5
Thoi Lai District Medical Center | 13-17/03 | 10-14/04 | 11-15/09 | |
6 | Phong Dien District Medical Center | 20-24/03 | 17-21/04 | 18-22/09 |
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- Conduct a re-evaluation of knowledge, practice of occupational disease prevention caused by microorganisms and hepatitis B vaccination rate among 626 health workers selected for the study after 6 months of intervention.
+ Assess knowledge and practice after intervention using the same set of tools, questionnaires and checklists used before intervention ( Appendix 5 and Appendix 6 ).
+ Evaluate the effectiveness of the HBV vaccination intervention by determining the proportion of healthcare workers who have not been vaccinated against HBV; the number of healthcare workers eligible for vaccination and the proportion of healthcare workers who have been informed and agreed to be vaccinated against HBV.
2.6. Methods of error control, analysis and data processing
2.6.1. Deviation control
Clearly define the subject based on selection and exclusion criteria.
All research subjects were interviewed, and those who were absent at the interview were scheduled to be interviewed the following day.
Provide detailed and thorough training on survey content, sampling techniques, and interviewing skills. Conduct a pilot survey and revise the questionnaire before officially printing to ensure that the data collection toolkit is appropriate for the research subjects and conditions.
Research testing techniques are all performed in a single laboratory with the same chemicals and the same technical procedures by a specific group of testing technicians.
2.6.2. Data processing and analysis
- Each questionnaire after interview will be checked immediately for completeness and appropriateness. Incomplete or inappropriate questionnaires will be re-interviewed. If necessary, questionnaires with a lot of missing information will be discarded. In this case, additional interviews will be conducted to reach the sample size.
- Clean and encrypt data.
- Enter and process data on SPSS 18.0 software.
- Descriptive statistics: frequencies and percentages for qualitative variables.
- Statistical analysis: Chi-square test was used to determine the relationship between independent variables qualitatively with dependent variable. The relationship was determined by odds ratio (OR) and 95% confidence interval. The relationships were statistically significant when p < 0.05.
- Use the effectiveness index to evaluate the effectiveness of the intervention. The effectiveness index is calculated according to the formula:
P SCT – P TCT
CSHQ% = x 100
P TCT
P TCT : ratio/average value at pre-intervention time P SCT : ratio/average value at post-intervention time
2.7. Ethical issues in research
All research participants are completely voluntary, and subjects have the right to refuse to be interviewed.
On the basis of conducting the topic to collect necessary data and to ensure medical ethics, we only ask questions of a professional nature and do not affect or harm the interviewees. All collected data is kept confidential to protect the interviewees, including those who refuse to participate in the investigation process.
This research does not have any impact on local customs, practices, cultural traditions, or health. The local authorities will be informed of the scale and duration of the research.
The research protocol was approved by the Ethics Council of the Institute of Occupational and Environmental Health to review the ethical aspects, ensuring that no ethical requirements were violated before conducting the research.
Chapter 3
RESEARCH RESULTS
3.1. Risk factors for occupational diseases caused by microorganisms in medical staff in Can Tho City in 2015-2017
3.1.1. General information about the research facility
Table 3.1. Characteristics of planned and actual number of hospital beds, ratio of actual beds/planned beds, hospital bed utilization rate
TT
Medical facility | Number of planned beds | Number of actual beds | Actual bed ratio/ next bed plan | Bed occupancy rate (%) | |
1 | Maternity Hospital | 350 | 474 | 1.35/1 | 119.2 |
2 | Eye Hospital - Dentistry | 60 | 70 | 1.17/1 | 103.7 |
3 | Ear - Nose Hospital - Throat | 40 | 50 | 1.25/1 | 101.3 |
4 | General Hospital O Mon district | 200 | 300 | 1.50/1 | 121.4 |
5 | Medical Center | 100 | 145 | 1.45/1 | 118.8 |
Thoi Lai district | |||||
6 | Medical Center Phong Dien district | 80 | 87 | 1.09/1 | 108.1 |
Medium | 138 | 186 | 1.30/1 | 112.1 | |
Among the 6 research facilities, the Obstetrics Hospital has the highest number of planned beds at 350 beds, followed by O Mon District General Hospital with 200 beds and the lowest is the Ear - Nose - Throat Hospital with 40 beds.
Regarding the actual number of beds at the 6 facilities: Maternity Hospital has the highest number of actual beds: 474 beds, followed by O Mon District General Hospital with 300 beds, Thoi Lai District Medical Center: 145 beds, the lowest is at Ear - Nose - Throat Hospital with 50 beds.
The average ratio of actual beds to planned beds was 1.30/1, the average bed utilization rate at the participating health facilities was 112.1%. This ratio shows the overload of hospitals in public health care.
Table 3. 2. Number of medical staff at each facility
TT
Unit | Total number of medical staff | Medical staff directly providing medical examination and treatment | ||
SL | % | |||
1 | Maternity Hospital | 279 | 241 | 86.4 |
2 | Eye - Maxillofacial Hospital | 69 | 49 | 71.0 |
3 | Ear - Nose - Throat Hospital | 47 | 32 | 68.1 |
4 | O Mon District General Hospital | 234 | 183 | 78.2 |
5 | Thoi Lai District Medical Center | 126 | 98 | 77.8 |
6 | Phong Dien District Medical Center | 107 | 70 | 65.4 |
Total | 862 | 673 | 78.1 | |
Among the 6 medical facilities in the study, Can Tho Maternity Hospital and O Mon District General Hospital are the 2 units with the highest number of medical staff (279 medical staff and 234 medical staff). The two specialized hospitals, the Eye - Dental Hospital and the Ear - Nose - Throat Hospital, have the lowest number of medical staff. The total number of medical staff at the 6 facilities is 862 medical staff, of which 673 medical staff are directly involved in medical examination and treatment (78.1%).
