Dataset Information

Healthcare workers' challenges in the implementation of tuberculosis infection prevention and control measures in Mozambique.

ABSTRACT:

Objective

Healthcare Workers (HCWs) have a higher frequency of TB exposure than the general population and have therefore an occupational TB risk that infection prevention and control (IPC) measures aim to reduce. HCWs are crucial in the implementation of these measures. The objective of the study was to investigate Mozambican HCWs' perceptions of their occupational TB risk and the measures they report using to reduce this risk. In addition, we explored the challenges HCWs encounter while using these TBIPC measures.

Methods

Focus group discussion. Analysis according content method.

Participants

Four categories of HCWs: auxiliary workers, medical (doctors and clinical officers), nurses and TB program staff.

Results

HCWs are aware of their occupational TB risk and use various measures to reduce their risk of infection. HCWs find it challenging to employ measures that minimize such risks and a lack of clear guidelines contributes to these challenges. HCWs' and patient behavior further complicate the use of TBIPC measures.

Conclusion

HCWs in Mozambique perceive a high occupational risk of TB infection. They report several challenges using measures to reduce this risk such as shortage of material, lack of clear guidelines, insufficient motivation and inadequate training. Robust training with motivational approaches, alongside supervision and support for HCWs could improve implementation of TBIPC measures. Healthcare management should address the areas for improvement that are beyond the individual HCW's control.

SUBMITTER: Brouwer M

PROVIDER: S-EPMC4266607 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Healthcare workers' challenges in the implementation of tuberculosis infection prevention and control measures in Mozambique.

Brouwer Miranda M Coelho Eliana E Mosse Carla das Dores Cd Brondi Luciana L Winterton Laura L van Leth Frank F

PloS one 20141215 12

<h4>Objective</h4>Healthcare Workers (HCWs) have a higher frequency of TB exposure than the general population and have therefore an occupational TB risk that infection prevention and control (IPC) measures aim to reduce. HCWs are crucial in the implementation of these measures. The objective of the study was to investigate Mozambican HCWs' perceptions of their occupational TB risk and the measures they report using to reduce this risk. In addition, we explored the challenges HCWs encounter whil ...[more]

PMID: 25501847

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Project description:The ability of a health system to withstand shocks such as a pandemic depends largely on the availability and preparedness of health-care workers (HCWs), who are at the frontline of disease management and prevention. Despite the heavy burden placed on HCWs during the COVID-19 pandemic, little is known regarding their experiences in low-income countries. We conducted a web-based survey with HCWs in randomly selected districts of Tanzania to explore their experiences with COVID-19-related prevention and control measures. The survey assessed implementation of COVID-19 control guidelines in health facilities, HCW perceptions of safety, well-being and ability to provide COVID-19 care, and challenges faced by frontline workers during the pandemic. We used multivariate regression analysis to examine the association between HCW and health facility characteristics, a score of guideline implementation, and challenges faced by HCWs. 6,884 Tanzanian HCWs participated in the survey between December 2021 to March 2022. The majority of respondents were aware of the COVID-19 guidelines and reported implementing preventive measures, including masking of both HCWs and patients. However, HCWs faced several challenges during the pandemic, including increased stress, concerns about infection, and inadequate personal protective equipment. In particular, female HCWs were more likely to report exhaustion from wearing protective equipment and emotional distress, while physicians were more likely to experience all challenges. While most HCWs reported feeling supported by facility management, they also reported that their concerns about COVID-19 treatment were not fully addressed. Notably, perceptions of protection and well-being varied widely among different HCW cadres, highlighting the need for targeted interventions based on level of exposure. In addition, various factors such as HCW cadre, facility ownership and COVID-19 designation status influenced HCWs' opinions about the health system's response to COVID-19. These findings highlight the importance of consistent implementation of guidelines and social and emotional support for HCWs.

