Dissertation submitted in partial compliance with the requirements for the Masters Degree in Technology: Chiropractic, Durban Institute of Technology, 2005. / Emergency medical personnel have a number of occupational risk factors that are listed in the reviewed literature (Davis and Heaney 2000, Volinn 1997 and Andersson 1999) as risk factors for low back pain. Physical lifting and carrying of patients and equipment increases stress on the lower back, while occupational stress and a high level of patient responsibility are mental risk factors (Davis and Heaney, 2000). Emergency medical personnel that spend long hours in response vehicles, ambulances or helicopters are exposed to vibrational stressors and may therefore have an increased risk of low back pain due to this whole body vibration (Palmer et al, 2000). In addition it has been noted that the number of motor vehicle accidents will also increase the risk of low back pain due to mechanical injury (Cassidy et al, 2003). Low back pain could therefore interfere with their ability to carry out their duties, affect their attitude towards patients and colleagues, impact on the level of patient care required of them, and result in increased absenteeism. Persistence of chronic low back with the inability to perform their duties may result in the need to find alternative employment or result in premature dismissal. The objectives of this study were: to determine if emergency medical personnel have a higher risk factor for the development of low back pain due to their occupation than the general population; as well as determine if an increase in the number of years working in the field (i.e. years of exposure) leads to an increased incidence and / or prevalence of low back pain. / M

published_or_final_version / Public Health / Master / Master of Public Health

Thesis (M.Tech.:Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 126 leaves, Annexures A-N / Emergency medical personnel have a number of occupational risk factors that are listed in the reviewed literature (Davis and Heaney 2000, Volinn 1997 and Andersson 1999) as risk factors for low back pain. Physical lifting and carrying of patients and equipment increases stress on the lower back, while occupational stress and a high level of patient responsibility are mental risk factors (Davis and Heaney, 2000). Emergency medical personnel that spend long hours in response vehicles, ambulances or helicopters are exposed to vibrational stressors and may therefore have an increased risk of low back pain due to this whole body vibration (Palmer et al, 2000). In addition it has been noted that the number of motor vehicle accidents will also increase the risk of low back pain due to mechanical injury (Cassidy et al, 2003). Low back pain could therefore interfere with their ability to carry out their duties, affect their attitude towards patients and colleagues, impact on the level of patient care required of them, and result in increased absenteeism. Persistence of chronic low back with the inability to perform their duties may result in the need to find alternative employment or result in premature dismissal. The objectives of this study were: to determine if emergency medical personnel have a higher risk factor for the development of low back pain due to their occupation than the general population; as well as determine if an increase in the number of years working in the field (i.e. years of exposure) leads to an increased incidence and / or prevalence of low back pain.

published_or_final_version / Community Medicine / Master / Master of Public Health

published_or_final_version / Nursing Studies / Master / Master of Nursing in Advanced Practice

Hospitals have been directed by the Centers for Disease Control and Prevention and the Occupational Safety and Health Administration to educate health care workers about bloodborne pathogens. The purpose of this descriptive study is to assess the knowledge and concerns of health care workers regarding bloodborne pathogens and describe the application of universal precautions in practice.Orem's Theory of Self-Care was used for the framework because nurses are self-care agents, responsible for personal well-being, as well as patient's well-being. The instrument "Bloodborne Pathogens and Universal Precautions Test" was used to collect the data (Jones & Ryan, 1992). A convenience sample of twelve hospitals within the state of Indiana with four hundred-fifty licensed nursing personnel responded to the questionnaire.Findings revealed a mean score of 84.5 on the knowledge scale. Perception of availability of supplies and equipment ranged from consistently available (68.5% to 98.7%) to never available (0.0% to 0.9%). Perception of application of universal precautions ranged from consistently applied (32.4% to 84.0%) to never applied (0.0% to 9.5%). Content analysis of concerns related by health care workers included fear of contagion and accidental injury.Conclusions indicated knowledge of transmission and availability of supplies do not ensure compliance with universal precautions. Increased knowledge levels will decrease, but not eliminate, fear of contagion.Universal precaution training alone does not adequately prepare health care workers for HIV/AIDS patients. On-going educational endeavors are needed, including affective concerns. / School of Nursing

