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Vicentini C, Russotto A, Bussolino R, Castagnotto M, Gastaldo C, Bresciano L, Bazzolo S, Gamba D, Corcione S, De Rosa FG, D'Ancona F, Zotti CM. Impact of COVID-19 on healthcare-associated infections and antimicrobial use in Italy, 2022. J Hosp Infect 2024; 149:14-21. [PMID: 38677480 DOI: 10.1016/j.jhin.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/15/2024] [Accepted: 04/16/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND It is unknown whether COVID-19 patients are at higher risk due to demographic and clinical characteristics associated with higher COVID-19 infection risk and severity of infection, or due to the disease and its management. AIM To assess the impact of COVID-19 on healthcare-associated infection (HAI) transmission and antimicrobial use (AMU) prevalence during the later stages of the pandemic. METHODS A point-prevalence survey (PPS) was conducted among 325 acute care hospitals of 19 out of 21 Regions of Italy, during November 2022. Non-COVID-19 patients were matched to COVID-19 patients according to age, sex, and severity of underlying conditions. HAI and AMU prevalence were calculated as the percentage of patients with at least one HAI or prescribed at least one antimicrobial over all included patients, respectively. FINDINGS In total, 60,403 patients were included, 1897 (3.14%) of which were classified as COVID-19 patients. Crude HAI prevalence was significantly higher among COVID-19 patients compared to non-COVID-19 patients (9.54% vs 8.01%; prevalence rate ratio (PRR): 1.19; 95% confidence interval (CI): 1.04-1.38; P < 0.05), and remained higher in the matched sample; however, statistical significance was not maintained (odds ratio (OR): 1.25; 95% CI: 0.99-1.59; P = 0.067). AMU prevalence was significantly higher among COVID-19 patients prior to matching (46.39% vs 41.52%; PRR: 1.21; 95% CI: 1.11-1.32; P < 0.001), and significantly lower after matching (OR: 0.77; 95% CI: 0.66-0.89; P < 0.001). CONCLUSION COVID-19 patients could be at higher HAI risk due to underlying clinical conditions and the intensity of healthcare needs. Further efforts should be dedicated to antimicrobial stewardship among COVID-19 patients.
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Affiliation(s)
- C Vicentini
- Department of Public Health and Paediatrics, University of Turin, Turin, Italy.
| | - A Russotto
- Department of Public Health and Paediatrics, University of Turin, Turin, Italy
| | - R Bussolino
- Department of Public Health and Paediatrics, University of Turin, Turin, Italy
| | - M Castagnotto
- Department of Public Health and Paediatrics, University of Turin, Turin, Italy
| | - C Gastaldo
- Department of Public Health and Paediatrics, University of Turin, Turin, Italy
| | - L Bresciano
- Department of Public Health and Paediatrics, University of Turin, Turin, Italy
| | - S Bazzolo
- Department of Environment, Land and Infrastructure Engineering (DIATI), Politecnico of Turin, Turin, Italy
| | - D Gamba
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - S Corcione
- Infectious Diseases, Department of Medical Sciences, University of Turin, Turin, Italy
| | - F G De Rosa
- Infectious Diseases, Department of Medical Sciences, University of Turin, Turin, Italy
| | - F D'Ancona
- Epidemiology, Biostatistics and Mathematical Modeling Unit (EPI), Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - C M Zotti
- Department of Public Health and Paediatrics, University of Turin, Turin, Italy
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Loudet CI, Jorro Barón F, Reina R, Arias López MDP, Alegría SL, Barrios CDV, Buffa R, Cabana ML, Cunto ER, Fernández Nievas S, García MA, Gibbons L, Izzo G, Llanos MN, Meregalli C, Joaquín Mira J, Ratto ME, Rivet ML, Roberti J, Silvestri AM, Tévez A, Uranga LJ, Zakalik G, Rodríguez V, García-Elorrio E. Quality improvement collaborative for improving patient care delivery in Argentine public health sector intensive care units. BMJ Open Qual 2024; 13:e002618. [PMID: 38830729 PMCID: PMC11149125 DOI: 10.1136/bmjoq-2023-002618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 05/13/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND The demand for healthcare services during the COVID-19 pandemic was excessive for less-resourced settings, with intensive care units (ICUs) taking the heaviest toll. OBJECTIVE The aim was to achieve adequate personal protective equipment (PPE) use in 90% of patient encounters, to reach 90% compliance with objectives of patient flow (OPF) and to provide emotional support tools to 90% of healthcare workers (HCWs). METHODS We conducted a quasi-experimental study with an interrupted time-series design in 14 ICUs in Argentina. We randomly selected adult critically ill patients admitted from July 2020 to July 2021 and active HCWs in the same period. We implemented a quality improvement collaborative (QIC) with a baseline phase (BP) and an intervention phase (IP). The QIC included learning sessions, periods of action and improvement cycles (plan-do-study-act) virtually coached by experts via platform web-based activities. The main study outcomes encompassed the following elements: proper utilisation of PPE, compliance with nine specific OPF using daily goal sheets through direct observations and utilisation of a web-based tool for tracking emotional well-being among HCWs. RESULTS We collected 7341 observations of PPE use (977 in BP and 6364 in IP) with an improvement in adequate use from 58.4% to 71.9% (RR 1.2, 95% CI 1.17 to 1.29, p<0.001). We observed 7428 patient encounters to evaluate compliance with 9 OPF (879 in BP and 6549 in IP) with an improvement in compliance from 53.9% to 67% (RR 1.24, 95% CI 1.17 to 1.32, p<0.001). The results showed that HCWs did not use the support tool for self-mental health evaluation as much as expected. CONCLUSION A QIC was effective in improving healthcare processes and adequate PPE use, even in the context of a pandemic, indicating the possibility of expanding QIC networks nationwide to improve overall healthcare delivery. The limited reception of emotional support tools requires further analyses.
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Affiliation(s)
- Cecilia Inés Loudet
- Sociedad Argentina de Terapia Intensiva, Ciudad Autónoma de Buenos Aires, Argentina
- Hospital Interzonal General de Agudos General San Martín, La Plata, Buenos Aires, Argentina
| | - Facundo Jorro Barón
- Instituto de Efectividad Clínica y Sanitaria, Ciudad Autónoma de Buenos Aires, Argentina
| | - Rosa Reina
- Sociedad Argentina de Terapia Intensiva, Ciudad Autónoma de Buenos Aires, Argentina
| | | | | | | | | | | | - Eleonora Roxana Cunto
- Hospital de Infecciosas Dr Francisco Javier Muñiz, Ciudad Autónoma de Buenos Aires, Argentina
| | - Simón Fernández Nievas
- Instituto de Efectividad Clínica y Sanitaria, Ciudad Autónoma de Buenos Aires, Argentina
| | | | - Luz Gibbons
- Instituto de Efectividad Clínica y Sanitaria, Ciudad Autónoma de Buenos Aires, Argentina
| | - Gabriela Izzo
- Hospital Simplemente Evita, González Catán, Buenos Aires, Argentina
| | | | - Claudia Meregalli
- Sociedad Argentina de Terapia Intensiva, Ciudad Autónoma de Buenos Aires, Argentina
| | - José Joaquín Mira
- Departamento de Salud Alicante-Sant Joan, Sant Joan d'Alacant, Spain
| | - María Elena Ratto
- Sociedad Argentina de Terapia Intensiva, Ciudad Autónoma de Buenos Aires, Argentina
| | - Mariano Luis Rivet
- Hospital General de Agudos Bernardino Rivadavia, Ciudad Autónoma de Buenos Aires, Argentina
| | - Javier Roberti
- Instituto de Efectividad Clínica y Sanitaria, Ciudad Autónoma de Buenos Aires, Argentina
- CIESP/CONICET, Buenos Aires, Argentina
| | | | - Analía Tévez
- Hospital Balestrini, La Matanza, Buenos Aires, Argentina
| | | | | | - Viviana Rodríguez
- Instituto de Efectividad Clínica y Sanitaria, Ciudad Autónoma de Buenos Aires, Argentina
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Guerrero-Soler M, Gras-Valentí P, Gómez-Sotero IL, Platas-Abenza G, Silva-Afonso RDF, Benito-Miralles CM, Fuster-Pérez M, Cartagena-Llopis L, Sánchez-Valero M, Sánchez-Payá J, Chico-Sánchez P. Impact of COVID-19 on the degree of compliance with hand hygiene: a repeated cross-sectional study. Epidemiol Infect 2024; 152:e69. [PMID: 38557427 PMCID: PMC11077604 DOI: 10.1017/s0950268824000505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 02/22/2024] [Accepted: 02/25/2024] [Indexed: 04/04/2024] Open
Abstract
Hand hygiene (HH) is the paramount measure used to prevent healthcare-associated infections. A repeated cross-sectional study was undertaken with direct observation of the degree of compliance on HH of healthcare personnel during the SARS-CoV-2 pandemic. Between, 2018-2019, 9,083 HH opportunities were considered, and 5,821 in 2020-2022. Chi squared tests were used to identify associations. The crude and adjusted odds ratios were used along with a logistic regression model for statistical analyses. Compliance on HH increased significantly (p < 0.001) from 54.5% (95% CI: 53.5, 55.5) to 70.1% (95% CI: 68.9, 71.2) during the COVID-19 pandemic. This increase was observed in four of the five key moments of HH established by the World Health Organization (WHO) (p < 0.05), except at moment 4. The factors that were significantly and independently associated with compliance were the time period considered, type of healthcare-personnel, attendance at training sessions, knowledge of HH and WHO guidelines, and availability of hand disinfectant alcoholic solution in pocket format. Highest HH compliance occurred during the COVID-19 pandemic, reflecting a positive change in healthcare-personnel's behaviour regarding HH recommendations.
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Affiliation(s)
- Maria Guerrero-Soler
- Epidemiology Unit, Preventive Medicine Service, Alicante Dr. Balmis University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Paula Gras-Valentí
- Epidemiology Unit, Preventive Medicine Service, Alicante Dr. Balmis University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, Alicante, Spain
| | - Isel Lilibeth Gómez-Sotero
- Epidemiology Unit, Preventive Medicine Service, Alicante Dr. Balmis University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Guillermo Platas-Abenza
- Epidemiology Unit, Preventive Medicine Service, Alicante Dr. Balmis University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Raissa de Fátima Silva-Afonso
- Epidemiology Unit, Preventive Medicine Service, Alicante Dr. Balmis University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Carmen-María Benito-Miralles
- Epidemiology Unit, Preventive Medicine Service, Alicante Dr. Balmis University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Marina Fuster-Pérez
- Epidemiology Unit, Preventive Medicine Service, Alicante Dr. Balmis University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Lidia Cartagena-Llopis
- Epidemiology Unit, Preventive Medicine Service, Alicante Dr. Balmis University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - María Sánchez-Valero
- Epidemiology Unit, Preventive Medicine Service, Alicante Dr. Balmis University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - José Sánchez-Payá
- Epidemiology Unit, Preventive Medicine Service, Alicante Dr. Balmis University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Pablo Chico-Sánchez
- Epidemiology Unit, Preventive Medicine Service, Alicante Dr. Balmis University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, Alicante, Spain
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Minehmorad M, Nemati-Vakilabad R, Badpeyma M, Mirzaei A. Examining nurses' understanding and knowledge about preparation for COVID-19 in Ardabil hospitals in Iran. BMC Health Serv Res 2024; 24:312. [PMID: 38454446 PMCID: PMC10921800 DOI: 10.1186/s12913-024-10826-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 03/05/2024] [Indexed: 03/09/2024] Open
Abstract
AIMS The purpose of this study was to evaluate the preparedness of Iranian nurses for potential pandemics. BACKGROUND Nurses play a critical role in managing pandemics. They require adequate training, proper equipment, and organizational support to be well-prepared. METHODS A descriptive cross-sectional study was conducted in Ardabil, Iran, from July to September 2023, involving 233 nurses from five hospitals. The number of nurses required for each hospital was calculated based on the proportion of nurses in each hospital. Data was collected through a paper-based form that included information about the participants' demographic characteristics and their level of pandemic preparedness in health services. The collected data was analyzed using descriptive statistics to determine the demographic characteristics and levels of pandemic preparedness. Pearson's test was also conducted to establish a relationship between different dimensions of pandemic preparedness. RESULTS Most participants relied on clinical measures and supported using human resources and environmental methods to curb the transmission of a pandemic. They felt assured in their ability to explain the preventive measures against the pandemic. However, fewer respondents had access to healthcare improvement programs, and only a few worked remotely from home. CONCLUSIONS According to our study, 90.1% of nurses believe hand washing is the most effective way to prevent spreading infections. Additionally, healthcare professionals can use various tools to respond to the pandemic, including screening for COVID-19 at work, health and wellness programs, telecommuting, COVID-19 Safe programs, social media, and posters. Nurses need continuous education in hand hygiene, health programs, remote work options, and pandemic-safe programs to control infections, reduce risks, and optimize patient care during the pandemic.
