The Influence of an All-Female Healthcare Environment on Mentorship and Empowerment of Female Healthcare Professionals

Abstract Background: Low- and middle-income countries (LMICs) have the greatest need for additional healthcare providers, and women outside the workforce help address the need. Women in healthcare historically need more mentorship and leadership training to advance their careers. This study evaluates how women working together on a medical team influences mentorship, leadership and empowerment. Methods: An all-female volunteer team participating in a cleft surgery mission in Oujda, Morocco were surveyed before and after the mission. Responses were analyzed according to country of origin, national gender equality ranking, volunteer role, and prior mentorship experiences. Statistical analysis with student’s t-test or chi-squared were performed with significance defined as p<0.05. Results: 95 female volunteers from 23 countries participated and 85% completed surveys. Volunteers from HICs (32%) and LMICs (68%) had similar mission roles (p=0.58) and duration of volunteerism (p=0.69). Experience as a mission volunteer (p=0.47), team leader (p=0.28), and educator (p=0.18) were equivalent between cohorts. 73% of women had previously received mentorship but 98% wanted more. 75% had previously mentored others, but 97% wanted to be mentors. Over 90% of past mentor-mentee relationships were between women. 73% of volunteers who had no prior mentorship found their first mentor during the mission. All participants found a long-term peer relationship and felt motivated to mentor women at home. All volunteers felt empowered and enjoyed the mission. Over 95% were inspired to pursue leadership positions, advance professionally, and work with other women at home. Conclusion: Our results found that this population of female healthcare professionals in HICs and LMICs overwhelmingly desired more mentorship than is felt to be available. An all-female healthcare environment appears to provide opportunities for mentorship and create lasting motivation to teach, lead, and advance professionally. Increasing the visibility of female professionals may effectively empower women in healthcare.

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The Impact of an All-female Healthcare Environment on Mentorship and Empowerment of Female Healthcare Professionals in LMICs

10.21203/rs.3.rs-120642/v1 ◽

2020 ◽

Author(s):

Naikhoba Munabi ◽

Allyn Auslander ◽

Meredith D. Xepoleas ◽

Libby D. Bunker ◽

Kella L. Vangsness ◽

...

Keyword(s):

Healthcare Professionals ◽

Healthcare Providers ◽

Middle Income ◽

Healthcare Environment ◽

Before And After ◽

Chi Squared ◽

Working Together ◽

Student’S T ◽

The Impact ◽

At Home

Abstract Background: Low- and middle-income countries (LMICs) have the greatest need for additional healthcare providers, and women outside the workforce could help address the need. Women in healthcare need more mentorship and leadership training to advance their careers. This study evaluates how women working together on a medical team impacts mentorship, leadership and empowerment. Methods: An all-female volunteer team participating in a cleft surgery mission in Oujda, Morocco were surveyed before and after the mission. Responses were analyzed according to country of origin, national gender equality ranking, volunteer role, and prior mentorship experiences. Statistical analysis with student’s t-test or chi-squared were performed with significance defined as p<0.05. Results: 95 female volunteers from 23 countries participated and 85% completed surveys. Volunteers from HICs (32%) and LMICs (68%) had similar mission roles (p=0.58) and duration of volunteerism (p=0.69). Experience as a mission volunteer (p=0.47), team leader (p=0.28), and educator (p=0.18) were equivalent between cohorts. 73% of women had previously received mentorship but 98% wanted more. 75% had previously mentored others, but 97% wanted to be mentors. Over 90% of past mentor-mentee relationships were between women. 73% of volunteers who had no prior mentorship found their first mentor during the mission. All participants found a long-term peer relationship and felt motivated to mentor women at home. All volunteers felt empowered and enjoyed the mission. Over 95% were inspired to pursue leadership positions, advance professionally, and work with other women at home.Conclusion: Female healthcare professionals in HICs and LMICs desire more mentorship than is available. An all-female healthcare environment can provide opportunities for mentorship and create lasting motivation to teach, lead, and advance professionally. Increasing the visibility of female professionals may effectively empower women in healthcare.

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The Impact of an All-Female Healthcare Environment on Mentorship and Empowerment of Female Healthcare Professionals in LMICs

10.21203/rs.3.rs-127292/v1 ◽

2020 ◽

Author(s):

Naikhoba Munabi ◽

Allyn Auslander ◽

Meredith D. Xepoleas ◽

Libby D. Bunker ◽

Kella L. Vangsness ◽

...

