Evaluation of a culture change program to reduce unprofessional behaviours by hospital co-workers in Australian hospitals.

BACKGROUND: Unprofessional behaviours between healthcare workers are highly prevalent. Evaluations of large-scale culture change programs are rare resulting in limited evidence of intervention effectiveness. We conducted a multi-method evaluation of a professional accountability and culture change program "Ethos" implemented across eight Australian hospitals. The Ethos program incorporates training for staff in speaking-up; an online system for reporting co-worker behaviours; and a tiered accountability pathway, including peer-messengers who deliver feedback to staff for 'reflection' or 'recognition'. Here we report the final evaluation component which aimed to measure changes in the prevalence of unprofessional behaviours before and after Ethos. METHODS: A survey of staff (clinical and non-clinical) experiences of 26 unprofessional behaviours across five hospitals at baseline before (2018) and 2.5-3 years after (2021/2022) Ethos implementation. Five of the 26 behaviours were classified as 'extreme' (e.g., assault) and 21 as incivility/bullying (e.g., being spoken to rudely). Our analysis assessed changes in four dimensions: work-related bullying; person-related bullying; physical bullying and sexual harassment. Change in experience of incivility/bullying was compared using multivariable ordinal logistic regression. Change in extreme behaviours was assessed using multivariable binary logistic regression. All models were adjusted for respondent characteristics. RESULTS: In total, 3975 surveys were completed. Staff reporting frequent incivility/bullying significantly declined from 41.7% (n = 1064; 95% CI 39.7,43.9) at baseline to 35.5% (n = 505; 95% CI 32.8,38.3; χ2(1) = 14.3; P < 0.001) post-Ethos. The odds of experiencing incivility/bullying declined by 24% (adjusted odds ratio [aOR] 0.76; 95% CI 0.66,0.87; P < 0.001) and odds of experiencing extreme behaviours by 32% (aOR 0.68; 95% CI 0.54,0.85; P < 0.001) following Ethos. All four dimensions showed a reduction of 32-41% in prevalence post-Ethos. Non-clinical staff reported the greatest decrease in their experience of unprofessional behaviour (aOR 0.41; 95% CI 0.29, 0.61). Staff attitudes and reported skills to speak-up were significantly more positive at follow-up. Awareness of the program was high (82.1%; 95% CI 80.0, 84.0%); 33% of respondents had sent or received an Ethos message. CONCLUSION: The Ethos program was associated with significant reductions in the prevalence of reported unprofessional behaviours and improved capacity of hospital staff to speak-up. These results add to evidence that staff will actively engage with a system that supports informal feedback to co-workers about their behaviours and is facilitated by trained peer messengers.

Effect of COVID-19 response work experience on turnover intention among employees of dedicated COVID-19 hospitals in Seoul.

BACKGROUND: According to previous studies, stress and job burnout among medical personnel increased during the COVID-19 pandemic. This study analyzed the effect of the experience of COVID-19 response work on the intention of municipal hospital staffs to leave their workplaces during the pandemic. METHODS: The 3556 employees who had worked for more than 1 year at one of the eight Seoul Municipal Hospitals that either provided inpatient treatment for quarantined COVID-19 patients or operated as screening clinics were taken as the study population. In total, 1227 employees completed a web or mobile survey between October 21 and November 18, 2020. A chi-squared test was performed to confirm the difference in the distribution of turnover intention depending on whether the employees performed COVID-19 response tasks. Multiple logistic regression analyses were performed to determine the factors that affected the intention to leave. RESULTS: Of the 1227 respondents, 761 (62.0%) were frontline workers who were the first line of response to COVID-19. Experience with COVID-19 response tasks (OR = 1.59, p = 0.003) was significantly associated with the intention to leave. Additionally, the probability of turnover intention was significantly higher among workers aged 20-29 years (OR = 2.11, p = 0.038) and 40-49 years (OR = 1.57, p = 0.048), unmarried individuals (OR = 1.66, p = 0.005), doctors (OR = 2.41, p = 0.010), nurses (OR = 1.59, p = 0.036), and technical staff members (OR = 2.22, p = 0.009). High turnover intention was found among those who experienced high levels of burnout (OR = 2.03, p < 0.001) and those working in non-directly managed municipal hospitals (OR = 1.87, p = 0.018). CONCLUSION: Employees directly involved in COVID-19 response work displayed higher turnover intention. Various personal, job, and organizational factors significantly influenced employees' intentions to leave their positions in dedicated COVID-19 hospitals. These findings suggest the necessity of introducing management programs to aid workers who have experienced sudden changes in their duties and loss of autonomy while performing COVID-19 response tasks.

