Dissertations / Theses on the topic 'Hospitals Staff Health and hygiene'
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Al-Mohaithef, Mohammed. "Food hygiene in hospitals : evaluating food safety knowledge, attitudes and practices of foodservice staff and prerequisite programs in Riyadh's hospitals, Saudi Arabia." Thesis, University of Birmingham, 2014. http://etheses.bham.ac.uk//id/eprint/5194/.
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In global terms, Saudi Arabia is a rapidly developing country. As such, its food industries have yet to fully implement the food safety management systems common in the EU. In the hospitals sector, the Ministry of Health intends to implement Hazard Analysis Critical Control Points (HACCP) system to provide safe meals for patients, staff and hospital visitors. The aim of this study was to evaluate the readiness of the Saudi Arabian hospitals to implement HACCP by assessing the pre-requisites programmes in their foodservices departments. An audit form was used in four hospitals in Riyadh. Questionnaires were also used to assess self-reported behaviour, knowledge and attitudes of 300 foodservices staff. Lack of training was known to be a major omission in the pre-requisite programs (PRP’s) of all hospitals. Therefore a bespoke food safety training program was developed and delivered to food handlers in the participating hospitals. An assessment was then made to determine whether this intervention had any effect on their knowledge, attitude to food safety and self-reported behaviour. The results show that, the prerequisite programs were not implemented properly in the participating hospitals. Also, foodservices staff had a poor knowledge with regard to food safety. However, staff knowledge was significantly improved following the training (p. value < 0.05) and their level of knowledge remained stable after six months. Participants’ behaviours and attitudes also improved after the training. This indicates that, training has a positive impact on food handlers knowledge, practices and attitude.
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Harris, John. "Unravelling the epidemiology of norovirus outbreaks in hospitals." Thesis, University of Liverpool, 2014. http://livrepository.liverpool.ac.uk/17973/.
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Norovirus is the commonest cause of outbreaks of gastrointestinal disease in the U.K. Most reported outbreaks occur in health care settings, such as hospitals and nursing homes, and can cause severe disruption through ward closures, cancelled operations and staff sickness. Previous studies estimated these outbreaks cost the NHS around £115 million a year. Despite previous studies some questions remain. What is the burden of norovirus in hospitals - how many outbreaks occur and how many people are hospitalised each year as a result of norovirus infection? Do published reports of outbreaks provide evidence of what works in infection control? Can the factors facilitating norovirus transmission during outbreaks in hospitals be identified? These questions were answered through a series of inter-linked studies that explored mortality, morbidity, transmission pathways and aspects of infection control. The introduction of a new surveillance system provided greater insights into the heavy burden that norovirus imposes on English hospitals. In the years 2009-2011, 3,980 reports of outbreaks of suspected and confirmed norovirus were received. There was little difference in the epidemiology of outbreaks from one season to the next. On average outbreaks were associated with 13,000 patients and 3,400 staff becoming ill, 8,900 days of ward closure and the loss of over 15,500 bed-days annually. Analysis of mortality data demonstrated a clear association between norovirus infection and mortality in the elderly (65 years and over) with an estimated 80 deaths per year in this age group. The number of deaths increased in years where norovirus activity was higher but this was not associated with increased pathogenicity of the virus. Norovirus was the only pathogen that had a significant association with mortality in the regression models. Modeling of routine hospital admission data demonstrates that norovirus accounted for around 3,000 norovirus admissions a year to English hospitals, two thirds of which were in the elderly. A review of published papers did not provide clear evidence for the effectiveness of infection control measures. However, this was largely because the reporting of outbreaks was poor and that the introduction of more rigorous reporting protocols would improve this. Analysis of 3,500 outbreaks of norovirus demonstrated that closing a ward or bay promptly (within three days of the first person becoming ill) is beneficial. The duration of outbreak, the total duration of disruption were shorter, and fewer patients overall were affected, if closure occurred promptly. When closure occurred 7 or more days after the first onset date outbreaks were twice as long as those where closure was prompt. The duration of outbreak was also increased by ward size and in outbreaks occurring in winter time. Outbreaks were longer if they occurred on care of the elderly wards. A strategy of prompt closure is beneficial, particularly in larger wards and during winter time. The time between the first two cases of each outbreak was used to estimate the serial interval for norovirus in a hospital setting and was estimated to be 1.86 days. This distribution and dates of illness onset were used to calculate epidemic trees for each outbreak. A permutation test found strong evidence that proximity was a significant driver of outbreaks (p < 0.001). Patients occupying the same bay as patients with symptomatic norovirus infection are at increased risk of becoming infected by these patients compared with patients elsewhere in the same ward. In summary, there is a demonstrable association with mortality in older people, and around 3,000 admissions to hospital each year. Over 3,900 outbreaks were reported in three years (2009-2011). On average 13,000 patients were affected each year leading to 8,900 days of ward closures. Vomiting appears to be an important driver of outbreaks. Acting quickly by closing affected areas appears to be beneficial in controlling outbreaks caused by norovirus. This is especially the case in larger wards during the winter.
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Guzman, Castillo M. "Modelling patient length of stay in public hospitals in Mexico." Thesis, University of Southampton, 2012. https://eprints.soton.ac.uk/345554/.
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This thesis is concerned with the modelling of patient length of stay in public hospitals in Mexico. Patient length of stay is the most commonly worldwide employed outcome measure for hospital resource consumption and performance monitoring. Most of the hospitals around the world use average length of stay as starting point for resource planning. However average estimates frequently gives non-accurate results due to the high variability of the length of stay data. The reason for such high variability may be attributable to the diversity in the patient population and the environment where the patient is treated. Through a systematic review of the literature on methods and models in the field of calculating and predicting patient length of stay, this research highlights the areas of opportunity and research gap from previous studies and practices, and proposes the use of finite mixture models to approximate the distribution of length of stay. Also, these models are proposed as the foundation of more sophisticated models designed to include the internal and external factors associated with LoS. In this context, the thesis proposes three different approaches to explore such factors: individual-based approach, group-based approach and multilevel group-based approach. These interrelated approaches allow a better understanding of the diversity in the patient population and enable length of stay predictions for individual patients, and for cohorts of patients within and between hospitals. In addition, this research is built and evaluated using data from all types of patients treated at two public hospitals operating in Mexico. It is the consideration of the full case-mix of these healthcare facilities that gives this research its unique nature.
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Johnson, Kimberly Lynn. "The Structure and Implementation of Respiratory Therapy Orientation for Clinical Staff in Acute Care Hospitals." The Ohio State University, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=osu1316123707.
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Cole, Mark. "Social construction of hand hygiene as a simple measure to prevent health care associated infection." Thesis, University of Nottingham, 2014. http://eprints.nottingham.ac.uk/14426/.
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The incidence of Heath Care Associated Infection is a major patient safety concern in the United Kingdom and reducing the morbidity and mortality associated with this has become a National Health Service priority. It is generally accepted that this objective will require a multi-factorial approach where infection prevention and control is seen as everybody’s business. However, some strategies receive greater exposure than others and hand hygiene is widely touted as a common sense solution to a complex problem. This discourse based study combined the techniques of Corpus Linguistics with Critical Discourse Analysis to explore the Textual, Discursive and Sociocultural features of hand hygiene discourse. This took place across three language domains, the Academy, the Newspaper Media and Organisational Policy Makers. These three cultural elites take a consistent account of the problem and the solution. Broadly hand hygiene is portrayed as effective, compliance is basic, performance is poor and Health Care Workers should be held to account through zero tolerance policies and if necessary disciplinary action. However, not only does this background the messy, contextual factors of implementing a hand hygiene policy it imposes a one size fits all approach and measurement programme on compliance that hides the true nature of performance and this ultimately impacts on patient care. This study calls for junior clinicians for whom policy has the greatest impact to become more engaged in the policy making process. In a spirit of openness trusts should adopt linguistic devices that recognise the dynamic nature of practice and a more educational, sophisticated approach to audit.
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Kerrigan, Anita Cimino. "The relationship of hardiness and health behavior practices among university faculty and staff." Virtual Press, 1990. http://liblink.bsu.edu/uhtbin/catkey/722457.
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The purpose of this correlational study was to investigate the relationship of-hardiness, a personality characteristic composed of the elements control, challenge, and commitment, to health behavior practices among a midwestern university faculty and staff. The hypothesis of the study was there is a negative correlation between scores on the Health Related Hardiness Scale (HRHS) and the HealthPromoting Lifestyle Profile (HPLP) among university faculty and staff. Prior to conducting the study, approval of the university internal review board was obtained. Using a random numbers table and the university faculty and staff phone directory, a random sample of 100 participants was obtained. The participants were sent the Health Related Hardiness Scale (HRHS) to measure hardiness, the HealthPromoting Lifestyle Profile (HPLP) to measure health behaviors, a demographic questionnaire, and an addressed return envelope. Confidentiality of the participants was assured. Returned questionnaires implied consent to participate. The completed forms were returned to the researcher by campus mail in the envelope provided. Seventy-three questionnaires were returned; 50 could be used for analysis. The Pearson's r was used to analyze the data and tested at the 0.05 level of significance. Results revealed r = - 0.5473 with.R<0.001. The hypothesis of the study was supported. Post hoc analysis using the Pearson's r revealed negative correlations with varying degrees of significance between the three subscales of the HRHS and the six subscales of the HPLP. The information obtained from the study is valuable to nursing in planning educational and supportive strategies for a variety of clients in various settings.School of Nursing
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Hanyinda, Kelvin. "The availability and adequacy of water, sanitation and hygiene (wash) infrastructure in 13 mission hospitals in rural Zambia." University of the Western Cape, 2019. http://hdl.handle.net/11394/6939.
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Magister Public Health - MPHBackground and Rationale The World Health Organization (WHO) has shown that the provision of Water Sanitation and Hygiene (WASH) in Health Care Facilities (HCFs) of many low and middle-income countries is poor. This is compounded by the lack of national plans and consolidated data on WASH in HCFs. This study assessed the availability and adequacy of Water Sanitation and Hygiene (WASH) infrastructure in 13 mission hospitals spanning 13 districts in Zambia. The objectives of this study were to identify the different kinds of WASH infrastructure available, and their adequacy, and factors influencing the status of WASH infrastructure and services in the selected hospitals. Methodology This study had a mixed methods design with semi-quantitative, descriptive and qualitative components. Assessments were conducted of the WASH infrastructure on the hospital property, and specifically in the male medical wards and outpatient facilities as two tracer areas, using a WHO checklist adapted and administered by the researcher. Checklist items were assigned scores (0=absent/bad to 2=on target/good) and total WASH scores for each facility compiled. For the qualitative component, individual semi-structured interviews using an interview guide were conducted, also by the researcher, with the facility managers and the head staff of the male medical wards. Results Overall coverage with an improved water source was reasonably good with 11 of the 13 hospitals reporting availability of improved water sources within the facilities. Hand washing basin coverage was similarly good. In contrast, coverage by well-functioning toilets was not as high, with 5 hospitals reporting toilets that were either broken, blocked, or having no running water and no toilet paper. Facility WASH scores varied from 22 (38%) to 57 (97%) out of a possible total of 58 points. Most of the Facility Managers indicated that the hospital WASH infrastructure was old, and with frequent breakdowns. This was worsened by lack of readily available spares and materials for repairing once there was a fault. Conclusion This study reveals an uneven coverage of WASH across facilities and elements, with poor sanitation a challenge across facilities. This is compounded by ongoing challenges in WASH infrastructure maintenance. Moving forward, there is need for government to develop a clear policy on WASH in HCFs. A national plan with resources and a monitoring framework need to be in place for streamlined support and tracking of progress by all stakeholders.
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Ilkiw-Lavalle, Olga. "Enhancing mental health staff confidence and skills in response to aggression and violence a longitudinal study of aggression minimisation training /." Access electronically, 2006. http://www.library.uow.edu.au/adt-NWU/public/adt-NWU20060712.143008/index.html.
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Fender, Hannah Elizabeth. "Exploring the Knowledge and Perceptions of Elementary and Middle School Staff with Regard to the Utilization of a Dental Hygienist in a School Setting." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/honors/489.
