Components of hospital personnel preparedness to evacuate patients in disasters: a systematic review

BACKGROUND

During natural catastrophes, hospital staff members' readiness for crisis management-particularly concerning patient evacuation and improving their safety-becomes paramount. This study aimed to identify the components contributing to hospital staff members' preparedness to evacuate patients in an emergency.

METHOD

A systematic review was conducted by searching databases such as Scopus, Web of Science, PubMed, ProQuest, and grey literature through May 2023. Studies that offered unique qualitative or quantitative data regarding hospital personnel readiness to evacuate patients in an emergency were included. Thematic analysis and descriptive statistics were used to examine the extracted data points.

RESULTS

In total, there were 274 scientific articles. The total number of unique studies decreased to 181 after removing duplicate articles. 28 papers that were deemed appropriate for additional study were found based on the titles and abstracts of these articles. Eighteen papers that met the inclusion criteria were selected for the systematic review after their entire texts were finally assessed. Hospital staff preparedness for patient evacuation was divided into four primary topics and nineteen sub-themes. The four primary themes that emerged were management, communication, individual issues, and training on the evacuation process.

CONCLUSION

The implementation of proper disaster evacuation training programs can be achieved by elevating the perceived sensitivity and protective motive of personnel and considering the personnel's stages of change. Training hospital staff to properly evacuate patients during disasters is also significantly impacted by other factors, such as effective administration, leadership and prompt and efficient communication.

Coping with the hospital environment during the COVID-19 pandemic: A qualitative study of the survivors' perspective during their stay at the ICU and inpatient ward

The COVID-19 pandemic has significantly affected the clinical practice of healthcare professionals. This study aimed to explore the perspectives of COVID-19 survivors regarding the healthcare they received during their stay in the Intensive Care Unit (ICU) and the inpatient COVID-19 ward. A qualitative case-study approach was implemented. Participants were recruited using non-probabilistic purposeful sampling strategy. Inclusion criteria included patients aged ≥18 years who received follow-up from the Pulmonology service at a Hospital in de North of Spain, were diagnosed with COVID-19 and bilateral pneumonia, and were admitted to the ICU before being transferred to a COVID-19 inpatient ward. Data was collected through in-depth interviews and researchers' field notes, and thematic analysis was performed. Techniques such as credibility, transferability, dependability, and confirmability were employed to ensure the trustworthiness of the data. A total of 25 individuals (six women) were included in the study. Three main themes emerged from the analysis: common challenges faced in both units, coping with the hospital stay, and developing strategies. Findings highlighted the need to improve information dissemination, individualize care, and enhance direct patient interaction. Moreover, the study shed light on the psychological impact of hospitalization and ICU experience, including feelings of loneliness, confinement, and the lack of memories from the ICU stay, as well as the influence of care and healthcare language. Finally, strategies such as keeping the mind occupied and maintaining self-discipline were identified as crucial during hospitalization. These findings provide valuable insights for healthcare professionals in delivering care to individuals with COVID-19 in the ICU and hospital ward settings.

Educational intervention based on health action model to promote safe behavior of hospital service workers

BACKGROUND

Hospitals are considered to be one of the most hazardous environments to work in, and their service workers are exposed to many serious risks. So The purpose of this study was to investigate the effect of educational intervention based on the Health Action Model to promote the safe behavior of hospital service workers.

METHODS

In this quasi-experimental study, 45 workers in each of the control and experimental groups participated. Demographic information and data related to Health Action Model constructs were collected through a questionnaire and a checklist, immediately and three months after the intervention. Cronbach's alpha coefficients were used to confirm the properties of the tools. Educational intervention accompanied was applied in the form of four training classes. The data were analyzed using SPSS 20 software.

RESULTS

Before the intervention, there was no significant difference between the two groups in terms of demographics and the study's main variables. results showed significant changes in mean scores of safe behavior, Attitude, norms, belief, intention, knowledge in the experimental group three months after the intervention (P < 0.001).

CONCLUSIONS

The research results show that Health Action Model educational intervention can change workers' awareness, attitudes, norms, beliefs, and intentions toward unsafe behavior and improve their safety performance.

