Compliance with standard precautions among operating room nurses in South Korea

Compliance of healthcare workers in a psychiatric inpatient ward to infection control practices during the COVID-19 pandemic: a participant observation study supplemented with a self-reported survey

BACKGROUND

As an emerging infectious disease with a heterogenous and uncertain transmission pattern, coronavirus disease 2019 (COVID-19) has created a catastrophe in healthcare-associated infections (HAIs) and posed a significant challenge to infection control practices (ICPs) in healthcare settings. While the unique characteristics of psychiatric patients and clinical settings may make the implementation of ICPs difficult, evidence is lacking for compliance with ICPs among healthcare workers (HCWs) in a psychiatric setting during the COVID-19 pandemic.

METHODS

A cross-sectional multi-method study based on participant unobtrusive observation coupled with the completion of a self-administered ICP survey was conducted to assess compliance with ICPs among HCWs in a psychiatric inpatient ward in a regional hospital. An online checklist, called eRub, was used to record the performance of HCWs in hand hygiene (HH) and other essential ICPs. Furthermore, a well-validated questionnaire (i.e., Compliance with Standard Precautions Scale, CSPS) was used to collect the participants' self-reported ICP compliance for later comparison.

RESULTS

A total of 2,670 ICP opportunities were observed from January to April 2020. The overall compliance rate was 42.6%. HCWs exhibited satisfactory compliance to the wearing of mask (91.2%) and the handling of clinical waste (87.5%); suboptimal compliance to the handling of sharp objects (67.7%) and linen (72.7%); and poor compliance to HH (3.3%), use of gloves (40.9%), use of personal protective equipment (20%), and disinfection of used surface/area (0.4%). The compliance rates of the nurses and support staff to HH were significantly different (χ2 = 123.25, p < 0.001). In the self-reported survey, the overall compliance rate for ICPs was 64.6%.

CONCLUSION

The compliance of HCWs in a psychiatric inpatient ward to ICPs during the COVID-19 pandemic ranged from poor to suboptimal. This result was alarming. Revisions of current ICP guidelines and policies that specifically target barriers in psychiatric settings will be necessary.

Occupational Prevention of COVID-19 Among Healthcare Workers in Primary Healthcare Settings: Compliance and Perceived Effectiveness of Personal Protective Equipment

OBJECTIVES

It is crucial for healthcare workers (HCWs) to comply with infection prevention and control precautions such as the appropriate use of personal protective equipment (PPE) for their safety and the safety of patients. In this study, we aimed to assess HCWs' compliance with the appropriate use of PPE in primary healthcare settings in Qatar along with its associated factors and explore their perceived effectiveness of different PPE items in protecting against COVID-19 infection.

METHODS

A Web-based survey was conducted between November 2020 and January 2021 targeting all clinical HCWs under the umbrella of Primary Health Care Corporation.

RESULTS

A total of 757 HCWs completed the survey, and most were between 30 and 39 years of age (50.2%), females (62.7%), and nurses (35.3%). Eighty eight percent of participants believed that PPE could provide high or very high protection against COVID-19. About one-half (53%) were found to be fully compliant with PPE use during patient interactions with suspected or confirmed COVID-19 cases, whereas three-quarters (76.3%) were fully compliant while performing aerosol-generating procedures. Healthcare workers' age, nationality, health center region, area of work, clinical experience, frequency of interaction with suspected or confirmed COVID-19 cases, and the perceived effectiveness of PPE were significant predictors of full compliance with PPE. Shortage of PPE was the commonest reported barrier to appropriate use.

CONCLUSIONS

Despite HCWs' high perceived effectiveness for PPE in protecting against COVID-19 infection, their full compliance rate with using PPE was moderate and needs further improvement.

Knowledge and Perceived Effectiveness of Infection Prevention and Control Measures Among Health Care Workers During the COVID-19 Pandemic: A National Survey

BACKGROUND

Being the first line of defense against COVID-19 infection, health care workers (HCWs) are at an increased risk of getting infected. Infection prevention and control (IPC) measures were deemed to be instrumental in protecting them and their patients against infection.

PURPOSE

To assess HCWs' knowledge of IPC measures and their perceived effectiveness in protecting against COVID-19.

