Relationship between hair and salivary cortisol and pregnancy in women undergoing IVF.

Evidence for an association between cortisol and clinical pregnancy in women undergoing In Vitro Fertilisation (IVF) is mixed with previous studies relying exclusively on short term measures of cortisol in blood, saliva, urine, and/or follicular fluid. Hair sampling allows analysis of systemic levels of cortisol over the preceding 3-6 months. The present study sought to explore the relationship between cortisol and clinical pregnancy outcome in women undergoing IVF utilising multiple indices of cortisol derived from both saliva and hair measured prior to commencing gonadotrophin treatment.

Issues in understanding the impact of the Needlestick Safety and Prevention Act on hospital sharps injuries.

Objective: Measuring the effect of the Needlestick Safety and Prevention Act (NSPA) is challenging. No agreement exists on a common denominator for calculating injury rates. Does it make a difference? How are the law and safety-engineered devices related? What is the effect on injuries and costs? This study examines those issues in assessing the impact of the legislation on hospital worker percutaneous injuries.

Risk of bloodborne pathogen exposure among Zambian healthcare workers.

Purpose: Understanding the risks of bloodborne pathogen transmission is fundamental to prioritizing interventions when resources are limited. This study investigated the risks to healthcare workers in Zambia.

Design: A survey was completed anonymously by a convenience sample of workers in three hospitals and two clinics in Zambia.

Disposal of sharps medical waste in the United States: impact of recommendations and regulations, 1987-2007.

Background: To gauge the impact of regulatory-driven improvements in sharps disposal practices in the United States over the last 2 decades, we analyzed percutaneous injury (PI) data from a national surveillance network from 2 periods, 1993-1994 and 2006-2007, to see whether changes in disposal-related injury patterns could be detected.

Methods: Data were derived from the EPINet Sharps Injury Surveillance Research Group, established in 1993 and coordinated by the International Healthcare Worker Safety Center at the University of Virginia. For the period 1993-1994, 69 hospitals contributed data; the combined average daily census for the 2 years was 24,495, and the total number of PIs reported was 7,854.

Practice of universal precautions and risk of occupational blood-borne viral infection among Congolese health care workers.

The extent of occupational injuries among health care workers in central Africa, particularly in the Democratic Republic of Congo, is not documented. We sought to determine the incidence of percutaneous injury and exposure to blood and other body fluids in Congolese urban and rural hospitals in the previous year. Our data show high rates of percutaneous injury and exposure to blood and other body fluids, reflecting poor safety conditions for most Congolese health care workers.

Education and career opportunities for nurses in offender health care.

This article, the last in a five-part series, examines the education opportunities and career pathways available to nurses who work in the criminal justice system. The five articles in this series reflect the many challenges faced by nurses who provide health care in the prison setting and the varied complex and specialist skills needed to perform their role. These skills range from early intervention, health promotion, health needs assessment, nurse-led services and acute care, to advanced practice and non-medical prescribing.

Supporting prison nurses: an action research approach to education.

Since April 2006, commissioning responsibility for healthcare services in public prisons has been fully devolved to NHS primary care trusts (PCTs), with the expectation that offenders will have access to the same range and quality of health services available to the wider population. In order to support prison nurses in meeting this goal, a PCT and university established a partnership, which used an action research approach to develop, instigate and evaluate a bespoke educational programme for nurses working in two local prisons. This article outlines the processes involved in the design and implementation of the programme.

Assessment of acutely ill patients in the criminal justice system.

This article, the third in a five-part series, explores the difficulties that nurses experience when dealing with an offender who becomes acutely ill within the prison setting. The authors compare and apply the recommendations from the National Institute for Health and Clinical Excellence, the National Patient Safety Agency and the Department of Health to offender health care. The article also explores how education and simulation can be used to equip nurses to deal with any difficulties they experience.

Leadership skills for nurses working in the criminal justice system.

This article, the second in a five-part series, explores leadership skills for nurses working in the criminal justice system to effect change in service provision. The article discusses different leadership styles and distinguishes management from leadership. Factors that influence change are outlined, as is the need for emotional intelligence, teamwork and collaborative working.

Nursing in prisons: developing the specialty of offender health care.

This article, the first in a five-part series, examines offender health care as a specialty. It explores the role of the nurse and the developments that have occurred over the last ten years in this field. In later articles, the authors discuss leadership skills for nurses working in the criminal justice system, assessment of the acutely ill patient, management of long-term conditions, and the future of nursing in offender health care.

The impact of U.S. policies to protect healthcare workers from bloodborne pathogens: the critical role of safety-engineered devices.

In the United States (U.S.), federal legislation requiring the use of safety-engineered sharp devices, along with an array of other protective measures, has played a critical role in reducing healthcare workers' (HCWs) risk of occupational exposure to bloodborne pathogens over the last 20 years.

Needlestick injuries to the feet of Japanese healthcare workers: a culture-specific exposure risk.

A comparison of needlestick injury surveillance data from Japan and the United States revealed a higher proportion of foot injuries to Japanese healthcare workers (HCWs), compared with US HCWs. This study investigates the underlying factors that contribute to this difference and proposes evidence-based prevention strategies to address the risk, including the use of safety-engineered needle devices, point-of-use disposal containers for sharp instruments and devices, and closed-toe footwear.

Infected health care workers and patient safety: a double standard.

US policy regarding health care worker-to-patient transmission of bloodborne pathogens, issued in 1991, is flawed. We review current evidence of such nosocomial infections and conclude that a standardized national policy is needed, which includes improved surveillance and follow-up of blood exposures to patients and targeted practice restrictions for infected practitioners performing exposure-prone procedures.

Slash sharps risk for surgical personnel.

Injury patterns for OR staff members differ from those in other healthcare settings. For this reason, tailor safety strategies to the OR environment to reduce injuries and blood exposures in this setting.