[Professional satisfaction of the medical staff of the scientific and practical dental complex]

A survey of dentists and managing clinics-branches of the scientific and practical dental complex showed a high level of professional satisfaction. The main advantages in the activities of rapidly developing network-type dental clinics that actively implement the most advanced, unique technologies and tools have been identified. The main motivational factors that positively affect the result of staff activities, as well as reduce their degree of professional satisfaction, are identified. Moreover, according to the results of respondents' answers, approaches were identified to improve the motivating component in personnel management, as well as to level existing problems within the team. Studying the opinions of medical personnel (doctors and managers) will help the administration to analyze the potential of the personnel potential of clinics and will contribute to the development of plans to improve the organization of staff work and network development.

[Basic aspects of organizing medical training in the context of a coronavirus pandemic]

The article discusses the changes made to the existing procedure for continuing medical education and the accreditation of medical workers due to a pandemic that began with the outbreak of coronavirus infection COVID-19 in early 2020. Under current circumstances, medical organizations encountered difficulties in organizing quarantine, purchasing disinfecting drugs, personal protective equipment and additional medical equipment, the need to introduce an emergency mode of work for employees, so there was a need to review and develop new rules for the work of medical workers during a coronavirus pandemic. Medicine is one of the progressive fields of scientific and entrepreneurial activity, making high demands on medical workers. Therefore, continuous training of doctors and medical personnel is caused by vital necessity, especially in the context of the coronavirus pandemic. Currently, the legislative level provides for the re-profiling of doctors of other specialties and the involvement of teachers and general medical organizations in the fight against coronavirus infection. In the face of the threat of the spread of coronavirus infection, on the recommendation of the Ministry of Science and Higher Education of the Russian Federation, it was decided to transfer educational institutions to distance learning using educational technologies, which also requires great efforts on the part of doctors, as medical specialists need not only a large amount of theoretical knowledge , but also a sufficient number of practical skills. The article presents statistical and analytical data, the results of surveys of Russian doctors, expert estimates that allow us to draw conclusions regarding the effectiveness of educational programs and courses for the professional retraining of doctors in the context of a coronavirus pandemic.

[Relationship between the evaluation of the health system personnel by their users and their subjective well-being: A cross-sectional study]

Introduction

This cross-sectional study sought to examine the relationships between the perception of efficiency and quality of the service provided by the staff of the health system with users well-being (satisfaction with life), in the Chilean context. Based on the literature review, we hypothesized that satisfaction with the services provided by the health system would be associated with the well-being of its users.

Objective

To determine the relationship between the evaluation of the health system, medical staff, and perceived efficiency, with users subjective well-being.

Methods

On a sample of 1,201 respondents (52.4% women, mean age 42.82 years), descriptive analysis, bivariate analysis, and a structural equation model were performed between the evaluation of the health system, medical staff, and perceived efficiency with users subjective well-being.

Results

These three variables are positively related to each other and have effects on subjective well-being.

Discussion

Health systems also influence the subjective well-being of their users and can be associated with indicators of quality of life. Some implications and considerations related to the Chilean health system are discussed. Also, some of the possible limitations of the study are mentioned. Lastly, the importance of the health systems as part of the state and government functions is discussed.

A Comparison of Burnout Frequency Among Oncology Physicians and Nurses Working on the Frontline and Usual Wards During the COVID-19 Epidemic in Wuhan, China

CONTEXT

The epidemic of coronavirus disease 2019 (COVID-19) was first identified in Wuhan, China and has now spread worldwide. In the affected countries, physicians and nurses are under heavy workload conditions and are at high risk of infection.

OBJECTIVES

The aim of this study was to compare the frequency of burnout between physicians and nurses on the frontline (FL) wards and those working in usual wards (UWs).

METHODS

A survey with a total of 49 questions was administered to 220 medical staff members from the COVID-19 FL and UWs, with a ratio of 1:1. General information, such as age, gender, marriage status, and the Maslach Burnout Inventory-medical personnel, were gathered and compared.