The Impact of COVID-19 on Mental Health and Sleep Function of Hospital Staff Working With COVID-19 Patients: A Cross-Sectional Nationwide Study.

The coronavirus disease 2019 (COVID-19) pandemic has presented a globally challenging situation for human physical and mental health. Healthcare workers (HCWs) are affected by increased levels of anxiety, stress, and insomnia. This study aimed to evaluate the effect of COVID-19 on HCWs anxiety, stress, and insomnia levels. This cross-sectional study employed the Hospital Anxiety and Depression Scale, Perceived Stress Scale 10, and Insomnia Severity Index to assess anxiety, stress, and insomnia among HCWs at 10 COVID-19 isolation and treatment hospitals/centers after the first COVID-19 wave in Jordan. A web-based survey was used to collect data from 183 participants. Statistical analysis of factors affecting the mean scores of anxiety, stress, and insomnia was carried using student t-test or ANOVA while factors associated with differences in anxiety, stress, and insomnia frequencies were tested using Chi-square/Fisher exact test. Multivariate analysis was performed to determine the independent risk factors. Among participants, 97.3% reported moderate to severe levels of stress, 68% reported borderline to high abnormal levels of anxiety, and 32% had moderate to severe insomnia. The mean of anxiety total score was 9.8 ± 4.8, stress total score was 22.7 ± 4.5, and insomnia total score was 11.0 ± 7.1. Significant positive correlations were noted between anxiety, stress, and insomnia (P < .005). Female gender, migraine, less working years, increased time spent with patients, lower workforce, clinical insomnia and high stress were significant independent factors associated with anxiety (P < .05). Younger age, being single or divorced, heart disease, smoking, occupation (nurses), lower workforce, vaccination dose, and anxiety were significant independent factors associated with insomnia (P < .05). Increased time spent with patients, lower workforce, lower spouse and colleagues support, sadness due to isolation and anxiety were significant independent factors associated with stress. HCWs at COVID-19 centers had high levels of stress, anxiety, and insomnia. Appropriate interventions to maintain HCWs mental health are recommended.

Chinese hospital staff in anxiety and depression: Not only comfort patients but also should be comforted - A nationwide cross-sectional study.

BACKGROUND: Healthcare professionals are in short supply worldwide, especially in China, which can result in increased stress in the work environment and allostatic load for Chinese hospital staff. This study aimed to investigate the prevalence of anxiety and depressive symptoms and their relationship with total stress, allostatic overload, sleep quality, and episodic memory among Chinese hospital staff. METHOD: In this cross-sectional study, self-assessments including Generalized Anxiety Disorder 7-item (GAD-7), Patient Health Questionnaire-9 (PHQ-9), PsychoSocial Index (PSI), Pittsburgh Sleeping Quality Index (PSQI), and MemTrax test were used to evaluate participants' anxiety symptoms, depressive symptoms, total stress, allostatic load/overload, sleep quality, and episodic memory. RESULTS: A total of 9433 hospital staff from 304 cities participated. Anxiety prevalence was 21.0 % (95 % confidential interval (CI) 20.2 %, 21.8 %), while the prevalence of depressive symptoms was at 21.4 % (95 % CI 20.5 %, 22.2 %). 79.8 % (95 % CI 79.0 %, 80.6 %) of the hospital staff had allostatic overload. Poor sleep quality affected 50.4 % of participants, and 32.1 % experienced poor episodic memory. LIMITATIONS: This study utilized a convenience sampling approach, relying on an online survey as its data collection method. CONCLUSIONS: Hospital staff in China are facing a stressful environment with a high prevalence of anxiety and depressive symptoms, significant allostatic overload, poor sleep quality, and compromised episodic memory. It is imperative that local management and community structures enhance their support and care for these essential workers, enabling them to manage and withstand the stresses of their professional roles effectively.