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Background: Dental hygienists can be utilized to provide care to adolescents and young adults in a school-based setting. These dental health care professionals work to improve upon public oral health through educational practices, preventative methods, and referrals. The purpose of this study was to explore the knowledge and perceptions of elementary and middle school staff with regard to the utilization of a dental hygienist in a school setting. Methods: The international review board at approved the following study. A total of eight faculty and staff members from Unicoi County Elementary School and Unicoi County Middle School completed a 14-question survey. Participants included each school’s principal, nurse, physical education/wellness teacher and science teacher or K-6. All surveys were distributed by hand to each school. Results: All eight participants saw a need for their students and would be in support of having a hygienist assigned to their school. Questions in the survey revealed that the facility believed a hygienist would be beneficial, but a full-time nurse was the major care provider in their institution. The schools that had interactions with a dental hygienist could not give the correct answer for how frequently they were coming, what services they were providing, and who was sending the dental hygienists. Discussion: The Northeast Regional Health Office supply dental hygienist for student dental health centered care and application of preventative services. However, there are only three hygienists working with the Northeast Regional Health Office to provide care for seven counties in this region.
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Anthony, Mary Kathleen. "The relationship between decentralization and expertise to participation in decision-making among staff nurses working in acute care hospitals." Case Western Reserve University School of Graduate Studies / OhioLINK, 1995. http://rave.ohiolink.edu/etdc/view?acc_num=case1062525361.
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Hammers, Garfield Compton. "Transformation of service delivery in the Westcoast winelands region's hospitals: challenges and prospects." Thesis, University of the Western Cape, 2003. http://etd.uwc.ac.za/index.php?module=etd&.
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Mrara, Msibulele Theophilus. "An investigation of turnover and retention factors of health professional staff within the Eastern Cape Department of Health." Thesis, Rhodes University, 2010. http://hdl.handle.net/10962/d1003875.
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Health Professionals are critical in the provision of health services, more especially when it comes to nurses who are next to the patient most of the time. It is critically important for the Eastern Cape Department of Health to ensure that skilled health professionals such as doctors, pharmacists, nurses and the like are retained and the staff turnover regarding this category of staff is appropriately managed. The difficulty to attract and retain health professionals is negatively affecting service delivery in the Eastern Cape department of Health and leaves the department with an unacceptably high vacancy rate. This often put more of a burden on to the health professionals who remain within the organization. Some of them will end up leaving the organization. There is a great shortage of health professionals in South Africa and it becomes easier for the health professionals to get employment elsewhere, particularly in the private sector which appears to have a competitive advantage as compared to the public sector. In this study, both quantitative and qualitative methods were used to gather information through the utilization of a questionnaire and interviews were conducted mainly to confirm the results obtained. The results of the study have assisted to reflect factors that could be influencing the health professionals to leave health facilities of the Eastern Cape Department of Health. The respondents were drawn from the two areas within the Health Department, and these are, Mthatha and Port Elizabeth areas. One hundred (100) questionnaires were issued to the health professionals and sixty three responded. Documents that were received from the department were helpful in determining the turnover rate. The study has revealed that the Eastern Cape Department of Health may succeed in retaining the health professionals if they can be made to feel that their job is important. It appears that health professionals would like to be given enough opportunity to perform their functions and participate in the decision making processes of the department. Some factors may be contributing to the staff turnover and these are, lack of career opportunities to develop, challenges in the workplace, conflict with the management and colleagues. It is always important for the organizations to recognize its employees by giving them space to practice their profession and create a comfortable workplace that could have an impact in influencing the employee to remain within the organization. Employee turnover can be minimized, if employees can be exposed to a healthy workplace environment that will assist if fostering happiness, and in the process, enhance their motivation. It is imperative for the Eastern Cape Department of Health to focus on the training and development of its employees in order to increase the efficiency and competitiveness. As the employees gain the necessary skills to perform their job, productivity may improve. The performance of the employees should be properly managed, and the resultant incentives and rewards must be fairly distributed. This could promote harmony in the workplace and that could help in building relationships among employees. If employees are satisfied, there is an increased chance that they will stay within the organization and it becomes difficult for other competitors to attract them. Employees must be given adequate space to participate in the decision making processes of the organization, and by doing so, their loyalty to the organization could be increased.
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Woldeselassie, Berhe Hailemariam. "Pre-eclampsia and its outcome (maternal and neonatal morbidity and mortality) in two referral hospitals (Windhoek Central and Katutura), Namibia." Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&.
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Pre-eclampsia is a multi-organ system disorder that occurs after the 20th week of gestation in pregnancy and is characterized by hypertension and proteinuria with or with out oedema. It is a major cause of morbidity and mortality for the woman and her child. Based on surveillance data, pre-eclampsia is one of the leading causes of maternal mortality in Namibia. However, there is no depth study done in Namibia that looks at the extent of confirmed pre-eclampia and its contribution to maternal and perinatal morbidity and mortality. There is also no standard management protocol currently recommended in Namibia. The aim of this study was to evaluate the outcomes and quality of care given to pre-eclamptic patients treated in Windhoek Central and Katutura referral hospitals in Namibia within the period of January 2003 to December 2004.
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Johansson, Isabelle. "Dental- and nursing care collaborations in Sweden – A way to support nursing staff in oral hygiene care for older people." Licentiate thesis, Hälsohögskolan, Högskolan i Jönköping, HHJ. ARN-J (Aging Research Network - Jönköping), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-43631.
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Background: Oral health is an integral part of the general health and quality of life. Yet oral health among older people requiring nursing care is often poor. Despite this group’s frequent contact with health care services, they tend to lose contact with dental care. In nursing care, nursing staff are tasked to assist with oral hygiene care, but this has become more demanding as many older people retain more teeth or have advanced prosthetic constructions. Previous research in the field emphasised the need of collaboration between dental- and nursing care to support the nursing staff in this task. However, there is a lack of evidence regarding the effects of these collaborations. Aim: The overall aim of the thesis is to examine two oral health programmes used within nursing care with different design regarding support from and collaboration with dental care. Methods: Quantitative research methods was used. The data in Study I comes from an oral health assessments guide (ROAG-J) performed by nursing staff in a national health register. Oral health, assessed at two occasions from older people with nursing care, were used. Study II was a controlled intervention study performed at a nursing home. The intervention involved individual coaching of nursing staff in oral hygiene care by dental hygienist for four hours per week at the ward for a period of three months. Oral assessments of older people were performed by dental hygienists and questionnaires to nursing home staff were used. Result: In Study I, 667 individuals aged 65 years or older, receiving nursing care services and assessed using ROAG-J between November 2011 and March 2014 were included. No statistically significant difference in any of the oral health variables was found between the first and subsequent assessments. At the first assessments, less than one third of participants had oral health problems. At the first assessment, status of the tongue differed in men and women (p < .01); at the subsequent assessment, gender differences were found in voice (p < .05), mucous membranes (p < .003), tongue (p < .01), and saliva (p < .006). In Study II, 33 nursing staff and 48 residents participated at the baseline measurement and 22 and 32 respectively at the 9-month follow-up. The nursing staff changed in knowledge and attitudes related to gum disease, approximal cleaning, usage of fluoride and the likelihood that older persons would express the need for oral health support. The most frequently reported oral health problems among the residents pertained to teeth and gums. The residents relatively high level of oral health was stable during the study period. Conclusions: The participants in the oral health programmes were able to maintain an acceptable level of oral health during the study periods although health was likely to decline. The nursing staff maintained a high level of knowledge and attitudes about oral health. However, there seems to be a discrepancy regarding the prevalence of oral health problems among older people. A collaboration between dental- and nursing care providers indicates a positive influence on providing oral hygiene care.
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Duffy, Brianne Michelle. "Identification of stressors related to emergency department employment." Honors in the Major Thesis, University of Central Florida, 2003. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/315.
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This item is only available in print in the UCF Libraries. If this is your Honors Thesis, you can help us make it available online for use by researchers around the world by following the instructions on the distribution consent form at http://library.ucf.edu/Systems/DigitalInitiatives/DigitalCollections/InternetDistributionConsentAgreementForm.pdf You may also contact the project coordinator, Kerri Bottorff, at kerri.bottorff@ucf.edu for more information.Bachelors
Health and Public Affairs
Nursing
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Friedman, Olivia Ray. "Exploring Communication Between Staff and Clinicians on an Inpatient Adolescent Psychiatric Unit." Antioch University / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1612392669512216.
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Mosesman, Leonard. "The Occupationally Injured Employee: Emotional and Behavioral Outcomes from Psychosocial Stressors." Thesis, University of North Texas, 1995. https://digital.library.unt.edu/ark:/67531/metadc277759/.
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This research explores whether a firm's psychosocial stressors contribute to strains or outcomes important to the organization. The psychosocial stressors chosen for study include: role conflict and ambiguity, workload (qualitative and quantitative), participative decision making, autonomy, and security. Independent variables were the emotional strains of job satisfaction and job commitment. The independent variables for behavioral strains included injury, lost days, workers' compensation claims, and absenteeism. Three moderators: age, gender, and social support were evaluated for interaction effects. The study sampled 77 occupationally injured and 81 non-injured employees from one medium sized Army community hospital. This study uses multivariate hierarchical multiple set regression as its principal analytical method. The hierarchial procedure orders the sets into an a priori hierarchy and enters each set sequentially from the hierarchy, evaluating the increase in $\rm R\sp2.$ The results suggest that psychosocial stressors are significant variables to consider when investigating workers' emotional and behavioral strains. For example, age, participation, and satisfaction were found statistically significant in differentiating between the occupationally injured and the non-injured samples. The study also found that ambiguity, participation, and autonomy influenced emotional strains. Additionally, age and social support appear to moderate the relationship between some psychosocial factors and emotional and behavioral strains. Age moderated the relationship with only emotional strains, while social support moderated both emotional and behavioral strains. Further, social support was found to have a main effect on the emotional strains of satisfaction and commitment, but not on any behavioral ones. Age was found to have a direct effect on the behavioral strains of workers' compensation claims. Finally, although not statistically significant when entered as a set and evaluated using the statistical analysis techniques in this study, a relationship between age and workers' compensation claims and qualitative workload and absenteeism were suggested. The economic and human costs associated with occupational injury are staggering. These findings suggest that attention to psychosocial factors within control of the employer, can promote good management outcomes, improve employee quality of worklife, and contain costs.
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Snyman, J. S. "Effectiveness of the basic antenatal care package in primary health care clinics." Thesis, Nelson Mandela Metropolitan University, 2007. http://hdl.handle.net/10948/728.
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Pregnancy challenges the health care system in a unique way in that it involves at least two individuals – the woman and the fetus. The death rates of both pregnant women (maternal mortality) and newborns (perinatal mortality) are often used to indicate the quality of care the health system is providing. In terms of maternal and perinatal outcomes South Africa scores poorly compared to other upper-middle income countries (Penn-Kekana & Blaauw, 2002:14). The high stillbirth rate compared to the neonatal death rate reflects poor quality of antenatal care. Maternal and perinatal mortality is recognised as a problem and as a priority for action in the Millennium Development Goals (Thieren & Beusenberg, 2005:11). The Saving Mothers (Pattinson, 2002: 37-135) and Saving Babies (Pattinson, 2004:4-35) reports describe the causes and avoidable factors of these deaths with recommendations on how to improve care. The quality of care during the antenatal period may impact on the health of the pregnant woman and the outcome of the pregnancy, in particular on the still birth rate. In primary health care services there are many factors which may impact on and influence the quality of antenatal care. For example with the implementation of the comprehensive primary health care services package (Department of Health, 2001a:21-35) changes at clinic level resulted in a large number of primary health care professional nurses having to provide antenatal care, who previously may only have worked with one aspect of the primary health care package such as minor ailments or childcare. Because skills of midwifery or antenatal care, had not been practiced by some of these professional nurses, perhaps since completion of basic training, their level of competence has declined, and they have not been exposed to new developments in the field of midwifery. The practice of primary health care nurses is also influenced by the impact of diseases not specifically related to pregnancy like HIV/AIDS and tuberculosis. The principles of quality antenatal care are known (Chalmers et al. 2001:203) but despite the knowledge about these principles the maternal and perinatal mortality remains high. The Basic Antenatal Care quality improvement package is designed to assist clinical management and decision making in antenatal care. The implementation of the BANC package may influence the quality of antenatal care positively, which in turn may impact on the outcome of pregnancy for the mother and her baby. The aim of this study was to evaluate the effectiveness of the Basic antenatal care (BANC) package to improve the quality of antenatal care at primary health care clinics.
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Koonce, Glenn L. "The effects of a structured wellness program on physical and mental well-being of public school teachers and staff members." Diss., This resource online, 1986. http://scholar.lib.vt.edu/theses/available/etd-07282008-140001/.
