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Barriers and Facilitators of Nurses' and Physicians' Willingness to Work during a Respiratory Disease Outbreak: A Mixed-Methods Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136841. [PMID: 34202234 PMCID: PMC8296986 DOI: 10.3390/ijerph18136841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/23/2021] [Accepted: 06/24/2021] [Indexed: 11/17/2022]
Abstract
This review was undertaken to identify the perceived barriers and facilitators of nurses’ and physicians’ willingness to work during a respiratory disease outbreak. This mixed-methods systematic review involved the extraction of data from the electronic databases PubMed, Web of Science, CINAHL, and PsycINFO and from a manual search of articles published between 2003 and April 2021. The quality of the included studies was assessed using a mixed-method appraisal tool. A total of 29 studies were eligible for inclusion: 21 quantitative and 8 qualitative. Using the Integrated Behavioral Model, perceived barriers and facilitators were identified under seven categories: demographics, attitude, perceived norm, personal agency, knowledge and skills to perform the behavior, environmental constraints, and habit. The results of this study broaden the understanding of various factors that affect nurses’ and physicians’ willingness to work during a respiratory disease outbreak. These findings will facilitate the modification of current pandemic workplace staffing strategies and practices and will inform preparedness planning for similar situations in the future.
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152
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Sustained behavior change is key to preventing and tackling future pandemics. Nat Med 2021; 27:749-752. [PMID: 33972794 DOI: 10.1038/s41591-021-01345-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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153
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Anand G, Perry AM, Cummings CL, St Raymond E, Clemens RA, Steed AL. Surface Proteins of SARS-CoV-2 Drive Airway Epithelial Cells to Induce IFN-Dependent Inflammation. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2021; 206:3000-3009. [PMID: 34078711 PMCID: PMC8278276 DOI: 10.4049/jimmunol.2001407] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 04/06/2021] [Indexed: 01/08/2023]
Abstract
SARS-CoV-2, the virus that has caused the COVID-19 pandemic, robustly activates the host immune system in critically ill patients. Understanding how the virus engages the immune system will facilitate the development of needed therapeutic strategies. In this study, we demonstrate both in vitro and in vivo that the SARS-CoV-2 surface proteins spike (S) and envelope (E) activate the key immune signaling IFN pathway in both human and mouse immune and epithelial cells independent of viral infection and replication. These proteins induce reactive oxidative species generation and increases in human- and murine-specific, IFN-responsive cytokines and chemokines, similar to their upregulation in critically ill COVID-19 patients. Induction of IFN signaling is dependent on canonical but discrepant inflammatory signaling mediators, as the activation induced by S is dependent on IRF3, TBK1, and MyD88, whereas that of E is largely MyD88 independent. Furthermore, these viral surface proteins, specifically E, induced peribronchial inflammation and pulmonary vasculitis in a mouse model. Finally, we show that the organized inflammatory infiltrates are dependent on type I IFN signaling, specifically in lung epithelial cells. These findings underscore the role of SARS-CoV-2 surface proteins, particularly the understudied E protein, in driving cell specific inflammation and their potential for therapeutic intervention.
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Affiliation(s)
- Gautam Anand
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO
| | - Alexandra M Perry
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO
| | - Celeste L Cummings
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO
| | - Emma St Raymond
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO
| | - Regina A Clemens
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO
| | - Ashley L Steed
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO
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154
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Sandor AM, Sturdivant MS, Ting JPY. Influenza Virus and SARS-CoV-2 Vaccines. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2021; 206:2509-2520. [PMID: 34021048 PMCID: PMC8722349 DOI: 10.4049/jimmunol.2001287] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 03/29/2021] [Indexed: 12/13/2022]
Abstract
Seasonal influenza and the current COVID-19 pandemic represent looming global health challenges. Efficacious and safe vaccines remain the frontline tools for mitigating both influenza virus and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-induced diseases. This review will discuss the existing strategies for influenza vaccines and how these strategies have informed SARS-CoV-2 vaccines. It will also discuss new vaccine platforms and potential challenges for both viruses.
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Affiliation(s)
- Adam M Sandor
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Division of Pharmacoengineering and Molecular Pharmaceutics, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC; and
| | - Michael S Sturdivant
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Biological and Biomedical Sciences Program, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Jenny P Y Ting
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC;
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC
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155
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Elgibaly O, Daef E, Elghazally SA, Hassan HM, ElsaidTash RM, Bahgat SM, ELantouny NG, Zarzour AA, Othman MMA, El-Sokkary RH. Knowledge, perception, and confidence of healthcare workers about COVID-19 preventive measures during the first wave of the pandemic: a cross-sectional study from Egypt. Germs 2021; 11:179-188. [PMID: 34422690 PMCID: PMC8373401 DOI: 10.18683/germs.2021.1255] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/02/2021] [Accepted: 04/18/2021] [Indexed: 12/23/2022]
Abstract
INTRODUCTION The ongoing coronavirus-disease-19 (COVID-19) pandemic had a variable history with differences in its various stages. This study evaluates the status of knowledge, perception, and confidence about COVID-19 preventive measures during the first wave of the COVID-19 pandemic among healthcare workers (HCWs) in Egypt. METHODS A cross-sectional study was conducted during the first wave of the COVID-19 pandemic, in July 2020, in Egypt. An-online-based questionnaire was used to collect data. It included items to record demographic data, and an assessment of knowledge, the perception of healthcare facilities preparedness, and HCW confidence about applying infection prevention measures. RESULTS A total of 465 responses were analyzed. HCWs' mean age was 36.76 ± 9.57 years, 94.2% (n=438) had an adequate level of knowledge, 31% (n=144) had an adequate perception level, and 39.4% (n=183) had an adequate confidence level. The main source of information was international organizations' websites 46.5% (n=216). The main barriers to applying preventive measures were the overcrowding of patient care areas 73.1% (n=339), and limited infection control supplies 68% (n=316). Factors associated with COVID-19 among HCWs were COVID-19 infected family members (OR: 5.86), inability to protect themselves and their families (OR: 5.73), uncertainty about the available hand hygiene supplies (OR: 3.76), male gender (OR: 3.07), and single HCWs (OR: 2.88). CONCLUSIONS Although the majority reported an adequate knowledge level, lower rates of adequate perception and confidence were observed. Revision of preparedness plans in different facilities should be further studied. Psychological support and gender differences should be considered in response programs.
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Affiliation(s)
- Omaima Elgibaly
- Prof, PhD, Public Health & Community Medicine, Assiut University, PO 71515, Assiut, Egypt
| | - Enas Daef
- Prof, PhD, Medical Microbiology & Immunology, Faculty of Medicine, Assiut University, PO 7151, Assiut, Egypt
| | - Shimaa A. Elghazally
- Dr, PhD, Occupational and Environmental Medicine, Faculty of Medicine, Assiut University, PO 7151, Assiut, Egypt
| | - Hebatallah M. Hassan
- Dr, PhD, Medical Microbiology & Immunology, Faculty of Medicine, Assiut University, PO 7151, Assiut, Egypt
| | - Rehab M. ElsaidTash
- Ass Prof, PhD, Infection Control Consultant, Medical Microbiology & Immunology, Faculty of Medicine, Zagazig University, PO 44519, Zagazig, Egypt
| | - Shereen M. Bahgat
- Ass Prof, PhD, Family Medicine, Faculty of Medicine, Zagazig University, PO 44519, Zagazig, Egypt
| | - Neveen G. ELantouny
- Prof, PhD, Internal Medicine, Faculty of Medicine, Zagazig University, PO 44519, Zagazig, Egypt
| | - Amro A. Zarzour
- Dr, PhD, Anesthesia and Intensive Care, Faculty of Medicine, Assiut University, PO 7151, Assiut, Egypt
| | - Marwa M Ayesh Othman
- Dr, MsC, Tropical Medicine, Faculty of Medicine, Zagazig University, PO 44519, Zagazig, Egypt
| | - Rehab H. El-Sokkary
- Prof, PhD, Infection Control Consultant, Medical Microbiology & Immunology, Faculty of Medicine, Zagazig University, PO 44519, Zagazig, Egypt
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156
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Su Z, McDonnell D, Cheshmehzangi A, Abbas J, Li X, Cai Y. The promise and perils of Unit 731 data to advance COVID-19 research. BMJ Glob Health 2021; 6:bmjgh-2020-004772. [PMID: 34016575 PMCID: PMC8141376 DOI: 10.1136/bmjgh-2020-004772] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 04/17/2021] [Accepted: 04/17/2021] [Indexed: 12/17/2022] Open
Affiliation(s)
- Zhaohui Su
- Center on Smart and Connected Health Technologies, Mays Cancer Center, School of Nursing, UT Health San Antonio, San Antonio, Texas, USA
| | - Dean McDonnell
- Department of Humanities, Institute of Technology Carlow, Carlow, Ireland
| | - Ali Cheshmehzangi
- Architecture and Built Environment, University of Nottingham, Ningbo, Zhejiang, China
| | - Jaffar Abbas
- Antai College of Economics and Management, and School of Media and Communication, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaoshan Li
- Program of Public Relations and Advertising, Beijing Normal University-Hong Kong Baptist University United International College, Zhuhai, Guangdong, China
| | - Yuyang Cai
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China
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157
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de Arriba-Fernández A, Molina-Cabrillana MJ, Serra Majem L. [Evolution of adherence to hand hygiene in health care professionals in a third level hospital in relation to the SARS-CoV-2 pandemic]. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2021; 34:214-219. [PMID: 33829723 PMCID: PMC8179943 DOI: 10.37201/req/150.2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/20/2021] [Accepted: 02/22/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Proper hand hygiene is the main measure in the prevention and control of infection associated with healthcare. It describes how the pandemic period of 2020 has influenced the evolution of the degree of compliance with hand hygiene practices in health professionals at the Hospital Universitario Insular de Gran Canaria with respect to previous years. METHODS Descriptive cross-sectional study of direct observation on compliance with the five moments of hand hygiene in the 2018-2020 period. Adherence is described with the frequency distribution of the different moments in which it was indicated. RESULTS Total adherence has increased from 42.5% in 2018, to 47.6% in 2019, and 59.2% in 2020 (p <0.05). Total adherence was greater in the moments after contact with the patient (67%) than in the moments before contact (48%). The area with the highest adherence was dialysis (83%). There is a greater adherence in open areas than in hospitalization areas (65% vs 56%). Higher adherence was determined in physicians (73%) and nurses (74%), than in nursing assistants (50%) (p<0.05). CONCLUSIONS In 2020 there was an increase in adherence to hand hygiene compared to previous years. A higher percentage of adherence was determined in physicians and nurses than in nursing assistants. We consider that the current SARS-CoV-2 pandemic has played a relevant role in this increase in adherence.
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Affiliation(s)
- A de Arriba-Fernández
- Alejandro de Arriba-Fernández, Universidad de Las Palmas de Gran Canaria. Paseo Blas Cabrera Felipe "Físico", 310, Las Palmas Gran Canaria. Spain.
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158
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Etafa W, Gadisa G, Jabessa S, Takele T. Healthcare workers' compliance and its potential determinants to prevent COVID-19 in public hospitals in Western Ethiopia. BMC Infect Dis 2021; 21:454. [PMID: 34011263 PMCID: PMC8132019 DOI: 10.1186/s12879-021-06149-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 05/06/2021] [Indexed: 02/07/2023] Open
Abstract
Background Globally, Coronavirus disease-19 has created unprecedented challenges to public health. Healthcare workers (HCWs) are at risk of COVID-19 because of their profession. There are limited studies conducted in Ethiopia among HCWs regarding their compliance with COVID-19 preventive measures. Therefore, this study intended to assess HCWs’ compliance with measures to prevent COVID-19, and its potential determinants in public hospitals in Western Ethiopia. Methods A self-administered, multicenter hospital-based cross-sectional survey was proposed to 422 randomly selected HCWs working in seven public hospitals in Western Ethiopia identified as COVID-19 referral centers. Data were entered into Epi Data version 3.1 and analyzed using SPSS version 24. Binary logistic regression was used to identify potential determinants of outcome variables at p-value < 0.05. Results Out of 422 completed questionnaires, the overall HCWs’ compliance with COVID-19 prevention is 22% (n = 404). In multivariate regression analysis, factors such as spending most of caring time at bedside (AOR = 1.94, 95%CI, 1.06–3.55), receiving training on infection prevention/COVID-19 (AOR = 1.86, 95%CI, 1.04–3.33), reading materials on COVID-19 (AOR = 2.04, 95%CI, 1.14–3.63) and having support from hospital management (AOR = 2.09, 95%CI, 1.20–3.64) were found to be significantly associated with COVID-19 preventive measures. Furthermore, inadequate supplies of appropriate personal protective equipment (83.2%), insufficient supportive medications (78.5%), and lack of provision of adequate ventilation (77.7%) were the barriers to COVID-19 prevention most frequently mentioned by participants. Conclusion Our findings highlight HCWs’ poor compliance with COVID-19 preventive measures. Providing information and refreshing training to improve the level of healthcare workers’ adherence with COVID-19 prevention is as imperative as increasing staff commitment to supply resources necessary to protect HCWs and to reduce healthcare-associated infections transmission of SARS-COV-2. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06149-w.
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Affiliation(s)
- Werku Etafa
- Institute of Health Science, Wollega University, Nekemte, Ethiopia.
| | - Gosa Gadisa
- College of Natural and Computational Science, Wollega University, Nekemte, Ethiopia
| | - Shibiru Jabessa
- College of Natural and Computational Science, Wollega University, Nekemte, Ethiopia
| | - Tagay Takele
- College of Natural and Computational Science, Wollega University, Nekemte, Ethiopia
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159
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Tsopra R, Frappe P, Streit S, Neves AL, Honkoop PJ, Espinosa-Gonzalez AB, Geroğlu B, Jahr T, Lingner H, Nessler K, Pesolillo G, Sivertsen ØS, Thulesius H, Zoitanu R, Burgun A, Kinouani S. Reorganisation of GP surgeries during the COVID-19 outbreak: analysis of guidelines from 15 countries. BMC FAMILY PRACTICE 2021; 22:96. [PMID: 34000985 PMCID: PMC8127252 DOI: 10.1186/s12875-021-01413-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 03/10/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND General practitioners (GPs) play a key role in managing the COVID-19 outbreak. However, they may encounter difficulties adapting their practices to the pandemic. We provide here an analysis of guidelines for the reorganisation of GP surgeries during the beginning of the pandemic from 15 countries. METHODS A network of GPs collaborated together in a three-step process: (i) identification of key recommendations of GP surgery reorganisation, according to WHO, CDC and health professional resources from health care facilities; (ii) collection of key recommendations included in the guidelines published in 15 countries; (iii) analysis, comparison and synthesis of the results. RESULTS Recommendations for the reorganisation of GP surgeries of four types were identified: (i) reorganisation of GP consultations (cancelation of non-urgent consultations, follow-up via e-consultations), (ii) reorganisation of GP surgeries (area partitioning, visual alerts and signs, strict hygiene measures), (iii) reorganisation of medical examinations by GPs (equipment, hygiene, partial clinical examinations, patient education), (iv) reorganisation of GP staff (equipment, management, meetings, collaboration with the local community). CONCLUSIONS We provide here an analysis of guidelines for the reorganisation of GP surgeries during the beginning of the COVID-19 outbreak from 15 countries. These guidelines focus principally on clinical care, with less attention paid to staff management, and the area of epidemiological surveillance and research is largely neglected. The differences of guidelines between countries and the difficulty to apply them in routine care, highlight the need of advanced research in primary care. Thereby, primary care would be able to provide recommendations adapted to the real-world settings and with stronger evidence, which is especially necessary during pandemics.
