scholarly journals Variability of Clinical Practice in the Third Stage of Labour in Spain

2019 ◽  
Vol 8 (5) ◽  
pp. 637 ◽  
Author(s):  
Inmaculada Ortiz-Esquinas ◽  
Juan Gómez-Salgado ◽  
Ana I. Pascual-Pedreño ◽  
Julián Rodríguez-Almagro ◽  
Juan Miguel Martínez-Galiano ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Work Environment ◽  
Clinical Management ◽  
Active Management ◽  
Odds Ratios ◽  
Cross Sectional ◽  
Environment Factors ◽  
The Third ◽  
Third Stage ◽  
Work Environment Factors

Clinical practice guidelines recommend the active management of the third stage of labour, but it is currently unknown what practices professionals actually perform. Therefore, the aim of this study was to determine the variability of professional practices in the management of the third stage of labour and to identify any associated professional and work environment factors. A nationwide cross-sectional study was performed with 1054 obstetrics professionals between September and November 2018 in Spain. A self-designed questionnaire was administered online. The crude odds ratios (OR) and adjusted odds ratios (ORa) were estimated using binary logistic regression. The main outcome measures were included in the clinical management of the third stage of labour and they were: type of management, drugs, doses, routes of administration, and waiting times used. The results showed that 75.3% (783) of the professionals used uterotonic agents for delivery. Oxytocin was the most commonly administered drug. Professionals who attend home births were less likely to use uterotonics (ORa: 0.23; 95% confidence interval (CI): 0.12–0.47), while those who completed their training after 2007 (ORa: 1.57 (95% CI: 1.13–2.18) and worked in a hospital that attended >4000 births per year (ORa: 7.95 CI: 4.02–15.72) were more likely to use them. Statistically significant differences were also observed between midwives and gynaecologists as for the clinical management of this stage of labour (p < 0.005). These findings could suggest that there is clinical variability among obstetrics professionals regarding the management of delivery. Part of this variability can be attributed to professional and work environment factors.

scholarly journals Active management of the third stage of labour: knowledge and challenges of obstetric caregivers in selected health facilities in Fako Division, Cameroon

2021 ◽  
Author(s):  
William Ntchompbopughu Tih ◽  
Egbe Obinchemti Thomas ◽  
Tendongfor Nicholas
Keyword(s):  
Maternal Mortality Ratio ◽  
Logistic Models ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Active Management ◽  
Good Knowledge ◽  
Cross Sectional ◽  
The Third ◽  
Third Stage ◽  
Mortality Ratio

Abstract Background: In Cameroon, the decrease in MMR (Maternal Mortality Ratio) from PPH (Postpartum Haemorrhage) despite reported use of the Active Management of the Third Stage of Labour (AMTSL) is slower than required to achieve the Third Sustainable Development Goal (SDG3) hence the need to question obstetric caregivers’ competence in AMTSL, as well as the factors hindering its proper useWe therefore aimed to assess obstetric caregivers’ knowledge about AMTSL, as well as the determinants and barriers of AMTSL in selected hospitals in Fako Division, Cameroon.Methods: This was a hospital-based cross-sectional study of 150 participants recruited in 27 health facilities in Buea, Limbe and Tiko health districts from January 15, 2020, to March 31, 2020. Participants’ socio-demographic and qualification characteristics, knowledge and challenges, and the references guiding their practice of AMTSL were collected using a structured questionnaire. AMTSL knowledge was categorized as poor or good and the determinants of good AMTSL knowledge were evaluated. The data was analyzed in SPSS version 25.0. Results: Of the 150 caregivers interviewed, only 48.7% had good knowledge of AMTSL. In logistic models, participants’ use of AMTSL increased Good knowledge of AMTSL (AOR: 12.96, CI: 1.12 -150.3, p=0.04). Unavailability of drugs and/or equipment, insufficient staff coverage and lack of knowledge and training of the staff were the major challenges reported. Conclusion: Obstetric caregivers in Fako division have knowledge gaps and face numerous challenges in AMTSL use, which could account for the consistently high MMR from PPH. Filling this knowledge gap and mitigating the challenges of these caregivers would certainly accelerate progress towards the achievement of SDG3.

scholarly journals Absenteeism and Presenteeism among Care Workers in Swiss Nursing Homes and Their Association with Psychosocial Work Environment: A Multi-Site Cross-Sectional Study

Gerontology ◽  
2015 ◽  
Vol 62 (4) ◽  
pp. 386-395 ◽  
Author(s):  
Suzanne Dhaini ◽  
Franziska Zúñiga ◽  
Dietmar Ausserhofer ◽  
Michael Simon ◽  
Regina Kunz ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Work Environment ◽  
Cross Sectional Study ◽  
Psychosocial Work Environment ◽  
Sectional Study ◽  
Psychosocial Work ◽  
Cross Sectional ◽  
Environment Factors ◽  
Care Workers ◽  
Work Environment Factors

