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Roman RC, Faur CI, Gordan E, Văleanu M, Moldovan MA. Impact of the COVID-19 Pandemic on the Surgical Management of Head and Neck Non-Melanoma Skin Cancers in a Maxillofacial Center of Cluj-Napoca. J Clin Med 2024; 13:3934. [PMID: 38999499 PMCID: PMC11242733 DOI: 10.3390/jcm13133934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 06/14/2024] [Accepted: 07/03/2024] [Indexed: 07/14/2024] Open
Abstract
Background: The COVID-19 era has been a bleak period for both cancer and non-cancer patients, with delayed non-emergency treatments, such as for non-melanoma skin cancer (NMSC). This study aimed to evaluate how the treatment of NMSC patients was influenced by the management of the COVID-19 pandemic in an Eastern European Maxillofacial Surgery center. Materials and Methods: A total of 176 patients with a histopathological diagnosis of head and neck NMSC who were surgically treated in Cluj-Napoca Emergency County Hospital between 2016 and 2022 were included in this study, and divided into two samples, pre-pandemic (2016-2019) and COVID-19 (2020-2022) periods. Results: The pandemic presented with a decrease of 46.15% in patients' hospitalization, with wealthy and educated patients being prevalent. Even if the waiting time for surgery was increased, the stage of cancer and preference method for reconstruction did not differ. Despite the lower addressability of NMSC patients during the pandemic, there were no changes in surgical treatment. Conclusions: During COVID-19, the number of patients was reduced, with a longer waiting time for surgery, but without any changes in tumor stage and treatment preferences. However, the benefit of removing a cancer tumor is higher compared to the risk of developing COVID-19 infection during hospitalization.
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Affiliation(s)
- Rareș Călin Roman
- Department of Oral and Maxillofacial Surgery and Implantology, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Cosmin Ioan Faur
- Department of Oral Radiology, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Edina Gordan
- Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Mădălina Văleanu
- Department of Statistics, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Mădălina Anca Moldovan
- Department of Oral and Maxillofacial Surgery and Implantology, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
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Kim E, Park Y, Choi H. Factors influencing nurses' compliance related to the use of personal protective equipment during the COVID-19 pandemic: A descriptive cross-sectional study. Nurs Open 2024; 11:e2235. [PMID: 38958036 PMCID: PMC11220485 DOI: 10.1002/nop2.2235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 06/11/2024] [Accepted: 06/21/2024] [Indexed: 07/04/2024] Open
Abstract
AIM To determine how nurses' experiences with the coronavirus disease (COVID-19) pandemic affected their knowledge, awareness, and compliance related to the use of personal protective equipment (PPE) during the COVID-19 pandemic in South Korea. DESIGN A descriptive cross-sectional study. METHODS A total of 247 nurses in South Korea participated in this study between May 10 and 19, 2023. An online self-report questionnaire was used to collect data on demographic and occupational characteristics, COVID-19 experience, knowledge, awareness, and compliance related to the use of PPE. Factors affecting compliance were analysed using hierarchical multiple linear regression. RESULTS Mean age of the nurses was 31.92, and 94.3% were women. Most had a bachelor's degree or higher and the mean clinical experience as a nurse was 6.45 years. Knowledge of the use of PPE was 8.45 out of 10, awareness was 3.52 out of 5, and compliance was 4.28 out of 5. Knowledge and awareness were correlated with compliance related to PPE use. Awareness (β = 0.234, p < 0.001), knowledge (β = 0.218, p < 0.001), experience caring for COVID-19 patients (β = 0.234, p = 0.004), optional fourth dose vaccine (β = 0.150, p = 0.017), clinical experience (β = 0.140, p = 0.022), and COVID-19 infection control education (β = 0.115, p = 0.037) were found to have a significant impact on compliance. CONCLUSION During the COVID-19 pandemic, nurses' knowledge and awareness of PPE use was a crucial factor in compliance. factors such as clinical experience, experience in caring for COVID-19 patients, optional vaccination, and completion of COVID-19 education also influenced compliance. We hope that these factors can provide a basis for developing training programs for nurses to respond to future emerging infectious diseases.
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Affiliation(s)
- Eun‐Jin Kim
- Department of NursingSeoul National University HospitalSeoulRepublic of Korea
| | - Yeon‐Hwan Park
- College of Nursing, The Research Institute of Nursing ScienceSeoul National UniversitySeoulRepublic of Korea
| | - Hye‐Ran Choi
- Department of Clinical NursingUniversity of UlsanSeoulRepublic of Korea
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Liu Y, Tan F, Yao Q, Wang S, Zhou P, Sun Y, Li L. Contributing Risk Factors to Self-Contamination During the Process of Donning and Doffing Personal Protective Equipment. Disaster Med Public Health Prep 2024; 18:e19. [PMID: 38329113 DOI: 10.1017/dmp.2023.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
OBJECTIVE The goal of this study is to explore the risk factors associated with self-contamination points during personal protective equipment (PPE) donning and doffing among health care workers (HCWs). METHODS In total, 116 HCWs were randomly sampled and trained to don and doff the whole PPE set. We smeared the whole PPE set with the fluorescent powder. After each participant finished PPE doffing, the whole body was irradiated with ultraviolet light in order to detect contamination points and record the position and quantity. Sociodemographic characteristics and previous infection prevention control (IPC) training experience, among others, were collected by using electronic questionnaires. Poisson regression was used in identifying risk factors that are associated with the number of contamination points, and the relative risk (RR) and its 95% confidence interval (CI) were calculated. RESULTS About 78.5% of participants were contaminated. Ever training experience (RR = 0.37; 0.26, 0.52), clinical departments (RR = 0.67; 0.49, 0.93), body mass index (BMI) (RR = 1.09; 1.01, 1.18), and shoulder width (RR = 1.07; 1.01, 1.13) were associated with the number of contamination points. CONCLUSIONS Previous IPC training experience, department types, BMI, and shoulder width were associated with self-contamination points after the PPE was removed.
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Affiliation(s)
- Yunyun Liu
- Department of Infection Control and Management, The Second Affiliated Hospital of Soochow University, Suzhou, PR China
- School of Public Health, Zhejiang University, Hangzhou, PR China
| | - Fengling Tan
- Department of Infection Control and Management, The Second Affiliated Hospital of Soochow University, Suzhou, PR China
| | - Qiu Yao
- Department of Infection Control and Management, The Second Affiliated Hospital of Soochow University, Suzhou, PR China
| | - Shuqi Wang
- Department of Infection Control and Management, The Second Affiliated Hospital of Soochow University, Suzhou, PR China
| | - Ping Zhou
- Department of Infection Control and Management, The Second Affiliated Hospital of Soochow University, Suzhou, PR China
| | - Yihui Sun
- Department of Infection Control and Management, The Second Affiliated Hospital of Soochow University, Suzhou, PR China
| | - Liubing Li
- Department of Infection Control and Management, The Second Affiliated Hospital of Soochow University, Suzhou, PR China
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Jongdeepaisal M, Chunekamrai P, Maude RR, Maude RJ. Risks and challenges in COVID-19 infection prevention and control in a hospital setting: Perspectives of healthcare workers in Thailand. PLoS One 2023; 18:e0267996. [PMID: 38113209 PMCID: PMC10729973 DOI: 10.1371/journal.pone.0267996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 10/16/2023] [Indexed: 12/21/2023] Open
Abstract
INTRODUCTION In hospital settings, awareness of, and responsiveness to, COVID-19 are crucial to reducing the risk of transmission among healthcare workers and protecting them from infection. Healthcare professionals can offer insights into the practicalities of infection prevention and control (IPC) measures and on how the guideline aimed to ensure adherence to IPC, including use of personal protective equipment (PPE), could best be delivered during the pandemic. To inform future development of such guideline, this study examined the perspectives of healthcare professionals working in a large hospital during the pandemic regarding their infection risks, the barriers or facilitators to implementing their tasks and the IPC measures to protect their safety and health and of their patients. METHOD In-depth interviews were conducted with 23 hospital staff coming into contact with possible or confirmed cases of COVID-19, or were at potential risk of contracting the disease, including medical doctors, nurses, virology laboratory staff, and non-medical workers. This qualitative study was carried out as part of a knowledge, attitudes and practice survey to prevent COVID-19 transmission at Ramathibodi Hospital in Thailand. We used content analysis to categorize and code transcribed interview data. Existing IPC guideline and evidence synthesis of organisational, environmental, and individual factors to IPC adherence among healthcare workers were used to guide the development of the interview questions and analysis. FINDING Factors identified as influencing the use of, and adherence to, prevention measures among healthcare workers included knowledge, perceived risk and concerns about the infection. The extent to which these factors were influential varied based on the medical procedures, among other features, that individuals were assigned to perform in the hospital setting. Beyond availability of PPE and physical safety, ease of and readiness to utilize the equipment and implement IPC measures were crucial to motivate hospital staff to follow the practice guideline. Having a ventilated outdoor space for screening and testing, and interaction through mobile technology, facilitated the performance of healthcare workers while reducing the transmission risk for staff and patients. Adequate training, demonstration of guided practices, and streamlined communications are crucial organisational and management support factors to encourage appropriate use of, and adherence to, implementation of infection prevention and control measures among healthcare workers. CONCLUSION This finding could help inform the development of recommendations to optimise compliance with appropriate use of these measures, and to improve guidance to reduce HCW's risk of disease in hospital settings. Further study should explore the perceptions and experiences of health professionals in smaller health facilities and community-based workers during the pandemic, particularly in resource-limited settings.
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Affiliation(s)
- Monnaphat Jongdeepaisal
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Puri Chunekamrai
- Faculty of Medicine, Srinakharinwirot University, Nakhonnayok, Thailand
- Faculty of Medicine and Health Science, University of Nottingham, Nottingham, United Kingdom
| | - Rapeephan Rattanawongnara Maude
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Richard James Maude
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Harvard TH Chan School of Public Health, Harvard University, Boston, MA, United States of America
- The Open University, Milton Keynes, United Kingdom
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Zungu M, Yassi A, Ramodike J, Voyi K, Lockhart K, Jones D, Kgalamono S, Thunzi N, Spiegel J. Systematizing Information Use to Address Determinants of Health Worker Health in South Africa: A Cross-sectional Mixed Method Study. Saf Health Work 2023; 14:368-374. [PMID: 38187209 PMCID: PMC10770277 DOI: 10.1016/j.shaw.2023.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/20/2023] [Accepted: 10/24/2023] [Indexed: 01/09/2024] Open
Abstract
Background Recognizing that access to safe and healthy working conditions is a human right, the World Health Organization (WHO) calls for specific occupational safety and health (OSH) programs for health workers (HWs). The WHO health systems' building blocks, and the International Labour Organization (ILO), highlight the importance of information as part of effective systems. This study examined how OSH stakeholders access, use, and value an occupational health information system (OHIS). Methods A cross-sectional survey of OSH stakeholders was conducted as part of a larger quasi experimental study in four teaching hospitals. The study hospitals and participants were purposefully selected and data collected using a modified questionnaire with both closed and open-ended questions. Quantitative analysis was conducted and themes identified for qualitative analysis. Ethics approval was provided by the University of Pretoria and University of British Columbia. Results There were 71 participants comprised of hospital managers, health and safety representatives, trade unions representatives and OSH professionals. At least 42% reported poor accessibility and poor timeliness of OHIS for decision-making. Only 50% had access to computers and 27% reported poor computer skills. When existing, OHIS was poorly organized and needed upgrades, with 85% reporting the need for significant reforms. Only 45% reported use of OHIS for decision-making in their OSH role. Conclusion Given the gap in access and utilization of information needed to protect worker's rights to a safe and healthy workplace, more attention is warranted to OHIS development and use as well as education and training in South Africa and beyond.