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Affiliation(s)
- Rosy Tsopra
- INSERM, Université de Paris, Sorbonne Université, Centre de Recherche des Cordeliers, Information Sciences to support Personalized Medicine, F-75006, Paris, France. .,Department of Medical Informatics, Hôpital Européen Georges-Pompidou, AP-HP, Paris, France.
| | - Paul Frappe
- Department of general practice, Faculty of medicine Jacques Lisfranc, University of Lyon, Saint-Etienne, France.,Inserm UMR 1059, Sainbiose DVH, University of Lyon, Saint-Etienne, France.,Inserm CIC-EC 1408, University of Lyon, Saint-Etienne, France.,College of General Practice / Collège de la Médecine Générale, Paris, France
| | - Sven Streit
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Ana Luisa Neves
- Patient Safety Translational Research Centre, Institute of Global Health Innovation, Imperial College London, London, UK.,Center for Health Technology and Services Research / Department of Community Medicine, Health Information and Decision, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Persijn J Honkoop
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Berk Geroğlu
- İzmir Karşıyaka District Health Directorate, İzmir, Turkey
| | - Tobias Jahr
- Medizinische Hochschule Hannover, OE 5430, Carl Neuberg Str. 1, 30625, Hannover, Germany
| | - Heidrun Lingner
- Medizinische Hochschule Hannover, Medizinische Psychologie, OE 5430, Hannover, Germany.,Member of the German Center for Lung Research (DZL)/ BREATH - Biomedical Research in Endstage and Obstructive Lung Disease Hannover, Carl Neuberg Str. 1, 30625, Hannover, Germany
| | - Katarzyna Nessler
- Department of Family Medicine, Jagiellonian University Medical College, Kraków, Poland.,Vasco da Gama Movement, Wonca Europe, Kraków, Poland
| | | | - Øyvind Stople Sivertsen
- Torshovdalen Health Center, Oslo, Norway.,Editor of the Journal of the Norwegian Medical Association, Oslo, Norway
| | | | - Raluca Zoitanu
- National Federation of Family Medicine Employers in Romania (FNPMF), București, Romania
| | - Anita Burgun
- INSERM, Université de Paris, Sorbonne Université, Centre de Recherche des Cordeliers, Information Sciences to support Personalized Medicine, F-75006, Paris, France.,Department of Medical Informatics, Hôpital Européen Georges-Pompidou & Necker Children's Hospital, AP-HP, Paris, France
| | - Shérazade Kinouani
- INSERM, Bordeaux Population Health Research Center, team HEALTHY, UMR 1219, university of Bordeaux, F-33000, Bordeaux, France.,Department of General Practice, University of Bordeaux, 146 rue Léo Saignat, F-33000, Bordeaux, France
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160
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Roberti J, Jorro F, Rodríguez V, Belizán M, Arias P, Ratto ME, Reina R, Ini N, Loudet C, García-Elorrio E. Theory-driven, rapid formative research on quality improvement intervention for critical care of patients with COVID-19 in Argentina. Glob Qual Nurs Res 2021; 8:23333936211015660. [PMID: 34026926 PMCID: PMC8120599 DOI: 10.1177/23333936211015660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 04/14/2021] [Accepted: 04/19/2021] [Indexed: 11/23/2022] Open
Abstract
The challenges of implementing interventions in healthcare settings have been more apparent during the COVID-19 pandemic. This pre-implementation evaluation used a rapid qualitative approach to explore barriers and facilitators to an intervention in intensive care units in Argentina, aimed to promote the use of personal protection equipment, provide emotional support for professionals, and achieve patient flow goals. Data were collected using semi-structured interviews with health professionals of 15 public hospitals in Argentina. Normalization Process Theory was used to guide content analysis of the data. Participants identified potential barriers such as the incorporation of non-specialist staff, shortage of resources, lack of communication between groups and shifts. Potential facilitators were also identified: regular feedback and communication related to implementation, adequate training for new and non-specialist staff, and incentives (e.g., scholarships). The immediacy of the pandemic demanded rapid qualitative research, sharing actionable findings in real time.
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Affiliation(s)
- Javier Roberti
- Institute for Clinical Effectiveness and Health Policy, (IECS), Buenos Aires, Argentina.,Centre for Research in Epidemiology and Public Health at National Scientific and Technical Research Council (CIESP - CONICET), Buenos Aires, Argentina
| | - Facundo Jorro
- Institute for Clinical Effectiveness and Health Policy, (IECS), Buenos Aires, Argentina
| | - Viviana Rodríguez
- Institute for Clinical Effectiveness and Health Policy, (IECS), Buenos Aires, Argentina
| | - María Belizán
- Institute for Clinical Effectiveness and Health Policy, (IECS), Buenos Aires, Argentina
| | - Pilar Arias
- Argentine Society of Intensive Care (SATI), Buenos Aires, Argentina
| | | | - Rosa Reina
- Argentine Society of Intensive Care (SATI), Buenos Aires, Argentina
| | - Natalí Ini
- Institute for Clinical Effectiveness and Health Policy, (IECS), Buenos Aires, Argentina.,Centre for Research in Epidemiology and Public Health at National Scientific and Technical Research Council (CIESP - CONICET), Buenos Aires, Argentina
| | - Cecilia Loudet
- Argentine Society of Intensive Care (SATI), Buenos Aires, Argentina
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161
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Patella V, Sanduzzi A, Bruzzese D, Florio G, Brancaccio R, Fabbrocini G, Delfino G. A Survey Among Italian Physicians During COVID-19 Outbreak. Could Bacillus Calmette-Guérin Vaccine Be Effective Against SARS-CoV2? Front Pharmacol 2021; 12:646570. [PMID: 34012395 PMCID: PMC8126664 DOI: 10.3389/fphar.2021.646570] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 04/08/2021] [Indexed: 01/07/2023] Open
Abstract
Background: Epidemiological studies show that BCG-vaccinated population seems to be more likely protected from COVID-19 infection, but WHO gave a stark warning on use of BCG vaccine without confirmed COVID-19 trials. The aim of the study is to evaluate whether TB vaccination, performed several years earlier, could confer protection against COVID-19. Methods: After the Ethical Committee authorization, professional orders were used to contact physicians with an online survey. Specialty, COVID-19 infection and previous BCG vaccination were recorded. Statistical data analysis was performed. Results: 1906 physicians answered the questionnaire, (M = 1068; F = 838; mean age 50.7 ± 13.3 years; range 24–87), more than half (1062; 55.7%) experienced BCG vaccination. Professional activity was recorded, and only 49 subjects (2.6%) of them were infected by SARS-CoV2. Among the group of infected people, asymptomatic form occurred in 12 subjects (24.5%); a pauci-symptomatic form in 24 subjects (49.0%); and a severe form (pneumonia and/or respiratory distress) in 13 (26.5%). Considering only the clinically relevant form of COVID-19, period prevalence was 2.2% (23/1062) in the vaccinated group and 1.7% (14/844) in the unvaccinated group (OR: 1.31, 95% C.I.: 0.68–2.63, p = 0.427). Conclusion: Our experience does not confirm the possible protective role of BCG vaccination, performed years earlier, against COVID-19. Although recent epidemiological studies point out in BCG-vaccinated population a lower prevalence of SARS-CoV2 infection, in our cohort of physicians no significant difference was found in terms of prevalence of COVID-19 infection. Our data underline the necessity to follow the WHO warning about the indiscriminate use of BCG vaccine, until clear evidence of protection by BCG vaccination against COVID-19 is fully demonstrated.
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Affiliation(s)
- Vincenzo Patella
- Division of Allergy and Clinical Immunology, Department of Medicine ASL Salerno, "Santa Maria Della Speranza" Hospital, Salerno, Italy.,Postgraduate Program in Allergy and Clinical Immunology, University of Naples Federico II, Naples, Italy
| | - Alessandro Sanduzzi
- Department of Clinical Medicine and Surgery, Section of Respiratory Disease, University of Naples Federico II, Naples, Italy.,Staff of UNESCO Chair on Health Education and Sustainable Development, University Federico II, Naples, Italy
| | - Dario Bruzzese
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Giovanni Florio
- Division of Allergy and Clinical Immunology, Department of Medicine ASL Salerno, "Santa Maria Della Speranza" Hospital, Salerno, Italy
| | - Raffaele Brancaccio
- Division of Allergy and Clinical Immunology, Department of Medicine ASL Salerno, "Santa Maria Della Speranza" Hospital, Salerno, Italy.,Postgraduate Program in Allergy and Clinical Immunology, University of Naples Federico II, Naples, Italy
| | - Gabriella Fabbrocini
- Staff of UNESCO Chair on Health Education and Sustainable Development, University Federico II, Naples, Italy.,Department of Clinical Medicine and Surgery, Dermatology, Section of Dermatology, University of Naples Federico II, Naples, Italy.,Laboratory of Clinical Biochemistry, Monaldi Hospital, Naples, Italy
| | - Gabriele Delfino
- Division of Allergy and Clinical Immunology, Department of Medicine ASL Salerno, "Santa Maria Della Speranza" Hospital, Salerno, Italy
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162
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Effect of a national policy of universal masking and uniform criteria for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) exposure on hospital staff infection and quarantine. Infect Control Hosp Epidemiol 2021; 43:757-763. [PMID: 33934743 PMCID: PMC8144835 DOI: 10.1017/ice.2021.207] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objective: To determine the effect of 2 regulations issued by the Israel Ministry of Health on coronavirus disease 2019 (COVID-19) infections and quarantine among healthcare workers (HCWs) in general hospitals. Design: Before-and-after intervention study without a control group (interrupted time-series analysis). Setting: All 29 Israeli general hospitals. Participants: All HCWs. Interventions: Two national regulations were issued on March 25, 2020: one required universal masking of HCWs, patients, and visitors in general hospitals and the second defined what constitutes HCW exposure to severe acute respiratory coronavirus virus 2 (SARS-CoV-2) and when quarantine is required. Results: Overall, 283 HCWs were infected at work or from an unknown source. Before the intervention, the number of HCWs infected at work increased by 0.5 per day (95% confidence interval [CI], 0.2–0.7; P < .001), peaking at 16. After the intervention, new infections declined by 0.2 per day (95% CI, −0.3 to −0.1; P < .001). Before the intervention, the number of HCWs in quarantine or isolation increased by 97 per day (95% CI, 90–104; P < .001), peaking at 2,444. After the intervention, prevalence decreased by 59 per day (95% CI, −72 to −46; P < .001). Epidemiological investigations determined that the most common source of HCW infection (58%) was a coworker. Conclusions: Universal masking in general hospitals reduced the risk of hospital-acquired COVID-19 among HCWs. Universal masking combined with uniform definitions of HCW exposure and criteria for quarantine limited the absence of HCWs from the workforce.
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Dinić M, Šantrić Milićević M, Mandić‐Rajčević S, Tripković K. Health workforce management in the context of the COVID-19 pandemic: A survey of physicians in Serbia. Int J Health Plann Manage 2021; 36:92-111. [PMID: 33817831 PMCID: PMC8251267 DOI: 10.1002/hpm.3141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/07/2021] [Accepted: 02/09/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND & AIM The study describes the experiences and opinions of Serbian physicians regarding workforce management during the COVID-19 pandemic. MATERIALS & METHODS A total of 1553 licensed physicians (65% males; average age 44.0 years) responded to an online survey in September 2020. Differences in the respondents' general data and attitudes regarding workforce management and outbreak preparedness in Serbia were analysed in relation to their engagement during the COVID-19 pandemic (Pearson χ2 and the independent samples t-test, p < 0.05). The logistic regression model explained the need for changing health workforce management. RESULTS The results reveal that the physicians engaged in the fight against the spread of COVID-19 (64.4% of the respondents) more often than their counterparts, were clinicians from the public sector, younger, with less work experience, influenced negatively by the pandemic, and reassigned to other positions (p < 0.001). Health workers dissatisfied with workplace preparedness and those reassigned due to COVID-19 were by 2.61 times and 1.38 times, respectively, more likely than their counterparts to consider changes in health workforce management. DISCUSSION & CONCLUSION COVID-19 underlines the need for changes in health workforce management during public health emergencies. An internal incident management team and a panel of external experts may support health workforce management during the prolonged and rapidly changing crises.
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Affiliation(s)
| | | | - Stefan Mandić‐Rajčević
- Faculty of MedicineInstitute of Social Medicine and the Centre‐School of Public Health and Health ManagementUniversity of BelgradeBelgradeSerbia
| | - Katica Tripković
- Department for Analysis, Planning and Organization of Health CareInstitute of Public Health of BelgradeBelgradeSerbia
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Collins N, Crowder J, Ishcomer-Aazami J, Apedjihoun D. Perceptions and Experiences of Frontline Urban Indian Organization Healthcare Workers With Infection Prevention and Control During the COVID-19 Pandemic. FRONTIERS IN SOCIOLOGY 2021; 6:611961. [PMID: 33996989 PMCID: PMC8119887 DOI: 10.3389/fsoc.2021.611961] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 03/19/2021] [Indexed: 06/12/2023]
Abstract
Coronavirus disease 2019 (COVID-19) has created significant challenges for outpatient healthcare providers and patients across the United States (U.S.). Forty-one Urban Indian Organizations (UIOs), who provide a wide spectrum of health services for American Indian and Alaska Native (AI/AN) populations and other underinsured and uninsured populations in urban areas across the country, are no exception. The National Council of Urban Indian Health (NCUIH), in collaboration with the U.S. Centers for Disease Control and Prevention (CDC), set out to understand the needs, challenges, and opportunities for improvement in infection prevention and control (IPC) training and systems from the perspective of UIO frontline healthcare workers. As part of the CDC's Project Firstline, NCUIH was chosen as a partner in a national collaborative. The first task was to conduct listening sessions with frontline UIO staff to learn more about IPC practices in the context of the COVID-19 pandemic. Thirty staff from 16 UIOs, representing full ambulatory, limited ambulatory, outreach and referral, and outpatient and residential treatment programs participated in virtual video focus groups in July of 2020. Thematic and content analysis protocols guided data analysis and coding. Analysis of findings generated four major themes: staff adaptation in the context of resilience; responsibility and duty to protect patients, families, and coworkers; mental and emotional issues for UIO staff; and IPC challenges in the context of COVID-19. Participants' challenges ranged from lack of access to personal protective equipment (PPE) to the absence of standardized training. Significant disparities in social determinants of health experienced by Native American and non-Native populations served by UIOs create additional challenges to the delivery of and access to care during the pandemic. The diverse array of tribal cultural values and contexts of the people and communities served by UIOs reportedly serve as both facilitators and barriers to care, awareness, and uptake of infectious disease public health practices.