RESULTS

The group working on the FLs had a lower frequency of burnout (13% vs. 39%; P < 0.0001) and were less worried about being infected compared with the UW group.

CONCLUSION

Compared with medical staff working on their UWs for uninfected patients, medical staff working on the COVID-19 FL ward had a lower frequency of burnout. These results suggest that in the face of the COVID-19 crisis, both FL ward and UW staff should be considered when policies and procedures to support the well-being of health care workers are devised.

The Prevalence, Characteristics, and Prevention Status of Skin Injury Caused by Personal Protective Equipment Among Medical Staff in Fighting COVID-19: A Multicenter, Cross-Sectional Study

Objective: To investigate the prevalence, characteristics, and preventive status of skin injuries caused by personal protective equipment (PPE) in medical staff. Approach: A cross-sectional survey was conducted online for understanding skin injuries among medical staff fighting COVID-19 in February 8-22, 2020. Participants voluntarily answered and submitted the questionnaire with cell phone. The questionnaire items included demographic data, grade of PPE and daily wearing time, skin injury types, anatomical sites, and preventive measures. Univariable analyses and logistic regression analyses were used to explore the risk factors associated with skin injuries. Results: A total of 4,308 respondents were collected from 161 hospitals and 4,306 respondents were valid. The overall prevalence of skin injuries was 42.8% (95% confidence interval [CI] 41.30-44.30) with three types of device-related pressure injuries, moist-associated skin damage, and skin tear. Co-skin injuries and multiple location injuries were 27.4% and 76.8%, respectively. The logistic regression analysis indicated that sweating (95% CI for odds ratio [OR] 87.52-163.11), daily wearing time (95% CI for OR 1.61-3.21), male (95% CI for OR 1.11-2.13), and grade 3 PPE (95% CI for OR 1.08-2.01) were associated with skin injuries. Only 17.7% of respondents took prevention and 45.0% of skin injuries were treated. Innovation: This is the first cross-sectional survey to understand skin injuries in medical staff caused by PPE, which is expected to be a benchmark. Conclusion: The skin injuries among medical staff are serious, with insufficient prevention and treatment. A comprehensive program should be taken in the future.

Clinical characteristics of 54 medical staff with COVID-19: A retrospective study in a single center in Wuhan, China

In December 2019, an outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection occurred in Wuhan, and rapidly spread to worldwide, which has attracted many people's concerns about the patients. However, studies on the infection status of medical personnel is still lacking. A total of 54 cases of SARS-Cov-2 infected medical staff from Tongji Hospital between 7 January and 11 February 2020 were analyzed in this retrospective study. Clinical and epidemiological characteristics were compared between different groups by statistical method. From 7 January to 11 February 2020, 54 medical staff of Tongji Hospital were hospitalized due to coronavirus disease 2019 (COVID-19). Most of them were from other clinical departments (72.2%) rather than emergency department (3.7%) or medical technology departments (18.5%). Among the 54 patients with COVID-19, the distribution of age had a significant difference between non-severe type and severe/critical cases (median age: 47 years vs 38 years; P = .0015). However, there was no statistical difference in terms of gender distribution and the first symptoms between theses two groups. Furthermore, we observed that the lesion regions in SARS-Cov-2 infected lungs with severe-/critical-type of medical staff were more likely to exhibit lesions in the right upper lobe (31.7% vs 0%; P = .028) and right lung (61% vs 18.2%; P = .012). Based on our findings with medical staff infection data, we suggest training for all hospital staff to prevent infection and preparation of sufficient protection and disinfection materials.

Mental health status of medical staff in the epidemic period of coronavirus disease 2019

OBJECTIVES

To explore the psychological status of medical staff in the epidemic period of coronavirus disease 2019 (COVID-19), and to analyze its influential factors.

METHODS

A total of 373 medical staff from Xiangya Hospital and the Second Xiangya Hospital of Central South University were enrolled for this study. The General Sociological Data Questionnaire, Symptom Check-List 90 (SCL-90), and self-designed public opinion response questionnaire were used to assess general sociological data, mental health scores, and ability to respond to COVID-19 related public opinion information of medical staff. The mental health scores of medical staff with different general sociological data and public opinion information coping abilities were compared. Influential factors of mental health were analyzed.