TRIAL REGISTRATION

IRCTID: IRCT20160619028529N7.

Experiences, risk perceptions, and COVID-19 vaccination outcomes among hospital workers

BACKGROUND

Although COVID-19 vaccinations have been available to hospital workers in the U.S. since December 2020, coverage is far from universal, even in groups with patient contact. The aim of this study was to describe COVID-19-related experiences at work and in the personal lives of nurses, allied health workers, and non-clinical staff with patient contact, and to assess whether these experiences relate to COVID-19 vaccination.

METHODS

Health care workers at a large Midwestern hospital in the U.S. were contacted to participate in an online cross-sectional survey during February 2021. A logistic regression model was used to estimate odds ratios (OR) for vaccination by different experiences, and we assessed mediation through models that also included measures of risk perceptions.

RESULTS

Among 366 nurse practitioners / nurse midwives / physician assistant, 1,698 nurses, 1,798 allied health professionals, and 1,307 non-clinical staff with patient contact, the proportions who had received or intended to receive a COVID-19 vaccination were 94 %, 87 %, 82 %, and 88 %, respectively. Working and being physically close to COVID-19 patients was not significantly associated with vaccine intent. Vaccination intent was significantly lower among those with a previous COVID-19 diagnosis vs not (OR = 0.33, 95 % CI: 0.27, 0.40) and higher for those who knew close family members of friends hospitalized or died of COVID-19 (OR = 1.33, 95 % CI: 1.10, 1.60).

CONCLUSION

Even when COVID-19 vaccination was available in February 2021, a substantial minority of hospital workers with patient contact did not intend to be vaccinated. Moreover, their experiences working close to COVID-19 patients were not significantly related to vaccination intent. Instead, personal experiences with family members and friends were associated with vaccination intent through changes in risk perceptions. Interventions to increase uptake among hospital workers should emphasize protection of close family members or friends and the severity of COVID-19.

The nature and pre-disposing factors of workplace violence: A qualitative study of how violence is experienced by ED personnel

BACKGROUND

Workplace violence against emergency department (ED) personnel, especially nurses, is a growing global challenge, and it can have serious adverse impacts on the personnel's life and patient care. Investigating the experience of ED personnel can help healthcare authorities find the underlying factors causing violence and use proper strategies to prevent it.

METHODS

In this qualitative exploratory study, data were collected using in-depth, face to face and semi-structured interviews with 20 ED personnel working in five hospitals in west Azerbaijan of Iran. The interviews were transcribed and transferred to MaxQda10 software for coding. Then, six steps conventional content analysis process proposed by Graneheim and Lundman (2004) was used to analyze the data.

RESULTS

Two overarching categories of "perceived violence" and "predisposing factors of violence" were extracted from the data analysis. Perceived violence was supported by "verbal violence," "physical violence," "ethnic violence," and "sexual violence." The sub-categories of the "predisposing factors of violence included "inefficient management," "low professional competence of personnel," and " violent atmosphere."

CONCLUSION

Concerning the high perceived experiences of violence in the ED, health care systems should take fundamental measures such as supporting the ED personnel, improving management, developing and implementing standard guidelines for triaging patients, conducting continuous educational courses on clinical knowledge and skills, and how to interact and communicate with clients would help prevent violence.

Measles immunity in medical center staff after changes in national and local hospital vaccination policies

Background

Measles vaccination was introduced in Taiwan in 1978, and the disease was declared eliminated in Taiwan in 2007. However, new cases have been reported unpredictably since then. Hospital medical staff are at particularly high risk for measles. We evaluated the immunity status of hospital medical staff after changes in national and local hospital vaccination policies.

Methods

This retrospective study was conducted in a tertiary care medical center from January 2008 to June 2018. Data were retrieved from all healthcare workers receiving employment medical examinations. Those with a full medical record including the geometrical mean titer (GMT) of anti-measles IgG were included. Age and sex differences in the GMT were analyzed by Student’s t-tests and Chi-squared tests. Univariate and multivariate logistic regression analysis were used to determine the odds of immunity.