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Affiliation(s)
- Noah Collins
- National Council of Urban Indian Health, Technical Assistance and Research Center, Washington, DC, United States
| | - Jolie Crowder
- International Association for Indigenous Aging, Silver Spring, MD, United States
| | - Jamie Ishcomer-Aazami
- National Council of Urban Indian Health, Technical Assistance and Research Center, Washington, DC, United States
| | - Dionne Apedjihoun
- National Council of Urban Indian Health, Technical Assistance and Research Center, Washington, DC, United States
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165
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Drysdale HRE, Downie E, Lau S, Stupart DA, Page R, Nagra S, Watters DA, Guest GD. Did operating theatre staff understand the COVID-19 guidelines for surgery during Victoria's second wave? ANZ J Surg 2021; 91:515-518. [PMID: 33847051 PMCID: PMC8250072 DOI: 10.1111/ans.16702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 12/17/2020] [Accepted: 02/13/2021] [Indexed: 11/28/2022]
Affiliation(s)
| | - Emma Downie
- Department of Surgery, Barwon Health, Geelong, Victoria, Australia
| | - Steve Lau
- Department of Surgery, Barwon Health, Geelong, Victoria, Australia
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- Department of Surgery, Barwon Health, Geelong, Victoria, Australia.,Department of Surgery, Epworth Geelong Hospital and Deakin University, Geelong, Victoria, Australia.,Department of Surgery, St John of God Geelong, Geelong, Victoria, Australia
| | - Douglas A Stupart
- Department of Surgery, Barwon Health, Geelong, Victoria, Australia.,Department of Surgery, Epworth Geelong Hospital and Deakin University, Geelong, Victoria, Australia
| | - Richard Page
- Department of Surgery, Barwon Health, Geelong, Victoria, Australia.,Department of Surgery, St John of God Geelong, Geelong, Victoria, Australia.,Barwon Centre of Orthopaedic Research and Education, Deakin University, Geelong, Victoria, Australia
| | - Sonal Nagra
- Department of Surgery, Barwon Health, Geelong, Victoria, Australia.,Department of Surgery, Epworth Geelong Hospital and Deakin University, Geelong, Victoria, Australia
| | - David A Watters
- Department of Surgery, Barwon Health, Geelong, Victoria, Australia.,Department of Surgery, Epworth Geelong Hospital and Deakin University, Geelong, Victoria, Australia
| | - Glenn D Guest
- Department of Surgery, Barwon Health, Geelong, Victoria, Australia.,Department of Surgery, Epworth Geelong Hospital and Deakin University, Geelong, Victoria, Australia
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166
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Gross JV, Fritschi L, Mohren J, Wild U, Erren TC. Contribution of Occupational Health to multidisciplinary team work for COVID-19 prevention and management. LA MEDICINA DEL LAVORO 2021; 112:171-176. [PMID: 33881012 PMCID: PMC8095326 DOI: 10.23749/mdl.v112i2.11056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 01/26/2021] [Indexed: 12/29/2022]
Abstract
Introduction: The SARS-CoV-2/Covid-19 pandemic is a challenge for public health and occupational medicine and developing prevention and protection strategies needs expertise from many disciplines. To make prevention successful, individuals have to be motivated to participate and, in turn, motivation depends on understanding how and why prevention measures are implemented. We present a structured approach (the Cycle of prevention) which involves different stakeholders and perspectives to develop, and monitor, prevention strategies in transparent and effective ways.
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Affiliation(s)
- J Valérie Gross
- Institute and Policlinic for Occupational Medicine, Environmental Medicine and Prevention Research, University Hospital of Cologne.
| | - Lin Fritschi
- School of Public Health, Curtin University, Perth, Australia.
| | - Judith Mohren
- 1Institute and Policlinic for Occupational Medicine, Environmental Medicine and Prevention Research, University Hospital of Cologne, D-50938 Cologne, Germany.
| | - Ursula Wild
- 1Institute and Policlinic for Occupational Medicine, Environmental Medicine and Prevention Research, University Hospital of Cologne, D-50938 Cologne, Germany.
| | - Thomas C Erren
- 1Institute and Policlinic for Occupational Medicine, Environmental Medicine and Prevention Research, University Hospital of Cologne, D-50938 Cologne, Germany.
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167
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Loveday H, Wilson J. Pandemic preparedness and the role of infection prevention and control - how do we learn? J Infect Prev 2021; 22:55-57. [PMID: 33859721 DOI: 10.1177/17571774211001040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Heather Loveday
- Director of Research, Richard Wells Research Centre, University of West London, UK
| | - Jennie Wilson
- Professor of Healthcare Epidemiology, Richard Wells Research Centre, University of West London, UK
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168
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Zenbaba D, Sahiledengle B, Takele A, Tekalegn Y, Yassin A, Tura B, Abdulkadir A, Tesa E, Tasew A, Ganfure G, Fikadu G, Seyoum K, Abduku M, Assefa T, Morka G, Kemal M, Gemechu A, Bekele K, Tessema A, Haji S, Haile G, Girma A, Mama M, Negero A, Nigussie E, Gezahegn H, Atlaw D, Regasa T, Usman H, Esmael A. Compliance towards infection prevention measures among health professionals in public hospitals, southeast Ethiopia: a cross-sectional study with implications of COVID-19 prevention. Trop Med Health 2021; 49:30. [PMID: 33863397 PMCID: PMC8050993 DOI: 10.1186/s41182-021-00318-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/23/2021] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION The new coronavirus disease 2019 is an emerging respiratory disease caused by the highly contagious novel coronavirus which has currently overwhelmed the world. Realizing a comprehensive set of infection prevention measures is a key to minimize the spread of this virus and its impacts in all healthcare settings. Therefore, this study was aimed to assess the compliance towards COVID-19 preventive measures and associated factors among health professionals in selected public hospitals, southeast Ethiopia. METHODS A descriptive hospital-based cross-sectional study was conducted among 660 health professionals in public hospitals of southeast Ethiopia from October 1 to 31, 2020. A multistage sampling technique was used to select the study participants. Data were collected by interview using structured and pretested questionnaires. Ordinary logistic regression modeling was used to estimate the crude and adjusted odds ratio. To declare the statistical significance of factors associated with the outcome variable, P-value < 0.05 and 95% confidence interval were used. RESULTS A total of 654 health professionals were involved in the study; of whom, 313 participants were nurses. The overall good compliance and knowledge of health professionals regarding COVID-19 preventive measures were 21.6 and 25.5%, respectively. Working in the general hospital (AOR = 0.55; 95% CI 0.38, 0.79), service year (AOR = 2.10; 95% CI 1.35, 3.21), knowledge (AOR = 1.80; 95% CI 1.14, 2.89), and water availability (AOR = 3.26; 95% CI 2.25, 4.72) were some of the factors found to have a statistically significant association to compliance of health professionals regarding COVID-19 preventive measures. CONCLUSION In this study, nearly one fifth of health professionals had good compliance towards COVID-19 prevention practices. Thus, a consistent supply of COVID-19 prevention materials, facilities, and improving the knowledge of health professionals through on and off-job training are crucial.
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Affiliation(s)
- Demisu Zenbaba
- Department of Public Health, School of Health Sciences, Madda Walabu University Goba Referral Hospital, Bale, Goba, Ethiopia.
| | - Biniyam Sahiledengle
- Department of Public Health, School of Health Sciences, Madda Walabu University Goba Referral Hospital, Bale, Goba, Ethiopia
| | - Abulie Takele
- Department of Public Health, School of Health Sciences, Madda Walabu University Goba Referral Hospital, Bale, Goba, Ethiopia
| | - Yohannes Tekalegn
- Department of Public Health, School of Health Sciences, Madda Walabu University Goba Referral Hospital, Bale, Goba, Ethiopia
| | - Ahmed Yassin
- Department of Public Health, School of Health Sciences, Madda Walabu University Goba Referral Hospital, Bale, Goba, Ethiopia
| | - Birhanu Tura
- Department of Public Health, School of Health Sciences, Madda Walabu University Goba Referral Hospital, Bale, Goba, Ethiopia
| | - Adem Abdulkadir
- Department of Public Health, School of Health Sciences, Madda Walabu University Goba Referral Hospital, Bale, Goba, Ethiopia
| | - Edao Tesa
- Department of Public Health, School of Health Sciences, Madda Walabu University Goba Referral Hospital, Bale, Goba, Ethiopia
| | - Alelign Tasew
- Department of Public Health, School of Health Sciences, Madda Walabu University Goba Referral Hospital, Bale, Goba, Ethiopia
| | - Gemechu Ganfure
- Department of Midwifery, School of Health Science, Madda Walabu University Goba Referral Hospital, Bale, Goba, Ethiopia
| | - Genet Fikadu
- Department of Midwifery, School of Health Science, Madda Walabu University Goba Referral Hospital, Bale, Goba, Ethiopia
| | - Kenbon Seyoum
- Department of Midwifery, School of Health Science, Madda Walabu University Goba Referral Hospital, Bale, Goba, Ethiopia
| | - Mohammedawel Abduku
- Department of Midwifery, School of Health Science, Madda Walabu University Goba Referral Hospital, Bale, Goba, Ethiopia
| | - Tesfaye Assefa
- Department of Nursing, School of Health Science, Madda Walabu University Goba Referral Hospital, Bale, Goba, Ethiopia
| | - Garoma Morka
- Department of Nursing, School of Health Science, Madda Walabu University Goba Referral Hospital, Bale, Goba, Ethiopia
| | - Makida Kemal
- Department of Nursing, School of Health Science, Madda Walabu University Goba Referral Hospital, Bale, Goba, Ethiopia
| | - Adisu Gemechu
- Department of Nursing, School of Health Science, Madda Walabu University Goba Referral Hospital, Bale, Goba, Ethiopia
| | - Kebebe Bekele
- Department of Medicine and Surgery, School of Medicine, Madda Walabu University Goba Referral Hospital, Bale, Goba, Ethiopia
| | - Abdi Tessema
- Department of Medicine and Surgery, School of Medicine, Madda Walabu University Goba Referral Hospital, Bale, Goba, Ethiopia
| | - Safi Haji
- Department of Medicine and Surgery, School of Medicine, Madda Walabu University Goba Referral Hospital, Bale, Goba, Ethiopia
| | - Gebisa Haile
- Department of Medicine and Surgery, School of Medicine, Madda Walabu University Goba Referral Hospital, Bale, Goba, Ethiopia
| | - Alemu Girma
- Department of Anesthesia, School of Medicine, Madda Walabu University Goba Referral Hospital, Bale, Goba, Ethiopia
| | - Mohammedaman Mama
- Department of Medical Laboratory, School of Medicine, Madda Walabu University Goba Referral Hospital, Bale, Goba, Ethiopia
| | - Asfaw Negero
- Department of Medical Laboratory, School of Medicine, Madda Walabu University Goba Referral Hospital, Bale, Goba, Ethiopia
| | - Eshetu Nigussie
- Department of Medical Laboratory, School of Medicine, Madda Walabu University Goba Referral Hospital, Bale, Goba, Ethiopia
| | - Habtamu Gezahegn
- Department of biomedical science, School of Medicine, Madda Walabu University Goba Referral Hospital, Bale, Goba, Ethiopia
| | - Daniel Atlaw
- Department of biomedical science, School of Medicine, Madda Walabu University Goba Referral Hospital, Bale, Goba, Ethiopia
| | - Tadele Regasa
- Department of biomedical science, School of Medicine, Madda Walabu University Goba Referral Hospital, Bale, Goba, Ethiopia
| | - Heyder Usman
- Department of Pharmacy, School of Medicine, Madda Walabu University Goba Referral Hospital, Bale, Goba, Ethiopia
| | - Adem Esmael
- Department of Nursing, School of Health Science, Madda Walabu University Goba Referral Hospital, Bale, Goba, Ethiopia
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Russell L, Campani L, Jones J, Healy B. Fluid-repellent surgical mask (FRSM) fit - one size does not fit all. Clin Med (Lond) 2021; 21:e283-e286. [PMID: 33824138 DOI: 10.7861/clinmed.2021-0054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Fluid-repellent surgical masks (FRSMs) are recommended by the UK government for healthcare workers as personal protective equipment (PPE) against SARS-COV-2. UK Infection Prevention and Control (IPC) national guidelines states that 'masks must be well-fitting and fit for purpose, fully covering the mouth and nose'. AIM To review the fit of the FRSM supplied to the NHS front line workers against the national IPC guidelines and, through re-audit, assess for improvements in fit with FRSM worn with a plastic strap (intervention A) and FFP3 mask (intervention B). METHOD A three-part closed-loop audit was carried out comprising controlled observation, observation in the clinical area and questionnaire. Re-audit was carried out following interventions A and B. RESULTS FRSMs slipped below the nose in 43% and below the mouth of 10% of participants during the controlled observation and below the nose (above or below the mouth) in 30% of staff in the clinical area. No masks slipped below the nose or mouth with intervention A or B. 86% of participants reported touching the FRSM to keep it in the correct position and 66% reported touching the FFP3. CONCLUSION The current supply of FRSMs are poorly fitting for many users and do not meet the UK IPC guideline standard. These issues were not evident when worn with a plastic strap or with FFP3 masks.
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Affiliation(s)
| | | | - Jack Jones
- Swansea University Medical School Swansea, UK
| | - Brendan Healy
- Public Health Wales Microbiology, Swansea and Cardiff, UK and Department of Medical Microbiology, Morriston Hospital, Swansea, UK
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170
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Agarwal A, Ranjan P, Saikaustubh Y, Rohilla P, Kumari A, Prasad I, Baitha U, Dwivedi SN. Development and validation of a questionnaire for assessing preventive practices and barriers among health care workers in COVID-19 pandemic. Indian J Med Microbiol 2021; 39:200-211. [PMID: 33902981 PMCID: PMC8063603 DOI: 10.1016/j.ijmmb.2021.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 10/25/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVES COVID-19 has affected thousands of health care workers worldwide. Suboptimal infection control practices have been identified as important risk factors. The objective of this study was to develop and validate a questionnaire to holistically assess the preventive practices of health care workers related to COVID-19 and identify the reasons for shortcomings therein. METHODS The development of the questionnaire involved item generation through literature review, focus group discussions and in-depth interviews with health care workers and experts, followed by validation through expert opinion, pilot testing and survey. A cross-sectional survey on 147 healthcare workers was done using an online platform and/or interviews in August 2020 in New Delhi, India. Exploratory factor analysis using principal component extraction with varimax rotation was performed to establish construct validity. Internal consistency of the tool was tested using Cronbach's alpha coefficient. RESULTS The developed questionnaire consists of two sections: Section A contains 29 items rated on a five-point Likert scale to assess preventive practices and Section B contains 27 semi-structured items to assess reasons for suboptimal practices. The first section has good validity (CVR = 0.87, S-CVI/Av = 0.978) and internal consistency (Cronbach's alpha coefficient = 0.85) CONCLUSIONS: This questionnaire is a valid and reliable tool for holistic assessment of preventive practices and barriers to it among health care workers. It will be useful to identify vulnerable practices and sections in health care settings which would assist policymakers in designing appropriate interventions for infection prevention and control. This will also be useful in future pandemics of similar nature.
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Affiliation(s)
- Ayush Agarwal
- Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Piyush Ranjan
- Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
| | - Yellamraju Saikaustubh
- Department of Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Priyanka Rohilla
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Archana Kumari
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Indrashekhar Prasad
- Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Upendra Baitha
- Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Sada Nand Dwivedi
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
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Wong J, Gallagher M, Friedt J, Trinder K, McKague M, Stevenson K, Cattell V. Health Science Students as PPE Coaches in the Emergency Department - a Pandemic Pilot Project. Infect Prev Pract 2021; 3:100139. [PMID: 34316578 PMCID: PMC8012167 DOI: 10.1016/j.infpip.2021.100139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 03/23/2021] [Indexed: 11/24/2022] Open
Abstract
PPE is an integral part of reducing transmission of COVID-19. We assessed a 5-week pilot project of utilising health science student volunteers as PPE coaches in the adult and paediatric emergency department (ED) during the pandemic. PPE coaches were provided with training, PPE checklist, area for written observations, and feedback surveys. Overall, correct PPE use improved over time. Coaches felt safe, that training was adequate, and part of the team. Factors that contributed to project effectiveness included institutional support, role clarification, and continuous feedback from staff. Our findings support the utilisation of students in IPC projects.
