Protecting the health of health care workers : a global perspective

"Fundamental elements for the provision, organization, and establishment of occupational health and safety (OHS) services for health care workers in rural/remote areas and developing countries include adequate resources, a strong safety culture, recognition of occupational health professionals, collaborative practice, and capability for communication and local risk analysis. First, however, assessment of existing OHS services is required. Adaptable needs assessment tools designed for use by local health care workers should allow progression from analysis to action. Essential elements of these tools include utility, recognition of the surrounding political, health care, and physical environments, and clear definition of the roles and responsibilities of users to act upon findings and implement solutions. Securing adequate financial, physical, and human resources for occupational health and safety requires critical analysis of topics such as health care culture, political motivation, health care worker migration, and national and international financing. It is necessary to reshape attitudes towards valuing the health of health care workers. This includes acknowledging occupational health professional accreditation and educating health care students about OHS. It is also crucial to create awareness of workers' health among health care managers and administrators and to develop their knowledge and capability to support OHS. Resources such as the Pan American Health Organization's (PAHO) document "Workers' Health and Safety in the Health Sector: A Manual for Managers and Administrators" are valuable assets. Suggestions for collaborative practice include the formation and use of local OHS committees that involve decision makers, administrators, and health care workers. Communication strategies involve the free flow of information between policy makers, educators, employers, research laboratories, and health care workers. Mobile occupational health clinics and portable libraries are two examples of innovative methods of communication and information dissemination. Risk analyses allow occupational health practitioners to target local services to the most needed areas. Point prevalence surveys and workplace audit tools are effective methods to collect this data in remote and resource poor settings. Priorities for prevention of blood-borne and air-borne disease transmission include education and comprehensive protocols and guidelines. Adequate, up-to-date, and ongoing OHS education and training for health care workers is essential. Protocols and guidelines should direct practice and uphold internationally endorsed standards while being responsive to local realities and needs. Protocol and guideline development and implementation must also involve the multiple stakeholder groups such as infection control, public health, funders, administrators, and health care workers. Immunizations and adequate access to post exposure management are vital for secondary prevention. Information such as prevalence and incidence rates of diseases endemic to the local area, transmission patterns and trends, and population projections are necessary to make informed decisions about vaccination priorities. Adequate institutional support for post exposure prophylaxis and follow-up consultations is also vital to ensure the quality of appropriate care following workrelated injuries. " - NIOSHTIC-2Publication authors, contributors, and workshop participants -- Acknowledgements -- Abbreviations -- Workshop overview -- Introduction -- Section One: Organization and provision of occupational health services in health care -- Section Two: Establishing occupational health programs -- Section Three: Primary prevention for blood-borne and air-borne pathogens -- Section Four: Immunizations and post exposure follow-up -- Concluding remarks -- Appendix A: Workshop agendaRebman, R., (Ed.). Rodri\ucc?guez Guzma\ucc?n, J.; Dybka, L.; Watson, R.; Lavoie, M.; Yassi, A.; Gamage, B.; Pugh, S.; Lehtinen, S.; Tennassee, M.; Nophale, L.E. (2008)."This synthesis report stems from a one-day pre-conference workshop, "Occupational Health Services for Health Care Workers in Rural/Remote Areas and Developing Countries." The workshop was part of the International Commission on Occupational Health (ICOH) Conference on Health Care Worker Health / 2007 State-of-the-Art Conference (SOTAC) held from 26 to 28 October 2007 in Vancouver, Canada. For this conference, ICOH and the American College of Occupational and Environmental Medicine (ACOEM) joined together to share research and understanding on protecting the health of health care workers." - p. 1"February 2009."Also available via the World Wide Web as an Acrobat .pdf file (956.69 KB, 58 p.).Includes bibliographical references (p. 47-48)

The role of social workers in palliative, end of life and bereavement care

Social work has an important role in the delivery of meaningful palliative, end of life and bereavement care. Some social workers are palliative care social workers, working in services which specialise in this area of support. All social workers will encounter people who are experiencing loss, the end of life or bereavement. This resource aims to ensure that people benefit from good social work at the end of their life, and that those close to them are supported during this time and into bereavement

Managing an Online Survey about Influenza Vaccination in Primary Healthcare Workers

Online surveys are increasingly used due to their speed and efficiency. The aim of this study was to analyze factors that may have contributed to the quality and speed of response of an online survey on influenza vaccination in primary healthcare workers. A multicenter study including family physicians, nurses and pediatricians from primary healthcare teams from seven Spanish Autonomous Communities was designed. The centers were selected by simple random sampling. The survey remained active and accessible for 56 days and four reminders were sent. The odds ratios (OR) and their 95% confidence intervals (CI) were calculated to assess the association of sociodemographic variables and responding to the survey before the second reminder. Complete, validated information was obtained from 1965 primary healthcare workers. The total response rate was 36.2%. More nurses (46.3%) responded before the second reminder and more family physicians (52.8%) after the second reminder. The adjusted OR shows that family physicians responded later (AOR 1.46, 95% CI 1.2¿1.8) than nurses. The responses obtained in the first 24 h after the initial sending and the reminders accounted for 41.7% of the completed surveys, indicating the importance of reminders