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Affiliation(s)
- Muzimkhulu Zungu
- National Institute for Occupational Health, A Division of the National Health Laboratory Service, Johannesburg, South Africa
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Annalee Yassi
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jonathan Ramodike
- National Institute for Occupational Health, A Division of the National Health Laboratory Service, Johannesburg, South Africa
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Kuku Voyi
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Karen Lockhart
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - David Jones
- National Institute for Occupational Health, A Division of the National Health Laboratory Service, Johannesburg, South Africa
| | - Spo Kgalamono
- National Institute for Occupational Health, A Division of the National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nkululeko Thunzi
- National Institute for Occupational Health, A Division of the National Health Laboratory Service, Johannesburg, South Africa
| | - Jerry Spiegel
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
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Brat GA, Hersey S, Chhabra K, Gupta A, Scott J. Protecting Surgical Teams During the COVID-19 Outbreak: A Narrative Review and Clinical Considerations. Ann Surg 2023; 278:e957-e959. [PMID: 32379080 PMCID: PMC7224623 DOI: 10.1097/sla.0000000000003926] [Citation(s) in RCA: 62] [Impact Index Per Article: 62.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Gabriel A Brat
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA
| | - Sean Hersey
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA
| | - Karan Chhabra
- National Clinician Scholars Program at the Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI
- Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI
- Department of Surgery, Brigham and Women's Hospital, Boston, MA
| | - Alok Gupta
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA
| | - John Scott
- Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI
- Department of Surgery, University of Michigan, Ann Arbor, MI
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Tsandila-Kalakou F, Wiig S, Aase K. Factors contributing to healthcare professionals' adaptive capacity with hospital standardization: a scoping review. BMC Health Serv Res 2023; 23:799. [PMID: 37496014 PMCID: PMC10369840 DOI: 10.1186/s12913-023-09698-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 06/13/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Certain factors contribute to healthcare professionals' adaptive capacities towards risks, challenges, and changes such as attitudes, stress, motivation, cognitive capacity, group norms, and teamwork. However, there is limited evidence as to factors that contribute to healthcare professionals' adaptive capacity towards hospital standardization. This scoping review aimed to identify and map the factors contributing to healthcare professionals' adaptive capacity with hospital standardization. METHODS Scoping review methodology was used. We searched six academic databases to September 2021 for peer-reviewed articles in English. We also reviewed grey literature sources and the reference lists of included studies. Quantitative and qualitative studies were included if they focused on factors influencing how healthcare professionals adapted towards hospital standardization such as guidelines, procedures, and strategies linked to clinical practice. Two researchers conducted a three-stage screening process and extracted data on study characteristics, hospital standardization practices and factors contributing to healthcare professionals' adaptive capacity. Study quality was not assessed. RESULTS A total of 57 studies were included. Factors contributing to healthcare professionals' adaptive capacity were identified in numerous standardization practices ranging from hand hygiene and personal protective equipment to clinical guidelines or protocols on for example asthma, pneumonia, antimicrobial prophylaxis, or cancer. The factors were grouped in eight categories: (1) psychological and emotional, (2) cognitive, (3) motivational, (4) knowledge and experience, (5) professional role, (6) risk management, (7) patient and family, and (8) work relationships. This combination of individual and group/social factors decided whether healthcare professionals complied with or adapted hospital standardization efforts. Contextual factors were identified related to guideline system, cultural norms, leadership support, physical environment, time, and workload. CONCLUSION The literature on healthcare professionals' adaptive capacity towards hospital standardization is varied and reflect different reasons for compliance or non-compliance to rules, guidelines, and protocols. The knowledge of individual and group/social factors and the role of contextual factors should be used by hospitals to improve standardization practices through educational efforts, individualised training and motivational support. The influence of patient and family factors on healthcare professionals' adaptive capacity should be investigated. TRIAL REGISTRATION Open Science Framework ( https://osf.io/ev7az ) https://doi.org/10.17605/OSF.IO/EV7AZ .
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Affiliation(s)
- Foteini Tsandila-Kalakou
- Centre for Resilience in Healthcare SHARE, Faculty of Health Sciences, University of Stavanger, N-4036, Stavanger, Norway.
| | - Siri Wiig
- Centre for Resilience in Healthcare SHARE, Faculty of Health Sciences, University of Stavanger, N-4036, Stavanger, Norway
| | - Karina Aase
- Centre for Resilience in Healthcare SHARE, Faculty of Health Sciences, University of Stavanger, N-4036, Stavanger, Norway
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Staying proper with your personal protective equipment: How to don and doff. J Clin Anesth 2023; 86:111057. [PMID: 36696834 PMCID: PMC9869806 DOI: 10.1016/j.jclinane.2023.111057] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 01/09/2023] [Accepted: 01/15/2023] [Indexed: 01/24/2023]
Abstract
INTRODUCTION The global COVID-19 pandemic highlighted the importance of protecting frontline healthcare workers from novel respiratory infections while also exposing the limited instruction that medical students receive on proper donning of personal protective equipment (PPE) and more importantly the safe doffing of contaminated PPE to minimize their risk of nosocomial infection. The best methods of providing this kind of instruction have not yet been determined. METHODS Anesthesiology interns and CA-1 residents were trained on proper PPE donning and doffing for AGPs using a methodology based on Miller's pyramid and following a "knows-knows how-shows-does" progression. Participants donned PPE without instruction and were sprayed with Glo Germ® to identify areas of contamination, after which they received both video and in-person instruction on best practices for donning and doffing PPE for AGPs. Following instruction, they again donned PPE and were sprayed with Glo Germ® to identify areas of contamination. RESULTS 54 participants completed the study. Before training, overall donning compliance was 60% and overall doffing compliance was 48%. Overall, 70% were contaminated after PPE doffing, with 46% having multiple sites of contamination. After training, donning compliance increased by nearly 30% (P < 0.001), doffing compliance increased by over 20% (P < 0.001), and overall contamination decreased by nearly 30% (P = 0.029), with multiple-site contamination decreasing to only 6% (P = 0.013). DISCUSSION While best methods for providing instruction regarding topics such as PPE donning and doffing have not yet been determined, we have demonstrated that the underlying knowledge base from medical school regarding proper donning and doffing for respiratory isolation is insufficient for preventing self-contamination, and that Miller's pyramid-based training using both video and in-person instruction combined with task execution by learners can improve compliance with PPE donning and doffing protocols and more importantly decrease skin contamination among a group of early training anesthesiology residents.
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George J, Shafqat N, Verma R, Patidar AB. Factors Influencing Compliance With Personal Protective Equipment (PPE) Use Among Healthcare Workers. Cureus 2023; 15:e35269. [PMID: 36968930 PMCID: PMC10035759 DOI: 10.7759/cureus.35269] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2023] [Indexed: 02/23/2023] Open
Abstract
Introduction Accurate and appropriate use of personal protective equipment (PPE) is an integral component in infection prevention and control policy to ensure healthcare workers' safety. Poor compliance with personal protective behaviours and inconsistent use of PPE has been identified as the main cause of transmission of nosocomial infections in healthcare settings and this reduced compliance is linked to many individual, environmental, and organizational factors. Therefore, the current study was carried out to identify various factors influencing PPE use among healthcare workers. Materials and methods A descriptive cross-sectional survey has been carried out among healthcare workers selected from two selected tertiary care hospitals in central India. Data on compliance with PPE and factors influencing compliance were collected using a three-point rating scale and structured questionnaire. Quantile regression was performed to identify the factors associated with adherence to PPE use among healthcare workers. Results The median score for compliance with PPE use among healthcare workers was found to be 22 with an interquartile range (IQR) of 16-24. The multiple quantile regression found that variables such as occupation (p<0.001), institutional policy (p=0.003), quality of PPE (p=0.002), availability of PPE (p<0.001), and improper size (p=0.042) were significantly associated with PPE compliance by healthcare workers. Conclusion The current study highlights the importance of taking adequate measures by the government and healthcare organizations to eliminate various factors hindering PPE compliance levels among healthcare workers to ensure consistent use of PPE by healthcare workers to safeguard themselves and patients.
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Affiliation(s)
- Jisa George
- Medical Surgical Nursing (Oncology Nursing), All India Institute of Medical Sciences, Bhopal, Bhopal, IND
| | - Naseema Shafqat
- Obstetrics & Gynaecology, All India Institute of Medical Sciences, Bhopal, Bhopal, IND
| | - Ranjana Verma
- Nursing, All India Institute of Medical Sciences, Bhopal, Bhopal, IND
| | - Anurag Bhai Patidar
- Medical Surgical Nursing (Cardiothoracic and Vascular Nursing), All India Institute of Medical Sciences, Bhopal, Bhopal, IND
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Wang SJ, Chang YC, Hu WY, Shih YH, Yang CH. Improving Patient Safety Culture During the COVID-19 Pandemic in Taiwan. Front Public Health 2022; 10:889870. [PMID: 35903386 PMCID: PMC9315290 DOI: 10.3389/fpubh.2022.889870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 06/14/2022] [Indexed: 11/13/2022] Open
Abstract
Background and AimPatient safety culture attitude is strongly linked to patient safety outcomes. Since the onset of the COVID-19 pandemic in early 2020, pandemic prevention has become the priority of hospital staff. However, few studies have explored the changes in patient safety culture among hospital staff that have occurred during the pandemic. The present study compared the safety attitudes, emotional exhaustion (EE), and work–life balance (WLB) of hospital staff in the early (2020) and late (2021) stages of the COVID-19 pandemic and explored the effects of EE and WLB on patient safety attitudes in Taiwan.Materials and MethodsIn this cross-sectional study, the Joint Commission of Taiwan Patient Safety Culture Survey, including the six-dimension Safety Attitudes Questionnaire (SAQ) and EE and WLB scales, were used for data collection.ResultsThis study included a total of 706 hospital employees from a district hospital in Taipei City. The respondents' scores in each SAQ sub-dimension (except for stress recognition) increased non-significantly from 2020 to 2021, whereas their EE and WLB scores improved significantly (P < 0.05 and P < 0.01, respectively). The results of hierarchical regression analysis indicated that although a respondent's WLB score could predict their scores in each SAQ sub-dimension (except for stress recognition), EE was the most important factor affecting the respondents' attitudes toward patient safety culture during the later stage of the COVID-19 pandemic.ConclusionIn the post-pandemic, employees' attitudes toward safety climate, job satisfaction, and perception of Management changed from negative to positive. Additionally, both EE and WLB are key factors influencing patient safety culture. The present study can be used as a reference for hospital managers to formulate crisis response strategies.
