Safe hospital environment             No Of Abstract is : 10  
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Burnout among healthcare workers of Emergency Hospital, Tanta University   
  Sanaa Abd El-Fatah Abdo, Rania Moustafa Al-Salamy, Ali Ali Al-Sherbini and Ibrahim Ali Kabbash   
  Public health and Community Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt   
Background: The future of health care around the world continues to be affected by burnout. It affects quality of life and work ability of health care workers thus affects quality of care provided, safety and satisfaction of patients. Little is known about professional burnout among healthcare workers in Egypt. Aim: The current study aimed to reveal the extent of burnout among physicians and nursing staff working in the emergency hospital of Tanta University and to identify some of its determinants. Methods: A cross sectional study was carried out on all physicians (n = 266) and a systematic random sample of nurses (n = 284) for a period of six months. Burnout was assessed using the Maslach Burnout Inventory and its subscales. Results: Most of the participants (66.0%) had a moderate level of burnout and 24.9% of them had high burnout. Considerably, 46.9% of subjects showed high emotional exhaustion, 97.7% showed highly reduced personal accomplishment and 14.4% showed high depersonalization. Multivariate analysis showed that age, frequency of exposure to work-related violence, years of experience, work burden, supervision and work activities were significant predictors of burnout among the respondents. Conclusion: burnout syndrome is prevalent among the staff of Emergency hospital. Thus, health education interventions during pre-employment training programmes for prevention of burnout syndrome and periodic screening for early detection and management of burnout are essential.      

Assessment of policies and practices of managing occupational exposure to blood borne infections in Tanta University Hospitals   
  Asmaa Mohammad Kammona, Nadira Mansour Hassan, Nashwa Mohammad Radwan and Ibrahim Ali Kabbash   
  Public health and Community Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt   
Background: blood brone infections pose a serious risk for both patients and health care workers (HCWs). Objective: To evaluate policies of Tanta University Hospitals for managing occupational exposure to blood borne viral infections and to assess knowledge, attitude and practice of HCWs regarding the hospital’s policy. Method: A cross-sectional survey using a checklist was carried out to collect data. HCWs (621) from six departments of Tanta University Hospitals filled a designed questionnaire by direct interviews. Results: about one third (32.5%) of HCWs were not aware of needle injury clinic place or its services. Only 28.6% of infection control (IC) team reported that pre-placement screening for baseline blood tests for HBV, HCV or HIV was conducted. About one half of IC team (57.1%) recorded availability of post-exposure evaluation and counseling. There was an overall low level of knowledge of HCWs concerning NSIs and PEP. Significant positive attitude concerning mandatory Hepatitis B was recorded by physicians and surgical HCWs. The study revealed an overall low adherence of HCWs to standard precautions. The great majority of participants (95%) were injured by sharp objects over their lifetime mainly those working in surgical departments especially the emergency department. Conclusions: Exposure management policies were not aligning with the national guidelines. There was an overall low level of knowledge concerning NSIs and PEP especially among workers. There was a positive attitude regarding mandating hepatitis B vaccination of HCWs and informing IC committee about NSIs. There was an overall low adherence of HCWs to SP and PEP.      

Assessment of food safety in Hospital kitchens in Tanta city, Gharbia governorate, Egypt   
  Yasmin El-Sersy, Asmaa Atallah, Nihal Salah, and Gamalat Mohamed   
  Public health and Community Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt   
Background: Food borne infections in health care settings have represented as an important public health problem worldwide. They are a leading cause of morbidity and mortality and economic losses in both developed and developing countries. Aim: was to assess food safety in hospital kitchens (university and other governmental hospital kitchens) in Tanta city, Gharbia Governorate, Egypt. Subjects and methods: This study was carried out in university and other governmental hospital kitchens in Tanta city, Gharbia Governorate, Egypt. The study subjects included nine hospital kitchens (3 university kitchens and 6 governmental kitchens) and all food handlers in these kitchens (n=175). Three tools were modified by the researcher to collect the necessary data. Tool (1):-Modified kitchen observational check list, Tool (II):-Food handlers' observational checklist and Tool (III):-The questionnaire sheet for food handlers. Results:-All university kitchens had insufficient application of food safety measures in both morning and evening shifts. Regarding governmental kitchens; 40% were insufficient and 60% were somewhat sufficient in morning shift ,but in the evening shift 60% of kitchens were insufficient and 40% of them were somewhat sufficient The majority of both university and governmental food handlers had insufficient practice regarding application of food safety measures (94.9% and 84.2%) respectively. Conclusion: The study revealed that the insufficient conduction of food safety measures in both university and governmental hospital kitchens as well as insufficient application of food safety measures by food handlers revealed that patients are at risk of getting food borne infections.      