METHODS

A national web-based survey was conducted in different health care sectors in Qatar.

RESULTS

A total of 1757 HCWs completed the survey. HCWs believed in applying stricter IPC precautions while dealing with confirmed COVID-19 cases than with suspected cases. Males and physicians were more likely to have high perceived effectiveness of IPC measures than females, nurses, and pharmacists. Higher proportions of HCWs believed in the effectiveness of hand hygiene than most types of personal protective equipment.

CONCLUSION

Further research is recommended to assess the impact of HCWs' knowledge and perceived effectiveness of IPC measures on their compliance.

Compliance and barriers to the use of infection prevention and control measures among health care workers during COVID-19 pandemic in Qatar: A national survey

AIM

To assess health care workers' compliance with infection prevention and control measures in different health care sectors in Qatar during COVID-19 pandemic.

BACKGROUND

Being the first line of defense against COVID-19 infection, health care workers are particularly at increased risk of getting infected. Compliance with infection prevention and control measures is essential for their safety and the safety of patients.

METHODS

A web-based national survey was conducted between November 2020 and January 2021 targeting all health care workers in governmental, semi-governmental, and private health care sectors.

RESULTS

Of 1757 health care workers, 49.9% were between 30-39 years of age, majority (47.5%) were nurses. Participants reported a significant increase in the median self-rated compliance scores during the pandemic compared to before it (p<0.001). During the pandemic, 49.7% of health care workers were fully compliant with personal protective equipment (PPE) use, 83.1% were fully compliant with hand hygiene. Overall, 44.1% were fully compliant with infection prevention and control measures (PPE and hand hygiene). Nationality, health sector, profession, and frequency of interactions with suspected or confirmed COVID-19 cases were significantly associated with compliance with overall infection prevention and control measures. The most reported barriers were work overload, and shortages of PPE and handwashing agents.

CONCLUSIONS

Compliance of health care workers with infection prevention and control measures needs further improvement.

IMPLICATIONS FOR NURSING MANAGEMENT

Frequent quality checks, provision of adequate supplies, and behavior change interventions are recommended strategies for hospital and nursing administrators to improve health care workers' compliance.

Interdisciplinary differences in needlestick injuries among healthcare professionals in training: Improving situational awareness to prevent high-risk injuries

BACKGROUND

Needlestick injuries among healthcare professionals continue to be an occupational hazard, frequently and incorrectly regarded as low-risk, and exacerbated by underreporting. We aimed to investigate rates of needlestick injury, reasons for underreporting, and how explicit announcements that patients are "high-risk" (i.e., human immunodeficiency virus, hepatitis, or intravenous drug abuse history) might affect the actions of those at risk of sustaining an injury.

METHODS

A cross-sectional survey was administered to medical students (MS), nursing students (NS), and residents.

RESULTS

30/224 (13%) of MS, 6/65 (9%) of NS, and 67/126 (53%) of residents experienced needlestick injuries. 37% of MS, 33% of NS, and 46% of residents attributed "lack of concentration" as cause of injury. Residents had the lowest percentage of underreporting (33%), with rates of 40% and 83% among MS and NS, respectively. Top reasons for non-reporting included the injury being perceived as "trivial" (22%) and patient being "low-risk" (18%). A majority stated pre-operative "high-risk" announcements should be required (91%), and would promote "culture of safety" (82%), reporting of injuries (85%), and increased concentration during procedures (70%).

CONCLUSIONS

We recommend routine announcements during pre-operative time-out and nursing/resident hand-offs that state a patient is "high-risk" if applicable. We hypothesize such policy will promote a "culture of safety," situational awareness, and incident reporting.

