Findings provide information for nursing and health policymakers to develop policies to improve quality of work life among nurses that can contribute to quality of nursing care. This includes the working environment, commitment to the organization and measures to reduce job stress.
BackgroundUnderstanding injection practices is crucial for evidence-based development of intervention initiatives. This study explored the extent of injection use and injection safety practices in primary care hospitals in Bangladesh.MethodsThe study employed both quantitative and qualitative research methods. The methods used were - a retrospective audit of prescriptions (n = 4320), focus group discussions (six with 43 participants), in-depth interviews (n = 38) with a range service providers, and systematic observation of the activities of injection providers (n = 120), waste handlers (n = 48) and hospital facilities (n = 24). Quantitative and qualitative data were assessed with statistical and thematic analysis, respectively, and then combined.ResultsAs many as 78% of our study sample (n = 4230) received an injection. The most commonly prescribed injections (n = 3354) including antibiotics (78.3%), IV fluids (38.6%), analgesics/pain killers (29.4%), vitamins (26.7%), and anti-histamines (18.5%). Further, 43.7% (n = 1145) of the prescribed antibiotics (n = 2626) were given to treat diarrhea and 42.3% (n = 600) of IV fluids (n = 1295) were used to manage general weakness conditions. Nearly one-third (29.8%; n = 36/120) of injection providers reported needle-stick injuries in the last 6 months with highest incidences in Rajshahi division followed by Dhaka division. Disposal of injection needles, syringes and other materials was not done properly in 83.5% (n = 20/24) of the facilities. Health providers' safety concerns were not addressed properly; only 23% (n = 28/120) of the health providers and 4.2% (n = 2/48) of the waste handlers were fully immunized against Hepatitis B virus. Moreover, 73% (n = 87/120) of the injection providers and 90% (n = 43/48) of the waste handlers were not trained in injection safety practices and infection prevention. Qualitative data further confirmed that both providers and patients preferred injections, believing that they provide quick relief. The doctors' perceived injection use as their prescribing norm that enabled them to prove their professional credibility and to remain popular in a competitive health care market. Additionally, persistent pressure from hospital administration to use up injections before their expiry dates also influenced doctors to prescribe injections regardless of actual indications.ConclusionsAs far as the patients and providers' safety is concerned, this study demonstrated a need for further research exploring the dynamics of injection use and safety in Bangladesh. In a context where a high level of injection use and unsafe practices were reported, immediate prevention initiatives need to be operated through continued intervention efforts and health providers' training in primary care hospitals in Bangladesh.
Aim To explore and provide understanding of the barriers to quality of work life among registered nurses in Bangladesh. Background Globally, there is growing interest in the working environments of nurses, especially at a time of nursing shortages and with the focus on safety and care quality in health systems. In a low socio‐economic country like Bangladesh, nurses struggle in a grossly underfunded healthcare system to deliver care to the people but no studies have been conducted on their quality of work life. Methods This qualitative descriptive study was conducted at three Bangladeshi tertiary hospitals in May 2015–January 2016. Three focus group discussions were held with 30 registered nurses exploring their perceived barriers to quality of work life. Data were analysed with content analysis. Findings Seven barriers to their work‐life arose: heavy workloads; lack of government accommodation and transportation; poor health status; lack of support from nursing supervisors; lack of promotion opportunities; incomplete hospital policies and procedures; and lack of night shift and risk allowances. Discussion Participants described many issues and barriers impacting on their work‐life. They perceived little reward for their hard work, felt that their health suffered from their working conditions and described a low QWL. Conclusion and policy implications Findings provide information for nursing and health policymakers and leaders to reduce barriers to improve work‐life quality among nurses that can contribute better to quality of nursing care, and nursing retention and satisfaction. Work policies and practices, and funding and other resources need to be scrutinized to ensure better working conditions for Bangladeshi nurses. Limitations Interviews were conducted with nurses only in tertiary hospitals in the Bangladeshi capital, and understanding of barriers to work‐life quality of nurses in other health settings and regions needs to be explored.
Chitosan-reinforced starch-based biodegradable composite films were prepared by solution casting. The chitosan content in the films was varied from 20% to 80% (w/w). Tensile strength (TS) and tensile modulus (TM) of the starch-based composites were improved significantly with the addition of chitosan. Water vapor permeability (WVP) and oxygen transmission rate (OTR) of chitosan-reinforced starch-based films showed a significant reduction compared to native chitosan film and indicated better barrier properties to water vapor and oxygen. The water uptake of the films pointed out better hydrophobic character due to the incorporation of chitosan in starch-based films. Thermal stability was also found to increase with the addition of chitosan in starch-based films and was confirmed by thermogravimetric analysis (TGA) and differential thermal analysis (DTA). Fourier transform infrared (FT-IR) spectroscopy supported the molecular interactions due to the reinforcement of chitosan in starch-based films. Surface and interface morphologies of chitosan film and starch/chitosan composite film were examined by
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