Tuberculosis (TB) is one of the most important occupational risks for healthcare workers (HCWs) in South Korea. Many policies regarding the control and prevention of TB in healthcare settings recommend that HCWs are tested for latent tuberculosis infection (LTBI) in addition to active TB. Moreover, the Korean Tuberculosis Prevention Act also recommends that HCWs receive regular testing for LTBI. However, there are no specific or detailed guidelines for dealing with LTBI in HCWs. Herein, we discuss the diagnosis and treatment of LTBI in HCWs and focus particularly on the baseline screening of hired HCWs, routine follow-up, and contact investigation.
Purpose: The human papillomavirus (HPV) vaccine is safe and effective for preventing HPV-related diseases. However, HPV vaccination rates in Japan are low because the "Ministry of Health, Labour and Welfare" had stopped recommending vaccination. We assessed healthcare workers' (HCWs) current recommendations regarding the HPV vaccine and how the provision of information about HPV vaccination affected their recommendations. Materials and Methods: A survey was conducted among nurses and physicians in Nara prefecture from March 2021 to July 2021. The questionnaire asked about their understanding, recommendations, and opinions regarding HPV vaccination. Before answering the last two questions (optional), the HCWs read evidence-based information quantifying the risks and benefits of HPV vaccination. Results: A total of 441 HCWs completed the questionnaire. Only 19% of HCWs always recommended HPV vaccination for girls aged 12-16 years. The evidence-based information significantly improved the percentage of HCWs who would "always recommend" vaccination. Conclusion: This study showed that the proportion of HCWs who recommend HPV vaccination to adolescent girls remains low in Japan. However, we found that evidence-based information describing the causal relationship between adverse events and vaccination, quantifying the risks and benefits, noting the importance of HCW communications with families, and reporting the recommendations of national societies, might increase HCWs' recommendations for HPV vaccination.
Purpose: The study aimed at monitoring the immune status of health care workers (HCWs) of a tertiary hospital after accidental exposure to Hepatitis B virus (HBV). Methods: Between January 2004 and December 2006, 353 cases of exposure to Hepatitis B virus were reported. The HBV-exposed HCWs were required to undergo follow-up serum tests to analyze their immune status one year after the exposure. The obtained data were then analyzed to determine the incidence of exposure and of sero-conversion. Results: In this hospital, an average of 9.8 cases of Hepatitis B exposure among HCWs was reported in a month. Follow-up tests conducted after exposure revealed that 90.4% of the HBV-exposed HCWs were positive for Hepatitis B antibody and 66.9% of the HBV-exposed HCWs were reported to have antibody levels exceeding 10 mIU/mL. Results of serum tests for the HBV antigen conducted one year after exposure were negative for all the exposed HCWs. Conclusion: Among the 79.6% of the HCWs who underwent serum tests one year after exposure the HBV sero-conversion rate was 0.0%. However, a further investigation in the form of long-term and multi-center studies is required to confirm this result. Furthermore, an active system should be established to ensure that all exposed HCWs undergo follow-up serum tests.
Kang, Ji-Man;Lee, Jinhong;Park, Yoon Soo;Park, Yoonseon;Kwak, Yee Gyung;Song, Je Eun;Choi, Young Ju
Pediatric Infection and Vaccine
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v.26
no.3
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pp.170-178
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2019
Purpose: Annual influenza vaccination is the best strategy to prevent healthcare-associated influenza transmission. Influenza vaccination rates among healthcare workers (HCWs) vary by country, region, and year. We investigated the influenza vaccination rates for HCWs during the 2017-2018 influenza season in South Korea, where a non-mandatory vaccination campaign was conducted. Methods: We retrospectively investigated factors affecting the influenza vaccination rate among HCWs during the 2017-2018 influenza season in three tertiary hospitals in Goyang City, where the non-mandatory influenza vaccination program is conducted. Results: Consequently, 6,994 of 7,180 HCWs (97%) were included, and the overall vaccination rate was 85%. Nurses had the highest rate with 92%, followed by health technicians (88%), physicians (84%), and non-medical HCWs (79%, P<0.001). Vaccination rates differed, depending on the frequency of contact with patients in the non-medical HCWs (frequent contact vs. less-frequent contact; 90% vs. 73%, P<0.001). Conclusions: The influenza vaccination rate among HCWs during the 2017-2018 influenza season in Korea was 85%, which is among the highest rates compared with previously reported non-mandatory vaccination rates in other countries. The vaccination rate may vary depending on the HCW's occupational characteristics, including the extent of contact with the patient. Therefore, a multifaceted strategy is needed to increase the vaccination rate of HCWs.
