Examples of holistic good practices in promoting and protecting mental health in the workplace: current and future challenges

Background: While attention has been paid to physical risks in the work environment and the promotion of individual employee health, mental health protection and promotion have received much less focus. Psychosocial risk management has not yet been fully incorporated in such efforts. This paper presents good practices in promoting mental health in the workplace in line with World Health Organization (WHO) guidance by identifying barriers, opportunities, and the way forward in this area. Methods: Semistructured interviews were conducted with 17 experts who were selected on the basis of their knowledge and expertise in relation to good practice identified tools. Interviewees were asked to evaluate the approaches on the basis of the WHO model for healthy workplaces. Results: The examples of good practice for Workplace Mental Health Promotion (WMHP) are in line with the principles and the five keys of the WHO model. They support the third objective of the WHO comprehensive mental health action plan 2013e2020 for multisectoral implementation of WMHP strategies. Examples of good practice include the engagement of all stakeholders and representatives, science-driven practice, dissemination of good practice, continual improvement, and evaluation. Actions to inform policies/legislation, promote education on psychosocial risks, and provide better evidence were suggested for higher WMHP success. Conclusion: The study identified commonalities in good practice approaches in different countries and stressed the importance of a strong policy and enforcement framework as well as organizational responsibility for WMHP. For progress to be achieved in this area, a holistic and multidisciplinary approach was unanimously suggested as a way to successful implementation

Patient Safety in the World

AbstractPatient safety is a fundamental principle of health care. However, many medical practices and risks associated with health care are emerging as major challenges for patient safety globally and contribute significantly to the burden of harm due to unsafe care. Available evidence suggests hospitalizations in low- and middle-income countries lead annually to 134 million adverse events, contributing to 2.6 million deaths. About 134 million adverse events worldwide give rise to 2.6 million deaths every year. Estimates indicate that in high-income countries, about 1 in 10 patients is harmed while receiving hospital care. This problem affects both high-income countries and low- and middle countries even if priorities and issues may differ. The most important adverse events concern medication procedures, healthcare-associated infections, surgical procedures, injection safety, blood transfusions, venous thromboembolism, sepsis, and diagnostic and radiation errors. Since 1999 when the Institute of Medicine (IOM) published its report "To err is human," some progress has been made but patient harm is still a daily problem in healthcare. As a matter of fact, new threats are emerging due to population aging, along with new treatments and technologies which must be dealt with in addition to still-unresolved, long-standing problems. In this context, it is very important to adopt an international common strategy that creates networks, shares knowledge, programs, tools, good practices and develop and track indicators focusing on the specific priorities of each country and region

Public health order helps protect the public from Australian Bat Lyssavirus

[Extract] Australian Bat Lyssavirus (ABLV) is a member of the Lyssavirus genus in the family Rhabdoviridae. ABLV has been found in both flying fox and insectivorous bat species.1 Testing has demonstrated ABLV is widely distributed in wild bat populations in Australia.2 It is estimated about 1% of bats in the wild have ABLV, but about 30% of bats found sick or injured have had ABLV.3 Humans most commonly come into contact with bats that are sick, injured or orphaned, placing vets and animal handlers at high risk of exposure to ABLV.2 The mode of transmission for ABLV is presumably similar to rabies virus, i.e. by the virus-laden saliva of an infected animal introduced by a bite or scratch, or by contamination of mucous membranes or broken skin.4 It is assumed that all Australian bat species have the potential to carry and transmit ABLV.