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Affiliation(s)
- Shu Jung Wang
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yun Chen Chang
- School of Nursing and Graduate Institute of Nursing, China Medical University, Taichung, Taiwan
- *Correspondence: Yun Chen Chang
| | - Wen Yu Hu
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
- Wen Yu Hu
| | - Yang Hsin Shih
- Superintendent Office, Central Clinic & Hospital, Taipei, Taiwan
| | - Ching Hsu Yang
- Department of Emergency Medicine, Hsinchu Mackay Memorial Hospital, Hsinchu, Taiwan
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Thermal discomfort caused by personal protective equipment in healthcare workers during the delta COVID-19 pandemic in Guangzhou, China: A case study. CASE STUDIES IN THERMAL ENGINEERING 2022; 34:101971. [PMCID: PMC8983079 DOI: 10.1016/j.csite.2022.101971] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 02/10/2022] [Accepted: 03/23/2022] [Indexed: 06/17/2023]
Abstract
Background In contrast to the previous COVID-19 pandemic, most frontline healthcare workers (HCWs) worked on residents’ nucleic acid tests in outdoor environments, instead of taking care of COVID-19 patients in hospitals during the hot summer of 2021. Therefore, it is necessary to investigate the prevalence and characteristics of thermal discomfort caused by personal protective equipment (PPE). Methods A cross-sectional survey was conducted online at hospitals from 11 administrative regions of Guangzhou for the assessment of thermal discomfort among HCWs from June 12–16, 2021. Univariate and logistic regression analyses were used to explore the risk factors associated with thermal discomfort. Results A total of 3658 valid responses were collected. The thermal discomfort and humid discomfort levels increased from 2.91 ± 1.19 to 3.61 ± 0.72 and from 0.98 ± 1.36 to 3.06 ± 1.1 after wearing PPE, respectively (p < 0.01). Feelings of being “very hot” and “uncomfortably humid” were the most influenced by wearing PPE, increasing from 31% to 69.1% and from 9.1% to 45.7%, respectively. There were significant increases in the thermal discomfort level (3.75 ± 0.57 vs. 3.33 ± 0.89, p < 0.01) and the humid discomfort level (3.33 ± 0.95 vs. 2.54 ± 1.19, p < 0.01) between the comfortable group and uncomfortable group, accompanied by similar patterns in the feelings of being “very hot” and “uncomfortably humid.” For general thermal-related symptoms, the most common new-onset symptom was profuse sweating (80%) followed by labored breathing (55.2%) and excessive dehydration (46.8%), while facial swelling (74%) was associated with local thermal-related symptoms, followed by hand maceration erosion (56.7%) and visual impairment (49.3%). In the multivariate analysis, the apparent temperature of the environment (≥35 °C), working in negative-pressure ambulances and outdoors, continuing to wear PPE for 1–3 days during this period, being aged >40 years, and previous experiences fighting the pandemic were independently associated with thermal discomfort (p < 0.01). Immediately after PPE removal, 32.3% of respondents considered drinking ice water/another drink, followed by 25% shortening the duration of wearing PPE and 19.1% going to the toilet. A large proportion of the participants looked forward to modifications to the material of the suit (72.9%) and mask (53.4%) for heat dissipation and dehumidification, as well as anti-fogging goggles (60.2%), adding hydration equipment to PPE (53.4%), and using soft materials to reduce pressure (40%). Conclusions Thermal discomfort is common and degrades health physiology related to PPE in summer environments. This suggests that modifications to the current working practices are urgently required to improve the resilience of HCWs and enhance their services during pandemics.
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Qureshi M, Chughtai A, Seale H. Supporting the Delivery of Infection Prevention and Control Training to Healthcare Workers: Insights from the Sector. Healthcare (Basel) 2022; 10:healthcare10050936. [PMID: 35628072 PMCID: PMC9141703 DOI: 10.3390/healthcare10050936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/13/2022] [Accepted: 05/16/2022] [Indexed: 11/25/2022] Open
Abstract
Infection prevention and control (IPC) cannot be implemented without healthcare workers (HCWs) being properly trained and competent. The provision of training is essential, yet there is a gap in our understanding of the factors impacting the implementation of IPC training. This paper reports the results from in-depth interviews that explored the current landscape around IPC training delivered across low-, middle-, and high-income countries. Semi-structured interviews were conducted with the key stakeholders involved in policymaking or IPC implementation in Saudi Arabia, Pakistan, India, Indonesia, the Philippines, and Australia. Although the training was mandated for many HCWs, participants indicated that only some training elements were mandatory. Participants spoke about covering various topics, but those in low-resource settings spoke about the challenges of delivering training. Classroom-based training dominated, but online delivery modes were also used in some locations. Whilst HCW’s training was postulated to have improved during the COVID-19 pandemic, the capacity to deliver training did not improve in some settings. More research is needed to establish the essential elements that could underpin the development of training packages.
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Haas EJ, Casey ML, Furek A, Moore SM. EXPLORING PERCEPTIONS of U.S. Healthcare & Public Safety Workers at the Onset of the COVID-19 Pandemic. PROFESSIONAL SAFETY 2022; 67:16-21. [PMID: 37200832 PMCID: PMC10191144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Affiliation(s)
- Emily J Haas
- NIOSH's National Personal Protective Technology Laboratory (NPPTL)
| | - Megan L Casey
- NIOSH's National Personal Protective Technology Laboratory (NPPTL)
| | - Alexa Furek
- NIOSH's National Personal Protective Technology Laboratory (NPPTL)
| | - Susan M Moore
- NIOSH's National Personal Protective Technology Laboratory (NPPTL)
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Gilbert GL, Kerridge I. What is needed to sustain improvements in hospital practices post-COVID-19? a qualitative study of interprofessional dissonance in hospital infection prevention and control. BMC Health Serv Res 2022; 22:504. [PMID: 35421985 PMCID: PMC9009283 DOI: 10.1186/s12913-022-07801-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 03/16/2022] [Indexed: 11/11/2022] Open
Abstract
Background Hospital infection prevention and control (IPC) depends on consistent practice to achieve its purpose. Standard precautions are embedded in modern healthcare policies, but not uniformly observed by all clinicians. Well-documented differences in attitudes to IPC, between doctors and nurses, contribute to suboptimal IPC practices and persistence of preventable healthcare-associated infections. The COVID-19 pandemic has seriously affected healthcare professionals’ work-practices, lives and health and increased awareness and observance of IPC. Successful transition of health services to a ‘post-COVID-19’ future, will depend on sustainable integration of lessons learnt into routine practice. Methods The aim of this pre-COVID-19 qualitative study was to investigate factors influencing doctors’ IPC attitudes and practices, whether they differ from those of nurses and, if so, how this affects interprofessional relationships. We hypothesised that better understanding would guide new strategies to achieve more effective IPC. We interviewed 26 senior clinicians (16 doctors and 10 nurses) from a range of specialties, at a large Australian tertiary hospital. Interview transcripts were reviewed iteratively, and themes identified inductively, using reflexive thematic analysis. Results Participants from both professions painted clichéd portraits of ‘typical’ doctors and nurses and recounted unflattering anecdotes of their IPC behaviours. Doctors were described as self-directed and often unaware or disdainful of IPC rules; while nurses were portrayed as slavishly following rules, ostensibly to protect patients, irrespective of risk or evidence. Many participants believed that doctors object to being reminded of IPC requirements by nurses, despite many senior doctors having limited knowledge of correct IPC practice. Overall, participants’ comments suggested that the ‘doctor-nurse game’—described in the 1960s, to exemplify the complex power disparity between professions—is still in play, despite changes in both professions, in the interim. Conclusions The results suggest that interprofessional differences and inconsistencies constrain IPC practice improvement. IPC inconsistencies and failures can be catastrophic, but the common threat of COVID-19 has promoted focus and unity. Appropriate implementation of IPC policies should be context-specific and respect the needs and expertise of all stakeholders. We propose an ethical framework to guide interprofessional collaboration in establishing a path towards sustained improvements in IPC and bio-preparedness.
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Impact of Face-to-Face Teaching in Addition to Electronic Learning on Personal Protective Equipment Doffing Proficiency in Student Paramedics: Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19053077. [PMID: 35270768 PMCID: PMC8910255 DOI: 10.3390/ijerph19053077] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 03/02/2022] [Accepted: 03/03/2022] [Indexed: 01/04/2023]
Abstract
Personal protective equipment doffing is a complex procedure that needs to be adequately performed to prevent health care worker contamination. During the COVID-19 pandemic, junior health care workers and students of different health care professions who had not been trained to carry out such procedures were often called upon to take care of infected patients. To limit direct contact, distance teaching interventions were used, but different trials found that their impact was rather limited. We therefore designed and carried out a randomized controlled trial assessing the impact of adding a face-to-face intervention using Peyton's four-step approach to a gamified e-learning module. Sixty-five student paramedics participated in this study. The proportion of doffing sequences correctly performed was higher in the blended learning group (33.3% (95%CI 18.0 to 51.8) versus 9.7% (95%CI 2.0 to 25.8), p = 0.03). Moreover, knowledge and skill retention four to eight weeks after the teaching intervention were also higher in this group. Even though this study supports the use of a blended learning approach to teach doffing sequences, the low number of student paramedics able to adequately perform this procedure supports the need for iterative training sessions. Further studies should determine how often such sessions should be carried out.
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Skinner C, Ablir L, Bloom T, Fujimoto S, Rozenfeld Y, Leung P. Effects of Safety Zone Implementation on Perceptions of Safety and Well-being When Caring for COVID-19 Patients. Am J Crit Care 2022; 31:104-110. [PMID: 35028660 DOI: 10.4037/ajcc2022633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND In March 2020, the caseload of patients positive for COVID-19 in hospitals began increasing rapidly, creating fear and anxiety among health care workers and concern about supplies of personal protective equipment. OBJECTIVES To determine if implementing safety zones improves the perceptions of safety, well-being, workflow, and teamwork among hospital staff caring for patients during a pandemic. METHODS A safety zone process was implemented to designate levels of contamination risk and appropriate activities for certain areas. Zones were designated as hot (highest risk), warm (moderate risk), or cold (lowest risk). Caregivers working in the safety zones were invited to complete a survey regarding their perceptions of safety, caregiver well-being, workflow, and teamwork. Each question was asked twice to obtain caregiver opinions for the periods before and after implementation of the zones. RESULTS Significant improvements were seen in perceptions of caregiver safety (P < .001) and collaboration within a multidisciplinary staff (P < .001). Significant reductions in perceived staff fatigue (P = .03), perceived cross contamination (P < .001), anxiety (P < .001), and fear of exposure (P < .001) were also seen. Teamwork (P = .23) and workflow (P = .69) were not significantly affected. CONCLUSIONS Safety zone implementation improved caregivers' perceptions of their safety, their well-being, and collaboration within the multidisciplinary staff but did not improve their perceptions of teamwork or workflow.
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Affiliation(s)
- Claudia Skinner
- Claudia Skinner is director of clinical excellence, St Jude Medical Center, Fullerton, California
| | - Lilian Ablir
- Lilian Ablir is an infection prevention RN specialist, St Jude Medical Center
| | - Todd Bloom
- Todd Bloom is an infection preventionist specialist, St Jude Medical Center
| | - Stacie Fujimoto
- Stacie Fujimoto is an infection prevention RN specialist, St Jude Medical Center
| | - Yelena Rozenfeld
- Yelena Rozenfeld is director of advanced analytics and data science, St Jude Medical Center
| | - Peggy Leung
- Peggy Leung is an infection prevention RN specialist, St Jude Medical Center
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Burnell K, Robbins M, Kulali S, Wells EM. Prevalence and predictors of mask use on a large US university campus during the COVID-19 pandemic: A brief report. Am J Infect Control 2022; 50:349-351. [PMID: 34883161 PMCID: PMC8648375 DOI: 10.1016/j.ajic.2021.11.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 01/16/2023]
Abstract
This observational study was conducted to determine the prevalence and correlates of wearing masks at a large Midwestern US university during the COVID-19 pandemic. A total of 7,237 individuals were observed over 24 hours. Overall mask use prevalence was 90.6% (95% confidence interval: 89.9, 91.2); mask use was significantly associated with being indoors (vs outdoors), female (vs male), and at the athletic center (vs the student union).
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Affiliation(s)
- Kenneth Burnell
- School of Health Sciences, Purdue University, West Lafayette, IN, USA
| | - Meredith Robbins
- School of Health Sciences, Purdue University, West Lafayette, IN, USA
| | - Sharon Kulali
- Department of Biochemistry, Purdue University, West Lafayette, IN, USA,Department of Public Health, Purdue University, West Lafayette, IN, USA
| | - Ellen M. Wells
- School of Health Sciences, Purdue University, West Lafayette, IN, USA,Department of Public Health, Purdue University, West Lafayette, IN, USA,Address correspondence to Ellen M. Wells, PhD, MPH, School of Health Sciences, Purdue University, 550 Stadium Mall Drive, West Lafayette, IN 47906, USA
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Driscoll B, Evans D. Nursing Infection Control Practice Adherence, Related Barriers, and Methods of Intervention. J Nurs Adm 2022; 52:132-137. [PMID: 35170577 DOI: 10.1097/nna.0000000000001120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aims to evaluate the level of infection control (IC) practice adherence and related barriers among nursing staff at a US academic medical center. Furthermore, it surveys staff to identify interventions to improve adherence with IC practices. BACKGROUND Infectious disease emergencies have exposed healthcare workers to increased infection risk. This study aims to explore IC practice adherence in the tertiary hospital setting and further investigate the personal protective equipment (PPE) champion role as a method to boost adherence. METHODS This descriptive quality improvement study includes 2 parts: 1) A PPE champion role was piloted to support healthcare worker adherence to IC practices; and 2) a survey was disseminated to nursing staff to identify the perceptions of their own and coworkers' adherence to IC practices as well as suggestions for improvement. RESULTS Twenty-six percent of PPE champion observations found nursing staff nonadherent with IC practices and policies. Barriers included knowledge deficit (38%), lack of motivation (38%), time constraints (21%), and lack of supplies (3%). Two hundred sixty-four RNs and nurse technicians responded to the IC survey. Nursing staff rated their IC adherence higher than observed by their peers. Perceived barriers to adherence included the lack of supplies (53%), knowledge of proper technique (41%), time constraints (35%), and motivation (5%). Staff recommended using PPE champions (52%) and mandating supervised practice of essential skills (48%) to increase adherence. CONCLUSIONS Nursing staff reported barriers related to their knowledge of proper technique and suggested interventions including supervised practice of critical skills. It seems that the PPE champion role is a popular method to boost IC practice adherence that can be implemented during pandemic and nonpandemic environments at minimal cost.