Keyword(s):

Healthcare Professionals ◽

Healthcare Providers ◽

Middle Income ◽

Healthcare Environment ◽

Before And After ◽

Chi Squared ◽

Working Together ◽

Student’S T ◽

The Impact ◽

At Home

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Abstract WMP89: Stroke Code De-escalation: Safety and Outcomes

Stroke ◽

10.1161/str.48.suppl_1.wmp89 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Jessica Jarnot ◽

Christopher Streib ◽

Angela Heyer ◽

Amy Reichert ◽

David Anderson ◽

...

Keyword(s):

Chart Review ◽

Healthcare Providers ◽

Retrospective Chart Review ◽

Before And After ◽

Chi Squared ◽

Cost Implications ◽

The Impact ◽

Timely Treatment ◽

Iv Tpa ◽

Missed Opportunity

Introduction: “Stroke codes” (SCs) facilitate the timely treatment of acute ischemic stroke (AIS) with IV tPA or intra-arterial thrombectomy (IAT), but are inherently resource-intensive and can expose patients to unnecessary and potentially harmful interventions. While all healthcare providers are encouraged to activate SCs, this might lead to low SC-to-treatment-ratios (SCTR). We examined the impact of de-escalation of stroke codes (DSCs) on SCTR. Methods: DSCs were initiated in our institution in January 2015. All DSCs were reviewed for the patient’s eligibility for IV tPA or IAT, and reason for de-escalation. We reviewed all stroke codes 12 months before and after the initiation of this process and compared the SCTR by chi-squared testing. Results: In 2014, prior to DSCs, 253 SCs resulted in 22 AIS interventions (22 IV tPA) for a SCTR of 8.7%. In 2015, 348 SCs were activated with 64 subsequent DSCs (18.4%) and 45 AIS interventions (38 IV tPA, 7 IAT, 7 both), for a SCTR of 15.8%. The improvement in SCTR after introducing DSCs was statistically significant (p=0.012). When restricting the analysis to IV tPA interventions alone, there remained a trend (p=0.068) towards improvement in SCTR. Retrospective chart review did not reveal any DSC cases that resulted in missed opportunity for IV TPA or IAT treatment. No DSCs were due to an acute ICH. Justifications for de-escalations are summarized in figure 1. Conclusions: The introduction of DSCs resulted in a statistically significant absolute improvement in SCTR of 7.1%. Importantly, DSCs did not result in any eligible AIS patient forgoing IV tPA or IAT, nor missed ICH. More research is needed to increase the yield of stroke codes, refine the criteria for both activating and de-escalating them, and quantify the resource and cost implications of such de-escalations.

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1170. A Quality Improvement Study to Assess the Effectiveness of a Meaningful Use Protocol in the Reduction of PICC Line Use and Complications

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1033 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S419-S419

Author(s):

William P Dillon ◽

Susan Szpunar ◽

Mamta Sharma

Keyword(s):

Retrospective Chart Review ◽

Bloodstream Infections ◽

Meaningful Use ◽

Outpatient Setting ◽

Vein Thrombosis ◽

Relative Safety ◽

Before And After ◽

Chi Squared ◽

Picc Line ◽

Student’S T

Abstract Background The use of peripherally-inserted central catheters (PICC) has grown substantially over time because of their ease of insertion, cost-effectiveness and relative safety. With increased use; however, there are increased complications including catheter-related bloodstream infections (CLABSI) and PICC line-associated deep vein thrombosis (DVT). To help decrease complications a meaningful use protocol was implemented based on the Michigan Appropriateness Guide for Intravenous Catheters (MAGIC) to define appropriate indications for PICC line use. The objectives of this study were (1) to determine the rate of PICC line use at our hospital; (2) to determine rates of complications associated with PICC lines, including CLABSI and DVT; and (3) to compare the metrics listed above before and after implementation of the meaningful use protocol. Methods We performed a retrospective chart review of all inpatient admissions before (June 1, 2017 to September 1, 2017) and after the implementation of the meaningful use protocol (June 1, 2018 to September 1, 2018). Patients who had a PICC line inserted at another institution or in the outpatient setting were excluded. We compared the rate of insertion, patient demographics, characteristics of the use of PICC lines and complications from the two periods. Data were analyzed using the chi-squared test, Student’s t-test, the Mann–Whitney U test and the z test for proportions. Results We reviewed 281 patient charts, 166 before the implementation of the meaningful use protocol and 115 after implementation. Overall, the mean age was 55.8 ± 17.9 years, 58.7% male and 54.1% white. There were no significant differences between groups with respect to demographics, comorbidities, source of admission, or complications. Post-implementation there was a significant reduction in lines used for unknown reasons as well as lines used for multiple blood draws (P <0.0001). The overall rate of PICC line use decreased from 23 per 1,000 admissions to 17.2 per 1,000 admissions after the intervention (P = 0.007). Conclusion Implementation of a meaningful use protocol reduced the rate of PICC line use at our institution by 25%. The proportion of lines used for unknown reasons decreased as well. Widespread implementation could have a significant impact on the reduction of PICC line use. Disclosures All authors: No reported disclosures.

