COMPLIANCE OF HEALTHCARE STAFF TOWARDS INFECTION CONTROL PRECAUTIONS IN HEMODIALYSIS UNITS – GAZA GOVERNORATES

Abstract:Objective: Health care associated infections are the most frequent adverse event in health care delivery, which lead to significant mortality and financial burden for health systems. This study aimed to assess the health care providers' compliance with infection control practices in the hemodialysis units.Methods: A cross sectional, analytical design with census sample was used.  The data were collected using interviewing questionnaire and observational checklist for the practice of health care providers. In total, 77 questionnaires were collected, 228 practice observational checklists and five physical environment observational checklists.Results: The study findings revealed that hospital management does not practice its role efficiently in encouraging health care providers to be compliant with infection prevention and control protocol. Findings of the study revealed that the majority of the study participants had not adequate training (79.2%) about the infection prevention and control protocol. The findings of the standard precaution showed that the compliance with hand hygiene score was 56.2%; personnel protective equipment score was 87.5%; using waste management score was 39.6%; environmental infection control practices score was 54.3% and aseptic technique score was 62.8%. however, additional precaution score was 56.5%.  Moreover, the study revealed that 45.8% of the health care providers were exposed to an injury from used needles or sharp medical instruments. The study also found that 93.5% of the health care providers working in the hemodialysis unit received the recommended three doses of hepatitis B vaccine. Finally, the study showed that there are a statistical deference's between hospitals and all standard precaution domains (P value= .000), while part of standard precaution domains (personnel protective equipment, waste management, environmental infection control practices) had a statistical difference with occupational type respectively (.000, .008, .031).Conclusion: There is a need to develop a Palestinian infection prevention and control protocol special for hemodialysis unit. A continuous education and training programs for healthcare staff and physical environmental fitness concerning Infection Prevention and Control protocol should be implemented.Key words:  Hospital acquired, Hemodialysis units, Infection control, Complianc

Hip Fracture and Disabilities among Elderly in Gaza Governorates, Palestine

Hip fracture is the most common fracture in the elderly people and causes many disabilities for people who don't receive appropriate rehabilitation after fracture or surgery. Objective: The general objective of this study is to recognize the disabilities arising as a result of hip fracture among the elderly in Gaza Strip. Methods: a descriptive correlation cross sectional design was used. Face to face structured questionnaire and international Barthel index tool were used to determine the disabilities among hip fracture population. One hundred one patients with old hip fracture were included. Sixty patients were from Khan Younis city and forty-one patients from Rafah city. Descriptive statistics, ANOVA test, t-test, correlation coefficient and Scheffe Multiple Comparisons test were used to analyze results in the study. Results: the results revealed that 82.2% of patients complaint from disability. 15.8% had total disability, 30.7% had severe disability, 19.8% had moderate disability, 9.9% had mild disability and 5.9% had minimal disability. Eighty-five percent of patients suffered from pain. 24.8% had mild pain, 36.6% had moderate pain, 17.8% had severe pain and 5.9% suffered from intolerable pain. The most common cause of hip fracture was falling down (81.2%). Also, the most common complications were failure of operation (32.3%), wound infection (29%) and bed sores (29%). The most common type of hip fracture operation was Plate & screw fixation which represented 63.1% from the operated patients. There were significant statistical differences between age and pain slope with development of disability. Conclusion: hip fractures among the elderly caused a high percent of disability, complications and pain which can be reduced by improving operation's techniques and good rehabilitation programs

Impact assessment of traffic emission on the respiratory system of non-smoking traffic policemen in Palestine