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Affiliation(s)
- J Wong
- University of Saskatchewan, Canada
| | | | - J Friedt
- Saskatchewan Health Authority, Canada
| | | | | | | | - V Cattell
- University of Saskatchewan, Canada.,Saskatchewan Health Authority, Canada
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172
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Suppan M, Abbas M, Catho G, Stuby L, Regard S, Achab S, Harbarth S, Suppan L. Impact of a Serious Game (Escape COVID-19) on the Intention to Change COVID-19 Control Practices Among Employees of Long-term Care Facilities: Web-Based Randomized Controlled Trial. J Med Internet Res 2021; 23:e27443. [PMID: 33685854 PMCID: PMC7996198 DOI: 10.2196/27443] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/07/2021] [Accepted: 03/07/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Most residents of long-term care facilities (LTCFs) are at high risk of complications and death following SARS-CoV-2 infection. In these facilities, viral transmission can be facilitated by shortages of human and material resources, which can lead to suboptimal application of infection prevention and control (IPC) procedures. To improve the dissemination of COVID-19 IPC guidelines, we developed a serious game called "Escape COVID-19" using Nicholson's RECIPE for meaningful gamification, as engaging serious games have the potential to induce behavioral change. OBJECTIVE As the probability of executing an action is strongly linked to the intention of performing it, the objective of this study was to determine whether LTCF employees were willing to change their IPC practices after playing "Escape COVID-19." METHODS This was a web-based, triple-blind, randomized controlled trial, which took place between November 5 and December 4, 2020. The health authorities of Geneva, Switzerland, asked the managers of all LTCFs under their jurisdiction to forward information regarding the study to all their employees, regardless of professional status. Participants were unaware that they would be randomly allocated to one of two different study paths upon registration. In the control group, participants filled in a first questionnaire designed to gather demographic data and assess baseline knowledge before accessing regular online IPC guidelines. They then answered a second questionnaire, which assessed their willingness to change their IPC practices and identified the reasons underlying their decision. They were then granted access to the serious game. Conversely, the serious game group played "Escape COVID-19" after answering the first questionnaire but before answering the second one. This group accessed the control material after answering the second set of questions. There was no time limit. The primary outcome was the proportion of LTCF employees willing to change their IPC practices. Secondary outcomes included the factors underlying participants' decisions, the domains these changes would affect, changes in the use of protective equipment items, and attrition at each stage of the study. RESULTS A total of 295 answer sets were analyzed. Willingness to change behavior was higher in the serious game group (82% [119/145] versus 56% [84/150]; P<.001), with an odds ratio of 3.86 (95% CI 2.18-6.81; P<.001) after adjusting for professional category and baseline knowledge, using a mixed effects logistic regression model with LTCF as a random effect. For more than two-thirds (142/203) of the participants, the feeling of playing an important role against the epidemic was the most important factor explaining their willingness to change behavior. Most of the participants unwilling to change their behavior answered that they were already applying all the guidelines. CONCLUSIONS The serious game "Escape COVID-19" was more successful than standard IPC material in convincing LTCF employees to adopt COVID-19-safe IPC behavior. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/25595.
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Affiliation(s)
- Mélanie Suppan
- Division of Anesthesiology, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Mohamed Abbas
- Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Gaud Catho
- Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | | | - Simon Regard
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
- Division of the Surgeon General, Geneva Directorate of Health, Geneva, Switzerland
| | - Sophia Achab
- Specialized Facility in Behavioral Addictions ReConnecte, University of Geneva Hospitals, Geneva, Switzerland
- WHO Collaborating Center in Training and Research in Mental Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Stephan Harbarth
- Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Laurent Suppan
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
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Ike ID, Durand-Hill M, Elmusharaf E, Asemota N, Silva E, White E, Awad WI. NHS staff mental health status in the active phase of the COVID-19 era: a staff survey in a large London hospital. Gen Psychiatr 2021; 34:e100368. [PMID: 34192241 PMCID: PMC7987534 DOI: 10.1136/gpsych-2020-100368] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 11/30/2020] [Accepted: 01/18/2021] [Indexed: 11/25/2022] Open
Abstract
Background Experiencing a pandemic can be very unsettling and may have a negative impact on the mental health of frontline healthcare workers (HCWs). This may have serious consequences for the overall well-being of HCWs, which in turn may adversely affect patient safety and the productivity of the institution. Aims We designed a study to assess the prevalence of generalised anxiety disorder (GAD), depression and work-related stress experienced by the National Health Service staff in a large tertiary London hospital treating patients with COVID-19 during the current active phase of the COVID-19 era. Methods An anonymous survey was designed with demographic data and three questionnaires. The Generalised Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 were used to assess anxiety and depression, respectively. The Health and Safety Executive Management Standards Indicator Tool was used to assess work-related stress. Staff from multiple specialties embracing cardiothoracic surgery, cardiology, respiratory medicine, endocrinology, oncology, imaging, anaesthesia and intensive care at our hospital were asked to complete the questionnaire between 25 May and 15 June 2020. Results A total of 302 staff members (106 males and 196 females) completed the survey. The overall prevalence of GAD and depression was 41.4% and 42.7%, respectively. The prevalence of GAD and depression was significantly higher in females than in males and was statistically significant. Nurses were four times more likely to report moderate to severe levels of anxiety and depression as compared with doctors. Work-related stress was also observed to be prevalent in our surveyed population with the following standards: relationships, role, control and change showing a need for improvement. Conclusions Our study presents early evidence suggestive of a high prevalence of GAD, depression and work-related stress in HCWs. It is imperative that coherent strategies are implemented to improve the healthcare work environment during this pandemic and mitigate further injury to the mental health status of the healthcare population.
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Affiliation(s)
- Ikenna David Ike
- Department of Cardiothoracic Surgery, St Bartholomew's Hospital, London, UK
| | | | - Eiman Elmusharaf
- Department of Cardiothoracic Surgery, St Bartholomew's Hospital, London, UK
| | - Nicole Asemota
- Department of Cardiothoracic Surgery, St Bartholomew's Hospital, London, UK
| | - Elizabeth Silva
- Department of Cardiothoracic Surgery, St Bartholomew's Hospital, London, UK
| | - Elliott White
- Department of Cardiothoracic Surgery, St Bartholomew's Hospital, London, UK
| | - Wael I Awad
- Department of Cardiothoracic Surgery, St Bartholomew's Hospital, London, UK
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174
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Hetzmann MS, Mojtahedzadeh N, Nienhaus A, Harth V, Mache S. Occupational Health and Safety Measures in German Outpatient Care Services during the COVID-19 Pandemic: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062987. [PMID: 33799465 PMCID: PMC8001336 DOI: 10.3390/ijerph18062987] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/04/2021] [Accepted: 03/11/2021] [Indexed: 12/18/2022]
Abstract
Due to the coronavirus disease 2019 (COVID-19) pandemic, outpatient caregivers are exposed to new serious health threats at work. To protect their health, effective occupational health and safety measures (OHSM) are necessary. Outpatient caregivers (n = 15) participated in semi-structured telephone interviews in May/June 2020 (1) to examine the pandemic-related OHSM that have been implemented in their outpatient care services, as well as (2) to identify their corresponding unmet needs. Interviews were recorded, transcribed and analysed by using qualitative content analysis in accordance with Mayring. Available OHSM in outpatient care services described by outpatient caregivers mainly included personal protective equipment (PPE) and surface disinfection means after an initial shortage in the first peak of the pandemic. Further OHSM implied social distancing, increased hygiene regulations and the provision of pandemic-related information by the employer, as well as the possibility to consult a company doctor. Our study revealed that OHSM were largely adapted to the health threats posed by COVID-19, however an optimum has not yet been achieved. There is still a need for improvement in the qualitative and quantitative supply of PPE, as well as on the organisational level, e.g., with regard to the development of pandemic plans or in work organisation.
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Affiliation(s)
- Mara Shirin Hetzmann
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Centre Hamburg-Eppendorf (UKE), Seewartenstr. 10, 20459 Hamburg, Germany; (M.S.H.); (N.M.); (V.H.)
| | - Natascha Mojtahedzadeh
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Centre Hamburg-Eppendorf (UKE), Seewartenstr. 10, 20459 Hamburg, Germany; (M.S.H.); (N.M.); (V.H.)
| | - Albert Nienhaus
- Department of Occupational Medicine, Hazardous Substances and Public Health, Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), Pappelallee 33/35/37, 22089 Hamburg, Germany;
- Institute for Health Service Research in Dermatology and Nursing (IVDP), Competence Centre for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Centre Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Volker Harth
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Centre Hamburg-Eppendorf (UKE), Seewartenstr. 10, 20459 Hamburg, Germany; (M.S.H.); (N.M.); (V.H.)
| | - Stefanie Mache
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Centre Hamburg-Eppendorf (UKE), Seewartenstr. 10, 20459 Hamburg, Germany; (M.S.H.); (N.M.); (V.H.)
- Correspondence: ; Tel.: +49-40-428-37-4313
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175
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Ashinyo ME, Dubik SD, Duti V, Amegah KE, Ashinyo A, Asare BA, Ackon AA, Akoriyea SK, Kuma-Aboagye P. Infection prevention and control compliance among exposed healthcare workers in COVID-19 treatment centers in Ghana: A descriptive cross-sectional study. PLoS One 2021; 16:e0248282. [PMID: 33690699 PMCID: PMC7943010 DOI: 10.1371/journal.pone.0248282] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 02/24/2021] [Indexed: 02/07/2023] Open
Abstract
Compliance with infection prevention and control (IPC) protocols is critical in minimizing the risk of coronavirus disease (COVID-19) infection among healthcare workers. However, data on IPC compliance among healthcare workers in COVID-19 treatment centers are unknown in Ghana. This study aims to assess IPC compliance among healthcare workers in Ghana's COVID-19 treatment centers. The study was a secondary analysis of data, which was initially collected to determine the level of risk of COVID-19 virus infection among healthcare workers in Ghana. Quantitative data were conveniently collected using the WHO COVID-19 risk assessment tool. We analyzed the data using descriptive statistics and logistic regression analyses. We observed that IPC compliance during healthcare interactions was 88.4% for hand hygiene and 90.6% for Personal Protective Equipment (PPE) usage; IPC compliance while performing aerosol-generating procedures (AGPs), was 97.5% for hand hygiene and 97.5% for PPE usage. For hand hygiene during healthcare interactions, lower compliance was seen among nonclinical staff [OR (odds ratio): 0.43; 95% CI (Confidence interval): 0.21-0.89], and healthcare workers with secondary level qualification (OR: 0.24; 95% CI: 0.08-0.71). Midwives (OR: 0.29; 95% CI: 0.09-0.93) and Pharmacists (OR: 0.15; 95% CI: 0.02-0.92) compliance with hand hygiene was significantly lower than registered nurses. For PPE usage during healthcare interactions, lower compliance was seen among healthcare workers who were separated/divorced/widowed (OR: 0.08; 95% CI: 0.01-0.43), those with secondary level qualifications (OR 0.08; 95% CI 0.01-0.43), non-clinical staff (OR 0.16 95% CI 0.07-0.35), cleaners (OR: 0.16; 95% CI: 0.05-0.52), pharmacists (OR: 0.07; 95% CI: 0.01-0.49) and among healthcare workers who reported of insufficiency of PPEs (OR: 0.33; 95% CI: 0.14-0.77). Generally, healthcare workers' infection prevention and control compliance were high, but this compliance differs across the different groups of health professionals in the treatment centers. Ensuring an adequate supply of IPC logistics coupled with behavior change interventions and paying particular attention to nonclinical staff is critical in minimizing the risk of COVID-19 transmission in the treatment centers.
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Affiliation(s)
- Mary Eyram Ashinyo
- Institutional Care Division, Ghana Health Service Headquarters, Accra, Ghana
- * E-mail:
| | - Stephen Dajaan Dubik
- School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Vida Duti
- IRC-Ghana, Cantonments, Accra, Ghana
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176
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Patel T, Umeh K, Poole H, Vaja I, Newson L. Cultural Identity Conflict Informs Engagement with Self-Management Behaviours for South Asian Patients Living with Type-2 Diabetes: A Critical Interpretative Synthesis of Qualitative Research Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2641. [PMID: 33807965 PMCID: PMC7967381 DOI: 10.3390/ijerph18052641] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/01/2021] [Accepted: 03/03/2021] [Indexed: 02/07/2023]
Abstract
The prevalence of type-2 diabetes (T2D) is increasing, particularly among South Asian (SA) communities. Previous research has highlighted the heterogeneous nature of SA ethnicity and the need to consider culture in SA patients' self-management of T2D. We conducted a critical interpretative synthesis (CIS) which aimed to a) develop a new and comprehensive insight into the psychology which underpins SA patients' T2D self-management behaviours and b) present a conceptual model to inform future T2D interventions. A systematic search of the literature retrieved 19 articles, including 536 participants. These were reviewed using established CIS procedures. Analysis identified seven constructs, from which an overarching synthesizing argument 'Cultural Conflict' was derived. Our findings suggest that patients reconstruct knowledge to manage their psychological, behavioural, and cultural conflicts, impacting decisional conflicts associated with T2D self-management and health professional advice (un)consciously. Those unable to resolve this conflict were more likely to default towards cultural identity, continue to align with cultural preferences rather than health professional guidance, and reduce engagement with self-management. Our synthesis and supporting model promote novel ideas for self-management of T2D care for SA patients. Specifically, health professionals should be trained and supported to explore and mitigate negative health beliefs to enable patients to manage social-cultural influences that impact their self-management behaviours.
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Affiliation(s)
- Tasneem Patel
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool L69 3BX, UK;
- Faculty of Health, School of Psychology, Liverpool John Moores University, Liverpool L3 3AF, UK; (K.U.); (H.P.); (I.V.)
| | - Kanayo Umeh
- Faculty of Health, School of Psychology, Liverpool John Moores University, Liverpool L3 3AF, UK; (K.U.); (H.P.); (I.V.)
| | - Helen Poole
- Faculty of Health, School of Psychology, Liverpool John Moores University, Liverpool L3 3AF, UK; (K.U.); (H.P.); (I.V.)
| | - Ishfaq Vaja
- Faculty of Health, School of Psychology, Liverpool John Moores University, Liverpool L3 3AF, UK; (K.U.); (H.P.); (I.V.)
- NHS Bradford Teaching Hospital, Bradford BD9 6RJ, UK
| | - Lisa Newson
- Faculty of Health, School of Psychology, Liverpool John Moores University, Liverpool L3 3AF, UK; (K.U.); (H.P.); (I.V.)
