Attitude of Health Care Workers to Patients and Colleagues Infected with Human Immunodeficiency Virus

Discrimination against persons living with HIV/AIDS in hospital settings has been documented. This study examined the attitude of health care workers (HCWs) to nurses; doctors and patients infected with HIV. A total of 345 respondents selected by multistage sampling techniques were surveyed; using a semi-structured questionnaire; which explored respondents' attitude to HIV-infected patients and colleagues with HIV/AIDS. HCWs were unwilling to accept that medical procedures be carried out on them by HIV-infected doctors and nurses; with almost 80refusing surgery or assistance at surgery on them by an HIV-infected doctor or nurse. They were also significantly more unwilling to accept that medical procedures be carried out on them by an infected colleague; compared with their carrying out the same procedure on an HIV-infected patient. Thus; HCWs seemed to believe that the risk of contracting HIV was higher if an infected HCW were to perform medical procedures on them; and fear of contracting HIV seemed to be the driving force for their negative attitudes. Education on occupational risks of HIV; provision of a safe working environment with enforcement of universal precautions; as well as provision of post-exposure prophylaxis are suggested as ways to enable HCWs to change their attitudes

Evaluation of criteria-based clinical audit in improving quality of obstetric care in a developing country hospital

Study evaluated criteria­based clinical audit in measuring and improving quality of obstetric care for five life-threatening obstetric complications: obstetric haemorrhage, eclampsia, genital tract infections, obstructed labor and uterine rupture. Clinical management of 65 patients was audited using a 'before (Phase I) and after (Phase II)' audit cycle design using standard criteria. Following Phase I, areas in need of improvement were identified; mechanisms for improving quality of care were identified and implemented. Overall care of the complications improved significantly in obstetric haemorrhage (61 to 81%, p = 0.000), eclampsia (54.3 to 90%, p=0.00), obstructed labour (81.7 to 93.5%, p<0.001) and genital tract sepsis (66 to 85.2%, p < 0.01). Clinical monitoring, drug use, and urgent attention by senior medial staff also improved significantly after intervention. Criteria-based clinical audit is feasible and acceptable for improving management of life-threatening obstetric complications. Its application is recommended in health institutions in developing countries (Afr J Reprod Health 2008; 12[3]:59-70)