Reducing the incidence of exposure to blood and body fluids

Methods: we used a Pareto chart to identify priority areas for our project based on magnitude of incidence of BBF exposures. A driver diagram was developed with four main primary drivers including risk awareness, attitudes and practice, staff experience, and leadership engagement. Interventions ramps and changes were implemented using multiple PDSA cycles addressing staff knowledge and awareness about BBF exposure prevention and management using surveys and learning brochures and assessment of staff compliance with safe practice. The project included the following measures (i) outcome measure: number of days between BBF exposure incidents; (ii) Process measures: BBF exposure risk awareness score, attitude and practice score, and proportion of staff compliant with BBF exposure safe practice; (iii) BBF reporting exposure score and proportion of staff satisfied with BBF exposure prevention and management policy. Ethical approval of the project was not required. Results: about 80% of BBF exposure incidents were due to needlestick injuries. Emergency unit, operating theatre, hemodialysis unit, laboratory unit, and utility services accounted for 80% of all BBF exposure incidents. Around 47% of the incidents occurred among nurses. Our project was associated with increase in attitude and safe practice score form 75% to 100%. The compliance with safe practice increased from 77% to 86%, and reporting of exposure increased from 75% to 100%. Staff satisfaction increased from 65% at baseline to 96%. Knowledge about prevention and management of BBF exposure (safe practice) increased from 60% to 92% in the hemodialysis unit. However, the median number of days between BBF exposures increased from 13 days at baseline to 18 days in May 2019. Conclusion: our quality improvement project has identified the priorities clinical areas accounting for the majority of BBF exposure incident. The initial phase of the project in hemodialysis unit was associated with significant increase in knowledge scores about prevention and management of BBF exposure, compliance with safe practice, and staff satisfaction. In addition, the project was associated with significant increase in reporting of BBF exposure, which explains why we were not able to increase the median number of days between BBF exposures to 50 days. We have started spreading our interventions and change ideas to other units in Al-Khor general Hospital. Quality improvement projects can reduce the incidence of BBF exposure having the priority areas identified and the relevant drivers are addressed appropriatel

Assessing disparities in medical students’ knowledge and attitude about monkeypox: a cross-sectional study of 27 countries across three continents

Background and aimsThe recent monkeypox (Mpox) outbreak confirmed by the World Health Organization (WHO) underscores the importance of evaluating the knowledge and attitude of medical students toward emerging diseases, given their potential roles as healthcare professionals and sources of public information during outbreaks. This study aimed to assess medical students’ knowledge and attitude about Mpox and to identify factors affecting their level of knowledge and attitude in low-income and high-income countries.MethodsA cross-sectional study was conducted on 11,919 medical students from 27 countries. A newly-developed validated questionnaire was used to collect data on knowledge (14 items), attitude (12 items), and baseline criteria. The relationship between a range of factors with knowledge and attitude was studied using univariate and multivariate analyses.Results46% of the study participants were males; 10.7% were in their sixth year; 54.6% knew about smallpox; 84% received the coronavirus disease 2019 (COVID-19) vaccine; and 12.5% had training on Mpox. 55.3% had good knowledge of Mpox and 51.7% had a positive attitude towards it. Medical students in their third, fifth, or sixth year high- income countries who obtained information on Mpox from friends, research articles, social media and scientific websites were positive predictors for good knowledge. Conversely, being male or coming from high-income countries showed a negative relation with good knowledge about Mpox. Additionally, a positive attitude was directly influenced by residing in urban areas, being in the fifth year of medical education, having knowledge about smallpox and a history of receiving the coronavirus disease 2019 (COVID-19) vaccine. Receiving information about Mpox from social media or scientific websites and possessing good knowledge about Mpox were also predictors of a positive attitude. On the other hand, being male, employed, or receiving a training program about Mpox were inversely predicting positive attitude about Mpox.ConclusionThere were differences in knowledge and attitude towards Mpox between medical students in low and high-income countries, emphasizing the need for incorporating epidemiology of re-emerging diseases like Mpox into the medical curriculum to improve disease prevention and control

Acceptance of COVID-19 Vaccine Booster Doses Using the Health Belief Model : A Cross-Sectional Study in Low-Middle- and High-Income Countries of the East Mediterranean Region

Coronavirus disease (COVID-19) booster doses decrease infection transmission and disease severity. This study aimed to assess the acceptance of COVID-19 vaccine booster doses in low, middle, and high-income countries of the East Mediterranean Region (EMR) and its determinants using the health belief model (HBM). In addition, we aimed to identify the causes of booster dose rejection and the main source of information about vaccination. Using the snowball and convince sampling technique, a bilingual, self-administered, anonymous questionnaire was used to collect the data from 14 EMR countries through different social media platforms. Logistic regression analysis was used to estimate the key determinants that predict vaccination acceptance among respondents. Overall, 2327 participants responded to the questionnaire. In total, 1468 received compulsory doses of vaccination. Of them, 739 (50.3%) received booster doses and 387 (26.4%) were willing to get the COVID-19 vaccine booster doses. Vaccine booster dose acceptance rates in low, middle, and high-income countries were 73.4%, 67.9%, and 83.0%, respectively (p < 0.001). Participants who reported reliance on information about the COVID-19 vaccination from the Ministry of Health websites were more willing to accept booster doses (79.3% vs. 66.6%, p < 0.001). The leading causes behind booster dose rejection were the beliefs that booster doses have no benefit (48.35%) and have severe side effects (25.6%). Determinants of booster dose acceptance were age (odds ratio (OR) = 1.02, 95% confidence interval (CI): 1.01–1.03, p = 0.002), information provided by the Ministry of Health (OR = 3.40, 95% CI: 1.79–6.49, p = 0.015), perceived susceptibility to COVID-19 infection (OR = 1.88, 95% CI: 1.21–2.93, p = 0.005), perceived severity of COVID-19 (OR = 2.08, 95% CI: 137–3.16, p = 0.001), and perceived risk of side effects (OR = 0.25, 95% CI: 0.19–0.34, p < 0.001). Booster dose acceptance in EMR is relatively high. Interventions based on HBM may provide useful directions for policymakers to enhance the population’s acceptance of booster vaccination