  Rania El-sallamy,SanaaAbd El-fatah ,Asmaa El-feky, and Ibrahim kabbash   
  Public health and Community Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt   
Background: Hospital workers are exposed to many occupational hazards that may threaten their health and safety. Physical hazards that are encountered in hospital working environment include temperature, illumination, noise, electrical injuries, and radiation. Aim: to assess the awareness of healthcare workers (HCWs) about physical hazards in Tanta university hospitals.Subjects and methods: Cross sectional study included 625 HCWs (physicians, nurses,technicians, administrative staff and workers) from seven departments(general surgery, orthopedics, radiology, ophthalmology, kitchen, incinerator and laundry) through interview questionnaire to assess seven types of physical hazards (noise, electrical, fire, ergonomics, lighting, temperature and radiation).Results:most of administrative staff(98%) were aware of the level of noise compared to 62% of physicians.Most of HCWs reported that hearing protective devices were not available; physicians(73.5%), nurses (68.4%), technicians (75.6%), administrative staff (91.7%) and workers (75.2%) and periodic hearing examination wasn't performed; physicians (82.4%), nurses (66.2%), technicians (70.7%), administrative staff (87.5%) and workers (69.6%). Nurses (72.20%) and workers (66.40%)didn't attended emergency training and around two thirds of all HCWs were not briefed about emergency evacuation.63.95% of nurses and 53.7% of technicians weren't given appropriate radiation safety training before starting work and more than half of physicians, nurses and technicians (57.8%, 57.1%, and 53.7%) denied regular environmental monitoring for radiation level inside work place. Conclusion: Health care workers continue to face several hazards in their workplace especially due to unavailablePPEs, lack of periodic medical examination, lack of training for staff.      

HIV/AIDS Related Stigma and Discrimination among Health Care Workers at Tanta University Hospitals, Egypt   
  Ibrahim Ali Kabbash, Ehab A. Abo Ali, Mostafa Mahmoud Elgendy, Mostafa abdrabo, Helal Salem, Mohammed gooda, Yousef Saleh elbasiony, Nader elboshy, and Mohammed hamed   
  Public health and Community Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt   
Background: HIV/AIDS related stigma and discrimination among people and health care professionals is one of the most important factors of this disease expansion. Objective: This study aimed to assess the stigmatized attitude among health care providers toward people living with HIV (PLWHA) at Tanta University Hospitals. Methods: The study is a cross-sectional survey. Data was gathered using a structured questionnaire. Randomly selected 310 health care providers of Tanta University Hospital. Results: Among studied participants only 24% had previous contact with HIV patients during work and 21.3% felt worried to touch cloths of HIV patients, 26.4% were worried to dress HIV patients’ wounds and 27.4% were afraid to get blood sample for HIV patients. Those who were unwilling to care for HIV patients represented 40% and only 36% reported that if discriminating against HIV patients they may get in trouble. Less than one half (42%) reported having enough supply for reducing risk of nosocomial infection with HIV and 86% reported having no guidelines to deal with HIV patients. Out of participants, 78.7% reported that HIV patients should be ashamed of themselves. Among participants, 35%, 48% and 43% preferred not to provide medical services to injecting drug users, men having sex with men or sex workers suspected to have HIV infection. Conclusion: Infection control is defect in the supplies and procedures. There is absence of policy and protocols with regard to dealing with PLWH. Health care providers showed stigma and discrimination against people living with HIV.      

Knowledge, Attitude, and practice towards Ergonomics among undergraduates student faculty of Dentistry Tanta University   
  Rania El-sallamy,Salwa A. Atlam , Sanaa Abd El-fatah ,Asmaa El-flaky, and Ibrahim kabbash   
  Public health and Community Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt   
Background: Ergonomics is the scientific study of people and their working Environment. Dentistry is a profession that generally produces various musculoskeletal disorders. If ergonomic principles are applied it helps to prevent occupational ergonomic hazards and improving productivity. Objectives: To Assess Knowledge, attitudes, and practice of ergonomics during routine dental procedures among undergraduates of Faculty of Dentistry, Tanta University Methods: Cross sectional study conducted among Dental Students of Tanta University during the year 2015-2016 using predesigned self administered questionnaire. Knowledge, attitude and practice were assessed by 16, 5 and 6 items Results: Included in this study 479 dental students, of them 291 (60.75%) were females, 359(74.95%) from urban areas and 359 students(74.95% ) were 22 years and below. Only one-quarter of the students had good knowledge whereas nearly half of the students (48.9%) had fair knowledge concerning ergonomics. Out of the participants 84.8% had positive attitudes and 95.4% had poor practice of ergonomics Conclusion: Most of Dental students don’t know a lot about Ergonomics, Only 5% of students practice it .But About 84.8% of students have a positive attitude towards studying ergonomics. Recommendations Dental students need to ensure involving ergonomics in the routine dental practice. This may be achieved via addition of Ergonomics in their curriculum      

