Prevalence and related factors of nephrolithiasis among medical staff in Qingdao, China: a retrospective cross-sectional study.

BACKGROUND: Certain occupations may predispose individuals to urolithiasis, a multi-factorial disease. The study aimed to evaluate the prevalence and related factors of nephrolithiasis in medical staff in Qingdao, China. METHODS: Physical examination results of 5115 in-service medical staff aged 22-60 years old were retrospectively analyzed. Multivariable logistic regression analysis and stratified analyses by age and gender were applied to explore the related factors of nephrolithiasis in these medical staff. RESULTS: The overall nephrolithiasis prevalence in medical staff in Qingdao, China was 4.65%. Doctors were more prone to nephrolithiasis than nurses (5.63% vs. 3.96%, P = 0.013) and the peak prevalence (6.69%) was observed in medical staff working in the emergency department (ED). Male gender (OR = 1.615, 95% CI = 1.123-2.323, P = 0.010), overweight or obesity (OR = 1.674, 95% CI = 1.266-2.214, P < 0.001), work seniority ≥ 10 years (OR = 2.489, 95%CI = 1.675-3.699, P < 0.001) and working in the ED (OR = 1.815, 95% CI = 1.202-2.742, P = 0.005) were independent predictors for nephrolithiasis in medical staff based on the results of multivariate logistic regression analysis. The associations between overweight or obesity and nephrolithiasis risk as well as between work seniority ≥ 10 years and nephrolithiasis risk in medical staff were independent of age or gender in stratified analysis. CONCLUSIONS: Nephrolithiasis prevalence in medical staff in Qingdao, China seemed not to be higher than that in the general population. Medical staff with work seniority ≥ 10 years and working in the ED should pay abundant attention to take measures to modify their nephrolithiasis risk.

Monitoring of surgical staff x-ray exposure in the operating room with DosiBadge.

Surgical procedures involving the use of x-rays in the operating room (OR) have increased in recent years, thereby increasing the exposure of OR staff to ionizing radiation. An individual dosimeter makes it possible to record the radiation exposure to which these personnel are exposed, but there is a lack of compliance in the wearing of these dosimeters for several practical reasons. This makes the dose results obtained unreliable. To try to improve the rate of dosimeter wearing in the OR, the Dosibadge project studied the association of the individual dosimeter with the hospital access badge, forming the Dosibadge. Through a study performed at the Tours University Hospital in eight different ORs for two consecutive periods of 3 months. The results show a significant increase in the systematic use of the dosimeter thanks to the Dosibadge, which improves the reliability of the doses obtained on the dosimeters and the monitoring of personnel. The increase is especially marked with clinicians. Following these results and the very positive feedback to this first single-centre study, we are then planning a second multicentre study to validate our proof of concept on different sites, with the three brands of individual dosimeters used in France i.e. dosimeters supplied by Dosilab; Landauer and IRSN.

Predicting the number of IT staff needed in hospitals of Isfahan University of Medical Sciences based on modeling in 2023: A descriptive-analytical study.

Background and Aims: Considering the increasing use of information technology (IT) and the need of the implementation of related projects, the lack of IT specialists in the health system is one of the major challenges that require planning and foreseeing. This study was conducted with the aim of predicting the number of required IT personnel in hospitals of Isfahan University of Medical Sciences based on the modeling of identified and weighed influential factors in 2023. Method: First, Delphi method and multi-criteria decision-making (MCDM) using the Expository Posthaste Effective Resemblant Tool (ExPERT) were conducted to identify and weigh the components that affect IT staff's workload in hospitals. Then, the model for predicting the required number of IT personnel for the involved hospitals was developed. In all stages, the obtained information and results were checked and confirmed using experts' opinions in Focus Group Discussions. Results: Twenty-one hospitals (57%) out of 37 hospitals are facing a shortage of IT personnel. This varies from 0.5 to 1.6 personnel in different hospitals. Thirteen hospitals (35%) were reported to have adequate IT staffing and three hospitals (8%) had excess IT staffing. Conclusion: This study provided a predictive model for required IT staff in hospitals using MCDM through ExPERT which can be used in cases where the use of workload-based methods such as Workload Indicators of Staffing Need is complex or time-consuming.

