scholarly journals Current Guidelines for Protecting Health Workers from Occupational Tuberculosis Are Necessary, but Not Sufficient: Towards a Comprehensive Occupational Health Approach

2020 ◽  
Vol 17 (11) ◽  
pp. 3957 ◽  
Author(s):  
Rodney Ehrlich ◽  
Jerry M. Spiegel ◽  
Prince Adu ◽  
Annalee Yassi
Keyword(s):  
Occupational Health ◽  
Health System ◽  
Health Workers ◽  
Infection Prevention And Control ◽  
Occupational Health Services ◽  
Ethical Implications ◽  
And Control ◽  
Statutory Regulation ◽  
Current Guidelines ◽  
Health System Framework

Health workers globally are at elevated occupational risk of tuberculosis infection and disease. While a raft of guidelines have been published over the past 25 years on infection prevention and control (IPC) in healthcare, studies in different settings continue to show inadequate implementation and persistence of risk. The aim of this commentary is to argue, based on the literature and our own research, that a comprehensive occupational health approach is an essential complement to IPC guidelines. Such an approach includes a health system framework focusing on upstream or mediating components, such as a statutory regulation, leadership, an information system, and staff trained in protective disciplines. Within the classical prevention framework, primary prevention needs to be complemented by occupational health services (secondary prevention) and worker’s compensation (tertiary prevention). A worker-centric approach recognises the ethical implications of screening health workers, as well as the stigma perceived by those diagnosed with tuberculosis. It also provides for the voiced experience of health workers and their participation in decision-making. We argue that such a comprehensive approach will contribute to both the prevention of occupational tuberculosis and to the ability of a health system to withstand other crises of infectious hazards to its workforce.

scholarly journals A health worker knowledge, attitudes and practices survey of SARS-CoV-2 infection prevention and control in South Africa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saiendhra Vasudevan Moodley ◽  
Muzimkhulu Zungu ◽  
Molebogeng Malotle ◽  
Kuku Voyi ◽  
Nico Claassen ◽  
...  
Keyword(s):  
South Africa ◽  
Health Worker ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Health Workers ◽  
Health Facilities ◽  
World Health ◽  
Infection Prevention And Control ◽  
Successful Implementation ◽  
And Control

Abstract Background Health workers are crucial to the successful implementation of infection prevention and control strategies to limit the transmission of SARS-CoV-2 at healthcare facilities. The aim of our study was to determine SARS-CoV-2 infection prevention and control knowledge and attitudes of frontline health workers in four provinces of South Africa as well as explore some elements of health worker and health facility infection prevention and control practices. Methods A cross-sectional study design was utilised. The study population comprised both clinical and non-clinical staff working in casualty departments, outpatient departments, and entrance points of health facilities. A structured self-administered questionnaire was developed using the World Health Organization guidance as the basis for the knowledge questions. COVID-19 protocols were observed during data collection. Results A total of 286 health workers from 47 health facilities at different levels of care participated in the survey. The mean score on the 10 knowledge items was 6.3 (SD = 1.6). Approximately two-thirds of participants (67.4%) answered six or more questions correctly while less than a quarter of all participants (24.1%) managed to score eight or more. A knowledge score of 8 or more was significantly associated with occupational category (being either a medical doctor or nurse), age (< 40 years) and level of hospital (tertiary level). Only half of participants (50.7%) felt adequately prepared to deal with patients with COVD-19 at the time of the survey. The health workers displaying attitudes that would put themselves or others at risk were in the minority. Only 55.6% of participants had received infection prevention and control training. Some participants indicated they did not have access to medical masks (11.8%) and gloves (9.9%) in their departments. Conclusions The attitudes of participants reflected a willingness to engage in appropriate SARS-CoV-2 infection prevention and control practices as well as a commitment to be involved in COVID-19 patient care. Ensuring adequate infection prevention and control training for all staff and universal access to appropriate PPE were identified as key areas that needed to be addressed. Interim and final reports which identified key shortcomings that needed to be addressed were provided to the relevant provincial departments of health.

scholarly journals Evaluation of Infection, Prevention and Control Program in Goromonzi District, Zimbabwe, 2018: A process outcome evaluation