RESULTS

The average score of 10 factors in SCL-90 of 373 medical staff was less than 2 points. 14.21% medical staff had one or more factor scores more than two points, including 11.26% with terror symptoms, 7.77% with compulsive symptoms, and 5.63% with anxiety. The main sources of COVID-19 information for medical staff included WeChat, microblog, Jinri toutiao, TV and radio. 66.22% medical staff regularly verified information about COVID-19 through official websites or formal channels. A great deal of COVID-19 information in WeChat could make medical staff nervous (34.05%), anxious (30.29%), and insecure (29.22%). 68.63% medical staff sometimes were worried about getting infected because they knew information about COVID-19. Different departments of medical staff, getting cough or having a fever recently, and the degree of fear of infection had an impact on the SCL-90 score of medical staff, the differences were all statistically significant (all P<0.05). Stepwise regression analysis showed that the impact of COVID-19 information on their life in WeChat, getting cough or having a fever recently, insomnia-early caused by COVID-19 information in WeChat, different departments, and the degree of fear of infection COVID-19 were the influential factors for the mental health of medical staff (all P<0.05).

CONCLUSIONS

During the epidemic of COVID-19, medical staff suffered from psychological problems to various degrees. It is necessary to establish a psychological assistance platform and guide the direction of public opinion correctly to promote the mental health of medical staff.

Influential factors for insomnia in medical staff in the national medical aid team for Hubei Province during the outbreak of coronavirus disease 2019

OBJECTIVES

To investigate the insomnia status and relevant factors for the medical staff in the medical aid team for Hubei Province during the outbreak of coronavirus disease 2019.

METHODS

A convenient sampling survey was conducted among 1 056 medical staff in the national medical team of Hubei Province by using the Insomnia Severity Index (ISI) and the Regulatory Emotional Self-Efficacy (RES).

RESULTS

The incidence from moderate to severe insomnia was 35.14%, and the total self-efficacy of emotion regulation was 3.60±0.91. Univariate analysis showed that the incidence of insomnia in female medical workers in Hubei Province was higher than that of male medical workers, which was increased with the elongation of work time and frequency. In addition, insomnia was associated with age, perceived ambient exposure and infection, and RES scores. Stepwise regression analysis showed that the occurrence of insomnia was mainly related to gender, perceived peripheral exposure, infection, and RES scores.

CONCLUSIONS

Insomnia is very common among medical workers in Hubei Province during the COVID-19 epidemic. Insomnia is related to the medical work status, the gender and their own emotional management and regulation in the epidemic area.

Anxiety in Chinese pediatric medical staff during the outbreak of Coronavirus Disease 2019: a cross-sectional study

BACKGROUND

Our study aimed to explore the anxiety levels and possible associated factors in the pediatric medical staff in Jiangsu province during an outbreak of Coronavirus Disease 2019 (COVID-19).

METHODS

Pediatric medical staff (n=534) from nine hospitals in Jiangsu province were enrolled. Their anxiety levels and quality of sleep were assessed using the online SAS and PSQI questionnaires.

RESULTS

The prevalence of anxiety was 14.0% among the medical staff. In children's hospital staff, anxiety levels in outpatient and emergency departments were significantly higher than those in inpatient departments, except for the intensive care unit. The SAS scores were significantly associated with educational background, professional title, lifestyle, and physical condition. Stepwise multiple linear regression showed that physical condition, lifestyle, attention to the epidemic, professional title, and educational background all had a linear relationship with the individual's anxiety levels. Pearson correlation analysis showed that sleep quality was moderately associated with anxiety levels.

CONCLUSIONS

The prevalence of anxiety was 14.0% in pediatric medical staff in Jiangsu province during an outbreak of COVID-19. Department, professional title, and educational background were associated with anxiety levels in these workers. More attention should be paid to staff who are in poor health, and this anxiety can also be accompanied by poor sleep quality. Peer support can assist with anxiety relief.