This study was carried out to investigate the effects of prolonged exposure of non-smoking traffic police men to vehicular emission within the northern Gaza Governorate-Palestine. Samples of atmospheric pollutants such as PM10, CO and CO2 were collected alongside respiratory data involving lung function, chest and respiratory status and direct physical examination. This was done in order to understand the level of association between respiratory status such as effect on breathing, upper respiratory tract irritation, frequent cough and eye irritation. Chi-square statistical techniques and descriptive statistics were applied in the datasets. The result shows that there is a strong association between air pollution and respiratory disease with a p-value 0.027 at significance of alfa 0.05. The statistical result shows that about 20 non-smoking traffic policemen have upper respiratory tract infection, 15 with frequent cough symptom, 6 with shortness of breathing and 25 with eye irritation. This study is an indication that vehicular emission within the study area is a primary source of pollution that possesses a risk in exposing non-smoking policemen to series of respiratory diseases. Government agencies and other stakeholders should provide preventive measures in either reducing the number, concentration and sizes of pollutants emitted or provide protective measures to reduce the level of exposure of traffic policemen and other habitants

Health-related quality of life in diabetic patients and controls without diabetes in refugee camps in the Gaza strip: a cross-sectional study

BACKGROUND: Prevalence of diabetes mellitus is increasing in developed and developing countries. Diabetes is known to strongly affect the health-related quality of life (HRQOL). HRQOL is also influenced by living conditions. We analysed the effects of having diabetes on HRQOL under the living conditions in refugee camps in the Gaza strip. METHODS: We studied a sample of 197 diabetic patients who were recruited from three refugee camps in the Gaza strip and 197 age- and sex-matched controls living in the same camps. To assess HRQOL, we used the World Health Organization Quality of Life questionnaire (WHOQOL-BREF) including four domains (physical health, psychological, social relations and environment). Domain scores were compared for cases (diabetic patients) and controls (persons without diabetes) and the impact of socio-economic factors was evaluated in both groups. RESULTS: All domains were strongly reduced in diabetic patients as compared to controls, with stronger effects in physical health (36.7 vs. 75.9 points of the 0–100 score) and psychological domains (34.8 vs. 70.0) and weaker effects in social relationships (52.4 vs. 71.4) and environment domains (23.4 vs. 36.2). The impact of diabetes on HRQOL was especially severe among females and older subjects (above 50 years). Low socioeconomic status had a strong negative impact on HRQOL in the younger age group (<50 years). CONCLUSION: HRQOL is strongly reduced in diabetic patients living in refugee camps in the Gaza strip. Women and older patients are especially affected

The influence of demographic characteristics, living conditions, and trauma exposure on the overall health of a conflict-affected population in Southern Sudan

BACKGROUND: There remains limited evidence on how armed conflict affects overall physical and mental well-being rather than specific physical or mental health conditions. The aim of this study was to investigate the influence of demographic characteristics, living conditions, and violent and traumatic events on general physical and mental health in Southern Sudan which is emerging from 20 years of armed conflict. METHODS: A cross-sectional survey of 1228 adults was conducted in November 2007 in the town of Juba, the capital of Southern Sudan. Multivariate linear regression analysis was used to investigate the associations and relative influence of variables in three models of demographic characteristics, living conditions, and trauma exposure, on general physical and mental health status. These models were run separately and also as a combined model. Data quality and the internal consistency of the health status instrument (SF-8) were assessed. RESULTS: The variables in the multivariate analysis (combined model) with negative coefficients of association with general physical health and mental health (i.e. worse health), respectively, were being female (coef. -2.47; -2.63), higher age (coef.-0.16; -0.17), absence of soap in the household (physical health coef. -2.24), and experiencing within the past 12 months a lack of food and/or water (coef. -1.46; -2.27) and lack of medical care (coef.-3.51; -3.17). A number of trauma variables and cumulative exposure to trauma showed an association with physical and mental health (see main text for data). There was limited variance in results when each of the three models were run separately and when they were combined, suggesting the pervasive influence of these variables. The SF-8 showed good data quality and internal consistency. CONCLUSIONS: This study provides evidence on the pervasive influence of demographic characteristics, living conditions, and violent and traumatic events on the general physical and mental health of a conflict-affected population in Southern Sudan, and highlights the importance of addressing all these influences on overall health

Diabetes mellitus and quality of life of the Palestinian diabetic refugees in the refugee camps in Gaza Strip