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Holm, Moa, and Pernilla Larsson. "Oral Care Assistance at Geriatric Homes in the County of Västerbotten, Sweden : A Questionnaire Interview." Thesis, Umeå universitet, Institutionen för odontologi, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-142488.
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The elderly population in Sweden is growing and as a result of that, society is facing different types of challenges. Oral hygiene is important for preventing oral disease but also for the general health (GH). A goal for the Swedish dental society is that every inhabitant should have an equal right to dental-care and oral health (OH) under the same conditions. This is not only a challenge for dental staff but also for medical and healthcare personnel. Our hypothesis is that nursing staff do not possess the education needed regarding oral hygiene, especially not in relation to GH. The opinions regarding support for nursing staff differ between nursing staff and managers. This study was conducted through questionnaire interviews with managers and nursing staff at geriatric homes in three municipalities in the county of Västerbotten. Questions were asked about education and routines, performance of oral care, and OH linked to GH. Response frequencies were compared between municipalities, professions, and response options. A significant lower part (p <0.001) of nursing staff found that non-existing oral care could cause suffering in the form of general disease than in the form of oral disease. The opinion differs between managers and staff in questions about established routines (p <0.05). This study indicates that knowledge about relationships between oral and general health might be inadequate and that education is both wanted and needed among nursing staff. More extensive studies, and studies about how dental professions could support nursing staff in a better way is desirable.
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Du, Mei. "The effects of leisure time physical activity, coping strategies, job stress and job satisfaction on perceived wellness : a study with managerial staff in sport and recreation in Hong Kong." HKBU Institutional Repository, 2009. http://repository.hkbu.edu.hk/etd_ra/1010.
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Gelčienė, Donata. "Personalo organizavimo ypatumai Lietuvos bendrojo pobūdžio ligoninėse." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2010. http://vddb.laba.lt/obj/LT-eLABa-0001:E.02~2010~D_20100621_093353-11947.
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Darbo tikslas: išanalizuoti personalo organizavimo ypatumus Lietuvos bendrojo pobūdžio ligoninėse.
Tyrimo metodika: Vienmomentinė apklausa buvo vykdoma Lietuvos bendrojo pobūdžio ligoninėse nuo 2009 m. birželio 20 d. iki 2009 m. spalio 20 d. Tyrimo metu buvo apklausti asmenys atsakingi už personalo organizavimą Lietuvos bendrojo pobūdžio ligoninėse. Statistinėje analizėje buvo naudotos 58 teisingai užpildytos anketos (90,6 proc. visų išdalintų anketų).
Rezultatai: Tyrimo rezultatai atskleidė, kad bendrojo pobūdžio ligoninėse vykdomi ne visi personalo organizavimo etapai. Rečiausiai vykdomi personalo organizavimo etapai yra darbuotojų karjeros planavimas (36,8 proc.) ir reguliaraus darbuotojų vertinimo atlikimas (40,4 proc.). Tyrimo metu nustatyta, kad dažniausiai (82,5 proc.) darbuotojų kaita ligoninėse yra nedidelė – iki 5 proc. darbuotojų per metus. Absoliuti dauguma bendrojo pobūdžio ligoninių turi parengtus darbo vietų aprašymus (pareigybines nuostatas), tačiau keturiose (7,0 proc.) bendrojo pobūdžio ligoninėse yra parengti ne visų darbuotojų darbo vietų aprašymai. Lietuvos bendrojo pobūdžio ligoninėms ieškant darbuotojų dažniau pritrūksta kvalifikuotų darbuotojų nei nekvalifikuotų. 71,9 proc. ligoninių vadovų ir asmenų, atsakingų už darbuotojų organizavimą, teigė, kad yra sunku surasti naujoms darbo vietoms tinkamos kvalifikacijos gydytojus. Didžioji dalis (79,3 proc.) tiriamųjų teigė, jog norėtų pagilinti savo žinias personalo organizavimo srityje. Labiausiai norėtų... [toliau žr. visą tekstą]The aim of the work: to analyze the peculiarities of staff organization in general hospitals of Lithuania. Research methods: Cross-sectional survey was carried out in general hospitals of Lithuania from 20th June 2009 till 20th October 2009. Persons responsible for the staff organization in general hospitals of Lithuania were interviewed. The statistical analysis was performed using 58 correctly filled questionnaires (90.6 % of all distributed questionnaires). Results: The results revealed that not all stages of staff organization were implemented in general hospitals. The rarest implemented stages of staff organization are the planning of employees’ career (36.8 %) and the regular evaluation work performance (40.4 %). The study assessed that employee turnover in hospitals is low mostly (82.5 %) – up to 5 % employees during the year. The absolute majority of general hospitals have prepared job descriptions, meanwhile four (7.0 %) hospitals have had job descriptions not for all positions. General hospitals of Lithuania were lacking of skilled workers more often than unskilled workers. 71.9 % of hospital directors and persons, responsible for staff organization, stated that it is difficult to find appropriate and qualified physicians for new workplaces. The majority (79.3%) of respondents said they would like to increase their knowledge in the area of personnel organization. The most disrere topics were indentifies the analysis of workplaces, personnel training and evaluation... [to full text]
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Mnyembane, Adiel. "The experience of hospital management and employees in transforming the public health system in the Western Cape 1996-2001." Thesis, Stellenbosch : Stellenbosch University, 2002. http://hdl.handle.net/10019.1/53117.
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Thesis (MPhil)--Stellenbosch University, 2002.ENGLISH ABSTRACT: One of the main objectives of the new South African government who came into power in 1994 was to improve the daily living conditions of its citizens. To what extent did the government succeed in this objective? This is the basic research question informing the present study. In order to keep it within manageable proportions, the study investigated a very specific area of service delivery, namely the delivery of public health services. This was further narrowed down to the Western Cape and more specifically, to the role of public hospitals in the area. The Western Cape promised to be an interesting case, because although the government of national unity was dominated by the ANC, the Western Cape was ruled by a NNP dominated coalition. On the national level, the Province had to follow national policy guidelines, while on the provincial level it had more freedom to formulate and implement its own policies. The study itself consists of two parts. The first concerns policy formulation, the second policy implementation. As far as policy formulation is concerned, a study was made of basic documents articulating the fundamental values, national priorities and main objectives informing government policy. These included the Freedom Charter, the Constitution, and the Reconstruction and Development Program. It was found that these values and priorities were in general well translated into policy options on both the national and provincial level, especially in the various documents aimed at transforming the national health system. The second part of the study investigates the implementation of the broad policy guidelines in the area of public heath in selected public hospitals in the Western Cape. The main method of investigation was the use of structured interviews with representative employees from all different levels. The findings were therefore of a qualitative rather than a quantitative nature. The focal areas selected were personnel management issues, human resource planning, labour relation issues and human resource development issues. The main findings were that the formulation of policy both from basic values to the level of health care policies and from the national to provincial level in general was quite successful. On the other hand, there were serious shortcomings in the implementation of these policies on various levels. The investigation revealed a mixed and often contradictory picture. Although some hospitals made good progress in some respects, there is still a long way before quality health care will be delivered to all patients. A commitment to equity in the health services of the country implies a commitment to correcting the historical gender, class and racial imbalances in the development of human recourses for health care. Of necessity, a compassionate and caring health service will address the issue of corrective action. There is a real need to provide proper planning of those most disadvantaged by apartheid in managerial skills to fill managerial positions in the health sector. It is therefore is necessary to introduce as a matter of urgency new health management programmes, which will promote efficient and effectiveness management at all levels of health care service delivery. Current health managers need to be reoriented from the predominantly bureaucratic, rule-based approach towards a participative approach. The development of managerial capacity in areas such as participative and change management, leadership development, strategic planning, programme management and evaluation, and policy development and implementation is of crucial importance. The study concludes with a series of specific recommendations with regard to affirmative action, managerial and institutional capacity, human resource planning, and training needs for various sectors.
AFRIKAANSE OPSOMMING: Een van die hoofdoelstellings van die nuwe Suid-Afrikaanse regering wat in 1994 aan bewind gekom het, was om die leefomstandinghede van al die land se inwoners te verbeter. Tot watter mate het die regering geslaag in hierdie doelwit? Dit is die basiese navorsingsvraag onderliggend aan hierdie studie. Ten einde die ondersoek binne hanteerbare grense te hou, is op slegs een aspek van dienslewering gekonsenteer, naamlik die lewering van gesondheidsdienste. Hierdie terrein is verder vernou tot die Wes-Kaap en meer spesifiek tot die rol van openbare hospitale. Die Wes-Kaap was interessant omdat hoewel die regering op nasionale vlak deur die ANC beheer is, die Wes-Kaap basies deur die NNP in die periode van ondersoek geregeer is. Die provinsie was verplig om nasionale beleidsriglyne te volg, maar op provinsiale vlak het dit 'n sekere speelruimte geniet om eie beleid te formuleer en te implementeer. Die studie bestaan uit twee dele. Die eerste het te doen met beleidsformulering, die tweede met beleidsimplementering. Wat beleidsformulering betref, is 'n studie gemaak van die basisdokumente wat die kernwaardes, nasionale prioriteite en hoof doelstellings van die regering bevat. Dit het ingesluit die Vryheidmanifes, die Konstitusie en die Heropbou- en Ontwikkelingsprogram. Daar is bevind dat hierdie waardes en prioriteite in die algemeen suksesvol vertaal is in beleidsopsies op beide die nasionale en provinsiale vlak, veral in die dokumente wat gerig was op die transformasie van die nasionale gesondheidsektor. Die tweede deel van die studie het die implementering van die breë beleidsriglyne in die area van openbare gesondheid in geselekteerde publike hospitale in die Wes-Kaap ondersoek. Die hoof-ondersoekmetode was gestruktureerde onderhoude met verteenwoordigende werknemers van alle vlakke. Die bevindinge was gevolglik meer van 'n kwalitatiewe as kwantitatiewe aard. Die fokusareas waarop geskonsentreer is, was personeelbestuur, menslike hulpbronbeplanning, arbeidsverhoudinge en die ontwikkeling van menslike potensiaal. Die hoofbevindinge was dat die formulering van beleid beide van basiese waardes na gesondheidsbeleid en van die nasionale na provinsiale vlak in die algemeen suksesvol was. Aan die ander kant het ernstige gebreke aan die lig gekom sover dit die implementering van beleid op verskillende vlakke betref. Die resultaat was 'n gemengde en dikwels kontrasterende prentjie. Hoewel sommige hospitale goeie vordering gemaak het in sekere opsigte, laat die lewering van gehalte-diens aan alle pasiënte nog veel te wense oor. Die verbintenis to gelykheid in gesondheidsdienste veronderstel 'n verbintenis tot die regstelling van geslags-, klas- en rasse-ongelykhede in die ontwikkeling van menslike hulpbronne in die gesondheidsektor. Dienslewering gebaseer op sorg en empatie is van deurslaggewende belang in hierdie opsig. Daar is 'n groot behoefte aan behoorlike beplanning vir die verbetering van bestuur- en ander vaardighede van agtergestelde groepe. Die implementering van behoorlike bestuursopleidingsprogramme is van die uiterste belang, wat kan bydra tot effektiewe en goeie dienslewering. Die huidige oorwegend burokratiese en reëlsgebonde bestuurstyl behoort in 'n deelnemende benadering omgeskakel te word. Die ontwikkeling van bestuurskapasiteit in gebiede soos deelnemende veranderingsbestuur, leierskapsontwikkeling, strategiese beplanning, programbestuur en -evaluering en beleidsformulering is van die grootse belang. Die ondersoek sluit af met 'n reeks konkrete aanbevelings met betrekking tot regstellende aksie, verbetering van bestuurskapasiteit, menslike hulpbronontwikkeling en die opleidingsbehoeftes van die verskillende afdelings.
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Neptin, Martin, and Angelica Preigård. "Sjukvårdspersonalens compliance gällande hygienrutiner." Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-25715.
