalities among EMS personnel. CONCLUSION: In conclusion, this study demonstrates that tuberculosis is the most common occupational disease acquired whilst needle stick injury is the commonest occupational injury sustained by healthcare workers of the Department of Health, Limpopo Province. The employees were therefore affected by preventable occupational injuries and diseases. RECOMMENDATIONS: Preventative programs need to be strengthened to reduce morbidity of tuberculosis and needle stick injuries amongst employees.
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Turnberg, Wayne L. "Respiratory infection control practices among healthcare workers in primary care and emergency department settings /." Thesis, Connect to this title online; UW restricted, 2006. http://hdl.handle.net/1773/8475.
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Olukoga, Idowu Abiodun. "An analysis of the perceptions of hospitals' institutional capacity by healthcare workers in Nigeria." Thesis, University of East Anglia, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.522248.
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Ollier, Katherine J. "Inhalation Exposure and Respiratory Protection of Home Healthcare Workers Administering Aerosolized Medications (Simulation Study)." University of Cincinnati / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1535460244928302.
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Bruintjies, Grace Colleen. "Challenges faced by healthcare workers in conducting clinical Research in selected Western Cape sites." University of the Western Cape, 2013. http://hdl.handle.net/11394/3794.
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Magister Artium (Development Studies) - MA(DVS)This study is interested in understanding and describing the everyday reality of clinical researchers from the perspective of those who operate on the grassroots level –in this case, the field staff working under the guidance of the study coordinator and principal investigators.
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Lochhead, Lois Edna. "Impact of prior hysterectomy on risk of subsequent back injury in front line healthcare workers." Thesis, University of British Columbia, 2015. http://hdl.handle.net/2429/55350.
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Low back injury (LBI) is associated with altered core muscle function and studies have validated the role of these deep stabilizing muscles in prevention and treatment of back pain and injury. No previous studies have evaluated the impact of surgery such as abdominal hysterectomy (AH) on these deep stabilizers and the potential for increased risk of LBI following surgery. The aims of this research were to investigate a link between AH and LBI first with administrative health data analysis and then clinically by measuring muscle thickness with rehabilitation ultrasound imaging (RUSI) before and after surgery.
A retrospective cohort of 37,057 female frontline healthcare workers, a population at high risk of occupational LBI due to the heavy nature of their work, was extracted. Exclusion of 27,987 due to a history of back pain or injury, prior hysterectomy or failure to meet the provincial residency requirement of five years left a sample size of 9,070. Within this research sample, 634 (7%) had undergone hysterectomy, a prevalence much lower than the published value of 30%. Statistical analysis revealed no increased risk of LBI in this cohort of healthcare workers without prior history of LBI. Clinical RUSI assessment of the core muscles would investigate if this was because there was no change in the muscle function post-surgically. Validity and reliability of RUSI to evaluate core muscle function have been established for intersessions up to two weeks. A group of women not undergoing AH was used to establish reliability over intervals of four, eight and twelve weeks. Intraclass correlations (ICC₃,₁) ranging from 0.75 to 0.90 for measured muscle thickness in the deep abdominal and lumbar muscles exceeded the minimum standard of 0.70 for research purposes. Percent change measures did not meet this standard. A prospective descriptive case series involving nine individuals undergoing AH found post-surgical decreases in measurements of the deep abdominal stabilizers most notably in the participants with a history of previous low back pain/injury or who were obese. These findings support continued investigation of the relationship between AH and LBI including individuals with risk factors such as prior low back pain/injury and/or obesity.Medicine, Faculty of
Graduate
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Gill, Megumi. "Voices of healthcare workers : experience of being on an interdisciplinary team in hospice palliative care." Thesis, University of British Columbia, 2012. http://hdl.handle.net/2429/42209.
