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King EC, Van Belle TA, Zagrodney KA, McKay SM, Giosa J, Holubiec I, Holness DL, Nichol KA. Factors Influencing Self-reported Facial Protective Equipment adherence among Home Care Nurses and Personal Support Workers - A multi-site cross-sectional study. Am J Infect Control 2024:S0196-6553(24)00553-4. [PMID: 38885790 DOI: 10.1016/j.ajic.2024.06.005] [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: 02/28/2024] [Revised: 06/08/2024] [Accepted: 06/08/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Facial Protective Equipment (FPE) use increased during the SARS-CoV-2 pandemic. This study explored factors influencing home care personal support workers' (PSWs) and nurses' self-reported adherence to FPE. METHODS A cross-sectional, electronic, survey was distributed to PSWs and nurses (1108 complete responses) at three home care agencies in Ontario, Canada, in May-June 2022. Descriptive, bivariate, and multivariable analysis were used to assess individual, environmental, and organizational factors influencing adherence. RESULTS Among participants (786 PSWs, 322 nurses), 64% reported being adherent to both respiratory and eye FPE (Respiratory: 96%, Eye: 64%). Higher adherence was associated with facility-based work; better knowledge of FPE; pre-pandemic FPE use; good availability and convenient access; strong organizational support for health and safety; and Caribbean identity. Lower adherence was found for men; nurses with 2-year diplomas; shorter length of employment; communal transportation; and experiencing negative mental health effects from workplace infectious disease exposure. DISCUSSION Agencies should prioritize increasing providers' knowledge of FPE, supporting mental well-being, fostering a supportive culture, and ensuring availability of FPE. The influences of gender, ethnicity, and role require further exploration. CONCLUSION FPE adherence may be improved by addressing modifiable factors and developing population-specific strategies.
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Affiliation(s)
- Emily C King
- VHA Home HealthCare, 30 Soudan Avenue, Suite 600, Toronto, ON, Canada M4S 1V6; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Room 500, Toronto, ON, Canada M5T 3M7; School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada N2L 3G1.
| | - Travis A Van Belle
- VHA Home HealthCare, 30 Soudan Avenue, Suite 600, Toronto, ON, Canada M4S 1V6
| | - Katherine Ap Zagrodney
- VHA Home HealthCare, 30 Soudan Avenue, Suite 600, Toronto, ON, Canada M4S 1V6; Institute for Health Policy, Management, and Evaluation, University of Toronto, 155 College Street, Suite 425, Toronto, ON, Canada M5T 3M6; Canadian Health Workforce Network, University of Ottawa, 120 University Private Street, Room 5051, Ottawa, ON, Canada K1N 6N5
| | - Sandra M McKay
- VHA Home HealthCare, 30 Soudan Avenue, Suite 600, Toronto, ON, Canada M4S 1V6; Institute for Health Policy, Management, and Evaluation, University of Toronto, 155 College Street, Suite 425, Toronto, ON, Canada M5T 3M6; Department of Physical Therapy, University of Toronto, 500 University Ave, Toronto, ON, Canada M5G 1V7; Ted Rogers School of Management, Toronto Metropolitan University, 55 Dundas St W, Toronto, ON, Canada M5G 2C3; The Institute for Education Research (TIER), University Health Network, 222 St. Patrick St., Toronto, ON, Canada M5T 1V4; Michener Institute of Education, University Health Network, 222 St. Patrick Street, Toronto, ON, Canada M5T 1V4; Micheal Garron Hospital, Toronto East Health Network, 825 Coxwell Ave, East York, ON, Canada M4C 3E7
| | - Justine Giosa
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada N2L 3G1; SE Research Centre, SE Health, 90 Allstate Parkway, Suite 300, Markham, ON, Canada L3R 6H3
| | - Irene Holubiec
- VON, 2315 St. Laurent Boulevard, Suite 100, Ottawa, ON, Canada K1G 4J8
| | - D Linn Holness
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Room 500, Toronto, ON, Canada M5T 3M7; Centre for Research Expertise in Occupational Disease, Toronto, ON Canada; Department of Medicine, University of Toronto, 6 Queen's Park Crescent West, Third Floor, Toronto, ON, Canada M5S 3H2; Department of Medicine and MAP Centre for Urban Health Solutions, St Michael's Hospital, Unity Health Toronto, 30 Bond St, Toronto, ON, Canada M5B 1W8
| | - Kathryn A Nichol
- VHA Home HealthCare, 30 Soudan Avenue, Suite 600, Toronto, ON, Canada M4S 1V6; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Room 500, Toronto, ON, Canada M5T 3M7; Centre for Research Expertise in Occupational Disease, Toronto, ON Canada
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Van Belle TA, King EC, Roy M, Michener M, Hung V, Zagrodney KAP, McKay SM, Holness DL, Nichol KA. Factors influencing nursing professionals' adherence to facial protective equipment usage: A comprehensive review. Am J Infect Control 2024:S0196-6553(24)00164-0. [PMID: 38657906 DOI: 10.1016/j.ajic.2024.04.006] [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: 11/24/2023] [Revised: 04/01/2024] [Accepted: 04/02/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Facial protective equipment (FPE) adherence is necessary for the health and safety of nursing professionals. This review was conducted to synthesize predisposing, enabling, and reinforcing factors that influence FPE adherence, and thus inform efforts to promote adherence. METHODS Articles were collected using Cumulated Index to Nursing and Allied Health Literature and MEDLINE and screened for inclusion. Included articles were original studies focused on FPE adherence by nurses to prevent respiratory infection which contained occupation-specific data from at least 10 individuals and were published in English between January 2005 and February 2022. RESULTS Thirty articles were included, 21 of which reported adherence rates. Adherence ranged from 33% to 100% for respiratory protection and 22% to 100% for eye protection. Predisposing demographic factors influencing adherence included tenure and occupation, while modifiable predisposing factors included knowledge and perception of FPE, infection transmission, and risk. Enabling factors included geography, care settings, and FPE availability. Reinforcing factors included organizational support for health and safety, clear policies, and training. CONCLUSIONS The identified demographic factors suggest populations that may benefit from targeted interventions, while modifiable factors suggest opportunities to enhance education as well as operational processes and supports. Interventions that target these areas have the potential to promote adherence and thereby improve the occupational safety of nurses.
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Affiliation(s)
| | - Emily C King
- Research Department, VHA Home HealthCare, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
| | - Meghla Roy
- Research Department, VHA Home HealthCare, Toronto, Ontario, Canada
| | - Mel Michener
- Research Department, VHA Home HealthCare, Toronto, Ontario, Canada
| | - Vivian Hung
- Research Department, VHA Home HealthCare, Toronto, Ontario, Canada
| | - Katherine A P Zagrodney
- Research Department, VHA Home HealthCare, Toronto, Ontario, Canada; Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada; Canadian Health Workforce Network, University of Ottawa, Ottawa, Ontario, Canada
| | - Sandra M McKay
- Research Department, VHA Home HealthCare, Toronto, Ontario, Canada; Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada; Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada; Ted Rogers School of Management, Toronto Metropolitan University, Toronto, Ontario, Canada; The Institute for Education Research (TIER), University Health Network, Toronto, Ontario, Canada; Michener Institute of Education, University Health Network, Toronto, Ontario, Canada; Micheal Garron Hospital, Toronto East Health Network, East York, Ontario, Canada
| | - D Linn Holness
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Medicine and MAP Centre for Urban Health Solutions, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada; Centre for Research Expertise in Occupational Disease, Toronto, Ontario Canada
| | - Kathryn A Nichol
- Research Department, VHA Home HealthCare, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Centre for Research Expertise in Occupational Disease, Toronto, Ontario Canada
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Shahriarirad S, Asmarian N, Shahriarirad R, Moghadami M, Askarian M, Hashemizadeh Fard Haghighi L, Javadi P, Sabetian G. High Post-Infection Protection after COVID-19 among Healthcare Workers: A Population-Level Observational Study. IRANIAN JOURNAL OF MEDICAL SCIENCES 2024; 49:247-258. [PMID: 38680224 PMCID: PMC11053253 DOI: 10.30476/ijms.2023.97708.2951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 04/04/2023] [Accepted: 05/04/2023] [Indexed: 05/01/2024]
Abstract
Background Even though a few years have passed since the coronavirus disease 2019 (COVID-19) outbreak, information regarding certain aspects of the disease, such as post-infection immunity, is still quite limited. This study aimed to evaluate post-infection protection and COVID-19 features among healthcare workers (HCWs), during three successive surges, as well as the rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection, reactivation, re-positivity, and severity. Methods This cross-sectional population-level observational study was conducted from 20 April 2020 to 18 February 2021. The study population included all HCWs in public or private hospitals in Fars Province, Southern Iran. The infection rate was computed as the number of individuals with positive polymerase chain reaction (PCR) tests divided by the total number of person-days at risk. The re-infection was evaluated after 90 days. Results A total of 30,546 PCR tests were performed among HCWs, of which 13,749 (61.94% of total HCWs) were positive. Considering the applied 90-day threshold, there were 44 (31.2%) cases of reactivation and relapse, and 97 (68.8% of infected and 1.81% of total HCWs) cases of reinfection among 141 (2.64%) diagnosed cases who experienced a second episode of COVID-19. There was no significant difference in symptoms (P=0.65) or the necessity for ICU admission (P=0.25). The estimated protection against repeated infection after a previous SARS-CoV-2 infection was 94.8% (95% CI=93.6-95.7). Conclusion SARS-CoV-2 re-positivity, relapse, and reinfection were rare in the HCW population. After the first episode of infection, an estimated 94.8% protection against recurring infections was achieved. A preprint version of this manuscript is available at DOI:10.21203/rs.3.rs-772662/v1 (https://www.researchsquare.com/article/rs-772662/v1).
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Affiliation(s)
- Sepehr Shahriarirad
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Naeimehossadat Asmarian
- Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Shahriarirad
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohsen Moghadami
- Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehrdad Askarian
- Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Parisa Javadi
- Department of Anesthesiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Golnar Sabetian
- Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Avusuglo WS, Mosleh R, Ramaj T, Li A, Sharbayta SS, Fall AA, Ghimire S, Shi F, Lee JKH, Thommes E, Shin T, Wu J. Workplace absenteeism due to COVID-19 and influenza across Canada: A mathematical model. J Theor Biol 2023; 572:111559. [PMID: 37419242 DOI: 10.1016/j.jtbi.2023.111559] [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: 10/16/2022] [Revised: 05/18/2023] [Accepted: 06/05/2023] [Indexed: 07/09/2023]
Abstract
The continual distress of COVID-19 cannot be overemphasized. The pandemic economic and social costs are alarming, with recent attributed economic loss amounting to billions of dollars globally. This economic loss is partly driven by workplace absenteeism due to the disease. Influenza is believed to be a culprit in reinforcing this phenomenon as it may exist in the population concurrently with COVID-19 during the influenza season. Furthermore, their joint infection may increase workplace absenteeism leading to additional economic loss. The objective of this project will aim to quantify the collective impact of COVID-19 and influenza on workplace absenteeism via a mathematical compartmental disease model incorporating population screening and vaccination. Our results indicate that appropriate PCR testing and vaccination of both COVID-19 and seasonal influenza may significantly alleviate workplace absenteeism. However, with COVID-19 PCR testing, there may be a critical threshold where additional tests may result in diminishing returns. Regardless, we recommend on-going PCR testing as a public health intervention accompanying concurrent COVID-19 and influenza vaccination with the added caveat that sensitivity analyses will be necessary to determine the optimal thresholds for both testing and vaccine coverage. Overall, our results suggest that rates of COVID-19 vaccination and PCR testing capacity are important factors for reducing absenteeism, while the influenza vaccination rate and the transmission rates for both COVID-19 and influenza have lower and almost equal affect on absenteeism. We also use the model to estimate and quantify the (indirect) benefit that influenza immunization confers against COVID-19 transmission.
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Affiliation(s)
- W S Avusuglo
- Africa-Canada Artificial Intelligence and Data Innovation Consortium, Laboratory for Industrial and Applied Mathematics (LIAM), York University, Toronto, On., Canada
| | - Rahele Mosleh
- Laboratory for Industrial and Applied Mathematics (LIAM), York University, Toronto, On., Canada
| | - Tedi Ramaj
- Department of Mathematics, Western University, London, On., Canada
| | - Ao Li
- Department of Mathematics, Western University, London, On., Canada
| | | | | | | | - Fenglin Shi
- Department of Mathematics and Statistics, York University, Toronto, On., Canada
| | | | | | | | - Jianhong Wu
- Africa-Canada Artificial Intelligence and Data Innovation Consortium, Laboratory for Industrial and Applied Mathematics (LIAM), York University, Toronto, On., Canada.