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Vårdrelaterade infektioner kostar årligen 3,7 miljarder kronor och drabbar 10 % av dem som ligger inne för akut sjukvård. Det är därför viktigt med en god vård-hygien. Syftet med studien var att undersöka hur väl vårdpersonal följer Handbo-ken för hälso- och sjukvård då gäller handhygien, smycken, klädsel och hår. Data-insamlingen skedde med hjälp av en enkät som delades ut på en klinik. Resultatet analyserades sedan kvantitativt och visade att compliance var hög över lag men att den på vissa punkter behövde förbättras. Det var ca 19 % som ansåg att det gick bra att använda släta ringar och 74 % bytte kläder dagligen vilket motiverades med att det inte fanns tillräcklig tillgång på rena kläder. Det visade sig att det fanns små skillnader mellan de olika yrkeskategorierna samt mellan de olika av-delningarna.Cross infections cost 3,7 milliards Swedish crowns a year and affect 10 % of the patients who are treated for an acute disease. This is why it is important with a satisfactory hygiene in hospital treatment. The aim of this study was to assess how well nursing staff adhered to prescribed hygiene routines concerning hand hy-giene, jewellery, clothing and hair. The collection of data was made by a ques-tionnaire that was handed out at one medical clinic. The result was analysed with a quantitative method. The study showed high compliance but also that certain points need to be improved. Approximately 19 % consider that it was acceptable to wear engagement rings at work and 74 % change clothes daily. The motivation was that the access to clean clothes was insufficient. There were small differences between different categories of work and between the different wards.
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Galo, Luntu. "A case study describing factors perceived to be impacting staff satisfaction amongst health care professionals at the East London Hospital complex." Thesis, Rhodes University, 2012. http://hdl.handle.net/10962/d1003905.
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This thesis was born from a concern the researcher had with regard to negative reports in the media emanating from 4 babies that died at Cecilia Makiwane Hospital Peadiatric ICU unit due to power supply failure. The most significant of these negative reports was in 2007 when the Daily Dispatch ran a series of articles regarding what they termed avoidable deaths over the last 14 years. The ease with which staff communicated with the media together with the high absenteeism rate and high turnover was a cause for concern. When the researcher analysed the history of the problem, it immerged from the respondents’ responses that the rationalistion process undertaken by the Eastern Cape Department of Health (ECDoH) was a significant root cause to the problem. The literature review focused on three areas viz.: Organisational Culture, Organisational Change, Foundations of Satisfaction. This focus was used to confine the problem to a manageable project but secondly each of the aspects are interwoven. Routledge (2010) notes that culture is the reflection of the values advocated by a founder or leader by way of his/her day to day actions. This is done by the leader creating a perception or viewpoint that assists the employees to achieve the organisation’s mission, vision and goals. In any organisation change is a constant and it needs to be effectively managed. With government institutions like the East London Hospital Complex (ELHC) directives come from the top and are implemented by an unprepared and untrained leadership and management cadre and clear communication of vision and objective of the desired outcomes never happens. The aim of the research was to: describe the existing Organisational Culture present at ELHC (Perform an organisational diagnosis); describe the impact of change (rationalisation) and to analyze why there was such a high staff turnover. It is clear from the results of the survey conducted that significant dissatisfaction prevailed relating to how the institution was managed. Dissatisfaction amongst the health professionals was general but also specific to the following: leadership and management issues, fairness, remuneration and lack of resources. The recommendations therefore focused on developing management and leadership within the proposal of Dubrin’s model (2001).
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Rossouw, Liezel. "The prevalence of burnout and depression among medical doctors working in the Cape Town Metropole community health care clinics and district hospitals of the Provincial Government of the Western Cape : a cross-sectional study." Thesis, Stellenbosch : Stellenbosch University, 2011. http://hdl.handle.net/10019.1/46747.
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Thesis (MMed)--Stellenbosch University, 2011.Aim: This study investigated burnout and depression among medical doctors in the context of work-related conditions and the role of resilience as a modifiable factor. Methods: A cross-sectional, observational study was conducted on all consenting medical doctors (N=132) working at Cape Town metropole primary health care facilities of the Provincial Government of the Western Cape. Data were collected from doctors at 27 facilities by means of a self-administered questionnaire battery containing socio-demographic information, the Beck Depression Inventory (BDI), the Maslach Burnout Inventory (MBI) and the Connor-Davidson Resilience Scale (CD-RISC). Results: Of 132 doctors included in the analysis, 76 % experienced burnout, as indicated by high scores on either the emotional exhaustion or depersonalisation subscales. In addition, 27% of doctors had cut-off scores on the BDI indicating moderate depression, while 3 % were identified with severe depression. The number of hours, work-load, working conditions and system-related frustrations were ranked as the most important contributing factors to burnout. More experienced doctors and those with higher resilience scores had lower levels of burnout as evident by lower scores on the emotional exhaustion and depersonalisation domains of the MBI. Conclusion: Both burnout and depression are prevalent problems among doctors working at district level and in communities. Resilience appears to be protective and may be a useful target for future intervention.
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Amanambu, Rochelle Aneeta. "An investigation of the intention to leave or stay of health care professionals at St. Andrews Hospital." Thesis, Rhodes University, 2014. http://hdl.handle.net/10962/d1011091.
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Background: The demand for and retention of talent worldwide is aggravated by revolutionary trends that include global competition, demographic changes and technological advances. In South Africa this phenomenon according to Frost (2002) is further challenged by the emigration of skilled people; the relative scarcity of specialist and managerial employees; employment equity and affirmative action procedures. But the development of strategies first requires an understanding of the factors which influence decisions to leave or stay particularly in rural and remote areas. St. Andrews Hospital is a rural district hospital in Ugu District, KZN. Its remoteness from urban areas and the lack of resources contributes towards challenges of attracting and retaining health care professionals to the area. It is the aim of this study to identify the ten most prevalent turnover and retention factors in a rural district hospital with the intention of making recommendations towards strategies to mitigate turnover and improve retention of health care professionals. This study will not only serve the local Human Resource Department but may also be used to inform district and provincial policies as well as departments’ decisions in the design or the review of current retention strategies aimed at reducing turnover. Method: The survey method was used to collect the primary data by distribution of self-administered questionnaires to Health Care Professionals at St. Andrews Hospital. Of the one hundred and fifty questionnaires distributed, one hundred and seven were returned (71% response rate) and formed the basis of the study. Results: Based on the impact scores, the top three turnover factors identified were, the way the organisation is led by top management (0.934); the size of the workload (0.862); and the way problems are dealt with by managers in the organisation (0.817). No statistically significant relationships were found between turnover factors and biographical variable. Availability of quality health services was ranked as the external factor that had the highest influence (78%) on turnover, while geographical location was ranked the lowest. The main reason given by respondents for leaving their previous employment was promotion, followed by distance and personal/family reasons. The top three retention factors identified from the impact scores were the quality of relationships with colleagues (1.698); the amount of support received from managers and colleagues (1.484); and the level of engagement and involvement with the job (1.390). This demonstrates that the salary package often thought to be a first priority factor Mobley, Horner and Hollingsworth (1978); Mobley (1982) and Herzberg (2003) is far less of a determining factor at St. Andrews Hospital than management support, job involvement and person-organisation fit as well as the social relationships formed in the workplace. A positive relationship was found between leadership and job dimension factors at the 1% level of significance. This supports the strong social bond (person-organisation fit) formed in the work environment between management and colleagues that supports retention and increases level of commitment. An important result of the study was that 46% of the respondents were thinking of leaving the town within the year while 29% were considering resigning from St. Andrews Hospital within the year. Conclusion: The results reveal a complex interaction of factors impacting on turnover and retention. The Human Resource Management function has a pivotal role to play in improving its ability to attract and retain professionals through developing comprehensive strategies based on external and internal and environmental factors. The study conveys to the St. Andrews Hospital management that turnover and retention factors are unique to the location and the working environment and differs amongst Health Care Professionals – this should be deliberated on when formulating Hospital Human Resource retention policies.
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Burford, Eva-Maria. "The analysis of the strain level and the predicted human error probability for critical hospital tasks." Thesis, Rhodes University, 2012. http://hdl.handle.net/10962/d1005182.
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South African hospitals, as a result of numerous factors, have the problem of an increasing workload for nursing staff, which in turn may affect patient treatment quality. This project aimed at addressing patient treatment quality specifically from the perspective of worker capabilities by investigating the strain level and predicted human error probability associated with specific patient-centered tasks in the South African health care sector. This was achieved through two independent yet interlinked studies which focused on seven patient-centred tasks. The tasks analysed were the tasks of setting up and changing intravenous medication, administering injection and pill medication, measuring blood glucose, temperature and heart rate and blood pressure. In the first study, work environment and task characteristics, task structure and execution were analysed. In addition to the task execution, the resulting strain levels, in the form of heart rate measures and subjective ratings of workload, were studied. The second study determined the error protocols and predictive error probability within the healthcare environment for the seven pre-defined tasks. The results for the first study established that different organizational and environment factors could affect task complexity and workload. The individual task components and information processing requirements for each task was also established. For the strain analysis, significant results for the tasks were determined for heart rate frequency and the heart rate variability measures, but some of these were contradictory. For the second study, specific error protocols and error reporting data were determined for the hospital where this research was conducted. Additionally the predictive error probability for the pre-defined tasks was determined. This combined approach and collective results indicate that strain and predictive error probability as a result of task workload can be determined in the field as well as being able to identify which factors have an effect on task strain and error probability. The value of this research lies in the foundation that the gathered information provides and the numerous potential applications of this data. These applications include providing recommendations aimed at improving nursing work environment with regards to workload, improving patient treatment as a result of a reduction in errors and the potential foundation these results provide for future research
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Araújo, Márcia Mello de Oliveira. "Adesão à higienização das mãos: instrumento de observação fundamentado na estratégia multimodal aplicado à UTI neonatal." Universidade Federal Fluminense, 2016. https://app.uff.br/riuff/handle/1/3064.
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Mestrado Profissional em Enfermagem Assistencial
Situação-problema: O objeto deste estudo é a adesão ao uso de solução alcoólica para higienização simples das mãos pelos profissionais de saúde que atuam na Unidade de Terapia Intensiva Neonatal (UTIN) da Maternidade Escola da Universidade Federal do Rio de Janeiro. Objetivos: Apresenta o seguinte objetivo geral: Determinar a adesão ao uso de solução alcoólica para higienização das mãos pelos profissionais de saúde da UTIN, a partir de observações realizadas em conformidade com a estratégia multimodal da OMS. Tem como objetivos específicos: Elaborar um instrumento de observação da higienização das mãos fundamentado no “Manual para observadores: estratégia multimodal da OMS”, considerando as especificidades relacionadas à UTI Neonatal. Observar a adesão ao uso de solução alcoólica para higiene das mãos dos profissionais de saúde nas oportunidades durante a assistência ao paciente e a adequação da técnica. Calcular a adesão dos profissionais ao uso de solução alcoólica na higiene simples das mãos. Bases conceituais: A importância da higienização das mãos na redução das infecções relacionadas à assistência à saúde, a unidade de terapia intensiva neonatal e o controle de infecção com ênfase na estratégia multimodal. Metodologia: Estudo quantitativo do tipo observacional, cujos participantes foram os membros da equipe multiprofissional que atuam na UTI Neonatal. A coleta de dados se deu por meio de sessões de observação baseada nas oportunidades de higienização das mãos durante a assistência ao paciente propostas no “Manual para observadores: estratégia multimodal da OMS”. Resultados e discussão: O índice global de adesão à higienização das mãos da UTI neonatal foi elevado em comparação aos estudos publicados e destacados pela OMS.Os dados demonstram que a utilização do álcool na higiene das mãos predominou, mesmo com erros na técnica na utilização da solução alcoólica pelos profissionais de saúde,há um reconhecimento das indicações para efetivação da adesão.Produto:O produto consiste num instrumento denominado formulário de observação com enfoque na UTI neonatal e um roteiro de orientação para o observador registrar as oportunidades de higienização das mãos e o cálculo da adesão dos profissionais
The object of this study is the adherence to the use of alcoholic solution for simple sanitization of the hands by healthcare professionals working in the Neonatal Intensive Care Unit (NICU) of maternity School of the Federal University of Rio de Janeiro. Objectives: Displays the following general objective: to determine the adherence to the use of alcoholic solution for hand hygiene by health professionals of the NICU, from observations carried out in accordance with the strategy of the multimodal WHO. Has as specific objectives: to draw up an instrument of observation of hand hygiene in "Manual for reasoned observers: multimodal strategy of WHO", considering the specificities related to neonatal ICU. Observe the adherence to the use of alcoholic solution for hand hygiene of health professionals in the opportunities during patient care and the adequacy of the technique. Calculate the adherence of professionals to the use of alcoholic solution in simple hygiene of hands. Conceptual bases: the importance of hand washing in the reduction of infections related to health care, the neonatal intensive care unit and the control of infection with emphasis on multimodal strategy. Methodology: a quantitative study of the observational study, whose participants were the multiprofessional team members that act in the neonatal ICU. The data collection was carried out through observation sessions based on opportunities for hand hygiene during patient care proposals in the "Manual to observers: multimodal strategy WHO." Results and Discussion: The overall rate of adherence to hand hygiene in the neonatal ICU was high in comparison to other studies published and highlighted by WHO.The data shows that the use of alcohol on hand hygiene was predominant, even with errors in the technique in the use of alcoholic solution by health professionals,there is a recognition of the signs for effectuation of membership. Product: The product consists of an instrument called the observation form with focus in the neonatal ICU and a roadmap of guidance for the observer to register opportunities of hand washing and the calculation of the accession of the professionals
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Horníková, Monika. "Zabezpečení kvality zdravotní péče středním zdravotnickýcn personálem." Master's thesis, Vysoká škola ekonomická v Praze, 2010. http://www.nusl.cz/ntk/nusl-18128.