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Affiliation(s)
- Milad Minehmorad
- Students Research Committee, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Reza Nemati-Vakilabad
- Students Research Committee, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
- Student Research Committee, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Badpeyma
- Students Research Committee, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Alireza Mirzaei
- Department of Emergency Nursing, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran.
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Ji B, Ye W. Prevention and control of hospital-acquired infections with multidrug-resistant organism: A review. Medicine (Baltimore) 2024; 103:e37018. [PMID: 38277558 PMCID: PMC10817162 DOI: 10.1097/md.0000000000037018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 01/02/2024] [Indexed: 01/28/2024] Open
Abstract
Multidrug-resistant is defined as nonsusceptibility to at least 1 agent in 3 or more antimicrobial categories. Controlling the spread of drug-resistant organisms is a key step in the management of hospital-acquired infections (HAIs). To review the progress of research on the prevention and control of HAIs with multidrug-resistant organism (MDRO) in the past 5 years, and to provide reference for the development of comprehensive measures for the prevention and control of HAIs with MDRO. We conducted a search in the PUBMED database for studies related to MDRO and HAIs from 2018 to 2023, then integrated this data with information sourced from the U.S.A. The Centers for Disease Control and Prevention. Utilizing information technology to monitor and provide feedback on hand hygiene practices can enhance compliance. Environmental disinfection techniques such as ultraviolet or hydrogen peroxide demonstrate potential in reducing MDRO transmission. While some studies support that contact isolation measures for MDRO-infected or colonized patients can reduce HAIs, others do not confirm this outcome. Approaches for MDRO colonization among patients or physicians may mitigate MDRO transmission risk. Implementing clusterization interventions proves to enhance efficiency and cost-effectiveness in preventing and controlling MDRO. Early screening for pathogen species emerges as a valuable strategy aiding in antimicrobial use control. Combined with evidence from the literature, implementing clusterization interventions that include measures such as monitoring and feedback on hand hygiene and improved environmental disinfection techniques can help prevent and control HAIs with MDRO. However, further clinical studies are needed to validate the optimal clusterization intervention.
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Affiliation(s)
- Binghui Ji
- Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
| | - Weijiang Ye
- The Rehabilitation Hospital of the Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
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6
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Valim MD, Rossetto JR, Bortolini J, Herwaldt L. Hand hygiene compliance in a Brazilian COVID-19 unit: the impact of moments and contact precautions. Antimicrob Resist Infect Control 2024; 13:7. [PMID: 38254156 PMCID: PMC10801978 DOI: 10.1186/s13756-023-01356-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 12/12/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Healthcare-associated infections are among the most common complications during hospitalization. These infections increase morbidity and mortality and they increase length of hospital stay and the cost of healthcare. The aims of our study were to monitor hand hygiene (HH) compliance, HH technique quality and factors related to HH practice among health professionals in a COVID-19 Intensive Care Unit (ICU). METHODS An observational, prospective study. Between September and December 2021, we observed 69 healthcare professionals in an eight-bed ICU for patients with COVID-19 in midwestern Brazil. We used the WHO observation form to collect data. The dependent variable was HH compliance and independent variables were professional category, sex, HH quality (3-step technique for at least 15 s), number of HH opportunities observed, observation shift and inappropriate glove use. RESULTS We observed 1185 HH opportunities. The overall compliance rate was 26.4%, but only 6.5% were performed with the correct 3-step technique for the minimum time. HH compliance was considerably lower for moments "before" tasks (6.7%; 95% CI 4.8%, 9.2%) compared with moments "after" tasks (43.8%; 95% CI 39.9%, 47.8%). The logistic model found that inappropriate glove use, night shift and physicians (p < 0.001) were associated with low HH compliance. The infrastructure analysis found that the unit had an insufficient number of alcohol-based handrub (ABHR) dispensers at the point of care and that the mechanism for activating them was poorly designed. CONCLUSIONS HH compliance was very low. Inappropriate glove use was associated with low compliance and the unit's infrastructure did not support good HH practice. The fact that healthcare professionals were more likely to do HH after tasks, suggests that they use HH to protect themselves rather than the patients. Adequate infrastructure and ongoing health education with a focus on HH while caring for patients in contact precautions are essential for improving HH compliance and patient safety.
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Affiliation(s)
- Marília Duarte Valim
- Nursing Department, Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil.
| | | | - Juliano Bortolini
- Statistics Department, Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil
| | - Loreen Herwaldt
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
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Oh J, Lee M, Lee H, Yang H, Park J, Rahmati M, Koyanagi A, Smith L, Fond G, Boyer L, Kim MS, Lee SW, López Sánchez GF, Dragioti E, Woo HG, Yon DK. Hand and Oral Hygiene Practices of South Korean Adolescents Before and During the COVID-19 Pandemic. JAMA Netw Open 2023; 6:e2349249. [PMID: 38147331 PMCID: PMC10751599 DOI: 10.1001/jamanetworkopen.2023.49249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 11/10/2023] [Indexed: 12/27/2023] Open
Abstract
Importance Only a few studies have examined the long-term trends of hand and oral hygiene, especially among adolescents. Objective To investigate the 15-year trends in frequency of handwashing and toothbrushing and examine the factors associated with hand and oral hygiene, particularly during the COVID-19 pandemic. Design, Setting, and Participants This cross-sectional study, performed from January 1, 2008, to December 31, 2022, used general population-based data from 963 644 individuals in a national representative survey (Korea Youth Risk Behavior Web-based Survey [KYRBS]). Exposure COVID-19 pandemic. Main Outcomes and Measures Trends in hand and oral hygiene practices were measured by how frequently adolescents washed their hands and whether they fulfilled the recommended guidelines for toothbrushing. An interrupted time series analysis using linear and logistic regression models was performed to assess any associations with the COVID-19 pandemic. Hand and oral hygiene behaviors before and during the pandemic in each sociodemographic subgroup were also compared. Results In the 963 644 adolescents (495 697 [51.4%] male; mean [range] age, 15.01 [12-18] years) who participated in the KYRBS from 2008 to 2022, a 73.3% (95% CI, 59.4%-97.4%; P < .001) immediate increase was seen in overall hand hygiene behavior at the onset of the COVID-19 pandemic compared with the prepandemic period, with a sustained decrease thereafter (β = -0.018; 95% CI, -0.022 to -0.015; P < .001). Meanwhile, no immediate increase was observed in terms of overall oral hygiene behavior (0.1%; 95% CI, -0.9% to 1.1%; P = .82); however, there was a sustained decrease during the pandemic (β = -0.018; 95% CI, -0.020 to -0.016; P < .001). Older age, female sex, nonsmoking status, alcohol use, low household economic level, and poor school performance were significantly associated with poor hand hygiene during the pandemic. Conclusions and Relevance In this cross-sectional study of South Korean adolescents, an increase in the prevalence of hand hygiene was observed during the early pandemic; however, this prevalence decreased over time. Meanwhile, the decrease in the prevalence of oral hygiene was more pronounced during the pandemic. This study recommends stronger guidelines for adolescent health coaches, such as teachers or public health advisers, regarding hygiene behaviors, even after the COVID-19 pandemic ends.
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Affiliation(s)
- Jiyeon Oh
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Myeongcheol Lee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Hojae Lee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Hwi Yang
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Jaeyu Park
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Masoud Rahmati
- Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran
- Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, Barcelona, Spain
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, United Kingdom
| | - Guillaume Fond
- CEReSS-Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France
| | - Laurent Boyer
- CEReSS-Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France
| | - Min Seo Kim
- Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Seung Won Lee
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, South Korea
| | - Guillermo F. López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain
| | - Elena Dragioti
- Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Research Laboratory Psychology of Patients, Families, and Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Ho Geol Woo
- Department of Neurology, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Dong Keon Yon
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
- Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
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Voidarou C, Rozos G, Stavropoulou E, Giorgi E, Stefanis C, Vakadaris G, Vaou N, Tsigalou C, Kourkoutas Y, Bezirtzoglou E. COVID-19 on the spectrum: a scoping review of hygienic standards. Front Public Health 2023; 11:1202216. [PMID: 38026326 PMCID: PMC10646607 DOI: 10.3389/fpubh.2023.1202216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
The emergence of COVID-19 in Wuhan, China, rapidly escalated into a worldwide public health crisis. Despite numerous clinical treatment endeavors, initial defenses against the virus primarily relied on hygiene practices like mask-wearing, meticulous hand hygiene (using soap or antiseptic solutions), and maintaining social distancing. Even with the subsequent advent of vaccines and the commencement of mass vaccination campaigns, these hygiene measures persistently remain in effect, aiming to curb virus transmission until the achievement of herd immunity. In this scoping review, we delve into the effectiveness of these measures and the diverse transmission pathways, focusing on the intricate interplay within the food network. Furthermore, we explore the virus's pathophysiology, considering its survival on droplets of varying sizes, each endowed with distinct aerodynamic attributes that influence disease dispersion dynamics. While respiratory transmission remains the predominant route, the potential for oral-fecal transmission should not be disregarded, given the protracted presence of viral RNA in patients' feces after the infection period. Addressing concerns about food as a potential viral vector, uncertainties shroud the virus's survivability and potential to contaminate consumers indirectly. Hence, a meticulous and comprehensive hygienic strategy remains paramount in our collective efforts to combat this pandemic.
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Affiliation(s)
| | - Georgios Rozos
- Veterinary Directorate, South Aegean Region, Ermoupolis, Greece
| | - Elisavet Stavropoulou
- Department of Medicine, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Elpida Giorgi
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Christos Stefanis
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Georgios Vakadaris
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Natalia Vaou
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Christina Tsigalou
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Yiannis Kourkoutas
- Laboratory of Applied Microbiology and Biotechnology, Department of Molecular Biology and Genetics, Democritus University of Thrace, Alexandroupolis, Greece
| | - Eugenia Bezirtzoglou
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
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Garcell HG, Al-Ajmi J, Arias AV, Abraham JC, Garmendia AMF, Hernandez TMF. Ten-year incidence and impact of coronavirus infections on incidence, etiology, and antimicrobial resistance of healthcare-associated infections in a critical care unit in Western Qatar. Qatar Med J 2023; 2023:11. [PMID: 37521091 PMCID: PMC10375912 DOI: 10.5339/qmj.2023.11] [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: 08/05/2022] [Accepted: 10/30/2022] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND Healthcare-associated infections (HAI) in critical patients affect the quality and safety of patient care as they impact morbidity and mortality. During the COVID-19 pandemic, an increase in the incidence rate was reported worldwide. We aim to describe the incidence of HAI in the intensive care unit (ICU) during a 10-year follow-up period and compare the incidence during the pre-COVID-19 and COVID-19 periods. METHODS A retrospective observational study of HAI in the medical-surgical ICU at The Cuban Hospital was conducted. The data collected include the annual incidence of HAI, its etiology, and antimicrobial resistance, using the Centers for Disease Control and Prevention definitions, except for other respiratory tract infections (RTIs). RESULTS A total of 155 patients had HAI, of which 130 (85.5%) were identified during COVID-19. The frequency of device-associated infections (DAI) and non-DAI was higher during COVID-19, except for Clostridium difficile infections. Etiology was frequently related to species of Enterobacter, Klebsiella, and Pseudomonas in both periods, and a higher frequency of Acinetobacter, Enterococcus, Candida, Escherichia coli, Serratia marcescens, and Stenotrophomonas maltophilia was noted during the COVID-19 period. Device utilization ratio increased by 10.7% for central lines and 12.9% for ventilators, while a reduction of 15% in urinary catheter utilization ratio was observed. DAI incidence was higher during the COVID-19, with a 2.79 higher risk of infection (95% CI: 0.93-11.21; p < 0.0050), 15.31 (2.53-625.48), and 3.25 (0.68-31.08) for CLABSI, VAP, and CAUTI, respectively. CONCLUSION The incidence of DAI increased during the pandemic period as compared to the pre-pandemic period, and limited evidence of the impact on antimicrobial resistance was observed. The infection control program should evaluate strategies to minimize the impact of pandemics on HAI.
