Questioning of medical workers of VOKB No. 1 on the organization of safety in the workplace

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Relevance. Every year, the number of new medical institutions equipped with modern technology is increasing all over the world, and the Russian Federation is no exception. Improving the equipment of departments leads to a higher risk for a medical worker, therefore, ensuring labor protection and life safety is required in full. [1]
Purpose: to study the features of the occupational health and safety system at VOKB No. 1.
Methods.
40 people took part in the research work. All subjects were divided into subgroups according to their position, of which 20 are doctors and 20 nurses from various departments. The search for study participants was carried out in the Voronezh Regional Clinical Hospital No. 1.
For the study, a questionnaire was developed for a systematic survey of subjects. Aspects of the study were the issues of various areas of safety in the hospital. The first block of questions included briefing and checking the readiness of emergency warning systems: the frequency of primary and secondary briefing, drills, and smoke detectors testing. The next block of questions related to ensuring the personal safety of a medical worker: conducting medical examinations, providing employees with personal protective equipment, ensuring safety when working in the emergency department. Further, a block of questions about sanitary and hygienic safety in the hospital was touched upon: visiting operating rooms without PPE, staying in the ward outside of visiting hours. The latter touched upon the issues of doctors' readiness for emergencies and the availability of behavioral skills in these conditions: where are emergency exits, fire escapes, the nearest shelter, the order of evacuation of patients, removal of bedridden patients. The analysis of the answers of the subjects was carried out in relation to the standard, which was compiled for each question separately in accordance with regulatory enactments. Evaluation of the research results was carried out by manual counting for each question and statistical evaluation of data in the general sample and separately in subgroups. Statistical research was carried out using Microsoft Office Excel.
Results.
The study was conducted with the participation of the medical personnel of the Voronezh Regional Clinical Hospital. The object of the research was the respondents' answers to testing questions. All workers were divided into subgroups of doctors and nurses by criteria for a comparative assessment of the responses.
The first question in the questionnaire was "How do you assess the state of health and safety in your organization?" Among doctors, it was found that only 11% are absolutely satisfied with the provision of labor safety at the place of work, the same percentage considers the safety unsatisfactory, the majority considers it relatively satisfactory, and 50% of nurses also consider it, the remaining respondents were equally divided in answers.
The aspect of the following questions was instructing and checking the readiness of emergency warning systems. All medical personnel are obliged to undergo initial instruction when hiring. According to the results of the survey, all nurses and 89% of doctors passed it, the rest are at a loss to answer. Secondary instruction should be given once every 6 months, but in reality, with such a period of time, only all nurses and 11% of doctors undergo it, most of them (56%) are instructed once every 12 months.
Training alarms in accordance with regulatory enactments must be carried out in medical institutions at least once a year. 67 percent of doctors and 87% of nurses say they are performed with the same frequency, 11 doctors and 13 nurses say they are performed every few years, or not at all (22% of doctors). This indicates an increased risk of alarm failure in a real emergency.
Smoke detectors should be checked annually, and most of the surveyed medical staff note this. But an insignificant part is not sure that the check was carried out at all.
The following questions were related to the personal safety of the healthcare professional.
Periodic medical examinations should be carried out annually, which is confirmed by all interviewees.
Provision of personal protective equipment is considered relatively satisfactory by 76% of doctors and 92% of nurses, and 22% of doctors and 18% of nurses say the need for replenishment, but it is worth noting that no one said it was stable.
When working in the admission department, a security guard must monitor the safety of medical personnel and be in quick access to PPE. The presence of both items is noted by only 34% of doctors and 25% of nurses. 11% of doctors say that both are absent. The rest of those surveyed speaks of the presence of only one of the components, more often a guard.