Did a workplace sugar-sweetened beverage sales ban reduce anxiety-related sugar-sweetened beverage consumption during the COVID-19 pandemic?

OBJECTIVE: Workplace sugar-sweetened beverage (SSB) sales bans can reduce SSB consumption. Because stress and anxiety can promote sugar consumption, we examined whether anxiety among hospital employees during the COVID-19 pandemic was associated with changes in SSB consumption and explored whether this relationship varied by exposure to a workplace SSB sales ban. DESIGN: In a prospective, controlled trial of workplace SSB sales bans, we examined self-reported anxiety (generalised anxiety disorder-7) and self-reported SSB consumption (fluid ounces/d) before (July 2019) and during (May 2020) the COVID-19 pandemic. SETTING: Hospital sites in two conditions (four with SSB sales bans and three without sales bans) in Northern California. PARTICIPANTS: We sampled 580 participants (hospital employees) from a larger trial of sales bans; all were regular consumers of SSB (minimum 3/week at main trial enrollment). This subsample was chosen based on having appropriately timed data for our study questions. RESULTS: Across conditions, participants reduced SSB consumption over the study period. However, participants with higher pandemic-era anxiety scores experienced smaller reductions in SSB consumption after 9 months compared with those with lower anxiety scores (ß = 0·65, P < 0·05). When the sample was disaggregated by sales ban condition, this relationship held for participants in the control group (access to SSB at work, ß = 0·82, P < 0·05), but not for those exposed to an SSB sales ban (ß = 0·42, P = 0·25). CONCLUSIONS: SSB sales bans likely reduce SSB consumption through multiple pathways; buffering stress-related consumption may be one mechanism.

Spiritual Support Staff Influence Stress Among Hospital-Based Health Care Personnel: A Cross-Sectional Study.

BACKGROUND: Stress negatively affects well-being, relating to poor physical, emotional, and occupational outcomes for health care personnel. Health care professionals faced extreme stressors in the context of the COVID-19 pandemic, making occupational stress relief a top priority for hospital administrators. Many health systems employ specially trained spiritual support staff as one strategy to alleviate work-related stressors. It is unclear whether health care personnels' perceptions of the availability of spiritual care staff influence self-reported stress. OBJECTIVE: The purpose of this study was to explore relationships between perceived stress and perceptions of availability of spiritual support among acute care health care personnel. METHODS: This study analyzed cross-sectional, survey-based data collected between February and April 2022 from 1352 interdisciplinary health care staff working in a large, nonprofit Catholic health system in the Western United States. Bivariate tests and multivariate linear regression models were conducted to test for factors influencing perceived stress. RESULTS: Results support that high stress was prevalent in the sample. Perceived availability of spiritual support staff in the hospital and seeking coworker and professional support for work-related stress all independently influence stress in this population when controlling for confounders. CONCLUSIONS: Stress of health care personnel may be influenced by the perceived availability of specially trained spiritual support staff. Hospital administrators should advocate for spiritual support staff availability in all health care settings as one strategy to mitigate occupational stress that health care professionals may experience through providing high-stakes patient care. Further research is warranted to uncover targeted spirituality-related strategies to reduce stress and preserve well-being of health care personnel.

