Hospital safety climate, psychosocial risk factors and needlestick injuries in Japan

Analysis of factors associated with needlestick injuries of clinical nurses by applying a human factor analysis and classification system: A nationwide cross-sectional survey

AIMS

This study aims to investigate the current situation of needlestick injuries (NSIs) of clinical nurses and identify associated factors by using the theoretical framework of the human factors analysis and classification system (HFACS).

DESIGN

A nationwide cross-sectional survey was conducted.

METHODS

Multi-stage sampling was used to investigate 3336 nurses in 14 Chinese hospitals. Descriptive statistics and univariate and multivariate logistic regression were employed to reveal the rate of NSIs and their associated factors.

RESULTS

A total of 970 nurses (29.1%) reported having experienced at least one NSI in the past year. The multivariate logistic regression analysis showed that good hospital safety climate and clinical nurses in intensive care unit (ICU) and emergency department had protective effects against NSIs compared with nurses in internal medicine department. The nurse, senior nurse, and nurse in charge have significantly increased the risk for NSIs compared with the associate chief nurse or above. Patients with poor vision but wearing glasses and poor vision but not wearing glasses were more prone to have NSIs. Working in the operating room compared with internal medicine, average weekly working time of >45 h compared with ≤40 h and poor general health led to increased risk of NSIs.

CONCLUSION

The rate of NSIs in clinical nurses was high in China. Individual factors including professional title, department, visual acuity and general mental health and organisational factors including weekly working hours and hospital safety atmosphere were significantly correlated with the occurrence of NSIs.

RELEVANCE TO CLINICAL PRACTICE

Nursing managers should focused on physical and psychological conditions of clinical nurses, and organisational support is required to enhance the hospital safety atmosphere.

NO PATIENT OR PUBLIC CONTRIBUTION

Contributions from patients or the public are irrelevant because this study aims to explore current situation and factors associated with NSIs in clinical nurses.

Interprofessional collaboration mediates the relationship between perceived organizational learning and safety climate in hospitals: A cross-sectional study

BACKGROUND

Organizational learning (OL) and interprofessional collaboration (IPC) are said to enhance medical safety in hospitals, but the relationship between these variables has not been quantitatively tested.

OBJECTIVE

This study examines the mediating effects of IPC on the relationship between OL and safety climate (improvement, compliance, and patient/family involvement).

METHODS

An anonymous self-reporting questionnaire was administered to 1,495 healthcare workers from November 2021 to January 2022. The questions regarded the hospital's safety climate, OL, and IPC. A mediation analysis using structural equation modeling was conducted to examine the mediating role of IPC on the relationship between OL and the three safety climates. The indirect effect was estimated using 2,000 bootstrap samples.

RESULTS

Responses from 643 healthcare workers were analyzed. The direct effects of OL were 𝛽 = .74, 75 (p < .001) on improvement and involvement and 𝛽 = 0.1 (p > .05) on compliance. The indirect effects of IPC on improvement and involvement were 𝛽 = .14 (95%CI: .00 ∼ .06) and 𝛽 = .37 (95%CI: .04 ∼ .09), respectively.

CONCLUSION

This study determined the mechanisms that enhance a hospital's safety climate, demonstrating that IPC mediates the relationship between OL and improvement and patient/family involvement. However, OL and IPC are not related to compliance.

Impact of job control on hospital workers' safety performance: A moderated mediation analysis of the influences of hospital safety climate and social support

AIM

To improve the level of hospital workers' safety performance in response to emergencies (e.g. COVID-19), this paper examines the relationship between hospital workers' job control on safety performance, and the mediating role of hospital safety climate and the moderating role of social support.

DESIGN

In this cross-sectional questionnaire survey, a convenience sampling of hospital workers from three hospitals that have COVID-19 cases from Beijing and Shandong Province in China.

METHODS

These questionnaires were used to obtain self-reported data on hospital workers' job control, hospital safety climate, social support and safety performance. Mplus software was used to calculate CFA. SPSS25.0 software was used to calculate mean values, standard deviations, correlations and regression analyses.

