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Sample records for care workers focusing

  1. Information needs of health care workers in developing countries: a literature review with a focus on Africa

    PubMed Central

    Pakenham-Walsh, Neil; Bukachi, Frederick

    2009-01-01

    Health care workers in developing countries continue to lack access to basic, practical information to enable them to deliver safe, effective care. This paper provides the first phase of a broader literature review of the information and learning needs of health care providers in developing countries. A Medline search revealed 1762 papers, of which 149 were identified as potentially relevant to the review. Thirty-five of these were found to be highly relevant. Eight of the 35 studies looked at information needs as perceived by health workers, patients and family/community members; 14 studies assessed the knowledge of health workers; and 8 looked at health care practice. The studies suggest a gross lack of knowledge about the basics on how to diagnose and manage common diseases, going right across the health workforce and often associated with suboptimal, ineffective and dangerous health care practices. If this level of knowledge and practice is representative, as it appears to be, it indicates that modern medicine, even at a basic level, has largely failed the majority of the world's population. The information and learning needs of family caregivers and primary and district health workers have been ignored for too long. Improving the availability and use of relevant, reliable health care information has enormous potential to radically improve health care worldwide. PMID:19356239

  2. Health-Care Workers' Perspectives on Ebola Virus Vaccine: A Focus Group and In-Depth Interview Interventional Study.

    PubMed

    Esangbedo, Dorothy O; Ughasoro, Maduka D; Tagbo, Beckie N; Olowu, Adebiyi; Anikene, Chukwuemeka; Iwegbulam, Chimaobi C

    2016-09-01

    Health-care workers (HCWs) will require Ebola virus vaccine (EVV) when it is introduced because of the high risk of exposure to the disease. Evaluations of factors that facilitate or limit vaccine uptake are critical for a successful vaccine program. Nigerian HCWs were interviewed to evaluate their knowledge, levels of acceptance, determinants of acceptance, and willingness to pay for EVV. The significance level was set at P ≤ 0.05. None of the 193 participating HCWs had correct knowledge of EVV; 34.7% (67/193) of workers thought that EVV was an extract of the serum of Ebola virus patients. About 77.3% (51/66) of workers in a region that reported Ebola cases (Lagos) were willing to be vaccinated, compared with 4.7% (3/61) in Enugu and 13.6% (9/66) in Abia (P = 0.0001). After health education, the proportion of HCWs willing to receive EVV increased (P = 0.006) except for doctors (P < 0.1). The percentage of HCWs willing to pay for EVV was 86.4%, 72.1%, and 59% in Lagos, Enugu, and Abia, respectively. The workers had fears about EVV based on nonfactual assumptions. Therefore, the EVV introduction strategy should include a strong awareness campaign with adequate explanation about the content of EVV. PMID:27382077

  3. Occupational closure in nursing work reconsidered: UK health care support workers and assistant practitioners: A focus group study.

    PubMed

    Traynor, Michael; Nissen, Nina; Lincoln, Carol; Buus, Niels

    2015-07-01

    In healthcare, occupational groups have adopted tactics to maintain autonomy and control over their areas of work. Witz described a credentialist approach to occupational closure adopted by nursing in the United Kingdom during the 19th and early 20th centuries. However, the recent advancement of assistant, 'non-qualified' workers by governments and managers forms part of a reconfiguration of traditional professional work. This research used focus groups with three cohorts of healthcare support workers undertaking assistant practitioner training at a London university from 2011 to 13 (6 groups, n = 59). The aim was to examine how these workers positioned themselves as professionals and accounted for professional boundaries. A thematic analysis revealed a complex situation in which participants were divided between articulating an acceptance of a subordinate role within traditional occupational boundaries and a usurpatory stance towards these boundaries. Participants had usually been handpicked by managers and some were ambitious and confident in their abilities. Many aspired to train to be nurses claiming that they will gain recognition that they do not currently get but which they deserve. Their scope of practice is based upon their managers' or supervisors' perception of their individual aptitude rather than on a credentialist claim. They 'usurp' nurses claim to be the healthcare worker with privileged access to patients, saying they have taken over what nursing has considered its core work, while nurses abandon it for largely administrative roles. We conclude that the participants are the not unwilling agents of a managerially led project to reshape the workforce that cuts across existing occupational boundaries.

  4. Unionizing: A Guide for Child Care Workers.

    ERIC Educational Resources Information Center

    Whitebook, Marcy; And Others

    Including excerpts from contracts protecting unionized child care workers, this booklet explains basic terminology and facts about unionizing and addresses child care workers' concerns. Section 1 answers commonly asked questions about unions and offers advice about how to answer parents' questions about workers' attempts to organize. Section 2…

  5. [Calculation of workers' health care costs].

    PubMed

    Rydlewska-Liszkowska, Izabela

    2006-01-01

    In different health care systems, there are different schemes of organization and principles of financing activities aimed at ensuring the working population health and safety. Regardless of the scheme and the range of health care provided, economists strive for rationalization of costs (including their reduction). This applies to both employers who include workers' health care costs into indirect costs of the market product manufacture and health care institutions, which provide health care services. In practice, new methods of setting costs of workers' health care facilitate regular cost control, acquisition of detailed information about costs, and better adjustment of information to planning and control needs in individual health care institutions. For economic institutions and institutions specialized in workers' health care, a traditional cost-effect calculation focused on setting costs of individual products (services) is useful only if costs are relatively low and the output of simple products is not very high. But when products form aggregates of numerous actions like those involved in occupational medicine services, the method of activity based costing (ABC), representing the process approach, is much more useful. According to this approach costs are attributed to the product according to resources used during different activities involved in its production. The calculation of costs proceeds through allocation of all direct costs for specific processes in a given institution. Indirect costs are settled on the basis of resources used during the implementation of individual tasks involved in the process of making a new product. In this method, so called map of processes/actions consisted in the manufactured product and their interrelations are of particular importance. Advancements in the cost-effect for the management of health care institutions depend on their managerial needs. Current trends in this regard primarily depend on treating all cost reference

  6. Measuring Group Care Worker Interventions in Residential Youth Care

    ERIC Educational Resources Information Center

    Bastiaanssen, Inge L. W.; Kroes, Gert; Nijhof, Karin S.; Delsing, Marc J. M. H.; Engels, Rutger C. M. E.; Veerman, Jan Willem

    2012-01-01

    Background: By interacting with children, group care workers shape daily living environments to influence treatment. Current literature provides little knowledge about the content of youth residential care. Objective: In this study, a questionnaire called the Group care worker Intervention Checklist was developed. Method: Group care workers…

  7. Requiring Influenza Vaccination for Health Care Workers

    PubMed Central

    Anikeeva, Olga; Rogers, Wendy

    2009-01-01

    Annual influenza vaccination for health care workers has the potential to benefit health care professionals, their patients, and their families by reducing the transmission of influenza in the health care setting. Furthermore, staff vaccination programs are cost-effective for health care institutions because of reduced staff illness and absenteeism. Despite international recommendations and strong ethical arguments for annual influenza immunization for health care professionals, staff utilization of vaccination remains low. We have analyzed the ethical implications of a variety of efforts to increase vaccination rates, including mandatory influenza vaccination. A program of incentives and sanctions may increase health care worker compliance with fewer ethical impediments than mandatory vaccination. PMID:19008501

  8. Emotional Exhaustion in Day-Care Workers

    ERIC Educational Resources Information Center

    Løvgren, Mette

    2016-01-01

    Although childcare workers have the second-worst occupation for work-related health problems and the number of professional day-care centers is growing throughout Europe, few studies have examined these workers' emotional well-being. This study investigates the effect of position, competence, work role, role clarity, and work tasks on emotional…

  9. Care workers, care drain, and care chains: reflections on care, migration, and citizenship.

    PubMed

    Lutz, Helma; Palenga-Möllenbeck, Ewa

    2012-01-01

    In this article, we discuss a case study that deals with the care chain phenomenon and focuses on the question of how Poland and the Ukraine as sending countries and Poland as a receiving country are affected and deal with female migrant domestic workers. We look at the ways in which these women organize care replacement for their families left behind and at those families’ care strategies. As public discourse in both countries is reacting to the feminization of migration in a form that specifically questions the social citizenship obligations of these women, we also look at the media portrayal of the situation of nonmigrating children. Finally, we explore how different aspects of citizenship matter in transnational care work migration movements.

  10. Quality of physiotherapy services for injured workers compensated by workers' compensation in Quebec: a focus group study of physiotherapy professionals.

    PubMed

    Hudon, Anne; Laliberté, Maude; Hunt, Matthew; Feldman, Debbie Ehrmann

    2015-02-01

    Musculoskeletal disorders are among the leading causes of work-related physical disability in the province of Quebec in Canada. The authors conducted a focus group study with physiotherapists and physical rehabilitation therapists working with patients whose treatments are compensated by the Quebec Workers' Compensation Board with the goal of exploring quality of care and ethical issues. Three main themes were identified: (1) systemic factors, (2) complexity in treatment decisions and (3) inequality of care. Although physiotherapy professionals strive to give these patients the best possible care, patients might not always be provided with optimal or equal treatment. When compared with other patients, there appear to be differences with respect to access to care and types of services offered to injured workers, raising equity concerns. Factors that shape and constrain quality of physiotherapy services for injured workers need to be addressed to improve care for these patients.

  11. Quality of Physiotherapy Services for Injured Workers Compensated by Workers' Compensation in Quebec: A Focus Group Study of Physiotherapy Professionals

    PubMed Central

    Laliberté, Maude; Hunt, Matthew; Feldman, Debbie Ehrmann

    2015-01-01

    Musculoskeletal disorders are among the leading causes of work-related physical disability in the province of Quebec in Canada. The authors conducted a focus group study with physiotherapists and physical rehabilitation therapists working with patients whose treatments are compensated by the Quebec Workers' Compensation Board with the goal of exploring quality of care and ethical issues. Three main themes were identified: (1) systemic factors, (2) complexity in treatment decisions and (3) inequality of care. Although physiotherapy professionals strive to give these patients the best possible care, patients might not always be provided with optimal or equal treatment. When compared with other patients, there appear to be differences with respect to access to care and types of services offered to injured workers, raising equity concerns. Factors that shape and constrain quality of physiotherapy services for injured workers need to be addressed to improve care for these patients. PMID:25947032

  12. Help! A Handbook for Child Care Workers.

    ERIC Educational Resources Information Center

    Looney, Sue; And Others

    Suggestions designed to aid those who work with young children, in particular, the day care workers, are provided. Following the booklet's introductory material, the following subjects are discussed: Language in the Day Care Center (Crib Babies--birth to six months; Six Months to 12 Months; Toddlers--one to two years old; and Over Two Years); Room…

  13. Health care of female commercial sex workers.

    PubMed

    Mårdh, P A; Shoubnikova, M; Genç, M; Chaplinkas, S; Unzeitig, V

    1999-09-01

    This article highlights health issues related to prostitution, with special reference to the situation in Europe. Strategies aimed at improving the health care of commercial sex workers, including programs for screening for sexually transmitted infections, are discussed. Problems related to failure to follow-up, particularly of mobile (migratory, international) commercial sex workers, are considered. Other topics covered include counselling on sexual risk reduction, including medical hotline telephone services and clinical outreach work. Counselling commercial sex workers on contraception, desired termination of pregnancy and hazards of illicit drug use are also highlighted. The public-health consequences of delivering poor health care to commercial sex workers are generally severely underestimated, particularly in societies where prostitution is illegal.

  14. The development of Korea's new long-term care service infrastructure and its results: focusing on the market-friendly policy used for expansion of the numbers of service providers and personal care workers.

    PubMed

    Chon, Yongho

    2013-01-01

    One of the main reasons for reforming long-term care systems is a deficient existing service infrastructure for the elderly. This article provides an overview of why and how the Korean government expanded long-term care infrastructure through the introduction of a new compulsory insurance system, with a particular focus on the market-friendly policies used to expand the infrastructure. Then, the positive results of the expansion of the long-term care infrastructure and the challenges that have emerged are examined. Finally, it is argued that the Korean government should actively implement a range of practical policies and interventions within the new system.

  15. Primary health care for Hispanic children of migrant farm workers.

    PubMed

    Wilson, A H; Wold, J L; Spencer, L; Pittman, K

    2000-01-01

    Providing primary care to children of culturally diverse populations is a challenge for pediatric nurse practitioners and educators. The challenge is intensified when providing care to Hispanic children who are uprooted because their parent(s) are migrant farm workers. The creation of health-focused academic community partnerships is one unique strategy to improve primary care to these children. One such partnership is the ongoing Migrant Family Health Program in which practitioner nursing students and their faculty members provide primary health care to children who are enrolled in a summer education program for migrant children. PMID:11005882

  16. Paraprofessional Social Workers in Day Care

    ERIC Educational Resources Information Center

    Peterman, Phylis Johnson

    1977-01-01

    Describes an 8-week, inservice, college-level course for paraprofessional social workers employed in day care centers. Bi-weekly classes, supplemented by on-site observation and consultation, covered child development, attitudes, systems, resources, roles and practice skills. Opportunities were also provided to test roles and techniques on the…

  17. Older Workers' Perspectives on Training and Retention of Older Workers: Victorian Aged Care Workers Survey. Support Document

    ERIC Educational Resources Information Center

    Lundberg, David; Marshallsay, Zariah

    2007-01-01

    Older workers' perspectives are examined in a national survey of the finance sector and case studies of aged care and construction workers. The majority of older workers intend to work beyond retirement age, to achieve a better lifestyle. With training, older workers could mentor younger workers. This support document includes a national survey of…

  18. Older Workers' Perspectives on Training and Retention of Older Workers: South Australian Aged Care Workers Study. Support Document

    ERIC Educational Resources Information Center

    Lundberg, David; Marshallsay, Zariah

    2007-01-01

    Older workers' perspectives are examined in a national survey of the finance sector and case studies of aged care and construction workers. The majority of older workers intend to work beyond retirement age, to achieve a better lifestyle. With training, older workers could mentor younger workers. This support document includes a national survey of…

  19. Workers' perception of chemical risks: a focus group study.

    PubMed

    Hambach, Ramona; Mairiaux, Philippe; François, Guido; Braeckman, Lutgart; Balsat, Alain; Van Hal, Guido; Vandoorne, Chantal; Van Royen, Paul; van Sprundel, Marc

    2011-02-01

    Workers' perceptions with respect to health and safety at work are rarely taken into account when considering the development of prevention programs. The aim of this study was to explore workers' perceptions of chemical risks at the workplace, in order to investigate the prerequisites for a workplace health program. A qualitative study was conducted involving seven focus groups of 5-10 participants (blue-collar workers) each. All groups were homogeneous in terms of sex, work status, language, and company membership. Results showed that several factors have an important influence on workers' perception of chemical risks. Workers assess risks by means of both sensory and empirical diagnosis and are concerned about the long-term health consequences. They perceive the threat of chemical risks as high. Despite this, they are resigned to accepting the risks. Existing formal sources of information are rarely consulted because they are judged to be difficult to understand and not user friendly. Instead, workers tend to obtain information from informal sources. Communication problems with and lack of trust in prevention advisers and hierarchy are frequently mentioned. Workers feel that their specific knowledge of their working conditions and their proposals for practical, cost-effective solutions to improve health and safety at the workplace are insufficiently taken into account. The use of focus groups yielded a useful insight into workers' perceptions of chemical risks. Our findings suggest that training programs for prevention advisers should include topics such as understanding of workers' perceptions, usefulness of a participatory approach, and communication and education skills. PMID:20846168

  20. Interactions and relationships in long term care: photography and narratives by direct care workers.

    PubMed

    Shenk, Dena

    2012-09-01

    The challenge of hiring and retaining well-trained caregivers for the growing numbers of elders in need of care is a global concern. This study was designed to understand the views of direct care workers and included 15 nurse aides and med techs working in an assisted living and special care assisted living community for people with dementia. Each participant was provided with a digital camera and asked to take photographs "to show what caregiving means to you." Analysis is based on group discussions about the full set of photographs created by the direct care workers and individual written and oral narratives about four photographs chosen by each participant. The categories generated from these data represent the direct care workers' perceptions of the approaches to quality caregiving and the relationships involved in doing their jobs well. By focusing on the essential relationships and interactions, rather than primarily on the required care, we can begin to imagine the caregiving experience in terms of a communal rather than an institutional experience. We can then productively turn our focus to the people involved rather than emphasize their roles as providers or recipients of care. PMID:22539061

  1. Literacy in the World of the Aged Care Worker.

    ERIC Educational Resources Information Center

    Wyse, Linda; Casarotto, Nadia

    Australia's Aged Care Act of 1997 mandates a number of key reforms aimed at ensuring consistency in the quality of care and well-being for all residents of aged care facilities. The law required residential aged care facilities to provide high-quality care within a framework of continuous improvement which requires aged care workers to perform the…

  2. Work satisfaction and intention to leave among direct care workers in community and residential aged care in Australia.

    PubMed

    King, Debra; Wei, Zhang; Howe, Anna

    2013-01-01

    Turnover in the Australian aged-care workforce is lower than in the United States but is still of concern. This research examined the effects of worker satisfaction, worker characteristics, work conditions, and workplace environment on intention to leave, using data from a 2007 national census of the aged-care workforce. A probit model was used to estimate the probability of care workers leaving their jobs in the next 12 months. While workers were satisfied, overall, with their work, improving some components of satisfaction and converting casual contracts to permanent work would reduce intention to leave. To these ends, a shift in focus is required away from worker characteristics and the nature of care work to job conditions and organizational matters amenable to management and policy action.

  3. Person-focused care at Kaiser Permanente.

    PubMed

    Bellows, Jim; Young, Scott; Chase, Alide

    2014-01-01

    Patient-focused care has been described as an extension of patient-centered care, recognizing that patients’ medical needs are best understood and addressed in the context of their entire lives, including their life goals and social, economic, emotional, and spiritual functioning. Kaiser Permanente is expanding its ability to care for members as whole persons, not just as patients, with sensitivity to nonmedical factors in planning and delivering care. We describe emerging examples in several areas: interdisciplinary care planning, behavior change, social care, patient-reported outcome measures, and Total Health. Realizing the vision of person-focused care requires taking every opportunity to fully recognizing that each patient we serve is first and foremost a person.

  4. Moving survivorship care plans forward: focus on care coordination.

    PubMed

    Salz, Talya; Baxi, Shrujal

    2016-07-01

    After completing treatment for cancer, the coordination of oncology and primary care presents a challenge for cancer survivors. Many survivors need continued oncology follow-up, and all survivors require primary care. Coordinating the shared care of a cancer survivor, or facilitating an informed handoff from oncology to primary care, is essential for cancer survivors. Survivorship care plans are personalized documents that summarize cancer treatment and outline a plan of recommended ongoing care, with the goal of facilitating the coordination of post-treatment care. Despite their face validity, five trials have failed to demonstrate the effectiveness of survivorship care plans. We posit that these existing trials have critical shortcomings and do not adequately address whether survivorship care plans improve care coordination. Moving forward, we propose four criteria for future trials of survivorship care plans: focusing on high-needs survivor populations, tailoring the survivorship care plan to the care setting, facilitating implementation of the survivorship care plan in clinical practice, and selecting appropriate trial outcomes to assess care coordination. When trials meet these criteria, we can finally assess whether survivorship care plans help cancer survivors receive optimal oncology and primary care. PMID:27075650

  5. Moving survivorship care plans forward: focus on care coordination.

    PubMed

    Salz, Talya; Baxi, Shrujal

    2016-07-01

    After completing treatment for cancer, the coordination of oncology and primary care presents a challenge for cancer survivors. Many survivors need continued oncology follow-up, and all survivors require primary care. Coordinating the shared care of a cancer survivor, or facilitating an informed handoff from oncology to primary care, is essential for cancer survivors. Survivorship care plans are personalized documents that summarize cancer treatment and outline a plan of recommended ongoing care, with the goal of facilitating the coordination of post-treatment care. Despite their face validity, five trials have failed to demonstrate the effectiveness of survivorship care plans. We posit that these existing trials have critical shortcomings and do not adequately address whether survivorship care plans improve care coordination. Moving forward, we propose four criteria for future trials of survivorship care plans: focusing on high-needs survivor populations, tailoring the survivorship care plan to the care setting, facilitating implementation of the survivorship care plan in clinical practice, and selecting appropriate trial outcomes to assess care coordination. When trials meet these criteria, we can finally assess whether survivorship care plans help cancer survivors receive optimal oncology and primary care.

  6. Perceived Challenges in Dementia Care by Vietnamese Family Caregivers and Care Workers in South Australia.

    PubMed

    Xiao, Lily Dongxia; Habel, Lesley; De Bellis, Anita

    2015-09-01

    The majority of Vietnamese Australians migrated to Australia as refugees to escape a war and this unique migration background may affect their ability to access and utilize healthcare services in Australia. Inability to utilize dementia services is associated with higher levels of caregiver burden, higher rates of morbidities and mortality and hospitalization. The aim of the study was to explore the perceived challenges of dementia care from Vietnamese family caregivers and Vietnamese care workers. Gadamer's philosophical hermeneutics was used to interpret and describe the experiences of the participants. Data were collected from in-depth interviews with six Vietnamese family caregivers and a focus group with Vietnamese care workers using purposive sampling. Participants were recruited from a Vietnamese community care organization in South Australia. Five themes were identified from the data analysis namely: (1) a need for culturally and linguistically appropriate dementia education programs; (2) a willingness and unwillingness to seek help; (3) poor knowledge of health care service availability related to dementia; (4) the effect of language barrier in accessing services; and (5) the main sources of services utilized. The study revealed that Vietnamese family caregivers and Vietnamese care workers held different views on the association of stigma with dementia. Findings also revealed factors that impacted accessing and utilizing dementia services. These findings facilitate a more comprehensive understanding of Vietnamese family caregivers' needs and have implications for developing individualized support for family caregivers and for consumer-directed dementia services in Australia.

  7. Perceived Challenges in Dementia Care by Vietnamese Family Caregivers and Care Workers in South Australia.

    PubMed

    Xiao, Lily Dongxia; Habel, Lesley; De Bellis, Anita

    2015-09-01

    The majority of Vietnamese Australians migrated to Australia as refugees to escape a war and this unique migration background may affect their ability to access and utilize healthcare services in Australia. Inability to utilize dementia services is associated with higher levels of caregiver burden, higher rates of morbidities and mortality and hospitalization. The aim of the study was to explore the perceived challenges of dementia care from Vietnamese family caregivers and Vietnamese care workers. Gadamer's philosophical hermeneutics was used to interpret and describe the experiences of the participants. Data were collected from in-depth interviews with six Vietnamese family caregivers and a focus group with Vietnamese care workers using purposive sampling. Participants were recruited from a Vietnamese community care organization in South Australia. Five themes were identified from the data analysis namely: (1) a need for culturally and linguistically appropriate dementia education programs; (2) a willingness and unwillingness to seek help; (3) poor knowledge of health care service availability related to dementia; (4) the effect of language barrier in accessing services; and (5) the main sources of services utilized. The study revealed that Vietnamese family caregivers and Vietnamese care workers held different views on the association of stigma with dementia. Findings also revealed factors that impacted accessing and utilizing dementia services. These findings facilitate a more comprehensive understanding of Vietnamese family caregivers' needs and have implications for developing individualized support for family caregivers and for consumer-directed dementia services in Australia. PMID:25935206

  8. Preserving workers' compensation benefits in a managed health care environment.

    PubMed

    Dembe, A E

    1998-01-01

    Managed care techniques are increasingly being applied in the workers' compensation setting. Many workers, labor representatives and public health advocates fear that the introduction of managed care into workers' compensation may reflect a broader employer-driven campaign to erode benefits, tighten eligibility criteria, and weaken employees' control over health care and compensation issues. The potential threats to workers can be mitigated by involving them in the design of the workers' compensation health plan and selection of provider organization, assuring access to appropriate specialists and diagnostic testing, minimizing delays, increasing accountability through contract provisions and government oversight, and enhancing communications through the use of ombudsmen and alternative dispute resolution approaches. Additional outcomes studies assessing the long-term impact of managed care in workers' compensation are needed. PMID:9670702

  9. More Health Care Workers Need Flu Shots: CDC

    MedlinePlus

    ... https://medlineplus.gov/news/fullstory_161257.html More Health Care Workers Need Flu Shots: CDC Vaccination protects both ... FRIDAY, Sept. 30, 2016 (HealthDay News) -- More U.S. health care workers need to get their annual flu shots, ...

  10. Community Health Workers as Support for Sickle Cell Care.

    PubMed

    Hsu, Lewis L; Green, Nancy S; Donnell Ivy, E; Neunert, Cindy E; Smaldone, Arlene; Johnson, Shirley; Castillo, Sheila; Castillo, Amparo; Thompson, Trevor; Hampton, Kisha; Strouse, John J; Stewart, Rosalyn; Hughes, TaLana; Banks, Sonja; Smith-Whitley, Kim; King, Allison; Brown, Mary; Ohene-Frempong, Kwaku; Smith, Wally R; Martin, Molly

    2016-07-01

    Community health workers are increasingly recognized as useful for improving health care and health outcomes for a variety of chronic conditions. Community health workers can provide social support, navigation of health systems and resources, and lay counseling. Social and cultural alignment of community health workers with the population they serve is an important aspect of community health worker intervention. Although community health worker interventions have been shown to improve patient-centered outcomes in underserved communities, these interventions have not been evaluated with sickle cell disease. Evidence from other disease areas suggests that community health worker intervention also would be effective for these patients. Sickle cell disease is complex, with a range of barriers to multifaceted care needs at the individual, family/friend, clinical organization, and community levels. Care delivery is complicated by disparities in health care: access, delivery, services, and cultural mismatches between providers and families. Current practices inadequately address or provide incomplete control of symptoms, especially pain, resulting in decreased quality of life and high medical expense. The authors propose that care and care outcomes for people with sickle cell disease could be improved through community health worker case management, social support, and health system navigation. This paper outlines implementation strategies in current use to test community health workers for sickle cell disease management in a variety of settings. National medical and advocacy efforts to develop the community health workforce for sickle cell disease management may enhance the progress and development of "best practices" for this area of community-based care.

  11. Informal payments and the quality of health care: Mechanisms revealed by Tanzanian health workers.

    PubMed

    Mæstad, Ottar; Mwisongo, Aziza

    2011-02-01

    Informal payments for health services are common in many transitional and developing countries. The aim of this paper is to investigate the nature of informal payments in the health sector of Tanzania and to identify mechanisms through which informal payments may affect the quality of health care. Our focus is on the effect of informal payments on health worker behaviours, in particular the interpersonal dynamics among health workers at their workplaces. We organised eight focus groups with 58 health workers representing different cadres and levels of care in one rural and one urban district in Tanzania. We found that health workers at all levels receive informal payments in a number of different contexts. Health workers sometimes share the payments received, but only partially, and more rarely within the cadre than across cadres. Our findings indicate that health workers are involved in 'rent-seeking' activities, such as creating artificial shortages and deliberately lowering the quality of service, in order to extract extra payments from patients or to bargain for a higher share of the payments received by their colleagues. The discussions revealed that many health workers think that the distribution of informal payments is grossly unfair. The findings suggest that informal payments can impact negatively on the quality of health care through rent-seeking behaviours and through frustrations created by the unfair allocation of payments. Interestingly, the presence of corruption may also induce non-corrupt workers to reduce the quality of care. Positive impacts can occur because informal payments may induce health workers to increase their efforts, and maybe more so if there is competition among health workers about receiving the payments. Moreover, informal payments add to health workers' incomes and might thus contribute to retention of health workers within the health sector.

  12. Understanding the concept of the key worker: do focus groups help?

    PubMed

    Hull, Ken; Turton, Pat

    2014-08-12

    The concept of the 'key-worker role' within paediatric haematology and oncology services is recognised in the UK through inclusion in published policies and guidance. Such guidance originates from both statutory and voluntary sector organisations. Within the policy direction itself, references are made to both 'designated' and 'non-designated' key workers, and there remains ongoing confusion within the professional field about the exact nature of the process of 'key-working' and how this should operate. This confusion therefore also exists for parents, carers and service users. The project described here aimed to examine the concept of the key-worker role through consultation with users as part of local service development. Focus group discussion was identified as the methodology of choice. Careful planning and delivery ensured that meaningful data emerged. Active participation by those attending the focus group discussion was observed. The focus group was in two sessions, both of which were digitally recorded and transcribed, with contemporaneous notes taken. These were subjected to thematic analysis and clear themes emerged regarding the importance of terminology, communication, skill mix and the use of technology. This local project achieved greater clarity about how to develop the key-worker role to best meet the needs of users through highlighting the need to include both the key-worker role, and the process of key-working. It is concluded that the use of focus groups is both a valid and valuable mechanism of consultation, as user consultation regarding service design and evaluation of care delivered is high on the wider agenda of the NHS.

  13. Occupational hazards to health care workers: Diverse, ill-defined, and not fully appreciated

    SciTech Connect

    Moore, R.M. Jr.; Kaczmarek, R.G. )

    1990-10-01

    Health care workers are challenged by an imposing group of occupational hazards. These hazards include exposure to ionizing radiation, stress, injury, infectious agents, and chemicals. The magnitude and diversity of these hazards are not fully appreciated. The acquired immunodeficiency syndrome epidemic has created additional occupational hazards and has focused attention on the problem of occupational hazards to health care workers. Concern over the nosocomial transmission of the human immunodeficiency virus has contributed to efforts to implement universal infection control precautions and to decrease needlestick injuries. Health care organizations and providers, who have prompted health and safety campaigns for the general public, should not overlook the dangers associated with the health care setting.

  14. A multidimensional approach for selecting child care workers.

    PubMed

    Jones, J W; Joy, D S; Martin, S L

    1990-10-01

    A multidimensional selection battery was designed to predict a variety of criteria important in the selection of child care workers. The battery assesses constructs related to honesty, violence, substance abuse, emotional stability and safety. A series of studies were used to test the validity of the selection battery. Scores on the test battery were compared with those from three alternative selection procedures to define the measured constructs. Three additional studies show the relation of scores on the selection battery and the behavior of child care workers. The test battery was correlated with the job performance of child care workers and identified adults convicted for sexual offenses against minors. PMID:2263707

  15. Dilemmas in providing patient-focused care.

    PubMed

    Drayton, Shirley; Canter, Amy; Allen, Cynthia

    2003-01-01

    The provision of patient-focused care to the elderly is often fraught with many ethical and challenging dilemmas. However, for health care professionals, these dilemmas can be magnified when the chronic disease is accompanied by dementia. Such was the case of Mrs. A. The multidisciplinary team of a 36-bed acute care unit identified the challenges they experienced while caring for a 65-year-old female with multiple medical problems: diabetes; hypertension; cardiovascular disease; end stage renal disease and dementia probably due to cardiovascular and metabolic causes. Mrs. A. was admitted to start hemodialysis treatments. Her care was complicated by frequent outbursts of verbal and physical aggression towards staff. Mrs. A. was deemed incapable with regard to personal care and property. Her son believed she required long-term placement, and control of her property was assumed by the Public Guardian and Trustee. Mrs. A. vehemently objected to this total loss of control. This paper will describe how the multidisciplinary team implemented a variety of strategies to help staff intervene more effectively in meeting the care needs of Mrs. A. PMID:14753100

  16. Potential allergy and irritation incidents among health care workers.

    PubMed

    Alamgir, Hasanat; Yu, Shicheng; Chavoshi, Negar; Ngan, Karen

    2008-07-01

    This study describes the types, causes, and outcomes of potential irritation and allergy incidents among workers in British Columbia's health care industry. Data on occupation-induced allergy and irritation incidents were extracted from a standardized database using the number of productive hours obtained from payroll data as a denominator during a 1-year period from three British Columbia health regions. Younger workers, female workers, facility support service workers, laboratory assistants and technicians, and maintenance and acute care workers were found to be at higher risk for allergy and irritation incidents. Major causes of allergy and irritation incidents included chemicals, blood and body fluids, food and objects, communicable diseases, air quality, and latex. A larger proportion of chemically induced incidents resulted in first aid care only, whereas non-chemical incidents required more emergency room visits. PMID:18669179

  17. Becoming-Worker: Vocational Training for Workers in Aged Care

    ERIC Educational Resources Information Center

    Somerville, Margaret

    2006-01-01

    Women's care work sits on the boundary between unpaid work in the private domain and poorly paid, low-status work in the public sphere. It continues to be a site for the expression of complex, high-level knowledge and skills, and of ongoing gender oppression. The aged-care industry is a particularly salient example of such work. It is a…

  18. Preparing Health Care Workers for the Year 2000.

    ERIC Educational Resources Information Center

    Philadelphia Hospital and Health Care-District 1199C, PA.

    Technological changes affecting the health care industry spurred the development and implementation of a curriculum to upgrade the skills of Philadelphia health care workers in written communication, mathematics, computer literacy, oral and listening communication, and issues surrounding their union employment in the health care field. The…

  19. Social Workers' Role in the Canadian Mental Health Care System

    ERIC Educational Resources Information Center

    Towns, Ashley M.; Schwartz, Karen

    2012-01-01

    Objective: Using Canadian survey data this research provides social workers in Canada with a better understanding of their role in the Canadian mental health care system. Methods: By analyzing data from the Canadian Community Health Survey, Cycle 1.2 Mental Health and Well-being, the role of social workers in the Canadian mental health system was…

  20. Oncology Social Workers' Attitudes toward Hospice Care and Referral Behavior

    ERIC Educational Resources Information Center

    Becker, Janet E.

    2004-01-01

    Members of the Association of Oncology Social Workers completed a survey, which included the Hospice Philosophy Scale (HPS) assessing the likelihood of the worker referring a terminally ill patient to hospice, background and experience, and demographics. The respondents held overwhelmingly favorable attitudes toward hospice philosophy and care,…

  1. Will universal access to antiretroviral therapy ever be possible? The health care worker challenge.

    PubMed

    Maddison, André R; Schlech, Walter F

    2010-01-01

    The United Nations millennium development goal of providing universal access to antiretroviral therapy (ART) for patients living with HIV/AIDS by 2010 is unachievable. Currently, four million people are receiving ART, of an estimated 13.7 million who need it. A major challenge to achieving this goal is the shortage of health care workers in low-income and low-resource areas of the world. Sub-Saharan African countries have 68% of the world's burden of illness from AIDS, yet have only 3% of health care workers worldwide. The shortage of health care providers is primarily caused by a national and international 'brain drain,' poor distribution of health care workers within countries, and health care worker burnout.Even though the millennium development goal to provide universal access to ART will not be met by 2010, it is imperative to continue to build on the momentum created by these humanitarian goals. The present literature review was written with the purpose of attracting research and policy attention toward evidence from small-scale projects in sub-Saharan Africa, which have been successful at increasing access to ART. Specifically, a primary-care model of ART delivery, which focuses on decentralization of services, task shifting and community involvement will be discussed. To improve the health care worker shortage in sub-Saharan Africa, the conventional model of health care delivery must be replaced with an innovative model that utilizes doctors, nurses and community members more effectively.

  2. Job satisfaction, burnout, and turnover in health care social workers.

    PubMed

    Siefert, K; Jayaratne, S; Chess, W A

    1991-08-01

    The findings of two consecutive surveys of job satisfaction and burnout in national samples of health care social workers are presented. Between 1979 and 1989, there were significant increases in the proportion of social workers employed in private versus public agencies, in quantitative workload, and in social workers' perceptions of the challenges presented by their jobs. Role conflict and role ambiguity, lack of comfort, and dissatisfaction with financial rewards emerged as significant predictors of depersonalization and burnout. However, a significant increase in social workers' feelings of personal accomplishment also occurred, and high challenge emerged as a significant predictor of sense of effectiveness. PMID:1894206

  3. Community Health Workers as Support for Sickle Cell Care.

    PubMed

    Hsu, Lewis L; Green, Nancy S; Donnell Ivy, E; Neunert, Cindy E; Smaldone, Arlene; Johnson, Shirley; Castillo, Sheila; Castillo, Amparo; Thompson, Trevor; Hampton, Kisha; Strouse, John J; Stewart, Rosalyn; Hughes, TaLana; Banks, Sonja; Smith-Whitley, Kim; King, Allison; Brown, Mary; Ohene-Frempong, Kwaku; Smith, Wally R; Martin, Molly

    2016-07-01

    Community health workers are increasingly recognized as useful for improving health care and health outcomes for a variety of chronic conditions. Community health workers can provide social support, navigation of health systems and resources, and lay counseling. Social and cultural alignment of community health workers with the population they serve is an important aspect of community health worker intervention. Although community health worker interventions have been shown to improve patient-centered outcomes in underserved communities, these interventions have not been evaluated with sickle cell disease. Evidence from other disease areas suggests that community health worker intervention also would be effective for these patients. Sickle cell disease is complex, with a range of barriers to multifaceted care needs at the individual, family/friend, clinical organization, and community levels. Care delivery is complicated by disparities in health care: access, delivery, services, and cultural mismatches between providers and families. Current practices inadequately address or provide incomplete control of symptoms, especially pain, resulting in decreased quality of life and high medical expense. The authors propose that care and care outcomes for people with sickle cell disease could be improved through community health worker case management, social support, and health system navigation. This paper outlines implementation strategies in current use to test community health workers for sickle cell disease management in a variety of settings. National medical and advocacy efforts to develop the community health workforce for sickle cell disease management may enhance the progress and development of "best practices" for this area of community-based care. PMID:27320471

  4. Occupational health nursing with Navajo workers. Providing culturally competent care.

    PubMed

    Lusk, P; Holst, P

    2001-01-01

    1. Native Americans in the southwestern United States are considered a "vulnerable population." Native Americans have economic difficulties, poor health, and little access to health care. The Navajo nation is the largest Native American reservation in the United States. 2. Occupational health nurses who provide culturally competent care increase the likelihood for Navajo workers to obtain optimal benefits from workplace health services. 3. The nurse uses cultural assessment skills and critical thinking abilities to maximize therapeutic interactions and minimize barriers in communications with workers of other cultural backgrounds. 4. The nurse who is knowledgeable about the Navajo way can help achieve a balance between the traditional ways and Western ways of addressing serious health care issues facing the Navajo worker. This knowledge and cultural awareness also increases the effectiveness of health promotion and health education programs offered to workers, their families, and their communities. PMID:11760275

  5. Observations of Group Care Worker-Child Interaction in Residential Youth Care: Pedagogical Interventions and Child Behavior

    ERIC Educational Resources Information Center

    Bastiaanssen, Inge L. W.; Delsing, Marc J. M. H.; Geijsen, Luuk; Kroes, Gert; Veerman, Jan W.; Engels, Rutger C. M. E.

    2014-01-01

    Background: The work of group care workers in residential youth care is often described as professional parenting. Pedagogical interventions of group care workers influence the quality of care for looked-after children. Objective: The aim of the current study was to observe the pedagogical interventions of group care workers within residential…

  6. Understanding Nursing Home Worker Conceptualizations about Good Care

    ERIC Educational Resources Information Center

    Chung, Gawon

    2013-01-01

    This study explored how direct care workers in nursing homes conceptualize good care and how their conceptualizations are influenced by external factors surrounding their work environment and the relational dynamics between them and residents. Study participants were drawn from a local service employees' union, and in-depth interviews were…

  7. A Behavioral Approach to Training Day Care Workers

    ERIC Educational Resources Information Center

    Ivy, Jonathan W.; Schreck, Kimberly A.

    2008-01-01

    Day care workers are not only responsible for meeting the needs of the children they care for but creating an enriched and friendly environment as well. Few daycare centers require any specific inservice training for their staff members. When provided, training typically occurs as a didactic workshop. For this study a multiple baseline design…

  8. Social Workers in Home Care: The Israeli Case

    ERIC Educational Resources Information Center

    Ayalon, Liat; Baum, Nehami

    2010-01-01

    In Israel, the government partially supports personal home care services (grooming, feeding, assistance with transfers) as a means to maintain frail individuals in their home environment for as long as possible. Social workers capture a prominent position in these arrangements as initiators and supervisors of personal home care services. This…

  9. Social workers' use of spiritual practices in palliative care.

    PubMed

    Dane, Barbara; Moore, Robert

    2005-01-01

    Numerous studies have examined client use of spiritual and/or religious practices to cope with illness and adversity. This study explores social workers' use of spiritual practices as reflected in their work with palliative care clients. Survey results (n = 327) indicated significant relationships of spiritual practices such as yoga, prayer and meditation to working with palliative care clients. The total number of these approaches is predicted by factors such as theoretical orientation and the social workers' own struggles with palliative care and other issues. Our study supports the need for additional investigation of spiritual issues in practice.

  10. Dissemination and Implementation of Function Focused Care for Assisted Living.

    PubMed

    Resnick, Barbara; Galik, Elizabeth; Vigne, Erin; Carew, Allison Payne

    2016-06-01

    Assisted living (AL) settings are residential settings that provide housing and supportive services for older and disabled adults. Although individuals in AL are less functionally impaired than those in nursing home settings, they engage in limited amounts of physical activity and experience more rapid functional decline than their peers in nursing homes. Function Focused Care for Assisted Living (FFC-AL) was developed to prevent decline, improve function, and increase physical activity among residents living in these settings. The purpose of this study was to disseminate and implement the previously established, effective FFC-AL approach to 100 AL settings. Evidence of our ability to successfully disseminate and implement FFC-AL across these settings was established using the Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance model. Settings were eligible to participate if they had more than eight beds and identified a nurse (i.e., registered nurse, licensed practical nurse, or direct care worker) champion to facilitate the implementation process. Setting recruitment was done via mailed invitations to 300 eligible ALs and e-mails to relevant AL organizations. Evidence of reach was based on our ability to recruit 99 ALs with adoption of the intervention in 78 (78%). There was a significant improvement in policies supporting function-focused care and in establishing environments that supported function-focused care, and there was evidence of enduring changes in settings indicative of maintenance. We were able to implement all aspects of the intervention although challenges were identified. Future work should focus on using more face-to-face interactions with champions along with identified stakeholders, evaluating characteristics of champions to establish those who are most successful, and recruiting residents to obtain resident-specific outcomes.

  11. Measuring Worker Turnover in Long-Term Care: Lessons from the Better Jobs Better Care Demonstration

    ERIC Educational Resources Information Center

    Piercy, Kathleen Walsh, Ed.; Barry, Theresa; Kemper, Peter; Brannon, S. Diane

    2008-01-01

    Purpose: Turnover among direct-care workers (DCWs) continues to be a challenge in long-term care. Both policy makers and provider organizations recognize this issue as a major concern and are designing efforts to reduce turnover among these workers. However, there is currently no standardized method of measuring turnover to define the scope of the…

  12. Workplace Spanish for Health Care Workers.

    ERIC Educational Resources Information Center

    Garcia, Paula

    This syllabus and curriculum guide were developed for a 12-week course in workplace Spanish for clinical workers at the Claretian Medical Center on the south side of Chicago. The purpose of the class was to provide basic communicative abilities in Spanish to the medical staff---registered nurses, triage nurses, and laboratory technologists--such…

  13. Occupationally acquired HIV: the vulnerability of health care workers under workers' compensation laws.

    PubMed

    Tereskerz, P M; Jagger, J

    1997-09-01

    Approximately 800,000 needlesticks and other sharp injuries from contaminated medical devices occur in health care settings each year, of which an estimated 16,000 are contaminated by human immunodeficiency virus (HIV). Health care workers who are occupationally infected by HIV are at risk of being left without workers' compensation coverage. In some states, the definition of an occupational disease is so restrictive that infected health care workers are unlikely to qualify for benefits. For those who are able to meet the definition, compensation is often inadequate. Recourse is also limited by statutory provisions that preclude health care workers from bringing civil suits against their employers. We recommend the amendment of legislation to provide more equitable remedies, including: (1) broadening the definition of occupational disease; (2) eliminating provisions that require a claimant to prove that (a) a specific occupational incident resulted in infection and (b) HIV is not an ordinary disease of life; (3) expanding the time for filing a claim; (4) assuring that lifetime benefits will be provided to the disabled health care worker; and (5) assuring that claims will remain confidential.

  14. Teaching the Principles of Applied Behavior Modification to Direct-Care Workers in Mental Retardation.

    ERIC Educational Resources Information Center

    Brautman, Edwin Jay

    Intended for direct care workers at institutions for severely and profoundly retarded persons, the curriculum focuses on behavior modification skill instruction. Eight lesson plans are presented, with information on topic, content, and teaching methods. Topics include the following (sample subtopics in parentheses): 1) introduction; 2) observing…

  15. Understanding and prevention of low back pain in care workers.

    PubMed

    Minematsu, Akira

    2007-01-01

    The aim of this study was to investigate the actual situation of low back pain (LBP) prevention in care workers with questionnaires, and this data were used to clarify and decrease LBP factors. Subjects were 52 care workers (30.7 ± 10.0 years old) in a nursing home who filled out two kinds of questionnaires about LBP, one about the prevalence of LBP (QN1) and the other about LBP control measures (QN2). They had either license of certified care worker, 1st or 2nd class care worker. The data were collected for the purpose of finding differences in age and career (QN1) and differences in LBP control measures (QN2) between subjects with and without LBP. The average career of the subjects was 19.1 ± 12.5 months, and the prevalence of LBP among them was 46.2% (24 care workers), of which 66.7% began having LBP after starting work as care workers. Moreover, 75.0% of these subjects began having LBP within a year after starting work. Further, of the 24 care workers with LBP, 66.7% reported constantly experiencing LBP. The major risk factors given for LBP in care work were transfer, the replacement of diapers, and movement in a half-sitting posture. Compared with LBP subjects, rates of taking preventative steps in the non-LBP group were low. More than 80% of the subjects with LBP engaged in prevention methods such as using body mechanics, learning the proper way to perform care activities, using LBP support belts, and increasing their skills and knowledge with regard to their job responsibilities. Most subjects began to engage in such prevention methods after the onset of LBP. The results of this investigation indicated that most subjects did not engage in measures to counter their LBP until after it had already started, and that they selected prevention methods which were easy to perform and effective. It is important for care workers to learn the best ways to inhibit pain and prevent the occurrence, or recurrence, of LBP. It is necessary for physical therapists to grasp

  16. Prevalence of latex hypersensitivity among health care workers in Malaysia.

    PubMed

    Shahnaz, M; Azizah, M R; Hasma, H; Mok, K L; Yip, E; Ganesapillai, T; Suraiya, H; Nasuruddin, B A

    1999-03-01

    Health care workers have been reported to constitute one of the few high-risk groups related to IgE-mediated hypersensitivity associated with the use of latex products. This paper describes the first ever study of prevalence carried out in Malaysia among these workers. One hundred and thirty health care personnel from Hospital Kuala Lumpur were skin tested. Extracts used were prepared from seven different brands of natural rubber latex gloves with varying levels of extractable protein (EPRRIM). Out of the 130 volunteers, 4 (3.1%) had positive skin test to latex with extracts with high levels of EPRRIM (> 0.7 mg/g). The prevalence among the Malaysian health care workers can be considered to be low in comparison to that of some consumer countries as the USA which reported a prevalence of as high as 16.9%.

  17. Risk factors for latex sensitization among health care workers.

    PubMed

    Vila, L; Sánchez, G; Añó, M; Uasuf, C G; Sanz, M L

    1999-01-01

    Health care workers, children with spina bifida and rubber industry workers show higher prevalence of latex sensitization compared to the general population, and they are considered at-risk groups. Our aim was to establish the prevalence of latex allergy among health care workers at the Clínica Universitaria of Navarra and to analyze potential risk factors, including personal and family history of atopy, sex, as well as factors leading to enhanced exposure to latex, such as being a nurse, belonging to surgical departments, having undergone previous surgery and the number of gloves employed per week. Health care workers (n = 1,150) (doctors, nurses, assistant nurses, laboratory technicians and practicing medical and nursing students) were evaluated using a questionnaire and skin prick test (SPT). Serum specific IgE was determined by CAP-FEIA (Pharmacia, Sweden) in those with positive SPT. The participation index was 26.17%: 301 volunteers answered the questionnaire and underwent SPT. Fifteen subjects presented positive SPT to latex. It was found that 5% of the health care workers from the Clínica Universitaria were sensitized to latex allergens. Thirteen were females and two males. Mean age was 38.4 (+/- 7.09) years. Nine were nurses, three assistant nurses, one nursing student and two medical doctors. Eight belonged to medical, five to surgical and two to laboratory departments. There were no significant differences among the subjects in the prevalence of latex sensitization. Fourteen reported symptoms related to latex, mostly pruritus, dryness and/or redness of the hands (n = 12) and rhinitis (n = 6). Only one subject reported no symptoms when using latex products. Eight were atopic; personal history of atopy was the only significant (odds ratio = 5.10, p < 0.01) risk factor for latex sensitization. It was concluded that atopic health care workers show a more increased risk of latex sensitization than those who are nonatopic. PMID:10664929

  18. Support workers in social care in England: a scoping study.

    PubMed

    Manthorpe, Jill; Martineau, Stephen; Moriarty, Jo; Hussein, Shereen; Stevens, Martin

    2010-05-01

    This paper reports the findings of a scoping study designed to describe the evidence base with regard to support workers in social care in the United Kingdom and to identify gaps in knowledge. Multiple bibliographic databases were searched for studies published since 2003. The results revealed that the support worker role, though not well-defined, could be characterised as one aimed at fostering independence among service users, undertaking tasks across social and health-care, and not being trained in, or a member of, a specific profession. The studies identified were predominantly small-scale qualitative projects which considered issues such as role clarity, training and pay, worker satisfaction, service user views and the amount of time support workers are able to spend with service users compared to other staff. The review concluded that the research base lacks longitudinal studies, there is definitional confusion and imprecision, and there is limited evidence about employment terms and conditions for support workers or about their accountability and performance. The desirability and value of training and how it is resourced need further analysis. It is concluded that moves to self-directed support or personalisation and the increased reliance on and use of support workers, in the form of personal assistants, call for closer scrutiny of the role. PMID:20345887

  19. [Pertussis as health care workers infectious disease--the clinical case with a commentary].

    PubMed

    Kuchar, Ernest; Nitsch-Osuch, Aneta; Szenborn, Leszek

    2013-01-01

    We discuss the changing epidemiological situation of pertussis observed in recent years, with a focus on the shift of cases from young children to older age groups, teenagers and adults. Whooping cough may affect healthcare workers who belong to a high-risk group and cause hospital infections. We present a case report of pertussis in a nurse and the recommended prophylactic measures in healthcare workers. The current definition and diagnosis of pertussis is also discussed. The clinical course of pertussis can be significantly alleviated and highly non-specific, with no typical coughing and vomiting in people vaccinated against whooping cough a few years earlier. Pertussis should be considered in the differential diagnosis of cough lasting more than fourteen days. Improvement of the epidemiological situation requires, besides immunization of infants, regular and universal booster immunization for adolescents and adults. Vaccinations for health care workers of neonatal and pediatric wards are recommended in the National Program of Immunization for 2013. It seems that booster vaccination of health care workers with a triple vaccine against diphtheria, tetanus and acellular pertussis (dTpa) of the reduced quantity of antigens, particularly of health workers caring for infants, children and the elderly, may be the most effective way to reduce the risk of pertussis transmission in the health care environment. PMID:24502135

  20. Development of the Child Care Worker Job Stress Inventory.

    ERIC Educational Resources Information Center

    Curbow, Barbara; Spratt, Kai; Ungaretti, Antoinette; McDonnell, Karen; Breckler, Steven

    2000-01-01

    Examined psychometric characteristics of three 17-item measures of child care worker job demands, job control, and job resources. Found that job demands scale had lower reliability than job control or job resources. Demonstrated known groups validity through conceptually meaningful pattern of differences between family childcare providers and…

  1. Social Workers Training Primary Care Physicians: Essential Psychosocial Principles.

    ERIC Educational Resources Information Center

    Zayas, Luis H.; Dyche, Larry A.

    1992-01-01

    Notes that growth of primary care medicine is opening new roles for social worker in medical education. Describes family-oriented, community-based medical residency program in which social work faculty plays prominent role in education of young physicians. Discusses relevance of core social work principles to medicine and how they are introduced…

  2. Direct Care Workers' Recommendations for Training and Continuing Education

    ERIC Educational Resources Information Center

    Menne, Heather L.; Ejaz, Farida K.; Noelker, Linda S.; Jones, James A.

    2007-01-01

    Training of direct care workers (DCWs) varies depending upon the setting in which they work and the state in which they are trained. Evidence points to the importance of adequate training as critical to DCW job satisfaction and reduction in turnover. Several approaches have been taken to enhance the training of DCWs with the objective that as job…

  3. Cultural Support Workers and Long Day Care Services

    ERIC Educational Resources Information Center

    Miller, Melinda G.; Knowles, Meg; Grieshaber, Susan

    2011-01-01

    In Australia, eligible long day care services may apply for support at the state level to assist with the transition of children from culturally or linguistically diverse backgrounds into childcare settings. For staff in childcare services, this support comes in the form of a cultural support worker (CSW). The primary role of a CSW is to build…

  4. Understanding Burnout in Child and Youth Care Workers

    ERIC Educational Resources Information Center

    Barford, Sean W.; Whelton, William J.

    2010-01-01

    Burnout is a major concern in human service occupations as it has been linked to turnover, absenteeism, a reduction in the quality of services, numerous physical and psychological disorders, and a disruption in interpersonal relations (Maslach et al. "2001"). Child and youth care workers are especially susceptible to burnout as the inherent…

  5. V-TECS Guide for Child Care Worker.

    ERIC Educational Resources Information Center

    Elliott, Ronald T.; Benson, Robert T.

    This guide is intended to assist teachers responsible for instructing future child care workers. The competency-based course outline provided covers the following topics: planning activities or programs for young children, performing child guidance activities, performing food service activities, performing housekeeping activities, and performing…

  6. How decentralisation influences the retention of primary health care workers in rural Nigeria

    PubMed Central

    Abimbola, Seye; Olanipekun, Titilope; Igbokwe, Uchenna; Negin, Joel; Jan, Stephen; Martiniuk, Alexandra; Ihebuzor, Nnenna; Aina, Muyi

    2015-01-01

    Background In Nigeria, the shortage of health workers is worst at the primary health care (PHC) level, especially in rural communities. And the responsibility for PHC – usually the only form of formal health service available in rural communities – is shared among the three tiers of government (federal, state, and local governments). In addition, the responsibility for community engagement in PHC is delegated to community health committees. Objective This study examines how the decentralisation of health system governance influences retention of health workers in rural communities in Nigeria from the perspective of health managers, health workers, and people living in rural communities. Design The study adopted a qualitative approach, and data were collected using semi-structured in-depth interviews and focus group discussions. The multi-stakeholder data were analysed for themes related to health system decentralisation. Results The results showed that decentralisation influences the retention of rural health workers in two ways: 1) The salary of PHC workers is often delayed and irregular as a result of delays in transfer of funds from the national to sub-national governments and because one tier of government can blame failure on another tier of government. Further, the primary responsibility for PHC is often left to the weakest tier of government (local governments). And the result is that rural PHC workers are attracted to working at levels of care where salaries are higher and more regular – in secondary care (run by state governments) and tertiary care (run by the federal government), which are also usually in urban areas. 2) Through community health committees, rural communities influence the retention of health workers by working to increase the uptake of PHC services. Community efforts to retain health workers also include providing social, financial, and accommodation support to health workers. To encourage health workers to stay, communities also

  7. Promoting the role of patients in improving hand hygiene compliance amongst health care workers

    PubMed Central

    Ahmed Awaji, Maryam; Al-Surimi, Khaled

    2016-01-01

    Hand hygiene is one of the fundamental measures necessary for reducing healthcare-associated infections. The adherence of health care workers to safe hand hygiene practices is low worldwide, despite evidence showing compliance with hand hygiene guidelines decreases infection rate. This project focuses on the role of patients in promoting healthcare workers' compliance with hand hygiene practices. Several plan-do-study-act (PDSA) cycles were conducted to test interventions which aimed to empower patients and increase staff members' adherence to hand hygiene practices. The initial findings presented on the run chart demonstrate that compliance among healthcare workers increased with the interventions; there was an increase of 15% compliance during the 10 days of project testing. We will need to collect more data to show continued and sustained improvement. Patients can play an important role in promoting safe care and hand hygiene practices. PMID:27493752

  8. Promoting the role of patients in improving hand hygiene compliance amongst health care workers.

    PubMed

    Ahmed Awaji, Maryam; Al-Surimi, Khaled

    2016-01-01

    Hand hygiene is one of the fundamental measures necessary for reducing healthcare-associated infections. The adherence of health care workers to safe hand hygiene practices is low worldwide, despite evidence showing compliance with hand hygiene guidelines decreases infection rate. This project focuses on the role of patients in promoting healthcare workers' compliance with hand hygiene practices. Several plan-do-study-act (PDSA) cycles were conducted to test interventions which aimed to empower patients and increase staff members' adherence to hand hygiene practices. The initial findings presented on the run chart demonstrate that compliance among healthcare workers increased with the interventions; there was an increase of 15% compliance during the 10 days of project testing. We will need to collect more data to show continued and sustained improvement. Patients can play an important role in promoting safe care and hand hygiene practices. PMID:27493752

  9. Job Stress and Job Satisfaction: Home Care Workers in a Consumer-Directed Model of Care

    PubMed Central

    Delp, Linda; Wallace, Steven P; Geiger-Brown, Jeanne; Muntaner, Carles

    2010-01-01

    Objective To investigate determinants of job satisfaction among home care workers in a consumer-directed model. Data Sources/Setting Analysis of data collected from telephone interviews with 1,614 Los Angeles home care workers on the state payroll in 2003. Data Collection and Analysis Multivariate logistic regression analysis was used to determine the odds of job satisfaction using job stress model domains of demands, control, and support. Principal Findings Abuse from consumers, unpaid overtime hours, and caring for more than one consumer as well as work-health demands predict less satisfaction. Some physical and emotional demands of the dyadic care relationship are unexpectedly associated with greater job satisfaction. Social support and control, indicated by job security and union involvement, have a direct positive effect on job satisfaction. Conclusions Policies that enhance the relational component of care may improve workers' ability to transform the demands of their job into dignified and satisfying labor. Adequate benefits and sufficient authorized hours of care can minimize the stress of unpaid overtime work, caring for multiple consumers, job insecurity, and the financial constraints to seeking health care. Results have implications for the structure of consumer-directed models of care and efforts to retain long-term care workers. PMID:20403063

  10. Quarantine, Isolation, and Health Care Workers.

    PubMed

    Webb, Adam

    2015-12-01

    Although Ebola virus disease and other hemorrhagic fevers are not generally considered infectious diseases of the nervous system, neurologists may be asked to participate in the management of patients with these and other dangerous communicable illnesses, including possible bioterrorism agents. It is essential for all health professionals to understand the public health, legal, and ethical frameworks behind autonomy-limiting interventions such as quarantine and isolation. Health care professionals represent the front line of defense during public health emergencies. They are often disproportionately affected by the illnesses themselves as well as by the public health interventions intended to prevent spread. The global health crisis caused by the spread of Ebola virus disease has been instructional for examining these ethical issues. PMID:26633787

  11. Focus on Preschool Aquatics: Child Care Regulations.

    ERIC Educational Resources Information Center

    Sayre, Nancy E.

    This paper proposes state regulations for the training of child care staff members in developmentally appropriate safe aquatic practices, outlines required features of any pools that children visit, and suggests safe practices for water-related activities at child care centers and swimming pools. The staff training regulation suggestions include…

  12. Working on reform. How workers' compensation medical care is affected by health care reform.

    PubMed Central

    Himmelstein, J; Rest, K

    1996-01-01

    The medical component of workers' compensation programs-now costing over $24 billion annually-and the rest of the nation's medical care system are linked. They share the same patients and providers. They provide similar benefits and services. And they struggle over who should pay for what. Clearly, health care reform and restructuring will have a major impact on the operation and expenditures of the workers' compensation system. For a brief period, during the 1994 national health care reform debate, these two systems were part of the same federal policy development and legislative process. With comprehensive health care reform no longer on the horizon, states now are tackling both workers' compensation and medical system reforms on their own. This paper reviews the major issues federal and state policy makers face as they consider reforms affecting the relationship between workers' compensation and traditional health insurance. What is the relationship of the workers' compensation cost crisis to that in general health care? What strategies are being considered by states involved in reforming the medical component of workers compensation? What are the major policy implications of these strategies? Images p13-a p14-a p15-a p16-a p18-a p19-a p20-a p22-a p24-a PMID:8610187

  13. Hepatitis B in Health Care Workers: Indian Scenario

    PubMed Central

    Singhal, Varsha; Bora, Dhrubajyoti; Singh, Sarman

    2009-01-01

    Healthcare workers have a high risk of occupational exposure to many blood-borne diseases including HIV, Hepatitis B, and Hepatitis C viral infections. Of these Hepatitis B is not only the most transmissible infection, but also the only one that is preventable by vaccination. In developing countries, Hepatitis B vaccination coverage among healthcare workers is very low for various reasons, including awareness, risk assessment, and low priority given by the health managements of both government and private hospitals. Most of the hospitals lack post-exposure management strategies including the coordination among various departments for reporting, testing, and vaccination. This review, therefore, focuses on the current situation of Hepatitis B vaccine status in the healthcare workers of India, and provides updated guidelines to manage the accidental exposure to hepatitis B virus-infected biological materials in healthcare workers. The review also emphasizes on what options are available to a healthcare worker, in case of exposure and how they can respond to the standard vaccination schedules, besides the need to educate the healthcare workers about Hepatitis B infection, available vaccines, post-vaccine immune status, and post-exposure prophylaxis. PMID:21938248

  14. Using the Focus Group in Assessing Training Needs: Empowering Child Welfare Workers.

    ERIC Educational Resources Information Center

    Denning, Janice D.; Verschelden, Cia

    1993-01-01

    Describes an assessment process in a public child welfare agency that included workers as a primary source of knowledge about their own needs. Argues that the use of focus groups (a marketing research technique) encourages high levels of direct input and helps engage workers in subsequent phases of the training process. (MM)

  15. Direct care worker's perceptions of job satisfaction following implementation of work-based learning.

    PubMed

    Lopez, Cynthia; White, Diana L; Carder, Paula C

    2014-02-01

    The purpose of this study was to understand the impact of a work-based learning program on the work lives of Direct Care Workers (DCWs) at assisted living (AL) residences. The research questions were addressed using focus group data collected as part of a larger evaluation of a work-based learning (WBL) program called Jobs to Careers. The theoretical perspective of symbolic interactionism was used to frame the qualitative data analysis. Results indicated that the WBL program impacted DCWs' job satisfaction through the program curriculum and design and through three primary categories: relational aspects of work, worker identity, and finding time. This article presents a conceptual model for understanding how these categories are interrelated and the implications for WBL programs. Job satisfaction is an important topic that has been linked to quality of care and reduced turnover in long-term care settings. PMID:24652945

  16. Review of Pesticide Education Materials for Health Care Providers Providing Care to Agricultural Workers

    ERIC Educational Resources Information Center

    Hiott, Ann E.; Quandt, Sara A.; Early, Julie; Jackson, David S.; Arcury, Thomas A.

    2006-01-01

    Context: Pesticide exposure is an important environmental and occupational health risk for agricultural workers and their families, but health care providers receive little training in it. Objective: To evaluate the medical resources available to providers caring for patients, particularly farmworkers, exposed to pesticides and to recommend a…

  17. Antibiotic stewardship: a focus on ambulatory care.

    PubMed

    Gangat, M Azhar; Hsu, Jennifer L

    2015-01-01

    Antibiotic resistance is one of the major health threats facing modern medicine. While there are many tactics to address this issue, antibiotic stewardship has been shown effective in reducing antimicrobial resistance, adverse drug effects, mortality and health care cost. Most antibiotic stewardship programs have evolved within acute care settings where the bulk of resistant infections are identified. Unfortunately, hospitals are just the tip of the iceberg in terms of overall antibiotic use. The vast majority of the antibiotic prescriptions are dispensed in ambulatory care settings, making this a critical target for stewardship programs. This article discusses the global need for antibiotic stewardship, highlights the importance of outpatient stewardship, and discusses strategies and challenges for implementation of stewardship in community settings.

  18. Valuable human capital: the aging health care worker.

    PubMed

    Collins, Sandra K; Collins, Kevin S

    2006-01-01

    With the workforce growing older and the supply of younger workers diminishing, it is critical for health care managers to understand the factors necessary to capitalize on their vintage employees. Retaining this segment of the workforce has a multitude of benefits including the preservation of valuable intellectual capital, which is necessary to ensure that health care organizations maintain their competitive advantage in the consumer-driven market. Retaining the aging employee is possible if health care managers learn the motivators and training differences associated with this category of the workforce. These employees should be considered a valuable resource of human capital because without their extensive expertise, intense loyalty and work ethic, and superior customer service skills, health care organizations could suffer severe economic repercussions in the near future. PMID:16905991

  19. Is it racism? Skepticism and resistance towards ethnic minority care workers among older care recipients.

    PubMed

    Jönson, Håkan

    2007-01-01

    The study investigates the occurrence and character of skepticism and resistance towards ethnic minority care workers among older care recipients in a municipality in Sweden. Twelve representatives of caregiver organizations were interviewed about their experience of this phenomenon. Three additional interviews were conducted with ethnic minority care workers. Representatives described the problem as rare and mostly occurring as language difficulties or as a temporary problem characterized as a fear of the unknown among some care recipients. They tended to apply a pragmatic or pathologizing approach when talking about causes of and solutions to the problem. These approaches enabled care providers to comply with "potential racism" without challenging an official ideology of anti-racism. In contrast, staff of foreign descent described the problem as more frequent and severe, particularly for short-term employees who experience many first-time encounters with care recipients.