2019 ◽  
Author(s):  
Govha Emmanuel ◽  
Zizhou Simukai Tirivanhu ◽  
Shambira Gerald ◽  
Gombe Tafara Notion ◽  
Tsitsi Juru ◽  
...  
Keyword(s):  
Health Facility ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Health Workers ◽  
Outcome Evaluation ◽  
Hazard Identification ◽  
Health Facilities ◽  
Infection Prevention And Control ◽  
Hiv Test ◽  
And Control

Abstract Background A healthcare-associated infection (HAI) is defined as an infection originating in the environment of a health facility that was not present or incubating at the time of patient admission. HAIs can be prevented through infection, prevention and control (IPC) measures. No hazard identification and risk assessment IPC rounds and monthly meetings were conducted in Goromonzi district since 1st of January to 30th of June 2018. No trainings nor orientation for the new employees was conducted. We therefore evaluated Goromonzi District IPC program. Methods A process-outcome evaluation using the logic model was conducted in Goromonzi district’s 15 health facilities. Checklists, interviewer administered questionnaires and key informant guides were used to collect data on availability of inputs, knowledge of health workers, processes performed, outputs and outcomes achieved. Data were entered into Epi Info 7TM, which was used to generate frequencies and proportions. Qualitative data from checklists and key informants interviews was sorted manually into themes and analysed. Results All 15 health facilities had adequate stocks of HIV test kits and PEP kits. Adequate bins and detergents were found in only 3/15 (20%) of health facilities. All facilities failed to hold a single IPC meeting and none had specific budget for IPC in 2018. No IPC mentorship activities were carried out in the district. Only 7/13 (54%) health workers who had needle pricks received PEP with 2/7 (29%) of them finishing the course. No health facility had a functional HAI surveillance system. The overall knowledge rating was fair. Conclusion The IPC program inputs in Goromonzi district were inadequate hence its failure to achieve the intended outputs and outcomes. Inadequate knowledge, unavailability of health worker training plans, specific budgets and absence of IPC committees reflected non prioritisation of the program.

scholarly journals Health Worker Compliance with Infection Prevention and Control Policy in Ghana: A Case Study of La General Hospital

2021 ◽  
Vol 9 (2) ◽  
pp. 150-161
Author(s):  
Vincentia D. Kondor
Keyword(s):  
Health Care ◽  
General Hospital ◽  
Health Worker ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Health Workers ◽  
Control Policy ◽  
Time Constraints ◽  
Infection Prevention And Control ◽  
And Control

Infection Prevention And Control Is An Important Topic In The Delivery Of Quality Health Care Because It Aims At Protecting The Patient, The Health Worker, And The General Public. The Main Objective Of The Study Was To Determine Health Workers’ Compliance With Infection Prevention And Control Policy Guidelines During Health Care Delivery. A Cross-Sectional Design Using A Quantitative Method Was Used To Carry Out This Study In Which 143 Health Workers At The La General Hospital Were Selected Using A Stratified Sampling Method. The Data Collected Using A Structured Questionnaire Was Statistically Analyzed Using Chi-Square Test And Logistic Regression To Establish An Association Between The Dependent And Independent Variables Using A Significance Level Of P<0.05 At 95% Confidence Interval. The Results Indicated That Knowledge Of Infection Prevention And Control Among Health Workers Was High As 97% Had Adequate Knowledge, With 64% Of This Proportion Having Excellent Knowledge. Additionally, The Availability Of Infection Prevention Resources To Health Workers Always Was 31.4%; Non-Compliance Due To Time Constraints At Work Was 66.4%, And Compliance With Infection Prevention And Control Guidelines Was 30.7%. Time Constraint At Work Was Significantly Associated With Health Workers’ Compliance With Infection Prevention And Control (P = 0.001). The Paper Suggests That Regular In-Service Training On Infection Prevention And Control Must Be Continued To Improve The Standards Of Health Delivery Practice. Management Is Encouraged To Improve The Availability Of Infection Prevention Resources To Health Workers And To Duly Regulate Staff Workload In Order To Reduce Time Constraints And Prevent Burnout.

scholarly journals Pengembangan Program Pencegahan dan Pengendalian Infeksi COVID-19 dalam Mempertahankan Status Kesehatan pada Tenaga Kesehatan di Rumah Sakit Kota Medan

