Thesis (MPH) -- University of Limpopo, 2011. / Background: Health care workers (HCWs) are prone to occupational exposures to blood-borne viruses (BBVs), which include hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). Post exposure prophylaxis (PEP) is available for both HBV and HIV, and if administered correctly can reduce the risk of HBV and HIV transmission by 80%. This study investigated the knowledge and practices of HCWs regarding PEP for BBVs at Medunsa Oral Health Care Centre (MOHC). Methods: This was a cross sectional study conducted among 166 HCWs at the MOHC using a self-administered, anonymous questionnaire on knowledge and practices of HCWs regarding PEP for BBVs. Binary logistic regression method was used to determine factors associated with reporting an occupational exposure and uptake of PEP. Results: The response rate was 67%. The mean age was 27yrs (SO =7.67yrs), and 68.7% of . respondents were female. The overall knowledge regarding PEP among the HCWs was inadequate as 46.9% had poor knowledge. The majority (77.7% [128/166]) of HCWs experienced occupational exposures and amongst them 39.0% (50/128) experienced it twice or more. Almost two-thirds (60.9%) of HCWs experienced an occupational exposure while performing scaling and polishing. Only 28.9% (37/128) of those who were potentially exposed to a BBV reported the incident to the authorities. Out of those who reported, 37% (14/37) took PEP for HIV, and 32.4% (12/37) took PEP for HBV. Among those taking HIV PEP, 21.4% (3/14) indicated that they completed the course. HCWs who haq five or more years of experience j were less likely (OR=0.138, p=0.043) to report compared to those who had less than five years of experience. Conclusion: Overall, participants' knowledge regarding PEP as well as reporting of an exposure was inadequate. The majority of HCWs experienced an occupational exposure while performing scaling and polishing.

M.Tech.

Thesis (MPH) -- University of Limpopo, 2012. / SUMMARY OCCUPATIONAL INJURIES AND DISEASES AMONGST HEALTHCARE WORKERS OF THE DEPARTMENT OF HEALTH IN LIMPOPO PROVINCE AIM: To analyse and provide data on the incidence of occupational injuries and the prevalence of occupational diseases amongst healthcare workers of Department of Health in Limpopo Province. OBJECTIVES: The specific objectives of the study were as follows: 1. To determine the most common occupational types of injuries and/or diseases amongst healthcare workers with regard to the demographic profile (i.e. age, gender, occupation, workstation) of healthcare workers; 2. To establish outcomes of these injuries and diseases fatalities regard to the demographic profile (i.e. age, gender, occupation, workstation) of healthcare workers; and 3. To assess the association between the predominant injuries and diseases with the profile of the health care workers METHOD: The researcher sourced data electronically from Department of Health as quarterly reports, four (4) for each year of the financial years 2007/2008, 2008/2009 and 2009/2010 respectively. The data was consolidated into financial years, cleaned out part of 2007 and 2010 so at to remain with 3 calendar years (2007, 2008 &2009) prior analysis. RESULTS: There were 725 per 100 000 healthcare workers affected by injuries and diseases during the study period. These injuries/and diseases affected more males than females above 40 years with the mean age being 43 years. Of the 631 injuries and diseases reported, 89% were injuries whist 11 % were diseases with most employees from Mopani district. The most common injuries which affected HCWs thus included needle stick injuries (24%), slip/trip/fall (23%), motor vehicle accidents (14%), injuries by external objects (10%) and assaults (7%). The most common diseases which affected HCWs were found to be TB (69%), diseases by chemical agents (12%), cholera (9%) and poisoning (2%). The needle stick injury affected clinical nurses (59%) more than other professionals; moreover, TB affected 63.6% of nurses. The captured outcome of this injury/disease was 4 fatalities among EMS personnel. CONCLUSION: In conclusion, this study demonstrates that tuberculosis is the most common occupational disease acquired whilst needle stick injury is the commonest occupational injury sustained by healthcare workers of the Department of Health, Limpopo Province. The employees were therefore affected by preventable occupational injuries and diseases. RECOMMENDATIONS: Preventative programs need to be strengthened to reduce morbidity of tuberculosis and needle stick injuries amongst employees.