A quality improvement project to improve pediatric medical provider sleep and communication during night shifts

QUALITY PROBLEM OR ISSUE

Night-shift medical providers frequently experience limited sleep resulting in fatigue, often because of paging activity. Streamlined medical-specific communication interventions are known to improve sleep and communication among these providers.

INITIAL ASSESSMENT

We found that non-urgent paging communication occurred frequently during night-shifts, leading to provider sleep disturbances within our institution. We tested a quality improvement (QI) intervention to improve paging practices and determined its effect on provider sleep.

CHOICE OF SOLUTION

We used a Plan-Do-Study-Act QI model aimed at improving clinician sleep and paging communications.

IMPLEMENTATION

We initially conducted focus groups of nurses and physician trainees to inform the creation of a standardized paging intervention. We collected actigraphy and sleep log data from physicians, nurse practitioners, and physician trainees and performed electronic collection of paging frequency data.

EVALUATION

Data were collected between December 2015 and March 2017 from pediatric residents, pediatric hematology/oncology (PHO) fellows, hospitalist medicine nocturnists and nurses working during night-shift hours in PHO inpatient units. We collected baseline data before implementation of the QI intervention and at 1 month post-implementation. Although objective measures and provider reports demonstrated improved medical-specific communication paging practices, provider sleep was not affected.

LESSONS LEARNED

Provider-based standardization of paging communication was associated with improved medical-specific communication between nurses and providers; however, provider sleep was not affected. The strategies used in this intervention may be transferable to other clinics and institutions to streamline medical-specific communication.

The social psychological impact of the COVID-19 pandemic on medical staff in China: A cross-sectional study

BACKGROUND

The COVID-19 outbreak required the significantly increased working time and intensity for health professionals in China, which may cause stress signs.

METHODS

From March 2-13 of 2020, 4,618 health professionals in China were included in an anonymous, self-rated online survey regarding their concerns on exposure to the COVID-19 outbreak. The questionnaires consisted of five parts: basic demographic information and epidemiological exposure; occupational and psychological impact; concerns during the episode; coping strategies; and the Huaxi Emotional-Distress Index (HEI).

RESULTS

About 24.2% of respondents experienced high levels of anxiety or/and depressive symptoms since the COVID-19 outbreak. Respondents who worried about their physical health and those who had COVID-19 infected friends or close relatives were more likely to have high HEI levels, than those without these characteristics. Further, family relationship was found to have an independent protective effect against high HEI levels. Their main concerns were that their families would not be cared for and that they would not be able to work properly. Compared to respondents with clear emotional problems, those with somewhat hidden emotional issues adopted more positive coping measures.

CONCLUSIONS

About a quarter of medical staff experienced psychological problems during the pandemic of COVID-19. The psychological impact of stressful events was related to worrying about their physical health, having close COVID-19 infected acquaintances and family relationship issues. Therefore, the psychological supprot for medical staff fighting in the COVID-19 pandemic may be needed.

Classification and Prediction of Violence Against Chinese Medical Staff on the Sina Microblog Based on a Self-Organizing Map: Quantitative Study

Background

For the last decade, doctor-patient contradiction in China has remained prominent, and workplace violence toward medical staff still occurs frequently. However, little is known about the types and laws of propagation of violence against medical staff online.

Objective

By using a self-organizing map (SOM), we aimed to explore the microblog propagation law for violent incidents in China that involve medical staff, to classify the types of incidents and provide a basis for rapidly and accurately predicting trends in public opinion and developing corresponding measures to improve the relationship between doctors and patients.

Methods

For this study, we selected 60 cases of violent incidents in China involving medical staff that led to heated discussions on the Sina microblog from 2011 to 2018, searched the web data of the microblog using crawler software, recorded the amount of new tweets every 2 hours, and used the SOM neural network to cluster the number of tweets. Polynomial and exponential functions in MATLAB software were applied to predict and analyze the data.

