Assessment of needle stick injuries among healthcare workers: A cross-sectional study from Kakiri military and SOS hospitals, Uganda

The Ugandan military medical services work together with the civilian public health system to deliver quality healthcare. This Partnership is the mainstay of health service delivery in Uganda. The burden of needle stick injuries (NSIs) is increasing in Uganda’s larger health industry; however, data on needle stick injury in military and public health facilities is lacking. No published data exist on comparative studies for a mix of facilities both military and civilian health settings. This study represents the first time this issue has been studied in a military or public health hospital in Uganda. A hospital-based, cross-sectional study was conducted in July 2018 to September 2019 in Kakiri Military and SOS Hospitals in Uganda using a structured questionnaire. Respondents were purposively selected based on the objectives of study, occupation status and department (N = 310). The overall prevalence of NSIs among respondents was 27.2% and prevalence rates for the two facilities was nearly identical. The largest percentage of NSIs occurred during drawing venous blood samples (49.4%). Significant predictors of NSI were gender, occupational status, age, poor knowledge on prevention and post exposure of NSI, and less professional experience. Infection control practices were lacking in both selected health facilities. Over a quarter of HCWs in Uganda reported NSIs, which places them at significant health risk. Fostering the practice of universal precautions, best infection control practices and training of healthcare workers on bio-safety measures can reduce the prevalence of NSIs.

Family and religion’s influence on Arab immigrant mothers’ initiation and exclusive breastfeeding

Breastfeeding is known to provide health benefits for newborns and breastfeeding mothers. The World Health Organization and Health Canada recommend exclusive breastfeeding for the first six months of an infant’s life. However, the rates of exclusive breastfeeding practices among Arab immigrant mothers are lower when compared with rates for non-immigrant Canadian mothers and mothers in the immigrants’ countries of origin. Critical ethnography was used to explore the breastfeeding practices among immigrant Arab mothers in Alberta, Canada, and factors influencing their decision or ability to breastfeed exclusively. Face-to-face interviews were conducted with 10 participants, followed by thematic analysis of the qualitative narrative data. The results indicated that family and religion are the sociocultural factors that primarily influenced the mothers’ initiation and exclusive breastfeeding practices. The findings from this study can facilitate culturally safe and sensitive interventions to address Arab mothers’ breastfeeding needs and promote exclusive breastfeeding within this population in Canada.

Telework during COVID-19 outbreak: Impact on mental health among Italian workers

Objective: The outbreak of COVID-19 lead to an uptake of telework worldwide. We evaluated the prevalence of psychiatric symptoms, potential risks, and protective factors, across a sample of Italian workers that converted to teleworking.Methods: 804 participants completed an online survey, including sociodemographic information (current work routine, home environment and clinical history) and the psychometric scales “Depression, Anxiety and Stress Scale – 21 items” and “Insomnia Severity Index.”Results: 30% of participants presented pathological levels of depression, 20.8% of anxiety, 30.7% of stress, and 5% appeared to suffer from insomnia. Prevalence was higher in respondents with psychological and physical frailties, greater social isolation or inadequate working spaces. However, telework itself was broadly appreciated and did not seem to be directly associated with increased psychiatric symptoms, which were exacerbated instead by COVID-19-related stress or by constitutional and social determinants of health.Conclusions: Authorities should promote adequate measures to guarantee a healthy approach to teleworking.

Managing clinical risk retrospectively and prospectively with a risk management framework in an acute care hospital in Singapore