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The aim of the thesis was to define and map various indicators of health care quality that are monitored in the Jindřichův Hradec Hospital. It was further checked whether the National Accreditation Standards for Hospitals pertaining to paramedical staff were observed and monitored in the hospital. Finally, individual indicators and standards were assessed and solutions were suggested where any shortcomings occurred.
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Persson, Blom Jenny. "Förskolechefers följsamhet till arbetsmiljöregler om hygien och smittskydd : En tvärsnittsstudie." Thesis, Högskolan i Skövde, Institutionen för hälsovetenskaper, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-19278.
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Introduktion: Infektioner är vanligt bland barnen i förskolan. Vissa infektioner är av mer allvarlig karaktär, som antibiotikaresistenta bakterier. Det ger konsekvenser för samhället och folkhälsan, men innebär även en arbetsmiljörisk för personal på förskolan.Syfte: Att undersöka hur väl förskolechefer/rektorer följer arbetsmiljölagstiftningens krav på hygien och förebyggande smittskyddsåtgärder.Metod: Kvantitativ studie där en webbenkät skickades ut till 163 förskolechefer/rektorer i kommunala och fristående förskolor i tre olika regioner (Västra Götaland, Stockholm och Västmanland). Svaren analyserades med hjälp av statistikprogrammet SPSS, version 27.Resultat: Svarsfrekvens på webbenkäten var 39,9% (65 svar utav 163 skickade enkäter). Skillnad (p < 0,001) mellan regionerna kunde påvisas beträffande hygienutbildning av personal. Det var att vanligare att personalen fick hygienutbildning inom kommunalaförskolor jämfört med fristående förskolor (p=0,049) och att kommunala förskolor städas dagligen till skillnad mot fristående (p=0,016). Personal som varit yrkesverksamma en längre tid var bättre på att informera vikarier om hygienrutiner (p=0,005), förskolor med fler än 45 barn hade en högre frekvens av daglig städning (p=0,002) och förskolor med 5 eller fler avdelningar var bättre på att ge personal hygienutbildning (p=0,043). Samtliga förskolor svarade att de använder ytdesinfektionsmedel för rengöring av skötbord.Slutsats: Det finns signifikanta skillnader i hur vanligt det är att personalen fick hygienutbildning mellan regionerna och mellan kommunala och fristående förskolor. Det är vanligare med daglig städning av lokaler på kommunala förskolor. Samtliga förskolor använde ytdesinfektionsmedel och engångshandskar vid behov. Vid framtida studier skulle urvalet behöva vara större, framförallt andelen fristående förskolor och ett större deltagande eftersträvas.Introduction: Infections are common among preschool children. Some infectious agents, such as antibiotic-resistant bacteria have consequences for society and public health and pose a risk to the occupational health and safety of preschool staff.Aim: To investigate how well preschool principals comply with occupational health and safety legislation's requirements for preventive measures against risks of infections.Methods: A cross-sectional quantitative study was implemented. This study consisted of a web-based survey, sent via an e-mail link to 163 preschool principals in municipal and private preschools in three different regions of Sweden (Västra Götaland, Stockholm and Västmanland). Data were analyzed using the statistical program SPSS, version 27.Results: Of 163 email surveys sent, 65 responses (39.9%) were received. A difference (p < 0.001) between regions was demonstrated in terms of hygiene training of personnel. It was more common with hygiene training of personnel in municipal preschools (p=0.049) and daily cleaning was more common among municipal preschools (p=0.016). Staff who had worked for a longer time were better at informing substitutes about hygiene practices (p=0.005), preschools with more than 45 children had a higher frequency of daily cleaning(p=0.002) and preschools with 5 or more departments were better at hygiene training of personnel (p=0.043). All preschools used surface disinfectants to clean changing tables.Conclusion: There were differences in the level of hygiene training of personnel between regions and between municipal and private preschools. Daily cleaning among municipal preschools was more common. All preschools use surface disinfectants and disposable gloves when needed. Future surveys should include a larger sample size and focus on higher participation.
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Tholander, Hasselrot Maria. "Olika yrkeskategoriers följsamhet till basala hygienrutiner inom djursjukvården : En enkätstudie." Thesis, Högskolan i Skövde, Institutionen för hälsa och lärande, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-16625.
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Introduction: Infection control in animal health care is, as in human health care, most important to prevent and fight antibiotic resistance. Animal health can also influence public health. Basic hygiene routines; hand hygiene, routines for proper attire, and routines for personal protective equipment (PPE), such as protective aprons and gloves, represent the simplest and most important infection control and prevention measures. High compliance to these routines is important to achieve. However, due to few scientific publications in the animal health care arena, customized and efficient efforts have not been fully identified for this environment. Therefore, optimal oversight and compliance assessments are difficult to achieve. Similar to human health care, several infection control and prevention measures and responsibilities are addressed by nurses. Objectives: To study compliance to basic hygiene routines and assess whether compliance differs between different animal health care professions, such as nurses versus veterinarians. Method: A quantitative web-based survey about basic hygiene routines, was used to investigate compliance to basic hygiene routines among animal healthcare providers. The eligible respondent sample was comprised of 360-2600 providers. Difference in compliance among professions within animal health care was estimated using SPSS statistical analysis software. Results: Of a possible 360-2600 possible respondents, 313 animal healthcare providers responded to our web-based survey. Significant differences in compliance among professions were not found (between veterinarians and veterinary nurses with a degree, and veterinarians versus nurses without a degree). Higher compliance was observed at larger animal hospitals and among personnel educated at their work place in basic hygiene routines. Hand disinfectant use before contact with patients was most often missed, as well as not wearing a protective apron or coat if risk for contact with body fluids was evident. Conclusion: In contrast to previous practical experience and reports, our results showed no significant difference in compliance between animal healthcare veterinarians and nurses. Given our null findings, more studies are needed to identify hidden factors influencing compliance among animal health care workers, as well as attention to representative sampling. Even so, based on our results, potential interventions include enhanced work-based education programs on infection control and prevention, with attention to smaller (small to medium sized) animal health care clinics. Focus for such interventions should also address hand disinfection before contact with patients. In addition, more effective monitoring is required.Introduktion: Vårdhygien inom djursjukvården är liksom inom sjukvården viktigt för att förebygga och motverka utvecklingen av antibiotikaresistens vilken kan påverka folkhälsan. Basala hygienrutiner är en av de viktigaste vårdhygieniska åtgärderna för att förhindra smitta inom sjukvården och djursjukvården. En god följsamhet till basala hygienrutiner är mycket viktig att uppnå men på grund av liten kunskap om hur det förhåller sig inom djursjukvården är det svårt att skräddarsy insatser. Traditionellt riktas många vårdhygieniska insatser och ansvar till sköterskor i djursjukvården. Syfte: Undersöka om följsamheten till basala hygienrutiner skiljer sig mellan olika yrkeskategorier inom djursjukvården. Metod: Genom kvantitativ ansats utifrån 313 svar på en webenkät med ett utskick på 360-2600 enkäter om basala hygienrutiner undersöka självskattad följsamhet och med hjälp av statistikprogrammet SPSS beräkna om skillnader finns mellan olika yrkeskategorier inom djursjukvården. Resultat: Signifikanta skillnader i följsamhet till basala hygienrutiner mellan yrkeskategorierna veterinärer och sköterskor (djurvårdare och djursjukskötare) fanns inte. Bättre följsamhet sågs på större arbetsplatser samt om personalen fått utbildning på arbetsplatsen. Handdesinfektion före patientkontakt var svårast att följa samt användning av skyddsförkläde/rock vid risk för kontakt med kroppsvätskor. Slutsats: I motsats till tidigare praktisk erfarenhet visade resultaten att signifikant skillnad i följsamhet mellan veterinärer och djurvårdare eller mellan veterinärer och djursjukskötare inte kunde ses. Därmed kan konstateras att fler studier behövs för att identifiera dolda faktorer som påverkar följsamheten bland djursjukvårdens personal. Utifrån resultaten kan dock konstateras att interventioner som innebär förbättrade utbildningsprogram i vårdhygien på arbetsplatsen, särskilt på små till medelstora kliniker, bör genomföras. Dessa bör fokusera på handdesinfektion före patientkontakt. Mer effektiv övervakning behövs.
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Sanders, Carolyn L. "Clinical antecedents of a medical emergency team response as predictors of ICU transfer /." Connect to full text via ProQuest. Limited to UCD Anschutz Medical Campus, 2008.
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Thesis (Ph.D. in Nursing) -- University of Colorado Denver, 2008.Typescript. Includes bibliographical references (leaves 100-107). Free to UCD Anschutz Medical Campus. Online version available via ProQuest Digital Dissertations;
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Bernardes, Jaime Gil. "Construção de cenários prospectivos para o setor hospitalar no estado do Rio Grande do Sul." reponame:Repositório Institucional da UCS, 2011. https://repositorio.ucs.br/handle/11338/611.
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Estudos de futuro e construção de cenários prospectivos são recursos que se destacam na formulação da estratégia empresarial. No caso da área da saúde, em que o cenário presente pode ser alterado de forma rápida, por força de políticas governamentais, regulamentações, avanços tecnológicos, aspectos econômicos ou sociais, a modelagem de cenários se torna mais importante ainda, face as incertezas que se apontam. Neste ínterim, os hospitais estão muito comprometidos, pois são a referência para a população quando se trata de saúde. Este estudo teve como objetivo construir cenários prospectivos para o setor hospitalar, para um horizonte temporal de 10 anos, considerando a limitação geográfica do Estado do Rio Grande do Sul. O método utilizado foi uma pesquisa aplicada, exploratória e descritiva, e, quanto à abordagem do problema, a pesquisa pode ser classificada como qualitativa-quantitativa. Os dados foram obtidos junto a especialistas, oriundos do setor hospitalar, sendo que foi adotado o método Grumbach na modelagem de cenários e a utilização do software PUMA. Os objetivos deste estudo, além da própria modelagem dos cenários, foi identificar as variáveis que influenciam os cenários propostos, levantar a opinião de especialistas sobre estas variáveis, aplicar o software adequado e instrumentar as organizações hospitalares com elementos para a formulação de novas estratégias. Os resultados deste trabalho são os próprios cenários para o setor hospitalar nas condições geográficas e temporais estipuladas.Submitted by Marcelo Teixeira (mvteixeira@ucs.br) on 2014-06-05T16:41:35Z No. of bitstreams: 1 Dissertacao Jaime Gil Bernardes.pdf: 1851187 bytes, checksum: 5bb7b2d739648c8b8ca2f72b70af5b0f (MD5)
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Studies and construction of future scenarios are features that stand out in the formulation of business strategy. In the case of health, the scenario where this can be changed quickly, under government policies, regulations, technological advances, economic or social aspects, the modeling scenario becomes even more important, given the uncertainties which points. Meanwhile, hospitals are very committed, as are the reference for the population when it comes to health. This study aimed to construct scenarios for the hospital sector, for a time horizon of 10 years, given the geographical limitations of the State of Rio Grande do Sul. The method used was an applied research, exploratory and descriptive, and how to approach the research problem can be classified as qualitative and quantitative. Data were obtained from experts, from the hospital sector, and Grumbach method was adopted to model scenarios and the use of software. The objectives of this study, besides the modeling of the scenarios was to identify the variables that influence the scenarios proposed to raise the opinion of experts on these variables, apply the appropriate software instrument and hospital organizations with elements for the formulation of new strategies. These results are their own scenarios for the hospital sector in the geographical and temporal conditions stipulated.
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Anozie, Uchenna Johnpaul. "Knowledge of occupational safety by hospital cleaners and hospital managers towards HIV and other blood borne pathogens transmission in Abakaliki region in Eastern Nigeria." Thesis, Stellenbosch : Stellenbosch University, 2015. http://hdl.handle.net/10019.1/98120.
