Polish infection control nurses' job satisfaction and cooperation with their colleagues reflect how the value of infection control is appreciated by other health care workers: findings from surveys conducted before and during the COVID-19 pandemic.

BACKGROUND: Infection prevention and control (IPC) is based on the activity of specialized, trained and highly qualified personnel, especially infection control nurses (ICNs). Effective implementation of IPC procedures demands close cooperation between IPC teams (IPCTs) and hospital personnel. Based on disturbing results on the epidemiology of health care-associated infections (HAIs) and compliance with preventive procedures, we suspect that cooperation between ICNs and different groups of hospital staff is poor. The aim of this study was to assess the perceptions of ICNs working in Polish hospitals with regard to difficulties in working with various professional groups in the hospital, their organizational conditions, and their job satisfaction before and after the COVID-19 pandemic. METHODS: The study was conducted twice, in 2014 and 2021, among ICNs working in Polish hospitals. The survey used an anonymous questionnaire designed by the authors. RESULTS: In 2014, 183 ICNs participated in the study, and 175 ICNs participated in 2021. The respondents' average age and seniority (duration of work as an ICN) were higher in 2021. Depending on the ward specialty, approximately 30-48.8% of the ICNs had difficulty cooperating with physicians. However, the ICNs declared better cooperation with nurses in various hospital wards and with other professionals. For some groups of hospital staff, there was a negative correlation between poor cooperation and ICNs' job satisfaction. The job satisfaction data were disturbing; for example, more than half of the respondents considered changing jobs, and the lack of a sense of purpose in their work was declared by 29.7% of ICNs in 2014 and by 54.3% of ICNs in 2021. CONCLUSIONS: Our results suggest that infection prevention and control is not highly appreciated by health care workers and hospital management. Our study reveals difficulties in ICNs' cooperation with hospital staff and managers in both 2021 and 2014, moderate job satisfaction, a high level of willingness to change jobs, and insufficient training in interpersonal skills and the implementation of changes. These findings clearly indicate an urgent need to introduce modern competence development systems in infection control beyond the scope of traditional training.

Declared Intention to Vaccinate against COVID-19 and Actual Vaccination-The Role of Trust in Science, Conspiratorial Thinking and Religiosity.

AIMS: The study aims to investigate how trust in science, conspiratorial thinking, and religiosity affected people's declared willingness to vaccinate against COVID-19 at the onset of the vaccination program in Poland, their actual vaccination, and the consistency between intention and vaccination. METHODS: In a longitudinal design, a representative sample of 918 members of the Polish general population was polled at the beginning of the vaccination program (February 2021) and polled again after 6 months of mass vaccination (August 2021). We measured the willingness to vaccinate, actual vaccination after 6 months, and individual variables-trust in science, conspiratorial thinking and religiosity. RESULTS: The actual vaccination rate was higher than the declared intent, especially in the initially undecided and unwilling groups. Higher Trust in science and lower Conspiratorial Thinking were associated with declared intent to vaccinate and actual vaccination, while Religiosity was not clearly associated with vaccination. CONCLUSIONS: Declared willingness to vaccinate is not an effective indicator of actual vaccination. Trust in science and Conspiratorial thinking are important factors associated with vaccine hesitancy. There may be a possibility to influence those unwilling to vaccinate and that are undecided to eventually get vaccinated.

The Seroprevalence of SARS-CoV-2 Antibodies among HealthCare Workers in University Hospital in Krakow before the Era of Vaccination.

BACKGROUND: Knowledge of occupational health is crucial to the safety of healthcare workers in the pandemic period. The aim of our study was the rating of SARS-CoV-2 seroprevalence in connection with selected demographic, social, and organizational factors, as well as the identification of key elements determining the safety of HCWs and patients of the University Hospital in Krakow. METHODS: This was a non-interventional, uncontrolled, open, single-center, cross-sectional online survey on the preparedness for the COVID-19 epidemic and the seroprevalence of medical and non-medical HCWs and students. Serum specimens from 1221 persons were tested using an immunoassay analyzer based on the ECLIA technique for the anti-SARS-CoV-2 antibodies IgM + IgG. RESULTS: The total seroprevalence was 42.7%. In medical students it was 25.2%, while in physicians it was 43.4% and in nurses/midwives it was 48.1%. Of those who tested positive, 21.5% did not know their serological status. The use of personal protective equipment did not have any significant impact on the result of testing for anti-SARS-CoV-2 antibodies. The risk of developing the disease was not influenced by sex, professional work experience, workplace, or intensity of contact with the patient. Among the studied elements, only care of COVID-19 patients significantly increased the risk. The protective factor was starting work between the waves of the epidemic (June-September 2020). CONCLUSIONS: PPE is only one element of infection prevention and control-without other components, such as hand hygiene, it can be dangerous and contribute to self-infection. It is also very important to test healthcare workers. Not being aware of the COVID-19 status of HCWs poses a threat to other staff members, as well as patients and the family and friends of the infected. Thus, extreme caution should be applied when employing respirators with exhalation valves during the COVID-19 pandemic.