  20. Understanding informal payments in health care: motivation of health workers in Tanzania

    PubMed Central

    Stringhini, Silvia; Thomas, Steve; Bidwell, Posy; Mtui, Tina; Mwisongo, Aziza

    2009-01-01

    Background There is growing evidence that informal payments for health care are fairly common in many low- and middle-income countries. Informal payments are reported to have a negative consequence on equity and quality of care; it has been suggested, however, that they may contribute to health worker motivation and retention. Given the significance of motivation and retention issues in human resources for health, a better understanding of the relationships between the two phenomena is needed. This study attempts to assess whether and in what ways informal payments occur in Kibaha, Tanzania. Moreover, it aims to assess how informal earnings might help boost health worker motivation and retention. Methods Nine focus groups were conducted in three health facilities of different levels in the health system. In total, 64 health workers participated in the focus group discussions (81% female, 19% male) and where possible, focus groups were divided by cadre. All data were processed and analysed by means of the NVivo software package. Results The use of informal payments in the study area was confirmed by this study. Furthermore, a negative relationship between informal payments and job satisfaction and better motivation is suggested. Participants mentioned that they felt enslaved by patients as a result of being bribed and this resulted in loss of self-esteem. Furthermore, fear of detection was a main demotivating factor. These factors seem to counterbalance the positive effect of financial incentives. Moreover, informal payments were not found to be related to retention of health workers in the public health system. Other factors such as job security seemed to be more relevant for retention. Conclusion This study suggests that the practice of informal payments contributes to the general demotivation of health workers and negatively affects access to health care services and quality of the health system. Policy action is needed that not only provides better financial

  1. Health system challenges to integration of mental health delivery in primary care in Kenya- perspectives of primary care health workers

    PubMed Central

    2013-01-01

    Background Health system weaknesses in Africa are broadly well known, constraining progress on reducing the burden of both communicable and non-communicable disease (Afr Health Monitor, Special issue, 2011, 14-24), and the key challenges in leadership, governance, health workforce, medical products, vaccines and technologies, information, finance and service delivery have been well described (Int Arch Med, 2008, 1:27). This paper uses focus group methodology to explore health worker perspectives on the challenges posed to integration of mental health into primary care by generic health system weakness. Methods Two ninety minute focus groups were conducted in Nyanza province, a poor agricultural region of Kenya, with 20 health workers drawn from a randomised controlled trial to evaluate the impact of a mental health training programme for primary care, 10 from the intervention group clinics where staff had received the training programme, and 10 health workers from the control group where staff had not received the training). Results These focus group discussions suggested that there are a number of generic health system weaknesses in Kenya which impact on the ability of health workers to care for clients with mental health problems and to implement new skills acquired during a mental health continuing professional development training programmes. These weaknesses include the medicine supply, health management information system, district level supervision to primary care clinics, the lack of attention to mental health in the national health sector targets, and especially its absence in district level targets, which results in the exclusion of mental health from such district level supervision as exists, and the lack of awareness in the district management team about mental health. The lack of mental health coverage included in HIV training courses experienced by the health workers was also striking, as was the intensive focus during district supervision on HIV to

  2. Service quality assessment of workers compensation health care delivery programs in New York using SERVQUAL.

    PubMed

    Arunasalam, Mark; Paulson, Albert; Wallace, William

    2003-01-01

    Preferred provider organizations (PPOs) provide healthcare services to an expanding proportion of the U.S. population. This paper presents a programmatic assessment of service quality in the workers' compensation environment using two different models: the PPO program model and the fee-for-service (FFS) payor model. The methodology used here will augment currently available research in workers' compensation, which has been lacking in measuring service quality determinants and assessing programmatic success/failure of managed care type programs. Results indicated that the SERVQUAL tool provided a reliable and valid clinical quality assessment tool that ascertained that PPO marketers should focus on promoting physician outreach (to show empathy) and accessibility (to show reliability) for injured workers. PMID:15271631

  3. Service quality assessment of workers compensation health care delivery programs in New York using SERVQUAL.

    PubMed

    Arunasalam, Mark; Paulson, Albert; Wallace, William

    2003-01-01

    Preferred provider organizations (PPOs) provide healthcare services to an expanding proportion of the U.S. population. This paper presents a programmatic assessment of service quality in the workers' compensation environment using two different models: the PPO program model and the fee-for-service (FFS) payor model. The methodology used here will augment currently available research in workers' compensation, which has been lacking in measuring service quality determinants and assessing programmatic success/failure of managed care type programs. Results indicated that the SERVQUAL tool provided a reliable and valid clinical quality assessment tool that ascertained that PPO marketers should focus on promoting physician outreach (to show empathy) and accessibility (to show reliability) for injured workers.

  4. Serological survey of mumps immunity among health care workers in the Catalonia region of Spain.

    PubMed

    Campins, Magda; Urbiztondo, Luis; Costa, Josep; Broner, Sonia; Esteve, Maria; Bayas, José Maria; Borras, Eva; Dominguez, Angela

    2013-04-01

    Susceptible health care workers are at risk of acquiring and transmitting mumps to or from patients. A survey was carried out in 639 health care workers from tertiary public hospitals and primary care centers in the Catalonia region of Spain during 2009 to determine the prevalence of immunity to mumps among this group. The prevalence of immune health care workers was 87.5% (95% confidence interval, 84.7-89.9). Vaccination with 2 doses of vaccine should be reinforced in health care workers to minimize the risk of mumps transmission in health care settings.

  5. Stakeholders’ Perceptions on Shortage of Healthcare Workers in Primary Healthcare in Botswana: Focus Group Discussions

    PubMed Central

    Nkomazana, Oathokwa; Mash, Robert; Shaibu, Sheila; Phaladze, Nthabiseng

    2015-01-01

    Background An adequate health workforce force is central to universal health coverage and positive public health outcomes. However many African countries have critical shortages of healthcare workers, which are worse in primary healthcare. The aim of this study was to explore the perceptions of healthcare workers, policy makers and the community on the shortage of healthcare workers in Botswana. Method Fifteen focus group discussions were conducted with three groups of policy makers, six groups of healthcare workers and six groups of community members in rural, urban and remote rural health districts of Botswana. All the participants were 18 years and older. Recruitment was purposive and the framework method was used to inductively analyse the data. Results There was a perceived shortage of healthcare workers in primary healthcare, which was believed to result from an increased need for health services, inequitable distribution of healthcare workers, migration and too few such workers being trained. Migration was mainly the result of unfavourable personal and family factors, weak and ineffective healthcare and human resources management, low salaries and inadequate incentives for rural and remote area service. Conclusions Botswana has a perceived shortage of healthcare workers, which is worse in primary healthcare and rural areas, as a result of multiple complex factors. To address the scarcity the country should train adequate numbers of healthcare workers and distribute them equitably to sufficiently resourced healthcare facilities. They should be competently managed and adequately remunerated and the living conditions and rural infrastructure should also be improved. PMID:26284617

  6. The role of the social worker in the adult critical care unit: a systematic review of the literature.

    PubMed

    Hartman-Shea, Katherine; Hahn, Anne P; Fritz Kraus, Joanne; Cordts, Grace; Sevransky, Jonathan

    2011-01-01

    Social workers provide care to patients and families in the adult critical care unit. We conducted a systematic review of the literature to more clearly identify the role of the social worker practicing in the intensive care unit. We conducted a comprehensive search of the literature using the Pubmed, Embase, ISI, Scopus, and Social Work Abstracts databases using the terms "intensive care," "critical care," and "social work." Articles were selected for review if they met the following criteria: formal studies or opinion papers whose primary focus was the role or scope of practice of the social worker in the adult critical care unit. Articles were selected and reviewed independently by two social work investigators. Our search retrieved 550 potentially relevant articles. Twelve full-text articles were deemed eligible for abstracting. Three of the articles were studies that examined different aspects of social work practice including implementation of a family assistance program, social work response to anxiety levels of families in critical care and common activities of critical care social workers. Nine articles were primarily opinion pieces. All of the opinion articles described psychosocial support and counseling as a primary role of critical care social work. Other frequently identified roles were crisis intervention, psychosocial assessment, facilitating communication, end-of-life care, and practical assistance. There is little empiric data describing the role of the critical care social worker. Consistent themes from the articles identified include the role of social workers as counseling professionals, facilitators of communication, and resource agents. Further research to identify formal assessment tools and outcome studies of specific counseling techniques will provide important information for best practice guidelines in this area.

  7. Occupational safety among dental health-care workers

    PubMed Central

    Shimoji, Shigehiro; Ishihama, Kohji; Yamada, Hidefumi; Okayama, Masaki; Yasuda, Kouichi; Shibutani, Tohru; Ogasawara, Tadashi; Miyazawa, Hiroo; Furusawa, Kiyofumi

    2010-01-01

    Compared to other health-care workers, dental health-care workers come in close contact with patients and use a variety of sharp and high-speed rotating instruments. It is important to understand the characteristics of the occupational accidents that occur. We reviewed incident reports from April 1, 2005, to March 31, 2010, at Matsumoto Dental University Hospital. In addition, questionnaires dealing with identification of occupational safety issues, especially splash exposures, were conducted for dentists, dental hygienists, and nurses. Thirty-two occupational injuries were reported during the study period, including 23 sharp instrument injuries (71.9%), 6 splash exposures (18.8%), and 3 others. Of the six splash exposures, only two cases involved potential contamination with blood or other potentially infectious patient material. Of the 66 workers who experienced sharps injuries, 20 workers (30.3%, 20/66) reported them to the hospital work safety team. The questionnaire revealed high incident of splash exposures and conjunctiva exposures: 87.9% (51/58) and 60.3% (35/58) in dentists and 88.6% (39/44) and 61.4% (27/44) in dental hygienists. The compliance rate for routine use of protective eyewear was 60.3% (35/58) for dentists and 34.1% (15/44) for hygienists. Of the presented informational items included in the questionnaire, those that strongly persuaded respondents to use protective eyewear were ‘splatters from the patient’s mouth contain blood’ (90%, 99/110) and ‘dental operations at our clinic are performed based only on a questionnaire without serious examinations for HBV, HCV, and HIV’ (71.8%, 79/110). The reason of low compliance of protective eyewear among dentists might relate to fine dental procedures. Appropriate information is important for the motive of wearing personal protective equipment, and an early educational program may have a potential to increase compliance with the use of that equipment. PMID:23745061

  8. Improving occupational health care for construction workers: a process evaluation

    PubMed Central

    2013-01-01

    Background To evaluate the process of a job-specific workers’ health surveillance (WHS) in improving occupational health care for construction workers. Methods From January to July 2012 were 899 bricklayers and supervisors invited for the job-specific WHS at three locations of one occupational health service throughout the Netherlands. The intervention aimed at detecting signs of work-related health problems, reduced work capacity and/or reduced work functioning. Measurements were obtained using a recruitment record and questionnaires at baseline and follow-up. The process evaluation included the following: reach (attendance rate), intervention dose delivered (provision of written recommendations and follow-up appointments), intervention dose received (intention to follow-up on advice directly after WHS and remembrance of advice three months later), and fidelity (protocol adherence). The workers scored their increase in knowledge from 0–10 with regard to health status and work ability, their satisfaction with the intervention and the perceived (future) effect of such an intervention. Program implementation was defined as the mean score of reach, fidelity, and intervention dose delivered and received. Results Reach was 9% (77 workers participated), fidelity was 67%, the intervention dose delivered was 92 and 63%, and the intervention dose received was 68 and 49%. The total programme implementation was 58%. The increases in knowledge regarding the health status and work ability of the workers after the WHS were graded as 7.0 and 5.9, respectively. The satisfaction of the workers with the entire intervention was graded as 7.5. The perceived (future) effects on health status were graded as 6.3, and the effects on work ability were graded with a 5.2. The economic recession affected the workers as well as the occupational health service that enacted the implementation. Conclusions Programme implementation was acceptable. Low reach, limited protocol adherence and

  9. Relationship-Focused Child Care Practices: Quality of Care and Child Outcomes for Children in Poverty

    ERIC Educational Resources Information Center

    Owen, Margaret Tresch; Klausli, Julia F.; Mata-Otero, Ana-Maria; Caughy, Margaret O'Brien

    2008-01-01

    Research Findings: Child care delivery practices promoting continuous, primary caregiver-child relationships (relationship-focused child care) were evaluated for 223 preschool-age children (45% African American, 55% Latino) attending child care centers serving low-income children. Both relationship-focused and non-relationship-focused centers were…

  10. 'We are despised in the hospitals': sex workers' experiences of accessing health care in four African countries.

    PubMed

    Scorgie, Fiona; Nakato, Daisy; Harper, Eric; Richter, Marlise; Maseko, Sian; Nare, Prince; Smit, Jenni; Chersich, Matthew

    2013-01-01

    Sex workers in east and southern Africa are exposed to multiple occupational health and safety risks. Detailed understanding of barriers to accessing care would optimise design of improved services for this population. In this study, trained sex workers conducted 55 in-depth interviews and 12 focus group discussions with 106 female, 26 male and 4 transgender sex workers across 6 urban sites in Kenya, Zimbabwe, Uganda and South Africa. Data were analysed thematically, following an interpretive framework. Participants cited numerous unmet health needs, including diagnosis and treatment for sexually transmitted infections and insufficient access to condoms and lubricant. Denial of treatment for injuries following physical assault or rape and general hostility from public-sector providers was common. Resources permitting, many sex workers attended private services, citing higher quality and respect for dignity and confidentiality. Sex workers in southern Africa accessed specialised sex worker clinics, reporting mostly positive experiences. Across sites, participants called for additional targeted services, but also sensitisation and training of public-sector providers. Criminalisation of sex workers and associated stigmatisation, particularly of transgender and male sex workers, hinder HIV-prevention efforts and render access to mainstream healthcare precarious. Alongside law reform, sex worker-led peer outreach work should be strengthened and calls by sex workers for additional targeted services heeded. PMID:23414116

  11. Risk factors for nosocomial tuberculosis transmission among health care workers.

    PubMed

    Ito, Yutaka; Nagao, Miki; Iinuma, Yoshitsugu; Matsumura, Yasufumi; Yamamoto, Masaki; Takakura, Shunji; Igawa, Junko; Yamanaka, Hiroe; Hashimoto, Akiko; Hirai, Toyohiro; Niimi, Akio; Ichiyama, Satoshi; Mishima, Michiaki

    2016-05-01

    We conducted hospital-based contact investigations of 55 serial sputum smear-positive tuberculosis (TB) patients and 771 health care workers (HCWs) from 2006-2013. HCWs who made contact with TB patients in the absence of appropriate airborne precautions were evaluated using interferon gamma release assays to identify TB infection. Twenty-nine HCWs (3.8%) were newly diagnosed with TB infection. The 10 TB patients responsible for transmission had a duration of contact of >7 days by multivariate analysis. PMID:26777287

  12. Tuberculosis: a re-emerging problem for health care workers.

    PubMed

    Bagg, J

    1996-05-25

    The current upward trend in the incidence of tuberculosis, particularly in the USA, and the problems of treating multiply drug resistant strains of Mycobacterium tuberculosis have caused a resurgence of interest in this infection. This review describes the microbiology, routes of transmission and epidemiology of Mycobacterium tuberculosis infections. The emergence and problems of treating multiply drug resistant strains are outlined. The significant potential for occupationally acquired infection among health care workers is discussed, together with a summary of the available infection control measures currently being examined. The true level of occupational risk to dental personnel remains uncertain.

  13. Older Workers: An Opportunity to Expand the Long-Term Care/Direct Care Labor Force

    ERIC Educational Resources Information Center

    Hwalek, Melanie; Straub, Victoria; Kosniewski, Karen

    2008-01-01

    Purpose: This study examined issues related to using older workers in frontline jobs in long-term care from employers' and prospective employees' perspectives. Design and Methods: Telephone surveys were conducted with employers representing 615 nursing homes and 410 home health agencies, and 1,091 low-income participants aged 40+ in Operation ABLE…

  14. Exposure of health workers in primary health care to glutaraldehyde

    PubMed Central

    2013-01-01

    Background In order to avoid proliferation of microorganisms, cleaning, disinfection and sterilisation in health centres is of utmost importance hence reducing exposure of workers to biological agents and of clients that attend these health centres to potential infections. One of the most commonly-used chemical is glutaraldehyde. The effects of its exposure are well known in the hospital setting; however there is very little information available with regards to the primary health care domain. Objective To determine and measure the exposure of health workers in Primary Health Care Centres. Environmental to glutaraldehyde and staff concentration will be measured and compared with regulated Occupational Exposure Limits. Methods/Design Observational, cross-sectional and multi-centre study. The study population will be composed of any health professionals in contact with the chemical substance that work in the Primary Health Care Centres in the areas of Barcelonès Nord, Maresme, and Barcelona city belonging to the Catalan Institute of Health. Data will be collected from 1) Glutaraldhyde consumption from the previous 4 years in the health centres under study. 2) Semi-structured interviews and key informants to gather information related to glutaraldehyde exposure. 3) Sampling of the substance in the processes considered to be high exposure. Discussion Although glutaraldehyde is extensively used in health centres, scientific literature only deals with certain occupational hazards in the hospital setting. This study attempts to take an in-depth look into the risk factors and environmental conditions that exist in the primary care workplace with exposure to glutaraldehyde. PMID:24180250

  15. [Home care workers' oral health awareness and practice for disabled elderly].

    PubMed

    Atsushi, Ohyama; Yoshinori, Toriyama; Yoshiyuki, Sasaki; Izumi, Koyama; Chie, Shimizu; Norimasa, Kurosaki; Shiro, Mataki

    2003-03-01

    The purpose of this study was to investigate the level of oral health awareness, and to explore the needs for home care workers to provide oral health care for disabled elderly. We conducted a questionnaire survey at two home-help service centers and a social welfare council. Subjects for this investigation were 63 home care workers. The results were as follows: 1. Ninety-six percent of home care workers thought it was necessary to provide oral health care for disabled elderly, but only 11 percent of them put oral care into practice on a daily basis. 2. From the results of a cause and effect diagram, necessities of oral care were summarized as six major causes: 1) Disabled elderly are often unable to brush their teeth, 2) The oral hygiene level may affect physical condition, 3) Disabled elderly should be protected from oral diseases, 4) Disabled elderly should have their mouths kept clean, 5) Eating and swallowing may become increasingly difficult, 6) Disabled elderly should take in adequate nutrition. 3. Sixty-eight percent of home care workers took part in a training course of nursing care including oral care. 4. Home care workers, dentists, dental hygienists, and nurses taught oral health care to home care workers. 5. From the results of a cause and effect diagram, there were three major items that home care workers want to know: 1) denture management, 2) the routine of oral care, 3) infection control. 6. Home care workers recognized that oral care should be provided by family members of disabled elderly or home care workers. PMID:12708030

  16. Healthcare organization-education partnerships and career ladder programs for health care workers.

    PubMed

    Dill, Janette S; Chuang, Emmeline; Morgan, Jennifer C

    2014-12-01

    Increasing concerns about quality of care and workforce shortages have motivated health care organizations and educational institutions to partner to create career ladders for frontline health care workers. Career ladders reward workers for gains in skills and knowledge and may reduce the costs associated with turnover, improve patient care, and/or address projected shortages of certain nursing and allied health professions. This study examines partnerships between health care and educational organizations in the United States during the design and implementation of career ladder training programs for low-skill workers in health care settings, referred to as frontline health care workers. Mixed methods data from 291 frontline health care workers and 347 key informants (e.g., administrators, instructors, managers) collected between 2007 and 2010 were analyzed using both regression and fuzzy-set qualitative comparative analysis (QCA). Results suggest that different combinations of partner characteristics, including having an education leader, employer leader, frontline management support, partnership history, community need, and educational policies, were necessary for high worker career self-efficacy and program satisfaction. Whether a worker received a wage increase, however, was primarily dependent on leadership within the health care organization, including having an employer leader and employer implementation policies. Findings suggest that strong partnerships between health care and educational organizations can contribute to the successful implementation of career ladder programs, but workers' ability to earn monetary rewards for program participation depends on the strength of leadership support within the health care organization. PMID:25441318

  17. Healthcare organization-education partnerships and career ladder programs for health care workers.

    PubMed

    Dill, Janette S; Chuang, Emmeline; Morgan, Jennifer C

    2014-12-01

    Increasing concerns about quality of care and workforce shortages have motivated health care organizations and educational institutions to partner to create career ladders for frontline health care workers. Career ladders reward workers for gains in skills and knowledge and may reduce the costs associated with turnover, improve patient care, and/or address projected shortages of certain nursing and allied health professions. This study examines partnerships between health care and educational organizations in the United States during the design and implementation of career ladder training programs for low-skill workers in health care settings, referred to as frontline health care workers. Mixed methods data from 291 frontline health care workers and 347 key informants (e.g., administrators, instructors, managers) collected between 2007 and 2010 were analyzed using both regression and fuzzy-set qualitative comparative analysis (QCA). Results suggest that different combinations of partner characteristics, including having an education leader, employer leader, frontline management support, partnership history, community need, and educational policies, were necessary for high worker career self-efficacy and program satisfaction. Whether a worker received a wage increase, however, was primarily dependent on leadership within the health care organization, including having an employer leader and employer implementation policies. Findings suggest that strong partnerships between health care and educational organizations can contribute to the successful implementation of career ladder programs, but workers' ability to earn monetary rewards for program participation depends on the strength of leadership support within the health care organization.

  18. Learning and knowledge-integration strategies of nurses and client care workers serving homeless persons.

    PubMed

    Guirguis-Younger, Manal; McNeil, Ryan; Runnels, Vivien

    2009-06-01

    Health-care workers serving homeless persons often face difficulties in addressing the needs of this population due to the complexity of the health challenges and gaps in clinical knowledge. How can health-care workers enhance their ability to care for this population? The authors explore the learning and knowledge-integration strategies of nurses and client care workers employed by organizations targeting homeless persons in a Canadian city. Semi-structured qualitative interviews were conducted with 8 health-care workers.The data were examined using narrative analysis and constant comparative analysis. Three strategies were identified: integrating past experiences into clinical practice, interacting with clients to identify care needs and boundaries, and engaging in interprofessional knowledge exchange. A better understanding of these strategies may help nursing programs and health-services organizations to equip health-care workers with the skills they need to serve homeless persons.

  19. Double jeopardy: the impact of neoliberalism on care workers in the United States and South Africa.

    PubMed

    Abramovitz, Mimi; Zelnick, Jennifer

    2010-01-01

    Many researchers have explored how neoliberal restructuring of the workplace has reduced the standard of living and increased workplace stress among private sector employees. However, few have focused on how neoliberal restructuring of public policy has had similar effects on the public sector workforce. Using original case study research, the authors examine how two iconic pieces of neoliberal policy--the 1996 welfare reform bill in the United States and the GEAR macroeconomic policy in South Africa--affected public/nonprofit human service workers in New York City, United States, and public sector nurses in KwaZulu-Natal, South Africa. The authors argue that in both situations, despite national differences, these policies created a "double jeopardy," in which patients/clients and care workers are adversely affected by neoliberal public policy. This "double jeopardy" creates significant hardship, but also the opportunity for new social movements.

  20. [Overview of sharps injuries among health-care workers].

    PubMed

    Gopar-Nieto, Rodrigo; Juárez-Pérez, Cuauhtémoc Arturo; Cabello-López, Alejandro; Haro-García, Luis Cuauhtémoc; Aguilar-Madrid, Guadalupe

    2015-01-01

    Sharps injuries are one of the most frequent health-care related accidents. It is estimated globally that 35 million workers are at risk; in Mexico there is no data available for this type of injuries. They are associated with lack of training, instrument and procedure risk, fatigue and stress. The occupational distribution is nurses 45 %, technicians 20 %, doctors 20 % and maintenance workers 5 %. The most commonly associated procedures are injection, venipuncture, suture, and insertion and manipulation of IV catheters. Hepatitis B is the most commonly transmitted agent. Emotional distress is huge as well as the cost of prophylaxis and follow-up. More than half of the injuries are not notified. The most common reasons for not reporting are: the belief that the exposure has low risk of infection, the lack of knowledge of reporting systems and the assumption that it is difficult to notify. Many strategies have been created to reduce the incidence of sharps injuries, such as: identifying the risk of blood exposure, the creation of politics to minimize the risk, the education and training to create a safe workplace, the enhancing of the reporting system, the use of double-gloving and using safety-engineered sharps devices. In many countries these politics have reduced the incidence of sharps injuries as well as the economic burden.

  1. [Overview of sharps injuries among health-care workers].

    PubMed

    Gopar-Nieto, Rodrigo; Juárez-Pérez, Cuauhtémoc Arturo; Cabello-López, Alejandro; Haro-García, Luis Cuauhtémoc; Aguilar-Madrid, Guadalupe

    2015-01-01

    Sharps injuries are one of the most frequent health-care related accidents. It is estimated globally that 35 million workers are at risk; in Mexico there is no data available for this type of injuries. They are associated with lack of training, instrument and procedure risk, fatigue and stress. The occupational distribution is nurses 45 %, technicians 20 %, doctors 20 % and maintenance workers 5 %. The most commonly associated procedures are injection, venipuncture, suture, and insertion and manipulation of IV catheters. Hepatitis B is the most commonly transmitted agent. Emotional distress is huge as well as the cost of prophylaxis and follow-up. More than half of the injuries are not notified. The most common reasons for not reporting are: the belief that the exposure has low risk of infection, the lack of knowledge of reporting systems and the assumption that it is difficult to notify. Many strategies have been created to reduce the incidence of sharps injuries, such as: identifying the risk of blood exposure, the creation of politics to minimize the risk, the education and training to create a safe workplace, the enhancing of the reporting system, the use of double-gloving and using safety-engineered sharps devices. In many countries these politics have reduced the incidence of sharps injuries as well as the economic burden. PMID:25984621

  2. Applying a solution-focused approach to support a worker who is under stress.

    PubMed

    Mishima, Norio; Kubota, Shinya; Nagata, Shoji

    2005-06-01

    The solution-focused approach (SFA) developed by Insoo Kim Berg and Steve de Shazer at the Brief Family Therapy Center, Milwaukee, USA is classified as brief psychotherapy. We believe that SFA can give an occupational healthcare staff useful tools that will positively influence their relationships with workers, because it focuses on workers' strengths rather than their weaknesses when the staff interviews them using SFA. In this report, we explain the case of a worker who was under stress and was interviewed using SFA. Although the worker came to the interview because of his physical symptoms, he disclosed that he was under considerable stress at work and that his main concern was his relationship with his superior. One of the authors interviewed him using SFA. In the interview the worker discovered his own resources and strengths, and finally defined his goal. In the end, he discovered solutions by himself, and has been doing well in follow-up. We describe this process in detail, and discuss potential applications of SFA in occupational medicine.

  3. Supporting home care aides: what employers can do to assist their workers.

    PubMed

    Butler, Sandra S; Rowan, Noell

    2013-01-01

    The demand for personal care workers in home-based care is expected to double with the aging of the baby boomer population at the same time that home care agencies struggle with high rates of turnover. This article examines the job experience of 171 home care aides who remained on the job over 18 months of data collection in the longitudinal home care worker retention study. The three groups of themes that emerged from the analysis of telephone interviews with study participants-challenges of the job, compensating strategies, and potential employer interventions-provide insight on how to offer support to these valuable workers. PMID:24189019

  4. What Makes Migrant Live-in Home Care Workers in Elder Care Be Satisfied with Their Job?

    ERIC Educational Resources Information Center

    Iecovich, Esther

    2011-01-01

    Purpose: The study aims to examine job satisfaction of migrant live-in home care workers who provide care to frail older adults and to examine the extent to which quality of relationships between the care provider and care recipient and workplace characteristics is associated with job satisfaction. Design and Methods: A convenience sample that…

  5. A Challenging Job: Physical and Sexual Violence towards Group Workers in Youth Residential Care

    ERIC Educational Resources Information Center

    Alink, Lenneke R. A.; Euser, Saskia; Bakermans-Kranenburg, Marian J.; van IJzendoorn, Marinus H.

    2014-01-01

    Background: Residential or group care social workers appear to be at increased risk for experiencing physical violence at work. However, little is known about "sexual harassment" in addition to physical victimization of social workers in "youth" residential or group care. Objective We investigated the prevalence of physical and…

  6. Learning to Facilitate Advance Care Planning: The Novice Social Worker's Experience

    ERIC Educational Resources Information Center

    Washington, Karla; Bowland, Sharon; Mueggenburg, Kay; Pederson, Margaret; Otten, Sheila; Renn, Tanya

    2014-01-01

    Professional leaders have identified clear roles for social workers involved in advance care planning (ACP), a facilitated process whereby individuals identify their preferences for future medical care; yet information about effective teaching practices in this area is scant. This study reports on the experiences of 14 social workers who…

  7. Re-engineering pharmaceutical care: towards a patient-focused care approach.

    PubMed

    al-Shaqha, W M; Zairi, M

    2000-01-01

    As healthcare reform takes shape, many challenges face hospital pharmacists. An opportunity exists to combine the principles of patient-focused care and pharmaceutical care to redesign the role of pharmacy. To achieve this objective, pharmacy departments should adopt business concepts such as process re-engineering. Process re-engineering is a change management tool which aims to produce dramatic improvement in performance measures by re-designing the process. The goal of restructuring is to increase the amount of time pharmacists spend providing pharmaceutical care to patients. The pharmaceutical care concept is a method of delivering pharmaceutical care services that match individual patient needs with the services provided. This article describes many hospital pharmacy department transitions to a patient focused care environment by adopting the patient focused care concept and the process re-engineering to improve the quality of patient care through systems improvement.

  8. Nurses' and care workers' attitudes toward death and caring for dying older adults in Japan.

    PubMed

    Matsui, Miho; Braun, Kathryn

    2010-12-01

    Registered nurses (RNs) and care workers (CWs) have important roles in providing end-of-life care to older adults, but little is known about the attitudes of RNs and CWs in Japan. In this study, 464 RNs and CWs working in facilities in Japan were asked to complete a self-administered questionnaire that included the Frommelt Attitude Toward Care of the Dying Scale, Form B, Japanese version (FATCOD-Form B-J) and the Death Attitude Profile (DAP), Japanese version. A total of 388 (83.6%) questionnaires were returned, and 367 (79.1%) were fully completed. The final sample included 190 RNs and 177 CWs. Multiple regression analysis showed that better attitudes toward caring for the dying were positively associated with seminar attendance and negatively associated with fear of death.

  9. A new neurological focus in neonatal intensive care.

    PubMed

    Bonifacio, Sonia L; Glass, Hannah C; Peloquin, Susan; Ferriero, Donna M

    2011-09-01

    Advances in the care of high-risk newborn babies have contributed to reduced mortality rates for premature and term births, but the surviving neonates often have increased neurological morbidity. Therapies aimed at reducing the neurological sequelae of birth asphyxia at term have brought hypothermia treatment into the realm of standard care. However, this therapy does not provide complete protection from neurological complications and a need to develop adjunctive therapies for improved neurological outcomes remains. In addition, the care of neurologically impaired neonates, regardless of their gestational age, clearly requires a focused approach to avoid further injury to the brain and to optimize the neurodevelopmental status of the newborn baby at discharge from hospital. This focused approach includes, but is not limited to, monitoring of the patient's brain with amplitude-integrated and continuous video EEG, prevention of infection, developmentally appropriate care, and family support. Provision of dedicated neurocritical care to newborn babies requires a collaborative effort between neonatologists and neurologists, training in neonatal neurology for nurses and future generations of care providers, and the recognition that common neonatal medical problems and intensive care have an effect on the developing brain. PMID:21808297

  10. Improving the quality of workers' compensation health care delivery: the Washington State Occupational Health Services Project.

    PubMed

    Wickizer, T M; Franklin, G; Plaeger-Brockway, R; Mootz, R D

    2001-01-01

    This article has summarized research and policy activities undertaken in Washington State over the past several years to identify the key problems that result in poor quality and excessive disability among injured workers, and the types of system and delivery changes that could best address these problems in order to improve the quality of occupational health care provided through the workers' compensation system. Our investigations have consistently pointed to the lack of coordination and integration of occupational health services as having major adverse effects on quality and health outcomes for workers' compensation. The Managed Care Pilot Project, a delivery system intervention, focused on making changes in how care is organized and delivered to injured workers. That project demonstrated robust improvements in disability reduction; however, worker satisfaction suffered. Our current quality improvement initiative, developed through the Occupational Health Services Project, synthesizes what was learned from the MCP and other pilot studies to make delivery system improvements. This initiative seeks to develop provider incentives and clinical management processes that will improve outcomes and reduce the burden of disability on injured workers. Fundamental to this approach are simultaneously preserving workers' right to choose their own physician and maintaining flexibility in the provision of individualized care based on clinical need and progress. The OHS project then will be a "real world" test to determine if aligning provider incentives and giving physicians the tools they need to optimize occupational health delivery can demonstrate sustainable reduction in disability and improvements in patient and employer satisfaction. Critical to the success of this initiative will be our ability to: (1) enhance the occupational health care management skills and expertise of physicians who treat injured workers by establishing community-based Centers of Occupational

  11. Improving the quality of workers' compensation health care delivery: the Washington State Occupational Health Services Project.

    PubMed

    Wickizer, T M; Franklin, G; Plaeger-Brockway, R; Mootz, R D

    2001-01-01

    This article has summarized research and policy activities undertaken in Washington State over the past several years to identify the key problems that result in poor quality and excessive disability among injured workers, and the types of system and delivery changes that could best address these problems in order to improve the quality of occupational health care provided through the workers' compensation system. Our investigations have consistently pointed to the lack of coordination and integration of occupational health services as having major adverse effects on quality and health outcomes for workers' compensation. The Managed Care Pilot Project, a delivery system intervention, focused on making changes in how care is organized and delivered to injured workers. That project demonstrated robust improvements in disability reduction; however, worker satisfaction suffered. Our current quality improvement initiative, developed through the Occupational Health Services Project, synthesizes what was learned from the MCP and other pilot studies to make delivery system improvements. This initiative seeks to develop provider incentives and clinical management processes that will improve outcomes and reduce the burden of disability on injured workers. Fundamental to this approach are simultaneously preserving workers' right to choose their own physician and maintaining flexibility in the provision of individualized care based on clinical need and progress. The OHS project then will be a "real world" test to determine if aligning provider incentives and giving physicians the tools they need to optimize occupational health delivery can demonstrate sustainable reduction in disability and improvements in patient and employer satisfaction. Critical to the success of this initiative will be our ability to: (1) enhance the occupational health care management skills and expertise of physicians who treat injured workers by establishing community-based Centers of Occupational

  12. Front-line worker engagement: greening health care, improving worker and patient health, and building better jobs.

    PubMed

    Chenven, Laura; Copeland, Danielle

    2013-01-01

    Frontline workers have a great deal to contribute to improving environmental sustainability of their employers and the health of workers and patients. This article discusses a national project of the Healthcare Career Advancement Program, funded by the U.S. Department of Labor to support green jobs development. Implementation was accomplished through a labor/management collaboration between union locals and 11 employers in four regions throughout the United States. The project developed and implemented a model of training and education for environmental service workers and other frontline health-care workers in hospital settings that supported systems change and built new roles for these workers. It empowered them to contribute to triple bottom line outcomes in support of People (patients, workers, the community), Planet (environmental sustainability and a lower carbon footprint), and Profit (cost savings for the institutions). In the process workers more clearly articulated their important role as a part of the healthcare team and learned how they could contribute to improved patient and worker health and safety.

  13. Front-line worker engagement: greening health care, improving worker and patient health, and building better jobs.

    PubMed

    Chenven, Laura; Copeland, Danielle

    2013-01-01

    Frontline workers have a great deal to contribute to improving environmental sustainability of their employers and the health of workers and patients. This article discusses a national project of the Healthcare Career Advancement Program, funded by the U.S. Department of Labor to support green jobs development. Implementation was accomplished through a labor/management collaboration between union locals and 11 employers in four regions throughout the United States. The project developed and implemented a model of training and education for environmental service workers and other frontline health-care workers in hospital settings that supported systems change and built new roles for these workers. It empowered them to contribute to triple bottom line outcomes in support of People (patients, workers, the community), Planet (environmental sustainability and a lower carbon footprint), and Profit (cost savings for the institutions). In the process workers more clearly articulated their important role as a part of the healthcare team and learned how they could contribute to improved patient and worker health and safety. PMID:23896075

  14. Organizational change, patient-focused care: an Australian perspective.

    PubMed

    Braithwaite, J

    1995-08-01

    Hospitals throughout the world are attempting to improve organizational performance through a variety of means. The focus in this paper is on a leading teaching hospital in Australia for a review of current management strategy. In a time of shrinking resources, management adopted a multi-faceted change management program including restructuring the organization, becoming more patient-focused via a product-line management approach and emphasising efficiency and cost-reduction measures. The next stage in management thinking is to place greater emphasis on patient-focused care. It is concluded this has the propensity to yield substantial further benefits, including improved financial and quality of care outcomes, in the Australian as well as the British and wider Organization for Economic Co-operation and Development (OECD) context. 'Professionally, we have committed ourselves to creating caring environments that promote healing. We cannot meet this goal until we make a commitment to be patient-focused and give up being nurse-focused or facility-focused' (Kerfort and LeClair, 1991). 'In a customer-driven [organization], the distribution of roles is different. The organization is decentralized, with responsibility delegated to those who until now have comprised the order-obeying bottom level of the pyramid. The traditional, hierarchical corporate structure, in other words, is beginning to give way to a flattened, more horizontal structure' (Carlzon, 1987). PMID:10151089

  15. Assessing the skills of home care workers in helping older people take their prescribed medications.

    PubMed

    Smyth, Elizabeth E J

    2015-08-01

    The Southern Health and Social Care Trust in Northern Ireland applied a modified version of the Objective Structured Clinical Examination (OSCE) to assess the skills of home care workers in assisting older people taking prescribed medications. In Northern Ireland, home care workers are care workers employed by health and social care trusts or private agencies. The application of the model has developed the skills of this staff group, improved the relationship between the commissioner and provider, significantly reduced the time spent by community nurses in individual training and assessment, and enhanced the patient experience for those taking medication. Overall, the application of this model has provided assurances to the Trust board, the executive director of nursing, and operational directors that home care workers are competent in assisting older people in this high-risk activity. PMID:26252238

  16. Mandatory influenza immunization for health care workers--an ethical discussion.

    PubMed

    Steckel, Cynthia M

    2007-01-01

    Influenza is a serious vaccine-preventable disease affecting 20% of the U.S. population each year. Vaccination of high-risk groups has been called the single most important influenza control measure by the Centers for Disease Control and Prevention. Studies show that vaccination can lead to decreases in flu-related illness and absenteeism among health care workers, as well as fewer acute care outbreaks and reduced patient mortality in long-term care settings. However, to date, voluntary programs have achieved only a 40% vaccination rate among health care workers, causing concern among government and infectious disease organizations. This article addresses the ethical justification for mandating influenza vaccination for health care workers. Health care workers' attitudes toward vaccination are presented, as well as historical and legal perspectives on compulsory measures. The ethical principles of effectiveness, beneficence, necessity, autonomy, justice, and transparency are discussed.

  17. Cost reduction using patient-focused care concepts.

    PubMed

    Snyder, G H; Lathrop, J P

    1995-01-01

    The latest wave of hospital reengineering has been based on the concepts of patient-focused care (PFC). PFC concepts include decentralizing low-scale activities to the point-of-care, cross-training employees to minimize hand-offs, simplifying processes to eliminate unnecessary complexity, redesigning the organization structure to focus on the care continuum, and adopting empowerment and teamwork to change individual behavior. Three innovative health systems have begun to reap the benefits of their PFC implementation efforts. Based on these three case study organizations, PFC is not only cost-justified, but also drives increases in quality and service levels. Each of the three case study organizations chose significantly different routes to implement these concepts due to various internal and external factors. Size of cost savings was the result of three main factors: level of change implemented, size of investment required to effect change, and time frame for implementation. Article includes results of economic analysis.

  18. The Womanly World of Long Term Care: The Plight of the Long Term Care Worker. Gray Paper.

    ERIC Educational Resources Information Center

    Older Women's League, Washington, DC.

    Long-term care workers (those who are paid to provide custodial care for long-term patients in nursing homes or at home) must care for a growing number of increasingly disabled or dependent persons. They are working for agencies and institutions under growing pressure to increase productivity. They face new training and competency requirements,…

  19. Complex routes into HIV care for migrant workers: a qualitative study from north India.

    PubMed

    Rai, Tanvi; Lambert, Helen S; Ward, Helen

    2015-01-01

    Migrant workers are designated a bridge population in the spread of HIV and therefore if infected, should be diagnosed and treated early. This study examined pathways to HIV diagnosis and access to care for rural-to-urban circular migrant workers and partners of migrants in northern India, identifying structural, social and individual level factors that shaped their journeys into care. We conducted a qualitative study using in-depth interviews with HIV-positive men (n = 20) and women (n = 13) with a history of circular migration, recruited from an antiretroviral therapy centre in one district of Uttar Pradesh, north India. Migrants and partners of migrants faced a complex series of obstacles to accessing HIV testing and care. Employment insecurity, lack of entitlement to sick pay or subsidised healthcare at destination and the household's economic reliance on their migration-based livelihood led many men to continue working until they became incapacitated by HIV-related morbidity. During periods of deteriorating health they often exhausted their savings on private treatments focused on symptom management, and sought HIV testing and treatment at a public hospital only following a medical or financial emergency. Wives of migrants had generally been diagnosed following their husbands' diagnosis or death, with access to testing and treatment mediated via family members. For some, a delay in disclosure of husband's HIV status led to delays in their own testing. Diagnosing and treating HIV infection early is important in slowing down the spread of the epidemic and targeting those at greatest risk should be a priority. However, despite targeted campaigns, circumstances associated with migration may prevent migrant workers and their partners from accessing testing and treatment until they become sick. The insecurity of migrant work, the dominance of private healthcare and gender differences in health-seeking behaviour delay early diagnosis and treatment initiation

  20. Complex routes into HIV care for migrant workers: a qualitative study from north India

    PubMed Central

    Rai, Tanvi; Lambert, Helen S.; Ward, Helen

    2015-01-01

    ABSTRACT Migrant workers are designated a bridge population in the spread of HIV and therefore if infected, should be diagnosed and treated early. This study examined pathways to HIV diagnosis and access to care for rural-to-urban circular migrant workers and partners of migrants in northern India, identifying structural, social and individual level factors that shaped their journeys into care. We conducted a qualitative study using in-depth interviews with HIV-positive men (n = 20) and women (n = 13) with a history of circular migration, recruited from an antiretroviral therapy centre in one district of Uttar Pradesh, north India. Migrants and partners of migrants faced a complex series of obstacles to accessing HIV testing and care. Employment insecurity, lack of entitlement to sick pay or subsidised healthcare at destination and the household's economic reliance on their migration-based livelihood led many men to continue working until they became incapacitated by HIV-related morbidity. During periods of deteriorating health they often exhausted their savings on private treatments focused on symptom management, and sought HIV testing and treatment at a public hospital only following a medical or financial emergency. Wives of migrants had generally been diagnosed following their husbands' diagnosis or death, with access to testing and treatment mediated via family members. For some, a delay in disclosure of husband's HIV status led to delays in their own testing. Diagnosing and treating HIV infection early is important in slowing down the spread of the epidemic and targeting those at greatest risk should be a priority. However, despite targeted campaigns, circumstances associated with migration may prevent migrant workers and their partners from accessing testing and treatment until they become sick. The insecurity of migrant work, the dominance of private healthcare and gender differences in health-seeking behaviour delay early diagnosis and treatment

  1. Ebola Virus Disease in Health Care Workers--Guinea, 2014.

    PubMed

    Grinnell, Margaret; Dixon, Meredith G; Patton, Monica; Fitter, David; Bilivogui, Pépé; Johnson, Candice; Dotson, Ellen; Diallo, Boubacar; Rodier, Guenael; Raghunathan, Pratima

    2015-10-02

    An outbreak of Ebola virus disease (Ebola) began in Guinea in December 2013 and has continued through September 2015. Health care workers (HCWs) in West Africa are at high risk for Ebola infection owing to lack of appropriate triage procedures, insufficient equipment, and inadequate infection control practices. To characterize recent epidemiology of Ebola infections among HCWs in Guinea, national Viral Hemorrhagic Fever (VHF) surveillance data were analyzed for HCW cases reported during January 1–December 31, 2014. During 2014, a total of 162 (7.9%) of 2,210 laboratory-confirmed or probable Ebola cases among Guinean adults aged ≥15 years occurred among HCWs, resulting in an incidence of Ebola infection among HCWs 42.2 times higher than among non-HCWs. The disproportionate burden of Ebola infection among HCWs taxes an already stressed health infrastructure, underscoring the need for increased understanding of transmission among HCWs and improved infection prevention and control measures to prevent Ebola infection among HCWs.

  2. Intention to leave the job among live-in foreign home care workers in Israel.

    PubMed

    Ayalon, Liat

    2010-01-01

    In Israel, almost all around-the-clock home care services are provided by foreign workers. Despite the fact that these workers are considered temporary, the Israeli government has acknowledged the need for consistency in care and now allows workers to stay in the country for as long as their care recipient is alive. Nonetheless, there have been increasing concerns about the tendency of foreign home care workers to view Israel as a temporary station on their way to more attractive destinations, such as Canada or England. Using the job rewards and concerns model, this article evaluates determinants of foreign home care workers' intentions to leave their job. This study was a cross-sectional analysis of 178 Filipino home care workers in Israel. Only 15 workers (8.4%) reported that they would be likely or very likely to leave their job within the next 3 months. The final model suggested that negative experiences within the home/work environment as well as within Israeli society at large contribute to depression and posttraumatic stress symptoms. However, caring for an older adult with dementia was the only predictor of intention to leave the job. The majority of workers do not report an intention to leave their job. Nonetheless, greater supervision of this caregiving arrangement in an attempt to protect the rights of foreign home care workers within the home/work environment is an important step, which has to be followed up by attitudinal changes within society at large. Specific training in dementia care is also warranted. PMID:20544459

  3. Factors affecting motivation and retention of primary health care workers in three disparate regions in Kenya

    PubMed Central

    2014-01-01

    Background The World Health Organization (WHO) and the Government of Kenya alike identify a well-performing health workforce as key to attaining better health. Nevertheless, the motivation and retention of health care workers (HCWs) persist as challenges. This study investigated factors influencing motivation and retention of HCWs at primary health care facilities in three different settings in Kenya - the remote area of Turkana, the relatively accessible region of Machakos, and the disadvantaged informal urban settlement of Kibera in Nairobi. Methods A cross-sectional cluster sample design was used to select 59 health facilities that yielded interviews with 404 health care workers, grouped into 10 different types of service providers. Data were collected in November 2011 using structured questionnaires and a Focus Group Discussion guide. Findings were analyzed using bivariate and multivariate methods of the associations and determinants of health worker motivation and retention. Results The levels of education and gender factors were lowest in Turkana with female HCWs representing only 30% of the workers against a national average of 53%. A smaller proportion of HCWs in Turkana feel that they have adequate training for their jobs. Overall, 13% of the HCWs indicated that they had changed their job in the last 12 months and 20% indicated that they could leave their current job within the next two years. In terms of work environment, inadequate access to electricity, equipment, transport, housing, and the physical state of the health facility were cited as most critical, particularly in Turkana. The working environment is rated as better in private facilities. Adequate training, job security, salary, supervisor support, and manageable workload were identified as critical satisfaction factors. Family health care, salary, and terminal benefits were rated as important compensatory factors. Conclusions There are distinct motivational and retention factors that affect

  4. Burnout and use of HIV services among health care workers in Lusaka District, Zambia: a cross-sectional study

    PubMed Central

    Kruse, Gina R; Chapula, Bushimbwa Tambatamba; Ikeda, Scott; Nkhoma, Mavis; Quiterio, Nicole; Pankratz, Debra; Mataka, Kaluba; Chi, Benjamin H; Bond, Virginia; Reid, Stewart E

    2009-01-01

    Background Well-documented shortages of health care workers in sub-Saharan Africa are exacerbated by the increased human resource demands of rapidly expanding HIV care and treatment programmes. The successful continuation of existing programmes is threatened by health care worker burnout and HIV-related illness. Methods From March to June 2007, we studied occupational burnout and utilization of HIV services among health providers in the Lusaka public health sector. Providers from 13 public clinics were given a 36-item, self-administered questionnaire and invited for focus group discussions and key-informant interviews. Results Some 483 active clinical staff completed the questionnaire (84% response rate), 50 staff participated in six focus groups, and four individuals gave interviews. Focus group participants described burnout as feeling overworked, stressed and tired. In the survey, 51% reported occupational burnout. Risk factors were having another job (RR 1.4 95% CI 1.2–1.6) and knowing a co-worker who left in the last year (RR 1.6 95% CI 1.3–2.2). Reasons for co-worker attrition included: better pay (40%), feeling overworked or stressed (21%), moving away (16%), death (8%) and illness (5%). When asked about HIV testing, 370 of 456 (81%) reported having tested; 240 (50%) tested in the last year. In contrast, discussion groups perceived low testing rates. Both discussion groups and survey respondents identified confidentiality as the prime reason for not undergoing HIV testing. Conclusion In Lusaka primary care clinics, overwork, illness and death were common reasons for attrition. Programmes to improve access, acceptability and confidentiality of health care services for clinical providers and to reduce workplace stress could substantially affect workforce stability. PMID:19594917

  5. [Home care of children with chronic diseases: cooperation between hospital and home care workers].

    PubMed

    Cologna, M; Zeni, F; Bobbi, C

    1996-01-01

    Newborns with chronic problems needing continuous and special care even after discharge are not very frequent but represent a challenge for the caring team. The discharge program of the Neonatal Care ward of Trento hospital includes several steps: discharge meetings of teh neonatologist and the nurse responsible for the child, the head nurse, the psychologist and, when possible, the social worker; a training program for the parents; the coordination of communications and interventions of the home-care nurses and a detailed post-discharge planning. From 1995 a home-hospital program, as an alternative to the hospital admission was started. To describe how the team functions and stress the need of a close integration among the team members, the case of Ahmed is presented. This case faced the team with several challenges, because of the lack of parent's knowledge of the italian language and of the severity of the child's problems. Every care plan is developed building on newborn's needs and patients' resources. Data on the patients-problems dealt with from 1991 to 1995 and the interventions and resources needed are presented.

  6. 22 CFR 40.53 - Uncertified foreign health-care workers.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... a non-clinical health care occupation as described in 8 CFR 212.15(b)(1); or (2) Who is the... entry into the United States in order to perform health care services as described in 8 CFR 212.15. ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Uncertified foreign health-care workers....

  7. 22 CFR 40.53 - Uncertified foreign health-care workers.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... a non-clinical health care occupation as described in 8 CFR 212.15(b)(1); or (2) Who is the... entry into the United States in order to perform health care services as described in 8 CFR 212.15. ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Uncertified foreign health-care workers....

  8. 8 CFR 1212.15 - Certificates for foreign health care workers.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 8 Aliens and Nationality 1 2014-01-01 2014-01-01 false Certificates for foreign health care... CERTAIN INADMISSIBLE ALIENS; PAROLE § 1212.15 Certificates for foreign health care workers. (a... coming to the United States for the primary purpose of performing labor in a health care...

  9. 22 CFR 40.53 - Uncertified foreign health-care workers.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... a non-clinical health care occupation as described in 8 CFR 212.15(b)(1); or (2) Who is the... entry into the United States in order to perform health care services as described in 8 CFR 212.15. ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Uncertified foreign health-care workers....

  10. 22 CFR 40.53 - Uncertified foreign health-care workers.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... a non-clinical health care occupation as described in 8 CFR 212.15(b)(1); or (2) Who is the... entry into the United States in order to perform health care services as described in 8 CFR 212.15. ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Uncertified foreign health-care workers....

  11. Managed Care and the Evolving Role of the Clinical Social Worker in Mental Health.

    ERIC Educational Resources Information Center

    Cohen, Jeffrey A.

    2003-01-01

    Discusses developments for practitioners in mental health care with the advent of managed care. With managed care's influence and new cost-containment strategies, the roles of clinical social workers, clinical psychologists, and psychiatrists are evolving, creating role conflict and competition. This article outlines the changes that have occurred…

  12. Care Orders as Successful Interventions: The Social Workers' Point of View

    ERIC Educational Resources Information Center

    Pösö, Tarja; Eronen, Tuija

    2014-01-01

    This article examines the outcomes of care orders from the point of view of social workers. The aim is to cast light on the "black box" of substitute care by analysing the practice-based view on outcome in order to contribute to the complex debate on the relations of care and outcome. The article is based on a study using a survey, focus…

  13. 8 CFR 1212.15 - Certificates for foreign health care workers.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 8 Aliens and Nationality 1 2012-01-01 2012-01-01 false Certificates for foreign health care... CERTAIN INADMISSIBLE ALIENS; PAROLE § 1212.15 Certificates for foreign health care workers. (a... coming to the United States for the primary purpose of performing labor in a health care...

  14. 8 CFR 1212.15 - Certificates for foreign health care workers.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 8 Aliens and Nationality 1 2013-01-01 2013-01-01 false Certificates for foreign health care... CERTAIN INADMISSIBLE ALIENS; PAROLE § 1212.15 Certificates for foreign health care workers. (a... coming to the United States for the primary purpose of performing labor in a health care...

  15. Impact of health care worker policy awareness on hand hygiene and urinary catheter care in nursing homes: results of a self-reported survey.

    PubMed

    Montoya, Ana; Chen, Shu; Galecki, Andrzej; McNamara, Sara; Lansing, Bonnie; Mody, Lona

    2013-06-01

    Utilizing a self-administered questionnaire in 440 health care workers (81% response rate), we evaluated the impact of health care workers policy awareness on hand hygiene and urinary catheter care in nursing homes. We show that health care workers aware of their nursing home policies are more likely to report wearing gloves and practicing hand hygiene as per evidence-based recommendations during urinary catheter care compared with those who are unaware of their facility policies.

  16. Patient-focused care: what managers should know.

    PubMed

    Myers, S M

    1998-01-01

    Implementation of PFC is considered a "rational" strategic choice in that it is thought to decrease the cost of providing health care while increasing the quality of services. Published research and evaluation studies that describe PFC are analyzed and the information is synthesized in hopes of discovering and describing commonalties among definitions, goals, and principles underlying PFC. The commonly accepted description of PFC is a model which "seeks to integrate the organization's values and culture with the operational excellence vision and processes to transform the institution into a customer-focused organization." Staff satisfaction is addressed by encouraging staff to plan and execute their clinical work in ways that are most responsive to patient needs. Grouping similar patients, bringing services closer to these patients, and appropriate cross-training of multidisciplinary care providers to enhance continuity of care are seen as the four most common elements described in most of the literature. PMID:9748983

  17. Quality of care provided by mid-level health workers: systematic review and meta-analysis

    PubMed Central

    Lassi, Zohra S; Cometto, Giorgio; Huicho, Luis

    2013-01-01

    Abstract Objective To assess the effectiveness of care provided by mid-level health workers. Methods Experimental and observational studies comparing mid-level health workers and higher level health workers were identified by a systematic review of the scientific literature. The quality of the evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation criteria and data were analysed using Review Manager. Findings Fifty-three studies, mostly from high-income countries and conducted at tertiary care facilities, were identified. In general, there was no difference between the effectiveness of care provided by mid-level health workers in the areas of maternal and child health and communicable and noncommunicable diseases and that provided by higher level health workers. However, the rates of episiotomy and analgesia use were significantly lower in women giving birth who received care from midwives alone than in those who received care from doctors working in teams with midwives, and women were significantly more satisfied with care from midwives. Overall, the quality of the evidence was low or very low. The search also identified six observational studies, all from Africa, that compared care from clinical officers, surgical technicians or non-physician clinicians with care from doctors. Outcomes were generally similar. Conclusion No difference between the effectiveness of care provided by mid-level health workers and that provided by higher level health workers was found. However, the quality of the evidence was low. There is a need for studies with a high methodological quality, particularly in Africa – the region with the greatest shortage of health workers. PMID:24347706

  18. An outbreak of hepatitis A among health care workers: risk factors for transmission.

    PubMed Central

    Doebbeling, B N; Li, N; Wenzel, R P

    1993-01-01

    OBJECTIVES. The purpose of this study was to investigate a nosocomial outbreak of hepatitis A that occurred in the burn treatment center of a referral hospital. METHODS. Retrospective cohort and case-control studies were performed to determine acquisition rates and risk factors for transmission. Adjusted infection rates were calculated by week of exposure. A case-control study was conducted to determine potential mechanisms for nosocomial acquisition. Recently infected health care workers were defined as case patients; exposed, serosusceptible health care workers without infection served as controls. RESULTS. The outbreak of hepatitis A affected 11 health care workers and 1 other burn patient (1 secondary patient case). All 11 health care workers became ill after the admission of a man and his 8-month-old son who developed hepatitis A while in the hospital. The cumulative incidence risk ratio was elevated for health care workers caring for either the infant or the father during the same week of exposure. The case-control study implicated the behavior of eating on the hospital ward as the single most important risk factor for infection. CONCLUSION. Inadequate hand-washing and subsequent oral contamination appear responsible for the outbreak. Hospitals may witness other institutional outbreaks if health care workers regularly eat on the wards. PMID:8259794

  19. Expanding the Role of Nurse Practitioners: Effects on Rural Access to Care for Injured Workers

    ERIC Educational Resources Information Center

    Sears, Jeanne M.; Wickizer, Thomas M.; Franklin, Gary M.; Cheadle, Allen D.; Berkowitz, Bobbie

    2008-01-01

    Context: A 3-year pilot program to expand the role of nurse practitioners (NPs) in the Washington State workers' compensation system was implemented in 2004 (SHB 1691), amid concern about disparities in access to health care for injured workers in rural areas. SHB 1691 authorized NPs to independently perform most functions of an attending…

  20. Violence against Primary Health Care Workers in Al-Hassa, Saudi Arabia

    ERIC Educational Resources Information Center

    El-Gilany, Abdel-Hady; El-Wehady, Adel; Amr, Mostafa

    2010-01-01

    This self-report questionnaire study was carried out in Al-Hassa, Saudi Arabia to highlight the magnitude, predictors, and circumstances of workplace violence against primary health care (PHC) workers. A total of 1,091 workers completed a self-administered questionnaire. About 28% were exposed to at least one violent event during the past year.…

  1. Compassion Fatigue and Compassion Satisfaction among Residential Child Care Workers: The Role of Personality Resources

    ERIC Educational Resources Information Center

    Zerach, Gadi

    2013-01-01

    This study assessed compassion fatigue (CF) and compassion satisfaction (CS) among Israeli residential child-care workers (RCWs) working in residential treatment facilities for children and youth at risk (N = 147) as compared to educational boarding schools workers (BSWs; N = 74). Furthermore, we assessed the relationship of potential…

  2. A Survey of the Asthma Knowledge and Practices of Child Care Workers.

    ERIC Educational Resources Information Center

    Ramm, John; And Others

    1994-01-01

    Investigated the asthma knowledge and practices of 247 child-care workers in southwestern Sydney. Two hundred and twelve (86 percent) correctly identified a persistent cough as the predominant symptom of childhood asthma, with wheezing (98 percent) being the response chosen most often. Nearly 50 percent of workers had used a nebulizer and/or a…

  3. Caring for migrant farm workers on medical-surgical units.

    PubMed

    Anthony, Maureen J

    2011-01-01

    Over 3 million migrant farm workers are employed in the United States. Many factors place them at risk for work-related disease and injury. Knowledge of workers' health issues can prepare medical-surgical nurses to anticipate and meet the needs of this underserved population. PMID:21786487

  4. Providing care for migrant farm worker families in their unique sociocultural context and environment.

    PubMed

    Connor, Ann; Layne, Laura; Thomisee, Karen

    2010-04-01

    This article highlights the Farm Worker Family Health Program's (FWFHP) strategies for providing care to migrant farm workers residing within a unique social and cultural context. The care provided by health professions students from a variety of disciplines extends and augments the work of the local migrant farm worker clinic that is pushed beyond capacity during peak growing and harvest times. Nursing's social responsibility to care for underserved populations is a guiding principle of the FWFHP and shapes how the work is translated into action. The FWFHP is a community-academic partnership that began in the rural southeastern United States in 1993. Challenges facing migrant farm worker families include access to health care, language, health literacy, housing and sanitation, family and community integrity, and workplace safety. The nursing practice strategies used to address these health challenges may be adapted to strengthen health programs serving other populations who live in poverty or reside in low-resource settings. PMID:20301816

  5. Hand hygiene practices among health care workers (HCWs) in a tertiary care facility in Pune

    PubMed Central

    Anargh, V.; Singh, Harpreet; Kulkarni, Aniket; Kotwal, Atul; Mahen, Ajoy

    2012-01-01

    Background Improper hand hygiene by healthcare workers (HCWs) is responsible for about 40% of nosocomial infections resulting in prolonged illnesses, hospital stays, long-term disability and unexpected high costs on patients and their families, and also lead to a massive additional financial burden on the health-care system. Objective To assess knowledge and practices regarding hand hygiene among HCWs of a tertiary health care facility. Methods A cross sectional, questionnaire and observation based study was carried out in a tertiary care health care facility in Pune. Based on sample size calculations, 100 HCWs working in medical and surgical wards were studied. Results The proportion knowledgeable about hand hygiene practices was 85% and 73% HCWs were of the belief that unclean hands are an important route of cross transmission. WHO guidelines regarding procedure were being followed by 90% for hand washing with soap and water and 64% for alcohol based rubs. Majority preferred hand washing with soap and water over hand rubbing with alcohol based solutions. 21% of HCWs were missing hand hygiene opportunities 1 in 5 times. Heavy workload (38%), non availability (52%) and inaccessibility (9%) of hand hygiene facilities were the common reasons for non-compliance. Availability of ‘one time use paper towels’ was low (12%). Conclusion Inadequate compliance despite knowledge and false sense of security by alcohol based rubs was seen. A multi disciplinary, multifaceted approach is required to tackle issues of non-compliance. PMID:24532935

  6. Job Perceptions and Intent to Leave among Direct Care Workers: Evidence from the Better Jobs Better Care Demonstrations

    ERIC Educational Resources Information Center

    Brannon, Dianne; Barry, Teta; Kemper, Peter; Schreiner, Andrea; Vasey, Joe

    2007-01-01

    Purpose: We assess how perceived rewards and problems with caregiving work and supervision relate to intent to leave among direct care workers who are employed in provider organizations participating in the Better Jobs Better Care (BJBC) demonstration; we also examine how these relationships vary by provider type. Design and Methods: Direct care…

  7. Predictors of Ethical Stress, Moral Action and Job Satisfaction in Health Care Social Workers

    PubMed Central

    O'Donnell, Patricia; Farrar, Adrienne; BrintzenhofeSzoc, Karlynn; Conrad, Ann Patrick; Danis, Marion; Grady, Christine; Taylor, Carol; Ulrich, Connie M.