Results

Trends in the propagation of online public opinion regarding the violent incidents were categorized into 8 types: bluff, waterfall, zigzag, steep, abrupt, wave, steep slope, and long slope. The communications exhibited different characteristics. The prediction effect of 4 types of incidents (ie, bluff, waterfall, zigzag, and steep slope) was good and accorded with actual spreading trends.

Conclusions

Our study found that the more serious the consequences of a violent incident, such as a serious injury or death, the more attention it drew on the microblog, the faster was its propagation speed, and the longer was its duration. In these cases, the propagation types were mostly steep slope, long slope, and zigzag. In addition, the more serious the consequences of a violent incident, the higher popularity it exhibited on the microblog. The popularity within a week was significantly higher for acts resulting from patients’ dissatisfaction with treatments than for acts resulting from nontherapeutic incidents.

The Correlation Between Visibility and Medical Staff Collaborative Communication in Emergency Departments

OBJECTIVES

This study empirically investigates the correlation between visibility and nurses and physicians' collaborative communication in emergency departments (EDs). The researchers hypothesized that higher visibility levels in EDs are associated with higher collaborative communication among nurses and physicians.

BACKGROUND

The review of related literature addresses the role of communication in EDs, and more specifically, how visibility has been found to affect nurse and physician behavior in healthcare facilities.

METHOD

The visibility levels in four EDs within the same hospital system were quantitatively measured in this study. Also, the communication levels among medical staff were explored by two methods. Data collection included computerized floor plan analyses, observations, and surveys.

RESULTS

The researchers found statistically significant relationships between several underlying dimensions of ED visibility and collaborative communication among the medical staff members.

CONCLUSION

Understanding the role of visibility provides a critical design principle for future EDs. The enhancement of ED design helps nurses and physicians to benefit from supportive environments.

Mental health care for medical staff and affiliated healthcare workers during the COVID-19 pandemic

The COVID-19 pandemic is an unprecedented challenge for society. Supporting the mental health of medical staff and affiliated healthcare workers (staff) is a critical part of the public health response. This paper details the effects on staff and addresses some of the organisational, team and individual considerations for supporting staff (pragmatically) during this pandemic. Leaders at all levels of health care organisations will find this a valuable resource.

The effect of an intervention program on the knowledge and attitudes among medical staff regarding adverse drug reaction reporting

PURPOSE

Adverse drug reactions (ADRs) are a growing important public health problem; however, underreporting of ADRs is very common. The aim of the current study was to explore the effect of an intervention program on the knowledge and attitudes among physicians and nurses regarding ADRs reporting.

METHODS

A multicentre study consisted of three phases: filling out a questionnaire; an intervention program; filling out the same questionnaire again. The intervention program consisted of posters, lectures, and distant electronic learning. The questionnaire contained questions about personal/professional demographic variables, and statements regarding knowledge and attitudes regarding ADR reporting.

RESULTS

The data revealed that the intervention program significantly elevated the "Objective knowledge" (P < 0.01) and "Practical knowledge" (P < 0.02) score as compared to the control group, while no significant differences were found regarding "Acquired knowledge" (P = 0.14). Seniority (P = 0.01) and experience in internal medicine (P = 0.05) were demonstrated as significant factors determining the knowledge of the staff. Obligation was the main motive for reporting in 80% of participants. After the intervention, no differences were found in the "Attitude related to the motive for reporting" or "Attitude related to the commitment to report", between the two groups. However, "Attitude related to the need to report" score significantly improved after the intervention (P = 0.04).

CONCLUSIONS

The intervention program increased knowledge and attitudes regarding ADRs reports. Seniority had the most effect on the influence of the intervention program. The data from this study encourages the necessity to hold ongoing intervention programs in order to improve ADRs reporting rate.