Incidence of Surgical Site Infections in Multicenter Study-Implications for Surveillance Practice and Organization.

INTRODUCTION: WHO core components of healthcare-associated infections (HAIs) prevention and control include their surveillance system. In Poland, there are no widespread multi-center infection surveillance networks based on continuous, targeted, active methodology. One of the most important form of HAIs are surgical site infections (SSIs). The aim of this study was to analyze the incidence of SSIs, in the context of seasonal differentiation. Seasonal differentiation could be connected with weather conditions, but it also can be affected by personnel absence due to holidays and furlough. The second aspect may influence organization of work and increased absenteeism may contribute to lowering the quality of patient care. Healthcare associated infections are the phenomenon which can be especially affected by such factors. METHODS: The data used originate from the targeted, active surveillance reports obtained from the six years period, based on the ECDC recommendations. RESULTS: Highest incidence rates of SSIs were found after operations performed in June and August, equal to 1.8% and 1.5% respectively and the lowest in October was 0.8%. These differences were statistically significant: for June incidence: OR 1.6, 95% CI 1.03-2.5, p = 0.015. Another approach showed a significant difference between the level of incidence in the period from November to January together with from June to August (1.35%), comparing to the rest of the year (1.05%). Also the rates of enterococcal and Enterobacterales infections were significantly higher for the period comprising months from November till January and from June to August. In Poland these are periods of increased number of absences associated with summer, national and religious holidays. CONCLUSIONS: Our results show that the short-term surveillance data limited to several days or months are not sufficient to obtain a valuable description of the epidemiological situation due to HAI. Efforts should be undertaken in order to implement wide net of hospital acquired infections, including SSI on the country level.

Interest in Working as an Infection Prevention and Control Nurse and Perception of This Position by Nursing Students-Results of a Pilot Study.

Background: The results of several studies in the area of infection control in Poland are disturbing. The situation may be shaped by many factors. However, the key factor for effective infection prevention and control is dedicated personnel, especially infection prevention and control nurses (IPCN). Nevertheless, based on the available published data and the authors' experience, in many Polish hospitals infection control is not sufficiently appreciated by managers, it is consequently underfunded, and treated by medical staff as a nuisance. This may influence the nurses willingness to work as IPCN. The aim of the study was to assess the nursing students' perception of the work of IPCN and their interest in employment in this position, as well as the potential reasons for choosing this particular specialization. Materials and methods: The study was conducted using the authors' anonymous questionnaire conducted among nursing students of three Polish universities. The questionnaire was prepared by a panel of experts working in the field of infection control, including nurses working both as academic teachers and infection control nurses in hospitals. The design of the questionnaire was based on the authors' own experience, knowledge, and exchanging information with the practitioners in infection control in Poland. The reliability of the questionnaire was confirmed by the Cronbach alpha test. The raw alpha values and 95% CI for two main questions concerning opinion were: 0.76 (0.72-0.81) and 0.69 (0.63-0.75). Results: The study was conducted among 253 students, mostly women (98%) of full-time (31.4%) and extramural (68.6%) studies. The age range of the respondents was 20-58 years, median = 26 years, IQR = 19 years. To the key item in the questionnaire, i.e., "Would you like to work as an IPCN?", 84.6% (214 respondents; first group) of the respondents answered "no" and 15.4% (39 respondents, second group) answered "yes". The results revealed no significant differences between the two groups concerning the position responsibilities and appreciation by other medical staff. Additionally, for respondents willing to work as ICPN the most important issues were the influence on patient safety, expected salary, and possibility of professional development; for the respondents from the other group the most important issue was lack of contact with patients. The results concerning the students' opinion on the perception of IPCN by medical personnel proved to be peculiar. About 80% of the respondents confirmed the IPCNs' key role in ensuring patient and personnel safety, while only 31.6% declared their high standing in the hospital hierarchy. Conclusions: The obtained results indicate the necessity of thorough studies on the organization and structure of infection control in Polish hospitals, with a particular emphasis on building a positive perception of IPCNs by medical staff, as well as implementing an education campaign on infection control in the hospital environment.

