Thesis (O.T.D.)--Boston University / Healthcare workers are reported to have a higher rate of work-related injuries than workers in private industry and most these injuries have been attributed to client handling tasks (BLS, 2009). Client handling tasks for all healthcare workers can include tasks such as: transfers, bed mobility, activities of daily living (ADL), sitting and standing balance training, ambulation/gait, wound care, lymphedema care and splinting. Research on the nursing profession indicates at least 12% of nurses are injured during client handling tasks and that at least 12% of nursing staff will leave client care or the profession because of an injury or fear of an injury (ANA, 20 12). Occupational therapists are conducting research to understand the injury rates of occupational therapy practitioners and the impact on the profession. The current research appears to mirror the nursing profession's findings. At least 12% of occupational therapy practitioners are injured during client care tasks and at least 12% will leave client care or the profession because of an injury or out of fear of an injury (Campo & Darragh, 2010; Darragh, et al., 2009; & Rice, et al., 2011). The nursing profession has found that the use of safe patient handling and movement (SPHM) devices and techniques can reduce the incidents of client care related injuries among nursing staff (ANA, 2012). However, the use of SPHM devices has been primarily limited to surface to surface transfers and rarely used for therapeutic purposes. In fact, research indicates that therapy practitioners, for many reasons, currently do not believe that SPHM is appropriate for therapeutic interventions (Campo & Darragh, 2010; & Darragh, Campo, & Olson, 2009). This research also indicates therapy practitioner beliefs that the SPHM providers have not met the needs of therapy practitioners to use the devices therapeutically. The Program is a face-to-face hands-on continuing education program designed to help occupational therapy practitioners investigate the causes and impacts of client care related injuries, problem-solve alternative direct care options and practice therapeutic use of SPHM devices and techniques.

Magister Public Health - MPH / Introduction: Despite ongoing training provided to healthcare workers (HCWs) on tuberculosis infection prevention and control (TB IPC), at the health institution and implementation of TB IPC precautions, nosocomial TB infection within the hospital persist. The facility’s 2017 Occupational Infection & Needle Prick Report showed the proportions of new nosocomial TB infection cases among HCWs rose steadily from (5.6%) n=2 in 2013/14, (7.8%) n= 4 2015/16 and (9%) n=7, to (11%) n=11 cases in 2017/18. Study findings confirmed high new nosocomial TB infections among HCWs and a likelihood that these cases were usually under- reported meaning the problem of nosocomial TB infection among HCWs was actually bigger than understood at the hospital. In fact during the period of the mini-thesis study (July 2018) alone, three (3) cases of nosocomial TB infections were reported among HCWs (a porter and 2 nurses). Aim: The aim of this study was to explore the factors which are perceived to be contributing to nosocomial TB infection amongst doctors and nurses in a Level 2 referral hospital in the Free State Province of South Africa.

In 2015 Dr. Pratiksha Vaghela started the “Stop Poking Me” campaign which was aimed at curbing the increase in the number of needlesticks at the James A. Haley Veteran Affairs Hospital (JAHVA). The data for needlesticks was collected by the Occupational Medicine Clinic (OMC) between Oct 2013 and Oct 2016. We then obtained the original data from Dr. Vaghela’s project and compared the data to assess whether the new implementations have truly decreased the number of needlesticks. There was a 23.6% reduction in the number of needlesticks between 2013 and 2016 and even more importantly a 60.1% reduction between 2015 and 2016. Our project shows that the decrease correlates to the implementation of the “Stop Poking Me” campaign.

>Magister Scientiae - MSc / Pharmaceutical marketing via a wide range of promotional tools to doctors and pharmacists is one of the primary methods used by the pharmaceutical industry to drive product sales. Pharmaceutical representatives are the key personnel employed in promoting pharmaceutical products, and their interactions with doctors and pharmacists may present a conflict of interest which may result in irrational prescribing or dispensing with the attendant negative outcomes for patients. As such, an awareness of the influence pharmaceutical marketing may have on their prescribing or dispensing practice is essential to mitigate its negative impact on professional practice. Although several studies have investigated the perception of healthcare professionals on the influence pharmaceutical marketing has on their prescribing and dispensing behaviour, no study has evaluated this in healthcare professionals in South Africa. This study aimed to investigate the perceptions and attitudes of doctors and pharmacists in private sector practice in Gauteng province of South Africa on the influence of marketing by pharmaceutical representatives on their decisions when prescribing and dispensing medication to patients. The study involved a mixed methods approach, using a semi-structured questionnaire to elicit information on doctors and pharmacists’ perceptions on gifts offered by pharmaceutical representatives, and the influence of pharmaceutical marketing on their dispensing and prescribing practice. A sample consisting of 120 doctors and pharmacists practising in the private sector of Gauteng province and who interacted with pharmaceutical representatives as part of their practice were included in the study using convenience sampling. The responses to the questionnaire were collated using descriptive statistics, and data analysed to identify relationships between the respondent’s perceptions and specific prescribing and dispensing practices using SPSS statistical software. The Chi-squared test was used to test for the differences between groups, and the Spearman rho coefficient used to analyse associations between identified themes in the data in SPSS. Ethical approval for the study was obtained from the University of Western Cape