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Having a model of interdisciplinary teamwork is an important part of clinical practice in hospice palliative care. It plays an integral role in providing patient care by multi-disciplines of healthcare professionals who are required to address the intricate needs of patients at the end of life. Yet, the nature of participating in an interdisciplinary patient care team has not been fully understood in theory or clinical work. The purpose of this research was to generate an understanding of the experience of being on an interdisciplinary team in hospice palliative care through healthcare workers’ own voices, using a content analysis method in a qualitative research paradigm. A total of 11 healthcare professionals across medical and psychosocial disciplines participated in this study. Data were collected from semi-structured interviews with these participants and were analyzed for thematic contents. The following six themes regarding the nature and quality of working as a member of an interdisciplinary team emerged; (a) collaborative work, (b) quality of relationships, (c) communication, (d) team building activities, (e) personal qualities, and (f) institutional influence. A conceptual framework is proposed as an “integrative and multidimensional” model of an interdisciplinary team approach to hospice palliative care. The proposed model offers a holistic view of an interdisciplinary team approach. Implications for clinical practice and future research are discussed. Further, suggestions are offered in order to enrich the understanding of interdisciplinary teamwork, to enhance the quality of patient care, to support and advocate the well-being of healthcare workers, and to develop accountability for hospice palliative care programs.
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Wong, Shan. "Psychological reaction of healthcare workers in the outbreak and aftermath of severe acute respiratory syndrome." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B29760239.
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Wong, Man-ying, and 黃文英. "A manual handling operations training program for healthcare workers in preventing back pain and injury." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B44626605.
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Mok, Anthony, and 莫彤. "Effectiveness of hand hygiene programs that improve compliance rate among healthcare workers: a systematic review." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48424985.
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Introduction:
Hand hygiene, the most effective and economical way to prevent the transmission of many bacteria and viruses in healthcare settings, yet, its compliance rate remained unacceptably poor in many countries. Compliance with hand hygiene among healthcare workers increased substantially during outbreak of serious acute respiratory symptoms (SARS) in 2003 but decreased to the baseline after SARS, to improve compliance rate sustainable, many hand hygiene intervention programs have been established since 2003. However, the effectiveness of these programs were in big variations. The objectives of this review were to identify the effectiveness of these hand hygiene intervention programs.
Methods:
This review was conducted using the search engines – PubMed. The key words “hand hygiene”, “hand-washing”, “compliance”, “healthcare personnel”, and “program*” were used for searching literature published from 2003 to July 2012.. Forty-Seven articles were initially obtained. After screening and reviewing of these articles,9 articles met the requirements for inclusion and exclusion criteria were included in this review. The outcome measure was set as the differences and relative ratios in the observed hand hygiene compliance rate before and after intervention.
Results:
Results showed that 8 hand hygiene programs were effective while 1 programme was ineffective in improving hand hygiene compliance rates. Of the eight studies that reported improvement in compliance with hand hygiene, improvement in compliance rate after the interventions was ranged from (24% to 50%) while the relative ratio of compliance (after vs. before intervention) was ranged from 1.78 to 4. The study that reported no improvement in compliance with hand hygiene had a relative high naseline hand hygiene compliance rate of 61%
Conclusion:
Hand hygiene programs that improve compliance rate among healthcare workers were effective overall. The effectiveness of hand hygiene programs seemed to be positively associated with the numbers of intervention types involved. Research on non-compliance and intrapersonal behavior on hand hygiene was suggested for future investigation.published_or_final_version
Public Health
Master
Master of Public Health
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Alshammari, Modhi Ali S. "Infection of Healthcare Workers: Identifying Potential Transmission Pathways of MERS-CoV in Saudi Arabia Hospitals." Thesis, The University of Arizona, 2016. http://hdl.handle.net/10150/613560.