Project description:IntroductionIn hospital settings, awareness of, and responsiveness to, COVID-19 are crucial to reducing the risk of transmission among healthcare workers and protecting them from infection. Healthcare professionals can offer insights into the practicalities of infection prevention and control (IPC) measures and on how the guideline aimed to ensure adherence to IPC, including use of personal protective equipment (PPE), could best be delivered during the pandemic. To inform future development of such guideline, this study examined the perspectives of healthcare professionals working in a large hospital during the pandemic regarding their infection risks, the barriers or facilitators to implementing their tasks and the IPC measures to protect their safety and health and of their patients.MethodIn-depth interviews were conducted with 23 hospital staff coming into contact with possible or confirmed cases of COVID-19, or were at potential risk of contracting the disease, including medical doctors, nurses, virology laboratory staff, and non-medical workers. This qualitative study was carried out as part of a knowledge, attitudes and practice survey to prevent COVID-19 transmission at Ramathibodi Hospital in Thailand. We used content analysis to categorize and code transcribed interview data. Existing IPC guideline and evidence synthesis of organisational, environmental, and individual factors to IPC adherence among healthcare workers were used to guide the development of the interview questions and analysis.FindingFactors identified as influencing the use of, and adherence to, prevention measures among healthcare workers included knowledge, perceived risk and concerns about the infection. The extent to which these factors were influential varied based on the medical procedures, among other features, that individuals were assigned to perform in the hospital setting. Beyond availability of PPE and physical safety, ease of and readiness to utilize the equipment and implement IPC measures were crucial to motivate hospital staff to follow the practice guideline. Having a ventilated outdoor space for screening and testing, and interaction through mobile technology, facilitated the performance of healthcare workers while reducing the transmission risk for staff and patients. Adequate training, demonstration of guided practices, and streamlined communications are crucial organisational and management support factors to encourage appropriate use of, and adherence to, implementation of infection prevention and control measures among healthcare workers.ConclusionThis finding could help inform the development of recommendations to optimise compliance with appropriate use of these measures, and to improve guidance to reduce HCW's risk of disease in hospital settings. Further study should explore the perceptions and experiences of health professionals in smaller health facilities and community-based workers during the pandemic, particularly in resource-limited settings.

Project description:IntroductionIn times of epidemic outbreaks, healthcare workers (HCWs) emerge as a particularly vulnerable group. This cross-sectional study endeavors to assess the COVID-19 infection rate among the primary HCWs in Jiangsu Province subsequent to the implementation of adjusted epidemic prevention and control strategies.MethodsFrom January 17 to February 2, 2023, an extensive survey was conducted among primary HCWs in Jiangsu Province, employing a self-designed questionnaire. Logistic regression analysis was utilized to identify the factors associated with COVID-19 infection.ResultsThe overall infection rate among primary HCWs stood at 81.05%, with a 95% confidence interval (CI) of 80.61-81.48%. Among those afflicted, cough, fatigue, and fever emerged as the three most prevalent symptoms, each with an incidence rate exceeding 80%. In the context of multivariate logistic regression, an elevated risk of COVID-19 infection was observed in correlation with female gender (adjusted odds ratio [aOR] = 1.12, 95% CI: 1.04-1.21), possessing a bachelor's degree or higher (aOR = 1.32, 95% CI: 1.23-1.41), accumulating over 10 years of work experience (aOR = 1.28, 95% CI: 1.11-1.47), holding a middle-level cadre position (aOR = 1.22, 95% CI: 1.11-1.35), assuming the role of a unit leader (aOR = 1.30, 95% CI: 1.11-1.54), and working in a fever clinic for 1 to 10 days per month (aOR = 1.42, 95% CI: 1.29-1.57). Conversely, advanced age (aOR = 0.76, 95% CI: 0.70-0.82), being underweight (aOR = 0.78, 95% CI: 0.69-0.90), current smoking (aOR = 0.64, 95% CI: 0.57-0.71), receiving 4 doses of COVID-19 vaccine (aOR = 0.49, 95% CI: 0.37-0.66), and pregnancy or perinatal status (aOR = 0.85, 95% CI: 0.72-0.99) were associated with a diminished risk of infection.ConclusionFollowing the implementation of adjusted policies, a substantial proportion of primary HCWs in Jiangsu province contracted COVID-19. Female gender and younger age emerged as risk factors for COVID-19 infection, while no discernible link was established between professions and COVID-19 susceptibility. The receipt of COVID-19 vaccines demonstrated efficacy in curtailing the infection rate, underscoring the significance of bolstering prevention knowledge and heightening self-protective awareness among primary HCWs.

Project description:BackgroundLack of trust in institutional control measures during Coronavirus disease 2019 (COVID-19) outbreaks may affect healthcare workers' (HCWs) levels of stress and wellbeing, and as a consequence, may influence their trust and confidence in their organization. This study aims to understand factors associated with healthcare workers perceptions of trust in organizational preparedness, communication, and infection risk during the COVID-19 pandemic.MethodsA cross-sectional study was conducted among HCWs (n = 876) in 16 COVID 19 healthcare facilities between October and December 2020 in Palestine (Gaza Strip, West Bank and East Jerusalem). A stratified purposive sample using an online self-administered Arabic version of a questionnaire was used for data collection. The questionnaire used for this study was adapted from the World Health Organization Blueprint Novel Coronavirus Perceptions of healthcare workers regarding local infection prevention and control procedures for a COVID-19 research protocol.Data were analyzed using Statistical Package for Social Sciences software version 23. In the bivariate analysis, T-test, one-way ANOVA and χ2 test were used at a significant p-value < 0.05. In the multivariable logistic regression analyses, the adjusted odds ratios and its 95% confidence intervals are presented.ResultsFindings showed that confidence in the systems' ability to manage COVID-19 cases, encouragement and support from senior medical/nursing staff to apply recommended IPC measures, and good levels of mental health increased trust in the organization. Additionally, receiving proper training on IPC procedures for other communicable diseases, having access to clear policies and procedures related to IPC procedures for COVID-19, and providing PPE during the previous clinical shift also increased trust. However, the intention to use recommended PPE when treating patients with suspected or confirmed COVID-19 when having access to it and feeling emotional was negatively correlated with this trust.ConclusionsHCWs should be provided with clear, accessible communications about policies and protocols, as well as training about infection prevention and control, personal protective equipment, and support during pandemics to increase their trust in the healthcare system. Additionally, the improvement in HCWs' wellbeing can be attributed to a greater sense of trust in institutions.