How to undertake an effective coaching session.

RATIONALE AND KEY POINTS: Nurse leaders and managers are being encouraged to adopt developmental and transformational leadership styles, and coaching is one tool that they can use to that effect. Beyond formal coaching relationships, the principles of coaching can be relevant to a variety of conversations with staff, for example during appraisals, clinical supervision or training. Applying the principles of coaching as a nurse leader or nurse manager appears to have benefits for all involved. Coaching can help build trusting relationships and empower staff to set themselves meaningful and solution-focused goals and actions and therefore facilitate change. However, the practice of coaching is sometimes misunderstood, while coaching that is unplanned or implemented ineffectively may compromise relationships. •  Coaching is not a directive approach, instead the coach needs to adopt a non-judgemental, supportive and collaborative stance. •  Coaching requires both parties to enter a learning process aimed at bringing about change and should be built on a commitment to that learning process. •  Asking 'curious' questions, encouraging critical reflection and using active listening form the basis of an effective coaching conversation. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: •  How this article might improve your practice when coaching a member of your immediate team or a colleague. •  How you could use this information to educate nursing students and colleagues on the appropriate techniques and evidence base relating to coaching.

Bedside critical care training: A quasi-experimental study in the paediatric emergency department of a referral hospital in Nigeria.

Background: There is a need for critical care services outside intensive care units (ICUs), especially in emergency departments (EDs). However, there is a paucity of skilled manpower for ED critical care or emergency critical care (ECC) in resource-limited settings. Objectives: To evaluate the impact of bedside training on emergency critical care practices of clinical staff. Methods: This was a quasi-experimental study using a pretest - post-test design in a paediatric ED. The intervention was a six-week structured bedside training on bubble continuous positive airway pressure (CPAP) high-flow nasal cannula (HFNC) and mechanical ventilation. Participants' actual ECC practices pre and post training were evaluated, including their perceived proficiency on an uncalibrated 100 mm visual analogue scale (VAS). Descriptive and inferential analyses were done; p<0.05 was considered significant. Results: A total of 35 clinical staff participated in the training, comprising 9 (24.3%) paediatric registrars, 12 (32.5%) senior registrars, 10 (27.0%) nurses, 4 (10.8%) house officers and 2 (5.4%) paediatric consultants. The male:female ratio of the participants was 1:1.6, and their mean (SD) age was 33.24 (6.30 years. Participants' understanding of testing the CPAP circuit, connecting the patient and weaning significantly improved following training (p=0.004). Their capacity to select appropriate HFNC parameters improved (p=0.013). They performed more endotracheal intubations in the post-training period (p=0.001). Their pretest-post-test proficiency in mechanical ventilation increased on VAS (mean scores 45.26+31.99 v. 63.26+22.26; p=0.038). Also, there was a significant increase in their perceived proficiency in paediatric analgesia/sedation (30.83+29.86 v. 49.83+23.90; p=0.029). Conclusion: Short-term bedside critical care training enhanced the self-reported competency of paediatric ED staff. There is a need for on-the-job ECC training and retraining of clinical staff in our setting. Contribution of the study: Paediatric emergency department clinical staff desire hands-on critical care training in developing settings. Bedside training improves the knowledge and skills of nursing staff in non-invasive ventilation. Bedside training also builds the capacity of medical staff in invasive ventilation in the emergency department. Overall, short-term bedside training enhances the clinical knowledge and self-reported critical care practice of clinical staff in Children's Emergency Room.

Occupational health staff's involvement contributes to supervisor's perceived organizational support in Japanese workforce: a prospective cohort study.