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Gallant AJ, Harding A, Johnson C, Steenbeek A, Curran JA. Identifying H1N1 and COVID-19 vaccine hesitancy or refusal among health care providers: a scoping review. JBI Evid Synth 2023; 21:913-951. [PMID: 36917102 PMCID: PMC10173945 DOI: 10.11124/jbies-22-00112] [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: 03/15/2023]
Abstract
OBJECTIVES The objective of this review was to describe and map the evidence on COVID-19 and H1N1 vaccine hesitancy or refusal by physicians, nurses, and pharmacists in North America, the United Kingdom and the European Union, and Australia. INTRODUCTION Since 2009, we have experienced two pandemics: H1N1 "swine flu" and COVID-19. While severity and transmissibility of these viruses varied, vaccination has been a critical component of bringing both pandemics under control. However, uptake of these vaccines has been affected by vaccine hesitancy and refusal. The vaccination behaviors of health care providers, including physicians, nurses, and pharmacists, are of particular interest as they have been priority populations to receive both H1N1 and COVID-19 vaccinations. Their vaccination views could affect the vaccination decisions of their patients. INCLUSION CRITERIA Studies were eligible for inclusion if they identified reasons for COVID-19 or H1N1 vaccine hesitancy or refusal among physicians, nurses, or pharmacists from the included countries. Published and unpublished literature were eligible for inclusion. Previous reviews were excluded; however, the reference lists of relevant reviews were searched to identify additional studies for inclusion. METHODS A search of CINAHL, MEDLINE, PsycINFO, and Academic Search Premier databases was conducted April 28, 2021, to identify English-language literature published from 2009 to 2021. Gray literature and citation screening were also conducted to identify additional relevant literature. Titles, abstracts, and eligible full-text articles were reviewed in duplicate by 2 trained reviewers. Data were extracted in duplicate using a structured extraction tool developed for the review. Conflicts were resolved through discussion or with a third team member. Data were synthesized using narrative and tabular summaries. RESULTS In total, 83 articles were included in the review. Studies were conducted primarily across the United States, the United Kingdom, and France. The majority of articles (n=70) used cross-sectional designs to examine knowledge, attitudes, and uptake of H1N1 (n=61) or COVID-19 (n=22) vaccines. Physicians, medical students, nurses, and nursing students were common participants in the studies; however, only 8 studies included pharmacists in their sample. Across health care settings, most studies were conducted in urban, academic teaching hospitals, with 1 study conducted in a rural hospital setting. Concerns about vaccine safety, vaccine side effects, and perceived low risk of contracting H1N1 or COVID-19 were the most common reasons for vaccine hesitancy or refusal across both vaccines. CONCLUSIONS With increased interest and attention on vaccines in recent years, intensified by the COVID-19 pandemic, more research that examines vaccine hesitancy or refusal across different health care settings and health care providers is warranted. Future work should aim to utilize more qualitative and mixed methods research designs to capture the personal perspectives of vaccine hesitancy and refusal, and consider collecting data beyond the common urban and academic health care settings identified in this review.
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Affiliation(s)
| | | | | | | | - Janet A. Curran
- IWK Health Centre, Halifax, NS, Canada
- School of Nursing, Dalhousie University, Halifax, NS, Canada
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Blanchet Zumofen MH, Frimpter J, Hansen SA. Impact of Influenza and Influenza-Like Illness on Work Productivity Outcomes: A Systematic Literature Review. PHARMACOECONOMICS 2023; 41:253-273. [PMID: 36515814 PMCID: PMC9748403 DOI: 10.1007/s40273-022-01224-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/10/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Influenza is a persistent public health problem with a significant burden on patients, employers, and society. A systematic review by Keech and Beardsworth (2008) characterized the burden of influenza/influenza-like illness (ILI) on absenteeism. We conducted a systematic literature review evaluating the impact of influenza/ILI on work productivity among adults as an update to the work of Keech and Beardsworth. METHODS This systematic review identified studies evaluating the impact of influenza/ILI on absenteeism, presenteeism, or related work productivity measures for employees and employed caregivers based on laboratory confirmation, physician diagnosis, and/or self-reported illness. Eligible studies were in English, French, or German published from 7 March 2007 through 15 February 2022, in PubMed, Embase, or BIOSIS. Two reviewers completed screening and full-text review, with conflicts resolved by a third advisor. Summary data were extracted by two analysts; all records were quality checked by one analyst. Work productivity outcomes were summarized qualitatively, and risk of bias was not evaluated. RESULTS A total of 14,387 records were retrieved; 12,245 titles/abstracts were screened and 145 full-text publications were reviewed, of which 63 were included in the qualitative assessment. Studies of self-reported ILI were most frequent (49%), followed by laboratory-confirmed cases (37%) and physician diagnoses (11%). Overall, approximately 20-75% of employees missed work due to illness across study settings and populations. Mean time out of work among ill employees varied widely across study designs and populations, ranging from < 1 to > 10 days, and was often reported to be approximately 2-3 days. Considerable heterogeneity was observed across study designs, populations, and outcomes. Most employees (≈ 60-80%) reported working while experiencing influenza/ILI symptoms. Reporting of costs was sparse and heterogeneous; one study reported annual costs of influenza-related absences equating to $42,851 per 100,000 employee health plan members. Results were partitioned based on the following categories. Among otherwise healthy adults, 1-74% of workers missed ≥1 workday due to influenza/ILI, for a mean [standard deviation (SD)] of 0.5 (1.44) to 5.3 (4.50) days, and 42-89% reported working while ill, for a mean (SD) of 0.3 (0.63) to 4.4 (3.73) days. Among working caregivers, 50-75% missed work to care for children/household members with influenza/ILI, for 1-2 days on average. Similarly, the mean absenteeism among healthcare workers ranged from 0.5 to 3.2 days. Across studies evaluating vaccination status, generally smaller proportions of vaccinated employees missed time from work due to influenza/ILI. CONCLUSIONS This systematic review summarized the productivity burden of influenza/ILI on the worldwide working-age population. Despite notable heterogeneity in study designs, influenza/ILI case definitions, and productivity outcome measures, this review highlighted the substantial productivity burden that influenza/ILI may have on employees, employers, and society, consistent with the findings of Keech and Beardsworth (2008).
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Ardiani EL, Hartono RK. Development of an infectious disease prevention behavior model for public health center workers in a rural area of Indonesia. J Public Health Afr 2022. [PMID: 37497147 PMCID: PMC10367035 DOI: 10.4081/jphia.2022.2405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The Infection Prevention Behavior (IPB) for health personnel at the Surade Public Health Center has not reached the target. The purpose of this study was to develop the IPB model for health personnel which is suitable to be applied in rural areas in Indonesia. The model was developed through a literature review from online journal database in the last 10 years. The model was tested using a cross-sectional design by the Structural Equation Model Partial Least Square (SEM-PLS). Six selected variables had direct and indirect influences on the IPB of health personnel. They were supervision (27.50%), facilities (9.87%), training (10.44%), compensation (16.97%), work climate (10.78%), and work motivation (8.15%). The model was valid and significant. The Q2 showed 95.7% which mean 95.7% of the components in the model could be applied to other Public Health Centers in the rural area. The development of IPB models for health personnel which wass measured from the direct and indirect effects of six variables proved valid and significant to help achievement Public Health Center reach the target of protecting health workers from infectious diseases.
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Gamble K, Murthy S, Silverberg SL, Gobat N, Puchalski Ritchie LM. Canadian critical care nurses experiences on the front lines of the COVID-19 pandemic: a qualitative descriptive study. BMC Nurs 2022; 21:330. [PMID: 36443791 PMCID: PMC9706905 DOI: 10.1186/s12912-022-01105-8] [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: 05/16/2022] [Accepted: 10/17/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Recent pandemics have provided important lessons to inform planning for public health emergencies. Despite these lessons, gaps in implementation during the COVID-19 pandemic are evident. Additionally, research to inform interventions to support the needs of front-line nurses during a prolonged pandemic are lacking. We aimed to gain an understanding of critical care nurses' perspectives of the ongoing pandemic, including their opinions of their organization and governments response to the pandemic, to inform interventions to improve the response to the current and future pandemics. METHODS This sub-study is part of a cross-sectional online survey distributed to Canadian critical care nurses at two time points during the pandemic (March-May 2020; April-May 2021). We employed a qualitative descriptive design comprised of three open-ended questions to provide an opportunity for participants to share perspectives not specifically addressed in the main survey. Responses were analyzed using conventional content analysis. RESULTS One hundred nine of the 168 (64.9%) participants in the second survey responded to the open-ended questions. While perspectives about effectiveness of both their organization's and the government's responses to the pandemic were mixed, most noted that inconsistent and unclear communication made it difficult to trust the information provided. Several participants who had worked during previous pandemics noted that their organization's COVID-19 response failed to incorporate lessons from these past experiences. Many respondents reported high levels of burnout and moral distress that negatively affected both their professional and personal lives. Despite these experiences, several respondents noted that support from co-workers had helped them to cope with the stress and challenges. CONCLUSION One year into the pandemic, critical care nurses' lived experiences continue to reflect previously identified challenges and opportunities for improvement in pandemic preparedness and response. These findings suggest that lessons from the current and prior pandemics have been inadequately considered in the COVID-19 response. Incorporation of these perspectives into interventions to improve the health system response, and support the needs of critical care nurses is essential to fostering a resilient health workforce. Research to understand the experience of other front-line workers and to learn from more and less successful interventions, and leaders, is needed.
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Affiliation(s)
- Kathleen Gamble
- Li Ka Shing Knowledge Institute, Knowledge Translation Program, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada
| | - Srinivas Murthy
- Department of Pediatrics, BC Children's Hospital, University of British Columbia, 4500 Oak Street, Vancouver, BC, V6H 3V4, Canada
| | - Sarah L Silverberg
- Department of Pediatrics, BC Children's Hospital, University of British Columbia, 4500 Oak Street, Vancouver, BC, V6H 3V4, Canada
| | - Nina Gobat
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Lisa M Puchalski Ritchie
- Li Ka Shing Knowledge Institute, Knowledge Translation Program, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada. .,Department of Medicine, University of Toronto, Toronto, ON, Canada. .,Department of Emergency Medicine, University Health Network, Toronto, ON, Canada. .,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
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Garbin AJÍ, Nascimento CCMP, Zacharias FCM, Garbin CAS, Moimaz SAS, Saliba NA. Sickness absenteeism of Primary Health Care professionals before and during the COVID-19 pandemic. Rev Bras Enferm 2022; 75Suppl 1:e20220028. [PMID: 36043603 DOI: 10.1590/0034-7167-2022-0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 05/04/2022] [Indexed: 05/31/2023] Open
Abstract
OBJECTIVE to identify the frequency of occurrence of sickness absenteeism, according to the profile of Primary Health Care (PHC) professionals, and verify if there was an impact of the pandemic on absence duration and reason. METHODS a cross-sectional study, from January/2019 to December/2020, with PHC professionals from a municipality in northeastern São Paulo. Descriptive statistics were performed, with frequency calculation. RESULTS of the 977 PHC professionals, 633 (64.79%) used a medical certificate to justify their absence from work in 2019, and 837 (85.67%) in 2020. The main reason for leave was diseases of the musculoskeletal system and connective tissue in the two years. The mean duration of leave was 7.33 days (SD=17.33) in 2019 and 9.88 days (SD=16.05) in 2020. Nursing assistants were the ones who took the most leave in both years. CONCLUSIONS there was an impact of the pandemic on absence duration and reason.
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Chaaban O, Balanay JAG, Sousan S. Assessment of best-selling respirators and masks: Do we have acceptable respiratory protection for the next pandemic? Am J Infect Control 2022; 51:388-395. [PMID: 35901992 PMCID: PMC9313532 DOI: 10.1016/j.ajic.2022.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/22/2022] [Accepted: 06/25/2022] [Indexed: 12/04/2022]
Abstract
Background COVID-19 pandemic caused a high demand for respiratory protection, caused a scarcity of approved respirators and the production of alternative respiratory protection. To raise public awareness through the scientific community, bestselling respirators and masks in the United States’ leading online retailer, Amazon.com, were evaluated. Methods Ten respirators and masks, 5 Face Protective Equipment (FPE) and 5 Cloth Face Masks (CFMs), were evaluated compared to the N95 standard. Two groups were established with the intention of comparing all masks together. The fractional efficiency and pressure drop were measured and compared to the National Institute for Occupational Safety and Health (NIOSH) standards. In addition, grading factors for protection, comfort, and affordability were developed that can be used by the scientific community to readily disseminate to consumers for the selection of the appropriate respiratory protection. Results Two FPE provided acceptable efficiency (>95%) similar to the N95, while the remaining products were below or extremely below NIOSH standards. All products provided pressure drops within NIOSH standards (≤35 mmH2O) ranging from 2.3-10.3 mmH2O. The grading factors show that the CFMs have minimal protection, and the N95 has average comfort and affordability compared to all the products. Conclusion The N95 remains the best respiratory protection, and in the event of the next airborne pandemic, FPEs could serve as adequate alternative protection against the viral spread.