Background: Healthcare workers’ hand hygiene remains a key pillar because it prevents and controls healthcare associated infections. Healthcare Workers’ hand hygiene compliance is suboptimal. Aim: The study developed contextualised guidelines for Healthcare Workers’ hand hygiene and infection control in patient care. Methods: The Precede-Proceed model with Theory of Planned Behaviour guided the study. The study was conducted following the mixed methodology approach, observational survey, exploratory, descriptive and contextual in nature study with mixed thematic analyses in a research wheel process. Data were collected through direct participant observation of hand hygiene opportunities through observing (n=95 Healthcare Workers; n=570 practices). Self-administered questionnaires were used to collect data from Healthcare workers (n=189) regarding challenges they faced in achieving hand hygiene. Structured interviews were conducted with patients (n=574). Retrospective reviews of healthcare associated infections and their associated mortalities were carried out from mortality records. Data were analysed retrospectively. Partly the data were statistically and mixed thematically analysed. Guidelines were developed using intervention alignment throughout, mapping, matching, pooling, patching and validation corroborated with Precede-Proceed models’ best practices. The study was ethically reviewed and approved by University of South Africa and the Medical Research Council of Zimbabwe project numbers, 6067662 and MRCZ/B/208. Results: Hand hygiene non-compliances were mostly found in the following contexts, after touching patients’ surroundings, and before doing an aseptic procedure. A non-hand hygiene compliance of Healthcare workers 167(29.3%) and compliance 403(70.7%) in context was suboptimal with sad patients and challenges faced by Healthcare workers. Conclusion: Healthcare Workers had gaps in hand hygiene compliance and availability of required resources. Gaps were also noted in ongoing hand hygiene promotion educational strategies and guidelines to comply and prevent. Guidelines to enhance hand hygiene included, attend to hand hygiene strictly after touching patient surroundings, bed linen, lockers and curtains to prevent gastroenteritis; follow standard precautions against HCAIs from spreading to patients' environments; and comply with hand hygiene guidelines, policies and regulations for best practice with patients. The study contributes generalisable knowledge. / Health Studies / D. Litt et Phil. (Health Studies)

The study investigated knowledge, attitudes and vaccination status of registered nurses regarding prevention and control of hepatitis B (HB). An analytical, cross-sectional study was conducted, and data was collected using self-administered questionnaires. 53.0% of the respondents (n=219) had good knowledge and 96.3% had positive attitudes regarding HB prevention and control. 86.8% had received at least 1 dose of the HB vaccine, but only 54.7% had received the 3 doses for complete vaccination. A positive attitude score was a significant predictor of HB vaccination uptake (OR=1.424, p=0.003). Female registered nurses were 3.479 times (95% CI: 1.495-8.098; p=0.004) more likely to be vaccinated than male registered nurses. Registered nurses are aware that hepatitis B virus infection can be prevented by a safe and effective vaccine, however, there is need to improve awareness and encourage complete HB vaccination uptake among all registered nurses to ensure their protection against the risk of HBV infection. / Health Studies / M. P. H. (Health Studies)

Critical Incident Stress has the potential to affect emergency services personnel to the degree that it can change the way the responder acts and reacts in all facets of his or her life, including the job and his or her family. Research into these potential effects has produced a greater understanding of the responders experiences within a short period of time after the perceived critical incident. This study investigates the long-term effects of critical incident stress among emergency responders from two cities in the three emergency services professions were interviewed to determine what their experiences were at least six months post critical incident. A structured incident had in three areas of teh emergency responders lives: impact on job, impact on the individual responder, and perceived impact on emergency responders families. For particpants, symptoms of Critical Incident Stress lasted between 6 months and 2 years after the perceived critical incident. Analysis of the data indicatees that single responder critical incidents have the potential to negatively affect emergency responders resulting in the loss of enthusiasm and passion for their work, debilitating psychological distress, and isolation from valued support systems. Long-term effects of Critical Incident Stress change the perceptions that responders have about the job, about themselves, and the relationships with their families. The culture of emergency services, changing identities, and the lack of support from both within the system and outside of the system were seen as variables that contribute to the long-term effects of Critical Incident Stress. / xi, 181 leaves ; 29 cm.

The purpose of the study was to describe the determinants and practice of HIV self-testing among health care workers (HCWs) in Nyeri provincial hospital, Kenya. A descriptive cross-sectional study was conducted to determine the rate of HIV self-testing, explore the factors influencing the practice and describe access to HIV psychosocial support, care and treatment. The study was guided by the concepts of the protection motivation theory. Data was collected from 348 HCWs and analysed by means of logistic regression. Results showed that 65.8% of the HCWs had practiced HIV self-testing among themselves. Age, self efficacy and response efficacy were found to be significant predictors of HIV self-testing. Willingness to access HIV psychosocial support (71.3%) and care and treatment (73.9%) was high. Self-testing is highly practiced by HCWs. / HIV self-testing among health care workers at Nyeri Provincial Hospital in Kenya / HIV self-testing among health care workers / Public Health / M.A. (Public Health)