Results

The IgG positive rate increased with age group (p < 0.001). Seropositive rates for the birth before 1977 and after 1978 groups were 94.8% and 70.2% (p < 0.001). The odds ratio was also significantly different between both cohorts (1.000 vs. 0.423, p = 0.002). Staff in the examination department showed the lowest positive percentage of 70.3% (95% CI: 66.9–73.7%), whereas staff in preventive and long-term care services disclosed the highest positive percentage of 83.2% (95% CI: 76.1–90.2%). Subgroups 2015, 2017, and 2018 (p = 0.046, 0.046, 0.049), after the vaccination booster policy was launched, showed significant increases in seropositivity.

Conclusions

Immunity efficacy is better in birth groups before 1977, which was highly related to natural infection before national policy launched. The policy of vaccination is an effective method, but medical staff attains inadequate protective antibody levels for maintenance of herd immunity. A pre-employment policy of screening a third booster vaccine of measles (or MMR) is recommended to lower the incidence of disease spreading and avoid outbreaks.

[Low incidence of SARS-CoV-2 infections in healthcare workers at a tertiary care hospital : Results of a prospective serological cohort study of the first and second COVID‑19 pandemic wave]

Hintergrund

Mitarbeiter im Gesundheitswesen mit Kontakt zu COVID‑19-Patienten sind einem erhöhten Risiko einer Infektion mit SARS-CoV‑2 ausgesetzt. Ziel dieser seroepidemiologischen Studie war es, das Infektionsrisiko für Klinikmitarbeiter eines Maximalversorgers zu evaluieren.

Methodik

Im Rahmen einer prospektiven Kohortenstudie wurden von März bis Juli 2020 (1. Welle) bei unmittelbar in der Versorgung von COVID‑19-Patienten eingesetzten Mitarbeitern im Abstand von jeweils 2 Wochen serologische Untersuchungen auf Antikörper gegen SARS-CoV‑2 durchgeführt. Von Dezember 2020 bis Februar 2021 (2. Welle) fand eine erneute Untersuchung des Antikörperstatus statt.

Ergebnisse

Die Seroprävalenz von Antikörpern gegen SARS-CoV‑2 betrug am Studienende im Februar 2021 5,1 %. Die kumulative Inzidenz betrug nach einer medianen Beobachtungsdauer von 261 Tagen 3,9 %.

Schlussfolgerung

In der untersuchten Kohorte von Klinikmitarbeitern, die in der Akutversorgung von COVID‑19-Patienten eingesetzt werden, fand sich unter den angewandten Hygiene- und Schutzmaßnahmen ein niedriges und mit der Gesamtbevölkerung vergleichbares Risiko einer SARS-CoV-2-Infektion.

An ergonomic comparison of three different patient transport chairs in a simulated hospital environment

The purpose of this study was to compare caregiver muscle activation and joint angles between two ergonomic transport chairs designed to mitigate discomfort and safety risks associated with patient transport, the Stryker® Prime TC and the Staxi® Medical Chair, and a depot wheelchair. Twenty-three caregivers completed level walking and ramped tasks with each device and an 84 kg manikin. Surface electromyography for the upper extremities and back muscles and motion data were collected. The Staxi showed a statistical trend for higher wrist extensor and flexor carpi ulnaris activity compared to the Stryker chair (p ≤ 0.078) and greater wrist flexion than the Stryker and depot chairs (p ≤ 0.004). The depot chair showed greater peak trunk flexion than the Stryker chair (p = 0.004). Overall results suggest that ergonomic chair design may improve joint positioning of the trunk and elbows when operating patient transport chairs over level and ramped surfaces.

Antibiotic resistance and molecular characteristics of methicillin-resistant Staphylococcus epidermidis recovered from hospital personnel in China

OBJECTIVES

Staphylococcus epidermidis is a major nosocomial pathogen predominantly associated with indwelling medical device infections. Studies reporting on S. epidermidis recovered from hospital personnel in China are scarce. The aim of this study was to evaluate the carriage and antibiotic resistance of S. epidermidis among the hospital personnel in Tianjin, China and provide insights into their genetic diversity.