Van Nguyen, Huy;Tran, Hieu Trung;Khuong, Long Quynh;Van Nguyen, Thanh;Ho, Na Thi Nhi;Dao, An Thi Minh;Van Hoang, Minh
Journal of Preventive Medicine and Public Health
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v.53
no.4
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pp.236-244
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2020
Objectives: Although the World Health Organization (WHO) initiative "My 5 Moments for Hand Hygiene" has been lauded as effective in preventing hospital-associated infections, little is known about healthcare workers (HCWs)' hand hygiene behavior. In this study, we sought to assess knowledge and attitudes towards the concepts in this initiative, as well as associated factors, among Vietnamese HCWs at a general hospital. Methods: A structured questionnaire was administered to HCWs at a central Vietnamese general hospital in 2015. Multiple logistic regression analysis was used to identify factors associated with HCWs' knowledge and attitudes towards hand hygiene. Results: Of 120 respondents, 65.8% and 67.5% demonstrated appropriate knowledge and a positive attitude, respectively, regarding all 5 hand hygiene moments. Logistic regression indicated better knowledge of hand hygiene in workers who were over 30 years old, who were direct HCWs (rather than managers), who had frequent access to clinical information, and who received their clinical information from training. Those who worked in infectious and tropical disease wards, who had frequent access to clinical information, and who received information from training were more likely to have a positive attitude towards hand hygiene than their counterparts. Conclusions: Although many Vietnamese HCWs displayed moderate knowledge and positive attitudes towards the WHO hand hygiene guidelines, a key gap remained. Regular education and training programs are needed to increase knowledge and to improve attitudes and practices towards hand hygiene. Furthermore, a combination of multimodal strategies and locally-adapted interventions is needed for sustainable hand hygiene adherence.
Journal of The Korea Institute of Healthcare Architecture
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v.26
no.3
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pp.17-26
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2020
Purpose: This paper presents research evidence that the environmental design of the doffing area in a biocontainment unit (BCU) can have a measurable impact on increasing the safety of frontline healthcare workers (HCW) during doffing of high-level personal protective equipment (PPE), and proposes optimized biocontainment unit design. Methods: From 2016 to 2019, The SimTigrate Design Lab conducted 3 consecutive studies, focusing on ways in which the built environment may support or hinder safe doffing. In the first study, to identify the risky behaviors, we observed 56 simulation exercises with HCWs in 4 BCUs and 1 high-fidelity BCU mockup. In the second study, we tested the effectiveness of a redesigned doffing area on improving the HCWs performance and used simulation, observation, and rapid prototyping in 1 high-fidelity mockup of a doffing area. In a follow-up study, we used simulation and co-design with HCWs to optimize the design of a safer doffing area in a full-size pediatric BCU mock-up. Results: We identified 11 specific risky behaviors potentially leading to occupational injury, or contamination of the PPE, or of the environment. We developed design strategies to create a space for safer doffing. In the second study, in a redesigned doffing area, the overall performance of HCW improved, and we observed a significant decrease in the number of risky behaviors; some risky behaviors were eliminated. There was a significant decrease in physical and cognitive load for the HCWs. Finally, we propose an optimized layout of a BCU for a safer process of PPE doffing. Implications: The proposed BCU design supports better staff communication, efficiency, and automates safer behaviors. Our findings can be used to develop design guidelines for spaces where patients with other highly infectious diseases are treated when the safety of the patient-facing HCWs is of critical importance.