Abstract Background: Foot screening is an important part of diabetic care as it prevents significant morbidity, loss of function and mortality from diabetic foot complications. However, foot screening is often neglected. This project was aimed at educating health care workers (HCWs) in a primary health care clinic to increase diabetic foot screening practices. Methods: A quality improvement project using a plan, do, study, act (PDSA) cycle was used. HCW needs were assessed using a questionnaire; this was followed by a focus group discussion with HCWs, which was recorded, transcribed and assessed using a general inductive approach for common themes. Staff training was done using the Diabetic Foot Assessment Questionnaire. Patient information pamphlets and screening tools were made available to all clinical staff. Thirty-two consecutive diabetic patient folders were audited to compare screening in 2013 to that in the first half of 2014 after initiation of the PDSA cycle. Results: HCW confidence in conducting foot screening using the Diabetic Foot Assessment Questionnaire improved markedly after initial training. Diabetic foot screening practices increased from 9% in 2013 to 69% in 2014 after the first PDSA cycle. A strengths, opportunities, aspirations and results (SOAR) analysis showed promise for continuing quality improvement cycles. Conclusions: The findings showed a significant improvement in the number of diabetic patients who received foot screening. A feedback session was held with the team of HCWs involved in the project to discuss their experience and for future improvement planning. Using strategic planning with appreciative intent based on SOAR, proved to be inspirational and will be used in the planning of the next cycle.

M.P.H., Faculty of Health Sciences, University of the Witwatersrand, 2008. / The purpose of the study is to ascertain the knowledge, attitudes and practices of hospital management at the Johannesburg Hospital regarding disaster preparedness. Objectives: The study is to assess the current status of awareness of the management regarding disaster preparedness; to determine whether there are hospital specific plans; knowledge of whether the plans are regularly updated or not; to determine attitudes towards disaster management plans and drills and to determine current practices with regards to disaster preparedness . Study design: The study design was a cross sectional survey. The study population included the hospital administrators, head of clinical units, head of casualties, the chief porter, the chief clerk, the theatre matron, senior sisters and doctors in the casualty department, head of security, head of transport and the chief pharmacist The study was conducted utilizing a self administered questionnaire with structured and open ended questions. In case where management were not available, the person acting in that capacity was requested to complete the questionnaire. Twenty five out of the thirty five managers selected completed a self administered questionnaire. The response rate was 71,4%. Findings: The management at the Johannesburg Hospital was aware of the disaster preparedness of the hospital and its plans, and disaster management preparedness. Their attitudes to the plans and drill were largely positive. However, the practices were deficient and work still needs to be done in regard to ongoing training, performance of drills and the frequency of regular updating of the plans.

Thesis (MPH)--University of Limpopo, 2010. / Introduction: Hepatitis B is a serious liver disease caused by the hepatitis B virus (HBV), with an estimated 360 million chronic infections worldwide, about a million of which die each year from chronic liver diseases. In South Africa (SA) over 50% of the population has been infected by HBV, and at least 3 million people are chronic HBV carriers. Chronic HBV carriers have the potential of transmitting HBV parenterally in the hospital setting, thus health care workers (HCWs) are at risk of contracting HBV, with the most likely exposure being via a needle stick injury (NSI). There is an effective vaccine against HBV which is recommended by the SA Department of Health, yet previous studies have shown that most HCWs are not vaccinated. Aim and objectives: The study aimed to investigate the knowledge, attitudes and practices regarding hepatitis B vaccination amongst HCWs in the Ekurhuleni Metro. Objectives were to determine: (1) the level of knowledge of HCWs about vaccination against HBV; (2) the attitudes of HCWs towards vaccination against HBV; (3) the practices of HCWs regarding HBV prevention and (4) the barriers to / predictors for effective HBV vaccination among HCWs at Ekurhuleni Metro Materials and Methods: This was a cross-sectional descriptive study which made use of a self-administered questionnaire that was sent to Ekurhuleni nurses and doctors who were working in 3 public hospitals, 7 district clinics, and 110 general practices. Results: Two hundred and fifteen questionnaires were distributed and 161 were returned giving an overall response rate of 74.9%. HCWs do not report their NSI; over a third [37.6% (41/81)] always reported the NSI; while 72% (116/161) of HCWs had been vaccinated, only 61.2% (71/116) of those vaccinated had received all 3 doses of the vaccine. For knowledge of HBV vaccination, 66.5% (107/161) scored poor; 31.7% (51/161) scored moderate; and 1.8% (3/161) scored high. For attitudes towards HBV vaccination, 0.6% (1/160) scored negative; 24.4% (39/160) scored neutral; and 74.5% (120/160) scored positive. A positive attitude score was a significant predictor for being vaccinated (OR=1.13, p=0.007) Conclusion: Guidelines should be put in place to increase vaccination uptake and reduce the risk of exposure to HBV infection by HCWs