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177
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Franklin P, Gkiouleka A. A Scoping Review of Psychosocial Risks to Health Workers during the Covid-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2453. [PMID: 33801517 PMCID: PMC7967576 DOI: 10.3390/ijerph18052453] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/18/2021] [Accepted: 02/25/2021] [Indexed: 12/17/2022]
Abstract
The Covid-19 pandemic has exposed health workers to a diverse set of hazards impacting their physical, psychological and social wellbeing. This review aims to provide an overview of the categories of the psychosocial risk factors and hazards affecting HCWs during the Covid-19 pandemic and the recommendations for prevention. We used the scoping review methodology to collate categories of psychosocial risks, the related health outcomes, interventions, and data gaps. The review was conducted on global peer-reviewed academic and authoritative grey literature, published between 1. January-26. October 2020; in total, 220 articles were included into the review and the subsequent analysis. Analysis of the extracted data found PSRs related to four sources: personal protective equipment (PPE), job content, work organisation, and social context. is. Women health workers and nurses reported worst health outcomes. Majority of the research to date concerns health workers in secondary care, while data on psychosocial risks at primary and community-based settings are scarce. However, the emerging research implies that the pandemic creates psychosocial risks also to non-clinical health workers. The intervention and mitigation measures address individual and organisational levels. Preventative and mitigating measures for social and societal risks-such as staff shortages, intersecting inequalities, and financial stressors require further research.
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Affiliation(s)
- Paula Franklin
- Occupational Safety & Health and Working Conditions Unit, European Trade Union Institute (ETUI), Boulevard du Roi Albert II, 1210 Brussels, Belgium
| | - Anna Gkiouleka
- Department of Public Health & Primary Care, University of Cambridge, Cambridge CB1 8RN, UK;
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178
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Graciaa DS, Kempker RR, Sanikidze E, Tukvadze S, Mikiashvili L, Aspindzelashvili R, Alkhazashvili D, Blumberg HM, Avaliani Z, Tukvadze N. TB research amidst the COVID-19 pandemic. Int J Tuberc Lung Dis 2021; 25:167-170. [PMID: 33688804 PMCID: PMC8105679 DOI: 10.5588/ijtld.20.0830] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- D S Graciaa
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - R R Kempker
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - E Sanikidze
- Department of Medical Ethics and Law, David Tvildiani Medical University, Tbilisi, Georgia
| | - S Tukvadze
- Georgian American University, Tbilisi, Georgia
| | - L Mikiashvili
- National Center for Tuberculosis and Lung Disease, Tbilisi, Georgia
| | | | - D Alkhazashvili
- Community Advisory Board, National Center for Tuberculosis and Lung Disease, Tbilisi, Georgia
| | - H M Blumberg
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Z Avaliani
- National Center for Tuberculosis and Lung Disease, Tbilisi, Georgia
| | - N Tukvadze
- National Center for Tuberculosis and Lung Disease, Tbilisi, Georgia
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179
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Bonvin E, Tacchini-Jacquier N, Monnay S, Verloo H. Protocol for a patient-reported experience measures (PREMs) survey of patients discharged during the COVID-19 pandemic and their family caregivers. BMJ Open 2021; 11:e047033. [PMID: 33622957 PMCID: PMC7907615 DOI: 10.1136/bmjopen-2020-047033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 02/04/2021] [Accepted: 02/04/2021] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION In the Swiss canton of Valais, the first cases of SARS-CoV-2 were detected on 28 February 2020. Discharged patients' and their family caregivers' experiences in relation to safety, quality of care, trust and communication during the COVID-19 hospitalisation period remain unexplored. The study aims to collect the patient-reported experience measures (PREMs) survey of patients discharged during the COVID-19 pandemic and their family caregivers. METHODS AND ANALYSIS Patients aged ≥18 years, hospitalised between 28 February and 11 May 2020 and then discharged home, plus their family caregivers will be invited to complete a self-administrated questionnaire made up of 14 closed questions and 1 open-ended question. The questionnaire will include items on the patient's hospital trajectory and assess the interpersonal trust placed in nurses and physicians based on Krajewska-Kułak et al's Trust in Nurse Scale and Anderson et al's Trust in Physician Scale. Participants' perceived stress will be assessed using Cohen et al's Perceived Stress Scale. Feelings of safety will be examined based on Dryhurst et al's questionnaire on Risk Perception During Pandemics. After ethical clearance, data will be collected using a postal paper questionnaire and via an online web link. Descriptive and inferential statistics will be computed, and the open question will undergo a qualitative thematic analysis. We will analyse perceptions of the different hospital trajectories experienced by patients undergoing surgery with and without a SARS-CoV-2 infection. ETHICS AND DISSEMINATION The Human Research Ethics Committee of Vaud (2020-02025) authorised this study. Gathering experiences and learning about the impact of the COVID-19 pandemic on the social determinants of health among discharged patients and families fit in well with the Triple Aim framework and the PREMs survey. The study will formulate recommendations to support interventions in the face of the second wave of COVID-19 pandemic and their effects on patients' and their family caregivers' experiences.
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Affiliation(s)
- Eric Bonvin
- General Direction, Valais Hospital, Sion, Valais, Switzerland
| | | | - Sevrine Monnay
- Social Affairs and Human Resources Specialist, Valais Hospital, Sion, Valais, Switzerland
| | - Henk Verloo
- Nursing, Haute Ecole Specialisee de Suisse Occidentale, Sion, Valais, Switzerland
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180
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Bahrs C, Kimmig A, Weis S, Ankert J, Hagel S, Maschmann J, Stallmach A, Steiner A, Bauer M, Behringer W, Baier M, Kesselmeier M, Richert C, Zepf F, Walter M, Scherag A, Kiehntopf M, Löffler B, Pletz MW. Prospective surveillance study in a 1,400-bed university hospital: COVID-19 exposure at home was the main risk factor for SARS-CoV-2 point seroprevalence among hospital staff. Transbound Emerg Dis 2021; 69:720-730. [PMID: 33605549 PMCID: PMC8014017 DOI: 10.1111/tbed.14041] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 02/08/2021] [Accepted: 02/17/2021] [Indexed: 02/06/2023]
Abstract
The Co‐HCW study is a prospective cohort study among hospital staff, including healthcare workers (HCWs) and administration staff, at the Jena University Hospital (JUH), Germany. The objectives of this study were to assess SARS‐CoV‐2 IgG seroprevalence, individual exposure risk factors and compliance of HCWs to wear personal protective equipment (PPE). After the first nosocomial COVID‐19 outbreak at JUH, mandatory masking was implemented on 20th March 2020. We evaluated point seroprevalence using two IgG detecting immunoassays and issued a questionnaire to assess COVID‐19 exposure, clinical symptoms and compliance to wear PPE. Antibody retesting was offered to participants with a divergent result of both immunoassays 5–10 weeks after the first test. Between 19th May and 19th June 2020, we analysed 660 participants [out of 3,228; 20.4%]. Among them, 212 participants (32.1%) had received a previous COVID‐19 test. Four of them (1.9%) reported a positive test result. After recruitment, 18 participants (2.7%) had SARS‐CoV‐2 antibodies in at least one immunoassay. Overall, 21 participants (3.2%) had any evidence of a past or current SARS‐CoV‐2 infection. Among them, 13 (61.9%) were not aware of direct COVID‐19 exposure and 9 (42.9%) did not report any clinical symptoms. COVID‐19 exposure at home (adjusted OR (aOR) with 95% CI: 47.82 (5.49, 416.62)) was associated with SARS‐CoV‐2 seroprevalence. We observed no evidence for an association between seroprevalence and exposure at work (aOR 0.48 (0.13, 1.70)) or with COVID‐19 risk area according to the working place (aOR for intermediate‐risk vs. high‐risk: 1.97 (0.42, 9.22), aOR for low‐risk versus high‐risk: 2.10 (0.40, 11.06); p = .655). Reported compliance of HCWs to wear PPE differed (p < .001) between working in high‐risk (98.3%) and in intermediate‐risk areas (69.8%). In conclusion, compared to administration staff, we observed no additional risk to acquire SARS‐CoV‐2 infections by patient care, probably due to high compliance to wear PPE.
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Affiliation(s)
- Christina Bahrs
- Institute for Infectious Diseases and Infection Control, Jena University Hospital/Friedrich-Schiller-University, Jena, Germany.,Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Aurelia Kimmig
- Institute for Infectious Diseases and Infection Control, Jena University Hospital/Friedrich-Schiller-University, Jena, Germany
| | - Sebastian Weis
- Institute for Infectious Diseases and Infection Control, Jena University Hospital/Friedrich-Schiller-University, Jena, Germany.,Department of Anesthesiology and Intensive Care Therapy, Jena University Hospital/Friedrich-Schiller-University, Jena, Germany
| | - Juliane Ankert
- Institute for Infectious Diseases and Infection Control, Jena University Hospital/Friedrich-Schiller-University, Jena, Germany
| | - Stefan Hagel
- Institute for Infectious Diseases and Infection Control, Jena University Hospital/Friedrich-Schiller-University, Jena, Germany
| | - Jens Maschmann
- Medical Executive Board, Jena University Hospital, Germany
| | - Andreas Stallmach
- Department of Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), Jena University Hospital/Friedrich-Schiller-University, Jena, Germany
| | - Andrea Steiner
- Department for Occupational Health, Jena University Hospital/Friedrich-Schiller-University, Jena, Germany
| | - Michael Bauer
- Department of Anesthesiology and Intensive Care Therapy, Jena University Hospital/Friedrich-Schiller-University, Jena, Germany
| | - Wilhelm Behringer
- Department of Emergency Medicine, Jena University Hospital/Friedrich-Schiller-University, Jena, Germany
| | - Michael Baier
- Institute of Medical Microbiology, Jena University Hospital/Friedrich-Schiller-University, Jena, Germany
| | - Miriam Kesselmeier
- Institute of Medical Statistics, Computer and Data Sciences, Jena University Hospital/Friedrich-Schiller-University, Jena, Germany
| | - Cora Richert
- Department of Clinical Chemistry and Laboratory Medicine, Jena University Hospital/Friedrich-Schiller-University, Jena, Germany
| | - Florian Zepf
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Jena University Hospital/Friedrich-Schiller-University, Jena, Germany
| | - Martin Walter
- Department of Psychiatry and Psychotherapy, Jena University Hospital/Friedrich-Schiller-University, Jena, Germany
| | - André Scherag
- Institute of Medical Statistics, Computer and Data Sciences, Jena University Hospital/Friedrich-Schiller-University, Jena, Germany
| | - Michael Kiehntopf
- Department of Clinical Chemistry and Laboratory Medicine, Jena University Hospital/Friedrich-Schiller-University, Jena, Germany
| | - Bettina Löffler
- Institute of Medical Microbiology, Jena University Hospital/Friedrich-Schiller-University, Jena, Germany
| | - Mathias W Pletz
- Institute for Infectious Diseases and Infection Control, Jena University Hospital/Friedrich-Schiller-University, Jena, Germany
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181
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Ammar N, Aly NM, Folayan MO, Khader Y, Mohebbi SZ, Attia S, Howaldt HP, Boettger S, Virtanen J, Madi M, Maharani DA, Rahardjo A, Khan I, Al-Batayneh OB, Rashwan M, Pavlic V, Cicmil S, Noritake K, Galluccio G, Polimeni A, Shamala AA, Arheiam A, Mancino D, Phantumvanit P, Kim JB, Choi YH, Dama MA, Abdelsalam MM, Castillo JL, Nyan M, Hussein I, Joury E, Vukovic AP, Iandolo A, Kemoli AM, El Tantawi M. Perceived Preparedness of Dental Academic Institutions to Cope with the COVID-19 Pandemic: A Multi-Country Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041445. [PMID: 33557068 PMCID: PMC7913785 DOI: 10.3390/ijerph18041445] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/28/2021] [Accepted: 01/31/2021] [Indexed: 12/24/2022]
Abstract
Dental academic institutions are affected by COVID-19. We assessed the perceived COVID-19 preparedness of these institutions and the characteristics of institutions with greater perceived preparedness. An international cross-sectional survey of dental academics was conducted from March to August 2020 to assess academics’ and institutional attributes, perceived preparedness, and availability of infection prevention and control (IPC) equipment. Principal component analysis (PCA) identified perceived preparedness components. Multilevel linear regression analysis assessed the association between perceived preparedness and fixed effect factors (academics’ and institutions’ attributes) with countries as random effect variable. Of the 1820 dental academics from 28 countries, 78.4% worked in public institutions and 75.2% reported temporary closure. PCA showed five components: clinic apparel, measures before and after patient care, institutional policies, and availability of IPC equipment. Significantly less perceived preparedness was reported in lower-middle income (LMICs) (B = −1.31, p = 0.006) and upper-middle income (UMICs) (B = −0.98, p = 0.02) countries than in high-income countries (HICs), in teaching only (B = −0.55, p < 0.0001) and in research only (B = −1.22, p = 0.003) than teaching and research institutions and in institutions receiving ≤100 patients daily than those receiving >100 patients (B = −0.38, p < 0.0001). More perceived preparedness was reported by academics with administrative roles (B = 0.59, p < 0.0001). Academics from low-income countries (LICs) and LMICs reported less availability of clinic apparel, IPC equipment, measures before patient care, and institutional policies but more measures during patient care. There was greater perceived preparedness in HICs and institutions with greater involvement in teaching, research, and patient care.
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Affiliation(s)
- Nour Ammar
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria 21253, Egypt; (N.M.A.); (M.E.T.)
- Correspondence: ; Tel.: +20-10-0964-7703
| | - Nourhan M. Aly
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria 21253, Egypt; (N.M.A.); (M.E.T.)
| | | | - Yousef Khader
- Department of Public Health, Jordan University of Science and Technology, Irbid 22110, Jordan;
| | - Simin Z. Mohebbi
- Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran 14399-55991, Iran;
- Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Tehran 14399-55991, Iran
| | - Sameh Attia
- Department of Cranio-Maxillofacial Surgery, Justus-Liebig University Giessen, 35392 Giessen, Germany; (S.A.); (H.-P.H.); (S.B.)
| | - Hans-Peter Howaldt
- Department of Cranio-Maxillofacial Surgery, Justus-Liebig University Giessen, 35392 Giessen, Germany; (S.A.); (H.-P.H.); (S.B.)
| | - Sebastian Boettger
- Department of Cranio-Maxillofacial Surgery, Justus-Liebig University Giessen, 35392 Giessen, Germany; (S.A.); (H.-P.H.); (S.B.)
| | - Jorma Virtanen
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, 5020 Bergen, Norway;
| | - Marwa Madi
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 34221, Saudi Arabia;
| | - Diah A. Maharani
- Department of Preventive and Public Health Dentistry, Faculty of Dentistry, Universitas Indonesia, 16424 Depok, Indonesia; (D.A.M.); (A.R.)
| | - Anton Rahardjo
- Department of Preventive and Public Health Dentistry, Faculty of Dentistry, Universitas Indonesia, 16424 Depok, Indonesia; (D.A.M.); (A.R.)
| | - Imran Khan
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Jamia Millia Islamia, New Delhi 110025, India;
| | - Ola B. Al-Batayneh
- Department of Preventive Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid 22110, Jordan;
| | - Maher Rashwan
- Center for Oral Bioengineering, Barts and the London, School of Medicine and Dentistry, Queen Mary University of London, Mile End Road, London E1 4NS, UK;
- Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria 21253, Egypt
| | - Verica Pavlic
- Department of Periodontology and Oral Medicine, Institute of Dentistry, 78000 Banja Luka, Bosnia and Herzegovina;
| | - Smiljka Cicmil
- Department of Oral Rehabilitation, Faculty of Medicine Foca, University of East Sarajevo, 73300 Foca, Bosnia and Herzegovina;
| | - Kanako Noritake
- Oral Diagnosis and General Dentistry Department, Dental Hospital, Tokyo Medical and Dental University, Tokyo 113-8510, Japan;
| | - Gabriella Galluccio
- Department of Oral and Maxillo Facial Sciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, 00185 Rome, Italy; (G.G.); (A.P.)