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Thesis (MPhil)--Stellenbosch University, 2015.ENGLISH ABSTRACT: The research focused on the knowledge of occupational safety by hospital managers towards HIV and other blood borne pathogens transmission in Abakaliki region in eastern Nigeria. These pathogens are easily transmissible by needle sticks and other occupational accidents. It is important to identify factors that pre-expose hospital cleaners to occupational risk exposure that can lead to the transmission of HIV, HBV and HCV. The research was conducted in 10 different hospitals. A total of 90 questionnaires were administered to the hospital cleaners that volunteered to participate in the research and 68 questionnaires were returned representing 75.6% of the total questionnaires. The mean age and standard deviation of the respondents in this study was 38.6 + or – 5.4 years. The researcher conducted a semi-structured interview with all the 10 hospital managers involved with the study and the interviews showed there was a need for an organised training on hospital work and occupational hazards, risk exposures and precautions. The questionnaires showed the knowledge of hospital cleaners on occupational safety and it was observed the majority of the hospital cleaners were not aware of post exposure prophylaxis for HIV. The workers relatively had good practices put in place to prevent HIV, HBV and HCV transmission but majority of them had not received HBV vaccine due to lack of awareness and availability. There was a significant positive correlation between the knowledge of the health workers and HIV transmission and the practice put in place by health workers to prevent HIV transmission (P<0.05). This implies as the knowledge of the health workers about HIV transmission increases, the practice put in place by health workers to prevent HIV transmission and Hepatitis B&C increases. Therefore there is need for continuous training on blood borne pathogens transmission such as HIV transmission in the hospitals and its routes of transmission. There is need for awareness creation for HBV vaccine and Post exposure prophylaxis for HIV exposure.
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Surtie, Adin Don. "An empirical investigation into the integration of foreign doctors into the public health case system of the Northern Cape in South Africa." Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/95690.
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Thesis (MBA)--Stellenbosch University, 2013.The South African Northern Cape Department of Health has many challenges to overcome in order to provide the province with quality public health care. One of these challenges is the recruitment and retention of foreign doctors in order to maintain and improve on the population’s access to physicians. Due to the lack of locally trained physicians willing to work and settle in the Northern Cape Province, the Department of Health in the province have been employing foreign-trained physicians to fill the gap in providing adequate medical care to its population. This study examined how well foreign doctors have integrated into the Northern Cape public health care system. It further identified, described and explored the factors that might influence the integration of these foreign physicians. This was done in order to make recommendations to improve the existing retention strategies of the Northern Cape Department of Health. This research utilised the mixed-method of research by obtaining secondary qualitative as well as primary quantitative data. The qualitative data were obtained through a literature review. Questionnaires informed by the literature review were utilised in order to obtain the primary quantitative data. The data obtained were subjected to a statistical analysis.The results indicated that the needs of the foreign doctors were generally met and the factors pertaining to work, community and family aspects of integration did not have an overtly negative or positive influence on integration. The results pertaining to rurality were not as prominent as expected. The main factors identified related to relational (professional as well as personal) factors. The researcher concluded that relational factors contributed the most as they had an influence on all the categories of possible factors that might influence integration. This finding stressed that the social phenomena that influence integration should not be overlooked. The implementation of interventions to improve integration and retention should be accompanied by a detailed examination of the factors that affect the recruitment, integration and retention of the workforce in a country/region. This research could be an important step towards achieving this goal for the Northern Cape Department of Health.
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Heus, Kamel. "Gestion des plannings infirmiers : application des techniques de programmation par contraintes." Université Joseph Fourier (Grenoble), 1996. http://www.theses.fr/1996GRE10071.
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Le problème d'établissement de plannings de travail, bien que n'étant pas spécifique au milieu hospitalier, est l'un des problèmes les plus difficiles et les plus délicats rencontre par tout service de soinsLa diversité des contraintes à satisfaire fait de la génération des plannings une tâche complexe qui inclut une phase importante de négociation et de calcul combinatoire. Décrits et explores par des techniques de recherche opérationnelle et d'intelligence artificielles, ces problèmes suscitent un intérêt nouveau en raison de l'émergence de nouvelles techniques de programmation et du développement du nouveaux modèles d'organisation de travail
Nous présentons dans le cadre de ce travail une nouvelle approche de résolution du problème de plannings infirmiers basée sur les techniques de programmation par contraintes (PPC). La formulation du problème comme un CSP permet une gestion transparente des contraintes et des affectations journalières des infirmiers, facilitant ainsi l'interactivité avec l'utilisateur et la prise en compte des vœux individuels, permettant par conséquent un management plus participatif des plannings
L'association de la programmation orientée objet avec la ppc facilite la maintenance du programme chaque fois qu'il est nécessaire d'ajouter, modifier ou supprimer des objets, règles ou contraintes
Afin de limiter la recherche de solutions dans un espace plus restreint, nous proposons deux méthodes de réduction de la complexité du problème, l'une basée sur l'élimination des valeurs permutables et l'autre sur la décomposition du problème en deux sous-problèmes
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Berni, Liana Bohrer. "PRAZER-SOFRIMENTO DE TRABALHADORES TERCEIRIZADOS DA HIGIENE E LIMPEZA DE UM HOSPITAL PÚBLICO." Universidade Federal de Santa Maria, 2013. http://repositorio.ufsm.br/handle/1/10321.
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This is quantitative study, whose goal was to identify and measure the
manifestations of pleasure-pain of outsourced workers of hygiene and cleanliness of a public
hospital. Were used as data collection instruments, data collection of sociodemographic and
labor indicators and scale of pleasure and pain at work (EIPST). Data were analyzed using
SPSS software. The results indicate that the vast majority of these workers are women and in
spare moments give priority to spend time with family, perform household chores, walking
and traveling. Their main wishes for the future are to have a better job and health. Regarding
measuring pleasure and suffering of these workers, it was found that the Professional
Achievement and Recognition in this workplace are sources of pleasure and suffering that
arises from the lack of Freedom of Expression and Emotional Exhaustion.Trata-se de uma pesquisa quantitativa, cujo objetivo foi identificar e mensurar as manifestações de prazer-sofrimento dos trabalhadores terceirizados da higiene e limpeza de um hospital público. Foram utilizados como instrumentos de coleta de dados, o levantamento de dados sóciodemográficos e laborais e a escala de indicadores de prazer e sofrimento no trabalho (EIPST). Os dados foram analisados através do programa estatístico SPSS. Os resultados apontam que a grande maioria destes trabalhadores são mulheres e nos momentos de folga dão prioridade para passar um tempo com a família, realizar os afazeres domésticos, passear e viajar. Já os desejos para o futuro são um emprego melhor e ter saúde. Ao mensurar o prazer e sofrimento destes trabalhadores constatou-se que a Realização Profissional e Reconhecimento neste local de trabalho são fontes de prazer e o sofrimento surge da Falta de Liberdade de Expressão e do Esgotamento Emocional.
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Forsyth, Rowena Public Health & Community Medicine Faculty of Medicine UNSW. "Tricky technology, troubled tribes: a video ethnographic study of the impact of information technology on health care professionals??? practices and relationships." Awarded by:University of New South Wales. School of Public Health and Community Medicine, 2006. http://handle.unsw.edu.au/1959.4/30175.
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Whilst technology use has always been a part of the practice of health care delivery, more recently, information technology has been applied to aspects of clinical work concerned with documentation. This thesis presents an analysis of the ways that two professional groups, one clinical and one ancillary, at a single hospital cooperatively engage in a work practice that has recently been computerised. It investigates the way that a clinical group???s approach to and actual use of the system creates problems for the ancillary group. It understands these problems to arise from the contrasting ways that the groups position their use of documentation technology in their local definitions of professional status. The data on which analysis of these practices is based includes 16 hours of video recordings of the work practices of the two groups as they engage with the technology in their local work settings as well as video recordings of a reflexive viewing session conducted with participants from the ancillary group. Also included in the analysis are observational field notes, interviews and documentary analysis. The analysis aimed to produce a set of themes grounded in the specifics of the data, and drew on TLSTranscription?? software for the management and classification of video data. This thesis seeks to contribute to three research fields: health informatics, sociology of professions and social science research methodology. In terms of health informatics, this thesis argues for the necessity for health care information technology design to understand and incorporate the work practices of all professional groups who will be involved in using the technology system or whose work will be affected by its introduction. In terms of the sociology of professions, this thesis finds doctors and scientists to belong to two distinct occupational communities that each utilise documentation technology to different extents in their displays of professional competence. Thirdly, in terms of social science research methodology, this thesis speculates about the possibility for viewing the engagement of the groups with the research process as indicative of their reactions to future sources of outside perturbance to their work.
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Tito, Renata Santos. "Burnout e Transtornos Mentais Comuns nos trabalhadores de enfermagem que assistem crianças com cardiopatia grave." Universidade de São Paulo, 2013. http://www.teses.usp.br/teses/disponiveis/7/7140/tde-14082013-132011/.
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A influência das características laborais sobre a saúde mental dos trabalhadores pode decorrer de inúmeros fatores ou formas de organização do trabalho. Na atualidade, verifica-se os crescentes índices de sintomas psíquicos entre determinadas categorias profissionais, com destaque para os trabalhadores de saúde atuantes em ambiente hospitalar Objetivo: Este estudo objetivou identificar a ocorrência de Transtornos Mentais Comuns (TMC), a ocorrência da síndrome de Burnout, e a associação de ambos os transtornos nos trabalhadores de enfermagem, bem como elaborar propostas de intervenção para redução do desgaste psíquico. Metodologia: Trata-se de um estudo exploratório, transversal com abordagem quanti-qualitativa. A pesquisa foi realizada em Hospital Público Universitário especializado em cardiologia, pneumologia e cirurgias cardíacas e torácicas. A amostra foi composta por trabalhadores de enfermagem que atuam em unidades de terapia semi-intensiva e intensiva pediátrica e neonatal, perfazendo um total de 92 participantes. Para a coleta de dados quantitativos foram utilizados: instrumento de caracterização sócio demográfica, Self-Reporting Questionnaire (SRQ-20), e o Maslach Burnout Inventory (MIB). Para os dados qualitativos, optou-se pela técnica de grupo focal, conduzido por questões norteadoras, com uma amostra de 17 trabalhadores de enfermagem. O período de coleta foi nos meses de junho e julho de 2012. Resultados: A análise dos resultados evidenciou a ocorrência de TMC em 44,60%(41) dos trabalhadores e a ocorrência de Burnout em 8,7%(8) trabalhadores. Houve associação estatística entre os TMC e o Burnout p=0,003, considerando nível de significância de 5%. Em relação aos TMC, as respostas dos trabalhadores foram distribuídas de acordo com os quatro grupos de sintomas avaliados pelo SRQ-20: Grupo somático, Decréscimo de energia vital, Humor depressivo-ansioso e Pensamentos depressivos. Em relação à sindrome de Burnout, os trabalhadores foram avaliados considerando-se a ocorrência de escores alto nas três dimensões (Desgaste Emocional, Despersonalização e Reduzida Realização Profissional) ou em uma delas apenas. Não foi constatada associação entre os transtornos e as variáveis sócio-demográficas. Houve associação entre ambos os transtornos. As sessões de grupo focal evidenciaram propostas de intervenção mediante três temas que emergiram das discussões: Aprender a lidar com a criança cardiopata grave, Receber o reconhecimento profissional e Repensar a gestão de pessoas. Conclusão: Os achados, em conjunto, evidenciam necessidade de medidas protetoras à saúde mental do trabalhador que assiste crianças cardiopatas graves. Palavras-chave: Estresse psicológico, Esgotamento profissional, Equipe de enfermagem, Hospitais públicos, Unidades de terapia intensiva pediátrica, Unidade de terapia intensiva neonatal, Saúde do trabalhador.The influence of work characteristics on mental health workers may be due to numerous factors or forms of work organization. At present, there is the growing rates of psychiatric symptoms among certain professions, especially health workers working in hospitals Objective: This study aimed to identify the occurrence of Common Mental Disorders (CMD), the occurrence of Burnout, and the association of both disorders among nursing staff, as well as elaborate proposals for intervention to reduce wear psychic. Methodology This is an exploratory study, cross-sectional with quantitative and qualitative approach. The research was conducted in a public University Hospital specialized in cardiology, pulmonology, thoracic and cardiac surgery. The sample consisted of nursing workers of care units, semi-intensive and intensive, pediatric and neonatal, making a total of 92 participants. For quantitative data collection was used: instrument of socio demographic, Self-Reporting Questionnaire (SRQ-20), and the Maslach Burnout Inventory (MIB). For qualitative data, we chose the technique of focal group, conducted by leading questions, with a sample of 17 nurse workers. The collection period was between June and July, 2012. Results The result of the analysis revealed the occurrence of CMD in 44.60% (41) of the workers and the occurrence of Burnout in 8.7% (8) of the workers. There was a statistical association between CMD and Burnout p = 0.003, considering level of significance 5%. Regarding CMD, the answer of the workers was distributed according to the four groups of prognostic evaluated by the SRQ-20: Somatic Group, Decrease of vital energy, Anxious-depressive humor and Depressive thoughts. Regarding Burnout syndrome, workers were evaluated considering the occurrence of high scores in all three dimensions (Emotional Exhaustion, Depersonalization, and Reduced Professional Accomplishment) or only in one of them. There was no association between the disorders and sociodemographic variables. There was an association between both disorders. The focal group sessions revealed proposals for intervention through three issues that emerged from the discussions: Learn to deal with severe heart disease children, professional acknowledgment and rethink people management. Conclusion: Findings, during the sessions, highlight the need for protective measures of mental health for workers who assist children with heart disease
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Bellagamba, Gauthier. "Qualité de vie au travail et environnement organisationnel : études qualitatives et quantitatives sur les personnels en établissement de santé." Thesis, Aix-Marseille, 2016. http://www.theses.fr/2016AIXM5028/document.