2021 ◽  
Vol 6 (2) ◽  
pp. 99
Author(s):  
Muhammad Taufik Daniel Hasibuan ◽  
Harsudianto Silaen
Keyword(s):  
Health Status ◽  
Focus Group ◽  
Data Collection ◽  
Vital Sign ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Health Workers ◽  
Control Program ◽  
Infection Prevention And Control ◽  
And Control

The COVID-19 infection prevention and control program in hospitals is an effort to provide guidance for health workers to stay healthy, safe, productive, and the community gets services that meet standards. Health workers who work in hospitals are very vulnerable to being exposed to  COVID -19, so it is very important that health workers and policy makers understand the basic concepts of infectious diseases. The purpose of this study was to develop a program to prevent and control covid-19 infection in maintaining the health status of health workers at the Medan City Hospital. The type of research used is action research. The participants in this study were 14 people consisting of 2 parts, namely 1) Participants for qualitative data were taken from managerial such as medical services, nursing, medical records, infection prevention and control units, and the head of the room. 2) Participants for quantitative data are taken from health workers, namely nurses. Data collection in this study used various methods, namely individual interviews, observation, self-report, focus group discussions and several data collection tools, namely interview guides, focus group discussion guides, questionnaires, observation sheets, and supporting tools, namely voice recorders. The results of this study obtained outputs, namely standard operating procedures for the prevention and control of covid-19 infection, and from the results of health status checks on health workers from before and after the implementation of the  COVID -19 infection prevention and control program, the results were before (PCR/Antigen: Negative). 71.43%, Positive: 28.57%; Vital sign normal: 85.71%, Abnormal 14.29%), and after (PCR/Antigen: Negative 85.71%, Positive: 14.29%; Vital sign normal: 100%). This proves that there is an influence of the Covid-19 infection prevention and control program in maintaining the health status of health workers in hospitals. Suggestions to hospital leaders to continue to evaluate prevention and control programs for COVID-19 infection in accordance with developments and the situation at hand.

scholarly journals Comprehensive occupational health services for healthcare workers in Zimbabwe during the SARS-CoV-2 pandemic

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260261
Author(s):  
Fungai Kavenga ◽  
Hannah M. Rickman ◽  
Rudo Chingono ◽  
Tinotenda Taruvinga ◽  
Takudzwa Marembo ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Occupational Health ◽  
Health Services ◽  
Healthcare Workers ◽  
Communicable Disease ◽  
Common Mental Disorder ◽  
Health Screening ◽  
Infection Prevention And Control ◽  
Nucleic Acid Detection ◽  
Occupational Health Services

Background Healthcare workers are disproportionately affected by COVID-19. In low- and middle- income countries, they may be particularly impacted by underfunded health systems, lack of personal protective equipment, challenging working conditions and barriers in accessing personal healthcare. Methods In this cross-sectional study, occupational health screening was implemented at the largest public sector medical centre in Harare, Zimbabwe, during the “first wave” of the country’s COVID-19 epidemic. Clients were voluntarily screened for symptoms of COVID-19, and if present, offered a SARS-CoV-2 nucleic acid detection assay. In addition, measurement of height, weight, blood pressure and HbA1c, HIV and TB testing, and mental health screening using the Shona Symptom Questionnaire (SSQ-14) were offered. An interviewer-administered questionnaire ascertained client knowledge and experiences related to COVID-19. Results Between 27th July and 30th October 2020, 951 healthcare workers accessed the service; 210 (22%) were tested for SARS-CoV-2, of whom 12 (5.7%) tested positive. Clients reported high levels of concern about COVID-19 which declined with time, and faced barriers including lack of resources for infection prevention and control. There was a high prevalence of largely undiagnosed non-communicable disease: 61% were overweight or obese, 34% had a blood pressure of 140/90mmHg or above, 10% had an HbA1c diagnostic of diabetes, and 7% had an SSQ-14 score consistent with a common mental disorder. Overall 8% were HIV-positive, with 97% previously diagnosed and on treatment. Conclusions Cases of SARS-CoV-2 in healthcare workers mirrored the national epidemic curve. Implementation of comprehensive occupational health services during a pandemic was feasible, and uptake was high. Other comorbidities were highly prevalent, which may be risk factors for severe COVID-19 but are also important independent causes of morbidity and mortality. Healthcare workers are critical to combatting COVID-19; it is essential to support their physical and psychological wellbeing during the pandemic and beyond.

