Healthcare Worker Ability and Willingness to Work During 医护人员能力和意愿来工作期间

HealthcareWorkerAbilityandWillingnesstoWorkDuringPandemicFluRiskperceptionandattitudes

(intendedaudience:managers)November2006AcknowledgementsThesetrainingmaterialsweredevelopedbyKayKoelemay,MDandJeffreyDuchin,MDPublicHealth–Seattle&KingCountywithsupportfromtheUniversityofWashingtonandTheNationalInstitutesofHealthRegionXCenterofExcellenceforBiodefenseandEmergingInfectiousDiseasesQuestions?PublicHealth206-296-4774November2006LessonsLearnedfromSARSTransmissionofSARStohealthcareworkerswasassociatedwith:lackofinfectioncontrolprecautionsinconsistentuseofPPEhaving<2hoursofinfectioncontroltrainingprocedures→aerosolizedparticleswithoutrequireduseoffit-testedN-95equivalentjobasnon-medicalsupportstaffLauJTFetal.EmergingInfectiousDiseases.August2019;10(8):1399-1404.SetoWHetal.TheLancet.May3,2019;361:1519-20.November2006ReadinessTrainingIsEssentialInfectioncontroltrainingFactsProceduresProtocolsPracticeEssentialtoincludeallhealthcarepersonnelTailoredtooccupationalgroupKnowledgeofpreventivemeasuresshouldnotbeassumedinanygroupNovember2006Nurses:ConflictedHighestscoreinknowledgeofpreventivemeasuresHighest“avoidanceofpatient”“Ishouldn’tbecaringforpatientswithSARS”HigherinyoungernursesthaninoldernursesHighestleveloffear(~61%)Jobchange/resignationconsideredin34%ImaiT,TakahashiK,HoshuyamaTetal.SARSriskperceptionsinhealthcareworkers,Japan.EmergingInfectiousDiseases.March,2019;11(3):404-10.November2006“Themostfrequentlycitedreasonforemployees’unwillingnesstoreporttodutyduringadisasterwasfearandconcernforthesafetyoftheirfamiliesandthemselves.”QureshiK,GershonRRM,ShermanMFetal.Healthcareworkers’abilityandwillingnesstoreporttodutyduringcatastrophicdisasters.JournalofUrbanHealth:BulletinoftheNewYorkAcademyofMedicine.2019;82(3):378-88.November2006ConcernforPersonalorFamilyHealthFactorsassociatedwithincreasedlevelPerceptionofgreaterriskofdeathfromSARSLivingwithchildrenLifestyleaffectedbytheSARSoutbreakBeingtreateddifferentlybecauseaHCWFactorsassociatedwithdecreased

levelManagementorsupervisorypositionBeliefinprecautionarymeasuresofworkplaceAge50yearsorolderNickellLA,CrightonEJ,TracyC.S.etal.PsychosocialeffectsofSARSonhospitalstaff:surveyofalargetertiarycareinstitution.CanadianMedicalAssociationJournal.2019;170(5):793-98.November2006AbilityversusWillingnessQureshiK,GershonRRM,ShermanMFetal.November2006BarrierstoAbilityQureshiK,GershonRRM,ShermanMFetal.November2006BarrierstoWillingnessQureshiK,GershonRRM,ShermanMFetal.November2006AssociatedDegreeofConcernQureshiK,GershonRRM,ShermanMFetal.November2006PersonalObligationsQureshiK,GershonRRM,ShermanMFetal.November2006AvailabilityforExtraShiftsQureshiK,GershonRRM,ShermanMFetal.November2006“Readinesstrainingforpublichealthworkersshouldalsoaddresstheirriskperceptionstowardemergencies,notjustthefactualorproceduralelementsoftheirresponseroles.”BarnettDJ,BalicerRD,BlodgettDWetal.Applyingriskperceptiontheorytopublichealthworkforcepreparednesstraining.JournalofPublicHealthManagementPractice.2019;November(Suppl):S33-S37November2006RiskPerceptionInterplaybetweenaffectiveandanalyticprocessesemotionvs.logicConstraints:resource-relatede.g.,transportation,childcareRiskperceptionbarriers:concernsaboutevents/consequenceslinkedtofeelingsBarnettDJ,BalicerRD,BlodgettDWetal.November2006RiskPerceptionBarriersSafetyoffamilymembersandselfSafetyofworkingenvironmentInsufficientemphasisonstressmanagementtechniquesUnclearexpectationsofrole-specificemergencyresponserequirements↓senseofcontrol;↑senseofvulnerabilityInadequateemphasisoncriticalvalueofeachemployeetoagencyresponseBarnettDJ,BalicerRD,BlodgettDWetal.November2006“…thesinglemostinfluentialconstructassociatedwithwillingnesstoreporttoduty–theperceptionoftheimportanceofone’sroleintheagency’soverallresponse.”BalicerRD,OmerSB,BarnettDJ,Everly,Jr.,GS.Localpublichealthworkers’perceptionstowardrespondingtoaninfluenzapandemic.BMCPublicHealth. 2019;6:99.Availableat:biomedcentral/1471-2458/6/99.November2006ConfrontingFearFearisassociatedwithunwillingnesstoreporttodutyduringadisasterPersonalsafetySafetyoflovedonesEffectivemethodstoallayfearsinclude:EducationofhealthcareworkersProvisionofappropriatePPEAssuranceofenvironmentalcontrolsNovember2006November2006TrainingCanIncreaseWillingnessCompetency-basedemergencypreparednesstrainingfornurses40-itemimmediatepre-andpost-testPretest:96%(n=48)feltresponsibilityfor reportingtoworkinemergencies

