Employee Health in Indian Hospitals

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Employee Health in Indian Hospitals

  1. 1. The presentation is solely meant forAcademic purpose
  2. 2.  Knowledge about blood and body fluid exposure Personal protective equipment Periodic immunization Safe equipment Reporting of exposure PEP Isolation precaution – MRSA, TB, H1N1, chicken pox
  3. 3.  Sharp injuries Blood and body fluid exposure Deficiency in PEP Deficiency in PPE Care of HCWs dealing with patients under isolation Radiation safety Infrastructural safety
  4. 4.  Globally a serious problem 6 to 8 L in US, 6 L in Germany Indian data ? 3 HCW/ 10,000 3.5 million HCWs 115 L estimated injuries Fortis Jan 2010 5
  5. 5. Job categories injured Others Doctors 16% 10%Housekeeper 19% Nurses 55%
  6. 6. Data A Data B Total dataYes 83 (49.1) 254 (51) 337 (55)No 66 (39) 182 (48) 248 (41)Unknown 14 (8.2) 0 14 (2.3)N-A 6 (3.5) 0 6 (1)
  7. 7.  Accountability towards nurses and technicians Budgeting expenses - HIPAC Change attitude of ‘super’ HCWs ◦ Waste disposal ◦ Appropriate handing over of sharps ◦ Sharp disposal units ◦ Personal protection equipment ◦ Educate and re educate
  8. 8.  Education of nurses, doctors and technicians Providing sharp disposal in the bedside Cheaper sharp disposals Surveillance of waste disposal Interventions Use of safety device Making sharp injury reporting more friendly
  9. 9.  What’s that?
  10. 10. correct segregation wrong segregation 20% 80%
  11. 11. 97.48 100 90 78.66 80Percentage of compliance 70 63.26 60 50 42.3 40 30 24.09 20 10 0 surgeon anesthetist technician nurse House keeping staff Profession
  12. 12. Surgeon Anesthetist Technician Nurse Housekeeping staff 19% 33%7% 26% 15%
  13. 13. Data A Data B Total dataSafety Design (SEMD) 34 (20.1) 19 (3.9) 53 (8)Not a Safety Design 114 (67.5) 467 (95.3) 581 (88.2)Unknown 11(6.5) 4 (0.8) 15 (2.3)N-A 10 (5.9) 0 10 (1.5)
  14. 14. Only from hospital A and B
  15. 15.  Prevalence of Hep B among the general population ranges from 2 to 8%, Among healthcare workers seroprevalence is two to four times higher than that of the general population. NY compensation board “compensable occupational hazard.” 1% HCWs HBsAg – positive
  16. 16.  In the US, 57 HIV sero conversion in 2001 alone 2000/ yr infected Hep C 400 contract hepatitis B. More than 20 infections Exposure to HIV, HBV or HCV also has implications on personal relationships, future employment, and even insurance coverage.
  17. 17. Hep B vaccination• Nursing 98%• Doctors: 75%• Technicians: 98%• Housekeeping- 60%
  18. 18. A1 A2 B1 B2 C1 C2 D1 D2 E1 E2Yes, partially, 1 or 2 doses 48 24 3 27 5 17 2 16 5 28 No 62 31 12 17 1 7 0 5 3 7 N-A 0 1 0 0 0 0 10 Total234 118 48 146 14 63 2 53 24 9 234
  19. 19. • Masks, caps, gowns, gloves – available mostly• N95 masks, disposable gowns, goggles – not common• Even if provided, compliance to use low
  20. 20.  Uncommon Reprimanded and location of work changed Asked to quit Looked down upon Avoiding PEP Approx 15k per HCW
  21. 21. Laboratory testing CostsHIV(Elisa) Rs.300 x 5 =Immediately after injury,6 weeks,3 months,6 1500months & 12 months laterHIV(Western Blot) Rs. 2000HBV(Elisa) Rs. 450HCV(Elisa) Rs. 500PCR test Rs. 2000HBSAg (antibody testing) Rs. 750HCV(antibody testing) Rs. 750 26
  22. 22.  Miserable No statutory requirement Unknown in many un-accredited hospitals Under reporting – prevalent Encouraged by administration No insurance cover for these shots Even decent facilities shun away when it comes to interferons
  23. 23.  Farrell GA, Shafiei T, Chan SP. Patient and visitor assault on nurses and midwives: An exploratory study of employer protective factors. Int J Ment Health Nurs. 2012 Dec 20.
  24. 24.  Nurses are most compliant! Housekeeping staff are next Doctors are very poor icons They think they know, but neither they think nor they know. Too proud to attend sessions run by nurses
  25. 25.  Healthcare worker safety is in jeopardy Every healthcare worker to prioritize issues regarding safety Set targets Strive working ambience safe Fortis Jan 2010 31

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