Utilizing Poetry as Spiritual Care for Hospital Staff.

This personal reflection emphasizes the potential benefits of poetry for interfaith spiritual and pastoral support of medical professionals. Details are provided for the implementation of several successful practices, including an Intensive Care Unit Poetry Basket, Portable Poetry with Aromatherapy Towelette Hand Blessings, and Presenting Poems to Nurse Practice Council. The references include the poetry used in the spiritual care activities and the author also provided a helpful "Further Resources" section.

Using Rasch Wright map to identify hospital employee satisfaction during and before COVID-19.

During the surge of the COVID-19 outbreak, medical personnel attended to countless patients, which adversely affected their mental well-being. To support their staff, hospitals implemented guidelines that focused on promoting mental health among medical professionals. The hypothesis that employee satisfaction declined during the COVID-19 pandemic needs confirmation. Several findings were derived from a series of visualizations using Rasch Wright map. The research sample was taken from a medical center in southern Taiwan based on satisfaction survey data from 2017 to 2022 (n = 1222). Perceptions on job satisfaction perceptions during and prior to COVID-19 in 2 stages of 2017 to 2019 and 2020 to 2022 were compared using Rasch Wright map. Through a series of visualizations, including the dimension with the highest satisfaction, the demographical category of hospital employees with the lowest satisfaction during the pandemic, and Rasch Wright map displaying employs' perfections on 4 domains over years. The results indicated: Employee satisfaction was significantly lower during the COVID-19 period in 2 domains: compensation and benefits, work atmosphere; among the 23 questions, Question 5 (regarding meals provided by the hospital to staff) scored the lowest, while Question 23 (regarding the hospital emergency response and disaster prevention capabilities) scored the highest. Among the 4 domains, organizational leadership had the highest satisfaction; out of 104 demographic variables, 21 groups showed that employee satisfaction during the pandemic was significantly (P < .05) lower than before the pandemic; the selection of specific demographic variables is for top-tier supervisors, and they showed that employee satisfaction during the pandemic was significantly (P < .05) lower than before the pandemic across all 4 dimensions. Therefore, this study accepts the hypothesis that employee satisfaction was negatively affected during the COVID-19 period on 2 domains only: compensation and benefits, work atmosphere. The study visual examination, especially using Rasch Wright map, offers a comparative perspective on hospital staff satisfaction and serves as a methodological guide for subsequent satisfaction research.

Team experiences of the root cause analysis process after a sentinel event: a qualitative case study.

BACKGROUND: Root cause analysis (RCA) is a systematic approach, typically involving several stages, used in healthcare to identify the underlying causes of a medical error or sentinel event. This study focuses on how members of a Norwegian RCA team experience aspects of an RCA process and whether it complies with the Norwegian RCA method. METHOD: Based on a sentinel event in which a child died unexpectedly during childbirth in a Norwegian hospital in 2021, the following research questions are addressed: 1. What was the RCA team's experience of the RCA process? 2. Was there compliance with the Norwegian RCA method in this case? A case study was chosen out of the desire to understand complex social phenomena and to allow in-depth focus on a case. RESULTS: The result covered three main themes. The first theme related to the hospital's management system and aspects of the case that made it challenging to follow all recommendations in the Norwegian RCA guidelines. The second theme encompassed external and internal assessment. The RCA team was composed of members with methodological and medical expertise. However, the police's involvement in the case made it complex for the team to carry out the process. The third and final theme covered intrapersonal challenges RCA team members faced. Team members experienced various challenges during the RCA process, including being neutral, dealing with role-related challenges, grappling with ambivalence, and managing the additional time burden and resource constraints. As anticipated in the RCA guidelines, the team's ability to remain neutral was tested. CONCLUSION: The findings of this study can help stakeholders better comprehend how an inter-professional RCA teamwork intervention can affect a healthcare organization and enhance the teamwork experience of healthcare staff while facilitating improvements in work processes and patient safety. Additionally, these results can guide stakeholders in creating, executing, utilizing, and educating others about RCA processes.