OBJECTIVES: Enhancing employees' perceived organizational support (POS) is crucial for organization, and one effective approach is enhancing supervisors' POS. However, there is limited research focusing specifically on enhancing supervisors' POS. We aimed to investigate the influence of occupational health staff's involvement for supervisors on their POS. METHODS: A prospective cohort study was conducted using an online survey targeting supervisors in various industries across Japan. We assessed supervisors' POS using an effective 8-items of the Japanese version of the Survey of Perceived Organizational Support. Data on the involvement of occupational health staff in providing occupational health staff's involvement in providing supervisors with training on workplace health management and guidance on addressing specific subordinates with health concerns were collected. The association between these involvement and POS was assessed through multiple regression analyses. RESULTS: The study involved 541 supervisors with occupational health staff at their workplace in the final analysis. Training from occupational health staff was significantly associated with an increase in POS at follow-up after adjustment for potential confounders, including demographic variables and POS at baseline. Similarly, guidance from occupational health staff was also significantly associated with an increase POS. This effect was particularly notable in small workplaces. CONCLUSIONS: Our study indicates that occupational health staff's involvement in supporting supervisors can contribute to enhancing supervisors' POS, especially in small workplaces. These findings suggest that by developing structured systems and establishing specific roles for occupational health staff, organizations may effectively enhance supervisors' POS.

To tell or not to tell about bullying-New insights from the study on the perceptions of criminal sanctioning, anticipation of school punishment, agency, and trust toward school staff.

The primary aim of this study was to determine whether perceptions of criminal sanctioning and school punishment predict students' willingness to report different types of bullying (material, physical, sexual, verbal, relational, and cyberbullying). An online survey was conducted with secondary school students (n = 1092) as participants. Traditionally included predictors (trust toward school staff, cost of reporting bullying, gender, and school agency) were also incorporated into a multiple linear regression analysis. The perception of criminal sanctioning for a particular type of bullying was a significant predictor of the willingness to report a given type of bullying, whereas anticipation of school punishment was relevant only in the case of cyberbullying. Trust toward school staff and gender were also significant predictors of willingness to report any type of bullying. School agency helped predict the willingness to report any kind of bullying except cyberbullying. Surprisingly, the costs of reporting bullying were relevant only in the case of material bullying. These results have important implications for stakeholders and school administration in identifying unreported bullying, developing and implementing anti-bullying policies, and introducing programs aimed at improving students' legal awareness.

Imposter phenomenon: recognising and addressing it among nurses.

Imposter phenomenon is described as persistently doubting one's accomplishments, leading to an internalised fear of being exposed as a 'fraud'. This article identifies the nature and prevalence of imposter phenomenon among nursing students, newly registered nurses and senior nurses. It also explores the effects of this phenomenon for nurses and healthcare organisations, including its potential association with burnout, suboptimal performance and a lack of career development. Evidence suggests that addressing imposter phenomenon is not something individuals can accomplish by themselves, but that it requires system-level interventions from healthcare organisations and higher education institutions. This could raise awareness, promote recognition and improve resources and training to mitigate the detrimental effects of this phenomenon on healthcare provision.

Does health-related college major have an effect on health-promoting behaviors? Evidence from Iranian's staff.

Background: Health-promoting behaviors and lifestyle changes can reduce the cost of health services, stress, and disease complications. This study examined the status of health-promoting behaviors and its influencing factors. Methods: This cross-sectional study was conducted on 171 staff members of Zanjan University of Medical Sciences, Iran, in 2023. The Persian version of the health-promoting lifestyle profile II questionnaire was used. Analyzes were performed in R 4.3.2 software. Results: Mean ± SD age was 37.67 ± 7.58 years. 83 % had the low levels of health-promoting behaviors, while 17.0 % had moderate levels. The physical activity and interpersonal relation had the lowest and highest scores. The most significant strong and weekly correlations was between health responsibility and physical activity with total score of health-promoting behavior scores (r = 0.81, r = 0.66). Staff with health-related college major performed better in the areas of nutrition, stress management, spiritual growth. Conclusion: Health-related college major is the most important factor affecting health-promoting behaviors. Also, health responsibility is most related to these behaviors. Educational interventions should be done at the community level, regardless of people's field of study, to increase people's knowledge and awareness about risk factors and improve the level of health.

