120. Antimicrobial Prescribing Guidance and Communication Among Health Care Professionals in Five Guatemalan Hospitals

Abstract Background Communication among health care professionals during antimicrobial prescribing is critical to ensure appropriate use. This is of concern in Guatemala where physicians seldom consider guidance from other professionals during antimicrobial prescribing activities. Methods We carried out a cross sectional questionnaire and open ended interviews with physicians from five hospitals in Guatemala to describe perceptions of communication between health care providers, and acceptance of antimicrobial guidance during prescribing. Results From January to April 2021 an electronic questionnaire was sent to enrolled physicians of which 74% completed participation (n=107/145). Fifty-five percent participated in open ended interviews (n=79/145). Respondents perceived high levels of communication between physicians and ID specialists (94% of respondents); 52%, and 54% perceived high levels of physician-pharmacist, and physician-nurse communication respectively. Significant differences in the perception of physician-pharmacist communication were detected when comparing responses between hospitals, and between respondent sex (chi2, p< 0.05). Barriers to communication between professionals included lack of local guidelines or protocols, patient overload, COVID-19 pandemic, lack of mentorship, and little room to discuss antimicrobial therapy with higher-ranking physicians. Eighty percent and 45% of physicians were open to receiving antibiotic optimization recommendations from other physicians, and pharmacists respectively. Notable barriers to accepting recommendations from pharmacists included lack of regular communication, lack of clinical experience, and concern about evidence based recommendations. Conclusion Effective communication is perceived between physicians during antimicrobial prescribing activities. Marginal levels of communication and acceptance of prescribing recommendations have been detected between physicians and pharmacists.In this milieu, there is an opportunity to strengthen multidisciplinary teams to optimize antimicrobial use. Disclosures Mario Augusto Melgar Toledo, MD, Merck (Grant/Research Support)Pfizer (Grant/Research Support)

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Risk Perception and Worries among Health Care Workers in the COVID-19 Pandemic: Findings from an Italian Survey

Healthcare ◽

10.3390/healthcare8040535 ◽

2020 ◽

Vol 8 (4) ◽

pp. 535

Author(s):

Mariangela Valentina Puci ◽

Guido Nosari ◽

Federica Loi ◽

Giulia Virginia Puci ◽

Cristina Montomoli ◽

...

Keyword(s):

Health Care ◽

Risk Perception ◽

Health Care Providers ◽

Health Care Workers ◽

Health Care Professionals ◽

Sleep Disturbances ◽

Well Being ◽

Care Providers ◽

Cross Sectional ◽

Care Workers

The ongoing pandemic scenario, due to the coronavirus disease 2019 (COVID-19), has had a considerable impact on public health all over the world. Italy was one of the most affected countries, as the first European full-blown outbreak occurred there. The exposure of the Italian health care workers to COVID-19 may be an important risk factor for psychological distress. The aim of this cross-sectional study was to describe worries and risk perception of being infected among Italian Health Care Workers (HCWs) during the first wave of the pandemic. In total, 2078 HCWs participated in a web survey (78.8% were females). The highest percentage of respondents were physicians (40.75%) and nurses (32.15%), followed by medical (18.00%), health care support (4.50%) and administrative (4.60%) staff. In a score range between 0 (not worried) and 4 (very worried), our results showed that participants declared that they were worried about the Coronavirus infection with a median score of 3 (IQR 2-3) and for 59.19% the risk perception of being infected was very high. In addition, HCWs reported they suffered from sleep disturbances (63.43%). From the analysis of the psychological aspect, a possible divergence emerged between the perceived need for psychological support (83.85%) and the relative lack of this service among health care providers emerged (9.38%). Our findings highlight the importance of psychological and psychiatric support services not only during the COVID-19 pandemic, but also in other emerging infectious diseases (EIDs) scenarios. These services may be useful for health authorities and policymakers to ensure the psychological well-being of health care professionals and to promote precautionary behaviors among them.

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Identifying the know-do gap in evidence-based neonatal care practices among informal health care providers—a cross-sectional study from Ujjain, India

BMC Health Services Research ◽

10.1186/s12913-020-05805-2 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Isaac Gikandi Mungai ◽

Sumit Singh Baghel ◽

Shuchi Soni ◽

Shailja Vagela ◽

Megha Sharma ◽

...