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Affiliation(s)
- Omar Chaaban
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC
| | - Jo Anne G Balanay
- Environmental Health Sciences Program, Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC
| | - Sinan Sousan
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC; North Carolina Agromedicine Institute, Greenville, NC.
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Krewski D, Saunders-Hastings P, Larkin P, Westphal M, Tyshenko MG, Leiss W, Dusseault M, Jerrett M, Coyle D. Principles of risk decision-making. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2022; 25:250-278. [PMID: 35980104 DOI: 10.1080/10937404.2022.2107591] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Risk management decisions in public health require consideration of a number of complex, often conflicting factors. The aim of this review was to propose a set of 10 fundamental principles to guide risk decision-making. Although each of these principles is sound in its own right, the guidance provided by different principles might lead the decision-maker in different directions. For example, where the precautionary principle advocates for preemptive risk management action under situations of scientific uncertainty and potentially catastrophic consequences, the principle of risk-based decision-making encourages decision-makers to focus on established and modifiable risks, where a return on the investment in risk management is all but guaranteed in the near term. To evaluate the applicability of the 10 principles in practice, one needs to consider 10 diverse risk issues of broad concern and explore which of these principles are most appropriate in different contexts. The 10 principles presented here afford substantive insight into the process of risk management decision-making, although decision-makers will ultimately need to exercise judgment in reaching appropriate risk decisions, accounting for all of the scientific and extra-scientific factors relevant to the risk decision at hand.
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Affiliation(s)
- Daniel Krewski
- McLaughlin Centre for Population Health Risk Assessment, Faculty of Medicine, University of Ottawa, ON, Canada
| | - Patrick Saunders-Hastings
- McLaughlin Centre for Population Health Risk Assessment, Faculty of Medicine, University of Ottawa, ON, Canada
| | - Patricia Larkin
- McLaughlin Centre for Population Health Risk Assessment, Faculty of Medicine, University of Ottawa, ON, Canada
| | - Margit Westphal
- McLaughlin Centre for Population Health Risk Assessment, Faculty of Medicine, University of Ottawa, ON, Canada
| | | | - William Leiss
- McLaughlin Centre for Population Health Risk Assessment, Faculty of Medicine, University of Ottawa, ON, Canada
| | - Maurice Dusseault
- Department of Earth and Environmental Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Michael Jerrett
- Department of Environmental Health Sciences, Fielding School of Public Health, UCLA, Los Angeles, CA, USA
| | - Doug Coyle
- School of Epidemiology and Public Health, University of Ottawa, ON, Canada
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12
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Advances in respiratory protective equipment: Practical experiences of CleanSpace® HALO™ by healthcare workers. J Hosp Infect 2022; 124:22-28. [DOI: 10.1016/j.jhin.2022.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/21/2022] [Accepted: 03/06/2022] [Indexed: 12/17/2022]
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Panthi S, Jaishi AR, Gautam S, Bhandari S, Bhatt N, Basnet LB, Sharma SK. Perception of Health Care Practitioners of Government Designated COVID-19 Hospitals of Nepal towards the Management of COVID-19 Pandemic: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc 2022; 60:40-46. [PMID: 35199671 PMCID: PMC9157657 DOI: 10.31729/jnma.7093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 01/17/2022] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Amidst the chaos of COVID-19, health care practitioners are persistently providing services and experiencing many challenges. This study aimed to determine the perception of health care practitioners of government designated COVID-19 hospitals of Nepal towards the management of COVID-19 pandemic. METHODS A descriptive cross-sectional study was conducted among the frontline health care practitioners working in the government designated COVID-19 hospitals in Nepal from 21st June, 2020 to 15th August, 2020. Ethical approval was obtained from the Ethical Review Board of the Nepal Health Research Council (Reference number: 347/2020 P). A total of 252 health care practitioners (doctors, nurses, and paramedics) working at the forefront in the emergency ward, general wards, intensive care units, isolation centers, fever clinics, laboratory, quarantine centers, help desks, etc. in the designated hospitals who consented to participate were included in the study. Convenience sampling was used. The data was analyzed using Statistical Package for the Social Sciences version 16.0. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. RESULTS Only 41 (16.3%) (11.73-20.86 at 95% Confidence Interval) of the health care practitioners were found to have satisfactory perception towards the management of COVID-19 pandemic in Nepal. CONCLUSIONS The satisfactory perception of the health care practitioners in our study towards the management of COVID-19 pandemic in Nepal is lower as compared to the other studies in Nepal and abroad.
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Affiliation(s)
- Sagar Panthi
- B. P. Koirala Institute of Health Sciences, Dharan, Nepal
| | | | | | - Siddhartha Bhandari
- Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | | | | | - Sanjib Kumar Sharma
- Department of Internal Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal
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Garbin AJÍ, Nascimento CCMP, Zacharias FCM, Garbin CAS, Moimaz SAS, Saliba NA. Absenteísmo-doença dos profissionais da Atenção Primária à Saúde antes e durante a pandemia de COVID-19. Rev Bras Enferm 2022. [DOI: 10.1590/0034-7167-2022-0028pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivo: identificar a frequência de ocorrência do absenteísmo-doença, de acordo com o perfil dos profissionais da Atenção Primária à Saúde (APS), e verificar se houve impacto da pandemia na duração e motivos dos afastamentos. Métodos: estudo transversal, no período de janeiro/2019 a dezembro/2020, com os profissionais de APS de um município do nordeste do estado de São Paulo. Realizou-se estatística descritiva, com cálculo de frequências. Resultados: dos 977 profissionais da APS, 633 (64,79%) utilizaram o atestado médico para justificar sua ausência no trabalho em 2019, e 837 (85,67%), em 2020. O principal motivo dos afastamentos foi as doenças osteomusculares e do tecido conjuntivo nos dois anos. A duração média dos afastamentos foi de 7,33 dias (DP=17,33) em 2019 e de 9,88 dias (DP=16,05) em 2020. Os auxiliares de enfermagem foram os que mais se afastaram em ambos os anos. Conclusões: houve impacto da pandemia na duração e motivos dos afastamentos.
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15
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Murphy AL, Simon K, Pelletier E, Miller L, Gardner DM. Bloom Program pharmacy teams’ experiences providing mental health services during the COVID-19 pandemic. Can Pharm J (Ott) 2021; 155:93-100. [PMID: 35300027 PMCID: PMC8922227 DOI: 10.1177/17151635211065426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 10/04/2021] [Accepted: 10/05/2021] [Indexed: 11/24/2022]
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16
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Hubble MW, Renkiewicz GK. Estimated Cost Effectiveness of Influenza Vaccination for Emergency Medical Services Professionals. West J Emerg Med 2021; 22:1317-1325. [PMID: 34787557 PMCID: PMC8597702 DOI: 10.5811/westjem.2021.7.50681] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 07/23/2021] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Because of their frequent contact with compromised patients, vaccination against influenza is recommended for all healthcare workers. Recent studies suggest that vaccination decreases influenza transmission to patients and reduces worker illness and absenteeism. However, few emergency medical services (EMS) agencies provide annual vaccination, and the vaccination rate among EMS personnel remains low. Reticence among EMS agencies to provide influenza vaccination to their employees may be due in part to the unknown fiscal consequences of implementing a vaccination program. In this study, we sought to estimate the cost effectiveness of an employer-provided influenza vaccination program for EMS personnel. METHODS Using data from published reports on influenza vaccination, we developed a cost-effectiveness model of vaccination for a hypothesized EMS system of 100 employees. Model inputs included vaccination costs, vaccination rate, infection rate, costs associated with absenteeism, lost productivity due to working while ill (presenteeism), and medical care for treating illness. To assess the robustness of the model we performed a series of sensitivity analyses on the input variables. RESULTS The proportion of employees contracting influenza or influenza-like illness (ILI) was estimated at 19% among vaccinated employees compared to 26% among non-vaccinated employees. The costs of the vaccine, consumables, and employee time for vaccination totaled $44.19 per vaccinated employee, with a total system cost of $4,419. Compared to no vaccination, a mandatory vaccination program would save $20,745 in lost productivity and medical costs, or $16,325 in net savings after accounting for vaccination costs. The savings were 3.7 times the cost of the vaccination program and were derived from avoided absenteeism ($7,988), avoided presenteeism productivity losses ($10,303), and avoided medical costs of treating employees with influenza/ILI ($2,454). Through sensitivity analyses the model was verified to be robust across a wide range of input variable assumptions. The net monetary benefits were positive across all ranges of input assumptions, but cost savings were most sensitive to the vaccination uptake rate, ILI rate, and presenteeism productivity losses. CONCLUSION This cost-effectiveness analysis suggests that an employer-provided influenza vaccination program is a financially favorable strategy for reducing costs associated with influenza/ILI employee absenteeism, presenteeism, and medical care.
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Affiliation(s)
- Michael W Hubble
- Wake Technical Community College, Department of Emergency Medical Science, Raleigh, North Carolina
| | - Ginny K Renkiewicz
- Wake Technical Community College, Department of Emergency Medical Science, Raleigh, North Carolina
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Effect of Different Types of Face Masks on the Ventilatory and Cardiovascular Response to Maximal-Intensity Exercise. BIOLOGY 2021; 10:biology10100969. [PMID: 34681068 PMCID: PMC8533493 DOI: 10.3390/biology10100969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/20/2021] [Accepted: 09/23/2021] [Indexed: 11/17/2022]
Abstract
The development of new models of face masks makes it necessary to compare their impact on exercise. Therefore, the aim of this work was to compare the cardiopulmonary response to a maximal incremental test, perceived ventilation, exertion, and comfort using FFP2 or Emotion masks in young female athletes. Thirteen healthy sportswomen (22.08 ± 1.75 years) performed a spirometry, and a graded exercise test on a treadmill, with a JAEGER® Vyntus CPX gas analyzer using an ergospirometry mask (ErgoMask) or wearing the FFP2 or the Emotion mask below the ErgoMask, randomized on 3 consecutive days. Also, menstrual cycle status was monitored to avoid possible intrasubject alterations. The results showed lower values for the ErgoMask+FFP2, compared to ErgoMask or ErgoMask+Emotion, in forced vital capacity (3.8 ± 0.2, 4.5 ± 0.2 and 4.1 ± 0.1 l, respectively); forced expiratory volume in 1 s (3.3 ± 0.2, 3.7 ± 0.2 and 3.5 ± 0.1 l); ventilation (40.9 ± 1.5, 50.6 ± 1.5 and 46.9 ± 1.2 l/min); breathing frequency (32.7 ± 1.1, 37.4 ± 1.1 and 35.3 ± 1.4 bpm); VE/VO2 (30.5 ± 0.7, 34.6 ± 0.9 and 33.6 ± 0.7); VE/VCO2 (32.2 ± 0.6, 36.2 ± 0.9 and 34.4 ± 0.7) and time to exhaustion (492.4 ± 9.7, 521.7 ± 8.6 and 520.1 ± 9.5 s) and higher values in inspiratory time (0.99 ± 0.04, 0.82 ± 0.03 and 0.88 ± 0.03 s). In conclusion, in young healthy female athletes, the Emotion showed better preservation of cardiopulmonary responses than the FFP2.
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Badran EF, Jarrah S, Masadeh R, Al Hammad A, Al Shimi R, Salhout S, Al Wahabi N, Al Jaberi M, Rayyan A, Madi T, Hassan S. Assessment of Perceived Compliance and Barriers to Personal Protective Equipment Use Among Healthcare Workers During the COVID-19 Pandemic's Second Wave Surge: "Walk to Talk" Cross-Sectional Correlational Study. Disaster Med Public Health Prep 2021; 17:e45. [PMID: 34496993 PMCID: PMC8545841 DOI: 10.1017/dmp.2021.289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE This study aimed at investigating HCWs' perceptions of PPE compliance and barriers, as well as influencing factors, in order to develop methods to combat the rise in their infection rates. METHODS During the 'second wave' surge, a cross-sectional correlational analysis was conducted over a 1-month period. It consists of HCWs from various hospital sectors that admit COVID-19 patients using an online self-administered predesigned tool. RESULTS Out of the 285 recruited participants, 36.1% had previously been diagnosed with COVID-19. Around 71% received training on PPE use. The perceived compliance was good for (PPE) usage (mean 2.60 ± 1.10). A significant higher compliance level was correlated with previous diagnosis with COVID-19, working with patients diagnosed with COVID-19, and having a direct contact with a family member older than 45 years old (P < 0.01). The main perceived barriers to the use of PPEs were unavailability of full PPEs (35%), interference with their ability to provide patient care (29%), not enough time to comply with the rigors of PPEs (23.2%) and working in emergency situations (22.5%). With regards to perceived barriers, those working with patients diagnosed with COVID-19 and those who reported having a direct contact with a family member older than 45 years old showed significantly higher level of barriers. CONCLUSION A series of measures, including prioritization of PPE acquisition, training, and monitoring to guarantee appropriate resources for IPC, are necessary to reduce transmission.