Studying During the COVID-19 Pandemic: A Qualitative Inductive Content Analysis of Nursing Students’ Perceptions and Experiences

Coronavirus disease 2019 (COVID-19) is the latest pandemic with a high rate of morbidity and mortality worldwide. Crises like these can harm the academic functioning and psychophysical health of nursing students. With this qualitative study, we aim to explore how students perceive the COVID-19 crisis and what their personal experiences were while studying during the global pandemic. In the study, data saturation was achieved after analyzing the reports of 33 undergraduate nursing students, using the inductive thematic saturation method. Data were collected using an online form, which students filled out, describing their perceptions and experiences. Qualitative inductive content analysis of students’ reports resulted in 29 codes, indicating different student perceptions of the efficiency of state institutions in crises. All students described the spread of misinformation on social networks and the risky behavior of the population. Most are afraid of infection and worried about the well-being of their family, so they constantly apply protective measures. Students recognize their responsibility to the community and the importance and risks of the nursing profession. They also describe negative experiences with public transportation and residence in the student dorm. The fear of possible infection in the classroom is not significant, however, students are afraid of the clinical settings. Thirteen students reported difficulty in concentrating and learning, while all students praised teacher support and faculty work in this crisis.

Exploratory Study on Occupational Health Hazards among Health Care Workers in the Philippines

BACKGROUND AND PURPOSE

Healthcare workers are prone to occupational hazards. The study aims to identify the occupational health hazards among healthcare workers in the Philippines and its essential relevant developmental framework. This article evolved on the responses of participants on how they can improve strategies and barriers for healthcare workers to comply with Occupational Health and Safety (OSH).

METHODS

A qualitative study design in which 15 healthcare workers from nurses (4), pharmacists (3), medical technologies (4) and medical doctors (4) participated: two focus group of three to four participants each and eight in-depth interviews. The thematic sessions were identified, including occupational health and safety policy implementations, hazards experiences, barriers, and strategies for quality improvement for OSH. Focus groups and interviews using transcript-based analysis were identified relating to emerging themes on the challenges they had experienced while accessing provisions of OSH in their workplace.

RESULTS

Majority of the participants revealed the existence of policy on Occupational Health and Safety (provisions, guidelines and regulations on OHS from the government) and mentioned that there were limited OHS officers to supervise the healthcare workers in their workplace. Some have limited accessibility to the requirements of the implementation of OHS (free facemasks, gloves, disinfectants, machines, OSH staff, etc.) among healthcare workers, while the workload of the staff in the implementation of OHS in the workplace gradually increased. The results indicated that the respondents were knowledgeable in the implementation of OHS in the workplace, and that there was no existing ASEAN framework on the protection and promotion of the rights of healthcare workers in their workplace. Facilities need to improve health assessment, and to ensure constant evaluation of the existing laws for healthcare workers (quality assurance of existing policies) in their working areas. Direct access to OSH officers, occupational hazards education, emergency contact etc. must be improved. Adherence must be strengthened to fully comply with the OHS standards.

CONCLUSION

The researchers inferred that issues and concerns regarding compliance on provisions of occupational health and safety among health care workers must be properly addressed through immediate monitoring and reevaluation of personnel in terms of their knowledge and practices in OHS. Barriers and challenges have been identified in the study that can lead to improved compliance among healthcare workers in regards to OHS.

Factors influencing preventive behavior against Middle East Respiratory Syndrome-Coronavirus among nursing students in South Korea

BACKGROUND

Middle East Respiratory Syndrome Coronavirus (MERS-CoV), an emerging infectious disease introduced in South Korea in 2015, spreads quickly through hospitals, and Korea became one of the major areas affected by the disease after the Middle East region. To stop the spread of an emerging disease, it is important to practice prevention guidelines correctly.

OBJECTIVES

The purpose of this study was to investigate factors influencing preventive behavior against MERS-CoV among Korean nursing students.

METHODS

This is a cross-sectional study using a questionnaire survey. Data were collected from 429 nursing students from three colleges of nursing in Korea from June 25 to July 3 in 2015.

RESULTS

Preventive behavior against MERS-CoV was affected mostly by attitude (β=.243, p<.001). Such behavior was also high in relation to the variables of perceived risk (β=.232, p<.001), older students (β=.202, p<.001), knowledge level (β=.153, p<.01), and female respondents (β=.115, p<.05).

CONCLUSION

Preventive behavior against emerging infectious diseases such as MERS-CoV was found to be affected most significantly by attitude and risk perception. It is crucial to provide nursing students with information or knowledge, but it is also important to help those in nursing education recognize that active preventive behavior can prevent this infectious disease and stop its spread.