Clinical characteristics of 54 medical staff with COVID-19: A retrospective study in a single center in Wuhan, China

In December 2019, an outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS‐Cov‐2) infection occurred in Wuhan, and rapidly spread to worldwide, which has attracted many people's concerns about the patients. However, studies on the infection status of medical personnel is still lacking. A total of 54 cases of SARS‐Cov‐2 infected medical staff from Tongji Hospital between 7 January and 11 February 2020 were analyzed in this retrospective study. Clinical and epidemiological characteristics were compared between different groups by statistical method. From 7 January to 11 February 2020, 54 medical staff of Tongji Hospital were hospitalized due to coronavirus disease 2019 (COVID‐19). Most of them were from other clinical departments (72.2%) rather than emergency department (3.7%) or medical technology departments (18.5%). Among the 54 patients with COVID‐19, the distribution of age had a significant difference between non‐severe type and severe/critical cases (median age: 47 years vs 38 years; P = .0015). However, there was no statistical difference in terms of gender distribution and the first symptoms between theses two groups. Furthermore, we observed that the lesion regions in SARS‐Cov‐2 infected lungs with severe‐/critical‐type of medical staff were more likely to exhibit lesions in the right upper lobe (31.7% vs 0%; P = .028) and right lung (61% vs 18.2%; P = .012). Based on our findings with medical staff infection data, we suggest training for all hospital staff to prevent infection and preparation of sufficient protection and disinfection materials.

Post-discharge surveillance and positive virus detection in two medical staff recovered from coronavirus disease 2019 (COVID-19), China, January to February 2020

Since December 2019, 62 medical staff of Zhongnan Hospital in Wuhan, China have been hospitalised with coronavirus disease 2019. During the post-discharge surveillance after clinical recovery, swabs were positive in two asymptomatic cases (3.23%). Case 1 had presented typical clinical and radiological manifestations on admission, while manifestation in Case 2 was very mild. In conclusion, a small proportion of recovered patients may test positive after discharge, and post-discharge surveillance and isolation need to be strengthened.

[The comparative analysis of training of paramedical personnel on the territory of the subjects of the Russian Federation of the Siberian Federal Okrug]

The comparative analysis of training of nursing staff in the territories of subjects of the Russian Federation, included in the Siberian Federal Okrug was implemented, based on data of the federal statistical monitoring of corresponding educational organizations in 2018. The analysis of calculated indices permitted to identify uncoordinated nature of provision of nursing staff and volumes of its training at the level of number of subjects of the RF on the territory of the Siberian Federal Okrug, and group them according to combination of level of the given indicators. The assessment was implemented concerning validity of manpower policy in the case of nursing staff in territories of mentioned regions. The study results permitted to determine role and place of the analyzed regions in training of nursing personnel considering groups of criteria characterizing training activities, infrastructure of educational organizations, financial economic aspects of implementation of educational process and employment of graduates with nursing education. The mentioned results are the basis for further research on issues of education of nursing staff at the level of particular subjects of the Russian Federation, analysis of indices in dynamics, factors determining level of development of manpower potential of medical organizations and other elements of scientifically grounded manpower policy in health care sector.

[The increasing of awareness of patients and medical personnel of security issues: the results of questionnaire survey within the framework of the World Patient Safety Day in the Russian Federation]

The specially developed questionnaires on the basis of the WHO materials developed for the World Patient Safety Day were applied in sociological survey of patients and medical workers. The sampling included 3946 respondents (1747 patients and 2199 medical workers). The study was carried out to establish awareness about course of treatment and medications taken, communication with the attending physician and nurse, involvement in decision-making regarding treatment and care provided, clinical decision-making, interaction with patients, informing patients on prescribed drugs and their possible adverse reactions.