Background: Worker productivity is central to the success of organizations such as healthcare institutions. However, both absenteeism and presenteeism impair that productivity. While various hospital studies have examined the prevalence of presenteeism and absenteeism and its associated factors among care workers, evidence from nursing home settings is scarce. Objective: To explore care workers' self-reported absenteeism and presenteeism in relation to nursing homes' psychosocial work environment factors. Methods: We performed a cross-sectional study utilizing survey data of 3,176 professional care workers in 162 Swiss nursing homes collected between May 2012 and April 2013. A generalized estimating equation ordinal logistic regression model was used to explore associations between psychosocial work environment factors (leadership, staffing resources, work stressors, affective organizational commitment, collaboration with colleagues and supervisors, support from other personnel, job satisfaction, job autonomy) and self-reported absenteeism and presenteeism. Results: Absenteeism and presenteeism were observed in 15.6 and 32.9% of care workers, respectively. While absenteeism showed no relationship with the work environment, low presenteeism correlated with high leadership ratings (odds ratio [OR] 1.22, 95% confidence interval [CI] 1.01-1.48) and adequate staffing resources (OR 1.18, 95% CI 1.02-1.38). Conclusion: Self-reported presenteeism is more common than absenteeism in Swiss nursing homes, and leadership and staffing resource adequacy are significantly associated with presenteeism, but not with absenteeism.

scholarly journals Work environment-related factors and nurses’ health outcomes: A cross-sectional study in Lebanese hospitals

2020 ◽  
Author(s):  
Martine ELBEJJANI ◽  
Mary Abed Al Ahad ◽  
Michael SIMON ◽  
Dietmar AUSSERHOFER ◽  
Nuhad DUMIT ◽  
...  
Keyword(s):  
Work Environment ◽  
Health Risks ◽  
Emotional Health ◽  
Health Problems ◽  
Related Factors ◽  
Cross Sectional ◽  
Environment Factors ◽  
Work Environment Factors ◽  
Relationship Of ◽  
The Relationship

Abstract Background: Worldwide, studies show that work environment factors are related with increased health risks among nurses. However, it remains unclear how specific work-related factors relate to certain health outcomes and data investigating allocation of nursing tasks and detailed assessments of self-perceived workload are lacking. Data are particularly lacking for Lebanese nurses. We assessed the relationship of several work environment factors (overall workload and specific temporal, physical, mental, effort, frustration, and performance demands, staffing resources adequacy, leadership, teamwork climate, and allocation of nursing tasks per professional category) with the presence of health problems, including musculoskeletal, cardiovascular, skin, and mental health diseases and emotional exhaustion among Lebanese nurses.Methods:Data come from a cross-sectional self-report survey of 289 registered nurses (RNs) working in two university-affiliated hospitals in Lebanon. Adjusted multivariable logistic regression models were used to assess the relationship of work-environment factors with nurses’ health conditions.Results:The most prevalent outcomes were musculoskeletal disease (69%), emotional exhaustion (59%), and mental health problems (56%); we found high co-comorbidity levels with 70% of RNs having ≥2 and 35.29% having ≥4 co-occurring health problems. There was a widespread pattern of associations between work environment-related factors and musculoskeletal and mental/emotional health problems, with positive associations of higher overall workloads and temporal demands and negative associations of teamwork climate with both musculoskeletal ((OR=1.36 (95%CI=1.03, 1.80); 1.30 (95%CI=1.09, 1.55); 0.60 (95%CI=0.36, 0.98), respectively) and mental/emotional health problems (increased risk ranging from 22% to 88%). Higher physical demands and allocation of nursing tasks to the RNs were associated with higher odds of musculoskeletal disease (OR=1.20 (95%CI=1.03, 1.49); 1.11 (95%CI=1.01, 1.23)); more frustration and effort demands and lower performance satisfaction and resources adequacy were related to mental/emotional problems (OR=1.22 (95%CI=1.06, 1.41); 1.26 (95%CI=1.06, 1.49); 0.82 (95%CI=0.70, 09.97); 0.54 (95%CI=0.35, 0.82)). Work-environment factors were also related to a higher co-occurrence of health problems among nurses.Conclusions:Results highlight the value of a more comprehensive approach towards improving the work environment of Lebanese nurses (including improving team climate, different components of workload demands, resources, and the allocation of nursing tasks) which can simultaneously improve multiple health risks in this burdened population.

scholarly journals Work environment-related factors and nurses’ health outcomes: a cross-sectional study in Lebanese hospitals