A visit to the operating room without personal protective equipment is not permissible, as it increases the risk of spreading infections and violates the sterility of the room. A smaller percentage of doctors canceled It is believed that people without PPE often enter the operating room, 37% of nurses and 33% of doctors say that this happened rarely, but a larger number (56% of doctors and 63% of nurses) say that they have never noticed this.
Most of the doctors (56%) noted that strangers are often found in the department outside of the visit time. The majority of nurses (75%) and 33% of doctors mention isolated such cases.
There were also asked questions about actions in case of emergency. Sample answer: Report a fire in the hospital, open the doors of the wards, show where to go for evacuation to walking patients, evacuate seriously ill patients, help extinguish the fire. All surveyed nurses and 89% of doctors know how to behave in a fire, 11% do not. [1]
All respondents know where the emergency exits are located, which indicates a quick response of personnel when evacuating patients. However, not all doctors (33% of respondents) knew where to get fire extinguishers.
Often, fire escapes in the department are locked so that patients and visitors do not smoke on them. In connection with the possibility of an emergency, the keys must be in quick access by the medical staff. All nurses note that the keys are at their fingertips, the majority of doctors also say (78%), but 11% note the lack of knowledge of where the keys are.
An important issue is the order in which patients are evacuated. First of all, during the evacuation, patients are taken out who can move by themselves and then only those who are lying, most doctors (56%) and nurses (63%) do not know this. [2]
In an emergency, bedridden patients are carried out on a stretcher, feet forward when descending the stairs and head forward when climbing, trying to give the stretcher a horizontal position. About a quarter of doctors and nurses do not know how to do this correctly. [2]
In an emergency, especially when martial law or a nuclear / chemical explosion is imposed, it is important to know where the nearest refuge is. 44% of doctors and 25% of nurses do not know this.
Discussion
On the basis of the Voronezh Regional Clinical Hospital, a study was carried out to study the features of the occupational health and safety system of the medical personnel of the VOKB No. 1. The study was carried out in the form of testing doctors and nurses. The questionnaire contained questions related to instructing and checking emergency warning systems, actions in emergency situations, as well as the personal safety of medical personnel.
According to the results of the study, the individual safety of medical personnel is insufficiently ensured in the departments: the secondary instruction of the majority of medical workers (56%) takes place every 12 months (according to the norm, once every 6 months). Also, drills are made not in accordance with regulatory enactments - at least once a year. 67% of doctors and 87% of nurses say that they are performed with such frequency, 11 doctors and 13 nurses say that they are performed every few years, or not at all (22% of doctors).
The sanitary regime in the hospital is not fully supported: a visit to the operating room without personal protective equipment is not permissible, as it increases the risk of spreading infections and violates the sterility of the room. A smaller percentage of doctors note that people without PPE often enter the operating room. However, 37% of nurses and 33% of doctors say this was rare. It is also noted that there are often strangers in the department outside of the visit time, which indicates a violation of the sanitary and hygienic regime of the hospital.
The disadvantage of our chosen method is the subjectivity of the respondents, which could have influenced the results of the study.
Conclusion
Based on the data of the survey, it can be concluded that the individual safety of the staff is not sufficiently ensured in the hospital departments, as they say about the simplified ones. The sanitary and hygienic regime is not sufficiently maintained, and medical workers are not fully instructed, which is confirmed by data on the lack of information of medical personnel on how to act in an emergency mode. In addition, it can be noted that the items of emergency response are monitored in due measure, since the respondents note the annual check of smoke detectors and warning of danger.

About the authors

Aleksandra Andreevna Tarasova

Воронежский государственный медицинский университет им. Н.Н.Бурденко, кафедра медицина катастроф и безопасность жизнедеятельности

Author for correspondence.
Email: lexsa.alya@gmail.com
ORCID iD: 0000-0002-7870-6842
SPIN-code: 6434-3575
Russian Federation

A. S. Borodina

Воронежский государственный медицинский университет им. Н.Н.Бурденко, кафедра медицина катастроф и безопасность жизнедеятельности

Email: lexsa.alya@gmail.com
ORCID iD: 0000-0002-7870-6842

M. A. Merzlikina

Воронежский государственный медицинский университет им. Н.Н.Бурденко, кафедра медицина катастроф и безопасность жизнедеятельности

Email: lexsa.alya@gmail.com
ORCID iD: 0000-0002-7870-6842
SPIN-code: 8997-7429

References