Objective: To expound on the implementation of the clinical risk management framework in an acute care hospital to minimise clinical risks and improve patient safety on account of systemic and human risk factors and patterns.Methods: The clinical risk management framework involves a 2-pronged approach through retrospective and prospective methods. The 5 stages of the retrospective approach include data collection, data aggregation, risk assessment and prioritisation, risk mitigation, and lastly, risk monitoring. The prospective approach entails horizon scanning which aims to detect risks early and ensure controls are swiftly implemented to prevent harm from arising. When combined, the framework seeks to be responsive to reduce the possibility and severity of patient harm. The number of incidents and risk scores for top clinical risks from 2016 to 2019 were monitored and studied to assess the effectiveness of the newly implemented clinical risk management framework.Results: When the clinical risk management framework was implemented in 2017, the number of incidents as well as corresponding risk scores for many of the identified clinical incident types and root causes decreased over the years. Most notably, two top clinical risks, results not being reviewed or delayed, and staff inadequate skills and knowledge, saw major improvements in risk scores.Conclusions: The systematic workflow of the 2-pronged clinical risk management framework allows the campus to manage risks comprehensively and efficiently. While retrospective risk analysis examines and reacts to reported clinical incidents, amidst volatile circumstances and advancements of technology exposing unprecedented risks in healthcare, prospective risk analysis conducted through horizon scanning is useful in anticipating and acting before harm arises, ultimately resulting in improved patient safety.

Work, stress, and well-being of healthcare and human service professionals during outbreak of COVID-19

Objective: This study explored the level of occupational stress experienced by healthcare and human service professionals during COVID-19 pandemic and assessed if their personal characteristics, occupational stressors, job satisfaction, and their satisfaction with diversity of staff composition, salary, and compensation influenced their perceived stress, and their physical and psychological well-being.Methods: A total of 227 healthcare and human service professionals participated in an online survey from March to August 2020. Participants provided background and job-related information and completed several measures to explore their perceived stress, job experiences, occupational stressors, as well as their physical and psychological problems. Bivariate analyses were used to assess the relationships between perceived stress, occupational stressors, satisfaction with job salary and compensation, satisfaction with diversity of staff composition, overall job satisfaction, and physical and psychological problems. Stepwise multiple regression analyses were performed to identify predictors of perceived stress and physical and psychological problems.Results: The study found a significant correlation between level of job satisfaction, satisfaction with diversity of staff composition, and satisfaction with job salary and compensation. Perceived stress was related positively with occupational stressors and physical and psychological problems, but negatively with overall job satisfaction, satisfaction with diversity of staff composition, and satisfaction with job salary and compensation. The findings found occupational stressors and being younger as significant predicators of perceived stress. Occupational stressors and female gender were significant predicators of experience of physical and psychological problems.Conclusions: This study provides understanding on critical factors that have impacted healthcare and human service professionals’ stress and wellbeing during outbreak of COVID-19 pandemic. These factors should be further investigated to inform public policy and interventions that mitigate health and mental health problems among these professionals during this and future outbreaks.

Post-Traumatic Stress Disorder among midwives after exposure to maternal death and stillbirth in Khomas Region of Namibia

Objective: Despite global efforts to decrease maternal death and stillbirths worldwide, maternal mortality rate and stillbirth remain high in the global south countries. These deaths often have immediate and long-lasting effects on midwives who care for these women.Methods: This paper explores the effects of maternal death and stillbirth on midwives in Namibia. A qualitative approach was adopted using a descriptive, exploratory and contextual design. The objective of this study was to explore the Post-Traumatic Stress Disorder (PTSD) related feelings among midwives after exposure to maternal death and stillbirth. Data was collected using Focus Group Discussions (FGD) and individual interviews. Four FGDs and four individual interviews were conducted with midwives from two state hospitals in Windhoek. Midwives were purposively selected, and a total of 29 midwives participated in the study. Individual interviews and FGDs were audiotaped and transcribed verbatim. Data were analysed using content analysis and coded using Tech’s steps of open-coding.Results: The researcher identified one central theme with six sub-themes. The study showed that the midwives experienced PTSD related feelings such as insomnia and nightmares, recollection of the event (flashbacks), sense of self-blame, guilt, anger, shame, and being haunted/tormented.Conclusions: It is concluded that maternal death and fresh stillbirth can lead to PTSD effects on midwives, hence addressing these challenges. Therefore, the researchers recommend that hospitals in the Khomas Region develop and implement the wellness programmes in the workplace, such as the Employee Assistance Programme, to support midwives who experienced these traumatic events to prevent and manage these effects in the future. Equally, further research is needed to evaluate the impact of the wellness programme on midwives who experienced MDs and FSBs in Namibia.