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Affiliation(s)
- Humberto Guanche Garcell
- Infection Control Department, The Cuban Hospital. E-mail: ORCID: https://orcid.org/0000-0001-7279-0062
| | - Jameela Al-Ajmi
- Corporate Infection Control Department, Hamad Medical Corporation, Qatar
| | - Ariadna Villanueva Arias
- Infection Control Department, The Cuban Hospital. E-mail: ORCID: https://orcid.org/0000-0001-7279-0062
| | - Joji C Abraham
- Corporate Infection Control Department, Hamad Medical Corporation, Qatar
| | - Angel M Felipe Garmendia
- Infection Control Department, The Cuban Hospital. E-mail: ORCID: https://orcid.org/0000-0001-7279-0062
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10
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Ishra R, Khanam R, Soar J, Sharif S. Food hygiene knowledge and behaviour among domestic food handlers during COVID 19 pandemic in Bangladesh. Food Control 2023; 153:109945. [PMID: 38620164 PMCID: PMC10303748 DOI: 10.1016/j.foodcont.2023.109945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 04/17/2024]
Abstract
The COVID-19 pandemic reshaped every aspect of life, including food safety. Understanding food safety behaviour at home is necessary for developing effective strategies to mitigate foodborne disease during and after this pandemic. This study administered a cross-sectional survey among 503 domestic food handlers to examine the food handlers' food safety concerns during the pandemic and pandemic-related knowledge and hygiene behaviour (PRKHB) in Bangladesh. The results found that only 35.8% of respondents in this study were more concerned about food safety because of the COVID-19 pandemic. Although the results found a good PRKHB among 95.8% of urban food handlers, overall, 62% showed a poor level of PRKHB. Only 38.8% reported washing their hands after returning home or preparing meals every time. The regression model found that food safety concerns positively related to the PRKHB, and participants who lived in rural areas had a negative association with the PRKHB. The study also explored sociodemographic variations and significant differences observed between urban and rural areas. Meticulous educational campaigns and targeted messages to the food handlers on food safety risks, food handling practices and hand hygiene are necessary to minimise the foodborne disease burden in this region.
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Affiliation(s)
- Rakia Ishra
- University of Southern Queensland, Toowoomba, Qld, 4350, Australia
| | - Rasheda Khanam
- University of Southern Queensland, Toowoomba, Qld, 4350, Australia
| | - Jeffrey Soar
- University of Southern Queensland, Toowoomba, Qld, 4350, Australia
| | - Saif Sharif
- University of Southern Queensland, Toowoomba, Qld, 4350, Australia
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11
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Zhang X, Ma Y, Kong L, Li Y, Wang J, Li N, Xia Y, Wang P, Zhang M, Liu L, Zhang D, Wen L, Wang S, Liu Z, Yue X, Wang J, Zhang T, Meng X. The impact of COVID-19 pandemic on hand hygiene compliance of healthcare workers in a tertiary hospital in East China. Front Med (Lausanne) 2023; 10:1160828. [PMID: 37425301 PMCID: PMC10324029 DOI: 10.3389/fmed.2023.1160828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 06/01/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction Hand hygiene is a cost-effective measure to reduce healthcare-associated infections (HAIs) in healthcare facilities. The impact of the coronavirus disease 2019 (COVID-19) pandemic on hand hygiene performance (HHP) provided evidence for targeted hand hygiene intervention measures. Methods This study evaluated the HHP rate in a tertiary hospital before and after the COVID-19 outbreak. HHP was checked by infection control doctors or nurses every day, and they inputted the HHP rate to the full-time infection control staff every week. A random examination of HHP was conducted by a confidential worker every month. The HHP of healthcare workers (HCWs) was monitored in the outpatient department, inpatient ward, and operating room from January 2017 to October 2022. The influence of COVID-19 prevention and control strategies on HHP was elucidated by analyzing the results of HHP during the study period. Results The average HHP rate of HCWs was 86.11% from January 2017 to October 2022. The HHP rate of HCWs after the COVID-19 pandemic was statistically significantly higher than that before the pandemic (P < 0.001). The HHP rate was the highest (93.01%) in September 2022 when the local epidemic occurred. Among the different occupation categories, medical technicians showed the highest HHP rate (89.10%). The HHP rate was the highest after contact with body fluids or blood of patients (94.47%). Conclusion The HHP rate of HCWs in our hospital showed an increasing trend in the recent 6 years, especially during the COVID-19 pandemic, and the increase was most obvious during the local epidemic.
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12
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Russotto A, Rolfini E, Paladini G, Gastaldo C, Vicentini C, Zotti CM. Hand Hygiene and Antimicrobial Resistance in the COVID-19 Era: An Observational Study. Antibiotics (Basel) 2023; 12:antibiotics12030583. [PMID: 36978450 PMCID: PMC10045068 DOI: 10.3390/antibiotics12030583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/09/2023] [Accepted: 03/13/2023] [Indexed: 03/17/2023] Open
Abstract
Hand hygiene (HH) is one of the most important infection prevention and control strategies at the hospital level. The aim of this study was to evaluate the potential COVID-19 pandemic impact on HH practices and rate of healthcare-associated infections. Data on alcohol-based handrub consumption (AHC) and antimicrobial resistance across 27 Italian hospitals over the period 2017–2021 were considered. Data on Methicillin-resistant Staphylococcus aureus (MRSA) and carbapenem-resistant Enterobacteria (CRE) were extracted from the antimicrobial resistance regional surveillance system. A significant increase was highlighted, with a peak in 2020 and a partial fall in 2021 for AHC (p < 0.001). The decrease in MRSA rates in 2021 compared to 2017–2019 was significant (p = 0.013). A significant Spearman’s correlation between AHC and CRE rates was found (Spearman’s ρ −0.646, p = 0.032). This study supports the importance of AHC monitoring and showed that improving AHC was an attainable goal in the COVID-19 era. However, other strategies are needed to maintain the high levels of AHC attained during the pandemic, in order to avoid a progressive drop that has already begun in 2021. Furthermore, our results support the inverse relationship between AHC and infection rates and antimicrobial-resistant bacteria.
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13
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Nour MO, Natto HA, Sinky TH, Alfaifi MS, Alharbi MFJ, Allahyani AMK, Bawahhab WA, Flemban AY, Al-Zahrani AAD. Infection transmission via mobile phones in a mass gathering setting: Public knowledge, attitudes and practices in Makkah city, Saudi Arabia. Heliyon 2023; 9:e13894. [PMID: 36923845 PMCID: PMC10009684 DOI: 10.1016/j.heliyon.2023.e13894] [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: 11/08/2022] [Revised: 02/07/2023] [Accepted: 02/15/2023] [Indexed: 02/24/2023] Open
Abstract
Background Mobile phones have become part of everyday life with a potential risk for microbial transmission. Makkah is a mass gathering city that may act as hotspots of disease transmission. The contact between public and both visitors and pilgrims to Makkah can't be overlooked, and any small outbreak within the public can be transmitted rapidly to them. Aim We aimed to assess knowledge, attitudes, and practices (KAP) of general population towards infection transmission via mobile phones in Makkah and different characteristics relevant to KAP scores. Methods A cross-sectional web-based survey was conducted on general population in Makkah city using a snowballing sampling method. Participants answered questions about their KAP towards infection transmission via mobile phone. The overall KAP scores were graded as good, fair, and poor and explored against different population characteristics using suitable statistical methods. Results The study included 385 participants aged 15-64 years. About 88.8% owned personal mobile phone, 3.9% encountering a patient with infections transmitted via mobile phones, and 60.5% know nothing about potential role of mobile phones in infection transmission. Only 16.6% had good knowledge, 64.1% with positive attitudes, and 55.3% reported poor practices. The mean knowledge score was significantly higher among young adults (p = 0.002) and those with higher education (p = 0.005). Their mean attitude and practice scores were significantly higher among older adults (p < 0.001 and p = 0.015), female (p = 0.001 and p = 0.022), and those with higher education (p = 0.036 and p = 0.041) respectively. Conclusion The overall public knowledge and practices towards the role of mobile phones in infection transmission in Makkah was below average though they have positive attitudes. Raising public awareness is important to decrease the possibility of cross-contamination via mobile phones and to develop adequate preventive strategies in a mass gathering setting like Makkah city.
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Affiliation(s)
- Mohamed O Nour
- Department of Public Health and Community Medicine, Damietta Faculty of Medicine, Al-Azhar University, Egypt.,Department of Health Promotion and Education, College of Public Health and Health Informatics, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Hatim A Natto
- Department of Epidemiology, College of Public Health and Health Informatics, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Tassnym H Sinky
- Department of Health Promotion and Education, College of Public Health and Health Informatics, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Mashael S Alfaifi
- Department of Epidemiology, College of Public Health and Health Informatics, Umm Al-Qura University, Makkah, Saudi Arabia
| | | | - Anoud Mateq Keshan Allahyani
- Department of Health Promotion and Education, College of Public Health and Health Informatics, Umm Al-Qura University, Makkah, Saudi Arabia
| | | | - Abdulrahman Yaser Flemban
- Department of Epidemiology, College of Public Health and Health Informatics, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Amal Ali Dhaifullah Al-Zahrani
- Department of Health Information Management & Technology, College of Public Health and Health Informatics, Umm Al-Qura University, Makkah, Saudi Arabia
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14
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Rickert J. On Patient Safety: Combating Antibiotic Resistance With Effective Hand Hygiene. Clin Orthop Relat Res 2023; 481:219-221. [PMID: 36534111 PMCID: PMC10482084 DOI: 10.1097/corr.0000000000002527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 11/22/2022] [Indexed: 12/23/2022]
Affiliation(s)
- James Rickert
- President, The Society for Patient Centered Orthopedics, Bloomington, IN, USA
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15
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Vaughan-Malloy AM, Yuen JC, Sandora TJ. Using a Human Factors Framework to Assess Clinician Perceptions of and Barriers to High Reliability in Hand Hygiene. Am J Infect Control 2023; 51:514-519. [PMID: 36933570 DOI: 10.1016/j.ajic.2023.01.013] [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: 09/12/2022] [Revised: 01/06/2023] [Accepted: 01/12/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Hand hygiene (HH) is critical to prevent healthcare-associated infections (HAIs). Clinician perspectives on maintaining high reliability are poorly defined. METHODS We surveyed physicians, nurse practitioners, and physician assistants to understand perceptions of and barriers to high reliability in HH. The Systems Engineering Initiative for Patient Safety 2.0 model was used to develop an electronic survey exploring six human factors engineering (HFE) domains. RESULTS . Among 61 respondents, 70% perceived HH as "essential" to patient safety. While 87% reported alcohol-based hand rub (ABHR) availability as very effective in improving HH reliability, 77% reported dispensers to be "sometimes" or "often" empty. Clinicians in surgery/anesthesia were more likely than those in medical specialties to note skin irritation from ABHR (OR 4.94; 95% CI 1.37-17.81) and less likely to believe feedback was effective in improving HH (OR 0.26; 95% CI 0.08-0.88). One quarter of respondents indicated the layout of patient care areas was not conducive to performing HH. Staffing shortages and the pace and demands of work precluded HH for 15% and 11% of respondents, respectively. CONCLUSIONS Aspects of organizational culture, environment, tasks, and tools were identified as barriers to high reliability in HH. HFE principles can be applied to more effectively promote HH.