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Affiliation(s)
- Eman F Badran
- Department of Pediatrics, School of Medicine, University of Jordan, Amman, Jordan
| | - Samiha Jarrah
- Department of Nursing, School of Nursing, Applied Science Private University, Amman, Jordan
| | - Rami Masadeh
- Department of Community Health, School of Nursing, Applied Science Private University, Amman, Jordan
| | | | - Rana Al Shimi
- School of Medicine, University of Jordan, Amman, Jordan
| | - Samar Salhout
- School of Medicine, University of Jordan, Amman, Jordan
| | | | | | | | - Thaira Madi
- Department of Accreditation, Healthcare Accreditation Council, Amman, Jordan
| | - Samar Hassan
- Department of Accreditation, Healthcare Accreditation Council, Amman, Jordan
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Brooks SK, Greenberg N, Wessely S, Rubin GJ. Factors affecting healthcare workers' compliance with social and behavioural infection control measures during emerging infectious disease outbreaks: rapid evidence review. BMJ Open 2021; 11:e049857. [PMID: 34400459 PMCID: PMC8370838 DOI: 10.1136/bmjopen-2021-049857] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE The 2019-2020 outbreak of novel coronavirus has raised concerns about nosocomial transmission. This review's aim was to explore the existing literature on emerging infectious disease outbreaks to identify factors associated with compliance with infection control measures among healthcare staff. METHODS A rapid evidence review for primary studies relevant to healthcare workers' compliance with infection control measures. RESULTS Fifty-six papers were reviewed. Staff working in emergency or intensive care settings or with contact with confirmed cases appeared more likely to comply with recommendations. There was some evidence that anxiety and concern about the risk of infection were more associated with compliance, and that monitoring from superiors could improve compliance. Observed non-compliance of colleagues could hinder compliance. Staff identified many barriers to compliance related to personal protective equipment, including availability, perceived difficulty and effectiveness, inconvenience, discomfort and a negative impact on patient care. There were many issues regarding the communication and ease of understanding of infection control guidance. CONCLUSION We recommend provision of training and education tailored for different occupational roles within the healthcare setting, managerial staff 'leading by example', ensuring adequate resources for infection control and timely provision of practical evidence-based infection control guidelines.
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Affiliation(s)
- Samantha K Brooks
- Department of Psychological Medicine, King's College London, London, UK
| | - N Greenberg
- Department of Psychological Medicine, King's College London, London, UK
| | - Simon Wessely
- Department of Psychological Medicine, King's College London, London, UK
| | - G J Rubin
- Department of Psychological Medicine, King's College London, London, UK
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20
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Los J, Gaydos CA, Gibert CL, Gorse GJ, Lykken J, Nyquist AC, Price CS, Radonovich LJ, Rattigan S, Reich N, Rodriguez-Barradas M, Simberkoff M, Bessesen M, Brown A, Cummings DAT, Perl TM. Take-home kits to detect respiratory viruses among healthcare personnel: Lessons learned from a cluster randomized clinical trial. Am J Infect Control 2021; 49:893-899. [PMID: 33581146 PMCID: PMC7874979 DOI: 10.1016/j.ajic.2021.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 02/02/2021] [Accepted: 02/04/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Health care personnel (HCP) working in outpatient settings routinely interact with patients with acute respiratory illnesses. Absenteeism following symptom development and lack of staff trained to obtain samples limit efforts to identify pathogens among infected HCP. METHODS The Respiratory Protection Effectiveness Clinical Trial assessed respiratory infection incidence among HCP between 2011 and 2015. Research assistants obtained anterior nasal and oropharyngeal swabs from HCP in the workplace following development of respiratory illness symptoms and randomly while asymptomatic. Participants received take-home kits to self-collect swabs when absent from work. Samples mailed to a central laboratory were tested for respiratory viruses by reverse transcription polymerase chain reaction. RESULTS Among 2,862 participants, 3,467 swabs were obtained from symptomatic participants. Among symptomatic HCP, respiratory virus was detected in 904 of 3,467 (26.1%) samples. Self-collected samples by symptomatic HCP at home had higher rates of viral detection (40.3%) compared to 24% obtained by trained research assistants in the workplace (P < .001). CONCLUSIONS In this randomized clinical trial, take-home kits were an easily implemented, effective method to self-collect samples by HCP. Other studies have previously shown relative equivalence of self-collected samples to those obtained by trained healthcare workers. Take-home kit self-collection could diminish workforce exposures and decrease the demand for personnel protective equipment worn to protect workers who collect respiratory samples.
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Affiliation(s)
- Jenna Los
- Johns Hopkins University School of Medicine, Baltimore, MD.
| | | | | | - Geoffrey J Gorse
- VA St. Louis Health Care System and Saint Louis University School of Medicine St. Louis, MO
| | | | - Ann-Christine Nyquist
- Children's Hospital Colorado, Aurora, CO; University of Colorado School of Medicine, Aurora, CO
| | - Connie S Price
- University of Colorado School of Medicine, Aurora, CO; Denver Health and Hospital, Denver, CO
| | - Lewis J Radonovich
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Atlanta, GA
| | | | | | | | | | - Mary Bessesen
- University of Colorado School of Medicine, Aurora, CO; VA-Eastern Colorado Healthcare System, Denver, CO
| | | | | | - Trish M Perl
- Johns Hopkins University School of Medicine, Baltimore, MD; University of Texas Southwestern Medical Center, Dallas, TX
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21
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Waring S, Giles S. Rapid Evidence Assessment of Mental Health Outcomes of Pandemics for Health Care Workers: Implications for the Covid-19 Pandemic. Front Public Health 2021; 9:629236. [PMID: 34095049 PMCID: PMC8175907 DOI: 10.3389/fpubh.2021.629236] [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: 11/13/2020] [Accepted: 04/14/2021] [Indexed: 01/03/2023] Open
Abstract
Background: Little is known about the long-term mental health (MH) impact of the Covid-19 pandemic on health care workers (HCWs). However, synthesizing knowledge from past pandemics can help to anticipate this, along with identifying interventions required, when, and target populations most in need. This paper provides a balanced evaluation of what is currently known about short- and long-term MH impacts of pandemics on HCWs and effect of methodological limitations on knowledge claims. Method: A rapid evidence assessment (REA) was conducted on 41 studies published in the past two decades that examined MH outcomes for HCWs in relation to pandemics. Results: Findings of literary synthesis highlight common MH outcomes across pandemics, including increased stress, distress, burnout, and anxiety in the short-term, and post-traumatic stress and depression in the long-term. Findings also show the key role that organizations and public health bodies play in promoting adaptive coping and reducing health worries and the emotional and psychological distress caused by this. Evidence highlights particular groups at risk of developing MH issues (contact with patients that are infected, having children), and time points where risk may increase (initial response phase, when quarantined). However, inconsistencies in measures, analysis, and reporting all create limitations for pooling data. Conclusions: Findings can be used by researchers to provide a knowledge framework to inform future research that will assist HCWs in responding to pandemics, and by policy makers and service planners to provide an evidence-led brief about direction and evidence base for related policy initiatives, interventions or service programmes.
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Affiliation(s)
- Sara Waring
- Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom
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Ong SK, Birgersson E, Low HY. Tuning Pressure Drop in Isoporous Membranes: Design with Fabrication Variability. ADVANCED THEORY AND SIMULATIONS 2021. [DOI: 10.1002/adts.202100088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Shi Ke Ong
- Engineering Product Development Singapore University of Technology and Design 8 Somapah Road Singapore 487372 Singapore
| | - Erik Birgersson
- Department of Mechanical Engineering National University of Singapore 9 Engineering Drive 1 Singapore 117574 Singapore
| | - Hong Yee Low
- Engineering Product Development Singapore University of Technology and Design 8 Somapah Road Singapore 487372 Singapore
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Pfenninger EG, Christ P, Neumüller M, Dinse-Lambracht A. [Assessment of the risk of infection from SARS-CoV-2 for healthcare workers-findings from practice]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:304-313. [PMID: 33496803 PMCID: PMC7837074 DOI: 10.1007/s00103-021-03277-1] [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: 04/28/2020] [Accepted: 12/17/2020] [Indexed: 01/19/2023]
Abstract
Das SARS-CoV-2-Virus als Erreger der COVID-19-Erkrankung hat sich innerhalb kurzer Zeit weltweit in der Bevölkerung ausgebreitet. Bei der Abfassung des Beitrags stehen noch keine Schutzimpfung und keine spezifische Therapie gegen SARS-CoV‑2 zur Verfügung. Bei Veröffentlichung des Artikels werden mindestens zwei Impfstoffe zur Verfügung stehen. In der internationalen Laienpresse wird das Risiko für medizinisches Personal, an SARS-CoV‑2 zu erkranken, als hoch eingeschätzt; das Robert Koch-Institut stuft das Risiko für die Gesamtbevölkerung in Deutschland als „hoch“ ein. Das Ziel des vorliegenden Beitrags ist es, das Infektions- und Erkrankungsrisiko für medizinisches Personal basierend auf Praxiserfahrungen, nationalen Verordnungen und Richtlinien sowie Infektionszahlen zu diskutieren und neu einzuschätzen. Dabei wird sowohl ungeschütztes als auch mit persönlicher Schutzausrüstung (PSA) ausgestattetes medizinisches Personal betrachtet. Eine entsprechende Risikomatrix wird erstellt. Das Infektionsrisiko für ungeschütztes medizinisches Personal entspricht dem in der Gesamtbevölkerung und ist mit „hoch“ einzustufen. Mit entsprechender persönlicher Schutzausrüstung ist das Infektionsrisiko für medizinisches Personal dagegen als „mittel“ einzuschätzen. Zur PSA gehören ein flüssigkeitsdichter Schutzkittel, Handschuhe, Maske – Schutzstufe FFP2 oder FFP3 – bei Tätigkeiten mit Tröpfchen oder Aerosolbildung, Kopfhaube und eine geeignete Schutzbrille. Ungenügende Handhygienemaßnahmen, falsche Handhabung der Schutzkleidung sowie lange Dienstzeiten erhöhen das Infektionsrisiko.
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Affiliation(s)
- Ernst G Pfenninger
- Stabsstelle Katastrophenschutz, Universitätsklinikum Ulm, Albert-Einstein-Allee 29, 89071, Ulm, Deutschland.
| | - Pascal Christ
- Stabsstelle Sicherheit, Universitätsklinikum Ulm, Ulm, Deutschland
| | - Martin Neumüller
- Stabsstelle Sicherheit, Universitätsklinikum Ulm, Ulm, Deutschland
| | - Alexander Dinse-Lambracht
- Zentrale Interdisziplinare Notaufnahme, Universitätsklinikum Ulm, Ulm, Deutschland.,Interdisziplinäres Notfallzentrum, Kliniken Aurich-Emden-Norden, Emden, Deutschland
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Rowan NJ, Laffey JG. Unlocking the surge in demand for personal and protective equipment (PPE) and improvised face coverings arising from coronavirus disease (COVID-19) pandemic - Implications for efficacy, re-use and sustainable waste management. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 752:142259. [PMID: 33207488 PMCID: PMC7481258 DOI: 10.1016/j.scitotenv.2020.142259] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/04/2020] [Accepted: 09/05/2020] [Indexed: 05/17/2023]
Abstract
Currently, there is no effective vaccine for tackling the ongoing COVID-19 pandemic caused by SARS-CoV-2 with the occurrence of repeat waves of infection frequently stretching hospital resources beyond capacity. Disease countermeasures rely upon preventing person-to-person transmission of SARS-CoV2 so as to protect front-line healthcare workers (HCWs). COVID-19 brings enormous challenges in terms of sustaining the supply chain for single-use-plastic personal and protective equipment (PPE). Post-COVID-19, the changes in medical practice will drive high demand for PPE. Important countermeasures for preventing COVID-19 transmission include mitigating potential high risk aerosol transmission in healthcare setting using medical PPE (such as filtering facepiece respirators (FFRs)) and the appropriate use of face coverings by the general public that carries a lower transmission risk. PPE reuse is a potential short term solution during COVID-19 pandemic where there is increased evidence for effective deployment of reprocessing methods such as vaporized hydrogen peroxide (30 to 35% VH2O2) used alone or combined with ozone, ultraviolet light at 254 nm (2000 mJ/cm2) and moist heat (60 °C at high humidity for 60 min). Barriers to PPE reuse include potentially trust and acceptance by HCWs. Efficacy of face coverings are influenced by the appropriate wearing to cover the nose and mouth, type of material used, number of layers, duration of wearing, and potentially superior use of ties over ear loops. Insertion of a nose clip into cloth coverings may help with maintaining fit. Use of 60 °C for 60 min (such as, use of domestic washing machine and spin dryer) has been advocated for face covering decontamination. Risk of virus infiltration in improvised face coverings is potentially increased by duration of wearing due to humidity, liquid diffusion and virus retention. Future sustained use of PPE will be influenced by the availability of recyclable PPE and by innovative biomedical waste management.