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Affiliation(s)
- Brendan Driscoll
- Author Affiliations : Project Manager (Mr Driscoll) and Associate Chief Nursing Officer (Ms Evans), University of Illinois Hospital and Health Sciences System, Chicago
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19
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Balmaks R, Grāmatniece A, Vilde A, Ļuļļa M, Dumpis U, Gross IT, Šlēziņa I. A Simulation-Based Failure Mode Analysis of SARS-CoV-2 Infection Control and Prevention in Emergency Departments. Simul Healthc 2021; 16:386-391. [PMID: 32910105 DOI: 10.1097/sih.0000000000000506] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2, the causative agent of coronavirus disease 2019 (COVID-19)] outbreak has been declared a global pandemic by the World Health Organization. The COVID-19 pandemic has highlighted problems of sustainable infection prevention and control measures worldwide, particularly the emerging issues with an insufficient supply of personal protective equipment. The aim of this study was to provide an action plan for mitigation of occupational hazards and nosocomial spread of SARS-CoV-2 through a failure mode analysis based on observations during in situ simulations. METHODS A multicenter, cross-sectional, observational, simulation-based study was performed in Latvia from March 2 to 26, 2020. This study was conducted at 7 hospitals affiliated with Riga Stradiņš University. The presentation of a COVID-19 patient was simulated with an in situ simulations, followed by a structured debrief. Healthcare Failure Modes and Effects Analysis is a tool for conducting a systematic, proactive analysis of a process in which harm may occur. We used Healthcare Failure Modes and Effects Analysis to analyze performance gaps and systemic issues. RESULTS A total of 67 healthcare workers from 7 hospitals participated in the study (range = 4-17). A total of 32 observed failure modes were rated using a risk matrix. Twenty-seven failure modes (84.4%) were classified as either medium or high risk or were single-point weaknesses, hence evaluated for action type and action; 11 (40.7%) were related to organizational, 11 (40.7%) to individual, and 5 (18.5%) to environmental factors. CONCLUSIONS Simulation-based failure mode analysis helped us identify the risks related to the preparedness of the healthcare workers and emergency departments for the COVID-19 pandemic in Latvia. We believe that this approach can be implemented to assess and maintain readiness for the outbreaks of emerging infectious diseases in the future.
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Affiliation(s)
- Reinis Balmaks
- From the Medical Education Technology Centre (R.B., M.L. IŠ), and Department of Clinical Skills and Medical Technology (R.B.), Riga Stradiņš University; Department of Internal Medicine and Infectious Diseases (A.G., A.V., U.D.), University of Latvia; Department of Infection Prevention and Control (A.G., A.V., U.D.), Pauls Stradiņš Clinical University Hospital, Riga, Latvia; and Department of Pediatric Emergency Medicine (I.T.G.), Yale University School of Medicine, New Haven, CT
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Hubert P, Abdel Hadi S, Mojzisch A, Häusser JA. The effects of organizational climate on adherence to guidelines for COVID-19 prevention. Soc Sci Med 2021; 292:114622. [PMID: 34871853 PMCID: PMC8629794 DOI: 10.1016/j.socscimed.2021.114622] [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: 06/28/2021] [Revised: 11/24/2021] [Accepted: 11/28/2021] [Indexed: 12/30/2022]
Abstract
Background During the current pandemic, it is essential that individuals follow the COVID-19 guidelines (e.g., physical distancing) to slow down the spread of the new coronavirus. Organizations generally affect their employees' behavior in a wide range of areas, but can they also affect how strictly employees adhere to COVID-19 guidelines? To answer this question, the present study examined the impact of an organizational climate for preventing infectious diseases (OCID) on employees' adherence to COVID-19 guidelines both at work and in their private life. Method We used a two-wave longitudinal online survey with a final sample of N = 304 UK employees. Results Our results show that OCID during the first lockdown in the UK in April 2020 (T1) was positively linked to adherence to COVID-19 guidelines at work one month later (T2). We also found a relationship between OCID (T1) and adherence to guidelines in one's private life (T2) that was mediated through adherence to guidelines at work (T2). Conclusion These results highlight the pivotal role organizations play in mitigating the COVID-19 pandemic.
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Affiliation(s)
- Philipp Hubert
- Department of Psychology, Justus-Liebig-University Giessen, 35394 Giessen, Germany.
| | - Sascha Abdel Hadi
- Department of Psychology, Justus-Liebig-University Giessen, 35394 Giessen, Germany
| | - Andreas Mojzisch
- Institute of Psychology, University of Hildesheim, 31141 Hildesheim, Germany
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Sanitary Aspects of Countering the Spread of COVID-19 in Russia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312456. [PMID: 34886181 PMCID: PMC8657366 DOI: 10.3390/ijerph182312456] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 11/22/2021] [Indexed: 12/23/2022]
Abstract
Due to the conditions that cause the spread of COVID-19, national health systems worldwide are under severe strain. Most countries face similar difficulties such as a lack of medical personnel and equipment and tools for diagnosis and treatment, overrun hospitals, and forced restriction of planned medical care. Public authorities in healthcare take the following measures due to increased pressure: limiting the transmission and spread of the virus (social distancing and quarantine), mobilizing medical personnel, ensuring the availability of diagnostic and treatment tools, and providing a sufficient number of premises, which are not always suitable for the provision of medical care (buildings and structures). To date, the stages of management decision-making to counter coronavirus infection and the risk of COVID-19 transmission at various facilities have not been analyzed. The authors propose a methodology for assessing the COVID-19 transmission risk at various social and transport facilities. A survey of 1325 respondents from Moscow demonstrated the most significant risk factors, such as visitation avoidance, infection risk, and facemask wearing. Risk categories were determined and objects classified according to high, medium, and low-risk levels.
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Galanis P, Vraka I, Fragkou D, Bilali A, Kaitelidou D. Impact of personal protective equipment use on health care workers' physical health during the COVID-19 pandemic: A systematic review and meta-analysis. Am J Infect Control 2021; 49:1305-1315. [PMID: 33965463 PMCID: PMC8102386 DOI: 10.1016/j.ajic.2021.04.084] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 01/29/2023]
Abstract
BACKGROUND During the coronavirus disease 2019 (COVID-19) pandemic, health care workers (HCWs) have been obliged to wear personal protective equipment (PPE). We assessed the impact of PPE use on HCWs' physical health and we examined factors related to a greater risk of adverse events due to PPE use. METHODS We applied the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and the Cochrane criteria. We searched PubMed, Medline, Scopus, ProQuest, CINAHL, and medRxiv from January 1, 2020 to December 27, 2020. RESULTS Our review included 14 studies with 11,746 HCWs. The estimated overall prevalence of adverse events among HCWs was 78% with a range from 42.8% to 95.1% among studies. Among others, the following factors were related to the risk of adverse events among HCWs due to PPE use: obesity, diabetes mellitus, smoking, pre-existing headache, longer duration of shifts wearing PPE, increased consecutive days with PPE, and increased exposure to confirmed or suspected COVID-19 patients. CONCLUSIONS The frequency of adverse events among HCWs due to PPE use is very high. Healthcare facilities should take the necessary precautions and change the working conditions during the COVID-19 pandemic to prevent adverse events associated with PPE use and minimize harm to HCWs.
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Affiliation(s)
- Petros Galanis
- Faculty of Nursing, Center for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece.
| | - Irene Vraka
- Department of Radiology, P & A Kyriakou Children's Hospital, Athens, Greece
| | - Despoina Fragkou
- Faculty of Nursing, Center for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece
| | - Angeliki Bilali
- Hospital Waste Management Unit, P & A Kyriakou Children's Hospital, Athens, Greece
| | - Daphne Kaitelidou
- Faculty of Nursing, Center for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece
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Zewude B, Melese B, Addis E, Solomon W. Changing Patterns of Compliance with Protective Behavioral Recommendations in the Post First-Round COVID-19 Vaccine Period Among Healthcare Workers in Southern Ethiopia. Risk Manag Healthc Policy 2021; 14:3575-3587. [PMID: 34475789 PMCID: PMC8405881 DOI: 10.2147/rmhp.s325699] [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] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/11/2021] [Indexed: 12/24/2022] Open
Abstract
Background Healthcare providers are facing an increasing threat as a result of confronting COVID-19. The aim of the present study was to assess the changes in compliance with the protective behavioral recommendations after taking the first round of COVID-19 vaccine among healthcare workers in Southern Ethiopia. Methods A cross-sectional study design was used in which quantitative data were collected using a survey method. A self-administered questionnaire was distributed to a sample of healthcare workers who were selected through a multi-stage cluster sampling technique. From the 403 healthcare workers who participated in the survey, 236 properly completed and returned the questionnaires. After inserting it into SPSS software, data were analyzed using frequency tables, percentage distributions, and logistic regression coefficients. Results While 30.5% of the healthcare workers disclosed a decreasing experience of wearing mask, 30.1% revealed that their experience of regularly washing hands has decreased after taking the first round of COVID-19 vaccine. The main reasons for not regularly wearing a mask are its inconvenience (60%), the need to appear indifferent (38.5%), and that they cannot afford to buy one due to its cost (15.4%). Above all, respondents’ level of compliance with regular wearing of a mask is significantly associated with sex (OR = 3.165, P<0.05; 95% CI: 1.186–8.448), the type of organization in which they are currently working (OR = 3.553, P<0.05; 95% CI: 1.185–10.647), knowing someone ever infected by COVID-19 (OR = 0.091, P<0.001; 95% CI: 0.030–0.275), and the belief that COVID-19 causes a severe illness (OR = 0.249, P<0.05; 95% CI: 0.299–2.615). Conclusion We have found significant reductions in adherence to the usual protective mechanisms. Therefore, increased access to the personal protective materials, including water, should be created and the healthcare workers should be continuously informed about the serious consequences of ignorance of self-protective behavior.
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Affiliation(s)
- Bewunetu Zewude
- Department of Sociology, College of Social Sciences and Humanities, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Belayneh Melese
- Department of Civics and Ethical Studies, College of Social Sciences and Humanities, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Enatihun Addis
- Department of Sociology, College of Social Sciences and Humanities, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Weynishet Solomon
- Department of Sociology, College of Social Sciences and Humanities, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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Environmental hygiene, knowledge and cleaning practice: a phenomenological study of nurses and midwives during COVID-19. Am J Infect Control 2021; 49:1123-1128. [PMID: 33915230 PMCID: PMC8074523 DOI: 10.1016/j.ajic.2021.04.080] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/21/2021] [Accepted: 04/21/2021] [Indexed: 12/02/2022]
Abstract
Background Environmental cleanliness is a fundamental tenet in nursing and midwifery but often overshadowed in practice. This study explored nurses’ and midwives’ knowledge and experiences of infection prevention and control (IPC) processes and cleaning, and perceptions about workplace risk-management during COVID-19. Methods Six registered and enrolled nurses (one with dual midwife qualifications) were recruited. In-depth telephone interviews were analyzed using Colaizzi's phenomenological method. Results Four major themes were identified: Striving towards environmental cleanliness; Knowledge and learning feeds good practice; There's always doubt in the back of your mind; and COVID has cracked it wide open. These articulate the nurses’ and midwives’ experiences and knowledge of IPC, particularly during COVID-19. Discussion The findings emphasize the dynamic, interdependent nature of clinical (time, staff knowledge and compliance, work processes, hospital design) and organizational contexts and environmental cleanliness, which must be constantly maintained. COVID-19 opened up critical insights regarding poor past practices and lack of IPC compliance. Conclusions COVID-19 has highlighted the criticality of environmental cleanliness within clinical and community settings. Evidence-based, experiential learning is important for nurses and midwives at all career stages, but provides only one solution. Clinician-led hospital design may also reduce the spread of infection; thus, promoting better patient care.