Bakgrund: Vårdskador som går att förebygga orsakar dödsfall, funktionsnedsättningar och stora ekonomiska förluster varje år. Vårdrelaterade infektioner är den vanligaste typen av vårdskador i Sverige. Det mest effektiva sättet att förebygga vårdrelaterade infektioner är handdesinfektion av vårdpersonalens händer. Vårdpersonal underlåter i allmänhet att följa riktlinjer för handhygien, trots att de erhåller utbildning och är skyldiga att tillhandahålla säker vård.   Syfte: Att belysa vad som hindrar vårdpersonalens följsamhet till handhygiensriktlinjer. Metod: Deskriptiv studie med litteraturöversikt som metod. Databassökningen utfördes systematiskt på tre databaser. Femton studier analyserades. De identifierade hindren grupperades enligt den Byråkratiska Omvårdnads Teorins faktorer.   Resultat: Det mest framträdande hindret var bristen på resurser, framför allt i bemanningen. Hinder relaterade till ledning och organisation, sociokulturella faktorer och personliga perspektiv var också frekventa. Brist på kunskap identifierades som en återkommande barriär men var inte bland de vanligaste. Viljan att skydda sig själv var ofta en drivkraft för att både följa och bryta mot riktlinjerna. Andra identifierade hinder var relaterade till själva riktlinjerna eller de artiklar som användes under proceduren för handhygien.   Slutsatser: Följsamheten till handhygien påverkas av flera faktorer. Multifaktoriella interventioner som fokuserar på flera faktorer kan ha större sannolikhet att bli framgångsrika. För att uppnå en hög efterlevnad till HH rutiner behöver hela vårdgivarorganisationen involveras, individanpassad utbildning i HH , ökad tillgänglighet för HH artiklar. Den sociala kulturen bör förändras. Mer forskning om de individuella faktorerna krävs för att vägleda effektivare riktlinjer eller interventioner. Byråkratiska Omvårdnads Teorin kan användas som ett verktyg för att implementera kliniska förändringar. / Background: Preventable patient harm causes deaths, disabilities, and big economic losses every year. Healthcare-associated infections are the most common type of preventable harm in Sweden. The most efficient way of preventing healthcare-associated infections is the disinfection of hands by healthcare workers. Healthcare workers generally fail to adhere to hand hygiene protocols, despite receiving training and being legally liable to provide safe care.   Aim: To explore the barriers that prevent healthcare workers from complying with hand hygiene protocols.   Methods: Descriptive review of the qualitative literature, following a systematic search on three databases. 15 studies were analysed. The identified barriers were grouped according to the Bureaucratic Caring Theory's factors.  Results: The most prominent barrier was the lack of resources, particularly human resources. Barriers related to leadership and organisation, socio-cultural factors and personal perspectives were also frequent. Lack of knowledge was identified as a recurrent barrier but was not among the most common ones. Self-protection was often a motivator for both following and breaking against the guidelines. Other identified barriers were related to the actual guidelines, or the materials used during hand hygiene procedures.   Conclusions: Adherence to HH is affected by several factors. To achieve a high level of compliance with HH routines, the entire organization needs to be involved, increased education, the social culture needs to change. More research on the individual factors is needed. Multifactorial interventions that focus on multiple factors may be more likely to be successful. The Theory of Bureaucratic Caring may be useful as a tool to implement or change practice.

Background: Physical activity (PA) improves cancer-related symptoms (e.g., fatigue, sleep) in cancer survivors, although there is low adherence due to barriers. Cancer survivors are interested in participating in PA but healthcare providers feel they have inadequate knowledge in PA and lack guidance to provide PA support. Purpose: Examine PA advice for cancer survivors and healthcare providers from cancer survivor interviews to understand cancer survivors’ PA and create an algorithm to help healthcare providers assess and provide PA advice to cancer survivors. Method: Qualitative content analysis of twenty interviews with cancer survivors regarding PA. Results: Cancer survivors advised health care providers to make PA a standard assessment, educate patient on PA benefits, provide motivation and support, and help them with an exercise plan. Cancer survivors advised other cancer survivors to prioritize PA, stay positive and encouraged, and get social support. Discussion: An algorithm was created to assess PA and guide health care providers in promoting PA in cancer survivors.

