Policies and procedures for personal protective equipment: Does inconsistency increase risk of contamination and infection?

Respiratory Protection: Lessons Learned from a Global Pandemic

The COVID-19 pandemic exposed the limitations of global health systems' abilities to manage the rapid spread of a novel infectious disease, which was exacerbated by shortages of respiratory protective devices and other critical personal protective equipment (PPE). An advisory panel of experienced health-care professionals with backgrounds in Occupational and Environmental Health and Safety (OEHS), Infection Prevention, Nursing, and Clinical Application Specialists convened to discuss challenges and strategies associated with the selection and use of respiratory protective devices as experienced during the first year of the COVID-19 pandemic. This discussion led to the following recommendations: 1) the need for clear communication of alternative respiratory protection selection and use recommendations in accordance with US regulatory and agency guidance; 2) the need for collaboration between Infection Prevention, OEHS, clinical staff, supply chain/materials management, emergency preparedness, executive leadership, and finance; 3) the need for adequate stockpiling, inventory rotation, and diverse respiratory protection options to accommodate the majority of health-care workers; 4) the need for efficient and innovative strategies to communicate evolving regulatory, agency, and facility recommendations and to deliver appropriate training on respiratory protection; and 5) the need for additional research on respiratory protection use - involving filtering facepiece respirators (FFRs) as well as other respirator types designed to be reused - to balance infection prevention best practices with a sustainable process. In conclusion, these considerations may offer guidance and identify areas for research on preparedness, communication, education, and training to enhance the preparation of health-care facilities including community-based health-care organizations for unexpected public health events.

Understanding healthcare workers' knowledge and attitudes regarding the coronavirus disease 2019 (COVID-19) vaccine: Overcoming gaps to improve public health response

Vaccines serve as a major tool against the coronavirus disease 2019 (COVID-19) pandemic, but vaccine hesitancy remains a major concern in the United States. Healthcare workers (HCWs) strongly influence a patient's decision to get vaccinated. We evaluated HCW knowledge and attitudes regarding the COVID-19 vaccine.

Healthcare design to improve safe doffing of personal protective equipment for care of patients with COVID-19

OBJECTIVE

Understand how the built environment can affect safety and efficiency outcomes during doffing of personal protective equipment (PPE) in the context of coronavirus disease 2019 (COVID-19) patient care.

STUDY DESIGN

We conducted (1) field observations and surveys administered to healthcare workers (HCWs) performing PPE doffing, (2) focus groups with HCWs and infection prevention experts, and (3) a with healthcare design experts.

SETTINGS

This study was conducted in 4 inpatient units treating patients with COVID-19, in 3 hospitals of a single healthcare system.

PARTICIPANTS

The study included 24 nurses, 2 physicians, 1 respiratory therapist, and 2 infection preventionists.

RESULTS

The doffing task sequence and the layout of doffing spaces varied considerably across sites, with field observations showing most doffing tasks occurring around the patient room door and PPE support stations. Behaviors perceived as most risky included touching contaminated items and inadequate hand hygiene. Doffing space layout and types of PPE storage and work surfaces were often associated with inadequate cleaning and improper storage of PPE. Focus groups and the design charrette provided insights on how design affording standardization, accessibility, and flexibility can support PPE doffing safety and efficiency in this context.

CONCLUSIONS

There is a need to define, organize and standardize PPE doffing spaces in healthcare settings and to understand the environmental implications of COVID-19-specific issues related to supply shortage and staff workload. Low-effort and low-cost design adaptations of the layout and design of PPE doffing spaces may improve HCW safety and efficiency in existing healthcare facilities.

Understanding the principles of infection prevention and control

Nurses have a crucial role in infection prevention and control. The coronavirus disease 2019 (COVID-19) pandemic has emphasised the importance of controlling the spread of infections, while reinforcing the challenges involved in the care of patients who already have an infection. This article discusses important elements of theory and practice related to infection prevention and control. The author also explores various areas that have come to prominence as a result of the COVID-19 pandemic, including measures such as risk assessment, the use of personal protective equipment, the role of surveillance, and outbreak management.

