Health System Strengthening Through Worker Protection in The - - PowerPoint PPT Presentation

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Health System Strengthening Through Worker Protection in The - - PowerPoint PPT Presentation

Health System Strengthening Through Worker Protection in The Gambia Led by Drs. Melissa McDiarmid & Joanna Gaitens, School of Medicine Why Occupational Health & Safety (OHS)? Healthcare is a high-hazard industry and/but without


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Health System Strengthening Through Worker Protection in The Gambia

Led by Drs. Melissa McDiarmid & Joanna Gaitens, School of Medicine

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Why Occupational Health & Safety (OHS)?

  • Healthcare is a high-hazard industry and/but without the healthcare

workers, the system falls apart

  • The Gambia
  • Lessons from Ebola epidemic
  • OHS concerns exacerbated in resource-poor settings
  • Biologic: need-stick injuries, TB exposure
  • Psychological: promoting a “no-blame” culture
  • Our Project: OHS training for healthcare workers
  • Groundwork done by Dr. McDiarmid in 2014
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Nicole Campion Dialo (SOM), Dr. Melissa McDiarmid (SOM), Sarah Gregorini (SSW),

  • Dr. Joanna Gaitens (SOM), Wesley Chan (SOM), Alyssa Riuli (SOD)
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Who was involved?

  • Partners
  • University of the Gambia School of Medicine & Allied Health

Sciences

  • Gambian Ministry of Health
  • Edward Francis Small Teaching Hospital (EFSTH)
  • Attendees
  • Clinicians
  • Regional & local public-health officers
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SLIDE 5
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What did we do?

  • 3-day training at EFSTH
  • “Train-the-trainer”
  • Lectures on minimizing risk of exposure to bloodborne & airborne

pathogens

  • Small-group case studies
  • Facility walk-through exercise
  • Sustainability plan: next meeting was scheduled before we

left

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SLIDE 7
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SLIDE 8

Collaboration Collegiality

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Occupational Health and Safety Dashboard

  • Assessment tool
  • Evaluate healthcare facility
  • Organization, Infection Control,

Training, etc.

  • Provides a rough idea of the

status of the healthcare facility and potential improvement areas

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Infection Control

  • Is there a policy requiring workers to wash hands

before caring for patients? 53% Yes 41% No 6% Don’t know

  • Do patient care areas have sinks readily available?

71% Yes 18% No 12% Don’t know

  • Are antiseptic soap, water and towels available?

82% Yes 6% No 12% Don’t know

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Infection Control

  • “Not all areas have sinks readily available”
  • “We have sinks but not enough”
  • “Antiseptic soap, water and towels are only sometime

available” –Their availability is not continuous

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Protection from Blood and Body Fluids

  • Is there a blood and body fluids exposure policy to

protect workers? 39% Yes 44% No 17% Don’t know

  • Is there a policy requiring use of sharp devices that

have safety features? 39% Yes 44% No 17% Don’t know

  • Are sharps disposal containers available in all patient

care areas? 73% Yes 20% No 7% Don’t know

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Employee Training/Record Keeping

  • In response to "Is a blame free

environment promoted to encourage reporting of exposures and incidents"- "Somehow, no one is prevented to report an incident"

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Dashboard Summary

  • Great tool to focus training and discussion
  • Provided a snapshot of the overall Gambian

healthsystem.

  • Both to our team and to other Gambian health officials
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Small Group Discussion

  • Discussed scenarios

about TB exposure and needlestick injuries

  • Allowed for application of

training material

  • Helped our team and

participants prepare for the walk-through

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Facility Walk-through

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Workplace Inspection Tool*

  • General Physical Environment
  • Pharmacy
  • Laboratory
  • Patient Care Unit
  • Central Sterilization Unit

*Modified from Workplace Inspection Tool for Pelonomi Hospital September 2007- Developed by Annlee Yassi and Elizabeth Bryce

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Laboratory

Item/Description Comments

  • 1. Equipment

a. Automated equipment clean and well maintained · The equipment in the Biochemistry Lab appeared to be in good working condition, although dust was noted on the tops of several machines. b. Biosafety and/or chemical containment cabinets present and regularly inspected · The Microbiology Lab had a fume hood of an unknown type. However, one employee said it was not regularly inspected.

  • d. Splashguards in place where specimens are opened

· There were no splashguards present in any visited laboratories.

  • e. Compressed gases (e.g., O2, N2O) chained in place,

regularly inspected, and maintained · There were many free-standing (i.e. not secured) compressed gas cylinders between patient beds, which could injure staff or patient if they fell. There was a reported case of a falling canister where the canister neck was broken at this facility. In addition, empty canisters were left free-standing outside. f. Equipment and supplies designated as single use not reused (e.g., blood tubes, syringes). · In all areas observed, no single-use supplies and equipment were reused.

  • g. Fire extinguishers available

· Fire extinguishers were available in rooms, however several were not properly fastened to the wall.

  • h. Eye wash facilities available

· There were no specific eye wash stations.

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Assessments and Recommendations

  • Waste Disposal
  • Needlestick Injury and other blood/ bodystick injuries
  • Sharps
  • Compressed Gas Canisters
  • Fire Extinguishers
  • Chemical Storage
  • Chemotherapy Drugs
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Acknowledgements

  • Dr. William (Bill) Roberts
  • Dr. Ousman Nyan and his staff
  • Dr. Samba Ceesay, Mr. Janko Jimbara and Mr. Bolong Jobarteh and other Members of

the Ministry of Health

  • Dr. M.I.A. Kahlil, Edward Francis Small Teaching Hospital
  • Mr. Gibril Sumbunu
  • Mr. Baboucarr Jallow, Mr. Omar Gaye, and Ms. Yamai Secka Jack
  • UMB Center for Global Education Initiatives
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Questions?