The relationship between medical staff burnout and subjective wellbeing: the chain mediating role of psychological capital and perceived social support.

Background: Medical staff play a crucial role in delivering healthcare services, especially during epidemics of infectious diseases such as coronavirus disease 2019 (COVID-19). However, there is a growing issue of burnout and low wellbeing among this group. While it is widely recognized that burnout has a negative impact on subjective wellbeing, the exact relationship between the two is not yet completely understood. The purpose of this study is to explore the chain mediating role of psychological capital and perceived social support between burnout and subjective wellbeing among medical staff. Methods: Using the convenient sampling method, 604 medical staff were selected for a cross-sectional study. All participants completed a self-report questionnaire that collected demographic information, as well as data from the Maslach Burnout Inventory-Human Services Survey, General Wellbeing Schedule, Psychological Capital Questionnaire, and Perceived Social Support Scale. SPSS 27.0 and SPSS PROCESS macro were used for data analysis. Results: There was a significant correlation between burnout, psychological capital, perceived social support, and subjective wellbeing (p < 0.01). Burnout not only has a direct negative impact on the subjective wellbeing of medical staff (effect: -0.2045; Bootstrap 95%CI: -0.2506, -0.1583), but also exerts an indirect influence on subjective wellbeing through three pathways: the independent mediating effect of psychological capital (effect: -0.0481; Bootstrap 95%CI: -0.0876, -0.0109), the independent mediating effect of perceived social support (effect: -0.0092; Bootstrap 95%CI: -0.0203, -0.0003), and the chained mediating effect of psychological capital and perceived social support (effect: -0.0092; Bootstrap 95%CI: -0.0183, -0.0019). Conclusion: High burnout in medical staff can impair the level of psychological capital, leading to diminished perceived social support and ultimately reduced subjective wellbeing. The findings of this study contribute to understanding the potential pathways between burnout and subjective wellbeing and provide preliminary data support for developing strategies to improve the mental health of medical staff.

Health and wellbeing of staff working at higher education institutions globally during the post-COVID-19 pandemic period: evidence from a cross-sectional study.

BACKGROUND: The ongoing global crisis of Higher Education (HE) institutions during the post-COVID-19 pandemic period has increased the likelihood of enduring psychological stressors for staff. This study aimed to identify factors associated with job insecurity, burnout, psychological distress and coping amongst staff working at HE institutions globally. METHODS: An anonymous cross-sectional study was conducted in 2023 with staff at HE institutions across 16 countries. Job insecurity was measured using the Job Insecurity Scale (JIS), burnout using the Perceived Burnout measure question, psychological distress using the Kessler Psychological Distress Scale (K10), and coping using the Brief Resilient Coping Scale. Multivariable logistic regression with a stepwise variable selection method was used to identify associations. RESULTS: A total of 2,353 staff participated; the mean age (± SD) was 43(± 10) years and 61% were females. Most staff (85%) did not feel job insecurity, one-third (29%) perceived burnout in their jobs, more than two-thirds (73%) experienced moderate to very high levels of psychological distress, and more than half (58%) exhibited medium to high resilient coping. Perceived job insecurity was associated with staff working part-time [Adjusted Odds Ratio 1.53 (95% Confidence Intervals 1.15-2.02)], having an academic appointment [2.45 (1.78-3.27)], having multiple co-morbidities [1.86 (1.41-2.48)], perceived burnout [1.99 (1.54-2.56)] and moderate to very high level of psychological distress [1.68 (1.18-2.39)]. Perceived burnout was associated with being female [1.35 (1.12-1.63)], having multiple co-morbidities [1.53 (1.20-1.97)], perceived job insecurity [1.99 (1.55-2.57)], and moderate to very high levels of psychological distress [3.23 (2.42-4.30)]. Staff with multiple co-morbidities [1.46 (1.11-1.92)], mental health issues [2.73 (1.79-4.15)], perceived job insecurity [1.61 (1.13-2.30)], and perceived burnout [3.22 (2.41-4.31)] were associated with moderate to very high levels of psychological distress. Staff who perceived their mental health as good to excellent [3.36 (2.69-4.19)] were more likely to have medium to high resilient coping. CONCLUSIONS: Factors identified in this study should be considered in reviewing and updating current support strategies for staff at HE institutions across all countries to reduce stress and burnout and improve wellbeing.