Project description:Tuberculosis remains a leading cause of death worldwide. Transmission is the dominant mechanism sustaining the multidrug-resistant tuberculosis epidemic. Tuberculosis infection prevention and control (TBIPC) guidelines for healthcare facilities are poorly implemented. This systematic review aimed to explore the barriers and facilitators of implementation of TBIPC guidelines in low- and middle-income countries from the perspective of healthcare workers. Two separate reviewers carried out an electronic database search to select qualitative and quantitative studies exploring healthcare workers attitudes towards TBIPC. Eligible studies underwent thematic synthesis. Derived themes were further organised into a macro-, meso- and micro-level framework, which allows us to analyse barriers at different levels of the healthcare system. We found that most studies focused on assessing implementation within facilities in accordance with the hierarchy of TBIPC measures-administrative, environmental and respiratory protection controls. TBIPC implementation was over-estimated by self-report compared with what researchers observed within facilities, indicating a knowledge-action gap. Macro-level barriers included the lack of coordination of integrated HIV/tuberculosis care, in the context of an expanding antiretroviral therapy programme and hence increasing opportunity for nosocomial acquisition of tuberculosis; a lack of funding; and ineffective occupational health policies, such as poor systems for screening for tuberculosis amongst healthcare workers. Meso-level barriers included little staff training to implement programmes, and managers not understanding policy sufficiently to translate it into an IPC programme. Most studies reported micro-level barriers including the impact of stigma, work culture, lack of perception of risk, poor supply and use of respirators and difficulty sensitising patients to the need for IPC. Existing literature on healthcare workers' attitudes to TBIPC focusses on collecting data about poor implementation at facility level. In order to bridge the knowledge-action gap, we need to understand how best to implement policy, taking account of the context.

Project description:Healthcare workers (HCWs) are at risk of contracting coronavirus disease-2019 (COVID-19) in their workplace. Infection prevention guidelines and standard operating procedures were introduced to reduce risk of exposure and prevent transmission. Safe practices during interaction with patients with COVID-19 are crucial for infection prevention and control (IPC). This study aimed to assess HCWs' compliance to IPC and to determine its association with sociodemographic and organizational factors. A cross-sectional study was conducted between March and April 2021 at public healthcare facilities in the east coast of Peninsular Malaysia. HCWs who were involved with COVID-19-related works were invited to participate in the online survey. The questionnaire was adapted from the World Health Organization (WHO) Interim Guidance: WHO Risk Assessment and Management of Exposure of Healthcare Workers in the Context of COVID-19. Respondents were categorized as compliant or non-compliant to IPC. A total of 600 HCWs involved in COVID-19-related works participated in the survey. Most of them (63.7%) were compliant to IPC as they responded to all items as "always, as recommended" during interaction with patients with COVID-19. The multivariate analysis showed that non-compliance was significantly associated with working in the emergency department (AOR = 3.16; 95% CI = 1.07-9.31), working as laboratory personnel (AOR = 15.13; 95% CI = 1.36-168.44), health attendant (AOR = 4.42; 95% CI = 1.74-11.24), and others (AOR = 3.63; 95% CI = 1.1-12.01), as well as work experience of more than 10 years (AOR = 4.71; 95% CI = 1.28-17.27). The odds of non-compliance among respondents without adequate new norms and personal protective equipment training were 2.02 (95% CI = 1.08-3.81) more than those with adequate training. Although most of the respondents complied to IPC protocols, compliance status differed according to department, work category, and years of service. Ensuring adequate training that will hopefully lead to behavioral change is crucial to prevent breach in IPC and thus minimize the risk of exposure to and transmission of COVID-19 in healthcare facilities.

Dataset Information

Healthcare workers' challenges in the implementation of tuberculosis infection prevention and control measures in Mozambique.

Objective

Methods

Participants

Results

Conclusion

Publications

Healthcare workers' challenges in the implementation of tuberculosis infection prevention and control measures in Mozambique.

Similar Datasets

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