METHODS

One hundred and seven S. epidermidis isolates were recovered from 68 hospital personnel in two public hospitals in Tianjin between March 2018 and May 2018. Staphylococcal cassette chromosome mec (SCCmec) types were determined by the combination of mec and ccr complexes. Multi-locus sequence typing was used to determine the sequence types (ST) of S. epidermidis isolates.

RESULTS

Sixty-two (76.5%) isolates were determined to be methicillin-resistant S. epidermidis (MRSE). Thirty-five (51%) of 68 hospital personnel carried S. epidermidis, of which 32 (91%) were carriers of MRSE. All 62 MRSE isolates had high levels of resistance to penicillin (90%) and cefoxitin (100%). Thirty-seven (60%) isolates carried SCCmec type IV, followed by 15 (24%) carrying SCCmec V, and 4 (6%) SCCmec II. Novel STs were assigned to four S. epidermidis isolates (ST832, ST833, ST834 and ST835).

CONCLUSIONS

In this study, the majority of MRSE belonged to cluster II domain of CC2. The ST59-IV was a dominant clone among isolates recovered from hospital personnel. Determination of new MLST types confirmed the genetic diversity of these isolates. These observations highlight the need to review the infection control strategies to reduce the carriage of MRSE among hospital personnel.

Flood disaster preparedness experiences of hospital personnel in Thailand: A qualitative study

BACKGROUND

Nurses, as well as other health personnel and health systems, worldwide need to be adequately prepared for disasters because it is often difficult to predict where and when disasters strike. The 2011 Thailand flood disaster caused significant damage, including to hospitals. The purpose of this study was to investigate the experiences of hospital personnel regarding flood disaster preparedness in the central region of Thailand.

METHODS

This qualitative study was conducted using content analysis. Purposive sampling was used to select the participants. Semi-structured interviews were conducted with 15 participants who were doctors, nurses, and persons involved in flood disaster preparedness. Content analysis was used for data analysis.

FINDINGS

Two themes and ten subthemes were extracted with regard to flood disaster preparedness. The two themes were maintaining the function of care provision and struggle with preparedness. Personnel realized that preparation levels of their hospital were inadequate and identified the challenges in providing care during and after floods.

CONCLUSIONS

The finding identified several areas to improve the current state of preparedness of all hospitals that experienced service disruption due to flood disasters. This can help healthcare personnel, hospitals, and healthcare system to enhance flood disaster preparedness so that they can be better prepared.

The Association Between Psychological Distress and Decision Regret During Armed Conflict Among Hospital Personnel

The association between psychological distress and decision regret during armed conflict among hospital personnel is of interest. The objective of this study was to learn of the association between psychological distress and decision regret during armed conflict. Data was collected from 178 hospital personnel in Barzilai Medical Center in Ashkelon, Israel during Operation Protective Edge. The survey was based on intranet data collection about: demographics, self-rated health, life satisfaction, psychological distress and decision regret. Among hospital personnel, having higher psychological distress and being young were associated with higher decision regret. This study adds to the existing knowledge by providing novel data about the association between psychological distress and decision regret among hospital personnel during armed conflict. This data opens a new venue of future research to other potentially detrimental factor on medical decision making and medical error done during crisis.

A study of job stress and burnout and related factors in the hospital personnel of Iran

INTRODUCTION

Job stress has become one of the main factors in reducing efficiency and the loss of human resources that may cause physical and psychological adverse effects in employees. Hospital personnel are facing different stressful events, such as birth, pain and death, in a single day. Hence, identifying the job stress rates and related factors may be effective in offering proper strategies. Therefore, the present research was done to study the rate of job stress and burnout in hospital personnel and compare some of the related factors in hospitals personnel of Yazd, Iran.

METHODS

This cross-sectional study was conducted on 306 hospital personnel (Male: 114, Female: 192) in Yazd in 2015-16. The data were collected using a demographic questionnaire, Maslach Burnout Inventory (MBI), and Hospital Stress (HSS-35). SPSS-16 software and Pearson-product moment correlation and independent-samples t-test were used for data analysis.