Eljedi AY. Diabetes mellitus and quality of life of the Palestinian diabetic refugees in the refugee camps in Gaza Strip. Bielefeld (Germany): Bielefeld University; 2005.Objectives: To examine the effect of the refugee life and diabetes on the health-related quality of life (HRQOL) of the diabetic refugees in Gaza Strip. Design and methods: A cross-sectional 1:1 paired matched case-control design was used. One case (diabetic refugees) and two age- and sex-matched control groups (diabetic non-refugees and non-diabetic refugees) were recruited from three refugee camps and their neighboring cities to complete the WHOQOL-BREF (World Health Organization Quality of Life - brief form) questionnaire and to conduct the interviews. Results: Refugees with diabetes had significantly poorer HRQOL than diabetic non-refugees and healthy refugees in the physical, psychological, social and environmental domains. Older age, female sex, longer duration of diabetes and presence of complications were associated with a lower HRQOL of the refugees

Compliance with the National Palestinian Infection Prevention and Control Protocol at Governmental Paediatric Hospitals in Gaza Governorates

Objectives: Nosocomial infections are a significant burden for both patients and the healthcare system. For this reason, infection prevention and control (IPC) practices are extremely important. The Palestinian Ministry of Health adopted the national IPC Protocol in 2004. This study aimed to assess the compliance of healthcare providers (HCPs) with the Protocol in three governmental paediatric hospitals in Gaza governorates. Methods: This descriptive cross-sectional study was conducted from February to November 2010. Data were collected from a sample of doctors, nurses and physiotherapists (N = 334) using a self-administered questionnaire and observation checklists to record HCP practices and assess the hospital environment. Results: The response rate was 92%. The most important reasons for non-compliance with the IPC Protocol were the absence of an education programme (61.5%), lack of knowledge (52.4%) and the scarcity of required supplies (46.9%). Only 2.3% of respondents had a copy of the IPC Protocol, while 65.8% did not know of its existence. Only 16.9% had participated in training sessions regarding general IPC practices. The observation checklist regarding HCP practices revealed low levels of compliance in hand washing (45.9%), wearing gloves (40.7%) and using antiseptics/disinfectants (49.16%). The health facilities checklist indicated that there was a lack of certain essential equipment and materials, such as covered waste containers and heavy-duty gloves. Conclusion: Due to the lack of HPC knowledge, the authors recommend that the IPC Protocol be made available in all hospitals. In addition, a qualified team should implement intensive IPC education and training programmes and facilities should provide the required equipment and materials

Burden of Family Caregivers of Schizophrenic Patients in Gaza Strip, Palestine

Background: Schizophreniais is one of the most devastating psychiatric disorders that affect the Palestinian families. Schizophrenic caregivers in Gaza strip experience more significant stressors and have a higher level of burden. Objectives: This study examined the level of physical, emotional, economic and social burden experienced by the caregivers of schizophrenic patients in Gaza strip as well as determining the association between burden and socio-demographic characteristics of both caregivers and patients. Method: Descriptive cross-sectional design was used. Eligible 120 caregivers of schizophrenic patients were randomly recruited from different governmental community mental health centers in Gaza strip. They were interviewed to complete a set of questionnaires including: socio-demographic characteristics of patients and caregivers, and the Caregiver Burden Assessment Scale (Cronbach's coefficient, 0.92). Descriptive measures, T-test, ANOVA and Pearson correlation coefficient (r) were used. P was significant at 0.05 or less. Results: Most of the caregivers were females (68.1%), aged 40 years or more (45.3%), low educated (47.5%) and unemployed (72.0%). About 52.5% provide care for at least 10 years. The caregivers suffer from very high level of overall burden (Relative weight 74.5%). The physical burden was the highest (RW 81.0%), while the social burden was the lowest (RW 68.3%). There were significant differences in level of burden, and education, occupation and monthly income of both caregivers and patients. Whereas, no significant association was found between level of burden and caregiver's age, gender, period of care, and the relationship with the patien