[Skill mix in medical and about medical professions]

An important problem faced by many healthcare systems is the shortage of medical staff, and in particular doctors and nurses. Their number, competences and qualifications determine the level of availability and quality of medical services. Unfortunately, the demand for medical services is increasing, along with the progressive aging of the population, as well as the increase in the incidence of chronic diseases and frequent reforms of health systems. Employee costs related to healthcare are the most burdensome for the system; therefore, based on the available resources, it is necessary to create effective teams of sector employees. This results in rationalizing employment, or providing new medical and about medical competencies to new groups of professionals, which gives rise to the skill mix phenomenon. A well-prepared and implemented skill mix contributes to improving the quality of patient care, increased patient satisfaction and better clinical outcomes. In the process of mixing of competences, the roles that have been exercised so far are being changed. While some professionals are expanding their existing roles, other employees are required to accept some aspects of the previous roles. In Poland, in order to counteract such negative trends (the shortage of doctors), changes have been introduced to increase access to medical services (e.g., nurses and midwives being vested with the right to issue prescriptions and medical ordinances, paramedics - with the right to perform medical emergency services and provide healthcare services, and physiotherapists - with the right to conduct independent physiotherapeutic visits). A new profession of a medical coordinator has also been introduced. Med Pr. 2020;71(3):337-52.

Automatic Work-Hours Recorder for Medical Staff (Staff Hours): Mobile App Development

Background

There are numerous mobile apps for tracking work hours, but only a few of them record work hours automatically instead of relying on manual logging. No apps have been customized for medical staff, whose work schedules are highly complicated as they have both regular hours and on-call duties.

Objective

The specific aims of this study were to (1) identify the Staff Hours app users’ GPS-defined work hours, (2) examine the overtime work hours from the app-recorded total work hours and the participants’ self-reported scheduled work hours, and (3) compare these app-recorded total work hours among different occupations.

Methods

We developed an app, Staff Hours, to automatically calculate a user’s work hours via GPS background data. Users can enter their scheduled hours, including regular hours and on-call duties. The app automatically generates overtime reports by comparing the app-recorded total work hours with the user-defined scheduled hours. A total of 183 volunteers (60 females and 123 males; mean age 32.98 years, SD 6.74) were included in this study. Most of the participants (162/183, 88.5%) were medical staff, and their positions were resident physicians (n=89), visiting staff (n=38), medical students (n=10), registered nurses (n=25), and non–health care professionals (non-HCPs; n=21).

Results

The total work hours (mean 55.69 hours, SD 21.34) of the 183 participants were significantly higher than their scheduled work hours (mean 50.67 hours, SD 21.44; P=.01). Medical staff had significantly longer total work hours (mean 57.01 hours, SD 21.20) than non-HCPs (mean 45.48 hours, SD 20.08; P=.02). Residents (mean 60.38 hours, SD 18.67) had significantly longer work hours than visiting staff (mean 51.42 hours, SD 20.33; P=.03) and non-HCPs (mean 45.48 hours, SD 20.08; P=.004).

Conclusions

Staff Hours is the first automatic GPS location–based app designed for medical staff to track work hours and calculate overtime. For medical staff, this app could keep complete and accurate records of work hours in real time, reduce bias, and allow for better complying with labor regulations.

Understanding the medication prior-authorization process: A case study of patients and clinical staff from a large rural integrated health delivery system

PURPOSE

The barriers and solutions to the current prior-authorization (PA) process at an integrated health system were evaluated.

METHODS

Focus groups were conducted with patients at an integrated health system who also had insurance from an affiliated health plan and at least 1 denial for a medication in the past year. Semistructured interviews were conducted with medical staff (physicians, office staff, and PA experts). Both focus groups and interviews were audio-recorded and transcribed. Inductive analysis was used to code transcripts and develop themes.

RESULTS

Three focus groups were conducted with 13 patients, and 9 medical staff (3 staff physicians, 2 office staff, and 4 PA staff) who have interactions with the PA process interviewed. Several themes were identified including the complexity of the PA process, consequences experienced, and ineffective communication between key stakeholders. A cross-cutting theme was that stakeholders expressed feelings of frustration, anxiety, and anger throughout the PA process. All stakeholders offered insights on how the process could be improved to better facilitate their preferences, such as access to the list of medications that require PA and the need for a patient advocate.

CONCLUSION

Results of this study revealed that the PA process was frustrating, upsetting, and infuriating to patients and medical staff involved in the process. Three main themes identified included the complexity of the PA process, consequences experienced from the PA process, and ineffective communication between stakeholders.