What helps hospital staff in times of crisis: qualitative results of a survey on psychosocial resources and stressors in German hospitals during the COVID-19 pandemic.

Background: Even before the COVID-19 pandemic, hospital workers faced a tremendous workload. The pandemic led to different and additional strain that negatively affected the well-being of employees. This study aims to explore psychosocial resources and strategies that were used by hospital staff. Methods: In the context of an intervention study, employees of three German hospitals were questioned in writing in summer and fall 2020. Five open-ended questions about the pandemic were asked to capture corresponding effects on daily work routine. Answers of 303 participants were evaluated using structuring qualitative content analysis. Results: Significant stressors and resources were identified in the areas of work content and task, social relations at work, organization of work, work environment and individual aspects. Stressors included, for example, emotional demands, conflicts, an increased workload, time and performance pressure. Important resources mentioned were, among others, the exchange with colleagues and mutual support. Sound information exchange, clear processes and guidelines and a positive work atmosphere were also important. In addition, the private environment and a positive mindset were perceived as helpful. Conclusion: This study contributes to a differentiated understanding of existing psychosocial resources of hospital staff in times of crisis. Identifying and strengthening these resources could reduce stress and improve well-being, making hospital staff better prepared for both normal operations and further crisis situations.

Anxiety and Depression Survey and Analysis of Hospital Staff in a Designated Hospital in Shannan City During the COVID-19 Pandemic.

BACKGROUND The aim of this study was to evaluate the psychological status of anxiety and depression of hospital staff in the designated hospital in the city of Shannan during the COVID-19 pandemic in order to provide a theoretical basis for effective psychological intervention. MATERIAL AND METHODS A cross-sectional survey was performed from September 10 to 16, 2022, by administering an online questionnaire to the hospital staff on duty in the hospital. We collected participants' demographic and general information. The Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) were used to investigate the anxiety and depression of hospital staff. RESULTS Among 267 hospital staff, anxiety was found in 98 individuals, with a prevalence of 36.70%. Depression was found in 170 individuals, with a prevalence of 63.67%. Anxiety combined with depression was found in 84 individuals, with a prevalence of 31.46%. The prevalence of depression was higher in women, Tibetan personnel, hospital staff with primary or lower titles, staff without career establishment, and non-aid Tibetan personnel, and the differences were all statistically significant (P.

Alcohol misuse, health-related behaviors, and burnout among clinical therapists in China during the early Covid-19 pandemic: A Nationwide survey.

Objectives: This study aimed to assess the extent of alcohol use and misuse among clinical therapists working in psychiatric hospitals in China during the early COVID-19 Pandemic, and to identify associated factors. Methods: An anonymous nationwide survey was conducted in 41 tertiary psychiatric hospitals. We collected demographic data as well as alcohol use using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) and burnout using the Maslach Burnout Inventory Human Services Survey. Results: In total, 396 clinical therapists completed the survey, representing 89.0% of all potential participants we targeted. The mean age of participants was 33.8 years old, and more than three-quarters (77.5%) were female. Nearly two-fifths (39.1%) self-reported as current alcohol users. The overall prevalence of alcohol misuse was 6.6%. Nearly one-fifth (19.9%) reported symptoms of burnout with high emotional exhaustion in 46 (11.6%), and high depersonalization in 61 (15.4%). Multiple logistic regression showed alcohol use was associated with male gender (OR = 4.392; 95% CI =2.443-7.894), single marital status (OR = 1.652; 95% CI =0.970-2.814), smoking habit (OR = 3.847; 95%CI =1.160-12.758) and regular exercise (OR = 2.719; 95%CI =1.490-4.963). Alcohol misuse was associated with male gender (OR = 3.367; 95% CI =1.174-9.655), a lower education level (OR = 3.788; 95%CI =1.009-14.224), smoking habit (OR = 4.626; 95%CI =1.277-16.754) and high burnout (depersonalization, OR = 4.848; 95%CI =1.433-16.406). Conclusion: During the COVID-19 pandemic, clinical therapists' alcohol consumption did not increase significantly. Male gender, cigarette smoking, and burnout are associated with an increased risk of alcohol misuse among clinical therapists. Targeted intervention is needed when developing strategies to reduce alcohol misuse and improve clinical therapists' wellness and mental health.