    2016-01-01

    Value conflicts can be a source of ethical stress for social workers in health care settings. That stress, unless mediated by the availability of ethical resource services, can lead to social workers' dissatisfaction with their positions and careers, and possibly result in needed professionals leaving the field. This study explored social workers' experiences in dealing with ethical issues in health care settings. Findings showed the inter-relationship between selected individual and organizational factors and overall ethical stress, the ability to take moral actions, the impact of ethical stress on job satisfaction, and the intent to leave position. PMID:18551828

  8. Low back pain among personal care workers in an old age home: work-related and individual factors.

    PubMed

    Yeung, Simon S; Yuan, Jun

    2011-08-01

    This cross-sectional study explored the work-related and individual factors that contributed to the occurrence of low back pain and affected activities of 36 personal care workers at an old age home in Hong Kong. The study was divided into four parts: (1) a questionnaire documenting workload exposure factors; (2) a musculoskeletal symptoms survey documenting the prevalence of low back pain in this group of workers; (3) a worksite evaluation focusing on personal care workers' work postures and the work environment; and (4) an evaluation of physical fitness and lifting capacities of personal care workers. Univariate followed by multiple logistic regression analyses were used to identify the risk factors associated with low back pain that affected work activities. The results revealed that low back pain was associated with the perceived physical demands of cleaning tasks (odds ratio [OR] = 7.28, 95% confidence interval [CI] = 1.35-39.35, p < .05), perceived demands of awkward sustained back (OR = 4.46, CI = 0.86-22.97, p = .074) and neck (OR = 0.18, CI = 0.04-0.81, p < .05) postures, and thermal stress at work (OR = 49.80, CI = 0.70-3541.79, p = .072). The results of the current study indicated that the work environment contributed to low back pain at work. Workers perceived that exertion in workplaces has a role in assessing workplace risk. To avoid progression of low back pain in the workplace, work adjustment or modification should be considered when workers report high levels of perceived exertion at work. PMID:21800797

  9. Outreach services to improve access to health care in South Africa: lessons from three community health worker programmes

    PubMed Central

    Nxumalo, Nonhlanhla; Goudge, Jane; Thomas, Liz

    2013-01-01

    Introduction In South Africa, there are renewed efforts to strengthen primary health care and community health worker (CHW) programmes. This article examines three South African CHW programmes, a small local non-governmental organisation (NGO), a local satellite of a national NGO, and a government-initiated service, that provide a range of services from home-based care, childcare, and health promotion to assist clients in overcoming poverty-related barriers to health care. Methods The comparative case studies, located in Eastern Cape and Gauteng, were investigated using qualitative methods. Thematic analysis was used to identify factors that constrain and enable outreach services to improve access to care. Results The local satellite (of a national NGO), successful in addressing multi-dimensional barriers to care, provided CHWs with continuous training focused on the social determinants of ill-health, regular context-related supervision, and resources such as travel and cell-phone allowances. These workers engaged with, and linked their clients to, agencies in a wide range of sectors. Relationships with participatory structures at community level stimulated coordinated responses from service providers. In contrast, an absence of these elements curtailed the ability of CHWs in the small NGO and government-initiated service to provide effective outreach services or to improve access to care. Conclusion Significant investment in resources, training, and support can enable CHWs to address barriers to care by negotiating with poorly functioning government services and community participation structures. PMID:23364101

  10. Risk factors of tuberculosis among health care workers in Sabah, Malaysia.

    PubMed

    Jelip, Jenarun; Mathew, George G; Yusin, Tanrang; Dony, Jiloris F; Singh, Nirmal; Ashaari, Musa; Lajanin, Noitie; Shanmuga Ratnam, C; Yusof Ibrahim, Mohd; Gopinath, Deyer

    2004-01-01

    Tuberculosis (TB) is one of the main public health problems in Sabah; 30% of the total number of TB cases reported in Malaysia every year occur in Sabah. The average incidence of TB among health care workers over the past 5 years is 280.4 per 100,000 population (1, Annual Report of Sabah State TB Control Programme, 1998). At present, there are no specific measures for the prevention of TB transmission in health care facilities. A case-control study was conducted among health care workers in Sabah in 2000-2001. Cases were health care workers with TB diagnosed between January 1990 and June 2000. Controls were health care workers without TB and working in the same facility as cases during the disease episode. The study attempted to identify risk factors for TB among the study population. Data were collected through structured interviews and review of patients' records. The notification rate of TB among health care workers was significantly higher than that to the general population (Z=4.893, p<0.01). The average notification rate of TB among health care workers over the last 5 years was two times higher than in the general population (280.4/100,000 compared to 153.9/100,000). Regression results showed that ethnicity, designation, family contact and TB related knowledge did not significantly contribute to the risk of contracting TB in this study. However, after controlling for the above factors, age, gender, history of TB contact outside the workplace (other than family contact), duration of service and failure to use respiratory protection when performing high-risk procedures, were the main risk factors of TB among health care workers. This study succeeded in identifying some of the risk factors of TB among health care workers. We managed to include the large ratio of controls to case (3:1) and those cases spanned over a period of 10 years. However, the findings from the study have to be applied with caution due to the limitations of this study, which include recall

  11. Work-family conflict, psychological distress, and sleep deficiency among patient care workers.

    PubMed

    Jacobsen, Henrik B; Reme, Silje Endresen; Sembajwe, Grace; Hopcia, Karen; Stoddard, Anne M; Kenwood, Christopher; Stiles, Tore C; Sorensen, Glorian; Buxton, Orfeu M

    2014-07-01

    This study examined whether work-family conflict was associated with sleep deficiencies, both cross-sectionally and longitudinally. In this two-phase study, a workplace health survey was completed by a cohort of patient care workers (n = 1,572). Additional data were collected 2 years later from a subsample of the original respondents (n = 102). Self-reported measures included work-family conflict, workplace factors, and sleep outcomes. The participants were 90% women, with a mean age of 41 ± 11.7 years. At baseline, after adjusting for covariates, higher levels of work-family conflict were significantly associated with sleep deficiency. Higher levels of work-family conflict also predicted sleep insufficiency nearly 2 years later. The first study to determine the predictive association between work-family conflict and sleep deficiency suggests that future sleep interventions should include a specific focus on work-family conflict.

  12. Vaccinating Health Care Workers Against Influenza: The Ethical and Legal Rationale for a Mandate

    PubMed Central

    Wu, Joel T.; Poland, Gregory A.; Jacobson, Robert M.; Koenig, Barbara A.; Tilburt, Jon C.

    2011-01-01

    Despite improvements in clinician education, symptom awareness, and respiratory precautions, influenza vaccination rates for health care workers have remained unacceptably low for more than three decades, adversely affecting patient safety. When public health is jeopardized, and a safe, low-cost, and effective method to achieve patient safety exists, health care organizations and public health authorities have a responsibility to take action and change the status quo. Mandatory influenza vaccination for health care workers is supported not only by scientific data but also by ethical principles and legal precedent. The recent influenza pandemic provides an opportunity for policymakers to reconsider the benefits of mandating influenza vaccination for health care workers, including building public trust, enhancing patient safety, and strengthening the health care workforce. PMID:21228284

  13. The First Identification of Encephalitozoon cuniculi Infection in an Animal Care Worker in Turkey

    PubMed Central

    CARHAN, Ahmet; OZKAN, Ozcan; OZKAYA, Ethem

    2015-01-01

    Background: As a zoonotic pathogen, Encephalitozoon cuniculi is a cause of serious disease in animals and people. The present study was to evaluate the health status examination of this seropositive animal care worker in our previous study. Methods: Blood samples were taken from five workers. CIA test was applied to detect antibodies against E. cuniculi in blood serum. The indirect immunofluorescence antibody test was used as confirmation test. Seropositive worker had a complete medical examination. Results: Only one worker was found to be seropositive according to the results of the serological test. Sera positive to E. cuniculi was confirmed with IFAT and spores were detected in the urine sample of the worker. The worker was treated with albendazole. Conclusion: Rabbits should be examined routinely for the presence of anti-E. cuniculi antibody. People working with laboratory animal should avoid contact with urine and faeces of infected or pay attention to personal hygiene. PMID:26246827

  14. Caring from Afar: Asian H1B Migrant Workers and Aging Parents.

    PubMed

    Lee, Yeon-Shim; Chaudhuri, Anoshua; Yoo, Grace J

    2015-09-01

    With the growth in engineering/technology industries, the United States has seen an increase in the arrival of highly skilled temporary migrant workers on H1B visas from various Asian countries. Limited research exists on how these groups maintain family ties from afar including caring for aging parents. This study explores the experiences and challenges that Asian H1B workers face when providing care from a distance. A total of 21 Chinese/Taiwanese, Korean, and Indian H1B workers participated in in-depth qualitative interviews. Key findings indicate that despite distance, caring relationships still continue through regular communications, financial remittances, and return visits, at the same time creating emotional, psychological, and financial challenges for the workers. Findings highlight the need for further research in understanding how the decline of aging parent's health impacts the migrants' adjustment and health in the United States. PMID:26267591

  15. Caring from Afar: Asian H1B Migrant Workers and Aging Parents.

    PubMed

    Lee, Yeon-Shim; Chaudhuri, Anoshua; Yoo, Grace J

    2015-09-01

    With the growth in engineering/technology industries, the United States has seen an increase in the arrival of highly skilled temporary migrant workers on H1B visas from various Asian countries. Limited research exists on how these groups maintain family ties from afar including caring for aging parents. This study explores the experiences and challenges that Asian H1B workers face when providing care from a distance. A total of 21 Chinese/Taiwanese, Korean, and Indian H1B workers participated in in-depth qualitative interviews. Key findings indicate that despite distance, caring relationships still continue through regular communications, financial remittances, and return visits, at the same time creating emotional, psychological, and financial challenges for the workers. Findings highlight the need for further research in understanding how the decline of aging parent's health impacts the migrants' adjustment and health in the United States.

  16. Making influenza vaccination mandatory for health care workers: the views of NSW Health administrators and clinical leaders.

    PubMed

    Leask, Julie; Helms, Charles M; Chow, Maria Y; Robbins, Spring C Cooper; McIntyre, Peter B

    2010-01-01

    The challenges of maintaining high influenza vaccination rates in health care workers have focused worldwide attention on mandatory measures. In 2007, NSW Health issued a policy directive requiring health care workers to be screened/vaccinated for certain infectious diseases. Annual influenza vaccine continued to be recommended but not required. This paper describes the views of NSW Health administrators and clinical leaders about adding influenza vaccination to the requirements. Of 55 staff interviewed, 45 provided a direct response. Of these, 23 supported inclusion, 14 did not and eight were undecided. Analysis of interviews indicated that successfully adding influenza vaccination to the current policy directive would require four major issues to be addressed: (1) providing and communicating a solid evidence base supporting the policy directive; (2) addressing the concerns of staff about the vaccine; (3) ensuring staff understand the need to protect patients; and (4) addressing the logistical challenges of enforcing an annual vaccination.

  17. Knowing Both: Towards Integrating Two Main Approaches to the Tertiary Education of Health Care Workers Involved in Caring for People Living with HIV/AIDS. A Needs Assessment of HIV/AIDS Tertiary Education for Health Care Workers in Metropolitan South Australia.

    ERIC Educational Resources Information Center

    Elsey, Barry; Mills, Patricia

    The need for continuing education about human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) was assessed for health care workers in metropolitan South Australia. Seventeen focus group discussions were held to solicit the views and experiences of various persons regarding HIV/AIDS tertiary education. Included in the…

  18. Public sector antiretroviral treatment programme in South Africa: health care workers' attention to mental health problems.

    PubMed

    Pappin, Michele; Wouters, Edwin; Booysen, Frederik L R; Lund, Crick

    2015-01-01

    Although there is a high prevalence of anxiety and depression amongst people receiving antiretroviral treatment (ART), many patients are not screened, diagnosed or referred for mental health problems. This study aims to determine whether public sector health care workers in South Africa observe, screen, diagnose and refer ART patients that show symptoms of common mental disorders. It also aims to ascertain the extent of mental health training received by public sector health care workers working in ART. The study was cross-sectional in design. Self-administered questionnaires were completed by 40 nurses and structured interviews were conducted with 23 lay workers across the five districts in the Free State between July 2009 and October 2009. STATA version 12 was used to perform statistical data analysis. The health care workers reported observing a high frequency of symptoms of common mental disorders among public sector ART patients. While 70% of nurses screened and diagnosed, only 40% of lay workers screened and diagnosed patients on ART for a mental disorder. Health care workers who had received training in mental health were more likely to screen or diagnose a mental disorder, but only 14% of the workers had received such training. We recommend that health care workers should receive task-specific training to screen and/or diagnose patients on ART for common mental disorders using the guidelines of the South African HIV Clinicians Society. A positive diagnosis should be referred to a health care practitioner for appropriate evidence-based treatment in the form of medication or psychotherapy.

  19. Mandatory influenza vaccination for health care workers as the new standard of care: a matter of patient safety and nonmaleficent practice.

    PubMed

    Cortes-Penfield, Nicolas

    2014-11-01

    A growing body of literature defends the efficacy of seasonal influenza vaccination for health care workers in reducing the mortality of hospitalized patients. I review the evidence concerning influenza vaccination, concluding that universal vaccination of health care workers against influenza should be considered standard patient care and that nonvaccination represents maleficent care. I further argue that the ethical responsibility to ensure universal vaccination of staff against seasonal influenza lies not only with individual health care providers but with each individual health care institution.

  20. Ending neglect: providing effective childhood tuberculosis training for health care workers in Tanzania

    PubMed Central

    Olotu, R.; Talbot, E. A.; Cronin, B. J.; Christopher, R.; Mkomwa, Z.

    2014-01-01

    Setting: Health care facilities in Dar es Salaam, Pwani, and Arusha, Tanzania. Objective: To assess health care worker (HCW) knowledge and practices 1 year after specialized training in childhood tuberculosis (TB). Design: Using a standardized survey, we interviewed a convenience sample of HCWs providing both general and specialized care to children. Results: We interviewed 117 HCWs in TB clinics, maternal and child health clinics, human immunodeficiency virus (HIV) clinics, out-patient departments, and pediatric in-patient wards at 12 facilities. A total of 81 HCWs (62% of nurses, 74% of clinicians) reported having attended the national childhood TB training course. Most HCWs responded correctly to questions on childhood TB diagnosis, treatment, and TB-HIV co-management, regardless of training history. Most HCWs reported that they routinely obtain chest radiographs, HIV testing, and a TB contact history when evaluating children for TB. Less than half of HCWs reported routinely obtaining sputum for mycobacterial culture or performing a tuberculin skin test. Three times as many trained as untrained HCWs reported having ever prescribed isoniazid preventive therapy (IPT) to a child (P < 0.05). Conclusion: In general, levels of childhood TB knowledge were high and practices were in accordance with national guidance. Specific gaps in diagnosis, treatment and use of IPT were identified for future focused training. PMID:26400701

  1. Slip, trip, and fall injuries among nursing care facility workers.

    PubMed

    Bell, Jennifer L; Collins, James W; Tiesman, Hope M; Ridenour, Marilyn; Konda, Srinivas; Wolf, Laurie; Evanoff, Bradley

    2013-04-01

    The objective of this research was to describe the slip, trip, and fall injury experience and trends in a population of nursing home workers, identify risk factors for slip, trip, and fall injuries, and develop prevention strategies for slip, trip, and fall hazards. Workers' compensation injury claims data and payroll data from 1996 through 2003 were obtained from six nursing homes and used to calculate injury incidence rates. Narrative information was used to describe details of slip, trip, and fall events. A total of 86 slip, trip, and fall-related workers' compensation claims were filed during the 8-year period. Slip, trip, and fall claim rates showed a nonsignificant increase during the 8-year period. Most slips, trips, and falls were attributed to hazards that can be mitigated (e.g., water on the floor or loose cords in a walkway). Nursing home workers experience more slip, trip, and fall-related injury claims than workers in other industries. Preventive programs should be implemented and evaluated in this industry. PMID:23521142

  2. 8 CFR 1245.14 - Adjustment of status of certain health care workers.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... RESIDENCE § 1245.14 Adjustment of status of certain health care workers. An alien applying for adjustment of status to perform labor in a health care occupation as described in 8 CFR 1212.15(c) must present... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Adjustment of status of certain health...

  3. 8 CFR 1245.14 - Adjustment of status of certain health care workers.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... RESIDENCE § 1245.14 Adjustment of status of certain health care workers. An alien applying for adjustment of status to perform labor in a health care occupation as described in 8 CFR 1212.15(c) must present... 8 Aliens and Nationality 1 2014-01-01 2014-01-01 false Adjustment of status of certain health...

  4. 8 CFR 1245.14 - Adjustment of status of certain health care workers.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... RESIDENCE § 1245.14 Adjustment of status of certain health care workers. An alien applying for adjustment of status to perform labor in a health care occupation as described in 8 CFR 1212.15(c) must present... 8 Aliens and Nationality 1 2012-01-01 2012-01-01 false Adjustment of status of certain health...

  5. 8 CFR 1245.14 - Adjustment of status of certain health care workers.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... RESIDENCE § 1245.14 Adjustment of status of certain health care workers. An alien applying for adjustment of status to perform labor in a health care occupation as described in 8 CFR 1212.15(c) must present... 8 Aliens and Nationality 1 2013-01-01 2013-01-01 false Adjustment of status of certain health...

  6. 8 CFR 1245.14 - Adjustment of status of certain health care workers.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... RESIDENCE § 1245.14 Adjustment of status of certain health care workers. An alien applying for adjustment of status to perform labor in a health care occupation as described in 8 CFR 1212.15(c) must present... 8 Aliens and Nationality 1 2011-01-01 2011-01-01 false Adjustment of status of certain health...

  7. The Attitudes of Direct Care Workers towards Persons with Disabilities: An Exploratory Study

    ERIC Educational Resources Information Center

    Diallo, Abdoulaye

    2010-01-01

    The purpose of this study is to examine the attitudes of direct care workers (DCWs) in group homes towards PWDs. This study also investigated DCWs' demographic and other variables on their attitudes towards PWDs. The scale of attitudes towards disabled persons (SADP) questionnaire was administered to a purposive sample of 108 direct care workers…

  8. Investing in Low-Wage Workers: Lessons from Family Child Care in Rhode Island

    ERIC Educational Resources Information Center

    Roder, Anne; Seavey, Dorie

    2006-01-01

    While child care is one of the fastest growing occupations in the country, most employment in this field is precarious and low-wage. Investing in Low-Wage Workers profiles the Day Care Justice Co-op, a group of largely Latina and African American women living and working in some of Rhode Island's poorest communities. Determined to improve family…

  9. A Study of New York Day Care Worker Salaries and Benefits.

    ERIC Educational Resources Information Center

    Zinsser, Caroline

    Compensation of day care workers in the State of New York was investigated in a study involving 451 day care centers, Head Start programs, and nursery schools representing 4,844 employees. Data for New York City and the rest of New York were analyzed separately. In New York State, head teachers earned an average of $5.33 per hour and classroom…

  10. [Russian Federation implementation of WHO global efforts plan on workers health care].

    PubMed

    Izmerov, N F; Bukhtiyarov, I V; Prokopenko, L V; Shigan, E E

    2015-01-01

    The article deals with problems of implementing global WHO efforts plan on workers health care, Target program of World Labor Organization on work and occupational environment safety "For safe labor", some WLO conventions. The authors justify priority directions of governmental policy on health care for working population in Russia.

  11. The Impact of Stress and Support on Direct Care Workers' Job Satisfaction

    ERIC Educational Resources Information Center

    Ejaz, Farida K.; Noelker, Linda S.; Menne, Heather L.; Bagaka's, Joshua G.

    2008-01-01

    Purpose: This research applies a stress and support conceptual model to investigate the effects of background characteristics, personal and job-related stressors, and workplace support on direct care workers' (DCW) job satisfaction. Design and Methods: Researchers collected survey data from 644 DCWs in 49 long-term care (LTC) organizations. The…

  12. Push, pull, and reverse: self-interest, responsibility, and the global health care worker shortage.

    PubMed

    Kirby, Katherine E; Siplon, Patricia

    2012-06-01

    The world is suffering from a dearth of health care workers, and sub-Saharan Africa, an area of great need, is experiencing the worst shortage. Developed countries are making the problem worse by luring health care workers away from the countries that need them most, while developing countries do not have the resources to stem the flow or even replace those lost. Postmodern philosopher Emmanuel Levinas offers a unique ethical framework that is helpful in assessing both the irresponsibility inherent in the current global health care situation and the responsibility and obligation held by the stakeholders involved in this global crisis. Drawing on Levinas' exploration of individual freedom and self-pursuit, infinite responsibility for the Other, and the potential emergence of a just community, we demonstrate its effectiveness in explaining the health care worker crisis, and we argue in favor of a variety of policy and development assistance measures that are grounded in an orientation of non-indifference toward Others.

  13. [Influenza vaccination in health-care workers: an effective method to reduce the consequences of influenza in health care users].

    PubMed

    de Jong, J C

    2007-09-29

    Only few usable studies into the effect of influenza vaccination of health-care workers on sick leave and influenza among their patients are available in the literature. However, together these studies provide consistent evidence that this vaccination is effective and cost effective, reducing the death rate from all causes of residents of nursing homes for the elderly by 27-44%. Therefore, measures to raise the vaccination rate among health-care workers, which is at present under 25%, are highly recommended. However, more studies in this field are needed.

  14. Quits and Job Changes among Home Care Workers in Maine: The Role of Wages, Hours, and Benefits

    ERIC Educational Resources Information Center

    Morris, Lisa

    2009-01-01

    Purpose: Figuring out how to make home care jobs more attractive has become a top policy priority. This study investigates the impact of wages, hours, and benefits on the retention of home care workers. Design and Methods: Using a 2-wave survey design and a sample of home care workers from Maine, the factors associated with turnover intentions,…

  15. Professional competencies and training needs of professional social workers in integrated behavioral health in primary care.

    PubMed

    Horevitz, Elizabeth; Manoleas, Peter

    2013-01-01

    The Affordable Care Act has led to a widespread movement to integrate behavioral health services into primary care settings. Integrated behavioral health (IBH) holds promise for treating mild to moderate psychiatric disorders in a manner that more fully addresses the biopsychosocial spectrum of needs of individuals and families in primary care, and for reducing disparities in accessing behavioral health care. For behavioral health practitioners, IBH requires a shift to a brief, outcome-driven, and team-based model of care. Despite the fact that social workers comprise the majority of behavioral health providers in IBH settings, little research has been done to assess the extent to which social workers are prepared for effective practice in fast-paced primary care. We conducted a survey of social workers (N = 84) in IBH settings to assess the following: (1) Key competency areas for social work practice in IBH settings and (2) Self-rated preparedness for effective practice in IBH settings. Online snowball sampling methods were used over a period of 1 month. Results indicate that social workers feel prepared for general practice in IBH settings, but would benefit from additional training in IBH-specific competency areas identified in the survey. Findings can help guide social work training to improve workforce preparedness for practice in IBH settings in the wake of health care reform. PMID:24028739

  16. Work-Family Conflict, Psychological Distress and Sleep Deficiency Among Patient Care Workers

    PubMed Central

    Jacobsen, Henrik Børsting; Reme, Silje Endresen; Sembajwe, Grace; Hopcia, Karen; Stoddard, Anne M.; Kenwood, Christopher; Stiles, Tore C.; Sorensen, Glorian; Buxton, Orfeu M.

    2015-01-01

    Objectives There is a well-established link between psychological distress, work-related stress and sleep. The aim of this study was to test the hypothesis that work-family conflict was associated with sleep deficiency both cross-sectionally and longitudinally while controlling for potential covariates. Methods In this two-phase study, a workplace health survey was collected from a cohort of patient care workers (n=1,572) at two large hospitals. Follow-up was collected nearly two years later in a subsample (n=102). Self-reported measures included work-family conflict, socio-demographics, workplace factors, psychological distress, and outcomes of sleep duration, sleep insufficiency, and sleep maintenance. Bivariate associations (P<0.2) from the baseline sample were used to build multivariable logistic regression models. Results The participants were 90 % women with a mean age of 41 (±11.7) years. At baseline, after adjusting for covariates, higher levels of work-family conflict were significantly associated with sleep deficiency, short sleep duration and perceived sleep insufficiency, but not with sleep maintenance problems. Higher levels of work-family conflict also predicted sleep insufficiency at follow-up nearly two years later. None of the other variables were associated with sleep outcomes longitudinally. Conclusion This is the first study to determine the predictive and cross-sectional associations of work-family conflict on sleep deficiency, also controlling for other measures of job stress and psychological distress. The results indicate that future interventions on sleep deficiency in patient care workers should include a specific focus on work-family conflict. PMID:25000547

  17. Oral health knowledge of health care workers in special children’s center

    PubMed Central

    Wyne, Amjad; Hammad, Nouf; Splieth, Christian

    2015-01-01

    Objective: To determine the oral health knowledge of health care workers in special children’s center. Methods: A self-administered questionnaire was used to collect following information: demographics, oral hygiene practices, importance of fluoride, dental visits, cause of tooth decay, gingival health, and sources of oral health information. The study was conducted at Riyadh Center for Special Children in Riyadh City from December 2013 to May 2014. Results: All 60 health care workers in the center completed the questionnaire. A great majority (95%) of the workers brushed their teeth twice or more daily. More than two-third (71.7%) of the workers knew that fluoride helps in caries prevention. One in five (21.7%) workers thought that a dental visit only becomes necessary in case of a dental problem. Similarly, 13.3% of the workers thought to “wait till there is some pain in case of a dental cavity” before seeking dental treatment. The workers ranked soft drinks/soda (98.3%), flavored fizzy drinks (60%) and sweetened/flavored milks (43.3%) as top three cariogenic drinks. A great majority (95%) of the workers correctly responded that blood on toothbrush most probably is a sign of “gum disease”. Dentists (50%) and media (45%) were the main source of their oral health information. There was no significant difference (p > 0.05) in workers’ response in relation to their specific job. Conclusion: The special health care workers in the disabled children’s center generally had satisfactory oral health knowledge and practices. PMID:25878636

  18. Knowledge of Maternal and Newborn Care Among Primary Level Health Workers in Kapilvastu District of Nepal

    PubMed Central

    Acharya, D; Paudel, R; Gautam, K; Gautam, S; Upadhyaya, T

    2016-01-01

    Background: Higher maternal and neonatal deaths are common in low- and middle-income countries; due to less access to skilled help. Adequate knowledge and skills on maternal and newborn care (MNC) of community health workers can improve maternal and newborn health. Aims: To identify the knowledge of primary level health workers on some components of MNC. Subjects and Methods: Respondents were selected using simple random sampling method. For collecting the data, enumerators visited health institutions for 2 months from 1st October to 31st November 2012, and structured interview schedule was used to gather the information. A cross-sectional study was conducted in a total of one hundred and thirty-seven primary level health workers in Kapilvastu district, Nepal. The Chi-square test was employed to examine the association between the knowledge of health workers on MNC and designation and work experience. Data were analyzed using SPSS version 17. Results: In a total of 137 primary level health workers, more than half 53.2% (73/137) were senior auxiliary health workers/health assistant. Health workers having correct knowledge on contents of MNC were-registration 32.1% (44/137), major components of antenatal care 57.7% (79/137), danger signs of pregnancy 39.4% (54/137), five cleans 59.1% (81/137), postnatal health problems 54.0% (74/137), majority to health action to newborn care, newborn bath and meaning of exclusive breastfeeding. There was a statistical association between designation of health workers and above-mentioned components of MNC (P < 0.05). Conclusions: The differentials in the knowledge of MNC among primary level health suggest improving knowledge of the grass root level health workers with appropriate training and development programs. PMID:27144073

  19. Family medicine model in Turkey: a qualitative assessment from the perspectives of primary care workers

    PubMed Central

    2014-01-01

    Background A person-list-based family medicine model was introduced in Turkey during health care reforms. This study aimed to explore from primary care workers’ perspectives whether this model could achieve the cardinal functions of primary care and have an integrative position in the health care system. Methods Four groups of primary care workers were included in this exploratory-descriptive study. The first two groups were family physicians (FP) (n = 51) and their ancillary personnel (n = 22). The other two groups were physicians (n = 44) and midwives/nurses (n = 11) working in community health centres. Participants were selected for maximum variation and 102 in-depth interviews and six focus groups were conducted using a semi-structured form. Results Data analysis yielded five themes: accessibility, first-contact care, longitudinality, comprehensiveness, and coordination. Most participants stated that many people are not registered with any FP and that the majority of these belong to the most disadvantaged groups in society. FPs reported that 40-60% of patients on their lists have never received a service from them and the majority of those who use their services do not use FPs as the first point of contact. According to most participants, the list-based system improved the longitudinality of the relationship between FPs and patients. However, based on other statements, this improvement only applies to one quarter of the population. Whereas there was an improvement limited to a quantitative increase in services (immunisation, monitoring of pregnant women and infants) included in the performance-based contracting system, participants stated that services not among the performance targets, such as family planning, postpartum follow-ups, and chronic disease management, could be neglected. FPs admitted not being able to keep informed of services their patients had received at other health institutions. Half of the participants stated that the list

  20. Overcoming Barriers to Eye Care: Patient Response to a Medical Social Worker in a Glaucoma Service.

    PubMed

    Fudemberg, Scott J; Amarasekera, Dilru C; Silverstein, Marlee H; Linder, Kathryn M; Heffner, Paul; Hark, Lisa A; Waisbourd, Michael

    2016-08-01

    This paper investigates the patient response to a medical social worker in a glaucoma clinic. The literature suggests that medical social workers are effective in a variety of health care settings, yet the efficacy of a medical social worker in an adult ophthalmic setting has not been studied. We present the results of a retrospective chart review of 50 patients with glaucoma referred to a medical social worker between January 5, 2015 and June 31, 2015 in an outpatient clinic of an urban eye hospital. Clinical and demographic data, as well as the data from a quality of care questionnaire, were collected for each patient. Patients rated their interaction with the medical social worker as highly positive (mean = 4.75, 5-point Likert scale), and nearly 90 % of patients expressed interest in future contact with the social worker. Additionally, most patients reported that the social worker resolved the issues they were facing (61.1 %), supported them in seeing their ophthalmologist (70.6 %), and helped them to manage their glaucoma (69.7 %). Reported barriers to glaucoma care were emotional distress; cost of office visits and medications; lack of medical insurance; transportation; poor medication adherence; impairment of daily activities; follow-up adherence; and language. As vision loss from glaucoma is irreversible, it is important to detect and treat patients at early stages of the disease. Therefore, it is imperative for patients to regularly visit their eye care providers and adhere to treatment and follow-up recommendations. This study suggests that a medical social worker could play a pivotal role in helping patients with glaucoma overcome barriers to treatment and facilitate disease management. PMID:26860278

  1. Risks to health care workers from nano-enabled medical products.

    PubMed

    Murashov, Vladimir; Howard, John

    2015-01-01

    Nanotechnology is rapidly expanding into the health care industry. However, occupational safety and health risks of nano-enabled medical products have not been thoroughly assessed. This manuscript highlights occupational risk mitigation practices for nano-enabled medical products throughout their life cycle for all major workplace settings including (1) medical research laboratories, (2) pharmaceutical manufacturing facilities, (3) clinical dispensing pharmacies, (4) health care delivery facilities, (5) home health care, (6) health care support, and (7) medical waste management. It further identifies critical research needs for ensuring worker protection in the health care industry. PMID:25950806

  2. Level of empowerment and health knowledge of home support workers providing care for frail elderly.

    PubMed

    Johnson, C Shanthi; Noel, Miriam

    2007-01-01

    The purpose of this study was to assess the profile of home support workers (HSWs) caring for the frail elderly and to determine the perceived empowerment levels and general health knowledge of these support workers. Background, work-profile, empowerment level and health knowledge related to seniors of 64 HSWs were assessed using questionnaires. Findings revealed the majority of workers to be middleaged women, and their health knowledge scores were low. Empowerment levels were moderate as was formal power. Findings demonstrate the need to revise the curriculum of HSWs to include health topics, as well as the need for continued education and strategies to enhance empowerment levels.

  3. Children's Mental Health in Child Welfare: A Child-Focused Curriculum for Child Welfare Workers and Social Work Students

    ERIC Educational Resources Information Center

    Mathiesen, Sally; Cash, Scottye; Barbanell Johnson, Lisa D.; Smith, Thomas E.; Graham, Pamela

    2006-01-01

    This paper describes a child-focused curriculum developed for child welfare workers and social work students. The results from a focus group evaluation are also provided that highlight how the content areas in the curriculum were perceived by participants in terms of interest, practicality, and importance. The major goal of the curriculum was to…

  4. Perspectives of Parents and Health Care Workers on Early Infant Male Circumcision Conducted Using Devices: Qualitative Findings From Harare, Zimbabwe

    PubMed Central

    Mavhu, Webster; Hatzold, Karin; Ncube, Getrude; Fernando, Shamiso; Mangenah, Collin; Chatora, Kumbirai; Mugurungi, Owen; Ticklay, Ismail; Cowan, Frances M

    2016-01-01

    ABSTRACT Background: The World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) recommend early infant male circumcision (EIMC) for prevention of HIV. Here, we present findings from a qualitative study in Zimbabwe that assessed parental and health care workers' perspectives of EIMC conducted using devices. Methods: This qualitative study was nested within a trial of EIMC devices. Between January and May 2013, we held 4 focus group discussions (FGDs) and 12 in-depth interviews with parents and 12 in-depth interviews with clinicians (7 trial clinicians and 5 non-trial clinicians). We also conducted 95 short telephone interviews with parents who had arranged to bring their sons for EIMC but then defaulted. Results: Parents who had adopted EIMC spoke of their initial anxieties about the procedure. Additionally, they commented on both the procedure and outcome. Parents who decided against EIMC cited fear of harm, specifically the infant's death, penile injury, and excessive pain. Misperceptions about male circumcision in general and EIMC specifically were a significant barrier to EIMC adoption and were prevalent among health care workers as well as parents. In particular, the findings suggest strong parental concerns about the fate of the discarded foreskin. Parents who chose EIMC for their newborn sons felt that the procedure was safe and expressed satisfaction with the outcome. For their part, health care workers largely thought that EIMC was safe and that the outcome was aesthetically pleasing. They also felt that it would be feasible to offer wide-scale EIMC for HIV prevention in the public sector; they recommended strategies to increase EIMC uptake, in addition to highlighting a few concerns. Conclusions: The qualitative study enables us to better understand parental and health care workers' perspectives of EIMC conducted using devices, especially their perspectives on EIMC safety, feasibility, acceptability, and barriers. These findings

  5. The HIV-positive dentist: balancing the rights of the health care worker and the patient.

    PubMed

    Gardam, M A; Flanagan, W F; Salit, I E

    2001-06-12

    We describe a hypothetical case of an HIV-positive dentist without cognitive impairment who uses proper infection control procedures. The dentist's physician notifies the medical officer of health without the dentist's consent. Although HIV-positive health care workers, including dentists, have been identified in the past, proven HIV transmission to patients is very rare. Most authorities recommend that an HIV-positive health care worker be monitored by an expert panel, which could then, if necessary, refer to the regulatory body to revoke or restrict the person's license to practice. Mandatory HIV testing is not required for health care workers because they generally do not pose a risk for infecting their patients; they are, however, ethically and legally obligated to report their HIV status to their profession's regulatory body. PMID:11450216

  6. Improving Adherence to Hand Hygiene among Health Care Workers

    ERIC Educational Resources Information Center

    Maskerine, Courtney; Loeb, Mark

    2006-01-01

    Increased adherence to hand hygiene is widely acknowledged to be the most important way of reducing infections in health care facilities. Despite evidence of benefit, adherence to hand hygiene among health care professionals remains low. Several behavioral and organizational theories have been proposed to explain this. As a whole, the success of…

  7. Evaluating a Hygiene Education Program for Child Care Workers.

    ERIC Educational Resources Information Center

    Petri, Cynthia J.; Winnail, Scott D.; Geiger, Brian F.; Artz, Lynn M.; Mason, J. W.

    Children, parents, and child caregivers are vulnerable to several infectious diseases as a result of contact with child care centers. This pilot program, implemented in a rural county in a southeastern state, was designed to enhance knowledge and skills related to improved hygiene practices in a child care setting. The target audience for the…

  8. Workplace stress, job satisfaction, job performance, and turnover intention of health care workers in rural Taiwan.

    PubMed

    Chao, Ming-Che; Jou, Rong-Chang; Liao, Cing-Chu; Kuo, Chung-Wei

    2015-03-01

    Workplace stress (WS) has been found to affect job satisfaction (JS), performance, and turnover intentions (TIs) in developed countries, but there is little evidence from other countries and especially rural areas. In rural Taiwan, especially, there is an insufficient health care workforce, and the situation is getting worse. To demonstrate the relationship, we used a cross-sectional structured questionnaire, and data from 344 licensed professionals in 1 rural regional hospital were analyzed using the structural equation model. The results showed that WS had a positive effect on both TI and job performance (JP) but a negative effect on satisfaction. JS did improve performance. For the staff with an external locus of control, stress affected JP and satisfaction significantly. For the staff with lower perceived job characteristics, JS affected performance significantly. The strategies to decrease stress relating to work load, role conflict, family factors, and working environment should be focused and implemented urgently to lower the turnover rate of health care workers in rural Taiwan.

  9. Workplace stress, job satisfaction, job performance, and turnover intention of health care workers in rural Taiwan.

    PubMed

    Chao, Ming-Che; Jou, Rong-Chang; Liao, Cing-Chu; Kuo, Chung-Wei

    2015-03-01

    Workplace stress (WS) has been found to affect job satisfaction (JS), performance, and turnover intentions (TIs) in developed countries, but there is little evidence from other countries and especially rural areas. In rural Taiwan, especially, there is an insufficient health care workforce, and the situation is getting worse. To demonstrate the relationship, we used a cross-sectional structured questionnaire, and data from 344 licensed professionals in 1 rural regional hospital were analyzed using the structural equation model. The results showed that WS had a positive effect on both TI and job performance (JP) but a negative effect on satisfaction. JS did improve performance. For the staff with an external locus of control, stress affected JP and satisfaction significantly. For the staff with lower perceived job characteristics, JS affected performance significantly. The strategies to decrease stress relating to work load, role conflict, family factors, and working environment should be focused and implemented urgently to lower the turnover rate of health care workers in rural Taiwan. PMID:24174390

  10. Engaging community health workers in maternal and newborn care in eastern Uganda

    PubMed Central

    Okuga, Monica; Kemigisa, Margaret; Namutamba, Sarah; Namazzi, Gertrude; Waiswa, Peter

    2015-01-01

    Background Community health workers (CHWs) have been employed in a number of low- and middle-income countries as part of primary health care strategies, but the packages vary across and even within countries. The experiences and motivations of a multipurpose CHW in providing maternal and newborn health have not been well described. Objective This study examined the perceptions of community members and experiences of CHWs around promoting maternal and newborn care practices, and the self-identified factors that influence the performance of CHWs so as to inform future study design and programme implementation. Design Data were collected using in-depth interviews with six local council leaders, ten health workers/CHW supervisors, and eight mothers. We conducted four focus group discussions with CHWs. Respondents included 14 urban and 18 rural CHWs. Key themes explored included the experience of CHWs according to their various roles, and the facilitators and barriers they encounter in their work particular to provision of maternal and newborn care. Qualitative data were analysed using manifest content analysis methods. Results CHWs were highly appreciated in the community and seen as important contributors to maternal and newborn health at grassroots level. Factors that positively influence CHWs included being selected by and trained in the community; being trained in problem-solving skills; being deployed immediately after training with participation of local leaders; frequent supervision; and having a strengthened and responsive supply of services to which families can be referred. CHWs made use of social networks to identify pregnant and newly delivered women, and were able to target men and the wider family during health education activities. Intrinsic motivators (e.g. community appreciation and the prestige of being ‘a doctor’), monetary (such as a small transport allowance), and material incentives (e.g. bicycles, bags) were also important to varying degrees

  11. Neglecting the Importance of the Decision Making and Care Regimes of Personal Support Workers: A Critique of Standardization of Care Planning Through the RAI/MDS

    PubMed Central

    Kontos, Pia C.; Miller, Karen-Lee; Mitchell, Gail J.

    2010-01-01

    Purpose: The Resident Assessment Instrument–Minimum Data Set (RAI/MDS) is an interdisciplinary standardized process that informs care plan development in nursing homes. This standardized process has failed to consistently result in individualized care planning, which may suggest problems with content and planning integrity. We examined the decision making and care practices of personal support workers (PSWs) in relation to the RAI/MDS standardized process. Design and Methods: This qualitative study utilized focus groups and semi-structured interviews with PSWs (n = 26) and supervisors (n = 9) in two nursing homes in central Canada. Results: PSWs evidenced unique occupational contributions to assessment via proximal familiarity and biographical information as well as to individualizing care by empathetically linking their own bodily experiences and forging bonds of fictive kinship with residents. These contributions were neither captured by RAI/MDS categories nor relayed to the interdisciplinary team. Causal factors for PSW exclusion included computerized records, low status, and poor interprofessional collaboration. Intraprofessional collaboration by PSWs aimed to compensate for exclusion and to individualize care. Implications: Exclusive institutional reliance on the RAI/MDS undermines quality care because it fails to capture residents’ preferences and excludes input by PSWs. Recommendations include incorporating PSW knowledge in care planning and documentation and examining PSWs’ nascent occupational identity and their role as interprofessional brokers in long-term care. PMID:20026525

  12. Vaccination against influenza: UK health care workers not on-message.

    PubMed

    Harrison, J; Abbott, P

    2002-08-01

    Vaccination of health care workers against influenza is considered to be important as a means of protecting patients from nosocomial infection. Vaccine uptake rates have been reported to be no more than 40% and often between 20 and 30%. An evaluation of the performance of UK National Health Service trusts, following a governmental directive to implement vaccination during the winter of 2000-2001, has shown a poor uptake of vaccine. Reasons for accepting or declining vaccine are discussed. There is a need for global leadership on this issue to promote the value of vaccination and to change the behaviour of health care workers.

  13. Understanding dissemination and implementation of a new intervention in assisted living settings: the case of function-focused care.

    PubMed

    Resnick, Barbara; Galik, Elizabeth; Gruber-Baldini, Ann; Zimmerman, Sheryl

    2013-04-01

    Function-focused care (FFC) was developed to change the philosophy of care in assisted living (AL) to one in which nurses, direct care workers (DCWs) and other members of the health care team work with residents to optimize function and time spent in physical activities. The purpose of this article is to describe dissemination and implementation of FFC within the two assisted living communities in Maryland that were randomized to our FFC for assisted living intervention (FFC-AL). The reach, efficacy/effectiveness, adoption, implementation, and maintenance (RE-AIM) model was used to evaluate dissemination and implementation of FFC in these communities. A total of 171 residents and 96 DCWs consented to participate in the study and outcomes based on data collected from the participants as well as evidence for dissemination and implementation at the site level are provided. Findings can be used to guide others in dissemination and implementation of similar interventions in AL communities.

  14. Informal economic activities of public health workers in Uganda: implications for quality and accessibility of care.

    PubMed

    McPake, B; Asiimwe, D; Mwesigye, F; Ofumbi, M; Ortenblad, L; Streefland, P; Turinde, A

    1999-10-01

    This paper reports the results of a study in Uganda of the 'informal' economic activities of health workers, defined as those which earn incomes but fall outside official duties and earnings. The study was carried out in 10 sub-hospital health facilities of varying size and intended role and used a variety of quantitative and qualitative methods. The paper focuses on those activities which are carried out inside public health facilities and which directly affect quality and accessibility of care. The main strategies in this category were the leakage of drug supply, the informal charging of patients and the mismanagement of revenues raised from the formal charging of patients. Few of the drugs supplied to health units were prescribed and issued in those sites. Most health workers who have the opportunity to do so, levy informal charges. Where formal charges are collected, high levels of leakage occur both at the point of collection and at higher levels of the system. The implications of this situation for the quality and accessibility of services in public health facilities were assessed. Utilisation levels are less than those expected of the smallest rural units and this workload is managed by a handful of the expected staff complement who are available for a fraction of the working week. Even given these few patients, drugs available after leakage were sufficient to cover less than half of those attending in most facilities. Evidence on staff motivation was mixed and better motivation was associated with better performance only in a minority of units. Informal charging was associated with better performance regarding hours worked by health workers and utilisation rates. Drug leakage was associated with worse performance with respect to both of these and unsurprisingly, with drug availability. Short term strategies to effect marginal performance improvements may focus on the substitution of strategies based inside health units (such as informal charging) for those

  15. Ethical Behaviours in Clinical Practice Among Mexican Health Care Workers

    PubMed Central

    Valdez-Martínez, Edith; Lavielle, Pilar; Bedolla, Miguel; Squires, Allison

    2009-01-01

    The objective of this study was to describe the cultural domain of ethical behaviours in clinical practice as defined by health care providers in Mexico. Structured interviews were carried out with 500 health professionals employed at the Mexican Institute of Social Security in Mexico City. The Smith Salience Index was used to evaluate the relevance of concepts gathered from the free listings of the interviewees. Cluster analysis and factor analysis facilitated construction of the conceptual categories, which the authors refer to as ‘dimensions of ethical practice’. Six dimensions emerged from the analysis to define the qualities that comprise ethical clinical practice for Mexican health care providers: overall quality of clinical performance; working conditions that favour quality of care; use of ethical considerations as prerequisites for any health care intervention; values favouring teamwork in the health professional–patient relationship; patient satisfaction scores; and communication between health care providers and patients. The findings suggest that improved working conditions and management practices that promote the values identified by the study’s participants would help to improve quality of care. PMID:18849364

  16. Relationship centred outcomes focused on compassionate care for older people within in-patient care settings.

    PubMed

    Smith, Stephen; Dewar, Belinda; Pullin, Simon; Tocher, Ria

    2010-06-01

    This paper describes outcomes from research titled Leadership in Compassionate Care. The research adopts a participatory action research approach, utilizing appreciative inquiry and relationship centred care. Outcomes of the research are based upon relationships between patients, families and staff. This paper focuses on in-patient care for older people. A range of data generation activities were undertaken including: observation, interviews using emotional touch points and reflective accounts. To highlight outcomes in compassionate care, this paper uses case studies from two participating services. Principles of compassionate care were derived from understanding experiences of patients, relatives and staff and initiating responsive action projects. The aim was to enhance the experience of relationship centred, compassionate care. The process of emotional touch points enabled a richer understanding of experience. In terms of outcomes for patients this involved, enhanced quality of time spent with family and opening up conversations between families and staff. Outcomes for families involved enhanced access to relevant information and the opportunity to make sense of their situation. Staff outcomes were gaining experience in working alongside family to co-create the service, enhanced understanding of the experiences of patients and relatives led to direct changes in individual and team practices.

  17. Job Stress and Job Satisfaction among Health-Care Workers of Endoscopy Units in Korea

    PubMed Central

    Nam, Seung-Joo; Chun, Hoon Jai; Moon, Jeong Seop; Park, Sung Chul; Hwang, Young-Jae; Yoo, In Kyung; Lee, Jae Min; Kim, Seung Han; Choi, Hyuk Soon; Kim, Eun Sun; Keum, Bora; Jeen, Yoon Tae; Lee, Hong Sik; Kim, Chang Duck

    2016-01-01

    Background/Aims: The management of job-related stress among health-care workers is critical for the improvement of healthcare services; however, there is no existing research on endoscopy unit workers as a team. Korea has a unique health-care system for endoscopy unit workers. In this study, we aimed to estimate job stress and job satisfaction among health-care providers in endoscopy units in Korea. Methods: We performed a cross-sectional survey of health-care providers in the endoscopy units of three university-affiliated hospitals in Korea. We analyzed the job stress levels by using the Korean occupational stress scale, contributing factors, and job satisfaction. Results: Fifty-nine workers completed the self-administered questionnaires. The job stress scores for the endoscopy unit workers (46.39±7.81) were relatively lower compared to those of the national sample of Korean workers (51.23±8.83). Job stress differed across job positions, with nurses showing significantly higher levels of stress (48.92±7.97) compared to doctors (42.59±6.37). Job stress and job satisfaction were negatively correlated with each other (R2=0.340, p<0.001). Conclusions: An endoscopy unit is composed of a heterogeneous group of health-care professionals (i.e., nurses, fellows, and professors), and job stress and job satisfaction significantly differ according to job positions. Job demand, insufficient job control, and job insecurity are the most important stressors in the endoscopy unit. PMID:26898513

  18. Perceived benefits and proposed solutions for teen pregnancy: qualitative interviews with youth care workers.

    PubMed

    Boustani, Maya Mroué; Frazier, Stacy L; Hartley, Chelsey; Meinzer, Michael; Hedemann, Erin

    2015-01-01

    The purpose of this article is to examine youth care workers' perceptions of the specific and unique sexual health needs of youth at risk for foster care. Semistructured interviews were conducted with youth care workers (N = 10) at a shelter for youth in or at risk for foster care. Youth care workers perceive that youth have unique experiences and needs related to sexual health programming and pregnancy prevention. Reflecting a great deal of family dysfunction, 3 themes emerged that revealed perceived benefits of teen pregnancy: youths' effort to prove themselves as adults, opportunity to secure their relationship with a partner, and desire to create an emotional connection with a baby. Lack of knowledge and accumulation of risk factors were viewed as most problematic. Current pregnancy prevention programs assume teen pregnancies are unwanted and emphasize the costs of sexual risk taking. Current findings suggest that sexual health programming for youth in or at risk for foster care should account for 3 perceived benefits of teen pregnancy. New opportunities for improving the reach and effectiveness of intervention for youth in or at risk for foster care are discussed.

  19. Developing the Child Care Workforce: Understanding "Fight" or "Flight" Amongst Workers

    ERIC Educational Resources Information Center

    Bretherton, Tanya

    2010-01-01

    The early childhood education and care sector in Australia is undergoing a shift in philosophy. Changes in policy are driving the industry towards a combined early childhood education and care focus, away from one only on child care. This move has implications for the skilling of the child care workforce. This report examines workforce development…

  20. Challenges Faced by Social Workers as Members of Interprofessional Collaborative Health Care Teams.

    PubMed

    Ambrose-Miller, Wayne; Ashcroft, Rachelle

    2016-05-01

    Interprofessional collaboration is increasingly being seen as an important factor in the work of social workers. A focus group was conducted with Canadian social work educators, practitioners, and students to identify barriers and facilitators to collaboration from the perspective of social work. Participants identified six themes that can act as barriers and facilitators to collaboration: culture, self-identity, role clarification, decision making, communication, and power dynamics. These findings carry important implications for interprofessional collaboration with social workers in health practice. PMID:27263200

  1. Population-focused care: a new rubric in the role definition for geriatric nurse practitioners in primary care practice?

    PubMed

    Kauffman, K S; Barlow, A R

    1999-03-01

    Traditionally, geriatric nurse practitioners (GNPs) provide care to individual older adults and their families in a primary care practice. Although the goal is to provide high-quality, cost-effective care, GNPs may be providing ineffective care by narrowly focusing on individuals and their families. Given today's health care climate, it is essential that GNPs practice with a wider perspective. This is done by noting health issue trends among the specific older adult population that are targeted for care and planning that care with a population focus delineated by either health issues or characteristics of the older adult population.

  2. Improving health workers' access to HIV and TB prevention, treatment, care and support services.

    PubMed

    Kisting, Sophia; Wilburn, Susan; Protsiv, Myroslava; Hsu, Lee-Nah

    2010-01-01

    The International Labour Organization (ILO) and the World Health Organization (WHO) jointly developed policy guidelines for improving health workers' access to HIV and TB prevention, treatment, care and support services. These 14-point policy guidelines support the key principles of the International Labour Standard concerning HIV and AIDS in the world of work adopted in 2010. The joint guidelines cover issues on workers' rights, national legislation and social protection of health workers. In addition, the guidelines provide framework for workplace policies, programmes, and training. To ensure proper implementation, the guidelines also addressed issues of budget, monitoring and evaluation. Turning these policy guidelines into effective practice would require advocacy to both the health and labour sectors, as well as the recognition of the important roles of health workers, employers of health services, and that of the Ministries of Health and Ministries of Labour. PMID:21391451

  3. Linking Emotional Labor, Public Service Motivation, and Job Satisfaction: Social Workers in Health Care Settings.

    PubMed

    Roh, Chul-Young; Moon, M Jae; Yang, Seung-Bum; Jung, Kwangho

    2016-01-01

    This study examines the determinants of emotional laborers'--social workers in health care organizations--job satisfaction and their public service motivation in using a structural equation model and provides empirical evidence regarding what contributes to job satisfaction or burnout in these workers. Among several latent variables, this study confirmed that false face significantly decreases the job satisfaction of social worker and is positively associated with burnout. In addition, commitment to public interest increases social workers' job satisfaction significantly. This study has implications for the management of emotional labor. By educating emotional laborers to reappraise situations to increase their job satisfaction and avoid burnout, reappraisal training and education are expected to result in increases in positive emotions and decreases in negative emotions, and to improve employees' performance in their organizations. PMID:26720584

  4. [Oncofertility: a new focus in women health-care...].

    PubMed

    Chevalier, N; Dewailly, Didier; Fenichel, Patrick

    2009-09-01

    Although treatment and survival are the primary focus of health-care patients, with cancer survivors living longer it is now appropriate to consider their quality of life after treatment, including the possibility of becoming parents. There are several options for fertility preservation in cancer patients. Even though most of them are still experimental and their efficacy and reliability have not been determined, especially in women. The most successful alternative for female survivors is embryo cryopreservation, an approach not suitable for many single or virgin women or even possible for prepubertal girls. Reports of live birth after transplantation of human ovarian tissue have reinforced the clinical potential of ovarian tissue banking for fertility preservation. Many exciting studies are underway to improve the efficacy and solve the problems with current fertility preservation strategies, especially for in vitro culture of cryopreserved tissue or follicles. Continuous efforts to improve current strategies and to develop new strategies will benefit many women and children who are facing premature ovarian failure and sterility. PMID:19878767

  5. Beyond 50. challenges at work for older nurses and allied health workers in rural Australia: a thematic analysis of focus group discussions

    PubMed Central

    2011-01-01

    Background The health workforce in Australia is ageing, particularly in rural areas, where this change will have the most immediate implications for health care delivery and workforce needs. In rural areas, the sustainability of health services will be dependent upon nurses and allied health workers being willing to work beyond middle age, yet the particular challenges for older health workers in rural Australia are not well known. The purpose of this research was to identify aspects of work that have become more difficult for rural health workers as they have become older; and the age-related changes and exacerbating factors that contribute to these difficulties. Findings will support efforts to make workplaces more 'user-friendly' for older health workers. Methods Nurses and allied health workers aged 50 years and over were invited to attend one of six local workshops held in the Hunter New England region of NSW, Australia. This qualitative action research project used a focus group methodology and thematic content analysis to identify and interpret issues arising from workshop discussions. Results Eighty older health workers from a range of disciplines attended the workshops. Tasks and aspects of work that have become more difficult for older health workers in hospital settings, include reading labels and administering medications; hearing patients and colleagues; manual handling; particular movements and postures; shift work; delivery of babies; patient exercises and suturing. In community settings, difficulties relate to vehicle use and home visiting. Significant issues across settings include ongoing education, work with computers and general fatigue. Wider personal challenges include coping with change, balancing work-life commitments, dealing with attachments and meeting goals and expectations. Work and age-related factors that exacerbate difficulties include vision and hearing deficits, increasing tiredness, more complex professional roles and a sense of

  6. Fitness for work in health care workers from the prospective of ethics, science and good practices.

    PubMed

    Alessio, L; Arici, Cecilia; Franco, G

    2012-01-01

    Fitness for work (FFW) is the final task of both risk assessment and health surveillance, aimed at protecting workers' health and working capacity. There are numerous specific concerns regarding health care workers. In particular: i) the frequent difficulty in determining at pre-employment/pre-placement examinations the specific task that the individual worker will perform; ii) the prevalence of female workers and the contemporary presence of numerous occupational risk factors that are a potential cause of harmful effects on women's reproductive health; iii) the progressive aging of the staff especially nurses; iv) the risk to third parties, with particular reference to the issues of biological risk and substance abuse, also in relation to shift work, fatigue and occupational stress; v) the increasing number of immigrant workers among support staff In such cases the occupational physician, respecting both ethical principles and regulations and with an appropriate balance between scientific evidence and the precautionary principle, should express a FFW judgment that allows both the adaptation of work to the worker and vice versa, as recommended by the World Health Organization (WHO) and the International Commission on Occupational Health (ICOH). Proper FFW judgment also permits the expected benefits to be achieved, not only for the workers but also for employers, companies and society.

  7. Violence towards health care workers in a Public Health Care Facility in Italy: a repeated cross-sectional study

    PubMed Central

    2012-01-01

    Background Violence at work is one of the major concerns in health care activities. The aim of this study was to identify the prevalence of physical and non-physical violence in a general health care facility in Italy and to assess the relationship between violence and psychosocial factors, thereby providing a basis for appropriate intervention. Methods All health care workers from a public health care facility were invited to complete a questionnaire containing questions on workplace violence. Three questionnaire-based cross-sectional surveys were conducted. The response rate was 75 % in 2005, 71 % in 2007, and 94 % in 2009. The 2009 questionnaire contained the VIF (Violent Incident Form) for reporting violent incidents, the DCS (demand/control/support) model for job strain, the Colquitt 20 item questionnaire for perceived organizational justice, and the GHQ-12 General Health Questionnaire for the assessment of mental health. Results One out of ten workers reported physical assault, and one out of three exposure to non-physical violence in the workplace in the previous year. Nurses and physicians were the most exposed occupational categories, whereas the psychiatric and emergency departments were the services at greatest risk of violence. Workers exposed to non-physical violence were subject to high job strain, low support, low perceived organizational justice, and high psychological distress. Conclusion Our study shows that health care workers in an Italian local health care facility are exposed to violence. Workplace violence was associated with high demand and psychological disorders, while job control, social support and organizational justice were protective factors. PMID:22551645

  8. Effects of Training Programme on HIV/AIDS Prevention among Primary Health Care Workers in Oyo State, Nigeria

    ERIC Educational Resources Information Center

    Ajuwon, Ademola; Funmilayo, Fawole; Oladepo, Oladimeji; Osungbade, Kayode; Asuzu, Michael

    2008-01-01

    Purpose: The purpose of this paper is to train primary health care workers to be trainers and implementers of community-based AIDS prevention activities in Oyo State, Nigeria, by describing an evaluation of the project. Design/methodology/approach: A total of 148 primary health care workers recruited from the 33 local government areas (LGA) of the…

  9. Health and Safety Resources for Child Care Workers.

    ERIC Educational Resources Information Center

    Child Care Employee Project, Berkeley, CA.

    Organized into three sections, these resource materials provide basic information for child caregivers about occupational hazards associated with child care work; personnel policies, staff burnout and environmental stressors; and employee rights. Contents of the first section include a general discussion of health and safety hazards in child care…

  10. Compassion Fatigue Risk and Self-Care Practices among Residential Treatment Center Childcare Workers

    ERIC Educational Resources Information Center

    Eastwood, Callum D.; Ecklund, Kathryn

    2008-01-01

    Exploration of the presence of risk for compassion fatigue among residential childcare workers (RCW) at residential treatment facilities and the relationship between self-care practices and compassion fatigue were explored. Using the Professional Quality of Life Survey (ProQOL-R III) to assess compassion fatigue, burnout, and compassion…

  11. The provision of primary care interventions by community health support workers in Pakistan.

    PubMed

    Smith, Sara; Kelly, Amber; Randhawa, Gurch

    2007-04-01

    Skill mix and role redesign have changed the face of the primary care workforce in the UK in recent years. In areas with minority ethnic communities, support workers with language skills and cultural knowledge have been employed to provide health care. Although this role is relatively new to the UK, countries like Pakistan have a long history of employing community support workers. This study seeks to learn from Pakistan's experience and apply the learning to the UK context. The findings from this study suggest that the support worker role in Pakistan is highly effective when training and adequate supervision is given and when the support worker is entrusted with a considerable degree of freedom to act. It was also observed that the same role might be highly effective in one context, but less so in another, which indicates the importance of exploring a range of factors that may affect outcomes. The study provided an invaluable opportunity to gain a better understanding of the health care system in Pakistan. This may assist in the development of services in the UK to improve primary health care, particularly for those who experience barriers in accessing services. PMID:17455572

  12. Fear of Severe Acute Respiratory Syndrome (SARS) among Health Care Workers

    ERIC Educational Resources Information Center

    Ho, Samuel M. Y.; Kwong-Lo, Rosalie S. Y.; Mak, Christine W. Y.; Wong, Joe S.

    2005-01-01

    In this study, the authors examined fear related to severe acute respiratory syndrome (SARS) among 2 samples of hospital staff in Hong Kong. Sample 1 included health care workers (n = 82) and was assessed during the peak of the SARS epidemic. Sample 2 included hospital staff who recovered from SARS (n = 97). The results show that participants in…

  13. Prevalence of Burnout Syndrome of Greek Child Care Workers and Kindergarten Teachers

    ERIC Educational Resources Information Center

    Rentzou, Konstantina

    2015-01-01

    The present study, employing the Maslach Burnout Inventory-Educators Survey, aims to compare and explore possible differences to the levels of burnout reported by the two main professional groups working in the early childhood education and care sector in Greece, that is kindergarten teachers and childcare workers. The correlation between the…

  14. Project WE CARE (Workers' Education and Community Awareness of Resources for Education). [August 1980-June 1981].

    ERIC Educational Resources Information Center

    Fogoros, Anne Walsh

    Project WE CARE (Workers' Education and Community Awareness of Resources for Education), in Allegheny County, Pennsylvania, developed, implemented, and documented the process of implementing adult basic education program linkage/outreach with business, industry, and human service organizations. The project emphasis was on educating human service…

  15. The Contribution of Non-Physician Health Workers to the Delivery of Primary Care.

    ERIC Educational Resources Information Center

    Ford, Amasa B.; Ransohoff, David F.

    Innovative solutions in training or retraining of health workers to meet the nationwide primary care deficiency are summarized. Programs described concern nurse clinicians, practitioners, and midwives; physicians' assistants; medical assistants, laboratory technicians, and secretaries; dental assistants, hygienists, and laboratory technicians;…

  16. Acute hepatitis A in an elderly patient after care worker travel to high endemicity country.

    PubMed

    Aasheim, Erlend T; Seymour, Martin; Balogun, Koye; Ngui, Siew-Lin; Williams, Chris J; Shankar, Ananda Giri

    2013-11-01

    Hepatitis A virus (HAV) is considered one of the most important vaccine-preventable diseases in travelers. HAV spreads from person to person via the fecal-oral route and gives rise to an estimated 1.4 million cases worldwide each year. In developing countries with poor sanitary conditions people tend to be infected during childhood and have few symptoms, whereas in developed countries with good sanitary conditions fewer people develop immunity during childhood. This leads to susceptible populations of adults, who are also more prone to severe complications. Here we describe two confirmed cases of hepatitis A associated with a nursing home. The index case was a care worker who had recently traveled to a high-endemicity country, and the second case was a resident at the nursing home where the index case worked. Both cases had an identical genotype IIIA strain, consistent with a transmission event. Current policy does not include a requirement for hepatitis A vaccine in care workers who travel to high endemicity countries despite the fact that infected care workers can potentially spread the disease to elderly patients and other groups at risk of severe complications from HAV infection. We suggest that employers should consider hepatitis A vaccine upon employment; particularly in care workers who plan to visit areas where HAV is known to be endemic.

  17. Modeling Dental Health Care Workers' Risk of Occupational Infection from Bloodborne Pathogens.

    ERIC Educational Resources Information Center

    Capilouto, Eli; And Others

    1990-01-01

    The brief paper offers a model which permits quantification of the dental health care workers' risk of occupationally acquiring infection from bloodborne pathogens such as human immunodeficiency virus and hepatitis B virus. The model incorporates five parameters such as the probability that any individual patient is infected and number of patients…

  18. Health care workers infected with the human immunodeficiency virus. The next steps.

    PubMed

    Lo, B; Steinbrook, R

    1992-02-26

    The tragedy of five patients who contracted human immunodeficiency virus (HIV) infection from a seropositive dentist has alarmed the public. The Centers for Disease Control (CDC) recently revised its recommendations for preventing the transmission of HIV infection to patients during invasive procedures. The CDC abandoned a previous plan to list exposure-prone invasive procedures that HIV-infected health care workers should not perform. The CDC said "expert review panels" should decide on a case-by-case basis whether seropositive health care workers may perform invasive procedures. As of February 1992, the revised recommendations were under review by the US Department of Health and Human Services. Many issues remain to be clarified, such as how these panels will operate and whether decisions will be consistent in similar cases. Disregarding the CDC guidelines or infection-control precautions may further erode public trust and lead to draconian restrictions on HIV-infected health care workers. Physicians and dentists should respond more effectively to public fears about HIV transmission. The challenge is to protect patients while respecting the privacy and livelihood of health care workers.

  19. Transfer of Learning: A Guide for Strengthening the Performance of Health Care Workers.

    ERIC Educational Resources Information Center

    Nelson, David, Ed.; Dufour, Wendy, Ed.

    This document shares strategies and techniques that can facilitate transfer of learning among health care workers. The guide begins with a discussion of reasons why "good" training fails and lists possible interventions for addressing the following performance factors: job expectations; performance feedback; physical environment and tools;…

  20. Work Stress, Burnout, and Social and Personal Resources among Direct Care Workers

    ERIC Educational Resources Information Center

    Gray-Stanley, Jennifer A.; Muramatsu, Naoko

    2011-01-01

    Work stress is endemic among direct care workers (DCWs) who serve people with intellectual and developmental disabilities. Social resources, such as work social support, and personal resources, such as an internal locus of control, may help DCWs perceive work overload and other work-related stressors as less threatening and galvanize them to cope…

  1. When the Job Has Lost Its Appeal: Intentions to Quit among Direct Care Workers

    ERIC Educational Resources Information Center

    Gray, Jennifer A.; Muramatsu, Naoko

    2013-01-01

    Background: Previous research indicates that work stress contributes to intentions to quit among direct care workers (DCWs) who provide services to people with intellectual and developmental disability (IDD). Though resources can help DCWs cope and remain in a job, little is known about how various dimensions of work stress and resources (social…

  2. Workplace Literacy for Psychiatric Health Care Workers. Final Performance Report [and] External Evaluation Report.

    ERIC Educational Resources Information Center

    Perin, Dolores; And Others

    This report documents the Workplace Literacy for Psychiatric Health Care Workers project, a partnership between a labor union and the City University of New York through which workplace literacy instruction was provided to mental hygiene therapy aides (MHTAs) employed in five state-operated psychiatric hospitals in New York City. Among the…

  3. Bacterial contamination of health care workers' pagers and the efficacy of various disinfecting agents.

    PubMed

    Beer, Darcy; Vandermeer, Ben; Brosnikoff, Cheryl; Shokoples, Sandy; Rennie, Robert; Forgie, Sarah

    2006-11-01

    Health care workers in our facility were surveyed, and their pagers were cultured before and after disinfection with various agents. All pagers were contaminated with bacteria, including the pathogens Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella spp. and methicillin-resistant S. aureus. Disinfection reduced bacterial contamination. No risk factors for pager contamination with pathogens were identified. PMID:17072134

  4. Social and relational identification as determinants of care workers' motivation and well-being.

    PubMed

    Bjerregaard, Kirstien; Haslam, S Alexander; Morton, Thomas; Ryan, Michelle K

    2015-01-01

    A growing body of research in the field of health and social care indicates that the quality of the relationship between the person giving care and the person receiving it contributes significantly to the motivation and well-being of both. This paper examines how care workers' motivation is shaped by their social and relational identification at work. Survey findings at two time points (T1, N = 643; T2, N = 1274) show that care workers' motivation increases to the extent that incentives, the working context (of residential vs. domiciliary care), and the professionalization process (of acquiring vs. not acquiring a qualification) serve to build and maintain meaningful identities within the organization. In this context care workers attach greatest importance to their relational identity with clients and the more they perceive this as congruent with their organizational identity the more motivated they are. Implications are discussed with regard to the need to develop and sustain a professional and compassionate workforce that is able to meet the needs of an aging society.