RESULTS

The mean job stress score was above average. The mean burnout dimensions that were above average included emotional exhaustion (21.7 ± 7.27), depersonalization (9.61 ± 3.74) and personal accomplishment (26.80 ± 6.17). While Pearson correlation revealed a significant positive relationship between job stress, emotional exhaustion, and depersonalization, there was a negative relationship between job stress and personal accomplishment (p < 0.01). Independent-samples t-test results showed that the rate of job stress, emotional exhaustion, and depersonalization in males is higher than females, married people have more emotional exhaustion than single ones, and, finally, health staff have more job stress than administrative staff. At the same time, the administrative staff and females have better personal accomplishment than other groups (p < 0.05).

CONCLUSION

Since the rate of job stress in hospital personnel is worrying and it has adverse effects on personnel health, effective strategies on physical and mental health, such as employment support and stress management training, seem crucial to enhance physical and psychological health of hospital personnel.

[Multidrug resistant tuberculosis among health personnel in Côte d'Ivoire]

Multidrug resistance tuberculosis (MDR-TB) of health workers raises the question of hospital-borne transmission of infection.

OBSERVATIONS

We report 4 cases of MDR-TB confirmed at the health workers over a period of 8 years (January, 2005 to December 2012), in the 2 services of pulmonology from Abidjan to Côte d'Ivoire). It was about young grown-up patients (aged between 28 and 39 years), all HIV negatives, in a no-win situation of antituberculosis treatment (3 patients/4). The most concerned staffs were the male nurses (2/4). Two agents worked in general hospital and the only one in a pulmonology department at the time of the diagnosis. The tuberculosis was of lung seat with bilateral radiographic hurt (3/4) and multiples excavations (4/4). The case index, when it was identified (2/2), was a family case. Among 3 agents who benefited from a second line treatment, 1 died further to an extensive drug resistance and 2 are declared to be cured. The fourth died before the beginning of the treatment. These cases of cure were in touch with a premature care.

CONCLUSION

Multidrug resistant tuberculosis at the health workers could have a negative impact on the antituberculosis fight imposing rigorous measures of infection control and better implication of the occupational medicine.

Improving smoking cessation outcomes in secondary care: Predictors of hospital staff willingness to provide smoking cessation referral

Since implementation of the New Smoking Cessation Policy in Taiwan, more patients are attending smoking cessation clinics. Many of these patients were referred by hospital staff. Thus, factors which influence the hospital staff's willingness to refer are important. In this study, we aim to understand the relation between smoking cessation knowledge and willingness for referral.

A cross-sectional study using a questionnaire was conducted with staff of a community hospital during the year 2012–2013. Willingness to provide smoking cessation referral and relevant correlated variables including demographic data, knowledge of basic cigarette harm, and knowledge of resources and methods regarding smoking cessation were measured.

A total of 848 of 1500 hospital staff returned the questionnaire: 249 physicians (29.4%), 402 nursing staff (47.4%), and 197 administration staff (23.2%). 790 (93.2%) staff members have never smoked, 19 (2.2%) had quit smoking, and 39 (4.6%) still smoke. 792 (93.4%) members had interest in receiving smoking cessation education. The mean total score (highest potential score of 6) of basic cigarette harm knowledge was 4.56 (± 1.25). The mean total score (highest potential score of 7) of resources and methods about smoking cessation was 4.79 (± 1.35). The significant variable correlated with willingness to refer was total score of resources and methods about smoking cessation.

Hospital staff who knew more about resources and methods about smoking cessation were more willing to refer smoking patients to the smoking cessation service. Thus, continuing medical education for hospital staff should include resources and methods about smoking cessation to promote smoking cessation.

•

Knowledge of methods and resources for smoking cessation increases referral rates.

•

Just educating about smoking harm will not increase willingness for referral.

•

Education should include resources and methods about smoking cessation.