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An outbreak of Middle East Respiratory Syndrome (MERS) among healthcare workers in Saudi Arabia in 2012 led to an investigation of hand-hygiene behaviors among healthcare professionals. Direct contact with patients is a major pathway for MERS, a droplet virus, which refers to a virus that lays on surfaces. This study investigated factors associated with respiratory disease transmission (e.g., MERS) in hospital settings among healthcare workers (i.e., physicians and nurses). I developed a 16-item checklist based on three sources: the CDC standards, the WHO Five Moments for Hand Hygiene, and Boyce and Pittet's (2002) guidelines of hand hygiene. I used those 16 items in both direct-observation and self-reported questionnaire formats. The checklist addressed three time frames of contact: before, during, and after contact with patients, devices, and surrounding surfaces. Hand-hygiene behaviors surrounding these time frames were assessed. The study also explored healthcare workers' beliefs about hygiene practices by comparing personal reports of hand hygiene assessed by questionnaire to observed actual hand-hygiene practices. The study was a cross-sectional research design and was conducted in the outpatient examination rooms and emergency departments of three hospitals (public, private, and military) in the Eastern region of Saudi Arabia. The total sample size included 87 physicians and nurses who were recruited while on duty during the researcher's observation periods. To provide clear results, I used two independent sample t-tests to test each of the 8 hypotheses. I found that no statistically significant differences were found among health-care workers when observing their behaviors of hand-hygiene practices. However, when using the self-reported questionnaire data, I found statistically significant differences between physicians' and nurses' hand-hygiene practices before, during, and after interacting with patients. Also, I found statistically significant differences between male and female hand-hygiene practices during interacting with patients, and I found statistically significant differences between health-care workers in public and military hospitals hand-hygiene practices during interacting with patients. For the primary hypothesis, I used Pearson correlation to determine the relationship between healthcare workers' reports of hand-hygiene practices, and observed healthcare workers behaviors of hand-hygiene practices. I found that no statistically significant correlation between the two data collection instruments. To provide a further analysis, a multivariate analysis of covariance (MANCOVA) was used to examine whether healthcare workers' hand-hygiene practices before, during, and after were different while controlling for their gender, department, and hospital type. I found that no statistically significant differences were found when observing the healthcare workers behaviors of hand-hygiene practices. However, when using the self-reported questionnaire data, I found that nurses and females reported better hand-hygiene than physicians and males. From these data, I conclude healthcare workers understand the importance of hand-hygiene and fail to appropriately implement the practice.
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Eberhardt, Darlene Michele. "Antibacterial and Laundering Properties of Ams and Phmb as Finishing Agents for Healthcare Workers Uniforms." Diss., Virginia Tech, 2004. http://hdl.handle.net/10919/27403.
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The safety of healthcare workers (HCW) has become a serious concern; therefore, a need for protection against bacterial penetration and transmission is realized. The purpose of this research is to examine whether antibacterial finishes can effectively reduce the presence of bacteria that have the potential for penetration and transmission on healthcare workers uniforms (HCWU). The specific objective of this research is to compare the antibacterial properties (i.e., bacterial reduction), two descriptive properties (i.e., fabric weight, fabric thickness), and one durability property (i.e., breaking strength loss due to abrasion) of a 65/35% polyester/cotton blend fabric treated with two commercially available antibacterial agents (i.e., 3-trimethoxysilylpropyldimethyloctadecyl ammonium chloride) or AEGIS Microbeshield, (AMS) and polyhexamethylene biguanide (PHMB) or Reputexâ · before laundering and after 5, 10, and 25 laundering cycles. The independent variables were the treatments (i.e., AMS, PHMB, no treatment) and the laundering cycles (i.e., 0, 5, 10, 25). The dependent variables were the four fabric properties: (a) antibacterial properties against Staphylococcus aureus (S. aureus) and Klebsiella pneumoniae (K. pneumoniae) bacteria, (b) fabric weight, (c) fabric thickness, and (d) breaking strength loss due to abrasion. Multiple Analysis of Variance (MANOVA) and Two-way Analysis of Variance (ANOVA) were used to examine the effects of the independent variables and their interaction on each dependent variable.
The results showed PHMB treated specimens had a significantly higher log reduction against both S. aureus and K. pneumoniae before laundering and after 5, 10 and 25 laundering cycles than AMS treated specimens and the no treatment specimens. Initially, AMS had some reduction against S. aureus and K. pneumoniae before laundering; however after laundering, the reductions against both bacteria were diminished greatly. As expected, the no treatment specimen had no reduction against S. aureus or K. pneumoniae before and after laundering. The addition of PHMB and AMS increased the fabric weight of 65/35% polyester/cotton fabric and kept the fabric thickness throughout 25 laundering cycles. The untreated specimens became thicker after 25 laundering cycles. In addition, the breaking strength loss due to abrasion indicated that treatments had no effect on fabric strength.
In conclusion, adding antibacterial agents do have some influence on bacterial reduction for both Gram-positive and Gram-negative bacteria as well as descriptive properties (i.e., fabric weight, fabric thickness). However, there was no influence on durability property (i.e., breaking strength loss due to abrasion). More studies are needed to test both agents on other types of fabrics such 100% cotton and nonwoven to incorporate more treated HCWU in the marketplace.Ph. D.