Knowledge Attitude and practice of physicians and nurses regarding infection control measures at Tanta University Hospitals   
  Eman Younis, Salwa Atlam, Gamalat Mohammed, and Sayed Al kafas   
  Public health and Community Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt   
Inspite of advances in health care system, the threat to hospital acquired infections still remains worldwide. Prevention of transmission of any pathogen to the patient and /or health care workers is based on the strict application of standard precautions measures and practices. Aim: To study knowledge, attitude, and practice of physicians and nurses regarding infection control measures at Tanta University hospitals. Subjects and methods: This study was carried out in general surgery, urology, and pediatric ICU departments at Tanta University Hospitals. The study subjects included; all physicians (52) added to 246 nurses out of 262 at Tanta University Hospitals. Two tools were developed by the researcher to collect the necessary data; a structured questionnaire sheet. and Observational check lists. Results: most of the studied physicians and nurses had good total knowledge score (55.8% and 68.7% respectively). The majority of both physicians and nurses had a positive attitude towards infection control measures. The majority of physicians (69.2%) had poor total practice grades, while the majority of nurses (69.9%) had average practice. Conclusion: The studied physicians and nurses and their patients were seriously at risk of infection due to poor compliance with standard precautions. So emphasis on conduction of pre-service and in-service training program, training of infection control team, and continuous supervision is strongly recommended to obtain high quality for the patient care.      

Violence against healthcare workers of Emergency Hospital, Tanta University, Egypt   
  Ibrahim Kabbash, Rania El-sallamy, Sanaa Abd El-fatah, and Amira Elshennawy   
  Public health and Community Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt   
Background: WHO defined workplace violence as the intentional use of power, threatened or actual, against another person or against a group in work-related circumstances, that either results in or has a high degree of likelihood of resulting in injury, death, psychological harm, or deprivation. Staff involved directly to patient care and emergency staffs are most liable to violence. Aim: to reveal the extent of violence against staff of Emergency Hospital and to determine its risk factors. Methods: a cross sectional study was conducted including physicians (101) and nurses (169) from different departments of Emergency Hospital using a predesigned questionnaire. Results: Most of emergency staff (78%) was exposed to verbal violence, 32% exposed to physical violence and only 6% experienced sexual assault. In most case of verbal and physical violence, patient relatives were perpetrators (86% and 82% respectively) while patients themselves were involved in majority of sexual harassment (43.8%). Verbal and physical violence occurred nearly equally in different shifts but sexual violence dominated in evening shifts (78.3%). In physical violence 70.8% of events were reported compared to 45.5% of verbal and 14.8% of sexual assault. Causes of violence as reported by participants were; patient dissatisfaction of service quality (67.7%), ineffective security system (56.2%), long waiting time for patients (53.6%), alcohol and drug addiction (53.5%). Conclusion: Verbal violence is most frequent type of violence. Evening shifts were times for all types of violence. Causes were; poor service quality, ineffective security system, long waiting time and alcohol and drug addiction.      

Knowledge, Attitude and Practice of Tanta University Medical Students towards Hepatitis B and C   
  Salwa A. Atlam, Hala M. Elsabagh, and Nihal S.Shehab   
  Public health and Community Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt   
Background:. Egypt lies among the world’s highest prevalence rates of HCV and intermediate levels of HBV infection. Objectives: Detection of the knowledge, attitude and practice of Medical Students of Tanta University towards hepatitis B and C. Methods: This was a cross-sectional study, conducted in The Faculty of Medicine, Tanta University, Egypt; from 15th October 2013 to 15th of January 2014.Results: The study included 185 Students; Their ages ranged between 17 to 28 years with a mean 20±1.731years. Sixty percent of students were males and 65% were urban residents. 50.8% of the participants were in the basic level of the academic study. More than half (57.85%) of the participants had sufficient knowledge, 77.3% of them had a positive attitude towards hepatitis C and B and more than two-thirds (68.1%) showed good practice. A significant association occurred between a positive attitude and good practice. Sufficient knowledge was significantly recorded among older students, females, urban residents and the clinical stage students. The most frequent sources of student information were family or friends, internet followed by TV or radio, healthcare workers, and newspapers. Conclusion: The students had reasonable knowledge, positive attitude and good practices towards B and C viral hepatitis. Areas of insufficient knowledge needed to be reinforced included some modes of transmission, complications, and treatment for B and C viral hepatitis. Keywords: Hepatitis B and C, Knowledge, Attitude, Practice, Medical student      

Quality Management and Implementation of Best Practice Guidelines for patient safety   
  Amel Hashish, MD, CT, JMHPE, DHM, FAIMER f   
  Faculty of Medicine, Tanta University, Egypt   
Quality health care means doing the right thing, at the right time, in the right way, for the right person—and having the best possible results. The use of new technologies in medicine was so great and offers the promise of increasing longevity, improving health, and alleviating pain and suffering. Physicians, hospitals and other health care organizations operate independently and often do not share information about the patient's condition, medical history, services provided in other settings, or medications prescribed. As medical science and technology have advanced, and patients have become more complex, the health care system has not been able to provide consistently high quality care to all patients. Research on the quality of care shows that the health care system falls short in translating knowledge into practice, and applying new technology safely and in a timely manner. Many types of medical errors require additional health care services to treat patients who have been harmed. Quality measurement is a relatively new science and requires a large amount of resources to develop and collect the information. Fully developed and tested measures are only available for reporting on some of the most common conditions or processes of care. The goal is to make these measures more reliable, uniform, and helpful to consumers in making health care choices.      


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