RESULTS

The participants were 241 hospital workers from three hospitals in China (male = 55.2%, female = 44.8%; age range <30 to >45; physician = 58%, nurse = 22%, other hospital worker = 20%). A moderated mediation model among job control, hospital safety climate, social support and safety performance was supported. Moderated mediation analysis indicates hospital workers' job control effectively improves the level of safety performance; hospital safety climate plays a partially mediating role in the process of job control affecting hospital workers' safety performance; social support moderates the effect of work control on medical workers' safety climate. Hence, it is important to increase job control and hospital safety climate. Further, social support for hospital workers should be encouraged, advocated and supported.

Organizational Factors Are Key Predictors of Physicians’ Confidence in Handling Workplace Violence

Many studies have investigated health-care workers’ confidence in handling workplace violence with the aim of preventing negative outcomes and fear of such events. The aim of this cross-sectional study was to identify the predictors of physicians’ confidence in handling workplace violence. A self-administered questionnaire was used to collect data on various factors related to workplace violence against physicians in four regional teaching hospitals in northern Taiwan. Of the 180 respondents, 78 (43.3%) had experienced workplace violence in the 3 months preceding the study; they were assigned to the “victim group”. The others (102 respondents) were assigned to the “nonvictim group”. According to multiple linear regression analysis, the factors significantly associated with physicians’ confidence in handling workplace violence in the victim group were perceived organizational support and workplace violence-related training courses. In the nonvictim group, affiliated department and perceived safety climate were key factors. Organizational factors are key predictors of physicians’ confidence in handling workplace violence. Therefore, hospital managers should strive to bolster physicians’ confidence in handling workplace violence. For victims of workplace violence, team-based trainings may improve their interpersonal skills and perceived support from colleagues, both of which can prevent workplace violence events and the repetition of such events.

Assessing Risks Awareness in Operating Rooms among Post-Graduate Students: A Pilot Study

Background: In this study, we promote a global approach to occupational risk perception in order to improve occupational health and safety training programs. The study investigates the occupational risk perception of operating room healthcare workers using an Analytic Hierarchy Process approach. Methods: A pilot study was carried out through a cross-sectional survey in a university hospital in Southern Italy. An ad hoc questionnaire was administered to enrolled medical post-graduate students working in the operating room. Results: Fifty medical specialists from seven fields (anaesthetists, digestive system surgeons, general surgeons, maxillofacial surgeons, thoracic surgeons, urologists, and gynaecologists) were questioned about perceived occupational risk by themselves. Biological, ionizing radiation, and chemical risks were the most commonly perceived in order of priority (w = 0.300, 0.219, 0.210). Concerning the biological risk, gynaecologists unexpected perceived this risk as less critical (w = 0.2820) than anaesthesiologists (w = 0.3354), which have the lowest perception of the risk of ionizing radiation (w = 0.1657). Conclusions: Prioritization methods could improve risk perception in healthcare settings and help detect training needs and perform sustainable training programs.

A Systematic Review on the Research Progress and Evolving Trends of Occupational Health and Safety Management: A Bibliometric Analysis of Mapping Knowledge Domains

Background: Effective occupational health and safety management (OHSM) is important to employee health, enterprise sustainability, and social stability. However, scientific research into OHSM lags behind practice, and contextualizing OHSM research from the perspective of its historical evolution is urgently required.

Methods: The mapping of knowledge domains, based on bibliometric analysis, was adopted to classify 4,852 journal articles related to OHSM listed in the core database of Web of Science and published between 1900 and 2018.

Results and Conclusions: Risk assessment/management at the organizational level were found to have always been research hotspots, and the relationship between safety culture/atmosphere, sickness absence, and safety performance, among other factors, have become core research topics in the field in recent years. Research at the individual level has gradually evolved from an early focus on physiological problems such as work-related musculoskeletal disorders and low back pain, further toward issues such as occupational stress, mental health, and quality of life. In addition, the results of clustering analysis based on high-frequency keywords indicated six aspects of OHSM: OHSM mode and method; OHSM systems and standards; OHS risk assessment and management; OHSM and safety culture; mental health and quality of life; and specific disease management. Future development trends in OHSM research are described providing theoretical and practical reference for further study.