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Assessment of Knowledge, Practice and Attitude about Biomedical Waste Management among Healthcare Professionals during COVID-19 Crises in Al-Ahsa

Healthcare ◽

10.3390/healthcare9060747 ◽

2021 ◽

Vol 9 (6) ◽

pp. 747

Author(s):

Sahbanathul Missiriya Jalal ◽

Fahima Akhter ◽

Amal Ismael Abdelhafez ◽

Ahmed Mansour Alrajeh

Keyword(s):

Work Experience ◽

Healthcare Professionals ◽

Cross Sectional Study ◽

Demographic Variables ◽

Cross Sectional ◽

Biomedical Waste ◽

Respiratory Therapists ◽

Global Pandemic ◽

Before And After ◽

Knowledge Practice

Biomedical waste (BMW) management is an essential practice of healthcare professionals (HCPs) for preventing health and also environmental hazards. Coronavirus disease (COVID-19) has become a global pandemic, posing significant challenges for healthcare sectors. A cross-sectional study was performed to assess the knowledge, practice, and attitude on BMW management among HCPs when taking care of patients with COVID-19 and associated with demographic variables. From Al-Ahsa healthcare sectors, 256 HCPs were selected randomly, of which 105 (41%) had excellent knowledge, 87 (34%) had good knowledge, and 64 (25%) had poor knowledge with a mean score of 13.1 ± 3.6. A higher mean score was (14.4 ± 3.2) obtained by physicians, and (13.6 ± 3.8) nurses than the other HCPs. Regarding practice, 72 (28.1%) HCPs used and discarded PPE while handling biomedical wastes. Additionally, 88 (34.4%) followed proper hand hygiene before and after each procedure and whenever needed. Physicians, nurses, and respiratory therapists had a more favorable attitude than other HCPs. There was a statistically significant association found among knowledge level and educational qualification (p < 0.0001), gender (p < 0.001), and work experience (p < 0.05). Emphasis is needed to train all HCPs regarding proper BMW management during this pandemic to prevent infection transmission.

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Understanding the needs of carers in Vietnam and the development of online supportive resources

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1098 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

C Jenkins ◽

H t Ho ◽

O Santin

Keyword(s):

Cancer Diagnosis ◽

Healthcare Providers ◽

Treatment Decision ◽

Nutrition Support ◽

Specific Information ◽

Supportive Services ◽

Middle Income ◽

Treatment Decision Making ◽

Lack Of Information ◽

Online Resource

Abstract Issue Informal carers provide an important and often overlooked role in the care of people with a cancer diagnosis. Our study sought to better understand carers needs and develop an online resource to help address the needs identified. There are not currently any widespread or embedded support services for cancer carers in Vietnam. Description of the Problem We conducted in-depth interviews and focus groups with both carers (n = 20) and healthcare providers (n = 22) to understand the needs and challenges of caring for someone with a cancer diagnosis. We discussed what resources would alleviate challenges and used these discussions to inform a process of co-designing an online resource. This process was modelled off a peer-led online resource intervention developed in the United Kingdom. This process of co-design is transferable to other contexts, and when adapted could help meet the needs of cancer carers in other lower and middle income countries. Results Carers in Vietnam reported (i) economic challenges of care; (ii) not being able to access facilities and secure accommodation when caring for inpatients; (iii) lack of information about cancer and nutrition; (iv) lacking emotional support; and (v) requiring training to support both the treatment and recovery of people under their care. Suggestions for content of an online resource included the need for contextually appropriate Vietnamese content, specific information on diet and nutrition, support in making decisions around treatment, and signposting for other services. Lessons Successful co-design of resources requires input from multiple key stakeholders. This is necessary to successful adapt and modify interventions for new contexts. Our process revealed new information about the roles and needs of carers, and enabled us to incorporate solutions to these needs within our online resource. Given the lack of other supportive services for carers, the development of such resources should be considered a priority. Key messages Cancer carers in Vietnam experience specific challenges including provision of nutrition, supporting navigation of hospital administration, and taking a central role in treatment decision-making. Co-designed online resources have the potential to support carers in providing relevant and appropriate information and signposting to other important services.