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Affiliation(s)
- Neil J Rowan
- Department of Nursing and Healthcare, Athlone Institute of Technology, Ireland; Centre for Disinfection, Sterilization and Biosecurity, Athlone Institute of Technology, Ireland; Empower Eco Sustainability Hub, Lough Boora, Co. Offaly, Ireland.
| | - John G Laffey
- Lung Biology Group, Regenerative Medicine Institute at CURAM Centre for Medical Devices, National University of Ireland Galway, Galway, Ireland; Anaesthesia and Intensive Care Medicine, University Hospital Galway, Galway, Ireland
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Strauch AL, Brady TM, Niezgoda G, Almaguer CM, Shaffer RE, Fisher EM. Evaluación de la eficacia de las lengüetas en las tiras de la mascarilla autofiltrante para mejorar las técnicas de retirada adecuadas al mismo tiempo que se reduce la transmisión por contacto de los patógenos. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2021; 18:S35-S43. [PMID: 33822693 DOI: 10.1080/15459624.2021.1877058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
RESUMENLas mascarillas respiratorias autofiltrantes (filtering facepiece respirators, FFR) N95 certificadas por el Instituto Nacional de Seguridad y Salud Laborales (National Institute for Occupational Safety and Health, NIOSH) se utilizan en los centros de atención sanatoria como medida de control para mitigar las exposiciones a partículas atmosféricas infecciosas. Cuando la superficie externa de una FFR se contamina, supone un riesgo de transmisión para el usuario. La guía de los Centros para el Control y Prevención de Enfermedades (Centers for Disease Control and Prevention, CDC) recomienda que el personal sanitario retire las FFR agarrando las tiras en la parte posterior de la cabeza para evitar el contacto con la superficie posiblemente contaminada. Al parecer, la adherencia a la técnica de retirada adecuada es baja, debido a numerosos factores que incluyen la dificultad para ubicar y agarrar las tiras. En este estudio se compara el impacto de lengüetas ubicadas en las tiras de la FFR con el de mascarillas comparativas (sin lengüetas) sobre la retirada adecuada, la facilidad de uso, la comodidad y la reducción de la transmisión de la contaminación al usuario. El uso de un agente fluorescente como rastreador de contactos para explorar la contaminación de las FFR en manos y áreas de la cabeza de 20 sujetos humanos demostró que no hubo diferencia entre las tiras de la FFR con lengüetas y las mascarillas comparativas en el sentido de estimular la retirada adecuada de las mismas (p = 0.48), pero la hizo más fácil (p = 0.04), según indican siete de ocho sujetos que usaron las lengüetas. Siete de 20 sujetos opinaron que las FFR con lengüetas son más fáciles de retirar, mientras que solo dos de 20 sujetos indicaron que las FFR sin lengüetas son más fáciles de retirar. La incomodidad no fue un factor relevante para ninguno de los tipos de tiras de las FFR. Al retirar una FFR con las manos contaminadas, el uso de lengüetas redujo de forma importante la cantidad del rastreador de contactos transferida en comparación con las tiras sin lengüetas (p = 0.012). Las FFR con lengüetas en las tiras están asociadas con la facilidad de la retirada y una transferencia notablemente menor del rastreador de contactos fluorescente.
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Affiliation(s)
- Amanda L Strauch
- National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory, Pittsburgh, Pennsylvania
| | - Tyler M Brady
- National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory, Pittsburgh, Pennsylvania
| | - George Niezgoda
- National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory, Pittsburgh, Pennsylvania
| | - Claudia M Almaguer
- National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory, Pittsburgh, Pennsylvania
| | - Ronald E Shaffer
- National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory, Pittsburgh, Pennsylvania
| | - Edward M Fisher
- National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory, Pittsburgh, Pennsylvania
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Assunção AÁ, Simões MRL, Maia EG, Alcantara MA, Jardim R. COVID-19: estudo de protocolos de proteção individual para profissionais da saúde. REVISTA BRASILEIRA DE SAÚDE OCUPACIONAL 2021. [DOI: 10.1590/2317-6369000042120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Objetivo: realizar comparação interpaíses e entre estados brasileiros quanto ao conteúdo dos protocolos de proteção para profissionais de saúde que atuam na assistência aos doentes da COVID-19 e desenvolver análise crítica ao modelo de prevenção que adota indicação e uso de equipamentos de proteção individual (EPI) como resposta única a um problema de caráter multidimensional. Métodos: estudo exploratório com base em revisões disponíveis na biblioteca Cochrane, articuladas com a análise dos protocolos nacionais de Argentina, Brasil, China e Estados Unidos da América e as normas previstas nos estados do Amazonas, Bahia, Minas Gerais e São Paulo, todos selecionados por critérios de conveniência. Resultados: observou-se dissensos quanto aos tipos de proteção recomendados. Somente na China eram indicados respiradores de alta eficiência de filtragem, além de modelos para o rosto inteiro nos casos de procedimentos invasivos. O reuso de equipamentos não é indicado, mas estava autorizado no protocolo brasileiro. Quanto aos dispositivos de vestuário, também não há convergência. Conclusão: os resultados reforçam a necessidade de revisão dos protocolos de proteção dos profissionais da saúde que atuam no enfrentamento da Covid-19. Ações em busca de debate institucional, interpaíses e interestaduais sobre modelos de prevenção são essenciais para alcançar consistência nas recomendações.
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Pfenninger EG, Kaisers UX. [Provisioning of personal protective equipment in hospitals in preparation for a pandemic]. Anaesthesist 2020; 69:909-918. [PMID: 32936348 PMCID: PMC7493059 DOI: 10.1007/s00101-020-00843-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND At the beginning of the SARS-CoV‑2 outbreak, personal protective equipment (PPE) was scarce worldwide, leading to the treatment of patients partially without sufficient protection for the medical personnel. In order to be prepared for a new epidemic or pandemic or a "second wave" of COVID-19 outbreak and to meet a renewed deficiency of PPE, considerations were made on how personnel and patients can be better protected by appropriate provisioning. OBJECTIVE The aim of this study was to develop a tool to predict the necessary amount of PPE to be in stock at a transregional university hospital for a certain period of time during a pandemic. MATERIAL AND METHODS The consumption of PPE needed for every patient was calculated based on the following data of the Ulm University Hospital: the total consumption of healthcare workers' PPE for April 2020 recorded by the materials management department and the number of patients suffering from COVID-19 and their treatment days. From the amount of PPE necessary for every patient in the intensive care unit (ICU) or in an infection ward, a PPE calculator was created in which the estimated amount of PPE can be calculated with the input variables "patients in intensive care unit", "patients in infection ward" and "treatment days". To validate the PPE calculator, the actual consumption of PPE for May 2020 at the Ulm University hospital was compared to the theoretically calculated demand by the PPE calculator. RESULTS In April 2020 PPE consisting of 18 different items were kept in stock at Ulm University Hospital and in total 1,995,500 individual items were used. 22 intensive care patients with 257 nursing days and in the infection ward 39 patients with 357 nursing days were treated for COVID-19 disease, leading to a total of 603.2 man-days. A total of 34,550 KN95 masks, 1,558,780 gloves and 1100 goggles or protective visors were used, with a daily average of 49 NK95 masks and 2216 gloves required per ICU patient. In May 2020, 6 ICU patients and 19 patients in infection wards were treated for COVID-19 with 34 nursing days in intensive care and 201 nursing days in infection wards. The use of PPE material was 39% lower than in the previous month but in absolute terms 82% and on average 39% higher than calculated. CONCLUSION The developed tool allows our hospital to estimate the necessary amount of PPE to be kept in stock for future pandemics. By taking local conditions into account this tool can also be helpful for other hospitals.
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Affiliation(s)
- E G Pfenninger
- Stabsstelle Katastrophenschutz, Klinikum der Universität Ulm, Albert-Einstein-Allee 29, 89081, Ulm, Deutschland.
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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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Webb SR, Twyman RM, Moloney M. Agtech infrastructure for pandemic preparedness. Nat Biotechnol 2020; 38:1025-1027. [DOI: 10.1038/s41587-020-0654-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Ng-Kamstra J, Stelfox HT, Fiest K, Conly J, Leigh JP. Perspectives on personal protective equipment in acute care facilities during the COVID-19 pandemic. CMAJ 2020; 192:E805-E809. [PMID: 32586837 PMCID: PMC7828870 DOI: 10.1503/cmaj.200575] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Affiliation(s)
- Josh Ng-Kamstra
- Department of Critical Care Medicine (Ng-Kamstra, Stelfox, Fiest), Cumming School of Medicine, University of Calgary and Alberta Health Services; Departments of Community Health Sciences and O'Brien Institute for Public Health (Stelfox, Fiest), Psychiatry and Hotchkiss Brain Institute (Fiest), Medicine (Conly), Pathology and Laboratory Medicine (Conly) and Microbiology, Immunology, and Infectious Diseases, and Snyder Institute for Chronic Diseases (Conly), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Faculty of Health ( Parsons Leigh), School of Health Administration, and Department of Critical Care Medicine, Faculty of Medicine (Parsons Leigh), Dalhousie University, Halifax, NS
| | - Henry T Stelfox
- Department of Critical Care Medicine (Ng-Kamstra, Stelfox, Fiest), Cumming School of Medicine, University of Calgary and Alberta Health Services; Departments of Community Health Sciences and O'Brien Institute for Public Health (Stelfox, Fiest), Psychiatry and Hotchkiss Brain Institute (Fiest), Medicine (Conly), Pathology and Laboratory Medicine (Conly) and Microbiology, Immunology, and Infectious Diseases, and Snyder Institute for Chronic Diseases (Conly), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Faculty of Health ( Parsons Leigh), School of Health Administration, and Department of Critical Care Medicine, Faculty of Medicine (Parsons Leigh), Dalhousie University, Halifax, NS
| | - Kirsten Fiest
- Department of Critical Care Medicine (Ng-Kamstra, Stelfox, Fiest), Cumming School of Medicine, University of Calgary and Alberta Health Services; Departments of Community Health Sciences and O'Brien Institute for Public Health (Stelfox, Fiest), Psychiatry and Hotchkiss Brain Institute (Fiest), Medicine (Conly), Pathology and Laboratory Medicine (Conly) and Microbiology, Immunology, and Infectious Diseases, and Snyder Institute for Chronic Diseases (Conly), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Faculty of Health ( Parsons Leigh), School of Health Administration, and Department of Critical Care Medicine, Faculty of Medicine (Parsons Leigh), Dalhousie University, Halifax, NS
| | - John Conly
- Department of Critical Care Medicine (Ng-Kamstra, Stelfox, Fiest), Cumming School of Medicine, University of Calgary and Alberta Health Services; Departments of Community Health Sciences and O'Brien Institute for Public Health (Stelfox, Fiest), Psychiatry and Hotchkiss Brain Institute (Fiest), Medicine (Conly), Pathology and Laboratory Medicine (Conly) and Microbiology, Immunology, and Infectious Diseases, and Snyder Institute for Chronic Diseases (Conly), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Faculty of Health ( Parsons Leigh), School of Health Administration, and Department of Critical Care Medicine, Faculty of Medicine (Parsons Leigh), Dalhousie University, Halifax, NS
| | - Jeanna Parsons Leigh
- Department of Critical Care Medicine (Ng-Kamstra, Stelfox, Fiest), Cumming School of Medicine, University of Calgary and Alberta Health Services; Departments of Community Health Sciences and O'Brien Institute for Public Health (Stelfox, Fiest), Psychiatry and Hotchkiss Brain Institute (Fiest), Medicine (Conly), Pathology and Laboratory Medicine (Conly) and Microbiology, Immunology, and Infectious Diseases, and Snyder Institute for Chronic Diseases (Conly), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Faculty of Health ( Parsons Leigh), School of Health Administration, and Department of Critical Care Medicine, Faculty of Medicine (Parsons Leigh), Dalhousie University, Halifax, NS
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Rowan NJ, Laffey JG. Challenges and solutions for addressing critical shortage of supply chain for personal and protective equipment (PPE) arising from Coronavirus disease (COVID19) pandemic - Case study from the Republic of Ireland. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 725:138532. [PMID: 32304970 PMCID: PMC7195029 DOI: 10.1016/j.scitotenv.2020.138532] [Citation(s) in RCA: 214] [Impact Index Per Article: 53.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 04/05/2020] [Indexed: 05/17/2023]
Abstract
Coronavirus (COVID-19) is highly infectious agent that causes fatal respiratory illnesses, which is of great global public health concern. Currently, there is no effective vaccine for tackling this COVID19 pandemic where disease countermeasures rely upon preventing or slowing person-to-person transmission. Specifically, there is increasing efforts to prevent or reduce transmission to front-line healthcare workers (HCW). However, there is growing international concern regarding the shortage in supply chain of critical one-time-use personal and protective equipment (PPE). PPE are heat sensitive and are not, by their manufacturer's design, intended for reprocessing. Most conventional sterilization technologies used in hospitals, or in terminal medical device sterilization providers, cannot effectively reprocess PPE due to the nature and severity of sterilization modalities. Contingency planning for PPE stock shortage is important. Solutions in the Republic of Ireland include use of smart communication channels to improve supply chain, bespoke production of PPE to meets gaps, along with least preferred option, use of sterilization or high-level disinfection for PPE reprocessing. Reprocessing PPE must consider material composition, functionality post treatment, along with appropriate disinfection. Following original manufacturer of PPE and regulatory guidance is important. Technologies deployed in the US, and for deployment in the Republic of Ireland, are eco-friendly, namely vaporised hydrogen peroxide (VH2O2), such as for filtering facepiece respirators and UV irradiation and High-level liquid disinfection (Actichlor+) is also been pursed in Ireland. Safeguarding supply chain of PPE will sustain vital healthcare provision and will help reduce mortality.