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Moreno, Touhtouh Sonia. "Interventions from an occupational therapy perspective for musculoskeletal disorders among healthcare workers: A systematic review." Thesis, Jönköping University, HHJ, Avd. för rehabilitering, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-51362.
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BACKGROUND: Work-related musculoskeletal disorders (WMSD) are the leading cause of work disability. Healthcare workers (HCW) have a particularly high risk of developing these disorders. OBJECTIVE: To review the current knowledge, from an occupational therapy (OT) perspective, on interventions for upper body WMSD among HCW in close contact with clients through manual handling. METHODS: This systematic review attempted to gather experimental and observational studies published between 2008 and 2019, that discussed interventions within OT practice to prevent or treat WMSD of the upper body among HCW. The searches were conducted on CINAHL, Cochrane Library, PsycINFO, PubMed, OTSeeker, AMED and Emerald. RESULTS: Nine articles were included in the final analysis. Overall, the methodological quality of the articles was moderate. The main preventive measures used were classified according to the components of the Person-Environment-Occupation-Performance model. The identified interventions were training in ergonomics and safe patient-handling, the use of assistive devices and equipment, physical exercise, and workplace modifications. CONCLUSIONS: Findings suggest that these interventions are effective in the prevention and treatment of upper body WMSD in HCW. Furthermore, these interventions appear to be more beneficial when combined together. Researchers could also investigate the effectiveness of interventions targeting psychological factors in the prevention of WMSD.
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Prematunge, Chatura. "An Analysis of Healthcare Worker Attitudes & Barriers to Influenza Vaccination." Thèse, Université d'Ottawa / University of Ottawa, 2013. http://hdl.handle.net/10393/24111.
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Influenza is a major concern across healthcare environments. Annual vaccination of healthcare workers (HCWs) remains essential for maintaining the health and availability of HCWs, as well as influenza prevention in healthcare environments. Yet, annual vaccination coverage among HCWs continues to be below recommended standards during pandemic (pH1N1) and non-pandemic (sINFLU) influenza seasons. The primary aim of this research is to inform the design and implementation of effective HCW targeted influenza vaccination campaigns via a 1) systematic review of the existing literature on HCW pH1N1 vaccination, 2) qualitative content analysis of motivators and barriers to HCW pH1N1 and sINFLU vaccination, as well as 3) quantitative regression analysis of modifiable factors predicting pH1N1 and sINFLU vaccination. The qualitative and quantitative analysis processes were applied to data collected from a large-scale multi-professional sample of HCWs.
Findings from all analysis sections were found to be consistent. Most attitudes, beliefs, motivators, and barriers influencing HCW influenza vaccination were similar for pH1N1 and sINFLU vaccinations. Yet, a number of notable differences were also identified. HCWs were likely to accept vaccination if they perceived, 1) vaccination to be safe, 2) vaccination to be protective against influenza for self, loved ones, patients or communities, and 3) influenza to be a serious and severe infection to self and others. Additionally, encouragement from supervisors and colleagues, physicians, and loves ones also enhanced vaccine uptake. Most HCWs avoided vaccination because of 1) limited knowledge or misinformation about vaccination, 2) concern for vaccine induced side-effects and 3) assuming vaccination was not a requirement for healthy adults. With respect to pH1N1 vaccination, mass media communications, perceptions of novel vaccinations, and rapid vaccine development processes especially deterred HCW pH1N1 vaccination.
Future vaccination programs targeting HCWs should look towards influencing HCWs’ vaccination attitudes and promoting pro-vaccination cultures in healthcare workplaces.
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Preshaw, Deborah Hazel Louise. "Ethical issues experienced by healthcare workers providing palliative care in nursing homes : a mixed methods study." Thesis, Queen's University Belfast, 2017. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.728393.