Background: The adult inpatient psychiatric care is regulated by law and allows certain amount of coercion, most commonly restraint, forced medication and seclusion. To be treated according to this law you need to suffer from a serious mental disorder, oppose to the care and have an indispensable need of care. Many studies describe patients experiences to be treated with coercion but few about health care workers experiences. Aim: To describe health care workers experiences of performing coercion in psychiatric compulsory care. Method: A literature review was made and eight articles is the basis for the result. Results: From the articles used inthis study four themes were created. These are coercions impact on relations, health care workers feelings during coercion, coercion as a necessary evil and health care workers need for reflection. The themes are presented as headlines in the result. Conclusion: To use coercive measures brings out many different feelings among health care workers. There are both positive and negative aspects about coercive measures, but not enough support and time for reflection for the health care workers that execute them. The health care workers needto be acknowledged and feel that they have made the right decision and that they used coercion as a last resort. The result shows that there is a need for reflection and support among health care workers.

No description available.

Master of Public Health - MPH / Nigeria is experiencing shortages of health care workers within its national health services, especially with respect to doctors, nurses and pharmacists. These shortages are traceable to, among other factors, low job satisfaction, which leads to health care workers exiting the national health services, as well as reduced entry of health care workers into the health care system. Understanding the nature of job satisfaction and its causes is critical to informing strategies to halt attrition of the health workforce. The current study surveyed job satisfaction among 180 health care workers, employed in 20randomly selected primary health care centres in the Bwari Area Council of Abuja in the Federal Capital Territory, Nigeria. An observational, descriptive cross-sectional survey was conducted using the abbreviated form of the Minnesota Satisfaction Questionnaire. Descriptive and inferential statistics were calculated using Epi Info v3.1 statistical software. The results from the study revealed that more than half of the respondents (53.2%), were dissatisfied to varying degrees with their current employment. Out of the respondents that said they were dissatisfied, 33.3% stated that they were likely to leave their current employment. The most salient causes for job dissatisfaction were: (1) Institutional factors such as management support (69%); (2) Implementation of policies and procedures (66%); (3) Employee benefits including salaries and wages (33%) and other benefits (56%). It is pertinent to note that issues related to poor implementation of policies and procedures in the work place, and poor conditions of employment need to be addressed urgently to prevent the imminent loss of a third of the workforce to either private health institutions in the country or international migration.

Introduction: Pediatric health care settings are high risk environments for spreading communicable and vaccine preventable diseases from health care workers to susceptible patients. Methods: All managers of pediatric clinics operating in the state of Utah were included. Participants were invited to complete a two-page questionnaire regarding their clinic vaccination policies. Results: Half (n = 23, 50%) of Utah pediatric outpatient clinics recommend employee vaccinations, although employee refusal is allowed without consequence. Of all adult vaccines, influenza was most often included as part of the employee vaccination policy. Some clinics required unvaccinated employees to wear masks in the event of illness, but many had no additional requirements for unvaccinated and ill employees. Discussion: Vaccination of health care workers is an effective approach to reduce disease transmission. Mandatory vaccination policies can significantly improve vaccination rates among health care workers.