Keyword(s):

Health Care ◽

Quantile Regression ◽

Health Care Providers ◽

Knowledge Score ◽

Neonatal Care ◽

Evidence Based ◽

Care Providers ◽

Cross Sectional ◽

Evidence Based Practices ◽

Multivariate Quantile

Abstract Background More than a quarter of global neonatal deaths are reported from India, and a large proportion of these deaths are preventable. However, in the absence of robust public health care systems in several states in India, informal health care providers (IHCPs) with no formal medical education are the first contact service providers. The aim of this study was to assess the knowledge of IHCPs in basic evidence-based practices in neonatal care in Ujjain district and investigated factors associated with differences in levels of knowledge. Methods A cross-sectional survey was conducted using a questionnaire with multiple-choice questions covering the basic elements of neonatal care. The total score of the IHCPs was calculated. Multivariate quantile regression model was used to look for association of IHCPs knowledge score with: the practitioners’ age, years of experience, number of patients treated per day, and whether they attended children in their practice. Results Of the 945 IHCPs approached, 830 (88%) participated in the study. The mean ± SD score achieved was 22.3 ± 7.7, with a median score of 21 out of maximum score of 48. Although IHCPs could identify key tenets of enhancing survival chances of neonates, they scored low on the specifics of cord care, breastfeeding, vitamin K use to prevent neonatal hemorrhage, and identification and care of low-birth-weight babies. The practitioners particularly lacked knowledge about neonatal resuscitation, and only a small proportion reported following up on immunizations. Results of quantile regression analysis showed that more than 5 years of practice experience and treating more than 20 patients per day had a statistically significant positive association with the knowledge score at higher quantiles (q75th and q90th) only. IHCPs treating children had significantly better scores across quantiles accept at the highest quantile (90th). Conclusions The present study highlighted that know-do gap exists in evidence-based practices for all key areas of neonatal care tested among the IHCPs. The study provides the evidence that some IHCPs do possess knowledge in basic evidence-based practices in neonatal care, which could be built upon by future educational interventions. Targeting IHCPs can be an innovative way to reach a large rural population in the study setting and to improve neonatal care services.

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Lifestyle modification advice provided by health care professionals in the treatment and management of hypertension in Kenya

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20202447 ◽

2020 ◽

Vol 7 (6) ◽

pp. 2018

Author(s):

Teresia Mbogori

Keyword(s):

Physical Activity ◽

Health Care ◽

Health Care Providers ◽

Health Care Professionals ◽

Fruits And Vegetables ◽

Salt Intake ◽

Lifestyle Modification ◽

Care Providers ◽

Cross Sectional ◽

Sugary Beverages

Background: Hypertension is one of the main modifiable risk factors for cardiovascular disease morbidity and mortality. Pharmacological and lifestyle modification approaches are used in the treatment and management of hypertension. The purpose of this study was to identify lifestyle modification advice provided to the general population and to those diagnosed with hypertension by health care providers (HCP) in Kenya.Methods: A secondary data analysis of cross-sectional data collected among 4500 Kenyans participating in the 2015 Kenya stepwise approach to surveillance study was conducted. Questions related to the consumption of salt, sugar, fat, fruits and vegetables as well as physical activity and weight management were evaluated.Results: Among all the participants, only 12.5%, 20.7%, 12.2%, 10.7%, 10.3% and 11.6% were advised to either reduce salt intake, eat 5 or more servings of fruits and vegetables, reduce fat intake, reduce intake of sugary beverages, lose or maintain weight and start or do more physical activity respectively. Of those diagnosed with HTN, 37% were advised to increase intake fruits and vegetables, 37%, 27% and 25% were advised to reduce, salt, fat and sugary beverages intake respectively, 21% and 22% were advised to start or do more physical activity and maintain a healthy body weight or lose weight respectively.Conclusions: Majority of Kenyans had not received dietary modification advice from HCP despite this being a policy recommendation in Kenya. Policy makers need to work closely with HCP to develop appropriate policy implementation strategies.