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Affiliation(s)
- Ana M Vaughan-Malloy
- Infection Prevention and Control, Boston Children's Hospital, Boston, MA 02115; Division of Infectious Diseases, Department of Pediatrics, Boston Children's Hospital, Boston, MA 02115; Department of Pediatrics, Harvard Medical School, Boston, MA, 02115.
| | - Jenny Chan Yuen
- Infection Prevention and Control, Boston Children's Hospital, Boston, MA 02115
| | - Thomas J Sandora
- Infection Prevention and Control, Boston Children's Hospital, Boston, MA 02115; Division of Infectious Diseases, Department of Pediatrics, Boston Children's Hospital, Boston, MA 02115; Department of Pediatrics, Harvard Medical School, Boston, MA, 02115
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16
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Guanche Garcell H, Al-Ajmi J, Villanueva Arias A, Abraham JC, Felipe Garmendia AM, Fernandez Hernandez TM. Impact of the COVID-19 pandemic on the incidence, etiology, and antimicrobial resistance of healthcare-associated infections in a critical care unit in Western Qatar. Qatar Med J 2022; 2023:2. [PMID: 36578436 PMCID: PMC9792289 DOI: 10.5339/qmj.2023.2] [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: 08/05/2022] [Accepted: 10/30/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Healthcare-associated infections (HAIs) in critical patients affect the quality and safety of patient care and increase patient morbidity and mortality. During the COVID-19 pandemic, an increase in the incidence of HAIs, particularly device-associated infections (DAIs), was reported worldwide. In this study, we aimed to estimate the incidence of HAIs in an intensive care unit (ICU) during a 10-year period and compare HAI incidence during the preCOVID-19 and COVID-19 periods. METHODS A retrospective, observational study of HAIs in the medical-surgical ICU at The Cuban Hospital was conducted. DAIs included central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), and ventilator-associated pneumonia (VAP). Data included the annual incidence of HAIs, etiology, and antimicrobial resistance, using definitions provided by the Centers for Disease Control and Prevention, except for other respiratory tract infections (RTIs). RESULTS 155 patients with HAI infections were reported, from which 130 (85.5%) were identified during the COVID-19 period. The frequencies of DAIs and non-DAIs were higher during the COVID-19 period, except for Clostridium difficile infections. Species under Enterobacter, Klebsiella, and Pseudomonas dominated in both periods, and higher frequencies of Acinetobacter, Enterococcus, Candida, Escherichia coli, Serratia marcescens, and Stenotrophoma maltophila were noted during COVID-19 period. Device utilization ratio increased to 10.7% for central lines and 12.9% for ventilators, while a reduction of 15% in urinary catheter utilization ratio was observed. DAI incidence was higher during the COVID-19 pandemic, with risks for CLABSI, VAP, and CAUTI increased by 2.79 (95% confidence interval, 0.93-11.21; p < 0.0050), 15.31 (2.53-625.48), and 3.25 (0.68-31.08), respectively. CONCLUSION The incidence of DAIs increased during the pandemic period, with limited evidence of antimicrobial resistance observed. The infection control program should evaluate strategies to minimize the impact of the pandemic on HAIs.
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Affiliation(s)
- Humberto Guanche Garcell
- Infection Control Department, The Cuban Hospital. E-mail: ORCID: https://orcid.org/0000-0001-7279-0062,E-mail: ORCID: https://orcid.org/0000-0001-7279-0062
| | - Jameela Al-Ajmi
- Corporate Infection Control Department, Hamad Medical Corporation, Qatar
| | - Ariadna Villanueva Arias
- Infection Control Department, The Cuban Hospital. E-mail: ORCID: https://orcid.org/0000-0001-7279-0062
| | - Joji C Abraham
- Corporate Infection Control Department, Hamad Medical Corporation, Qatar
| | - Angel M Felipe Garmendia
- Infection Control Department, The Cuban Hospital. E-mail: ORCID: https://orcid.org/0000-0001-7279-0062
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17
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Si Ali A, Cherel O, Brehaut P, Garrait V, Lombardin C, Schortgen F, Constan A, Lanceleur F, El-Assali A, Poullain S, Jung C. Impact of COVID-19 pandemic waves on health-care worker hand hygiene activity in department of medicine and ICU as measured by an automated monitoring system. Infect Dis Health 2022; 28:95-101. [PMID: 36641288 PMCID: PMC9760610 DOI: 10.1016/j.idh.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Hand hygiene (HH) compliance among health-care workers is important for preventing transmission of infectious diseases. AIM To describe health-care worker hand hygiene activity in ICU and non-ICU patients' rooms, using an automated monitoring system (AMS), before and after the onset of the COVID-19 pandemic. METHODS At the Intercommunal Hospital of Créteil, near Paris, France, alcohol-based hand sanitizer (ABHS) consumption in the Department of Medicine (DM) and ICU was recorded using an AMS during four periods: before, during, and after the first wave of the COVID-19 pandemic, and during its second wave. FINDINGS From 1st February to 30th November 2020, in the DM, the mean number of doses per patient-day for each of the four periods was, respectively, 5.7 (±0.3), 19.4 (±1.3), 17.6 (±0.7), and 7.9 (±0.2, P < 0.0001). In contrast, ICU ABHS consumption remained relatively constant. In the DM, during the pandemic waves, ABHS consumption was higher in rooms of COVID-19 patients than in other patients' rooms. Multivariate analysis showed ABHS consumption was associated with the period in the DM, and with the number of HCWs in the ICU. CONCLUSION An AMS allows real-time collection of ABHS consumption data that can be used to adapt training and prevention measures to specific hospital departments.
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Affiliation(s)
- Amine Si Ali
- Department of Infection Prevention and Control, Centre Hospitalier Intercommunal de Créteil (CHIC), Créteil, France,Corresponding author
| | - Olivia Cherel
- Department of Infection Prevention and Control, Centre Hospitalier Intercommunal de Créteil (CHIC), Créteil, France
| | - Paula Brehaut
- Department of Infection Prevention and Control, Centre Hospitalier Intercommunal de Créteil (CHIC), Créteil, France
| | | | | | | | | | | | | | | | - Camille Jung
- Clinical Research Centre, CHIC, Créteil, France,Corresponding author
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18
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Risk stratification for selecting empiric antibiotherapy during and after COVID-19. Curr Opin Infect Dis 2022; 35:605-613. [PMID: 36165454 DOI: 10.1097/qco.0000000000000881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
PURPOSE OF REVIEW SARS-CoV-2 deeply modified the risk of bacterial infection, bacterial resistance, and antibiotic strategies. This review summarized what we have learned. RECENT FINDINGS During the COVID-19 pandemic, we observed an increase in healthcare-acquired infection and multidrug-resistant organism-related infection, triggered by several factors: structural factors, such as increased workload and ongoing outbreaks, underlying illnesses, invasive procedures, and treatment-induced immunosuppression. The two most frequently healthcare-acquired infections described in patients hospitalized with COVID-19 were bloodstream infection, related or not to catheters, health-acquired pneumonia (in ventilated or nonventilated patients). The most frequent species involved in bacteremia were Gram-positive cocci and Gram-negative bacilli in health-acquired pneumonia. The rate of Gram-negative bacilli is particularly high in late-onset ventilator-associated pneumonia, and the specific risk of Pseudomonas aeruginosa- related pneumonia increased when the duration of ventilation was longer than 7 days. A specificity that remains unexplained so far is the increase in enterococci bacteremia. SUMMARY The choice of empiric antibiotimicrobials depends on several factors such as the site of the infection, time of onset and previous length of stay, previous antibiotic therapy, and known multidrug-resistant organism colonization. Pharmacokinetics of antimicrobials could be markedly altered during SARS-CoV-2 acute respiratory failure, which should encourage to perform therapeutic drug monitoring.
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19
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Peters A, Carry J, Cave C, Sauser J, Pittet D. Acceptability of an alcohol-based handrub gel with superfatting agents among healthcare workers: a randomized crossover controlled study. Antimicrob Resist Infect Control 2022; 11:97. [PMID: 35841075 PMCID: PMC9283849 DOI: 10.1186/s13756-022-01129-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 05/31/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Healthcare workers often experience skin dryness and irritation from performing hand hygiene frequently. Low acceptability and tolerability of a formulation are barriers to hand hygiene compliance, though little research has been conducted on what specific types of formulation have higher acceptability than others. Objective To compare the acceptability and tolerability of an ethanol-based handrub gel with superfatting agents to the isopropanol-based formulations (a rub and a gel formulation) currently used by healthcare workers at the University of Geneva Hospitals, Geneva, Switzerland. Methods Forty-two participants were randomized to two sequences, testing the isopropanol-based formulation that they are using currently (Hopirub® or Hopigel®), and the ethanol-based formulation containing superfatting agents (Saniswiss Sanitizer Hands H1). Participants tested each of the formulations over 7–10 day work shifts, after which skin condition was assessed and feedback was collected. Results H1 scored significantly better than the control formulations for skin dryness (P = 0.0209), and participants felt less discomfort in their hands when using that formulation (P = 0.0448). H1 caused less skin dryness than Hopirub®/Hopigel® (P = 0.0210). Though overall preference was quite polarized, 21 participants preferred H1 intervention formulation and 17 preferred the Hopirub®/Hopigel® formulation that they normally used in their care activities. Conclusion We observed a difference in acceptability and strongly polarized preferences among the participants' reactions to the formulations tested. These results indicate that giving healthcare workers a choice between different high-quality products is important to ensure maximum acceptability. Supplementary Information The online version contains supplementary material available at 10.1186/s13756-022-01129-4.
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20
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Karami H, Karimi Z, Karami N. SARS-CoV-2 in brief: from virus to prevention. Osong Public Health Res Perspect 2022; 13:394-406. [PMID: 36617546 DOI: 10.24171/j.phrp.2022.0155] [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: 05/21/2022] [Accepted: 10/11/2022] [Indexed: 11/29/2022] Open
Abstract
The recent outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), ahighly transmissible virus with a likely animal origin, has posed major and unprecedentedchallenges to millions of lives across the affected nations of the world. This outbreak firstoccurred in China, and despite massive regional and global attempts shortly thereafter, itspread to other countries and caused millions of deaths worldwide. This review presents keyinformation about the characteristics of SARS-CoV-2 and its associated disease (namely,coronavirus disease 2019) and briefly discusses the origin of the virus. Herein, we also brieflysummarize the strategies used against viral spread and transmission.