Improving domestic violence screening practices in the emergency department: an Australian perspective.

INTRODUCTION: Domestic violence (DV) is a major cause of morbidity worldwide. The ED is a location recommended for opportunistic screening. However, screening within EDs remains irregular. OBJECTIVE: To examine intrinsic and extrinsic barriers to routine screening in Australian EDs, while describing actions taken after identification of DV. METHODS: Emergency clinicians at nine public hospitals participated in an anonymous online survey. Factor analysis was performed to identify principal components around attitudes and beliefs towards screening. RESULTS: In total, 496 emergency clinicians participated. Universal screening was uncommon; less than 2% of respondents reported screening all adults or all women. Although willing, nearly half (45%) reported not knowing how to screen. High patient load and no single rooms were 'very or severely limiting' for 88% of respondents, respectively, while 24/7 social work and interpreter services, and online/written DV protocols were top enablers. Factor analysis identified four distinct intrinsic belief components: (1) screening is not futile and could be done in ED, (2) screening will not cause harm, (3) there is a duty to screen and (4) I am willing to screen. CONCLUSION: This study describes a culture of Queensland ED clinicians that believe DV screening in ED is important and interventions are effective. Most ED clinicians are willing to screen. In this setting, availability of social work and interpreter services are important mitigating resources. Clinician education focusing on duty to screen, coupled with a built-in screening tool, and e-links to a local management protocol may improve the uptake of screening and subsequently increase detection.

Risk factors for reduction in adherence to protective measures following coronavirus disease 2019 (COVID-19) vaccination and vaccine perceptions among healthcare workers, in São Paulo, Brazil.

A survey evaluated 2,300 healthcare workers following the first dose of a coronavirus disease 2019 (COVID-19) vaccine in a tertiary-quaternary hospital in São Paulo, Brazil. Adherence to protective measures following vaccination was compared to previous non-work-related behaviors. Younger age, previous COVID-19, and burnout symptoms were associated with reduced adherence to mitigation measures.

Stakeholder perspectives on scaling up medical device reprocessing: A qualitative study.

BACKGROUND: The United States health care sector is one of the largest polluting industries, which has significant adverse effects on human health. Medical device reprocessing (MDR) is a sustainability solution that has the potential to decrease hospital waste, cut carbon emissions, reduce spending, and improve supply chain resiliency; however, only a small proportion of FDA-approved devices are actually reprocessed. Thus, we conducted a qualitative study to understand barriers and facilitators of scaling up MDR. METHODS AND FINDINGS: We conducted in-depth interviews with 17 stakeholders (exceeding thematic saturation) at a large academic health system in New England and national MDR organizations. We also collected observations through site visits at the health system. We recruited participants from June 2021 to April 2022 through purposive sampling. Using an analytic approach guided by the Consolidated Framework for Implementation Research, we applied inductive and deductive codes related to key implementation constructs. We then conducted a thematic analysis and identified five overarching themes related to barriers and facilitators of MDR. First, respondents explained that regulatory bodies and original equipment manufacturers determine which devices can be reprocessed. For example, some respondents described that original equipment manufacturers use tactics of forced obsolescence that prevent their devices from being reprocessed. Second, respondents explained that MDR has variable compatibility with hospital priorities; for example, the potential cost savings of MDR is compatible with their priorities, while the perception of decreased functionality of reprocessed medical devices is incompatible. Third, respondents described that physician preferences influence which reprocessed devices get ordered. Fourth, respondents explained that variable staff knowledge and beliefs about MDR influence their motivations to select and collect reprocessable devices. Lastly, respondents emphasized that there was a lack of infrastructure for evaluating and maintaining MDR programs within their health system. CONCLUSIONS: Based on our findings, we have outlined a number of recommendations that target these barriers and facilitators so that the environmental and financial benefits of MDR can be realized at this health system and nationally. For example, implementing federal policies that prevent original equipment manufacturers from using tactics of forced obsolescence can facilitate the scale-up of MDR nationally. Additionally, providing life cycle assessments that compare the environmental effects of single-use disposable, reprocessable disposable, and reusable devices could facilitate health systems' purchasing decisions. Creating and disseminating audit and feedback reports to hospital staff might also facilitate their continued engagement in the program. Lastly, hiring a full-time program manager that leads MDR programs within health systems could improve program sustainability.