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Affiliation(s)
- Neil J Rowan
- Department of Nursing and Healthcare, Athlone Institute of Technology, Ireland; Centre for Disinfection, Sterilization and Biosecurity, Athlone Institute of Technology, Ireland.
| | - John G Laffey
- Lung Biology Group, Regenerative Medicine Institute at CURAM Centre for Medical Devices, National University of Ireland Galway, Galway, Ireland; Anaesthesia and Intensive Care Medicine, University Hospital Galway, Galway, Ireland
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Sharififar S, Jahangiri K, Zareiyan A, Khoshvaghti A. Factors affecting hospital response in biological disasters: A qualitative study. Med J Islam Repub Iran 2020; 34:21. [PMID: 32551310 PMCID: PMC7293813 DOI: 10.34171/mjiri.34.21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Indexed: 11/05/2022] Open
Abstract
Background: The fatal pandemics of infectious diseases and the possibility of using microorganisms as biological weapons are both rising worldwide. Hospitals are vital organizations in response to biological disasters and have a crucial role in the treatment of patients. Despite the advances in studies about hospital planning and performance during crises, there are no internationally accepted standards for hospital preparedness and disaster response. Thus, this study was designed to explain the effective factors in hospital performance during biological disasters. Methods: Qualitative content analysis with conventional approach was used in the present study. The setting was Ministry of Health and related hospitals, and other relevant ministries responsible at the time of biologic events in Islamic Republic of Iran (IR of Iran) in 2018. Participants were experts, experienced individuals providing service in the field of biological disaster planning and response, policymakers in the Ministry of Health, and other related organizations and authorities responsible for the accreditation of hospitals in IR of Iran. Data were collected using 12 semi-structured interviews in Persian language. Analysis was performed according to Graneheim method. Results: After analyzing 12 interviews, extraction resulted in 76 common codes, 28 subcategories, and 8 categories, which are as follow: detection; treatment and infection control; coordination, Resources; training and exercises; communication and information system; construction; and planning and assessment. Conclusion: Hospital management in outbreaks of infectious diseases (intentional or unintentional) is complex and requires different actions than during natural disasters. In such disasters, readiness to respond and appropriate action is a multifaceted operation. In IR of Iran, there have been few researches in the field of hospital preparation in biologic events, and the possibility of standardized assessment has be reduced due to lack of key skills in confronting biological events. It is hoped that the aggregated factors in the 8 groups of this study can evaluate hospital performance more coherently.
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Affiliation(s)
- Simintaj Sharififar
- Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,School of Nursing, Aja University of Medical Sciences, Tehran, Iran
| | - Katayoun Jahangiri
- Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Armin Zareiyan
- Department of Health in Disasters and Emergencies, School of Nursing, Aja University of Medical Sciences, Tehran, Iran
| | - Amir Khoshvaghti
- Infectious Diseases Research Center, Aerospace and Subaquatic Medicine Faculty, Aja University of Medical Sciences, Tehran, Iran
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Fix GM, Reisinger HS, Etchin A, McDannold S, Eagan A, Findley K, Gifford AL, Gupta K, McInnes DK. Health care workers' perceptions and reported use of respiratory protective equipment: A qualitative analysis. Am J Infect Control 2019; 47:1162-1166. [PMID: 31182235 PMCID: PMC7115305 DOI: 10.1016/j.ajic.2019.04.174] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 04/21/2019] [Accepted: 04/22/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Little is known about health care workers' (HCW) perceptions of, or experiences using, respiratory protective equipment (RPE). We sought to characterize their perceptions and identify reasons underlying inappropriate use. METHODS We conducted 12 focus groups with nurses and nursing assistants at 4 medical centers. We analyzed the thematic content of 73 discrete "stories" told by focus group participants. RESULTS We identified 5 story types surrounding RPE use: 1) policies are known and seen during work routines; 2) during protocol lapses, use is reinforced through social norms; 3) clinical experiences sometimes supersede protocol adherence; 4) when risk perception is high, we found concern regarding accessing RPE; and 5) HCWs in emergency departments were viewed as not following protocol because risk was ever-present. DISCUSSION HCWs were aware of the importance of RPE and protocols for using it, and these supported use when protocol lapses occurred. However, protocol adherence was undermined by clinical experience, perceived risk, and the distinct context of the emergency department where patients continually arrive with incomplete or delayed diagnoses. CONCLUSIONS Protocols, visual cues, and social norms contribute to a culture of safety. This culture can be undermined when HCWs experience diagnostic uncertainty or they mistrust the protocol and instead rely on their clinical experiences.
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Affiliation(s)
- Gemmae M Fix
- Center for Healthcare Organization and Implementation Research (CHOIR), ENRM VA Hospital, Bedford, MA; Boston University School of Public Health, Boston, MA.
| | - Heather Schacht Reisinger
- Comprehensive Access & Delivery Research & Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, IA; University of Iowa Carver College of Medicine, Iowa City, IA
| | - Anna Etchin
- Center for Healthcare Organization and Implementation Research (CHOIR), ENRM VA Hospital, Bedford, MA; Center for Healthcare Organization and Implementation Research (CHOIR), Boston University School of Medicine, VA Boston Healthcare System, Boston, MA
| | - Sarah McDannold
- Center for Healthcare Organization and Implementation Research (CHOIR), ENRM VA Hospital, Bedford, MA
| | - Aaron Eagan
- VHA Office of Public Health, National Center for Occupational Health and Infection Control, Gainesville, FL
| | - Kimberly Findley
- VHA Office of Public Health, National Center for Occupational Health and Infection Control, Gainesville, FL
| | - Allen L Gifford
- Center for Healthcare Organization and Implementation Research (CHOIR), Boston University School of Medicine, VA Boston Healthcare System, Boston, MA; Boston University School of Public Health, Boston, MA
| | - Kalpana Gupta
- Center for Healthcare Organization and Implementation Research (CHOIR), Boston University School of Medicine, VA Boston Healthcare System, Boston, MA
| | - D Keith McInnes
- Center for Healthcare Organization and Implementation Research (CHOIR), ENRM VA Hospital, Bedford, MA; Center for Healthcare Organization and Implementation Research (CHOIR), Boston University School of Medicine, VA Boston Healthcare System, Boston, MA; Boston University School of Public Health, Boston, MA
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Adam DC, Scotch M, MacIntyre CR. Phylodynamics of Influenza A/H1N1pdm09 in India Reveals Circulation Patterns and Increased Selection for Clade 6b Residues and Other High Mortality Mutants. Viruses 2019; 11:E791. [PMID: 31462006 PMCID: PMC6783925 DOI: 10.3390/v11090791] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 08/23/2019] [Accepted: 08/24/2019] [Indexed: 01/03/2023] Open
Abstract
The clinical severity and observed case fatality ratio of influenza A/H1N1pdm09 in India, particularly in 2015 and 2017 far exceeds current global estimates. Reasons for these frequent and severe epidemic waves remain unclear. We used Bayesian phylodynamic methods to uncover possible genetic explanations for this, while also identifying the transmission dynamics of A/H1N1pdm09 between 2009 and 2017 to inform future public health interventions. We reveal a disproportionate selection at haemagglutinin residue positions associated with increased morbidity and mortality in India such as position 222 and clade 6B characteristic residues, relative to equivalent isolates circulating globally. We also identify for the first time, increased selection at position 186 as potentially explaining the severity of recent A/H1N1pdm09 epidemics in India. We reveal national routes of A/H1N1pdm09 transmission, identifying Maharashtra as the most important state for the spread throughout India, while quantifying climactic, ecological, and transport factors as drivers of within-country transmission. Together these results have important implications for future A/H1N1pdm09 surveillance and control within India, but also for epidemic and pandemic risk prediction around the world.
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Affiliation(s)
- Dillon C Adam
- Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Matthew Scotch
- Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
- Biodesign Center for Environmental Health Engineering, Biodesign Institute, Arizona State University, Tempe, AZ 85287, USA
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA
| | - C Raina MacIntyre
- Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA
- College of Public Service & Community Solutions, Arizona State University, Tempe, AZ 85004, USA
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Which healthcare workers work with acute respiratory illness? Evidence from Canadian acute-care hospitals during 4 influenza seasons: 2010-2011 to 2013-2014. Infect Control Hosp Epidemiol 2019; 40:889-896. [PMID: 31208477 DOI: 10.1017/ice.2019.141] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Healthcare workers (HCWs) are at risk of acquiring and transmitting respiratory viruses while working in healthcare settings. OBJECTIVES To investigate the incidence of and factors associated with HCWs working during an acute respiratory illness (ARI). METHODS HCWs from 9 Canadian hospitals were prospectively enrolled in active surveillance for ARI during the 2010-2011 to 2013-2014 influenza seasons. Daily illness diaries during ARI episodes collected information on symptoms and work attendance. RESULTS At least 1 ARI episode was reported by 50.4% of participants each study season. Overall, 94.6% of ill individuals reported working at least 1 day while symptomatic, resulting in an estimated 1.9 days of working while symptomatic and 0.5 days of absence during an ARI per participant season. In multivariable analysis, the adjusted relative risk of working while symptomatic was higher for physicians and lower for nurses relative to other HCWs. Participants were more likely to work if symptoms were less severe and on the illness onset date compared to subsequent days. The most cited reason for working while symptomatic was that symptoms were mild and the HCW felt well enough to work (67%). Participants were more likely to state that they could not afford to stay home if they did not have paid sick leave and were younger. CONCLUSIONS HCWs worked during most episodes of ARI, most often because their symptoms were mild. Further data are needed to understand how best to balance the costs and risks of absenteeism versus those associated with working while ill.
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Shapira S, Friger M, Bar-Dayan Y, Aharonson-Daniel L. Healthcare workers' willingness to respond following a disaster: a novel statistical approach toward data analysis. BMC MEDICAL EDUCATION 2019; 19:130. [PMID: 31053130 PMCID: PMC6499969 DOI: 10.1186/s12909-019-1561-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 04/17/2019] [Indexed: 05/31/2023]
Abstract
BACKGROUND The willingness of healthcare workers (HCW) to respond is an important factor in the health system's response capacity during emergencies. Although much research has been devoted to exploring this issue, the statistical methods employed have been predominantly traditional and have not enabled in-depth analysis focused on absenteeism-prone employees during emergencies. The present study employs an innovative statistical approach for modeling HCWs' willingness to respond (WTR) following an earthquake. METHODS A validated questionnaire measuring knowledge, perceptions, and attitudes toward an earthquake scenario was distributed among Israeli HCWs in a hospital setting. Two regression models were employed for data analysis - a traditional linear model, and a quantile regression model that makes it possible to examine associations between explanatory variables across different levels of a dependent variable. A supplementary analysis was performed for selected variables using broken line spline regression. RESULTS Females under the age of forty, and nurses were the most absenteeism-prone sub-groups of employees (showed low WTR) in earthquake events. Professional commitment to care and perception of efficacy were the most powerful predictors associated with WTR across all quantiles. Both marital status (married) and concern for family wellbeing, designated as statistically significant in the linear model, were found to be statistically significant in only one of the WTR quantiles (the former in Q10 and the latter in Q50). Gender and number of children, which were not significantly associated with WTR in the linear model, were found to be statistically significant in the 25th quantile of WTR. CONCLUSIONS This study contributes to both methodological and practical aspects. Quantile regression provides a more comprehensive view of associations between variables than is afforded by linear regression alone. Adopting an advanced statistical approach in WTR modeling can facilitate effective implementation of research findings in the field.