scholarly journals 1616. Confronting Measles: The View from a New York City Health System at the Center of the Outbreak

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S589-S589
Author(s):  
Jennifer Lighter ◽  
Stephanie Sterling ◽  
Kelly McKinney ◽  
Judith Medefindt ◽  
Sarah Hochman ◽  
...  
Keyword(s):  
New York ◽  
Health System ◽  
Ambulatory Setting ◽  
Infection Prevention And Control ◽  
Prevention Measures ◽  
Educational Materials ◽  
Outbreak Area ◽  
Measles Outbreak ◽  
Inpatient Settings ◽  
And Control

Abstract Background A measles outbreak was identified in NYC in October, 2018. Over 430 cases have been confirmed to date, mostly in under-vaccinated children. Due to referral patterns, our health system provided care to a large number of these patients in the ambulatory, Emergency Department and inpatient settings, placing significant pressure on Infection Prevention and Control efforts. Our response utilized the engineering, administrative, protective equipment and educational hierarchy of controls to prevent transmission to patients, visitors and staff. Methods Patients residing from outbreak zip codes were flagged in our electronic medical record. Screening for symptoms, measles exposure, vaccine opportunities and education were provided when patients presented for care. Enhanced controls for premature infants and immunocompromised patients were enacted. Automated emails to providers caring for patients from the outbreak area served as reminders to consider measles in differential diagnosis. As most cases of measles occurred in children, special effort was taken to prevent transmissions in pediatrics. Patient rooms on multiple inpatient floors were converted to negative pressure with respect to corridor, as admitted patients developed symptomatic (contagious) illness while hospitalized. We limited all nonimmune visitors <5 years from entering inpatient units. Patients were contacted prior to ambulatory visits, procedures, and surgery to ensure patients from outbreak zip codes were triaged appropriately. Automated alerts to Infection Control when measles testing was ordered allowed timely implementation of prevention measures and surveillance. Finally, educational materials for patients and visitors were translated into 7 languages and shared with other NYC hospitals. Results To date, 95 patients with suspect measles presented to our system, with 20 patients (16 pediatric and 4 adult) laboratory-confirmed cases requiring hospital admission due to measles pneumonia, hepatitis, and encephalitis. There was no evidence of transmission within the hospital and ambulatory setting to patients or staff. Conclusion A coordinated response involving engineering and administrative controls, PPE training and education is necessary when confronting a large urban measles outbreak. Disclosures All authors: No reported disclosures.

AIDS Control and the Workplace: The Role of Occupational Health Services in South Africa

1998 ◽  
Vol 28 (3) ◽  
pp. 575-591 ◽  
Author(s):  
Leslie London
Keyword(s):  
South Africa ◽  
Occupational Health ◽  
Health Services ◽  
Prevention And Control ◽  
Aids Prevention ◽  
Occupational Health Services ◽  
Manufacturing Companies ◽  
Theoretical Understanding ◽  
And Control

AIDS interventions typically fail to address the disjuncture between private behaviors and the social determinants of HIV infection. Data from a telephone survey of manufacturing companies and a postal survey of occupational health nurses in the Western Cape, South Africa, were used to explore the possible role of occupational health services in prevention and control of AIDS. The author found limited evidence of worker involvement in AIDS programs, particularly in companies with occupational health professionals. The management of sexually transmitted diseases was incomplete. Mandatory pre-employment testing of workers for HIV was not widespread. Respondents' opinions on priorities for AIDS prevention and control reflected a preoccupation with knowledge transfer. To ensure their effectiveness, workplace AIDS programs must improve worker participation and integrate AIDS prevention in general workplace health and safety programs. In addition, education programs must develop objectives within a critical theoretical understanding of the behavioral issues relevant to AIDS prevention, and must emphasize the empowerment of women in the workplace. In the context of the present restructuring of health services in South Africa, occupational health services, using the strategies outlined, can make a major contribution to national AIDS prevention and control.

scholarly journals Infection Prevention and Control in Liberia 5 Years After Ebola: A Case Study