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Berber E, Sumbria D, Çanakoğlu N. Meta-analysis and comprehensive study of coronavirus outbreaks: SARS, MERS and COVID-19. J Infect Public Health 2021; 14:1051-1064. [PMID: 34174535 PMCID: PMC8214867 DOI: 10.1016/j.jiph.2021.06.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 05/31/2021] [Accepted: 06/10/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Zoonotic coronaviruses have caused several endemic and pandemic situations around the world. SARS caused the first epidemic alert at the beginning of this century, followed by MERS. COVID-19 appeared to be highly contagious, with human-to-human transmission by aerosol droplets, and reached nearly all countries around the world. A plethora of studies were performed, with reports being published within a short period of time by scientists and medical physicians. It has been difficult to find the relevant data to create an overview of the situation according to studies from accumulated findings and reports. In the present study we aimed to perform a comprehensive study in the context of the case fatality ratios (CFRs) of three major human Coronavirus outbreaks which occurred during the first twenty years of 21st century. METHODS In this study, we performed meta-analyses on SARS, MERS and COVID-19 outbreak events from publicly available records. Study analyses were performed with the help of highly reputable scientific databases such as PubMed, WOS and Scopus to evaluate and present current knowledge on zoonotic coronavirus outbreaks, starting from 2000 to the end of 2020. RESULTS A total of 250,194 research studies and records were identified with specific keywords and synonyms for the three viruses in order to cover all publications. In the end, 41 records were selected and included after applying several exclusion and inclusion criteria on identified datasets. SARS was found to have a nearly 11% case fatality ratio (CFR), which means the estimated number of deaths as a proportion of confirmed positive cases; Taiwan was the country most affected by the SARS outbreak based on the CFR analysis. MERS had CFRs of 35.8 and 26 in Saudi Arabia during the 2012 and 2015 outbreaks, respectively. COVID-19 resulted in a 2.2 CFR globally, and the USA reported the highest mortality ratio in the world in the end of first year of COVID-19 pandemic. CONCLUSION Some members of the Coronaviridae family can cause highly contagious and devastating infections among humans. Within the last two decades, the whole world has witnessed several deadly emerging infectious diseases, which are most commonly zoonotic in nature. We conclude that pre-existing immunity during the early stages of a pandemic might be important, but case control and management strategies should be improved to decrease CFRs. Finally, we have addressed several concerns in relation to outbreak events in this study.
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Affiliation(s)
- Engin Berber
- University of Tennessee, Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, Knoxville, TN, USA; Erciyes University, College of Veterinary Medicine, Department of Virology, Kayseri, Turkey.
| | - Deepak Sumbria
- University of Tennessee, Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, Knoxville, TN, USA; Dr. Yashwant Singh Parmar University of Horticulture and Forestry, Department of Silviculture and Agroforestry, College of Forestry, Solan, Himachal Pradesh, India
| | - Nurettin Çanakoğlu
- Muğla Sıtkı Koçman University, Milas Faculty of Veterinary Science, Department of Virology, Muğla, Turkey
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Mokhtari R, Safdari A, Hekmatpou D, Sahebi A, Moayedi S, Torres M, Golitaleb M. Investigating the Effective Factors of Using Personal Protective Equipment from the Perspective of Nurses Caring for COVID-19 Patients: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157882. [PMID: 34360175 PMCID: PMC8345363 DOI: 10.3390/ijerph18157882] [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] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 07/10/2021] [Accepted: 07/13/2021] [Indexed: 11/23/2022]
Abstract
Considering the importance of appropriate personal protective equipment (PPE) for preventing COVID-19 transmission, the aim of this study was to investigate the factors affecting the use of PPE from the perspective of the nurses caring for COVID-19 patients. This descriptive cross-sectional study surveyed 240 nurses working in the central COVID-19 hospitals of Arak, Iran. Nurses were enrolled in the study by a convenience sampling method. The data collection tool was a validated questionnaire. Data were analyzed by SPSS 16 software using descriptive statistics, analysis of variance (ANOVA), and independent sample t-test. Environmental (4.24 ± 0.45), personal (4.16 ± 0.42), and organizational (4.04 ± 0.50) factors all contribute significantly to nursing attitudes about PPE use (p < 0.05). The average score, combining all identified factors, was 4.15 ± 0.31. The most influential factor contributing to appropriate use of PPE was environmental, while the least impactful parameters were related to rules and regulations. Environmental factors have the greatest impact on the use of PPE from the perspective of the nurses caring for patients with COVID-19. Managers and healthcare organizations should provide appropriate and adequate PPE to nurses, educate them on proper use, and monitor the process to resolve barriers.
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Affiliation(s)
- Razieh Mokhtari
- Department of Nursing, School of Nursing, Arak University of Medical Sciences, Arak 3819693345, Iran; (R.M.); (D.H.)
| | - Ali Safdari
- Student Research Committee, Arak University of Medical Sciences, Arak 3819693345, Iran;
| | - Davood Hekmatpou
- Department of Nursing, School of Nursing, Arak University of Medical Sciences, Arak 3819693345, Iran; (R.M.); (D.H.)
| | - Ali Sahebi
- Non-Communicable Diseases Research Center, Ilam University of Medical Sciences, Ilam 6931851147, Iran;
| | - Siamak Moayedi
- Department of Emergency Medicine, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (S.M.); (M.T.)
| | - Mercedes Torres
- Department of Emergency Medicine, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (S.M.); (M.T.)
| | - Mohamad Golitaleb
- Department of Nursing, School of Nursing, Arak University of Medical Sciences, Arak 3819693345, Iran; (R.M.); (D.H.)
- Correspondence: or ; Tel.: +98-93-7936-6279
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Infection Prevention Performance among In-Flight Cabin Crew in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126468. [PMID: 34203806 PMCID: PMC8296313 DOI: 10.3390/ijerph18126468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/10/2021] [Accepted: 06/12/2021] [Indexed: 12/23/2022]
Abstract
COVID-19 was declared a worldwide pandemic in 2020; thus, preventing in-flight infection transmission is important for stopping global spread via air travel. Infection prevention (IP) performance among aircraft cabin crew is crucial for preventing in-flight transmission. We aimed to identify the level of IP performance and factors affecting IP performance among aircraft cabin crew during the COVID-19 pandemic in South Korea. An online survey was conducted with 177 cabin crew members between August and September 2020. The survey assessed IP performance, and IP awareness, using a five-point Likert scale, and also evaluated simulation-based personal protective equipment (PPE) training experience, and organizational culture. The average IP performance score was 4.56 ± 0.44. Although the performance level for mask-wearing was high (4.73 ± 0.35), hand hygiene (HH) performance (4.47 ± 0.56) was low. Multivariate analysis showed that IP performance was significantly associated with IP awareness (p < 0.05) and simulation-based PPE training experience (p < 0.05). Since HH performance was relatively low, cabin crew and airlines should make efforts to improve HH performance. Furthermore, a high level of IP awareness and PPE training experience can improve IP performance among cabin crew members. Therefore, simulation-based PPE training and strategies to improve IP awareness are essential for preventing in-flight infection transmission.
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Alhumaid S, Al Mutair A, Al Alawi Z, Alsuliman M, Ahmed GY, Rabaan AA, Al-Tawfiq JA, Al-Omari A. Knowledge of infection prevention and control among healthcare workers and factors influencing compliance: a systematic review. Antimicrob Resist Infect Control 2021; 10:86. [PMID: 34082822 PMCID: PMC8173512 DOI: 10.1186/s13756-021-00957-0] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 05/26/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Knowledge of infection prevention and control (IPC) procedures among healthcare workers (HCWs) is crucial for effective IPC. Compliance with IPC measures has critical implications for HCWs safety, patient protection and the care environment. AIMS To discuss the body of available literature regarding HCWs' knowledge of IPC and highlight potential factors that may influence compliance to IPC precautions. DESIGN A systematic review. A protocol was developed based on the Preferred Reporting Items for Systematic reviews and Meta-Analysis [PRISMA] statement. DATA SOURCES Electronic databases (PubMed, CINAHL, Embase, Proquest, Wiley online library, Medline, and Nature) were searched from 1 January 2006 to 31 January 2021 in the English language using the following keywords alone or in combination: knowledge, awareness, healthcare workers, infection, compliance, comply, control, prevention, factors. 3417 papers were identified and 30 papers were included in the review. RESULTS Overall, the level of HCW knowledge of IPC appears to be adequate, good, and/or high concerning standard precautions, hand hygiene, and care pertaining to urinary catheters. Acceptable levels of knowledge were also detected in regards to IPC measures for specific diseases including TB, MRSA, MERS-CoV, COVID-19 and Ebola. However, gaps were identified in several HCWs' knowledge concerning occupational vaccinations, the modes of transmission of infectious diseases, and the risk of infection from needle stick and sharps injuries. Several factors for noncompliance surrounding IPC guidelines are discussed, as are recommendations for improving adherence to those guidelines. CONCLUSION Embracing a multifaceted approach towards improving IPC-intervention strategies is highly suggested. The goal being to improve compliance among HCWs with IPC measures is necessary.
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Affiliation(s)
- Saad Alhumaid
- Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa, Saudi Arabia
| | - Abbas Al Mutair
- Research Center, Almoosa Specialist Hospital, Dhahran Street, Al-Ahsa, 31982, Saudi Arabia. .,College of Nursing, Princess Nourah Bint Abdul Rahman University, Riyadh, Saudi Arabia. .,School of Nursing, University of Wollongong, Wollongong, Australia.
| | - Zainab Al Alawi
- Department of Paediatrics, College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Murtadha Alsuliman
- Department of Pharmacy, Hereditary Blood Diseases Centre, Al-Ahsa, Saudi Arabia
| | - Gasmelseed Y Ahmed
- Research Center, Almoosa Specialist Hospital, Dhahran Street, Al-Ahsa, 31982, Saudi Arabia
| | - Ali A Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | - Jaffar A Al-Tawfiq
- Infectious Disease Unit, Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia.,Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.,Infectious Disease Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Awad Al-Omari
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.,Research Center, Dr. Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia
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Pandemics: Implications for research and practice in industrial and organizational psychology. INDUSTRIAL AND ORGANIZATIONAL PSYCHOLOGY-PERSPECTIVES ON SCIENCE AND PRACTICE 2021. [DOI: 10.1017/iop.2020.48] [Citation(s) in RCA: 138] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractPandemics have historically shaped the world of work in various ways. With COVID-19 presenting as a global pandemic, there is much speculation about the implications of this crisis for the future of work and for people working in organizations. In this article, we discuss 10 of the most relevant research and practice topics in the field of industrial and organizational psychology that will likely be strongly influenced by COVID-19. For each of these topics, the pandemic crisis is creating new work-related challenges, but it is also presenting various opportunities. The topics discussed herein include occupational health and safety, work–family issues, telecommuting, virtual teamwork, job insecurity, precarious work, leadership, human resources policy, the aging workforce, and careers. This article sets the stage for further discussion of various ways in which I-O psychology research and practice can address the issues that COVID-19 creates for work and organizational processes that are affecting workers now and will shape the future of work and organizations in both the short and long term. This article concludes by inviting I-O psychology researchers and practitioners to address the challenges and opportunities of COVID-19 head-on by proactively adapting the work that we do in support of workers, organizations, and society as a whole.