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Affiliation(s)
- Stav Shapira
- PREPARED Center for Emergency Response Research, Ben-Gurion University of the Negev, P.O. Box 653, Beer-Sheva, Israel
- School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, Beer-Sheva, Israel
| | - Michael Friger
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, Beer-Sheva, Israel
| | - Yaron Bar-Dayan
- PREPARED Center for Emergency Response Research, Ben-Gurion University of the Negev, P.O. Box 653, Beer-Sheva, Israel
- School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, Beer-Sheva, Israel
| | - Limor Aharonson-Daniel
- PREPARED Center for Emergency Response Research, Ben-Gurion University of the Negev, P.O. Box 653, Beer-Sheva, Israel
- School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, Beer-Sheva, Israel
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Application of Nanomaterials in Personal Respiratory Protection Equipment: A Literature Review. SAFETY 2018. [DOI: 10.3390/safety4040047] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Exposure to air pollutants leads to a variety of health effects in humans. Inhalation is one of the most common routs of exposure to poor quality air, mostly in work environments. Respiratory masks are used to prevent breathing in hazardous gases and vapors, especially in the absence of proper controlling measures. This study aims to review the effectiveness of respiratory masks with a nanostructure. The electronic search of the genuine databases, including PubMed, Magiran, Iran Medex, Science Database (SID), Science Direct, Web of Science, and Scopus, was conducted in January and February 2017 in chronological order of publications with the keywords defined in the search strategy. Of all identified papers, nine were collected and included in the study. The results of this study indicated that the use of nanomaterials in the structure of brand new mask filters compared with conventional masks enhances the performance and efficiency of breathing air filtration, improves permeability, increases antimicrobial properties, and offers reasonable comfort to the workers.
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Or PPL, Chung JWY, Wong TKS. A study of environmental factors affecting nurses’ comfort and protection in wearing N95 respirators during bedside procedures. J Clin Nurs 2018; 27:e1477-e1484. [DOI: 10.1111/jocn.14268] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Peggy PL Or
- Department of Health and Physical Education; The Education University of Hong Kong; Hong Kong
| | - Joanne WY Chung
- Department of Health and Physical Education; The Education University of Hong Kong; Hong Kong
| | - Thomas KS Wong
- Ginger Knowledge Transfer and Consultancy Limited; Hong Kong
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Jones RM, Xia Y. Annual Burden of Occupationally-Acquired Influenza Infections in Hospitals and Emergency Departments in the United States. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2018; 38:442-453. [PMID: 28697286 DOI: 10.1111/risa.12854] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 05/09/2017] [Accepted: 05/18/2017] [Indexed: 06/07/2023]
Abstract
Infections among health-care personnel (HCP) occur as a result of providing care to patients with infectious diseases, but surveillance is limited to a few diseases. The objective of this study is to determine the annual number of influenza infections acquired by HCP as a result of occupational exposures to influenza patients in hospitals and emergency departments (EDs) in the United States. A risk analysis approach was taken. A compartmental model was used to estimate the influenza dose received in a single exposure, and a dose-response function applied to calculate the probability of infection. A three-step algorithm tabulated the total number of influenza infections based on: the total number of occupational exposures (tabulated in previous work), the total number of HCP with occupational exposures, and the probability of infection in an occupational exposure. Estimated influenza infections were highly dependent upon the dose-response function. Given current compliance with infection control precautions, we estimated 151,300 and 34,150 influenza infections annually with two dose-response functions (annual incidence proportions of 9.3% and 2.1%, respectively). Greater reductions in infectious were achieved by full compliance with vaccination and IC precautions than with patient isolation. The burden of occupationally-acquired influenza among HCP in hospitals and EDs in the United States is not trivial, and can be reduced through improved compliance with vaccination and preventive measures, including engineering and administrative controls.
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Affiliation(s)
- Rachael M Jones
- School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - Yulin Xia
- School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
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Kouassi D, Angbo-Effi O, Aka L, Coulibaly M, Soumahoro S, Yao G, Soro N. Perceptions and practice of health care workers regarding hepatitis B vaccination, Bouaké, Côte d'Ivoire, 2016. J Public Health Afr 2017; 8:715. [PMID: 29416843 PMCID: PMC5793046 DOI: 10.4081/jphia.2017.715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 07/24/2017] [Accepted: 07/29/2017] [Indexed: 11/23/2022] Open
Abstract
Barriers to immunization are seen in both the general population and the health care workforce. We conducted this study to determine the perception of health workers on vaccination and the immunization of their patients. This cross-sectional descriptive analytical study was carried out among the medical staff in Bouaké, from 10 January to 07 March 2016. The data collected from the interviews were analyzed using Epi info 2000 software and SPSS 17.0. The Chi-2 test and logistic regression were performed and the significance threshold of the tests was 5%. The vaccination status of the 291 health care workers (HCWs) for the hepatitis B virus (HBV) was statistically related to their participation in the course in vaccination during their training (ORa = 1.69, 95% CI: 1.04-2.75 P<0.05) and the systematic verification of the vaccination status of the patient was statistically related to the vaccination status of the HCW (ORa = 4.33, 95% CI: 2.97-8.18, P<0.05). Promoting the vaccination among the population should be dependent on the promotion among HCWs.
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Affiliation(s)
- Damus Kouassi
- Public health Department, Alassane Ouattara University
- National Institute of Public Hygiene
| | - Odile Angbo-Effi
- Public health Department, Alassane Ouattara University
- Teaching Hospital of Bouaké
| | - Lepri Aka
- Public Health Department, Houphouet Boigny University
- National Immunization Program Coordination Office
| | | | - Sory Soumahoro
- Public health Department, Alassane Ouattara University
- National Institute of Public Hygiene
| | - Gnissan Yao
- Public health Department, Alassane Ouattara University
- National Institute of Public Hygiene
| | - Nagho Soro
- Alassane Ouattara University, Abidjan, Côte d’Ivoire
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Bernard L, Biron A, Lavigne G, Frechette J, Bernard A, Mitchell J, Lavoie-Tremblay M. An exploratory study of safety culture, biological risk management and hand hygiene of healthcare professionals. J Adv Nurs 2017; 74:827-837. [PMID: 29117448 DOI: 10.1111/jan.13500] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2017] [Indexed: 11/29/2022]
Abstract
AIMS The objectives of the study were to: (1) examine the relationships between three different qualitative perceptions of safety culture and the Canadian Patient Safety Climate Survey factors; (2) determine whether these perceptions are associated with different hand hygiene practices. BACKGROUND Healthcare-associated infections and safety cultures are a worldwide issue. During the A/H1N1 Influenza pandemic, Europe and North America did not have the same responses. Importantly, healthcare professionals' perceptions can influence patient safety through infection prevention practices like hand hygiene. DESIGN A cross-sectional design was used with data collected in 2015. METHODS The Canadian Patient Safety Culture Survey and hand hygiene observations were gathered from three healthcare centres (two Canadian and one European). Descriptive analyses and ANOVAs were conducted to explore healthcare professionals' safety perceptions and practices. RESULTS The rates of hand hygiene practices varied widely between the three sites, ranging from 35-77%. One site (Site 3) was found to have the highest scores of management follow-up, feedback about incidents, supervisory leadership for safety, unit learning culture and senior leadership support for safety, and the highest levels of overall patient safety grades for the unit and organization. CONCLUSION The quantitative results of this study support the previously described model based on qualitative results: individual culture, blaming culture and collaborative culture. Differences between continents emerged regarding infection prevention practices and the way we qualify infections. The results raise concerns about infection practices and about safety cultures and challenges worldwide.
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Affiliation(s)
- Laurence Bernard
- McGill University, Montreal, QC, Canada.,University of Montreal, Montreal, QC, Canada
| | - Alain Biron
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | | | - Julie Frechette
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | - Agnès Bernard
- ACOS Operations and training/Staff, Belgian Defence, Brussels, Belgium
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Fujiki S, Ishizaki T, Nakayama T. Variations in status of preparation of personal protective equipment for preventing norovirus gastroenteritis in long-term care facilities for the elderly. J Eval Clin Pract 2017; 23:1203-1210. [PMID: 28508408 DOI: 10.1111/jep.12761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 03/28/2017] [Accepted: 03/28/2017] [Indexed: 11/27/2022]
Abstract
RATIONALE, AIM, AND OBJECTIVES Residents of long-term care facilities are highly susceptible to norovirus gastroenteritis, and each facility is concerned about the need to implement norovirus infection control. Among control measures, personal protective equipment (PPE), such as disposable gloves and masks, plays a major role in reducing infectious spread. However, the preparation status of PPE in facilities before infection outbreaks has not been reported. The aim was to clarify the implementation status of preventive measures for norovirus gastroenteritis and the cost of preparing the necessary PPE in long-term care facilities. METHOD A questionnaire survey of facilities affiliated with the Kyoto Prefecture and Osaka Prefecture branches of the Japan Association of Geriatric Health Services Facilities was conducted. The survey items were the characteristics of the facility, whether preventive measures had been implemented for norovirus gastroenteritis from October through the following March in both 2009 and 2010, and the quantities and unit prices of PPE prepared for preventive measures. RESULTS Twenty-six (11.2%) of 232 surveyed facilities (as of August 2011) answered the survey. Among them, 24 (92.3%) in 2009 and 25 (96.2%) in 2010 reported having implemented preventive measures for norovirus gastroenteritis, while 21 facilities (80.8%) in 2009 and 22 facilities (84.6%) in 2010 had prepared PPE. The median total cost for preparing the PPE needed for the preventive measures was US $2601 (range US $221-9192) in 2009 and US $3904 (range US $305-6427) in 2010. CONCLUSION Although the results need careful interpretation because of the low response rate, most of the surveyed long-term care facilities had implemented preventive measures for norovirus gastroenteritis. However, the cost of preparing the PPE needed for the preventive measures varied among the facilities.
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Affiliation(s)
- Saori Fujiki
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Tatsuro Ishizaki
- Department of Human Care Research Team, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
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Seo Y, Vaughan J, Quinn TD, Followay B, Roberge R, Glickman EL, Kim JH. The Effect of Inspiratory Resistance on Exercise Performance and Perception in Moderate Normobaric Hypoxia. High Alt Med Biol 2017; 18:417-424. [PMID: 29112466 PMCID: PMC10542912 DOI: 10.1089/ham.2017.0103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Seo, Yongsuk, Jeremiah Vaughan, Tyler D. Quinn, Brittany Followay, Raymond Roberge, Ellen L. Glickman, and Jung-Hyun Kim. The effect of inspiratory resistance on exercise performance and perception in moderate normobaric hypoxia. High Alt Med Biol. 18:417-424, 2017. PURPOSE Respirators are simple and efficient in protecting workers against toxic airborne substances; however, their use may limit the physical performance of workers. The purpose of this study was to determine the effect of inspiratory resistance on physical performance and breathing perception in normobaric hypoxia. METHOD Nine healthy men wore a tight-fitting respiratory mask outfitted with one of four different inspiratory resistors (R) (0, 1.5, 4.5, 7.5 cm H2O/L/Sec) while exercising at normobaric hypoxia (17% O2) at submaximal exercise workloads of 50, 100, and 150 W on a cycle ergometer for 10 minutes each, followed by a maximal oxygen uptake (VO2max) test to exhaustion. RESULTS Maximal power output at R7.5 was significantly lower than R0 (p = 0.016) and R1.5 (p = 0.035). Respiration rate was significantly reduced at R4.5 (p = 0.011) and R7.5 (p ≤ 0.001) compared with R0. Minute ventilation was significantly decreased in R7.5 compared with R0 (p = 0.003), R1.5 (p = 0.010), and R4.5 (p = 0.016), whereas VO2 was not significantly changed. Breathing comfort (BC) and breathing effort (BE) were significantly impaired in R7.5 (BC: p = 0.025, BE: p = 0.001) and R4.5 (BC: p = 0.007, BE: p = 0.001) compared with R0, but rating of perceived exertion (RPE) remained unchanged. CONCLUSIONS Added inspiratory resistance limited maximal power output and increased perceptions of BC and BE in normobaric hypoxia. However, low-to-moderate inspiratory resistance did not have a deleterious effect on VO2 or RPE at submaximal or maximal exercise. Perceptual and physiological characteristics of respirators of varying inspiratory resistances should be considered by manufacturers and end users during design and respirator selection processes.