BMC Nursing ◽  
2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Martine Elbejjani ◽  
Mary Abed Al Ahad ◽  
Michael Simon ◽  
Dietmar Ausserhofer ◽  
Nuhad Dumit ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Work Environment ◽  
Emotional Exhaustion ◽  
Task Allocation ◽  
Health Problems ◽  
Cross Sectional ◽  
Environment Factors ◽  
Perceived Workload ◽  
Work Environment Factors

Abstract Background Worldwide, studies show a relationship between nurses’ health and some work environment factors; however, data on nurses’ health and self-perceived workload and nursing task allocation are lacking, particularly for Lebanese nurses. We assessed the relationship of several work environment factors: overall workload and specific temporal, physical, mental, effort, frustration, and performance demands (NASA Task Load Index), staffing resources and adequacy and leadership (Practice Environment Scale of Nursing Work Index), teamwork climate (Safety Attitudes Questionnaire), and nursing task allocation (Basel Extent of Rationing of Nursing Care)) with self-reported musculoskeletal, cardiovascular, skin, and mental health diseases (Work Ability Index) and emotional exhaustion (Maslach Burnout Inventory) among Lebanese nurses. Methods A cross-sectional self-report survey was distributed to all 289 registered nurses (RNs) in the medical, surgical, and pediatric units in two Lebanese university-affiliated hospitals; 170 RNs had complete data. Adjusted multivariable logistic regression models were used to estimate the association between work environment factors and health outcomes. Results The most prevalent outcomes were musculoskeletal disease (69%), emotional exhaustion (59%), and mental health problems (56%); 70% of RNs had ≥2 and 35.29% had ≥4 co-occurring health problems. Musculoskeletal disease was associated with higher overall (OR = 1.36 (95%CI = 1.03, 1.80)), temporal (OR = 1.30 (95%CI = 1.09, 1.55)), and physical demands (OR = 1.20 (95%CI = 1.03, 1.49)), higher task allocation to RNs (OR = 1.11 (95%CI = 1.01, 1.23)) and lower teamwork climate (OR = 0.60 (95%CI = 0.36, 0.98). Higher odds of mental/emotional problems were associated with higher overall, temporal, frustration, and effort demands, and lower teamwork climate, performance satisfaction, and resources adequacy (increased odds ranging from 18 to 88%). Work environment indicators were associated with higher co-occurrence of health problems. Conclusions Results show elevated health burden and co-morbidity among Lebanese RNs and highlight the value of comprehensive approaches that can simultaneously improve several work environment factors (namely self-perceived workload, teamwork,, resources, and nursing task allocation) to reduce this burden.

scholarly journals Work environment-related factors and nurses’ health outcomes: A cross-sectional study in Lebanese hospitals

2020 ◽  
Author(s):  
Martine ELBEJJANI ◽  
Mary Abed Al Ahad ◽  
Michael SIMON ◽  
Dietmar AUSSERHOFER ◽  
Nuhad DUMIT ◽  
...  
Keyword(s):  
Mental Health ◽  
Work Environment ◽  
Emotional Exhaustion ◽  
Maslach Burnout Inventory ◽  
Health Problems ◽  
Cross Sectional ◽  
Environment Factors ◽  
Work Environment Factors ◽  
Relationship Of ◽  
The Relationship

Abstract Background: Worldwide, studies show that nurses’ health is related to some work environment factors; however, data on nursing tasks’ allocation and self-perceived workload are lacking, particularly for Lebanese nurses. We assessed the relationship of several work environment factors (overall workload and specific temporal, physical, mental, effort, frustration, and performance demands (NASA Task Load Index), staffing resources adequacy and leadership (Practice Environment Scale of Nursing Work Index), teamwork climate (Safety Attitudes Questionnaire), and nursing task allocation (Basel Extent of Rationing of Nursing Care) with self-reported musculoskeletal, cardiovascular, skin, and mental health diseases (Work Ability Index) and emotional exhaustion (Maslach Burnout Inventory) among Lebanese nurses. Methods: A cross-sectional self-report survey was distributed to all 289 registered nurses (RNs) in the medical, surgical, and pediatric units in two university-affiliated hospitals in Lebanon; 170 RNs provided complete data. Adjusted multivariable logistic regression models were used to assess the relationship of work environment factors with health conditions. Results: The most prevalent outcomes were musculoskeletal disease (69%), emotional exhaustion (59%), and mental health problems (56%); 70% of RNs had ≥2 and 35.29% had ≥4 co-occurring health problems. Musculoskeletal disorders were associated with higher overall (OR=1.36 (95%CI=1.03, 1.80)), temporal (OR=1.30 (95%CI=1.09, 1.55)), and physical demands (OR=1.20 (95%CI=1.03, 1.49)), more nursing tasks allocation to RNs (OR=1.11 (95%CI=1.01, 1.23)) and lower teamwork climate (OR=0.60 (95%CI=0.36, 0.98). Higher odds of mental/emotional problems were related to higher overall, temporal, frustration, and effort demands, and lower teamwork climate, performance satisfaction, and resources adequacy (increased odds ranging from 18% to 88%). Work-environment factors were related to higher co-occurrence of health problems. Conclusions: Results show high health burden and co-morbidity among Lebanese RNs and highlight the value of more comprehensive approaches towards improving many work environment factors (including team climate, various components of workload, resources, and nursing tasks’ allocation) to reduce this burden.

