Community health needs assessment: a nurses' global health project in Vietnam.

BACKGROUND: Global health has been directed to providing solutions to various health issues cross-nations, and nurses have received wide recognition as a key health workforce to reduce health disparities globally. Nurses involved in global health research are required to implement evidence-based global nursing practices based on the assessments of local health needs. AIM: To assess health needs and to suggest future interventions in rural communities of Vietnam. METHODS: A multifaceted rapid participatory appraisal with information pyramid was used applying mixed methods from six sources: existing record review, surveys of community residents, surveys of healthcare providers, focus group discussions with community leaders, informal discussions with governmental health administrators and observations of community health station (CHS) facilities. RESULTS: The majority used the CHSs as primary health facilities with high satisfaction for services currently provided. However, there were needs for the stations to provide more comprehensive services including chronic diseases, and for healthcare providers to improve their competences. Community leaders showed high interest in health information for chronic diseases and strong commitment to involvement in the activities for health of their communities. The findings suggest future interventions in the areas of the enhancement of CHS' functions, human resources and the self-care capacity of community residents. CONCLUSION AND POLICY IMPLICATIONS: The rapid participatory appraisal approach emphasizing community participation and partnership was a useful tool to compile accurate information about the current needs of the community on health, the preparedness of healthcare services to meet community's demands and about community capacity. This process is fundamental to nurses, who initiate global health projects in resource-limited international countries, to generate evidences regarding practice, research and policy for taking responsibilities in promoting the sustainable development goals.

Test of the Fishbein and Ajzen models as predictors of health care workers' glove use.

The aim of this study was to identify predictors of health care workers' glove use when there is a potential for blood exposure. The study hypothesis was that an extension of the theory of planned behavior would explain more of the variance in glove use behavior than the theory of reasoned action or theory of planned behavior. A random sample of nurses and laboratory workers (N = 527) completed a 26-item questionnaire with acceptable content validity and reliability estimates. Using structural equation modeling techniques, intention, attitude, and perceived risk were significant predictors of behavior. Perceived control and attitude were the significant determinants of intention. The theory of reasoned action was the most parsimonious model, explaining 70% of the variance in glove use behavior. The theory of planned behavior extension was a viable model to study behavior related to glove use and reducing workers' risks to bloodborne diseases.

Insights of nurses about assault in hospital-based emergency departments.

PURPOSE: To explore contributing factors, consequences, and solutions to the assault of nurses working in U.S. hospital emergency departments. This preliminary study targeted emergency nurses whose risk for assault was significantly greater than many other workers. Exploring nurses' opinions about factors they believe contribute to assault provides important information for designing acceptable preventive measures. DESIGN: In this descriptive study, an ecological, occupational-health framework was used which integrates personal, organizational, and societal influences. The six components of the framework were personal factors, workplace factors, environmental factors, assault injuries, solutions, and effects of workplace violence. METHOD: Four focus groups were used comprised of 22 RNs employed in emergency departments in one large metropolitan area in the United States. Half the nurses had been physically assaulted at work. FINDINGS: Fourteen themes emerged: nurse attitude, vulnerability, security, administrative issues, assault reporting, safety training, beyond control, societal changes, types of patients, geographic location, pervasiveness of anger, previous assault experiences, effects and possible solutions. Personal, workplace, and environmental factors all contribute to assault. Verbal and physical assaults are common and affect nurses' personal and professional lives. CONCLUSIONS: Assault-related injuries are preventable. Only physical injuries are treated; all employees who have been verbally or physically assaulted should be referred for post-incident debriefing. Hospital managers should implement violence-prevention programs. The ecological, occupational health framework is useful for identifying factors that contribute to assault.

Violence in the workplace.

This integrative review of research on workplace violence in Canada and the United States showed that risk factors for homicide and nonfatal assault injuries differed significantly. In 1993, there were 1,063 work-related homicides in the United States (Bureau of Labor Statistics, 1994). Workplace homicide was the second leading cause of fatal occupational injuries overall, but the primary cause for women. The highest risk for workplace homicide was observed among males, the self-employed, and those employed in grocery stores, eating and drinking establishments, gas service stations, taxicab services, and government service, including law enforcement. The majority of workplace homicides occurred during robberies. Unlike workplace homicide, the majority of nonfatal assaults that involved lost work time occurred to women, primarily employed in health care or other service sector work. The assault rates for residential care and nursing and personal care workers were more than ten times that of private non-health care industries. Minimal intervention research has been reported. In recent years, some governmental agencies and professional organizations have begun to address policy issues related to workplace violence.

Workplace violence: female occupational homicides in metropolitan Chicago.

Homicide is the leading cause of fatal occupational injuries for women and accounts for 39% of all fatal injuries for women at work. Using medical examiner and coroner reports, this study analyzed female workplace homicides in three counties within metropolitan Chicago from 1984 to 1990. These workplace homicides were compared to non-workplace homicides of women. There were 1,354 female homicides; of the 17 workplace homicides, all occurred in Cook County. The annual rate of female occupational homicides was higher (1.5/10(5)) for Cook County, while for the metropolitan Chicago area (Cook, DuPage, and Lake counties) it was 1.19/10(5). Black women experienced a higher workplace homicide rate (2.3/10(5)) than white women (1.2/10(5)). Most of these occupational homicides occurred in retail trade, predominately in eating and drinking establishments; robbery was a frequent occurrence, and the women often worked alone. Only three medical examiner reports cited a known assailant. The leading cause of death was from gunshot wounds. Workplace homicides were similar to non-workplace homicides in relation to age, race, and cause of death. Identified risk factors associated with workplace homicides, as well as non-fatal assaults, should be used to develop effective preventive measures. A national standard for general workplace security also is needed.

Improving compliance with universal precautions: effectiveness of interventions.

1. Compliance with universal barrier precautions is associated with the type of patient contact, such as emergent or nonemergent. Compliance may also vary by the type of barrier and health care worker group. 2. Stronger research designs are needed to determine the effect of interventions on improving health care workers' use of barrier precautions. 3. Occupational health nurses have the opportunity to take a leadership role to resolve issues that include accessibility to proper fitting gloves and safe work practice procedures.

Health hazards of nursing: identifying workplace hazards and reducing risks.

Nurses often work in settings in which they may be exposed to a wide array of psychosocial, chemical, biological, and physical hazards. The authors outline several ways in which occupational exposures occur and the general process for reducing or preventing workplace hazards. Several commonly encountered workplace hazards and their potential health risks are identified and discussed. Specific health hazards that are addressed include the chemical hazards of antineoplastic and antiviral drugs; the biological hazards of human immunodeficiency virus, hepatitis B, herpes viruses, rubella, and tuberculosis; and the physical hazards of noise and ionizing and nonionizing radiation. The authors suggest specific preventive measures that nurses can take to make their workplaces safer.

Female workplace homicides: an integrative research review.

1. Between 1980 and 1985, murder on the job was the leading cause of fatal injuries for women compared to being the third leading cause for men. The annual female homicide rate per 100,000 women ranged from 0.05 to 0.7. 2. Risk factors that were identified included age 65 and over, black, and work involving the exchange of money. The primary cause of death was gunshot wounds. 3. Suggested prevention strategies were environmental controls, training, policy, and research. 4. Occupational health nurses need to recognize homicide as an occupational hazard, determine high risk employees and situations, and implement programs to reduce violence related stress.