Factors associated with physicians' behaviours to prevent needlestick and sharp injuries

OBJECTIVE

Needlestick and sharp injuries (NSIs) experienced by physicians have been identified as a major occupational hazard. Blood-borne pathogens resulting from the NSIs experienced by physicians pose severe physical and psychological threats to them, as well as people who are around them. However, there is little research focusing on physicians' behaviours to prevent NSIs. In the present study, we investigated the roles of safety climate, job demands experienced by physicians, and physicians' self-efficacy in affecting physicians' behaviours to prevent NSIs.

METHODS

401 physicians from four teaching hospitals in Northern Taiwan were recruited to participate in an anonymous survey. Among them, 189 physicians returned the completed survey with a response rate of 47.1%.

RESULTS

Overall, respondents reported frequently engaging in NSI prevention behaviours. As expected, safety climate in hospitals and physicians' self-efficacy to prevent NSIs were significantly related to their behaviours to prevent NSIs (r = 0.22 and r = 0.33, respectively). The moderating analysis also revealed that physicians with high self-efficacy tended to engage in NSI prevention behaviours regardless of levels of job demand they experienced. In contrast to our expectation, however, physicians with low self-efficacy engaged in more NSI prevention behaviours when job demands were high than when the demands were low.

CONCLUSIONS

Our findings show the important roles safety climate, job demands and self-efficacy play in shaping physicians' NSI prevention behaviours. Hospitals may consider improving safety climate via strengthening management commitments to NSIs prevention, reducing job demands by training physicians to proactively redesign their own jobs, and increasing physicians' self-efficacy via well-designed skill-based training.

Job stress and needlestick injuries in nurses: a retrospective observational study

Background:

The prevention of needlestick injuries (NSIs) in nurses employed in Emergency Departments (EDs) represents a special issue for healthcare organizations globally. Stressful working conditions, lack of organizational arrangements and lack of supporting one another at work, may contribute to increase the risk of NSIs.

Methods:

We conducted an observational study to analyze: 1) the effectiveness of organizational interventions to minimize the occurrence of NSIs in ED nurses; 2) to measure the impact of such interventions on the safety budget.

Results:

The occurrence of NSIs detected after organizational level interventions was significantly lower than the occurrence observed previously such interventions (p<0,05). By results, cost saving from managing fewer NSIs than the previous period was found.

Conclusion:

The study shows that the proactive, integrated and comprehensive management of organizational features at workplace brings benefits to employees and reduces the burden of the occurrence of NSIs. As result of the reduced NSIs frequency, the overall costs for follow-up of injured workers were reduced. (www.actabiomedica.it)

Estimating the national cost burden of in-hospital needlestick injuries among healthcare workers in Japan

BACKGROUND

Needlestick injury (NSI) is one of the most burdensome professional hazards in any medical setting; it can lead to transmission of fatal infectious diseases, such as hepatitis B, hepatitis C and human immunodeficiency virus. In the United States, the annual cost burden was estimated as somewhere between $118 million to $591 million; in the United Kingdom it is approximated to be £500,000 (US$919,117.65) per the National Health Service.

METHOD

This is the first published paper on the national cost burden of NSIs in Japan. A systematic literature review was conducted to review previous study design in global studies and to extract parameter values from Japanese studies. We conducted abstract searches through PubMed and the Japan Medical Abstracts Society (Ichushi), together with grey literature and snowball searches. A simple economic model was developed to calculate cost burden of NSIs from a societal perspective over a one-year time horizon. We assumed all NSIs are reported and perfect adherence in post NSI management that presented in the labour compensation scheme. Local guidelines were also referenced to extract resource utilization. Lastly, a deterministic sensitivity analysis was conducted and a scenario analysis which considered a payer perspective was also included.

RESULT AND CONCLUSION

The national cost burden of in-hospital NSIs is estimated as ¥33.4 billion (US$302 million) annually, based on an average cost per NSI of ¥63,711 (US$577) and number of NSIs at 525,000/year. 70% of the cost is due to initial laboratory tests, followed by productivity loss, estimated at 20% of the total cost. Cost of contaminated NSIs remains at 5% of the total cost. Change in number of NSIs significantly influences outcomes. Variation in post-exposure management practices suggests a need for NSI specific National guidelines and holistic labour compensation scheme development in Japan.