  5. Health care utilisation amongst Shenzhen migrant workers: does being insured make a difference?

    PubMed Central

    2009-01-01

    Background As one of the most populous metropolitan areas in the Pearl River Delta of South China, Shenzhen attracts millions of migrant workers annually. The objectives of this study were to compare health needs, self-reported health and healthcare utilisation of insured and uninsured migrant workers in Shenzhen, China, where a new health insurance scheme targeting at migrant workers was initiated. Methods A cross-sectional survey using multi-staged sampling was conducted to collect data from migrant factory workers. Statistical tests included logistic regression analysis were used. Results Among 4634 subjects (96.54%) who responded to the survey, 55.11% were uninsured. Disease patterns were similar irrespective of insurance status. The uninsured were more likely to be female, single, younger and less educated unskilled labourers with a lower monthly income compared with the insured. Out of 1136 who reported illness in the previous two weeks, 62.15% did not visit a doctor. Of the 296 who were referred for inpatient care, 48.65% did not attend because of inability to pay. Amongst those who reported sickness, 548 were insured and 588 were uninsured. Those that were insured, and had easier access to care were more likely to make doctor visits than those who were uninsured. Conclusion Health care utilisation patterns differ between insured and uninsured workers and insurance status appears to be a significant factor. The health insurance system is inequitably distributed amongst migrant workers. Younger less educated women who are paid less are more likely to be uninsured and therefore to pay out of pocket for their care. For greater equity this group need to be included in the insurance schemes as they develop. PMID:19930580

  6. Comparison of the 1996 and 2001 census data for Aboriginal and non-Aboriginal workers in health care occupations.

    PubMed

    Lecompte, Emily; Baril, Mireille

    2008-01-01

    To meet the unique health needs of Aboriginal peoples (First Nations, Inuit and Métis), it is important to increase and encourage Aboriginal representation in health care. One Federal initiative, the Aboriginal Health Human Resource Initiative (AHHRI) at Health Canada, focuses on: (1) increasing the number of Aboriginal people working in health careers; (2) adapting health care educational curricula to support the development of cultural competencies; and (3) improving the retention of health care workers in Aboriginal communities. A health care system that focuses on understanding the unique challenges, concerns, and needs of Aboriginal people can better respond to this specific population, which suffers disproportionately from ill health in comparison to their non-Aboriginal counterparts. This report examines the supply of Aboriginal health care providers in Canada, based on geographic region, area of residence, Aboriginal identity, and occupation. Findings are drawn from the 1996 and 2001 censuses from Statistics Canada. Quantitative results provide a greater understanding of labour force characteristics of First Nation, Inuit, Métis, and non-Aboriginal health providers. PMID:18447068

  7. Attitudes of physicians, patients, and village health workers toward glaucoma and diabetic retinopathy in rural China: a focus group study.

    PubMed

    Yan, Xixi; Liu, Tianyu; Gruber, Layla; He, Mingguang; Congdon, Nathan

    2012-06-01

    OBJECTIVE To understand the knowledge and attitudes of rural Chinese physicians, patients, and village health workers (VHWs) toward diabetic eye disease and glaucoma. METHODS Focus groups for each of the 3 stakeholders were conducted in 3 counties (9 groups). The focus groups were recorded, transcribed, and coded using specialized software. Responses to questions about barriers to compliance and interventions to remove these barriers were also ranked and scored. RESULTS Among 22 physicians, 23 patients, and 25 VHWs, knowledge about diabetic eye disease was generally good, but physicians and patients understood glaucoma only as an acutely symptomatic disease of relatively low prevalence. Physicians did not favor routine pupillary dilation to detect asymptomatic disease, expressing concerns about workflow and danger and inconvenience to patients. Providers believed that cost was the main barrier to patient compliance, whereas patients ranked poorly trained physicians as more important. All 3 stakeholder groups ranked financial interventions to improve compliance (eg, direct payment, lotteries, and contracts) low and preferred patient education and telephone contact by nurses. All the groups somewhat doubted the ability of VHWs to screen for eye disease accurately, but patients were generally willing to pay for VHW screening. The VHWs were uncertain about the value of eye care training but might accept it if accompanied by equipment. They did not rank payment for screening services as important. CONCLUSIONS Misconceptions about glaucoma's asymptomatic nature and an unwillingness to routinely examine asymptomatic patients must be addressed in training programs. Home contact by nurses and patient education may be the most appropriate interventions to improve compliance. PMID:22801838

  8. Study on workloads of human care worker with the introduction of IT system - the characteristics of work loads by observational research and the suggestions for KAIZEN.

    PubMed

    Mizuno, Yuki; Yoshikawa, Toru; Matsuda, Fumiko; Takeuchi, Yuriko; Motegi, Nobuyuki; Ikegami, Thor; Sakai, Kazuhiro

    2012-01-01

    The purpose of this study was to clarify the characteristic of workloads on human care worker with the introduction of IT system, and suggested the support measures for KAIZEN in Japan. The investigation method is workflow line and hearing with a focus on work observation. The objects were 8 human care workers of the acute hospital that introduced an electronic system. By the introduction of the electronic chart, the nurse station sojourn time decreased, sickroom sojourn time increased, and time about direct nursing care to a patient increased. In addition, access to patient information became easy, and the offer of the health care service based on correct information came to be possible in real time. By The point of workflow line, it was effect that moving lengths decreased in order to install the electronic chart in patients' rooms. Though, it was a problem that it hasn't formed where to place the instruments such as sphygmomanometer, clinical thermometer and others.

  9. Workforce Development Innovations with Direct Care Workers: Better Jobs, Better Services, Better Business.

    PubMed

    Dailey, Wayne F; Morris, John A; Hoge, Michael A

    2015-08-01

    This study describes findings from a national search to identify innovative workforce practices designed to improve the lives of direct care workers serving individuals with mental health and substance use conditions, while simultaneously improving client care, and the business vitality of the employer. The search process, conducted by The Annapolis Coalition on the Behavioral Health Workforce, resulted in the selection of five programs to receive the Pacesetter Award from among 51 nominations received. Awardees understood the value of investing in direct care workers, who constitute an essential, but often overlooked, group within the behavioral health workforce. A review of these innovations yielded six cross-cutting principles that should inform future workforce efforts (a) supporting educational and career development (b) increasing wages and benefits PMID:25535046

  10. The Impact of a Participatory Care Model on Work Satisfaction of Care Workers and the Functionality, Connectedness, and Mental Health of Community-Dwelling Older People.

    PubMed

    Bernoth, Maree; Burmeister, Oliver K; Morrison, Mark; Islam, Md Zahidul; Onslow, Fiona; Cleary, Michelle

    2016-06-01

    This study describes and evaluates an innovative program designed to reduce functional decline among seniors, using a participatory care approach and integrated health teams. The evaluation provides older people and community support workers (CSWs) with the opportunity to share their experiences of being involved with an innovative program to reduce functional decline (mobility, skin integrity, nutrition, mental health, continence) of older, community dwelling adults implemented by a Nursing Service in a major capital city in Australia. As part of the program, CSWs were trained to provide care that aimed to reduce functional decline, and improve the quality of life for the care recipients. Data were collected through in-depth interviews with older people receiving care and a focus group (FG) was conducted with CSWs. Seven themes emerged during data analysis: 1) functionality/independence; 2) prevention; 3) confidence; 4) connection; 5) the approach; 6) care plans; and 7) the role of the CSWs. The relationship built between care giver and receiver and the mutual respect facilitated through adopting a participatory care approach was crucial. This relationship-focused care contributed to improved functionality and consequently quality of life for the older person, and for the CSW professional it contributed to their development, improved satisfaction with their role, and increased pride in the difference they make in the lives of their clients. Opportunities for improvement of the program included ensuring that participants understood the rationale for all aspects of the program, including regular reminders, as well as the use of regular reviews of individual outcomes. PMID:27070378

  11. Assessment of hand hygiene compliance after hand hygiene education among health care workers in Cambodia

    PubMed Central

    Sansam, Sim; Yamamoto, Eiko; Srun, Sok; Sinath, Yin; Moniborin, Mey; Bun Sim, Kheang; Reyer, Joshua A.; Yoshida, Yoshitoku; Hamajima, Nobuyuki

    2016-01-01

    ABSTRACT Health care-associated infection (HCAI) is the most frequent adverse event for hospitalized patients. Hand hygiene is a simple and effective solution to protect patients from HCAI. This study aimed to introduce hand hygiene to health care workers based on the World Health Organization guideline for reducing HCAI in Cambodia and to assess their behavioral patterns on hand hygiene. All health care workers at Kampong Cham provincial hospital had lectures and practice on hand hygiene in January 2012. The surveys for hand hygiene compliance (HHC) were performed after 6 months, 1 year and 2 years, respectively. The number of surgical site infections (SSI) was counted in 2011 and 2014. Our analysis used the data of 58 workers, who were observed at all three points, although 139 workers were observed during the study period. The average of HHC at 6 months, 1 year and 2 years were 62.37%, 85.76% and 80.36%, respectively. The improved group (HHC 2 years/1 year≧1) had 32 workers, whereas the worsened group (HHC 2 years/1 year<1) had 26. There was a significant difference in departments of the two groups (P=0.011) but not in sex, age or occupations. The improved group had more workers of General (31.2% vs. 19.2%), Surgical (25.0% vs. 11.5%) and Infection (21.9% vs. 11.5%) categories compared to the worsened group. The incidence of SSI was improved from 32.26% in 2011 to 0.97% in 2014. Our results suggest that the education and the survey on hand hygiene are effective for reducing HCAI in Cambodia. PMID:27303102

  12. Assessment of hand hygiene compliance after hand hygiene education among health care workers in Cambodia.

    PubMed

    Sansam, Sim; Yamamoto, Eiko; Srun, Sok; Sinath, Yin; Moniborin, Mey; Bun Sim, Kheang; Reyer, Joshua A; Yoshida, Yoshitoku; Hamajima, Nobuyuki

    2016-05-01

    Health care-associated infection (HCAI) is the most frequent adverse event for hospitalized patients. Hand hygiene is a simple and effective solution to protect patients from HCAI. This study aimed to introduce hand hygiene to health care workers based on the World Health Organization guideline for reducing HCAI in Cambodia and to assess their behavioral patterns on hand hygiene. All health care workers at Kampong Cham provincial hospital had lectures and practice on hand hygiene in January 2012. The surveys for hand hygiene compliance (HHC) were performed after 6 months, 1 year and 2 years, respectively. The number of surgical site infections (SSI) was counted in 2011 and 2014. Our analysis used the data of 58 workers, who were observed at all three points, although 139 workers were observed during the study period. The average of HHC at 6 months, 1 year and 2 years were 62.37%, 85.76% and 80.36%, respectively. The improved group (HHC 2 years/1 year≧1) had 32 workers, whereas the worsened group (HHC 2 years/1 year<1) had 26. There was a significant difference in departments of the two groups (P=0.011) but not in sex, age or occupations. The improved group had more workers of General (31.2% vs. 19.2%), Surgical (25.0% vs. 11.5%) and Infection (21.9% vs. 11.5%) categories compared to the worsened group. The incidence of SSI was improved from 32.26% in 2011 to 0.97% in 2014. Our results suggest that the education and the survey on hand hygiene are effective for reducing HCAI in Cambodia. PMID:27303102

  13. [Guidelines for the prevention and control of tuberculosis in health care workers].

    PubMed

    Casas, Irma; Dominguez, Jose; Rodríguez, Soledad; Matllo, Joan; Altet, Neus

    2015-12-21

    Tuberculosis remains one of the communicable diseases that cause increased morbidity and mortality worldwide. With an incidence rate of 13,04 per 100,000 population, Spain ranks third among the most affected European countries. These data show a tendency to decrease meaning that it may go unnoticed with the potential to miss the appropriate preventive measures in a suspected case. In centers where patients are treated with tuberculosis, health care worker presents risk of transmission. This risk is higher in some areas or work units. The Occupational health physicians' services, which monitorize the health of health care workers, use different strategies in order to prevent and detect tuberculosis infection. The national guidelines include the tuberculin skin test as a screening test for tuberculosis infection with mention of new diagnostic tests based on the in vitro detection of gamma interferon (IGRA) for certain cases. The purpose of this guide is to establish common criteria for IGRA tests, as a supplementary aid to the tuberculin skin test in health care workers, from the evidence available today. Recommendations for its use have been adapted to the different situations faced by the professionals involved in monitoring the health of health workers.

  14. [Guidelines for the prevention and control of tuberculosis in health care workers].

    PubMed

    Casas, Irma; Dominguez, Jose; Rodríguez, Soledad; Matllo, Joan; Altet, Neus

    2015-12-21

    Tuberculosis remains one of the communicable diseases that cause increased morbidity and mortality worldwide. With an incidence rate of 13,04 per 100,000 population, Spain ranks third among the most affected European countries. These data show a tendency to decrease meaning that it may go unnoticed with the potential to miss the appropriate preventive measures in a suspected case. In centers where patients are treated with tuberculosis, health care worker presents risk of transmission. This risk is higher in some areas or work units. The Occupational health physicians' services, which monitorize the health of health care workers, use different strategies in order to prevent and detect tuberculosis infection. The national guidelines include the tuberculin skin test as a screening test for tuberculosis infection with mention of new diagnostic tests based on the in vitro detection of gamma interferon (IGRA) for certain cases. The purpose of this guide is to establish common criteria for IGRA tests, as a supplementary aid to the tuberculin skin test in health care workers, from the evidence available today. Recommendations for its use have been adapted to the different situations faced by the professionals involved in monitoring the health of health workers. PMID:26520610

  15. Evaluation of a stroke family care worker: results of a randomised controlled trial.

    PubMed Central

    Dennis, M.; O'Rourke, S.; Slattery, J.; Staniforth, T.; Warlow, C.

    1997-01-01

    OBJECTIVE: To examine the effect of contact with a stroke family care worker on the physical, social, and psychological status of stroke patients and their carers. DESIGN: Randomised controlled trial with broad entry criteria and blinded outcome assessment six months after randomisation. SETTING: A well organised stroke service in an Edinburgh teaching hospital. SUBJECTS: 417 patients with an acute stroke in the previous 30 days randomly allocated to be contacted by a stroke family care worker (210) or to receive standard care (207). The patients represented 67% of all stroke patients assessed at the hospital during the study period. MAIN OUTCOME MEASURES: Patient completed Barthel index, Frenchay activities index, general health questionnaire, hospital anxiety and depression scale, social adjustment scale, mental adjustment to stroke scale, and patient satisfaction questionnaire; carer completed Frenchay activities index, general health questionnaire, hospital anxiety and depression scale, social adjustment scale, caregiving bassles scale, and carer satisfaction questionnaire. RESULTS: The groups were balanced for all important baseline variables. There were no significant differences in physical outcomes in patients or carers, though patients in the treatment group were possibly more helpless less well adjusted socially, and more depressed, whereas carers in the treatment group were possibly less hassled and anxious. However, both patients and carers in the group contacted by the stroke family care worker expressed significantly greater satisfaction with certain aspects of their care, in particular those related to communication and support. CONCLUSIONS: The introduction of a stroke family care worker improved patients' and their carers' satisfaction with services and may have had some effect on psychological and social outcomes but did not improve measures of patients' physical wellbeing. PMID:9133884

  16. Contact urticaria from rubber gloves: an occupational skin disorder for health care workers.

    PubMed

    Tanglertsampan, C; Patrakarn, S; Vassansiri, E

    1998-01-01

    Rubber allergy is an important occupational health problem for an increasing number of patients. It may produce a type I urticarial reaction, or more commonly, a type IV delayed eczematous dermatitis. The risk groups include health care workers, rubber industry workers, and children with spina bifida (meningomyelocele) and urogenital abnormalities. In this report, we describe a physician with a relevant history who was found to have type I hypersensitivity to rubber by prick test and use test. Our aim is to increase awareness among physicians, discuss diagnosis and management, and review the literature. PMID:9470325

  17. Mandatory Influenza Vaccination for Health Care Workers as the New Standard of Care: A Matter of Patient Safety and Nonmaleficent Practice

    PubMed Central

    2014-01-01

    A growing body of literature defends the efficacy of seasonal influenza vaccination for health care workers in reducing the mortality of hospitalized patients. I review the evidence concerning influenza vaccination, concluding that universal vaccination of health care workers against influenza should be considered standard patient care and that nonvaccination represents maleficent care. I further argue that the ethical responsibility to ensure universal vaccination of staff against seasonal influenza lies not only with individual health care providers but with each individual health care institution. PMID:24328628

  18. The weather-stains of care: interpreting the meaning of bad weather for front-line health care workers in rural long-term care.

    PubMed

    Joseph, Gillian M; Skinner, Mark W; Yantzi, Nicole M

    2013-08-01

    This paper addresses the gap in health services and policy research about the implications of everyday weather for health care work. Building on previous research on the weather-related challenges of caregiving in homes and communities, it examines the experiences of 'seasonal bad weather' for health care workers in long-term care institutions. It features a hermeneutic phenomenology analysis of six transcripts from interviews with nurses and personal support workers from a qualitative study of institutional long-term care work in rural Canada. Focussing on van Manen's existential themes of lived experience (body, relations, space, time), the analysis reveals important contradictions between the lived experiences of health care workers coping with bad weather and long-term care policies and practices that mitigate weather-related risk and vulnerability. The findings contribute to the growing concern for rural health issues particularly the neglected experiences of rural health providers and, in doing so, offer insight into the recent call for greater attention to the geographies of health care work.

  19. Predicting Health Care Utilization in Marginalized Populations: Black, Female, Street-based Sex Workers

    PubMed Central

    Varga, Leah M.; Surratt, Hilary L.

    2014-01-01

    Background Patterns of social and structural factors experienced by vulnerable populations may negatively affect willingness and ability to seek out health care services, and ultimately, their health. Methods The outcome variable was utilization of health care services in the previous 12 months. Using Andersen’s Behavioral Model for Vulnerable Populations, we examined self-reported data on utilization of health care services among a sample of 546 Black, street-based female sex workers in Miami, Florida. To evaluate the impact of each domain of the model on predicting health care utilization, domains were included in the logistic regression analysis by blocks using the traditional variables first and then adding the vulnerable domain variables. Findings The most consistent variables predicting health care utilization were having a regular source of care and self-rated health. The model that included only enabling variables was the most efficient model in predicting health care utilization. Conclusions Any type of resource, link, or connection to or with an institution, or any consistent point of care contributes significantly to health care utilization behaviors. A consistent and reliable source for health care may increase health care utilization and subsequently decrease health disparities among vulnerable and marginalized populations, as well as contribute to public health efforts that encourage preventive health. PMID:24657047

  20. Musculoskeletal Symptoms and Risk of Burnout in Child Care Workers — A Cross-Sectional Study

    PubMed Central

    Koch, Peter; Stranzinger, Johanna; Nienhaus, Albert; Kozak, Agnessa

    2015-01-01

    Objectives German child care workers' job satisfaction is influenced by the consequences of unfavourable underlying conditions. Child care workers tend to suffer from psychosocial stress, as they feel that their work is undervalued. The objective of the present study is to investigate how the psychosocial factors of the effort-reward imbalance (ERI) model influence musculoskeletal symptoms (MS) and the risk of burnout. To our knowledge this is the first study investigating the association between the factors of the ERI model and MS in child care workers. Methods and Findings Data from 199 child care workers were examined in a cross-sectional study. Psychosocial factors were recorded with the ERI questionnaire. MS was recorded with the Nordic Questionnaire and risk of burnout with the Personal Burnout scale of the Copenhagen Burnout Inventory. Multivariate analysis was performed using linear and logistic regression models. The response rate was 57%. In most of the sample (65%), an effort-reward imbalance was observed. 56% of the child care workers were at risk of burnout and 58% reported MS. Factors associated with risk of burnout were subjective noise exposure (OR: 4.4, 95%CI: 1.55–12.29) and overcommitment (OR: 3.4; 95%CI: 1.46–7.75). There were statistically significant associations between MS and overcommitment (low back pain—OR: 2.2, 95%CI: 1.04–4.51), low control (overall MS OR: 3.8; 95%CI: 1.68–3.37) and risk of burnout (overall MS OR: 2.3, 95%CI: 1.01–5.28). For ERI no statistically significant associations were found with reference to risk of burnout or MS. Conclusion Overcommitment in child care workers is related to MS and risk of burnout. There is also evidence that low control is associated with MS and subjective noise exposure with risk of burnout. Effort-reward imbalance is not related to either outcome. This occupational health risk assessment identifies changeable working factors in different types of facilities. PMID:26488770

  1. Risk and management of blood-borne infections in health care workers.

    PubMed

    Beltrami, E M; Williams, I T; Shapiro, C N; Chamberland, M E

    2000-07-01

    Exposure to blood-borne pathogens poses a serious risk to health care workers (HCWs). We review the risk and management of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infections in HCWs and also discuss current methods for preventing exposures and recommendations for postexposure prophylaxis. In the health care setting, blood-borne pathogen transmission occurs predominantly by percutaneous or mucosal exposure of workers to the blood or body fluids of infected patients. Prospective studies of HCWs have estimated that the average risk for HIV transmission after a percutaneous exposure is approximately 0.3%, the risk of HBV transmission is 6 to 30%, and the risk of HCV transmission is approximately 1.8%. To minimize the risk of blood-borne pathogen transmission from HCWs to patients, all HCWs should adhere to standard precautions, including the appropriate use of hand washing, protective barriers, and care in the use and disposal of needles and other sharp instruments. Employers should have in place a system that includes written protocols for prompt reporting, evaluation, counseling, treatment, and follow-up of occupational exposures that may place a worker at risk of blood-borne pathogen infection. A sustained commitment to the occupational health of all HCWs will ensure maximum protection for HCWs and patients and the availability of optimal medical care for all who need it. PMID:10885983

  2. Present principles of workers' health care organization in Poland and directions of future changes.

    PubMed

    Dawydzik, L; Izycki, J; Kopias, J

    1993-01-01

    The present-day legal regulations on workers' health care are far from satisfactory. The work on the modification of the occupational health service has been carried out for the last two years although the preparatory activities started much earlier. In May 1991, under the initiative of the Nofer Institute of Occupational Medicine in Lodz, the bill on the Labor Code has been amended so that it would regulate the employer's responsibilities with respect to providing health care for workers and to participating in respective costs. These activities have overrun the more general ones pertaining to the reform of the national health service in Poland. Under conditions of the growing free market economy the previously operated organizational system of health care for workers has become out-of-date and needs immediate modification to adjust it to the new economic situation. Evidently, the trends and rate of the policy in this respect have been considerably influenced by the more general activities to make Poland associated with the European Community and hence to develop an occupational health care system which would take into consideration the principles of the Charter of Social Rights of the EEC as well as of the ILO Conventions.

  3. Evaluation of Minnesota and Illinois hospital respiratory protection programs and health care worker respirator use.

    PubMed

    Brosseau, Lisa M; Conroy, Lorraine M; Sietsema, Margaret; Cline, Kari; Durski, Kara

    2015-01-01

    The objective of this study was to assess respiratory protection programs for aerosol-transmissible diseases in acute care hospitals for conformance with regulatory requirements and public health guidelines. Twenty-eight representative hospitals were selected by size, location, and ownership in Minnesota and Illinois. Interviews were conducted with 363 health care workers and 171 managers from high-risk departments. Written programs from each hospital were reviewed for required elements. Seventy-seven health care workers were observed donning and doffing a FFR. The most serious deficiency in many written programs was failure to identify a program administrator. Most written programs lacked adequate details about medical evaluation, fit-testing, and training and did not include a comprehensive risk assessment for aerosol transmissible diseases; tuberculosis was often the only pathogen addressed. Employees with the highest probability of tuberculosis exposure were most likely to pick a respirator for close contact, but higher levels of respiratory protection were rarely selected for aerosol-generating procedures. Surgical masks were most commonly selected for close contact with droplet disease- or influenza-infected patients; better protection (e.g., respirator) was rarely selected for higher-risk exposures. Most of the observed health care workers had access to a NIOSH-certified N95 FFR, properly positioned the facepiece, and formed the nose clip. The most frequent deficiencies were failure to correctly place straps, perform a user seal check, and remove the respirator using straps. PMID:24918755

  4. Evaluation of Minnesota and Illinois hospital respiratory protection programs and health care worker respirator use.

    PubMed

    Brosseau, Lisa M; Conroy, Lorraine M; Sietsema, Margaret; Cline, Kari; Durski, Kara

    2015-01-01

    The objective of this study was to assess respiratory protection programs for aerosol-transmissible diseases in acute care hospitals for conformance with regulatory requirements and public health guidelines. Twenty-eight representative hospitals were selected by size, location, and ownership in Minnesota and Illinois. Interviews were conducted with 363 health care workers and 171 managers from high-risk departments. Written programs from each hospital were reviewed for required elements. Seventy-seven health care workers were observed donning and doffing a FFR. The most serious deficiency in many written programs was failure to identify a program administrator. Most written programs lacked adequate details about medical evaluation, fit-testing, and training and did not include a comprehensive risk assessment for aerosol transmissible diseases; tuberculosis was often the only pathogen addressed. Employees with the highest probability of tuberculosis exposure were most likely to pick a respirator for close contact, but higher levels of respiratory protection were rarely selected for aerosol-generating procedures. Surgical masks were most commonly selected for close contact with droplet disease- or influenza-infected patients; better protection (e.g., respirator) was rarely selected for higher-risk exposures. Most of the observed health care workers had access to a NIOSH-certified N95 FFR, properly positioned the facepiece, and formed the nose clip. The most frequent deficiencies were failure to correctly place straps, perform a user seal check, and remove the respirator using straps.

  5. Test of the Fishbein and Ajzen models as predictors of health care workers' glove use.

    PubMed

    Levin, P F

    1999-08-01

    The aim of this study was to identify predictors of health care workers' glove use when there is a potential for blood exposure. The study hypothesis was that an extension of the theory of planned behavior would explain more of the variance in glove use behavior than the theory of reasoned action or theory of planned behavior. A random sample of nurses and laboratory workers (N = 527) completed a 26-item questionnaire with acceptable content validity and reliability estimates. Using structural equation modeling techniques, intention, attitude, and perceived risk were significant predictors of behavior. Perceived control and attitude were the significant determinants of intention. The theory of reasoned action was the most parsimonious model, explaining 70% of the variance in glove use behavior. The theory of planned behavior extension was a viable model to study behavior related to glove use and reducing workers' risks to bloodborne diseases.

  6. The itinerant health worker: an experiment in rural health care delivery.

    PubMed

    Isely, R B; Sanwogou, L L

    1983-03-01

    A model of rural health-care delivery employing itinerant health workers has been presented. Itinerant workers, whose role is principally community organization and technical assistance to village health committees in matters of environment health and endemic disease control, are suggested as an interim measure for strengthening village social structures in preparation for the eventual emergence of village health workers. The effectiveness of the model is reflected in the multiplier effect on the number of organized villages, the diffusion of the model to other parts of the Cameroun, and the impact on policy-making. The efficiency of the model, however, may be limited by such questions as budget for transport and per diem expenses and more seriously the limitation on training facilities. A deliberate allocation of budget to overcoming these obstacles is suggested as important to bringing the advantages of the model to the entire rural population.

  7. Test of the Fishbein and Ajzen models as predictors of health care workers' glove use.

    PubMed

    Levin, P F

    1999-08-01

    The aim of this study was to identify predictors of health care workers' glove use when there is a potential for blood exposure. The study hypothesis was that an extension of the theory of planned behavior would explain more of the variance in glove use behavior than the theory of reasoned action or theory of planned behavior. A random sample of nurses and laboratory workers (N = 527) completed a 26-item questionnaire with acceptable content validity and reliability estimates. Using structural equation modeling techniques, intention, attitude, and perceived risk were significant predictors of behavior. Perceived control and attitude were the significant determinants of intention. The theory of reasoned action was the most parsimonious model, explaining 70% of the variance in glove use behavior. The theory of planned behavior extension was a viable model to study behavior related to glove use and reducing workers' risks to bloodborne diseases. PMID:10435547

  8. Pre-event Smallpox Vaccination for Healthcare Workers Revisited – the Need for a Carefully Screened Multidisciplinary Cadre

    SciTech Connect

    Malone, JD D.

    2007-03-01

    Abstract As healthcare institutions are a focus of smallpox transmission early in an epidemic, several mathematical models support pre-event smallpox vaccination of healthcare workers (HCWs). The deciding factor for HCW voluntary vaccination is the risk of disease exposure versus the risk of vaccine adverse events. In a United States military population, with careful screening to exclude atopic dermatitis/eczema and immunosuppression, over 1 million vaccinia vaccinations were delivered with 1 fatality attributed to vaccination. Among 37,901 U.S. civilian volunteer healthcare workers vaccinated, 100 serious adverse events were reported including 10 ischemic cardiac episodes and six myocardial infarctions – 2 were fatal. This older population had a higher rate of adverse events due to age related coronary artery disease. T-cell mediated inflammatory processes, induced by live vaccinia vaccination, may have a role in the observed acute coronary artery events. With exclusion of individuals at risk for coronary artery disease, atopic dermatitis/eczema, and immunosuppression, HCWs can be smallpox vaccinated with minimal risk. A smallpox pre-vaccinated multidisciplinary cadre (physician, nurse, infection control practitioner, technician) will supply leadership to deal with fear and uncertainty while limiting spread and initial mortality of smallpox. Stochastic – from the Greek meaning “skillful in aiming” – is currently interpreted as arising from chance and involving probability. This issue’s article “Containing a large bioterrorist smallpox attack: a computer simulation approach” by Longini et al. is a discrete time, stochastic computer simulation model that offers additional planning guidance for a smallpox (variola virus) outbreak (1). Although interpretation of the model’s information may differ, Longini’s article concludes “Given that surveillance and containment measures are in place, preemptive vaccination of hospital workers would further

  9. FEMALE SEXUAL DYSFUNCTION (FSD) IN WOMEN HEALTH CARE WORKERS

    PubMed Central

    Stamatiou, Konstantinos; Margariti, Maria; Nousi, Eftichia; Mistrioti, Dimitra; Lacroix, Richard; Saridi, Maria

    2016-01-01

    Purpose: The main aim of this study is to investigate the occurrence and severity of FSD in women working in tertiary hospitals. Material and methods: The study sample was drawn from health care women between the ages of 20 and 65 years, working in two hospitals in Greece. This descriptive study used a structured Greek questionnaire and sexual function screener and quality of life sectors were consisted of rated scale questions. Eighty eight questionnaires were returned properly completed. The statistical analysis used the SPSS statistical program. Results: Female sexual dysfunction is a highly prevalent health issue whose exact incidence is not well defined. Factors that can contribute to female sexual dysfunction may be psychogenic, physical, mixed or unknown. Each of these factors consists of individual components that influence the sexual response; however their precise impact in FSD development and progression is unknown. Moreover, the role of circadian rhythm disorders (especially that of shift work sleep disorder) to the development and progression of FSD has been poorly investigated. Conclusion: Working environment and patterns of work schedules may play a role in FSD however it has been difficult to specify in what extent they contribute to FSD development. PMID:27482157

  10. Perceptions of health and risk management among home care workers in Sweden

    PubMed Central

    Larsson, A; Karlqvist, L; Westerberg, M; Gard, G

    2013-01-01

    Background: Municipal home care workers provide high-quality services to an increasing proportion of elderly people living in private homes. The work environments and working conditions of these workers vary to a great extent, implying rapid priority-making among both employers and employees to ensure that the work can be performed in a safe way. Objectives: This study aims to examine home care workers’ perceptions of health, risks, working conditions, and risk management within their organization. Method: The study was based on cross-sectional data collected from home care service staff in a municipality in the north of Sweden. Nursing assistants and care aides (n = 133) replied to a self-administered questionnaire. Descriptive statistics and between-group differences were analysed. Results: Home care work was perceived to require high levels of professional skill and ingenuity, a good psychosocial work situation, but required a high physical workload. The general health, the capacity and self-efficacy of the staff in relation to work were good. Difficulty in performing risk assessments and following safety regulations due to lack of time, equipment, and information were identified. Conclusion: There is a need to increase participation in risk assessments among the staff, improve management support, structures, and cooperation with other divisions of the social services and the medical care organizations. PMID:24078781

  11. Outsourcing Elderly Care to Migrant Workers: The Impact of Gender and Class on the Experience of Male Employers

    PubMed Central

    Gallo, Ester; Scrinzi, Francesca

    2015-01-01

    This article, based on semi-structured interviews, addresses masculinity in the international division of reproductive labour through an analysis of the impact of gender and class on the outsourcing of elderly care services to migrant care workers. In the Italian context, characterised by a limited provision of long-term care services and by cash-for-care benefits, the strategies of men as employers of migrant care workers are shaped by class and gender. The outsourcing of care to migrant workers reproduces hegemonic masculinity in so far as male employers are able to withdraw from the ‘dirty work’. At the same time, men engage with tasks which are, in principle, kept at a distance. The employers’ family status, combined with their class background, are crucial factors in shaping the heterogeneity of men’s experiences as employers and managers of care labour, and the ways in which they make sense of their masculinity. PMID:27041775

  12. Data on the migration of health-care workers: sources, uses, and challenges.

    PubMed Central

    Diallo, Khassoum

    2004-01-01

    The migration of health workers within and between countries is a growing concern worldwide because of its impact on health systems in developing and developed countries alike. Policy decisions need to be made at the national, regional and international levels to manage more effectively this phenomenon, but those decisions will be effective and correctly implemented and evaluated only if they are based on adequate statistical data. Most statistics on the migration of health-care workers are neither complete nor fully comparable, and they are often underused, limited (because they often give only a broad description of the phenomena) and not as timely as required. There is also a conflict between the wide range of potential sources of data and the poor statistical evidence on the migration of health personnel. There are two major problems facing researchers who wish to provide evidence on this migration: the problems commonly faced when studying migration in general, such as definitional and comparability problems of "worker migrations" and those related to the specific movements of the health workforce. This paper presents information on the uses of statistics and those who use them, the strengths and limitations of the main data sources, and other challenges that need to be met to obtain good evidence on the migration of health workers. This paper also proposes methods to improve the collection, analysis, sharing, and use of statistics on the migration of health workers. PMID:15375450

  13. Engaging health care workers to prevent catheter-associated urinary tract infection and avert patient harm.

    PubMed

    Fakih, Mohamad G; Krein, Sarah L; Edson, Barbara; Watson, Sam R; Battles, James B; Saint, Sanjay

    2014-10-01

    Preventing catheter-associated urinary tract infection (CAUTI) remains a significant challenge for US hospitals. The "On the CUSP: Stop CAUTI" initiative represents the single largest national effort (involving >950 hospitals) to mitigate urinary catheter risk. The program brings together key organizations to assist state hospital associations and hospitals by providing education and coaching support, addressing both the technical aspects of preventing CAUTI and CAUTI-specific socio-adaptive challenges. At the local level, engaging health care workers, from physicians and nurses to other ancillary services, is critical. This includes (1) making the importance of addressing CAUTI stakeholder specific, (2) ensuring support from leaders of essential disciplines, (3) underscoring the importance of the collaborative nature of CAUTI prevention, and (4) identifying champions within the organization to lead and be accountable for the work. Sustainability is ensured by integrating the process into the health care worker's daily routine activities.

  14. Challenges of Transcultural Caring Among Health Workers in Mashhad-Iran: A Qualitative Study

    PubMed Central

    Amiri, Rana; Heydari, Abbas; Dehghan-Nayeri, Nahid; Vedadhir, Abou Ali; Kareshki, Hosein

    2016-01-01

    Background: One of the consequences of migration is cultural diversity in various communities. This has created challenges for healthcare systems. Objectives: The aim of this study is to explore the health care staffs’ experience of caring for Immigrants in Mashhad- Iran. Setting: This study is done in Tollab area (wherein most immigrants live) of Mashhad. Clinics and hospitals that immigrants had more referral were selected. Participants: Data were collected through in-depth interviews with medical and nursing staffs. 15 participants (7 Doctors and 8 Nurses) who worked in the more referred immigrants’ clinics and hospitals were entered to the study. Design: This is a qualitative study with content analysis approach. Sampling method was purposive. The accuracy and consistency of data were confirmed. Interviews were conducted until no new data were emerged. Data were analyzed by using latent qualitative content analysis. Results: The data analysis consisted of four main categories; (1) communication barrier, (2) irregular follow- up, (3) lack of trust, (4) cultural- personal trait. Conclusion: Result revealed that health workers are confronting with some trans- cultural issues in caring of immigrants. Some of these issues are related to immigration status and some related to cultural difference between health workers and immigrants. These issues indicate that there is transcultural care challenges in care of immigrants among health workers. Due to the fact that Iran is the context of various cultures, it is necessary to consider the transcultural care in medical staffs. The study indicates that training and development in the area of cultural competence is necessary. PMID:26925887

  15. Clinical mentorship to improve pediatric quality of care at the health centers in rural Rwanda: a qualitative study of perceptions and acceptability of health care workers

    PubMed Central

    2014-01-01

    Background Despite evidence supporting Integrated Management of Childhood Illness (IMCI) as a strategy to improve pediatric care in countries with high child mortality, its implementation faces challenges related to lack of or poor post-didactic training supervision and gaps in necessary supporting systems. These constraints lead to health care workers’ inability to consistently translate IMCI knowledge and skills into practice. A program providing mentoring and enhanced supervision at health centers (MESH), focusing on clinical and systems improvement was implemented in rural Rwanda as a strategy to address these issues, with the ultimate goal of improving the quality of pediatric care at rural health centers. We explored perceptions of MESH from the perspective of IMCI clinical mentors, mentees, and district clinical leadership. Methods We conducted focus group discussions with 40 health care workers from 21 MESH-supported health centers. Two FGDs in each district were carried out, including one for nurses and one for director of health centers. District medical directors and clinical mentors had individual in-depth interviews. We performed a hermeneutic analysis using Atlas.ti v5.2. Results Study participants highlighted program components in five key areas that contributed to acceptability and impact, including: 1) Interactive, collaborative capacity-building, 2) active listening and relationships, 3) supporting not policing, 4) systems improvement, and 5) real-time feedback. Staff turn-over, stock-outs, and other facility/systems gaps were identified as barriers to MESH and IMCI implementation. Conclusion Health care workers reported high acceptance and positive perceptions of the MESH model as an effective strategy to build their capacity, bridge the gap between knowledge and practice in pediatric care, and address facility and systems issues. This approach also improved relationships between the district supervisory team and health center-based care

  16. Field experiment of a very brief worksite intervention to improve nutrition among health care workers.

    PubMed

    Armitage, Christopher J

    2015-08-01

    Despite the potential of worksite interventions to boost productivity and save insurance costs, they tend to be costly and tested in nonrandomized trials. The aim of the present study was to test the ability of a very brief worksite intervention based on implementation intentions to improve nutrition among health care workers. Seventy-nine health care workers were randomly allocated to a control condition or to form implementation intentions using standard instructions or with a supporting tool. Fruit intake and metacognitive processing (operationalized as awareness of standards, self-monitoring and self-regulatory effort) were measured at baseline and follow-up. Participants who formed implementation intentions ate significantly more fruit and engaged in significantly more metacognitive processing at follow-up than did participants in the control condition (ds > .70). The findings support the efficacy of implementation intentions for increasing fruit intake in health care workers and preliminary support for the utility of a tool to support implementation intention formation. PMID:25822117

  17. Proceedings of the Annual National Conference for Child Care Workers (2nd, Valley Forge, PA, October 9-12, 1980).

    ERIC Educational Resources Information Center

    Powell, Norman W., Jr., Ed.

    The speeches, papers, and workshops descriptions presented at the second annual National Conference for Child Care Workers are presented. Several issues relating to child care supervision, child care work, and child development are considered along with the management of group living environments and various aspects of supervision. Job…

  18. Social Capital Theory: Another Lens for School Social Workers to Use to Support Students Living in Foster Care

    ERIC Educational Resources Information Center

    Fram, Maryah Stella; Altshuler, Sandra J.

    2009-01-01

    Schools have a wide range of connections with the child welfare system, with common interests in the care, well-being, and future life opportunities of children living in foster care. Children in foster care are often the most vulnerable students in the school system, and school social workers often serve as important resources for these children.…

  19. A Sharper Focus on Technical Workers: How to Educate and Train for the Global Economy

    ERIC Educational Resources Information Center

    Lamos, Erin; Simon, Martin; Waits, Mary Jo

    2010-01-01

    This report presents a case study of the Automotive Manufacturing Technical Education Collaborative (AMTEC), which brings together auto manufacturers and community colleges across 12 states to identify and implement wide-ranging improvements in technical education for automotive manufacturing workers. A "Big Collaboration"--AMTEC involves 30…

  20. Sharing the Focus: Engaging with Support Workers to Include People with Communication Needs in Research

    ERIC Educational Resources Information Center

    Lutz, Deborah; Fisher, Karen R.; Robinson, Sally

    2016-01-01

    Inclusive research is an increasing expectation to value and include people's voice in research and evaluations intended to benefit them. The active participation of people with communication support needs can be difficult due to the practical constraints of evaluations. One technique is to engage with workers who are familiar with the person, but…

  1. A focus of lymphatic filariasis in a tea garden worker community of central Assam.

    PubMed

    Khan, A M; Dutta, P; Khan, S A; Mahanta, J

    2004-10-01

    A survey for lymphatic filariasis was conducted among tea garden workers of central Assam. Of the 656 night blood samples examined, 31 were found positive for Wuchereria bancrofti parasite (microfilaria rate 4.7%). Microfilaria rate was higher in male (7.3%) than females (2.1%). Culex quinquefasciatus was incriminated as vector mosquito. PMID:15907073

  2. Effects of a psycho-educational intervention on direct care workers' communicative behaviors with residents with dementia.

    PubMed

    Barbosa, Ana; Marques, Alda; Sousa, Liliana; Nolan, Mike; Figueiredo, Daniela

    2016-01-01

    This study assessed the effects of a person-centered care-based psycho-educational intervention on direct care workers' communicative behaviors with people with dementia living in aged-care facilities. An experimental study with a pretest-posttest control-group design was conducted in four aged-care facilities. Two experimental facilities received an 8-week psycho-educational intervention aiming to develop workers' knowledge about dementia, person-centered care competences, and tools for stress management. Control facilities received education only, with no support to deal with stress. In total, 332 morning care sessions, involving 56 direct care workers (female, mean age 44.72 ± 9.02 years), were video-recorded before and 2 weeks after the intervention. The frequency and duration of a list of verbal and nonverbal communicative behaviors were analyzed. Within the experimental group there was a positive change from pre- to posttest on the frequency of all workers' communicative behaviors. Significant treatment effects in favor of the experimental group were obtained for the frequency of inform (p < .01, η(2)partial = 0.09) and laugh (p < .01, η(2)partial = 0.18). Differences between groups emerged mainly in nonverbal communicative behaviors. The findings suggest that a person-centered care-based psycho-educational intervention can positively affect direct care workers' communicative behaviors with residents with dementia. Further research is required to determine the extent of the benefits of this approach.

  3. Integration of the leprosy programme into primary health care: a case study of perceptions of primary health care workers.

    PubMed

    Raju, M S; Dongre, V V

    2003-01-01

    Integration of the vertical leprosy programme into the existing horizontal health programme poses various administrative and operational challenges to programmers. In order to understand the preparedness of the PHC workers for integration of leprosy into primary health care services, 71 PHC workers were interviewed using a structured interview schedule. The results showed that about 42% of the staff have heard of the concept of integration earlier and 90% of the PHC staff are willing to treat leprosy patients in the primary health care centre, but only 72% were in favour of integration. The reasons for favouring integration were (1) wider coverage with MDT, (2) frequent field visits by the worker, (3) better rapport with the community, (4) timely treatment and (5) cost-effectiveness. About 28% of the staff members did not favour integration for the reasons that the leprosy programme would suffer, targets cannot be met, supervision would be difficult, knowledge of the staff was inadequate and importance cannot be given to leprosy as family planning is always a priority in PHC centres. About 43% of the staff felt that the performance of the leprosy programme would be better after integration. With regard to workload, 60% of the sample felt that there would be increase in the workload in the field, record maintenance and supervision. The difficulties foreseen by the workers were grouped into 6 categories, viz., administrative, managerial, technical, personnel, social and miscellaneous. It is worth noting that 91% of the staff that included all categories said they were not afraid of leprosy, but needed training in leprosy work. About 50% of the staff expected increase in salaries and promotions if integration took place.

  4. Community care workers in rural southern Illinois: job satisfaction and implications for employee retention.

    PubMed

    Roberts, D N; Sarvela, P D

    1989-01-01

    This study examined factors related to community care worker job satisfaction, as a method of assessing problems related to employee turnover, based on data collected from 393 community care workers who worked with elderly clients from the 13 southernmost rural counties in Illinois in 1987. Results suggested that the majority of workers were satisfied with their job; however, there was a difference in the mean scores of those employed for more than one year and those employed for less than one year (those employed for longer than one year had significantly lower satisfaction scores than those employed for less than one year). Although only 19 individuals indicated they were intending to quit within the year, 88 respondents answered "no opinion." Reasons given why new employees quit were: low wages, no benefits, no raises or promotions, cannot cope with the elderly, do not like the elderly, or not well-suited for this type of work. Also, many of the workers responded that people quit because the job was not what they expected, they did not give it a chance, they did not receive the proper training, and that the job was too stressful or frustrating. Recommendations made on the basis of these study data include the development of a new job hierarchy (which will increase the probability of being promoted) and more detailed pre-service training program which covers in detail what new employees can expect from the job. Health education training programs are recommended as a major tool for reducing the problem of employee turnover by helping the worker manage the high levels of stress experienced on the job.

  5. Community Care Workers, Poor Referral Networks and Consumption of Personal Resources in Rural South Africa

    PubMed Central

    Sips, Ilona; Haeri Mazanderani, Ahmad; Schneider, Helen; Greeff, Minrie; Barten, Francoise; Moshabela, Mosa

    2014-01-01

    Although home-based care (HBC) programs are widely implemented throughout Africa, their success depends on the existence of an enabling environment, including a referral system and supply of essential commodities. The objective of this study was to explore the current state of client referral patterns and practices by community care workers (CCWs), in an evolving environment of one rural South African sub-district. Using a participant triangulation approach, in-depth qualitative interviews were conducted with 17 CCWs, 32 HBC clients and 32 primary caregivers (PCGs). An open-ended interview guide was used for data collection. Participants were selected from comprehensive lists of CCWs and their clients, using a diversified criterion-based sampling method. Three independent researchers coded three sets of data – CCWs, Clients and PCGs, for referral patterns and practices of CCWs. Referrals from clinics and hospitals to HBC occurred infrequently, as only eight (25%) of the 32 clients interviewed were formally referred. Community care workers showed high levels of commitment and personal investment in supporting their clients to use the formal health care system. They went to the extent of using their own personal resources. Seven CCWs used their own money to ensure client access to clinics, and eight gave their own food to ensure treatment adherence. Community care workers are essential in linking clients to clinics and hospitals and to promote the appropriate use of medical services, although this effort frequently necessitated consumption of their own personal resources. Therefore, risk protection strategies are urgently needed so as to ensure sustainability of the current work performed by HBC organizations and the CCW volunteers. PMID:24781696

  6. Community care workers, poor referral networks and consumption of personal resources in rural South Africa.

    PubMed

    Sips, Ilona; Haeri Mazanderani, Ahmad; Schneider, Helen; Greeff, Minrie; Barten, Francoise; Moshabela, Mosa

    2014-01-01

    Although home-based care (HBC) programs are widely implemented throughout Africa, their success depends on the existence of an enabling environment, including a referral system and supply of essential commodities. The objective of this study was to explore the current state of client referral patterns and practices by community care workers (CCWs), in an evolving environment of one rural South African sub-district. Using a participant triangulation approach, in-depth qualitative interviews were conducted with 17 CCWs, 32 HBC clients and 32 primary caregivers (PCGs). An open-ended interview guide was used for data collection. Participants were selected from comprehensive lists of CCWs and their clients, using a diversified criterion-based sampling method. Three independent researchers coded three sets of data - CCWs, Clients and PCGs, for referral patterns and practices of CCWs. Referrals from clinics and hospitals to HBC occurred infrequently, as only eight (25%) of the 32 clients interviewed were formally referred. Community care workers showed high levels of commitment and personal investment in supporting their clients to use the formal health care system. They went to the extent of using their own personal resources. Seven CCWs used their own money to ensure client access to clinics, and eight gave their own food to ensure treatment adherence. Community care workers are essential in linking clients to clinics and hospitals and to promote the appropriate use of medical services, although this effort frequently necessitated consumption of their own personal resources. Therefore, risk protection strategies are urgently needed so as to ensure sustainability of the current work performed by HBC organizations and the CCW volunteers.

  7. Community health workers in primary care practice: redesigning health care delivery systems to extend and improve diabetes care in underserved populations.

    PubMed

    Collinsworth, Ashley; Vulimiri, Madhulika; Snead, Christine; Walton, James

    2014-11-01

    New, comprehensive, approaches for chronic disease management are needed to ensure that patients, particularly those more likely to experience health disparities, have access to the clinical care, self-management resources, and support necessary for the prevention and control of diabetes. Community health workers (CHWs) have worked in community settings to reduce health care disparities and are currently being deployed in some clinical settings as a means of improving access to and quality of care. Guided by the chronic care model, Baylor Health Care System embedded CHWs within clinical teams in community clinics with the goal of reducing observed disparities in diabetes care and outcomes. This study examines findings from interviews with patients, CHWs, and primary care providers (PCPs) to understand how health care delivery systems can be redesigned to effectively incorporate CHWs and how embedding CHWs in primary care teams can produce informed, activated patients and prepared, proactive practice teams who can work together to achieve improved patient outcomes. Respondents indicated that the PCPs continued to provide clinical exams and manage patient care, but the roles of diabetes education, nutritional counseling, and patient activation were shifted to the CHWs. CHWs also provided patients with social support and connection to community resources. Integration of CHWs into clinical care teams improved patient knowledge and activation levels, the ability of PCPs to identify and proactively address specific patient needs, and patient outcomes.

  8. The Strengths and Difficulties Questionnaire: A Useful Screening Tool to Identify Mental Health Strengths and Needs in Looked after Children and Inform Care Plans at Looked after Children Reviews? A Focus Group Study of the Views of Social Workers and Their Managers

    ERIC Educational Resources Information Center

    Whyte, Stewart; Campbell, Anne

    2008-01-01

    The mental health of Looked After Children is not routinely assessed either upon entering the care system or during their period in care. Many children only receive help when difficulties become entrenched and more intensive treatment is required. Often this occurs when placements are fragile or have broken down. The Department of Health, Social…

  9. Racial disparities in job strain among American and immigrant long-term care workers

    PubMed Central

    Hurtado, David A.; Sabbath, Erika L.; Ertel, Karen A.; Buxton, Orfeu M.; Berkman, Lisa F.; Cabot, Thomas D.

    2013-01-01

    Background Nursing homes are occupational settings, with an increasing minority and immigrant workforce where several psychosocial stressors intersect. Aim To examine racial/ethnic differences in job strain between Black (n=127) and White (n=110) immigrant and American direct-care workers at nursing homes (total n=237). Methods Cross-sectional study with data collected at four nursing homes in Massachusetts, during 2006-2007. We contrasted Black and White workers within higher-skilled occupations such as Registered Nurses (RNs) or Licensed Practical Nurses (LPNs, n=82) and lower-skilled staff such as Certified Nursing Assistants (CNAs, n=155). Results Almost all Black workers (96 percent) were immigrants. After adjusting for demographic and occupational characteristics, Black employees were more likely to report job strain, compared to Whites (Relative Risk [RR]: 2.9, 95% CI 1.3 to 6.6). Analyses stratified by occupation showed that Black CNAs were more likely to report job strain, compared to White CNAs (RR: 3.1, 95% CI: 1.0 to 9.4). Black workers were also more likely to report low control (RR: 2.1, 95% CI: 1.1 to 4.0). Additionally, Black workers earned $2.58 less per hour and worked 7.1 more hours per week on average, controlling for potential confounders. Conclusion Black immigrant workers were 2.9 times more likely to report job strain than Whites, with greater differences among CNAs. These differences may reflect organizational and job characteristics, individual characteristics, or potentially interpersonal or institutional racial or ethnic discrimination. Further research should consider the role of race/ethnicity in shaping patterns of occupational stress. PMID:22591096

  10. Inverse roles of emotional labour on health and job satisfaction among long-term care workers in Japan.

    PubMed

    Tsukamoto, Erika; Abe, Takeru; Ono, Michikazu

    2015-01-01

    Emotional labour increases among long-term care workers because providing care and services to impaired elders causes conflicting interpersonal emotions. Thus, we investigated the associations between emotional labour, general health and job satisfaction among long-term care workers. We conducted a cross-sectional study among 132 established, private day care centres in Tokyo using a mail survey. The outcome variables included two health-related variables and four job satisfaction variables: physical and psychological health, satisfaction with wages, interpersonal relationships, work environment and job satisfaction. We performed multiple regression analyses to identify significant factors. Directors from 36 facilities agreed to participate. A total of 123 responses from long-term care workers were analysed. Greater emotional dissonance was associated with better physical and psychological health and worse work environment satisfaction (partial regression coefficient: -2.93, p = .0389; -3.32, p = .0299; -1.92, p = .0314, respectively). Fewer negative emotions were associated with more job satisfaction (partial regression coefficient: -1.87, p = .0163). We found that emotional labour was significantly inversely associated with health and job satisfaction. Our findings indicated that the emotional labour of long-term care workers has a negative and positive influence on health and workplace satisfaction, and suggests that care quality and stable employment among long-term care workers might affect their emotional labour. Therefore, we think a programme to support emotional labour among long-term care workers in an organized manner and a self-care programme to educate workers regarding emotional labour would be beneficial. PMID:25263457

  11. Health care innovation: progress report and focus on biotechnology.

    PubMed

    Read, J L; Lee, K B

    1994-01-01

    Funding for biomedical research has shifted from government to the private sector. One reason is rapid expansion in the number and strength of U.S. biotechnology companies, which collectively spend more than $6 billion a year on biomedical research. Most of these companies are not yet profitable and therefore depend on flows of capital from private investors, Wall Street, and large pharmaceutical company collaborations. Investment in the new drugs, devices, and vaccines in this pipeline is sensitive to signals emanating from the debate on health care reform, suggesting that new federal policy will have a major impact on steering the type of innovation to emerge in the future.

  12. [TUTORS AND NURSING STUDENTS WITH FOCUS ON PRIMARY CARE].

    PubMed

    Berlanga Fernández, Sofía; Solà Pola, M Montserrat; Fabrellas-Padrgs, Nuria; Berlanga Fernández, Francisco

    2015-09-01

    Primary Health Care sets up an area influenced by the relationship between professionals and users, in which different disciplines, such as nursing, develop their learning procedures both in graduate and postgraduate training. In this context, students are tutored by professionals who have developed teaching skills. Along these lines, this manuscript aims to identifying the different types of nursing students and tutors who develop their teaching skills in Primary Health Centers. To this purpose, we invite the reader to know the historical and current milestones that characterize teaching systems and influence learning profiles of students and teachers.

  13. [TUTORS AND NURSING STUDENTS WITH FOCUS ON PRIMARY CARE].

    PubMed

    Berlanga Fernández, Sofía; Solà Pola, M Montserrat; Fabrellas-Padrgs, Nuria; Berlanga Fernández, Francisco

    2015-09-01

    Primary Health Care sets up an area influenced by the relationship between professionals and users, in which different disciplines, such as nursing, develop their learning procedures both in graduate and postgraduate training. In this context, students are tutored by professionals who have developed teaching skills. Along these lines, this manuscript aims to identifying the different types of nursing students and tutors who develop their teaching skills in Primary Health Centers. To this purpose, we invite the reader to know the historical and current milestones that characterize teaching systems and influence learning profiles of students and teachers. PMID:26738232

  14. Status of Oregon's Children: 1998 County Data Book. Special Focus: Children's Health Care.

    ERIC Educational Resources Information Center

    Children First for Oregon, Portland.

    This Kids Count report examines statewide trends in the well-being of Oregon's children, focusing on children's health care. The statistical portrait is based on indicators of well-being including: (1) children's insurance coverage; (2) health care access; (3) health outcomes, including immunization rates and early prenatal care; (4) juvenile…

  15. 'Sometimes they fail to keep their faith in us': community health worker perceptions of structural barriers to quality of care and community utilisation of services in Bangladesh.

    PubMed

    Puett, Chloe; Alderman, Harold; Sadler, Kate; Coates, Jennifer

    2015-10-01

    Community health workers (CHWs) have strong potential to extend health and nutrition services to underserved populations. However, CHWs face complex challenges when working within weak health systems and among communities with limited abilities to access and utilise CHW services. It is crucial to understand these challenges to improve programme support mechanisms. This study describes the results of qualitative investigations into CHW perceptions of barriers to quality of care among two groups of workers implementing community case management of acute respiratory infection, diarrhoea and severe acute malnutrition in southern Bangladesh. We explored systemic barriers to service delivery, pertaining to communities and health systems, which limited the usefulness and effectiveness of CHW services. Focus group discussions (n = 10) were conducted in March 2010. Discussions were analysed for themes related to CHWs' work challenges. Findings highlight several perceived barriers to effective service provision, including community poverty constraining uptake of recommended practices, irregular supplies of medicine from the health facility and poor quality of care for CHW referrals sent there. This study further documents interactions between demand-side and supply-side constraints including the influence of health system resource constraints on community trust in CHW services, and the influence of community resource constraints on the utilisation and effectiveness of CHW services. By documenting service delivery challenges from the perspective of the frontline workers themselves, this article contributes evidence to help identify appropriate support mechanisms for these workers, in order to develop scalable and sustainable CHW programmes in countries with under-resourced public health care infrastructure.

  16. Health care worker protection in mass casualty respiratory failure: infection control, decontamination, and personal protective equipment.

    PubMed

    Daugherty, Elizabeth L

    2008-02-01

    Maintenance of a safe and stable health care infrastructure is critical to an effective mass casualty disaster response. Both secondary contamination during chemical disasters and hospital-associated infections during epidemic illness can pose substantial threats to achieving this goal. Understanding basic principles of decontamination and infection control during responses to chemical and biologic disasters can help minimize the risks to patients and health care workers. Effective decontamination following toxic chemical exposure should include both removal of contaminated clothing and decontamination of the victim's skin. Wet decontamination is the most feasible strategy in a mass casualty situation and should be performed promptly by trained personnel. In the event of an epidemic, infection prevention and control measures are based on essential principles of hand hygiene and standard precautions. Expanded precautions should be instituted as needed to target contact, droplet, and airborne routes of infectious disease transmission. Specific equipment and measures for critical care delivery may serve to decrease risk to health care workers in the event of an epidemic. Their use should be considered in developing comprehensive disaster response plans.

  17. Safe practice of population-focused nursing care: Development of a public health nursing concept.

    PubMed

    Issel, L Michele; Bekemeier, Betty

    2010-01-01

    Patient safety, a cornerstone of quality nursing care in most healthcare organizations, has not received attention in the specialty of public health nursing, owing to the conceptual challenges of applying this individual level concept to populations. Public health nurses (PHNs), by definition, provide population-focused care. Safe practice of population-focused nursing care involves preventing errors that would affect the health of entire populations and communities. The purpose of this article is to conceptually develop the public health nursing concept of safe practice of population-focused care and calls for related research. Key literature on patient safety is reviewed. Concepts applying to population-focused care are organized based on Donabedian's Framework. Structural, operational and system failures and process errors of omission and commission can occur at the population level of practice and potentially influence outcomes for population-patients. Practice, research and policy implications are discussed. Safe PHN population-focused practice deserves attention.

  18. Primary care mental health workers: models of working and evidence of effectiveness.

    PubMed Central

    Bower, Peter

    2002-01-01

    The NHS Plan proposed the creation of a new role in primary care to assist with the management of common mental health problems: the primary care mental health worker (PCMHW). However, it is not clear how PCMHWs should be employed to be most effective. Current literature concerning different models of mental health care is reviewed. This suggests that four key dimensions are of relevance: the types of patients that PCMHWs will manage; the degree to which PCMHWs will work autonomously, or as part of a system of care; at what stage in patients' illness trajectory they will intervene; and whether the role of PCMHWs will be related to clinical interventions, or whether they will have a wider, non-clinical role in the organisation and monitoring of care. Finally, published data concerning relevant interventions are presented. Experimental studies reporting the empirical outcomes associated with these models are reviewed in relation to four different outcomes: clinical effectiveness, cost effectiveness, patient satisfaction, and access to care. The data suggest that problem-solving therapy, group psycho-education, self-help, and some models of 'collaborative care' may be highly relevant to PCMHWs. Each model provides different advantages and disadvantages in terms of the four dimensions of outcome. PMID:12434963

  19. A Descriptive Analysis of Incidents Reported by Community Aged Care Workers.

    PubMed

    Tariq, Amina; Douglas, Heather E; Smith, Cheryl; Georgiou, Andrew; Osmond, Tracey; Armour, Pauline; Westbrook, Johanna I

    2015-07-01

    Little is known about the types of incidents that occur to aged care clients in the community. This limits the development of effective strategies to improve client safety. The objective of the study was to present a profile of incidents reported in Australian community aged care settings. All incident reports made by community care workers employed by one of the largest community aged care provider organizations in Australia during the period November 1, 2012, to August 8, 2013, were analyzed. A total of 356 reports were analyzed, corresponding to a 7.5% incidence rate per client year. Falls and medication incidents were the most prevalent incident types. Clients receiving high-level care and those who attended day therapy centers had the highest rate of incidents with 14% to 20% of these clients having a reported incident. The incident profile indicates that clients on higher levels of care had higher incident rates. Incident data represent an opportunity to improve client safety in community aged care. PMID:25526960

  20. Assessment of fitness for work in health care workers: biomechanical risk factors.

    PubMed

    Violante, E S; Mattioli, S; Camagni, Angela; Bottoli, Elena; Farioli, A; Bonfiglioli, Roberta

    2012-01-01

    In current practice the assessment of fitness for work in health care workers exposed to biomechanical risk factors is often based on conventional approaches rather than on evidence-based guidelines. However, an accurate evaluation of worker's psychophysical resources compared to job demand and potential occupational risk factors is essential in order to properly assess fitness for work. The latest published guidelines on the management of patients suffering from back pain reported that the evidence-based approach can minimize the period of inactivity by encouraging return to work (and to other non-dangerous physical activities) in a relatively short period of time. As for carpal tunnel syndrome, there is no scientific evidence supporting a restriction of physical activities requiring forceful movements of the hand/wrist. PMID:22838297

  1. Migration of health-care workers from developing countries: strategic approaches to its management.

    PubMed Central

    Stilwell, Barbara; Diallo, Khassoum; Zurn, Pascal; Vujicic, Marko; Adams, Orvill; Dal Poz, Mario

    2004-01-01

    Of the 175 million people (2.9% of the world's population) living outside their country of birth in 2000, 65 million were economically active. The rise in the number of people migrating is significant for many developing countries because they are losing their better-educated nationals to richer countries. Medical practitioners and nurses represent a small proportion of the highly skilled workers who migrate, but the loss for developing countries of human resources in the health sector may mean that the capacity of the health system to deliver health care equitably is significantly compromised. It is unlikely that migration will stop given the advances in global communications and the development of global labour markets in some fields, which now include nursing. The aim of this paper is to examine some key issues related to the international migration of health workers and to discuss strategic approaches to managing migration. PMID:15375449

  2. Health Care Workers in the Dominican Republic: Self-perceived role in smoking cessation

    PubMed Central

    Ossip-Klein, Deborah J.; Diaz, Sergio; Sierra, Essie; Quiñones, Zahira; Armstrong, Latoya; Chin, Nancy P.; McIntosh, Scott

    2013-01-01

    A Dominican Republic (DR) based multi-community trial of smoking cessation viewed health care workers (HCWs) as potential interventionists. Effectively engaging them, requires a clear understanding of their attitudes and practices regarding smoking. A Rapid Assessment Procedure, conducted among HCWs in six economically disadvantaged communities, included physicians, nurses, other health professionals, paraprofessionals and lay workers. Attitudes and practices about smoking were consistent across the 82 HCWs and mostly reflected community views. HCWs lacked proactiveness related to smoking cessation and had a limited view of their role, attributing clients’ quitting successes to personal will. Prior cessation training was limited although interest was generally high. Material resources about smoking cessation were virtually absent. DR HCWs’ views represented features both distinct from and common to HCWs elsewhere. Any intervention with HCWs must first raise awareness before addressing their role in smoking cessation, discussing implementation barriers and include training and materials about risks and effective interventions. PMID:19448160

  3. Differences in Hospital Managers', Unit Managers', and Health Care Workers' Perceptions of the Safety Climate for Respiratory Protection.

    PubMed

    Peterson, Kristina; Rogers, Bonnie M E; Brosseau, Lisa M; Payne, Julianne; Cooney, Jennifer; Joe, Lauren; Novak, Debra

    2016-07-01

    This article compares hospital managers' (HM), unit managers' (UM), and health care workers' (HCW) perceptions of respiratory protection safety climate in acute care hospitals. The article is based on survey responses from 215 HMs, 245 UMs, and 1,105 HCWs employed by 98 acute care hospitals in six states. Ten survey questions assessed five of the key dimensions of safety climate commonly identified in the literature: managerial commitment to safety, management feedback on safety procedures, coworkers' safety norms, worker involvement, and worker safety training. Clinically and statistically significant differences were found across the three respondent types. HCWs had less positive perceptions of management commitment, worker involvement, and safety training aspects of safety climate than HMs and UMs. UMs had more positive perceptions of management's supervision of HCWs' respiratory protection practices. Implications for practice improvements indicate the need for frontline HCWs' inclusion in efforts to reduce safety climate barriers and better support effective respiratory protection programs and daily health protection practices.

