Evaluating a framework for tuberculosis screening among healthcare workers in clinical settings, Inner Mongolia, China

Prevalence of positive TST among healthcare workers in high-burden TB setting in Peru

Background

Tuberculosis (TB) transmission has long been recognized as an important occupational hazard for healthcare workers (HCWs). HCWs have a 5.8% annual risk of exposure and three times greater risk of developing active TB than the general population.

Methods

We conducted an observational cross-sectional study between September 2014 and March 2015 among HCWs in a high-burden TB setting in Lima to estimate the prevalence of positive Tuberculin Skin Test (TST) and to investigate factors associated with a positive TST.

Results

Two hundred forty participants were included in the analysis; TST was administered to 190 (79.2%) while the rest were exempt due to a previous positive TST result, history of TB, or test refusal. A positive TST result was found among 56.2% of participants to whom the TST was applied (95% CI: 49.22–63.55%). When considering those who had a previous positive TST result and those with a history of TB, the prevalence of a positive TST result was 64.3% (95% CI: 57.8–70.3%). No significant differences were observed between clinical/paramedical and administrative staff in the health center. The use of N95 masks during work hours was reported by 142 (69.9%) participants. Prevalence ratios (PR) show that workers with more than 120 months as a HCW were 1.44 times more likely to be TST positive. The multivariate analysis found that HCWs with over 10 years of service were 1.52 times more likely to be TST positive.

Conclusion

This study supports previous reports that TB infection is an occupational hazard for HCWs. Prevention of TB transmission through control measures, as well as timely diagnosis of LTBI in this particular high-risk group, is critical for individual and public health.

Survival-Day @ Wiesbaden business school - evaluation of a short-term educational intervention to reduce work-associated health risks during nursing internships of students in health care economics

BACKGROUND

In 2013 RheinMain University launched its bachelor's degree program Health Care Economics requiring each student to participate in a mandatory two-month nursing internship. A preliminary risk assessment revealed serious risks for both students and patients and had to be addressed by appropriate measures such as mandatory systematic safety training for each student.

METHODS

A short-term educational intervention named "Survival-Day" was designed to minimize risks related to nursing internships of students. This intervention consists of six 45-min-units with theoretical input (2 units) and hands-on training (4 units) imparting basic knowledge and skills in CPR, hand hygiene and handling of masks and protective gowns, prevention of needle stick injuries, fire protection and firefighting. Performance of CPR was assessed using computerized manikins. Acceptance, necessity and usability were assessed anonymously by standardized written questionnaires after completion of nursing internships.

RESULTS

462 students have completed the Survival-Day until January 2019. CPR performance showed acceptable adherence rates to guideline recommendations (mean 78.8%, SD ±22.6%). The majority of students performed aseptic health care activities (66%), treated patients with multi-resistant pathogens (62%) and disposed sharp instruments such as blood-contaminated needles (76%). According to students' self-reports about these hazardous activities, less than 50% of these students received adequate safety training at nursing facilities. However, no sentinel events such as needle stick injuries or students becoming second victim have been reported.

CONCLUSION

Our study reveals severe discrepancies between legal obligation of nursing facilities to ensure safety instructions for nursing interns and initial training as perceived by this group. Mandatory initial training before conduction of hazardous tasks was mainly covered by our short-term educational intervention (Survival-Day). Regarding responsibility for their students a preliminary safety instruction program like the Survival-Day should be considered for all educational institutions sending students to nursing internships unless mandatory and sufficient safety trainings for nursing interns can be guaranteed by nursing facilities.

Descriptive review of junior OB/GYN physicians' work task financial compensation in German hospitals

Beginning in the first decade of the 21st centruy, there was a growing disregard for the benefits of the German medical system concerning the junior obstetricians/gynecologists (OB/GYN) job situation. As in other fields of medicine, numerous colleagues left Germany to work in other countries such as the United Kingdom, Noway, Sweden, or Switzerland. According to studies, financial factors represent one of the reasons for the discontent. We here present a practical descriptive approach to assess/review the actual compensation of single work tasks of OB/GYNs on the basis of previously published, existing data. Using the workflow data from the Medical work Assessment in German hospitals (MAGRO) platform of twenty junior OB/GYNs with an average workday of 9:24:35 h (SD = 01:05:07 h), a large scale data analysis of 2,325,556 different time points was performed to calculate the financial valuation of single work tasks. In order to assess the evolution over the past years, different modern and historic (e.g. AiP) pay scales were used and analysed in relation to the actual work on a weekly, monthly and per annum basis. Our review shows that there has been a dramatic increase in the financial reward of the practical work tasks of junior OB/GYN physicians in German hospitals in comparison to the situation of the early 2000s years. In this respect, it can not be further argued that the German system has large disadvantages concerning the payment of junior doctors in comparison to other European countries.