Introduction: This study was carried out to find out the existing prevalence rates of the Needle Stick Injuries (NSIs) among nursing officers in Sri Lankan health delivery system and to identify the factors associated with NSIs including the level of knowledge, attitude and practice on prevention.Methods: A descriptive cross sectional study was conducted in three District General Hospitals. Five routine working units identified from each hospital. Proportional allocations were made with a final step of simple random sampling to select the sample. Self-administered questionnaire was used for data collection. Results:Response rate was 95% and the prevalence of NSIs was 43%. IV cannulation was the most risky procedure (51%). Re-capping was seen in 24% of the exposed group. Medical wards accounted for 78% of the NSIs. There was a significant difference in NSIs seen in maturity in age (p=0.015) and increase working experience (p=0.044) but no difference was found with increased work load (no. of patients seen per day, p=0.765, increase number of working hours per week, p=0.204) and participation in in-service training programs (p=0.592). Pre exposure Hepatitis B immunization was seen in only 64%. A significant 49% did not report the injury and the main reason was assumed less risk (46%). Conclusion:Prevalence of NSIs was still high and ignorance and neglect are the main causes. Health education and in-service training should be mainly directed at inculcating knowledge into practice and changing attitudes towards safe practices. Hepatitis B immunization should be provided as early as possible.

Introduction: Patient safety and high reliability related to obstetric care has become a global concern especially during this COVID-19 pandemic period.Aim of this study is to assess the components of Socio Technical system as the factors affecting while adopting High-Reliability Organization (HRO) Principles as perceived by staff. Methodology: This is a hospital based descriptive cross-sectional study conducted using a self-administered questionnaire.Results: Out of the five factors affecting HRO practices as perceived by staff, "Organizational Safety Culture" (Mean- 4.25., SD-0.454 Significant at <0.01 level), Communication (SD-4.15, SD-0.579), and Teamwork (Mean:3.95, SD:0.499). are having a statistically significant (p <0.05 corresponding to Spearman’s correlation Coefficient positive association with the practice of HRO principles. According to Multiple linear regression model explains 29% of the variability of the HRO practices (dependent variable) can be explained by the factors affecting HRO practices (independent variables) if all the factors operate together. Gender, age, educational level, designation and working experience act as moderating variables to Organizational Safety Culture. There is a significant (p <0.05) difference of HRO practices among female gender, nursing category of staff which is better than other categories.Conclusion: Organizational safety culture, communication and Teamwork and work environment show significant effect on determining HRO practices which is important for policy makers and administrators to pay attention on above three factors to improve reliability. But these five factors (including leadership and working environment) explains only one third of variability of HRO practices), hence need to study other factors affecting reliability of performance.

Introduction: COVID-19 was declared as public health emergency of international concern (PHEIC) by World Health Organization (WHO) on 30th of January 2020 as it was spreading all over the world. There was a rise in the number of cases of COVID-19 during the second wave in Sri Lanka. The epicenter was in Gampaha district. Ministry of Health embarked several strategies in preventive sector. Contact tracing is one of such strategy.objective: To identify the challenges and issues of contact tracing in Mahara Medical Officer of Health (MOH) area in Gampaha district. Methodology:This descriptive cross-sectional study was carried out in Mahara MOH area using qualitative and quantitative methods. Results:The study revealed that a total number of 1532 cases were identified as contacts and they were subjected to Polymerase Chain Reaction (PCR) testing. The total number of positive cases was 575 out of 1532 contacts (37.5%). Mahara MOH region had a relatively higher incidence rate during the study period compared to district and national figures.Discussion: Public health staff faced many challenges during contact tracing. As contact tracing is a subjective procedure, when an index case is identified, the public health staff had to engage in various contact tracing processes during which, they faced difficulties in tracking the contacts. For example, some of them were not willing to reveal true primary contact details due to stigma and experienced that, giving false addresses added further burden to this challenging task. Recall bias had also affected contact tracing to a certain extent. Conclusion & Recommendation:Increasing public awareness through continuous public education would reduce the stigma of the disease and further strengthen the contact tracing.

The operation theatre (OT) complex is a costly component of a hospital budget expenditure. This area of hospital activity requires maximum utilization to ensure optimum cost-benefit ratio. Two tertiary care centers in the Colombo district, Sri Jayewardenepura General Hospital (SJGH), the only semi-government tertiary care center in Sri Lanka, and Colombo South Teaching Hospital (CSTH) providing similar service delivery to government hospitals were studied to compare utilization patterns. The results showed no significant statistical difference in average per-bed utilization of SJGH and CSTH (P=0.499). The average per-bed utilization rate at CSTH was 23.26%, and SJGH was 25.66%. There was a significant statistical difference in the average per-bed capacity utilization of operating theaters at CSTH and SJGH. The average per bed capacity utilization time per day was significantly higher at SJGH (P=0.040). The average per-bed capacity utilization rate at CSTH was 11.63% and 15.2% at SJGH. According to the Consultants' perception of the importance of factors affecting utilization, less significance is given to time management and related administrative functions even though they have the highest correlation to utilization factors. Utilization observed at both hospitals was lower than the global benchmark between 70% and 80%. The study identified the importance of factors affecting utilization towards human resource availability, motivation, training needs and equipment, and resource availability. Surgeons have given less priority to time management and related administrative functions though the literature suggests time management and relative administratively modifiable factors as the most critical factors. (Gupta, 2011). Therefore, it is recommended to address the factors such as "cancellation of planned surgeries", "accurate prediction of procedure times in scheduling theatre lists", "convenient theater time schedules with other clinical work", "patient turn over time", and "patient transport time from wards" as they can result in overall improvement in operating facility utilization.

There is a growing concern regarding patient safety and high reliability which made more intense with this ongoing pandemic.Aim of this study is to assess the organizational factors affecting the practice of High-Reliability Organization (HRO) Principles as perceived by staff in selected Accident and Emergency Units. Methodology: A hospital based cross-sectional study in three Accident and Emergency care setting, among healthcare staff, conducted using a self-administered questionnaire.Results: Out of the five factors affecting HRO practices as perceived by staff, “Organizational Safety Culture” (Mean-4.27., SD-0.49) has the highest mean value followed by Leadership (Mean: 3.96, SD: 0.44) and Teamwork (Mean: 3.95, SD: 0.5). “Work Environment” (Mean: 3.94, SD: 0.46) has the lowest score. All independent and dependent variables have a significant positive correlation with HRO principles (Correlation is significant at the 0.01 level-1-tailed). Multivariate analysis was carried out to assess the proportion variability of the dependent variable. The linear regression model explains 22% of the variability of the HRO practices (dependent variable) by factors affecting HRO practices (independent variables) if all the factors operate together.The distribution of Coefficients, Standardized B value is 0.29 (significant at the 0.01 level), showing if “Organizational Safety Culture” operates together with the other four independent variables 29% of the variability of the HRO practices (dependent variable) can be explained by Organizational Safety Culture.Conclusion: Organizational safety culture shows significant (< 0.01) effect on determining HRO practices.