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Affiliation(s)
- Hassan Karami
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeinab Karimi
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Negin Karami
- Department of Nursing, School of Nursing, Alborz University of Medical Sciences, Karaj, Iran
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21
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Kouyate M, Barry L, Sow A, De Maesschalck J, De Put WV, Sidibé S, Adrianaivo N, Kolié D, Delamou A. Improving access to and use of maternal health services during COVID-19: Experience from a health system strengthening project in Guinea. Front Public Health 2022; 10:1004134. [PMID: 36353275 PMCID: PMC9639210 DOI: 10.3389/fpubh.2022.1004134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/21/2022] [Indexed: 01/27/2023] Open
Abstract
The purpose of this study was to document the experience of health providers' capacity strengthening during health crises and the contribution of such to the health system and the population resilience in the face of the COVID-19 pandemic in Guinea. We conducted a cross-sectional study using routine data collected from 41 health facilities in the project intervention areas, including associative health centers, community health centers, and district hospitals,. These data covered the period between 2019 and 2021. Results showed that all the community health centers (CMCs) had a clean internal and external environment, compared to health centers (95.2%) and district hospitals (33.3%). Hand washing was systematic among visitors attending CMCs and district hospitals (HPs). However, 28.6% of visitors attending associative health centers (AHCs) did not wash their hands. Temperature taking for visitors was not carried out in all CMCs and in 90.5% of the AHCs; unlike in the HC and HP where the temperature of each patient was taken before entering the consultation room. The obligation to wear masks was higher in the HP and in the HC, compared to the CMC and AHC where the order of non-compliance with the wearing of masks was, respectively 36.4 and 19%. Non-compliance with social distancing in the waiting rooms and between users was observed in all facilities. The project's interventions mainly contributed to improving the utilization of prenatal consultation and institutional delivery services; the beginning of the interventions was marked by an increase of an average of 17 ANC1 per month in CMCs and 116 ANC1 in health centers. Ongoing training on capacity strengthening for providers in infection prevention and control, followed by the offering of delivery kits and materials during epidemics, would contribute to the improvement and utilization of health facilities by the population.
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Affiliation(s)
- Mariama Kouyate
- African Center of Excellence for the Prevention and Control of Communicable Diseases, Gamal Abdel Nasser University of Conakry, Conakry, Guinea,*Correspondence: Mariama Kouyate
| | - Lansana Barry
- National Center for Training and Research in Rural Health of Maferinyah, Forecariah, Guinea
| | | | | | | | - Sidikiba Sidibé
- African Center of Excellence for the Prevention and Control of Communicable Diseases, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | | | - Delphin Kolié
- African Center of Excellence for the Prevention and Control of Communicable Diseases, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - Alexandre Delamou
- African Center of Excellence for the Prevention and Control of Communicable Diseases, Gamal Abdel Nasser University of Conakry, Conakry, Guinea,National Center for Training and Research in Rural Health of Maferinyah, Forecariah, Guinea
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Cullen L, Laures E, Hanrahan K, Edmonds S. The Coat Hook Analogy and the Precision Implementation Approach® Solution. J Perianesth Nurs 2022; 37:732-736. [PMID: 36182248 DOI: 10.1016/j.jopan.2022.07.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 07/29/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Laura Cullen
- Nursing Research and Evidence-Based Practice, Department of Nursing Services and Patient Care, University of Iowa Hospitals & Clinics, Iowa City, IA.
| | - Elyse Laures
- Nursing Research and Evidence-Based Practice, Department of Nursing Services and Patient Care, University of Iowa Hospitals & Clinics, Iowa City, IA
| | - Kirsten Hanrahan
- Nursing Research and Evidence-Based Practice, Department of Nursing Services and Patient Care, University of Iowa Hospitals & Clinics, Iowa City, IA
| | - Stephanie Edmonds
- Nursing Research and Evidence-Based Practice, Department of Nursing Services and Patient Care, University of Iowa Hospitals & Clinics, Iowa City, IA
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Lee MC, Chang H, Sun FJ, Wu AYJ, Lu CH, Lee CM. Association between Antimicrobial Consumption and the Prevalence of Nosocomial Carbapenem-Resistant Escherichia coli and Klebsiella pneumoniae in a Tertiary Hospital in Northern Taiwan. Am J Trop Med Hyg 2022; 107:467-473. [PMID: 35895586 PMCID: PMC9393431 DOI: 10.4269/ajtmh.21-1242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 02/21/2022] [Indexed: 08/03/2023] Open
Abstract
Carbapenem-resistant Enterobacteriales has become a threat in Taiwan. This is the first local study focusing on the association between carbapenem-resistant Enterobacteriales and antimicrobial consumption. From January 2012 to December 2020, data were collected in a tertiary care hospital in Taipei, Taiwan. Antimicrobial consumption was estimated by the defined daily dose/1,000 patient-days. During the same period, the prevalence of carbapenem-resistant Escherichia coli (CREC) and carbapenem-resistant Klebsiella pneumoniae (CRKP) were collected through routine surveillance data. The following retrospective analyses were conducted: 1) analysis of antimicrobial consumption over time, (2) analysis and forecast of CREC and CRKP prevalence over time, and 3) analysis of correlation between antimicrobial consumption and the prevalence of CREC and CRKP. The consumption of piperacillin/tazobactam (β = 0.615), fluoroquinolones (β = 0.856), meropenem (β = 0.819), and doripenem (β = 0.891) increased during the observation period (P < 0.001), and the consumption of aminoglycosides (β = -0.852) and imipenem/cilastatin (β = -0.851) decreased (P < 0.001). The prevalence of CRKP rose over time (β = 0.522, P = 0.001) and correlated positively with the consumption of fluoroquinolones, levofloxacin, penicillin/β-lactamase inhibitor, piperacillin/tazobactam, meropenem, and doripenem (P < 0.05). The prevalence of CRKP and CREC both correlated negatively with consumption of aminoglycosides (P < 0.01). The prevalence of CRKP in our hospital increased as the forecast predicted based on an autoregressive integrated moving average model. This study provides alarming messages for members participating in antimicrobial stewardship programs, including the increasing prevalence of CRKP, the increasing consumption of broad-spectrum antibiotics, and the positive correlation between them.
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Affiliation(s)
- Mei-Chun Lee
- Department of Pharmacy, MacKay Memorial Hospital, Taipei, Taiwan
- Nursing and Management, Mackay Junior College of Medicine, Taipei, Taiwan
| | - Hsun Chang
- Division of Infectious Diseases, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Fang-Ju Sun
- Nursing and Management, Mackay Junior College of Medicine, Taipei, Taiwan
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
| | - Alice Ying-Jung Wu
- Division of Infectious Diseases, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Chien-Hung Lu
- Department of Pharmacy, MacKay Memorial Hospital, Taipei, Taiwan
| | - Chun-Ming Lee
- Nursing and Management, Mackay Junior College of Medicine, Taipei, Taiwan
- Division of Infectious Diseases, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan
- MacKay Medical College, New Taipei City, Taiwan
- Department of Internal Medicine, St. Joseph’s Hospital, Yunlin County, Taiwan
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24
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Opoku MM, Asante KP, Gyaase S, Teviu EA, Amponsah K, Twum A, Kusi KF, Ampofo AK, Adomako-Boateng F. Risk factors for COVID-19 Virus Infection among Health Workers: A Case-control study in the Bono East Region of Ghana. Am J Infect Control 2022; 51:498-505. [PMID: 35970420 PMCID: PMC9373466 DOI: 10.1016/j.ajic.2022.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 08/03/2022] [Accepted: 08/04/2022] [Indexed: 11/05/2022]
Abstract
Background Disproportionately high rates of COVID-19 infection among health workers prompts the need to identify the risk factors to help guide the design and implementation of interventions. The aim of this study was to characterize the risk factors for COVID-19 infection among health workers. Methods A case-control study was designed to recruit 154 health workers who tested positive for the COVID-19 virus and 308 who tested negative from 8 hospitals and 11 health directorates in the Bono East Region of Ghana. Crude and adjusted logistic regression analysis was used to determine risk factors. Results Hand hygiene compliance for the recommended moments ranged from 55.3% to 77.4%. Personal protective equipments (PPE) use was 59.5% when patients’ COVID-19 status was unknown and at least 90.7% when patient was positive. We identified years of practice experience (adjusted odds ratio (AOR) = 1.81; 95% CI: 1.07, 3.07; P = .028), adherence to infection prevention and control (IPC) when in contact with patients whose COVID-19 status is unspecified (AOR = 1.71; 95% CI: 1.09, 2.70; P = .020) and type of facility (AOR = 1.69, 95% CI: 1.09, 2.62; P = .019) as risk factors. Conclusion The findings underscore the need for health workers to improve in COVID-19 risk perception.
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Affiliation(s)
- Michael Mireku Opoku
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana.
| | - Kwaku Poku Asante
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service Kintampo North Muicipality, Bono East Region Ghana
| | - Stephaney Gyaase
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service Kintampo North Muicipality, Bono East Region Ghana
| | | | | | - Anthony Twum
- Sene West District Hospital, Ghana Health Service, Ghana Health Service
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Shirreff G, Zahar JR, Cauchemez S, Temime L, Opatowski L. Measuring Basic Reproduction Number to Assess Effects of Nonpharmaceutical Interventions on Nosocomial SARS-CoV-2 Transmission. Emerg Infect Dis 2022; 28:1345-1354. [PMID: 35580960 PMCID: PMC9239897 DOI: 10.3201/eid2807.212339] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Outbreaks of SARS-CoV-2 infection frequently occur in hospitals. Preventing nosocomial infection requires insight into hospital transmission. However, estimates of the basic reproduction number (R0) in care facilities are lacking. Analyzing a closely monitored SARS-CoV-2 outbreak in a hospital in early 2020, we estimated the patient-to-patient transmission rate and R0. We developed a model for SARS-CoV-2 nosocomial transmission that accounts for stochastic effects and undetected infections and fit it to patient test results. The model formalizes changes in testing capacity over time, and accounts for evolving PCR sensitivity at different stages of infection. R0 estimates varied considerably across wards, ranging from 3 to 15 in different wards. During the outbreak, the hospital introduced a contact precautions policy. Our results strongly support a reduction in the hospital-level R0 after this policy was implemented, from 8.7 to 1.3, corresponding to a policy efficacy of 85% and demonstrating the effectiveness of nonpharmaceutical interventions.
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Tankel J, Keinan A, Gillis R, Yoresh M, Gillis M, Tarnovsky Y, Riessman P. Exploring the trends of acute appendicitis following recovery or vaccination from COVID-19. J Surg Res 2022; 279:633-638. [PMID: 35926313 PMCID: PMC9234038 DOI: 10.1016/j.jss.2022.06.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 05/06/2022] [Accepted: 06/08/2022] [Indexed: 11/06/2022]
Abstract
Introduction The relationship that vaccination against corona virus disease 19 (COVID-19) or recovery from the acute form of the illness may have with the incidence or severity of acute appendicitis (AA) has not been explored. The aim of this study was to evaluate this relationship. Methods A single centre retrospective study of all consecutive adult patients presenting with AA in the 6 mo after the initiation of a national vaccination program was performed. The presenting characteristics and pathological data of patients who had either been vaccinated against or recovered from COVID-19 were compared with those who had not. In addition, historical data from the equivalent period 12 and 24 mo beforehand was also extracted. The incidence of AA was compared between each of these time-frames. Results Of the 258 patients initially identified, 255 were included in the analysis of which 156 had either been vaccinated and/or recovered from COVID-19 (61.2%) whilst 99 (38.8%) patients had not. When comparing these two groups, there were no significant differences in the presenting characteristics, operative findings or postoperative courses. There was also no significant change in the incidence of AA when comparing the study dates with historical data (median weekly incidence of AA 8.0 versus 8.0 versus 8.0 respectively, P = 0.672). Conclusions Based on the data presented here, we failed to find a relationship between a national vaccination program and both the nature and incidence of AA presenting to a busy urban hospital.