2021 ◽  
pp. 216507992199807
Author(s):  
Laura Jean Ridge ◽  
Amy Witkoski Stimpfel ◽  
Robin Toft Klar ◽  
Victoria Vaughan Dickson ◽  
Allison Patricia Squires
Keyword(s):  
Occupational Health ◽  
Personal Protective Equipment ◽  
Disaster Response ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
Protective Equipment ◽  
Clinician Training ◽  
And Control

Background: Effective management of health emergencies is an important strategy to improve health worldwide. One way to manage health emergencies is to build and sustain national capacities. The Ebola epidemic of 2014 to 2015 resulted in greater infection prevention and control (IPC) capacity in Liberia, but few studies have investigated if and how that capacity was sustained. The purpose of this study was to examine the maintenance of IPC capacity in Liberia after Ebola. Methods: For this case study, data were collected via direct observation of nurse practice, semistructured interviews, and document collection. Data were collected in two counties in Liberia. Data were analyzed using directed content and general thematic analysis using codes generated from the safety capital theoretical framework, which describes an organization’s intangible occupational health resources. Findings: Thirty-seven nurses from 12 facilities participated. Ebola was a seminal event in the development of safety capital in Liberia, particularly regarding nurse knowledge of IPC and facilities’ investments in safety. The safety capital developed during Ebola is still being applied at the individual and organizational levels. Tangible resources, including personal protective equipment, however, have been depleted. Conclusions/Application to Practice: IPC capacity in Liberia had been sustained since Ebola but was threatened by under-investments in physical resources. Donor countries should prioritize sustained support, both financial and technical, in partnership with Liberian leaders. Occupational health nurses participating in disaster response should advocate for long-term investment by donor countries in personal protective equipment, access to water, and clinician training.

scholarly journals SARS-CoV-2 Serological testing in frontline health workers in Zimbabwe

2021 ◽  
Vol 15 (3) ◽  
pp. e0009254
Author(s):  
Simbarashe Rusakaniko ◽  
Elopy Nemele Sibanda ◽  
Takafira Mduluza ◽  
Paradzayi Tagwireyi ◽  
Zephaniah Dhlamini ◽  
...  
Keyword(s):  
Blood Sample ◽  
Health Workers ◽  
Infection Prevention And Control ◽  
Antibody Testing ◽  
Full Spectrum ◽  
Staff Members ◽  
Co Morbidity ◽  
Test Kit ◽  
Seroprevalence Data ◽  
And Control

Background In order to protect health workers from SARS-CoV-2, there is need to characterise the different types of patient facing health workers. Our first aim was to determine both the infection and seroprevalence of SARS-COV-2 in health workers. Our second aim was to evaluate the occupational and demographic predictors of seropositivity to inform the country’s infection prevention and control (IPC) strategy. Methods and principal findings We invited 713 staff members at 24 out of 35 health facilities in the City of Bulawayo in Zimbabwe. Compliance to testing was defined as the willingness to uptake COVID-19 testing by answering a questionnaire and providing samples for both antibody testing and PCR testing. SARS-COV-2 antibodies were detected using a rapid diagnostic test kit and SAR-COV-2 infection was determined by real-time (RT)- PCR. Of the 713 participants, 635(89%) consented answering the questionnaire and providing blood sample for antibody testing while 560 (78.5%) agreed to provide nasopharyngeal swabs for the PCR COVID-19 testing. Of the 635 people (aged 18–73) providing a blood sample 39.1% reported a history of past COVID-19 symptoms while 14.2% reported having current symptoms of COVID-19. The most-prevalent co-morbidity among this group was hypertension (22.0%) followed by asthma (7.0%) and diabetes (6.0%). The SARS-CoV-2 sero-prevalence was 8.9%. Of the 560 participants tested for SARS-CoV-2 infection, 2 participants (0.36%) were positive for SAR-CoV-2 infection by PCR testing. None of the SARS-CoV-2 antibody positive people were positive for SAR-CoV-2 infection by PCR testing. Conclusion and interpretation In addition to clinical staff, several patient-facing health workers were characterised within Zimbabwe’s health system and the seroprevalence data indicated that previous exposure to SAR-CoV-2 had occurred across the full spectrum of patient-facing staff with nurses and nurse aides having the highest seroprevalence. Our results highlight the need for including the various health workers in IPC strategies in health centres to ensure effective biosecurity and biosafety.

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