Perceived Stress and Coping Strategies Among Undergraduate Health Science Students of Jimma University Amid the COVID-19 Outbreak: Online Cross-Sectional Survey

Background: The rapid spread of COVID-19 infection has led countries across the globe to take various measures to contain the outbreak, including the closure of Universities. Forcing University students to stay at home has created enormous stress and uncertainty in their daily life. Objective: This study aimed to assess the perceived stress and coping strategies among undergraduate health science students of Jimma University amid the COVID-19 outbreak. Materials and methods: An online cross-sectional survey was conducted involving 337 undergraduate health science students from August to September 5, 2020. The perceived stress scale (PSS)-10 and Brief-COPE scale were used to assess the level of stress and coping strategies, respectively. Statistical Package for Social Science (SPSS) Version 22 was employed for data analysis. Logistic regression was conducted to identify predictors of high perceived stress. Results: The overall mean [±standard deviation (SD)] age of the participants was 22.88 (±1.78) years. The mean (±SD) PSS score was 22.16 (±1.41), and high perceived stress was reported in 121 (35.9%) participants. The overall mean (±SD) coping score was 72.34 (±12.31), and approach coping was the predominantly used strategy for coping with stress. Personal perception of being stressed by the daily number of COVID-19 cases/deaths in Ethiopia (AOR = 4.61, p < 0.01), rare online talk/chat with friends (AOR = 4.07, p = 0.01), presence of confusion due to the inconsistent strategies developed by the health/government authorities in view of the scientific recommendations (AOR = 2.22, p = 0.01), perception of self/family members being at risk of getting sick (AOR = 0.53, p = 0.03), decreased household income following the COVID-19 pandemic (AOR = 3.92, p = 0.01), practicing denial (AOR = 1.34, p < 0.01), self-blame (AOR = 1.23, p = 0.02), planning (AOR = 1.28, p = 0.01), and religion (AOR = 1.41, p < 0.01) as means of coping with stress were associated with high perceived stress. Conclusion: Over one-third of the participants had a high level of perceived stress, and the majority of them were practicing effective means of coping with stress. The authors recommend that the hosting University in collaboration with the concerned bodies develop innovative strategies to improve the psychological well-being of the students.

Experiences of New Zealand registered nurses of Chinese ethnicity during the COVID-19 pandemic

AIMS

This study aimed to investigate the experiences and challenges of New Zealand registered nurses of Chinese ethnicity who have been working during the COVID-19 pandemic.

BACKGROUND

New Zealand's nursing workforce is becoming increasingly multicultural as foreign nurses make up an essential part of the New Zealand health workforce. The ongoing COVID-19 pandemic has highlighted the contributions that nurses have made in providing front-line services to the public. However, little has been documented about challenges and experiences of this minority ethnic group-Chinese nurses-who have been working as registered nurses in New Zealand during the COVID-19 pandemic.

METHODS

This study used an anonymous online questionnaire and a thematic approach to establishing understandings of the experiences of New Zealand registered nurses of Chinese ethnicity in working through the COVID-19 pandemic. A total of 51 Chinese nurses completed this survey. A self-explanatory checklist for reporting results of Internet e-surveys (CHERRIES) was used for the purpose of the quality of this online survey.

RESULTS

The result showed that 47.06% participants (n = 24) reported negative experiences including racial discrimination, workplace bullying and judgement, while 52.94% (n = 27) participants reported positive working experiences including supports received in the workplace and positive recognition by the pubic in New Zealand.

CONCLUSION

Ethnic minority nurses are key assets to the New Zealand health system. It is important to understand their experiences and challenges, particularly during the COVID-19 pandemic to make sure they are supported and protected from any physical and emotional injury.

RELEVANCE TO CLINICAL PRACTICE

COVID-19 has brought additional challenges and concerns to nurses who are working on the front line of health services. Having knowledge of nurses' working experiences will help with their job satisfaction and has potential implications for the sustainability of the New Zealand nursing workforce and retention strategies to address nursing workforce shortages which is foreseeable in New Zealand.