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Background: Ethical issues experienced by healthcare providers can be associated with detrimental outcomes, however, little is known about the nature of these issues within palliative care provision in nursing homes. Aim: To provide a comprehensive understanding of care providers’ experiences of ethical issues during palliative care provision in nursing homes in the United Kingdom. Methods: A two phase, exploratory, sequential, mixed methods design was utilised. Semi-structured interviews with 13 Registered Nurses and ten Healthcare Assistants were used to explore ethical issues during palliative care provision. An instrument was developed measuring the frequency and level of distress associated with these ethical issues and utilised in a cross-sectional survey with 69 RNs and 129 HCAs. Results: Three themes grouped experiences of ethical issues. Issues in practice were found when conflicts arose between what felt right and the duty of care. Within this theme, making decisions in the residents’ best interests to prevent them from coming to harm (Mean = 2.68; SD= 1.24) was most frequently reported. Relational issues focused on conflicts within interpersonal relationships. Caring for residents who were only accepting small amounts or refusing food/fluids (Mean = 2.71; SD= 1.19) occurred most frequently. Organisational issues resulted from the structure and quality of services. Poor staff communication (Mean = 2.48; SD= 1.39); and lack of time (Mean = 2.36; SD= 1.44) resulted in the highest distress scores. No significant differences were identified between RNs and HCAs in the frequency (t= -.85, d.f. =196, p=.40), or level of distress (t= -.24, d.f. =176, p=.81) associated with ethical issues. Conclusions: Ethical issues within the UK nursing homes focus on acting within the duty of care, interpersonal relationships, and coping with a routinized organisational structure. Improved communication between healthcare professionals, residents, and families, and palliative care training may improve the palliative care experience.
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Johnston, Suzanne. "The effect of antimicrobial impregnated fabrics on the contamination of healthcare workers uniforms in clinical environments." Thesis, University of Ulster, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.560809.
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Healthcare workers (HCWs) uniforms are subject to increasing debate regarding the levels of bacterial contamination and the clinical significance of any pathogenic contaminants. Some information is available within the literature, however much of this is dated, and there stilI lacks a standard, reproducible sampling method for use on HCWs uniforms that could be easily implemented worldwide. During this study there was recovery of S. aureus, MRSA, and Enterococcus spp. in communal staff changing rooms, clearly demonstrating that such non-patient areas present sources for the transmission of pathogenic bacteria between wards within the hospital. It was established that current international standard methods of determining antimicrobial activity in fabrics may not provide accurate indications of the efficacy of such products under ward conditions, or dealing effectively with "wild type" agents of hospital acquired infections. These findings suggest that further work is necessary in the development and use of such fabrics. Furthermore, contact plates were optimised as a method for the sampling of used nurses scrub suits and assessing the 'in-use' effect of antimicrobial impregnated fabrics. The main finding of this project was that scrub suits frequently became (and remained) heavily contaminated with pathogenic bacteria during ward use. MRSA was recovered from 40 % of standard nurses scrub suits, and 38% of antimicrobial impregnated (Permagard) scrub suits. Thus, the incorporation of Permagard fabric had no observable effect on the incidence of contamination on scrub suits under ward conditions. MRSA was enumerated at 1.65 cfus per 25 cm2 suggesting counts of around 100-200 cfus per 25 cm''.
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Yeung, Suk-ching Stephenie, and 楊淑貞. "The effectiveness of educational programs to improve the knowledge andcompliance of healthcare workers towards standard precautions." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2007. http://hub.hku.hk/bib/B45012180.
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Vingård, Frank Linda. "How healthcare workers experience violence against women and how it influences the care : A qualitative study." Thesis, Högskolan i Borås, Institutionen för Vårdvetenskap, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-20028.
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Violence against women (VAW) is a global problem existing in all cultures. This study is performed because there is a lack of knowledge about how healthcare personnel treat VAW to promote health and to alleviate suffering. The aim is to describe how healthcare workers experience violence against women and how it influences the care. Qualitative semi structured individual interviews were made with three nurses and one medical student in Egypt. The interviews were taped and transcribed before the text was analyzed by qualitative content analysis. The result showed that women were subordinated and discriminated in Egypt and in the healthcare. The care for the abused women was focused on first aid, and the respondents expressed that it was the woman’s own decision and responsibility to report or do any further actions. Often the violence was ignored or silenced. Violence and threats was accepted by the society and individuals as a mean for handling conflicts and was used in the healthcare settings as well. The respondents expressed a need for change and a wish for decreasing the violence, work for equality and stressed the importance of education in society. They also emphasised the need for women to gain more economic independence. Attitudes of healthcare workers need to be addressed and further investigation is necessary to prevent VAW.Program: Sjuksköterskeutbildning
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Mullaney, Robert Jason. "A STUDY ON THE PERCEPTIONS OF HEALTHCARE WORKERS DURING PERIODS OF ABSENTEEISM IN THE CLINICAL SETTING." NSUWorks, 2009. http://nsuworks.nova.edu/hsbe_etd/81.