| | - Antonella Polimeni
- Department of Oral and Maxillo Facial Sciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, 00185 Rome, Italy; (G.G.); (A.P.)
| | - Anas A. Shamala
- Department of Preventive and Biomedical Science, Faculty of Dentistry, University of Science and Technology, Sanaa 15201, Yemen;
| | - Arheiam Arheiam
- Department of Community and Preventive Dentistry, Faculty of Dentistry, University of Benghazi, Benghazi, Libya;
| | - Davide Mancino
- Department of Endodontics and Conservative Dentistry, Faculty of Dental Medicine, University of Strasbourg, 67000 Strasbourg, France;
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Strasbourg University, 67000 Strasbourg, France
| | | | - Jin-Bom Kim
- Department of Preventive and Community Dentistry, School of Dentistry, Pusan National University, Yangsan 50612, Korea;
| | - Youn-Hee Choi
- Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu 41940, Korea;
| | - Mai A. Dama
- Orthodontics and Pediatric Dentistry Department, Faculty of Dentistry, Arab American University, Jenin 240, Zababdeh 13, Palestine;
| | - Maha M. Abdelsalam
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 34221, Saudi Arabia;
| | - Jorge L. Castillo
- Department of Dentistry for Children and Adolescents, Universidad Peruana Cayetano Heredia, Lima 15102, Peru;
| | - Myat Nyan
- Department of Prosthodontics, University of Dental Medicine, Mandalay 05041, Myanmar;
| | - Iyad Hussein
- Department of Pediatric Dentistry, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 800 MBRU (6278), United Arab Emirates;
| | - Easter Joury
- Centre for Dental Public Health and Primary Care, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AD, UK;
| | - Ana P. Vukovic
- Department of Pediatric and Preventive Dentistry, School of Dental Medicine, University of Belgrade, Beograd, 11000 Belgrade, Serbia;
| | - Alfredo Iandolo
- Department of Endodontics, University of Salerno, 84080 Fisciano, Italy;
| | - Arthur M. Kemoli
- Department of Paediatric Dentistry & Orthodontics, School of Dental Sciences, University of Nairobi, Nairobi 30197-00100, Kenya;
| | - Maha El Tantawi
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria 21253, Egypt; (N.M.A.); (M.E.T.)
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Tubiana S, Burdet C, Houhou N, Thy M, Manchon P, Blanquart F, Charpentier C, Guedj J, Alavoine L, Behillil S, Leclercq A, Lucet JC, Yazdanpanah Y, Attia M, Demeret C, Rose T, Bielicki JA, Bruijning-Verhagen P, Goossens H, Descamps D, van der Werf S, Lina B, Duval X. High-risk exposure without personal protective equipment and infection with SARS-CoV-2 in-hospital workers - The CoV-CONTACT cohort. J Infect 2021; 82:186-230. [PMID: 33545165 PMCID: PMC7857039 DOI: 10.1016/j.jinf.2021.01.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 01/30/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Sarah Tubiana
- AP-HP, Hôpital Bichat, Centre d'Investigation Clinique, Inserm CIC 1425, F-75018 Paris, France; Université de Paris, IAME, INSERM, F-75018 Paris, France; AP-HP, Hôpital Bichat, Centre de Ressources Biologiques, F-75018 Paris, France
| | - Charles Burdet
- AP-HP, Hôpital Bichat, Centre d'Investigation Clinique, Inserm CIC 1425, F-75018 Paris, France; Université de Paris, IAME, INSERM, F-75018 Paris, France; AP-HP, Hôpital Bichat, Département d'Epidémiologie, Biostatistique et Recherche, F-75018 Paris, France
| | - Nadhira Houhou
- AP-HP, Hôpital Bichat, Laboratoire de Virologie, F-75018 Paris, France
| | - Michael Thy
- AP-HP, Hôpital Bichat, Centre d'Investigation Clinique, Inserm CIC 1425, F-75018 Paris, France
| | - Pauline Manchon
- AP-HP, Hôpital Bichat, Centre d'Investigation Clinique, Inserm CIC 1425, F-75018 Paris, France; AP-HP, Hôpital Bichat, Département d'Epidémiologie, Biostatistique et Recherche, F-75018 Paris, France
| | - François Blanquart
- Université de Paris, IAME, INSERM, F-75018 Paris, France; Center for Interdisciplinary Research in Biology (CIRB), Collège de France, CNRS, INSERM, PSL Research University, Paris, France
| | - Charlotte Charpentier
- Université de Paris, IAME, INSERM, F-75018 Paris, France; AP-HP, Hôpital Bichat, Laboratoire de Virologie, F-75018 Paris, France
| | - Jérémie Guedj
- AP-HP, Hôpital Bichat, Centre d'Investigation Clinique, Inserm CIC 1425, F-75018 Paris, France; Université de Paris, IAME, INSERM, F-75018 Paris, France
| | - Loubna Alavoine
- AP-HP, Hôpital Bichat, Centre d'Investigation Clinique, Inserm CIC 1425, F-75018 Paris, France
| | - Sylvie Behillil
- Molecular Genetics of RNA Viruses, Department of Virology, CNRS UMR3569, Université de Paris, Institut Pasteur, Paris, France; National Reference Center for Respiratory Viruses, Institut Pasteur, Paris, France
| | - Anne Leclercq
- AP-HP, Beaujon Hospital, Direction des soins, F-92118 Clichy, France
| | - Jean-Christophe Lucet
- Université de Paris, IAME, INSERM, F-75018 Paris, France; AP-HP, Hôpital Bichat, Equipe de Prévention du Risque Infectieux, F-75018 Paris, France
| | - Yazdan Yazdanpanah
- Université de Paris, IAME, INSERM, F-75018 Paris, France; AP-HP, Hôpital Bichat, Service de Maladies Infectieuses et tropicales, F-75018 Paris, France
| | - Mikaël Attia
- Physique des fonctions biologiques, CNRS UMR3738, Institut Pasteur, Paris, France
| | - Caroline Demeret
- Molecular Genetics of RNA Viruses, Department of Virology, CNRS UMR3569, Université de Paris, Institut Pasteur, Paris, France
| | - Thierry Rose
- Biologie cellulaire des lymphocytes, INSERM - U1221, Department of Immunology, Institut Pasteur, Paris, France
| | - Julia Anna Bielicki
- Paediatric Infectious Diseases Research Group, Institute for Infection and Immunity, St George's University of London, London SW17 0RE, United Kingdom; Paediatric Pharmacology and Paediatric Infectious Diseases, University of Basel Children's Hospital, Basel, Switzerland
| | | | - Herman Goossens
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium
| | - Diane Descamps
- Université de Paris, IAME, INSERM, F-75018 Paris, France; AP-HP, Hôpital Bichat, Laboratoire de Virologie, F-75018 Paris, France
| | - Sylvie van der Werf
- Molecular Genetics of RNA Viruses, Department of Virology, CNRS UMR3569, Université de Paris, Institut Pasteur, Paris, France; National Reference Center for Respiratory Viruses, Institut Pasteur, Paris, France
| | - Bruno Lina
- CIRI, Centre International de Recherche en Infectiologie, (Team VirPath), Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007, Lyon, France; Laboratoire de Virologie, Centre National de Référence des Virus des infections respiratoires (dont la grippe), Institut des Agents Infectieux, Groupement Hospitalier Nord, Hospices Civils de Lyon, 69004, Lyon, France
| | - Xavier Duval
- AP-HP, Hôpital Bichat, Centre d'Investigation Clinique, Inserm CIC 1425, F-75018 Paris, France; Université de Paris, IAME, INSERM, F-75018 Paris, France.
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183
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Gallagher M, Wong J, Friedt J, Cattell V, McKague M. Personal protective equipment coaching in the pediatric and adult emergency departments: a pilot project for health sciences students during COVID-19. CANADIAN MEDICAL EDUCATION JOURNAL 2021; 12:e184-e185. [PMID: 33680251 PMCID: PMC7931488 DOI: 10.36834/cmej.70601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Megan Gallagher
- College of Medicine, University of Saskatchewan, Saskatchewan, Canada
| | - Jennifer Wong
- College of Medicine, University of Saskatchewan, Saskatchewan, Canada
| | - Jill Friedt
- Saskatchewan Health Authority, Saskatchewan, Canada
| | - Vicki Cattell
- College of Medicine, University of Saskatchewan, Saskatchewan, Canada
- Saskatchewan Health Authority, Saskatchewan, Canada
| | - Meredith McKague
- College of Medicine, University of Saskatchewan, Saskatchewan, Canada
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184
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Chambers ST, Slow S, Scott-Thomas A, Murdoch DR. Legionellosis Caused by Non- Legionella pneumophila Species, with a Focus on Legionella longbeachae. Microorganisms 2021; 9:291. [PMID: 33572638 PMCID: PMC7910863 DOI: 10.3390/microorganisms9020291] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/23/2021] [Accepted: 01/26/2021] [Indexed: 12/13/2022] Open
Abstract
Although known as causes of community-acquired pneumonia and Pontiac fever, the global burden of infection caused by Legionella species other than Legionella pneumophila is under-recognised. Non-L. pneumophila legionellae have a worldwide distribution, although common testing strategies for legionellosis favour detection of L. pneumophila over other Legionella species, leading to an inherent diagnostic bias and under-detection of cases. When systematically tested for in Australia and New Zealand, L. longbeachae was shown to be a leading cause of community-acquired pneumonia. Exposure to potting soils and compost is a particular risk for infection from L. longbeachae, and L. longbeachae may be better adapted to soil and composting plant material than other Legionella species. It is possible that the high rate of L. longbeachae reported in Australia and New Zealand is related to the composition of commercial potting soils which, unlike European products, contain pine bark and sawdust. Genetic studies have demonstrated that the Legionella genomes are highly plastic, with areas of the chromosome showing high levels of recombination as well as horizontal gene transfer both within and between species via plasmids. This, combined with various secretion systems and extensive effector repertoires that enable the bacterium to hijack host cell functions and resources, is instrumental in shaping its pathogenesis, survival and growth. Prevention of legionellosis is hampered by surveillance systems that are compromised by ascertainment bias, which limits commitment to an effective public health response. Current prevention strategies in Australia and New Zealand are directed at individual gardeners who use potting soils and compost. This consists of advice to avoid aerosols generated by the use of potting soils and use masks and gloves, but there is little evidence that this is effective. There is a need to better understand the epidemiology of L. longbeachae and other Legionella species in order to develop effective treatment and preventative strategies globally.
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Affiliation(s)
- Stephen T. Chambers
- Department of Pathology and Biomedical Science, University of Otago, Christchurch 8011, New Zealand; (S.S.); (A.S.-T.); (D.R.M.)
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185
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Algorithmic matching of personal protective equipment donations with healthcare facilities during the COVID-19 pandemic. NPJ Digit Med 2021; 4:13. [PMID: 33514805 PMCID: PMC7846564 DOI: 10.1038/s41746-020-00375-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 11/19/2020] [Indexed: 01/05/2023] Open
Abstract
GetUsPPE.org has built a centralized platform to facilitate matches for PPE donations, with an active role in matching donors with the appropriate recipients. A manual match process was limited by volunteer hours, thus we developed an open-access matching algorithm using a linear programming-based transportation model. From April 14, 2020 to April 27, 2020, the algorithm was used to match 83,136 items of PPE to 135 healthcare facilities in need across the United States with a median of 214.3 miles traveled, 100% of available donations matched, met the full quantity of requested PPE for 67% of recipients matched, and with 46% matches under 30 miles traveled. Compared with the period April 1, 2020 to April 13, 2020, when PPE matching was manual, the algorithm resulted in a 280% increase in matches/day. This publicly available automated algorithm could be deployed in future situations when the healthcare supply chain is insufficient.
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186
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Monteiro KS, Santino TA, Jácome AC, Silva B, Patino CM, Chaves G, Alchieri JC, Leite S, Luz KG, Guerra RO, Mendonça KMPPD. Barriers and facilitators to populational adherence to prevention and control measures of COVID-19 and other respiratory infectious diseases: a rapid qualitative evidence synthesis protocol. BMJ Open 2021; 11:e045529. [PMID: 33514584 PMCID: PMC7849319 DOI: 10.1136/bmjopen-2020-045529] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION The current COVID-19 pandemic has increased the need for populational adherence to measures for the prevention and control of respiratory infectious diseases. However, their effectiveness depends on the population's preventive behaviour, which may be divergent from public policies. Therefore, this study aims to summarise and evaluate the evidence on barriers and facilitators to populational adherence to prevention and control measures in COVID-19 and other respiratory infectious diseases. METHODS AND ANALYSIS We will search on MEDLINE, Embase and PsycINFO for studies focusing on adults receiving protective behaviour recommendations to combat COVID-19 and other respiratory infectious diseases. The searches will be carried out from database's inception to the present. We will include studies that use qualitative methods in their data collection and analysis and studies that use mixed methods if they include any qualitative methods of analysis. Studies published in English, Portuguese and Spanish will be included. Two review authors will independently screen the studies for inclusion and extract data. We will assess the quality of the included studies using the Critical Skills Appraisal Programme tool. For the assessment of the confidence in the synthesised findings, we will use the GRADE-Confidence in the Evidence from Reviews of Qualitative research. Data analysis will be conducted using the best-fit framework approach based on adapted dimensions from the Health Belief Model and the Behaviour Change Wheel. ETHICS AND DISSEMINATION This study will be conducted on published evidence, and thus, no ethical approval is required. The findings of this rapid qualitative evidence synthesis will be disseminated to academic audiences, health policy-makers and the general population. We will publish the results in peer-reviewed journals, present our findings in conferences, and disseminate results via social media. We also aim to present the research findings in plain language and disseminate the knowledge to the general population to increase public interest. PROSPERO REGISTRATION NUMBER CRD42020205750.
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Affiliation(s)
- Karolinne Souza Monteiro
- Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Thayla Amorim Santino
- Department of Physical Therapy, Graduate Program in Physical Therapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Ada Cristina Jácome
- Department of Physical Therapy, Graduate Program in Physical Therapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Baldomero Silva
- Department of Physical Therapy, Federal University of Delta do Parnaíba, Parnaíba, Brazil
| | - Cecilia M Patino
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | | | - João Carlos Alchieri
- Department of Psychology, Graduate Program in Science, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Sarah Leite
- Department of Physical Therapy, Graduate Program in Physical Therapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Kleber Giovanni Luz
- Department of Infectious Diseases, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Ricardo O Guerra
- Department of Physical Therapy, Graduate Program in Physical Therapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil
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Poortaghi S, Shahmari M, Ghobadi A. Exploring nursing managers' perceptions of nursing workforce management during the outbreak of COVID-19: a content analysis study. BMC Nurs 2021; 20:27. [PMID: 33514351 PMCID: PMC7844784 DOI: 10.1186/s12912-021-00546-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 01/24/2021] [Indexed: 12/20/2022] Open
Abstract
Background The COVID-19 pandemic is a serious threat to public health worldwide. Therefore, a coordinated global response is needed to prepare health care systems to face this unprecedented challenge. Proper human resource management can increase nurses’ productivity and quality of care. Therefore, the present study aims to explore the nursing managers’ perception of nursing workforce management during the outbreak of COVID-19. Methods This is a qualitative study with conventional content analysis using Granheim and Landman approach. In this study, 15 nursing managers were selected by purposeful sampling method. Data were collected using in-depth semi-structured interviews. Ethical considerations were applied to all stages of the study. In this study, MAXQDA software version 10 was used to help manage the data. Results 66% of the participants (10/5) were female. The mean age of participants was 44 years, mean work experience of 19 years, and mean management experience of 9 years. Three categories and seven sub-categories emerged from the data analysis: 1) management of workforce recruitment (volunteer workforces, non-volunteer workforces), 2) management of workforce arrangement (flexible work schedule, rearrangement of the workforce), and 3) management of workforce retention (preventive measures, motivational measures, and psychological support). Conclusion Management in critical situations requires the use of flexible and situational management principles to recruit, arrange and retain workforce, and also to compensate for the lack of manpower. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-021-00546-x.