Occupational Stress and Mental Health: A Comparison Between Frontline Medical Staff and Non-frontline Medical Staff During the 2019 Novel Coronavirus Disease Outbreak

Background: During an epidemic, both frontline and non-frontline medical staff endure stressful work circumstances that render their mental health a major public health concern. This study aims at investigating and comparing the prevalence and severity of mental health symptoms (i.e., anxiety, depression and insomnia) between frontline medical staff and non-frontline medical staff during the coronavirus disease 2019 (COVID-19) outbreak. It also seeks to evaluate the association of their mental health with occupational stress. Methods: A cross-sectional study was conducted in Wenzhou, China from 2020 February 16th to 2020 March 2th. A total of 524 medical staff responded to the Generalized Anxiety Disorder Scale, the Patient Health Questionnaire, the Insomnia Severity Index, the Occupational stress Questionnaire, and a demographic data form. Data were principally analyzed with logistic regression. Results: Of the 524 participants, 31.3% reported depression, 41.2% reported anxiety, and 39.3% reported insomnia. Compared with the citizens during the COVID-19 epidemic, medical staff experienced higher level of anxiety, depression and insomnia, especially the frontline medical staff. Furthermore, male, married medical staff with poorer physical health reported lower mental health. Frontline medical staff endorsed higher self-reported occupational stress, especially higher occupational hazards, than non-frontline medical staff. In addition, four indicators on occupational stress (working intensity, working time, working difficulty and working risk) were correlated positively with mental health symptoms. Regression analyses found a significant association between occupational stress and mental health symptoms in both frontline and non-frontline medical staff during COVID-19 outbreak. Conclusion: The results indicated that during the COVID-19 epidemic, medical staff experienced higher levels of anxiety, depression and insomnia than citizens, and their occupational stress had positive effects on their psychological distress. These findings emphasize the importance of occupational stress management interventions to decrease the risk of developing mental health problems among the medical staff during a biological disaster.

Survey of Insomnia and Related Social Psychological Factors Among Medical Staff Involved in the 2019 Novel Coronavirus Disease Outbreak

OBJECTIVE

The outbreak of the 2019 novel coronavirus disease (COVID-19) not only caused particularly large public health problems, but also caused great psychological distress, especially for medical staff. We aimed to investigate the prevalence rate of insomnia and to confirm the related social psychological factors among medical staff in hospitals during the COVID-19 outbreak.

METHOD

Medical staff members in China were recruited, including frontline medical workers. The questionnaire, administered through the WeChat program, obtained demographic data and asked self-design questions related to the COVID-19 outbreak, insomnia/depressive/anxiety symptoms, and stress-related symptoms. We used a logistic regression analysis to examine the associations between sociodemographic factors and insomnia symptoms.

RESULT

There were a total of 1,563 participants in our study. Five-hundred-and-sixty-four (36.1%) participants had insomnia symptoms according to the Insomnia Severity Index (ISI) (total score ≥ 8). A multiple binary logistic regression model revealed that insomnia symptoms were associated with an education level of high school or below (OR = 2.69, p = 0.042, 95% CI = 1.0-7.0), being a doctor (OR = 0.44, p = 0.007, 95% CI = 0.2-0.8), currently working in an isolation unit (OR = 1.71, p = 0.038, 95% CI = 1.0-2.8), is worried about being infected (OR = 2.30, p < 0.001, 95% CI = 1.6-3.4), perceived lack of helpfulness in terms of psychological support from news or social media with regard to COVID-19 (OR = 2.10, p = 0.001, 95% CI = 1.3-3.3), and having very strong uncertainty regarding effective disease control (OR = 3.30, p = 0.013, 95% CI = 1.3-8.5).

CONCLUSION

Our study found that more than one-third of the medical staff suffered insomnia symptoms during the COVID-19 outbreak. The related factors included education level, an isolation environment, psychological worries about the COVID-19 outbreak, and being a doctor. Interventions for insomnia among medical staff are needed considering the various sociopsychological factors at play in this situation.