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Tang ACY, Kwong EWY, Chen L, Cheng WLS. Associations between demographic characteristics, perceived threat, perceived stress, coping responses and adherence to COVID-19 prevention measures among Chinese healthcare students. J Adv Nurs 2021; 77:3759-3771. [PMID: 34008883 PMCID: PMC8242843 DOI: 10.1111/jan.14889] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 03/05/2021] [Accepted: 04/25/2021] [Indexed: 11/27/2022]
Abstract
Aim To investigate the associations between demographic characteristics, perceived threat, perceived stress, coping responses and adherence to COVID‐19 prevention measures in Chinese Healthcare students. Design A cross‐sectional survey collecting data in Hong Kong and Fujian Province of China in April 2020. Methods A convenience and snowball sample of 2706 students aged 18 years or older and studying a healthcare programme were recruited in tertiary education institutions/universities in Hong Kong and Putian. The participants completed the questionnaire with six scales: Social Distancing Scale; Personal Hygiene Scale; Empathic Responding Scale; Wishful Thinking Scale; Perceived Stress Scale and Perceived Threat Scale. Path analysis was performed to identify factors associated with the preventive measures outcomes. p value < .05 was considered as statistical significance. Results The participants reported high compliances to both social distancing (SoD) and personal hygiene measures (PHM). Confidence to manage the current situation, wishful thinking and empathetic responding directly predicted compliance with SoD and PHM. The final model constructed demonstrated a very good fit to the data. Conclusion The findings suggest that students who are male, habituate in Hong Kong, have more clinical experience and weak confidence to manage the threat tend to have lower compliance with the COVID‐19 preventive measures. Impact The predictive model constructed is the first one to explore factors associating with the compliance with infection control measures in healthcare students amid the COVID‐19 outbreak. As the infection control behaviours of healthcare students, whom are still under training and are the high‐risk group of being infected and infecting others in the community, are rarely reported in literature, this study has provided empirical evidence to nurses and other healthcare professionals to identify students susceptible to poor compliance and provide early monitoring and education to suppress the COVID‐19 transmission.
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31
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Keilman AE, Umoren R, Lo M, Roberts J, Yoshida H, Hartford E, Patrao F, Burns B, Fenstermacher S, Masse E, Reid J. Virtual protective equipment: paediatric resuscitation in the COVID-19
era. BMJ SIMULATION & TECHNOLOGY ENHANCED LEARNING 2021; 7:169-170. [PMID: 35518557 PMCID: PMC8936725 DOI: 10.1136/bmjstel-2020-000658] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 05/07/2020] [Indexed: 11/07/2022]
Affiliation(s)
- Ashley Elizabeth Keilman
- Pediatrics, Division of Emergency Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Rachel Umoren
- Pediatrics, Division of Neonatology, University of Washington School of Medicine, Seattle, Washington, USA
| | - Mark Lo
- Pediatrics, Division of Emergency Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Joan Roberts
- Pediatrics, Division of Critical Care Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Hiromi Yoshida
- Pediatrics, Division of Emergency Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Emily Hartford
- Pediatrics, Division of Emergency Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Fiona Patrao
- Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Brian Burns
- Emergency Medicine, Seattle Children's Hospital, Seattle, Washington, USA
| | - Sara Fenstermacher
- Emergency Medicine, Seattle Children's Hospital, Seattle, Washington, USA
| | - Elizabeth Masse
- Critical Care Medicine, Seattle Children's Hospital, Seattle, Washington, USA
| | - Jennifer Reid
- Pediatrics, Division of Emergency Medicine, University of Washington School of Medicine, Seattle, Washington, USA
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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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33
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Krüger S, Leskien M, Schuller P, Prifert C, Weißbrich B, Vogel U, Krone M. Performance and feasibility of universal PCR admission screening for SARS-CoV-2 in a German tertiary care hospital. J Med Virol 2021; 93:2890-2898. [PMID: 33386772 DOI: 10.1002/jmv.26770] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/27/2020] [Accepted: 12/29/2020] [Indexed: 01/14/2023]
Abstract
Anamnestic screening of symptoms and contact history is applied to identify coronavirus disease 2019 (COVID-19) patients on admission. However, asymptomatic and presymptomatic patients remain undetected although the viral load may be high. In this retrospective cohort study, all hospitalized patients who received polymerase chain reaction (PCR) admission testing from March 26th until May 24th, 2020 were included. Data on COVID-19-specific symptoms and contact history to COVID-19 cases were retrospectively extracted from patient files and from contact tracing notes. The compliance to the universal testing protocol was high with 90%. Out of 6940 tested patients, 27 new severe acute respiratory syndrome coronavirus-2 infections (0.4%) were detected. Seven of those COVID-19 cases (26% of all new cases) were asymptomatic and had no positive contact history, but were identified through a positive PCR test. The number needed to identify an asymptomatic patient was 425 in the first wave of the epidemic, 1218 in the low incidence phase. The specificity of the method was above 99.9%. Universal PCR testing was highly accepted by staff as demonstrated by high compliance. The costs to detect one asymptomatic case in future studies need to be traded off against the costs and damage caused by potential outbreaks of COVID-19.
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Affiliation(s)
- Sören Krüger
- Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany
| | - Miriam Leskien
- Infection Control Unit, University Hospital Würzburg, Würzburg, Germany
| | - Patricia Schuller
- Infection Control Unit, University Hospital Würzburg, Würzburg, Germany
| | - Christiane Prifert
- Institute for Virology and Immunobiology, University of Würzburg, Würzburg, Germany
| | - Benedikt Weißbrich
- Institute for Virology and Immunobiology, University of Würzburg, Würzburg, Germany
| | - Ulrich Vogel
- Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany.,Infection Control Unit, University Hospital Würzburg, Würzburg, Germany
| | - Manuel Krone
- Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany
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Kong JY, Bharadwaj SS, Chinnadurai A, Ho SKY. Being Prepared During the Evolving COVID-19 Pandemic: A Neonatal Experience in Training and Simulation. Front Pediatr 2021; 9:785524. [PMID: 34926355 PMCID: PMC8674782 DOI: 10.3389/fped.2021.785524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/09/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Rapid spread of the COVID-19 pandemic raised an urgent need for preparedness in the healthcare sector, including training of healthcare workers to cope with the burden of infected cases while ensuring proper protection of themselves. Improper infection prevention and control measures were key reasons for infection in healthcare workers during the early phase of the outbreak. Objectives/Methods: This paper describes the combined approach of 3 restructured hospitals in Singapore in preparing and training neonatal healthcare workers' during the COVID-19 pandemic crisis, as well as lessons learnt during this process. Results: Information sharing was conducted in the form of e-learning, emphasizing on topics like disease knowledge and infection prevention and control procedures. Skills and competency training were carried out in the form of simulation, with sessions scaled into 4 levels progressing from individual task training to larger group simulations involving multiple disciplines and departments. Challenges encountered included information fatigue by large amount of constantly changing information and multiple amendments to workflows as more information arose. Difficulties conducting training and simulation sessions included restriction of group size to mitigate infection risk amongst participants and the limited supply of personal protective equipment prioritized for direct patient care. Conclusion: Healthcare institutions should ensure adequate dissemination of conceptual knowledge as well as skills competency training of staff in infection control measures for the protection of healthcare workers and patient safety. Ongoing training for sustainability of knowledge and skills, while adapting to the rapidly evolving situation is important in the preparation for future outbreaks.
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Affiliation(s)
- Juin Yee Kong
- Department of Neonatology, KK Women's and Children's Hospital, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Srabani Samanta Bharadwaj
- Duke-NUS Medical School, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Neonatal and Developmental Medicine, Singapore General Hospital, Singapore, Singapore
| | - Amutha Chinnadurai
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Neonatology, Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore
| | - Selina Kah Ying Ho
- Duke-NUS Medical School, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Neonatal and Developmental Medicine, Singapore General Hospital, Singapore, Singapore
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35
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Çağlar A, Kaçer İ, Hacımustafaoğlu M, Öztürk B, Öztürk S. Impact of personal protective equipment on prehospital endotracheal intubation performance in simulated manikin. Australas Emerg Care 2020; 24:235-239. [PMID: 33358480 PMCID: PMC7759446 DOI: 10.1016/j.auec.2020.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 11/10/2020] [Accepted: 11/25/2020] [Indexed: 12/18/2022]
Abstract
Background Tracheal intubation in COVID-19 patients is a potentially high-risk procedure for healthcare professionals. Personal protective equipment (PPE) is recommended to minimize contact with critical patients with COVID-19 infection. This study aimed to primarily examine the effect of PPE use on intubation time and success rate among prehospital healthcare professionals; additionally, we compared intubation times among prehospital health care professionals using PPE with direct laryngoscopy and video laryngoscopy assistance. Methods In this prospective simulation study, we compared the intubation times and success rates among prehospital healthcare professionals who were or were not using PPE. Furthermore, demographic data, previous intubation experience, and previous intubation experience with PPE were recorded. Results Overall time to intubation with PPE use was 51.28 ± 3.89 s, which was significantly higher than that without PPE use (33.03 ± 2.65 s; p < 0.001). In addition, the overall success rate with PPE use was 74.4%, which was significantly lower than that without PPE use (93%;p < 0.001). PPE use increased the average intubation time by 19.73 ± 2.59 s with direct laryngoscopy and by 16.81 ± 2.86 s with video laryngoscopy (p < 0.001). Conclusions PPE use is associated with increased intubation time and decreased success rate. Video laryngoscopy assistance in cases where PPE use is required facilitates faster endotracheal intubation than does direct laryngoscopy assistance.
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Affiliation(s)
- Ahmet Çağlar
- Department of Emergency Medicine, Aksaray University Training and Research Hospital, Aksaray, Turkey.
| | - İlker Kaçer
- Department of Emergency Medicine, Aksaray University Training and Research Hospital, Aksaray, Turkey.
| | - Muhammet Hacımustafaoğlu
- Department of Emergency Medicine, Aksaray University Training and Research Hospital, Aksaray, Turkey.
| | - Berkant Öztürk
- Department of Emergency Medicine, Aksaray University Training and Research Hospital, Aksaray, Turkey.
| | - Sema Öztürk
- Department of Emergency Medicine, Aksaray University Training and Research Hospital, Aksaray, Turkey.
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36
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Wataganara T, Ruangvutilert P, Sunsaneevithayakul P, Sutantawibul A, Chuchotirot M, Phattanachindakun B, Russameecharoen K. Minimizing cross transmission of SARS-CoV-2 in obstetric ultrasound during COVID-19 pandemic. J Perinat Med 2020; 48:931-942. [PMID: 32681782 DOI: 10.1515/jpm-2020-0228] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 06/28/2020] [Indexed: 12/18/2022]
Abstract
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-associated infection (COVID-19) is affecting populations worldwide. This statement may serve as guidance for infection prevention and safe ultrasound practices during the COVID-19 pandemic. Ultrasound examination is a fundamental part of obstetric care, yet it is a potential vector for transmission of SARS-CoV-2. Decontamination methods should always be implemented for ultrasound equipment, especially in the presence of suspected or confirmed COVID-19 cases. There must be workflow policies to protect pregnant women and healthcare providers from nosocomial cross transmission of SARS-CoV-2. Cleaning and disinfecting of equipment must be in accordance with their potential of pathogen transmission. Consider using telemedicine and genetic technologies as an adjunctive of obstetric ultrasound to reduce patient crowding. Patient triage and education of healthcare providers of infection prevention are crucial to minimize cross contamination of SARS-CoV-2 during obstetric ultrasound.