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A qualitative transcendental phenomenological methodology was used to identify the essence of healthcare workers' perceptions at the workplace. In-depth interviews were conducted on 25 physical therapists and physical therapist assistants consisting of over 214 years of clinical experience representing 11 clinical sites in the South Florida area. The perceptions towards their coworkers and managers during times of change were explored from a variety of angles and yielded an insightful essence of the work they do on a day to day basis as front-line medical professionals.
There were eight major concerns identified as influential factors that impact job performance, coworker and manager relationships, and patient care in this segment of the healthcare system. Based on the essence derived from the therapists' and assistants' experiences, 14 functional propositions were posited and lay the foundation for future research. Managerial recommendations along with the Healthcare Workers Systematic Daily Flow Model were offered to guide in the development of the recommended initiatives.
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Gibson, Smith Kathrine Lesley. "Promoting and implementing self care : a mixed methods study of offshore workers and remote healthcare practitioners." Thesis, Robert Gordon University, 2016. http://hdl.handle.net/10059/2127.
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The oil and gas industry is a vital contributor to the global economy and a key source of employment within oil-producing countries. Oil production is largely dependent on a skilled population who are adept in coping with the demands of an offshore environment. Due to the high risk nature of work offshore, it is a requisite that personnel engage in health promoting behaviours. The research aimed to identify aspects of offshore workers self care which required behaviour change and the behavioural determinants which were associated with engagement in self care. A mixed methods design was utilised to generate novel data and original findings. Phase 1 used a quantitative cross-sectional online survey to assess offshore workers’ (n=352, 53.6% response rate) health, quality of life, mental wellbeing and self care status. The findings highlighted key areas of concern, as indicated by negative scoring across measures, relating to: overweight/obesity; medication adherence; absenteeism (with regard to travelling offshore); medical evacuation; lack of adherence to 5-a-day fruit and vegetable guidelines; physical activity; smoking; hazardous alcohol use, and insomnia. Phase 2 used qualitative theory-based telephone interviews to explore self care behaviours from the perspective of offshore workers (n=16). Offshore workers who had completed a survey and indicated they would like to receive further information on the interviews were invited to participate. Both the interview schedule and data analysis were informed by the Theoretical Domains Framework (TDF). Healthy eating and physical activity were the behaviours most frequently discussed by offshore workers and identified as areas requiring behaviour change. TDF domains representing both behaviours included: beliefs about capabilities; beliefs about consequences; intentions; goals; memory, attention and decision processes; environmental context and resources; social influences; emotion, and behavioural regulation. Phase 3 used qualitative theory-based telephone interviews to explore offshore workers’ (n=13) self care behaviours from the perspective of remote healthcare practitioners. Both the interview schedule and data analysis were informed by TDF. Healthy eating and harmful/hazardous alcohol use were the behaviours most frequently discussed by remote healthcare practitioners and identified as areas requiring behaviour change. TDF domains representing both behaviours included: knowledge; environmental context and resources; social influences; emotion, and behavioural regulation. The findings, when triangulated suggest that offshore workers may benefit from the implementation of a self care intervention which targets healthy eating, physical activity and alcohol consumption. It is advised that the intervention target multiple self care behaviours and that development is underpinned by behaviour change theory to ensure effectiveness. The intervention may be tailored in accordance with the TDF domains identified in this research as determinants of healthy eating, physical activity and alcohol use behaviours.
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Kemp, McKinsey. "Social Work Services: How can Social Workers Improve the Healthcare Experience for People who are Homeless?" CSUSB ScholarWorks, 2018. https://scholarworks.lib.csusb.edu/etd/639.
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This research project focuses on how social workers can improve the healthcare experience for people who are homeless. The twelve participants in this study were recruited from a homeless shelter located in Southern California. Data was collected for this study using qualitative methods by means of interviews. Interviews were conducted in person, audio recorded, and then transcribed for data analysis. Findings from this study indicated that the concepts of time, perception of needs being met, service connection, staff interaction, social work intervention, and potential social work intervention were all connected to whether participants viewed their healthcare visit as a negative experience or a positive experience. In addition, findings from this study revealed a low percentage of reported social work encounters at healthcare facilities among study participants. Results from this study have implications for social work practice in regards to location of social work intervention at healthcare facilities and extension of social work roles in healthcare settings.