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Affiliation(s)
- Sarieh Poortaghi
- PhD of Nursing Education, Tehran University of Medical Sciences, School of Nursing and Midwifery, Community Health Nursing Department, Tehran, Iran
| | - Mehraban Shahmari
- School of Nursing and Midwifery, Tehran University of Medical Science, Tehran, Iran
| | - Akram Ghobadi
- School of Nursing and Midwifery, Tehran University of Medical Science, Tehran, Iran. .,PhD student in Nursing, School of Nursing and Midwifery, Tehran University of Medical Science; Lecturer, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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188
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Burton C, Coles B, Adisesh A, Smith S, Toomey E, Chan XHS, Ross L, Greenhalgh T. Performance and impact of disposable and reusable respirators for healthcare workers during pandemic respiratory disease: a rapid evidence review. Occup Environ Med 2021; 78:679-690. [PMID: 33504624 DOI: 10.1136/oemed-2020-107058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/29/2020] [Accepted: 11/20/2020] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To synthesise evidence concerning the range of filtering respirators suitable for patient care and guide the selection and use of different respirator types. DESIGN Comparative analysis of international standards for respirators and rapid review of their performance and impact in healthcare. DATA SOURCES Websites of international standards organisations, Medline and Embase, hand-searching of references and citations. STUDY SELECTION Studies of healthcare workers (including students) using disposable or reusable respirators with a range of designs. We examined respirator performance, clinician adherence and performance, comfort and impact, and perceptions of use. RESULTS We included standards from eight authorities across Europe, North and South America, Asia and Australasia and 39 research studies. There were four main findings. First, international standards for respirators apply across workplace settings and are broadly comparable across jurisdictions. Second, effective and safe respirator use depends on proper fitting and fit testing. Third, all respirator types carry a burden to the user of discomfort and interference with communication which may limit their safe use over long periods; studies suggest that they have little impact on specific clinical skills in the short term but there is limited evidence on the impact of prolonged wearing. Finally, some clinical activities, particularly chest compressions, reduce the performance of filtering facepiece respirators. CONCLUSION A wide range of respirator types and models is available for use in patient care during respiratory pandemics. Careful consideration of performance and impact of respirators is needed to maximise protection of healthcare workers and minimise disruption to care.
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Affiliation(s)
- Christopher Burton
- Academic Unit of Primary Medical Care, The University of Sheffield Faculty of Medicine Dentistry and Health, Sheffield, UK
| | - Briana Coles
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, Leicestershire, UK
| | - Anil Adisesh
- Occupational Medicine, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
| | - Simon Smith
- Canadian Standards Biological Aerosols Group, Canadian Standards Association, Toronto, Ontario, Canada
| | - Elaine Toomey
- School of Allied Health, University of Limerick Faculty of Education and Health Sciences, Limerick, Ireland
| | - Xin Hui S Chan
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford Medical Sciences Division, Oxford, Oxfordshire, UK
| | - Lawrence Ross
- Infectious Diseases, Children's Hospital of Los Angeles, Los Angeles, California, USA
| | - Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire, UK
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189
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Gunnink LB, Arouri DJ, Jolink FE, Lokate M, de Jonge K, Kampmeier S, Kreis C, Raschke M, Kleinjan M, ter Maaten JC, Friedrich AW, Bathoorn E, Glasner C. Compliance to Screening Protocols for Multidrug-Resistant Microorganisms at the Emergency Departments of Two Academic Hospitals in the Dutch-German Cross-Border Region. Trop Med Infect Dis 2021; 6:tropicalmed6010015. [PMID: 33530494 PMCID: PMC7838951 DOI: 10.3390/tropicalmed6010015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/19/2021] [Accepted: 01/21/2021] [Indexed: 12/12/2022] Open
Abstract
Infections caused by multidrug-resistant organisms (MDROs) are associated with prolonged hospitalization and higher risk of mortality. Patients arriving in the hospital via the emergency department (ED) are screened for the presence of MDROs in compliance with the screening protocols in order to apply the correct isolation measures. In the Dutch–German border region, local hospitals apply their own screening protocols which are based upon national screening protocols. The contents of the national and local MDRO screening protocols were compared on vancomycin-resistant enterococci (VRE), methicillin-resistant Staphylococcus aureus (MRSA), and carbapenemase-producing and carbapenem-resistant Enterobacteriaceae (CPE/CRE). The practicality of the screening protocols was evaluated by performing an audit. As a result, the content of the MDRO screening protocols differed regarding risk factors for MDRO carriage, swab site, personal protective equipment, and isolation measures. The observations and questionnaires showed that the practicality was sufficient; however, the responsibility was not designated clearly and education regarding the screening protocols was deemed inappropriate. The differences between the MDRO screening protocols complicate patient care in the Dutch–German border region. Arrangements have to be made about the responsibility of the MDRO screening, and improvements are necessary concerning education regarding the MDRO screening protocols.
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Affiliation(s)
- Lisa B. Gunnink
- Department of Medical Microbiology and Infection Control, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; (L.B.G.); (D.J.A.); (F.E.J.J.); (M.L.); (K.d.J.); (A.W.F.); (E.B.)
| | - Donia J. Arouri
- Department of Medical Microbiology and Infection Control, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; (L.B.G.); (D.J.A.); (F.E.J.J.); (M.L.); (K.d.J.); (A.W.F.); (E.B.)
| | - Floris E.J. Jolink
- Department of Medical Microbiology and Infection Control, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; (L.B.G.); (D.J.A.); (F.E.J.J.); (M.L.); (K.d.J.); (A.W.F.); (E.B.)
| | - Mariëtte Lokate
- Department of Medical Microbiology and Infection Control, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; (L.B.G.); (D.J.A.); (F.E.J.J.); (M.L.); (K.d.J.); (A.W.F.); (E.B.)
| | - Klaas de Jonge
- Department of Medical Microbiology and Infection Control, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; (L.B.G.); (D.J.A.); (F.E.J.J.); (M.L.); (K.d.J.); (A.W.F.); (E.B.)
| | - Stefanie Kampmeier
- Institute of Hygiene, University Hospital Münster, Robert-Koch-Straße 41, 48149 Münster, Germany;
| | - Carolin Kreis
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus 1, Building W1, 48149 Münster, Germany; (C.K.); (M.R.)
| | - Michael Raschke
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus 1, Building W1, 48149 Münster, Germany; (C.K.); (M.R.)
| | - Mirjam Kleinjan
- Department of Emergency Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands;
| | - Jan C. ter Maaten
- Department of Internal Medicine, Emergency Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands;
| | - Alex W. Friedrich
- Department of Medical Microbiology and Infection Control, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; (L.B.G.); (D.J.A.); (F.E.J.J.); (M.L.); (K.d.J.); (A.W.F.); (E.B.)
| | - Erik Bathoorn
- Department of Medical Microbiology and Infection Control, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; (L.B.G.); (D.J.A.); (F.E.J.J.); (M.L.); (K.d.J.); (A.W.F.); (E.B.)
| | - Corinna Glasner
- Department of Medical Microbiology and Infection Control, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; (L.B.G.); (D.J.A.); (F.E.J.J.); (M.L.); (K.d.J.); (A.W.F.); (E.B.)
- Correspondence: ; Tel.: +31-(0)-50-36-13480
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190
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Duggal S, Ahuja B, Biswas PS, Choudhuri AH. A survey of physicians' appreciation and knowledge about airway safety measures in the wake of COVID-19 pandemic. J Anaesthesiol Clin Pharmacol 2021; 36:350-358. [PMID: 33487902 PMCID: PMC7812955 DOI: 10.4103/joacp.joacp_294_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/03/2020] [Accepted: 06/13/2020] [Indexed: 11/17/2022] Open
Abstract
Background and Aims: The implementation of safety measures during airway management is a major concern to prevent COVID-19 transmission during pandemic. Various guidelines and advisories are in vogue to ensure safe practices. However, their success depends on the caregivers’ knowledge and understanding. This survey was conducted to assess the knowledge and safety concerns amongst physicians towards airway management in the background of COVID-19 pandemic. Material and Methods: A survey instrument of thirty questions covering three timelines of airway management viz. ‘before’, ‘during’ and ‘after’ airway intervention was created. The questionnaire was electronically mailed to the eligible physicians over a period of one month via a web-based platform and the responses were analyzed. The responses were depicted numerically as percentage. A multiple discriminant analysis was used to test the accuracy of responses after adjusting for common variables. Results: Out of 407 responses, 300 were eligible for analysis. The respondents with correct answers to questions with single correct response were 46%, 69% and 57.3%, along the three timelines and the respondents with more than 75% correct responses in questions with multiple correct responses were 49%, 58% and 31% along the same timelines. About 75% of the participants became aware of transmission through aerosols aftermath pandemic. About two-third of the participants had knowledge about the safety guidelines and recommendations. Majority of the respondents were aware of the safety measures ‘during airway intervention’. Conclusion: Our study found satisfactory knowledge and appreciable concern among the practicing physicians regarding airway safety measures in the wake of COVID-19 pandemic. However, more physicians were aware about the measures required to be adopted ‘during’ airway intervention. The survey highlights the need for a more focused training of the caregivers about safety measures ‘before’ and ‘after’ airway intervention.
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Affiliation(s)
- Sakshi Duggal
- Department of Anesthesiology and Intensive Care, GB Pant Institute of Medical Education and Research, New Delhi, India
| | - Bhuvna Ahuja
- Department of Anesthesiology and Intensive Care, ESI Hospital, Noida, Uttar Pradesh, India
| | - Partha S Biswas
- Department of Psychiatry, GB Pant Institute of Medical Education and Research, New Delhi, India
| | - Anirban Hom Choudhuri
- Department of Anesthesiology and Intensive Care, GB Pant Institute of Medical Education and Research, New Delhi, India
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191
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Axén I, Björk Brämberg E, Galaasen Bakken A, Kwak L. Recruiting in intervention studies: challenges and solutions. BMJ Open 2021; 11:e044702. [PMID: 33495262 PMCID: PMC7839899 DOI: 10.1136/bmjopen-2020-044702] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/22/2020] [Accepted: 01/12/2021] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION In order for study results to be relevant for practice, the study participants should represent the source population. A common problem is recruitment of sufficient and representative subjects, threatening the external validity of the study and, ultimately, evidence-based practice. The aim was to highlight common challenges and to present possible solutions to recruitment. METHODS Using four recent randomised controlled trials as examples, common recruitment challenges were highlighted and solutions were proposed. The four studies represented some common and some specific challenges, but they investigated interventions for the prevention of the two major public health challenges of today: musculoskeletal pain and common mental disorders. RESULTS Identified challenges and suggested solutions were presented as a checklist to be used for future trials in order to aid recruitment and reporting thereof.
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Affiliation(s)
- Iben Axén
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Lydia Kwak
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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192
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Mersha A, Shibiru S, Girma M, Ayele G, Bante A, Kassa M, Abebe S, Shewangizaw M. Perceived barriers to the practice of preventive measures for COVID-19 pandemic among health professionals in public health facilities of the Gamo zone, southern Ethiopia: a phenomenological study. BMC Public Health 2021; 21:199. [PMID: 33482790 PMCID: PMC7820827 DOI: 10.1186/s12889-021-10256-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 01/17/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Novel coronavirus is a global pandemic and killed many individuals, including health care professionals. It caused stress on the health care system of all countries. Presently, studies are emerging regarding the COVID-19 pandemic in different aspects. However, a few have explored barriers that affecting the practice of preventive measures for the COVID-19. As such, the study aimed to fill these research gaps in the study setting. METHODS A semi-structured interview guide was used to conduct this phenomenological study among 16 key informants. Key informants were recruited by the purposive sampling method. To analyze that data, thematic content analysis was employed by using an inductive approach in NVivo 12 Pro software. RESULTS In this study, six main themes were identified with the sub-themes. Overview of COVID-19 pandemic (with the six sub-themes), consequences (with the two sub-themes), perceived practice (with four sub-themes), perceived barriers (with four sub-themes), newfangled activities (with three sub-themes), and suggestion for improvement (with seven sub-themes) were the major themes. The participants perceived the influence of shortage of personal protective equipment and solutions for hand hygiene, negligence and ignorance, inadequate infrastructure, lack of training, and lack of attention and recognition for the staff on the practice of preventive measures. CONCLUSIONS This study showed a gap in preventive measure practices for the COVID-19 in the health care system. Community influences, health care provider related barriers, institutional barriers, and lack of communication and support affect the practice. Hence, attention should give to fulfill the necessary supplies in the health facilities, improve the infrastructures, and equip health professionals by providing capacity-building activities. Besides, health care workers must recognize, and attention is needed.
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Affiliation(s)
- Abera Mersha
- School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Shitaye Shibiru
- School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Meseret Girma
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Gistane Ayele
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Agegnehu Bante
- School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Mekidim Kassa
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Sintayehu Abebe
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Misgun Shewangizaw
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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193
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[Safe surgery and COVID-19: A narrative review]. J Healthc Qual Res 2021; 36:160-167. [PMID: 33589399 PMCID: PMC7826109 DOI: 10.1016/j.jhqr.2020.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 11/02/2020] [Accepted: 11/25/2020] [Indexed: 12/15/2022]
Abstract
Fundamentos La interrupción de la actividad asistencial quirúrgica en España provocada por la pandemia debe finalizar. La recuperación de esta actividad ha de realizarse de forma electiva y en convivencia con posibles casos de COVID-19. El objetivo de esta revisión fue la incorporación de criterios de buenas prácticas relacionados con la COVID-19 al contexto de cirugía segura, que permitiesen desarrollar una propuesta de lista de verificación de seguridad quirúrgica adaptada a pacientes con esta enfermedad. Métodos Revisión bibliográfica narrativa, siguiendo el protocolo PRISMA, en los repertorios Medline y Cochrane, utilizando los términos MeSH (coronavirus, infections, safety, surgical procedures, operative, checklist) y el operador booleano AND. Además, se revisaron recomendaciones de organismos y sociedades científicas (literatura gris). Resultados Se incluyeron 33 estudios finales con recomendaciones para la cirugía segura y lista de verificación de seguridad quirúrgica adaptada para COVID-19, siendo los más frecuentes los aspectos relacionados con el tratamiento (41,3%) y medidas de prevención y control (27,6%). Conclusiones La existencia de un amplio consenso en buenas prácticas recomendadas a pacientes COVID quirúrgicos permite realizar una propuesta de lista de verificación de seguridad quirúrgica a estos enfermos.