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Kajian Praktik Kefarmasian Apoteker pada Tatanan Rumah Sakit

Kesmas National Public Health Journal ◽

10.21109/kesmas.v7i8.23 ◽

2013 ◽

Vol 7 (8) ◽

pp. 365 ◽

Cited By ~ 1

Author(s):

Max Joseph Herman ◽

Rini Sasanti Handayani ◽

Selma Arsit Siahaan

Keyword(s):

Health Care ◽

Health Care Providers ◽

Health Care Professionals ◽

Government Regulation ◽

Hospital Pharmacist ◽

Standard Operating Procedure ◽

Care Providers ◽

District Health ◽

Cross Sectional ◽

The Government

Undang-undang Republik Indonesia No. 36 tahun 2009 tentang kesehatan dan peraturan pemerintah No. 51 tahun 2009 menyatakan bahwa tenaga kesehatan harus mempunyai kualifikasi minimum yang ditetapkan oleh pemerintah. Studi kualitatif secara potong lintang pada tahun 2010 untuk mengidentifikasi kualifikasi apoteker rumah sakit dalam memenuhi persyaratan tersebut di Bandung, Yogyakarta dan Surabaya. Data dikumpulkan dengan wawancara mendalam terhadap 10 orang apoteker dari enam rumah sakit dan empat orang direktur/wakil direktur rumah sakit, masing-masing satu orang apoteker dari enam perguruan tinggi farmasi, tiga pengurus Ikatan Apoteker Indonesia, tiga dinas kesehatan provinsi dan kabupaten/kota. Observasi praktek kefarmasian dengan menggunakan daftar tilik dilakukan pada tiap rumah sakit dan data sekunder terkait dokumentasi pemantauan dan evaluasi obat, kepuasan pasien, standar operasional prosedur dan kurikulum perguruan tinggi farmasi juga dikumpulkan. Analisis dilakukan dengan metode triangulasi dan hasil menunjukkan bahwa pengelolaan obat dalam hal pengadaan, distribusi dan penyimpanan dilaksanakan dengan baik oleh apoteker rumah sakit. Praktek farmasi klinik dan keselamatan pasien masih sangat terbatas karena alasan sumber daya manusia dan dokumentasi yang memadai. Informasi obat dan konseling kadang dilakukan tanpa fasilitas yang cukup dan apoteker juga terlibat dalam berbagai tim di rumah sakit seperti penanggulangan infeksi nosokomial dan komite farmasi dan terapi.The Indonesian Health Law No. 36 in 2009 and the Government Regulation No. 51 in 2009 state that health-care providers, including pharmacist, shall have minimum qualification set by the government. A qualitative cross sectional was conducted to to identify hospital pharmacist qualification as health care professionals in meeting the requirements was done in 2010 in Bandung, Yogyakarta and Surabaya. Data were collected through indepth interviews with pharmacists involving ten hospital pharmacists and four hos- pital directors/vice directors, six pharmacy colleges, three regional pharmacist associations, three provincial health offices and district health offices and observation of pharmacy practices using check list in each hospital was also conducted. Secondary data concerning documentation of drug monitoring and evaluation, patient satisfaction, standard operating procedure and pharmacy college curricula were collected too. Qualitative analysis was done descriptively using triangulation method. The study shows that drug procurement, distribution and storage, was well-managed by pharmacist. Practice in clinical pharmacy and patient safety was still limited for the reason of human resources and appropriate documentation. Drug information and counseling was sometimes conducted without adequate facilities and pharmacist was involved in various hospital teams like nosocomial infection control and pharmacy and therapy committee.

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Identifying the know-do gap in evidence-based neonatal care practices among informal health care providers—A cross-sectional study from Ujjain, India

10.21203/rs.3.rs-27837/v2 ◽

2020 ◽

Author(s):

Isaac Gikandi Mungai ◽

Sumit Singh Baghel ◽

Suchi Soni ◽

Shailja Vagela ◽

Megha Sharma ◽

...