Compliance of Jordanian registered nurses with infection control guidelines: a national population-based study

BACKGROUND

This national study aims to evaluate compliance of Jordanian staff nurses with infection control guidelines.

METHODS

Cross-sectional, descriptive design was used. Proportional-multistage, probability sampling was used to obtain a sample of 10% of all staff nurses working in Jordanian hospitals. Standardized self-reported instruments were used to evaluate the compliance.

RESULTS

The total sample consisted of 22 hospitals, of which 8 were governmental, 7 military, 5 private, and 2 university-affiliated hospitals. Of the total 889 participating nurses, 52.6% were females, 81.9% holding a bachelor degree. The mean age was 29.0 years (standard deviation [SD] = 5.9) with a mean of experience of 6.9 years (SD = 5.8). According to the scale categories, 65.0% of participants demonstrated "high compliance," 32.3% "weak compliance," and 2.7% "unsafe compliance." Nurses who received infection control training in the hospital demonstrated higher compliance (mean = 120.2, SD = 13.6); than those who never received such training (mean = 115.8, SD = 15.2), P < .001. Nurses who work in university affiliated hospitals demonstrated higher compliance than other types of hospital (P < .001).

CONCLUSION

This study provides information about infection control practices in various health care sectors in Jordan. Results from this study expected to guide efforts to develop educational tools, programs, and curricula to improve infection control practices in Jordan.

Instruments for evaluating compliance with infection control practices and factors that affect it: an integrative review

AIMS AND OBJECTIVES

To search for instruments to measure compliance with infection control practices and to report on which dimensions and contents the instruments evaluate, their psychometric characteristics, compliance and factors influencing compliance.

BACKGROUND

Low compliance with infection control practices has been reported among healthcare professionals around the world over the years. Existing data concerning health professionals' compliance with standard precautions are based on measuring instruments.

DESIGN

Integrative review.

METHODS

The descriptors were identified and used separately and in combination to search in the following databases: Lilacs, PubMed (MEDLINE), ISI Web of Knowledge, Scopus and CINAHL. The selected articles complied with inclusion and exclusion criteria.

RESULTS

Twenty-three studies were analysed, resulting in the identification of 18 instruments. No instrument addressed all compliance topics, and the most commonly addressed topics were the use of personal protective equipment, hand hygiene and safe practices in the handling of cutting material. Most authors explored content validity and some performed reliability analysis by means of Cronbach's alpha and test-retest. Countries in the sample have different human development indices, and countries with medium and low human development indices show less compliance. Some variables were strong predictors of compliance: training, perceptions of safe environment, perception of obstacles to comply with standard precautions and knowledge.

CONCLUSIONS

Compliance is below the recommended levels. Health professionals seem to be selective in following standard precautions. Significant influences include institutional management and psychosocial variables, which deserve further study.

RELEVANCE TO CLINICAL PRACTICE

Health managers and government policies and interventions should pay greater attention to this subject.

Use of hands-free technique among operating room nurses in the Republic of Korea

BACKGROUND

The recently introduced concept of hands-free technique (HFT) currently has no recommendations or formal educational program for use in the Republic of Korea. This study evaluated the level of HFT use and investigated factors related to HFT use among Korean operating room nurses.

METHOD

Data were obtained through a self-administered questionnaire from 158 operating room nurses in 7 general hospitals in Busan, Republic of Korea, in April and May 2006. The questionnaire elicited information on demographics, exposure to education on HFT, attitude toward the need for HFT, concerns about exposure to bloodborne pathogens, and experience with HTF use. Multilevel multiple logistic regression analysis with generalized estimating equations was used, and adjusted odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated.

RESULTS

We found that 56% of the participants had used HFT, and 50% had received education on HFT. The use of HFT had a significant association with both education on HFT (OR = 12.02; 95% CI = 7.50 to 19.25) and attitude toward the need for HFT (OR = 4.22; 95% CI = 2.43 to 7.35).

CONCLUSION

Increasing education about HFT could be the most important approach to increasing the use of HFT among Korean operating room nurses. Thus, routine teaching about HFT should be provided to these nurses.