Worker knowledge of occupational legislation and related health and safety benefits

Background: Environmental hazards such as fumes, gases, poor ventilation and extreme temperatures might lead to occupational illnesses and injuries. To protect workers from potential occupational health and safety risks, the government has promulgated occupational legislation that must be implemented in work settings. Objectives: The objective of this study was to explore the knowledge of workers about occupational legislation and its benefits for their health and safety. The aim was to make recommendations that would be implemented to improve the knowledge and compliance with occupational legislation as advised by the occupational health nurse. Methods: A quantitative approach was used for this study. One hundred and ten respondents were sampled from an accessible population of 1590 workers. A self-administered questionnaire was used for gathering data. Data were analysed through descriptive analysis using Statistical Package for Social Sciences. Results: Research findings indicated that only 18 (16.36%) respondents were knowledgeable about occupational legislation. Eighty-two (75.54%) respondents were unable to mention even one occupational act by name. Respondents mentioned five benefits of occupational legislation for the health and safety of workers. These benefits were that legislation ensured safety, gave rights to workers, ensured compensation for occupational injuries and illnesses, and provided guidance in the prevention of occupational injuries and illnesses. Conclusion: Most respondents (75.54%) were found not to be knowledgeable about occupational legislation. The positive finding was that respondents knew the benefits of occupational legislation. To improve the respondents’ knowledge about legislation, five recommendations are made by the researcher

Health and safety risks affecting part-time nursing students

Background: Professional nurses who are employed full-time can study their postgraduate programmes part-time to add to the basic qualification they obtained through relevant institutions of higher education like universities or colleges. Although there are advantages for part-time study such as improvement of qualifications, enhancement of personal development and increased chance of promotion, there are disadvantages as well, which includes keeping a job, attending to family and social responsibilities, time management to ensure that studying is done after work or in-between work and other activities, attending to assignments and complying with the requirements to acquire the qualification. Aim: This study aimed to explore health and safety risks faced by nurses who work and study part-time. Setting: The study was conducted at a university in Gauteng province, South Africa. Nurses who undertake part-time studies at this university were the focus of study. Method: The research design used in the study was an exploratory, quantitative method that was contextual in nature. Data were collected using a self-administered questionnaire that comprised of demographical and health and safety aspects. Data were analysed by means of descriptive statistics using the Statistics package for Social Sciences version 26. Results: Research findings indicated that students who study part-time experience health and safety risks such as fatigue (n = 86; 49%), stress (n = 95; 54%), sleep disorders (n = 60; 34%), poor eating habits (n = 123; 70%), abuse of caffeine (n = 91; 52%) and are prone to road accidents (n = 54; 31%). Conclusion: Nurses who work and study part-time need support from their employers and families. Employers should grant study leave as a way of support

The ASOS Surgical Risk Calculator: development and validation of a tool for identifying African surgical patients at risk of severe postoperative complications

Background: The African Surgical Outcomes Study (ASOS) showed that surgical patients in Africa have a mortality twice the global average. Existing risk assessment tools are not valid for use in this population because the pattern of risk for poor outcomes differs from high-income countries. The objective of this study was to derive and validate a simple, preoperative risk stratification tool to identify African surgical patients at risk for in-hospital postoperative mortality and severe complications. Methods: ASOS was a 7-day prospective cohort study of adult patients undergoing surgery in Africa. The ASOS Surgical Risk Calculator was constructed with a multivariable logistic regression model for the outcome of in-hospital mortality and severe postoperative complications. The following preoperative risk factors were entered into the model; age, sex, smoking status, ASA physical status, preoperative chronic comorbid conditions, indication for surgery, urgency, severity, and type of surgery. Results: The model was derived from 8799 patients from 168 African hospitals. The composite outcome of severe postoperative complications and death occurred in 423/8799 (4.8%) patients. The ASOS Surgical Risk Calculator includes the following risk factors: age, ASA physical status, indication for surgery, urgency, severity, and type of surgery. The model showed good discrimination with an area under the receiver operating characteristic curve of 0.805 and good calibration with c-statistic corrected for optimism of 0.784. Conclusions: This simple preoperative risk calculator could be used to identify high-risk surgical patients in African hospitals and facilitate increased postoperative surveillance. © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.Medical Research Council of South Africa gran

Maternal and neonatal outcomes after caesarean delivery in the African Surgical Outcomes Study: a 7-day prospective observational cohort study.

BACKGROUND: Maternal and neonatal mortality is high in Africa, but few large, prospective studies have been done to investigate the risk factors associated with these poor maternal and neonatal outcomes. METHODS: A 7-day, international, prospective, observational cohort study was done in patients having caesarean delivery in 183 hospitals across 22 countries in Africa. The inclusion criteria were all consecutive patients (aged ≥18 years) admitted to participating centres having elective and non-elective caesarean delivery during the 7-day study cohort period. To ensure a representative sample, each hospital had to provide data for 90% of the eligible patients during the recruitment week. The primary outcome was in-hospital maternal mortality and complications, which were assessed by local investigators. The study was registered on the South African National Health Research Database, number KZ_2015RP7_22, and on ClinicalTrials.gov, number NCT03044899. FINDINGS: Between February, 2016, and May, 2016, 3792 patients were recruited from hospitals across Africa. 3685 were included in the postoperative complications analysis (107 missing data) and 3684 were included in the maternal mortality analysis (108 missing data). These hospitals had a combined number of specialist surgeons, obstetricians, and anaesthetists totalling 0·7 per 100 000 population (IQR 0·2-2·0). Maternal mortality was 20 (0·5%) of 3684 patients (95% CI 0·3-0·8). Complications occurred in 633 (17·4%) of 3636 mothers (16·2-18·6), which were predominantly severe intraoperative and postoperative bleeding (136 [3·8%] of 3612 mothers). Maternal mortality was independently associated with a preoperative presentation of placenta praevia, placental abruption, ruptured uterus, antepartum haemorrhage (odds ratio 4·47 [95% CI 1·46-13·65]), and perioperative severe obstetric haemorrhage (5·87 [1·99-17·34]) or anaesthesia complications (11·47 (1·20-109·20]). Neonatal mortality was 153 (4·4%) of 3506 infants (95% CI 3·7-5·0). INTERPRETATION: Maternal mortality after caesarean delivery in Africa is 50 times higher than that of high-income countries and is driven by peripartum haemorrhage and anaesthesia complications. Neonatal mortality is double the global average. Early identification and appropriate management of mothers at risk of peripartum haemorrhage might improve maternal and neonatal outcomes in Africa. FUNDING: Medical Research Council of South Africa.Medical Research Council of South Africa