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Livshiz-Riven I, Azulay H, Koyfman L, Gushanski A, Askira S, Abar VI, Gruenbaum BF, Ivanov E, Klein M, Danziger A, Nativ R, Borer A, Ziv-Baran T, Brotfain E. The long-term impact of immediate verbal feedback of hand hygiene compliance after overt observation sessions, as assessed by continuous closed-circuit television monitoring in an intensive care setting. Arch Public Health 2022; 80:141. [PMID: 35585634 PMCID: PMC9115739 DOI: 10.1186/s13690-022-00887-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 04/27/2022] [Indexed: 12/03/2022] Open
Abstract
Background Hand hygiene compliance by health care workers (HCWs) is pivotal in controlling and preventing health care associated infections. The aim of this interventional study is to assess the long-term impact of personal verbal feedback on hand hygiene compliance of HCWs in an intensive care unit (ICU) immediately after overt observation by an infection control nurse. Methods An infection control nurse overtly observed HCWs’ hand hygiene compliance and immediately gave personal verbal feedback with emphasis on aseptic technique. Overt non-interventional sessions were also performed. We measured compliance rates using covert continuous closed-circuit television (CCTV) monitoring. We compared these rates to previously-published hand hygiene compliance data. Results Overall compliance rates in the first (41.5%) and third phases (42%) of the study, before and after the intervention were similar. The two moments that were lowest in the first phase, “before aseptic contact” and “after exposure to body fluids”, showed significant improvement, but two moments showed a significant decline in compliance: “before patient contact” and “after contact with patient surrounding”. The compliance rates during the intervention phase were 64.8% and 63.8% during the sessions with and without immediate verbal personal feedback, respectively. Conclusion The overall hand hygiene compliance rate of HCWs did not show an improvement after immediate verbal personal feedback. Covert CCTV observational sessions yielded much lower hand hygiene compliance rates then overt interventional and non-interventional observations. We suggest that a single intervention of personal feedback immediately after an observational session is an ineffective strategy to change habitual practices.
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Affiliation(s)
- Ilana Livshiz-Riven
- Quality Unit, Soroka Medical Center, Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel.,Department of Nursing, Faculty of Health Science, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Hovav Azulay
- Department of Internal Medicine C, Soroka Medical Center, Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Leonid Koyfman
- Department of Anesthesiology and Critical Care, General Intensive Care Unit, Soroka Medical Center, Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Alex Gushanski
- Infection Control Unit, Soroka Medical Center, Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Seada Askira
- Infection Control Unit, Soroka Medical Center, Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Vered Ischa Abar
- Infection Control Unit, Soroka Medical Center, Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Benjamin F Gruenbaum
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Evgenia Ivanov
- Department of Internal Medicine A, Soroka Medical Center, Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Moti Klein
- Department of Anesthesiology and Critical Care, General Intensive Care Unit, Soroka Medical Center, Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Asaf Danziger
- Department of Anesthesiology and Critical Care, General Intensive Care Unit, Soroka Medical Center, Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Ronit Nativ
- Infection Control Unit, Soroka Medical Center, Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Abraham Borer
- Infection Control Unit, Soroka Medical Center, Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Tomer Ziv-Baran
- School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Evgeni Brotfain
- Department of Anesthesiology and Critical Care, General Intensive Care Unit, Soroka Medical Center, Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel.
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Wang Y, Yang J, Qiao F, Feng B, Hu F, Xi ZA, Wu W, Ni ZL, Liu L, Yuan Y. Compared hand hygiene compliance among healthcare providers before and after the COVID-19 pandemic: A rapid review and meta-analysis. Am J Infect Control 2022; 50:563-571. [PMID: 34883162 PMCID: PMC8648372 DOI: 10.1016/j.ajic.2021.11.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/22/2021] [Accepted: 11/22/2021] [Indexed: 02/05/2023]
Abstract
Background Hand hygiene (HH) is a cost-effective measure to reduce health care-associated infections. The overall characteristics and changes of hand hygiene compliance (HHC) among health care providers during the COVID-19 pandemic provided evidence for targeted HH intervention measures. Aim To systematically review the literature and conduct a meta-analysis of studies investigating the rate of HHC and the characteristics of HH during the COVID-19 pandemic. Methods The PubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang Data, VIP, and CBM databases were searched. All the original articles with valid HHC data among health care providers during the COVID-19 pandemic (from January 1, 2020 to October 1, 2021) were included. Meta-analysis was performed using a DerSimonian and Laird model to yield a point estimate and a 95% CI for the HHC rate. The heterogeneity of the studies was evaluated using the Cochrane Q test and I2 statistics and a random-effects model was used to contrast between different occupations, the WHO 5-moments of HH and different observation methods. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines were followed. Findings Seven studies with 2,377 health care providers reporting HHC were identified. The estimated overall HHC was 74%, which was higher than that reported in previous studies (5%-89%). Fever clinic has become a new key place for HHC observation. Nurses had the highest HHC (80%; 95% CI:74%-87%) while auxiliary workers (70%; 95%CI:62%-77%) had the lowest. For the WHO 5-moments, the health care providers had the highest HHC after contact with the body fluids of the patients (91%; 95% CI:88%-94%), while before contact with patient's health care providers had the lowest HHC (68%; 95% CI:62%-74%) which was consistent with before the pandemic. There existed great HHC differences among different monitoring methods (automatic monitoring system:53%; 95% CI:44%-63% versus openly and secretly observation: 91%; 95% CI: 90%-91%). Conclusions During the COVID-19 pandemic, the compliance of health care providers’ HH showed a great improvement. The fever clinics have become the focused departments for HH monitoring. The HHC of auxiliary workers and the HH opportunity for “before contact with patients” should be strengthened. In the future, it will be necessary to develop standardized HH monitoring tools for practical work.
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Affiliation(s)
- Ying Wang
- Department of Infection Management, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, P. R. China; Institute of Hospital Management, Wuhan University, Wuhan, Hubei, P. R. China
| | - Jinru Yang
- Cancer Center of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P. R. China
| | - Fu Qiao
- Infection Prevention and Control Department, West China Hospital, Sichuan University, Chengdu, Sichuan, P. R. China
| | - Bilong Feng
- Department of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, P. R. China
| | - Fen Hu
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, P. R. China; Clinical Research Center of Hubei Critical Care Medicine, Wuhan, Hubei, P. R. China
| | - Zi-Ang Xi
- School of Architecture, Tsinghua University, Beijing, P. R. China
| | - Wenwen Wu
- School of Public Health and Management, Hubei University of Medicine, Shiyan, China
| | - Zi-Ling Ni
- School of Medicine, Hangzhou Normal University, Hangzhou, China
| | - Li Liu
- School of Architecture, Tsinghua University, Beijing, P. R. China.
| | - Yufeng Yuan
- Department of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, P. R. China.
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It is complicated: Potential short- and long-term impact of coronavirus disease 2019 (COVID-19) on antimicrobial resistance—An expert review. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY 2022; 2:e27. [PMID: 36310817 PMCID: PMC9614949 DOI: 10.1017/ash.2022.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 12/28/2021] [Indexed: 12/24/2022]
Abstract
As of December 2021, the coronavirus disease 2019 (COVID-19) pandemic has claimed millions of deaths and caused disruptions in health systems around the world. The short- and long-term effects of COVID-19 on antimicrobial resistance (AMR), which was already a global threat before the pandemic, are manifold and complex. In this expert review, we summarize how COVID-19 might be affecting AMR in the short term (by influencing the key determinants antibiotic use, infection control practices and international/local mobility) and which additional factors might play a role in the long term. Whereas reduced outpatient antibiotic use in high-income countries, increased awareness for hand hygiene, and reduced mobility have likely mitigated the emergence and spread of AMR in the short term, factors such as overuse of antibiotics in COVID-19 patients, shortage of personal protective equipment, lack of qualified healthcare staff, and patient overcrowding have presumably facilitated its propagation. Unsurprisingly, international and national AMR surveillance data for 2020 show ambiguous trends. Although disruptions in antibiotic stewardship programs, AMR surveillance and research might promote the spread of AMR, other developments could prove beneficial to the cause in the long term. These factors include the increased public awareness for infectious diseases and infection control issues, the strengthening of the One Health perspective as outlined by the Centers for Disease Control and Prevention, and the unprecedented number of international research collaborations and platforms. These factors could even serve as leverage and provide opportunities to better combat AMR in the future.
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Impact of the world hand hygiene and global handwashing days on public awareness between 2016 and 2020: Google trends analysis. Am J Infect Control 2022; 50:141-147. [PMID: 34718066 DOI: 10.1016/j.ajic.2021.08.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/28/2021] [Accepted: 08/30/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Scientific evidence suggest that hand hygiene as one of the most effective measures to control infection. To promote good hand hygiene practices, the World Health Organization introduced May 5 as World Hand Hygiene Day (WHHD), and international stakeholders established Global Handwashing Day (GHD) on October 15. However, its contributions to raising public awareness of hand hygiene is unclear. METHODS This study evaluates the impact of the WHHD and GHD on the public awareness of hand hygiene in Japan, the United Kingdom, the United States, and worldwide from 2016 to 2020, using the relative search volume of "Hand hygiene" in Google Trends as a surrogate. To identify a statistically significant timepoint of a trend change, we performed Joinpoint regression analysis. RESULTS Upticks of the relative search volumes as well as joinpoints were noted worldwide around the WHHD and GHD from 2016 to 2019, but no joinpoints were identified around the WHHD and GHD in 2020. No such changes were observed in Japan, the United Kingdom, and the United States during these periods. CONCLUSIONS While the WHHD was originally established to raise awareness of hand hygiene in healthcare facilities, our result suggests that the WHHD and GHD may not have effectively disseminated the importance of hand hygiene to the general public at a country level. Additional policy measures to advocate hand hygiene to the public are necessary to communicate its benefits.
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Knowledge, attitudes, and self-reported practices (KAP) towards hand hygiene in medical students versus the public. Ir J Med Sci 2022; 191:2797-2802. [PMID: 35028897 PMCID: PMC8757399 DOI: 10.1007/s11845-022-02918-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 12/15/2021] [Indexed: 11/30/2022]
Abstract
Background The COVID-19 pandemic and its associated morbidity, mortality, and economic disruption has reignited interest in simple protective and preventive measures. Aims The aim of this study was to assess the knowledge, attitudes, and practices (KAP) of hand hygiene in a sample of medical students in Ireland and members of the public to evaluate these within the context of the COVID-19 pandemic. We also explored any differences between the two groups. Methods A 35-question survey was formulated and circulated to potential participants comprising Irish medical students and members of the public. The data was analysed using Microsoft Excel with P-values being calculated using chi-squared goodness-of-fit analysis. Results There were 356 responses to the survey, categorised into medical students and general public populations. Incomplete surveys were removed leaving 303 responses. There was no statistical difference between the groups for attitudes and self-reported practices towards hand hygiene. Statistical differences were found between the two groups in terms of knowledge. Conclusions The study showed that medical students and the public had a good knowledge base and positive attitude in regards to hand hygiene. Both groups displayed consensus that the practices are essential, especially within the current pandemic context. However, larger studies, involving multiple universities and a larger portion of the public, may be useful to ascertain whether there is a true difference in the KAP between healthcare students and the general public.
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Stress Perception, Sleep Quality and Work Engagement of German Outpatient Nurses during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010313. [PMID: 35010573 PMCID: PMC8751216 DOI: 10.3390/ijerph19010313] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/09/2021] [Accepted: 12/23/2021] [Indexed: 12/11/2022]
Abstract
Since the outbreak of the COVID-19 pandemic, outpatient nurses have been exposed to a double burden of already known occupational and new pandemic-related stressors. Recent studies suggest that increased pandemic-related stress can affect mental health and promote the development of negative mental health outcomes for nurses. This includes a decrease in sleep quality and work engagement. In addition, certain groups appear to be particularly vulnerable to pandemic-related stress. The aim of this study was to investigate the stress perception of German outpatient nurses during the COVID-19 pandemic. The aim was to determine associations between their pandemic-related stress and variables such as sleep quality, work engagement, pandemic-related worries and concerns. For this purpose, a questionnaire was developed based on well-established measurement instruments such as the 10-item Perceived Stress Scale, the Pittsburgh Sleep Quality Index and the Copenhagen Psychosocial Questionnaire to conduct a cross-sectional online survey among outpatient nurses from Germany. Participants (n = 166) showed rather moderate overall pandemic-related stress levels, good sleep quality, high work engagement, and moderate pandemic-related worries and concerns. Pandemic-related stress proved to be a predictor of decreased sleep quality and work engagement of outpatient nurses with weak effect sizes. Despite the surprisingly moderate stress levels, the effects of pandemic-related stress on selected aspects of participants' mental health could be demonstrated. Therefore, behavioural and organisational health promotion measures are recommended to support outpatient nurses during the pandemic. However, further research is needed to determine the causal relationships and long-term effects of pandemic-related stress on the mental health of outpatient caregivers.