Predicting needlestick and sharps injuries and determining preventive strategies using a Bayesian network approach in Tehran, Iran

OBJECTIVES

Recent studies have shown that the rate of needlestick and sharps injuries (NSIs) is unacceptably high in Iranian hospitals. The aim of the present study was to use a systematic approach to predict and reduce these injuries.

METHODS

This cross-sectional study was conducted in 5 hospitals in Tehran, Iran. Eleven variables thought to affect NSIs were categorized based on the Human Factors Analysis and Classification System (HFACS) framework and modeled using a Bayesian network. A self-administered validated questionnaire was used to collect the required data. In total, 343 cases were used to train the model and 50 cases were used to test the model. Model performance was assessed using various indices. Finally, using predictive reasoning, several intervention strategies for reducing NSIs were recommended.

RESULTS

The Bayesian network HFACS model was able to predict 86% of new cases correctly. The analyses showed that safety motivation and fatigue were the most important contributors to NSIs. Supervisors' attitude toward safety and working hours per week were the most important factors in the unsafe supervision category. Management commitment and staffing were the most important organizational-level factors affecting NSIs. Finally, promising intervention strategies for reducing NSIs were identified and discussed.

CONCLUSIONS

To reduce NSIs, both management commitment and sufficient staffing are necessary. Supervisors should encourage nurses to engage in safe behavior. Excessive working hours result in fatigue and increase the risk of NSIs.

[Job perception and well-being among healthcare workers in Morocco]

OBJECTIVES

The aim of this study was to evaluate the well-being and occupational perception of healthcare workers in Morocco.

METHODS

This observational and cross-sectional survey, carried out by self-administered questionnaire, was conducted in public hospitals in three cities. The target population consisted of 2,453 healthcare workers, comprising physicians and paramedics with at least two years of clinical experience.

RESULTS

1951 healthcare workers returned the questionnaire (29.4% physicians and 70.6% allied health personnel).The mean age was 40.3 ± 10.1 years. 79.8% drank tea and 59.6% drank coffee daily to remain alert at work. 13.9% were smokers and 5.5% drank alcohol. Medication use consisted of analgesics for 28.1% and psychotropic drugs for 11.6%. The respective prevalence of general health perception was ?bad or very bad? for 14.1% to 24.5%. Perceived symptoms varied from 20.4% to 26.2%. Pain and headache were the most common symptoms. 53.9% ?often and continuously? experienced stress at work. Work requirements were considered to be ?difficult? or ?very difficult? by 32.1% to 46.2%.The workplace was unsuitable for 37.2%, salary was inadequate for 39.4%, the workload was excessive for 39.8% and the work rate was excessive for 43.2%. Relationship with colleagues (work environments and trust) were appropriate for 55.6% and 65%, respectively. Relationships with hierarchical superiors were appropriate for 15.6% and based on confidence for 13.8%. Perceived social support outside of work was high.

CONCLUSION

Assessment of well-being and occupational risk perception among healthcare workers must be one of the priority tasks of occupational health utilities in Moroccan hospitals.

Organizational climate with gender equity and burnout among university academics in Japan

We investigated relationships between the perception of organizational climate with gender equity and psychological health among 94 women and 211 men in a Japanese private university in 2015 using the Copenhagen Burnout Inventory (i.e., personal, work-related and student-related burnout). Perceptions of organizational climate with respect to gender equity were measured with two scales including organizational engagement with a gender equal society in the workplace (consisting of three domains of 'Women utilization', 'Organizational promotion of gender equal society' and 'Consultation service'); and a gender inequality in academia scale that had been previously developed. Multivariable linear models demonstrated significant statistical interactions between gender and perceptions of organizational climate; 'Women utilization' or lack of 'Inequality in academia' alleviated burnout only in women. In consequence of this gender difference, when 'Women utilization' was at a lower level, both personal (p=.038) and work-related (p=.010) burnout scores were higher in women, and the student-related burnout score was lower in women when they perceived less inequality in academia than in men (p=.030). As such, it is suggested organizational fairness for gender equity may be a useful tool to help mitigate psychological burnout among women in academia.