Knowledge of and attitudes to influenza vaccination in healthy primary healthcare workers in Spain, 2011-2012

Annual influenza vaccination is recommended for healthcare workers, but many do not follow the recommendation. The objective of this study was to investigate the factors associated with seasonal influenza vaccination in the 2011– 2012 season. We carried out an anonymous web survey of Spanish primary healthcare workers in 2012. Information on vaccination, and knowledge and attitudes about the influenza vaccine was collected. Workers with medical conditions that contraindicated vaccination and those with high risk conditions were excluded. Multivariate analysis was performed using unconditional logistic regression. We included 1,749 workers. The overall vaccination coverage was 50.7% and was higher in workers aged ≥ 55 years (55.7%), males (57.4%) and paediatricians (63.1%). Factors associated with vaccination were concern about infection at work (aOR 4.93; 95% CI 3.72–6.53), considering that vaccination of heathcare workers is important (aOR 2.62; 95%CI 1.83–3.75) and that vaccination is effective in preventing influenza and its complications (aOR 2.40; 95% CI 1.56–3.67). No association was found between vaccination and knowledge of influenza or the vaccine characteristics. Educational programs should aim to remove the misconceptions and attitudes that limit compliance with recommendations about influenza vaccination in primary healthcare workers rather than only increasing knowledge about influenza and the characteristics of the vaccine

Barriers to access and minority ethnic carers' satisfaction with social care services in the community: a systematic review of qualitative and quantitative literature.

As populations age, the numbers of carers overall and numbers of carers from minority ethnic groups in particular are rising. Evidence suggests that carers from all sections of the community and particularly carers from minority groups often fail to access care services. This may relate to barriers in accessing services and service dissatisfaction. The aim of this systematic review was to identify and summarise minority ethnic carers' perceptions of barriers to accessing community social care services and their satisfaction with these services if accessed. The following databases were searched from their start until July 2013: Social Care Online, Social Policy and Research, Scopus, PsychINFO, HMIC, ASSIA, MEDLINE, Embase, CINAHL Plus and AMED. Thirteen studies met the inclusion criteria. Most investigated either barriers to access or satisfaction levels, although three explored both. Only 4 studies investigated minority ethnic carers' satisfaction with social care, although 12 studies reported perceived barriers to accessing services. Few studies compared minority ethnic carers' perceptions with majority ethnic groups, making it difficult to identify issues specific to minority groups. Most barriers described were potentially relevant to all carers, irrespective of ethnic group. They included attitudinal barriers such as not wanting to involve outsiders or not seeing the need for services and practical barriers such as low awareness of services and service availability. Issues specific to minority ethnic groups included language barriers and concerns about services' cultural or religious appropriateness. Studies investigating satisfaction with services reported a mixture of satisfaction and dissatisfaction. Barriers common to all groups should not be underestimated and a better understanding of the relationship between perceived barriers to accessing services and dissatisfaction with services is needed before the experiences of all carers can be improved

Assessment as the site of power:A Bourdieusian interrogation of service user and carer involvement in the assessments of social work students

The centrality of service user and carer involvement in social work education in England is now well established, both in policy and practice. However, research evidence suggests their involvement in student assessments is underdeveloped and under researched. This study focused on the positioning of service users and carers in relation to other stakeholders involved in the assessments of social work students in England. Using narrative research methodology, 21 participants, including service users, carers, social work students, social work employers and social work educators, were offered a semi-structured individual interview. Participants’ narratives revealed different power relations among those involved in social work students’ assessments and a lack of confidence among service users and carers in making failed assessment recommendations. The paper concludes by arguing the case for social work educators and service user organisations to provide joint training to support service users and carers in their role as assessors of social work students

Searching for a Social Work Language of Human Rights : Perspectives of Social Workers in an Integrated Mental Health Service

Human rights are described as central to the social work profession. However, whilst principles of human rights are generally accepted as fundamental to social work, their application in specific practice settings is far more complex and the perspectives of social workers themselves are largely absent in the literature. This research explored the perspectives of nine social workers in integrated mental health teams in a National Health Service (NHS) Trust in the north of England. Participants took part in semi-structured face-to-face interviews investigating the role of social workers in enacting rights-based social work in integrated mental health services, the issues they face and aspects of good practice. Participants identified rights-based approaches as inherent in their practice but lacked an adequate language to describe this work and confidence in using specific legislation. All described a lack of available training (post-qualification) and support, and the impact of a lack of both time and resources, in enacting rights-based work. The research suggests a need for further training in human rights, increased support for social workers in enacting rights-based work, and for a language of human rights to be more effectively embedded in organisations