Table 3. 3. Average ratio of doctors, physicians/nurses per hospital bed
TT
Medical facility | Quantity doctor/bed | Number of doctors, nursing/bed | Visits average/day | Visits average doctors/day | |
1 | Auxiliary Hospital product | 0.14 | 0.18 | 371 | 37.1 |
2 | Eye Hospital - Dentistry | 0.20 | 0.31 | 193 | 48.3 |
3 | Ear Hospital Nose and Throat | 0.22 | 0.22 | 141 | 35.3 |
4 | General Hospital O Mon district | 0.11 | 0.34 | 1211 | 50.5 |
5 | Medical Center Thoi Lai district | 0.09 | 0.26 | 916 | 45.8 |
6 | Medical Center Phong Dien district | 0.21 | 0.38 | 380 | 38.0 |
Medium | 0.16 | 0.28 | 535.3 | 42.5 | |
Reference data | 0.16 * | 0.9 ** | 35 | ||
0.2 *** |
Note: * national average in 2011; ** national average in 2015,
*** demand as of 2020;
The average number of doctors per hospital bed at the 6 research facilities was 0.16, ranging from 0.09-0.22 doctors/hospital bed, of which the ENT Hospital had the highest number of doctors/hospital bed: 0.22 doctors/hospital bed, the lowest was Thoi Lai District Medical Center with 0.09 doctors/hospital bed.
Regarding the number of doctors and nurses/hospital beds, among the 6 medical facilities, it is 0.28, ranging from 0.18-0.38. Phong Dien District Medical Center has the highest number of doctors and nurses/hospital beds at 0.38, the lowest is the Obstetrics Hospital at 0.18.
The average number of medical examinations per day at 6 facilities is 535.3. Of which, O Mon District General Hospital has the highest number of medical examinations: 1211, the lowest is the Ear, Nose and Throat Hospital: 141.
The average number of doctor visits per day at the research facilities was 42.5 (range 35.3-50.5).
Table 3.4. Results of the labor protection system in the medical facilities participating in the study
TT
Content | Quantity | Rate (%) | |
1 | Develop plans and budgets for daily labor protection year | 6 | 100.0 |
2 | Establish occupational hygiene records. | 4 | 66.7 |
3 | Periodic monitoring of working environment | 6 | 100.0 |
4 | Annually organize training on occupational safety and health | 0 | 0.0 |
5 | In-kind compensation for workers work in dangerous and toxic conditions | 4 | 66.7 |
TT
Content | Quantity | Rate (%) | |
6 | Organize KSK before arranging jobs for workers active, do tests related to work position | 0 | 0.0 |
7 | Regular health check-up and management | 6 | 100.0 |
8 | Examination, detection and monitoring of BNN | 0 | 0.0 |
9 | Accident prevention and timely emergency care time of occupational accident | 6 | 100.0 |
10 | Vaccination for all health workers who have contact with source of infection for vaccine-preventable diseases | 0 | 0.0 |
11 | Fully equipped and correct type of vehicle personal protective equipment | 6 | 100.0 |
12 | Fully equipped with fire prevention and fighting equipment on fire | 6 | 100.0 |
13 | Medical waste treatment | 6 | 100.0 |
14 | Report statistics | 6 | 100.0 |
Of the total 14 contents on the operation of the labor protection system in the participating medical establishments, there are 4 contents that no medical establishment implements, such as organizing annual training on occupational safety, occupational hygiene, and occupational health before assigning jobs and conducting tests related to work positions with occupational disease risks; examining, detecting and monitoring occupational diseases, and vaccinating all medical employees who have contact with sources of infection for which vaccines are available; There are 2 medical establishments that do not establish occupational hygiene records or provide in-kind compensation for employees working in conditions with dangerous and toxic factors; 100% of medical establishments fully implement the following contents: Developing annual labor protection plans and budgets, periodically monitoring the working environment, periodically examining and managing health, preventing accidents and injuries, and providing timely first aid when accidents occur.
profession, fully equipped with the right type of personal protective equipment, ...
3.1.2. Risk factors for occupational diseases caused by microorganisms in health care workers
Table 3.5. Results of monitoring microclimate factors in the working environment at research facilities (n = 229)
TT
Environmental factors | Average ± Standard | Measurement value (Min-Max) | Sample Number not meet TCVS | ||
Quantity | Proportion(%) | ||||
1 | Temperature ( oC ) | 28.9 ± 1.8 | 19.5-39.2 | 6 | 2.6 |
2 | Humidity (%) | 68.1 ± 8.8 | 44.2-83.5 | 11 | 4.8 |
3 | Wind speed (m/s) | 0.27 ± 0.10 | 0.20-1.40 | 0 | 0.0 |
The results of monitoring 229 microclimate samples show: Average temperature 28.9 ± 1.8 o C, ranging from 19.5-33.5 o C, 6 samples do not meet TCVSCP, accounting for 2.6%; Average humidity 68.1 ± 8.8%, ranging from 51.5-79.5%, 11 samples do not meet TCVSCP, accounting for 4.8%; Average wind speed 0.27 ± 0.10 m/s, ranging from 0.20-1.40 m/s, at all monitoring locations, TCVSCP is met.
Table 3.6. Results of light monitoring in the working environment at research facilities (n = 229)
Environmental factors
Average ± Standard | Measurement value (Min-Max) | Sample Number not meet TCVS | ||
Quantity | Proportion(%) | |||
Light (Lux) | 779 ± 1844 | 100- 13800 | 64 | 27.9 |
The results of the observation of 229 light samples showed that: average light
jar
779 ± 1844 Lux, ranging from 100 - 13800 Lux, there are 64 low-light samples that do not meet TCVSCP standards, accounting for 27.9%;