Work Pressure and Safety Behaviors among Health Workers in Ghana: The Moderating Role of Management Commitment to Safety

BACKGROUND

safety and healthy working environment has received numerous research attention over the years. Majority of these researches seem to have been conducted in the construction industry, with little attention in the health sector. Nonetheless, there are couple of studies conducted in Africa that suggest pressure in hospitals. Therefore the aim of the study was to examine how pressure influence safety behavior in the hospitals. With reference to the relevance of safety behavior in primary health care delivery, there was the need for the study.

METHOD

Data was obtained from 422 public hospital employees. Respondents were assured that all information would be kept confidential to increase the response rate and acquire more accurate information. Collection of questionnaires from participants took four weeks (20 working days), after which the data was analyzed.

RESULTS

The result of the study showed that work pressure correlated negatively with safety behavior. General safety climate significantly correlated positively with safety behavior and negatively with work pressure, although the effect size for the latter was smaller. Hierarchical regression analysis showed management commitment to safety to moderate the relationship between work pressure and safety behavior.

CONCLUSION

When employees perceive safety communication, safety systems and training to be positive, they seem to comply with safety rules and procedures than voluntarily participate in safety activities.

Long work hours and chronic insomnia are associated with needlestick and sharps injuries among hospital nurses in Taiwan: A national survey

BACKGROUND

Needlestick and sharps injuries are prevalent work-related injuries among nurses. Safety devices prevent only one-quarter of related injuries. More studies of modifiable risk factors are needed.

OBJECTIVES

To examine whether long work hours and chronic insomnia are associated with needlestick and sharps injuries among hospital nurses in Taiwan.

DESIGN

Cross-sectional survey.

SETTINGS/PARTICIPANTS

This analysis included 19,386 full-time bedside nurses working in 104 hospitals across Taiwan.

METHODS

Participants filled out an anonymous questionnaire from July to September 2014. Chronic insomnia, needlestick injuries, and sharps injuries during the past year were each measured by a yes/no question. Multivariate logistic regression models were applied to examine the effects of long work hours and chronic insomnia on needlestick and sharps injuries, given with control for sex, marital status, educational level, age, years of practice, work unit, and hospital level in the model.

RESULTS

More than 70% of study nurses worked long hours during the previous week (>50h: 27.5%; 41-50h: 43.2%), and 15.5% of nurses reported chronic insomnia. The percentage of sharps injuries (38.8%) was higher than that for needlestick injuries (22.4%) during the previous year among nurses. After adjusting for potential confounders, logistic regression yielded significant results showing that those who worked 41 to 50h per week, >50h per week, and had chronic insomnia were 1.17 times (95% C.I.=1.04-1.32), 1.51 times (95% C.I.=1.32-1.72), and 1.45 times (95% C.I.=1.25-1.68) more likely to experience needlestick injuries, and 1.29 times (95% C.I.=1.17-1.42), 1.37 times (95% C.I.=1.23-1.53), and 1.56 times (95% C.I.=1.37-1.77) more likely to experience sharps injuries, respectively, than those who worked fewer hours and did not have insomnia.

CONCLUSIONS

This nationwide nurse survey showed that high rates of needlestick and sharps injuries persist in hospital nurses in Taiwan. The common problems of long work hours and chronic insomnia increase the risk of these injuries. We suggest that hospital managers follow regulations on work hours and optimize shift schedules for nurses to decrease related injuries.

Working Conditions and Mental Health of Nursing Staff in Nursing Homes

Nursing staff in nursing homes suffer from poor mental health, probably associated with stressful working conditions. Working conditions may distribute differently among nursing assistants, licensed practical nurses, and registered nurses due to their different levels in the organizational hierarchy. The objectives of this study were to evaluate the association between working conditions and mental health among different nursing groups, and examine the potential moderating effect of job group on this association. Self-administered questionnaires were collected with 1,129 nursing staff in 15 for-profit non-unionized nursing homes. Working conditions included both physical and psychosocial domains. Multivariate linear regression modeling found that mental health was associated with different working conditions in different nursing groups: physical safety (β = 2.37, p < 0.05) and work-family conflict (β = -2.44, p < 0.01) in NAs; work-family conflict (β = -4.17, p < 0.01) in LPNs; and physical demands (β = 10.54, p < 0.05) in RNs. Job group did not moderate the association between working conditions and mental health. Future workplace interventions to improve mental health should reach to nursing staff at different levels and consider tailored working condition interventions in different nursing groups.

