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SARS was the first novel infectious disease to emerge in the 21st century. Its dramatic appearance in major cities around the world, together with the fact that 20% of the 8400 infected individuals were health care workers,[1][1] prompted epidemiologists and other scientists to move swiftly to study

The hands of 36 nurses and 21 nonnursing hospital employees were tested by culture with a modification of the broth wash technique. Seventy-five percent of the nurses and 81% of the nonnurses were found to harbor yeasts on their hands; 58% of nurses and 38% of nonnurses were carrying Candida spp.

There is a significant risk of clothing soilure and skin contamination from patients' blood or other body fluids whilst working in an accident and emergency (A&E) department. It is therefore unhygienic to wear personal clothing and traditional uniforms do not provide adequate protection. Contamination occurs despite operating 'universal precautions' and emergency presentations often preclude adopting such precautions despite the anticipation of possible contact with blood or other body fluids. The protection afforded to medical staff working in an A&E department by a suit made from a liquid repellent polyester fabric was assessed during the period 2 November 1992-1 January 1993. Ninety-one splash incidents were recorded. A total of 85.7% of splashes (78) were with patients' blood, 13.1% with vomitus (12) and 1.1% with pus (1). There were no instances of splashes to the suit that resulted in strike through to the inner surface or visible contamination of underlying skin. However, some 15.4% of splashes (14) resulted in contamination of exposed skin and 78.6% of these (11) occurred between glove and sleeve. Clothing of appropriated design and fabric can afford skin protection from blood and body fluid contamination. Such clothing alone does not provide overall protection and other precautions currently recommended should be taken.

An assessment of exposure to glutaraldehyde in cold sterilisation and x ray development processes was undertaken in 14 locations at six hospitals in south east England. The results obtained indicate that routine exposures of hospital workers to airborne concentrations of the compound are within the current United Kingdom occupational exposure limit of 0.7 mg m-3. There was the potential for skin contact in many of the activities observed and alternative sterilisation and disinfection procedures would have been more appropriate in some situations. Recommendations are made on reducing exposures as the current occupational exposure limit for this compound may not be appropriate.

In Tunisia, smoking prevalence is high1 (55.6% males vs 5.2% females).2 However, under-reporting of smoking may occur, particularly among women from cultures where social proscriptions still exist.3 No studies on women's smoking have been published in Tunisia which have validated self-reported smoking with biomarkers such as urinary cotinine.4 We aimed to assess the validity of self-reported smoking among female staff in a Tunisian hospital. Our data were extracted from a cross-sectional study5 conducted between January and May 2005 to assess smoking behaviours of the health professional staff at Charles Nicolle Hospital in Tunis, the largest University Hospital in Tunisia. About 1120 …

A consultation-liaison psychiatry program in a teaching nursing home helped implement six guiding principles including: make the patient human to the staff; assume no behavior is random; look for depression of psychosis as a source of problems; reduce medications and medication doses; create a more homelike environment; and use conditions in which learning still occurs in dementia.

Objective: To test whether healthcare workers' knowledge of and compliance with the basic principle of the Universal Precautions policy (i.e., that all patients should be treated equally regarding contact with body fluids) influenced the rate of contact with patient blood. Design: Survey based on anonymous questionnaires. Setting: A 380-bed secondary and tertiary care hospital receiving emergency and elective patients. Participants: All employees having any contact with patients. Nine hundred one of 1,308 (69%) of the questionnaires were returned. Results: Twelve percent of the respondents (95% confidence interval [CI 95 ] = 10.0%-14.4%) had experienced any contact with patient blood in the week preceding their answer. Physicians had the highest rate of contact with blood followed by nurses. In the five groups-physicians, nurses, laboratory technicians and phlebotomists, nursing aides, and student nurses-contact with blood was less frequent in the subgroup that did know and comply with the basic principle of the Universal Precautions policy, compared with the subgroup that did not. When adding the results for the 5 groups, contact with blood was experienced by 91 of 571 (15.9%, CI 95 =13%-19%) of the personnel who did not know and comply with Universal Precautions. The personnel who did know and comply with Universal Precautions had a significantly lower (9 of 111 [8.1%], p 95 = 3.8%- 15%) rate of contact with blood. Conclusions: The healthcare workers who knew and complied with Universal Precautions had a significant lower rate of contact with patient blood than those who did not.