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Lindblad, Amanda, and Emma Nordström. "”Tvätta händerna” : Hinder för en god handhygien." Thesis, Högskolan Väst, Avdelningen för omvårdnad - grundnivå, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:hv:diva-14082.
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Low hand hygiene compliance among health staff is a problem globally in health care settings. Improving hand hygiene could prevent many of the health care associated infections that affects hundreds of millions of patients every year around the globe. The aim of this literature study was to describe obstacles to maintain proper hand hygiene in hospitals, seen from a global perspective. Eight articles from seven countries, all based on qualitative research have been analysed according to Friberg's five-step method that contributes to evidence-based nursing. The challenges to sustain hand hygiene found in the results were split into two main categories: Organizational factors and Individual factors. Organizational factors included five subcategories: Work environment, Inadequate education, Infrastructure, Insufficient management and Power structures. The results showed that when these factors were negatively affected so was compliance regarding proper hand hygiene. These were often issuesthat the health staff felt powerless to change and affect. Individual factors included two subcategories: Attitudes and social factors. Example of this could be healthcare workers neglected hygiene guidelines out of personal reasons or healthcare workers giving care to patients that didn’t accept how it was carried out because of social and cultural differences. The complex issues revolving these matters need to be addressed on an overall perspective. Cooperation between management and health staff is fundamental to obtain changes within healthcare organizations. Both parties need to work together to be able to improve hand hygiene compliance and to reduce healthcare associated infections.
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ogbonna, ifeoma Dr, and Muktar Dr Aliyu. "Assessing the Knowledge of Tuberculosis (TB) among Healthcare Workers and Ancillary Staff in an Underserved Medical Institution." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/asrf/2018/schedule/10.
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Healthcare and ancillary workers in hospital settings are at an increased risk of Tuberculosis (TB) due to the nature of their job and exposure to persons with TB. Knowledge of healthcare workers (HCWs), (physicians, residents, nurses, midlevels etc.) who provide direct care and ancillary staff (technicians, aides, administrators, etc.) who provide indirect care in medical institutions play an important role in the diagnosis, treatment, control, and prevention of TB. Research has shown a variation in knowledge based on TB prevalence, facility type, available resources, provider training and clinical experience, education level of staff, etc. The purpose of this study is to assess the knowledge of TB among HCWs and ancillary staff in an underserved medical institution who provide care to low-income populations in the United States. This is a cross sectional observational study. A validated questionnaire that assesses TB knowledge will be used. Participants from a historically black college in Tennessee will be recruited in the study. Participants will include HCWs such as attending physicians and residents from all residency programs as well as nurses, midlevels, etc. within the institution. We will also recruit ancillary staff in the same departments. The survey will be distributed between Jan. 2018-Feb. 2018, and will contain 10 questions. Information on demographics, work history (age, sex, education, job category, duration of employment, training level) and TB knowledge (general information on TB) will be captured. The survey will be distributed via email through RedCap, a secure web application for creating and managing online surveys. Emails of participants will be obtained through the institution’s employee and student directory. A minimum of 200 participants will be surveyed, to obtain a power of 80% and CI of 95%. Survey will be entered into the REDCap electronic research database and entered data from participants will be checked for completeness and accuracy. Knowledge will be assessed as: poor (75%-85% correct); and outstanding (>85% correct). We will compare differences in TB knowledge of HCWs and ancillary staff and between practicing physicians and physicians in training. Data analysis will be performed using R software. The expected results are that healthcare workers have higher knowledge level than ancillary workers and that practicing physicians have higher knowledge level than physicians in training due to years of clinical experience and education. As TB continues to be one of the leading causes of death worldwide, it is important that HCWs exhibit a good level of knowledge. The findings from this study will generate data to guide TB education efforts for providers and healthcare facility ancillary staff. Results will help to clarify misconceptions about TB transmission and enhance the quality of care for patients with TB and reduce the risk of nosocomial transmission of TB.
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Yeung, Suk-ching Stephenie. "The effectiveness of educational programs to improve the knowledge and compliance of healthcare workers towards standard precautions /." View the Table of Contents & Abstract, 2007. http://sunzi.lib.hku.hk/hkuto/record/B38297279.
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