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194
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Hoernke K, Djellouli N, Andrews L, Lewis-Jackson S, Manby L, Martin S, Vanderslott S, Vindrola-Padros C. Frontline healthcare workers' experiences with personal protective equipment during the COVID-19 pandemic in the UK: a rapid qualitative appraisal. BMJ Open 2021; 11:e046199. [PMID: 33472794 PMCID: PMC7818840 DOI: 10.1136/bmjopen-2020-046199] [Citation(s) in RCA: 145] [Impact Index Per Article: 48.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To report frontline healthcare workers' (HCWs) experiences with personal protective equipment (PPE) during the COVID-19 pandemic in the UK. To understand HCWs' fears and concerns surrounding PPE, their experiences following its guidance and how these affected their perceived ability to deliver care during the COVID-19 pandemic. DESIGN A rapid qualitative appraisal study combining three sources of data: semistructured in-depth telephone interviews with frontline HCWs (n=46), media reports (n=39 newspaper articles and 145 000 social media posts) and government PPE policies (n=25). PARTICIPANTS Interview participants were HCWs purposively sampled from critical care, emergency and respiratory departments as well as redeployed HCWs from primary, secondary and tertiary care centres across the UK. RESULTS A major concern was running out of PPE, putting HCWs and patients at risk of infection. Following national level guidance was often not feasible when there were shortages, leading to reuse and improvisation of PPE. Frequently changing guidelines generated confusion and distrust. PPE was reserved for high-risk secondary care settings and this translated into HCWs outside these settings feeling inadequately protected. Participants were concerned about differential access to adequate PPE, particularly for women and Black, Asian and Minority Ethnic HCWs. Participants continued delivering care despite the physical discomfort, practical problems and communication barriers associated with PPE use. CONCLUSION This study found that frontline HCWs persisted in caring for their patients despite multiple challenges including inappropriate provision of PPE, inadequate training and inconsistent guidance. In order to effectively care for patients during the COVID-19 pandemic, frontline HCWs need appropriate provision of PPE, training in its use as well as comprehensive and consistent guidance. These needs must be addressed in order to protect the health and well-being of the most valuable healthcare resource in the COVID-19 pandemic: our HCWs.
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Affiliation(s)
- Katarina Hoernke
- Institute for Global Health, University College London, London, UK
| | - Nehla Djellouli
- Institute for Global Health, University College London, London, UK
| | - Lily Andrews
- Institute of Epidemiology and Health Care, University College London, London, UK
| | | | - Louisa Manby
- Institute of Epidemiology and Health Care, University College London, London, UK
| | - Sam Martin
- Oxford Vaccine Group, University of Oxford, Oxford, UK
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Abstract
OBJECTIVE The COVID-19 pandemic is demanding for occupational medicine and for public health. As healthcare workers (HCWs) fight impacts of SARS-CoV-2 on front lines, we must create safe work environments through comprehensive risk assessments, evaluation and effective implementation of counter-measures. We ask: 'What does current literature report on health risks at workplaces regarding COVID-19?' and 'What do current studies report on the effectiveness of enacted preventative recommendations?' METHODS As a snapshot of early HCW research, on 26 April 2020, we conducted a rapid systematic literature search in three databases (PubMed, Web of Science and PsycInfo) for COVID-19-related health outcomes and preventive measures in healthcare-associated workplaces. RESULTS 27 studies were identified as relevant for exploring the risk of infection, 11 studies evaluated preventive measures. The studies described that SARS-CoV-2 impacts significantly on HCW's health and well-being, not only through infections (n=6), but also from a mental health perspective (n=16). 4 studies reported indirect risks such as skin injuries, one study described headaches to result from the use of personal protective equipment. Few studies provided information on the effectiveness of prevention strategies. Overall, most studies on health risks as well as on the effectiveness of preventive measures were of a moderate-to-low quality; this was mainly due to limitations in study design, imprecise exposure and outcome assessments. CONCLUSIONS Due to widespread exposure of HCW to SARS-CoV-2, workplaces in healthcare must be as safe as possible. Information from HCW can provide valuable insights into how infections spread, into direct and indirect health effects and into how effectively counter-measures mitigate adverse health outcomes. However, available research disallows to judge which counter-measure(s) of a current 'mix' should be prioritised for HCW. To arrive at evidence-based cost-effective prevention strategies, more well-conceived studies on the effectiveness of counter-measures are needed.
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Affiliation(s)
- J Valérie Gross
- Institute and Policlinic for Occupational Medicine, Environmental Medicine and Prevention Research, University Hospital Cologne, Koln, Nordrhein-Westfalen, Germany
| | - Judith Mohren
- Institute and Policlinic for Occupational Medicine, Environmental Medicine and Prevention Research, University Hospital Cologne, Koln, Nordrhein-Westfalen, Germany
| | - Thomas C Erren
- Institute and Policlinic for Occupational Medicine, Environmental Medicine and Prevention Research, University Hospital Cologne, Koln, Nordrhein-Westfalen, Germany
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196
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Faria de Moura Villela E, López RVM, Sato APS, de Oliveira FM, Waldman EA, Van den Bergh R, Siewe Fodjo JN, Colebunders R. COVID-19 outbreak in Brazil: adherence to national preventive measures and impact on people's lives, an online survey. BMC Public Health 2021; 21:152. [PMID: 33461508 PMCID: PMC7812554 DOI: 10.1186/s12889-021-10222-z] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 01/12/2021] [Indexed: 12/23/2022] Open
Abstract
Background The first case of COVID-19 infection was diagnosed in Brazil 26th February 2020. By March 16th, physical distancing and confinement measures were implemented by the Brazilian government. Little is known about how these measures were followed up by the Brazilian people and their impact on daily routine. Methods In early April 2020, using an online platform, we organized an online survey among adults living in Brazil about their COVID-19 preventive behavior and impact on their daily routine. Results Data from 23,896 respondents were analyzed (mean age: 47.4 years). Due to COVID-19 restrictions, half (51.1%) of the professionals reported working from home. Regular handwashing was practiced by 98.7% of participants; 92.6% reported adhering to the 1.5-2 m physical distancing rule, but only 45.5% wore a face mask when going outside. While 29.3% of respondents found it relatively easy to stay at home, indoor confinement was extremely difficult for 7.9% of participants. Moreover, 11% of participants were extremely worried about their health during the COVID-19 epidemic. Younger people, male, persons living in a rural area/village or popular neighbourhoods, students and workers reported less preventive behaviour. Conclusion Restrictive measures markedly affected the daily and professional routines of Brazilians. Participants showed a satisfactory level of adherence to national COVID-19 prevention guidelines. Qualitative and follow-up studies are needed to monitor the impact of COVID-19 in the Brazilian society. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10222-z.
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Affiliation(s)
| | | | - Ana Paula Sayuri Sato
- Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil
| | | | - Eliseu Alves Waldman
- Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil
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197
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Isolation of COVID-19 patients in cohorted wards or single-patient rooms? Advantages and disadvantages to take into consideration. Infect Control Hosp Epidemiol 2021; 42:1392-1394. [PMID: 33427142 PMCID: PMC8485013 DOI: 10.1017/ice.2020.1425] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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198
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Cobb N, Papali A, Pisani L, Schultz MJ, Ferreira JC. Pragmatic Recommendations for Infection Prevention and Control Practices for Healthcare Facilities in Low- and Middle-Income Countries during the COVID-19 Pandemic. Am J Trop Med Hyg 2021; 104:25-33. [PMID: 33410392 PMCID: PMC7957238 DOI: 10.4269/ajtmh.20-1009] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 12/20/2020] [Indexed: 01/19/2023] Open
Abstract
Infection prevention and control (IPC) strategies are key in preventing nosocomial transmission of COVID-19. Several commonly used IPC practices are resource-intensive and may be challenging to implement in resource-constrained settings. An international group of healthcare professionals from or with experience in low- and middle-income countries (LMICs) searched the literature for relevant evidence. We report on a set of pragmatic recommendations for hospital-based IPC practices in resource-constrained settings of LMICs. For cases of confirmed or suspected COVID-19, we suggest that patients be placed in a single isolation room, whenever possible. When single isolation rooms are unavailable or limited, we recommend cohorting patients with COVID-19 on dedicated wards or in dedicated hospitals. We also recommend that cases of suspected COVID-19 be cohorted separately from those with confirmed disease, whenever possible, to minimize the risk of patient-to-patient transmission in settings where confirmatory testing may be limited. We suggest that healthcare workers be designated to care exclusively for patients with COVID-19, whenever possible, as another approach to minimize nosocomial spread. This approach may also be beneficial in conserving limited supplies of reusable personal protective equipment (PPE). We recommend that visitors be restricted for patients with COVID-19. In settings where family members or visitors are necessary for caregiving, we recommend that the appropriate PPE be used by visitors. We also recommend that education regarding hand hygiene and donning/doffing procedures for PPE be provided. Last, we suggest that all visitors be screened for symptoms before visitation and that visitor logs be maintained.
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Affiliation(s)
- Natalie Cobb
- 1Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Seattle, Washington
| | - Alfred Papali
- 2Division of Pulmonary and Critical Care Medicine, Atrium Health, Charlotte, North Carolina
| | - Luigi Pisani
- 3Section of Operative Research, Doctors with Africa, CUAMM, Padova, Italy.,4Mahidol-Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand
| | - Marcus J Schultz
- 4Mahidol-Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand.,5Department of Intensive Care, Laboratory of Experimental Intensive Care and Anesthesiology (L·E·I·C·A), Amsterdam University Medical Centers, Amsterdam, The Netherlands.,6Nuffield Department of Medicine, Oxford University, Oxford, United Kingdom
| | - Juliana C Ferreira
- 7Divisao de Pneumologia, Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, Brazil
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Maraqa B, Nazzal Z, Zink T. Mixed Method Study to Explore Ethical Dilemmas and Health Care Workers' Willingness to Work Amid COVID-19 Pandemic in Palestine. Front Med (Lausanne) 2021; 7:576820. [PMID: 33469543 PMCID: PMC7813812 DOI: 10.3389/fmed.2020.576820] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 11/25/2020] [Indexed: 12/22/2022] Open
Abstract
Background: The high potential risks involved in working in a healthcare setting during a pandemic and the associated fear that may affect health care workers' (HCWs') willingness to work are important to understand to eliminate potential barriers to working. This study aimed to assess Palestinian HCWs' willingness to work and the related factors as well as to explore their ethical dilemmas during the coronavirus disease 2019 (COVID-19) pandemic. Materials and Methods: Quantitative (survey questionnaire) and qualitative (semi-structured interviews) data were collected. Frontline HCWs (n = 550) received an online survey link via closed institutional networks. Frequencies summarized the data, and chi-square compared variables and outcomes. Odds ratios (ORs) and multivariable analysis examined predictors for willingness to work. Fifteen HCWs (physicians, nurses, and lab and radiology technicians) were purposefully sampled and agreed to interviews to explore their thoughts, motivations, and worries. Thematic analysis focused on ethical dilemmas to enhance the breadth and the depth of the study. Results: Almost 25% of surveyed HCWs were not willing to work during the pandemic. Logistic model results showed that physicians and nurses had higher willingness to work than others (p = 0.004, Adj. OR = 3.5). Lower stress levels and longer professional experience were predictors of more willing to work (p = 0.03, Adj. OR = 2.5; p = 0.03, Adj. OR = 2.6, respectively). Interviews showed that willingness to work did not preclude HCWs from fulfilling their duties despite grueling workloads and grave fears about safety and security. HCWs felt poorly prepared, unappreciated, and frustrated by unfair work distribution. The occupation presented additional safety issues. Conclusion: Physicians and nurses were more likely to comply with a commitment to their professional ethics and the duty or obligation to work. Stress levels could be mitigated in the future with better leadership, adding supports to address mental health and psychosocial challenges to enhance HCWs' well-being and improve quality of care. The realities of the occupation added additional threats and uncertainty.
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Affiliation(s)
- Beesan Maraqa
- Primary Health Directorate, Ministry of Health, Ramallah, Palestine.,Family Medicine Residency Program, Faculty of Graduate Studies, An-Najah National University, Nablus, Palestine
| | - Zaher Nazzal
- Department of Family and Community Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Therese Zink
- Department of Family Medicine & School of Public Health, Brown University, Providence, RI, United States
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200
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Toomey EC, Conway Y, Burton C, Smith S, Smalle M, Chan XHS, Adisesh A, Tanveer S, Ross L, Thomson I, Devane D, Greenhalgh T. Extended use or reuse of single-use surgical masks and filtering face-piece respirators during the coronavirus disease 2019 (COVID-19) pandemic: A rapid systematic review. Infect Control Hosp Epidemiol 2021; 42:75-83. [PMID: 33028441 PMCID: PMC7588721 DOI: 10.1017/ice.2020.1243] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND Shortages of personal protective equipment during the coronavirus disease 2019 (COVID-19) pandemic have led to the extended use or reuse of single-use respirators and surgical masks by frontline healthcare workers. The evidence base underpinning such practices warrants examination. OBJECTIVES To synthesize current guidance and systematic review evidence on extended use, reuse, or reprocessing of single-use surgical masks or filtering face-piece respirators. DATA SOURCES We used the World Health Organization, the European Centre for Disease Prevention and Control, the US Centers for Disease Control and Prevention, and Public Health England websites to identify guidance. We used Medline, PubMed, Epistemonikos, Cochrane Database, and preprint servers for systematic reviews. METHODS Two reviewers conducted screening and data extraction. The quality of included systematic reviews was appraised using AMSTAR-2. Findings were narratively synthesized. RESULTS In total, 6 guidance documents were identified. Levels of detail and consistency across documents varied. They included 4 high-quality systematic reviews: 3 focused on reprocessing (decontamination) of N95 respirators and 1 focused on reprocessing of surgical masks. Vaporized hydrogen peroxide and ultraviolet germicidal irradiation were highlighted as the most promising reprocessing methods, but evidence on the relative efficacy and safety of different methods was limited. We found no well-established methods for reprocessing respirators at scale. CONCLUSIONS Evidence on the impact of extended use and reuse of surgical masks and respirators is limited, and gaps and inconsistencies exist in current guidance. Where extended use or reuse is being practiced, healthcare organizations should ensure that policies and systems are in place to ensure these practices are carried out safely and in line with available guidance.
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Affiliation(s)
- Elaine C. Toomey
- School of Allied Health, University of Limerick, Limerick, Ireland
| | - Yvonne Conway
- Evidence Synthesis Ireland, School of Nursing and Midwifery, National University of Ireland, Galway, Ireland
| | - Chris Burton
- Academic Unit of Primary Medical Care, University of Sheffield, Sheffield, United Kingdom
| | - Simon Smith
- Canadian Standards Biological Aerosols Working Group, Canada
| | - Michael Smalle
- James Hardiman Library, National University of Ireland, Galway, Ireland
| | - Xin-Hui S. Chan
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Anil Adisesh
- Division of Occupational Medicine, Department of Medicine, University of Toronto and St Michael’s Hospital, Unity Health, Toronto, Canada
| | - Sarah Tanveer
- Department of Pharmaceutical Health Services Research, University of Maryland, Baltimore, Maryland, United States
| | - Lawrence Ross
- Department of Infectious Disease, Children’s Hospital of Los Angeles, Los Angeles, California, United States
| | - Iain Thomson
- Médecins Sans Frontières/Doctors without Borders, Geneva, Switzerland
| | - Declan Devane
- Evidence Synthesis Ireland, School of Nursing and Midwifery, National University of Ireland, Galway, Ireland
| | - Trish Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
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