Assessing flucloxacillin contamination and decontamination - a laboratory study

Background: Flucloxacillin is a widely used antibiotic but data are lacking on the risks associated with occupational exposure. Aim: To evaluate flucloxacillin stability; to identify an effective decontamination reagent for flucloxacillin; and to identify glove material that will prevent flucloxacillin permeation. Method: Decontamination reagents used for flucloxacillin wipe sampling and degradation/stability tests included: isopropanol 50% and 70%, ethanol 60% and 100%, benzalkonium chloride 0.1% (Pine O Cleen), sodium hypochlorite 0.5% (Chloroclens), sodium hydroxide 0.03M and distilled water. Short term (0 to 90 minutes) and daily degradation (0 to 6 days) of flucloxacillin in these media and flucloxacillin recovery from surface wipe sampling was investigated using high pressure liquid chromatography with ultraviolet detection. Flucloxacillin permeation was tested using disposable, powder-free latex and nitrile gloves in a disposable test cell to which solution was applied on one side of the glove material and wiped from the other side after 3 hours. Results: This analytical method for assessing flucloxacillin contamination has a limit of detection of 0.1 microg/mL. Distilled water was the most suitable solvent as degradation of flucloxacillin was minimal. Sodium hypochlorite 0.5%, followed by sodium hydroxide 0.03M and benzalkonium chloride 0.1%, were the most effective decontamination reagents. No permeation of flucloxacillin was detected through the latex or nitrile gloves after a 3 hour period. Conclusion: A method for assessing occupational exposure to flucloxacillin is described in this paper. Sodium hypochlorite 0.5% was the most effective decontamination reagent for flucloxacillin. Both the latex and nitrile gloves prevented flucloxacillin permeation for up to 3 hours.Su-Gil Lee, Ganyk J. Jankewicz, Nae-Woo Le

Paclitaxel exposure and its effective decontamination

Background: Apart from generic guidelines for the safe handling of cytotoxic drugs in pharmacy departments, there is no specific published literature pertaining to cleaning procedures and inadvertent exposure to paclitaxel. Aim: To examine occupational exposure to paclitaxel; to identify an effective decontamination reagent; and to determine suitable glove type for skin protection. Method: 8 decontamination reagents were tested for paclitaxel degradation. Air sampling filters, Ghost Wipes and cotton wipes were tested under different storage conditions (room temperature, ≤4°C) for 3 days. Disposable latex and nitrile gloves were tested for paclitaxel permeation using a one-inch ASTM standard test cell. Environmental (airborne and surface) monitoring was carried out in the cytotoxic compounding and work areas. High performance liquid chromatography and photo-ionisation detector were used for sample analysis and glove permeation tests, respectively. Results: Isopropanol 50% and ethanol 60% demonstrated the least degradation ( 99%) of paclitaxel in 20 minutes. Sample wipes should be stored at ≤4°C until analysis. Paclitaxel and sodium hypochlorite 0.5% w/v did not permeate through the latex and nitrile gloves after 4 hours of continuous exposure. No paclitaxel was detected in airborne and surface wipe samples. Conclusion: No detectable paclitaxel was measured within the cytotoxic compounding area. Sodium hypochlorite 0.5% w/v is a suitable decontamination reagent for paclitaxel surface contamination. Wearing either latex or nitrile gloves can prevent contamination when handling paclitaxel.Su-Gil Lee, Fotios Ambados, Michael Tkaczuk, and Ganyk Jankewiczhttp://search.informit.com.au/documentSummary;dn=202919724805953;res=IELHE

Survey of rabies vaccination status of Queensland veterinarians and veterinary students

Background: To determine the rabies vaccination status of Queensland veterinarians and veterinary students and their perception of zoonotic risk from Australian bat lyssavirus (ABLV). Design: Cross-sectional questionnaire surveys. Methods: Questionnaires were sent by post in 2011 to veterinary surgeons registered in Queensland, to final-year veterinary students at James Cook University via SurveyMonkey® in 2013 and to final-year veterinary students at James Cook University and University of Queensland via SurveyMonkey® in 2014. Results: The response rate for registered veterinarians was 33.5% and for veterinary students 33.3% and 30% in 2013 and 2014, respectively. Of the 466 registered veterinary surgeons, 147 (31.5%) had been vaccinated, with 72 (15.5%) currently vaccinated. For veterinary students the rabies vaccination rate was 20.0% (4/20) and 13.0% (6/46) in the 2013 and 2014 surveys, respectively. More than 95% of veterinary students had received the mandatory Q fever vaccine. Both veterinarians and students regarded bats and horses as high-risk species for zoonoses. Conclusions: Queensland veterinarians and veterinary students have low levels of protection against ABLV. Although incidents of ABLV spilling over from a bat to a domestic mammal are likely to remain rare, they pose a significant human health and occupational risk given the outcome of infection in humans is high consequence. Principals of veterinary practices and veterinary authorities in Australia should implement a policy of rabies vaccination for clinical staff and veterinary students