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OBJECTIF. Ces travaux de recherche ont étudié l’association entre la qualité de vie au travail (QVT) et les facteurs d’organisation auprès d’une population de personnels hospitaliers. METHODE. Deux études par questionnaires et deux études par entretiens semi-directifs ont été menées. Les études par questionnaires ont exploré les caractéristiques psychosociales professionnelles (JCQ), la qualité de vie (SF-12) et les contraintes psycho-organisationnelles des personnels (NWI-EO). Les entretiens se sont focalisés sur l’organisation du travail, l’environnement de travail, les relations interpersonnelles et l’influence du travail sur la santé. RESULTATS. Un total de 452 professionnels a participé aux enquêtes par questionnaires et 36 professionnels ont été interrogés en entretien. Les professionnels ayant vécu un transfert de services ont présenté des tensions au travail associés à un isolement social accrus et déclarent de plus fortes contraintes concernant le manque de communication ainsi que les relations dégradées au sein des équipes. Dans notre population, les autres principaux facteurs d’organisation associés à la dégradation des caractéristiques psychosociales et de la qualité de vie sont le fait de travailler plus de 2 week-ends par mois, d’être régulièrement de garde, de travailler dans des environnements non fonctionnels et de ne pas participer à des réunions régulières. CONCLUSION. Ces résultats appellent la gestion des hôpitaux à concevoir des processus de communication plus adaptés, de fournir un bon équilibre entre vie professionnelle et personnelle ainsi qu’un environnement ergonomique et fonctionnelAIM. These researches examined the association between quality of work life (QoWL) and organizational factors within health care workers. METHOD. Two studies by questionnaires and two studies by semi-structured interviews were conducted. Studies by questionnaires explored the professional psychosocial characteristics (JCQ), quality of life (SF-12) and psycho-organizational constraints (NWI-EO). The interviews focused on the work organization, the work environment, the interpersonal relationships and the influence of work on health. RESULTS. A total of 452 professionals participated in the studies by questionnaires and 36 professionals were interviewed. Professionals who lived a department relocation have presented an increase of job strain associated with social isolation and declared greater constraints concerning the lack of communication as well as team relationships. In our population, the other main factors associated with the degradation of psychosocial characteristics and quality of life are to work more than two weekends a month, to be regularly on call, to work in non-functional environments and to do not participate in regular meetings. CONCLUSION. These results call the hospital management to design more appropriate communication processes, to provide a good balance between professional and personal life as well as an ergonomic and functional environment
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Munro, G. D. "An evaluation of needlestick injuries amongst staff at a large urban hospital." Thesis, 1993. http://hdl.handle.net/10413/2389.
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Ackah, Shiroma. "The association of demographics and occupational factors with latent tuberculosis infection in radiology staff at public sector hospitals in the eThekwini health district." Thesis, 2015. http://hdl.handle.net/10321/1422.
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Submitted in fulfillment of the requirements for the degree of Master’s of Technology: Radiography, Durban University of Technology, Durban, South Africa, 2015.Introduction Tuberculosis remains a leading cause of death, second to the Human Immunodeficiency Virus. The risk of latent tuberculosis infection and active tuberculosis disease is a known occupational hazard. In South Africa, a high tuberculosis burden country, the potential of Mycobacterium tuberculosis transmission to health care workers is high. This includes diagnostic radiographers and other radiology staff working in radiology departments. Purpose of the Study This study aimed to investigate the association of demographic and occupational factors with latent tuberculosis infection in radiology staff in public sector hospitals of the eThekwini Health District. Methodology This cross-sectional study was conducted from 26 February 2013 to 07 June 2013. Quantitative methods were used to test for associations of demographic and occupational factors with latent tuberculosis infection in participants. A sample size of 181 participants for an estimated population of 340 radiology staff was recommended at the proposal stage. The study consisted of two phases; the questionnaire survey (phase one) and the administration of a two-step tuberculin skin test (phase two). Data was obtained with regard to demographics, occupational history, social behaviours, medical history; and family and home histories. Demographic and occupational associations with latent tuberculosis infection were made in relation to the size of the first tuberculin skin test induration. Frequency distributions were developed to describe data categories. Pearson’s and Spearman rho’ correlation coefficients were used to test for correlations between the independent variables. The chi-square test was used to determine associations between the categorical independent variables and the dependent variable. Bivariate analyses were performed using these tests. The multivariate analysis was performed using logistic and linear regression on the dependent variable. Results A total of 182 questionnaires were returned from approximately 280 radiology staff. At the outset, all doctors working in the radiology department had to be excluded due to numerous failed attempts to enlist their participation. Fifty-three (29.12 percent) participants were excluded from phase one of the study and a further thirteen participants were excluded from phase two. The total sample was 116 participants. Of the 116 participants, 86.2 percent tested positive for latent tuberculosis infection at the first step of the two-step testing method used. One (0.86 percent) participant went on to convert at the second step, testing positive at this level. Demographic associations with latent tuberculosis infection included age (older) as an associated factor. A significant demographic association with latent tuberculosis infection was the use of alcohol (p-value 0.033 on the multivariate analysis). Occupational associations with latent tuberculosis infection included longer durations of employment. The annual income (higher income earners) displayed significant associations with latent tuberculosis infection (p-value 0.048 on the multivariate analysis). It is necessary in this study to note that participants include support personnel (lower income earners) making up 37.8 percent of the study, diagnostic radiographers making up 48.3 percent; and radiography managers/assistant managers (highest income earners) making up 13.8 percent of the study. Conclusion and recommendations The risk of transmission of Mycobacterium Tuberculosis to health care workers is a known occupational hazard. This study has described the prevalence of latent tuberculosis infection in radiology staff, at district and regional hospitals within the eThekwini Health District. With 23.62 percent of all participants already having active TB disease and 86.2 percent of the tested group displaying positive results for latent tuberculosis infection, using the tuberculin skin tests, the need for tuberculosis screening is essential. The findings of this study will be used as a health improvement mechanism for stakeholders, having identified potential gaps in medical screening in healthcare in Kwa-Zulu Natal. This study makes recommendations for the early detection of active tuberculosis infection and the monitoring of health care workers that are latently infected, thus assisting in reducing the rate of conversion of latent tuberculosis infection to active tuberculosis disease in radiology staff. This reduces long-term exorbitant costs related to health care associated infections, such as tuberculosis. It also reduces rates of transmission and cross infection to both co-workers and already immunocompromised patients, helping to curb the overall epidemic in South Africa.
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Rose, Jillian Allison. "An Evaluation of a Hospital’s Communication Cultural Competence Staff Training to Increase Disclosure and Data Collection on Sexual Orientation and Gender Identity: Toward Reducing Health Disparities for Lesbian, Gay, Bisexual, and Transgender Patients." Thesis, 2019. https://doi.org/10.7916/d8-cq8f-j589.
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The study used a pre-/post-test design within a secondary analysis of existing de identified data obtained from a major Northeastern hospital for use by permission, in order to evaluate the impact of a communication cultural competency training of hospital registration personnel focused on teaching the collection of gender identity and sexual orientation data (SOGI). The study’s convenience sample (N=240) was diverse, given 34.6% (N=83) identified as White/Caucasian, 28.3% (N=68) as Hispanic/Latino, 27.1% (N=65) as Black /African American, and 10.0% (N=24) as Asian. For gender identity, 74.6% (N=179) identified as female, and 15.8% (N=37) as male. Those who identified their sexual orientation as heterosexual comprised 79.6% (N=191) of the sample. The mean time in current role for the sample was 3.97 years (Min = 1-1 to 6 months, Max = 6-over 10 years, SD = 1.547). For example, 18.3% (N=44) indicated being in their current role for between 5-10 years. Some 74.2% (N=178) indicated that they know someone who is LGBTQ+. Of note, 16.7% (N=38) indicated that they had other training in the last three months.
Cronbach’s Alphas ranged from .858-.978 for the 11 new study scales, as very good to excellent internal consistency. As main study findings, paired t-tests for all five global scale scores (knowledge, self-efficacy, skill/ability level, and personal preparation for collecting SOGI data—and engagement in recommended SOGI data collection behavior) demonstrated significant differences from pre- to post- training in this sample (p˂.000; Bonferroni Significance level, p<.007). This suggested that participation in the training was associated with statistically significant improvements from pre- to post-training for knowledge, self-efficacy, skill/ability level, personal, and engagement in recommended SOGI data collection behavior.
Through backward stepwise regression, having higher post-training self-efficacy was significantly predicted by: higher pre-training personal skill/ability (B=.589, SEB=.468, p=.000); and, higher post-training overall evaluation (B=.244, SEB=.305, p=.000). The adjusted R-squared value for this model was 0.346, meaning that 34.6% of the variance for higher post-training self-efficacy for collecting for collecting patients’ sexual orientation and gender identity data was explained by this model.
Findings suggest the need for further dissemination, implementation and evaluation of the new communication cultural competence training.
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Sehume, Odilia Monica Mamane. "Evidence-based guidelines to promote the health and safety of health care workers in selected public hospitals in the Tshwane health care district in Gauteng, South Africa." Thesis, 2016. http://hdl.handle.net/10500/22602.
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Text in EnglishThe purpose of this research was to investigate occupational health and safety challenges and their impact on health care workers (HCWs) in selected public hospitals from the Gauteng Province, South Africa. Method: A quantitative descriptive cross-sectional survey was conducted among HCWs in the study sites. A two-staged sampling that include purposive sampling of study sites and census sampling of 2000 HCWs was used. Self-administered questionnaires were used to obtain data from HCWs. In addition, two different checklists were used to conduct retrospective records reviews to assess occupational health and safety (OHS) policy compliance and occupational injuries and diseases occurrence. The SAS Release 9.3 was used to analyse data. The Fischer Exact test and Chi-square were also used to determine the association of variables and P-value was set at <0.05 to indicate significant association. Results: A total of eight public hospitals and 926 (46.3%) HCWs who were all females nurses participated in this survey. Major occupational health hazards reported by the participants include: needle-stick injuries 275 (54.67%), slips trips and falls 67 (13.32%) and splashes 57 (11.33%). The analysis of open-ended responses indicated increased workloads, long hours of work and shift work as the most reported psychosocial hazards among HCWs. The reviewed records indicated that back injuries 22 (4.37%), tuberculosis (TB) 17 (3.38%) and asthmatic reactions 8 (1.59%) were the commonly reported occupational injuries and diseases among the HCWs. The records review also revealed a lack in the conducting of adequate medical surveillance among participants. The results showed poor compliance with the OHS policy and a negative impact of biological and psychosocial hazards on the HCWs. Conclusion: There was a high risk of exposures to biological hazards whilst providing care to patients, thus warranting the implementation of robust preventive measures. As a result, the guidelines were developed to promote the health and safety of HCWs with a view to promoting policy compliance and preventing the occurrence of occupational injuries and diseases as well as their impact among HCWs.
Health Studies
D.Litt et Phil. (Health Studies)
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Mbindyo, Patrick Mutinda. "Roles, norms and incentives influencing the performance of clinical officers in Kenyan rural hospitals." Thesis, 2013. http://hdl.handle.net/10539/12288.