Pandemic-Related Experiences and Stress Among Children's Hospital Staff Predict Psychosocial Risk.

GOAL: COVID-19 has imposed unique challenges for healthcare workers who have faced increased risk of exposure to the virus, heightened work demands, and disruptions in work-life balance. For some healthcare workers, these challenges may have contributed to increased stress, burnout, and psychosocial impairment, including symptoms of depression and anxiety. The current study addresses a knowledge gap of associations between pandemic-related experiences and psychosocial risk among medical and nonmedical pediatric healthcare staff. METHODS: A sample of 369 staff (90% female) employed at an acute care, freestanding pediatric hospital in Connecticut completed an online survey. The survey assessed specific pandemic-related experiences and perceived impact with the Epidemic-Pandemic Impacts Inventory, and depression and anxiety risk with the 2-item Patient Health Questionnaire depression screen and 2-item Generalized Anxiety Disorder screen, respectively. Enrollment and survey completion occurred over a 6-week period during the pandemic (summer 2020). PRINCIPAL FINDINGS: High rates of adverse pandemic-related experiences included workplace experiences (e.g., inadequate support, interpersonal difficulties), home life (e.g., childcare difficulties, partner conflict), and experiences reflecting social isolation and quarantine, child and adult mental health difficulties, increased alcohol or substance use, and unhealthy lifestyle behaviors. Medical relative to nonmedical staff reported significantly more adverse and fewer positive experiences, and a significantly higher perceived negative impact of workplace experiences. A positive screen for depression or anxiety was significantly predicted by cumulative adverse workplace experiences (OR = 1.15), changes in emotional/physical health (OR = 1.35), and perceived negative impact of workplace experiences (OR = 1.32). APPLICATIONS TO PRACTICE: The present study joins recent reports of increased adverse experiences and psychosocial outcomes among healthcare workers during the COVID-19 pandemic. Findings underscore the need for pediatric hospitals to innovate ways to reduce burden and connect staff to mental health services during similar public health crises. Such services might include (1) assisting healthcare staff to navigate disruptions in their home and social lives as a result of new challenges faced at work, (2) adapting the hospital environment and culture to mitigate stress experienced by staff because of these challenges, and (3) bolstering mental health screening and services to address exacerbated or emerging mental health symptoms, such as depression and anxiety.

Burnout in hospital staff using partial least squares path modeling for job-person fit: The case of a tertiary referral hospital in southwest Iran.