Keyword(s):

Health Care ◽

Quantile Regression ◽

Health Care Providers ◽

Knowledge Score ◽

Neonatal Care ◽

Evidence Based ◽

Care Providers ◽

Cross Sectional ◽

Evidence Based Practices ◽

Multivariate Quantile

Abstract Background: More than a quarter of global neonatal deaths are reported from India, and a large proportion of these deaths are preventable. However, in the absence of robust public health care systems, informal health care providers (IHCPs) with no formal medical education are the first contact service providers. The aim of this study was to assess the knowledge of IHCPs in basic evidence-based practices in neonatal care in Ujjain district and investigated factors associated with differences in levels of knowledge. Methods: A cross-sectional survey was conducted using a questionnaire with multiple-choice questions covering the basic elements of neonatal care. The total score of the IHCPs was calculated. Multivariate quantile regression model was used to study association of IHCPs knowledge score with: the practitioners’ age, years of experience, number of patients treated per day, and whether they attended children in their practice. Results: Of the 945 IHCPs approached, 830 (88%) participated in the study. The mean±SD score achieved was 22.3±7.7, with a median score of 21 out of maximum score of 48. Although IHCPs could identify key tenets of enhancing survival chances of neonates, they scored low on the cord care, breastfeeding, vitamin K use to prevent neonatal hemorrhage, and care of low-birth-weight babies. The practitioners particularly lacked knowledge about neonatal resuscitation, and only a small proportion reported following up on immunizations. Results of quantile regression analysis showed that more than 5 years of practice experience and treating more than 20 patients per day had a statistically significant positive association with the knowledge score at higher quantiles (q75 th and q90 th ) only. IHCPs treating children had significantly better scores across quantiles accept at the highest quantile (90 th ). Conclusions: The present study highlighted that know-do gap exists in evidence-based practices for all key areas of neonatal care tested among the IHCPs. The study provides the evidence that some IHCPs do possess knowledge in basic evidence-based practices in neonatal care, which could be built upon in future educational interventions. Targeting IHCPs can be an innovative way to reach a large rural population and to improve neonatal care services.

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Identifying the know-do gap in evidence-based neonatal care practices among informal health care providers—A cross-sectional study from Ujjain, India

10.21203/rs.3.rs-27837/v1 ◽

2020 ◽

Author(s):

Isaac Gikandi Mungai ◽

Sumit Singh Baghel ◽

Suchi Soni ◽

Shailja Vagela ◽

Megha Sharma ◽

...

Keyword(s):

Health Care ◽

Health Care Providers ◽

Service Providers ◽

Neonatal Resuscitation ◽

Neonatal Care ◽

Evidence Based ◽

Care Providers ◽

Cross Sectional ◽

Evidence Based Practices ◽

Number Of Patients

Abstract Background More than a quarter of global neonatal deaths are reported from India, and a large proportion of these deaths are preventable. However, in the absence of robust public health care systems in several states in India, informal health care providers (IHCPs) with no formal medical education are the first contact service providers. The aim of this study was to assess the knowledge of IHCPs in basic evidence-based practices in neonatal care in Ujjain district and investigated factors associated with differences in levels of knowledge. Methods A cross-sectional survey was conducted using a questionnaire with multiple-choice questions covering the basic elements of neonatal care. The collective score per question among the respondents was calculated. The score achieved by each respondent was calculated, grouped into either “fair” or “low”, and then checked for association with the practitioners’ age and years of experience, number of patients examined per day, and whether they attended children in their practice. Results Of the 945 IHCPs approached, 830 (88%) participated in the study. Of the potential 39,840 points, only an average of 18,483 (46%) were achieved, indicating a knowledge gap. Although these providers could identify key tenets of enhancing survival chances of neonates, they scored low on the specifics of cord care, breastfeeding, vitamin K use to prevent neonatal hemorrhage, and identification and care of low-birth-weight babies. The practitioners particularly lacked knowledge about neonatal resuscitation, and only a small proportion reported following up on immunizations in children they attended. Fair knowledge of IHCPs was significantly associated with attending more than 10 but less than 50 patients per day and of being aged between 35 and 45 years. Offering pediatric consultations was not significantly associated with achieving a fair score. Conclusions The present study highlighted that know-do gap exists in evidence-based practices for all key areas of neonatal care tested among the IHCPs. The study provides the evidence that educational interventions targeting IHCPs can improve neonatal care services and is an innovative way to reach a large rural population in the study setting.