The paradox of workplace violence in the intensive care unit: a focus group study.

BACKGROUND: Conflicts with patients and relatives occur frequently in intensive care units (ICUs), driven by factors that are intensified by critical illness and its treatments. A majority of ICU healthcare professionals have experienced verbal and/or physical violence. There is a need to understand how healthcare professionals in ICUs experience and manage this workplace violence. METHODS: A qualitative descriptive analysis of four hospitals in Sweden was conducted using semi-structured focus-group interviews with ICU healthcare professionals. RESULTS: A total of 34 participants (14 nurses, 6 physicians and 14 other staff) were interviewed across the four hospitals. The overarching theme: "The paradox of violence in healthcare" illustrated a normalisation of violence in ICU care and indicated a complex association between healthcare professionals regarding violence as an integral aspect of caregiving, while simultaneously identifying themselves as victims of this violence. The healthcare professionals described being poorly prepared and lacking appropriate tools to manage violent situations. The management of violence was therefore mostly based on self-taught skills. CONCLUSIONS: This study contributes to understanding the normalisation of violence in ICU care and gives a possible explanation for its origins. The paradox involves a multifaceted approach that acknowledges and confronts the structural and cultural dimensions of violence in healthcare. Such an approach will lay the foundations for a more sustainable healthcare system.

At the break point: What needs to change for antimicrobial stewardship program pharmacists?

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

Enhancing COVID-19 Risk Mitigation in Bisha City Primary Schools: Investigating Teacher and Administrative Staff Awareness Through a Comprehensive Survey.

Background and aims This research investigates COVID-19 awareness among primary school teachers and staff in Bisha City. It aims to enhance safety protocols by examining knowledge, awareness levels, and demographic associations. Despite school reopening, concerns linger. The study promotes informed decision-making, fostering a safer school environment and contributing to the well-being of the educational community. Methods In an institutional-based cross-sectional study among primary school teachers and administrative staff in Bisha City, our research aimed to comprehensively evaluate awareness regarding specific measures for minimizing COVID-19 risks. With a sample size of 348 participants, we employed a robust methodology, including online questionnaires addressing sociodemographic characteristics and knowledge about COVID-19 risks. The data collection period spanned from March 2022 to December 2023, providing a temporal context for responses. A pilot test ensured questionnaire clarity, and efforts were made to enhance reliability and validity, incorporating validated scales and iterative adjustments based on feedback. Non-response or incomplete responses were handled transparently, with sensitivity analyses to assess potential impact. The awareness level was measured using 17 Likert scale questions, and predefined categories (poor, moderate, and good) facilitated result interpretation. Researcher influence was minimized through training and inter-rater reliability checks. Confidentiality and anonymity were rigorously maintained, adhering to ethical considerations. Statistical analyses employed frequency tables, percentages, mean, standard deviations, and the chi-square test. Dissemination included academic publications, reports to the educational directorate, and presentations at conferences. This holistic approach contributes to the robustness and societal impact of our study, offering insights into COVID-19 awareness among educators in Bisha City. Results In this study assessing awareness among teachers and administrative staff in Bisha City regarding COVID-19 risk minimization, data from 348 respondents revealed key bio-demographic characteristics. The majority demonstrated good knowledge of environmental (83%) and personal hygiene risks (84%). The chi-square test indicated no significant associations between bio-demographic factors and awareness levels. Specifically, for age groups, χ²(4, N = 348) = 5.46, p = 0.707; for gender, χ²(1, N = 348) = 1.95, p = 0.744; for educational levels, χ²(4, N = 348) = 2.13, p = 0.995; for residency, χ²(1, N = 348) = 1.11, p = 0.892; and for job types, χ²(3, N = 348) = 8.30, p = 0.404. The absence of significant associations underscores the potential universality of successful awareness campaigns, suggesting that future efforts can maintain an inclusive approach without tailoring messages. These results emphasize the importance of sustained awareness efforts across the diverse demographic spectrum of the educational community. Conclusion This study reveals robust COVID-19 awareness among primary school teachers and staff in Bisha City, with no significant demographic associations. Successful, inclusive awareness campaigns can further enhance safety measures and promote well-being in the educational community.