Manager Experiences with the Return to Work Process in a Large, Publically Funded, Hospital Setting: Walking a Fine Line

PURPOSE

Previous research on the role of managers in the return to work (RTW) process has primarily been conducted in contexts where the workplace has declared organizational responsibility for the process. While this is a common scenario, in some countries, including Denmark, there is no explicit legal obligation on the workplace to accommodate RTW. The aim of this study was to gain knowledge about the potential roles and contributions of managers in supporting returning employees in a context where they have no legal obligation to actively support RTW.

METHODS

Nineteen Danish hospital managers participated in a one-on-one interview or focus group discussions aimed at identifying barriers and facilitators for supporting employees in their RTW. Five individual interviews and two focus group discussions were conducted. Transcripts were analysed using thematic content analysis.

RESULTS

Four main themes were identified: (1) 'Coordinator and collaborator'; (2) 'Dilemmas of the RTW policy enforcer'; (3) 'The right to be sick and absent'; and (4) 'Keep the machinery running…'. Our findings indicated that supervisors' capacity to support returning workers was related to individual, communication, organizational, and policy factors. Instances were observed where supervisors faced the dilemma of balancing ethical and managerial principles with requirements of keeping staffing budgets.

CONCLUSION

Although it is not their legislative responsibility, Danish managers play a key role in the RTW process. As has been observed in other contexts, Danish supervisors struggle to balance considerations for the returning worker with those of their teams.

[Hospital-based multicenter study in Spain, Mexico and Cuba on attitudes to living liver donation]

INTRODUCTION

Given the lack of a sufficient number of livers available for transplantation, living liver donation (LLD) is being developed in the Spanish-speaking world. To do this, it is essential that health workers in hospitals are in favor of such donation, given that they are a key component in this treatment and that their attitudes influence public opinion.

OBJECTIVE

To analyze attitude toward LLD among hospital personnel from healthcare centers in Spain and Latin America.

MATERIAL AND METHOD

Ten hospitals were selected from the «International Donor Collaborative Project»: 3 from Spain, 5 from Mexico and 2 from Cuba. Random sampling stratified by type of service and job category was used. Attitudes to LLD were evaluated through a validated questionnaire on psychosocial aspects. The questionnaire was anonymous and self-administered. Statistical tests consisted of Student's T test, the chi-square test and logistic regression analysis.

RESULTS

Of the 2,618 employees surveyed, 85% (n=2,231) were in favor of related LLD; of these, 31% (n=804) were in favor of unrelated LLD. No association was found between the country of the interviewed, personal-social variables or work-related variables. The following factors were associated with a favorable attitude toward related LLD donation: having had personal experience of donation and transplantation (P<.001); being in favor of deceased donation (P<.001); believing that one might need a possible transplant (P<.001); being in favor of living kidney donation (P<.001); being willing to accept a liver from a living donor (P<.001); having discussed the matter of donation and transplantation within the family (P<.001) and with one's partner (P<.001); carrying out pro-social type activities (P<.001); being Catholic (P=.040); believing that one's religion is in favor of donation and transplantation (P<.001); and not being concerned about the possible mutilation of the body after donation (P<.001).

CONCLUSIONS

Hospital personnel from Spain and Latin America had a favorable attitude toward LLD, which was associated with factors directly and indirectly related to donation and transplantation, family and religious factors, and attitudes toward the body.

Opinion toward living liver donation of hospital personnel from units related to organ donation and transplantation: a multicenter study from Spain and latin-america

BACKGROUND

Hospital personnel of services related to donation and transplantation process play a fundamental role in the development of transplantation.

OBJECTIVES

The aim of this study was to investigate the attitude toward living liver donation (LLD) among hospital personnel from services related to donation and transplantation in hospital centers in Spain and Latin America.

MATERIALS AND METHODS

Eight hospitals within the "International Donor Collaborative Project" were selected, three in Spain, three in Mexico and two in Cuba. The study was performed in transplant-related services, using a randomized sample, which was stratified by the type of service and job category.