Wellbeing and occupational risk perception among health care workers: a multicenter study in Morocco and France

Background

The study analyzes health care workers’ (HCWs) occupational risk perception and compares exposure to occupational risk factors in Moroccan and French hospitals.

Method

Across nine public hospitals from three Moroccan regions (north, center and south), a 49 item French questionnaire, based on the Job Content Questionnaire, and 4 occupational risks subscales, was distributed to 4746 HCWs. Internal consistency of the study was determined for each subscale. Confirmatory factor analysis was conducted on the Moroccan questionnaire. Psychosocial job demand, job decision latitude and social support scores analysis was used to isolate high strain jobs. Occupational risks and high strain perception correlation were analyzed by univariate and multivariate logistic regression. A comparative analysis between Moroccan and French (Nantes Hospitals) investigations data was performed.

Results

In Morocco, 2863 HCWs (60 %) answered the questionnaire (54 % women; mean age 40 years; mean work seniority 11 years; 24 % physicians; 45 % nurses). 44 % Moroccan HCWs are at high strain. Casablanca region (1.75 OR; CI: 1.34–2.28), north Morocco (1.66 OR; CI: 1.27–2.17), midwives (2.35 OR; 95 % CI 1.51–3.68), nursing aides (1.80 OR; 95 % CI: 1.09–2.95), full-time employment (1.34 OR; 95 % CI 1.06–1.68); hypnotics, sedatives use (1.48 OR; 95 % CI 1.19–1.83), analgesics use (1.40 OR; 95 % CI 1.18–1.65) were statistically associated to high strain. 44% Moroccan HCWs are at high strain versus 37 % French (Nantes) HCWs (p < 0.001).

Conclusion

Moroccan HCWs have high strain activity. Moroccan HCWs and more Moroccan physicians are at high strain than Nantes HCWs. Moroccan and French’s results showed that full time workers, midwives, workers using hypnotics, and analgesics are at high strain. Our findings underscore out the importance of implementing a risk prevention plan and even a hospital reform. Further research, with an enlarged study pool will provide more information on psychosocial risks (PSR) and HCWs’ health.

Differences in Hospital Managers', Unit Managers', and Health Care Workers' Perceptions of the Safety Climate for Respiratory Protection

This article compares hospital managers' (HM), unit managers' (UM), and health care workers' (HCW) perceptions of respiratory protection safety climate in acute care hospitals. The article is based on survey responses from 215 HMs, 245 UMs, and 1,105 HCWs employed by 98 acute care hospitals in six states. Ten survey questions assessed five of the key dimensions of safety climate commonly identified in the literature: managerial commitment to safety, management feedback on safety procedures, coworkers' safety norms, worker involvement, and worker safety training. Clinically and statistically significant differences were found across the three respondent types. HCWs had less positive perceptions of management commitment, worker involvement, and safety training aspects of safety climate than HMs and UMs. UMs had more positive perceptions of management's supervision of HCWs' respiratory protection practices. Implications for practice improvements indicate the need for frontline HCWs' inclusion in efforts to reduce safety climate barriers and better support effective respiratory protection programs and daily health protection practices.

Incidence and reporting of sharps injuries amongst ENT surgeons

Background:

Sharps injuries are a common occupational hazard amongst surgeons. Limited work has been conducted on their effects within the ENT community.

Methods:

A literature review was performed and a survey on sharps injuries was distributed to the entire membership of ENT-UK electronically.

Results:

The literature review revealed 3 studies, with 2 of them performed more than 20 years ago. A total of 323 completed questionnaires were returned (24 per cent response rate). Of the respondents, 26.6 per cent reported having experienced sharps injuries. There was no statistical difference between the occurrence of sharps injuries and the grade, length of time spent in the specialty or subspecialty of respondents. Only 33.7 per cent of afflicted clinicians reported all their injuries as per local institutional policies. No seroconversions were reported.