Adaptation of the World Health Organization (WHO) Safe Surgery Checklist for Use With Cesarean Sections: Implementation and Outcomes With the Safe Cesarean Section Checklist.

Introduction The World Health Organization (WHO) Safe Surgery Checklist significantly decreases morbidity and mortality in regular operating room cases. However, significant differences in workflow and processes exist between regular operating room cases and cesarean sections performed on the labor and delivery unit. The aim of this study is to adapt the WHO Safe Surgery Checklist for the labor and delivery unit and cesarean sections to improve communication and patient safety. Methods A multidisciplinary team consisting of all major stakeholders reviewed and revised the WHO Safe Surgery Checklist making it more applicable to cesarean section operations. The new Safe Cesarean Section Checklist was tested and then integrated into the electronic medical record and utilized on the labor and delivery unit. A specific cesarean section safety attitudes questionnaire was developed, validated, and administered prior to and one year after implementation. Results Usage of the Safe Cesarean Section Checklist was greater than 95% after initial implementation. Significant improvements were reported by the staff on the cesarean section attitudes questionnaire for several key areas including the feeling that all necessary information was available at the beginning of the procedure, decreases in communication breakdowns and delays, and fewer issues related to not knowing who was in charge during the procedure. Discussion Implementation of the Safe Cesarean Section Checklist was successfully adopted by the staff, and improvements in staff perceptions of several key safety issues on our unit were demonstrated. Additional studies should be undertaken to determine if clinical outcomes from this intervention are comparable to those seen with the use of the WHO Safe Surgery Checklist.

A crisis of exhaustion in the game of escalation: a qualitative exploration of the consequences of occupational burnout among addiction therapists.

Purpose: Research shows that occupational burnout can affect health, the quality of personal relationships, and levels of job satisfaction and engagement. At the same time, the impact of individual burnout at the group and organisational levels has tended to be neglected. We aim to provide theoretical insights into the multidimensionality of burnout consequences at the individual, interpersonal and societal levels. Methods: A theory-driven, computer-assisted qualitative data analysis was conducted, comprising a thematic analysis of 40 semi- structured telephone interviews with therapists working in alcohol treatment facilities in Poland. Maximum variation sampling was used to ensure the representation of participants with different characteristics. Results: To theorise the implications of the collected data, the different viewpoints of addiction therapists on burnout and its consequences were interpreted through the lens of Rosa's resonance theory. Four interrelated sets of consequences were identified in the data: they related to (a) the therapists themselves, (b) their patients and the therapeutic process, and - in a broader sense - (c) the therapeutic team and (d) the treatment facility. Conclusions: Occupational burnout in individual therapists has serious implications for their patients and colleagues. It can also lead to a reduction in the quality and ultimately the effectiveness of the treatment of alcohol use disorders leading to a negative social image of the treatment facility and thus creating a further barrier to treatment for people with alcohol-related problems. Furthermore, the complexity of the individual experience of occupational burnout and a cause-and-effect chain forms a loop, deepening the severity of its consequences.

Evaluation of a training package to teach pairing procedures.

Pairing is a commonly recommended practice used to build rapport and create positive therapeutic environments. However, there are limited evaluations of training procedures to teach pairing skills to direct-care staff. The purpose of the present study was to formalize and improve the efficiency of the training process for the initial stages of pairing using video modeling with embedded voice-over instructions plus performance feedback. Participants included three dyads of behavior technicians and children with autism. The results indicated that the training package increased the consistency of pairing implementation. These outcomes were maintained in a novel setting and for up to 4 weeks following training. We also measured relevant child behaviors such as joint attention, engagement, indices of happiness, and calm. Specific areas for future research are described.