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Affiliation(s)
- Tuangsit Wataganara
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
| | - Pornpimol Ruangvutilert
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
| | - Prasert Sunsaneevithayakul
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
| | - Anuwat Sutantawibul
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
| | - Monsak Chuchotirot
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
| | - Buraya Phattanachindakun
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
| | - Kusol Russameecharoen
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
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Symptoms Associated With Personal Protective Equipment Among Frontline Health Care Professionals During the COVID-19 Pandemic. Disaster Med Public Health Prep 2020; 16:987-990. [PMID: 33208212 PMCID: PMC7985640 DOI: 10.1017/dmp.2020.455] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objective: Personal protective equipment (PPE) use is frequently construed as inconvenient and disturbing by health care professionals (HCPs). We hypothesized that new-onset symptoms among HCPs may be associated with extended use of PPE and aimed to investigate risk factors related with new-onset symptoms. In addition, the effects of new-onset symptoms on working performance were evaluated. Methods: In this cross-sectional study, 315 participants filled out a questionnaire that contains 4 main parts: (1) demographics, (2) new-onset symptoms with PPE use, (3) PPE usage hours, and (4) personal opinion about the effect of sensed symptoms on working performance. Results: The mean age was 31.58 ± 4.6 years, and 50.5% (n = 159) were female. New-onset symptom rate was 66% (n = 208). The most common new-onset symptom was headache (n = 115, 36.5%) followed by breathing difficulty-palpitation (n = 79, 25.1%), and dermatitis (n = 64, 20.3%). Extended use of PPE, smoking, and overweight were independently associated with developing new-onset symptoms. A clear majority of symptomatic participants pointed out the impact on working performance (193/208, 92.7%). Conclusion: Hospitals should take the necessary precautions (eg, shorter shifts and more frequent breaks) to prevent symptoms associated with PPE and ensure that HCPs comply with these precautions.
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Santamaría L, Hortal J. Chasing the ghost of infection past: identifying thresholds of change during the COVID-19 infection in Spain. Epidemiol Infect 2020; 148:e282. [PMID: 33183397 PMCID: PMC7729171 DOI: 10.1017/s0950268820002782] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 09/18/2020] [Accepted: 11/06/2020] [Indexed: 01/05/2023] Open
Abstract
One of the largest nationwide bursts of the first COVID-19 outbreak occurred in Spain, where infection expanded in densely populated areas through March 2020. We analyse the cumulative growth curves of reported cases and deaths in all Spain and two highly populated regions, Madrid and Catalonia, identifying changes and sudden shifts in their exponential growth rate through segmented Poisson regressions. We associate these breakpoints with a timeline of key events and containment measures, and data on policy stringency and citizen mobility. Results were largely consistent for infections and deaths in all territories, showing four major shifts involving 19-71% reductions in growth rates originating from infections before 3 March and on 5-8, 10-12 and 14-18 March, but no identifiable effect of the strengthened lockdown of 29-30 March. Changes in stringency and mobility were only associated to the latter two shifts, evidencing an early deceleration in COVID-19 spread associated to personal hygiene and social distancing recommendations, followed by a stronger decrease when lockdown was enforced, leading to the contention of the outbreak by mid-April. This highlights the importance of combining public health communication strategies and hard confinement measures to contain epidemics.
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Affiliation(s)
- Luis Santamaría
- Estación Biológica de Doñana (EBD-CSIC), C/ Américo Vespucio 26, Isla de la Cartuja, E41092Sevilla, Spain
| | - Joaquín Hortal
- Department of Biogeography and Global Change, Museo Nacional de Ciencias Naturales (MNCN-CSIC), C/José Gutiérrez Abascal 2, 28006Madrid, Spain
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Donaghy J. Organisational support improves adherence to infection prevention and control guidelines. Evid Based Nurs 2020; 25:10. [PMID: 33168574 DOI: 10.1136/ebnurs-2020-103305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2020] [Indexed: 11/03/2022]
Affiliation(s)
- Juliet Donaghy
- Emergency Assessment Unit, East Suffolk and North Essex Foundation Trust, Ipswich, Suffolk, UK
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Zhang Z, El-Moghazy AY, Wisuthiphaet N, Nitin N, Castillo D, Murphy BG, Sun G. Daylight-Induced Antibacterial and Antiviral Nanofibrous Membranes Containing Vitamin K Derivatives for Personal Protective Equipment. ACS APPLIED MATERIALS & INTERFACES 2020; 12:49416-49430. [PMID: 33089989 DOI: 10.1021/acsami.0c14883] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
During the development of antibacterial and antiviral materials for personal protective equipment (PPE), daylight active functional polymeric materials containing vitamin K compounds (VKs) and impacts of polymer structures to the functions were investigated. As examples, hydrophobic polyacrylonitrile (PAN) and hydrophilic poly(vinyl alcohol-co-ethylene) (PVA-co-PE) polymers were directly blended with three VK compounds and electrospun into VK-containing nanofibrous membranes (VNFMs). The prepared VNFMs exhibited robust photoactivity in generating reactive oxygen species (ROS) under both daylight (D65, 300-800 nm) and ultraviolet A (UVA, 365 nm) irradiation, resulting in high antimicrobial and antiviral efficiency (>99.9%) within a short exposure time (<90 min). Interestingly, the PVA-co-PE/VK3 VNFM showed higher ROS production rates and better biocidal functions than those of the PAN/VK3 VNFM under the same photoirradiation conditions, indicating that PVA-co-PE is a better matrix polymer material for these functions. Moreover, the prepared PVA-co-PE/VK3 VNFM maintains its powerful microbicidal function even after five times of repeated exposures to bacteria and viruses, showing the stability and reusability of the antimicrobial materials. The fabrication of photoinduced antimicrobial VNFMs may provide new insights into the development of non-toxic and reusable photoinduced antimicrobial materials that could be applied in personal protective equipment with improved biological protections.
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Affiliation(s)
- Zheng Zhang
- Department of Biological and Agricultural Engineering, University of California, Davis, California 95616, United States
| | - Ahmed Y El-Moghazy
- Department of Food Science and Technology, University of California, Davis, California 95616, United States
| | - Nicharee Wisuthiphaet
- Department of Food Science and Technology, University of California, Davis, California 95616, United States
| | - Nitin Nitin
- Department of Biological and Agricultural Engineering, University of California, Davis, California 95616, United States
- Department of Food Science and Technology, University of California, Davis, California 95616, United States
| | - Diego Castillo
- Department of Pathology, Microbiology, and Immunology, University of California, Davis, California 95616, United States
| | - Brian G Murphy
- Department of Pathology, Microbiology, and Immunology, University of California, Davis, California 95616, United States
| | - Gang Sun
- Department of Biological and Agricultural Engineering, University of California, Davis, California 95616, United States
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Nowacki K, Grabowska S, Łakomy K. Activities of employers and OHS services during the developing COVID-19 epidemic in Poland. SAFETY SCIENCE 2020; 131:104935. [PMID: 32834519 PMCID: PMC7392100 DOI: 10.1016/j.ssci.2020.104935] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 07/26/2020] [Indexed: 05/14/2023]
Abstract
BACKGROUND The epidemic is affecting the global economy, plunging many industries. The global extent of the epidemic and government controls, restrictions and constraints have led to imbalances in world trade and have put many companies under pressure. The epidemic is a test of individual companies' ability to operate effectively in the new environment. It is up to managers to mitigate its impact on business. The aim of the article is to identify the activities of employers in Poland related to the protection of workers with the developing epidemic COVID-19. METHODS A survey was carried out among the employees of OHS services employed in enterprises in Poland. The research was conducted in three stages at two-week intervals. The obtained results were subjected to statistical analyses. RESULTS In the analysed three periods a total of 588 answers were obtained, which allowed to formulate conclusions. The research showed that in connection with the COVID-19 epidemic, about 30% of the plants updated their occupational risk assessment, about 40% updated their safety instructions, about 90% of the plants equipped their employees with additional personal protective equipment. CONCLUSIONS The COVID-19 outbreak in Poland resulted in taking additional actions by employers to protect workers. Systematicity (methodicality) of these activities depended mainly on the seniority of the OHS service. As a border internship indicating a different approach to an emergency situation related to the epidemic, 7 years were set.
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Kempfle JS, Löwenheim H, Huebner MJ, Iro H, Mueller SK. [Management of tracheostomy patients during the COVID-19 pandemic: review of the literature and demonstration]. HNO 2020; 68:828-837. [PMID: 32514605 PMCID: PMC7278214 DOI: 10.1007/s00106-020-00892-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Since emergence of the new coronavirus in China in December 2019, many countries have been struggling to control skyrocketing numbers of infections, including among healthcare personnel. It has now been clearly demonstrated that SARS-CoV‑2 resides in the upper airways and transmits easily via aerosols and droplets, which significantly increases the risk of infection when performing upper airway procedures. Ventilated COVID-19 patients in a critical condition in the intensive care unit may require tracheotomy for long-term ventilation and to improve weaning. However, the risk of secondary infection of medical personnel performing subsequent tracheostomy care remains unclear. OBJECTIVE This study aimed to evaluate the risk of droplet dispersion during tracheostomy tube change and overview tracheostomy tube change in COVID-19 patients. MATERIALS AND METHODS The current literature was reviewed, quantitative and qualitative analyses of droplet formation during tracheostomy tube change in n = 8 patients were performed, and an overview of and checklist for tracheostomy tube change were compiled. RESULTS This study demonstrates that tracheostomy tube change, in particular insertion of the new tube, may cause significant droplet formation. The aerosolization of particles smaller than 5 µm was not analyzed. CONCLUSION Our data, together with the current literature, clearly emphasize that tracheostomy care is associated with a high infection risk and should only be performed by a small group of well-trained, maximally protected healthcare personnel.
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Affiliation(s)
- J S Kempfle
- Abteilung für Hals-Nasen-Ohren-Heilkunde, Universitätsklinikum Tübingen, Tübingen, Deutschland.,Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - H Löwenheim
- Abteilung für Hals-Nasen-Ohren-Heilkunde, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - M J Huebner
- Abteilung für Kinderkardiologie, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Deutschland
| | - H Iro
- Abteilung für Hals-Nasen-Ohren-Heilkunde, Kopf- und Halschirurgie, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Waldstraße 1, 1054, Erlangen, Deutschland
| | - S K Mueller
- Abteilung für Hals-Nasen-Ohren-Heilkunde, Kopf- und Halschirurgie, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Waldstraße 1, 1054, Erlangen, Deutschland.
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Çiriş Yildiz C, Ulaşli Kaban H, Tanriverdi FŞ. COVID-19 pandemic and personal protective equipment: Evaluation of equipment comfort and user attitude. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2020; 77:1-8. [PMID: 33063614 DOI: 10.1080/19338244.2020.1828247] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This study aimed to evaluate the comfort of personal protective equipment (PPE) used during the COVID-19 and attitudes of healthcare professionals regarding the use of PPE. Descriptive research was conducted with 553 healthcare professionals, who work in a pandemic center in Turkey. Findings showed that all participants used masks, 99.3% wore gloves, 89% wore protective glasses, and 89% wore aprons during the COVID-19. The most-reported physical complaints have been dryness, irritation, and wound on the hands. Age and gender, as well as PPE discomfort, has been determined to affect the use of PPE. It might be concluded that age and sex, as well as the discomfort caused by PPE, affected the use of PPE and the attitudes of healthcare professionals.