Excerpt Hospital personnel are at risk for acquiring tuberculosis through exposure to patients with active pulmonary disease (1). Although extrapulmonary disease is rarely considered contagious, an...

An outline of a research project into the use of the internet on hospital wards and its impact on nurses and professionals allied to medicine.

Rarely do saving money and saving lives fit so closely together as they do with sharps safety. Here's how to choose the best devices to reduce injuries in your hospital.

[Howarth MV. Blood and body fluid exposures: where does follow-up begin? Ann Emerg Med. January 2000;35:82-83.]

KUWAIT has a population of two million people. Between 200 and 250 new cases of renal failure are reported every year. About 100 of these are suitable for renal transplantation, but only around 40 have suitably related donors. Local brain-dead cadavers are potentially a good source of organs, particularly with the high incidence of deaths due to car accidents, estimated at one per day. Between February 1979 and March 1996, 595 renal transplants were performed in Kuwait. In only 22 of these (3.7%), kidneys were obtained from local cadaver donors. In March 1996, a new protocol was established for obtaining kidneys from local cadavers, which proved to be very successful in increasing the numbers of organs for transplantation. This study summarizes the results up to end of October 1998.

Purpose The objectives of this study are to compare the hospital employees' and patients' recognition and attitudes toward the opening of the medical services market, to analyze the differences between hospital employees and patients on the factors in selecting a foreign hospital. Materials and Methods This study collected and analyzed data using systematic questionnaires that were self-administered by employees and outpatients to compare their recognition of the opening of the medical services market and the factors involved in selecting a foreign hospital. Results Employees exhibited a higher level of recognition than the patients. Reasons for agreement were to ensure the right of selection for both the employees and patients. Reasons for disagreement, however, were split between the two groups: degraded public characteristics of medical services, for employees; and expensive medical fees, for patients. The most urgent task to prepare for the opening of the medical services market is the improvement of the diagnosis and treatment technologies for employees, and improvement of the services provided by hospital staff for patients. Conclusion Korean hospitals shall need to improve their diagnosis and treatment technologies and provide medical services of high quality in order to compete with foreign hospitals.

Hospitals are rather strange places to work. The rationale, after all, of purposely concentrating into close quarters the sick, the frail, and the contagious is elusive at times. Further compounding the situation is the introduction of healthcare workers into the mix, usually at the ratio of approximately five or six full-time employees for every hospital bed. In no other circumstance, except perhaps daycare or nursery schools, does a healthy person deliberately walk into an environment where billions of pathogens routinely are coughed and sneezed and excreted into the atmosphere.

A case is described of occupational asthma caused by indirect exposure to airborne latex allergens in an administrative hospital employee who never used latex gloves.

The smoking control, policy implemented at a Barcelona hospital over a 3-year period resulted in a reduction of smoking in the hospital and a raised awareness of the exemplary role health professionals can have. However, participation by health professionals in the project decreased over the 3-year period. Although reduced, the smoking rate in the hospital still is at a high level; this should trigger health professionals to further exploit their potential in smoking reduction efforts.

BMJ 1991;302:769-70 The use of needles is an essential part of providing medical care but is potentially hazardous to staff. Awareness of hazards, use of the correct equipment, and a consistent and careful technique are all of great importance in preventing needlestick injuries. To date 13 cases of occupationally contracted AIDS caused by needlestick injuries with hollow bore needles have been documented worldwide (N Gill, K Porter, personal communication). Nevertheless the overall risk of contracting HIV infection after a simple needle? stick injury with a needle known to be contaminated is estimated to be less than 0-5%,' ? whereas the risk of hepatitis B virus infection has been estimated to be 3 16%.2 Although the risk of hepatitis B virus infection can be eliminated by vaccination,4 vaccination of all staff at risk is probably unattainable. The recent Department of Health guidelines state

The degree to which a healthcare organization can effectively respond to changes that are brought about by managed care is often the result of how well the organization engages the workforce in the changes. The goal of a process-centered healthcare organization is to deliver service that is truly patient-centered. Successful organizations understand that the actualization of this goal begins with the decision to engage in an employee-guided approach to reengineering. This article describes issues of effective employee relations in the postreengineering era. Strategies for dealing effectively with labor unions or for preventing unionization are also discussed.