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Novysedlak R, Vachtenheim J, Stříž I, Viklický O, Lischke R, Strizova Z. SARS-CoV-2 viral load assessment in lung transplantation. Physiol Res 2021; 70:S253-S258. [PMID: 34913356 DOI: 10.33549/physiolres.934760] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
In the era of COVID-19 pandemic, organ transplantation programs were facing serious challenges. The lung transplantation donor pool was extremely limited and SARS-CoV-2 viral load assessment has become a crucial part of selecting an optimal organ donor. Since COVID-19 is a respiratory disease, the viral load is thought to be more important in lung transplantations as compared to other solid organ transplantations. We present two challenging cases of potential lung donors with a questionable COVID-19 status. Based on these cases, we suggest that the cycle threshold (Ct) value should always be requested from the laboratory and the decision whether to proceed with transplantation should be made upon complex evaluation of diverse criteria, including the nasopharyngeal swab and bronchoalveolar lavage PCR results, the Ct value, imaging findings and the medical history. However, as the presence of viral RNA does not ensure infectivity, it is still to be clarified which Ct values are associated with the viral viability. Anti-SARS-CoV-2 IgA antibodies may support the diagnosis and moreover, novel methods, such as quantifying SARS-CoV-2 nucleocapsid antigen in serum may provide important answers in organ transplantations and donor selections.
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Affiliation(s)
- R Novysedlak
- Third Department of Surgery, Prague Lung Transplant Program, First Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic; Department of Immunology, Second Faculty of Medicine, Charles University and University Hospital Motol, Praha 5, Czech Republic.
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Williams V, Kovacs-Litman A, Muller MP, Hota S, Powis JE, Ricciuto DR, Mertz D, Katz K, Castellani L, Kiss A, Linkenheld-Struk A, Leis JA. Impact of COVID-19 on hospital hand hygiene performance: a multicentre observational study using group electronic monitoring. CMAJ Open 2021; 9:E1175-E1180. [PMID: 34906993 PMCID: PMC8687486 DOI: 10.9778/cmajo.20210072] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Reliable reports on hand hygiene performance throughout the COVID-19 pandemic are lacking as most hospitals continue to rely on direct observation to measure this quality indicator. Using group electronic hand hygiene monitoring, we sought to assess the impact of COVID-19 on adherence to hand hygiene. METHODS Across 12 Ontario hospitals (5 university and 7 community teaching hospitals), a group electronic hand hygiene monitoring system was installed before the pandemic to provide continuous measurement of hand hygiene adherence across 978 ward and 367 critical care beds. We performed an interrupted time-series study of institutional hand hygiene adherence in association with a COVID-19 inpatient census and the Ontario daily count of COVID-19 cases during a baseline period (Nov. 1, 2019, to Feb. 29, 2020), the pre-peak period of the first wave of the pandemic (Mar. 1 to Apr. 24, 2020), and the post-peak period of the first wave (Apr. 25 to July 5, 2020). We used a Poisson regression model to assess the association between the hospital COVID-19 census and institutional hand hygiene adherence while adjusting for the correlation within inpatient units. RESULTS At baseline, the rate of hand hygiene adherence was 46.0% (6 325 401 of 13 750 968 opportunities) and this improved beginning in March 2020 to a daily peak of 79.3% (66 640 of 84 026 opportunities) on Mar. 30, 2020. Each patient admitted with COVID-19 was associated with improved hand hygiene adherence (incidence rate ratio [IRR] 1.0621, 95% confidence interval [CI] 1.0619-1.0623). Increasing Ontario daily case count was similarly associated with improved hand hygiene (IRR 1.0026, 95% CI 1.0021-1.0032). After peak COVID-19 community and inpatient numbers, hand hygiene adherence declined and returned to baseline. INTERPRETATION The first wave of the COVID-19 pandemic was associated with significant improvement in hand hygiene adherence, measured using a group electronic monitoring system. Future research should seek to determine whether strategies that focus on health care worker perception of personal risk can achieve sustainable improvements in hand hygiene performance.
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Affiliation(s)
- Victoria Williams
- Sunnybrook Health Sciences Centre (Williams, Linkenheld-Struk, Leis); Department of Medicine (Kovacs-Litman, Muller, Hota, Powis, Leis), University of Toronto; Division of Infectious Diseases (Muller), St. Michael's Hospital; University Health Network (Hota); Peterborough Regional Health Centre (Powis, Ricciuto), Peterborough, Ont.; Division of Infectious Diseases (Powis), Michael Garron Hospital, Toronto, Ont.; Division of Infectious Diseases (Ricciuto), Lakeridge Health, Oshawa, Ont.; Hamilton Health Sciences (Mertz), Hamilton, Ont.; North York General Hospital (Katz), Toronto, Ont.; Sault Area Hospital (Castellani), Sault Ste Marie, Ont.; Sunnybrook Research Institute (Kiss, Leis), Toronto, Ont
| | - Adam Kovacs-Litman
- Sunnybrook Health Sciences Centre (Williams, Linkenheld-Struk, Leis); Department of Medicine (Kovacs-Litman, Muller, Hota, Powis, Leis), University of Toronto; Division of Infectious Diseases (Muller), St. Michael's Hospital; University Health Network (Hota); Peterborough Regional Health Centre (Powis, Ricciuto), Peterborough, Ont.; Division of Infectious Diseases (Powis), Michael Garron Hospital, Toronto, Ont.; Division of Infectious Diseases (Ricciuto), Lakeridge Health, Oshawa, Ont.; Hamilton Health Sciences (Mertz), Hamilton, Ont.; North York General Hospital (Katz), Toronto, Ont.; Sault Area Hospital (Castellani), Sault Ste Marie, Ont.; Sunnybrook Research Institute (Kiss, Leis), Toronto, Ont
| | - Matthew P Muller
- Sunnybrook Health Sciences Centre (Williams, Linkenheld-Struk, Leis); Department of Medicine (Kovacs-Litman, Muller, Hota, Powis, Leis), University of Toronto; Division of Infectious Diseases (Muller), St. Michael's Hospital; University Health Network (Hota); Peterborough Regional Health Centre (Powis, Ricciuto), Peterborough, Ont.; Division of Infectious Diseases (Powis), Michael Garron Hospital, Toronto, Ont.; Division of Infectious Diseases (Ricciuto), Lakeridge Health, Oshawa, Ont.; Hamilton Health Sciences (Mertz), Hamilton, Ont.; North York General Hospital (Katz), Toronto, Ont.; Sault Area Hospital (Castellani), Sault Ste Marie, Ont.; Sunnybrook Research Institute (Kiss, Leis), Toronto, Ont
| | - Susy Hota
- Sunnybrook Health Sciences Centre (Williams, Linkenheld-Struk, Leis); Department of Medicine (Kovacs-Litman, Muller, Hota, Powis, Leis), University of Toronto; Division of Infectious Diseases (Muller), St. Michael's Hospital; University Health Network (Hota); Peterborough Regional Health Centre (Powis, Ricciuto), Peterborough, Ont.; Division of Infectious Diseases (Powis), Michael Garron Hospital, Toronto, Ont.; Division of Infectious Diseases (Ricciuto), Lakeridge Health, Oshawa, Ont.; Hamilton Health Sciences (Mertz), Hamilton, Ont.; North York General Hospital (Katz), Toronto, Ont.; Sault Area Hospital (Castellani), Sault Ste Marie, Ont.; Sunnybrook Research Institute (Kiss, Leis), Toronto, Ont
| | - Jeff E Powis
- Sunnybrook Health Sciences Centre (Williams, Linkenheld-Struk, Leis); Department of Medicine (Kovacs-Litman, Muller, Hota, Powis, Leis), University of Toronto; Division of Infectious Diseases (Muller), St. Michael's Hospital; University Health Network (Hota); Peterborough Regional Health Centre (Powis, Ricciuto), Peterborough, Ont.; Division of Infectious Diseases (Powis), Michael Garron Hospital, Toronto, Ont.; Division of Infectious Diseases (Ricciuto), Lakeridge Health, Oshawa, Ont.; Hamilton Health Sciences (Mertz), Hamilton, Ont.; North York General Hospital (Katz), Toronto, Ont.; Sault Area Hospital (Castellani), Sault Ste Marie, Ont.; Sunnybrook Research Institute (Kiss, Leis), Toronto, Ont
| | - Daniel R Ricciuto
- Sunnybrook Health Sciences Centre (Williams, Linkenheld-Struk, Leis); Department of Medicine (Kovacs-Litman, Muller, Hota, Powis, Leis), University of Toronto; Division of Infectious Diseases (Muller), St. Michael's Hospital; University Health Network (Hota); Peterborough Regional Health Centre (Powis, Ricciuto), Peterborough, Ont.; Division of Infectious Diseases (Powis), Michael Garron Hospital, Toronto, Ont.; Division of Infectious Diseases (Ricciuto), Lakeridge Health, Oshawa, Ont.; Hamilton Health Sciences (Mertz), Hamilton, Ont.; North York General Hospital (Katz), Toronto, Ont.; Sault Area Hospital (Castellani), Sault Ste Marie, Ont.; Sunnybrook Research Institute (Kiss, Leis), Toronto, Ont
| | - Dominik Mertz
- Sunnybrook Health Sciences Centre (Williams, Linkenheld-Struk, Leis); Department of Medicine (Kovacs-Litman, Muller, Hota, Powis, Leis), University of Toronto; Division of Infectious Diseases (Muller), St. Michael's Hospital; University Health Network (Hota); Peterborough Regional Health Centre (Powis, Ricciuto), Peterborough, Ont.; Division of Infectious Diseases (Powis), Michael Garron Hospital, Toronto, Ont.; Division of Infectious Diseases (Ricciuto), Lakeridge Health, Oshawa, Ont.; Hamilton Health Sciences (Mertz), Hamilton, Ont.; North York General Hospital (Katz), Toronto, Ont.; Sault Area Hospital (Castellani), Sault Ste Marie, Ont.; Sunnybrook Research Institute (Kiss, Leis), Toronto, Ont
| | - Kevin Katz
- Sunnybrook Health Sciences Centre (Williams, Linkenheld-Struk, Leis); Department of Medicine (Kovacs-Litman, Muller, Hota, Powis, Leis), University of Toronto; Division of Infectious Diseases (Muller), St. Michael's Hospital; University Health Network (Hota); Peterborough Regional Health Centre (Powis, Ricciuto), Peterborough, Ont.; Division of Infectious Diseases (Powis), Michael Garron Hospital, Toronto, Ont.; Division of Infectious Diseases (Ricciuto), Lakeridge Health, Oshawa, Ont.; Hamilton Health Sciences (Mertz), Hamilton, Ont.; North York General Hospital (Katz), Toronto, Ont.; Sault Area Hospital (Castellani), Sault Ste Marie, Ont.; Sunnybrook Research Institute (Kiss, Leis), Toronto, Ont
| | - Lucas Castellani
- Sunnybrook Health Sciences Centre (Williams, Linkenheld-Struk, Leis); Department of Medicine (Kovacs-Litman, Muller, Hota, Powis, Leis), University of Toronto; Division of Infectious Diseases (Muller), St. Michael's Hospital; University Health Network (Hota); Peterborough Regional Health Centre (Powis, Ricciuto), Peterborough, Ont.; Division of Infectious Diseases (Powis), Michael Garron Hospital, Toronto, Ont.; Division of Infectious Diseases (Ricciuto), Lakeridge Health, Oshawa, Ont.; Hamilton Health Sciences (Mertz), Hamilton, Ont.; North York General Hospital (Katz), Toronto, Ont.; Sault Area Hospital (Castellani), Sault Ste Marie, Ont.; Sunnybrook Research Institute (Kiss, Leis), Toronto, Ont
| | - Alex Kiss
- Sunnybrook Health Sciences Centre (Williams, Linkenheld-Struk, Leis); Department of Medicine (Kovacs-Litman, Muller, Hota, Powis, Leis), University of Toronto; Division of Infectious Diseases (Muller), St. Michael's Hospital; University Health Network (Hota); Peterborough Regional Health Centre (Powis, Ricciuto), Peterborough, Ont.; Division of Infectious Diseases (Powis), Michael Garron Hospital, Toronto, Ont.; Division of Infectious Diseases (Ricciuto), Lakeridge Health, Oshawa, Ont.; Hamilton Health Sciences (Mertz), Hamilton, Ont.; North York General Hospital (Katz), Toronto, Ont.; Sault Area Hospital (Castellani), Sault Ste Marie, Ont.; Sunnybrook Research Institute (Kiss, Leis), Toronto, Ont
| | - Amber Linkenheld-Struk
- Sunnybrook Health Sciences Centre (Williams, Linkenheld-Struk, Leis); Department of Medicine (Kovacs-Litman, Muller, Hota, Powis, Leis), University of Toronto; Division of Infectious Diseases (Muller), St. Michael's Hospital; University Health Network (Hota); Peterborough Regional Health Centre (Powis, Ricciuto), Peterborough, Ont.; Division of Infectious Diseases (Powis), Michael Garron Hospital, Toronto, Ont.; Division of Infectious Diseases (Ricciuto), Lakeridge Health, Oshawa, Ont.; Hamilton Health Sciences (Mertz), Hamilton, Ont.; North York General Hospital (Katz), Toronto, Ont.; Sault Area Hospital (Castellani), Sault Ste Marie, Ont.; Sunnybrook Research Institute (Kiss, Leis), Toronto, Ont
| | - Jerome A Leis
- Sunnybrook Health Sciences Centre (Williams, Linkenheld-Struk, Leis); Department of Medicine (Kovacs-Litman, Muller, Hota, Powis, Leis), University of Toronto; Division of Infectious Diseases (Muller), St. Michael's Hospital; University Health Network (Hota); Peterborough Regional Health Centre (Powis, Ricciuto), Peterborough, Ont.; Division of Infectious Diseases (Powis), Michael Garron Hospital, Toronto, Ont.; Division of Infectious Diseases (Ricciuto), Lakeridge Health, Oshawa, Ont.; Hamilton Health Sciences (Mertz), Hamilton, Ont.; North York General Hospital (Katz), Toronto, Ont.; Sault Area Hospital (Castellani), Sault Ste Marie, Ont.; Sunnybrook Research Institute (Kiss, Leis), Toronto, Ont.