Background: Pertussis is highly contagious respiratory disease. Healthcare workers (HCWs) can be an important mediator of the disease. A seroprevalence of pertussis was investigated in HCWs to determine the immune status against pertussis and to detect the unidentified pertussis. Methods: This study was conducted for HCWs at a hospital located in Korea in 2011. After obtaining written informed consent for HCWs voluntarily participating in the study, 10 mL of blood was collected from each subject. Demographic and medical data were collected using questionnaire. Data on the underlying disease and vaccination history were reviewed again through medical records. The presence of anti-pertussis toxin (anti-PT) immunoglobulin G (IgG), and immunoglobulin A (IgA) was detected by quantitative analysis using a commercially available ELISA kit (EUROIMMUN, $L{\ddot{u}}beck$, Germany). Results: A total of 412 HCW participated in the study. Among them, 14 were excluded due to the inadequate sample amount or medical history not secured. Of the 398 HCWs analyzed, 16.6% (66/398) were men and the mean age was $33.82{\pm}9.10years$ (range, 21-67). The mean anti-PT IgG titer was $8.32{\pm}20.40IU/mL$ (range, 0.4-287.5 IU/mL). The overall seroprevalence (rate of anti-PT IgG antibody [Ab] titer > 5 IU/mL) was 33.7%. Three (0.8%) HCWs had the Ab level > 100 IU/mL indicated acute infection. There was no statistically significant difference in the seroprevalence and mean titer of anti-PT IgG Ab according to age group, type of occupation, patient-facing position, or working in the pediatric department. Conclusion: The seroprevalence of pertussis of the HCWs of a university hospital in Korea was low, and there were some unrecognized acute infections. Therefore, booster immunization of pertussis to HCWs should be actively considered.
Background: The risk of tuberculosis (TB) infection among health care workers (HCWs) is higher than as noted among workers in the general population. The prevalence and risk factors of TB infection among HCWs were assessed in a tertiary hospital in South Korea, resulting in a conclusion of an intermediate TB burden within the country. Methods: This cross-sectional study enrolled HCWs who underwent a QuantiFERON-TB Gold In-Tube (QFT-GIT) test to detect the presence of a latent TB infection (LTBI), in patients admitted to a tertiary hospital in South Korea in 2017. The departments of the hospital were divided into TB-related and TB-unrelated departments, which were based on the risk of exposure to TB patients. In this sense, the risk factors for LTBI, including current working in the TB-related departments, were analyzed. Results: In this case, a total of 499 HCWs (54 doctors, 365 nurses and 80 paramedical personnel) were enrolled in this study. The median age of the subjects was 31 years (range, 20-67 years), 428 (85.8%) were female, and 208 (41.7%) were working in the TB-related departments. The prevalence of LTBI was 15.8% based on the QFT-GIT. Additionally, the prevalence of experience of exposure to pre-treatment TB patents was higher among HCWs working in the TB-related departments, than among HCWs working in the TB-unrelated departments (78.8% vs. 61.9%, p<0.001). However, there was no significant difference in the prevalence of LTBI between the two groups (17.3% vs. 14.8%, p=0.458). On a review of the multivariate analysis, only the factor of age was independently associated with an increased risk of LTBI (p=0.006). Conclusion: Broadly speaking, the factor of age was associated with an increased risk of LTBI among the HCWs in South Korea. However, those workers current working in the TB-related departments was not associated with an increased risk of LTBI.
Background: Organizational changes that involve healthcare hospital departments and care services of health districts, and ongoing technological innovations and developments in society increasingly expose healthcare workers (HCWs) to work-related stress (WRS). Minimizing occupational exposure to stress requires effective risk stress assessment and management programs. Methods: The authors conducted an integrated analysis of stress sentinel indicators, an integrated analysis of objective stress factors of occupational context and content areas, and an integrated analysis between nurses and physicians of hospital departments and care services of health districts in accordance with a multidimensional validated tool developed in Italy by the National Network for the Prevention of Work-Related Psychosocial Disorders. The purpose of this retrospective observational study was to detect and analyze in different work settings the level of WRS resulting from organizational changes implemented by hospital healthcare departments and care services of health districts in a sample of their employees. Results: The findings of the study showed that hospital HCWs seemed to incur a medium level risk of WRS that was principally the result of work context factors. The implementation of improvement interventions focused on team development, safety training programs, and adopting an ethics code for HCWs, and it effectively and significantly reduced the level of WRS risk in the workplace. Conclusion: In this study HCW resulted to be exposed to occupational stress factors susceptible to reduction. Stress management programs aimed to improve work context factors associated with occupational stress are required to minimize the impact of WRS on workers.
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