Conclusion:

The study found poor evidence on sharps injuries amongst ENT surgeons, and low reporting rates that were comparable to other studies conducted in the UK. This highlights the need for further research and increasing awareness on sharps injuries regulations within the specialty.

Determinants of workplace violence against clinical physicians in hospitals

OBJECTIVES

Workplace violence in the health sector is a worldwide concern. Physicians play an essential role in health-care teamwork; thus, understanding how organizational factors influence workplace violence against physicians is critical.

METHODS

A total of 189 physicians from three public hospitals and one private hospital in Northern Taiwan completed a survey, and the response rate was 47.1%. This study was approved by the institutional review board of each participating hospital. The 189 physicians were selected from the Taipei area, Taiwan.

RESULTS

The results showed that 41.5% of the respondents had received at least one workplace-related physical or verbal violent threat, and that 9.8% of the respondents had experienced at least one episode of sexual harassment in the 3 months before the survey. Logistic regression analysis revealed that physicians in psychiatry or emergency medicine departments received more violent threats and sexual harassment than physicians in other departments. Furthermore, physicians with a lower workplace safety climate (OR=0.89; 95% CI=0.81-0.98) and more job demands (OR=1.15; 95% CI=1.02-1.30) were more likely to receive violent threats.

CONCLUSIONS

This study found that workplace violence was associated with job demands and the workplace safety climate. Therefore, determining how to develop a workplace safety climate and ensure a safe job environment for physicians is a crucial management policy issue for health-care systems.

Psychosocial and occupational risk perception among health care workers: a Moroccan multicenter study

BACKGROUND

International studies on occupational risks in public hospitals are infrequent and only few researchers have focused on psychosocial stress in Moroccan Health Care Workers (HCWs). The aim of this study was to present and analyze Moroccan HCWs occupational risk perception. Across nine public hospitals from three Moroccan regions (northern, central and southern), a 49 item French questionnaire with 4 occupational risks subscales, was distributed to 4746 HCWs. This questionnaire was based on the Job Content Questionnaire. Psychosocial job demand, job decision latitude and social support scores analysis were used to isolate high strain jobs. Occupational risks and high strain perception correlation were analyzed by univariate and multivariate logistic regression.

RESULTS

2863 HCWs (60%) answered the questionnaire (54% women; mean age 40 years; mean work seniority 11 years; 24% physicians; 45% nurses). 44% of Moroccan HCWs were at high strain. High strain was strongly associated with two occupational categories: midwives (2.33 OR; CI 1.41-3.85), full-time employment (1.65 OR; CI 1.24-2.19), hypnotics and sedatives use (1.41 OR; CI 1.11-1.79), analgesics use (1.37 OR; CI 1.13-1.66).

CONCLUSION

Moroccan HCWs, physicians included, perceive their job as high strain. Moroccan HCWs use of hypnotics, sedatives and analgesics is high. Risk prevention plan implementation is highly recommended.

Psychosocial work characteristics and needle stick and sharps injuries among nurses in China: a prospective study

PURPOSE

Psychosocial work characteristics may be associated with needle stick and sharps injuries (NSIs) among nurses. The current evidence is, however, sparse, inconclusive, and mainly limited to cross-sectional investigations. We aimed to contribute prospective data.

METHODS

We conducted a prospective study among 1,791 female hospital nurses from China. At baseline and at a 1-year follow-up, fourteen psychosocial work characteristics were assessed by the short Copenhagen Psychosocial Questionnaire. At follow-up, any NSI in the workplace during the previous year was measured by participants' self-reports. We quantified associations between (1) psychosocial work characteristics at baseline and NSIs at follow-up by multivariate relative risks (Poisson regression) and (2) NSIs reported at follow-up with psychosocial work characteristics at follow-up (multivariate linear regression, among others, adjusted for psychosocial work characteristics at baseline).

RESULTS

The only psychosocial work characteristic associated with a slightly increased risk of subsequent NSIs was quantitative demands. Examining the opposite direction of effect, we found that NSIs during the year preceding the follow-up were associated with slightly worse ratings of seven psychosocial work characteristics at follow-up (i.e., influence at work, meaning of work, commitment to the workplace, quality of leadership, social support, social community at work, and job insecurity).