RESULTS

In total, 878 workers were surveyed of which 82% (n = 720) were in favor of related LLD, 10% (n = 90) were against and 8% (n = 68) undecided. Attitudes toward related LLD were more favorable in the following groups: the Latin Americans (86% in favor vs. 77% among the Spanish; P = 0.007); younger people (37 vs. 40 years, P = 0.002); those in favor of either deceased donation (P < 0.001) or living kidney donation (P < 0.001); those who believed that they might need a transplant in the future (P < 0.001); those who would accept a liver from a living donor (P < 0.001); those who discussed the subject of donation and transplantation with their families (P = 0.040); and those whose partner was in favor of donation and transplantation (P = 0.044).

CONCLUSIONS

Personnel from donation and transplantation-related units had a favorable attitude toward LLD. This attitude was not affected by psychosocial factors, although it was influenced by factors directly and indirectly related to the donation and transplantation process.

Microbial Contamination on Used Surgical Masks among Hospital Personnel and Microbial Air Quality in their Working Wards: A Hospital in Bangkok

OBJECTIVE

To assess the relationship of bacterial and fungal contamination on used surgical masks worn by the hospital personnel and microbial air quality in their working wards.

METHODS

This is a cross-sectional study of 230 used surgical masks collected from 214 hospital personnel, and 215 indoor air samples collected from their working wards to culture for bacterial and fungal counts. This study was carried out at the hospital in Bangkok. Group or genus of isolated bacteria and fungi were preliminarily identified by Gram's stain and lacto-phenol cotton blue. Data were analyzed using paired t-test and Pearson's correlation coefficient at the significant level of p<0.050.

RESULTS

Means and standard deviation of bacterial and fungal contamination on inside area of the used masks were 47 ± 56 and 15 ± 9 cfu/ml/piece, and on outside area were 166 ± 199 and 34 ± 18 cfu/ml/piece, respectively, p<0.001. The bacterial and fungal contamination on used masks from hospital personnel working in the male and female medical wards and out-patient department, as well as the bacterial and fungal counts of the indoor air sample collected from the same area were relatively higher than the other wards. The predominant isolated bacteria and fungi contaminated on inside and outside areas of the used masks and air samples were similar (Staphylococcus spp. and Aspergillus spp.; respectively). For its relationship, results found that bacterial and fungal counts in air samples showed significantly positive correlation with the bacterial contamination load on outside area of the used masks, r=0.16, p=0.018 and r=0.21, p=0.003, respectively.

CONCLUSION

High bacterial contamination on outside area of the used masks was demonstrated, and it showed a significant correlation with microbial air quality of working wards.

Ancillary personnel in Spanish and Latin-American hospitals faced with living related kidney donation

INTRODUCTION

Ancillary hospital personnel represent an important body of opinion because as they work in a hospital their opinion has more credibility for the general public as a result of their activity in hospitals. However, in most cases they do not have any health care training which means that their attitude could be based on a lack of knowledge or unfounded fears.

OBJECTIVE

To analyze the attitude toward living kidney donation (LKD) among ancillary personnel in Spanish and Latin-American hospitals and to analyze the variables that might influence such attitude.

PATIENTS AND METHOD

from «International Collaborative Donor Project» a random sample was taken among ancillary personnel in Spain, Mexico and Cuba hospitals. Attitude towards LKD was evaluated using a validated, anonymously filled and self-administered survey.

RESULTS

951 professionals were surveyed (Spain: 277, Mexico: 632, Cuba: 42). 89% (n=850) are in favor of related kidney donation, lowering to 31% (n=289) in non-related donation. Of the rest, 8% (n=78) are not in favor and the 3% (n=23) are unsure. By country, Cubans (98%) and Mexicans (91%) are more in favour than Spanish (84%) (P=.001). The following variables are related to favourable attitude towards LKD: female sex (P=.017), university degree (P=.010), work in health services (P=.035), labour stability (P=.016), personal experience in donation and transplantation (P=.001), positive attitude toward cadaveric donation (P<.001), belief that he or she might need a transplant in the future (P<.001), positive attitude towards living liver donation (P<.001), a willingness to receive a donated living liver if needed (P<.001), having discussed the subject of organ donation and transplantation within the family (P<.001), partner's positive attitude towards the subject (P<.001), participation in voluntary type pro-social activities (P=.002) and not being concerned about possible mutilation after donation (P<.001) CONCLUSIONS: The attitude toward living related kidney donation is favourable among ancillary personnel in Spanish and Latin-Americans hospitals. Because living donation is a better source of organs than cadaveric ones, this favourable predisposition can be used as promoting agent of living donation in order to develop it in Spanish-speaking countries.