  4. The facilitators of communication with people with dementia in a care setting: an interview study with healthcare workers

    PubMed Central

    Stanyon, Miriam Ruth; Griffiths, Amanda; Thomas, Shirley A.; Gordon, Adam Lee

    2016-01-01

    Objectives: to describe the views of healthcare workers on the facilitators of communication with people with dementia in a care setting. Design: thematic analysis of semi-structured interviews. Setting: all participants were interviewed in their place of work. Participants: sixteen healthcare workers whose daily work involves interacting with people with dementia. Results: four overarching categories of themes were identified from the interviews that impact on communication: the attributes of a care worker, communication strategies used, organisational factors and the physical characteristics of the care environment. Conclusion: many strategies used by healthcare workers to facilitate communication have not yet been studied in the research literature. Participants' views on training should be incorporated into future dementia training programmes. PMID:26764403

  5. The free health care initiative: how has it affected health workers in Sierra Leone?

    PubMed

    Witter, Sophie; Wurie, Haja; Bertone, Maria Paola

    2016-02-01

    There is an acknowledged gap in the literature on the impact of fee exemption policies on health staff, and, conversely, the implications of staffing for fee exemption. This article draws from five research tools used to analyse changing health worker policies and incentives in post-war Sierra Leone to document the effects of the Free Health Care Initiative (FHCI) of 2010 on health workers.Data were collected through document review (57 documents fully reviewed, published and grey); key informant interviews (23 with government, donors, NGO staff and consultants); analysis of human resource data held by the MoHS; in-depth interviews with health workers (23 doctors, nurses, mid-wives and community health officers); and a health worker survey (312 participants, including all main cadres). The article traces the HR reforms which were triggered by the FHCI and evidence of their effects, which include substantial increases in number and pay (particularly for higher cadres), as well as a reported reduction in absenteeism and attrition, and an increase (at least for some areas, where data is available) in outputs per health worker. The findings highlight how a flagship policy, combined with high profile support and financial and technical resources, can galvanize systemic changes. In this regard, the story of Sierra Leone differs from many countries introducing fee exemptions, where fee exemption has been a stand-alone programme, unconnected to wider health system reforms. The challenge will be sustaining the momentum and the attention to delivering results as the FHCI ceases to be an initiative and becomes just 'business as normal'. The health system in Sierra Leone was fragile and conflict-affected prior to the FHCI and still faces significant challenges, both in human resources for health and more widely, as vividly evidenced by the current Ebola crisis.

  6. Job Burnout, Job Satisfaction, and Related Factors among Health Care Workers in Golestan Province, Iran

    PubMed Central

    Kabir, Mohammad Javad; Heidari, Alireza; Etemad, Koorosh; Gashti, Ashrafi Babazadeh; Jafari, Nahid; Honarvar, Mohammad Reza; Ariaee, Mohammad; Lotfi, Mansureh

    2016-01-01

    Introduction Burnout causes physical and emotional tireness, job dissatisfaction, resulting in reduced efficiency and a feeling of alienation from colleagues. Also, job satisfaction has a major impact on job-related behaviors, such as turnover intention, absenteeism, and job performance. The aim of this study was to determine job burnout, job satisfaction rate, and related factors among health care workers in Golestan Province in Iran. Methods This cross-sectional study was conducted with 1,141 health workers in Golestan Province in northern Iran. Data were collected using a questionnaire that was comprised of four sections. It consisted of socio-economic characteristics, physical environment and facilities of health house (rural health clinic), Maslach burnout inventory, and a satisfaction questionnaire. Multi-nomial Logistic Regression was conducted to analyze the data using SPSS software, version 22. Results There were significant relationships between the intensity of job burnout and age (p < 0.001), years of experience (p < 0.001), low education level (p = 0.027), number of children (p = 0.002), dissatisfaction with income (p < 0.001), physical environment of health houses (p = 0.003), facilities of health houses (p = 0.025). There were significant relationships between the frequency of job burnout and age (p < 0.001), years of experience (p < 0.001), low education level (p = 0.016), number of children (p = 0.003), dissatisfaction with income (p < 0.001), and the physical environment of health houses (p = 0.008). There were significant relationships between job satisfaction and the satisfaction from income (p = 0.001), the physical environment of health houses (p = 0.001), and the facilities of health houses (p = 0.001). Conclusion Burnout was average among health workers, and health workers job satisfaction rate was lower than the average level in health workers. Effective interventions are recommended with regards to the unfavorable condition of job

  7. Medical supplies shortages and burnout among greek health care workers during economic crisis: a pilot study.

    PubMed

    Rachiotis, George; Kourousis, Christos; Kamilaraki, Maria; Symvoulakis, Emmanouil K; Dounias, George; Hadjichristodoulou, Christos

    2014-01-01

    Greece has been seriously affected by the economic crisis. In 2011 there were reports of 40% reduction to public hospital budgets. Occasional shortages of medical supplies have been reported in mass media. We attempted to pivotally investigate the frequency of medical supplies shortages in two Greek hospital units of the National Health System and to also assess their possible impact on burnout risk of health care workers. We conducted a cross-sectional study (n=303) of health care workers in two Greek hospitals who were present at the workplace during a casually selected working day (morning shift work). The Maslach Burnout Inventory (MBI) was used as the measure of burnout. An additional questionnaire was used about demographics, and working conditions (duration of employment, cumulative night shifts, type of hospital including medical supplies shortages and their impact on quality of healthcare. The prevalence of emotional exhaustion, depersonalization and low personal accomplishment was 44.5%, 43.2% and 51.5%, respectively. Medical supply shortages were significantly associated with emotional exhaustion and depersonalization. This finding provides preliminary evidence that austerity has affected health care in Greece. Moreover, the medical supply shortages in Greek hospitals may reflect the unfolding humanitarian crisis of the country.

  8. Medical supplies shortages and burnout among greek health care workers during economic crisis: a pilot study.

    PubMed

    Rachiotis, George; Kourousis, Christos; Kamilaraki, Maria; Symvoulakis, Emmanouil K; Dounias, George; Hadjichristodoulou, Christos

    2014-01-01

    Greece has been seriously affected by the economic crisis. In 2011 there were reports of 40% reduction to public hospital budgets. Occasional shortages of medical supplies have been reported in mass media. We attempted to pivotally investigate the frequency of medical supplies shortages in two Greek hospital units of the National Health System and to also assess their possible impact on burnout risk of health care workers. We conducted a cross-sectional study (n=303) of health care workers in two Greek hospitals who were present at the workplace during a casually selected working day (morning shift work). The Maslach Burnout Inventory (MBI) was used as the measure of burnout. An additional questionnaire was used about demographics, and working conditions (duration of employment, cumulative night shifts, type of hospital including medical supplies shortages and their impact on quality of healthcare. The prevalence of emotional exhaustion, depersonalization and low personal accomplishment was 44.5%, 43.2% and 51.5%, respectively. Medical supply shortages were significantly associated with emotional exhaustion and depersonalization. This finding provides preliminary evidence that austerity has affected health care in Greece. Moreover, the medical supply shortages in Greek hospitals may reflect the unfolding humanitarian crisis of the country. PMID:24688306

  9. Health-care worker engagement in HIV-related quality improvement in Dar es Salaam, Tanzania

    PubMed Central

    Garcia, Maria E.; Li, Michelle S.; Siril, Hellen; Hawkins, Claudia; Kaaya, Sylvia; Ismail, Shabbir; Chalamilla, Guerino; Mdingi, Sarah Geoffrey; Hirschhorn, Lisa R.

    2011-01-01

    Objective To assess health-care worker (HCW) awareness, interest and engagement in quality improvement (QI) in HIV care sites in Tanzania. Design Cross-sectional survey distributed in May 2009. Setting Sixteen urban HIV care sites in Dar es Salaam, Tanzania, 1 year after the introduction of a quality management program. Participants Two hundred seventy-nine HCWs (direct care, clinical support staff and management). Main Outcome Measures HCW perceptions of care delivered, rates of engagement, knowledge and interest in QI. HCW-identified barriers to and facilitators of the delivery of quality HIV care. Results Two hundred seventy-nine (73%) of 382 HCWs responded to the survey. Most (86%) felt able to meet clients’ needs. HCW-identified facilitators of quality included: teamwork (88%), staff communication (79%), positive work environment (75%) and trainings (84%). Perceived barriers included: problems in patients’ lives (73%) and too few staff or too high patient volumes (52%). Many HCWs knew about specific QI activities (52%) or had been asked for input on QI (63%), but fewer (40.5%) had participated in activities and only 20.1% were currently QI team members. Managers were more likely to report QI involvement than direct care or clinical support staff (P < 0.01). No difference in QI involvement was seen based on patient load or site type. Conclusions HCWs can provide important insights into barriers and facilitators of providing quality care and can be effectively engaged in QI activities. HCW participation in efforts to improve services will ensure that HIV/AIDS quality of care is achieved and maintained as countries strive for universal antiretroviral access. PMID:21441571

  10. Low back pain among care workers working at newly-built nursing homes for the aged.

    PubMed

    Tomioka, Kimiko

    2008-05-01

    The aim of this study was to investigate the association between severe low back pain (LBP) and work load for care workers (CWs) who were working at newly-built special nursing homes, because it has long been known that LBP is very common among CWs, and we consider that measures to reduce serious LBP should be the top priority. A total of 258 questionnaires were distributed to all CWs employed at 7 nursing homes. There were 214 replies, a response rate of 82.9%. The average age of respondents was 28.8 years old. A total of 212 (59 males and 153 females) completed questionnaires were analyzed. The results of factor analysis were based on 22 original questions about physical and mental care work load. Sixteen questions and 5 subscales were explored. Factor 1 was characteristics and ADL of care receivers; Factor 2, violence by care receivers; Factor 3, communication with staff at workplace; Factor 4, problems with work environment; and Factor 5, communication with care receivers. Severe LBP was defined as a subject who had always suffered from LBP in the last one month. Multiple logistic regression analysis was performed to estimate the relationship of severe LBP and care work load. Adjustments were made for sex and job tenure. In Factor 1, "characteristics and ADL of care receivers", heavy weight showed significant association, with adjusted Odds Ratios of 6.63 (95%CI: 1.71-25.75). Therefore, to prevent LBP of CWs, it is necessary to make staff assignments and to provide assistive devices based on careful considerations of the characteristics and ADL of care receivers. PMID:18434702

  11. Folding and unfolding manual wheelchairs: an ergonomic evaluation of health-care workers.

    PubMed

    White, Heather A; Lee Kirby, R

    2003-11-01

    The objective of this study was to test the hypotheses (i) that health-care workers vary greatly in the methods used to fold and unfold selected manual wheelchairs, and (ii) that many of the methods used include bent and twisted back postures that are known to be associated with a high risk of injury. We studied 20 health-care workers in a rehabilitation center. Subjects folded and unfolded two wheelchairs of cross-brace design, one with and one without a sling seat. As outcome measures, we used a questionnaire, time taken, visual analog scales of perceived exertion and back strain, folded width, videotape and Ovako Working Posture Analysis System (OWAS) back scores (1-4). Subjects used up to 14 different combinations of approach, hand placement and back posture to accomplish the tasks. The mean OWAS scores were in the 2.4-3.1 range and 49 (42%) of the 118 scores recorded were class 4 (back simultaneously "bent and twisted", considered to be associated with the highest risk of injury). We also observed methods that appeared to be safe and effective. Age, gender, profession, experience and seat condition did not generally influence the outcome measures. We conclude that health-care workers use a variety of methods to fold and unfold wheelchairs, many of which include bent and twisted back postures that may carry a risk of injury. Further study is needed to confirm this risk, to identify more ergonomically sound wheelchair designs and to develop better methods of carrying out the common and important task of folding and unfolding wheelchairs.

  12. Psychosocial factors and prevalence of burnout syndrome among nursing workers in intensive care units

    PubMed Central

    da Silva, Jorge Luiz Lima; Soares, Rafael da Silva; Costa, Felipe dos Santos; Ramos, Danusa de Souza; Lima, Fabiano Bittencourt; Teixeira, Liliane Reis

    2015-01-01

    Objective To evaluate the prevalence of burnout syndrome among nursing workers in intensive care units and establish associations with psychosocial factors. Methods This descriptive study evaluated 130 professionals, including nurses, nursing technicians, and nursing assistants, who performed their activities in intensive care and coronary care units in 2 large hospitals in the city of Rio de Janeiro, Brazil. Data were collected in 2011 using a self-reported questionnaire. The Maslach Burnout Inventory was used to evaluate the burnout syndrome dimensions, and the Self Reporting Questionnaire was used to evaluate common mental disorders. Results The prevalence of burnout syndrome was 55.3% (n = 72). In the quadrants of the demand-control model, low-strain workers exhibited a prevalence of 64.5% of suspected cases of burnout, whereas high-strain workers exhibited a prevalence of 72.5% of suspected cases (p = 0.006). The prevalence of suspected cases of common mental disorders was 27.7%; of these, 80.6% were associated with burnout syndrome (< 0.0001). The multivariate analysis adjusted for gender, age, educational level, weekly work duration, income, and thoughts about work during free time indicated that the categories associated with intermediate stress levels - active work (OR = 0.26; 95%CI = 0.09 - 0.69) and passive work (OR = 0.22; 95%CI = 0.07 - 0.63) - were protective factors for burnout syndrome. Conclusion Psychosocial factors were associated with the development of burnout syndrome in this group. These results underscore the need for the development of further studies aimed at intervention and the prevention of the syndrome. PMID:26340152

  13. Identification of a 46-kD latex protein allergen in health care workers.

    PubMed Central

    Beezhold, D H; Sussman, G L; Kostyal, D A; Chang, N S

    1994-01-01

    Latex allergy is an occupational hazard for health care workers. Extractable latex proteins are known to be allergenic, but most latex allergens have not been specifically identified. The purpose of this study was to characterize the IgE response of latex-allergic patients to latex proteins and to identify common protein allergens. Serum was obtained from 40 individuals who were skin test-positive to latex; 85% were health care workers. Western blots for IgE reactivity were performed using both ammoniated (AL) and non-ammoniated (NAL) latex proteins and IgE-reactive NAL proteins were analysed by microsequence analysis. The patients were grouped according to common patterns of reactivity. Pattern 1, the most common pattern of reactivity (9/40 patients) recognized two protein bands in both NAL and AL at 46 and 110 kD. A second, heterogeneous pattern of reactivity (pattern 2) recognized a diffuse pattern of polypeptides in the AL preparation. The n-terminal amino acid sequences for allergens at 14, 18, 29, 46 and 110 kD were determined. Sequence analysis identified the 14-kD and 18-kD allergens as the hevein proprotein. The 46-kD and 110-kD had identical sequences which were unique from known latex proteins. We conclude that multiple latex proteins are allergens with hevein preprotein and a previously unidentified 46/110-kD protein being commonly recognized in health care workers. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 PMID:7994905

  14. [The Relationship Between Burnout Symptoms and Work Satisfaction Among Child Welfare Workers in Residential Care].

    PubMed

    Steinlin, Célia; Dölitzsch, Claudia; Fischer, Sophia; Schmeck, Klaus; Fegert, Jörg M; Schmid, Marc

    2016-01-01

    Working in residential care is associated with high demands and high stress. As a result, employees may develop symptoms of burnout. These symptoms lead to absence from work and have a negative effect on the continuity and quality of the residential care. Until now, little is known about burnout risks in child welfare workers, although children and adolescents are especially dependent on continuous relationships and healthy caregivers. A better understanding of the relationship between burnout symptoms and work satisfaction may help to identify starting points for prevention and intervention. The present study assessed symptoms of burnout in a sample of 319 social education workers in residential care in Switzerland using the burnout-screening-scales (BOSS). Work satisfaction was assessed with a newly developed questionnaire based on concepts of trauma-sensitive care. The questionnaire was tested for reliability and factorial validity in the present study. In order to estimate the relationship between burnout symptoms and work satisfaction, correlations and relative risks were calculated. Almost one fifth (18 %) of the sample showed a risk of burnout. The principal component analysis of the questionnaire on work satisfaction revealed four factors: support by superiors, participation and transparency; communication and support within the team; gratification in the work; and institutional structures and resources. All four factors as well as the total score showed significant correlations with burnout symptoms. Among employees with a comparably lower work satisfaction, the risk of burnout was 5.4 times higher than among employees with a comparably higher work satisfaction. It is discussed how work satisfaction could be promoted and how, as a result, the quality and continuity of care for the children and adolescents could be improved.

  15. [The Relationship Between Burnout Symptoms and Work Satisfaction Among Child Welfare Workers in Residential Care].

    PubMed

    Steinlin, Célia; Dölitzsch, Claudia; Fischer, Sophia; Schmeck, Klaus; Fegert, Jörg M; Schmid, Marc

    2016-01-01

    Working in residential care is associated with high demands and high stress. As a result, employees may develop symptoms of burnout. These symptoms lead to absence from work and have a negative effect on the continuity and quality of the residential care. Until now, little is known about burnout risks in child welfare workers, although children and adolescents are especially dependent on continuous relationships and healthy caregivers. A better understanding of the relationship between burnout symptoms and work satisfaction may help to identify starting points for prevention and intervention. The present study assessed symptoms of burnout in a sample of 319 social education workers in residential care in Switzerland using the burnout-screening-scales (BOSS). Work satisfaction was assessed with a newly developed questionnaire based on concepts of trauma-sensitive care. The questionnaire was tested for reliability and factorial validity in the present study. In order to estimate the relationship between burnout symptoms and work satisfaction, correlations and relative risks were calculated. Almost one fifth (18 %) of the sample showed a risk of burnout. The principal component analysis of the questionnaire on work satisfaction revealed four factors: support by superiors, participation and transparency; communication and support within the team; gratification in the work; and institutional structures and resources. All four factors as well as the total score showed significant correlations with burnout symptoms. Among employees with a comparably lower work satisfaction, the risk of burnout was 5.4 times higher than among employees with a comparably higher work satisfaction. It is discussed how work satisfaction could be promoted and how, as a result, the quality and continuity of care for the children and adolescents could be improved. PMID:26947529

  16. Survey of heat use during peripheral IV insertion by health care workers.

    PubMed

    Kiger, Tammy; Knudsen, Élise Arsenault; Curran, Wendy; Hunter, Julia; Schaub, Anna; Williams, Mary Jane; Zechel, Janet; Kwekkeboom, Kristine

    2014-01-01

    Health care workers at an academic medical center in the Midwest were surveyed to identify common practices regarding heat use during peripheral intravenous (PIV) catheter insertion. Of the 907 who responded, the majority used heat to facilitate PIV insertion at least sometimes, when veins were not easily seen or not palpable, applying a commercial dry hot pack for 2 to 5 minutes before selecting an insertion site. Heat use correlated with practice role and population, frequency of PIV insertion, and perceived PIV skill. Findings will guide development of a research protocol to compare the effects of dry heat, moist heat, and no heat on PIV insertion success.

  17. HCV infection: aspects of epidemiology and transmission relevant to oral health care workers.

    PubMed

    Leao, J C; Teo, C G; Porter, S R

    2006-04-01

    Hepatitis C virus (HCV) infection is a common worldwide problem, giving rise to long-term viral carriage and risk of chronic hepatic disease, hepatic malignancy and a wide spectrum of immunologically mediated disorders. The present report describes relevant data suggesting that nosocomial transmission to oral health care workers is unlikely, but in view of medical and occupational consequences of such infection, and the absence of long-term effective treatment or vaccine, the oral surgery profession must continue to be vigilant and to maintain the highest standards of infection control procedures to minimize the possible acquisition of HCV during dental treatment.

  18. Caring for Children and Youth Who Have Been Sexually Abused: A Training Manual for Child and Youth Care Workers and Foster Parents. Second Edition.

    ERIC Educational Resources Information Center

    Croll, Linda

    This manual, which incorporates a developmental perspective, targets child and youth care workers and foster parents who are ready to enhance their practical skills in providing care and treatment for young people who have been sexually abused. Users of this manual should have some previous understanding in human growth and development, effective…

  19. Increasing Knowledge, Skills, and Empathy among Direct Care Workers in Elder Care: A Preliminary Study of an Active-Learning Model

    ERIC Educational Resources Information Center

    Braun, Kathryn L.; Cheang, Michael; Shigeta, Dennis

    2005-01-01

    Purpose: We describe the development of a 24-hr curriculum for nonclinical direct care workers in elder care that features active-learning strategies and consumer-directed approaches. Design and Methods: Our curricular design was based on adult education theory and a survey of 70% of the community's service providers. Training was completed by 88…

  20. Workforce Training: Employed Worker Programs Focus on Business Needs, But Revised Performance Measures Could Improve Access for Some Workers. Report to Congressional Requesters.

    ERIC Educational Resources Information Center

    General Accounting Office, Washington, DC.

    The General Accounting Office (GAO) examined publicly supported training programs for employed workers, including low-wage workers. The GAO surveyed local workforce boards nationwide and received responses from 470 boards. Two-thirds of the responding boards provided assistance to train employed workers, including partnering with employers to…

  1. Alcohol Outlet Workers and Managers: Focus Groups on Responsible Service Practices.

    ERIC Educational Resources Information Center

    Gehan, John P.; Toomey, Traci L.; Jones-Webb, Rhonda; Rothstein, Catherine; Wagenaar, Alexander C.

    1999-01-01

    Reports on focus group discussions with managers, bartenders, waitstaff, and security staff of retail alcohol establishments. Purpose of the focus groups was to identify beliefs, attitudes, behaviors, and practices among management and staff to guide development of training programs. Results indicate that, compared to management, staff had…

  2. Occupational HIV risk for health care workers: risk factor and the risk of infection in the course of professional activities

    PubMed Central

    Wyżgowski, Przemysław; Rosiek, Anna; Grzela, Tomasz; Leksowski, Krzysztof

    2016-01-01

    Virtually created panic among health care workers about pandemic acquired immune deficiency syndrome prompted us to review the scientific literature to investigate the risk of human immunodeficiency virus (HIV) transmission in the daily works of health care workers, especially surgeons and anesthesiologists. In this review, we report worldwide valuations of the number of HIV infections that may occur from unsafe daily work in health care. We also present how to minimize the risk of infection by taking precautions and how to utilize postexposure prophylaxis in accordance with the latest reports of the Centers for Disease Control and Prevention. HIV-infected patients will be aging, and most of them will become the candidates for procedures such as major vascular reconstruction and artery bypass grafting, where the risks of blood contact and staff injury are high. For these reasons, all health care workers need to know how to prevent, and fight following the accidental exposure to HIV. PMID:27366077

  3. Using function-focused care to increase physical activity among older adults.

    PubMed

    Resnick, Barbara; Galik, Elizabeth

    2013-01-01

    Despite the known benefits of physical activity for older adults, adherence to regular physical activity recommendations is poor. Less than half of adults in this country meet physical activity recommendations with reasons for lack of adherence including such things as access, motivation, pain, fear, comorbidities, among others. To overcome these challenges, function-focused care was developed. Function-focused care is a philosophy of care that focuses on evaluating the older adult's underlying capability with regard to function and physical activity and helping him or her optimize and maintain physical function and ability and continually increase time spent in physical activity. Examples of function-focused care include such things as using verbal cues during bathing, so the older individual performs the tasks rather than the caregiver bathing the individual; walking a resident or patient to the bathroom rather than using a urinal, or taking a resident to an exercise class. There are now over 20 studies supporting the benefits of function-focused care approaches across all settings and different types of patient groups (i.e, those with mild versus moderate-to-severe cognitive impairment). The approaches for implementation of function-focused care have also been well supported and have moved beyond establishing effectiveness to considering dissemination and implementation of this approach into real world clinical settings. The process of dissemination and implementation has likewise been articulated and supported, and ongoing work needs to continue in this venue across all care settings. PMID:24894140

  4. Effect of end of life education on medical students' and health care workers' death attitude.

    PubMed

    Hegedus, K; Zana, A; Szabó, G

    2008-04-01

    One of the goals of education in end of life care is to make communication more open by exploring critical issues related to fear of dying and death in order to reduce anxiety and improve an individual's attitude to dying patients. The aim of our research was to evaluate the effects of courses for health care workers and medical students in care at the end of life. One hundred and twenty-seven health care professionals and 41 undergraduate medical students completed the Multidimensional Fear of Death Scale (MFODS) on the first and last day of the course. The most significant factors of fear of death are: Fear for Significant Others, Fear of the Dying Process and Fear of the Unknown. Overall fear of death scores were reduced as an effect of the courses. Changes in the components and level of fear of death are influenced by the participants' gender, age and profession. Improvement was evident in the attitudes to dying patients in both groups, which was related to an increase in knowledge of high-quality care of dying patients.

  5. The Tanzania Connect Project: a cluster-randomized trial of the child survival impact of adding paid community health workers to an existing facility-focused health system

    PubMed Central

    2013-01-01

    . To garner detailed information on household characteristics, behaviors, and service exposure, a random sub-sample survey of 3,300 women of reproductive age will be conducted at the baseline and endline. The referral system intervention will use baseline, midline, and endline facility-based data to assess systemic changes. Implementation and impact research of Connect will assess whether and how the presence of the CHA at village level provides added life-saving value to the health system. Discussion Global commitment to launching community-based primary health care has accelerated in recent years, with much of the implementation focused on Africa. Despite extensive investment, no program has been guided by a truly experimental study. Connect will not only address Tanzania’s need for policy and operational research, it will bridge a critical international knowledge gap concerning the added value of salaried professional community health workers in the context of a high density of fixed facilities. Trial registration: ISRCTN96819844 PMID:23819587

  6. Foster care history and HIV infection among drug-using African American female sex workers.

    PubMed

    Surratt, Hilary L; Kurtz, Steven P

    2012-05-01

    Foster care has been associated with increased HIV risk behaviors among youth, yet long-term association with HIV infection has not been examined. This study explored the associations between foster placement, victimization, mental health, onset of sex work and HIV infection among highly vulnerable female sex workers. 562 drug-involved African American women were enrolled into an intervention study to increase health services utilization and reduce HIV risk. Seventeen percent reported a history of foster placement. Foster history was associated with significantly lower educational attainment, higher victimization, and more severe mental health problems. Women with foster histories reported significantly earlier entry into paid sex work, with some 62% active in the sex trade before age 18. Multivariate analyses found that foster care was independently associated with HIV seropositivity, and that early sex work partially mediated this association. The potential long-term health vulnerabilities associated with foster placement are understudied and warrant additional research. PMID:21818654

  7. Foster Care History and HIV Infection among Drug-Using African American Female Sex Workers

    PubMed Central

    Surratt, Hilary L.; Kurtz, Steven P.

    2011-01-01

    Foster care has been associated with increased HIV risk behaviors among youth, yet long-term association with HIV infection has not been examined. This study explored the associations between foster placement, victimization, mental health, onset of sex work and HIV infection among highly vulnerable female sex workers. 562 drug-involved African American women were enrolled into an intervention study to increase health services utilization and reduce HIV risk. Seventeen percent reported a history of foster placement. Foster history was associated with significantly lower educational attainment, higher victimization, and more severe mental health problems. Women with foster histories reported significantly earlier entry into paid sex work, with some 62% active in the sex trade before age 18. Multivariate analyses found that foster care was independently associated with HIV seropositivity, and that early sex work partially mediated this association. The potential long-term health vulnerabilities associated with foster placement are understudied and warrant additional research. PMID:21818654

  8. Medical "Brain Drain" and Health Care Worker Shortages: How Should International Training Programs Respond?

    PubMed

    Karan, Abraar; DeUgarte, Daniel; Barry, Michele

    2016-01-01

    The movement of health care workers from countries with resource scarcity and immense need ("source" countries) to areas of resource abundance and greater personal opportunity ("destination" countries) presents a complex set of decisions and relationships that affect the development of international health care systems. We explore the extent to which ethical quandaries arising from this movement are the responsibility of the said actors and the implications of these ethical quandaries for patients, governments, and physicians through the case of Dr. R, a surgeon from Nigeria who is considering working in the United States, where he is being trained to help develop surgical capacity in his country. We suggest how Dr. R, the United States, and Nigeria all contribute to "brain drain" in different but complementary ways. PMID:27437816

  9. HOW MANY REPETITIONS OF CHILD CARE SKILLS ARE REQUIRED FOR HEALTH WORKER STUDENTS TO ACHIEVE PROFICIENCY? LEARNING CURVE PATTERNS IN CHILD CARE SKILLS ACQUISITION

    PubMed Central

    Emami Moghadam, Zahra; Emami Zeydi, Amir; Mazlom, Seyed Reza; Abadi, Fatemeh Sardar; Pour, Parastoo Majidi; Davoudi, Malihe; Banafsheh, Elahe

    2015-01-01

    Introduction: The vulnerability of children under 5 years old requires paying more attention to the health of this group. In the Iranian health care system, health workers are the first line of human resources for health care in rural areas. Because most health workers begin working in conditions with minimal facilities, their clinical qualifications are crucial. The aim of this study was to determine the number of repetitions of child care skills, required for health worker students to achieve proficiency based on the learning curve. Methods: A time series research design was used. Participants in this study were first year health worker students enrolled in three health schools in 2011. Data were collected using a questionnaire consisting of demographic information and a checklist evaluating the health worker students’ clinical skills proficiency for child care. Data were analyzed using SPSS version 16.0 software (SPSS Inc., Chicago, IL) using descriptive and inferential statistics including Kruskal-Wallis and Pearson correlation coefficient tests. Results: Learning curve patterns in child care skills acquisition showed that for less than 20 and between 20 to 29 times, the level of skill acquisition had an upward slope. Between 30- 39 the learning curve was descending, however the slope became ascending once more and then it leveled off (with change of less than 5%). Conclusion: It seems that 40 repetitions of child care skills are sufficient for health worker students to achieve proficiency. This suggests that time, resources and additional costs for training health worker students’ trainees can be saved by this level of repetition. PMID:26622199

  10. Practice-Education Synergy: A Research Focus on Continuity of Care.

    ERIC Educational Resources Information Center

    Lee, Jan L.; Dean, Hannah

    1995-01-01

    Describes one focus of an ongoing partnership between a Veterans Health Administration medical center and a university-based school of nursing: to improve patient outcomes through patient-centered continuity of care. (Author)

  11. Are Nurses and Auxiliary Healthcare Workers Equally Effective in Delivering Smoking Cessation Support in Primary Care?

    PubMed Central

    Faulkner, Kathryn; Sutton, Stephen; Jamison, James; Sloan, Melanie; Boase, Sue

    2016-01-01

    Introduction: Smoking cessation support is increasingly delivered in primary care by auxiliary healthcare workers in place of healthcare professionals. However, it is unknown whether this shift might affect the quality and impact of the support delivered. Methods: Data from the iQuit in Practice randomized control trial of cessation support in General Practice was used (N = 602). Analyses assessed whether cessation advisor type (nurse or healthcare assistant [HCA]) was associated with abstinence (primary outcome: self-reported 2-week point prevalence abstinence at 8 weeks follow-up), the advice delivered during the initial consultation, pharmacotherapies prescribed, patient satisfaction, initial consultation length, and the number and type of interim contacts. Results: There were no statistically significant differences in abstinence for support delivered by HCAs versus nurses at 8 weeks (HCAs 42.8%, nurses 42.6%; unadjusted odds ratio [OR] = 1.01, 95% confidence interval [CI] = 0.73 to 1.40), or at 4 weeks or 6 months follow-up. There were no statistically significant differences in advice delivered, the types of pharmacotherapies prescribed or patient satisfaction. Compared with nurses, HCA consultations were longer on average (HCAs 23.6 minutes, nurses 20.8 minutes; P = .002) and they undertook more interim contacts (HCAs median 2, nurses median 1; P < .001), with contact more likely to be face-to-face than phone call (HCAs 91.2%, nurses 70.9%; OR = 4.23, 95% CI = 2.86 to 6.26). Conclusions: HCAs appear equally effective as nurses in supporting smoking cessation, although they do this with greater patient contact. Using auxiliary practitioners to deliver cessation support could free up nurse time and reduce costs. Implications: This study found that primary care patients receiving smoking cessation support from auxiliary healthcare workers were just as likely to be abstinent up to 6 months later as those patients seen by nurses. While the auxiliary healthcare

  12. Burnout and Workload Among Health Care Workers: The Moderating Role of Job Control

    PubMed Central

    Portoghese, Igor; Galletta, Maura; Coppola, Rosa Cristina; Finco, Gabriele; Campagna, Marcello

    2014-01-01

    Background As health care workers face a wide range of psychosocial stressors, they are at a high risk of developing burnout syndrome, which in turn may affect hospital outcomes such as the quality and safety of provided care. The purpose of the present study was to investigate the moderating effect of job control on the relationship between workload and burnout. Methods A total of 352 hospital workers from five Italian public hospitals completed a self-administered questionnaire that was used to measure exhaustion, cynicism, job control, and workload. Data were collected in 2013. Results In contrast to previous studies, the results of this study supported the moderation effect of job control on the relationship between workload and exhaustion. Furthermore, the results found support for the sequential link from exhaustion to cynicism. Conclusion This study showed the importance for hospital managers to carry out management practices that promote job control and provide employees with job resources, in order to reduce the burnout risk. PMID:25379330

  13. Methicillin-resistant Staphylococcus sp. colonizing health care workers of a cancer hospital

    PubMed Central

    Costa, Dayane de Melo; Kipnis, André; Leão-Vasconcelos, Lara Stefânia Netto de Oliveira; Rocha-Vilefort, Larissa Oliveira; Telles, Sheila Araújo; André, Maria Cláudia Dantas Porfírio Borges; Tipple, Anaclara Ferreira Veiga; Lima, Ana Beatriz Mori; Ribeiro, Nádia Ferreira Gonçalves; Pereira, Mayara Regina; Prado-Palos, Marinésia Aparecida

    2014-01-01

    The aim of the study was to analyze epidemiological and microbiological aspects of oral colonization by methicillin-resistant Staphylococcus of health care workers in a cancer hospital. Interview and saliva sampling were performed with 149 health care workers. Antimicrobial resistance was determined by disk diffusion and minimum inhibitory concentration. Polymerase Chain Reaction, Internal Transcribed Spacer-Polymerase Chain Reaction and Pulsed Field Gel Electrophoresis were performed for genotypic characterization of methicillin-resistant Staphylococcus. Risk factors were determined by logistic regression. Methicillin-resistant Staphylococcus colonization prevalence was 19.5%, denture wearing (p = 0.03), habit of nail biting (p = 0.04) and preparation and administration of antimicrobial (p = 0.04) were risk factors identified. All methicillin-resistant Staphylococcus were S. epidermidis, 94.4% of them had mecA gene. Closely related and indistinguishable methicillin-resistant S. epidermidis were detected. These results highlight that HCWs which have contact with patient at high risk for developing infections were identified as colonized by MRSE in the oral cavity, reinforcing this cavity as a reservoir of these bacteria and the risk to themselves and patients safety, because these microorganisms may be spread by coughing and talking. PMID:25477910

  14. Workplace violence on workers caring for long-term institutionalized schizophrenic patients in Taiwan.

    PubMed

    Chen, Wen-Ching; Wang, Jung-Der; Lew-Ting, Chih-Yin; Chiu, Hsien-Jane; Lin, Yi-Ping

    2007-07-01

    It has been noted that workplace violence most frequently occurs in psychiatric settings. The purpose of this study was to explore the workplace violence, including violence situation, victims' feeling, and the prevention strategies, on workers caring for long-term institutionalized schizophrenic patients in Taiwan. We conducted a face-to-face, in-depth, and semi-structured interview with 13 health care workers suffering from physical violence and/or sexual harassment by patients in 2002. First, the interviews were taped and/or paper-notes recorded, then transcribed, organized, and analyzed. Results found that all of the victims alleged they did not receive enough post-incident support, and more than a half of the victims could not call others for help during the violence. To avoid further attack, most victims offered prevention strategies which were considered valuable for establishing guidelines. However, some victims regarded workplace violence as inevitable and part of the job. The most common situations of workplace violence were during routine ward inspections, especially when the victims were alone. The most serious psychological harm was post-traumatic stress disorder (PTSD). In conclusion, we recommended a re-engineering of the organization to a supportive and safe working environment for prevention of workplace violence in the study hospital. PMID:17690525

  15. Professional and educational needs of hospice and palliative care social workers.

    PubMed

    Weisenfluh, Sherri M; Csikai, Ellen L

    2013-01-01

    In the past decade much growth has occurred in the numbers of patients and families served by hospices and palliative care services. Thus, not surprisingly, these services have also been subject to increasing regulation by governmental and accrediting entities. In order to stay up-to-date in this ever-changing environment and to continue to provide effective interventions, social workers must stay engaged in the professional community and continuing education. In this quantitative study, 1,169 practicing hospice and palliative care social workers provided information about their practice activities and agency characteristics, professional affiliations and certification, and ongoing educational needs. About one-half of respondents carried a caseload of 21-50 and were most engaged in communicating the psychosocial needs of the patient and family to other members of the team and assessing for grief and bereavement issues. The most important educational needs pertained to the psychological and social needs of patients and families and psychosocial interventions. Most were members of professional organizations and three-quarters were members of NASW. Although many were aware of the joint NASW-NHPCO social work hospice specialty certification, few held this certification yet. The results of this survey can be utilized in the design of continuing education programs and advocacy for programmatic and policy change within agencies and the industry. PMID:23438645

  16. Methicillin-resistant Staphylococcus sp. colonizing health care workers of a cancer hospital.

    PubMed

    Costa, Dayane de Melo; Kipnis, André; Leão-Vasconcelos, Lara Stefânia Netto de Oliveira; Rocha-Vilefort, Larissa Oliveira; Telles, Sheila Araújo; André, Maria Cláudia Dantas Porfírio Borges; Tipple, Anaclara Ferreira Veiga; Lima, Ana Beatriz Mori; Ribeiro, Nádia Ferreira Gonçalves; Pereira, Mayara Regina; Prado-Palos, Marinésia Aparecida

    2014-01-01

    The aim of the study was to analyze epidemiological and microbiological aspects of oral colonization by methicillin-resistant Staphylococcus of health care workers in a cancer hospital. Interview and saliva sampling were performed with 149 health care workers. Antimicrobial resistance was determined by disk diffusion and minimum inhibitory concentration. Polymerase Chain Reaction, Internal Transcribed Spacer-Polymerase Chain Reaction and Pulsed Field Gel Electrophoresis were performed for genotypic characterization of methicillin-resistant Staphylococcus. Risk factors were determined by logistic regression. Methicillin-resistant Staphylococcus colonization prevalence was 19.5%, denture wearing (p = 0.03), habit of nail biting (p = 0.04) and preparation and administration of antimicrobial (p = 0.04) were risk factors identified. All methicillin-resistant Staphylococcus were S. epidermidis, 94.4% of them had mecA gene. Closely related and indistinguishable methicillin-resistant S. epidermidis were detected. These results highlight that HCWs which have contact with patient at high risk for developing infections were identified as colonized by MRSE in the oral cavity, reinforcing this cavity as a reservoir of these bacteria and the risk to themselves and patients safety, because these microorganisms may be spread by coughing and talking. PMID:25477910

  17. Prevalence of cytomegalovirus infection among health care workers in pediatric and immunosuppressed adult units.

    PubMed

    Sobaszek, A; Fantoni-Quinton, S; Frimat, P; Leroyer, A; Laynat, A; Edme, J L

    2000-11-01

    The prevalence of cytomegalovirus (CMV) infection varies not only from one country to another, but also with social, economic, and environmental conditions and with professional activity. Health care workers in contact with the main vectors of the CMV (i.e., children and immunosuppressed patients) are particularly exposed to the infection. We assessed the prevalence of the virus among health care personnel in light of CMV epidemiology and the recent shift in living conditions and family size. Our study was included in a broader program evaluating the risk of infection among female hospital workers of childbearing age. The goal of the program was to implement appropriate preventive measures for personnel who were not immune to the infection. Consequently, we included only female caregivers who worked with children or immunosuppressed patients. The study was based on a clinical examination, a medical and occupational questionnaire, the assessment of tasks performed; and CMV serologic testing. The overall seroprevalence was 44.25% in our population (n = 400) and was comparable regardless of the place of work. Prevalence differed significantly with age and parity, and we also found that it was higher among personnel who worked in closer contact with the patients (nurse's aides, pediatric nurse's aides) than among those whose tasks required more technical skills (nurses, pediatric nurses) (57.3% vs 34.5%, P < 0.01). The logistic regression analysis between prevalence of CMV antibodies, age, parity, and type of job showed that "contact job" was as significant a factor as parity to explain immunization in our population (odds ratio, 2.2). We also determined a correlation between the prevalence of CMV antibodies and tasks performed. In addition, we found a non-negligible group of non-immune personnel (55.75%) and young workers (mean age: 33.4) who were potentially exposed to infection. This points to the need to establish a prevention program. PMID:11094790

  18. Health care worker perspectives inform optimization of patient panel-support tools: a qualitative study.

    PubMed

    Feldstein, Adrianne C; Schneider, Jennifer L; Unitan, Robert; Perrin, Nancy A; Smith, David H; Nichols, Gregory A; Lee, Nancy L

    2013-04-01

    Electronic decision-support systems appear to enhance care, but improving both tools and work practices may optimize outcomes. Using qualitative methods, the authors' aim was to evaluate perspectives about using the Patient Panel-Support Tool (PST) to better understand health care workers' attitudes toward, and adoption and use of, a decision-support tool. In-depth interviews were conducted to elicit participant perspectives about the PST-an electronic tool implemented in 2006 at Kaiser Permanente Northwest. The PST identifies "care gaps" and recommendations in screening, medication use, risk-factor control, and immunizations for primary care panel patients. Primary care physician (PCP) teams were already grouped (based on performance pre- and post-PST introduction) into lower, improving, and higher percent-of-care-needs met. Participants were PCPs (n=21), medical assistants (n=11), and quality and other health care managers (n=20); total n=52. Results revealed that the most commonly cited benefit of the PST was increased in-depth knowledge of patient panels, and empowerment of staff to do quality improvement. Barriers to PST use included insufficient time, competing demands, suboptimal staffing, tool navigation, documentation, and data issues. Facilitators were strong team staff roles, leadership/training for tool implementation, and dedicated time for tool use. Higher performing PCPs and their assistants more often described a detailed team approach to using the PST. In conclusion, PCP teams and managers provided important perspectives that could help optimize use of panel-support tools to improve future outcomes. Improvements are needed in tool function and navigation; training; staff accountability and role clarification; and panel management time.

  19. Felt Stigma in Injection Drug Users and Sex Workers: Focus Group Research with HIV-Risk Populations in Puerto Rico

    PubMed Central

    Jiménez, Julio; Puig, Marieva; Sala, Ana Cecilia; Ramos, Juan Carlos; Castro, Eida; Morales, Marangelie; Santiago, Lydia; Zorrilla, Carmen

    2016-01-01

    Though many studies have conclusively linked felt stigma and HIV, few have focused on the experiences of rejection felt by members of such socially marginalized groups as intravenous drug users (IDU) and sex workers (SW). Using focus groups, our study explored these experiences in 34 individuals (17 male UDUs and 17 female SWs) at risk of becoming infected with HIV, the objective being to discover why they engaged in maladaptive behaviors as a way of coping with felt stigma. We used deductive and inductive analysis to codify the resulting data. Concepts associated with the word stigma, emotional reactions to felt stigma, and the impact of felt stigma on self-schema helped elucidate how the internalization of felt stigma can lead to negative affective states and self-destructive behaviors (e.g., drug use and syringe exchange). Results underline the importance of developing intervention models that reduce stigma as a means of HIV prevention in vulnerable populations. PMID:27013930

  20. Primary Health Care: Potential Home for Family-Focused Preventive Interventions.

    PubMed

    Leslie, Laurel K; Mehus, Christopher J; Hawkins, J David; Boat, Thomas; McCabe, Mary Ann; Barkin, Shari; Perrin, Ellen C; Metzler, Carol W; Prado, Guillermo; Tait, V Fan; Brown, Randall; Beardslee, William

    2016-10-01

    Family-focused prevention programs have been shown to effectively reduce a range of negative behavioral health outcomes but have had limited reach. Three key barriers must be overcome to expand the reach of family-focused prevention programs and thereby achieve a significant public health impact. These barriers are (1) current social norms and perceptions of parenting programs; (2) concerns about the expertise and legitimacy of sponsoring organizations to offer parenting advice; and (3) a paucity of stable, sustainable funding mechanisms. Primary healthcare settings are well positioned to overcome these barriers. Recent changes within health care make primary care settings an increasingly favorable home for family-focused prevention and suggest possibilities for sustainable funding of family-focused prevention programs. This paper discusses the existing advantages of primary care settings and lays out a plan to move toward realizing the potential public health impact of family-focused prevention through widespread implementation in primary healthcare settings.

  1. Primary Health Care: Potential Home for Family-Focused Preventive Interventions.

    PubMed

    Leslie, Laurel K; Mehus, Christopher J; Hawkins, J David; Boat, Thomas; McCabe, Mary Ann; Barkin, Shari; Perrin, Ellen C; Metzler, Carol W; Prado, Guillermo; Tait, V Fan; Brown, Randall; Beardslee, William

    2016-10-01

    Family-focused prevention programs have been shown to effectively reduce a range of negative behavioral health outcomes but have had limited reach. Three key barriers must be overcome to expand the reach of family-focused prevention programs and thereby achieve a significant public health impact. These barriers are (1) current social norms and perceptions of parenting programs; (2) concerns about the expertise and legitimacy of sponsoring organizations to offer parenting advice; and (3) a paucity of stable, sustainable funding mechanisms. Primary healthcare settings are well positioned to overcome these barriers. Recent changes within health care make primary care settings an increasingly favorable home for family-focused prevention and suggest possibilities for sustainable funding of family-focused prevention programs. This paper discusses the existing advantages of primary care settings and lays out a plan to move toward realizing the potential public health impact of family-focused prevention through widespread implementation in primary healthcare settings. PMID:27498167

  2. Exploring the Pathogens Present at the Patient Care Equipments & Supplies to Sensitise the Health Care Workers for Preventing Health Care-Associated Infections among In-Patients.

    PubMed

    Dadhich, Amit; Arya, Sanjay; Kapil, Arti

    2014-01-01

    Health care-associated infection (HCAI) is an infection that a person acquires in hospital after 24 hours of his/her admission. A health care worker (HCW) does not have any right to provide another infection to in-patients. While caring the patients, HCW innocently or otherwise can transmit various pathogens to the patient. It is both ethically and legally wrong and HCW is answerable for it. The current study was conducted with the objectives to find out the rate of presence of pathogens at the patient care equipments & supplies, to identify the most common pathogens present at the patient care equipments & supplies and to identify such equipments & supplies that are at high risk of contamination. Investigator collected 1,145 samples of different equipments & supplies used for patient care from operation theaters, labour room & medical wards of a tertiary care hospital in New Delhi. The sample was collected from April 2012 to April 2013 by random sampling. Out of 1,145 samples, 112 were positive or contaminated with certain kind of pathogen. The finding revealed that the contamination rate of patient care equipments & supplies is 9.78 percent. The most common and frequent pathogen present at the equipments & supplies is Pseudomonas (39.29%) and water of oxygen humidifier is most commonly and frequently infected (47.32%). Nurses as the backbone of hospital should strictly adhere to the policies and protocols of the institution. She/he must update the knowledge of infection control practices and various methods of controlling HCAI including hand hygiene, disinfection of patient care equipments & supplies and cleanliness of environment. A Nurse should also transmit this knowledge to other team members so as to minimise the health care-associated infection rate.

  3. The approaches to learning of support workers employed in the care home sector: an evaluation study.

    PubMed

    Cowan, David T; Roberts, Julia D; Fitzpatrick, Joanne M; While, Alison E; Baldwin, Julie

    2004-02-01

    This study examined the approaches to learning of a cohort (n=76) of National Vocational Qualification (NVQ) Care Award candidates using the Approaches and Study Skills Inventory for Students. The NVQ candidates were support workers (SWs) (sometimes called care assistants) employed in United Kingdom (UK) care homes for older people. The aim was to identify SWs' approaches to learning and to determine whether or not a preparatory six-week College-based course had any impact on these approaches. The findings were encouraging. The course had a positive impact with a statistically significant increase in orientation towards a deep learning approach, which is associated with desirable learning outcomes as well as self-directed and lifelong learning skills. The UK government recognises that lifelong learning enables people to continually develop their talents, thereby enhancing local communities and contributing to a civilised, cohesive society. In a health care environment, adopting a deep approach is likely to be beneficial. Those who use evidence to inform practice, who are able to relate elements of what they are taught to their working experiences and who are able to adapt to meet new challenges, are more likely to enhance their practice and become more effective carers. PMID:14769453

  4. The approaches to learning of support workers employed in the care home sector: an evaluation study.

    PubMed

    Cowan, David T; Roberts, Julia D; Fitzpatrick, Joanne M; While, Alison E; Baldwin, Julie

    2004-02-01

    This study examined the approaches to learning of a cohort (n=76) of National Vocational Qualification (NVQ) Care Award candidates using the Approaches and Study Skills Inventory for Students. The NVQ candidates were support workers (SWs) (sometimes called care assistants) employed in United Kingdom (UK) care homes for older people. The aim was to identify SWs' approaches to learning and to determine whether or not a preparatory six-week College-based course had any impact on these approaches. The findings were encouraging. The course had a positive impact with a statistically significant increase in orientation towards a deep learning approach, which is associated with desirable learning outcomes as well as self-directed and lifelong learning skills. The UK government recognises that lifelong learning enables people to continually develop their talents, thereby enhancing local communities and contributing to a civilised, cohesive society. In a health care environment, adopting a deep approach is likely to be beneficial. Those who use evidence to inform practice, who are able to relate elements of what they are taught to their working experiences and who are able to adapt to meet new challenges, are more likely to enhance their practice and become more effective carers.

  5. Regulatory focus and adherence to self-care behaviors among adults with type 2 diabetes.

    PubMed

    Avraham, Rinat; Van Dijk, Dina; Simon-Tuval, Tzahit

    2016-09-01

    The aims of this study were, first, to test the association between regulatory focus of adults with type 2 diabetes and their adherence to two types of self-care behaviors - lifestyle change (e.g. physical activity and diet) and medical care regimens (blood-glucose monitoring, foot care and medication usage). Second, to explore whether a fit between the message framing and patients' regulatory focus would improve their intentions to adhere specifically when the type of behavior fits the patients' regulatory focus as well. A cross-sectional study was conducted among 130 adults with type 2 diabetes who were hospitalized in an academic medical center. The patients completed a set of questionnaires that included their diabetes self-care activities, regulatory focus, self-esteem and demographic, socioeconomic and clinical data. In addition, participants were exposed to either a gain-framed or a loss-framed message, and were then asked to indicate their intention to improve adherence to self-care behaviors. A multivariable linear regression model revealed that promoters reported higher adherence to lifestyle change behaviors than preventers did (B = .60, p = .028). However, no effect of regulatory focus on adherence to medical care regimens was found (B = .46, p = .114). In addition, preventers reported higher intentions to adhere to medical care behaviors when the message framing was congruent with prevention focus (B = 1.16, p = .023). However, promoters did not report higher intentions to adhere to lifestyle behaviors when the message framing was congruent with promotion focus (B = -.16, p = .765). These findings justify the need to develop tailor-made interventions that are adjusted to both patients' regulatory focus and type of health behavior. PMID:26576471

  6. Evaluation of lead exposure in battery-manufacturing workers with focus on different biomarkers.

    PubMed

    Kasuba, Vilena; Rozgaj, Ruzica; Milić, Mirta; Zeljezić, Davor; Kopjar, Nevenka; Pizent, Alica; Kljaković-Gaspić, Zorana

    2010-05-01

    The influence of exposure to lead on the frequency of micronuclei (MN), nuclear buds and nucleoplasmatic bridges was investigated in peripheral blood lymphocytes in 15 male battery-manufacturing workers and 15 controls matched for age and smoking habits. In addition to MN test, blood lead (B-Pb) and cadmium (B-Cd), delta aminolevulinic acid dehydratase (ALAD) activity, erythrocyte protoporphyrin (EP), serum vitamin B(12) (S-Vit B(12)) and folate (S-folate) were determined in all subjects. Lead-exposed subjects had significantly higher MN frequency and B-Pb concentrations than controls. In control smokers we found a significant negative correlation between B-Pb concentration and frequency of nucleoplasmatic bridges, and nuclear division index. In control non-smokers a significant positive correlation was observed only between age and nuclear buds frequency, and between S-folate and B-Pb level. In lead exposed smokers, significant positive correlations between MN frequency and S-Vit B(12), S-folate, and nuclear buds frequency were found. A positive correlation in exposed smokers was also found between nuclear buds frequency and S-Vit B(12) concentration. A negative correlation was found between ALAD and EP, and B-Pb in exposed smokers. Exposed non-smokers showed significant negative correlation between MN frequency and B-Cd, and ALAD and EP. The results indicate a genotoxicity of lead, pointing to a micronucleus assay as a relevant test for assessing genotoxic effects resulting from occupational exposure. The other indicators did not necessarily follow the results of THE MN test. Influence of smoking should be further investigated.

  7. It is not their war: the impact of military operations on Philippine migrant care workers for elderly people in Israel

    PubMed Central

    Ron, Pnina

    2015-01-01

    Objective A majority of work immigrants from the Philippines came to Israel to fill positions involving personal and nursing care. Most of them were in Israel during the Second Lebanon War, the Cast Lead operation, and the Protective Edge Operation. These migrant care workers experienced these events no differently than did the Israeli population. The goal of this study was to examine the connections between the Philippine migrant care workers’ exposure to the military operations and the levels of post-traumatic stress disorder (PTSD), death anxiety, and burnout among them. Methods A random sample of 147 Philippine migrant care workers was recruited through four agencies that employ migrant care workers. Participants completed a self-report questionnaire. Results Philippine migrant care workers reported high levels of PTSD, high levels of death anxiety, and low levels of burnout. Levels of exposure were positively associated with levels of PTSD, death anxiety, and negatively with burnout. A significant inverse relationship was found between interpersonal variables (self-esteem and sense of mastery) and the PTSD, death anxiety, and burnout levels reported by the participants. PMID:26170643

  8. "When Things Are Really Complicated, We Call the Social Worker": Post-Hip-Fracture Care Transitions for Older People.

    PubMed

    Sims-Gould, Joanie; Byrne, Kerry; Hicks, Elisabeth; Franke, Thea; Stolee, Paul

    2015-11-01

    Social workers play a key role in the delivery of interdisciplinary health care. However, in the past decade, concerns have been raised about social work's sustainability and contributions in a changing health care sector. These changes come at a time when older patients are more complex and vulnerable than ever before. In this article, using a strengths-based approach, the authors examine the key contributions made by social workers working with older patients with hip fracture as they strive to achieve successful care transitions. Twenty-five interviews with health care professionals (HCPs) were conducted and then analyzed using an analytical coding framework. Although social workers are vital, they are often underused and overlooked in the care of hip fracture patients. The authors sketch the important contributions that social workers make to care transitions after hip fracture, specifically informational continuity; patient-HCP relational continuity; conflict resolution; mediation among family, patient, and HCP (for example, doctors and nurses); collaboration with family caregivers and community supports; and relocation counseling. PMID:26638501

  9. The HIV Care Continuum among Female Sex Workers: A Key Population in Lilongwe, Malawi

    PubMed Central

    Lancaster, Kathryn Elizabeth; Powers, Kimberly A.; Lungu, Thandie; Mmodzi, Pearson; Hosseinipour, Mina C.; Chadwick, Katy; Go, Vivian F.; Pence, Brian W.; Hoffman, Irving F.; Miller, William C.

    2016-01-01

    Objective The HIV care continuum among female sex workers (FSW), a key population, has not been well characterized, especially within the generalized epidemics of sub-Saharan Africa. This was the first study to characterize the HIV care continuum among FSW in Lilongwe, Malawi. Methods From July through September 2014, we used venue-based sampling to enroll 200 adult FSW in Lilongwe, Malawi into a cross-sectional evaluation assessing HIV care continuum outcomes. Seropositive FSW, identified using HIV rapid testing, received rapid CD4 counts in addition to viral loads using dried blood spots. We calculated proportions of HIV-infected FSW who had history of care, were on ART, and had suppressed viral load and we used Poisson regression to estimate the associations of demographic characteristics and transmission risk behaviors with each outcome. Results HIV seroprevalence was 69% (n = 138). Among all FSW the median age was 24 years (IQR: 22–28). Among the 20% who were newly diagnosed and reported previously testing negative, the median time since last HIV test was 11 months (interquartile range: 3–17). The majority (69%) of HIV-infected FSW had a history of HIV care, 52% reported current ART use, and 45% were virally suppressed. Of the FSW who reported current ART use, 86% were virally suppressed. Transmission risk behaviors were not associated with continuum outcomes. Conclusions FSW in Lilongwe were predominately young and have a high HIV prevalence. Only half of HIV-infected FSW reported current ART use, but the majority of those on ART were virally suppressed. To reduce ongoing transmission and improve health outcomes, increased HIV testing, care engagement, and ART coverage is urgently needed among FSW. Universal testing and treatment strategies for all FSW in Malawi must be strongly considered. PMID:26808043

  10. Adherence to Safe Handling Guidelines by Health Care Workers Who Administer Antineoplastic Drugs

    PubMed Central

    Boiano, James M.; Steege, Andrea L.; Sweeney, Marie H.

    2015-01-01

    The toxicity of antineoplastic drugs is well documented. Many are known or suspected human carcinogens where no safe exposure level exists. Authoritative guidelines developed by professional practice organizations and federal agencies for the safe handling of these hazardous drugs have been available for nearly three decades. As a means of evaluating the extent of use of primary prevention practices such as engineering, administrative and work practice controls, personal protective equipment (PPE), and barriers to using PPE, the National Institute for Safety and Health (NIOSH) conducted a web survey of health care workers in 2011. The study population primarily included members of professional practice organizations representing health care occupations which routinely use or come in contact with selected chemical agents. All respondents who indicated that they administered antineoplastic drugs in the past week were eligible to complete a hazard module addressing self-reported health and safety practices on this topic. Most (98%) of the 2069 respondents of this module were nurses. Working primarily in hospitals, outpatient care centers, and physician offices, respondents reported that they had collectively administered over 90 specific antineoplastic drugs in the past week, with carboplatin, cyclophosphamide, and paclitaxel the most common. Examples of activities which increase exposure risk, expressed as percent of respondents, included: failure to wear nonabsorbent gown with closed front and tight cuffs (42%); intravenous (I.V.) tubing primed with antineoplastic drug by respondent (6%) or by pharmacy (12%); potentially contaminated clothing taken home (12%); spill or leak of antineoplastic drug during administration (12%); failure to wear chemotherapy gloves (12%); and lack of hazard awareness training (4%). The most common reason for not wearing gloves or gowns was “skin exposure was minimal”; 4% of respondents, however, reported skin contact during handling

  11. A Novel Educational Strategy Targeting Health Care Workers in Underserved Communities in Central America to Integrate HIV into Primary Medical Care

    PubMed Central

    Flys, Tamara; González, Rosalba; Sued, Omar; Suarez Conejero, Juana; Kestler, Edgar; Sosa, Nestor; McKenzie-White, Jane; Monzón, Irma Irene; Torres, Carmen-Rosa; Page, Kathleen

    2012-01-01

    Background Current educational strategies to integrate HIV care into primary medical care in Central America have traditionally targeted managers or higher-level officials, rather than local health care workers (HCWs). We developed a complementary online and on-site interactive training program to reach local HCWs at the primary care level in underserved communities. Methods The training program targeted physicians, nurses, and community HCWs with limited access to traditional onsite training in Panama, Nicaragua, Dominican Republic, and Guatemala. The curriculum focused on principles of HIV care and health systems using a tutor-supported blended educational approach of an 8-week online component, a weeklong on-site problem-solving workshop, and individualized project-based interventions. Results Of 258 initially active participants, 225 (225/258 = 87.2%) successfully completed the online component and the top 200 were invited to the on-site workshop. Of those, 170 (170/200 = 85%) attended the on-site workshop. In total, 142 completed all three components, including the project phase. Quantitative and qualitative evaluation instruments included knowledge assessments, reflexive essays, and acceptability surveys. The mean pre and post-essay scores demonstrating understanding of social determinants, health system organization, and integration of HIV services were 70% and 87.5%, respectively, with an increase in knowledge of 17.2% (p<0.001). The mean pre- and post-test scores evaluating clinical knowledge were 70.9% and 90.3%, respectively, with an increase in knowledge of 19.4% (p<0.001). A survey of Likert scale and open-ended questions demonstrated overwhelming participant satisfaction with course content, structure, and effectiveness in improving their HIV-related knowledge and skills. Conclusion This innovative curriculum utilized technology to target HCWs with limited access to educational resources. Participants benefited from technical skills acquired

  12. Increasing Job Satisfaction among Child Care Workers through the Training of First-Level Supervisors.

    ERIC Educational Resources Information Center

    Bonsutto, Angelo

    The high, voluntary turnover of child and youth care staff at a residential treatment center was due primarily to low job satisfaction levels. Since the relationship between employees and supervisors directly affects job satisfaction, it was posited that a training intervention focusing on improving the employee support skills of first-level…

  13. Health-care workers' perspectives on workplace safety, infection control, and drug-resistant tuberculosis in a high-burden HIV setting.

    PubMed

    Zelnick, Jennifer R; Gibbs, Andrew; Loveday, Marian; Padayatchi, Nesri; O'Donnell, Max R

    2013-08-01

    Drug-resistant tuberculosis (TB) is an occupational hazard for health-care workers (HCWs) in South Africa. We undertook this qualitative study to contextualize epidemiological findings suggesting that HCWs' elevated risk of drug-resistant TB is related to workplace exposure. A total of 55 HCWs and 7 hospital managers participated in focus groups and interviews about infection control (IC). Participants discussed caring for patients with drug-resistant TB, IC measures, occupational health programs, also stigma and support in the workplace. Key themes included: (i) lack of resources that hinders IC, (ii) distrust of IC efforts among HCWs, and (iii) disproportionate focus on individual-level personal protections, particularly N95 masks. IC programs should be evaluated, and the impact of new policies to rapidly diagnose drug-resistant TB and decentralize treatment should be assessed as part of the effort to control drug-resistant TB and create a safe workplace.

  14. Palliative Care Education: Focusing on Care and Not Just Disease | Division of Cancer Prevention

    Cancer.gov

    At the Institute for Palliative Medicine (IPM) in San Diego, medical residents are re-tooling for one of the most essential aspects of medicine: caring for seriously ill patients. “The goal is to teach them the core competencies in palliative care,” explained Dr. Charles von Gunten, the institute’s provost. These competencies include pain management, good communication skills, and the ability to provide patients with psychosocial and spiritual assessments and to work in interdisciplinary teams in hospitals, as well as through hospice and in nursing homes, he said. |

  15. Health Care Reform: A Caucus of Asian American Health Workers' Perspective.

    PubMed

    Lin-Fu, Jane S.

    1994-01-01

    PURPOSE OF THE PAPER: The purpose of this paper is to offer an American Public Health Association (APHA)/Caucus of Asian American Health Workers' (CAAHW) perspective on health care reform. Dr. William Chen, the CAAHW Chair had asked the author, a Caucus member to present the Caucus' perspective on health care reform as part of a special session that was held during the 1993 APHA annual meeting in San Francisco. This paper is based on the oral presentation made. SUMMARY OF METHODS UTILIZED: The author reviewed the September 7, 1993 draft of the President's Health Care Reform proposal, other related papers, and the literature on Asian and Pacific Islander American health care needs. This was followed by a discussion of major issues and concerns with the CAAHW Chair and key members. This paper has undergone review by the Caucus chair and his reviewers whom he selected and thus is endorsed as the CAAHW's perspective on health care reform. PRINCIPAL FINDINGS: The CAAHW applauds President Clinton for his leadership in introducing much­needed reform in the U.S. health care system. However, the CAAHW wants to point out that access to medical care is not equivalent to utilizing and benefiting from services. Three issues of special concern to Asian Pacific Islander Americans are: (1) cultural sensitivity and relevancy of health services; (2) adequacy of racial/ethnic specific health data; and (3) due representation and input to key health policy­making and administrative bodies. CONCLUSIONS: The CAHW supports universal health insurance for all Americans and is particularly concerned that cultural sensitivity and appropriateness be assured for all populations. RELEVANCE TO ASIAN PACIFIC ISLANDER AMERICAN POPULATIONS: This paper calls attention to Asian Pacific Islander Americans as the nation's fastest growing minority that is largely foreign­born and extremely heterogenous and the need for culturally sensitive services

  16. HIV/AIDS knowledge and occupational risk in primary care health workers from Chile

    PubMed Central

    Valdés, Baltica Cabieses; Lagunas, Lilian Ferrer; Villarroel, Luis Antonio; Acosta, Rosina Cianelli; Miner, Sarah; Silva, Margarita Bernales

    2014-01-01

    Objective To explore the relationship between knowledge level and occupational risk exposure to HIV/AIDS in primary care health workers. Methodology Analytical cross-sectional study. 720 health workers from Santiago answered a survey about HIV/AIDS that included: knowledge level (appropriate, inappropriate), occupational risk (with or without risk), and control variables (age, gender, health center, education and marital status). Descriptive and association analysis were performed. Odds Ratio (OR) was estimated through simple and multiple regressions logistics. Results 58.7% of the participants reported HIV occupational risk. 63.8% of the participants from the exposed group reported an appropriate level of knowledge, versus 36.1% of the non-exposed group (Adjusted OR of 3.1, IC95%OR: 2.0-4.8, p<0.0001). Technicians and cleaning staff reported a lower proportion of appropriate level of knowledge compared to the employees with college education (p<0.0001). Conclusion The level of HIV/AID occupational risk is directly associated with the level of knowledge of the disease. PMID:25284913

  17. Female genital mutilation/cutting: risk management and strategies for social workers and health care professionals

    PubMed Central

    Costello, Susan

    2015-01-01

    Female genital mutilation/cutting (FGM/C) is a traditional practice originating in Africa. Its worst forms cause irreparable harm to girls and women and have no medical justification. Based on a literature review of global responses to FGM/C and conversations with Australian women who migrated from FGM/C practicing countries, this paper provides some background on FGM/C and its epidemiology, outlining its prevalence, types, and health risks and complications for women and girls. It discusses risk-prevention strategies, first, for health practitioners in identifying, screening, and supporting women affected by FGM/C and, second, for welfare and social workers and health care professionals to identify, work with, and prevent girls from being cut. Consistent with international trends in addressing the risks of FGM/C, the paper suggests practice responses for coordinated responses between professionals, communities from practicing countries, and governments of different countries. PMID:26719732

  18. Safety considerations for Health care Workers involved in Cytoreductive Surgery and Perioperative chemotherapy.

    PubMed

    Bhatt, Aditi; Mittal, Sourabh; Gopinath, K S

    2016-06-01

    The combined modality treatment of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has gained worldwide acceptance for management of selected patients with peritoneal metastases from various cancers. Cytoreductive surgery is performed with the goal of removing all macroscopic disease and is coupled with perioperative chemotherapy (POC) in the form of HIPEC with or without EPIC (early postoperative intraperitoneal chemotherapy) to deal with the microscopic residual disease. These treatments entail the use of cytotoxic drugs in the operation theatre or in the intensive care unit where they are not commonly used and put the healthcare workers participating in the treatment at risk of exposure. CRS is performed with high voltage electrocautery generating a large amount of surgical smoke which is inhaled by the involved personnel and has potential health hazards. This article outlines the safety measures to be taken while performing CRS and POC. PMID:27065717

  19. Female genital mutilation/cutting: risk management and strategies for social workers and health care professionals.

    PubMed

    Costello, Susan

    2015-01-01

    Female genital mutilation/cutting (FGM/C) is a traditional practice originating in Africa. Its worst forms cause irreparable harm to girls and women and have no medical justification. Based on a literature review of global responses to FGM/C and conversations with Australian women who migrated from FGM/C practicing countries, this paper provides some background on FGM/C and its epidemiology, outlining its prevalence, types, and health risks and complications for women and girls. It discusses risk-prevention strategies, first, for health practitioners in identifying, screening, and supporting women affected by FGM/C and, second, for welfare and social workers and health care professionals to identify, work with, and prevent girls from being cut. Consistent with international trends in addressing the risks of FGM/C, the paper suggests practice responses for coordinated responses between professionals, communities from practicing countries, and governments of different countries. PMID:26719732

  20. Female genital mutilation/cutting: risk management and strategies for social workers and health care professionals.

    PubMed

    Costello, Susan

    2015-01-01

    Female genital mutilation/cutting (FGM/C) is a traditional practice originating in Africa. Its worst forms cause irreparable harm to girls and women and have no medical justification. Based on a literature review of global responses to FGM/C and conversations with Australian women who migrated from FGM/C practicing countries, this paper provides some background on FGM/C and its epidemiology, outlining its prevalence, types, and health risks and complications for women and girls. It discusses risk-prevention strategies, first, for health practitioners in identifying, screening, and supporting women affected by FGM/C and, second, for welfare and social workers and health care professionals to identify, work with, and prevent girls from being cut. Consistent with international trends in addressing the risks of FGM/C, the paper suggests practice responses for coordinated responses between professionals, communities from practicing countries, and governments of different countries.