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This work explored perceptions regarding the roles, norms and incentives influencing the performance of Clinical Officers (COs) in rural district hospitals in Kenya. In order to improve access to health care mainly in rural areas, COs are increasingly being used to perform tasks that were previously the preserve of physicians. The assumption underlying their use is that they are a viable option to doctors. Studies have shown with reference to HIV care and obstetric and gynaecological surgical tasks that COs’ performance is comparable to that of physicians. Other studies also show that the care offered by COs is cost effective when compared with the costs associated with physicians and obstetricians care. However, there is emerging work which shows that COs are not happy in their assigned role in the health system. These studies report CO’s dissatisfaction with the low remuneration, poor career progress and limited career options inherent their jobs as compared with those accorded to physicians. As revealed by a systematic review of mid-level worker literature, addressing these issues is at present difficult due to gaps in our understanding of CO functioning. The existence of these gaps is explained by the limited empirical work on COs in general. The aim of this thesis was to address this issue by exploring issues that affect their routine functioning in a typical rural hospital setting going beyond the fact that they are technically competent.
To investigate these issues, a conceptual framework was adopted that explores the tension between what institutions demand and what individuals within them feel able to do. Qualitative methods comprising of interviews, participant observation, review of official policy and hospital level documents on COs, and review of hospital statistics were used. A comparative approach was adopted that sought to; (1) examine perceptions regarding influences on the performance of COs from a variety of sources (COs, doctors, nurses, supervisors, hospital managers, policy makers and policy documents); (2) compare perceptions of respondents based in three faith-based hospitals with those in three government facilities; and, (3), explore features of different work settings (outpatient department, specialist clinics and vertically supported clinics) within these hospitals that encouraged good CO performance. Preliminary findings were reported back to respondents in the six study hospitals.
Analysis of the data showed three major issues. First, perceptions of CO roles are problematic despite an acknowledgement of the important function performed by COs in the health system. This is revealed by the variety of images regarding their roles that highlights the need for a redefinition of CO roles. An example of this is shown by the inconsistency between their importance as the ‘backbone of the health system’ versus the poor remuneration and career prospects that their position attracts. Second, there were differences in the norms of CO performance that have resulted in variations regarding what is expected of them. While there was much attention paid to norms of performance about technical aspects of work, less attention focussed on non-technical aspects of work. The adoption of a holistic approach to the notion of CO performance is needed that will enable facilities and the system to meet the needs of the CO which should prompt COs to reciprocate by working better. Third was the issue that there were minimal incentives were attached to COs work. In the public sector, there were some incentives but their availability depended on the work settings. For example, while COs in vertical clinics got training their colleagues in the outpatient department had few chances to get training opportunities. Faith-based hospitals did provide performance related bonuses that encouraged health workers to perform better although notably basic salaries in faith-based hospitals were no better than those given in the government sector. However, major incentives such as salary and promotions in the public sector are handled by the central government giving public sector hospital managers little opportunity to utilise such incentive mechanisms. Where hospital managers may have some leeway in implementing actions at the local level to improve performance, for example through improving CO recognition and working conditions, it was observed that public sector managers were generally less engaged in utilising such incentives. Therefore while it is important to consider and address system level factors that influence CO performance such as salaries and promotions, among others, facility managers would also appear to have some scope to improve performance.
In discussing these issues, it is becoming clear that the assumption that COs are altruistic and will continue to work flawlessly in their assigned niche presents a naïve view of COs. This thesis shows that COs are also influenced by self–interest and find ways to overcome or work around any perceived barriers to their growth, some of which may work against the institution. This calls for a re-examination of who COs are, what they do and how they should be managed. Ways of resolving the tension that exists between COs and the health institution exist and can be derived from examining the coping mechanisms that COs have adopted to make their lives better. These coping mechanisms show areas that need attention. Further, there should be greater consideration of the important role that facility managers play in mediating and/or modifying system level influences by creating local environments suitable for better staff performance. Underlying all this is the fact that a long term view of COs is needed. The long term view must go beyond the notion of ‘substitute physician’ as Kenya has made huge investments in this cadre over the last 40 years or more and, with other countries, is likely to continue to rely on such a cadre for much clinical care. This thesis therefore concludes with recommendations that seek to address issues identified with the performance of COs in the Kenyan health system focusing on potential hospital level and system level solutions. Also included is a reflection of the relevance of findings for countries similar to Kenya that are currently using or seek to use COs as a physician substitute.
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Shuiqing, Jin. "Work satisfaction of medical staff in China-aided hospitals in Africa: a study of China-aided hospitals in Angola." Doctoral thesis, 2019. http://hdl.handle.net/10071/22843.
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Degree of satisfaction, this measure, particularly applied to the medical staff, explores
the content of healthcare professionals for doing their job in medical institutions like hospitals
or clinics. But what if the cultural factor is added to this measurement, like the culture
differences between the western and eastern worlds?
This thesis provides an insight to this problem in the remote location of Angola, a
country in Africa, for the Chinese medical staff living there.
At the beginning the research provides a close view of the previous and actual situation
of the relations between the countries of China and Angola in the medical field. From there it
gets straight to the point of evaluating the medical staff working in a Chinese hospital in the
capital of Angola, Luanda.
Qualitative research was the main method used to gather the principal information
needed to make the evaluation of the degree of satisfaction of the Chinese medical staff in the
selected hospital; thus getting the personal experiences from them, sometimes affecting their
jobs, analysing their actual situation plus adding the data-values to this information provided a
solid understanding of the level of satisfaction of them in that hospital.
In the end, the information, conclusions and recommendations included in this thesis
could be used as a tool for the development of solutions to this topic and/or further research
into it, which also can show the contrast between two cultures where healthcare professionals
have to put aside those cultural differences in order to fulfil their duties.O grau de satisfação neste trabalho refere-se especificamente aos profissionais médicos, o presente trabalho dedica-se principalmente a explorar o grau do satisfação dos profissionais médicos que trabalham em instituições médicas, e se haverá diferenças de grau de satisfação quando se envolve os fatores culturais? Este trabalho fornece novos conhecimentos para os profissionais médicos chineses estabelecidos em áreas remotas de Angola, África. Em primeiro lugar, este estudo efetuou uma análise mais aprofundada do historial médico e a conjuntura atual da China e Angola, explicando as relações médicas entre os dois países, através da qual se passou diretamente para a avaliação do grau de satisfação dos profissionais médicos que trabalham num hospital chinês em Luanda, Angola. A investigação qualitativa é a maneira principal para a recolha de dados importantes para a avaliação do grau de satisfação dos profissionais médicos chineses no hospital escolhido, através da qual se adquire as experiências pessoais dos médicos, descobrindo os elementos que afetam o trabalho, analisando as situações reais deles, com o objetivo de acrescentar os dados úteis na avaliação de grau de satisfação, o que fornece um conhecimento real sobre o grau de satisfação dos médicos que trabalham nos hospitais estrangeiros. Em fim, os dados recolhidos, as conclusões e sugestões neste trabalho podiam ser os instrumentos para a elaboração de investigação do grau de satisfação dos profissionais médicos estabelecidos em África e para a pesquisa futura sobre o tema, além disso, também demonstra os choques culturais entre os dois países, ou seja, os profissionais médicos têm que deixar ao lado os choques culturais quando cumprem as suas tarefas.
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Lee, Hsiao-Ching, and 李曉晴. "A Study of Current Status and Self Evaluation of Staff Health Promotion among Hospitals in Taiwan." Thesis, 2010. http://ndltd.ncl.edu.tw/handle/26142025720717943777.
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碩士中國醫藥大學
醫務管理學研究所碩士班
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Objectives: The purpose of this study is to investigate the current status and its effects of staff health promotion among hospitals in Taiwan. Methods: This study sent out 166 questionnaires to medical centers, regional hospitals and small district hospitals, the response rate is 52.4%. The statistical analyses include one way ANOVA, birariate analysis and multiple regressions by using SPSS. Result: The top three events of hospital staff health promotion are smoking cessation (83.6%), working environment safety (67.2%) , and weight control-exercise (52.5%) in 2009. The only change in 2010 is stress management and mental health become number three (55.7%). HPH member hospital implemented more events and activities as well as had better performance than non-HPH membership hospitals. The multiple regression analyses show that hospital status, ownership, size, and HPH member are significant in explaining staff health promotion performance. Conclusions: Most hospitals have implemented many staff health promotion activities but the performance evaluations are still scarce. In order to effectively improve staff health top managers need to pay attention to health education and follow up evaluation.
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Yuan-Ting, Lo, and 羅元婷. "The Development of Health Promoting Hospitals in Tri-Service General Hospital－A Perspective base on Health Needs Assessment for Hospital’s Staff." Thesis, 2003. http://ndltd.ncl.edu.tw/handle/67120238435940158929.
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碩士國防醫學院
公共衛生學研究所
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Health promoting hospitals（HPH）, a movement supported by the World Health Organization, was initiated in Europe in the late 1990’s. A HPH incorporates the concept, value and standard of health promotion in order to improve health for staff, patients, relatives and communities. The first healthy hospital accreditation in November 2002 in Taiwan, was initiated by the Department of Health, Taipei City Government. However, due to lacking the experiences and related researches in the field of HPH in Taiwan previously, it is important to implement health policy for developing the domestic health promoting hospital projects to improve quality of health care. Therefore, the study is subject to the employees of the Tri-Service General Hospital in Taipei. The purposes of study were to understand health status of employees, work-related health problems, environmental conditions of the workplace, what kinds of the organizational factors influence health, how employees were willing to join the HPH project. By identifying the staffs’ health needs, then we can develop the HPH project to improve the employees’ health. This study was a cross-sectional study and stratified random sampling by administrative employee, doctors, nurses, medical technicians, and pharmacists. A structured questionnaire involved 798 staff and responsed rate was 81.3%. The research findings showed that 21.7% of the employees worked over 50 hours per week and most of them were doctors. Among respondents, 24.4% of the employees were overweight and men were heavier than women. Almost half of respondents in this study reported that they didn’t exercise regularly, the main reason was too tired to do exercise. In relation to work-related health problems and working environments, 73.1% of the staff complained that they got neck pain, fatigue and low back pain. We found that the main risk factor in the working environment was poor air circulation. Nearly 80% of the employees were under the working pressure in the past six months. However, there were no statistic significantly different between organizational factors and working stress. With regard to HPH project, 78.8% of the employees were willing to participate HPH and most of them were interested in stress management. In conclusion, to improve the employees’ health, the hospital should redesign the working hours and develop reasonable shift work schedules for employees, healthy diet, encourage employees to do exercise, implement smoking cessation plan, improve ergonomic design for staff, improve quality of indoor air, and finally, manage working stress effectively.
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Mashuba, Dorcus Mmaphefo. "Knowledge and practices of food service staff regarding food safety and food hygiene in the Capricorn District Hospitals in the Limpopo Province, South Africa." Thesis, 2016. http://hdl.handle.net/10386/1487.
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Thesis (MPH.) -- University of Limpopo, 2016The purpose of this study was to assess the knowledge and practices of food service staff regarding food safety and food hygiene in Capricorn District hospitals, Limpopo Province. Quantitative, cross-sectional research was conducted to determine the knowledge and practices of food service staff. A convenient sampling technique was employed to select 84 food service staff members (11 food service supervisor and 73 food service aids). Data collection was done using structured questionnaires. Food service staff members consisting of food service aids and food service supervisors participated in the study. The data were analysed using the statistical package for social sciences version 23. Of the respondents 50 (60%) are female whereas 34 (40%) are males. The largest group of them, 34 (40%) had secondary education, 23 (27%) had matric whereas 16 (19%) had post matric qualifications. 80 (95%) of them answered correctly that they use an air dryer or paper towel for drying hands after washing whereas 65 (77%) answered incorrectly when asked the difference between washing and sanitizing. Seventy eight of the respondents answered correctly on practice questionnaire that they only reheat leftovers once whereas 69 (82%) answered incorrectly about the temperature one should maintain for potentially hazardous food that has been cooked and needs to be reheated. In this study a significant correlation was observed between level of education and knowledge, with p-value 0.016 and again between level of education and practices (p-value 0.024), also between work activity and practice (p-value 0.021). There was significant difference between knowledge level and practice with p-value 0.045. The result of the study suggest that although most food service staff are knowledgeable regarding some aspects of food hygiene and food safety significant gaps remains in food safety practices, posing risk to hospitalised patients who are already vulnerable. There is a need for training in areas were food service staff are lacking knowledge.