70%(n=35)intendedtoreport Post-test:12%increaseinintentiontoreportQureshiKA,MerrillJA,GershonRRM,Calero-BreckheimerA.Emergencypreparednesstrainingforpublichealthnurses:apilotstudy.JournalofUrbanHealth:BulletinoftheNewYorkAcademyofMedicine.2019;79(3):413-16.November2006Conceptof“InstitutionalMeasures”Institutionalmeasures(facilityplan)ClearpoliciesandprotocolsSpecialistavailableforproblemswithPPEAdequatetraininginuseofmasksProtectivemeasuresatworkareeffectivePositivepredictorofacceptanceofriskNegativepredictorof“avoidanceof patient”November2006ReadinessTrainingMustAddress

RiskPerceptionConsiderasurveyassessmentOpportunitytoaddressbarriersamenabletochangeToenhanceabilityandwillingnesstoreportExamplesofcreativesolutions:TransportationFacilitateformationofcarpoolsArrangeemergencytransportofessentialpersonnelNovember2006ConfrontingResourceBarriersPersonalhealthEncourageemergencysupplyofmedsatworkKeeplistofmedsforchronicillnessinemployee’shealthfileChildand/oreldercareCreateemergencycarecenterson-oroff-siteFacilitateformationofco-opsamongemployeesMakeshiftaccommodationsforemployeeswithpartnerswhoalsomustreportforworkPetsCo-ops;enlistveterinariansorHumaneSocietyNovember2006ConfrontingPerceptionBarriersProvidefamilypreparednesstrainingAdvisewheretoobtaininfo&updatesProvidegenuineassurancesthatpersonalsafetymeasuresareavailableCommunicateclearexpectationsre:theemployee’sroleinaresponseEmphasizerelevanceofemployee’sroleCoachon“caringforthecaregiver”BarnettDJ,BalicerRD,BlodgettDWetal.November2006ClearExpectations:ProtocolsDonningandremovingPPESafehandlingofcontaminatedPPEManagingunprotectedstaffareasMonitoringstaffhealthQuarantineofstaffTransportofpatientsHigh-riskuseofrespiratoryequipmentVisitingpoliciesCleaning/disinfectingequipment&environment(Other)November2006ClearExpectations:PoliciesAbsenteeismpoliciesLeavepoliciesCompensationpoliciesEmploymentpoliciesEmployeesupportservicesHealthcareworkersneedthis informationbeforeapandemicNovember2006AbsenteeismPoliciesNotshowingup/notcallinginRefusingtoworkNotcompletingshift(unrelatedtoillness)ComingtoworklateKnowinglycomingtoworkillConcernaboutlostwagesisthelargestdeterrenttoself-isolationorquarantine.

November2006LeavePoliciesPersonalillnessFamilymemberillnessSchoolclosureExtendedmedicalleaveBereavem