  1. Knowledge and understanding of AIDS among health-care workers in Jamaica.

    PubMed

    Orrett, F A; Prabhakar, P

    1989-12-01

    Six hundred and fifty questionnaires were sent to Health-care Workers (HCW) in four hospitals to assess the knowledge and understanding on HIV transmission and isolation precautions to be instituted for control and also to ascertain whether any differences in knowledge existed between HCW of teaching and nonteaching hospitals. Five hundred and nine questionnaires were returned, a response rate of 79%. Questions on HIV transmission via blood transfusion and sexual intercourse and proper disposal of sharp instruments received the highest scores (85-100), embracing all groups of teaching and non-teaching hospitals. The greatest area of misconception and misunderstanding was reflected in responses obtained on isolation precautions (less than 30) for both teaching and non-teaching hospitals. Our study emphasizes an urgent need for a comprehensive, continuous education of HCW on prevention and control of HIV infections in Jamaica. PMID:2623847

  2. HIV Testing and Engagement in Care among Highly Vulnerable Female Sex Workers: Implications for Treatment as Prevention Models

    PubMed Central

    Surratt, Hilary L.; O’Grady, Catherine; Kurtz, Steven P.; Buttram, Mance E.; Levi-Minzi, Maria A.

    2014-01-01

    Background Although emerging Treatment as Prevention models can be effective in reducing HIV incidence among high-risk populations, many HIV infected individuals remain undiagnosed or fail to engage in HIV care. Methods This study examined the factors associated with HIV testing and care among a population of substance using female sex workers. Results Recent HIV testing was associated with higher education level, having a regular health care provider or clinic, recent crack use, and higher sexual risk behaviors; HIV treatment utilization was associated with higher levels of social support, having a regular health care provider or clinic, housing stability and insurance coverage. Qualitative data revealed HIV-related stigma, denial, social isolation, and substance use as barriers to HIV testing and treatment; social support and accessibility of services were key enablers. Conclusions Improving HIV testing and linkage to treatment among female sex workers will require structural initiatives to reduce stigma and increase service seeking support. PMID:25130245

  3. Health care and social issues of immigrant rescue and recovery workers at the World Trade Center site.

    PubMed

    de la Hoz, Rafael E; Hill, Scottie; Chasan, Rachel; Bienenfeld, Laura A; Afilaka, Aboaba A; Wilk-Rivard, Elizabeth; Herbert, Robin

    2008-12-01

    This article reviews the experience of a unique occupational group of World Trade Center (WTC) workers: immigrant workers. This group is comprised largely of men, laborers, who are first-generation immigrants. The majority of these workers are from Latin America (predominantly from Ecuador and Colombia) or from Eastern Europe (predominantly from Poland). Our data shows that the disease profile observed in these workers was what we have previously reported for WTC working population as a whole. Recent reports have begun to document the disproportionate burden of occupational hazards, injuries, and illnesses experienced by immigrant workers in the United States. The WTC experience of immigrants exemplified this burden but, additionally, highlighted that this burden is exacerbated by limitations in access to appropriate health care, disability and compensation benefits, and vocational rehabilitation services. A clinical program that was designed to address the complex medical and psychosocial needs of these workers in a comprehensive manner was successfully established. Full justice for these workers depends on larger societal changes. PMID:19092486

  4. Health care and social issues of immigrant rescue and recovery workers at the World Trade Center site.

    PubMed

    de la Hoz, Rafael E; Hill, Scottie; Chasan, Rachel; Bienenfeld, Laura A; Afilaka, Aboaba A; Wilk-Rivard, Elizabeth; Herbert, Robin

    2008-12-01

    This article reviews the experience of a unique occupational group of World Trade Center (WTC) workers: immigrant workers. This group is comprised largely of men, laborers, who are first-generation immigrants. The majority of these workers are from Latin America (predominantly from Ecuador and Colombia) or from Eastern Europe (predominantly from Poland). Our data shows that the disease profile observed in these workers was what we have previously reported for WTC working population as a whole. Recent reports have begun to document the disproportionate burden of occupational hazards, injuries, and illnesses experienced by immigrant workers in the United States. The WTC experience of immigrants exemplified this burden but, additionally, highlighted that this burden is exacerbated by limitations in access to appropriate health care, disability and compensation benefits, and vocational rehabilitation services. A clinical program that was designed to address the complex medical and psychosocial needs of these workers in a comprehensive manner was successfully established. Full justice for these workers depends on larger societal changes.

  5. Cardiovascular Risk and Its Associated Factors in Health Care Workers in Colombia: A Study Protocol

    PubMed Central

    2015-01-01

    Background Cardiovascular diseases are the leading cause of mortality worldwide, for this reason, they are a public health problem. In Colombia, cardiovascular diseases are the main cause of mortality, having a death rate of 152 deaths per 100,000 population. There are 80% of these cardiovascular events that are considered avoidable. Objective The objective of the study is to determine the prevalence of the cardiovascular risk and its associated factors among the institution’s workers in order to design and implement interventions in the work environment which may achieve a decrease in such risk. Methods An analytical cross-sectional study was designed to determine the cardiovascular risk and its associated factors among workers of a high complexity health care institution. A self-applied survey will be conducted considering sociodemographic aspects, physical activity, diet, alcohol consumption, smoking, level of perceived stress, and personal and family history. In a second appointment, a physical examination will be made, as well as anthropometric measurements and blood pressure determination. Also, blood samples for evaluating total and high density lipoprotein cholesterol, triglycerides, and fasting blood sugar will be taken. A ten-year global risk for cardiovascular disease will be determined using the Framingham score. A descriptive analysis of the population’s characteristics and a stratified analysis by sex, age, and occupation will be made. Bivariate and multivariate analysis will be made using logistic regression models to evaluate the association between cardiovascular risk and the independent variables. The research protocol was approved by the Scientific and Technical Committee and the Ethics Committee on Research of the Fundación Cardiovascular de Colombia. Results The protocol has already received funding and the enrollment phase will begin in the coming months. Conclusions The results of this study will give the foundation for the design

  6. Meeting Community Health Worker Needs for Maternal Health Care Service Delivery Using Appropriate Mobile Technologies in Ethiopia

    PubMed Central

    Little, Alex; Medhanyie, Araya; Yebyo, Henock; Spigt, Mark; Dinant, Geert-Jan; Blanco, Roman

    2013-01-01

    Background Mobile health applications are complex interventions that essentially require changes to the behavior of health care professionals who will use them and changes to systems or processes in delivery of care. Our aim has been to meet the technical needs of Health Extension Workers (HEWs) and midwives for maternal health using appropriate mobile technologies tools. Methods We have developed and evaluated a set of appropriate smartphone health applications using open source components, including a local language adapted data collection tool, health worker and manager user-friendly dashboard analytics and maternal-newborn protocols. This is an eighteen month follow-up of an ongoing observational research study in the northern of Ethiopia involving two districts, twenty HEWs, and twelve midwives. Results Most health workers rapidly learned how to use and became comfortable with the touch screen devices so only limited technical support was needed. Unrestricted use of smartphones generated a strong sense of ownership and empowerment among the health workers. Ownership of the phones was a strong motivator for the health workers, who recognised the value and usefulness of the devices, so took care to look after them. A low level of smartphones breakage (8.3%,3 from 36) and loss (2.7%) were reported. Each health worker made an average of 160 mins of voice calls and downloaded 27Mb of data per month, however, we found very low usage of short message service (less than 3 per month). Conclusions Although it is too early to show a direct link between mobile technologies and health outcomes, mobile technologies allow health managers to more quickly and reliably have access to data which can help identify where there issues in the service delivery. Achieving a strong sense of ownership and empowerment among health workers is a prerequisite for a successful introduction of any mobile health program. PMID:24204872

  7. Health care workers and disaster preparedness: barriers to and facilitators of willingness to respond

    PubMed Central

    2012-01-01

    Background There is limited research on preparation of health care workers for disasters. Prior research addressed systems-level responses rather than specific institutional and individual responses. Methods An anonymous online survey of hospital employees, who were grouped into clinical and non-clinical staff, was conducted. The objective of this study was to compare perceptions of clinical and non-clinical staff with regard to personal needs, willingness to report (WTR) to work, and level of confidence in the hospital‘s ability to protect safety and provide personal protective equipment (PPE) in the event of a disaster. Results A total of 5,790 employees were surveyed; 41 % responded (77 % were women and 63 % were clinical staff). Seventy-nine percent either strongly or somewhat agreed that they know what to do in the event of a disaster, and the majority was willing to report for duty in the event of a disaster. The most common barriers included ‘caring for children’ (55 %) and ‘caring for pets’ (34 %). Clinical staff was significantly more likely than non-clinical staff to endorse childcare responsibilities (58.9 % vs. 48 %) and caring for pets (36 % vs. 30 %, respectively) as barriers to WTR. Older age was a significant facilitator of WTR [odds ratio (OR) 1.49, 95 % CI: 1.27-1.65]. Non-clinical staff was more confident in the hospital’s ability to protect safety and provide PPE compared to clinical staff (OR 1.43, 95 % CI: 1.15-1.78). Conclusion Clinical and non-clinical staff differ in the types of barriers to WTR endorsed, as well as their confidence in the hospital’s ability to provide them with PPE and guarantee their safety. PMID:22716272

  8. Knowledge and Practice on Injection Safety among Primary Health Care Workers in Kaski District, Western Nepal

    PubMed Central

    Gyawali, Sudesh; Rathore, Devendra Singh; Shankar, P Ravi; Kc, Vikash Kumar; Jha, Nisha; Sharma, Damodar

    2016-01-01

    Background Unsafe injection practice can transmit various blood borne infections. The aim of this study was to assess the knowledge and practice of injection safety among injection providers, to obtain information about disposal of injectable devices, and to compare the knowledge and practices of urban and rural injection providers. Methods The study was conducted with injection providers working at primary health care facilities within Kaski district, Nepal. Ninety-six health care workers from 69 primary health care facilities were studied and 132 injection events observed. A semi-structured checklist was used for observing injection practice and a questionnaire for the survey. Respondents were interviewed to complete the questionnaire and obtain possible explanations for certain observed behaviors. Results All injection providers knew of at least one pathogen transmitted through use/re-use of unsterile syringes. Proportion of injection providers naming hepatitis/jaundice as one of the diseases transmitted by unsafe injection practice was significantly higher in urban (75.6%) than in rural (39.2%) area. However, compared to urban respondents (13.3%), a significantly higher proportion of rural respondents (37.3%) named Hepatitis B specifically as one of the diseases transmitted. Median (inter-quartile range) number of therapeutic injection and injectable vaccine administered per day by the injection providers were 2 (1) and 1 (1), respectively. Two handed recapping by injection providers was significantly higher in urban area (33.3%) than in rural areas (21.6%). Most providers were not aware of the post exposure prophylaxis guideline. Conclusion The knowledge of the injection providers about safe injection practice was acceptable. The use of safe injection practice by providers in urban and rural health care facilities was almost similar. The deficiencies noted in the practice must be addressed. PMID:27540325

  9. From 'solution shop' model to 'focused factory' in hospital surgery: increasing care value and predictability.

    PubMed

    Cook, David; Thompson, Jeffrey E; Habermann, Elizabeth B; Visscher, Sue L; Dearani, Joseph A; Roger, Veronique L; Borah, Bijan J

    2014-05-01

    The full-service US hospital has been described organizationally as a "solution shop," in which medical problems are assumed to be unstructured and to require expert physicians to determine each course of care. If universally applied, this model contributes to unwarranted variation in care, which leads to lower quality and higher costs. We purposely disrupted the adult cardiac surgical practice that we led at Mayo Clinic, in Rochester, Minnesota, by creating a "focused factory" model (characterized by a uniform approach to delivering a limited set of high-quality products) within the practice's solution shop. Key elements of implementing the new model were mapping the care process, segmenting the patient population, using information technology to communicate clearly defined expectations, and empowering nonphysician providers at the bedside. Using a set of criteria, we determined that the focused-factory model was appropriate for 67 percent of cardiac surgical patients. We found that implementation of the model reduced resource use, length-of-stay, and cost. Variation was markedly reduced, and outcomes were improved. Assigning patients to different care models increases care value and the predictability of care process, outcomes, and costs while preserving (in a lesser clinical footprint) the strengths of the solution shop. We conclude that creating a focused-factory model within a solution shop, by applying industrial engineering principles and health information technology tools and changing the model of work, is very effective in both improving quality and reducing costs.

  10. Utilization of the QuantiFERON-TB Gold Test in a Two-Step Process with the Tuberculin Skin Test To Evaluate Health Care Workers for Latent Tuberculosis▿

    PubMed Central

    Abdalhamid, Baha; Hinrichs, Steven H.; Garrett, Jodi L.; O'Neill, Jean M.; Hansen-Cain, Kristine M.; Armbrust, Amy A.; Iwen, Peter C.

    2010-01-01

    A cost analysis of combining a tuberculin skin test (TST) and the QuantiFERON-TB Gold test (QFT-GT) to detect latent tuberculosis in newly hired health care workers was performed. An approximately 50% reduction in the cost of additional care was realized when workers with positive TST results were subsequently screened using the QFT-GT. PMID:20573876

  11. A Configurational Approach to the Relationship between High-Performance Work Practices and Frontline Health Care Worker Outcomes

    PubMed Central

    Chuang, Emmeline; Dill, Janette; Morgan, Jennifer Craft; Konrad, Thomas R

    2012-01-01

    Objective To identify high-performance work practices (HPWP) associated with high frontline health care worker (FLW) job satisfaction and perceived quality of care. Methods Cross-sectional survey data from 661 FLWs in 13 large health care employers were collected between 2007 and 2008 and analyzed using both regression and fuzzy-set qualitative comparative analysis. Principal Findings Supervisor support and team-based work practices were identified as necessary for high job satisfaction and high quality of care but not sufficient to achieve these outcomes unless implemented in tandem with other HPWP. Several configurations of HPWP were associated with either high job satisfaction or high quality of care. However, only one configuration of HPWP was sufficient for both: the combination of supervisor support, performance-based incentives, team-based work, and flexible work. These findings were consistent even after controlling for FLW demographics and employer type. Additional research is needed to clarify whether HPWP have differential effects on quality of care in direct care versus administrative workers. Conclusions High-performance work practices that integrate FLWs in health care teams and provide FLWs with opportunities for participative decision making can positively influence job satisfaction and perceived quality of care, but only when implemented as bundles of complementary policies and practices. PMID:22224858

  12. Apartment residents' and day care workers' exposures to tetrachloroethylene and deficits in visual contrast sensitivity.

    PubMed Central

    Schreiber, Judith S; Hudnell, H Kenneth; Geller, Andrew M; House, Dennis E; Aldous, Kenneth M; Force, Michael S; Langguth, Karyn; Prohonic, Elizabeth J; Parker, Jean C

    2002-01-01

    Tetrachloroethylene (also called perchloroethylene, or perc), a volatile organic compound, has been the predominant solvent used by the dry-cleaning industry for many years. The U.S. Environmental Protection Agency (EPA) classified perc as a hazardous air pollutant because of its potential adverse impact on human health. Several occupational studies have indicated that chronic, airborne perc exposure adversely affects neurobehavioral functions in workers, particularly visual color discrimination and tasks dependent on rapid visual-information processing. A 1995 study by Altmann and colleagues extended these findings, indicating that environmental perc exposure at a mean level of 4,980 microg/m(3) (median=1,360 microg/m(3)) alters neurobehavioral functions in residents living near dry-cleaning facilities. Although the U.S. EPA has not yet set a reference concentration guideline level for environmental exposure to airborne perc, the New York State Department of Health set an air quality guideline of 100 microg/m(3). In the current residential study, we investigated the potential for perc exposure and neurologic effects, using a battery of visual-system function tests, among healthy members of six families living in two apartment buildings in New York City that contained dry-cleaning facilities on the ground floors. In addition, a day care investigation assessed the potential for perc exposure and effects among workers at a day care center located in the same one-story building as a dry-cleaning facility. Results from the residential study showed a mean exposure level of 778 microg/m(3) perc in indoor air for a mean of 5.8 years, and that perc levels in breath, blood, and urine were 1-2 orders of magnitude in excess of background values. Group-mean visual contrast sensitivity (VCS), a measure of the ability to detect visual patterns, was significantly reduced in the 17 exposed study participants relative to unexposed matched-control participants. The groups did not

  13. 75 FR 65515 - NRC Corporation, USPS Help Desk of Customer Care Center, Including On-Site Leased Workers of Volt...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-25

    ... Employment and Training Administration NRC Corporation, USPS Help Desk of Customer Care Center, Including On... September 3, 2010 (75 FR 54187). The workers supply information technology support services and are not... claim is of sufficient weight to justify reconsideration of the U.S. Department of Labor's...

  14. Words from the Heart Speak to the Heart: A Study of Deep Acting, Faking, and Hiding among Child Care Workers

    ERIC Educational Resources Information Center

    Lee, Raymond T.; Brotheridge, Celeste M.

    2011-01-01

    Purpose: The purpose of this paper is to understand, from the child care worker's perspective, how work experience, display rules, and affectivity are related to emotional labor. It also examines the utility of separating surface acting into its two components: the hiding and faking of emotions. Design/methodology/approach: This study is based on…

  15. Improving Diabetes Care and Health Measures among Hispanics Using Community Health Workers: Results from a Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Babamoto, Kenneth S.; Sey, Kwa A.; Camilleri, Angela J.; Karlan, Vicki J.; Catalasan, Joana; Morisky, Donald E.

    2009-01-01

    The increasing prevalence of diabetes and obesity, growing health disparities, and shortage of bilingual and culturally trained health care professionals underscore the role of trained community health workers (CHWs) to provide economically sustainable and culturally relevant services. This prospective randomized design evaluated the relative…

  16. Increasing the delivery of health care services to migrant farm worker families through a community partnership model.

    PubMed

    Connor, Ann; Rainer, Laura P; Simcox, Jordan B; Thomisee, Karen

    2007-01-01

    The Farm Worker Family Health Program (FWFHP) is a 13-year community partnership model designed to increase delivery of health care services for migrant farm worker families. During a yearly 2-week immersion experience, 90 students and faculty members provide health care services, including physical examinations, health screenings, health education, physical therapy, and dental care for 1,000 migrant farm workers and migrant children. Students and faculty members gain a deeper appreciation of the health and social issues that migrant farm worker families face by providing health care services in the places where migrant families live, work, and are educated. Although the model is not unique, it is significant because of its sustained history, interdisciplinary collaboration among community and academic partners, mutual trust and connections among the partners, and the way the program is tailored to meet the needs of the population served. The principles of social responsibility and leadership frame the FWFHP experience. This community partnership model can be replicated by others working with at-risk populations in low-resource settings. PMID:17553025

  17. With strengthened guidelines for health care workers, the CDC ups its game against the deadly Ebola virus.

    PubMed

    2014-12-01

    Informed by the cases of two nurses who contracted Ebola virus disease (EVD) while caring for a patient with the disease in Dallas, TX, the Centers for Disease Control and Prevention (CDC) in Atlanta, GA, has unveiled strengthened guidance for health care workers. Further, nursing organizations are pledging to work together to identify gaps and make system-level improvements to protect both patients and caregivers. The CDC's new recommendations emphasize rigorous training for health care workers in how to put on and take off personal protective equipment (PPE), and they state that this activity should always be carefully supervised by a monitor. The guidance also states that health care workers should use either an N-95' respirator mask or a powered air purifying respirator (PAPR) when they are providing care to a patient with Ebola. Experts stress that the new guidance does not change the fundamental issue that Ebola is transmitted through contact with infectious substances from patients. Nursing organizations are pledging to work together to identify problems and improve safety for both caregivers and patients. PMID:25522493

  18. Caring for Children and Youth Who Have Been Sexually Abused: A Training Manual for Child and Youth Care Workers and Foster Parents. Facilitator's Guide.

    ERIC Educational Resources Information Center

    Croll, Linda

    This facilitator's guide is part of an overall program developed as a resource for child and youth care workers and foster parents. Those using the facilitator's guide must possess considerable knowledge and training in the areas of child abuse, child welfare, child laws, human development, and group and family dynamics. Facilitators must be able…

  19. Intensive Care Nurses’ Belief Systems Regarding the Health Economics: A Focused Ethnography

    PubMed Central

    Heydari, Abbas; Vafaee-Najar, Ali; Bakhshi, Mahmoud

    2016-01-01

    Background: Health care beliefs can have an effect on the efficiency and effectiveness of nursing practices. Nevertheless, how belief systems impact on the economic performance of intensive care unit (ICU) nurses is not known. This study aimed to explore the ICU nurses’ beliefs and their effect on nurse’s: practices and behavior patterns regarding the health economics. Methods: In this study, a focused ethnography method was used. Twenty-four informants from ICU nurses and other professional individuals were purposively selected and interviewed. As well, 400 hours of ethnographic observations were used for data collection. Data analysis was performed using the methods described by Miles and Huberman (1994). Findings: Eight beliefs were found that gave meaning to ICU nurse’s practices regarding the health economics. 1. The registration of medications and supplies disrupt the nursing care; 2. Monitoring and auditing improve consumption; 3. There is a fear of possible shortage in the future; 4. Supply and replacement of equipment is difficult; 5. Higher prices lead to more accurate consumption; 6. The quality of care precedes the costs; 7. Clinical Guidelines are abundant but useful; and 8. Patient economy has priority over hospital economy. Maintaining the quality of patient care with least attention to hospital costs was the main focus of the beliefs formed up in the ICU regarding the health economics. Conclusions: ICU nurses’ belief systems have significantly shaped in relation to providing a high-quality care. Although high quality of care can lead to a rise in the effectiveness of nursing care, cost control perspective should also be considered in planning for improve the quality of care. Therefore, it is necessary to involve the ICU nurses in decision-making about unit cost management. They must become familiar with the principles of heath care economics and productivity by applying an effective cost management program. It may be optimal to implement the

  20. Physical violence against health care workers: A nationwide study from Iran

    PubMed Central

    Fallahi-Khoshknab, Masoud; Oskouie, Fatemeh; Najafi, Fereshteh; Ghazanfari, Nahid; Tamizi, Zahra; Afshani, Shahla

    2016-01-01

    Background: Workplace violence is a serious and problematic phenomenon in health care settings. Research shows that health care workers are at the highest risk of such violence. The aim of this study was to address the frequency of physical violence against Iranian health personnel, their response to such violence, as well as the contributing factors to physical violence. Materials and Methods: A cross-sectional study was conducted in 2011, in which 6500 out of 57,000 health personnel working in some teaching hospitals were selected using multi-stage random sampling. Data were collected using the questionnaire of “Workplace Violence in the Health Sector” developed by the International Labor Organization, the International Council of Nurses, the World Health Organization, and the Public Services International. Results: The findings revealed that 23.5% of the participants were exposed to physical violence in the 12 months prior to the study. Nurses were the main victims of physical violence (78%) and patients' families were the main perpetrators of violence (56%). The most common reaction of victims to physical violence was asking the aggressor to stop violence (45%). Lack of people's knowledge of employees' tasks was the most common contributing factor to physical violence (49.2%). Conclusions: Based on the results, legislating appropriate laws in order to prevent and control violence in the workplace is necessary. Moreover, developing educational programs to manage the incidence of physical violence should be on health centers' agenda. PMID:27186199

  1. Work Process in Primary Health Care: action research with Community Health Workers.

    PubMed

    Cordeiro, Luciana; Soares, Cassia Baldini

    2015-11-01

    The aim of this article was to describe and analyze the work of community health workers (CHW). The main objective of study was to analyze the development process of primary health care practices related to drug consumption. The study is based on the Marxist theoretical orientation and the action research methodology, which resulted in the performance of 15 emancipatory workshops. The category work process spawned the content analysis. It exposed the social abandonment of the environment in which the CHWs work is performed. The latter had an essential impact on the identification of the causes of drug-related problems. These findings made it possible to criticize the reiterative, stressful actions that are being undertaken there. Such an act resulted in raising of the awareness and creating the means for political action. The CHWs motivated themselves to recognize the object of the work process in primary health care, which they found to be the disease or addiction in the case of drug users. They have criticized this categorization as well as discussed the social division of work and the work itself whilst recognizing themselves as mere instruments in the work process. The latter has inspired the CHW to become subjects, or co-producers of transformations of social needs.

  2. Critical Incidents of Nonadherence with Standard Precautions Guidelines Among Community Hospital-based Health Care Workers

    PubMed Central

    Ferguson, Kristi J; Waitzkin, Howard; Beekmann, Susan E; Doebbeling, Bradley N

    2004-01-01

    OBJECTIVE To identify, categorize, and assess critical incidents of nonadherence to standard precautions. DESIGN Qualitative and quantitative analysis of a written, mail-out survey. SETTING Community hospitals. PARTICIPANTS Statewide stratified random sample of community hospital-based health care workers at risk for blood exposure. MAIN VARIABLE Responses to the question: “Think of an incident during the past year when you didn't adhere to universal precautions. Please describe the situation and why you didn't adhere.” RESULTS Reasons given for not using precautions included: belief that stopping to use standard precautions would have put the patient at risk (22%); using precautions would have interfered with patient care (20%); precautions were not warranted in a specific situation (14%); did not anticipate the potential for exposure (14%); and high job demands that had caused respondent to be in a hurry (11%). Less often, equipment was not available (7%), respondent forgot (6%), respondent thought that the patient did not pose a risk (4%), or the available equipment was not effective (3%). In terms of overall exposure rates, 34% of those who described an incident had experienced a sharps injury during the previous 3 months and 42% had experienced a mucocutaneous exposure. In terms of overall nonadherence, 44% wore gloves less than 100% of the time, while 61% washed their hands less than 100% of the time. Needlestick injuries were lowest among those who had forgotten to use precautions, while mucocutaneous exposures were highest among those who had not anticipated potential exposure while performing the task. Failure to wear gloves routinely was highest among those who said that following precautions interfered with their ability to provide care and among those who believed a particular patient to be low risk; failure to wash hands routinely was also highest among the latter group and lowest among those who said necessary equipment was not available

  3. Predictors of low prevalence of latent tuberculosis infection among Egyptian health care workers at intensive care and bronchoscopy units

    PubMed Central

    Hefzy, Enas Mamdouh; Wegdan, Ahmed Ashraf; Elhefny, Radwa Ahmed; Nasser, Samar Hassan

    2016-01-01

    Aim: Latent tuberculosis infections (LTBI) contain a significant reservoir for future epidemics. Screening of health care workers (HCWs) in a high-risk tuberculosis (TB) environment is an important strategy in TB control. The study aimed to assess the prevalence of LTBI among high risk Egyptian HCWs and to assess infection associated risk factors. Methods: Fifty-two HCWs who work at intensive care unit (ICU), bronchoscopy unit, and chest diseases department were tested for LTBI using both tuberculin skin test (TST) and Quantiferon TB Gold in-tube test (QFT). Risk factors for infection, knowledge of HCWs towards different aspects of TB infection and agreement between TST and QFT were also evaluated. Results: Prevalence of LTBI in this study was 13.5% by QFT and TST. It was 13.6% by TST alone and 10.3% by QFT alone. There was good concordance between both tests (Kappa=0.713). There was a statistically significant association between prevalence of LTBI and age of staff ≥30 yr (p=0.002), period of working experience (p=0.006) and working at the Bronchoscopy Unit (p=0.001). The total knowledge of HCWs towards different aspects of TB infection was generally good. Conclusion: Although the participants in the current study were among high risk HCWs, the prevalence of LTBI was low. Bacille Calmette-Guerin (BCG) vaccination, young age, short employment duration, good knowledge and a good infection control were the predictors of low risk of contracting TB at our hospitals. The risk of TB infection in resource-limited countries can be reduced with simple continuous educational and administrative infection control programmes. PMID:27777875

  4. Latent Tuberculosis in Health Care Workers Exposed to Active Tuberculosis in a Tertiary Care Hospital in Oman

    PubMed Central

    Khamis, Faryal; Al-Lawati, Adil; Al-Zakwani, Ibrahim; Al-Abri, Seif; Al-Naamani, Jaleelah; Al-Harthi, Harith; Al-Jardani, Amina; Al-Harthi, Aliya

    2016-01-01

    Objectives Data on the prevalence of tuberculosis (TB) in healthcare workers (HCW) in Oman and the Arabian Gulf is scarce. The aim of this study was to estimate the prevalence of latent tuberculosis (LTB) among HCW exposed to active TB in one of the tertiary care hospitals in Muscat. Methods Exposed HCW were screened for LTB from January to June 2012 using skin tuberculin and serum interferon tests. Candidates were followed-up for a total of nine months. Descriptive statistics were used to summarize the data. Results A total of 371 exposed HCW were involved in the study. The incidence of LTB in exposed HCW was 33.2% (n = 123). Almost 54% (66/123) of the HCW started treatment and only 42.4% (28/66) completed the full nine-month treatment course. Conclusions The high prevalence of LTBI in exposed HCW merits further evaluation of the screening and treatment programs in the country. Future countrywide studies are warranted to provide more precise statistics on the prevalence and management of this public health issue. PMID:27403243

  5. Prevalence of Latent Tuberculosis among Health Care Workers in High Burden Countries: A Systematic Review and Meta-Analysis

    PubMed Central

    Nasreen, Sharifa; Shokoohi, Mostafa; Malvankar-Mehta, Monali S.

    2016-01-01

    Background Tuberculosis is one of the leading causes of death worldwide. Twenty-two high burden countries contributed to the majority of worldwide tuberculosis cases in 2015. Health care workers are at high risk of acquiring tuberculosis through occupational exposure. Objective To estimate the prevalence of latent tuberculosis infection (LTBI) among health care workers in high burden countries. Methods Databases including MEDLINE (Ovid), EMBASE (Ovid), CINAHL (Ovid) and ISI Web of Science (Thompson-Reuters), and grey literature were searched for English language records on relevant medical subject headings (MeSH) terms of LTBI and health care providers. Literature was systematically reviewed using EPPI-Reviewer4 software. Prevalence and incidence of LTBI and 95% confidence intervals (CI) were reported. Pooled prevalence of LTBI and 95% CI were calculated using random-effects meta-analysis models and heterogeneity was assessed using I2 statistics. Sub-group analysis was conducted to assess the cause of heterogeneity. Results A total of 990 records were identified. Of those, 18 studies from only 7 high burden countries representing 10,078 subjects were included. Tuberculin skin test results were available for 9,545 participants. The pooled prevalence of LTBI was 47% (95% CI 34% to 60%, I2 = 99.6%). In subgroup analyses according to the country of the study, the pooled prevalence of LTBI was lowest in Brazil (37%) and highest in South Africa (64%). The pooled prevalence of LTBI among medical and nursing students was 26% (95% CI 6% to 46%, I2 = 99.3%) while the prevalence among all types of health care workers was 57% (95% CI 44% to 70%, I2 = 99.1%). Incidence of LTBI was available for health care workers in four countries. The cumulative incidence ranged from 2.8% in Brazilian medical students to 38% among all types of health care workers in South Africa. Conclusion The findings of this study suggest that there is a high burden of LTBI among health care workers in

  6. Care coordination between specialty care and primary care: a focus group study of provider perspectives on strong practices and improvement opportunities.

    PubMed

    Kim, Bo; Lucatorto, Michelle A; Hawthorne, Kara; Hersh, Janis; Myers, Raquel; Elwy, A Rani; Graham, Glenn D

    2015-01-01

    Care coordination between the specialty care provider (SCP) and the primary care provider (PCP) is a critical component of safe, efficient, and patient-centered care. Veterans Health Administration conducted a series of focus groups of providers, from specialty care and primary care clinics at VA Medical Centers nationally, to assess 1) what SCPs and PCPs perceive to be current practices that enable or hinder effective care coordination with one another and 2) how these perceptions differ between the two groups of providers. A qualitative thematic analysis of the gathered data validates previous studies that identify communication as being an important enabler of coordination, and uncovers relationship building between specialty care and primary care (particularly through both formal and informal relationship-building opportunities such as collaborative seminars and shared lunch space, respectively) to be the most notable facilitator of effective communication between the two sides. Results from this study suggest concrete next steps that medical facilities can take to improve care coordination, using as their basis the mutual understanding and respect developed between SCPs and PCPs through relationship-building efforts. PMID:25653538

  7. [Problems in Providing Care to Young Workers with Mental Health Disturbance - A Survey Using of the Cases of Workers Who Had Taken Sick Leave Due to Mental Health Disturbance].

    PubMed

    Ikegami, Kazunori; Eguchi, Masafumi; Osaki, Yohei; Nakao, Tomo; Nakamoto, Kengo; Hiro, Hisanori

    2016-06-01

    In this study we discuss the measures of providing care to young workers with mental health disturbance by analyzing the cases of workers who had taken sick leave due to mental health disturbance. We analyzed 36 cases, collected from 11 occupational physicians, of workers who had taken sick leave due to mental health disturbance, and discuss measures for providing care to such young workers. We organized and classified data containing the details of the care provided to the workers and analyzed the main aspects and problems in providing it. We compared two age groups of workers: a below age 30 group, and an age 30 and above group. We observed that occupational nurses were more frequently the primary persons who dealt with workplace consultations in the below age 30 group (before sick leave: 38.9%; during sick leave: 38.9%) compared to the age 30 and above group (before sick leave: 16.7%, during sick leave: 11.1%). Most of the case providers expressed the opinion that a support system is necessary to help the workers return to work and it is an important factor in providing care to workers who have taken sick leave due to mental health disturbance. Coordination with the families of the workers was also important in the below age 30 group. It might be difficult to assign young workers to suitable workplaces or duties because of their inadequate job skills, lack of sufficient experience, and influence of personal factors on mental health. Our results suggest that it is important to provide appropriate care for young workers with mental health disturbance, such as support by occupational nurses, and to strengthen the collaboration between their families and the workplace staff.

  8. [Problems in Providing Care to Young Workers with Mental Health Disturbance - A Survey Using of the Cases of Workers Who Had Taken Sick Leave Due to Mental Health Disturbance].

    PubMed

    Ikegami, Kazunori; Eguchi, Masafumi; Osaki, Yohei; Nakao, Tomo; Nakamoto, Kengo; Hiro, Hisanori

    2016-06-01

    In this study we discuss the measures of providing care to young workers with mental health disturbance by analyzing the cases of workers who had taken sick leave due to mental health disturbance. We analyzed 36 cases, collected from 11 occupational physicians, of workers who had taken sick leave due to mental health disturbance, and discuss measures for providing care to such young workers. We organized and classified data containing the details of the care provided to the workers and analyzed the main aspects and problems in providing it. We compared two age groups of workers: a below age 30 group, and an age 30 and above group. We observed that occupational nurses were more frequently the primary persons who dealt with workplace consultations in the below age 30 group (before sick leave: 38.9%; during sick leave: 38.9%) compared to the age 30 and above group (before sick leave: 16.7%, during sick leave: 11.1%). Most of the case providers expressed the opinion that a support system is necessary to help the workers return to work and it is an important factor in providing care to workers who have taken sick leave due to mental health disturbance. Coordination with the families of the workers was also important in the below age 30 group. It might be difficult to assign young workers to suitable workplaces or duties because of their inadequate job skills, lack of sufficient experience, and influence of personal factors on mental health. Our results suggest that it is important to provide appropriate care for young workers with mental health disturbance, such as support by occupational nurses, and to strengthen the collaboration between their families and the workplace staff. PMID:27302732

  9. Responder Status Criterion for Stepped Care Trauma-Focused Cognitive Behavioral Therapy for Young Children

    ERIC Educational Resources Information Center

    Salloum, Alison; Scheeringa, Michael S.; Cohen, Judith A.; Storch, Eric A.

    2015-01-01

    Background: In order to develop Stepped Care trauma-focused cognitive behavioral therapy (TF-CBT), a definition of early response/non-response is needed to guide decisions about the need for subsequent treatment. Objective: The purpose of this article is to (1) establish criterion for defining an early indicator of response/non-response to the…

  10. Mentoring the Next Generation of Social Workers in Palliative and End-of-Life Care: The Zelda Foster Studies Program.

    PubMed

    Gardner, Daniel S; Gerbino, Susan; Walls, Jocelyn Warner; Chachkes, Esther; Doherty, Meredith J

    2015-01-01

    As Americans live longer with chronic illnesses, there is a growing need for social workers with the knowledge and skills to deliver quality palliative care to older adults and their families. Nevertheless, there remains a critical shortage of social workers prepared to provide quality palliative and end-of-life care (PELC) and to maintain the field into the next generation. Formal mentorship programs represent an innovative approach to enhancing practice, providing support and guidance, and promoting social work leadership in the field. This article reviews the literature on mentorship as an approach to professional and leadership development for emerging social workers in PELC. The Zelda Foster Studies Program in Palliative and End-of-Life Care bolsters competencies and mentors social workers in PELC over the trajectory of their careers, and enhances the capacity in the field. Findings from the first six years of two components of the ZF Program are examined to illustrate the feasibility, benefits, and challenges of formal mentorship programs. The authors describe the background, structure, and evaluation of the initiative's mentorship programs, and discuss the implications of mentorship in PELC for social work education, practice, and research. PMID:26380922

  11. Development of Stepped Care Trauma-Focused Cognitive-Behavioral Therapy for Young Children

    PubMed Central

    Salloum, Alison; Scheeringa, Michael S.; Cohen, Judith A.; Storch, Eric A.

    2014-01-01

    Young children who are exposed to traumatic events are at risk for developing posttraumatic stress disorder (PTSD). While effective psychosocial treatments for childhood PTSD exist, novel interventions that are more accessible, efficient, and cost-effective are needed to improve access to evidence-based treatment. Stepped care models currently being developed for mental health conditions are based on a service delivery model designed to address barriers to treatment. This treatment development article describes how trauma-focused cognitive-behavioral therapy (TF-CBT), a well-established evidence-based practice, was developed into a stepped care model for young children exposed to trauma. Considerations for developing the stepped care model for young children exposed to trauma, such as the type and number of steps, training of providers, entry point, inclusion of parents, treatment components, noncompliance, and a self-correcting monitoring system, are discussed. This model of stepped care for young children exposed to trauma, called Stepped Care TF-CBT, may serve as a model for developing and testing stepped care approaches to treating other types of childhood psychiatric disorders. Future research needed on Stepped Care TF-CBT is discussed. PMID:25411544

  12. Caregiver Objective Burden and Assessments of Patient-Centered, Family-Focused Care for Frail Elderly Veterans

    ERIC Educational Resources Information Center

    Rose, Julia Hannum; Bowman, Karen F.; O'Toole, Elizabeth E.; Abbott, Katherine; Love, Thomas E.; Thomas, Charles; Dawson, Neal V.

    2007-01-01

    Purpose: There is a growing consensus that quality of care for frail elders should include family and be evaluated in terms of patient-centered, family-focused care (PCFFC). Family caregivers are in a unique and sometimes sole position to evaluate such care. In the context of caring for physically frail elders, this study examined the extent to…

  13. The Hospital Medicine Reengineering Network (HOMERuN): a learning organization focused on improving hospital care.

    PubMed

    Auerbach, Andrew D; Patel, Mitesh S; Metlay, Joshua P; Schnipper, Jeffrey L; Williams, Mark V; Robinson, Edmondo J; Kripalani, Sunil; Lindenauer, Peter K

    2014-03-01

    Converting the health care delivery system into a learning organization is a key strategy for improving health outcomes. Although the collaborative learning organization approach has been successful in neonatal intensive care units and disease-specific collaboratives, there are few examples in general medicine and none in adult medicine that have leveraged the role of hospitalists nationally across multiple institutions to implement improvements. The authors describe the rationale for and early work of the Hospital Medicine Reengineering Network (HOMERuN), a collaborative of hospitals, hospitalists, and multidisciplinary care teams founded in 2011 that seeks to measure, benchmark, and improve the efficiency, quality, and outcomes of care in the hospital and afterwards. Robust and timely evaluation, with learning and refinement of approaches across institutions, should accelerate improvement efforts. The authors review HOMERuN's collaborative model, which focuses on a community-based participatory approach modified to include hospital-based staff as well as the larger community. HOMERuN's initial project is described, focusing on care transition measurement using perspectives from the patient, caregiver, and providers. Next steps and sustainability of the organization are discussed, including benchmarking, collaboration, and effective dissemination of best practices to stakeholders. PMID:24448050

  14. Community-based delivery of maternal care in conflict-affected areas of eastern Burma: perspectives from lay maternal health workers.

    PubMed

    Teela, Katherine C; Mullany, Luke C; Lee, Catherine I; Poh, Eh; Paw, Palae; Masenior, Nicole; Maung, Cynthia; Beyrer, Chris; Lee, Thomas J

    2009-04-01

    In settings where active conflict, resource scarcity, and logistical constraints prevail, provision of maternal health services within health centers and hospitals is unfeasible and alternative community-based strategies are needed. In eastern Burma, such conditions necessitated implementation of the "Mobile Obstetric Maternal Health Worker" (MOM) project, which has employed a community-based approach to increase access to essential maternal health services including emergency obstetric care. Lay Maternal Health Workers (MHWs) are central to the MOM service delivery model and, because they are accessible to both the communities inside Burma and to outside project managers, they serve as key informants for the project. Their insights can facilitate program and policy efforts to overcome critical delays and insufficient management of maternal complications linked to maternal mortality. Focus group discussions (n=9), in-depth interviews (n=18), and detailed case studies (n=14) were collected from MHWs during centralized project management meetings in February and October of 2007. Five case studies are presented to characterize and interpret the realities of reproductive health work in a conflict-affected setting. Findings highlight the process of building supportive networks and staff ownership of the MOM project, accessing and gaining community trust and participation to achieve timely delivery of care, and overcoming challenges to manage and appropriately deliver essential health services. They suggest that some emergency obstetric care services that are conventionally delivered only within healthcare settings might be feasible in community or home-based settings when alternatives are not available. This paper provides an opportunity to hear directly from community-based workers in a conflict setting, perspectives seldom documented in the scientific literature. A rights-based approach to service delivery and its suitability in settings where human rights violations

  15. Community health workers for universal health-care coverage: from fragmentation to synergy.

    PubMed

    Tulenko, Kate; Møgedal, Sigrun; Afzal, Muhammad Mahmood; Frymus, Diana; Oshin, Adetokunbo; Pate, Muhammad; Quain, Estelle; Pinel, Arletty; Wynd, Shona; Zodpey, Sanjay

    2013-11-01

    To achieve universal health coverage, health systems will have to reach into every community, including the poorest and hardest to access. Since Alma-Ata, inconsistent support of community health workers (CHWs) and failure to integrate them into the health system have impeded full realization of their potential contribution in the context of primary health care. Scaling up and maintaining CHW programmes is fraught with a host of challenges: poor planning; multiple competing actors with little coordination; fragmented, disease-specific training; donor-driven management and funding; tenuous linkage with the health system; poor coordination, supervision and support, and under-recognition of CHWs' contribution. The current drive towards universal health coverage (UHC) presents an opportunity to enhance people's access to health services and their trust, demand and use of such services through CHWs. For their potential to be fully realized, however, CHWs will need to be better integrated into national health-care systems in terms of employment, supervision, support and career development. Partners at the global, national and district levels will have to harmonize and synchronize their engagement in CHW support while maintaining enough flexibility for programmes to innovate and respond to local needs. Strong leadership from the public sector will be needed to facilitate alignment with national policy frameworks and country-led coordination and to achieve synergies and accountability, universal coverage and sustainability. In moving towards UHC, much can be gained by investing in building CHWs' skills and supporting them as valued members of the health team. Stand-alone investments in CHWs are no shortcut to progress.

  16. Ex-worker is unprotected against COBRA caps on AIDS medical care.

    PubMed

    1996-08-23

    The 11th U.S. Circuit Court of Appeals ruled that the Americans with Disabilities Act (ADA) does not prohibit an employer from capping HIV-related health-care benefits once an infected worker leaves the job and continues insurance coverage under COBRA, the Consolidated Omnibus Budget Reconciliation Act of 1985. The rule, binding in Georgia, Florida and Alabama, came as a result of a suit filed by [name removed] on behalf of [name removed]. As an employee of a [name removed] restaurant owned by [name removed] Inc., [name removed] was fired 2 months after his employer learned of his AIDS diagnosis. [Name removed] contended he was fired because [name removed] wanted to avoid costs in its self-insured health plan. After his dismissal, [name removed] continued paying insurance premiums to his employers group health insurance plan through COBRA, which provides up to $1 million in health care coverage. [Name removed] changed the health insurance plan benefits, capping AIDS-related medical benefits at $10,000 a year, with a lifetime maximum limit of $40,000. By the time [name removed] died, he owed $90,000. The appeals court ruled that [name removed] did not qualify as an individual with a disability because he neither held nor desired to hold a position with [name removed] at or subsequent to the time the alleged discriminatory conduct was committed. The decision could have major implications for people with AIDS who leave their jobs because a former employee cannot use the ADA to challenge discrimination in post-employment fringe benefits.

  17. Where Caring Is Sharing: Evolving Ethical Considerations in Tuberculosis Prevention Among Healthcare Workers.

    PubMed

    Boulanger, Renaud F; Hunt, Matthew R; Benatar, Solomon R

    2016-05-15

    In many settings, the dedication of healthcare workers (HCWs) to the treatment of tuberculosis exposes them to serious risks. Current ethical considerations related to tuberculosis prevention in HCWs involve the threat posed by comorbidities, issues of power and space, the implications of intersectoral collaborations, (de)professionalization, just remuneration, the duty to care, and involvement in research. Emerging ethical considerations include mandatory vaccination and the use of geolocalization services and information technologies. The following exploration of these various ethical considerations demonstrates that the language of ethics can fruitfully be deployed to shed new light on policies that have repercussions on the lives of HCWs in underresourced settings. The language of ethics can help responsible parties get a clearer sense of what they owe HCWs, particularly when these individuals are poorly compensated, and it shows that it is essential that HCWs' contribution be acknowledged through a shared commitment to alleviate ethically problematic aspects of the environments within which they provide care. For this reason, there is a strong case for the community of bioethicists to continue to take greater interest both in the micro-level (eg, patient-provider interactions) and macro-level (eg, injustices that occur as a result of the world order) issues that put HCWs working in areas with high tuberculosis prevalence in ethically untenable positions. Ultimately, appropriate responses to the various ethical considerations explored here must vary based on the setting, but, as this article shows, they require thoughtful reflection and courageous action on the part of governments, policy makers, and managers responsible for national responses to the tuberculosis epidemic. PMID:27118857

  18. Community health workers for universal health-care coverage: from fragmentation to synergy.

    PubMed

    Tulenko, Kate; Møgedal, Sigrun; Afzal, Muhammad Mahmood; Frymus, Diana; Oshin, Adetokunbo; Pate, Muhammad; Quain, Estelle; Pinel, Arletty; Wynd, Shona; Zodpey, Sanjay

    2013-11-01

    To achieve universal health coverage, health systems will have to reach into every community, including the poorest and hardest to access. Since Alma-Ata, inconsistent support of community health workers (CHWs) and failure to integrate them into the health system have impeded full realization of their potential contribution in the context of primary health care. Scaling up and maintaining CHW programmes is fraught with a host of challenges: poor planning; multiple competing actors with little coordination; fragmented, disease-specific training; donor-driven management and funding; tenuous linkage with the health system; poor coordination, supervision and support, and under-recognition of CHWs' contribution. The current drive towards universal health coverage (UHC) presents an opportunity to enhance people's access to health services and their trust, demand and use of such services through CHWs. For their potential to be fully realized, however, CHWs will need to be better integrated into national health-care systems in terms of employment, supervision, support and career development. Partners at the global, national and district levels will have to harmonize and synchronize their engagement in CHW support while maintaining enough flexibility for programmes to innovate and respond to local needs. Strong leadership from the public sector will be needed to facilitate alignment with national policy frameworks and country-led coordination and to achieve synergies and accountability, universal coverage and sustainability. In moving towards UHC, much can be gained by investing in building CHWs' skills and supporting them as valued members of the health team. Stand-alone investments in CHWs are no shortcut to progress. PMID:24347709

  19. Caring with Confidence: Practical Information for Health Workers Who Prevent and Treat HIV Infection in Children. AHRTAG Briefing Paper.

    ERIC Educational Resources Information Center

    Attawell, Kathy, Comp.

    This briefing paper focuses on children ages birth to five years and is intended primarily for health workers in developing countries who are responsible for the management of young children with HIV and AIDS. It provides practical information on: (1) how HIV is transmitted to infants and young children; (2) how transmission can be prevented; (3)…

  20. Latex allergy and occupational asthma in health care workers: adverse outcomes.

    PubMed

    Amr, Sania; Suk, William A

    2004-03-01

    The prevalence of natural rubber latex (NRL) allergy has been estimated to be 5-18% in health care workers, and latex exposure has been one of the leading causes of occupational asthma in the last several years. We present the cases of two nurses who developed sensitivity to NRL, both with dermatologic symptoms and respiratory symptoms that included asthma. They were referred to the University of Maryland for evaluation of their allergies, then for occupational and environmental consults. The patients' allergy to NRL was confirmed on the basis of clinical history, a positive skin test to latex, and the presence of latex-specific immunoglobulin E (IgE) serology by radioallergosorbent test (RAST). Both patients worked in the same community hospital for approximately 20 years; one was an endoscopy nurse and the other worked in the emergency department. Following the diagnosis of allergy to latex, both patients avoided direct skin contact with latex, but they continued to work in the same respective environments, where powdered latex gloves and other potentially sensitizing chemicals were used. Instead of improving, the clinical condition of the patients worsened and they remained symptomatic, even after they were removed from their workplace. Their airways reacted to low levels of a variety of sensitizers and irritants in the environment, and they became depressed. Both nurses were referred for vocational rehabilitation. PMID:14998756

  1. Health care workers' knowledge, attitudes and practices on tobacco use in economically disadvantaged dominican republic communities.

    PubMed

    Prucha, Michael G; Fisher, Susan G; McIntosh, Scott; Grable, John C; Holderness, Heather; Thevenet-Morrison, Kelly; de Monegro, Zahíra Quiñones; Sánchez, José Javier; Bautista, Arisleyda; Díaz, Sergio; Ossip, Deborah J

    2015-04-01

    Tobacco use is increasing globally, particularly in low and middle-income countries like the Dominican Republic (DR) where data have been lacking. Health care worker (HCW) interventions improve quit rates; asking patients about tobacco use at each visit is an evidence-based first step. This study provides the first quantitative examination of knowledge, attitudes and practices of DR HCWs regarding tobacco use. All HCWs (N = 153) in 7 economically disadvantaged DR communities were targeted with anonymous surveys. Approximately 70% (N = 107) completed the primary outcome item, asking about tobacco use at each encounter. Despite >85% strongly agreeing that they should ask about tobacco use at each encounter, only 48.6% reported doing so. While most (94.39%) strongly agreed that smoking is harmful, knowledge of specific health consequences varied from 98.13% for lung cancer to 41.12% for otitis media. Few received training in tobacco intervention (38.32%). Exploratory analyses revealed that always asking even if patients are healthy, strongly agreeing that tobacco causes cardiac disease, and always advising smoke-free homes were associated with always asking. Overall, results demonstrate a disconnect between HCW belief and practice. Though most agreed that always asking about tobacco was important, fewer than half did so. Gaps in HCW knowledge and practices suggest a need for education and policy/infrastructure support. To our knowledge, this is the first reported survey of DR HCWs regarding tobacco, and provides a foundation for future tobacco control in the DR.

  2. [Empowering leadership style among health care workers. A study on the nurse manager].

    PubMed

    Bobbio, A; Manganelli Rattazzi, A M; Muraro, M

    2007-01-01

    The aim of the study is to supply a contribution to the validity analysis of the Empowering Leadership Questionnaire (ELQ) in the Italian context. The ELQ has been developed in order to measure empowering leadership style in organizational contexts and, in the present work, has been administered to a group of health care workers in order to evaluate the Nurse Manager's leadership style. Three hundred and eleven individuals from an important Local Health Unit of the Veneto Region participated in the study, filling out a self-administered structured questionnaires. Correlations between ELQ, task-oriented, relationship-oriented and transformational leadership stile are addressed. Moreover, the relationships between ELQ, organizational commitment, job burnout, turnover intentions and job satisfaction are analyzed. Exploratory, confirmatory, reliability analyses and path analyses techniques are applied. Results support the main results obtained by the authors of the scale. In addition, with regards to ELQ predictive validity, the selected dependent variables (turnover intentions and job satisfaction) are significantly influenced by some of the ELQ dimensions, via the mediation of affective commitment and job burnout, supporting the value of the ELQ measures in the healthcare context.

  3. HIV-related knowledge, attitudes and practice among health care workers in Montenegro.

    PubMed

    Gledović, Zorana; Rakočević, Božidarka; Mugoša, Boban; Grgurević, Anita

    2015-03-01

    The objective of the present study was to assess HIV-related knowledge, attitudes, and practice of health care workers (HCWs) in Montenegro. A cross-sectional study was conducted in the University Clinical Centre of Montenegro in Podgorica. A self-administered anonymous questionnaire was used for data collecting. Out of 526 HCWs, 422 were included in the survey and response rate was 80%. An insufficient level of knowledge on HIV transmission and the risk after exposure was observed generally, although the knowledge was better in physicians compared to other HCWs categories. A rather high proportion of HCWs showed inappropriate attitude regarding the need of HIV testing of all hospitalized patients (64.7%) and obligation of HIV+ patient to report his/her HIV status (88.9%) in order to practice universal precaution. Additionally, 6.2% HCWs would refuse to treat an HIV+ patient. More than a half (55.7%) of study participants were educated in HIV/AIDS and 15.9% of them were HIV tested. Majority of HCWs (67.5%) always applied universal precautions during their daily work with patients. In spite of applying protective devices, number of accidents was great. A continuous education is necessary to increase the level of knowledge of HCWs about the risk of infection at the workplace. This would potentially influence the modification of their attitudes regarding HIV patients and improve prevention at the workplace. Continuous research regarding the professional risk would provide better health and safety among medical staff.

  4. Pericardial effusion as the first manifestation of occupational tuberculosis in a health care worker.

    PubMed

    Flego, Veljko; Lender, Dubravka Matanić; Bulat-Kardum, Ljiljana

    2014-12-01

    Tuberculosis (TB) is an infectious disease and, apart from protecting patients, attention must be given to protecting the persons who come in contact with them, especially nurses and medical practitioners. A 43-year-old immunocompetent male nurse developed occupationally disseminated TB after contact with patients affected by active TB (culture positive) while working in a psychiatric hospital. The first manifestation of the disease was exudative pericarditis with Mycobacterium tuberculosis (MT) confirmed two months after pericardiocentesis and evacuation of 1200 mL of pericardial effusion. Many lymph nodes showed histologic findings of granulomatous inflammation with necrosis. Treatment with antituberculosis drugs caused complications, including transient short-term medication-induced toxic hepatitis, prolonged fever, left pleural nonspecific effusion, and mononeuritis of the right peroneus nerve. The treatment lasted 14 months and led to permanent consequences, including fibrothorax with restrictive ventilation disorders and reduced diffusion of the alveolar-capillary membrane. This case highlights the need to improve the protection of health care workers who are in contact with TB patients, as well as the usefulness of the tuberculin skin test and QuantiFERON-TB test, which can be used to identify early latent TB.

  5. Social-cognitive determinants of hoist usage among health care workers.

    PubMed

    Rickett, Bridgette; Orbell, Sheina; Sheeran, Paschal

    2006-04-01

    Injuries caused by unsafe manual handling of patients are a major source of ill health in health care workers. The present study evaluated the ability of 4 classes of variable to predict use of a hoist when moving a heavily dependent patient. Variables examined were occupational role characteristics, such as hours of work and type of shift worked; biographics, including age and height; aspects of occupational context, such as number of hoists available and number of patients; and motivational variables specified by the theory of planned behavior (Ajzen, 1985) and protection motivation theory (Rogers, 1983). Regression analyses showed that background and social-cognitive variables were able to account for 59% of variance in intention to use a hoist and 41% of variance in use of the hoist assessed 6 weeks later. Height, hoist availability, coworker injunctive norm, perceived behavioral control, response cost, response benefits, and social and physical costs of not using the hoist each explained independent variance in motivation to use a hoist at work. PMID:16649851

  6. Some Reasons Why Rural Workers Do Not Find Work in Tight Labor Markets: Results from Focus Groups Meetings in Rural Michigan. Staff Paper.

    ERIC Educational Resources Information Center

    Moser, Colletta H.; Begashaw, Getachew W.

    A study examined barriers to employment for rural Michigan residents, especially during an economic boom. Four focus groups conducted in four nonmetropolitan growth counties in Michigan indicated that educated, skilled workers were seeking to enter the labor force or to work more hours, even though community leaders, newspapers, and job developers…

  7. Primary Care Opportunities to Prevent Unintentional Home Injuries: A Focus on Children and Older Adults

    PubMed Central

    McDonald, Eileen M.; Mack, Karin; Shields, Wendy C.; Lee, Robin P.; Gielen, Andrea C.

    2016-01-01

    Unintentional injuries are a persistent public health problem in the United States. A new health care landscape has the potential to create a clinical environment that fosters greater involvement by health care providers in injury prevention. The aim of this article is to provide evidence supporting the need for engagement by primary care providers in unintentional home injury prevention along with examples of how this could be accomplished. We know a great deal about what population groups are at risk for certain types of injuries. We also know that many injuries can be prevented through policies, programs, and resources that ensure safe environments and promote safe behaviors. For example, the Centers for Disease Control and Prevention’s STEADI (Stopping Elderly Accidents, Deaths, and Injuries) initiative comprises clinical decision support tools and educational materials for health care providers. Two effective interventions that have demonstrated a reduction in falls among children are the redesign of baby walkers (engineering) and the mandated use of window guards (enforcement). Primary care clinicians can play a key role in promoting their patient’s safety. Taken collectively, a focused attention on preventing unintentional home injuries by primary care providers can contribute to the reduction of injuries and result in optimal health for all. PMID:27141210

  8. Facilitators and Barriers to Linkage to HIV Care among Female Sex Workers Receiving HIV Testing Services at a Community-Based Organization in Periurban Uganda: A Qualitative Study

    PubMed Central

    Kintu, Betty N.

    2016-01-01

    Introduction. While four in ten female sex workers (FSWs) in sub-Saharan Africa are infected with HIV, only a small proportion is enrolled in HIV care. We explored facilitators and barriers to linkage to HIV care among FSWs receiving HIV testing services at a community-based organization in periurban Uganda. Methods. The cross-sectional qualitative study was conducted among 28 HIV positive FSWs from May to July 2014. Key informant interviews were conducted with five project staff and eleven peer educators. Data were collected on facilitators for and barriers to linkage to HIV care and manually analyzed following a thematic framework approach. Results. Facilitators for linkage to HIV care included the perceived good quality of health services with same-day results and immediate initiation of treatment, community peer support systems, individual's need to remain healthy, and having alternative sources of income. Linkage barriers included perceived stigma, fear to be seen at outreach HIV clinics, fear and myths about antiretroviral therapy, lack of time to attend clinic, and financial constraints. Conclusion. Linkage to HIV care among FSWs is influenced by good quality friendly services and peer support. HIV service delivery programs for FSWs should focus on enhancing these and dealing with barriers stemming from stigma and misinformation. PMID:27493826

  9. Facilitators and Barriers to Linkage to HIV Care among Female Sex Workers Receiving HIV Testing Services at a Community-Based Organization in Periurban Uganda: A Qualitative Study.

    PubMed

    Nakanwagi, Sharon; Matovu, Joseph K B; Kintu, Betty N; Kaharuza, Frank; Wanyenze, Rhoda K

    2016-01-01

    Introduction. While four in ten female sex workers (FSWs) in sub-Saharan Africa are infected with HIV, only a small proportion is enrolled in HIV care. We explored facilitators and barriers to linkage to HIV care among FSWs receiving HIV testing services at a community-based organization in periurban Uganda. Methods. The cross-sectional qualitative study was conducted among 28 HIV positive FSWs from May to July 2014. Key informant interviews were conducted with five project staff and eleven peer educators. Data were collected on facilitators for and barriers to linkage to HIV care and manually analyzed following a thematic framework approach. Results. Facilitators for linkage to HIV care included the perceived good quality of health services with same-day results and immediate initiation of treatment, community peer support systems, individual's need to remain healthy, and having alternative sources of income. Linkage barriers included perceived stigma, fear to be seen at outreach HIV clinics, fear and myths about antiretroviral therapy, lack of time to attend clinic, and financial constraints. Conclusion. Linkage to HIV care among FSWs is influenced by good quality friendly services and peer support. HIV service delivery programs for FSWs should focus on enhancing these and dealing with barriers stemming from stigma and misinformation. PMID:27493826

  10. Health care workers' mobile phones: a potential cause of microbial cross-contamination between hospitals and community.

    PubMed

    Ustun, Cemal; Cihangiroglu, Mustafa

    2012-01-01

    This study evaluated the microbial contamination of health care workers' (HCWs) mobile phones. The study was conducted at a secondary referral hospital in July 2010. Samples were taken from all surfaces of the mobile phones using a sterile swab, and incubated on Brain Heart Infusion agar at 37.5°C for 24 hr. Any isolated microorganisms were grown aerobically on 5% sheep blood agar and eosin methylene-blue agar medium at 37.5°C for 24-48 hr. The Sceptor microdilution system was used to identify the microorganisms, together with conventional methods. The oxacillin disc diffusion test and double-disc synergy test were used to identify methicillin-resistant Staphylococcus aureus (MRSA) and expanded-spectrum beta-lactamase (ESBL)-producing Gram-negative bacilli, respectively. The mobile phones were also categorized according to whether the HCWs used them in the intensive care unit (ICU). Overall, 183 mobile phones were screened: 94 (51.4%) from nurses, 32 (17.5%) from laboratory workers, and 57 (31.1%) from health care staff. In total, 179 (97.8%) culture-positive specimens were isolated from the 183 mobile phones, including 17 (9.5%) MRSA and 20 (11.2%) ESBL-producing Escherichia coli, which can cause nosocomial infections. No statistical difference was observed in the recovery of MRSA (p = 0.3) and ESBL-producing E. coli (p = 0.6) between the HCW groups. Forty-four (24.6%) of the 179 specimens were isolated from mobile phones of ICU workers, including two MRSA and nine ESBL-producing E. coli. A significant (p = 0.02) difference was detected in the isolation of ESBL-producing E. coli between ICU workers and non-ICU workers. HCWs' mobile phones are potential vectors for transferring nosocomial pathogens between HCWs, patients, and the community.