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Commitment Levels of Health Care Providers in Using the District Health Information System and the Associated Factors for Decision Making in Resource-Limited Settings: Cross-sectional Survey Study

JMIR Medical Informatics ◽

10.2196/23951 ◽

2021 ◽

Vol 9 (3) ◽

pp. e23951

Author(s):

Shuma G Kanfe ◽

Berhanu F Endehabtu ◽

Mohammedjud H Ahmed ◽

Nebyu D Mengestie ◽

Binyam Tilahun

Keyword(s):

Health Care ◽

Decision Making ◽

Health Care Providers ◽

Data Use ◽

Health Information System ◽

Evidence Based ◽

Care Providers ◽

District Health ◽

Cross Sectional ◽

Evidence Based Decision Making

Background Changing the culture of information use, which is one of the transformation agendas of the Ministry of Health of Ethiopia, cannot become real unless health care providers are committed to using locally collected data for evidence-based decision making. The commitment of health care providers has paramount influence on district health information system 2 (DHIS2) data utilization for decision making. Evidence is limited on health care providers’ level of commitment to using DHIS2 data in Ethiopia. Therefore, this study aims to fill this evidence gap. Objective This study aimed to assess the levels of commitment of health care providers and the factors influencing their commitment levels in using DHIS2 data for decision making at public health care facilities in the Ilu Aba Bora zone of the Oromia national regional state, Ethiopia in 2020. Methods The cross-sectional quantitative study supplemented by qualitative methods was conducted from February 26, 2020 to April 17, 2020. A total of 264 participants were approached. SPSS version 20 software was used for data entry and analysis. Descriptive and analytical statistics, including bivariable and multivariable analyses, were performed. Thematic analysis was conducted for the qualitative data. Results Of the 264 respondents, 121 (45.8%, 95% CI 40.0%-52.8%) respondents showed high commitment levels to use DHIS2 data. The variables associated with the level of commitment to use DHIS2 data were found to be provision of feedback for DHIS2 data use (adjusted odds ratio [AOR] 1.85, 95% CI 1.02-3.33), regular supervision and managerial support (AOR 2.84, 95% CI 1.50-5.37), information use culture (AOR 1.92, 95% CI 1.03-3.59), motivation to use DHIS2 data (AOR 1.80, 95% CI 1.00-3.25), health needs (AOR 3.96, 95% CI 2.11-7.41), and competency in DHIS2 tasks (AOR 2.41, 95% CI 1.27-4.55). Conclusions In general, less than half of the study participants showed high commitment levels to use DHIS2 data for decision making in health care. Providing regular supportive supervision and feedback and increasing the motivation and competency of the health care providers in performing DHIS2 data tasks will help in promoting their levels of commitment that can result in the cultural transformation of data use for evidence-based decision making in health care.

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Level of willingness to report to work during a pandemic among the emergency department health care professionals

Asian Journal of Medical Sciences ◽

10.3126/ajms.v5i3.9343 ◽

2014 ◽

Vol 5 (3) ◽

pp. 58-62 ◽

Cited By ~ 1

Author(s):

Anas Khan ◽

Mohammad Al Johani

Keyword(s):

Health Care ◽

Health Care Providers ◽

Health Care Professionals ◽

Influenza Pandemic ◽

Medical Science ◽

Care Providers ◽

Cross Sectional ◽

Knowledge And Attitudes ◽

Positive Attitudes ◽

Hypothetical Scenario

Objectives: To quantify the knowledge and attitudes of Health care providers (HCP) towards their willingness to work during an influenza pandemic. Methods: A Questionnaire based cross sectional study among the 350 emergency departments’ staff in seven different tertiary hospitals in Riyadh, Saudi Arabia was conducted in Jan 2010. A structured questionnaire with items to quantify the knowledge and attitudes of health care providers based on hypothetical scenario about the occurrence of H1N1 pandemic was developed. The questionnaire was validated before it was distributed among the study subjects. Data was analyzed using SPSS Pc+ 21.0 statistical software. Results: Out of the 254 responders, 190 (74.8%) stated that they will report to work during a pandemic, 29 (11.4%) won’t, and 35 (13.7%) don’t know. From those who won’t report or don’t know; 29 (45.31%) won’t change their minds for salary increase, and 40 (62.5%) won’t change their mind even if it meant they were to be dismissed. About 93 (36.4%) of study subjects were of the opinion that, HCP without children should primarily look after the patients. Among the HCPs, higher number of consultants and nurses were more willing to work than other HCPs. The consultants were having positive attitudes towards working during pandemics. Conclusion: Our results suggested that most participants were having positive attitudes towards willingness to work during an influenza pandemic. Their concerns should be considered, so that during a real situation faced, plans could be translated to reality smoothly. Asian Journal of Medical Science, Volume-5(3) 2014: 58-62 http://dx.doi.org/10.3126/ajms.v5i3.9343