A Cross-Sectional Study of Emergency Care Services During the COVID-19 Pandemic: A Multicenter Study of Healthcare Staff Perspectives.

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted various aspects of healthcare services, including emergency care services. Healthcare staff face mental issues and physical exertion when caring for patients potentially infected with COVID-19. Understanding the experiences and perspectives of emergency department (ED) healthcare staff during the COVID-19 pandemic is essential to inform evidence-based interventions and strategies to mitigate the impact on emergency care services. This study aims to investigate the experiences of ED healthcare staff regarding emergency care services during the COVID-19 pandemic, thus providing valuable insights into the challenges faced. MATERIALS AND METHODS: This study utilized a cross-sectional study design. Data were collected from 256 ED healthcare staff working in nine different hospitals located in Turkey between November 15, 2021, and December 30, 2021. Data were analyzed using descriptive statistics. RESULTS: A total of 256 participants were included in the study. Of the participants, 58.6% were nurses, 19.5% were ED doctors, and 21.9% were emergency medical technicians. In addition, 67.2% of the participants were infected with COVID-19, and almost all of them (94.1%) were psychologically affected by the pandemic process. It was found that 85.2% of ED healthcare staff felt excluded by society due to being healthcare staff and 71.9% had to be separated from their families. Nurses were separated from their families at the highest rate (78%) during this period. CONCLUSION: More than half of the ED healthcare staff had problems accessing protective equipment and were separated from their families during the pandemic due to the risk of COVID-19 transmission. Although the number of ED visits decreased because of restrictions at the beginning of the pandemic, ED visits increased again with the abolition of restrictions.

Effect of the data-informed platform for health intervention on the culture of data use for decision-making among district health office staff in North Shewa Zone, Ethiopia: a cluster-randomised controlled trial.

BACKGROUND: Similar to other low and middle-income countries, Ethiopia faces limitations in using local health data for decision-making.We aimed to assess the effect of an intervention, namely the data-informed platform for health, on the culture of data-based decision making as perceived by district health office staff in Ethiopia's North Shewa Zone. METHODS: By designating district health offices as 'clusters', a cluster-randomised controlled trial was implemented. Out of a total of 24 districts in the zone, 12 districts were allocated to intervention arm and the other 12 in the control group arms. In the intervention arm district health office teams were supported in four-monthly cycles of data-driven decision-making over 20 months. This support included: (a) defining problems using a health system framework; (b) reviewing data; (c) considering possible solutions; (d) value-based prioritizing; and (e) a consultative process to develop, commit to, and follow up on action plans. To measure the culture of data use for decision-making in both intervention and control arms, we interviewed 120 health management staff (5 per district office). Using a Likert scale based standard Performance of Routine Information System Management tool, the information is categorized into six domains:- evidence-based decision making, emphasis on data quality, use of information, problem solving, responsibility and motivation. After converting the Likert scale responses into percentiles, difference-in-difference methods were applied to estimate the net effect of the intervention. In intervention districts, analysis of variance was used to summarize variation by staff designation. RESULTS: The overall decision-making culture in health management staff showed a net improvement of 13% points (95% C.I:9, 18) in intervention districts. The net effect of each of the six domains in turn was an 11% point increase (95% C.I:7, 15) on culture of evidence based decision making, a 16% point increase (95% C.I:8, 24) on emphasis on data quality, a 20% point increase (95% C.I:12, 28) on use of information, a 21% point increase (95% C.I:13, 29) on problem solving, and a 10% point increase (95% C.I:4, 16) on responsibility and motivation. In terms of variation by staff designation within intervention districts, statistically significant differences were observed only for problem solving and responsibility. CONCLUSION: The data-informed platform for health strategy resulted in a measurable improvement in data use and structured decision-making culture by using existing systems, namely the Performance Monitoring Team meetings. The intervention supported district health offices in identifying and solving problems through a structured process. After further research, DIPH intervention could also be applied to other health administration and facility levels. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT05310682, Dated 25/03/ 2022.