  11. Universal Coverage without Universal Access: Institutional Barriers to Health Care among Women Sex Workers in Vancouver, Canada

    PubMed Central

    Socías, M. Eugenia; Shoveller, Jean; Bean, Chili; Nguyen, Paul; Montaner, Julio; Shannon, Kate

    2016-01-01

    Background Access to health care is a crucial determinant of health. Yet, even within settings that purport to provide universal health coverage (UHC), sex workers’ experiences reveal systematic, institutionally ingrained barriers to appropriate quality health care. The aim of this study was to assess prevalence and correlates of institutional barriers to care among sex workers in a setting with UHC. Methods Data was drawn from an ongoing community-based, prospective cohort of women sex workers in Vancouver, Canada (An Evaluation of Sex Workers’ Health Access). Multivariable logistic regression analyses, using generalized estimating equations (GEE), were employed to longitudinally investigate correlates of institutional barriers to care over a 44-month follow-up period (January 2010-August 2013). Results In total, 723 sex workers were included, contributing to 2506 observations. Over the study period, 509 (70.4%) women reported one or more institutional barriers to care. The most commonly reported institutional barriers to care were long wait times (54.6%), limited hours of operation (36.5%), and perceived disrespect by health care providers (26.1%). In multivariable GEE analyses, recent partner- (adjusted odds ratio [AOR] = 1.46, % 95% Confidence Interval [CI] 1.10–1.94), workplace- (AOR = 1.31, 95% CI 1.05–1.63), and community-level violence (AOR = 1.41, 95% CI 1.04–1.92), as well as other markers of vulnerability, such as self-identification as a gender/sexual minority (AOR = 1.32, 95% CI 1.03–1.69), a mental illness diagnosis (AOR = 1.66, 95% CI 1.34–2.06), and lack of provincial health insurance card (AOR = 3.47, 95% CI 1.59–7.57) emerged as independent correlates of institutional barriers to health services. Discussion Despite Canada’s UHC, women sex workers in Vancouver face high prevalence of institutional barriers to care, with highest burden among most marginalized women. These findings underscore the need to explore new models of care

  12. From Practice to Research: Training Health Care Providers to Conduct Culturally Relevant Community Focus Groups

    PubMed Central

    Wallen, Gwenyth R.; Rivera-Goba, Migdalia V.

    2015-01-01

    Qualitative data from focus groups can provide an “insiders’ view” of the culture of those being studied. Such data can help health care providers and program planners understand how people perceive themselves, and therefore guide providers and planners in developing culturally appropriate outcome measures that can strengthen the planning, implementation, and evaluation of future programs. This article discusses the process used to train Latino and African American health care providers to moderate focus groups that will be conducted as one phase of a research study looking at health beliefs and health practices in an urban arthritis health center. After taking part in two lecture and discussion training sessions, members of the training class were asked to participate in a pilot focus group. The ½ to 2 hour focus group included nine individuals who fulfilled the roles of moderator, facilitator, or respondent. Community health center practitioners provided valuable insight into the design and feasibility of the focus groups during their training sessions. PMID:26225128

  13. Do they accept compulsory vaccination? Awareness, attitudes and behaviour of hospital health care workers following a new vaccination directive.

    PubMed

    Seale, Holly; Leask, Julie; Macintyre, C Raina

    2009-05-18

    Achieving high vaccination rates among health care workers (HCW) is an ongoing challenge. In 2007, the state of New South Wales, Australia instituted a policy directive with compulsory provisions for health care workers to be vaccinated. This study sought to identify staff awareness and attitudes in the early phase of implementation. It involved a self-completed paper-based or electronic survey of HCWs in two tertiary-referral teaching hospitals in Sydney, Australia in 2007. A total of 894/1200 completed the paper survey, whilst a further 185 completed it online. Of the 1079 respondents, 60% (646/1079) were aware of the policy directive but only 10% (63/646) described the specific requirements. Seventy-eight per cent supported the policy; 13% neither supported nor opposed it; and 4% opposed it. This survey provides an early, broad indication of the level of understanding and the attitudes of the HCWs towards the new directive.

  14. The job satisfaction and burnout levels of primary care health workers in the province of Malatya in Turkey

    PubMed Central

    Cagan, Ozlem; Gunay, Osman

    2015-01-01

    Objective: The objective was to determine the job satisfaction and burnout levels of primary care health workers in Malatya in Turkey. Methods: The sample of the study included 186 physicians, 126 midwives and 106 nurses working in primary health care. The Minnesota Job Satisfaction Scale and the Maslach Burnout Scale were used in the study. Results: The general, internal and external job satisfaction score medians of the study group were 3.35, 3.50 and 3.12 respectively, while the median of the Maslach Personal accomplishment score was 23.00, the Emotional Burnout score median was 15.00, and the Depersonalisation score median was found to be 3.00. Conclusions: The manner of their employment in the departments where they work, their perception of their economic circumstances and their satisfaction of the department where they work have an impact on the job satisfaction and burnout levels of workers. PMID:26150840

  15. "I Have to Push Him with a Wheelbarrow to the Clinic": Community Health Workers' Roles, Needs, and Strategies to Improve HIV Care in Rural South Africa.

    PubMed

    Loeliger, Kelsey B; Niccolai, Linda M; Mtungwa, Lillian N; Moll, Anthony; Shenoi, Sheela V

    2016-08-01

    With a 19.2% HIV prevalence, South Africa has the largest HIV/AIDS epidemic worldwide. Despite a recent scale-up of public sector HIV resources, including community-based programs to expand HIV care, suboptimal rates of antiretroviral therapy (ART) initiation and adherence persist. As community stakeholders with basic healthcare training, community health workers (CHWs) are uniquely positioned to provide healthcare and insight into potential strategies to improve HIV treatment outcomes. The study goal was to qualitatively explore the self-perceived role of the CHW, unmet CHW needs, and strategies to improve HIV care in rural KwaZulu-Natal, South Africa. Focus groups were conducted in May-August 2014, with 21 CHWs working in Msinga subdistrict. Interviews were audio-recorded, transcribed, and translated from Zulu into English. A hybrid deductive and inductive analytical method borrowed from grounded theory was applied to identify emergent themes. CHWs felt they substantially contributed to HIV care provision but were inadequately supported by the healthcare system. CHWs' recommendations included: (1) sufficiently equipping CHWs to provide education, counseling, social support, routine antiretroviral medication, and basic emergency care, (2) modifying clinical practice to provide less stigmatizing, more patient-centered care, (3) collaborating with traditional healers and church leaders to reduce competition with ART and provide more holistic care, and (4) offsetting socioeconomic barriers to HIV care. In conclusion, CHWs can serve as resources when designing and implementing interventions to improve HIV care. As HIV/AIDS policy and practice evolves in South Africa, it will be important to recognize and formally expand CHWs' roles supporting the healthcare system.

  16. "I Have to Push Him with a Wheelbarrow to the Clinic": Community Health Workers' Roles, Needs, and Strategies to Improve HIV Care in Rural South Africa.

    PubMed

    Loeliger, Kelsey B; Niccolai, Linda M; Mtungwa, Lillian N; Moll, Anthony; Shenoi, Sheela V

    2016-08-01

    With a 19.2% HIV prevalence, South Africa has the largest HIV/AIDS epidemic worldwide. Despite a recent scale-up of public sector HIV resources, including community-based programs to expand HIV care, suboptimal rates of antiretroviral therapy (ART) initiation and adherence persist. As community stakeholders with basic healthcare training, community health workers (CHWs) are uniquely positioned to provide healthcare and insight into potential strategies to improve HIV treatment outcomes. The study goal was to qualitatively explore the self-perceived role of the CHW, unmet CHW needs, and strategies to improve HIV care in rural KwaZulu-Natal, South Africa. Focus groups were conducted in May-August 2014, with 21 CHWs working in Msinga subdistrict. Interviews were audio-recorded, transcribed, and translated from Zulu into English. A hybrid deductive and inductive analytical method borrowed from grounded theory was applied to identify emergent themes. CHWs felt they substantially contributed to HIV care provision but were inadequately supported by the healthcare system. CHWs' recommendations included: (1) sufficiently equipping CHWs to provide education, counseling, social support, routine antiretroviral medication, and basic emergency care, (2) modifying clinical practice to provide less stigmatizing, more patient-centered care, (3) collaborating with traditional healers and church leaders to reduce competition with ART and provide more holistic care, and (4) offsetting socioeconomic barriers to HIV care. In conclusion, CHWs can serve as resources when designing and implementing interventions to improve HIV care. As HIV/AIDS policy and practice evolves in South Africa, it will be important to recognize and formally expand CHWs' roles supporting the healthcare system. PMID:27509239

  17. Building a taxonomy of integrated palliative care initiatives: results from a focus group

    PubMed Central

    Ewert, Benjamin; Hodiamont, Farina; van Wijngaarden, Jeroen; Payne, Sheila; Groot, Marieke; Hasselaar, Jeroen; Menten, Johann; Radbruch, Lukas

    2016-01-01

    Background Empirical evidence suggests that integrated palliative care (IPC) increases the quality of care for palliative patients and supports professional caregivers. Existing IPC initiatives in Europe vary in their design and are hardly comparable. InSuP-C, a European Union research project, aimed to build a taxonomy of IPC initiatives applicable across diseases, healthcare sectors and systems. Methods The taxonomy of IPC initiatives was developed in cooperation with an international and multidisciplinary focus group of 18 experts. Subsequently, a consensus meeting of 10 experts revised a preliminary taxonomy and adopted the final classification system. Results Consisting of eight categories, with two to four items each, the taxonomy covers the process and structure of IPC initiatives. If two items in at least one category apply to an initiative, a minimum level of integration is assumed to have been reached. Categories range from the type of initiative (items: pathway, model or guideline) to patients’ key contact (items: non-pc specialist, pc specialist, general practitioner). Experts recommended the inclusion of two new categories: level of care (items: primary, secondary or tertiary) indicating at which stage palliative care is integrated and primary focus of intervention describing IPC givers’ different roles (items: treating function, advising/consulting or training) in the care process. Conclusions Empirical studies are required to investigate how the taxonomy is used in practice and whether it covers the reality of patients in need of palliative care. The InSuP-C project will test this taxonomy empirically in selected initiatives using IPC. PMID:26647043

  18. What constitutes an excellent allied health care professional? A multidisciplinary focus group study

    PubMed Central

    Paans, Wolter; Wijkamp, Inge; Wiltens, Egbert; Wolfensberger, Marca V

    2013-01-01

    Background Determining what constitutes an excellent allied health care professional (AHCP) is important, since this is what will guide the development of curricula for training future physical therapists, oral hygienists, speech therapists, diagnostic radiographers, and dietitians. This also determines the quality of care. Aim To describe perspectives of AHCPs on which characteristics are commonly associated with an excellent AHCP. Methods AHCPs’ perspectives were derived from three focus group discussions. Twenty-one health care professionals participated. The final analysis of the focus group discussions produced eight domains, in which content validity was obtained through a Delphi panel survey of 27 contributing experts. Results According to the survey, a combination of the following characteristics defines an excellent AHCP: (1) cognizance, to obtain and to apply knowledge in a broad multidisciplinary health care field; (2) cooperativity, to effectively work with others in a multidisciplinary context; (3) communicative, to communicate effectively at different levels in complex situations; (4) initiative, to initiate new ideas, to act proactively, and to follow them through; (5) innovative, to devise new ideas and to implement alternatives beyond current practices; (6) introspective, to self-examine and to reflect; (7) broad perspective, to capture the big picture; and (8) evidence-driven, to find and to use scientific evidence to guide one’s decisions. Conclusion The AHCPs perspectives can be used as a reference for personal improvement for supervisors and professionals in clinical practice and for educational purposes. These perspectives may serve as a guide against which talented students can evaluate themselves. PMID:24049449

  19. Focused Cardiovascular Care for Women: The Need and Role in Clinical Practice.

    PubMed

    Garcia, Mariana; Miller, Virginia M; Gulati, Martha; Hayes, Sharonne N; Manson, JoAnn E; Wenger, Nanette K; Bairey Merz, C Noel; Mankad, Rekha; Pollak, Amy W; Mieres, Jennifer; Kling, Juliana; Mulvagh, Sharon L

    2016-02-01

    Over the past decade, an emerging clinical research focus on cardiovascular (CV) disease (CVD) risk in women has highlighted sex-specific factors that are uniquely important in the prevention and early detection of coronary atherosclerosis in women. Concurrently, a 30% decrease in the number of female deaths from CVD has been observed. Despite this, CVD continues to be the leading cause of death in women, outnumbering deaths from all other causes combined. Clinical practice approaches that focus on the unique aspects of CV care for women are needed to provide necessary resources for the prevention, diagnosis, and treatment of CVD in women. In addition to increasing opportunities for women to participate in CV research, Women's Heart Clinics offer unique settings in which to deliver comprehensive CV care and education, ensuring appropriate diagnostic testing, while monitoring effectiveness of treatment. This article reviews the emerging need and role of focused CV care to address sex-specific aspects of diagnosis and treatment of CVD in women. PMID:26848004

  20. Identification of nasal colonization with β-lactamase-producing Enterobacteriaceae in patients, health care workers and students in Madagascar

    PubMed Central

    Micheel, Volker; Hogan, Benedikt; Rakotoarivelo, Rivo Andry; Rakotozandrindrainy, Raphael; Razafimanatsoa, Fetra; Razafindrabe, Tsiriniaina; Rakotondrainiarivelo, Jean Philibert; Crusius, Sabine; Poppert, Sven; Schwarz, Norbert Georg; May, Jürgen; Hagen, Ralf Matthias

    2015-01-01

    This study assesses the nasal occurrence of β-lactamase-producing Enterobacteriaceae both in patients in a hospital department of infectious diseases at admission and in healthy Madagascan students and health care workers. Nasal swabs from 681 students, 824 health care workers, and 169 patients were obtained in Antananarivo, Madagascar, and transferred to Germany. Screening for β-lactamase (ESBL, ampC) producing Enterobacteriaceae was performed by cultural and molecular approaches, comprising Brilliance ESBL agar, E-testing, ABCD-testing, and commercial hyplex ESBL and SuperBug ID PCR. Regarding ESBL-positive strains and strains with resistance against at least three out of the four tested bactericidal antibiotic drugs, 0.3% (five out of 1541) of the students and health care workers group showed nasal colonization, whereas colonization was observed in 7.1% (12 out of 169) of the hospitalized patients at admission. No appreciably reduced detection rates after sample storage and intercontinental transport were observed. A considerable proportion of nasal colonization with cephalosporin-resistant Enterobacteriaceae was demonstrated in Madagascan hospital patients at admission, posing a risk of developing future endogenous infections. The nasal colonization of healthy individuals was negligible. Good storage and transport stability of Enterobacteriaceae will allow for future studies even in areas difficult to access. PMID:25908994

  1. A paired comparison of tuberculin skin test results in health care workers using 5 TU and 10 TU tuberculin

    PubMed Central

    Stuart, R.; Bennett, N.; Forbes, A.; Grayson, M

    2000-01-01

    BACKGROUND—Historically, 10 TU has been employed in Australia and the United Kingdom to perform the tuberculin skin test (TST). However, this makes it difficult to compare the rates of TST positivity with other countries such as the USA who use 5 TU. To assess the impact of the dose of tuberculin on the TST a comparison was made of TST responses in health care workers given a TST with both 5 and 10 TU.
METHODS—Two TSTs were performed simultaneously in each health care worker using 5 and 10 TU. Each dose was randomly assigned in a blinded manner to the right or left forearm and read at 48-72 hours by a single nurse who was blinded to the assignment of the 5 and 10 TU doses.
RESULTS—A total of 128 health care workers were enrolled, 119 (93%) of whom had a past history of BCG vaccination. The overall mean difference in paired reaction sizes for the two doses was 1.5 mm with 95% limits of agreement of -3.6 to 6.5 mm.
CONCLUSION—A slightly larger TST reading was seen with 10 TU than with 5 TU. The mean difference of 1.5 mm between the two doses should be considered when comparing rates of TST positivity between countries who use different doses of tuberculin to perform the tuberculin skin test.

 PMID:10899248

  2. Health care workers and researchers traveling to developing-world clinical settings: disease transmission risk and mitigation.

    PubMed

    Kortepeter, Mark G; Seaworth, Barbara J; Tasker, Sybil A; Burgess, Timothy H; Coldren, Rodney L; Aronson, Naomi E

    2010-12-01

    With the recent emphasis on funding and training opportunities for global health and humanitarian aid and the increased interest in the field, many health care workers and medical researchers are traveling from resource-replete to resource-limited settings. This type of travel brings unique disease risks not routinely considered for the business or vacationing traveler. This review provides practical advice for this special population of travelers, targeted to specific health care-related risks (needlestick, hemorrhagic fever viruses, severe viral respiratory disease, and tuberculosis), with suggestions for risk mitigation.

  3. Occupational health and safety for agricultural workers in Thailand: gaps and recommendations, with a focus on pesticide use.

    PubMed

    Kaewboonchoo, Orawan; Kongtip, Pornpimol; Woskie, Susan

    2015-05-01

    Over 16.7 million workers in Thailand (42 percent of the working population) are engaged in agriculture, disproportionately from the lower socioeconomic strata of Thai society. Most agricultural workers (over 93 percent) work in the informal sector without the protections of regulations or enforcement of labor or health and safety laws or enrollment in a social security system. Although Thailand's use of herbicides, fungicides, and insecticides is growing, there is little regulation of the sale, use, or application of these potentially toxic chemicals. This paper summarizes the research to date on occupational health and safety for Thai agricultural workers, identifies gaps in pesticide regulations and the current systems for occupational health and safety and social support for Thai agricultural workers, and makes recommendations for future policy and research initiatives to fill the identified gaps.

  4. The Role of Social Workers in Spiritual Care to Facilitate Coping With Chronic Illness and Self-Determination in Advance Care Planning.

    PubMed

    Francoeur, Richard B; Burke, Nancy; Wilson, Alicia M

    2016-01-01

    Spiritual values and beliefs of patients and families influence resilience during chronic illness and shape patient choices during advance care planning. The spiritual needs of Baby Boomers will be more diverse than previous generations, in connection with the questioning, experimental mind-set of this group and the fact that it includes a higher proportion of immigrant populations outside the Judeo-Christian tradition. Social workers are trained explicitly to intervene with diverse populations and are well positioned to offer spiritual support in ways that do not necessarily conform to traditional religions. To the extent of their individual expertise and competence, social workers should assess and provide spiritual care to clients, including those who either are underserved or prefer not to seek assistance from clergy or chaplains because they feel alienated from religious institutions and representatives. They should also be aware of ethical dilemmas in consulting with spiritual care professionals in developing spiritual interventions. Social work education should address clients' humanistic and existential concerns, beliefs and behaviors of the major religions, and forms of nontraditional religious and spiritual experiences; it should also provide experiential opportunities for engaging with grief and earlier advance care planning. There should be attention to different theodical perspectives of the major religions regarding the problem of good and evil, which may preoccupy even clients who no longer participate in organized religion, because these unresolved existential issues may weaken client coping with chronic conditions and may diminish clarity and self-awareness for engaging authentically and effectively in advance care planning.

  5. The Role of Social Workers in Spiritual Care to Facilitate Coping With Chronic Illness and Self-Determination in Advance Care Planning.

    PubMed

    Francoeur, Richard B; Burke, Nancy; Wilson, Alicia M

    2016-01-01

    Spiritual values and beliefs of patients and families influence resilience during chronic illness and shape patient choices during advance care planning. The spiritual needs of Baby Boomers will be more diverse than previous generations, in connection with the questioning, experimental mind-set of this group and the fact that it includes a higher proportion of immigrant populations outside the Judeo-Christian tradition. Social workers are trained explicitly to intervene with diverse populations and are well positioned to offer spiritual support in ways that do not necessarily conform to traditional religions. To the extent of their individual expertise and competence, social workers should assess and provide spiritual care to clients, including those who either are underserved or prefer not to seek assistance from clergy or chaplains because they feel alienated from religious institutions and representatives. They should also be aware of ethical dilemmas in consulting with spiritual care professionals in developing spiritual interventions. Social work education should address clients' humanistic and existential concerns, beliefs and behaviors of the major religions, and forms of nontraditional religious and spiritual experiences; it should also provide experiential opportunities for engaging with grief and earlier advance care planning. There should be attention to different theodical perspectives of the major religions regarding the problem of good and evil, which may preoccupy even clients who no longer participate in organized religion, because these unresolved existential issues may weaken client coping with chronic conditions and may diminish clarity and self-awareness for engaging authentically and effectively in advance care planning. PMID:27187806

  6. Gaps in the hepatitis C continuum of care among sex workers in Vancouver, British Columbia: Implications for voluntary hepatitis C virus testing, treatment and care

    PubMed Central

    Socías, M Eugenia; Shannon, Kate; Montaner, Julio S; Guillemi, Silvia; Dobrer, Sabina; Nguyen, Paul; Goldenberg, Shira; Deering, Kathleen

    2015-01-01

    BACKGROUND: Hepatitis C virus (HCV) eradication leads to reduced morbidity, mortality and transmission. Despite the disproportionate burden of HCV among sex workers, data regarding the HCV care continuum in this population remain negligible. METHODS: Using baseline data from an ongoing cohort of women sex workers in Vancouver (An Evaluation of Sex Workers’ Health Access, January 2010 to August 2013), the authors assessed HCV prevalence and engagement in the HCV care continuum within the past year. Multivariable logistic regression analyses were used to evaluate associations with recent (ie, in the past year) HCV testing. RESULTS: Among 705 sex workers, 302 (42.8%) were HCV seropositive. Of these, 22.5% were previously unaware of their HCV status, 41.7% had accessed HCV-related care, 13.9% were offered treatment and only 1.0% received treatment. Among 552 HCV-seronegative sex workers, only one-half (52.9%) reported a recent HCV test. In multivariable analysis, women who self-identified as a sexual/gender minority (adjusted OR [aOR] 1.89 [95% CI 1.11 to 3.24]), resided in the inner city drug use epicentre (aOR 3.19 [95%CI 1.78 to 5.73]) and used injection (aOR 2.00 [95% CI 1.19 to 3.34]) or noninjection drugs (aOR 1.95 [95% CI 1.00 to 3.78]) had increased odds of undergoing a recent HCV test, while immigrant participants (aOR 0.24 [95% CI 0.12 to 0.48]) had decreased odds. CONCLUSIONS: Despite a high burden of HCV among sex workers, large gaps in the HCV care continuum remain. Particularly concerning are the low access to HCV testing, with one-fifth of women living with HCV being previously unaware of their status, and the exceptionally low prevalence of HCV treatment. There is a critical need for further research to better understand and address barriers to engage in the HCV continuum for sex workers. PMID:26492129

  7. What Qualities Are Valued in Residential Direct Care Workers from the Perspective of People with an Intellectual Disability and Managers of Accommodation Services?

    ERIC Educational Resources Information Center

    Dodevska, G. A.; Vassos, M. V.

    2013-01-01

    Background: To date, the descriptions of a 'good' direct care worker used to recruit workers for disability services have largely been drawn up by managerial professionals in charge of hiring supports for people with disabilities. However, previous research highlights that these professionals conceptualise a "good" direct care…

  8. Focusing on psychiatric patients’ strengths: A new vision on mental health care in Iran

    PubMed Central

    Zargham-Boroujeni, Ali; Maghsoudi, Jahangir; Oreyzi, Hamid Reza

    2015-01-01

    Background: Identifying and using the strengths of patients, in practice, is a new territory. Today, the need to educate nurses and psychiatric patients about positive psychology in practice and the importance of understanding and focusing on strengths is clear. However, little is known about the strengths the psychiatric patients use and experience. Thus, this study has been designed and conducted in order to understand how people with psychiatric disorders demonstrate their strengths. Materials and Methods: In the present study, 13 semi-structured, qualitative interviews with patients and 2 focus groups with nurses were carried out. In addition, a qualitative content analysis was used to identify significant strengths. Results: Based on the results, the four main strengths consisted of: Finding a meaning in daily living, work as enduring strength, entertaining activities, and positive relationship. Patients also reported that health care providers rarely focused on patients’ strengths, and experts confirmed these findings. Our findings indicate that patients’ own strengths are a pivotal factor in getting through their illness from their perspective. Conclusions: Despite the enduring legacy of pessimism regarding psychiatric patients, these people have a repertoire of strengths. Nurses should, therefore, have a greater focus on eliciting and nourishing psychiatric patients’ strengths in their care. It is suggested that the theoretical and practical aspects of patients’ strengths be incorporated in nursing school curricula. PMID:26120334

  9. The inverse primary care law in sub-Saharan Africa: a qualitative study of the views of migrant health workers

    PubMed Central

    Moosa, Shabir; Wojczewski, Silvia; Hoffmann, Kathryn; Poppe, Annelien; Nkomazana, Oathokwa; Peersman, Wim; Willcox, Merlin; Derese, Anselme; Mant, David

    2014-01-01

    Background Many low-income and middle-income countries globally are now pursuing ambitious plans for universal primary care, but are failing to deliver adequate care quality because of intractable human resource problems. Aim To understand why migrant nurses and doctors from sub-Saharan Africa did not wish to take up available posts in primary and first-contact care in their home countries. Design and setting Qualitative study of migrant health workers to Europe (UK, Belgium, and Austria) or southern Africa (Botswana and South Africa) from sub-Saharan Africa. Method Semi-structured interviews with 66 health workers (24 nurses and 42 doctors) from 18 countries between July 2011 and April 2012. Transcripts were analysed thematically using a framework approach. Results The reasons given for choosing not to work in primary care were grouped into three main analytic streams: poor working environment, difficult living experiences, and poor career path. Responders described a lack of basic medicines and equipment, an unmanageable workload, and lack of professional support. Many had concerns about personal security, living conditions (such as education for children), and poor income. Primary care was seen as lower status than hospital medicine, with lack of specialist training opportunities and more exposure to corruption. Conclusions Clinicians are reluctant to work in the conditions they currently experience in primary care in sub-Saharan Africa and these conditions tend to get worse as poverty and need for primary care increases. This inverse primary care law undermines achievement of universal health coverage. Policy experience from countries outside Africa shows that it is not immutable. PMID:24868069

  10. Pathways towards chronic care-focused healthcare systems: evidence from Spain.

    PubMed

    García-Goñi, Manuel; Hernández-Quevedo, Cristina; Nuño-Solinís, Roberto; Paolucci, Francesco

    2012-12-01

    Increasing healthcare expenditure is a matter of concern in many countries, particularly in relation to the underlying drivers of such escalation that include ageing, medical innovation, and changes in the burden of disease, such as the growing prevalence of chronic diseases. Most healthcare systems in developed countries have been designed to 'cure' acute episodes, rather than to 'manage' chronic conditions, and therefore they are not suitably or efficiently organized to respond to the changing needs and preferences of users. New models of chronic care provision have been developed to respond to the changing burden of disease and there is already considerable practical experience in several different countries showing their advantages but also the difficulties associated with their implementation. In this paper, we focus on the Spanish experience in terms of policy changes and pilot studies focused on testing the feasibility of moving towards chronic care models. In particular, we discuss a framework that identifies and analyses ten key prerequisites to achieving high performing chronic care-based healthcare systems and apply it to the current Spanish National Health System (NHS). We find that the design of the Spanish NHS already meets some of these pre-requisites. However, other features are still in their early stages of development or are being applied only in limited geographical and clinical contexts. We outline the policies that are being implemented and the pathway that the Spanish NHS is taking to address the crucial challenge of the transition towards an optimal health system focused on chronic care. Given the current evidence and trends, we expect that the pathway for developing a chronicity strategy being followed by the Spanish NHS will significantly transform its current healthcare delivery model in the next few years.

  11. Ethical analyses of institutional measures to increase health care worker influenza vaccination rates.

    PubMed

    Zimmerman, Richard K

    2013-12-16

    Health care worker (HCW) influenza vaccination rates are modest. This paper provides a detailed ethical analysis of the major options to increase HCW vaccination rates, comparing how major ethical theories would address the options. The main categories of interventions to raise rates include education, incentives, easy access, competition with rewards, assessment and feedback, declination, mandates with alternative infection control measures, and mandates with administrative action as consequences. The aforementioned interventions, except mandates, arouse little ethical controversy. However, these efforts are time and work intensive and rarely achieve vaccination rates higher than about 70%. The primary concerns voiced about mandates are loss of autonomy, injustice, lack of due process, and subsuming the individual for institutional ends. Proponents of mandates argue that they are ethical based on beneficence, non-maleficence, and duty. A number of professional associations support mandates. Arguments by analogy can be made by mandates for HCW vaccination against other diseases. The ethical systems used in the analyses include evolutionary ethics, utilitarianism, principalism (autonomy, beneficence, non-maleficence, and justice), Kantism, and altruism. Across these systems, the most commonly preferred options are easy access, assessment and feedback, declinations, and mandates with infection control measures as consequences for non-compliance. Given the ethical imperatives of non-maleficence and beneficence, the limited success of lower intensive interventions, and the need for putting patient safety ahead of HCW convenience, mandates with additional infection control measures as consequences for non-compliance are preferred. For those who opt out of vaccination due to conscience concerns, such mandates provide a means to remain employed but not put patient safety at risk.

  12. Identifying genetic susceptibility to sensitization to cephalosporins in health care workers.

    PubMed

    Nam, Young-Hee; Kim, Jeong-Eun; Kim, Seung-Hyun; Jin, Hyun Jung; Hwang, Eui-Kyung; Shin, Yoo-Seob; Ye, Young-Min; Park, Hae-Sim

    2012-11-01

    Exposure to cephalosporins could cause occupational allergic diseases in health care workers (HCWs). We evaluated the prevalence of serum specific IgE and IgG antibodies to cephalosporin-human serum albumin (HSA) conjugate and to identify potential genetic risk factors associated with sensitization to cephalosporins in exposed HCWs. The study population consisted of 153 HCWs who had been exposed to antibiotics in a single university hospital and 86 unexposed healthy controls. A questionnaire survey of work-related symptoms (WRS) was administered. A skin-prick test (SPT) was performed, and serum-specific IgE and IgG antibodies to 3 commonly prescribed cephalosporins were measured by ELISA. Four single-nucleotide polymorphisms of the candidate genes related to IgE sensitization were genotyped. The prevalence of WRS to cephalosporins was 2.6%. The prevalence rates of serum-specific IgE and IgG antibodies to cephalosporins were 20.3% and 14.7%, respectively. The FcεR1β-109T > C polymorphism was significantly associated with IgE sensitization to cephalosporins in HCWs (P = 0.036, OR = 3.553; CI, 1.324-9.532). The in vitro functional assay demonstrated that the T allele of FcεR1β-109T had greater promoter activity than did the C allele (P < 0.001). The FcεR1β-109T > C polymorphism may be a potential genetic risk factor for increased IgE sensitization to cephalosporins.

  13. Integrated and Culturally Relevant Care: A Model to Prepare Social Workers for Primary Care Behavioral Health Practice.

    PubMed

    Davis, Tamara S; Guada, Joe; Reno, Rebecca; Peck, Adriane; Evans, Shannon; Sigal, Laura Moskow; Swenson, Staci

    2015-01-01

    Policymakers and researchers emphasize needs for an integrated, effective, and efficient health care system to address well-documented disparities and inequities in care experienced by diverse populations. The Affordable Care Act, through its support of integrated health care, addresses social determinants of health with a goal of increasing access to care. Social work is poised to assume a central position in health care reform and integrated behavioral health, but must prepare practitioners to work alongside medical providers in health care settings. This article describes a social work field education model developed in partnership with community mental health and health care providers. The model, Integrated and Culturally Relevant Care, prepares social work students to provide behavioral health services in integrated primary care environments.

  14. Factors affecting uptake of recommended immunizations among health care workers in South Australia.

    PubMed

    Tuckerman, Jane L; Collins, Joanne E; Marshall, Helen S

    2015-01-01

    Despite the benefits of vaccination for health care workers (HCWs), uptake of recommended vaccinations is low, particularly for seasonal influenza and pertussis. In addition, there is variation in uptake within hospitals. While all vaccinations recommended for HCWs are important, vaccination against influenza and pertussis are particularly imperative, given HCWs are at risk of occupationally acquired influenza and pertussis, and may be asymptomatic, acting as a reservoir to vulnerable patients in their care. This study aimed to determine predictors of uptake of these vaccinations and explore the reasons for variation in uptake by HCWs working in different hospital wards. HCWs from wards with high and low influenza vaccine uptake in a tertiary pediatric and obstetric hospital completed a questionnaire to assess knowledge of HCW recommended immunizations. Multiple logistic regression was used to determine predictors of influenza and pertussis vaccination uptake. Of 92 HCWs who responded, 9.8% were able to identify correctly the vaccines recommended for HCWs. Overall 80% of respondents reported they had previously received influenza vaccine and 50.5% had received pertussis vaccine. Independent predictors of pertussis vaccination included length of time employed in health sector (P < 0.001), previously receiving hepatitis B/MMR (measles, mumps, rubella) vaccine (P < 0.001), and a respondent being aware influenza infections could be severe in infants (p = 0.023). Independent predictors of seasonal influenza vaccination included younger age (P < 0.001), English as first language (P < 0.001), considering it important to be vaccinated to protect themselves (P < 0.001), protect patients (p = 0.012) or awareness influenza could be serious in immunocompromised patients (p = 0.030). Independent predictors for receiving both influenza and pertussis vaccinations included younger age (P < 0.001), time in area of work (P = 0.020), previously receiving hepatitis B vaccine (P = 0

  15. A Multidisciplinary Work-Related Low Back Pain Predictor Questionnaire: Psychometric Evaluation of Iranian Patient-Care Workers

    PubMed Central

    Sarallah, Shojaei; Jamshidi, Ahmad Reza; Joan, Wagner

    2016-01-01

    Study Design Psychometric evaluation design. Purpose Psychometric evaluation of a multidisciplinary work-related low back pain predictor questionnaire (MWRLBPPQ) of Iranians patient-care workers based on the social cognitive theory. Overview of Literature Healthcare is one of the professions in which work-related musculoskeletal disorders are prevalent. The chronic low back pain experienced by patient caregivers can negatively impact their professional performance, and patient handling in a hospital is the main cause of low back pain in this population. Methods This was a cross-sectional study carried out in Qom, Iran from July 2014 to November 2014. A MWRLBPPQ based on nine concepts of the social cognitive theory and existing literature regarding chronic low back pain was developed. Ten patient-care workers first completed the questionnaire as a pilot test, allowing the ambiguities of the instrument to be resolved. Exploratory factor analysis was used to confirm construct validity. This questionnaire was distributed among 452 patient-care workers in hospitals located in different geographically areas in Qom, Iran. Cronbach's Alpha was calculated to assess reliability. Results In all, 452 caregivers of patients with mean age of 37.71 (standard deviation=8.3) years participated in the study. An exploratory factor analysis loaded seven concepts of self-efficacy, knowledge, outcome perception, self-control, emotional coping, and self-efficacy in overcoming impediments and challenges in the environment. All concepts were jointly accounted for 50.08% of variance of behavior change. The Cronbach's alpha coefficient showed favorable internal consistency (alpha=0.83), and test-retest of the scale with 2-week intervals indicated an appropriate stability for the MWRLBPPQ. Conclusions The MWRLBPPQ is a reliable and valid theory-based instrument that can be used to predict factors influencing work-related low back pain among workers who lift and transfer patients in hospitals

  16. Features of Effective Medical Knowledge Resources to Support Point of Care Learning: A Focus Group Study

    PubMed Central

    Cook, David A.; Sorensen, Kristi J.; Hersh, William; Berger, Richard A.; Wilkinson, John M.

    2013-01-01

    Objective Health care professionals access various information sources to quickly answer questions that arise in clinical practice. The features that favorably influence the selection and use of knowledge resources remain unclear. We sought to better understand how clinicians select among the various knowledge resources available to them, and from this to derive a model for an effective knowledge resource. Methods We conducted 11 focus groups at an academic medical center and outlying community sites. We included a purposive sample of 50 primary care and subspecialist internal medicine and family medicine physicians. We transcribed focus group discussions and analyzed these using a constant comparative approach to inductively identify features that influence the selection of knowledge resources. Results We identified nine features that influence users' selection of knowledge resources, namely efficiency (with sub-features of comprehensiveness, searchability, and brevity), integration with clinical workflow, credibility, user familiarity, capacity to identify a human expert, reflection of local care processes, optimization for the clinical question (e.g., diagnosis, treatment options, drug side effect), currency, and ability to support patient education. No single existing resource exemplifies all of these features. Conclusion The influential features identified in this study will inform the development of knowledge resources, and could serve as a framework for future research in this field. PMID:24282535

  17. Retreat from Alma Ata? The WHO's report on Task Shifting to community health workers for AIDS care in poor countries.

    PubMed

    Campbell, C; Scott, K

    2011-01-01

    This paper examines the potential of community health worker (CHW) programmes, as proposed by the 2008 World Health Organisation (WHO) document Task Shifting to tackle health worker shortages, to contribute to HIV/AIDS prevention and treatment and various Millennium Development Goals in low-income countries. It examines the WHO proposal through a literature review of factors that have facilitated the success of previous CHW experiences. The WHO has taken account of five key lessons learnt from past CHW programmes (the need for strong management, appropriate selection, suitable training, adequate retention structures and good relationships with other healthcare workers). It has, however, neglected to emphasise the importance of a sixth lesson, the 'community embeddedness' of CHWs, found to be of critical importance to the success of past CHW programmes. We have no doubt that the WHO plans will increase the number of workers able to perform medically oriented tasks. However, we argue that without community embeddedness, CHWs will be unable to successfully perform the socially oriented tasks assigned to them by the WHO, such as health education and counselling. We locate the WHO's neglect of community embeddedness within the context of a broader global public health trend away from community-focused primary healthcare towards biomedically focused selective healthcare.

  18. Retreat from Alma Ata? The WHO's report on Task Shifting to community health workers for AIDS care in poor countries.

    PubMed

    Campbell, C; Scott, K

    2011-01-01

    This paper examines the potential of community health worker (CHW) programmes, as proposed by the 2008 World Health Organisation (WHO) document Task Shifting to tackle health worker shortages, to contribute to HIV/AIDS prevention and treatment and various Millennium Development Goals in low-income countries. It examines the WHO proposal through a literature review of factors that have facilitated the success of previous CHW experiences. The WHO has taken account of five key lessons learnt from past CHW programmes (the need for strong management, appropriate selection, suitable training, adequate retention structures and good relationships with other healthcare workers). It has, however, neglected to emphasise the importance of a sixth lesson, the 'community embeddedness' of CHWs, found to be of critical importance to the success of past CHW programmes. We have no doubt that the WHO plans will increase the number of workers able to perform medically oriented tasks. However, we argue that without community embeddedness, CHWs will be unable to successfully perform the socially oriented tasks assigned to them by the WHO, such as health education and counselling. We locate the WHO's neglect of community embeddedness within the context of a broader global public health trend away from community-focused primary healthcare towards biomedically focused selective healthcare. PMID:19916089

  19. Relational Autonomy in Assisted Living: A Focus on Diverse Care Settings for Older Adults

    PubMed Central

    Perkins, Molly M.; Ball, Mary M.; Whittington, Frank J.; Hollingsworth, Carole

    2012-01-01

    Consistent with Western cultural values, the traditional liberal theory of autonomy, which places emphasis on self-determination, liberty of choice, and freedom from interference by others, has been a leading principle in health care discourse for several decades. In context to aging, chronic illness, disability, and long-term care, increasingly there has been a call for a relational conception of autonomy that acknowledges issues of dependency, interdependence, and care relationships. Although autonomy is a core philosophy of assisted living (AL) and a growing number of studies focus on this issue, theory development in this area is lagging and little research has considered race, class, or cultural differences, despite the growing diversity of AL. We present a conceptual model of autonomy in AL based on over a decade of research conducted in diverse facility settings. This relational model provides an important conceptual lens for understanding the dynamic linkages between varieties of factors at multiple levels of social structure that shape residents' ability to maintain a sense of autonomy in this often socially challenging care environment. Social and institutional change, which is ongoing, as well as the multiple and ever-changing cultural contexts within which residents are embedded, are important factors that shape residents' experiences over time and impact resident-facility fit and residents' ability to age in place. PMID:22707852

  20. The relations between psychosocial factors at work and health status among workers in home care organizations.

    PubMed

    Eriksen, Hege R; Ihlebaek, Camilla; Jansen, Jeroen P; Burdorf, Alex

    2006-01-01

    A considerable proportion of sickness absence and disability pension is caused by subjective health complaints, especially low back pain (LBP). In recent years focus has been on psychosocial characteristics of work as potential risk factors. The aim of this study is to examine the relations between psychosocial work aspects and subjective health complaints, LBP, and need for recovery. A total of 779 employees working in home care participated in a cross-sectional study. Higher psychological demands were associated with subjective health complaints and need for recovery. However, decision authority, skill discretion, and the 2 aspects of social support did not seem to be important factors. Higher psychological demands do not seem to be associated with severity of LBP, but does show an association with sick leave. PMID:17078768

  1. Testing family-centered, function-focused care in hospitalized persons with dementia

    PubMed Central

    Boltz, Marie; Chippendale, Tracy; Resnick, Barbara; Galvin, James E

    2015-01-01

    Summary Aim Hospital-acquired disability causes decreased quality of life for patients with dementia and family caregivers, and increased societal costs. Materials & methods A comparative, repeated measures study tested the feasibility and preliminary efficacy of the family-centered, function-focused care intervention (Fam-FFC) in dyads of hospitalized, medical patients with dementia and family caregivers (FCGs). Results The intervention group demonstrated better activities of daily living and walking performance, and less severity/duration of delirium and hospital readmissions, but no significant differences in gait/balance. FCGs showed increased preparedness for caregiving and less anxiety but no significant differences in depression, strain and mutuality. Conclusion Fam-FFC presents a possible pathway to meeting the Triple Aim of improved patient care, improved patient health and reduced costs for persons with dementia. PMID:26107319

  2. Diabetes Connect: African American Women's Perceptions of the Community Health Worker Model for Diabetes Care.

    PubMed

    Richardson, Brittany S; Willig, Amanda L; Agne, April A; Cherrington, Andrea L

    2015-10-01

    Community health worker (CHW) interventions have potential to improve diabetes outcomes and reduce health disparities. However, few studies have explored patient perspectives of peer-delivered diabetes programs. The purpose of this qualitative study is to investigate possible benefits as well as risks of CHW-delivered peer support for diabetes from the perspectives of African American women living with type 2 diabetes in Jefferson County, Alabama. Four ninety-minute focus groups were conducted by a trained moderator with a written guide to facilitate discussion on the topic of CHWs and diabetes management. Participants were recruited from the diabetes education database at a safety-net hospital. Two independent reviewers performed content analysis to identify major themes using a combined deductive-inductive approach. There were 25 participants. Mean years with diabetes was 11.2 (range 6 months to 42 years). Participants were knowledgeable about methods for self-management but reported limited resources and stress as major barriers. Preferred CHW roles included liaison to the healthcare system and easily accessible information source. Participants preferred that the CHW be knowledgeable and have personal experience managing their own diabetes or assisting a family member with diabetes. Concerns regarding the CHW-model were possible breaches of confidentiality and privacy. The self-management strategies and barriers to management identified by participants were reflected in their preferred CHW roles and traits. These results suggest that African American women with diabetes in Alabama would support peer-led diabetes education that is community-based and socially and emotionally supportive.

  3. Diabetes Connect: African American Women's Perceptions of the Community Health Worker Model for Diabetes Care.

    PubMed

    Richardson, Brittany S; Willig, Amanda L; Agne, April A; Cherrington, Andrea L

    2015-10-01

    Community health worker (CHW) interventions have potential to improve diabetes outcomes and reduce health disparities. However, few studies have explored patient perspectives of peer-delivered diabetes programs. The purpose of this qualitative study is to investigate possible benefits as well as risks of CHW-delivered peer support for diabetes from the perspectives of African American women living with type 2 diabetes in Jefferson County, Alabama. Four ninety-minute focus groups were conducted by a trained moderator with a written guide to facilitate discussion on the topic of CHWs and diabetes management. Participants were recruited from the diabetes education database at a safety-net hospital. Two independent reviewers performed content analysis to identify major themes using a combined deductive-inductive approach. There were 25 participants. Mean years with diabetes was 11.2 (range 6 months to 42 years). Participants were knowledgeable about methods for self-management but reported limited resources and stress as major barriers. Preferred CHW roles included liaison to the healthcare system and easily accessible information source. Participants preferred that the CHW be knowledgeable and have personal experience managing their own diabetes or assisting a family member with diabetes. Concerns regarding the CHW-model were possible breaches of confidentiality and privacy. The self-management strategies and barriers to management identified by participants were reflected in their preferred CHW roles and traits. These results suggest that African American women with diabetes in Alabama would support peer-led diabetes education that is community-based and socially and emotionally supportive. PMID:25773991

  4. Competence of health workers in emergency obstetric care: an assessment using clinical vignettes in Brong Ahafo region, Ghana

    PubMed Central

    Lohela, Terhi Johanna; Nesbitt, Robin Clark; Manu, Alexander; Vesel, Linda; Okyere, Eunice; Kirkwood, Betty; Gabrysch, Sabine

    2016-01-01

    Objectives To assess health worker competence in emergency obstetric care using clinical vignettes, to link competence to availability of infrastructure in facilities, and to average annual delivery workload in facilities. Design Cross-sectional Health Facility Assessment linked to population-based surveillance data. Setting 7 districts in Brong Ahafo region, Ghana. Participants Most experienced delivery care providers in all 64 delivery facilities in the 7 districts. Primary outcome measures Health worker competence in clinical vignette actions by cadre of delivery care provider and by type of facility. Competence was also compared with availability of relevant drugs and equipment, and to average annual workload per skilled birth attendant. Results Vignette scores were moderate overall, and differed significantly by respondent cadre ranging from a median of 70% correct among doctors, via 55% among midwives, to 25% among other cadres such as health assistants and health extension workers (p<0.001). Competence varied significantly by facility type: hospital respondents, who were mainly doctors and midwives, achieved highest scores (70% correct) and clinic respondents scored lowest (45% correct). There was a lack of inexpensive key drugs and equipment to carry out vignette actions, and more often, lack of competence to use available items in clinical situations. The average annual workload was very unevenly distributed among facilities, ranging from 0 to 184 deliveries per skilled birth attendant, with higher workload associated with higher vignette scores. Conclusions Lack of competence might limit clinical practice even more than lack of relevant drugs and equipment. Cadres other than midwives and doctors might not be able to diagnose and manage delivery complications. Checking clinical competence through vignettes in addition to checklist items could contribute to a more comprehensive approach to evaluate quality of care. Trial registration number NCT00623337

  5. Lessons learned: medical and health care management for emergency workers at the TEPCO Fukushima Daiichi APP accident.

    PubMed

    Koerner, John; Yasui, Shojiro

    2014-01-01

    During the emergency work at the Fukushima Daiichi Atomic Power Plant (APP), the Tokyo Electric Power Company (TEPCO) and the Japanese government experienced various problems in medical and health care management issues, including special medical examinations, on-site triage and initial treatment, patient transportation, lodging and food, and long-term health care for emergency workers. To resolve these problems, the Ministry of Health, Labor and Welfare (MHLW) issued a series of compulsory directives and provided administrative guidance to TEPCO. Based on the experiences and lessons learned, the MHLW recognized that the proper management and implementation of medical and health care management in response to a similar accident would require sufficient measures and systematic preparation, including the following: 1. In case of large-scale nuclear accidents, the government needs to assist in dispatching medical staff to the affected plants. 2. Nuclear facility operators, medical facilities and fire departments should make an agreement to clarify the division of the roles played prior to the accident and should conduct emergency drills periodically with the full attendance of related personnel to identify and resolve the problems. 3. Operators need to develop a support base at a safe distance from the plant and to prepare to develop makeshift lodgings in case of emergency. 4. Operators need to come to an agreement to share food stocks among closely located nuclear plants and prepare cooking equipment that can be used in case of blackout to provide warm foods and drinks to as many workers as possible. 5. It is necessary to conduct long-term follow-up for emergency workers, including health care system, medical examinations and mental health consultations.

  6. Preventing Absenteeism and Promoting Resilience Among Health Care Workers In Biological Emergencies

    SciTech Connect

    Lesperance, Ann M.; Miller, James S.

    2009-05-08

    The ability to ensure adequate numbers of medical staff represents a crucial part of the medical response to any disaster. However, healthcare worker absenteeism during disasters, especially in the event of an attack of biological terrorism or an epidemic such as pandemic influenza, is a serious concern. Though a significant rate of absenteeism is often included as a baseline assumption in emergency planning, published reports on strategies to minimize absenteeism are comparatively few. This report documents interviews with managers and emergency response planners at hospitals and public health agencies and reviews existing survey data on healthcare worker absenteeism and studies of disasters to glean lessons about the needs of healthcare workers during those disasters. Based on this research, expected rates of absenteeism and individual determinants of absenteeism are presented along with recommendations of steps that hospitals, emergency medical services departments, public health organizations, and government agencies can take to meet the needs of healthcare workers and minimize absenteeism during a biological event.

  7. Mobile phone tools for field-based health care workers in low-income countries.

    PubMed

    Derenzi, Brian; Borriello, Gaetano; Jackson, Jonathan; Kumar, Vikram S; Parikh, Tapan S; Virk, Pushwaz; Lesh, Neal

    2011-01-01

    In low-income regions, mobile phone-based tools can improve the scope and efficiency of field health workers. They can also address challenges in monitoring and supervising a large number of geographically distributed health workers. Several tools have been built and deployed in the field, but little comparison has been done to help understand their effectiveness. This is largely because no framework exists in which to analyze the different ways in which the tools help strengthen existing health systems. In this article we highlight 6 key functions that health systems currently perform where mobile tools can provide the most benefit. Using these 6 health system functions, we compare existing applications for community health workers, an important class of field health workers who use these technologies, and discuss common challenges and lessons learned about deploying mobile tools. PMID:21598267

  8. What Do Young People Need When They Leave Care? Views of Care-Leavers and Aftercare Workers in North Dublin

    ERIC Educational Resources Information Center

    Daly, Fiona

    2012-01-01

    EPIC is an independent voluntary organisation in the Republic of Ireland that advocates for the rights of children in care and young people who have care experience. One aspect of EPIC's work is the Aftercare Advocacy and Support Service, which provides confidential advice and support to young people who are preparing to leave care, those in…

  9. Health care justice for temporary migrant workers on 457 visas in Australia: a case study of internationally qualified nurses.

    PubMed

    O'Brien, Paula; Phillips, Melissa

    2015-03-01

    Workers and their families in Australia under the Temporary Work (Skilled) Visa (subclass 457) scheme have no access to publicly funded health care. Rather, they are required by the Commonwealth government to purchase costly private health insurance. Our empirical study revealed the serious negative effects of the government's policy on the ability of internationally qualified nurses on 457 visas to meet their basic health care needs and to settle effectively into Australian society This article argues that the current policy is unjust and evaluates three options for reform which would accord more fully with the government's obligations to minimise harm to people's health and to ensure that all people in society have their health care needs met in a fair manner.

  10. Health care justice for temporary migrant workers on 457 visas in Australia: a case study of internationally qualified nurses.

    PubMed

    O'Brien, Paula; Phillips, Melissa

    2015-03-01

    Workers and their families in Australia under the Temporary Work (Skilled) Visa (subclass 457) scheme have no access to publicly funded health care. Rather, they are required by the Commonwealth government to purchase costly private health insurance. Our empirical study revealed the serious negative effects of the government's policy on the ability of internationally qualified nurses on 457 visas to meet their basic health care needs and to settle effectively into Australian society This article argues that the current policy is unjust and evaluates three options for reform which would accord more fully with the government's obligations to minimise harm to people's health and to ensure that all people in society have their health care needs met in a fair manner. PMID:25980190

  11. Heavy users of an emergency department: psycho-social and medical characteristics, other health care contacts and the effect of a hospital social worker intervention.

    PubMed

    Andrén, K G; Rosenqvist, U

    1985-01-01

    A small proportion of the patients coming to emergency departments of general hospitals account for a substantial share of the department's resources by making repeated visits. Repeater behaviour is a complex product of many, sometimes concurrent factors. This study has focused on the medical and psycho-social factors. A group of patients with repeated visits to an emergency department of a middle-sized Stockholm hospital was studied in 1980. The repeater group had a heavier load of psycho-social problems than the source population. The repeater behaviour profile included: feeling of loneliness, living alone, contacts with social agency, disability pension, high sick absenteeism from work and alcoholism. The repeater group had numerous contacts with health-care providers outside the emergency department. Some of the repeaters needed and received help by a social hospital worker. Of those that received such help 80% significantly decreased their emergency department visiting rate.

  12. Enhanced care by community health workers in improving treatment adherence to antidepressant medication in rural women with major depression

    PubMed Central

    Pradeep, Johnson; Isaacs, Anton; Shanbag, Deepthi; Selvan, Sumithra; Srinivasan, Krishnamachari

    2014-01-01

    Background & objectives: Depression remains largely undiagnosed in women residing in rural India and consequently many do not seek help. Moreover, among those who are diagnosed, many do not complete treatment due to high rates of attrition. This study was aimed to compare the effectiveness of enhanced care with usual care in improving treatment seeking and adherence to antidepressant medication in women with depression living in rural India. Methods: Six villages from rural Bangalore were randomized to either community health worker supported enhanced care or usual care. A total of 260 adult depressed women formed the final participants for the analysis. The outcome measures were number of women who sought and completed treatment, number of clinic visits, duration of treatment with antidepressant, changes in severity of depression (HDRS) and changes in quality of life [WHO-QOL (Brev) scale]. Results: A significantly greater number of women from the treatment intervention (TI) group completed the treatment and were on treatment for a longer duration compared to the treatment as usual (TAU) group. However, there were no significant differences in the severity of depression or quality of life between the TI and the TAU groups or between treatment completers and treatment dropouts at six months. Interpretation & conclusions: Enhanced care provided by the trained community health workers to rural women with major depression living in the community resulted in greater number of women seeking help and adhering to treatment with antidepressants. However, despite enhanced care a significant number of rural women diagnosed with depression either did not seek help or discontinued treatment prematurely. These findings have significant public health implications, as untreated depression is associated with considerable disability. PMID:24718398

  13. Less-Educated Workers' Unstable Employment: Can the Safety Net Help? Fast Focus. No. 19-2014

    ERIC Educational Resources Information Center

    Hill, Heather D.; Ybarra, Marci A.

    2014-01-01

    Since the 1980s, U.S. workers with less than a college education have faced increasing job instability at the same time that the safety net has become increasingly contingent on employment. The sources of instability are many, including variable schedules, not enough hours, and temporary employment. A policy forum hosted by the Employment…

  14. High death rates in health care workers and teachers in Malawi.

    PubMed

    Harries, A D; Hargreaves, N J; Gausi, F; Kwanjana, J H; Salaniponi, F M

    2002-01-01

    High death rates are reported in health care workers (HCWs) and teachers in urban areas of Malawi. The present study was carried out to determine the annual death rate in HCWs and primary school teachers working in semi-urban and rural areas of Malawi, and to try to ascertain the main causes of death. Forty district and mission hospitals in Malawi were visited. A record was made of the number of clinical and nursing-based HCWs in each hospital in 1999, the number of deaths in that calendar year and reported causes of death. A record was also made of the number of teachers working in 4 primary schools nearest to each hospital in 1999, the number of deaths in that calendar year and reported causes of death. There were 2979 HCWs, of whom 60 (2.0%) died. There were 4367 teachers of whom 101 (2.3%) died. Annual death rates, calculated per 100,000 people, were significantly higher in male HCWs compared with female HCWs (2495 versus 1770, RR 1.17, 95% CI 1.14-1.20, P < 0.001), and significantly higher in female teachers compared with male teachers (2521 versus 1934, RR 1.14, 95% CI 1.11-1.17, P < 0.001). In male HCWs and teachers the highest death rates were in those aged 35-44 years. In female HCWs and teachers, the highest death rates were in those aged 25-34 years and 35-44 years, respectively. Reported causes of death in HCWs were tuberculosis (TB) in 47%, chronic illness in 45% and acute illness in the remainder, while in teachers the causes were TB in 27%, chronic illness in 49% and acute illness in 25%. Chronic illness, thought to be due to AIDS, and TB were the common causes of death. The current high death rates from AIDS and TB will have a crippling toll on the health and education sectors, and effective ways of reducing these death rates must be found.

  15. Mindfulness-based interventions with social workers and the potential for enhanced patient-centered care: A systematic review of the literature.

    PubMed

    Trowbridge, Kelly; Mische Lawson, Lisa

    2016-01-01

    The use of mindfulness-based interventions (MBIs) is well documented in the mental health, medical, and education literature. There is minimal research on the use of mindfulness with social workers. As demonstrated in other professional and helping fields, mindfulness may enhance clinical skills, reduce burnout, and increase job satisfaction among social workers. In the health care field mindfulness appears integral to patient and family relationships and personal resilience. The evolving and expanding role of hospital social workers may lead to increased work stress and greater demands from both the medical system and patients and families. Research with medical providers, such as physicians and nurses, suggests mindfulness may help in reducing stress, enhancing relationships, and fostering the self-reflection required to provide patient-centered care. We systematically reviewed the existing literature to begin understanding both mindfulness qualities and practices and the effectiveness of MBIs among social workers as well as the relationship of mindfulness to patient-centered care. PMID:26745592

  16. Retention in HIV care among female sex workers in the Dominican Republic: implications for research, policy and programming.

    PubMed

    Zulliger, Rose; Maulsby, Cathy; Barrington, Clare; Holtgrave, David; Donastorg, Yeycy; Perez, Martha; Kerrigan, Deanna

    2015-04-01

    There are clear benefits of retention in HIV care, yet millions of people living with HIV are sub-optimally retained. This study described factors from Andersen's behavioral model that were associated with retention in HIV care among 268 female sex workers (FSWs) living with HIV in the Dominican Republic using two measures of retention: a 6-month measure of HIV clinic attendance and a measure that combined clinic attendance and missed visits. FSWs who ever attended HIV care reported high rates (92 %) of 6-month attendance, but 37 % reported missed visits. Using the combined retention measure, the odds of being retained in HIV care were higher among FSWs with more positive perceptions of HIV service providers [adjusted odds ratio (AOR) 1.17; 95 % confidence interval (CI) 01.09, 1.25] and lower among women who reported recent alcohol consumption (AOR 0.50; 95 % CI 0.28, 0.92) and self-stigmatizing beliefs related to sex work (AOR 0.93; 95 % CI 0.88, 0.98). These findings support the hypothesis that retention in HIV care may be best determined through a combined measure as missed visits are an important mechanism to identify in-care patients who require additional support.

  17. Carriage of Multidrug Resistant Bacteria on Frequently Contacted Surfaces and Hands of Health Care Workers

    PubMed Central

    Visalachy, Sowndarya; Kopula, Sridharan Sathyamoorthy; Sekar, Uma

    2016-01-01

    Introduction Maximal contact between the patients and Health Care Workers (HCWs) happens in the Intensive Care Units (ICU). Control of nosocomial infections requires compliance with hand hygiene and contamination free surfaces. Aim To determine the colonization of potential pathogens in the hands of HCWs and frequent contacted environmental surfaces. Materials and Methods A cross sectional study was conducted between September 2012 and May 2013 at Sri Ramachandra Medical College and Hospital. A total of 327 samples were collected using Glove juice technique from hands and swabs from frequently contacted surfaces. A sum of 157 samples were collected by glove juice technique from the hands of HCWs which included Consultants (20), Internees (3), Residents (10), Staff nurse (102) and support staff (22). A total of 170 samples were collected through swabbing which included frequently touched surfaces of apron and dress (140 which included 10 consultants, 3 internees, 9 Residents, 101 Staff nurse and 17 support staff), 9 door handle, 4 key board, 12 tap handles and 5 monitors. The samples were inoculated into Blood agar, Chocolate agar and Mac-Conkey agar plates and incubated at 370C aerobically. The plates showing growth were further processed to identify the organisms by Gram staining and biochemical reactions. Antibiotic susceptibility testing was done for the isolates by Kirby-baur disc diffusion method as per CLSI guidelines. Results Out of the 157 hand sampling done by glove juice method 67(42.7%) of them showed growth and 90(57.3%) showed no growth. The potential pathogens grown were 13 (8.3%), consisting of Methicillin Sensitive Staphylococcus aureus (MSSA) 6(3.8%), Methicillin Resistant Staphylococcus aureus (MRSA) 2(1.3%), Pseudomonas spp 4(2.6%) and Acenitobacter spp 1 (0.6%). The MRSA was seen in Consultant 1(5%; n=20) and Staff nurse 1(0.9%; n= 102). Among the 140 sampling from the dress of HCWs growth was observed in 69(49.3%) and growth was absent in 71

  18. Influenza vaccination for health-care workers who work with elderly people in institutions: a systematic review.

    PubMed

    Thomas, R E; Jefferson, T O; Demicheli, V; Rivetti, D

    2006-05-01

    Our aim was to review the evidence of efficacy and effectiveness of influenza vaccination of health-care workers in reducing cases of influenza-like illness, influenza, complications from influenza, death from influenza, and death from all causes among the elderly people they care for in institutions. We searched 11 electronic databases in any language and identified two cluster-randomised controlled trials with moderate risk of bias and one cohort study at high risk of bias that addressed our questions. Staff vaccination had a significant effect on influenza-like illness (vaccine effectiveness [VE] 86%, 95% CI 40-97%) only when patients were vaccinated too. If patients were not vaccinated, staff immunisation had no effect. Vaccinating health-care workers did not appear efficacious against influenza (RR 0.87, 95% CI 0.46-1.63). There was no significant effect of vaccination on lower respiratory tract infections: (RR 0.70, 95% CI 0.41-1.20). Deaths from pneumonia were significantly reduced (VE 39%, 95% CI 2-62%), as were deaths from all causes (VE 40%, 95% CI 27-50%). These findings must be interpreted in the light of possible selection, performance, attrition, and detection biases.

  19. Is hand hygiene before putting on nonsterile gloves in the intensive care unit a waste of health care worker time?—A randomized controlled trial

    PubMed Central

    Rock, Clare; Harris, Anthony D.; Reich, Nicholas G.; Johnson, J. Kristie; Thom, Kerri A.

    2015-01-01

    Background Hand hygiene (HH) is recognized as a basic effective measure in prevention of nosocomial infections. However, the importance of HH before donning nonsterile gloves is unknown, and few published studies address this issue. Despite the lack of evidence, the World Health Organization and other leading bodies recommend this practice. The aim of this study was to assess the utility of HH before donning nonsterile gloves prior to patient contact. Methods A prospective, randomized, controlled trial of health care workers entering Contact Isolation rooms in intensive care units was performed. Baseline finger and palm prints were made from dominant hands onto agar plates. Health care workers were then randomized to directly don nonsterile gloves or perform HH and then don nonsterile gloves. Postgloving finger and palm prints were then made from the gloved hands. Plates were incubated and colony-forming units (CFU) of bacteria were counted. Results Total bacterial colony counts of gloved hands did not differ between the 2 groups (6.9 vs 8.1 CFU, respectively, P = .52). Staphylococcus aureus was identified from gloves (once in “hand hygiene prior to gloving” group, twice in “direct gloving” group). All other organisms were expected commensal flora. Conclusion HH before donning nonsterile gloves does not decrease already low bacterial counts on gloves. The utility of HH before donning nonsterile gloves may be unnecessary. PMID:23891455

  20. Study of Prevalence and Response to Needle Stick Injuries among Health Care Workers in a Tertiary Care Hospital in Delhi, India

    PubMed Central

    Sharma, Rahul; Rasania, SK; Verma, Anita; Singh, Saudan

    2010-01-01

    Background: Because of the environment in which they work, many health care workers are at an increased risk of accidental needle stick injuries (NSI). Objective: To study prevalence and response to needle stick injuries among health care workers. Materials and Methods: Study Design: Cross-sectional study. Setting: A tertiary care hospital in Delhi. Participants: 322 resident doctors, interns, nursing staff, nursing students, and technicians. Statistical Analysis: Proportions and Chi-square test. Results: A large percentage (79.5%) of HCWs reported having had one or more NSIs in their career. The average number of NSIs ever was found to be 3.85 per HCW (range 0-20). 72 (22.4%) reported having received a NSI within the last month. More than half (50.4%) ascribed fatigue as a cause in their injury. Most of the injuries (34.0%) occurred during recapping. In response to their most recent NSI, 60.9% washed the site of injury with water and soap while 38 (14.8%) did nothing. Only 20 (7.8%) of the HCWs took post-exposure prophylaxis (PEP) against HIV/AIDS after their injury. Conclusions: The occurrence of NSI was found to be quite common. Avoidable practices like recapping of needles were contributing to the injuries. Prevention of NSI is an integral part of prevention programs in the work place, and training of HCWs regarding safety practices indispensably needs to be an ongoing activity at a hospital. PMID:20606925

  1. Needs assessment for home-based care and the strengthening of social support networks: the role of community care workers in rural South Africa

    PubMed Central

    Moshabela, Mosa; Sips, Ilona; Barten, Francoise

    2015-01-01

    Background Community care workers (CCWs) in rural South Africa provide medical, personal, household, educational, and social care services to their clients. However, little understanding exists on how provision of services is approached within a household, taking into account available social support networks. Objective The aim of this study was to generate an understanding of the processes that underpin the provision of care by CCWs in rural households and their engagement with clients, primary caregivers (PCGs), and other members of the social support network. Design We analysed in-depth interviews conducted in a triad of participants involved in a home-based care (HBC) encounter – 32 clients, 32 PCGs, and 17 CCWs. For each triad, a purposefully selected CCW was linked with a purposefully selected client and the corresponding PCG using maximum variation sampling. Three coders used an inductive content analysis method to describe participants’ references to the nuances of processes followed by CCWs in servicing HBC clients. Written informed consent was obtained from all participants. Findings The results suggest that, by intuition and prior knowledge, CCWs treated each household uniquely, depending on the clients’ care needs, cooperation, availability of a social network, and the reliability and resilience of the social support system for the client. Four distinct processes took place in rural households: needs assessment for care, rationing of care, appraisal of care, and reinforcement of a social support system. However, there was no particular order or sequence established for these processes, and caregivers followed no prescribed or shared standards. Conclusions CCWs bring a basket of services to a household, but engage in a constant, dynamic, and cyclical process of weighing needs against services provided. The service package is uniquely crafted and tailored for each household, depending on the absorptive capacity of the social support network

  2. Responder Status Criterion for Stepped Care Trauma-Focused Cognitive Behavioral Therapy for Young Children

    PubMed Central

    Salloum, Alison; Scheeringa, Michael S.; Cohen, Judith A.; Storch, Eric A.