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Perceived Barriers to Pediatric Clinical Trials Implementation: A Survey of Health Care Staff

10.21203/rs.3.rs-42309/v1 ◽

2021 ◽

Author(s):

Timothy Ryan Smith ◽

Russell McCulloh ◽

Minh-Thuy Bui ◽

Natalie Sollo ◽

Carolyn R. Ahlers-Schmidt ◽

...

Keyword(s):

Health Care ◽

Clinical Trials ◽

Health Care Providers ◽

Health Care Professionals ◽

Care Staff ◽

Health Care Staff ◽

Care Providers ◽

Cross Sectional ◽

Convenience Sample ◽

Clinic Staff

Abstract BackgroundClinical trials are the gold standard for assessing the effectiveness and safety of treatments. The objective of the current study was to assess provider opinions regarding implementing pediatric clinical trials in various practice settings across Kansas. MethodsThe study was completed within the Sunflower Pediatric Clinical Trials Research Extension (SPeCTRE), an affiliate of the IDeA States Pediatric Clinical Trials Network (ISPCTN). A cross-sectional, 36-item survey was administered to a state-wide convenience sample targeting health care providers and clinic staff. ResultsA total of 119 health care providers and clinic staff completed surveys; 31% were physicians. Physicians were more likely than other clinic staff to have experience with clinical trials (correlation coefficient [CC]=0.270, p=0.004). When compared to urban respondents, rural providers were less supportive of recruitment for clinical trials in their practices (CC=-0.251, p=0.008) and more likely to feel comfortable referring patients for clinical trials involving treatments that their insurance did not cover (CC=0.302, p=0.001).ConclusionA range of rural and urban health care professionals support the performance of pediatric clinical trials but identify several barriers as well. These results will support future pediatric clinical trials across the country including Kansas.TRIAL REGISTRATION: NA

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Development of an Outcome Measure of Observable Signs of Health and Well-Being in Infants With Orofacial Clefts

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665620922105 ◽

2020 ◽

Vol 57 (11) ◽

pp. 1266-1279

Author(s):

Carrie L. Heike ◽

Meredith Albert ◽

Cassandra L. Aspinall ◽

Suzel Bautista ◽

Claudia Crilly Bellucci ◽

...

Keyword(s):

Health Care ◽

Health Care Providers ◽

Health Care Professionals ◽

Cleft Lip ◽

Outcome Measure ◽

Psychometric Testing ◽

Well Being ◽

Care Providers ◽

Cross Sectional ◽

Health And Well Being

Objective: To develop an outcomes instrument that assesses observations that can be reliably reported by caregivers and can be used to assess health of infants with a cleft lip or cleft lip and cleft palate (CL±P) and impacts of treatments. Design: Cross-sectional, mixed methods study. Setting: Caregivers and health-care providers were recruited from 3 academic craniofacial centers and national advertisements. Most interviews were conducted by telephone, and surveys were completed online. Participants: Caregivers had a child less than 3 years of age with CL±P and spoke either English or Spanish. Health-care providers were members of a cleft team. Caregivers (n = 492) and health-care professionals (n = 75) participated in at least one component of this study. Main Outcome Measure(s): Caregivers and health-care providers participated in tasks related to instrument development: concept elicitation for items within relevant health domains, prioritization of items, and item review. Results: We identified 295 observations of infant well-being across 9 health areas. Research staff and specialists evaluated items for clarity, specificity to CL±P, and responsiveness to treatment. Caregivers and health-care providers rated the resulting list of 104 observations and developed the final instrument of 65 items. Conclusions: In this phase of development of the Infant with Clefts Observation Outcomes (iCOO) instrument, items were developed to collect caregiver observations about indicators of children’s health and well-being across multiple domains allowing for psychometric testing, sensitivity to changes associated with treatment, and documentation of the effects of treatment.

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