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Experiences and impact of international medical volunteering: a multi-country mixed methods study

BMJ Open ◽

10.1136/bmjopen-2020-041599 ◽

2021 ◽

Vol 11 (3) ◽

pp. e041599 ◽

Cited By ~ 1

Author(s):

Mary McCauley ◽

Joanna Raven ◽

Nynke van den Broek

Keyword(s):

Low Income ◽

Online Survey ◽

Positive Impact ◽

Healthcare Providers ◽

International Medical ◽

Middle Income ◽

Use Of Resources ◽

The Uk ◽

Medical Volunteers ◽

The Impact

ObjectiveTo assess the experience and impact of medical volunteers who facilitated training workshops for healthcare providers in maternal and newborn emergency care in 13 countries.SettingsBangladesh, Ghana, India, Kenya, Malawi, Namibia, Nigeria, Pakistan, Sierra Leone, South Africa, Tanzania, UK and Zimbabwe.ParticipantsMedical volunteers from the UK (n=162) and from low-income and middle-income countries (LMIC) (n=138).Outcome measuresExpectations, experience, views, personal and professional impact of the experience of volunteering on medical volunteers based in the UK and in LMIC.ResultsUK-based medical volunteers (n=38) were interviewed using focus group discussions (n=12) and key informant interviews (n=26). 262 volunteers (UK-based n=124 (47.3%), and LMIC-based n=138 (52.7%)) responded to the online survey (62% response rate), covering 506 volunteering episodes. UK-based medical volunteers were motivated by altruism, and perceived volunteering as a valuable opportunity to develop their skills in leadership, teaching and communication, skills reported to be transferable to their home workplace. Medical volunteers based in the UK and in LMIC (n=244) reported increased confidence (98%, n=239); improved teamwork (95%, n=232); strengthened leadership skills (90%, n=220); and reported that volunteering had a positive impact for the host country (96%, n=234) and healthcare providers trained (99%, n=241); formed sustainable partnerships (97%, n=237); promoted multidisciplinary team working (98%, n=239); and was a good use of resources (98%, n=239). Medical volunteers based in LMIC reported higher satisfaction scores than those from the UK with regards to impact on personal and professional development.ConclusionHealthcare providers from the UK and LMIC are highly motivated to volunteer to increase local healthcare providers’ knowledge and skills in low-resource settings. Further research is necessary to understand the experiences of local partners and communities regarding how the impact of international medical volunteering can be mutually beneficial and sustainable with measurable outcomes.

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A Randomized, Controlled, Parallel-Group, Trial on the Effects of Melatonin on Fatigue Associated with Breast Cancer and Its Adjuvant Treatments

Integrative Cancer Therapies ◽

10.1177/1534735420988343 ◽

2021 ◽

Vol 20 ◽

pp. 153473542098834

Author(s):

Abdolazim Sedighi Pashaki ◽

Kamal Mohammadian ◽

Saeid Afshar ◽

Mohammad Hadi Gholami ◽

Abbas Moradi ◽

...

Keyword(s):

Breast Cancer ◽

Adjuvant Chemotherapy ◽

Intervention Group ◽

Chi Square ◽

Significance Level ◽

Severe Fatigue ◽

Before And After ◽

Brief Fatigue Inventory ◽

Chi Square Test ◽

Student’S T

Objective: Fatigue associated with malignant conditions and their treatments is a disabling condition. This trial assessed the anti-fatigue effects of melatonin coadministration during adjuvant treatment of patients with the breast cancer. Material and Methods: Patients with breast cancer were randomly assigned to receive melatonin or placebo during adjuvant chemotherapy and radiotherapy. Thirty-seven patients were randomly enrolled in each group. The mean ages of patients in the intervention and control groups were 50.47 ± 10.79 and 46.05 ± 10.55 years, respectively ( P = .223). The intervention group received oral melatonin (18 mg/day) from 1 week before until 1 month after the adjuvant radiotherapy. The level of fatigue was assessed before and after intervention using Brief Fatigue Inventory (BFI) in both groups. To analyze data, the Student’s t-test and the Chi-square test were used at a significance level of P ≤ .05. Results: The BFI score was similar before the intervention in both groups, however, after the intervention, it was significantly lower in the melatonin group ( P < .001). Moreover, the frequency of severe fatigue in the melatonin group was significantly lower than in the placebo group after intervention (42.1% vs 83.3%, P < .001). Conclusion: Coadministration of melatonin during adjuvant chemotherapy and radiotherapy of women with breast cancer decreased the levels of fatigue associated with the malignant condition and its treatments.