Infection-associated hospitalizations of women in labour.

BACKGROUND: The article analyzes hospitalizations of women in the postpartum period in the Malopolska Province. Re-hospitalization of women as a result of puerperal complications may be used as an infection control quality measure in this patient population. METHODS: It was a population-based, retrospective analysis using data obtained from the Polish National Health Fund (paying for medical services, financed by all Polish employees contributing 9% of their salaries), collected routinely in 2013-14. The analysis encompassed 29 hospitals and 68 894 childbirths. RESULTS: In total, 1.7% of women were re-hospitalized and 563 of these re-hospitalizations (0.8%) were due to infection. Re-hospitalizations due to infections were significantly more often recorded among women who lived in villages compared with inhabitants of towns (OR 1.6, 95% CI 1.23-1.98; P < 0.001) and in women giving birth in primary referral hospitals in comparison with the second referral or clinical hospitals (OR 2.8, 95% CI 1.69-4.65; P < 0.001). On the one hand, the results of the study indicate that, in patients giving birth, the infection control system is not sensitive enough, and on the other hand, more detailed studies need to cover primary referral hospitals, specifically. CONCLUSIONS: The problem of the infection-associated hospitalizations in the postpartum period is not reliably assessed by infection control professionals and constitutes a challenge for surveillance, including prevention and control. Complications associated with childbirth should be an indication of the quality of healthcare provision and knowledge of the scale of the problem should be the basis for its evaluation and prevention. This is especially true for infections in puerperas.

Factors Shaping Attitudes of Medical Staff towards Acceptance of the Standard Precautions.

Standard precautions (SPs) guidelines are the minimum infection prevention practices that apply to all types of patient care, regardless of suspected or confirmed infection status of the patient. They are based on risk assessment, make use of common sense practices and personal protective equipment that protect healthcare providers from infection and prevent the spread of infection from patient to patient. The aim of this study was to determine medical staff's attitudes towards SPs and analyse the factors shaping these attitudes. The study was conducted using a questionnaire that comprised 25 statements describing the attitudes of medical personnel towards SPs. They were designed to pinpoint the factors that determine these attitudes. There were five factors identified that shape employees' attitudes towards SPs: assessment of the situation, favourable patterns of behaviour, negative norms, unfavourable patterns of behaviour and rationalising. The study analysed 505 questionnaires filled in by hospital workers from five Polish cities. The majority of the respondents were women (92.1%), nurses (87.5%); the average age was 41.8 and the average seniority was 19.2 years. Over one-third of the respondents worked in non-surgical (36.4%) and surgical (31.6%) wards, 12.3% were employed in intensive care units (ICUs) and 8.9% in emergency departments (EDs). The variable significantly affecting the level of acceptance of SPs was seniority: initially the support was high, then it later decreased, with the greatest decrease occurring between the third and eighth year of work. The staff of medical wards and ICUs demonstrated significantly lower support for SPs and strong environmental impact on SPs perception; low degree of acceptance among medical ward staff correlated negatively with factors from the category "favourable patterns of behaviour". The substantially strongest support for SPs was found in ED workers. The results indicate the need for continuous education of individual groups of workers concerning the application of SPs, but also the necessity to change the organisational culture in Polish hospitals.

An evaluation of family physicians' educational needs and experiences in health promotion and disease prevention in Poland and Lithuania--a qualitative study.

BACKGROUND: The aim of this study is to explore the views of family physicians/general practitioners about the most important competences in health promotion and diseases prevention and areas where these competences might be below the desired level. METHODS: A qualitative, descriptive study, combining two data collection techniques, was conducted in two Eastern European countries in June and July 2009. Focus groups numbering 10 and 9 physicians, respectively, practising in various clinical settings, were held in Poland and Lithuania. Seven well-informed health care experts were recruited in both countries to provide information during the in-depth interviews. In both formats, questions were devoted to three main areas of health promotion and disease prevention competences: (1) educational, (2) clinical, (3) organisational. A qualitative content analysis was performed. RESULTS: Lithuanian and Polish family physicians/general practitioners view preventive care as one of their main responsibilities. Among 3 areas of competences, participants identified clinical competences as the most important in everyday practice. They also acknowledged that organisational and educational competences might be below the level required for effective preventive care. Only clinical competences were indicated as sufficiently developed during under- and post-graduate medical education. CONCLUSIONS: In addressing current health promotion and disease prevention challenges, teachers of family medicine need to critically consider the training that currently exists for physicians. Development of a high-quality preventive service is not only a matter of proper education in the clinical field but also requires training in practice organisation and patient education.