Faced with the choice of working while sick or sitting out and not getting paid, most will work while sick. Pros and Cons of Sick Pay Schemes: Testing for Contagious Presenteeism and Shirking Behavior takes a look at the ramifications. Most organizations’ human resource policy is focused on short term goal. It is clearly that way with sick pay. While it might take some logistics wrangling, there generally are duties that can be accomplished at home. It is time to get smart and realize that working sick hurts business as well as the bottom line.
The spread of disease in a facility happens quickly, as noted in Office Germs: Viruses Spread Everywhere in Just Hours, Study Shows. Bacteria and viruses move through the water system, on the air, and are moved around a facility on shoes, hands and clothes. Dr Gerba’s study showing how quickly the bacteriophage MS-2 virus moved throughout and office was enlightening.
How long do nosocomial pathogens persist on inanimate surfaces? A systematic review shows that bugs can remain viable on surfaces for hours, even weeks.
Bugs (viruses, bacteria and fungi) all move through the air. The CDC always talks about droplet precaution. It contends that droplets fall out of the air to a surface within six feet of the patient. MIT showed droplets moving 6-8 meters through the air in Studying the Science of 100 Sneezes. High-speed video shows how far sneezes spread in The snot-spattered experiments that show how far sneezes really spread. Droplet nuclei can remain suspended in air for extended periods, according to ASHRAE.
Focusing on cleaning for health, hand hygiene and sub-micron air filtration is a must for a healthy environment.
Presenteeism is more costly than many might imagine. Health, absence, disability, and presenteeism cost estimates of certain physical and mental health conditions affecting U.S. employers makes an attempt to quantify it actual dollars but notes that standardization of future research is needed before the data can be interpreted more singularly. However, that presenteeism comes with negative health and financial implications is difficult to dispute.
Does our body have natural responses to tell us when we need to isolate from other people? There is a body of thought that believes that indeed is the case. Why Do We Feel Sick When Infected—Can Altruism Play a Role? offers an interesting – albeit debatable – take on the symptoms of illness. Authored by a pair whose chief disciplines are immunology and psychology, it suggests that the more people are genetically related, the more sense it makes that being sick might well be an evolutionary adaption as a means to ensure some of their genes can be passed on. Perhaps not directly but through others with whom they share some genetic ties. They cite a number of symptoms that tend to isolate the sick to support the theory.
As health care costs climb, shrewd companies will develop programs that allow folks to work from home if sick when it’s possible, and perhaps they will allow adequate sick days and encourage workers to use them when ill. Presenteeism can be more costly than absenteeism. When one infection becomes 10, it impacts health, safety and the bottom line.
To first do no harm is a fundamental principle followed by physicians and advanced practice clinicians (APCs). And few would argue that a decided majority believe they adhere to that precept most of the time. But it isn’t always the case when health-care folks are faced with the conundrum of sitting out or going to work while showing symptoms of infection, potentially spreading illness to patients and colleagues.
Reasons Why Physicians and Advanced Practice Clinicians Work While Sick tries to identify a comprehensive understanding of the reasons attending physicians and APCs work while sick. Of the medical professionals surveyed, 95 percent believe working while sick puts patients at risk. But of this same group, 83 percent reported working while sick at least once in the previous year. Nine percent said they worked while sick at least five times the previous year! Among the reasons cited for this disconnect: difficulty in finding someone to cover, a strong cultural norm to come to work unless remarkably ill and ambiguity about what constitutes “too sick to work.”
Effective hand hygiene is another way to help ensure no harm is done, yet hand hygiene remains low in most hospitals. Hand hygiene among physicians: performance, beliefs, and perceptions shows that at a large university hospital adherence averaged 57% and varied markedly across medical specialties. In multivariate analysis, adherence was associated with the awareness of being observed, the belief of being a role model for other colleagues, a positive attitude toward hand hygiene after patient contact, and easy access to hand-rub solution. Conversely, high workload, activities associated with a high risk for cross-transmission, and certain technical medical specialties (surgery, anesthesiology, emergency medicine, and intensive care medicine) were risk factors for non-adherence. Another related piece: Physician ‘defiance’ towards hand hygiene compliance: Is there a theory–practice–ethics gap?
Even when hand hygiene is practiced, potential problems arise. Contamination of Medical Charts: An Important Source of Potential Infection in Hospitals notes that medical charts should be considered a source of infection. The authors say “our study confirms that a hospital chart is not only a medical record but also an important source of potential infection. The plastic cover of the medical chart can harbor potential pathogens, thus acting as a vector of bacteria. Additionally, chart contamination is more common in ICUs. These findings highlight the importance of effective hand-washing before and after handling medical charts. However, managers and clinical staff should pay more attention to the issue and may consider some interventions.” In short, hand hygiene that is practiced at the door upon entry is largely negated when a non-gloved hand then pulls back a contaminated curtain or handles a bacteria-laden medical chart. We must stay ever aware of infection vectors all along the chain of infection.