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Affiliation(s)
- Cennet Çiriş Yildiz
- Nursing Department, İstanbul Kent University Faculty of Health Sciences, Istanbul, Turkey
| | - Hülya Ulaşli Kaban
- Istanbul Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - F Şule Tanriverdi
- Midwifery Department, Haliç University Faculty of Health Sciences, Istanbul, Turkey
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Mazzola SM, Grous C. Maintaining Perioperative Safety in Uncertain Times: COVID-19 Pandemic Response Strategies. AORN J 2020; 112:397-405. [PMID: 32990976 PMCID: PMC7537227 DOI: 10.1002/aorn.13195] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Givi B, Schiff BA, Chinn SB, Clayburgh D, Iyer NG, Jalisi S, Moore MG, Nathan CA, Orloff LA, O'Neill JP, Parker N, Zender C, Morris LGT, Davies L. Safety Recommendations for Evaluation and Surgery of the Head and Neck During the COVID-19 Pandemic. JAMA Otolaryngol Head Neck Surg 2020; 146:579-584. [PMID: 32232423 DOI: 10.1001/jamaoto.2020.0780] [Citation(s) in RCA: 386] [Impact Index Per Article: 96.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Importance The rapidly expanding novel coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2, has challenged the medical community to an unprecedented degree. Physicians and health care workers are at added risk of exposure and infection during the course of patient care. Because of the rapid spread of this disease through respiratory droplets, health care workers who come in close contact with the upper aerodigestive tract during diagnostic and therapeutic procedures, such as otolaryngologists-head and neck surgeons, are particularly at risk. A set of safety recommendations was created based on a review of the literature and communications with physicians with firsthand knowledge of safety procedures during the COVID-19 pandemic. Observations A high number of health care workers were infected during the first phase of the pandemic in the city of Wuhan, China. Subsequently, by adopting strict safety precautions, other regions were able to achieve high levels of safety for health care workers without jeopardizing the care of patients. The most common procedures related to the examination and treatment of upper aerodigestive tract diseases were reviewed. Each category was reviewed based on the potential risk imposed to health care workers. Specific recommendations were made based on the literature, when available, or consensus best practices. Specific safety recommendations were made for performing tracheostomy in patients with COVID-19. Conclusions and Relevance Preserving a highly skilled health care workforce is a top priority for any community and health care system. Based on the experience of health care systems in Asia and Europe, by following strict safety guidelines, the risk of exposure and infection of health care workers could be greatly reduced while providing high levels of care. The provided recommendations, which may evolve over time, could be used as broad guidance for all health care workers who are involved in the care of patients with COVID-19.
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Affiliation(s)
- Babak Givi
- Department of Otolaryngology, NYU Langone Health, New York, New York
| | - Bradley A Schiff
- Department of Otolaryngology, Montefiore Medical Center, New York, New York
| | - Steven B Chinn
- Department of Otolaryngology, University of Michigan, Ann Arbor
| | - Daniel Clayburgh
- Department of Otolaryngology, Oregon Health & Science University, Portland
| | - N Gopalakrishna Iyer
- Department of Head and Neck Surgery, Singapore General Hospital and National Cancer Centre, Singapore
| | - Scharukh Jalisi
- Department of Otolaryngology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Michael G Moore
- Department of Otolaryngology, Indiana University School of Medicine, Indianapolis
| | - Cherie-Ann Nathan
- Department of Otolaryngology, Louisiana State University, Shreveport
| | - Lisa A Orloff
- Department of Otolaryngology, Stanford University, Palo Alto, California
| | - James P O'Neill
- Department of Otolaryngology, Beaumont Hospital, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Noah Parker
- Department of Otolaryngology, Indiana University School of Medicine, Indianapolis
| | - Chad Zender
- Department of Otolaryngology, University of Cincinnati, Cincinnati, Ohio
| | - Luc G T Morris
- Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Louise Davies
- Department of Veterans Affairs, White River Junction, Vermont
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Recommendations to Safeguard Reconstructive Microsurgeons Performing High-risk Operations during the COVID-19 Pandemic. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e3215. [PMID: 33133990 PMCID: PMC7544379 DOI: 10.1097/gox.0000000000003215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 09/03/2020] [Indexed: 12/24/2022]
Abstract
An unprecedented number of health care providers have been infected and many have died during the COVID-19 pandemic. Reconstructive microsurgeons from different surgical backgrounds often are involved in the care of known COVID-19 and high-risk patients. The need for a magnification loupe/microscope makes it difficult for them to wear recommended personal protection equipment, increasing the risk of exposure. Although advanced technologies are available, they have not been exploited effectively. To date, no safety guidelines are available for safe reconstructive microsurgical procedures in high-risk operations/known COVID-19 patients—particularly, to address operations risk and COVID-19 status of the patients, who would operate, how many should be involved, how to equip the surgeons for the procedure, when to operate as the procedure unfolds, how to adapt surgical techniques to reduce exposure risk, and can advanced technology be used to minimize exposure. A set of safety recommendations were thus developed based on literature review and firsthand knowledge of safety procedures during the COVID-19 pandemic. Current understanding of COVID-19 virology can optimize surgical team buildup and dynamics. Operating smaller teams (in a sequential style), minimizing the use of aerosols-generating devices, and modifying surgical plan and flap selection could aid in diminishing the risk of exposure and in conserving resources. Modifications in loupes design, and the combined wear of surgical mask and N95 respirators, and efficient use of “buddy system” could aid in protecting surgeons during donning and doffing. “Remote operating” is a novel concept of using a surgical robot to maximize surgeons’ safety during COVID-19 pandemic.
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Dedeilia A, Esagian SM, Ziogas IA, Giannis D, Katsaros I, Tsoulfas G. Pediatric surgery during the COVID-19 pandemic. World J Clin Pediatr 2020; 9:7-16. [PMID: 33014718 PMCID: PMC7515751 DOI: 10.5409/wjcp.v9.i2.7] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/14/2020] [Accepted: 08/01/2020] [Indexed: 02/06/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has had a major impact on pediatric surgery. The infection is often asymptomatic and atypical in children, while overlapping presentations with other infectious diseases generate additional diagnostic challenges. The high probability of missed pediatric cases and the invasive nature of surgery generate great concern for widespread transmission in this setting. Current guidelines suggest that triage of cases should be made on a case-by-case basis by a multidisciplinary team of experts. Decision-making can be assisted by classifying cases as elective, urgent, or an emergency according to the risks of delaying their surgical management. A workflow diagram should ideally guide the management of all cases from admission to discharge. When surgery is necessary, all staff should use appropriate personal protective equipment, and high-risk practices, such as aerosol-generating tools or procedures, should be avoided if possible. Furthermore, carefully designed organizational protocols should be established to minimize transmission while ensuring the uninterrupted operation of pediatric surgery units. For example, surgical teams can be divided into small weekly rotating groups, and healthcare workers should be continuously monitored for COVID-19 symptoms. Additionally, team protocols in the operating room can optimize communication and improve adherence to personal protective equipment use. Isolated operating rooms, pediatric intensive care units, and surgical wards should be specifically designed for suspected or confirmed COVID-19 cases. Finally, transportation of patients should be minimal and follow designated short routes. All these measures can help mitigate the effects of the COVID-19 pandemic on pediatric surgery units.
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Affiliation(s)
- Aikaterini Dedeilia
- Surgery Working Group, Society of Junior Doctors, Athens 15123, Greece
- National and Kapodistrian University of Athens, Athens 15772, Greece
| | - Stepan M Esagian
- Surgery Working Group, Society of Junior Doctors, Athens 15123, Greece
| | - Ioannis A Ziogas
- Surgery Working Group, Society of Junior Doctors, Athens 15123, Greece
- Department of Surgery, Division of Hepatobiliary Surgery and Liver Transplantation, Vanderbilt University Medical Center, Nashville, TN 37232, United States
| | - Dimitrios Giannis
- Surgery Working Group, Society of Junior Doctors, Athens 15123, Greece
- Institute of Health Innovations and Outcomes Research, the Feinstein Institute for Μedical Research, Manhasset, NY 11030, United States
| | - Ioannis Katsaros
- Surgery Working Group, Society of Junior Doctors, Athens 15123, Greece
- Department of Surgery, Metaxa Cancer Hospital, Piraeus 18537, Greece
| | - Georgios Tsoulfas
- First Department of Surgery, Aristotle University of Thessaloniki, Thessaloniki 54622, Greece
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LoSavio PS, Eggerstedt M, Tajudeen BA, Papagiannopoulos P, Revenaugh PC, Batra PS, Husain I. Rapid implementation of COVID-19 tracheostomy simulation training to increase surgeon safety and confidence. Am J Otolaryngol 2020; 41:102574. [PMID: 32505992 PMCID: PMC7837027 DOI: 10.1016/j.amjoto.2020.102574] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 05/25/2020] [Indexed: 01/10/2023]
Abstract
Objective To determine if rapid implementation of simulation training for anticipated COVID-19 tracheostomy procedures can increase physician confidence regarding procedure competency and use of enhanced personal protective equipment (PPE). Methods A brief simulation training exercise was designed in conjunction with the development of a COVID-19 Tracheostomy Protocol. The simulation training focused primarily on provider safety, pre and post-surgical steps and the proper use of enhanced PPE. Simulation training was performed in the simulation lab at the institution over 2 days. Pre and post self-evaluations were measured using standardized clinical competency questionnaires on a 5-point Likert Scale ranging from “No knowledge, unable to perform” up to “Highly knowledgeable and confident, independent.” Results Physicians self-reported a significant increase in knowledge and competency immediately after completing the training exercise. Resident physicians increased from a mean score of 3.00 to 4.67, p-value 0.0041, mean increase 1.67 (CI 95% 0.81 to 2.52). Attending physicians increased from a mean score of 2.89 to 4.67, p-value 0.0002, mean increase 1.78 (CI 95% 1.14 to 2.42). Overall, all participants increased from a mean score of 3.06 to 4.71, p-value 0.0001, mean increase 1.65 (CI 95% 1.24 to 2.05). Discussion Implementation of this simulation training at our institution resulted in a significant increase in physician confidence regarding the safe performance of tracheostomy surgery in COVID-19 patients. Implications for practice Adoption of standardized COVID-19 tracheostomy simulation training at centers treating COVID-19 patients may result in improved physician safety and enhanced confidence in anticipation of performing these procedures in real-life scenarios. Rapid implementation of a COVID-19 mobile tracheostomy team is feasible in hospitals as the COVID-19 pandemic progresses. Continuing training of a groups of core providers promotes vigilance in pandemic situations. Simulation prior to pandemic peak is critical to ensure successful rollout. Training should focus on proper PPE donning and doffing, given the high risk of virus aerosolization during tracheostomy.
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Assessment of Health Workers’ Knowledge, Beliefs, Attitudes, and Use of Personal Protective Equipment for Prevention of COVID-19 Infection in Low-Resource Settings. ADVANCES IN PUBLIC HEALTH 2020. [DOI: 10.1155/2020/4619214] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly infectious disease with a potential for healthcare workers (HCWs) getting infected due to inadequate protection while attending to patients. Effective use of personal protective equipment (PPE) is key to mitigating the spread of SARS-CoV-2 infection in healthcare settings. Hence, there is a need to understand HCWs’ use of PPE in resource-limited settings and how closely the currently recommended guidelines for PPE are followed. This study assessed the HCWs’ knowledge about, attitudes towards, beliefs on, and use of PPE to prevent SARS-CoV-2 infection in a resource-limited setting. Methods. This cross-sectional study was conducted in April 2020 in Southwest and Northwest Nigeria. The selection of participants was performed via the snowball sampling technique using a 33-item, web-based, self-administered questionnaire via a social media network. We obtained relevant sociodemographic data and information on participants’ occupations and knowledge about, attitudes towards, beliefs on, and use of PPE. We analysed the data using SPSS version 23.0 for Windows (IBM, Armonk, New York, USA). A p values <0.05 were considered statistically significant. Results. A total of 290 subjects responded to the questionnaire, and 18 (6.2%) were excluded because of incomplete data. The mean age of the respondents was 32.3 ± 9.9 years. There were 116 males (42.6%). The majority of the respondents were medical doctors (114, 41.9%), followed by nurses and clinical students. Of the 272 respondents in this survey, only 70 (25.7%) had adequate knowledge about PPE. Of the respondents who presumed they had adequate knowledge about donning and doffing PPE, 94 (56%) were incorrect. The predictors of good knowledge were ages younger than 45 years (p=0.046) and practice location (p=0.009). Conclusion. This study showed that HCWs’ knowledge about, attitudes towards, and beliefs on PPE and their PPE skill in practice in Nigeria were remarkably poor. There is an urgent need for nationwide practical training on PPE use to curtail the spread of SARS-CoV-2 infection among HCWs.
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