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Affiliation(s)
- Yongsuk Seo
- National Personal Protective Technology Laboratory, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Pittsburgh, Pennsylvania
| | - Jeremiah Vaughan
- Department of Exercise Physiology, Kent State University, Kent, Ohio
| | - Tyler D. Quinn
- National Personal Protective Technology Laboratory, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Pittsburgh, Pennsylvania
| | - Brittany Followay
- Department of Exercise Physiology, Kent State University, Kent, Ohio
| | - Raymond Roberge
- National Personal Protective Technology Laboratory, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Pittsburgh, Pennsylvania
| | - Ellen L. Glickman
- Department of Exercise Physiology, Kent State University, Kent, Ohio
| | - Jung-Hyun Kim
- National Personal Protective Technology Laboratory, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Pittsburgh, Pennsylvania
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Restivo V, Costantino C, Mammina C, Vitale F. Influenza like Illness among Medical Residents Anticipates Influenza Diffusion in General Population: Data from a National Survey among Italian Medical Residents. PLoS One 2016; 11:e0168546. [PMID: 27997602 PMCID: PMC5173364 DOI: 10.1371/journal.pone.0168546] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 11/17/2016] [Indexed: 11/18/2022] Open
Abstract
The aim of this multicentre study was to assess incidence of influenza like illness (ILI) among Italian medical residents (MRs) during 2011–2012 influenza season, to detect variables associated with ILI and to compare estimated ILI incidence among MRs and general population. A cross-sectional survey was carried out throughout an anonymous questionnaire administered to all MRs attending the post-graduate medical schools of 18 Italian Universities. At the same time an analysis of the ILI incidence in the Italian general population was conducted through the Italian Influenza Surveillance Network. Of a total of 2,506 MRs, 1,191 (47.5%) reported at least one ILI episode. A higher proportion of ILIs was reported by MRs of Central (25.0% with ILI vs 20.2% without ILI) and Southern Italy (40.2% with ILI vs. 36.4 without ILI) compared to Northern Italy (34.8% with ILI vs. 43.4% without ILI) (p<0.001). Italian MRs had a higher cumulative incidence of ILIs (546.7 episodes per 1,000 vs. 75.9 episodes per 1,000) and an earlier peak (January 2012 vs. February 2012), compared to general population due to higher number of contacts in hospital setting. MRs reported a high rate of ILI infection probably in association with their working activities. These data suggest the need to offer an earlier influenza vaccination to HCWs than general population with the aim to both prevent ILI and its transmission to patients.
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Affiliation(s)
- Vincenzo Restivo
- Department of Sciences for Health Promotion and Mother-Child Care “G. D’Alessandro”, University of Palermo, Palermo, Italy
- * E-mail:
| | - Claudio Costantino
- Department of Sciences for Health Promotion and Mother-Child Care “G. D’Alessandro”, University of Palermo, Palermo, Italy
| | - Caterina Mammina
- Department of Sciences for Health Promotion and Mother-Child Care “G. D’Alessandro”, University of Palermo, Palermo, Italy
| | - Francesco Vitale
- Department of Sciences for Health Promotion and Mother-Child Care “G. D’Alessandro”, University of Palermo, Palermo, Italy
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Hulo S, Nuvoli A, Sobaszek A, Salembier-Trichard A. Knowledge and attitudes towards influenza vaccination of health care workers in emergency services. Vaccine 2016; 35:205-207. [PMID: 27919630 DOI: 10.1016/j.vaccine.2016.11.086] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 11/09/2016] [Accepted: 11/23/2016] [Indexed: 10/20/2022]
Abstract
Annual vaccination rates among French health care workers (HCWs) are in decline even in Emergency Services to which patients at highest risk of influenza complications are admitted, and in which HCWs have the greatest risk of exposure to influenza from patients. We aimed here to identify knowledge and attitudes towards influenza vaccination of HCWs in Emergency Services. We collected 344 self-administered questionnaires of 1060 HCWs. Only 18% of HCWs were vaccinated against influenza. Physicians were vaccinated more often (55%) than nurses (16%) or aid nurses (11%). The most important barriers to vaccination were reported as being a lack of time (33%), lack of safety of the vaccine (31%), fear of contracting influenza due to vaccination (29%), and lack of effectiveness (23%). Being vaccinated was significantly related to a higher knowledge score based on epidemiological influenza items (OR (95% CI)) (1.63 (1.08-2.46)) and vaccine features items (2.36 (1.36-4.10)).
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Affiliation(s)
- Sébastien Hulo
- Univ. Lille, EA 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000 Lille, France; CHU Lille, Service des Exploration Fonctionnelles Respiratoires, F-59000 Lille, France.
| | - Alexandra Nuvoli
- CHU Lille, Service de Médecine du Travail du Personnel Hospitalier, F-59000 Lille, France.
| | - Annie Sobaszek
- Univ. Lille, EA 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000 Lille, France; CHU Lille, Service de Médecine du Travail du Personnel Hospitalier, F-59000 Lille, France.
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Strauch AL, Brady TM, Niezgoda G, Almaguer CM, Shaffer RE, Fisher EM. Assessing the efficacy of tabs on filtering facepiece respirator straps to increase proper doffing techniques while reducing contact transmission of pathogens. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2016; 13:794-801. [PMID: 27105142 PMCID: PMC5682596 DOI: 10.1080/15459624.2016.1179386] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
NIOSH-certified N95 filtering facepiece respirators (FFRs) are used in healthcare settings as a control measure to mitigate exposures to airborne infectious particles. When the outer surface of an FFR becomes contaminated, it presents a contact transmission risk to the wearer. The Centers for Disease Control and Prevention (CDC) guidance recommends that healthcare workers (HCWs) doff FFRs by grasping the straps at the back of the head to avoid contact with the potentially contaminated surface. Adherence to proper doffing technique is reportedly low due to numerous factors including difficulty in locating and grasping the straps. This study compares the impact of tabs placed on FFR straps to controls (without tabs) on proper doffing, ease of use and comfort, and reduction of transfer of contamination to the wearer. Utilizing a fluorescent agent as a tracer to track contamination from FFRs to hand and head areas of 20 human subjects demonstrated that there was no difference in tabbed FFR straps and controls with respect to promoting proper doffing (p = 0.48), but did make doffing easier (p = 0.04) as indicated by 7 of 8 subjects that used the tabs. Seven of the 20 subjects felt that FFRs with tabs were easier to remove, while only 2 of 20 indicated that FFRs without tabs were easier to remove. Discomfort was not a factor for either FFR strap type. When removing an FFR with contaminated hands, the use of the tabs significantly reduced the amount of tracer transfer compared to straps without tabs (p = 0.012). FFRs with tabs on the straps are associated with ease of doffing and significantly less transfer of the fluorescent tracer.
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Affiliation(s)
- Amanda L Strauch
- a National Institute for Occupational Safety and Health , National Personal Protective Technology Laboratory , Pittsburgh , Pennsylvania
| | - Tyler M Brady
- a National Institute for Occupational Safety and Health , National Personal Protective Technology Laboratory , Pittsburgh , Pennsylvania
| | - George Niezgoda
- a National Institute for Occupational Safety and Health , National Personal Protective Technology Laboratory , Pittsburgh , Pennsylvania
| | - Claudia M Almaguer
- a National Institute for Occupational Safety and Health , National Personal Protective Technology Laboratory , Pittsburgh , Pennsylvania
| | - Ronald E Shaffer
- a National Institute for Occupational Safety and Health , National Personal Protective Technology Laboratory , Pittsburgh , Pennsylvania
| | - Edward M Fisher
- a National Institute for Occupational Safety and Health , National Personal Protective Technology Laboratory , Pittsburgh , Pennsylvania
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Johnson SA, Bennett N, Bull AL, Richards MJ, Worth LJ. Influenza vaccination uptake among Victorian healthcare workers: evaluating the success of a statewide program. Aust N Z J Public Health 2016; 40:281-3. [DOI: 10.1111/1753-6405.12517] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 11/01/2015] [Accepted: 12/01/2015] [Indexed: 11/28/2022] Open
Affiliation(s)
- Sandra A. Johnson
- Victorian Healthcare-Associated Infection Surveillance System (VICNISS) Coordinating Centre; Peter Doherty Institute; Victoria
| | - Noleen Bennett
- Victorian Healthcare-Associated Infection Surveillance System (VICNISS) Coordinating Centre; Peter Doherty Institute; Victoria
| | - Ann L. Bull
- Victorian Healthcare-Associated Infection Surveillance System (VICNISS) Coordinating Centre; Peter Doherty Institute; Victoria
| | - Michael J. Richards
- Victorian Healthcare-Associated Infection Surveillance System (VICNISS) Coordinating Centre; Peter Doherty Institute; Victoria
| | - Leon J. Worth
- Victorian Healthcare-Associated Infection Surveillance System (VICNISS) Coordinating Centre; Peter Doherty Institute; Victoria
- Department of Medicine; University of Melbourne; Victoria
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Engelbrecht M, van Rensburg A, Rau A, Yassi A, Spiegel J, O'Hara L, Bryce E, Nophale L. Tuberculosis and blood-borne infectious diseases: workplace conditions and practices of healthcare workers at three public hospitals in the Free State. S Afr J Infect Dis 2015. [DOI: 10.1080/23120053.2015.1103958] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Dorribo V, Lazor-Blanchet C, Hugli O, Zanetti G. Health care workers' influenza vaccination: motivations and mandatory mask policy. Occup Med (Lond) 2015; 65:739-45. [PMID: 26276758 DOI: 10.1093/occmed/kqv116] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Vaccination of health care workers (HCW) against seasonal influenza (SI) is recommended but vaccination rate rarely reach >30%. Vaccination coverage against 2009 pandemic influenza (PI) was 52% in our hospital, whilst a new policy requiring unvaccinated HCW to wear a mask during patient care duties was enforced. AIMS To investigate the determinants of this higher vaccination acceptance for PI and to look for an association with the new mask-wearing policy. METHODS A retrospective cohort study, involving HCW of three critical departments of a 1023-bed, tertiary-care university hospital in Switzerland. Self-reported 2009-10 SI and 2009 PI vaccination statuses, reasons and demographic data were collected through a literature-based questionnaire. Descriptive statistics, uni- and multivariate analyses were then performed. RESULTS There were 472 respondents with a response rate of 54%. Self-reported vaccination acceptance was 64% for PI and 53% for SI. PI vaccination acceptance was associated with being vaccinated against SI (OR 9.5; 95% CI 5.5-16.4), being a physician (OR 7.7; 95% CI 3.1-19.1) and feeling uncomfortable wearing a mask (OR 1.7; 95% CI 1.0-2.8). Main motives for refusing vaccination were: preference for wearing a surgical mask (80% for PI, not applicable for SI) and concerns about vaccine safety (64%, 50%) and efficacy (44%, 35%). CONCLUSIONS The new mask-wearing policy was a motivation for vaccination but also offered an alternative to non-compliant HCW. Concerns about vaccine safety and efficiency and self-interest of health care workers are still main determinants for influenza vaccination acceptance. Better incentives are needed to encourage vaccination amongst non-physician HCW.
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Affiliation(s)
- V Dorribo
- Service of Occupational Medicine, Institute for Work and Health, CH-1066 Epalinges - Lausanne, Switzerland,
| | - C Lazor-Blanchet
- Service of Hospital Preventive Medicine, Department of Medicine, Lausanne University Hospital, CH-1011 Lausanne, Switzerland
| | - O Hugli
- Emergency Department, Lausanne University Hospital, CH-1011 Lausanne, Switzerland
| | - G Zanetti
- Service of Hospital Preventive Medicine, Department of Medicine, Lausanne University Hospital, CH-1011 Lausanne, Switzerland, Service of Infectious Diseases, Department of Medicine, Lausanne University Hospital, CH-1011 Lausanne, Switzerland
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Murray MT, Pavia M, Jackson O, Keenan M, Neu NM, Cohen B, Saiman L, Larson EL. Health care-associated infection outbreaks in pediatric long-term care facilities. Am J Infect Control 2015; 43:756-8. [PMID: 25934066 PMCID: PMC7132675 DOI: 10.1016/j.ajic.2015.03.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 02/27/2015] [Accepted: 03/11/2015] [Indexed: 12/31/2022]
Abstract
Children in pediatric long-term care facilities (pLTCFs) have complex medical conditions and increased risk for health care-associated infections (HAIs). We performed a retrospective study from January 2010-December 2013 at 3 pLTCFs to describe HAI outbreaks and associated infection control interventions. There were 62 outbreaks involving 700 cases in residents and 250 cases in staff. The most common interventions were isolation precautions and education and in-services. Further research should examine interventions to limit transmission of infections in pLTCFs.
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