Yes / Childhood immunization has been globally recognized as the single most effective strategy in preventing childhood diseases and mortality. The perceptions of healthcare workers are important as their behavior and attitudes influence parental decision-making process. This research aimed to explore the factors that influence healthcare workers' experience and perceptions about delivering childhood immunization in Fiji. A qualitative study was conducted in three randomly selected health centers in Suva, Fiji from March 1st to April 5th, 2021. Five focus group discussions were conducted with healthcare workers who were chosen purposively, had worked in the health center for at least 6 months and included either gender. Those that did not consent or did not meet the inclusion criteria were excluded. The interviews were guided by semi-structured open-ended questionnaire and were recorded into a digital voice recorder. The data were coded, sorted, and then categorized into themes, and transcribed onto Microsoft Word. Thematic analysis was utilized to sort the key phrases from the recorded interviews. There were a total of 22 participants for the focus group discussions, with their ages ranging from 25 to 51 years, included 3 medical officers, 1 nurse practitioner and 18 registered nurses. Three major themes emerged, which included: healthcare worker factors, parental factors and health system factors. Subthemes identified from the healthcare worker factors were worker knowledge and attitudes. The subtheme for parental factors that emerged were defaulters, parental attitudes, perceived behavior and religious beliefs. For health system factors the subthemes were service delivery, registration, infrastructure, staff turnover, staff training and changes to the immunization schedule. Some of the perceived barriers reported by the healthcare workers were parental religious beliefs, parental knowledge and attitude, social or physical factors (finances, transportation, childcare and work conflicts), access to health services, immunization services and policies, hours of operation, waiting time and missed opportunities. Health workers acknowledged that they have an important role to play in immunization as they are the source of information and motivation for parents. Further studies are needed to be conducted nationally to determine the perceptions of healthcare workers towards immunization and how the services can be improved on a national level.

Yes / Immunization against common childhood diseases is an important strategy as it is critical for reducing the global child morbidity and mortality. This review explores the perceptions of parents and HCWs toward childhood immunization. The PRISMA guideline was used to search and include the studies. Relevant electronic databases were systemically searched for the years ranging from 2000 to 2021 to identify studies reported in English. Themes were then identified using thematic analysis. A total of 44 studies met the review criteria and were summarized and categorized into 4 themes: barriers to immunization, parental knowledge, attitude and behavior (KAB), health system factors and HCWs’ KAB. This review found that immunization decision-making is a complex process. Parental KAB leads to immunization decisions. HCWs were also noted to be the trusted sources of immunization information. Further research can be conducted on how to improve parents’ perceptions of immunization and immunization practices.

Yes / The COVID-19 pandemic, whose origin was established to be in China, wreaked havoc across the world infecting and killing huge numbers of people. Healthcare workers (HCWs) were affected in many ways especially mentally. The study aims at establishing how anxiety affected HCWs in Europe. Methodology: A systematic review study was carried out based on the Prefrred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) using five databases. The search period was from September 27th to December 7, 2021, and 2326 articles were yielded. Of these, 22 met the inclusion criteria. All the data was inputted onto a data extraction sheet and thematic analysis was carried out on the study outcomes to identify themes. Results: It was established that there was a significant increase in anxiety among HCWs in Europe. It was likewise found that there were non-modifiable (sex and age) and modifiable (nature of work, vulnerability, comorbidities, workload, social factors and geographical location) risk factors for anxiety among the workers. Young female HCWs were found to have a higher prevalence of anxiety compared to male health workers. Anxiety is also associated with other mental health issues as well as suicidal thoughts. Conclusion: There was a marked increase in anxiety among HCWs in Europe during the COVID-19 pandemic. Mental health during disease emergencies should be a priority in terms of policy among healthcare employers. There is a need for further research in this area of mental health to build more evidence that informs policy.

Yes / Workplace incivility is a pervasive complex problem within health care. Incivility manifests as subtle disrespectful behaviours, which seem inconsequential. However, evidence demonstrates that incivility can be harmful to targets and witnesses through negative emotions, poorer mental health, reduced job satisfaction, diminished performance and compromised patient care. It is unclear to what extent existing research critically explores how ethnicity, culture and racism influence how hospital staff experience incivility. This global scoping review systematically analysed existing research exploring the specific ways incivility manifests and impacts racially minoritised hospital workers. Of 2636 academic and 101 grey literature articles, 32 were included. Incivility experiences were categorised into four themes: (1) Cultural control, (2) Rejection of work contributions, (3) Disempowerment at work and (4) Managerial indifference. The included articles highlighted detrimental consequences, such as negative emotions, silencing, withdrawal and reduced support-seeking behaviours. Few studies presented evidence regarding the negative impacts of incivility on patient care. Racialisation and racial dynamics are a significant factor for hospital-based incivility. Currently we do not know the extent to which racialised incivility is associated directly or, perhaps either via burnout or disengagement, indirectly with poorer care. This knowledge can inform the creation of comprehensive, evidence-based interventions to address this important issue. / National Institute for Health Research Yorkshire and Humber Patient Safety Research Collaboration