Respiratory protection policies and practices among the health care workforce exposed to influenza in New York State: evaluating emergency preparedness for the next pandemic

BACKGROUND

New York State hospitals are required to implement a respiratory protection program (RPP) consistent with the Occupational Safety and Health Administration respirator standard. Guidance provided during the 2009 novel H1N1 pandemic expanded on earlier recommendations, emphasizing the need to keep staff in all health care settings healthy to maintain services.

METHODS

New York State hospitals with emergency departments having more than 1,000 visits annually were invited to participate; 23 hospitals participated. Health care workers, unit managers, and hospital managers were interviewed regarding knowledge, beliefs, and practices of respiratory protection. Interviewees were observed donning and doffing an N-95 respirator as they normally would during patient care. Written RPPs for each hospital were evaluated.

RESULTS

The majority of the hospitals surveyed had implemented an RPP, although unawareness of the policies and practices, as well as inadequacies in education and training exist among health care workers.

CONCLUSION

Health care workers and other hospital employees may be unnecessarily exposed to airborne infectious diseases. Having an RPP ensures safe and effective use of N-95 respirators and will help prevent avoidable exposure to disease during a pandemic, protecting the health care workforce and patients alike.

Spanish-Latin American multicenter study of attitudes toward organ donation among personnel from hospital healthcare centers

INTRODUCTION

Hospital personnel are a group which has an influence on the opinion of the rest of the population about healthcare matters. Any unfavorable attitude of this group would be an obstacle to an increase in organ donation.

OBJECTIVE

To analyze the attitude of hospital workers toward the donation of one's own organs in Spanish and Latin American hospitals and to determine the factors affecting this attitude.

MATERIAL AND METHOD

Eleven hospitals from the "International Collaborative Donor Project" were selected, 3 in Spain, 5 in Mexico, 2 in Cuba and one in Costa Rica. A random sample was stratified by the type of service and job category. Attitude toward donation and transplantation was assessed using a validated survey. The questionnaire was completed anonymously and was self-administered.

STATISTICAL ANALYSIS

Student's t-test, the χ2 test and logistic regression analysis.

RESULTS

Of the 2,785 workers surveyed, 822 were from Spain, 1,595 from Mexico, 202 from Cuba and 166 from Costa Rica and 79% (n=2,191) were in favor of deceased organ donation. According to country, 94% (n=189) of Cubans were in favor, compared to 82% (n=1,313) of the Mexicans, 73% (n=121) of the Costa Ricans and 69% (n=568) of the Spanish (P<.001). In the multivariate analysis, the following variables had the most specific weight: 1) originating from Cuba (odds ratio=8.196; P<.001); 2) being a physician (OR= 2.544; P<.001); 3) performing a job related to transplantation (OR = 1.610; P=.005); 4) having discussed the subject of donation and transplantation within the family (OR= 3.690; P<.001); 5) having a partner with a favorable attitude toward donation and transplantation (OR= 3.289; P<.001); 6) a respondent's belief that his or her religion is in favor of donation and transplantation (OR= 3.021; P=.001); 7) not being concerned about the possible mutilation of the body after donation (OR= 2.994; P<.001); 8) the preference for other options apart from burial for treating the body after death (OR= 2.770; P<.001); and 9) acceptance of carrying out an autopsy if one were needed (OR= 2.808; P<.001).

CONCLUSIONS

Hospital personnel in Spanish and Latin American healthcare centers had a favorable attitude toward donation, although 21% of respondents were not in favor of donating. This attitude was more favorable among Latin American workers and was very much conditioned by job-related and psychosocial factors.