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Stangerup M, Hansen MB, Hansen R, Sode LP, Hesselbo B, Kostadinov K, Olesen BS, Calum H. Hand hygiene compliance of healthcare workers before and during the COVID-19 pandemic: A long-term follow-up study. Am J Infect Control 2021; 49:1118-1122. [PMID: 34182068 PMCID: PMC8233047 DOI: 10.1016/j.ajic.2021.06.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/18/2021] [Accepted: 06/21/2021] [Indexed: 11/22/2022]
Abstract
Background Information about the long-term effects of hand hygiene (HH) interventions is needed. We aimed to investigate the change in HH compliance (HHC) of healthcare workers (HCWs) once a data-driven feedback intervention was stopped, and to assess if the COVID-19 pandemic influenced the HH behavior. Methods We conducted an observational, extension trial in a surgical department between January 2019–December 2020. Doctors (n = 19) and nurses (n = 53) were included and their HHC was measured using an electronic HH monitoring system (EHHMS). We compared the changes in HHC during 3 phases: (1) Intervention (data presentation meetings), (2) Prepandemic follow-up and (3) Follow-up during COVID-19. Results The HHC during phase 1 (intervention), phase 2 (prepandemic follow-up) and phase 3 (follow-up during COVID-19) was 58%, 46%, and 34%, respectively. Comparison analyses revealed that the HHC was significantly lower in the prepandemic follow-up period (46% vs 58%, P < .0001) and in the follow-up period during COVID-19 (34% vs 58%, P < .0001) compared with the intervention period (phase 1). Conclusions Despite the COVID-19 pandemic, the HHC of the HCWs significantly decreased over time once the data presentation meetings from management stopped. This study demonstrates that HCWs fall back into old HH routines once improvement initiatives are stopped.
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Affiliation(s)
- Marie Stangerup
- The Infection Control Unit, Bispebjerg and Frederiksberg Hospitals, Denmark
| | | | - Rosa Hansen
- Department of Orthopedic, Bispebjerg University Hospital, Denmark
| | - Louise P Sode
- Department of Orthopedic, Bispebjerg University Hospital, Denmark
| | - Bjørn Hesselbo
- The Infection Control Unit, Bispebjerg and Frederiksberg Hospitals, Denmark
| | | | - Bente S Olesen
- Department of Clinical Microbiology, Herlev and Gentofte Hospital, University of Copenhagen, Denmark
| | - Henrik Calum
- Department of Orthopedic, Bispebjerg University Hospital, Denmark; Department of Clinical Microbiology, Amager and Hvidovre Hospitals, Denmark
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Three-year hand hygiene monitoring and impact of real-time reminders on compliance. J Hosp Infect 2021; 117:111-116. [PMID: 34428506 DOI: 10.1016/j.jhin.2021.08.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 07/12/2021] [Accepted: 08/16/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Hand hygiene remains both the major strategy and an ongoing challenge for infection control. The main issues in the sustainability of hand hygiene automatic monitoring are healthcare worker (HCW) turnover rates and declining participation. AIM To assess hand hygiene compliance and the impact of real-time reminders over three years. METHODS HCW compliance was observed for the use of alcohol-based hand rubs (AHR) on room entry and exit. Linear multi-level mixed models with time autocorrelations were performed to analyse the repeated measurements of daily room compliance and the effect of reminders over eight quarters (24 months). FINDINGS In all, 111 HCWs were observed and 525,576 activities were identified in the database. There was an improvement in compliance both on room entry and exit over two years, and the rooms which had activated reminders had better performance than the rooms which did not have activated reminders. CONCLUSIONS This study showed the benefit of using real-time reminders; even 20% of rooms with an activated reminder improved overall hand hygiene compliance. A randomized real-time reminder setting may be a potential solution in reducing user fatigue and enhancing HCW self-awareness.
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Mojtahedzadeh N, Neumann FA, Rohwer E, Nienhaus A, Augustin M, Harth V, Zyriax BC, Mache S. The Health Behaviour of German Outpatient Caregivers in Relation to the COVID-19 Pandemic: A Mixed-Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8213. [PMID: 34360505 PMCID: PMC8346166 DOI: 10.3390/ijerph18158213] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/22/2021] [Accepted: 07/23/2021] [Indexed: 12/23/2022]
Abstract
The COVID-19 pandemic has affected outpatient caregivers in a particular way. While the German population becomes increasingly older, the number of people in need of care has also increased. The health and, thus, the health behaviour of employees in the outpatient care become relevant to maintain working capacity and performance in the long term. The aims of the study were (1) to examine the health behaviour and (2) to explore pandemic-related perceived change of health behaviour among outpatient caregivers during the COVID-19 pandemic. In a mixed-methods study, 15 problem-centred interviews and a web-based cross-sectional survey (N = 171) were conducted with outpatient caregivers working in Northern Germany. Interviewees reported partially poorer eating behaviour, higher coffee consumption, lower physical activity, skipping breaks more often and less sleep duration and quality during the pandemic. Some quantitative findings indicate the same tendencies. A majority of participants were smokers and reported higher stress perception due to the pandemic. Preventive behaviour, such as wearing PPE or hand hygiene, was increased among interviewees compared to the pre-pandemic period. Our findings indicate that the COVID-19 pandemic could negatively affect outpatient caregivers' health behaviour, e.g., eating/drinking behaviour and physical activity. Therefore, employers in outpatient care should develop workplace health promotion measures to support their employees in conducting more health-promoting behaviours during the COVID-19 pandemic.
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Affiliation(s)
- Natascha Mojtahedzadeh
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany; (N.M.); (E.R.); (V.H.)
| | - Felix Alexander Neumann
- Midwifery Science—Health Services Research and Prevention, Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany; (F.A.N.); (B.-C.Z.)
| | - Elisabeth Rohwer
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany; (N.M.); (E.R.); (V.H.)
- Midwifery Science—Health Services Research and Prevention, Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany; (F.A.N.); (B.-C.Z.)
| | - Albert Nienhaus
- Department of Occupational Medicine, Hazardous Substances and Public Health, Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), 22089 Hamburg, Germany;
- Competence Center for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany
| | - Matthias Augustin
- Competence Center for Health Services Research in Vascular Diseases (CVvasc), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany;
| | - Volker Harth
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany; (N.M.); (E.R.); (V.H.)
| | - Birgit-Christiane Zyriax
- Midwifery Science—Health Services Research and Prevention, Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany; (F.A.N.); (B.-C.Z.)
| | - Stefanie Mache
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany; (N.M.); (E.R.); (V.H.)
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Nuckchady DC. Impact of a Multimodal Improvement Strategy to Promote Hand Hygiene at a Hospital in Mauritius. Cureus 2021; 13:e15812. [PMID: 34306879 PMCID: PMC8294769 DOI: 10.7759/cureus.15812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2021] [Indexed: 12/26/2022] Open
Abstract
Introduction Limited data is available on which interventions are likely to improve compliance to hand hygiene, especially in underdeveloped countries. The objective of this study is to explore whether the introduction of a particular bundle of strategies to improve hand hygiene is effective. Material and methods In this pre-post study, a multimodal strategy comprised of educating healthcare staff, using reminders, providing feedback and increasing the availability of soap and alcohol, was implemented over a period of one year from 2019 to 2020. Trained observers assessed compliance to hand hygiene before and after the intervention. Results A total of 143 hand hygiene opportunities were observed. Hand hygiene compliance rate did not improve despite the introduction of multiple measures. Conclusions Other approaches should be considered to promote hand hygiene. The choice of which strategies to use should be adapted to the local setting. For instance, in some healthcare facilities, emphasis should be placed on leadership support and on the training of hand hygiene champions.
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Effectiveness of an electronic hand hygiene monitoring system in increasing compliance and reducing healthcare-associated infections. J Hosp Infect 2021; 115:71-74. [PMID: 34058262 DOI: 10.1016/j.jhin.2021.05.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/18/2021] [Accepted: 05/18/2021] [Indexed: 12/29/2022]
Abstract
During an interventional study in a nephrology department, we investigated the effect of an electronic hand hygiene monitoring system on the hand hygiene compliance of healthcare workers (N = 99) and hospital-acquired bloodstream infections. The hand hygiene compliance of the doctors and nurses improved significantly during the intervention phase when they received group and individual feedback based on actionable insights from the electronic hand hygiene monitoring system. The improvements in hand hygiene compliance were associated with a significant reduction in the number of hospital-acquired bloodstream infections.
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Affiliation(s)
- K Prescott
- Healthcare Infection Society, Montagu House, Wakefield Street, London, WC1N, UK.
| | - N Mahida
- Healthcare Infection Society, Montagu House, Wakefield Street, London, WC1N, UK
| | - M Wilkinson
- Healthcare Infection Society, Montagu House, Wakefield Street, London, WC1N, UK
| | - J Gray
- Healthcare Infection Society, Montagu House, Wakefield Street, London, WC1N, UK
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