Recent studies on burnout (BO) have included both individual and situational factors, referred to as job-person fit (JPF). The present study aimed to evaluate the prevalence rate of BO in the hospital staff working at a tertiary referral hospital in southwest Iran and then to highlight the importance of the person in the context of his/her work life. This cross-sectional study was conducted in 2020 on all hospital staff using a three-part questionnaire comprised of personal and work-situational factors, the Perceived Stress Scale (PSS), and the Psychological Empowerment Scale (PES). The partial least squares (PLS) path modelling and the neural network (NN) model were used to identify the significant variables within the BO dimensions. A total of 358 staff completed the questionnaire and were recruited for the study. Emotional exhaustion (EE) was seen in 137 medical staff (38.3%) and depersonalization (DP) was observed in 75 individuals (20.1%). Thinking about job change was the most important factor positively correlated with EE. Positive stress and work experience were among the most significant factors negatively associated with PA and DP, respectively. The hospital staff experienced BO in a way comparable to the national results. Work-situational and personal variables interacted with the three dimensions of BO in the hospital staff. More experienced staff also felt more accomplished and successful, resulting in the identification of a decreased level of DP and elevated PA.

Alcohol Consumption and COVID-19-Related Stress Among Health Care Workers: The Need for Continued Stress-Management Interventions.

OBJECTIVES: Although a known association exists between stress and alcohol consumption among health care workers (HCWs), it is not known how the COVID-19 pandemic has affected this association. We assessed pandemic work-related stress and alcohol consumption of HCWs. METHODS: We emailed a cross-sectional, anonymous survey in June 2020 to approximately 550 HCWs at an academic hospital in New Orleans, Louisiana. HCWs from all departments were eligible to complete the survey. Questions measured work-related stress and emotional reactions to the pandemic (using the Middle East Respiratory Syndrome [MERS-CoV] Staff Questionnaire), depressive symptoms (using the Patient Health Questionnaire-9 [PHQ-9]), coping habits (using the Brief COPE scale), and pre-COVID-19 (March 2020) and current (June 2020) alcohol consumption. We measured alcohol consumption using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C), with scores >3 considered positive. We asked 4 open-ended questions for in-depth analysis. RESULTS: One-hundred two HCWs participated in the survey. The average AUDIT-C scores for current and pre-COVID-19 alcohol consumption were 3.1 and 2.8, respectively. The level of current alcohol consumption was associated with avoidant coping (r = 0.46, P < .001). Relative increases in alcohol consumption from March to June 2020 were positively associated with PHQ-9 score and greater emotional reactions to the pandemic. Availability of mental health services was ranked second to last among desired supports. Qualitative data demonstrated high levels of work-related stress from potential exposure to COVID-19 and job instability, as well as social isolation and negative effects of the pandemic on their work environment. CONCLUSIONS: Ongoing prevention-based interventions that emphasize stress management rather than mental or behavioral health conditions are needed.

Preventing patient violence in hospitals: Applying critical decision method interviews to understand how skilled staff think and act differently.

AIMS: Our aims were to understand how hospital staff who are skilled at managing aggressive patients recognize and respond to patient aggression and to compare the approaches of skilled staff to the experiences of staff who were recently involved in incidents of patient violence. BACKGROUND: Violence from patients toward staff is prevalent and increasing. There is a need for greater understanding of effective approaches to managing patient aggression in a wide variety of hospital settings. METHODS: We conducted grounded theory qualitative research applying Critical Decision Method interviews at two hospitals. Skilled staff and incident-involved staff were asked to describe experiences involving aggressive patients and the data were analyzed qualitatively. RESULTS: Our interviews (N = 23) identified positive approaches and challenges to managing aggressive patients. Positive approaches included: maintaining empathy for the patient, allowing the patient time and space, exhibiting a calm demeanor, not taking things personally, and implementing strategies to build trust. Challenges included: inadequate psychiatric resources, balancing priorities between patients with urgent physical needs and those exhibiting difficult behaviors, and perceiving pressure to de-escalate situations quickly. Incident-involved staff were more likely to describe the challenges listed above and a limited tolerance for patients whose behavior they perceived as unjustified or detracting from other patients' care. CONCLUSION: The Critical Decision Method proved valuable for highlighting nuanced understandings of skilled staff that sometimes contrasted with perceptions of incident-involved staff. Our findings support investigation of novel approaches to training such as peer coaching and improving empathy through increased understanding of mental illnesses and addiction.