End of life care: A concept analysis

Background: End of life care is crucial to preserve a dying patient’s values and dignity. This type of care also works towards fulfilling any last wishes the dying person may have.Aim: The aim of this paper is to analyze the concept of end of life care using Rodgers’ evolutionary method as a guide.Methods: A systematic search of the literature was conducted in CINAHL, PsycINFO, and Medline databases. After reviewing the literature from 2006 to 2019, 14 articles were selected to be included in this analysis.Results: The consequences of this concept include a good death, peaceful death, and dying with dignity.Conclusions: This concept analysis provides attributes that could help to develop a standardized end of life care approach to patients who are dying.

COVID-19 creating challenges in a rehabilitation facility in Australia: A discussion paper

The COVID-19 pandemic has brought about many challenges and alterations to long-standing procedures within rehabilitation facilities. These updates of the processes undertaken by staff in such settings have been radical and ongoing. COVID-19 impact on the healthcare system should never be underestimated nor under appreciated. The impact that this pandemic has had on rehabilitation care is unique. This has been the catalyst to identifying significant challenges and subsequent changes within rehabilitation and mental health practices. Social measures that have been implemented in the community have had exaggerated and magnified effects both on the physical and mental wellbeing of rehabilitation and mental health patients. Over the course of these adaptations and implementations, impacts on communication, mental health, workload and care efficiencies were identified and explored. This paper is unique because different disciplines have shared their experiences of the impacts of the COVID-19 pandemic and how they provide rehabilitation. The paper will focus on the communication challenges using masks, not being able to engage families and carers, restriction of group therapies, social isolation of patients and healthcare workers while adhering to guidelines set by NSW Health (Sydney, Australia).

Smoking cessation counseling: Attitude in the background of poor practice compliance among Palestinian primary health care physicians: a cross-sectional study

Objectives: Healthcare systems have primary responsibility for treating tobacco dependence. Despite its proven effectiveness, international studies have shown that smoking cessation advice to patients in primary health care is suboptimal. This study aimed at assessing Palestinian PHC physicians’ compliance and attitude towards smoking cessation counseling and their determinants.Methods: The study utilized a cross-sectional study design using a self-reported questionnaire targeted general practitioners, family medicine doctors, obstetrics & gynecologists, and dentists working at PHC Centers in Palestine from April to September 2019. A proportional stratified random sampling method was used. Socio-demographic, medical experience, if received any training in smoking cessation counseling, smoking history, practice compliance, knowledge, confidence, and attitude, were assessed.Results: Two-hundred ninety-four PHC physicians participated in the study with a high response rate. More than half (53%) were between 31-45 years of age. Most of them (76.5%) were general practitioners seeing more than 30 patients per day (66%), and only 15% (n = 40) get training about smoking cessation counseling. Practice compliance was low; only 39 (13.3%) reported adherence to smoking cessation practice. The participant physicians’ attitude level was good as the overall attitude score mean 75.1 ± 9.6. A positive attitude, assigned as any score ≥ 65, was observed in 87.7% (n = 258) of physicians. Job title, experience, and knowledge are predictors of a positive attitude towards smoking cessation counseling.Conclusions: Building a supportive environment, improving physicians’ capabilities will reflect on their self-efficacy and their confidence level and enhance their practice in smoking cessation counseling.

Job satisfaction as a correlate of empathic behaviour among health care providers towards their patients

This study examined the influence of job satisfaction on empathic behaviour of health care workers towards their patients. Four research questions and five hypotheses guided the study. The study is an ex-post facto research design that adopted the correlation method. A sample size of 1,200 health care workers was selected through a multi-stage sampling method. The method of data collection is a questionnaire, whose psychometric properties were adjudged to be adequate. A total of 1,114 copies were questionnaire were returned after administration and was used for data analysis. The analysis was done using Pearson’s correlation and coefficient of determination for the research questions as well as regression and path analysis for the hypotheses at 0.05 alpha level. The result showed that job satisfaction is positively associated with emphatic behaviour of health care workers towards their patients. The study further revealed that the three components of job satisfaction; affective, cognitive and behavioural components were positively associated with emphatic behaviour and that gender does not moderate the influence of the three components of job satisfaction on empathic behaviour of health care workers towards their patients. Based on the findings, recommendations were made.