scholarly journals HUBUNGAN MANAJEMEN AKTIF KALA III DENGAN KEJADIAN PERDARAHAN POST PARTUM PRIMER DI PBM UMI SURABAYA

2020 ◽  
Vol 3 (1) ◽  
pp. 35
Author(s):  
Sulenti Widiastutik
Keyword(s):  
Health Services ◽  
Health Workers ◽  
Post Partum ◽  
Sampling Technique ◽  
Active Management ◽  
Chi Square ◽  
Cross Sectional ◽  
Post Partum Hemorrhage ◽  
The Third ◽  
Third Stage

ABSTRAK ABSTRAK         Manajemen akif kala III merupakan suatu intervesi yang sangat penting dilakukan pada setiapasuhan persalinan normal dengan tujuan menurunkan angka kemati ibu. Sebagian besar kasus perdarahan terjadi selama persalinan kala III salah satunya seperti atonia uteri.         Dalam penelitian ini menggunakan metode analitik observasional, dengan desain penelitian ini bersifat “ cross sectional “ populasi penelitian ini sebanyak  60 ibu bersalin di PBMUmi Surabaya.Hasil penelitian menunjukkan bahwa manajemen aktif kala III dilakukan dengan sempuirna sebanyak 36 ibu  bersalin.(60%) dan ibu bersalin yang tidak mengalami perdarahan post partum primer sebanyak 33 ibu (55%) Populasi dalam penelitian ini adalah semua ibu  yang bersalin di PBM Umi Surabayadengan besar sampel sebanyak 60 ibu bersalin dengan tehnik total sampling.Dari hasil analisis data menggunakan chi square menunjukkan hasil   hitung (21,237) >  tabel (3,84) = Ho ditolak H1 diterima. Sehingga ada hubungan manajemen aktif kala III dengan kejadian perdarahan post partum primer di PBM Umi Surabaya        Upaya percepatan penurunan  AKI dapat dilakukan dengan menjamin agar setiap ibu mampu mengakses pelayanan kesehatan ibu yang berkwalitras, seperti pelayanan kesehatan ibu hamil, pertolongan persalinan oleh tenaga kesehatan terlatih, dan perawatan pasca persalinan ibu dan bayi, perawatan khusus dan rujukan jika terjadi komplikasi Kata kunci Manajemen aktif kala III, Perdarahan Post Paetum PrimerABSTRACTThe third stage of active management is a very important intervention performed in every normal childbirth care with the aim of reducing maternal mortality. Most cases of bleeding occur during the third stage of labor such as uterine atony.         In this study using observational analytic methods, the design of this study is "cross sectional" in this study population of 60 women giving birth in PBM Umi Surabaya.The results showed that the active management of the third stage was carried out with up to 36 mothers (60%) and women who did not experience primary post partum hemorrhage as many as 33 mothers (55%). a large sample of 60 mothers with total sampling technique. From the results of data analysis using chi square showed the results of X2 count (21,237)> X2 table (3.84) = Ho rejected H1 accepted. So there is an active management relationship between the third stage and the incidence of primary post partum hemorrhage at PBM Umi Surabaya        Efforts to accelerate the reduction of MMR can be done by ensuring that every mother is able to access quality maternal health services, such as health services for pregnant women, delivery assistance by trained health workers, and postpartum care for mothers and babies, special care and referrals if complications occur. Keywords Active management stage III, Primary Post Partum Bleeding

O690 ACTIVE MANAGEMENT OF THE THIRD STAGE OF LABOR: ARE INTERNATIONAL GUIDELINES USED IN CLINICAL PRACTICE?

2012 ◽  
Vol 119 ◽  
pp. S503-S503
Author(s):  
J.E. Miranda ◽  
J.A. Rojas ◽  
A. Paternina ◽  
R. Mendoza ◽  
C.A. Bello ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Active Management ◽  
International Guidelines ◽  
The Third ◽  
Third Stage Of Labor ◽  
Third Stage
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