    2014-01-01

    Background In order to develop Stepped Care Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), a definition of early response/non-response is needed to guide decisions about the need for subsequent treatment. Objective The purpose of this article is to (1) establish criterion for defining an early indicator of response/nonresponse to the first step within Stepped Care TF-CBT, and (2) to explore the preliminary clinical utility of the early response/non-response criterion. Method Data from two studies were used: (1) treatment outcome data from a clinical trial in which 17 young children (ages 3 to 6 years) received therapist-directed CBT for children with PTSS were examined to empirically establish the number of posttraumatic stress symptoms to define early treatment response/non-response; and (2) three case examples with young children in Stepped Care TF-CBT were used to explore the utility of the treatment response criterion. Results For defining the responder status criterion, an algorithm of either 3 or fewer PTSS on a clinician-rated measure or being below the clinical cutoff score on a parent-rated measure of childhood PTSS, and being rated as improved, much improved or free of symptoms functioned well for determining whether or not to step up to more intensive treatment. Case examples demonstrated how the criterion were used to guide subsequent treatment, and that responder status criterion after Step One may or may not be aligned with parent preference. Conclusion Although further investigation is needed, the responder status criterion for young children used after Step One of Stepped Care TF-CBT appears promising. PMID:25663796

  3. The Effect of a Freely Available Flipped Classroom Course on Health Care Worker Patient Safety Culture: A Prospective Controlled Study

    PubMed Central

    Ling, Lowell; Gomersall, Charles David; Samy, Winnie; Joynt, Gavin Matthew; Leung, Czarina CH; Wong, Wai-Tat

    2016-01-01

    Background Patient safety culture is an integral aspect of good standard of care. A good patient safety culture is believed to be a prerequisite for safe medical care. However, there is little evidence on whether general education can enhance patient safety culture. Objective Our aim was to assess the impact of a standardized patient safety course on health care worker patient safety culture. Methods Health care workers from Intensive Care Units (ICU) at two hospitals (A and B) in Hong Kong were recruited to compare the changes in safety culture before and after a patient safety course. The BASIC Patient Safety course was administered only to staff from Hospital A ICU. Safety culture was assessed in both units at two time points, one before and one after the course, by using the Hospital Survey on Patient Safety Culture questionnaire. Responses were coded according to the Survey User’s Guide, and positive response percentages for each patient safety domain were compared to the 2012 Agency for Healthcare Research and Quality ICU sample of 36,120 respondents. Results We distributed 127 questionnaires across the two hospitals with an overall response rate of 74.8% (95 respondents). After the safety course, ICU A significantly improved on teamwork within hospital units (P=.008) and hospital management support for patient safety (P<.001), but decreased in the frequency of reporting mistakes compared to the initial survey (P=.006). Overall, ICU A staff showed significantly greater enhancement in positive responses in five domains than staff from ICU B. Pooled data indicated that patient safety culture was poorer in the two ICUs than the average ICU in the Agency for Healthcare Research and Quality database, both overall and in every individual domain except hospital management support for patient safety and hospital handoffs and transitions. Conclusions Our study demonstrates that a structured, reproducible short course on patient safety may be associated with an

  4. I strong administrative buy-in, firm mandates can push flu vaccination rates up to more than 99% among health care workers.

    PubMed

    2014-11-01

    While flu vaccination rates are inching up among health care workers, there is still room for improvement. The Centers for Disease Control and Prevention reports that slightly more than 75% of health care workers received the flu vaccination during the 2013-14 season--an increase of roughly 3% over the 2012-13 season. However, some hospitals have been able to achieve vaccination rates in excess of 99%. The apparent key to these efforts is a firm mandate that all personnel receive a flu shot as a condition of employment. There is always pushback to such policies, but hospitals report that most personnel eventually come around. While flu vaccination rates are on the increase among health, care personnel, data from the Centers for Medicare and Medicaid Services (CMS) note that rates vary widely from state to state. For example, the vaccination rate for health care workers in New Jersey stood at just 62% last year. In contrast, more than 95% of health care workers in Maryland received the shot during the 2013-14 flu season. Both Loyola University Medical Center and Henry Ford Hospital have been able to boost flu vaccination rates among their health care workers to more than 99% with the implementation of policies that require flu shots as a condition of employment. Experts say successful flu vaccination campaigns require strong administration buy-in and physician leadership.

  5. Clinical review: Tokyo - protecting the health care worker during a chemical mass casualty event: an important issue of continuing relevance.

    PubMed

    Okumura, Sumie; Okumura, Tetsu; Ishimatsu, Shinichi; Miura, Kunihisa; Maekawa, Hiroshi; Naito, Toshio

    2005-08-01

    Determine the effectiveness of decontamination, and perform thorough dry or wet decontamination, depending on the circumstances. Always remain cognizant of the fact that, even after decontamination has been completed, contamination may not have been completely eliminated. Perform periodic monitoring to determine whether secondary exposure has occurred in health care workers; if it appears that secondary exposure has occurred, then the PPE level must be increased and attempts must be made to identify and eliminate the source of the contamination. Finally, if the victims were exposed through ingestion, then consider the possibility that secondary exposure will occur during gastric lavage.

  6. Clinical review: Tokyo - protecting the health care worker during a chemical mass casualty event: an important issue of continuing relevance.

    PubMed

    Okumura, Sumie; Okumura, Tetsu; Ishimatsu, Shinichi; Miura, Kunihisa; Maekawa, Hiroshi; Naito, Toshio

    2005-08-01

    Determine the effectiveness of decontamination, and perform thorough dry or wet decontamination, depending on the circumstances. Always remain cognizant of the fact that, even after decontamination has been completed, contamination may not have been completely eliminated. Perform periodic monitoring to determine whether secondary exposure has occurred in health care workers; if it appears that secondary exposure has occurred, then the PPE level must be increased and attempts must be made to identify and eliminate the source of the contamination. Finally, if the victims were exposed through ingestion, then consider the possibility that secondary exposure will occur during gastric lavage. PMID:16137390

  7. 'When you visit a man you should prepare yourself': male community care worker approaches to working with men living with HIV in Cape Town, South Africa.

    PubMed

    Gittings, Lesley

    2016-08-01

    Caring is typically constructed as a feminised practice, resulting in women shouldering the burden of care-related work. Health-seeking behaviours are also constructed as feminine and men have poorer health outcomes globally. Employing men as carers may not only improve the health of the men they assist but also be transformative with regards to gendered constructions of caring. Using semi-structured interviews and observational home visits, this study explored the techniques that community care workers employ when working with male clients. The empirical analysis draws on the perspectives of eight care workers and three of their male clients from the Cape Town area. Interviews reveal how care workers and clients perform and negotiate masculinities as they navigate hegemonic masculine norms that require men to act tough, suppress emotions and deny weakness and sickness. Both parties bump up against ideals of what it means to be a man as they strive to provide care and receive support. Community care workers avoid rupturing client performances of hegemonic masculinities which inhibit confession and support. To do this, they use techniques of indirectly broaching sensitive subjects, acting in a friendly way and being clear about the intention of their work.

  8. Focusing on the software of managing health workers: what can we learn from high commitment management practices?

    PubMed

    Marchal, Bruno; Kegels, Guy

    2008-01-01

    Knowledge of what constitutes best practice in human resource management (HRM) in public-oriented services is limited and the operational aspects of managing health workers at provision level have been poorly studied. The magnet hospital concept offers some insights into HRM practices that are leading to high commitment. These have been shown to lead to superior performance in not only industrial business firms, but also service industries and the public service. The mechanisms that drive these practices include positive psychological links between managers and staff, organizational commitment and trust. Conditions for successful high commitment management (HiCoM) include health service managers with a strong vision and able to transmit this vision to their staff, appropriate decision spaces for healthcare managers and a pool of reasonable well-trained health workers. For this, adequate remuneration is the first condition. Equally important are the issues of cultural fit and of 'commitment'. What would staff expect from management in return for their commitment to the organization? Salary buys indeed time of employees, but other practices ensure their commitment. Only if these drivers are understood will managers be able to make their HRM practices more responsive to the needs and expectations of the health workers.

  9. Focusing on the software of managing health workers: what can we learn from high commitment management practices?

    PubMed

    Marchal, Bruno; Kegels, Guy

    2008-01-01

    Knowledge of what constitutes best practice in human resource management (HRM) in public-oriented services is limited and the operational aspects of managing health workers at provision level have been poorly studied. The magnet hospital concept offers some insights into HRM practices that are leading to high commitment. These have been shown to lead to superior performance in not only industrial business firms, but also service industries and the public service. The mechanisms that drive these practices include positive psychological links between managers and staff, organizational commitment and trust. Conditions for successful high commitment management (HiCoM) include health service managers with a strong vision and able to transmit this vision to their staff, appropriate decision spaces for healthcare managers and a pool of reasonable well-trained health workers. For this, adequate remuneration is the first condition. Equally important are the issues of cultural fit and of 'commitment'. What would staff expect from management in return for their commitment to the organization? Salary buys indeed time of employees, but other practices ensure their commitment. Only if these drivers are understood will managers be able to make their HRM practices more responsive to the needs and expectations of the health workers. PMID:17624868

  10. Wish to transfer to other jobs among long-term care workers.

    PubMed

    Aström, S; Waxman, H M; Nilsson, M; Norberg, A; Winblad, B

    1991-09-01

    This study is based on questionnaires that were sent to the homes of health care personnel working in geriatric care (N = 583) and acute care (N = 328). The purpose was to investigate differences between these groups of personnel regarding job assignment, intention to transfer to another job, attitudes towards demented patients, and the experience of burnout. The results showed that more persons working in acute care were self-assigned to their jobs than those working in geriatric care. More persons in geriatric care stated a wish to transfer to another job in the health care field than those in acute care. The personnel who constantly work with demented patients showed the most positive attitudes towards this group of patients. A larger proportion of personnel with high burnout scores wanted to transfer to another job, compared to those with low burnout scores.

  11. Is There a Role for Community Health Workers in Tobacco Cessation Programs? Perceptions of Administrators and Health Care Professionals

    PubMed Central

    2014-01-01

    Introduction: Studies have shown that with appropriate training, Community Health Workers (CHWs) can be actively involved in health promotion and disease prevention (including tobacco cessation). This study examined the perceptions of administrators and health care professionals regarding the actual and potential role(s) of CHWs in a tobacco cessation program (TCP) within a universal health care system. Methods: This study was part of a larger exploratory, cross-sectional comprehensive assessment of the implementation of the TCP through the primary care public health system in 7 towns in the state of Paraná, Brazil. Questionnaires were administered to 84 administrators at different levels (regional, municipal, and health units) and 80 health care professionals who were directly involved in the TCP. For this study, we assessed the perceptions of administrators and health care professionals on the actual and potential role(s) of CHWs in the TCP. Results: The overall response rate was 56.2%. Although 48.4% of respondents indicated that CHWs already participated in the TCP, there was a wide range in the participants’ responses regarding their involvement (33.3% among regional administrators and 65% among health care professionals). Identification/referral of patients and promotion of the TCP in the community were the most frequent CHWs’ activities reported. Overall, respondents were very receptive about trained CHWs having multiple roles in the TCP, except for delivery of a brief intervention. Conclusion: With appropriate training, health care administrators and health care professionals are very receptive regarding the involvement of CHWs in a TCP delivered through a public health system. PMID:24420327

  12. Health care infrastructure post-Katrina: disaster planning to return health care workers to their home communities.

    PubMed

    Griffies, W Scott

    2010-01-01

    One of the greatest challenges of restoring the New Orleans health care infrastructure since the post-Katrina disaster has been shortages of health care providers. Many providers had prolonged displacements or did not return to their practices, depleting the city of valuable resources. This Open Forum chronicles the displacement of Louisiana State University's Department of Psychiatry and discusses barriers to returning health care providers to their communities expeditiously. Predisaster planning and policy changes are proposed to facilitate a quicker return and decrease the attrition of health care providers after future disasters. A community's predisaster plans should include a mechanism to allow funds to follow patients instead of hospitals, to provide bridge funding that pays local health care providers to work as first responders and serve uninsured patients while these providers rebuild their practices, and to provide funds to quickly expand services and usable space in undamaged clinics and hospitals and to shore up reparable structures.

  13. Sexuality after burn in Brazil: survey of burn health-care workers.

    PubMed

    Piccolo, Monica Sarto; Daher, Ricardo Piccolo; Gragnani, Alfredo; Ferreira, Lydia Masako

    2011-12-01

    Patients who survive a major burn must live with emotional and physical sequela. In a literature review, we found that sexuality concerns of burn victims are rarely a focus of therapy. After suggestions from Rimmer et al. [12], using their questionnaire translated into Portuguese, we held a survey of burn-care professionals at the VII Brazilian Burn Congress. More than 120 practitioners from 41 centres, aged in average 41.2 years (1 standard deviation 10.96), completed the survey. A proportion of 63.7% were female, and 58.1% were Caucasians; 37.1% were physicians, 20.9% nurse practitioners and 16.9 were occupational therapists/physical therapists (OTs/PT)s. Psychologists made up 3.2%. Only 28% of the respondents felt comfortable in initiating a conversation about sexual intimacy with their patients. The vast majority believed it should be done by the psychologist. Only 38% felt their burn centre did an adequate job in that area. When compared with a study of our country's general population, we find similar results indicating that intimacy, sexuality and sexual intercourse are considered most important in a relationship. There is a significant lack of literature in sexuality after burn; most likely meaning it is ignored by most centres. There is a need for other similar surveys to be performed, as well as a collective consciousness of the need for discussions about sexuality with patients and their partners, providing counselling and treatment, when need.

  14. Determinants of Quality of Life in Primary Care Patients with Diabetes: Implications for Social Workers

    ERIC Educational Resources Information Center

    Ayalon, Liat; Gross, Revital; Tabenkin, Hava; Porath, Avi; Heymann, Anthony; Porter, Boaz

    2008-01-01

    Using a cross-sectional design of 400 primary care patients with diabetes, the authors evaluated demographics, health status, subjective health and mental health, health behaviors, health beliefs, knowledge of diabetes treatment, satisfaction with medical care, and quality of medical care as potential predictors of QoL and QoL in the hypothetical…

  15. Migration of health workers.

    PubMed

    Buchan, James

    2008-01-01

    The discussion and debate stimulated by these papers focused across a range of issues but there were four main areas of questioning: "measuring" and monitoring migration (issues related to comparability, completeness and accuracy of data sets on human resources); the impact of migration of health workers on health systems; the motivations of individual health workers to migrate (the "push" and "pull" factors) and the effect of policies designed either to reduce migration (e.g "self ufficiency") or to stimulate it (e.g active international recruitment). It was recognised that there was a critical need to examine migratory flows within the broader context of all health care labour market dynamics within a country, that increasing migration of health workers was an inevitable consequence of globalisation, and that there was a critical need to improve monitoring so as to better inform policy formulation and policy testing in this area. PMID:18561695

  16. Migration of health workers.

    PubMed

    Buchan, James

    2008-01-01

    The discussion and debate stimulated by these papers focused across a range of issues but there were four main areas of questioning: "measuring" and monitoring migration (issues related to comparability, completeness and accuracy of data sets on human resources); the impact of migration of health workers on health systems; the motivations of individual health workers to migrate (the "push" and "pull" factors) and the effect of policies designed either to reduce migration (e.g "self ufficiency") or to stimulate it (e.g active international recruitment). It was recognised that there was a critical need to examine migratory flows within the broader context of all health care labour market dynamics within a country, that increasing migration of health workers was an inevitable consequence of globalisation, and that there was a critical need to improve monitoring so as to better inform policy formulation and policy testing in this area.

  17. Does community emergency care initiative improve the knowledge and skill of healthcare workers and laypersons in basic emergency care in India?

    PubMed Central

    Bhoi, Sanjeev; Thakur, Nirmal; Verma, Pankaj; Sawhney, Chhavi; Vankar, Sameer; Agrawal, Deepak; Sinha, Tejprakash

    2016-01-01

    Background: Due to lack of training in emergency care, basic emergency care in India is still in its infancy. We designed All India Institute of Medical Sciences basic emergency care course (AIIMS BECC) to address the issue. Aim: To improve the knowledge and skill of healthcare workers and laypersons in basic emergency care and to identify impact of the course. Materials and Methods: Prospective study conducted over a period of 4 years. The target groups were medical and nonmedical personnel. Provider AIIMS BECC is of 1 day duration including lectures on cardio-pulmonary resuscitation, choking, and special scenarios. Course was disseminated via lectures, audio-visual aids, and mannequin training. For analysis, the participants were categorized on the basis of their education and profession. A pre- and a post-course evaluation were done and individual scores were given out of 20 and compared among all the groups and P value was calculated. Results: A total of 1283 subjects were trained. 99.81% became providers and 2.0% were trained as instructors. There was a significant improvement in knowledge among all the participants irrespective of their education level including medicos/nonmedicos. However, participants who had higher education (graduates and postgraduates) and/or belonged to medical field had better knowledge gain as compared to those who had low level of education (≤12th standard) and were nonmedicos. Conclusion: BECC is an excellent community initiative to improve knowledge and skill of healthcare and laypersons in providing basic emergency care. PMID:26957820

  18. Work stress, sleep deficiency and predicted 10-year cardiometabolic risk in a female patient care worker population

    PubMed Central

    Jacobsen, Henrik Børsting; Reme, Silje Endresen; Sembajwe, Grace; Hopcia, Karen; Stiles, Tore C.; Sorensen, Glorian; Porter, James H.; Marino, Miguel; Buxton, Orfeu M.

    2014-01-01

    Objectives The aim of this study was to investigate the longitudinal effect of work-related stress, sleep deficiency and physical activity on 10-year cardiometabolic risk among an all-female worker population. Methods Data on patient care workers (n=99) was collected two years apart. Baseline measures included: job stress, physical activity, night work and sleep deficiency. Biomarkers and objective measurements were used to estimate 10-year cardiometabolic risk at follow-up. Significant associations (P<0.05) from baseline analyses were used to build a multivariable linear regression model. Results The participants were mostly white nurses with a mean age of 41 years. Adjusted linear regression showed that having sleep maintenance problems, a different occupation than nurse, and/or not exercising at recommended levels at baseline increased the 10-year cardiometabolic risk at follow-up. Conclusions In female workers prone to work-related stress and sleep deficiency, maintaining sleep and exercise patterns had a strong impact on modifiable 10-year cardiometabolic risk. PMID:24809311

  19. Workplace interventions to reduce HIV and TB stigma among health care workers - Where do we go from here?

    PubMed

    Siegel, Jacob; Yassi, Annalee; Rau, Asta; Buxton, Jane A; Wouters, Edwin; Engelbrecht, Michelle C; Uebel, Kerry E; Nophale, Letshego E

    2015-01-01

    Fear of stigma and discrimination among health care workers (HCWs) in South African hospitals is thought to be a major factor in the high rates of HIV and tuberculosis infection experienced in the health care workforce. The aim of the current study is to inform the development of a stigma reduction intervention in the context of a large multicomponent trial. We analysed relevant results of four feasibility studies conducted in the lead up to the trial. Our findings suggest that a stigma reduction campaign must address community and structural level drivers of stigma, in addition to individual level concerns, through a participatory and iterative approach. Importantly, stigma reduction must not only be embedded in the institutional management of HCWs but also be attentive to the localised needs of HCWs themselves. PMID:25769042

  20. Activating the Worker in Elderly Care: A Technique and Tactics of Invitation

    ERIC Educational Resources Information Center

    Fejes, A.; Nicoll, K.

    2011-01-01

    Relatively little attention has been paid to questions of how language acts in and through the interactions of language in situations where people are encouraged to learn to be active in contexts of work. This paper argues that detailed analysis is needed to understand how activation through language acts in the shaping and governing of workers.…

  1. Social Workers' Perceptions of Older Parents Caring at Home for Sons and Daughters with Developmental Disabilities.

    ERIC Educational Resources Information Center

    McCallion, Philip; Tobin, Sheldon S.

    1995-01-01

    Social workers (n=395) were surveyed concerning their role in assisting older parents of developmentally disabled individuals with permanency planning. Practitioners, administrators, and educators similarly perceived ease in counseling aging families, but also noted their need for additional resources and specialized training. Recommendations…

  2. How Do Hired Workers Fare under Consumer-Directed Personal Care?

    ERIC Educational Resources Information Center

    Dale, Stacy; Brown, Randall; Phillips, Barbara; Carlson, Barbara Lepidus

    2005-01-01

    Purpose: This study describes the experiences of workers hired under consumer direction. Design and Methods: Medicaid beneficiaries who volunteered for the Cash and Counseling demonstration were randomly assigned to the treatment group, which could participate in the consumer-directed program, or the control group, which was referred to agency…

  3. Knowledge of Normal and Pathological Memory Aging in College Students, Social Workers, and Health Care Professionals

    ERIC Educational Resources Information Center

    Cherry, Katie E.; Allen, Priscilla D.; Jackson, Erin M.; Hawley, Karri S.; Brigman, Susan

    2010-01-01

    The Knowledge of Memory Aging Questionnaire (KMAQ) measures laypersons' knowledge of normal memory changes and pathological memory deficits in adulthood. In Experiment 1, undergraduate and graduate social work students and social work practitioners completed the KMAQ. Social workers and graduate students were more accurate on the pathological than…

  4. Community Health Workers and Health Care Delivery: Evaluation of a Women's Reproductive Health Care Project in a Developing Country

    PubMed Central

    Wajid, Abdul; White, Franklin; Karim, Mehtab S.

    2013-01-01

    Background As part of the mid-term evaluation of a Women's Health Care Project, a study was conducted to compare the utilization of maternal and neonatal health (MNH) services in two areas with different levels of service in Punjab, Pakistan. Methods A cross-sectional survey was conducted to interview Married Women of Reproductive Age (MWRA). Information was collected on MWRA knowledge regarding danger signs during pregnancy, delivery, postnatal periods, and MNH care seeking behavior. After comparing MNH service utilization, the two areas were compared using a logistic regression model, to identify the association of different factors with the intervention after controlling for socio-demographic, economic factors and distance of the MWRA residence to a health care facility. Results The demographic characteristics of women in the two areas were similar, although socioeconomic status as indicated by level of education and better household amenities, was higher in the intervention area. Consequently, on univariate analysis, utilization of MNH services: antenatal care, TT vaccination, institutional delivery and use of modern contraceptives were higher in the intervention than control area. Nonetheless, multivariable analysis controlling for confounders such as socioeconomic status revealed that utilization of antenatal care services at health centers and TT vaccination during pregnancy are significantly associated with the intervention. Conclusions Our findings suggest positive changes in health care seeking behavior of women and families with respect to MNH. Some aspects of care still require attention, such as knowledge about danger signs and neonatal care, especially umbilical cord care. Despite overall success achieved so far in response to the Millennium Development Goals, over the past two decades decreases in maternal mortality are far from the 2015 target. This report identifies some of the key factors to improving MNH and serves as an interim measure of a

  5. Clinical Practice Models for the Use of E-Mental Health Resources in Primary Health Care by Health Professionals and Peer Workers: A Conceptual Framework

    PubMed Central

    Griffiths, Kathleen M; Cunningham, John A; Bennett, Kylie; Bennett, Anthony

    2015-01-01

    Background Research into e-mental health technologies has developed rapidly in the last 15 years. Applications such as Internet-delivered cognitive behavioral therapy interventions have accumulated considerable evidence of efficacy and some evidence of effectiveness. These programs have achieved similar outcomes to face-to-face therapy, while requiring much less clinician time. There is now burgeoning interest in integrating e-mental health resources with the broader mental health delivery system, particularly in primary care. The Australian government has supported the development and deployment of e-mental health resources, including websites that provide information, peer-to-peer support, automated self-help, and guided interventions. An ambitious national project has been commissioned to promote key resources to clinicians, to provide training in their use, and to evaluate the impact of promotion and training upon clinical practice. Previous initiatives have trained clinicians to use a single e-mental health program or a suite of related programs. In contrast, the current initiative will support community-based service providers to access a diverse array of resources developed and provided by many different groups. Objective The objective of this paper was to develop a conceptual framework to support the use of e-mental health resources in routine primary health care. In particular, models of clinical practice are required to guide the use of the resources by diverse service providers and to inform professional training, promotional, and evaluation activities. Methods Information about service providers’ use of e-mental health resources was synthesized from a nonsystematic overview of published literature and the authors’ experience of training primary care service providers. Results Five emerging clinical practice models are proposed: (1) promotion; (2) case management; (3) coaching; (4) symptom-focused treatment; and (5) comprehensive therapy. We also

  6. Relational Issues Within Couples Coping With Parkinson's Disease: Implications and Ideas for Family-Focused Care.

    PubMed

    Martin, Summer C

    2016-05-01

    The ways in which Parkinson's disease (PD) impacts, and is experienced by, the couple (i.e., the individual with PD and his or her spouse or other romantic partner) have not been fully elucidated. Such research is strongly warranted because when one member of a couple is chronically ill, it can cause major distress for not only the patient but also for his or her partner and their relationship. Therefore, the goal of this study was to examine how PD affects a couple's relationship. Data from 44 individual, in-depth interviews (with 21 persons with PD and 23 partners) revealed several challenges that PD commonly invokes in the patient-partner relationship, though most participants reported that PD had not decreased their overall relational closeness. The findings have significant practical implications for family-focused care.

  7. The efficacy of Focused Acceptance and Commitment Therapy in VA primary care.

    PubMed

    Glover, Natalie G; Sylvers, Patrick D; Shearer, Erika M; Kane, Mary-Catherine; Clasen, Peter C; Epler, Amee J; Plumb-Vilardaga, Jennifer C; Bonow, Jordan T; Jakupcak, Matthew

    2016-05-01

    Focused Acceptance & Commitment Therapy (FACT) is a brief intervention based on traditional Acceptance and Commitment Therapy (ACT). Although there is a growing body of research on the efficacy of ACT for a variety of populations and disorders, there is little research to date on the use of FACT in group settings. This project is 1 of the first of its kind, as it examines data on psychological flexibility, health and mental health status, and symptom reduction from a 4-week FACT group. Participants in this study were 51 patients who attended this group as part of routine clinical care in a VA integrated primary care and mental health setting. They completed pre- and posttreatment measures of well-being, depression, anxiety, stress, psychological flexibility, and perceptions of physical and mental health functioning. Pre- to posttreatment analyses of variance demonstrated large effects for quality of life, F(1, 51) = 21.29, p < .001, η2 = 0.30, moderate effects for depressive symptoms, F(1, 51) = 11.47, p < .001, η2 = 0.08, and perceptions of mental health functioning (MCS scale), F(1, 51) = 9.67, p = .003, η2 = 0.11, and small effects for perceptions of perceived stress, F(1, 51) = 4.08, p = .04, η2 = 0.03, and physical health functioning (PCS scale), F(1, 51) = 6.60, p = .01, η2 = 0.08. There was a statistical trend for reductions in anxiety, F(1, 51) = 3.29, p = .07, η2 = 0.01, and a nonsignificant effect for psychological flexibility, F(1, 51) = 2.05, p = .16, η2 = 0.04. These data provide initial support for the implementation of a group-based FACT protocol within a VA primary care setting and help to lay a foundation for further, more controlled studies on Group FACT in future research. (PsycINFO Database Record PMID:27148950

  8. The efficacy of Focused Acceptance and Commitment Therapy in VA primary care.

    PubMed

    Glover, Natalie G; Sylvers, Patrick D; Shearer, Erika M; Kane, Mary-Catherine; Clasen, Peter C; Epler, Amee J; Plumb-Vilardaga, Jennifer C; Bonow, Jordan T; Jakupcak, Matthew

    2016-05-01

    Focused Acceptance & Commitment Therapy (FACT) is a brief intervention based on traditional Acceptance and Commitment Therapy (ACT). Although there is a growing body of research on the efficacy of ACT for a variety of populations and disorders, there is little research to date on the use of FACT in group settings. This project is 1 of the first of its kind, as it examines data on psychological flexibility, health and mental health status, and symptom reduction from a 4-week FACT group. Participants in this study were 51 patients who attended this group as part of routine clinical care in a VA integrated primary care and mental health setting. They completed pre- and posttreatment measures of well-being, depression, anxiety, stress, psychological flexibility, and perceptions of physical and mental health functioning. Pre- to posttreatment analyses of variance demonstrated large effects for quality of life, F(1, 51) = 21.29, p < .001, η2 = 0.30, moderate effects for depressive symptoms, F(1, 51) = 11.47, p < .001, η2 = 0.08, and perceptions of mental health functioning (MCS scale), F(1, 51) = 9.67, p = .003, η2 = 0.11, and small effects for perceptions of perceived stress, F(1, 51) = 4.08, p = .04, η2 = 0.03, and physical health functioning (PCS scale), F(1, 51) = 6.60, p = .01, η2 = 0.08. There was a statistical trend for reductions in anxiety, F(1, 51) = 3.29, p = .07, η2 = 0.01, and a nonsignificant effect for psychological flexibility, F(1, 51) = 2.05, p = .16, η2 = 0.04. These data provide initial support for the implementation of a group-based FACT protocol within a VA primary care setting and help to lay a foundation for further, more controlled studies on Group FACT in future research. (PsycINFO Database Record

  9. The Power of Kawaii: Viewing Cute Images Promotes a Careful Behavior and Narrows Attentional Focus

    PubMed Central

    Nittono, Hiroshi; Fukushima, Michiko; Yano, Akihiro; Moriya, Hiroki

    2012-01-01

    Kawaii (a Japanese word meaning “cute”) things are popular because they produce positive feelings. However, their effect on behavior remains unclear. In this study, three experiments were conducted to examine the effects of viewing cute images on subsequent task performance. In the first experiment, university students performed a fine motor dexterity task before and after viewing images of baby or adult animals. Performance indexed by the number of successful trials increased after viewing cute images (puppies and kittens; M ± SE = 43.9±10.3% improvement) more than after viewing images that were less cute (dogs and cats; 11.9±5.5% improvement). In the second experiment, this finding was replicated by using a non-motor visual search task. Performance improved more after viewing cute images (15.7±2.2% improvement) than after viewing less cute images (1.4±2.1% improvement). Viewing images of pleasant foods was ineffective in improving performance (1.2±2.1%). In the third experiment, participants performed a global–local letter task after viewing images of baby animals, adult animals, and neutral objects. In general, global features were processed faster than local features. However, this global precedence effect was reduced after viewing cute images. Results show that participants performed tasks requiring focused attention more carefully after viewing cute images. This is interpreted as the result of a narrowed attentional focus induced by the cuteness-triggered positive emotion that is associated with approach motivation and the tendency toward systematic processing. For future applications, cute objects may be used as an emotion elicitor to induce careful behavioral tendencies in specific situations, such as driving and office work. PMID:23050022

  10. Subcutaneous infusion in palliative care: a focus on the neria soft 90 infusion set.

    PubMed

    Gabriel, Janice

    2014-11-01

    Subcutaneous administration of medications and/or fluids can play a crucial part in supporting patients at home and thereby avoiding the need for hospitalisation. It is an area of patient care that has received little attention compared with other types of parenteral therapies. However, it is an effective and safe route for continuous administration for individuals requiring palliative care. Technological advancements have led to improved subcutaneous infusion devices, such as fine-gauge cannulae with integral sharps protection, as well as integral hypoallergenic dressings. These design features not only help to increase patient comfort but also minimise the potential for needlestick injuries, as well as providing the health professional with one sterile package containing all of the components needed to establish subcutaneous infusion. However, technological developments alone are insufficient to improve patient outcomes. Knowledge of the individual patient, together with their diagnosis and intended treatment, will influence the choice of subcutaneous infusion device, with the overall aim of minimising the potential for complications and improving comfort. This paper provides an overview of subcutaneous infusion, including the importance of patient assessment and the education and training needs of health professionals, and then focuses on one specific subcutaneous infusion device: the neria soft 90 infusion set. PMID:25426880

  11. Who knows, who cares? Dementia knowledge among nurses, care workers, and family members of people living with dementia.

    PubMed

    Robinson, Andrew; Eccleston, Claire; Annear, Michael; Elliott, Kate-Ellen; Andrews, Sharon; Stirling, Christine; Ashby, Michael; Donohue, Catherine; Banks, Susan; Toye, Christine; McInerney, Fran

    2014-01-01

    The number of people with dementia is increasing rapidly worldwide. Commensurate with population ageing, the use of nursing homes in Australia (known as residential aged care facilities) for individuals with dementia is growing. As a terminal condition, dementia is best managed by instituting a palliative approach to care. A good knowledge of dementia, including its progression and management, among staff and families of people living with dementia is essential for clear decision making and the provision of appropriate care. Yet there is limited information regarding relative levels of dementia knowledge. This paper reports the results of a study that assessed dementia knowledge among these two cohorts using the Dementia Knowledge Assessment Tool; the study surveyed 279 staff members and 164 family members of residents with dementia. Dementia knowledge deficits were evident in both cohorts across a range of areas. It is critical that dementia knowledge deficits are identified and addressed in order to support evidence-based dementia care. PMID:25265739

  12. Assessment of genotoxic risks in Croatian health care workers occupationally exposed to cytotoxic drugs: a multi-biomarker approach.

    PubMed

    Kopjar, Nevenka; Garaj-Vrhovac, Verica; Kasuba, Vilena; Rozgaj, Ruzica; Ramić, Snjezana; Pavlica, Vesna; Zeljezić, Davor

    2009-07-01

    The aim of the present study was to evaluate genome damage induced in peripheral blood lymphocytes of Croatian health care workers occupationally exposed to cytotoxic drugs. A comprehensive multi-biomarker approach using the alkaline comet assay and cytogenetic endpoints (analysis of structural chromosome aberrations, SCE assay, lymphocyte proliferation kinetics and cytokinesis-block micronucleus assay) was employed. The study included two populations of subjects: 50 health care workers occupationally exposed to cytotoxic drugs and 50 control subjects matched in age, gender and smoking habit. An investigation regarding the handling practice with cytotoxic drugs was conducted in parallel. Results obtained indicate high exposure levels at workplace that should be reduced. The values recorded among the occupationally exposed subjects were as follows: mean comet tail length: 17.46+/-0.08 microm; the incidence of long-tailed nuclei: 54.68+/-3.93%; 4.48+/-0.33 structural chromosome aberrations per 200 cells; 5.81+/-0.04 SCE per 50 cells; 29.28+/-2.21% of high-frequency cells; proliferation rate index: 1.97+/-0.12; and 16.32+/-0.85 micronuclei per 1000 binuclear cells. All these values indicated higher levels of DNA and cytogenetic damage compared to the general population. Obtained results also confirmed that the frequency of long-tailed nuclei in the alkaline comet assay represents a helpful complement to other well-established comet parameters. The age of subjects and smoking habit significantly influenced the values of both comet and cytogenetic endpoints. Overall results of this study confirmed that handling cytotoxic drugs without appropriate safety precautions involves a potential genotoxic risk for exposed subjects. Before a strict monitoring of exposure levels on each workplace becomes a standard practice in Croatian hospitals, cytogenetic surveillance of exposed workers is also recommended, at least in cases of accidental exposure. PMID:19049854

  13. A person-focused model of care for the twenty-first century: a system-of-systems perspective.

    PubMed

    Greene, Robert A; Dasso, Edwin; Ho, Sam; Genaidy, Ash M

    2014-06-01

    The US health care system is challenged to provide high-quality care and is burdened with unsustainable expenditures, making it difficult for health care participants (patients, payers, providers, caregivers) to create value. This communication presents the theoretical foundation for a person-focused model of care that addresses a number of these challenges. The model integrates aspects of prior models of chronic care with new empiric findings and complex adaptive system (CAS) theory. The model emphasizes the relationship among all health care stakeholders. The health care delivery process is examined in terms of the role of each stakeholder and the value each adds to and receives from the process. The authors present pilot results illustrating the implications of CAS theory in regard to multi-morbidity, disease management programs, multi-morbid households, and person- and household-focused care. The model incorporates the physical, mental, and social dimensions of health, and operationalizes an individual patient's health as a CAS, identifying CASs for each of the other stakeholders as well. Health care can then be conceptualized as a system-of-systems with a person's health as its output. Deploying the model need not require major infrastructure investments or changes. It can be implemented by repurposing, aligning, and better integrating currently available interventions. The authors believe that the model creates not only survival value (health) but also purposeful value. The model offers a unifying focus for all participants in the health care delivery process, thereby constructing a health care system that is structurally person-focused and meaningful for all participants. PMID:24720637

  14. Inter-professional perspectives of dementia services and care in England: Outcomes of a focus group study.

    PubMed

    Sutcliffe, Caroline L; Jasper, Rowan; Roe, Brenda; Jolley, David; Crook, Anthony; Challis, David J

    2016-09-01

    Many people living with dementia are supported at home using a variety of health and social care services. This paper reports the findings from a focus group study undertaken with staff in community mental health teams to explore areas for improvement in relation to national policies and recommendations for dementia care. Two focus groups were held with staff (n = 23) in 2011 to discuss topics including service delivery, information and communication, and provision of health and community care for people with dementia. Respondents identified problems with information sharing and incompatible electronic systems; inflexibility in home care services; and poor recognition of dementia in hospital settings. General practitioners had developed a greater awareness of the disease and some community services worked well. They felt that budgetary constraints and a focus on quality indicators impeded good dementia care. Key areas suggested by staff for improvements in dementia care included the implementation of more flexible services, dementia training for health and social care staff, and better quality care in acute hospital settings. PMID:25169885

  15. Inter-professional perspectives of dementia services and care in England: Outcomes of a focus group study.

    PubMed

    Sutcliffe, Caroline L; Jasper, Rowan; Roe, Brenda; Jolley, David; Crook, Anthony; Challis, David J

    2016-09-01

    Many people living with dementia are supported at home using a variety of health and social care services. This paper reports the findings from a focus group study undertaken with staff in community mental health teams to explore areas for improvement in relation to national policies and recommendations for dementia care. Two focus groups were held with staff (n = 23) in 2011 to discuss topics including service delivery, information and communication, and provision of health and community care for people with dementia. Respondents identified problems with information sharing and incompatible electronic systems; inflexibility in home care services; and poor recognition of dementia in hospital settings. General practitioners had developed a greater awareness of the disease and some community services worked well. They felt that budgetary constraints and a focus on quality indicators impeded good dementia care. Key areas suggested by staff for improvements in dementia care included the implementation of more flexible services, dementia training for health and social care staff, and better quality care in acute hospital settings.

  16. Barriers to Use of Workers' Compensation for Patient Care at Massachusetts Community Health Centers

    PubMed Central

    Azaroff, Lenore S; Davis, Letitia K; Naparstek, Robert; Hashimoto, Dean; Laing, James R; Wegman, David H

    2013-01-01

    Objectives To examine barriers community health centers (CHCs) face in using workers' compensation insurance (WC). Data Sources/Study Setting Leadership of CHCs in Massachusetts. Study Design We used purposeful snowball sampling of CHC leaders for in-depth exploration of reimbursement policies and practices, experiences with WC, and decisions about using WC. We quantified the prevalence of perceived barriers to using WC through a mail survey of all CHCs in Massachusetts. Data Collection/Extraction Methods Emergent coding was used to elaborate themes and processes related to use of WC. Numbers and percentages of survey responses were calculated. Principal Findings Few CHCs formally discourage use of WC, but underutilization emerged as a major issue: “We see an awful lot of work-related injury, and I would say that most of it doesn't go through workers' comp.” Barriers include lack of familiarity with WC, uncertainty about work-relatedness, and reliance on patients to identify work-relatedness of their conditions. Reimbursement delays and denials lead patients and CHCs to absorb costs of services. Conclusion Follow-up studies should fully characterize barriers to CHC use of WC and experiences in other states to guide system changes in CHCs and WC agencies. Education should target CHC staff and workers about WC. PMID:23445431

  17. Focusing on Patient Safety: the Challenge of Securely Sharing Electronic Medical Records in Complex Care Continuums.

    PubMed

    Key, Diana; Ferneini, Elie M

    2015-09-01

    The Patient Protection and Affordable Care Act's (PPACA) regulated approach to inclusive provision of care will increase the challenge health care administrators face ensuring secure communication and secure sharing of electronic medical records between divisions and care subcontractors. This analysis includes a summary overview of the PPACA; the Health Care and Education Reconciliation Act (HCERA) of 2010; and required Essential Health Benefits (EHB). The analysis integrates an overview of how secure communication and secure sharing of electronic medical records will be essential to clinical outcomes across complex care continuums; as well as the actionable strategies health care leadership can employ to overcome associated IT security challenges.

  18. An Approach for Safe Medication Assistance in Nursing Homes: A Workshop to Identify Problems of and Plan Measures for Care Workers.

    PubMed

    Park, Hyerim; Miki, Akiko; Satoh, Hiroki; Maki, Hideyuki; Asai, Kohei; Konishi, Yukari; Sawada, Yasufumi

    2016-01-01

    We conducted a workshop that aimed to clarify problems with care workers supporting medication use in nursing homes, to propose measures for solving these problems, and to raise awareness of these problems among care workers. Eighteen care workers from different fee-based elderly nursing homes were enrolled in the workshop, and divided into four groups. The participants in these groups identified the issues based on their experiences regarding medication-related incidents, and discussed related problems and viable measures using the KJ method. The issues identified by each group were "dropping a medication", "wrong resident", "refusal to take medication", and "confusion". To resolve these problems, the participants recommended: "conducting study sessions or testing of manuals and medication knowledge", "strengthening monitoring systems", "enhancing information sharing", etc. The involvement of pharmacists was hardly mentioned, despite the workshop being designed for "medication assistance". A post-workshop questionnaire revealed that 88.9% of the participants acknowledged an increased awareness of safe assistance in the use of medication. A follow-up questionnaire, distributed approximately seven months after the workshop, revealed that 82.4% of participants applied the experience and knowledge they learned at the workshop to their work. The workshop seemed to raise awareness and lead to preventive measures for safe medication assistance. Communication between care workers and other health care professionals, such as pharmacists, is important to designing and implementing safe medical care in nursing homes. PMID:27252069

  19. Employers' role in helping Latino workers obtain access to health care services: results of a community-based pilot demonstration project.

    PubMed

    Dembe, Allard E; Biehl, Jeffrey M; Smith, Alicia D; Garcia de Gutierrez, Teresa

    2013-06-01

    A coalition of employers in the hotel and restaurant industries collaborated with community-based organizations to undertake a unique demonstration project, called the Employed Latino Health Initiative, aimed at improving access to basic health care services for low-wage Latino workers in Columbus, Ohio. With grant funding from the Robert Wood Johnson Foundation, the project developed and tested protocols allowing Latino workers from participating companies to obtain basic health care screenings, referrals to medical providers, health education training, and the services of a qualified community health navigator. Data from the pilot project indicated high screening participation rates, extensive referrals to providers for follow-up care, and a substantial need for facilitation services by community health navigators. The project provides a model for how employers can potentially promote their own interests in boosting work productivity through facilitating expanded access to basic medical services among vulnerable workers, despite the absence of conventional health insurance coverage.

  20. Focused echocardiography: a systematic review of diagnostic and clinical decision-making in anaesthesia and critical care.

    PubMed

    Heiberg, J; El-Ansary, D; Canty, D J; Royse, A G; Royse, C F

    2016-09-01

    Focused echocardiography is becoming a widely used tool to aid clinical assessment by anaesthetists and critical care physicians. At the present time, most physicians are not yet trained in focused echocardiography or believe that it may result in adverse outcomes by delaying, or otherwise interfering with, time-critical patient management. We performed a systematic review of electronic databases on the topic of focused echocardiography in anaesthesia and critical care. We found 18 full text articles, which consistently reported that focused echocardiography may be used to identify or exclude previously unrecognised or suspected cardiac abnormalities, resulting in frequent important changes to patient management. However, most of the articles were observational studies with inherent design flaws. Thirteen prospective studies, including two that measured patient outcome, were supportive of focused echocardiography, whereas five retrospective cohort studies, including three outcome studies, did not support focused echocardiography. There is an urgent requirement for randomised controlled trials. PMID:27346556

  1. Awareness and practices regarding bio-medical waste management among health care workers in a tertiary care hospital in Delhi.

    PubMed

    Bhagawati, G; Nandwani, S; Singhal, S

    2015-01-01

    Health care institutions are generating large amount of Bio-Medical Waste (BMW), which needs to be properly segregated and treated. With this concern, a questionnaire based cross-sectional study was done to determine the current status of awareness and practices regarding BMW Management (BMWM) and areas of deficit amongst the HCWs in a tertiary care teaching hospital in New Delhi, India. The correct responses were graded as satisfactory (more than 80%), intermediate (50-80%) and unsatisfactory (less than 50%). Some major areas of deficit found were about knowledge regarding number of BMW categories (17%), mercury waste disposal (37.56%) and definition of BMW (47%). PMID:26470969

  2. 22 CFR 40.53 - Uncertified foreign health-care workers.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... a non-clinical health care occupation as described in 8 CFR 212.15(b)(1); or (2) Who is the... entry into the United States in order to perform health care services as described in 8 CFR 212.15. ....S.C. 1182(r), respectively, and the regulations found at 8 CFR 212.15. (b) Paragraph (a) of...

  3. (Under)Valuing Care Work: The Case of Childcare Workers in Small-Town Quebec

    ERIC Educational Resources Information Center

    Albanese, Patrizia

    2007-01-01

    This paper challenges the assumptions that women "care" as a matter of course, that care work is natural, inevitable, and easy--requiring little skill and as a result should not be highly valued or rewarded. It does so by assessing the impact of Quebec's (Canada's) $7/day childcare program on an economically disadvantaged community near the…

  4. How Does Sensitivity Training of Health Care Workers Impact Patient Satisfaction?

    ERIC Educational Resources Information Center

    De Vinci, Katrina Marie

    2010-01-01

    Health care of the 21st century is undergoing major changes due to a myriad of social factors affecting every level of society. From financial desperation due to the high cost of health care to the increased awareness of a generation asking for better services, the importance of patient satisfaction is paramount. The Centers for Medicare and…

  5. How Many Social Workers Are Needed in Primary Care? A Patient-Based Needs Assessment Example

    ERIC Educational Resources Information Center

    McGuire, James; Bikson, Karra; Blue-Howells, Jessica

    2005-01-01

    This study measured levels of self-reported social need in a sample of 684 veterans seen in four primary care clinics of a large Veterans Affairs health care system, using the Social Needs Checklist, and calculated levels of social work staffing to meet these needs. Data were obtained on the presence and severity of 15 areas of social needs,…

  6. Factors associated with establishment-based female sex workers accessing health care services in Shanghai.

    PubMed

    Pan, Rong; Mao, Limin; He, Na; Zhang, Jing; Chen, Kun; Liao, Cuiqin; Tang, Xian; Gong, Xiangzhen; Blaxland, Megan; de Wit, John

    2015-01-01

    Female sex workers are a priority population for HIV prevention and health promotion in China. This paper examines the patterns of and factors associated with the utilisation of HIV-related and general health services by establishment-based sex workers in Hongkou District, Shanghai. Participants were recruited through a three-stage sampling strategy and invited to self-complete a brief survey in 2012. The median age of the 400 participants included in the analyses was 33 years (range = 18-52 years old), with over three-quarters being married at the time of the survey. Participants were mostly internal migrants, more than half had lived in Shanghai for six months or longer and nearly two-thirds were working in an establishment with a total of less than five female sex workers. Routine physical examination and HIV testing were the most commonly accessed health services in the previous 12 months. Altogether, 347 women (86.8%) had actively sought, including 157 women had obtained, free health services mainly from local Community Health Service Centres (CHSCs) in the previous 12 months. The active seeking of free, largely CHSC-provided health services was associated with a longer duration of residence in Shanghai (adjusted odds ratio [AOR] = 2.55, 95% CI = 1.32-4.93; p < 0.01) and having tested for HIV in the previous 12 months (AOR = 3.68, 95% CI = 1.84-7.38; p < 0.001). Conversely, a higher annual income (AOR = 0.41, 95% CI = 0.21-0.80; p < 0.01), working in a larger establishment (AOR = 0.40, 95% CI = 0.20-0.79; p < 0.01) and knowing that HIV can be transmitted through blood transfusion with unscreened blood (AOR = 0.21, 95% CI = 0.05-0.91; p < 0.05) were associated with not actively seeking such services. Free, community-based health services are highly demanded by establishment-based female sex workers in Shanghai. Scaling-up of free and integrated health services provided by community-based health service providers in metropolitan areas in China and beyond holds

  7. Living 'a life like ours': support workers' accounts of substitute decision-making in residential care homes for adults with intellectual disabilities.

    PubMed

    Dunn, M C; Clare, I C H; Holland, A J

    2010-02-01

    In England and Wales, the Mental Capacity Act 2005 (MCA) provides a new legal framework to regulate substitute decision-making relating to the welfare of adults who lack the capacity to make one or more autonomous decisions about their care and support. Any substitute decision made on behalf of an adult lacking capacity must be in his/her 'best interests'. However, the value of adopting established principles and procedures for substitute decision-making in practice is uncertain, and little is known about the legal or ethical dynamics of social care support, including the day-to-day residential support provided to adults with intellectual disabilities (ID). Methods This paper reports a qualitative, grounded theory analysis of 21 interviews with support workers working in residential care homes for adults with ID, and observations of care practices. Results In contrast to the narrow legal responsibilities placed upon them, it is argued that support workers interpret substitute decision-making within a broad moral account of their care role, orientating their support towards helping residents to live 'a life like ours'. In so doing, support workers describe how they draw on their own values and life experiences to shape the substitute decisions that they make on behalf of residents. Conclusions Support workers' accounts reveal clear discrepancies between the legal regulation of substitute decision-making and the ways that these support workers make sense of their work. Such discrepancies have implications both for the implementation of the MCA, and for the role of support workers' values in the conceptualisation and delivery of 'good' care.

  8. The Significance of Education for Establishment in the Care Sector: Women and Men and Care Workers with a Migrant Background

    ERIC Educational Resources Information Center

    Johansson, Stina; Ahnlund, Petra

    2014-01-01

    In this article, we have followed women and men with a Swedish or an immigrant background that have completed the Upper Secondary Health Care Program. In which occupations do they work? Who employs them? Which target groups do they serve? Official statistics and survey data were used. The interaction between occupational structure and educational…

  9. [Health care of refugees - A short review with focus on infectious diseases].

    PubMed

    Lange, Berit; Stete, Katarina; Bozorgmehr, Kayvan; Camp, Johannes; Kranzer, Katharina; Kern, Winfried; Rieg, Siegbert

    2016-06-01

    Few guidelines for health care of refugees exist in Germany. Screening as a part of initial health checks as well as general organisation of early health care for refugees is very heterogenous across different regions. Current experience will be relevant to develop integrated health care models. Prevention and care of infectious diseases are an important part of early health care for refugees, even if non-communicable diseases and mental health conditions should also be considered in every effort to design early health care models. We are presenting a pragmatic review of current evidence for prevention and care of tuberculosis, HIV, chronic viral hepatitis and other infectious diseases. More evidence is needed to assess morbidity and efficacy of early health care interventions and integrated care models in refugees. PMID:27254625

  10. Analysis of Occupational Infections among Health Care Workers in Limpopo Province of South Africa

    PubMed Central

    Malangu, Ntambwe; Legothoane, Adelaide

    2013-01-01

    Objective: Occupational infections particularly hospital-acquired infections (HAIs) are a serious problem in the healthcare industry worldwide. This study purported to investigate their prevalence and risk factors among healthcare workers from Limpopo province of South Africa. Methods: Cases about occupational infectious diseases of healthcare workers from Limpopo province that were submitted to the Compensation Commissioner from January 2006 to December 2009 were reviewed. Results: The total number of cases of infectious diseases reported during the study period was 56; of these, 83.9% (47) of cases were for tuberculosis, 10.7% (6) for cholera, and 5.4% (3) for chickenpox. Nurses were the most affected. Risk factors associated with the acquisition of infection diseases were as follows. The majority of those infected were female (67.9%), aged over 40 years (57.1%), and who had worked for over 10 years (59.2%). With regard to length of time it took for one to be infected, overall it took 13.6±9.7 years from the year of employment to being infected. This duration was just 5.7±4.2 years in HCWs younger than 40 years versus 18.4±9.0 years in those 40 years and over (p=0.001); and 11.4±10.3 years in nurses versus 17.1±7.8 years in non-professional staff members (p=0.046). Mopani district, situated in a rural setting was the most affected as 24 of the 47 cases of tuberculosis occurred there. Conclusion: In conclusion, the most common occupational infection or hospital acquired infection among healthcare workers in Limpopo province of South Africa was tuberculosis. It infected mainly nurses from the rural health district of Mopani. Younger age and being a nurse were significant risk factors associated with being infected early. PMID:23283035

  11. Perception and prevalence of work-related health hazards among health care workers in public health facilities in southern India

    PubMed Central

    Senthil, Arasi; Anandh, Balasubramanian; Jayachandran, Palsamy; Thangavel, Gurusamy; Josephin, Diana; Yamini, Ravindran; Kalpana, Balakrishnan

    2015-01-01

    Background: Health care workers (HCWs) are exposed to occupational related health hazards. Measuring worker perception and the prevalence of these hazards can help facilitate better risk management for HCWs, as these workers are envisaged to be the first point of contact, especially in resource poor settings. Objective: To describe the perception of occupational health hazards and self-reported exposure prevalence among HCWs in Southern India. Methods: We used cross sectional design with stratified random sampling of HCWs from different levels of health facilities and categories in a randomly selected district in Southern India. Data on perception and exposure prevalence were collected using a structured interview schedule developed by occupational health experts and administered by trained investigators. Results: A total of 482 HCWs participated. Thirty nine percent did not recognize work-related health hazards, but reported exposure to at least one hazard upon further probing. Among the 81·5% who reported exposure to biological hazard, 93·9% had direct skin contact with infectious materials. Among HCWs reporting needle stick injury, 70·5% had at least one in the previous three months. Ergonomic hazards included lifting heavy objects (42%) and standing for long hours (37%). Psychological hazards included negative feelings (20·3%) and verbal or physical abuse during work (20·5%). Conclusion: More than a third of HCWs failed to recognize work-related health hazards. Despite training in handling infectious materials, HCWs reported direct skin contact with infectious materials and needle stick injuries. Results indicate the need for training oriented toward behavioral change and provision of occupational health services. PMID:25482656

  12. Conservative care of De Quervain’s tenosynovitis/ tendinopathy in a warehouse worker and recreational cyclist: a case report

    PubMed Central

    Howell, Emily R.

    2012-01-01

    Objective This case study was conducted to evaluate the conservative management of a patient presenting with right sided wrist and thumb pain diagnosed as De Quervain’s tenosynovitis/tendinopathy. Clinical features A 49-year-old female warehouse worker and recreational cyclist with right-sided De Quervain’s tenosynovitis/tendinopathy that began after a long-distance cycling trip. Intervention and outcome Treatment included ultrasound, soft tissue and myofascial release therapy, tool assisted fascial stripping or “guasha”, acupuncture, mobilizations and kinesiology taping. Home advice included icing, rest, wrist bracing, elevation and eccentric rehabilitation exercises. The positive outcome was a complete resolution of the patient’s complaint. Summary This case demonstrates how De Quervain’s disease is a challenging condition to treat with conservative methods and can be aggravated with new exacerbating factors as treatment continues. In this case, the addition of the active care (including eccentric exercises and self-care) helped to reinforce the passive care given in the office and accelerate the recovery. PMID:22675225

  13. Academic Institutions' Critical Guidelines for Health Care Workers Who Deploy to West Africa for the Ebola Response and Future Crises.

    PubMed

    Cranmer, Hilarie; Aschkenasy, Miriam; Wildes, Ryan; Kayden, Stephanie; Bangsberg, David; Niescierenko, Michelle; Kemen, Katie; Hsiao, Kai-Hsun; VanRooyen, Michael; Burkle, Frederick M; Biddinger, Paul D

    2015-10-01

    The unprecedented Ebola Virus Disease (EVD) outbreak in West Africa, with its first cases documented in March 2014, has claimed the lives of thousands of people, and it has devastated the health care infrastructure and workforce in affected countries. Throughout this outbreak, there has been a critical lack of health care workers (HCW), including physicians, nurses, and other essential non-clinical staff, who have been needed, in most of the affected countries, to support the medical response to EVD, to attend to the health care needs of the population overall, and to be trained effectively in infection protection and control. This lack of sufficient and qualified HCW is due in large part to three factors: 1) limited HCW staff prior to the outbreak, 2) disproportionate illness and death among HCWs caused by EVD directly, and 3) valid concerns about personal safety among international HCWs who are considering responding to the affected areas. These guidelines are meant to inform institutions who deploy professional HCWs. PMID:26271314

  14. Comparing the knowledge, attitude and practices of health care workers in public and private primary care facilities in Lagos State on Ebola virus disease

    PubMed Central

    Idris, Bilqisu Jibril; Inem, Victor; Balogun, Mobolanle

    2015-01-01

    Introduction The West African sub-region is currently witnessing an outbreak of EVD that began in December 2013. The first case in Nigeria was diagnosed in Lagos, at a private medical facility in July 2014. Health care workers are known amplifiers of the disease. The study aimed to determine and compare EVD knowledge, attitude and practices among HCWs in public and private primary care facilities in Lagos, Nigeria. Methods This was a comparative cross-sectional study. Seventeen public and private primary care facilities were selected from the 3 senatorial districts that make up Lagos State. 388 respondents from these facilities were selected at random and interviewed using a structured questionnaire. Results Proportion of respondents with good knowledge and practice among public HCWs was 98.5% and 93.8%; and among private HCW, 95.9% and 89.7%. Proportion of respondents with positive attitude was 67% (public) and 72.7% (private). Overall, there were no statistically significant differences between the knowledge, attitude and preventive practices of public HCWs and that of private HCWs, (p≤0.05). Conclusion Timely and intense social mobilization and awareness campaigns are the best tools to educate all segments of the community about public health emergencies. There exists significant surmountable gaps in EVD knowledge, negative attitude and sub-standard preventive practices that can be eliminated through continued training of HCW and provision of adequate material resources. PMID:26740847

  15. Use of gloves and handwashing behaviour among health care workers in intensive care units. A multicentre investigation in four hospitals in Denmark and Norway.

    PubMed

    Zimakoff, J; Stormark, M; Larsen, S O

    1993-05-01

    Glove use and handwashing frequencies (HW) were observed in intensive care units (ICU) in two university hospitals in Denmark and two in Norway. The study included a total of 1632 patient procedures performed by 325 persons. Handwashing (HW) has become an important part of general barrier precautions. Earlier studies have shown that health care workers (HCW) far too often neglect to wash their hands after patient procedures when handwashing is strongly recommended. Despite earlier claims that increased glove use in hospitals would discourage handwashing, our results showed that HCW washed their hands more often after glove use (57%) than when gloves had not been used (40%). This significant difference in HW frequency was also noted when similar procedures were carried out by HCW with or without gloves. This might be a matter of personal discomfort after wearing gloves, but could also be due to differences in awareness of hygienic aspects of patient care. In the two countries gloves were used on average at 17% of the procedures, but were not used appropriately for dirty procedures. The results of this study indicate that more effective methods for the implementation of appropriate glove use and HW should be emphasized.

  16. [Using focus groups to explore the group music therapy experience of long term care elderly].

    PubMed

    Lin, Hui-Chuan; Chen, Shu-Ling

    2007-04-01

    The purpose of this study was to explore the elderly's experience and perceptions of group music therapy. The residents of a long term care institution received group music therapy for one year. Afterwards, three interviews were conducted in focus groups of between six and eight of the elderly. Their ages ranged from 64 to 90. Ninety-five percent of these elderly subjects participated in the therapy for over ten months. The tape-recorded interviews were transcribed and analyzed using content analysis. Six themes emerged regarding the elderly subjects' experiences and perceptions of group music therapy, as follows: (1) becoming more willing to participate; (2) feeling pain relief and more controlled moods; (3) getting physically better; (4) being more motivated to live; (5) learning positive personal interaction and obedience to the rules of the group; and (6) learning skills to improve personal health. This information might be used as a helpful and valuable reference in nursing education and by administrative organizations involved in the planning of therapeutic programs for the elderly.

  17. Occupational stigma as a primary barrier to health care for street-based sex workers in Canada.

    PubMed

    Lazarus, Lisa; Deering, Kathleen N; Nabess, Rose; Gibson, Kate; Tyndall, Mark W; Shannon, Kate

    2012-01-01

    Individuals working in the sex industry continue to experience many negative health outcomes. As such, disentangling the factors shaping poor health access remains a critical public health priority. Within a quasi-criminalised prostitution environment, this study aimed to evaluate the prevalence of occupational stigma associated with sex work and its relationship to barriers to accessing health services. Analyses draw on baseline questionnaire data from a community-based cohort of women in street-based sex work in Vancouver, Canada (2006-2008). Of a total of 252 women, 141 (55.9%) reported occupational sex work stigma (defined as hiding occupational sex work status from family, friends and/or home community), while 125 (49.6%) reported barriers to accessing health services in the previous six months. In multivariable analysis, adjusting for sociodemographic, interpersonal and work environment risks, occupational sex work stigma remained independently associated with an elevated likelihood of experiencing barriers to health access. Study findings indicate the critical need for policy and societal shifts in views of sex work as a legitimate occupation, combined with improved access to innovative, accessible and non-judgmental health care delivery models for street-based sex workers that include the direct involvement of sex workers in development and implementation.

  18. Worker replacement and cost-benefit analysis of life-saving health care programs, a precautionary note.

    PubMed

    Tessier, Philippe; Sultan-Taïeb, Hélène; Barnay, Thomas

    2014-04-01

    The assumption according to which ill individuals can be replaced at work that underpins the 'friction cost method' (FCM) to value productivity costs has been primarily discussed within the framework of cost-utility analysis. This paper investigates the consequences of this assumption for cost-benefit analysis (CBA). It makes three contributions. First, it provides the first analytical account of the overall consequences of ill worker replacement on social welfare and it analyzes the associated compensation effects within a CBA framework. Second, it highlights a double counting problem that arises when ill worker replacement is assumed in the CBA of life-saving health care programs. To the best of our knowledge, no satisfactory solution to this problem has yet been provided in the literature. Third, this paper suggests and discusses two original ways to address this double counting issue. One consists in adjusting value of a statistical life estimations for the well-being provided by future incomes. Another possibility lies in the estimation of marginal rates of substitution between health and wealth so as to directly monetize the value of life over and above consumption. We show that both solutions raise unresolved questions that should be addressed in future research to enable appropriate use of the FCM in CBA.

  19. Latent Tuberculosis Infection and Associated Factors among Health Care Workers in Kigali, Rwanda

    PubMed Central

    Rutanga, Claude; Lowrance, David W.; Oeltmann, John E.; Mutembayire, Grace; Willis, Matt; Uwizeye, Claude Bernard; Hinda, Ruton; Bassirou, Chitou; Gutreuter, Steve; Gasana, Michel

    2015-01-01

    Introduction Data are limited regarding tuberculosis (TB) and latent TB infection prevalence in Rwandan health facilities. Methods We conducted a cross-sectional survey among healthcare workers (HCWs) in Kigali during 2010. We purposively selected the public referral hospital, both district hospitals, and randomly selected 7 of 17 health centers. School workers (SWs) from the nearest willing public schools served as a local reference group. We tested for latent TB infection (LTBI) using tuberculin skin testing (TST) and asked about past TB disease. We assessed risk of LTBI and past history of TB disease associated with hospital employment. Among HCWs, we assessed risk associated with facility type (district hospital, referral hospital, health center), work setting (inpatient, outpatient), and occupation. Results Age, gender, and HIV status was similar between the enrolled 1,131 HCWs and 381 SWs. LTBI was more prevalent among HCWs (62%) than SWs (39%). Adjusted odds of a positive TST result were 2.71 (95% CI 2.01–3.67) times greater among HCWs than SWs. Among HCWs, there was no detectable difference between prevalence of LTBI according to facility type, work setting, or occupation. Conclusion HCWs are at greater risk of LTBI, regardless of facility type, work setting, or occupation. The current status of TB infection control practices should be evaluated in the entire workforce in all Rwandan healthcare facilities. PMID:25919759

  20. [Perception of organizational climate and burnout amongst health care workers: the role of alexithymia as a moderator].

    PubMed

    Lazzari, D; Pisanti, R; Avallone, F

    2006-01-01

    This paper reports a study on 238 health care workers from an hospital in central Italy. We examined: 1) how some dimensions regarding perceived quality of the organizational and relational climate (social warmth and quality of working life both in the ward and in the organization) influence various indicators of burnout (emotional exhaustion, depersonalization, personal accomplishment); 2) if it was possible to improve the previous regressive models by including the personality construct, alexithymia. Controlling for age and gender, results of the hierarchical regression showed significant two-way interactions between organizational/relational climate and alexithymia in predicting emotional exhaustion (p = .005 for both the ward and the organization) and personal fulfillment (for ward, p = .020; for perceived relational climate, p = .037). Depersonalization was accounted by the main effect of alexithymia (p = .000). In conclusion, results demonstrate the need to include the alexithymia construct in models predicting the various dimensions of burnout.