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Improving Genetics Clinic Efficiency and Capacity Using Design and Human Factors Methods

Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care ◽

10.1177/2327857921101133 ◽

2021 ◽

Vol 10 (1) ◽

pp. 204-210

Author(s):

Maryam Attef ◽

Mireille Cloutier ◽

Meredith Gillespie ◽

Chantal Trudel ◽

Kym Boycott

Keyword(s):

Human Factors ◽

Task Analysis ◽

Healthcare Providers ◽

Time On Task ◽

Prenatal Genetics ◽

Factors Influencing ◽

Number Of Patients ◽

Clinic Efficiency ◽

Before And After ◽

Improve Access

This quality improvement study focused on developing an understanding of factors influencing the ability of prenatal genetics counsellors (GCs) to efficiently see patients during the COVID-19 pandemic and strategies to improve their workflow using techniques from human factors and design. The demand for Prenatal Genetics Clinics is rising which has increased pressure on GCs to become more efficient. Genetics counsellors can improve access to their services by reducing the time spent on the tasks performed before and after a genetic counselling encounter, thereby increasing the number of patients they see. We were limited to certain methods to understand the differences in workflow before and during the COVID-19 pandemic. This study involved a literature review, archival analysis of workflow studies conducted before the pandemic, stakeholder meetings and mapping, a brainstorming session, as well as documenting time-on-task in a diary and naturalistic observation sessions. A task analysis was developed to identify factors influencing efficiency related to the design of the space, processes and the use of artefacts. Virtual and on-site workflows show that GCs spend at least half of their time on tasks before and/or after the patient’s appointment. Looking at potential inefficiencies or bottlenecks in workflow formed the development of a strategic plan for improving GC workflows at the prenatal Genetics Clinic. Improvements suggested through this analysis were constrained to support the current number of healthcare providers working within the existing space configuration.

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Combining paid work and family care for a patient at the end of life at home: insights from a qualitative study among caregivers in the Netherlands

BMC Palliative Care ◽

10.1186/s12904-021-00780-9 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Femmy M. Bijnsdorp ◽

Bregje D. Onwuteaka-Philipsen ◽

Cécile R.L. Boot ◽

Allard J. van der Beek ◽

Hanna T. Klop ◽

...

Keyword(s):

End Of Life ◽

Family Caregivers ◽

Healthcare Professionals ◽

Family Care ◽

Work And Family ◽

Similar Process ◽

Paid Work ◽

Health And Wellbeing ◽

Care Situation ◽

At Home

Abstract Background Population ageing, an emphasis on home-based care of palliative patients and policies aimed at prolonging participation in the labour market are placing a growing demand on working family caregivers. This study aimed to provide insight into experiences with combining paid work and family care for patients at the end of life, factors facilitating and hindering this combination, and support needs. Method Semi-structured interviews were held between July 2018 and July 2019 with 18 working family caregivers of patients with a life-threatening illness who were living at home. Transcripts were analysed following the principles of thematic analysis. Results Some family caregivers could combine paid work and family care successfully, while this combination was burdensome for others. Family caregivers generally experienced a similar process in which four domains — caregiver characteristics, the care situation, the work situation and the context — influenced their experiences, feelings and needs regarding either the combination of paid work and care or the care situation in itself. In turn, experiences, feelings and needs sometimes affected health and wellbeing, or prompted caregivers to take actions or strategies to improve the situation. Changes in health and wellbeing could affect the situation in the four domains. Good health, flexibility and support at work, support from healthcare professionals and sharing care tasks were important in helping balance work and care responsibilities. Some caregivers felt ‘sandwiched’ between work and care and reported physical or mental health complaints. Conclusions Experiences with combining paid work and family care at the end of life are diverse and depend on several factors. If too many factors are out of balance, family caregivers experience stress and this impacts their health and wellbeing. Family caregivers could be better supported in this by healthcare professionals, employers and local authorities.

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