CONCLUSIONS

Overall, our study does not provide compelling evidence for an association of psychosocial work characteristics and subsequent occurrence of NSIs. By contrast, experience of NSIs may predict less favorable perceptions of psychosocial work characteristics.

Dimensions and reliability of a hospital safety climate questionnaire in Chinese health-care practice

The aim of the current study was to examine the dimensions and reliability of a hospital safety climate questionnaire in Chinese health-care practice. To achieve this, a cross-sectional survey of health-care professionals was undertaken at a university teaching hospital in Shandong province, China. Our survey instrument demonstrated very high internal consistency, comparing well with previous research in this field conducted in other countries. Factor analysis highlighted four key dimensions of safety climate, which centred on employee personal protection, employee interactions, safety-related housekeeping and time pressures. Overall, this study suggests that hospital safety climate represents an important aspect of health-care practice in contemporary China.

Patient safety climate and worker safety behaviours in acute hospitals in Scotland

OBJECTIVES

To obtain a measure of hospital safety climate from a sample of National Health Service (NHS) acute hospitals in Scotland and to test whether these scores were associated with worker safety behaviors, and patient and worker injuries.

METHODS

Data were from 1,866 NHS clinical staff in six Scottish acute hospitals. A Scottish Hospital Safety Questionnaire measured hospital safety climate (Hospital Survey on Patient Safety Culture), worker safety behaviors, and worker and patient injuries. The associations between the hospital safety climate scores and the outcome measures (safety behaviors, worker and patient injury rates) were examined.

RESULTS

Hospital safety climate scores were significantly correlated with clinical workers' safety behavior and patient and worker injury measures, although the effect sizes were smaller for the latter. Regression analyses revealed that perceptions of staffing levels and managerial commitment were significant predictors for all the safety outcome measures. Both patient-specific and more generic safety climate items were found to have significant impacts on safety outcome measures.

CONCLUSION

This study demonstrated the influences of different aspects of hospital safety climate on both patient and worker safety outcomes. Moreover, it has been shown that in a hospital setting, a safety climate supporting safer patient care would also help to ensure worker safety.

IMPACT ON INDUSTRY

The Scottish Hospital Safety Questionnaire has proved to be a usable method of measuring both hospital safety climate as well as patient and worker safety outcomes.

Occupational Exposure to Sharp Instrument Injuries among Dental, Medical and Nursing Students in Mahatma Gandhi Mission's Campus, Navi Mumbai, India

Background

Sharp instrument injuries among health care students significantly increase the risk of transmission of different blood-borne pathogens which can lead to serious consequences including death.

Objectives

The study was carried out to determine the prevalence and factors associated with sharp instrument injuries among the health care students in the Mahatma Gandhi Mission's Campus, Navi Mumbai and to make recommendations to the institutional authorities about measures to be undertaken to prevent such injuries among the students.

Materials and Methods

A cross-sectional questionnaire study was conducted among 700 health care students which included dental, medical and nursing students during their clinical training at Mahatma Gandhi Mission's Campus, Navi Mumbai from May 2012 to July 2012. It was a self-administered questionnaire with a 1-year recall period for sharp instrument injury. The data was analyzed using descriptive statistics and Chi-square test.

Results

The questionnaire was completed by 627 students of which 76.4% of nursing, 75.4% of dental and 48.7% of the medical students had experienced sharp instrument injuries in the past 1 year with hollow-bore needle being the most common instrument causing such injuries. Overall, 77.4% of the students had not reported the incident of the injury and only 34.4% of the students had taken postexposure prophylaxis.

Conclusion

Educational interventions with effective training on proper handling and disposal of sharp instruments and postexposure prophylaxis along with the formation of a reporting center are some of the recommendations which can reduce the occupational exposure to sharp instrument injuries among the health care students.

How to cite this article

Hussain JSA, Ram SM, Galinde J, Jingade RRK. Occupational Exposure to Sharp Instrument Injuries among Dental, Medical and Nursing Students in Mahatma Gandhi Mission's Campus, Navi Mumbai, India. J Contemp Dent 2012;2(2):1-10.